Improving Health-related Quality of Life for Patients With Nonambulatory Cerebral Palsy: Who Stands to Gain From Scoliosis Surgery?

Introduction: It is unclear what factors influence health-related quality of life (HRQOL) in neuromuscular scoliosis. The aim of this study was to evaluate which factors are associated with an improvement in an HRQOL after spinal fusion surgery for nonambulatory patients with cerebral palsy (CP). Methods: A total of 157 patients with nonambulatory CP (Gross Motor Function Classification System IV and V) with a minimum of 2-year follow-up after PSF were identified from a prospective multicenter registry. Radiographs and quality of life were evaluated preoperatively and 2 years postoperatively. Quality of life was evaluated using the validated Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) questionnaire. Patients who had an increase of 10 points or greater from baseline CPCHILD scores were considered to have meaningful improvement at 2 years postoperatively. 10 points was chosen as a threshold for meaningful improvement based on differences between Gross Motor Function Classification System IV and V patients reported during the development of the CPCHILD. Perioperative demographic, clinical, and radiographic variables were analyzed to determine predicators for meaningful improvement by univariate and multivariate regression analysis. Results: A total of 36.3% (57/157) of the patients reported meaningful improvement in CPCHILD scores at 2 years postoperatively. Preoperative radiographic parameters, postoperative radiographic parameters, a...
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Scoliosis Source Type: research

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This article summarizes the best available evidence interventions for preventing and managing cerebral palsy in 2019.Recent FindingsEffective prevention strategies include antenatal corticosteroids, magnesium sulfate, caffeine, and neonatal hypothermia. Effective allied health interventions include acceptance and commitment therapy, action observations, bimanual training, casting, constraint-induced movement therapy, environmental enrichment, fitness training, goal-directed training, hippotherapy, home programs, literacy interventions, mobility training, oral sensorimotor, oral sensorimotor plus electrical stimulation, pre...
Source: Current Neurology and Neuroscience Reports - Category: Neuroscience Source Type: research
Conclusions: Given the importance of accuracy in height measures to evaluate infant health, it is crucial to carry out more researches in order to safely establish an association between both estimate and real statures. The development of anthropometric protocols, emerged from such researches, would benefit the follow-up of children with severe psychomotor disabilities.RESUMO Objetivo: Revisar estudos que avaliam correspond ência entre a altura estimada por medidas segmentares e a estatura real de crianças com paralisia cerebral. Fonte de dados: Revisão sistemática da literatura entre 1995 e 2018...
Source: Revista Paulista de Pediatria - Category: Pediatrics Source Type: research
ConclusionAdults with spastic diplegic CP who received their first orthopaedic intervention more than 15  years ago (based on ISA) showed similar incidence of spinal deformities as reported in the younger CP population, suggesting stability of spinal curvature into adulthood.Graphic abstractThese slides can be retrieved under Electronic Supplementary Material.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
Publication date: May 2019Source: Spine Deformity, Volume 7, Issue 3Author(s): Steven M. Hollenbeck, Burt Yaszay, Paul D. Sponseller, Carrie E. Bartley, Suken A. Shah, Jahangir Asghar, Mark F. Abel, Firoz Miyanji, Peter O. NewtonAbstractStudy DesignRetrospective review of prospective data.ObjectiveTo delineate a curve threshold where further delay of surgery significantly increased the risks for patients with cerebral palsy (CP) scoliosis.Summary of Background DataTwo approaches exist in the management of CP scoliosis: a proactive one where surgery is recommended once there is a risk of progression (Cobb> 50°) and a...
Source: Spine Deformity - Category: Orthopaedics Source Type: research
Discussion Angular deformities of the lower extremities are common problems and can be idiopathic, congenital or acquired. Idiopathic knee deformities are usually managed by monitoring and family reassurance as these often improve with time or are minimal and do not cause problems. Those ≤ 10 degrees are considered non-problematic. Genu varus usually peaks between 1-3 years and if problematic can cause waddling gait, lateral thrust and ligamentous laxity. Genus valgus usually peaks around 3-6 years and if problematic can cause circumduction gait, anterior knee pain and patellofemoral instability. Treatment options are m...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
CONCLUSIONS: The "preferred" habitual posture frequently observed in immobile adults with CP, leads to established distortion of their body shape. The results indicate the need for early introduction of appropriate posture control, in immobile individuals with CP, from a young age. Implications for rehabilitation The preferred posture, observed in immobile adults with cerebral palsy, leads to a distortion of their body shape. One in four adults with cerebral palsy use only one position when in bed. The results indicate the need for early introduction of appropriate posture control in individuals unable to change ...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
For children with severe CP, surgery for scoliosis (sideways curvature of the spine) significantly improves the quality of life for them and their caregivers
Source: Disabled World - Category: Disability Tags: Back Pain Source Type: news
CONCLUSION: Many non-ambulant adults with cerebral palsy experience postural asymmetry associated with windswept hips, scoliosis, pelvic obliquity, and limb contracture. Options for non-radiographic monitoring of postural asymmetry should be identified, and conservative interventions formally were evaluated in this population. Implications for rehabilitation The common postural asymmetries of windswept hips, scoliosis, pelvic obliquity, and limb contracture require standardised clinical measurement. Radiography is most commonly used to monitor postural asymmetry in this population, but standardised positioning is not appli...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
Conclusions and implications Asymmetrical limited hip flexion affects the seating posture and is associated with scoliosis and windswept hip distortion.
Source: Research in Developmental Disabilities - Category: Disability Source Type: research
Books are great tools for teaching empathy to children. They can help kids understand what it’s like to walk in someone else’s shoes — someone with a physical or mental disability, chronic illness or learning difference. They can also help kids with medical issues see how other kids cope — which can be validating or even help spark new ideas. And books help younger generations recognize that no matter what obstacle they may face, they’re still just kids, and they’re not alone. Today, many children’s book authors are weaving characters with me...
Source: Thrive, Children's Hospital Boston - Category: Pediatrics Authors: Tags: Parenting autism cerebral palsy craniofacial anomaly scoliosis Source Type: news
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