Motricite Cerebrale最新文献

Objective

Evaluate at the psychosocial level, the experience of parents of children with cerebral palsy in Abidjan (RCI).

Methods

Analytical multicenter cross-sectional study carried out over 3 months (April-June 2021) from a sample of 246 biological parents or non-parents of children followed for cerebral palsy. Scales used: Hospital Anxiety and Depression Scale and Family Impact of Childhood Disability scale.

Results

Parents aged between 30 and 40 (44.3 %), living with a partner (n = 190) and attending school in 81.7 % of cases. The mean score of the positive FICD items was 14.5 out of 10 and that of the negative items was 20 out of 40, reflecting the presence of symptoms of anxiety and depression in 25 cases (10.3 %) and 22 cases (9 %) respectively in parents. The severity of children's motor impairments was associated with the occurrence of anxiety among parents (P = 0.01) despite their religious faith (P = 0.03). There was no significant association between the children's clinical and sociodemographic parameters, the parents’ religious faith and the parents’ onset of depression (P > 0.05).

Conclusion

Childhood CP had an impact on parents’ psychosocial experiences. This impact was associated with the severity of the child's motor impairment, but the social and economic discomfort was independent of the parents’ social and cultural background and family beliefs and ties. Psychological support for parents of children with CP should not be ignored in the follow-up of these children.

People with cerebral palsy experience frequent and complex pain situations. The co-occurrence of acute and chronic pain increases complexity. To provide an appropriate response, the challenge is to identify the type of pain experienced at a given moment when assessing pain. To understand a subject's unique experience of pain, it may be necessary to adopt a bio-psycho-social model, which considers the mutual interactions between factors of different natures. Recent scientific literature emphasizes the facilitating role that interoceptive sensitivity can play in identifying the specific characteristics of a painful experience. It seems that interoceptive awareness development occurs at an early stage, based on the child's verbal exchanges with those around him. As a result, body-psychological approaches to the development of interoceptive awareness could be advantageously included in the psychological care and therapeutic education programs of children with cerebral palsy, to help them identify the sensations associated with a specific pain experience.

Introduction

As part of the TOXSIALO-2 study (currently underway) on the drug treatment of drooling in children with cerebral palsy (CP), training material has been developed to intensify and standardize rehabilitation management.

Methods

A working group of experts (6 speech and language therapists, 1 occupational therapist, 2 rehabilitation doctors) in the care of CP children with persistent drooling has drawn up a booklet of exercises based on their clinical expertise, presented in an accessible and fun way, to be carried out daily at home as part of an approach based on individualized objectives.

Results

Using the Goal Attainment Scaling methodology, the booklet enables the functional goals to be defined with the child and his or her family (based on the difficulties encountered in daily life as a result of hypersialorrhoea). The therapist can then choose exercises that relate to the deficient skills and individualize them from among the 29 clearly illustrated exercises described in the booklet, divided into 4 key areas of swallowing: nasal breathing, oral sensory information, swallowing reflex and orofacial muscle strengthening. The booklet also enables therapists to monitor compliance with the rehabilitation program.

Discussion and conclusion

The booklet can help families to carry out self-rehabilitation or stimulation exercises at home to reduce sialorrhoea. In research, the booklet should also make it possible to better standardize oromotor rehabilitation associated with medical or surgical therapies in this indication, thereby improving the reliability of the therapy.

The text reviews the challenges faced by young people with cerebral palsy. We underline their suffering and its related aspects (suffering regarding pain, suffering regarding the gaze of others, suffering regarding the view of themselves). The article highlights the importance of communicating with these young people, to address these different issues. It aims to encourage healthcare prefessionals to listen to them carefully and to support them in expressing their emotions, even non-verbally. The author shares her experience of using hypnosis or relaxation to help young people suffering from cerebral palsy to overcome their pain. This work aims to take better account of the psychological needs of young people with cerebral palsy, such as the need for security, surroundings, affection, the need to be heard, the need to build their identity and to get positive feedback. It highlights the importance of an empathetic and holistic approach to meet these needs and to promote their well-being.

Objective

To assess the effect of superficial fibular transcutaneous neurostimulation as a treatment for hypertonic varus foot in children with unilateral cerebral palsy.

Method

We made a retrospective assessment of a transcutaneous electric stimulation protocol, applied on the superficial fibular nerve territory 3 hours per day during 3 months. We measured and compared maximum foot varus angle during swing phase and during stance, and fore-foot supination angle at initial contact and at mid-stance, on gait video captures before and after stimulation.

Results

Five children with unilateral cerebral palsy were included in this retrospective study. Their mean age was 8.5 years, and the average follow up after the end of the electric stimulation was 12 months. Statistical analysis was made with non-parametric Wilcoxon test. We found a significant decrease of fore-foot supination angle at initial contact (P = 0.042) and a significant decrease of rear-foot varus angle at mid-stance (P = 0.039), one month after the end of the electric stimulation, compared with the measures before electric stimulation. We found non-significant decrease of supination angle at mid-stance and maximal varus angle during swing phase.

Conclusion

Superficial fibular transcutaneous neurostimulation seams to be an effective treatment for hypertonic varus foot in children with unilateral cerebral palsy. Our findings are limited by the retrospective design of our study, and the small sample size. These encouraging results need to be confirmed by a bigger comparative prospective survey.