Motricite Cerebrale最新文献

Scoliosis is common in cerebral palsy. The higher the GMFCS (Gross Motor Function Classification System), the more severe the scoliosis. Depending on the degree of scoliosis, surgery may be required. The compensatory strategies put in place by the young person to perform certain acts of daily life frequently include the spine. We need to establish a predictive functional assessment in order to explain to the young person and his family the advantages and disadvantages of surgery, as well as the new strategies to be acquired to limit any functional restrictions. This assessment will be illustrated using a case study. This predictive assessment will enable us to anticipate certain problems and adapt our rehabilitation objectives.

Background

Children with cerebral palsy often have gait abnormalities that can affect their daily activities. Insoles have been used as a treatment option to improve walking in children with cerebral palsy, but their efficacy remains uncertain. The aim of this study was to investigate the effects of postural insoles with corrective elements on gait parameters in children with cerebral palsy.

Methods

Children with cerebral palsy often have gait abnormalities that can affect their daily activities. Insoles have been used as a treatment option to improve walking in children with cerebral palsy, but their efficacy remains uncertain. The aim of this study was to investigate the effects of postural insoles with corrective elements on gait parameters in children with cerebral palsy.

Results

Of 35 initial registrations, three studies met the inclusion criteria. Results showed that postural insoles are effective in improving foot biomechanics and posture. However, the quality of the evidence was generally low, and further high-quality studies are needed to confirm these results.

Conclusions

Postural insoles with corrective elements may be an effective treatment option for improving gait parameters in children with cerebral palsy. The use of these semelles can lead to an increase in cadence and speed, as well as an improvement in the range of motion of ankle dorsiflexion and a decrease in the range of motion of knee flexion and hip internal rotation.

Objective

This study determined which muscle tone assessment scale has the best psychometric properties in patients with acquired brain injury.

Methods

The systematic review included cross-sectional studies of diagnostic accuracy in which the sample consisted of adult patients with acquired brain injury of various etiologies, and the outcomes were the psychometric properties of muscle tone rating scales. The main databases consulted were PubMed, Cochrane Central Register of Controlled Trials and PEDro. Risk of bias and applicability were assessed using QUADAS-2, a specific tool for diagnostic studies. The characteristics of each study were presented in a synaptic table, and the results were described schematically and narratively.

Results

The search yielded 1056 results, of which only 13 were included in the systematic review after full-text analysis. The population of nine studies involved adult patients with upper motor neuron lesions of various etiologies, while in four studies the sample analyzed consisted of children with cerebral palsy. With regard to spasticity, the Ashworth scale and the modified Ashworth scale demonstrated low to moderate inter-operator reliability and low validity. The modified Ashworth scale, on the other hand, demonstrated high inter-operator reliability in the assessment of upper limb districts. The modified Tardieu scale was found to have low to moderate inter-operator reliability and moderate to high intra-operator reliability, with greater concordance of scores than the modified Ashworth scale. The Hypertonia Assessment Tool, the Barry-Albright Dystonia Scale, the Unified Dystonia Assessment Scale and the Burke-Fahn-Marsden Movement Scale, studied on samples of children with cerebral palsy, showed moderate to good inter-operator reliability and good internal consistency.

Conclusion

The systematic review identified a series of muscle tone assessment scales and analyzed the psychometric properties of each tool.

How do parents of children with PIMD understand and experience their child's orthopaedic issues ? How do they perceive and approach the various treatments proposed during their child's growth? Surgical indications are almost systematically part of the journey for children and adolescents with polyhandicap. How do parents receive these proposals and how do they navigate with professionals, their child, and their siblings during these significant periods? These are the questions that we discussed with three parents during this roundtable discussion.

The occupational therapist plays a central role in the development of an assistive device. They are in contact with the individual with PIMD for whom the assistive device project arises, their family, and the medical-educational teams. They accompany the orthoprosthetist from the molding stage to the delivery of the device. They contribute by proposing additions and potential new positioning devices to enhance the manufactured device. Each assistive device project is unique, and we will illustrate this diversity through several objectives related to clinical situations: limiting deformities, reducing risk situations, promoting well-being, enhancing participation in daily activities, managing pathological contractions to improve function, and improving cause-and-effect relationships.

The management of orthopaedic disorders in individuals with PIMD has been evolving rapidly in recent years. Knowledge related to polyhandicap is expanding, and our understanding of the interplay between the orthopaedic disorder itself and the neurological condition is leading to new therapeutic approaches. Reference texts on the support and care of individuals with PIMD have been published. The context of healthcare organization is also changing, prompting our institutions to adapt their operations. The role of families is also shifting access to a wealth of information about care and methods has diverse effects, ranging from dispersion to the development of expertise. These current developments represent challenges to be addressed in order to continue improving the quality of life and the future of children with PIMD and their families.