In order to assess patterns of usage of complementary and alternative medicine (CAM) in families of children with cerebral palsy (CP), 213 families with a child (0 to 18 years) with CP were recruited at the university medical center in Ann Arbor, MI, USA as part of a descriptive survey. Two hundred and thirty-five surveys were distributed. Mean age of the child was 8 years 6 months (SD 4y : 9mo) and 56% of the sample was male with 35% full-time independent ambulators, while the rest used an assistive device or a wheelchair. Fifty-four percent were in special education classrooms. Families were given a survey on functional status of the child with CP, CAM usage of the child and the parent, factors influencing the decision to use CAM, demographics, and clinical information. Of the families, 56%, used one or more CAM techniques. Massage therapy (25%) and aquatherapy (25%) were the most common. Children of families that used CAM were significantly younger (7y : 9mo, SD 4y : 7mo) than non-users (9y : 6mo, SD 4y : 6mo: t-test p < 0.01 two-tailed). Children with quadriplegic CP, with spasticity, and those who could not walk independently were more commonly exposed to CAM (Pearson's chi2 [P(chi)2] p = 0.01 two-tailed; for mobility, odds ratio [OR] of 2.5 with regression). Mothers with a college degree had a greater tendency to use CAM for their child than those without (P(chi)2 p = 0.01 two-tailed). Fathers of children who used CAM were older than fathers of those who did not (37y : 9mo versus 33y : 2mo, p = 0.04 two-tailed). There was no significant difference between groups for mother's age, father's education, income, or for population of home town. Parents who used CAM for themselves were more likely to try CAM for their child (70% versus 47%, OR 2.1), and were much more likely to be pleased with the outcome (71% versus 42%, OR 3.5). Child's age (younger), lack of independent mobility, and parental use of CAM were the most significant predictive factors identified via logistic regression.
SUMMARY: ITB pumps are widely used in the treatment of intractable spasticity for many clinical indications, including cerebral palsy and spinal cord injury. High-dose intrathecal administration places the patient at significant risk for withdrawal in the event of device malfunction, necessitating rapid and complete evaluation of the pump-catheter system. This article reviews the approach to imaging evaluation of ITB pump-catheter systems, with specific emphasis on radiography, fluoroscopy, CT, and nuclear scintigraphy.ABBREVIATIONS: AP ϭ anteroposterior; DTPA ϭ diethylene-triamine pentaacetic acid; GABA ϭ gamma-aminobutyric acid;111 In ϭ Indium-111; IT ϭ intrathecal; ITB ϭ intrathecal baclofen; Tc99m ϭ technetium-99m
CP patients with baclofen pumps who underwent spinal fusion had more complications compared with similar patients without pumps. There was no significant difference in surgical correction between matched pairs. Physicians and families should be aware of the increased risks of reoperation and rehospitalization after spinal fusion in the presence of baclofen pumps.
This study examined the psychometric properties of test presentation and response formats that were modified to be accessible with the use of assistive technology (AT). First, the stability of psychometric properties was examined in 60 children, ages 6 to 12, with no significant physical or communicative impairments. Population-specific differences were then examined with samples that included 24 children with cerebral palsy and matched control peers. Children were administered standard and modified versions of tests. The type of AT access did not have a statistically significant effect on modified test scores. Measurement stability between the standard and modified versions of quadrant forced-choice format tests was sufficient. The findings support the potential use of AT and accessible procedures for some test instruments in the assessment of children with cerebral palsy.
In order to assess patterns of usage of complementary and alternative medicine (CAM) in families of children with cerebral palsy (CP), 213 families with a child (0 to 18 years) with CP were recruited at the university medical center in Ann Arbor, MI, USA as part of a descriptive survey. Two hundred and thirty-five surveys were distributed. Mean age of the child was 8 years 6 months (SD 4y:9mo) and 56% of the sample was male with 35% full-time independent ambulators, while the rest used an assistive device or a wheelchair. Fifty-four percent were in special education classrooms. Families were given a survey on functional status of the child with CP, CAM usage of the child and the parent, factors influencing the decision to use CAM, demographics, and clinical information. Of the families, 56%, used one or more CAM techniques. Massage therapy (25%) and aquatherapy (25%) were the most common. Children of families that used CAM were significantly younger (7y:9mo, SD 4y:7mo) than non-users (9y:6mo, SD 4y:6mo: t-test p<0.01 two-tailed). Children with quadriplegic CP, with spasticity, and those who could not walk independently were more commonly exposed to CAM (Pearson's χ 2 [Pχ 2 ] p=0.01 two-tailed; for mobility, odds ratio [OR] of 2.5 with regression). Mothers with a college degree had a greater tendency to use CAM for their child than those without (Pχ 2 p=0.01 twotailed). Fathers of children who used CAM were older than fathers of those who did not (37y:9mo versus 33y:2mo, p=0.04 two-tailed). There was no significant difference between groups for mother's age, father's education, income, or for population of home town. Parents who used CAM for themselves were more likely to try CAM for their child (70% versus 47%, OR 2.1), and were much more likely to be pleased with the outcome (71% versus 42%, OR 3.5). Child's age (younger), lack of independent mobility, and parental use of CAM were the most significant predictive factors identified via logistic regression.
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