Despite recent improvements in survival rates, cerebral palsy remains highly prevalent among very preterm children. Severe cranial ultrasound abnormalities predict motor disability strongly, but one third of infants with cerebral palsy had no ultrasound abnormalities.
Very preterm children have a higher risk of behavioral problems at 3 years of age compared with term-born children. Health and neurodevelopmental status of the child were significantly associated with behavioral difficulties.
Aim: To estimate the re‐hospitalization rate of extremely preterm children during infancy and associated factors after the recent improvement in survival rates. Method: The cohort included all children born before 29 wk of gestation in nine French regions in 1997. All admissions between discharge from initial hospitalization and 9 mo after birth were considered. Factors studied included the child's characteristics at birth and during neonatal hospitalization, risk factors for infection after discharge and parents' socio‐demographic characteristics. Adjusted odds ratios (aOR) for re‐hospitalization for all reasons and for respiratory disorders were obtained from logistic regression models. Results: Of the 376 children, 178 were re‐admitted at least once (47.3%; 95% CI: 42.3–52.4). Fifty‐five percent of the hospitalized children were admitted at least once for respiratory disorders. The re‐hospitalization rate was higher for children who had had chronic lung disease (aOR: 2.2; 95% CI: 1.3–3.7), those initially discharged between August and October (aOR: 2.5; 95% CI: 1.2–5.1) or between November and January (aOR: 3.2; 95% CI: 1.5–6.8), and children living with other children under six (aOR: 3.4; 95 %CI: 1.6–7.5). Re‐hospitalizations were associated with neither gestational age nor the duration of neonatal hospitalization. Adjusted odds ratios for re‐hospitalization for respiratory tract disorders were very similar to those for the overall hospitalizations.
Conclusion: Infants born before 29 wk have a very high risk of re‐hospitalization. The associated factors can help define high‐risk groups at discharge from the neonatal unit who need special surveillance.
Infants born before 29 wk have a very high risk of re-hospitalization. The associated factors can help define high-risk groups at discharge from the neonatal unit who need special surveillance.
BackgroundMotor imagery is considered as a promising therapeutic tool for rehabilitation of motor planning problems in patients with cerebral palsy. However motor planning problems may lead to poor motor imagery ability.AimThe aim of this functional magnetic resonance imaging study was to examine and compare brain activation following motor imagery tasks in patients with hemiplegic cerebral palsy with left or right early brain lesions. We tested also the influence of the side of imagined hand movement.MethodTwenty patients with clinical hemiplegic cerebral palsy (sixteen males, mean age 12 years and 10 months, aged 6 years 10 months to 20 years 10 months) participated in this study. Using block design, brain activations following motor imagery of a simple opening-closing hand movement performed by either the paretic or nonparetic hand was examined.ResultsDuring motor imagery tasks, patients with early right brain damages activated bilateral fronto-parietal network that comprise most of the nodes of the network well described in healthy subjects. Inversely, in patients with left early brain lesion brain activation following motor imagery tasks was reduced, compared to patients with right brain lesions. We found also a weak influence of the side of imagined hand movement.ConclusionDecreased activations following motor imagery in patients with right unilateral cerebral palsy highlight the dominance of the left hemisphere during motor imagery tasks. This study gives neuronal substrate to propose motor imagery tasks in unilateral cerebral palsy rehabilitation at least for patients with right brain lesions.
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