Contracture formation in the upper limb in cerebral palsy starts early

Pontén, Eva

doi:10.1111/dmcn.14047

Cited by 2 publications

(2 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The difficulties that accompany individuals with CP lead to their registration in different and continuous rehabilitation programmes to promote the development of general motor skills, and some studies defend the importance of upper limb tasks to promote physical activity for people with CP. According to Pontén et al ( 2 ) and Sarcher et al ( 3 ), contractions in the upper limbs of individuals with CP start early and require adequate intervention and special attention to provide increases in (or maintenance of) range of movement, better performance and physical activity (especially for the ones with less global mobility), improving the performance of the functions of daily life, increasing independence, activities, and participation ( 4 ). Likewise, there is growing evidence of the higher prevalence of metabolic syndrome, cardiovascular disease risk factors, and autonomic nervous system (ANS) dysfunctions in adults with CP ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Effect of Combined Therapy of Virtual Reality and Transcranial Direct Current Stimulation in Children and Adolescents With Cerebral Palsy: A Study Protocol for a Triple-Blinded Randomized Controlled Crossover Trial

et al. 2020

View full text Add to dashboard Cite

Background: Transcranial direct current stimulation (tDCS) and therapy-based virtual reality (VR) have been investigated separately. They have shown promise as efficient and engaging new tools in the neurological rehabilitation of individuals with cerebral palsy (CP). However, the recent literature encourages investigation of the combination of therapy tools in order to potentiate clinic effects and its mechanisms. Methods: A triple-blinded randomised sham-controlled crossover trial will be performed. Thirty-six individuals with gross motor function of levels I to IV (aged 4–14 years old) will be recruited. Individuals will be randomly assigned to Group A (active first) or S (sham first): Group A will start with ten sessions of active tDSC combined with VR tasks. After a 1-month washout, this group will be reallocated to another ten sessions with sham tDCS combined with VR tasks. In contrast, Group S will carry out the opposite protocol, starting with sham tDCS. For the active tDCS the protocol will use low frequency tDCS [intensity of 1 milliampere (mA)] over the primary cortex (M1) area on the dominant side of the brain. Clinical evaluations (reaction times and coincident timing through VR, functional scales: Abilhand-Kids, ACTIVLIM-CP, Paediatric Evaluation of Disability Inventory-PEDI- and heart rate variability-HRV) will be performed at baseline, during, and after active and sham tDCS. Conclusion: tDCS has produced positive results in treating individuals with CP; thus, its combination with new technologies shows promise as a potential mechanism for improving neurological functioning. The results of this study may provide new insights into motor rehabilitation, thereby contributing to the better use of combined tDCS and VR in people with CP. Trial Registration: ClinicalTrials.gov , NCT04044677. Registered on 05 August 2019.

show abstract

Section: Introductionmentioning

confidence: 99%

Effect of Combined Therapy of Virtual Reality and Transcranial Direct Current Stimulation in Children and Adolescents With Cerebral Palsy: A Study Protocol for a Triple-Blinded Randomized Controlled Crossover Trial

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Studies have shown that the increase of tone in upper limbs of children with CP, which occurs around the age of 10 years [4], and is mainly predominant in the shoulder (adductors and internal rotators), forearm (pronators), elbow, wrist and finger (flexors), leads to structural and functional contractures [5,6]. Hyperactivity of different muscle combinations in CP forces the affected extremity into abnormal posture and movement patterns [7].…”

Section: Introductionmentioning

confidence: 99%

The relationship between different upper extremity patterns and independence level in individuals with spastic cerebral palsy from the ICF perspective

Bingöl¹,

Kocaman²,

Günel³

2020

Journal of Surgery and Medicine

View full text Add to dashboard Cite

Aim: Although various upper limb and hand involvement patterns in individuals with cerebral palsy (CP) have been defined, our knowledge about their functionality in daily life is still insufficient. The purpose of this study was to investigate upper extremity involvement patterns concerning the level of functionality in individuals with spastic CP. Methods: A total of 101 individuals, aged 7 to 21 years, with spastic cerebral palsy (30% unilateral CP, 70% bilateral CP), and a total of 172 hand and upper limb patterns were evaluated in this study. To identify different spastic upper extremity patterns, two classification systems, one for the upper limb and one for the hand (Classification of Upper Limbs and Hand Patterns), were used separately. Then, the Manual Ability Classification System [MACS] and Functional Independency Measure [Wee-FIM] were utilized to quantify hand functions and functional independency level, respectively, in the activities of daily living. Results: A strong correlation was found between MACSI and Simple Flex of Hand Pattern (r=0.72) while a moderate correlation was detected between MACSII and Simple Flex of Hand Pattern (r2=0.57). Besides, the level of independence in daily living activities was consistent with Type Ia and Type Ic patterns of the upper limb (r1=0.56 and r2=0.44) Conclusion: It was concluded in the light of the obtained data that Type Ia and Type Ic patterns of the upper limb, as well as Simple Flex of the hand pattern, are very efficient for functionality. Additionally, the pattern of Simple Flex Plus and Intrinsic Punching Hand were significantly related to bad capacity in hand functioning. The various upper limb and hand patterns affect the functionality or functional independence in daily living. Consequently, abnormal upper limb and hand patterns, which commonly occur in the upper extremities of children with CP, are quite different from each other in terms of functionality. Hence, it is recommended that before the application of BoNT-A or orthopedic surgery in managing spasticity, the client should be comprehensively evaluated in both terms of rigidity and functionality.

show abstract

Contracture formation in the upper limb in cerebral palsy starts early

Abstract: This commentary is on the original article by Hedberg‐Graff et al. on pages 204–211 of this issue.

Cited by 2 publications

References 6 publications

Effect of Combined Therapy of Virtual Reality and Transcranial Direct Current Stimulation in Children and Adolescents With Cerebral Palsy: A Study Protocol for a Triple-Blinded Randomized Controlled Crossover Trial

Effect of Combined Therapy of Virtual Reality and Transcranial Direct Current Stimulation in Children and Adolescents With Cerebral Palsy: A Study Protocol for a Triple-Blinded Randomized Controlled Crossover Trial

The relationship between different upper extremity patterns and independence level in individuals with spastic cerebral palsy from the ICF perspective

Contact Info

Product

Resources

About