Management of Spasticity and Cerebral Palsy

Awaad, Yasser M.; Rizk, Tamer; Švraka, Emira

doi:10.5772/58311

Cited by 4 publications

(3 citation statements)

References 44 publications

(25 reference statements)

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“…Patients with cerebral palsy are associated with motor impairments, and presented with increased muscle tone, spasms, and clonus. Spasticity and spasms can cause significant discomfort through waking and sleeping hours [ 27 , 40 ]. Treatment of such conditions may involve invasive surgical procedures and other painful injections or interventions.…”

Section: Risk Factors For Pain With Intellectual Disabilitymentioning

confidence: 99%

Pain Management in the Most Vulnerable Intellectual Disability: A Review

2023

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This review is made up of two parts; the first part discussing intellectual disability (ID) in general, while the second part covers the pain associated with intellectual disability and the challenges and practical tips for the management of pain associated with (ID). Intellectual disability is characterized by deficits in general mental abilities, such as reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience. ID is a disorder with no definite cause but has multiple risk factors, including genetic, medical, and acquired. Vulnerable populations such as individuals with intellectual disability may experience more pain than the general population due to additional comorbidities and secondary conditions, or at least the same frequency of pain as in the general population. Pain in patients with ID remains largely unrecognized and untreated due to barriers to verbal and non-verbal communication. It is important to identify patients at risk to promptly prevent or minimize those risk factors. As pain is multifactorial, thus, a multimodal approach using both pharmacotherapy and non-pharmacological management is often the most beneficial. Parents and caregivers should be oriented to this disorder, given adequate training and education, and be actively involved with the treatment program. Significant work to create new pain assessment tools to improve pain practices for individuals with ID has taken place, including neuroimaging and electrophysiological studies. Recent advances in technology-based interventions such as virtual reality and artificial intelligence are rapidly growing to help give patients with ID promising results to develop pain coping skills with effective reduction of pain and anxiety. Therefore, this narrative review highlights the different aspects regarding the current status of the pain associated with intellectual disability, with more emphasis on the recent pieces of evidence for the assessment and management of pain among populations with intellectual disability.

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Section: Risk Factors For Pain With Intellectual Disabilitymentioning

confidence: 99%

Pain Management in the Most Vulnerable Intellectual Disability: A Review

2023

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“…The risks and benefits of any particular intervention should be carefully considered. Goals therapy of CP spastic quadriplegic children are aimed to reduce pain, prevent or decrease contractures, improve ambulation, facilitate activities of daily living (ADL), promote participation in rehabilitation, improve the ease of care and safety ( 88 ). A multidisciplinary team approach provides the best model for medical care of children with CP across their lifespan to manage various associated and secondary conditions as well as address support system and psychosocial needs ( 88 ).…”

Section: Management Strategy In Spastic Quadriplegic Cp Childrenmentioning

confidence: 99%

Multisystem compensations and consequences in spastic quadriplegic cerebral palsy children

Wahyuni

2023

Front. Neurol.

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Spastic quadriplegic cerebral palsy (CP) is a permanent neuromuscular disorder causing limitation on all four limbs following a lesion on the developing brain. Most children with spastic quadriplegic CP are identified to be Gross Motor Function Classification System (GMFCS) level V, thus they have more comorbidities compared to other types at lower levels. Spastic quadriplegic CP is characterized by weak and inactive postural muscles of the neck and trunk, hence, they will undergo a total body extension as a compensatory mechanism leading to an atypical movement pattern, that give rise to multisystem consequences that reduce their quality of life. The relationship between atypical movement patterns, compensatory strategies, and multisystem consequences have not yet been explored. In fact, these multisystem consequences aggravate their condition and make movement much more atypical, forming a vicious cycle. This review aimed to provide a summary and highlight the mechanism of atypical movement pattern, multisystem compensations, and consequences in spastic quadriplegic CP children. It is true that central nervous system (CNS) lesion in CP is non-progressive, however the multisystem consequences may impair overall function over time. An understanding of how compensatory strategy and multisystem consequences in spastic quadriplegic CP offers the opportunity to intervene as early as possible to improve their quality of life.

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“…scissors-type gait. The patient usually has typical pattern of muscle weakness, sensory and motor control impairment, 1 which affects the activities of daily living of children. 5 In spastic CP patient malnutrition and growth failure is common condition and mainly occurs due to reduced fluid and calorie intake, excessive loss of nutrients and abnormal energy metabolism.…”

Section: Introductionmentioning

confidence: 99%

Effects of Stretching Exercises With or Without Baclofen on Spasticity, Fluid Intake and Calories Intake in Cerebral Palsy Children

Ahmad¹,

Liaqat²,

Kanwal

et al. 2021

TRJ

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Objectives: to find out the effectiveness of stretching exercises and baclofen alone and combined in spastic cerebral palsy children on spasticity, fluid and calorie intake. Material & Methods: A single-blinded, randomized control trial was conducted at Allama Iqbal Hospital, and Idrees Teaching Hospital. The participants between 5-15 years, having spasticity score of 2 or more on Modified Ashworth Scale (MAS). The participants were randomly divided into three treatment groups i.e. group A received baclofen, group B received stretching and group C received both baclofen and sustained stretching. Data were collected by Performa / Questionnaire, which calculated basic demographics, BMI, fluid and calorie intake, and Modified Ashworth Scale (MAS). Results: The result showed significant difference (p<0.05) among group with large effect size while comparing mean differences of Fluid intake {F(df)=2,57(988.603), η2 =0.972, p<0.001} and Calories intake {F(df)= 2,57(166.877), η2 =0.854, p<0.001}. While there was no significant difference in mean difference of spasticity {F(df)= 2,57(2.119), p=0.130}. Conclusion: baclofen along with stretching exercises significantly improved fluid, calorie intake and spasticity.

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Management of Spasticity and Cerebral Palsy

Cited by 4 publications

References 44 publications

Pain Management in the Most Vulnerable Intellectual Disability: A Review

Pain Management in the Most Vulnerable Intellectual Disability: A Review

Multisystem compensations and consequences in spastic quadriplegic cerebral palsy children

Effects of Stretching Exercises With or Without Baclofen on Spasticity, Fluid Intake and Calories Intake in Cerebral Palsy Children

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