Multidisciplinary rehabilitation for patients with cerebral palsy: improving long-term care

Abstract

Cerebral palsy (CP) is one of the most frequent causes of child disability in developed countries. Children with CP need lifelong assistance and care. The current prevalence of CP in industrialized countries ranges from 1.5 to 2.5 per 1,000 live births, with one new case every 500 live births. Children with CP have an almost normal life expectancy and mortality is very low. Despite the low mortality rate, 5%–10% of them die during childhood, especially when the severe motor disability is comorbid with epilepsy and severe intellectual disability. Given this life expectancy, children with CP present with a lifelong disability of varying severity and complexity, which requires individualized pathways of care. There are no specific treatments that can remediate the brain damage responsible for the complex clinical–functional dysfunctions typical of CP. There are, however, a number of interventions (eg, neurorehabilitation, functional orthopedic surgery, medication, etc) aimed at limiting the damage secondary to the brain insult and improving these patients’ activity level and participation and, therefore, their quality of life. The extreme variability of clinical aspects and the complexity of affected functions determine a multifaceted skill development in children with CP. There is a need to provide them with long-term care, taking into account medical and social aspects as well as rehabilitation, education, and assistance. This long-term care must be suited according to children’s developmental stage and their physical, psychological, and social development within their life contexts. This impacts heavily on the national health systems which must set up a network of services for children with CP, and it also impacts heavily on the family as a whole, due to the resulting distress, adjustment efforts, and changes in quality of life. This contribution is a narrative review of the current literature on long-term care for children with CP, aiming at suggesting reflections to improve these children’s care.

Motor Abnormalities and Epilepsy in Infants and Children With Evidence of Congenital Zika Virus Infection

“…86 Children with developmental disabilities, which include CP and epilepsy, require increased medical and rehabilitative services. 87 The lifetime costs for a cohort of US children with CP born in 2003 was $11 billion, and the per-person lifetime cost approached $1 million. 88 Medical costs for Medicaid-enrolled children with CP were 10 times higher than for Medicaid-enrolled children without CP.…”

Consistency in Assessing Physical Development of Children With Cerebral Palsy According to Regional and Specialized Centile Scales: A Population-Based Cross-Sectional Stud

“…Практически у всех младенцев (90%) диагностируются орально-моторная и орально-сенсорная дисфункции, для 57% детей харак-терны проблемы сосания, для 38% -проблемы гло-тания; вследствие задержки развития 80% детей при приеме пищи постоянно нуждаются в помощи роди-телей (не могут самостоятельно держать ложку) [4,5]. Нутритивный дефицит у детей с ДЦП способствует повы-шению риска развития интеркуррентных заболеваний (сердечно-сосудистой и иммунной систем, дыхательной недостаточности) [6][7][8], нарушению трофики тканей (возникновение пролежней, замедление заживления ран, атрофия мышц, снижение минерализации костной ткани) [9,10], снижению эффективности специализиро-ванной медицинской помощи (кинезио-и ботулиноте-рапии) [11,12], развитию побочных эффектов от специ-фической терапии (противосудорожной, гормональной и др.) [13].…”

A Multidisciplinary Approach to the Assessment and Management of Pre-school Age Neuro-developmental Disorders: A Local Experience

“…Neurodevelopment ASD Diagnosis and management [42,38,37] Learning and behavioural problems [43] Language-impairment [44] Cerebral Palsy [45,46] Developmental Surveillance [47] Respiratory Asthma [48] infants with chronic lung disease [49] Neurology Spinal Muscular Atropy (SMA) [50] Traumatic brain injury [51] Epilepsy [52] Neurocritical care [32] Nutritional Obesity [53,54] Health Services Transitioning [55] Minimizing drug errors [55] Genetic Beckwith-Wiedeman syndrome [57] Haemophilia [58] Mental Health Eating disorders in children and adolescents.…”