Spasticity and pain in adults with cerebral palsy

Flanigan, Megan; Gaebler‐Spira, Deborah; Kocherginsky, Masha; Garrett, Ariane; Marciniak, Christina

doi:10.1111/dmcn.14368

Cited by 34 publications

(38 citation statements)

References 29 publications

(53 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This population has previously been described. 19 Participants were enrolled from November 2014 through February 2017. Inclusion criteria for the main study were a CP diagnosis and age ranging from 16 to 89 years.…”

Section: Methodsmentioning

confidence: 99%

Diet quality in adults with cerebral palsy: a modifiable risk factor for cardiovascular disease prevention

Brown

Marciniak

Garrett

et al. 2021

Develop Med Child Neuro

View full text Add to dashboard Cite

Aim To assess diet quality and its relationship with cardiovascular health measures for adults with cerebral palsy (CP). Method A convenience sample of 45 adults with CP (26 females, 19 males; mean age 35y 10mo [SD 14y 9mo]). were recruited for this cross‐sectional study. Demographic, medical, and Gross Motor Function Classification System (GMFCS) information were obtained through in‐person visits. Participants completed two 24‐hour dietary recalls using the Automated Self‐Administered 24‐hour Dietary Assessment Tool. Specific macronutrient intake was compared to 2015 to 2020 US Department of Agriculture (USDA) guidelines. Other data included body mass index (BMI), waist‐to‐hip ratio (WHR), blood pressure, and hemoglobin A1c (HgA1c;n=43). Results Adults across GMFCS levels I to V were enrolled, 20 participants were in GMFCS levels IV or V. Mean calorie intake was 1777.91/day (SD 610.54), while sodium intake was 3261.75mg/day (SD 1484.92). Five participants met USDA vegetable and seven fruit guidelines. None met whole grain targets. Sixteen were overweight/obese by BMI. Sixteen participants without hypertension diagnoses had elevated blood pressure and nine had abnormal HgA1c without prediabetes/diabetes history. Percent calories from saturated fat was inversely associated with WHR in unadjusted and adjusted models (p=0.002 and p=0.003 respectively); all other dietary recommendations assessed (total calories, sodium, and sugar) were non‐significant. Post hoc analyses were unchanged using 2020 to 2025 USDA guidelines. Interpretation Assessment of nutrient intake and diet quality is feasible and warrants further study in adults with CP, as USDA guidelines are largely unmet. Adults with cerebral palsy (CP) do not meet US Department of Agriculture dietary quality recommendations. Prediabetes and hypertension may be common, but unrecognized, in adults with CP. Screening for nutrient intake and diet quality should be performed to facilitate nutritional counseling.

show abstract

Section: Methodsmentioning

confidence: 99%

Diet quality in adults with cerebral palsy: a modifiable risk factor for cardiovascular disease prevention

Brown

Marciniak

Garrett

et al. 2021

Develop Med Child Neuro

View full text Add to dashboard Cite

show abstract

“…Common clinical explanatory causes include arthropathy, postsurgical pain, neuropathic pain, and muscle-tone abnormalities. Spasticity, a commonly proposed causative factor (4,5), is present in 9 of 10 individuals with CP (6). Spasticity is characterized by a velocity-dependent resistance of a muscle to stretch (7) and could, hypothetically, cause mechanical stresses on musculoskeletal structures with secondary development of chronic pain.…”

Section: Introductionmentioning

confidence: 99%

A First Clinical Trial on Botulinum Toxin-A for Chronic Muscle-Related Pain in Cerebral Palsy

et al. 2021

View full text Add to dashboard Cite

Objective: To test if botulinum toxin-A (BoNT-A) is effective in reducing chronic muscle-related pain in adults with spastic cerebral palsy (CP), as compared to placebo.Design: A single-center, double-blind, parallel, randomized placebo-controlled trial. The design included an interim analysis to allow for confirmatory analysis, as well as pilot study outcomes.Setting: Tertiary university hospital.Participants: Adults with spastic CP and chronic pain associated with spastic muscle(s).Intervention: Treatment was one session of electromyographically guided intramuscular injections of either BoNT-A or placebo normosaline.Main Study Outcomes: The primary outcome was the proportion who achieved a reduction of pain intensity of two or more steps on the Numerical Rating Scale 6 weeks after treatment.Results: Fifty individuals were screened for eligibility, of whom 16 were included (10 female, 6 male, mean age = 32 years, SD = 13.3 years). The randomization yielded eight participants per treatment arm, and all completed the study as randomized. The study was stopped at the interim analysis due to a low probability, under a preset threshold, of a positive primary outcome. Four individuals were treatment responders in the BoNT-A group for the primary outcome compared to five responders in the placebo group (p = 1.000). Adverse events were mild to moderate. In exploratory analysis, the BoNT-A group had a trend of continuing reduction of pain at the last follow-up, after the primary endpoint.Conclusions: This study did not find evidence that BoNT-A was superior to placebo at the desired effect size (number needed to treat of 2.5) at 6 weeks after treatment.Trial registration:ClinicalTrials.gov: NCT02434549

show abstract

“…Considering the fact that the primary LTPAs of individuals are unvaried in our study, it is thought that special efforts should be made to increase the density and diversity of LTPA in order to provide health benefits in adults with CP in our country. During these interventions, it's important to note that during the conduct of these studies, the participants need to be carefully evaluated and monitored in order to prevent injuries caused by the excessive use of adults with disabilities, and it is thought that the interventions should be implemented slowly and progressively (Benner et al, 2017;Opheim et al, 2009;Gillett, Lichtwark, Boyd et al, 2018;Flanigan, Gaebler-Spira, Kocherginsky et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Leisure Time Physical Activity in Adolescents and Adults with Cerebral Palsy

Ciddi

Tunca

2021

Ergoterapi Ve Rehabilitasyon Dergisi

View full text Add to dashboard Cite

This study aimed to investigate the level of participation in leisure time physical activities (LTPA) of adolescents and adults with cerebral palsy (CP). Material and Methods: 35 individuals with CP at Gross Motor Function Classification System levels I (n=9), II (n=3), III (n=17), and IV (n=6); 15 female and 20 male, over the age of 16 (22.6 ± 5.5 years) were included in the study. A questionnaire has been prepared by researchers to investigate participation of individuals in LTPA. Individuals were asked whether they did any LTPA. If so, the type, frequency, intensity, duration were questioned. Results: It was determined 91.4% of individuals were interested in some form of LTPA, and they were interested in 8 activities (home exercises, walking, swimming, fitness, exercise bike, bowling, cycling and football) out of 14 activities offered to them, 74.2% of them did this activity once a week, and 65.7% of them wanted to do new activities, but couldn't perform them due to various barriers. Discussion: It was demonstrated that diversity and frequency of activities in adolescents and adults with CP were inadequate and interventions aimed at increasing community participation, and diversity and frequency of LTPA in adolescent and adult CP patients are needed.

show abstract

Spasticity and pain in adults with cerebral palsy

Cited by 34 publications

References 29 publications

Diet quality in adults with cerebral palsy: a modifiable risk factor for cardiovascular disease prevention

Diet quality in adults with cerebral palsy: a modifiable risk factor for cardiovascular disease prevention

A First Clinical Trial on Botulinum Toxin-A for Chronic Muscle-Related Pain in Cerebral Palsy

Leisure Time Physical Activity in Adolescents and Adults with Cerebral Palsy

Contact Info

Product

Resources

About