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Query: UMLS:C0018991 (hemiplegia)
 3,997 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a prospective study it was found that cerebral palsy constituted 0.29% of total paediatric outdoor cases during the study period of 1988-1990. Seventy-five children suffering from cerebral palsy were studied at SN Children Hospital, Allahabad. Male to female ratio was 1:2. There were 42.8% cases who belonged to the age between one and 2 years. Hypertonic cases were predominant over hypotonic cases (3:1). Hemiplegia was commonest (68%) while triplegia was least common (2.7%). There were 24.5% cases who were mentally retarded. Hypertonic cases improved more frequently than hypotonic cases. An early management by paediatric physiotherapy may play an important role in the treatment of cerebral palsy.
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PMID:Cerebral palsy. 826 49

The primary aim of this investigation was to assess the correlation between the POSNA Musculoskeletal Functional Health Questionnaire (POSNA) and gait analysis in children with cerebral palsy (CP). POSNA and computerized gait analysis were used to evaluate individuals with CP. Correlations were investigated between POSNA scales, gait parameters, and the Gillette Functional Assessment Questionnaire (FAQ) in 63 children (31 males, 32 females; mean age 9.17 years [SD 3.06], age range 3.75 to 16.44 years) with spastic CP. Twelve participants had hemiplegia, 29 diplegia, 12 quadriplegia, and 10 triplegia. The result of backwards stepwise multiple regression analysis indicated that the Log normalcy index (NI) was a significant predictor of the POSNA Global Function and Comfort scale. Energy expenditure (EE) did not add significantly to the prediction. The POSNA scales differentiated between the different topographical types of CP. The POSNA scale is a valid and useful clinical measure. Used in conjunction with the NI, EE, and FAQ, the POSNA scale provides a more complete appraisal of change in functioning.
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PMID:Correlation between physical functioning and gait measures in children with cerebral palsy. 1200 21

This study compared the effects of low and high doses of botulinum toxin A (BTX-A) to improve upper extremity function. Thirty-nine children (22 males, 17 females) with a mean age of 6 years 2 months (SD 2y 9mo) diagnosed with spastic hemiplegia or triplegia were enrolled into this double-blind, randomized controlled trial. The high-dose group received BTX-A in the following doses: biceps 2U/kg, brachioradialis 1.5U/kg, common flexor origin 3U/kg, pronator teres 1.5U/kg, and adductor/opponens pollicis 0.6U/kg to a maximum of 20U. The low-dose group received 50% of this dosage. Outcomes were measured at baseline and at 1 and 3 months after injection, and results were analyzed with a repeated-measures analysis of variance. There was no significant difference between the low-dose and high-dose groups in upper extremity function over the 3-month period as measured by the Quality of Upper Extremity Skills Test (F[1,37]=0.18, p=0.68). There was no difference between the groups in the Pediatric Evaluation of Disability Inventory Self Care Domain (F[1,37]=0.05, p=0.83). Although grip strength decreased over the 3-month period, there was no difference between groups (F[1,32]=0.45, p=0.51). These findings indicate that there is no difference in hand and arm function between a low dose and a high dose of BTX-A at 1 and 3 months after injection. This information can be used to guide dosage of BTX-A for the management of upper extremity spasticity in children.
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PMID:A randomized controlled trial comparing botulinum toxin A dosage in the upper extremity of children with spasticity. 1748 5

This paper proposes a simple method of hand skill assessment in children that can be useful in clinical practice. A reduced 5-hole version of Annett's Peg Moving Task was used to quantify hand skill bilaterally in 435 normally developing preschool and school-children, and adolescents aged 3-18 years from Brazil. The cross-cultural validity of the normative data obtained in Brazil was verified in 157 school-children aged 6-11 years from France. An application in 76 children with cerebral palsy (hemiplegia 21, diplegia 34, triplegia 6, mixed type 15) showed very important variability of the deficits in hand function within each subtype of cerebral palsy (CP). Hand deficits were more severe in children in special schools than in children in regular schools within each CP subtype. A qualitative analysis showed which difficulties during the execution of the task were specific to children with CP and which were also observed in normally developing children.
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PMID:Hand skill assessment with a reduced version of the Peg Moving Task (PMT-5) in children: normative data and application in children with cerebral palsy. 1791 51

The aim of this study was to investigate the participation of children with cerebral palsy (CP) in activities outside school and to compare their participation with a large representative sample of children. A population-based survey was conducted of children with CP born in Victoria, Australia in 1994 and 1995. Of 219 living children identified, 114 (52.1%) returned completed surveys. The children (65 males, 49 females) were aged between 10 years 9 months and 12 years 9 months (mean age 11y 9mo, SD 6mo). Thirty-eight per cent had hemiplegia, 23% diplegia, 4% triplegia, 34% quadriplegia, and 1% was of unknown topography. Distribution according to the Gross Motor Function Classification System (GMFCS) was 22.8% Level I, 36% Level II, 10.5% Level III, 8.8% Level IV, and 21.9% Level V. Distribution according to the Manual Ability Classification System (MACS) was: 19.3% Level I, 38.6% Level II, 14.0% Level III, 8.8% Level IV, and 19.3% Level V. Participation was measured using the Children's Assessment of Participation and Enjoyment. Participation in selected sport, cultural, and quiet leisure activities was compared with population-based data for 11-year-olds from the Australian Bureau of Statistics. Children with CP undertook a median of 26.5 activities (interquartile range 10) in 4 months which were commonly informal rather than formal. Intensity of participation was low. Diversity and intensity of participation was similar for children in each level of the MACS and the GMFCS, except for participants in Level V. More children with CP participated in organized sports (p<0.001) compared with other Australian children, although with lower frequency (p<0.001). Participation diversity and level of intensity of Australian children with CP were similar to those reported in a Canadian study.
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PMID:Diversity of participation in children with cerebral palsy. 1835 37

This article describes a new multivariate measure of overall gait pathology called the Gait Deviation Index (GDI). The first step in developing the GDI was to use kinematic data from a large number of walking strides to derive a set of mutually independent joint rotation patterns that efficiently describe gait. These patterns are called gait features. Linear combinations of the first 15 gait features produced a 98% faithful reconstruction of both the data from which they were derived and 1000 validation strides not used in the derivation. The GDI was then defined as a scaled distance between the 15 gait feature scores for a subject and the average of the same 15 gait feature scores for a control group of typically developing (TD) children. Concurrent and face validity data for the GDI are presented through comparisons with the Gillette Gait Index (GGI), Gillette Functional Assessment Questionnaire Walking Scale (FAQ), and topographic classifications within the diagnosis of Cerebral Palsy (CP). The GDI and GGI are strongly correlated (r(2)=0.56). The GDI scales with FAQ level, distinguishes levels from one another, and is normally distributed across FAQ levels six to ten and among TD children. The GDI also scales with respect to clinical involvement based on topographic CP classification in Hemiplegia Types I-IV, Diplegia, Triplegia and Quadriplegia. The GDI offers an alternative to the GGI as a comprehensive quantitative gait pathology index, and can be readily computed using the electronic addendum provided with this article.
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PMID:The Gait Deviation Index: a new comprehensive index of gait pathology. 1856 53

Little data exists assessing the relationship between functional limitations in children with cerebral palsy (CP) and their participation in everyday activities. This prospective study evaluates the relationship between the Pediatric Outcomes Data Collection Instrument (PODCI), a functional health-related quality of life instrument for children and their parents, and the School Function Assessment (SFA), a school-based functional assessment. One hundred and two children with CP (80.4% dipliegia; 10.8% hemiplegia; 3.9% triplegia; 2.0% quadriplegia; 2.9% unspecified; 60 males, 42 females, mean age 11 years 8 months (SD 3 y 3 mo, range 6-8 y), Gross Motor Function Classification System levels I to IV (13.7% Level I 50% Level II 35.3% Level III 1% Level IV), had complete PODCI and SFA assessments. Significant relationships were noted among multiple PODCI subscales and subscales of the SFA, as well as among individual questions. PODCI predicted performance in all 31 subscales of the SFA when comorbidity subscales were included (r =0.35-0.64). The PODCI in-clinic questionnaire provides an accurate reflection of the child's actual participation in the community setting, as assessed by the SFA. PODCI can reliably be used to help ensure that outcomes assessed in the clinic setting reflect function within the community, and can be used to help with treatment planning, goal setting, and improved patient care.
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PMID:Relationship between parental PODCI questionnaire and School Function Assessment in measuring performance in children with CP. 1875 19

This randomized, double-blind, placebo-controlled study compared the efficacy of inhaled nitrous oxide (N(2)O) with enteral midazolam for sedation of children with cerebral palsy (CP) undergoing botulinum toxin A (BoNT-A) injections. Fifty children (29 males, 21 females; mean age 8y 2mo [SD 4y 5mo]; range 1-16y) were randomized to sedation with N(2)O (n=25) or midazolam (n=25). Groups were similar in type of CP (diplegia, 11; triplegia, three; quadriplegia, 16; hemiplegia, 16; other, three) and Gross Motor Function Classification System level (Level I, 4; II, 24; III, 4; IV, 13; V, 5). Both groups were equally sedated at time of injection (p=0.661), but those in the midazolam group were more sedated at time of discharge (p<0.001). N(2)O was more effective in reducing pain compared with midazolam as measured using the Face, Legs, Activity, Cry, Consolability (FLACC) scale (p=0.010), parental estimate of pain (p=0.009), and nursing estimate of pain (p=0.007). Parents in the N(2)O group rated it better than prior sedation with midazolam for BoNT-A injections (p=0.031). Physicians and nurses reported no difference in ease of procedure between the groups. One child in the midazolam group and eight in the N(2)O group had adverse effects, all of which resolved promptly. N(2)O appears to be an effective means of sedation for children undergoing outpatient BoNT-A injections.
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PMID:Effectiveness of sedation using nitrous oxide compared with enteral midazolam for botulinum toxin A injections in children. 1974 81

We introduce the Movement Deviation Profile (MDP), which is a single curve showing the deviation of an individual's movement from normality. Joint angles, recorded from typically developing children over one gait cycle, were used to train a self-organizing map (SOM) which then generated MDP curves for patients with gait problems. The mean MDP over the gait cycle showed a high correlation (r(2) = .927) with the Gait Deviation Index (GDI), a statistically significant difference between groups of patients with a range of functional levels (Gillette Functional Assessment Questionnaire Walking Scale 7-10) and a trend of increasing values for patients with cerebral palsy through hemiplegia I-IV, diplegia, triplegia, and quadriplegia. The small difference between the MDP and GDI can be explained by the SOM's method of operation comparing biomechanical patterns to the nearest abstract reference pattern, and its flexibility to compensate for temporal shifts in movement data. The MDP is an alternative method of processing complex biomechanical data, potentially supporting clinical interpretation. The electronic addendum accompanying this article is a standalone program, which can be used to calculate the MDP from gait data, and can also be used in other applications where the deviation of multi-channel temporal data from a reference is required.
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PMID:Movement deviation profile: a measure of distance from normality using a self-organizing neural network. 2072 53

This article introduces a new index, the GDI-Kinetic; a direct analog of the GDI based on joint kinetics rather than kinematics. The method consists of: (1) identifying "features" of the raw gait kinetic data using singular value decomposition, (2) identifying a subset of features that account for a large percentage of the information in the raw gait kinetic data, (3) expressing the raw data from a group of typically developing children as a linear combination of these features, (4) expressing a subject's raw data as a linear combination of these features, (5) calculating the magnitude of the difference between the subject and the mean of the control, and (6) scaling and transforming the difference, in order to provide a simple, and statistically well-behaved, measure. Linear combinations of the first 20 gait features produced a 91% faithful reconstruction of the data. Concurrent and face validity for the GDI-Kinetic are presented through comparisons with the GDI, Gillette Functional Assessment Questionnaire Walking Scale (FAQ), and topographic classifications within the diagnosis of Cerebral Palsy (CP). The GDI-Kinetic and GDI are linearly related but not strongly correlated (r(2)=0.24). Like the GDI, the GDI-Kinetic scales with FAQ level, distinguishes levels from one another, and is normally distributed across FAQ levels six to ten, and among typically developing children. The GDI-Kinetic also scales with respect to clinical involvement based on topographic CP classification in Hemiplegia types I-IV, Diplegia, Triplegia, and Quadriplegia. The GDI-Kinetic complements the GDI in order to give a more comprehensive measure of gait pathology.
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PMID:The GDI-Kinetic: a new index for quantifying kinetic deviations from normal gait. 2145 78


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