Friday, March 12, 2010

Decline in Function in Adolescents with Cerebral Palsy

A recent study followed 76 males and 59 females with cerebral palsy with a mean age of 14 yrs. 6 months at the start of the study. The participants had quadriplegia (96), diplegia (32) and hemiplegia (1) with the majority having spasticity. For four years, data was collected consisting of: anthropometric characteristics, the Spinal Alignment and Range of Motion Measurement, the Gross Motor Function Measure, health status, pain and exercise participation. The Gross Motor Function Measure scores were compared to previous scores from childhood which indicated a decline in gross motor function. The decline in Gross Motor Function Measure was significantly associated with limitations in range of motion and spinal alignment and pain. Less decline was correlated with increased triceps skinfold, increased mid arm circumference and ratio of mid arm circumference to knee height. The researchers concluded that management of range of motion, pain and nutrition may help to prevent declines in gross motor functions in adolescents with cerebral palsy.

Reference: Correlates of decline in gross motor capacity in adolescents with cerebral palsy in Gross Motor Function Classification System levels III to V: an exploratory study (p )DOREEN J BARTLETT, STEVEN E HANNA, LISA AVERY, RICHARD D STEVENSON, BARBARA GALUPPI Devel Med Child Neur Published Online: Feb 24 2010 5:48AM DOI: 10.1111/j.1469-8749.2010.03632.x

Teaching Motor Skills to Children with Cerebral Palsy and Similar Movement Disorders - A Guide for Parents and Professionals

Author: Sieglinde Martin M.S., P.T.


K said...

I wonder how the removal of OT and PT services from educational programming plays into this? I think everyone who is involved in some way in the field knows that after late elementary school OT and PT and other interventions are removed as "not educational". Every day I see that impact pain levels and tone in my students with CP and other issues.

Your Therapy Source Inc said...

I concur that pain is definitely an educational issue and can effect a student's ability to access the curriculum and absenteeism rates. The problem is that pain management from a PT perspective can be difficult to be successful in a school setting. In a PT clinic, where various modalities are available to help with pain control, PT sessions may be more successful. Perhaps, PT on a consultation basis in the schools would help to educate staff members and students on pain management and range of motion exercises.

TheRextras said...

ROM is a thorny issue in schools. How much physical support is provided is very individual. (The I in IEP and IDEA.)

The maintenance of flexibility is a lifestyle issue. Looking to the schools to provide daily maintenance to that level is to invite disappointment. Barbara

Your Therapy Source Inc said...

Well said Barbara! As usual.

Anonymous said...

I can believe this and corroborate it with my own experiences. I am stiffer and less mobile than I was 5, 10, or even q5 years ago. Birth defects people and preemies are often less capable motor wise with age. My legs and lower half are stiffer as I get older even with top end PT, Orthotics, and spasticity interventions. Even with frequent stretching and PT love. But I have overcome a lot and had to work for every gain I have made in my own life with CP, and spina bifida and more.