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Christos P Panteliadis Editor Cerebral Palsy A Multidisciplinary Approach Third Edition 123 Cerebral Palsy Christos P Panteliadis Editor Cerebral Palsy A Multidisciplinary Approach Third Edition Editor Christos P Panteliadis Division of Paediatric Neurology Aristotle University of Thessaloniki Division of Paediatric Neurology Thessaloniki, Greece ISBN 978-3-319-67857-3 ISBN 978-3-319-67858-0 (eBook) https://doi.org/10.1007/978-3-319-67858-0 Library of Congress Control Number: 2017964310 © Springer International Publishing AG 2018 This work is subject to copyright All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed The use of general descriptive names, registered names, trademarks, service marks, etc in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Preface to the Third Edition Six years has passed since the release of the second edition of the book Cerebral Palsy: A Multidisciplinary Approach There was a good response from the readership, and the text was also translated into the Turkish language As the scientific knowledge of the early diagnosis, management and rehabilitation of cerebral palsy has expanded since 2011, the production of the third edition of this book was inevitable as a means of incorporating all of the latest data and nuances New distinguished authors from around the world, along with many authors of the second edition, have provided sharper and more acute dimensions to the overall upgraded version of this book All of the chapters have been revised and updated, and new chapters have been added The editor would like to thank all of the expert authors for their invaluable input, cooperation and patience towards the successful realization of this project and the publisher Springer Medicine Books, Continental, Europe & UK for the unwavering commitment in disseminating medical knowledge Special thanks to Christos Livanos from Thessaloniki, for his relentless administrative assistance Thessaloniki, Greece Christos P. Panteliadis v Preface to the Second Edition Brain damage of the foetal and early infant brain, clinically presented as cerebral palsy, results from a diversity of aetiologies, manifesting as different clinical pictures, and follows different clinical courses demanding for an interdisciplinary treatment This book systematically reviews the recent developments of diagnosis and treatment of cerebral palsy It was written by an international team of specialists, including neuro-paediatricians, orthopaedics, psychologists, epidemiologists and others who work in the field of cerebral palsy Six years has passed since the first edition of Cerebral Palsy was published, and I would like to take the opportunity to thank all the readers for their feedback, which helped to improve the text The updated manuscript has been thoroughly edited for language usage and grammar New chapters have been included covering additional aspects of this multifaceted disorder Finally, I would like to thank all authors of the present edition for sharing their expertise, as well as the publisher for their professional support and patience for listening to all of the wishes of the editor Thessaloniki, Greece Christos P. Panteliadis vii Preface (Parts from First Edition) Cerebral palsy (CP) institutes a nosologic entity with multiple diagnostic and therapeutic dilemmas It also specifies a scientific issue with particular social, ethical and economic extensions CP has been shown to be one of the most frequent problems which occupy paediatricians, paediatric neurologist, orthopaedist and physicians of other specialities The delay in kinetic operation, which characterizes CP, becomes even more serious when accompanied by other problems Thus, the rehabilitation programme becomes multidimensional The consequences on family, education and society are very important After diagnosis, the biggest burden is undertaken by the rehabilitation group, along with family cooperation The insecurity and the uncertainty for the child’s future dominate each family In time, signs of deterioration appear on the collective attempt This book is a complete effort of Greek and German authors who have been engaged for many years with CP and the problems related to it A great effort has been put in by all the authors: everyone in his/her own field has better approached the multidimensional issue of cerebral palsy Modern views are expressed on the explanation, clinical demonstration, prompt diagnosis and the related problems and ways of confronting them We hope that in this new edition we could improve the weaknesses which might appear in this first edition Thessaloniki, Greece Wuerzburg, Germany Christos P. Panteliadis H-M Strassburg ix Contents 1 Cerebral Palsy: A Historical Review�� 1 Christos P Panteliadis and Photios Vassilyadi 2 The Definition of Cerebral Palsy�� 13 Eve Blair and Christine Cans 3 Epidemiology of the Cerebral Palsies�� 19 Eve Blair, Christine Cans, and Elodier Sellier 4 Philosophy, Epidemiology, and Cerebral Palsy Causation�� 29 Olaf Dammann 5 Neuropathology of Cerebral Palsy �� 35 Christian Hagel 6 Aetiological Factors�� 49 Mary Jane Platt, Christos P Panteliadis, and Martin Häusler 7 Intrauterine Infection and Cerebral Palsy�� 59 Michael E Tsimis 8 Magnesium Sulfate for the Prevention of Cerebral Palsy�� 65 Dwight J Rouse 9 Early Markers for Cerebral Palsy�� 69 Christa Einspieler and Peter B Marschik 10 Clinical Characteristics �� 75 Kate Himmelmann and Christos P Panteliadis 11 Early Diagnosis and Differential Diagnosis of Cerebral Palsy�� 89 Rudolf Korinthenberg and Christos P Panteliadis 12 Cranial Ultrasound in Cerebral Palsy �� 101 Summer Kaplan and Ammie M White 13 Brain Imaging: Magnetic Resonance Imaging�� 113 Arastoo Vossough 14 Nuclear and Molecular Imaging in Cerebral Palsy�� 133 Marc Hickeson and Efrosyni Sfakianaki xi xii 15 Muscle Biology of Contractures in Children with Cerebral Palsy�� 143 Sudarshan Dayanidhi and Richard L Lieber 16 Physiotherapeutic Interventions: Bobath, Vojta, and Motor Learning Approaches�� 155 Dieter Karch and Karl Heinemann 17 An Overview of Evidence-Based Occupational and Physiotherapy for Children with Cerebral Palsy�� 165 Christine Imms and Noula Gibson 18 Early Intervention for Children with Cerebral Palsy�� 193 Alicia J Spittle and Cathy Morgan 19 Hip Dysplasia in Children with Cerebral Palsy�� 201 M Wade Shrader and Bopha Crea 20 Scoliosis in Children with Cerebral Palsy�� 209 M Wade Shrader and Bopha Crea 21 Management of the Upper Limb in Cerebral Palsy�� 219 Erich Rutz and H Kerr Graham 22 Integrated Management in Cerebral Palsy: Musculoskeletal Surgery and Rehabilitation in Ambulatory Patients�� 229 Erich Rutz, Pam Thomason, Kate Willoughby, and H Kerr Graham 23 Bone Status in Cerebral Palsy�� 253 Sandra Mergler 24 Oral Medication Use in Cerebral Palsy �� 259 James Rice 25 Intrathecal Baclofen Therapy �� 269 Michael Vassilyadi 26 Dorsal Root Rhizotomy for the Treatment of Spasticity�� 277 Michael Vassilyadi 27 Hyperbaric Oxygen Therapy in Cerebral Palsy �� 283 Marian S McDonagh 28 Visual Impairment in Cerebral Palsy�� 295 Nikolaos Kozeis and Saurabh Jain 29 Pulmonary Management of the Patient with Cerebral Palsy�� 303 Garey Noritz 30 Gastrointestinal Problems in Children with Cerebral Palsy�� 309 Peter B Sullivan and Morag J Andrew Contents Contents xiii 31 Nutritional Management of the Patient with Cerebral Palsy�� 319 Wendelin Burdo-Hartman and Garey Noritz 32 Long-Term Prognosis�� 327 Harald Bode 33 Quality of Life�� 335 Anna McCormick 34 Rehabilitation Principles of Adults with Cerebral Palsy�� 343 Mintaze Kerem Gỹnel, Yeim Sỹỗỹlỹ Karada, and Banu Anlar Index 349 344 c ontrol; skeletal deformities due to the adverse effect of gravity; hypertonia; and dystonia all might further limit ambulation and physical independence over time [1] The factor of “growing,” a normal process for other individuals, represents a struggle against secondary problems for physicians and physiotherapists treating CP patients during the transition period [2] Elderly CP patients also need specific management: their condition amplifies the physiological and psychological results of aging, often causing “premature aging.” As they grow older, many adults with CP are in danger of other health problems such as osteoarthritis, fatigue, loss of balance, and pain, which are often more serious than those of healthy elderly people The extent of secondary problems varies according to the type and severity of CP [3] It is important to maintain elderly CP patients’ ability to walk independently in order to continue their participation For such a multidimensional situation, the multidisciplinary team caring for the child with CP needs to be enlarged to include adult specialists in order to manage the transition and try to improve the quality of life in adults with CP In this chapter, we will examine growing up with CP especially in terms of physical and motor functions through the principles of rehabilitation 34.2 Cerebral Palsy and Age Most children with CP survive into adulthood: 80% live to their 20s and 80% of adults with CP live to 55—although this rate is lower than the approximately 90% in the non-CP population, individuals with CP who are able to walk are known to have a relatively normal lifespan [4] For this reason the adult life of individuals with CP has been gathering more interest in recent years [5] Physicians and physiotherapists should be aware of changes in mobility, strength, and endurance to be expected during the maturation process of persons with CP The particular problems of aging with CP stem from alterations in existing motor and other impairments: the natural decline due to aging is steeper in persons with CP due to associated sec- M.K Günel et al ondary problems [6] Significant deterioration in the ability to walk with or without aids was reported in 40% of adults with CP [3] The possibility of losing independent walking ability in adulthood seems to be higher for individuals with choreoathetosis or quadriplegic spastic CP than for those with hemiplegic and diplegic forms [7] Adults with CP are also at significantly higher odds for chronic disorders like arthritis, premature aging, pain, fatigue, and cardiopulmonary problems resulting in reduced independence, a sedentary lifestyle, and social isolation [8] The presence of sensory and cognitive problems increases the severity of limitations [9] 34.3 Reduction in Mobility Walking is one of the most important functions: during all the physiotherapy applied in childhood, the greatest hope of the family and the child is to ambulate independently However, adults with CP, especially those with poor gait function who required the use of aids during childhood (GMFCS level III), are likely to report deterioration in their walking ability over time and may stop walking entirely [10] This possibility increases with age: Jahnsen et al [11] reported progressive risk of deterioration from age 25 to 45 years, and more than 70% of CP patients over 45 years old report a decline in walking ability The age of deterioration also appears to be associated with the distribution of motor impairment and muscle weakness: median 37 years in bilateral CP vs 52 years in hemiplegic CP [1] Walking may cease altogether in the early 20s and 30s [7] Sometimes this is due to personal choices in response to current or changing symptoms, environment, activities of daily life, or vocation Previously ambulant adults with CP may decide to use walking aids or a wheelchair to save energy for other activities, to prevent falling, and to feel safer [12] However, losing the ability to walk affects patients’ symptoms; their social, educational, and professional life; and the level of assistance needed with activities of daily life like personal hygiene or getting dressed [8] 34 Rehabilitation Principles of Adults with Cerebral Palsy Spasticity may appear more pronounced in adulthood, frequently related to pain, fatigue, and secondary muscle and skeletal problems Balance is one of the most commonly reported problem areas, with more than 60% of adults affected; progressive postural instability can be due to factors associated with aging, like weight gain and diminishing vision, hearing, and vestibular functions, and also to factors associated with CP itself, namely, spasticity, poor muscle strength, and joint limitations Falls or other negative experiences may discourage the older adult with CP [10, 11] Physical fitness In addition to the natural decrease associated with aging, the tendency to reduce energy loss leads to gradual reduction in physical activity and fitness [13] Musculoskeletal deformities Relatively common are dislocations of the hip, skeletal abnormalities, and contractions of some muscle groups [14] They result from muscle hypo- or hyper-tone; asymmetrical strength of the pelvic, hip, and leg muscles; weakness of trunk muscles; or problems in bone alignment and asymmetrical weight-bearing Hip dislocation is an acquired condition that affects individuals with CP. Patella alta and ankle deformities resulting from spasticity and weak antigravity muscles are among other common musculoskeletal disorders reported to affect 18–59% of adults with CP [15] Joint degeneration Insufficient joint loading in childhood due to delayed weight-bearing, asymmetrical muscle activity, abnormal muscle tone, insufficient strength, and abnormal postural control and postural alignment may lead to poor joint integrity and irreversible damage to the articular cartilage of the joint surface This leads to an early onset of osteoarthritis, a common cause of pain, predominantly affecting the hips, knees, and feet Studies report osteoarthritis is more frequent, more severe, and earlier in individuals with CP: approximately 25% of young adults with CP between the ages of 15 and 25 are at risk of osteoarthritis The incidence is reported to be higher in ambulatory individuals due to postural control and impaired movement [16] The affected joints vary according 345 to the form of impairment and therefore to the clinical type of CP. The hip deserves special consideration: the incidence of hip osteoarthritis is reported to exceed 50% in ambulatory adults with CP [17] Moreover, the rate of complications after surgical intervention is higher in CP compared to non-CP patients Nevertheless, surgery for hip joint misalignment and degeneration improves pain and walking function The timing of the operation is very important and requires close follow-up by the orthopedic surgeon, the physiotherapist, and the caregivers Physiotherapists should start strengthening the hip and trunk muscles, standing up, and ambulation in the early postoperative period Patella alta or a high-riding patella is another relatively frequent condition in ambulatory adults with CP, often associated with chronic anterior knee pain or a crouched gait pattern especially in diplegic CP [18] Pain is a very common, if not the most common, physical symptom which is directly proportional to age and inactivity in CP. Approximately one-third of adults with CP suffer from chronic pain which contributes to the decline in motor functional capacity [19] Pain is often experienced in more than one part of the body, most commonly the neck, back, hips, knees, and feet It is worse after fatigue, maintenance of a certain position for extended periods, and on early morning hours It improves with rest, physical therapy, and exercise Some studies recommend physiotherapy programs to focus on pain-reducing exercises [20] The pathogenesis of pain varies: it is frequently presumed to be caused by “arthritis,” but other causes to be considered are deconditioning; narrowing of the spinal canal; soft tissue injuries in muscles, tendons, or ligaments; and entrapment or compression of peripheral nerves, all likely to result from posture and activity patterns that involve repetitive movements, poor alignment, and poor postural control [21] Chronic pain is significantly associated with deterioration of functional skills Preventive treatment aimed at correcting skeletal and muscle abnormalities early in life may help to avoid progressive deterioration 346 34.4 Rehabilitation Approaches in Adults with CP M.K Günel et al Physiotherapy involves evidence-based practice whenever possible However, guidelines for people with CP and research on the effects of Rehabilitation should help the patient reach their physical activity in adults with CP are limited full functioning potential at home, school, recre- Some studies report benefit from strength traination, and community settings For the sake of ing and improvement in cardiorespiratory fitness clarity, the problems of adults with CP who with physical endurance training which may conrequire physiotherapy and rehabilitation manage- tribute to reaching higher levels of physical activment can be listed in the following order: limita- ity Besides studies focusing on health issues tion in physical activity and functional mobility, such as medical and functional status, research pain and fatigue, musculoskeletal disorders and has addressed the effectiveness of various physdeformities, arthritis, osteoporosis and fractures, iotherapy interventions such as neurodevelopand premature aging [22] mental treatment, strength training, and orthotic Physiotherapy plays a central role in managing management [24] Biofeedback, electrical stimuthese conditions In most settings the physiothera- lation, and behavioral approaches may be pist applies the therapeutic program, recommends included into the physiotherapy program [25] equipment, plans for home life, and provides an Functional exercises combining aerobic and interface with the occupation of the individual anaerobic capacity and strength training signifiPreventing further disabilities and secondary dis- cantly improve physical fitness, the intensity of orders and minimizing functional limitations and activities, and quality of life in ambulatory indiimpairments that may develop over time are also viduals Isotonic, isometric, and isokinetic exerwithin the physiotherapist’s scope cises can be used to increase muscle strength and Physiotherapy and rehabilitation programs in improve motor functions Training programs on CP vary based on the individual’s age and func- static bicycles or treadmills can be beneficial for tional status Their spectrum covers daily life gait and gross motor development without activities and specific training schedules In prin- improving spasticity levels and abnormal moveciple, the dynamic motor control approach based ment patterns [26] The treadmill is a functional on changing motor patterns and tasks is used for training method that may help the patient to learn a realistic assessment of the individual (rather to walk at higher speeds and for longer distances than the hierarchical model of neurological motor For non-ambulatory CP patients, treadmills that development): it focuses on improving and main- support body weight can be used taining existing skills and capabilities, particuRecommendations on the type, frequency, and larly gross motor function, movement, and duration of exercise are tailored for the adult with functional mobility by working on positioning, CP taking into account muscle tone, coordinasitting, transition from sitting to standing, and tion, and pulmonary capacity Exercise improves walking with or without assistive aiding devices strength, flexibility, posture and balance, and and orthoses, wheelchair use, and transfers consequently functional activities such as walkTherapy can be applied at home, in clinics and ing, running, and activities of daily life Another hospitals as outpatients, in rehabilitation hospi- important and proven effect is on reducing tals as inpatients, or even at the workplace of the depression and anxiety that accompany aging patient Physiotherapy and rehabilitation plans Strengthening exercises are to be emphasized should include specific goals, objectives, and as studies demonstrate the relationship between measurable short-term priorities These short- muscle strength and activity Methods widely term goals allow therapists and patients to have a used in all age groups include functional activiclear understanding of the process Adolescent ties and the use of gravity as well as body weight physiotherapy programs should be supported by These methods require a sufficient level of loadrecreational activities to provide motivation for ing in order to increase muscle strength: the new skills [23] patient needs to apply more effort against pro- 34 Rehabilitation Principles of Adults with Cerebral Palsy gressive resistance This is highly emphasized to increase power generation capacity and improve muscle performance, motor skills, and range of motion [27, 28] Such exercises applied to upper and lower extremities increase strength without increasing spasticity in adults with spastic CP Exercises that not include weight-bearing not easily transfer to weight-bearing situations, which use diverse and more complicated muscle patterns Better improvement in functional motor performance is achieved when strengthening exercises contain closed kinetic chain exercises associated with functions In these exercises, the person puts weight on the legs and raises the body mass using concentric and eccentric activation of the muscles of the lower extremity Manual resistance, gym equipment, free weights, gym balls, thera-bands, treadmills, static bikes, leg presses, and isokinetic devices are some other examples of progressive resistance exercises [29] Electrical stimulation is proposed as a useful modality when selective muscle control is required for specific strengthening programs Muscle strength training is most commonly used for patients especially at GMFCS levels I–III who have better selective control and less co-activation than others Muscle strengthening for individuals in level IV and V is controversial because of problems related to motor control: although strengthening develops motor skills, its positive influence on functional capacity has not been proven; it is significant only when it is aimed to improve a specific motor skill or function At these levels, hydrotherapy may be preferable to muscle strengthening Any pain before or during the exercise should prompt modification of the strengthening training program, such as working different muscle groups on different days Some other interventions applied during childhood such as muscle tendon lengthening, selective dorsal rhizotomy, botulinum toxin injections, and intrathecal baclofen pump implantation can help to improve postural and motor control, preserve functional capacity, and, especially, maintain joint mobility and muscle strength in adulthood [30] However, the long-term effects 347 of treatment received in childhood raise concerns for two reasons The first is a possible deleterious effect of these interventions in the long run related to the stress created by weight-bearing on poorly aligned joints and by uncontrolled movements on joints and muscle tendons The second is about late effects of surgical interventions on functionality and personal and social well-being Some CP patients reaching late adolescence or young adulthood decide to discontinue therapy, even including those who had achieved mobility with or without aid Reasons are multiple Sometimes, parents’ encouragement, urging, and assistance lose their effect at later ages Therapy meeting the goals of the parent or caregiver, such as the use of a mobility aid rather than a wheelchair, or a position facilitating the care of the patient might not result in satisfaction and comfort from the patient’s part [31] Moreover, as the patient gets older, decreased motivation, increased body weight, and secondary problems may further reduce the functional capacity, resulting in loss of functional mobility and even in a totally dependent state Another important reason is the lack of continuity in maintenance or prevention programs 34.5 Summary As adult CP patients live longer and grow older, the need for more specialized care becomes evident CP is a lifelong condition that cannot be cured; long-term rehabilitation requires health practitioners to be aware of and prepared for problems arising in adulthood, expecting and preventing functional decline with increasing age Adults with CP need specific information in order to make their own choices They also require age-appropriate physical training to deal with decreased mobility and balance, management of pain and fatigue, treatment for secondary osteoarthritis, and support and guidance for challenges faced in the workplace and at home Because many people with CP outlive their caregivers, planning for long-term care is of crucial importance for health and social services 348 References Opheim A, Jahnsen R, Olsson E, Stanghelle JK. Walking function, pain, and fatigue in adults with cerebral palsy: a 7-year follow-up study Dev Med Child Neurol 2009;51:381–8 Donkervoort M, Roebroeck M, Wiegerink D. Determinants of functioning of adolescents and young adults with cerebral palsy Disabil Rehabil 2007;29:453–63 Andersson C, Mattsson E. Adults with cerebral palsy: a survey describing problems, needs, and resources, with special emphasis on locomotion Dev Med Child Neurol 2001;43:76–82 Strauss D, Shavelle R. Life expectancy of adults with cerebral palsy Dev Med Child Neurol 1998;40:369–75 Morgan P, McGinley J. Gait function and decline in adults with cerebral palsy: a systematic review Disabil Rehabil 2014;36:1–9 Maher CA, Williams MT, Olds T, Lane AE. Physical and sedentary activity in adolescents with cerebral palsy Dev Med Child Neurol 2007;49:450–7 Morgan P, McGinley J. Performance of adults with cerebral palsy related to falls, balance and function: a preliminary report Dev Neurorehabil 2013;16:113–20 Peterson MD, Ryan JM, Hurvitz EA, Mahmoudi E. Chronic conditions in adults with cerebral palsy JAMA 2015;314:2303–5 Andren E, Grimby G. Activity limitations in personal, domestic and vocational tasks: a study of adults with inborn and early acquired mobility disorders Disabil Rehabil 2004;26:262–71 10 Bottos M, Feliciangeli A, Sciuto L, Gericke C. Functional status of adults with cerebral palsy and implications for treatment of children Dev Med Child Neurol 2001;43:516–28 11 Jahnsen R, Villien L, Egeland T, et al Locomotion skills in adults with cerebral palsy Clin Rehabil 2004;18:309–16 12 Horsman M, Suto M, Dudgeon B, Harris SR. Growing older with cerebral palsy: insiders’ perspectives Pediatr Phys Ther 2010;22:296–303 13 Slaman J, Roebroeck ME, van Meeteren J, et al Learn move 16-24: effectiveness of an intervention to stimulate physical activity and improve physical fitness of adolescents and young adults with spastic cerebral palsy: a randomized controlled trial BMC Pediatr 2010;10:79 14 Gajdosik CG, Cicirello N. Secondary conditions of the musculoskeletal system in adolescents and adults with cerebral palsy Phys Occup Ther Pediatr 2001;21:49–68 15 Root L. Surgical treatment for hip pain in the adult cerebral palsy patient Dev Med Child Neurol 2009;51(Suppl 4):84–91 16 Cathels BA, Reddihough DS. The health care of young adults with cerebral palsy Med J Aust 1994;159:444–6 M.K Günel et al 17 Carter DR, Tse B. The pathogenesis of osteoarthritis in cerebral palsy Dev Med Child Neurol 2009;51(Suppl 4):79–83 18 Schroeder K, Hauck C, Wiedenhöfer B, Braatz F. Long-term results of hip arthroplasty in ambulatory patients with cerebral palsy Int Orthop 2010;34:335–9 19 Vogtle LK, Malone LA, Azuero A. Outcomes of an exercise program for pain and fatigue management in adults with cerebral palsy Disabil Rehabil 2014;36:818–25 20 Hilberink SR, Roebroeck ME, Nieuwstraten W, et al Health issues in young adults with cerebral palsy: towards a life-span perspective J Rehabil Med 2007;39:605–11 21 Kent RM. Cerebral palsy Handb Clin Neurol 2013;110:443–59 22 Jeglinsky I, Surakka J, Carlberg EB, Autti-Rämö I. Evidence on physiotherapeutic interventions for adults with cerebral palsy is sparse A systematic review Clin Rehabil 2010;24:771–88 23 Kerem Günel M. Rehabilitation of children with cerebral palsy from a physiotherapist's perspective Acta Orthop Traumatol Turc 2009;43:173–80 24 Tsorlakis N, Evaggelinou C, Grouios G, Tsorbatzoudis C. Effect of intensive neurodevelopmental treatment in gross motor function of children with cerebral palsy Dev Med Child Neurol 2004;46:740–5 25 Kerr C, McDowell B, McDonough S. Electrical stimulation in cerebral palsy: a review of effects on strength and motor function Dev Med Child Neurol 2004;46:205–13 26 MacPhail HE, Kramer JF. Effect of isokinetic strength-training on functional ability and walking efficiency in adolescents with cerebral palsy Dev Med Child Neurol 1995;37:763–75 27 Slaman J, Roebroeck M, Dallmijer A, et al Can a lifestyle intervention programme improve physical behaviour among adolescents and young adults with spastic cerebral palsy? A randomized controlled trial Dev Med Child Neurol 2015;57:159–66 28 Tyson S. The use of musculoskeletal techniques in adult cerebral palsy Physiother Res Int 1998;3:292–5 29 Dodd KJ, Taylor NF, Damiano DL. A systematic review of the effectiveness of the strength-training programs in people with cerebral palsy Arch Phys Med Rehabil 2002;83:1157–64 30 Kerem Gunel M. Physiotherapy for children with Cerebral palsy In: Petelin Gadze Z, editor Epilepsy in children-clinical and social aspects Rijeka: Intech; 2011 p. 213–134 31 Opheim A, Jahnsen R, Olsson E, Stanghelle JK. Physical and mental components of health-related quality of life and musculoskeletal pain sites over seven years in adults with spastic cerebral palsy J Rehabil Med 2011;43:382–7 Index A Absent fidgety movements, 72 Acetabular dysplasia, 204 Acetabular index (AI), 203 Achilles tendon lengthening (ATL), 236 Activity- and goal-directed interventions, 172 Activity competence, 176 Activity-dependent plasticity, 195 Acute intrapartum/peripartum asphyxia, 53 Acute neonatal hypoxic-ischaemic encephalopathy, 91 Adductor tightness, 78 Adults, 344 motor function, 328–329 rehabilitation principles (see Rehabilitation principles) tissue stem cell, 149 transition, 331 Advanced MRI imaging, 127, 128, 130 Aetiology, 50, 90 acquired coagulation defects, 56 genetic factors, 55, 56 hypoxia and neonatal encephalopathy, 52, 53 intrauterine exposure-toxic agents, 51 IPH, 54 maternal and familial factors, 56 meconium and asphyxia, 54 multiple pregnancies, 51, 52 perinatal stroke, 54 postneonatal factors, 55 pre-term labour, 52 risk factors, 50 SAH, 54 SDH, 54 Age of deterioration, 344 Age-specific fidgety movements, 69 Alexander disease, 97 α-Amino-3-hydroxy-5-methyl-4-isoxazolepropionate (AMPA)-kainate receptors, 38 Amblyopia, 297 Ambulatory patients, gait, 78 American Academy of Neurology and the Child Neurology Society, 76, 102 Anal fissure, 315 Anisometropia, 296 Ankle and foot deformities, 247 Ankle-foot orthoses (AFOs), 234, 242 Antifibrinolytics, 213 Antiphospholipid autoantibodies, 56 Apparent diffusion coefficient (ADC), 123, 124 Arm posturing score (APS), 221 Arterial ischaemic stroke (AIS), 126 Asphyxia, 54 Assistive technology, 156 Ataxic cerebral palsy, 300 Ataxic CP, 83, 84, 96, 97 Athetosis, 5, 82, 261 levetiracetam, 265 tetrabenazine, 265 Australian Cerebral Palsy Register (ACPR), 21 Australian CP Registry, 202 Avascular necrosis (AVN), 206 B Baclofen, 261 Barry-Albright Dystonia (BAD) Scale, 24, 237 BEAM trial, 66, 67 Best corrected visual acuity (BCVA), 296 Bilateral choreoathetosis, 43 Bilateral spastic cerebral palsy (BSCP), 79, 80, 299 apparent equinus, 236, 245 crouch gait, 236, 245 jump gait, 236, 245 true equinus, 236, 244 Bi-level positive airway pressure (BiPAP), 305 Bimanual training, 177 Bioelectrical impedance, 320 Birth asphyxia, 53, 134 Birthday syndrome, 240 Bisphosphonates, 256 Bobath approach, 157, 158, 161, 162 Bobath therapy, 196 Bone status, 255 bisphosphonates, 256 bone health, determinants, 254 calcium, 256 diagnostic measures, 255 fracture risk, 253 growth hormone, 256 incidence, 254 © Springer International Publishing AG 2018 C P Panteliadis (ed.), Cerebral Palsy, https://doi.org/10.1007/978-3-319-67858-0 349 350 Bone status (cont.) malnutrition, 256 physical activity, 256 prevalence, 255 with severe osteopenia, 254 vitamin D, 256 weight-bearing, 256 Botulinum toxin A (BoNT-A), 220, 222, 231, 237–239 analgesic agent, 239 in children black box warning, 239 denervation atrophy, 239 lower limb, 237–239 mechanism of action, 239 systemic side effects, 239 muscle-tendon lengthening, 240 preoperative test, 240 Boyle’s law, 285 Brain acute, 286 chronic, 286 intrinsic vasculature, 37 malformation, 50 maturation, 134 ontogenesis, 36 tumours, 95 vascularisation, 36 Bronchopulmonary dysplasia (BPD), 62 Burnout syndrome, 329 C 11 C-alpha-methyl-l-tryptophan (11C-AMT)-PET, 140 Canadian occupational performance measure (COPM), 170, 340 Cardiotocography (CTG), 53 Caregiver priorities and child health index of life with disabilities (CPCHILD©) questionnaire, 207, 337 Causal inference, 32 Cerebral abnormality, 16 Cerebral gamma-aminobutyric acid (GABA) receptor PET radiopharmaceuticals, 139 Cerebral palsy quality of life (CPQOL) questionnaire, 237, 337 Cerebral paresis, Cerebral sinovenous thrombosis (CSVT), 126 Cerebral visual impairment (CVI), 296 Chest wall deformity, 305 Child Health Questionnaire (CHQ), 237, 337 Child occupational self-assessment (COSA), 174 Chorea, 260 levetiracetam, 265 tetrabenazine, 265 Choreoathetosis, 162 Choreoathetotic cerebral palsy, 300 Chorioamnionitis, 62 Chronic intrauterine hypoxia, 53 Clinical evaluation, CP, 76 muscle tone assessment, 76 optimal age for diagnosis, 78, 79 Index posture, balance and equilibrium responses in standing position, 78 selective motor control measurement, 77 severity of gross motor function, 79 static deformity and/or muscle contracture at each joint, 77, 78 Clonidine, 264 Cognitive stimulation theory, 287 Color vision, 297 Communication function classification system (CFCS), 170, 230 Congenital anomalies, 109 Congenital hemiplegia, 136 Congenital malformations, 115 Congenital muscular dystrophy, 94 Congenital myotonic dystrophy, 93 Constipation in children, 314 chronic, 314 contributory factors, 314 dietary factors, 314 first-line treatment, 314–315 second line treatment, 315 surgical treatment, 315 Constraint-induced movement therapy (CIMT), 197, 222 definition, 177 hybrid CIMT, 178 types, 178 Continuous positive airway pressure (CPAP), 305 Contractures, children clinical treatments, 145 in gait impairments, 144 mechanical properties, 144 and muscle growth, 146 and muscle stem cells, 149 passive stiffness, 148, 149 population-based studies, 144 postnatal developmental changes, 145 progression of walking, 144 range of motion, 144 surgical dorsal rhizotomies, 144 Contralateral diaschisis, 136 Contrast sensitivity, 297 Cortical infraction, 43 CPUP program, 202 Cramped-synchronised GMs, 72 Cranial ultrasound, 101–103, 106, 109 abnormalities, 102 Circle of Willis flow, 102 high-frequency linear array and low-frequency curved array transducers, 102 and ischemic pathologies infectious and congenital pathologies, 109 premature infants, 102, 103, 106 term infants, 106, 109 vascular insults, 102 Crouch gait, 80 Curved osteotomy, 204 Cystic periventricular leukomalacia (cPVL), 62, 121 Cytokines, 60 Cytomegalovirus (CMV), 109, 110 Index D Danish Cerebral Palsy Registry, 332 Dantrolene, 263 Delayed gastric emptying (DGE), 313 Developmental considerations, 168 Developmental dysplasia, 201 Developmental movement disorder, 143 Developmental quotient (DQ), 331 Developmental skills approach, 196 Diagnostic work-up, 90–93 Diazepam, 262 Differential diagnosis, 93 ataxia, 96, 97 brain tumours, 95 dystonic syndromes, 95, 96 FSPs, 96 neurometabolic diseases, 97 neuromuscular disorders, 93 severe psycho-intellectual delay, 93 spinal cord diseases, 94 Diffuse excessive high signal intensity (DEHSI), 121 Diffusion tensor imaging (DTI), 128, 129 Diffusion-weighted imaging (DWI), 123 Disorder movement/posture, 15 Diplegics cerebral palsy, 299 Dorsal root rhizotomy (DRR), 270, 279 classification, 278 complications, 280 effectiveness, 280 patient selection, 278–279 side effects, 280 surgical treatment contralateral and suprasegmental spread, 279 electrophysiologic abnormalities, 279 laminotomy, 279 variability, 279 Dorsal stream, 299 Drooling, 312 Dual-energy X-ray absorptiometry (DXA), 255, 320 Duncan-Ely test, 78 Dynamic airway obstruction, 306 Dynamic and static deformity, 77 Dynamic phase, 230 Dyskinesia, 82 Dyskinetic cerebral palsy, 82, 83, 95, 300 Dyskinetic strabismus, 297 Dysmotility, 322 Dystonia, 77, 95, 321 anticholinergics and dopaminergic medication, 264 l-Dopa (Levodopa), 265 perinatal asphyxia, 264 trihexyphenidyl, 264, 265 Dystonic cerebral palsy, 270 Dystonic hypertonia, 77 Dystonic syndromes, 95–96 E Early diagnosis, of CP, 90 Early intervention, 196 351 CP early detection, 194 definition, 194 environmental enrichment, 195 ICF model, 194, 195 in NICU, 195, 196 motor interventions (see Motor interventions) Eating and Drinking Ability Classification System (EDACS), 170 Effective interventions, 173 Electrical stimulation, 347 Electroencephalogram, 93 Environmental enrichment (EE), 195 Environment-based interventions activity competence, 176 adolescents, MACS/GMFCS level, 173 bimanual training, 177 CIMT, 177–179 equipment adaptive technology and environmental modifications, 175, 176 goal-directed training, 176, 177 interrupted time series designs, 173 leisure goals, 173 optimising leisure participation intervention programme, 174, 175 project TEAM, 174 solution-focused intervention approach, 173 therapist training requirements, 173 time-limited intervention period, 173 Epidemiology, 19, 22–24 cerebral palsy, 22 associated impairments, 23 motor function loss, 22, 23 neuro-imaging results, 24 neurological signs and topography of motor impairment, 22 severity assessment, 23 factors affecting ascertainment, 20, 21 interpretation of trends, 25, 26 prevalence of trend times, 24, 25 rate and trends, methodological issues, 20 Epilepsy, 23, 82, 137–139 Equinovarus deformities, 244 Etiology, CP, 30 European SCPE network, 22 Evidence-based practice, 167 Exposure-outcome evidence, 30 Extra-axial hemorrhage, 106 Extracellular matrix (ECM), 147, 148, 150 F Familial spastic paraplegias (FSPs), 96 Family of Participation-Related Constructs (fPRC), 167 Family-centred care, 167 Fetal brain development, 60 Fetal inflammatory response syndrome (FIRS), 61 Fetal neuroprotection, 66 Fidgety movements, 70, 71 FIRS, see Fetal inflammatory response syndrome (FIRS) Foregut dysmotility, 312 Freud’s phenomenological approach, 14 352 FSPs, see Familial spastic paraplegias (FSPs) Functional Assessment Questionnaire (FAQ), 237 Functional classification systems CFCS, 170 EDACS, 170 GMFCS, 169 MACS, 169, 170 Functional electrical stimulation (FES), 243 Functional Mobility Scale (FMS), 237 Functional therapy approaches, 196–197 Functional training method, 346 Fundus abnormalities, 297 G Gabapentin, 264 Gait Outcomes Assessment List (GOAL), 241 Gait Profile Score (GPS), 221 Galveston fixation, 213 Gastric dysmotility, 313 Gastrointestinal (GI) motility, 210 Gastro-oesophageal reflux disease (GER), 210, 313 delayed gastric emptying, 313 gastric dysmotility, 313 occurrence, 313 retching, 313 Gastrostomy, 313–315 anecdotal reports, 310 anticholinergic medications, 312 botulinum toxin, 312 complications, 311 conservative management, 312 constipation in children, 314 chronic, 314 contributory factors, 314 dietary factors, 314 first-line treatment, 314–315 second line treatment, 314–315 surgical treatment, 315 drooling, 312 family stress, 310 foregut dysmotility, 312 gastro-oesophageal reflux delayed gastric emptying, 313 gastric dysmotility, 313 occurence, 313 retching, 313 indications, 310 malnourished children, 310 nutritional management, 311–312 oral feeding, 309 oropharyngeal dysfunction, 310 overfeeding, risk of, 311 peptic oesophagitis, 313 General movement toolbox, 70 General movements assessment (GMA), 91, 194 Germinal matrix (GM) hemorrhage, 102, 103, 118 GFAP-mutated Alexander disease, 97 Index Gillette Gait Index (GGI), 240 Glial fibrillary acidic protein (GFAP), 44 Glutaric aciduria type 1, 96 Goal attainment scale (GAS), 170, 174, 339, 340 Goal setting tools, 170, 171 Goal-directed training, 176, 177 Goal-Plan-Do-Check, 174 Goals, activity, motor enrichment (GAME), 197 Gross motor function classification system (GMFCS), 9, 23, 79, 144, 168, 169, 220, 230–234, 270, 278, 296, 320 Gross motor function measure (GMFM) scale, 289 Growth hormone, 256 H Hammersmith infant neurological examination (HINE), 90, 194 Hand function, 328 Hand-arm bimanual intensive training (HABIT), 177 HBO, see Hyperbaric oxygen therapy (HBO) Head-shaft angle, 202 Health utilities index (HUI), 337 Health-related quality of life (HRQoL), 336 Hemiparesis, Hemiplegia, 222, 329 Hemorrhage, 40, 42, 102, 106 Hemorrhagic and ischemic pathologies premature infants, 102, 103, 106 term infants, 106, 108 Hepatosplenomegaly, 76 Heubner’s artery, 37 Hip displacement, 247 Hip dysplasia, 244 botulinum toxin injections, 203 complications, 205, 206 developmental dysplasia, 201 long-term outcome data, 207 NDT, 203 neuromuscular hip dysplasia, 201 pathophysiology, 202 physical examination, 202 postoperative care, 205 postural treatment, 203 prevalence, 201 preventive surgery, 203, 204 prognosis, 202 radiographic evaluation, 203 radiostereometric analysis, 207 reconstructive surgery, 204, 207 salvage procedures, 205 Horizontal tonic gaze deviation, 297 House classification of upper extremity functional use, 223 Hydranencephaly, 44 Hydrotherapy, 347 Hydroxyproline assays, 147 Hyperaminoacidaemias, 51 Hyperbaric chambers, 284 Index Hyperbaric oxygen therapy (HBO), 287, 289–291 acute brain injury, 286 adverse effects, 287 biochemical and cellular effects, 285 cerebral palsy evidence harms, 291 GMFM scale, 289, 290 Jebsen test, 291 meta-analysis, 289, 290 methodological issues, 291 methods, 290 outcome assessors, 291 PEDI, 289 stable baselines, 291 study characteristics, 287 TOVA, 289 validated scales, 291 videotapes, 291 chronic brain injury, 286–287 complications, 287 definition, 284 hyperbaric chambers, 284 hyperoxic effect, 285 indications, 284 mechanical and physiologic effects, 284 monoplace chambers, 284, 285 multiplace chambers, 285 off-label use, 284, 285 regulatory process, 284 study characteristics, 288–289 theoretical basis, 285 US Food and Drug Administration, 284 Hypermetropia, 296 Hyperthermia, 39 Hypertonia, 76 Hypocaloric diets, 321 Hypoperfusion abnormalities, 135 Hypotensive brain injury, 37 Hypotonia, 210 Hypoxia, 52 Hypoxia/ischaemia-related brain damage, 36 Hypoxic ischemic encephalopathy (HIE), 108, 123, 134 Hypoxic-ischaemic injury, 44, 123 Hypoxic-ischaemic insults, 114 I Idling neuron theory, 287 Illness causation, 30 Immunization, 305 In vitro fertilisation (IVF), 51 Incidence, CP, 20 Infant motor profile (IMP), 91 Infants, 69, 72 MRI, 102 neurological examination, 76 progressive neurological deficit, 92 ultrasound, 102 unilateral spastic CP, 71 353 Intellectual impairment, 23 Intelligence quotient (IQ), 331 Intensity of practice, 172 Intensive self-initiated practice, 193 Interferon-γ, 38 Interictal SPECT, 139 International classification function (ICF), 194, 195 International classification of functioning disability and health: children and youth (ICT-CY) additional qualifiers, 166 classification system, 166 theoretical framework, 166 Intracranial bleed parenchymal hemorrhage, 103 Intracranial haemorrhage, 106, 116 Intradural haemorrhage, 40 Intramuscular recession, 244 Intraparenchymal haemorrhages (IPH), 55 Intrathecal baclofen (ITB) therapy baclofen pump implantation, 272 Chiari I malformation, 272 complications, 272 doses, 269 effectiveness, 273 infection, 272 patient selection, 270 shunt malfunction, 272 side-effects, 269 surgical implantation, 270–272 Intrauterine disease, 1–2 Intrauterine hypoxia, 52, 53 Intrauterine infection (IUI), 59, 61 clinical evidence, 62 etiology, CP, 60 fetal brain development, 60 FIRS, 61 preclinical models, 61 Intraventricular hemorrhage (IVH), 37, 52, 62, 103, 116–119 Investigational New Drug (IND) application, 284 Iodine deficiency, 51 Ischemia, 102, 103 Ischemic injury, 108 J Jebsen test, 291 Joint degeneration, 345 Jump gait, 80 K Karyorrhexis, 42 KIDSCREEN QoL measure, 337 Kyphosis, 211 L l-DOPA, 95 Leukodystrophy, 97 Index 354 Lever arm disease, 246 Levetiracetam, 265 Life-course health development model, 167 Lipopolysaccharide (LPS), 61 Little’s Disease, Live births (LB), 51 Lobal hypoxic-ischaemic encephalopathy, 44, 45 Long-term prognosis, 330, 331 direct and indirect economic costs, 332 domestic assistance, 332 empirical experiences, 331 hand function, 328 legislation, 332 morbidity behavioural and emotional problems, 330 contractures, 330 fatigue, 330 fractures, 330 neurogenic lower urinary tract dysfunction, 330 pain, 330 mortality life expectancy, 330, 331 SMR, 330 motor developmental profiles, 328 motor function, 328 participation, 332 quality of life, 332 rehabilitation techniques, 332 spastic hemiparesis, 328 spastic tetraplegia, 328 transition, 331 unaided walking, 328 Low bone density, 254–255 Lower limb, 223, 243, 244 BoNT-A, 237–239 USCP type I hemiplegia, 243 type II hemiplegia, 243 type III hemiplegia, 244 type IV hemiplegia, 244 Lumbar lordosis, 211 Lung disease, 210 M Macrocephaly, 92 Magnesium sulfate (MgSO4), CP prevention, 65–67 Magnetic resonance imaging (MRI), 76, 102, 114, 115 Magnetic resonance venographies (MRV), 127 Manual ability classification system (MACS), 169, 170, 220, 221, 230 Markerless systems, 224 Maternal cytokines, 60 Maternal immune activation (MIA), 61 Maternal intrauterine infection, 62 Meconium aspiration syndrome, 54 Medtronic N’Vision®hand-held wireless portable programmer device, 271 Melbourne unilateral upper limb assessment, 223 Mental retardation, 93 Meticulous sterile technique, 214 Mid-twentieth century, Miller flexibility test, 210 Mineralised neurons, 44 Minor maternal trauma, 37 Modified Ashworth scale (MAS), 221, 237 Modified Tardieu scale (MTS), 221 Monoamine metabolism disorders, 95–96 Monoplace chambers, 284, 285 Motor impairment, 84 Motor interventions Bobath therapy, 196 developmental skills approach, 196 functional therapy approaches, 196–197 NDT, 196 Motor learning control of motor function and cognition, 159 goal-directed/task-oriented interventions, 159 learning objectives, 159 neuropsychological model, 158, 159 principles, 197, 198 therapeutic interventions, 159 Motor learning coaching (MLC), 161 Multicystic encephalopathy, 45 Multiplace chambers, 285 Muscle hypertonia, 260 Muscle strength training, 347 Muscle tone assessment, 76, 77, 81 Muscle-tendon units (MTU), 236 Musculoskeletal deformities, 345 Musculoskeletal management algorithm, 238 Musculoskeletal pathology, 230 Myelination, 59 N Necrosis, 43 Neonatal arterial ischaemic stroke (AIS), 126 Neonatal brain perfusion (rCBF), 137 Neonatal cerebral sinovenous ischaemic stroke, 126 Neonatal intraparenchymal haematomas, 116 Neonatal white matter injury, 119, 121 Neurodevelopmental therapy (NDT), 162, 167, 196, 203 Neurometabolic diseases, 76, 97 Neuromuscular disorders, 93 Neuromuscular hip dysplasia, 201, 204 Neuronal necrosis, in premature, 40, 42 Neuropathology, 36, 40–45 animal models, 38–40 brain development and pathophysiology, 36–38 morphology of brain lesion cortical infraction, 43 haemorrhages, 40 lobal hypoxic-ischaemic encephalopathy, 41, 44, 45 periventricular leukomalacia, 42 prenatal neuronal death, 40, 42 status marmoratus, 43 Neuroplasticity, 195, 197 Neuropsychological theory, 286 Non-ambulant children, 246 Nonprogressive ataxia, 96 Index Nuclear/molecular imaging (N/MI) brain function and pathology, 134 imaging method, 133 PET and SPECT imaging methods, 139 radiopharmaceuticals, 133 single photon emission computed tomography, 134 therapeutic and preventive methods, 137 Nutritional status assessment, 323 bioelectrical impedance, 320 body composition, 320 body fat assessment, 320 contractures/kyphoscoliosis, 320 dual-energy absorptiometry, 320 dysmotility, 322 dysphagia, 321 dystonia, 321 GMFCS level, 320 height measurement, 320 low-calorie diets, 321 management, 323–324 medication effects, 322, 323 REE, 320 and respiratory status, 247 skinfold measures, 320 tongue lateralization, 321 undernutrition, 321 weight measurement, 320 Nystagmus, 298 O Occipito-parieto-temporal junction (o-p-t junction), 299 Occupational therapy, 155, 165, 220 Occupational therapy-based bimanual training, 177 Oligodendroglial precursors, 38 Ontogenesis, of brain, 36 Optimising leisure participation intervention programme, 174, 175 Optokinetic reflex (OKR), 298 Oral medication, 261–265 abnormal tone, 261 athetosis levetiracetam, 265 tetrabenazine, 265 chorea levetiracetam, 265 tetrabenazine, 265 and dose ranges, 262 dystonia anticholinergics and dopaminergic medication, 264 l-Dopa (Levodopa), 265 perinatal asphyxia, 264 trihexyphenidyl, 264, 265 function model, 260 movement disorders, 261 muscle hypertonia, 260 spasticity baclofen, 261 clonidine, 264 355 dantrolene, 263 diazepam, 262 gabapentin, 264 tizanidine hydrochloride, 263 Oropharyngeal dysfunction, 310 Orthopedic interventions, 305 Orthotics, 156 Osteoclasts, 254 Oxygen deprivation, 285 Oxygen therapy, 285 P Paediatric evaluation of disability inventory (PEDI), 289 Paediatric health-care professionals, 69 Pan-dispositionalist theory, 31 Panthotenate kinase-associated neurodegeneration (PKAN), 96 Paraspinal spasticity, 210 Parenchymal hemorrhage, 103, 108 Participation and environment measure-children and youth (PEM-CY), 173 Pediatric outcomes data collection instrument (PODCI), 337 Pediatric quality of life inventory (PedsQL), 237 PedsQL measurement model, 337 Pelizaeus-Merzbacher disease (PMD), 97 Pelvic obliquity, 210 Pelvic osteotomy, 204 Perinatal arterial ischaemic stroke, 126 Perinatal asphyxia, CP, 31, 264 Perinatal brain lesions, 41 Perinatal stroke, 54, 126, 127 Periventricular haemorrhage, 37 Periventricular leukomalacia (PVL), 37, 42, 52, 60, 61, 103, 119–121, 123, 128, 296 Periventricular venous infarction (PHVI), 118 Physical fitness, 345 Physician’s rating scale (PRS), 239 Physiotherapy, 166, 346 abnormal posture improvement, 155 effect studies, 160 indications, 162 movement control, 155 neurophysiological basis, 156 sensorimotor development, 155 statistical methodology, 159 treatment, 159–161 upper limb, 220 Polioencephalitis, Poliomyelitis, Pontosubicular neuronal necrosis, 38 Poor repertoire, of GMs, 72 Popliteal angle measurement, 78 Porencephaly, 5, 44 Post term infants, 72 Posthaemorrhagic hydrocephalus, 119 Postnatal hypoxic-ischaemic brain injury, 45 Postnatal muscle development, 145 Postneonatal CP, 55 Prechtl’s method of assessment, 194 356 Premature infants, 102–106 Prenatal and neonatal infections, 109 Prenatal and perinatal brain lesions, CP, 41, 91 Presumed perinatal arterial ischaemic stroke (PPAIS), 127 Pre-Wallerian degeneration, 126 Progressive/fluctuating ataxia, 97 Project TEAM COSA, 174 definition, 174 14-week manualised programme, 174 GAS, 174 goal-plan-do-check, 174 modification strategies, 174 participation goal achievement, 174 single-group design, 174 for 12–17 years adolescents, 174 Proteolipid protein gene (PLP), 97 Proton MR spectroscopy (1H–MRS), 128 Proxy data, 339 Pulmonary function tests (PFTs), 305 Pulmonary management acute setting, 304 aspiration, 306 assessment, 304 chest radiography, 304 chest wall deformity, 305 chest x-ray, 304 chronic hypoxia, 304 dynamic airway obstruction, 306 echocardiography, 305 immunization, 305 infectious transmission, 306 orthopedic interventions, 305 PFTs, 305 physiology, 303–304 prevention, 306 pulse oximetry, 304 respiratory function, 305 respiratory insufficiency/failure, 306 skeletal abnormalities, 304 sleep-disordered breathing, 305 Pulse oximetry, 304 Pupillary reflex, 298 Q Quality of life (QoL) age, 338 in caregivers, 339 CHQ, 337 COPM, 339, 340 CP QOL-Child questionnaire, 337 CPCHILD©, 337 function, 338 Goal Attainment Scale, 339, 340 health, 338 vs HRQoL, 336 HUI, 337 individual determinants, 338–339 KIDSCREEN QoL measure, 337 Index outcome measures, 336 PedsQL measurement model, 337 physical aspects, 338 PODCI, 337 pre- and post-interventions, 340 proxy data, 339 self-report, 340 tools, 336 Quality of upper extremity skills test (QUEST), 224 R Radiostereometric analysis (RSA), 207 Randomised controlled trials (RCT), 162 Range of movement (ROM), 77 Reconstructive surgery, 204, 207 Refractive errors abnormalities, 297 accommodation, 298 amblyopia, 297 anisometropia, 296 BCVA, 296 color vision, 297 contrast sensitivity, 297 dorsal stream, 299 fixation, 297 fundus abnormalities, 297 horizontal tonic gaze deviation, 297 hypermetropia, 296 nystagmus, 298 OKR, 298 perception, 298 pupillary reflex, 298 saccades, 297 smooth pursuits, 297 stereopsis and binocular vision, 297 strabismus, 298 ventral stream, 298 visual disorders, 299 visual field defect, 297 VOR, 298 Regional cerebral glucose metabolism (rCGM), 134, 135 clinical abnormalities, 135, 136 FDG-PET, 135 in ipsilateral sensorimotor cortex, 136 prognostic value, 136 Regional cortical glucose utilization, 135 Rehabilitation principles age of deterioration, 344 aging, 344 balance, 345 electrical stimulation, 347 functional exercises, 346 hydrotherapy, 347 interventions, 347 joint degeneration, 345 muscle strength training, 347 musculoskeletal deformities, 345 pain, 345 patella alta/high-riding patella, 345 physical fitness, 345 Index physiotherapy, 346 spasticity, 345 strengthening exercises, 346 survive, 344 walking, 344 Relative risk (RR), 62 Remodelling units, 254 Respiratory system, 304, 305 Resting energy expenditure (REE), 320 Retching, 313 Richard’s deformity, Rigid hypertonia, 77 Russo-Williamson Thesis (RWT), 30 S Saccades, 297 Sagittal gait patterns, 234–236, 243–246 BSCP apparent equinus, 236, 245 crouch gait, 236, 245, 246 jump gait, 236, 245 true equinus, 236, 244 USCP ankle-foot orthoses, 234 botulinum toxin injections, 234 type I hemiplegia, 234, 243 type II hemiplegia, 234, 243 type III hemiplegia, 235, 244 type IV hemiplegia, 235, 244 Winters, Gage and Hicks classification, 234 Sarcomeres, 145–147 Satellite cells, 149, 150 Schizencephaly, 115 Scoliosis Cobb angle measurements, 211 complications, 214–216 early treatment, 211 GERD, 210 long-term clinical outcomes, 216 pathophysiology, 210 physical examination, 210 posterior-only instrumentation, 216 postoperative care, 214 prevalence, 209 prognosis, 210 radiographic evaluation, 211 short-term follow-up, 216 surgical planning, 211, 212 surgical treatment, 213, 214 sweeping C-shaped curves, 211 thoracic and lumbar curve, 211 Segawa’s disease, 95, 96, 265 Segmental movements, 72 Selective dorsal rhizotomy (SDR), 231 Selective dorsal root rhizotomy (SDDR), 278, 279 absolute requirement, 279 complications, 280 functional benefits, 278 Severe visual impairment (SVI), 296 357 Shriner’s hospital upper extremity evaluation (SHUEE), 224, 225 Silfverskiold test, 78 Single-event multilevel surgery (SEMLS), 231, 240 Skeletal abnormalities, 304 Sleep-disordered breathing (SDB), 305 Smooth pursuits, 297 Spastic cerebral palsy, 79 Spastic diplegia cerebral palsy, 6, 231, 278, 299 See also Bilateral spastic cerebral palsy (BSCP) Spastic hemiplegia, see Unilateral spastic cerebral palsy (USCP) Spastic hemiplegia function, 223 Spastic hypertonia, 76 Spastic quadriparesis, 278 Spastic unilateral cerebral palsy, 300 Spasticity, 270, 277, 345 baclofen, 261–262 clonidine, 264 dantrolene, 263 diazepam, 261–263 dorsal root rhizotomy (see Dorsal root rhizotomy (DRR)) gabapentin, 264 ITB therapy, 270 tizanidine hydrochloride, 263–264 Spasticity interferes, 278 Spasticity management, 222 Spinal cord diseases, 94 Split anterior tibial tendon (SPLATT), 244 Split posterior tibial tendon (SPOTT), 244 Standardised assessments, 171 Standardised mortality rate (SMR), 330 Standardised assessments, 171 Stereotypical motor patterns, 194 Stiff-knee gait, 80 Strabismus, 298 Subarachnoid haemorrhages (SAH), 40, 54 Subdural haematomas, 40 Subdural haemorrhages (SDH), 54 Subependymal haemorrhage, 102, 117 Subependymal parenchyma, 40 Superficial siderosis, 40 Supracondylar extension osteotomy (SEO), 243 SynchroMed programmable pumps, 271 T Targeted motor training, 194 Task-oriented interventions, 161, 162 Tenotomy, Test of variables of attention (TOVA), 289 Tetrabenazine, 265 Thomas test, 78, 202 Three-dimensional gait analysis (3DGA), 221, 237 Thrombomodulin, 56 Tizanidine hydrochloride, 263 Tongue lateralization, 321 Top-down approach, 172 Tourette’s syndrome, Index 358 Tracheostomy, 303 Trihexyphenidyl, 264, 265 U Ulegyria, 37, 43 Ultrasound (US), 102, 114 Unilateral spastic cerebral palsy (USCP), 81, 82 ankle-foot orthoses, 234 botulinum toxin injections, 234 type I hemiplegia, 234, 243 type II hemiplegia, 234, 243 type III hemiplegia, 235, 244 type IV hemiplegia, 235, 244 Winters, Gage and Hicks classification, 234 Unilateral spastic gait pattern, 82 Upper extremity functional use, 221 Upper limb, 223–225 bilateral CP, 220 biomechanical factors, 220 clinical assessment, 220–221 effective treatment, 220 functional profile, 221 non-surgical treatment, 222 occupational therapy, 220 physiotherapy, 220 spasticity management, 222, 223 surgical treatment, 222 active and passive range of motion, 223 assessment measures, 225 in children, 223 child’s functional use, 223 deformities, 223 elbow, 224 fingers, 225 forearm pronation, 224 functional and cosmetic outcomes, 225 functional impairment, 223 Melbourne assessment, 223 objective evaluation, 223 postural and functional assessments, 224 principles, 223 rehabilitation, 224 thumb-in-palm deformity, 225 wrist, 224 unilateral CP, 220 V Vanishing twin phenomenon, 51 Varus derotational osteotomy (VDRO), 204, 207 Vascular insults, 102 Venous thrombosis, 126 Ventilatory support, 306 Ventral stream, 298 Ventriculomegaly, 108 Very-low-birth-weight (VLBW), 114 Vestibulo-ocular reflex (VOR), 298 Visual deficits, 296 Visual disorders, 299 Visual field defect, 297 Visual impairment, 23, 296–300 causative factors, 295 cerebral palsy ataxic, 300 bilateral spastic, 299 choreoathetotic, 300 diplegics, 299 dyskinetic, 300 spastic diplegia, 299 spastic unilateral, 300 CVI, 296 dyskinetic strabismus, 296 myopia, 296 ocular and visual abnormalities, 296 PVL, 296 refractive errors abnormalities, 297 accommodation, 298 amblyopia, 297 anisometropia, 296 BCVA, 296 color vision, 297 contrast sensitivity, 297 dorsal stream, 299 fixation, 297 fundus abnormalities, 297 horizontal tonic gaze deviation, 297 hypermetropia, 296 nystagmus, 298 OKR, 298 perception, 298 pupillary reflex, 298 saccades, 297 smooth pursuits, 297 stereopsis and binocular vision, 297 strabismus, 298 ventral stream, 298 visual disorders, 299 visual field defect, 297 VOR, 298 severe gaze dysfunction, 296 SVI, 296 Visual processing, 296 Vojta approach, 156, 157, 160, 162 W Walking patterns in children, 144 World Confederation for Physical Therapy’s (WCPT), 166 ... Mintaze Kerem Gỹnel, Yeim Sỹỗỹlỹ Karada, and Banu Anlar Index 349 Cerebral Palsy: A? ?Historical Review Christos P. Panteliadis and Photios Vassilyadi Abstract Cerebral palsy (CP) is a term that... South Australia and Victoria Recently, new registers were implemented in other parts of Australia, and a common database, the Australian Cerebral Palsy Register (ACPR), has been created, gathering... palsy because of a lack of clinical classification and neuropathological correlation In 1903 and 1906, Batten [67, 68] described ataxia as a type of cerebral palsy, which was later corroborated by

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