Publications by authors named "D L Fehlings"
Aim: To systematically review the prevalence and incidence of osteoporosis, osteopenia, low bone mass, and fragility fracture in adults with cerebral palsy (CP), and identify the risk factors for osteoporosis and fracture.
Method: A systematic literature search was performed in the MEDLINE, PubMed, CINAHL, AMED, Cochrane Reviews, EMBASE, and EBM database reviews from inception until May 2024. Search terms covered a combination of keywords for CP, fracture, osteoporosis, incidence and prevalence, and risk factors.
Aim: To evaluate the efficacy and safety of onabotulinumtoxinA for treating upper and lower limb spasticity among pediatric patients in 2 open-label extension trials.
Methods: Patients aged <18 years received ≤5 doses of onabotulinumtoxinA (maximum: 8 U/kg [300 U], cycle 1; 10 U/kg [340 U], cycles 2-5) over 60 weeks. Week 6 efficacy endpoints included mean change from baseline in Modified Ashworth Scale-Bohannon and Modified Tardieu Scale scores, and mean Clinical Global Impression of Overall Change score.
Importance: Single gene variants can cause cerebral palsy (CP) phenotypes, yet the impact of genetic diagnosis on CP clinical management has not been systematically evaluated.
Objective: To evaluate how frequently genetic testing results would prompt changes in care for individuals with CP and the clinical utility of precision medicine therapies.
Data Sources: Published pathogenic or likely pathogenic variants in OMIM genes identified with exome sequencing in clinical (n = 1345) or research (n = 496) cohorts of CP were analyzed.
Aim: To compare, in term-born children with cerebral palsy (CP), the characteristics of those who exhibit detectable risk factors for CP at birth with those who do not.
Method: This was a cross-sectional study of term-born children using the Canadian Cerebral Palsy Registry comparing those with and without perinatal risk factors and/or neonatal symptoms for pregnancy, birth and neonatal characteristics, magnetic resonance imaging (MRI) findings, CP subtype, and impairment severity. Risk factors were quantified with a CP risk calculator.
Article Synopsis
- The article focuses on a clinical case that highlights the importance of early identification of cerebral palsy (CP) and the challenges of communicating this diagnosis to parents and providers.
- It reviews literature on effective communication strategies and discusses findings from thirteen relevant studies that involve parent experiences and interdisciplinary team perspectives.
- Key recommendations for successful communication include engaging families and therapy teams, ensuring individualized approaches, and using inclusive language to avoid ableism.