"That's frustrating": Perceptions of ankle foot orthosis provision, use, and needs among people with cerebral palsy and caregivers.

Background: Cerebral palsy (CP) affects roughly 3 per 1000 births in the United States and is the most common pediatric developmental motor disability. Ankle foot orthoses (AFOs) are commonly prescribed to provide support and improve function for individuals with CP.

Objectives: The study objective was to evaluate the lived experiences of individuals with CP and their caregivers regarding AFO access, use, and priorities.

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

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.

Gradual increase of perturbation load induces a longer retention of locomotor adaptation in children with cerebral palsy.

The goal of this study is to determine whether the size and the variability of error have an impact on the retention of locomotor adaptation in children with cerebral palsy (CP). Eleven children with CP, aged 7-16 years old, were recruited to participate in this study. Three types of force perturbations (i.

Dance and rehabilitation in cerebral palsy: a systematic search and review.

Aim: To conduct a review of research literature on the use of dance and movement with music (rhythmic auditory stimulation [RAS]) in the neurorehabilitation of children and adults with cerebral palsy (CP).

Method: We conducted a systematic search and quality appraisal of the research literature on dance and RAS in CP. Additionally, we linked the research outcomes to the International Classification of Functioning, Disability and Health (ICF) framework.

Effects of the Integration of Dynamic Weight Shifting Training Into Treadmill Training on Walking Function of Children with Cerebral Palsy: A Randomized Controlled Study.

Objective: The aim of the study was to determine whether applying an assistance force to the pelvis and legs during treadmill training can improve walking function in children with cerebral palsy.

Design: Twenty-three children with cerebral palsy were randomly assigned to the robotic or treadmill only group. For participants who were assigned to the robotic group, a controlled force was applied to the pelvis and legs during treadmill walking.

Effects of an Off-Axis Pivoting Elliptical Training Program on Gait Function in Persons With Spastic Cerebral Palsy: A Preliminary Study.

This preliminary study examined the effects of off-axis elliptical training on reducing transverse-plane gait deviations and improving gait function in 8 individuals with cerebral palsy (CP) (15.5 ± 4.1 years) who completed an training program using a custom-made elliptical trainer that allows transverse-plane pivoting of the footplates during exercise.

Robotic Resistance Treadmill Training Improves Locomotor Function in Children With Cerebral Palsy: A Randomized Controlled Pilot Study.

Objective: To determine whether applying controlled resistance forces to the legs during the swing phase of gait may improve the efficacy of treadmill training as compared with applying controlled assistance forces in children with cerebral palsy (CP).

Design: Randomized controlled study.

Setting: Research unit of a rehabilitation hospital.

Pilot study of a targeted dance class for physical rehabilitation in children with cerebral palsy.

Introduction: This pilot study evaluates the effects of a targeted dance class utilizing classical ballet principles for rehabilitation of children with cerebral palsy on balance and upper extremity control.

Methods: Twelve children with cerebral palsy (ages 7-15 years) with Gross Motor Function Classification scores II-IV participated in this study and were assigned to either a control group or targeted dance class group. Targeted dance class group participated in 1-h classes three times per week in a 4-week period.

Kinematic and EMG Responses to Pelvis and Leg Assistance Force during Treadmill Walking in Children with Cerebral Palsy.

Treadmill training has been used for improving locomotor function in children with cerebral palsy (CP), but the functional gains are relatively small, suggesting a need to improve current paradigms. The understanding of the kinematic and EMG responses to forces applied to the body of subjects during treadmill walking is crucial for improving current paradigms. The objective of this study was to determine the kinematics and EMG responses to the pelvis and/or leg assistance force.

Locomotor training through a 3D cable-driven robotic system for walking function in children with cerebral palsy: a pilot study.

Locomotor training using treadmill has been shown to elicit significant improvements in locomotor ability for some children with cerebral palsy (CP), the functional gains are relatively small and it requires greater involvement from a physical therapist. Current robotic gait training systems are effective in reducing the strenuous work of a physical therapist during locomotor training, but are less effective in improving locomotor function in some children with CP due to the limitations of the systems. Thus, a 3D cable-driven robotic gait training system was developed and tested in five children with CP through a 6 week of long-term gait training.

Motor impairment factors related to brain injury timing in early hemiparesis. Part I: expression of upper-extremity weakness.

Background: Extensive neuromotor development occurs early in human life, but the time that a brain injury occurs during development has not been rigorously studied when quantifying motor impairments.

Objective: This study investigated the impact of timing of brain injury on the magnitude and distribution of weakness in the paretic arm of individuals with childhood-onset hemiparesis.

Methods: A total of 24 individuals with hemiparesis were divided into time periods of injury before birth (PRE-natal, n = 8), around the time of birth (PERI-natal, n = 8), or after 6 months of age (POST-natal, n = 8).

Motor impairments related to brain injury timing in early hemiparesis. Part II: abnormal upper extremity joint torque synergies.

Background: Extensive neuromotor development occurs early in human life, and the timing of brain injury may affect the resulting motor impairment. In Part I of this series, it was demonstrated that the distribution of weakness in the upper extremity depended on the timing of brain injury in individuals with childhood-onset hemiparesis.

Objective: The goal of this study was to characterize how timing of brain injury affects joint torque synergies, or losses of independent joint control.

Pallidal deep-brain stimulation associated with complete remission of self-injurious behaviors in a patient with Lesch-Nyhan syndrome: a case report.

The purpose of this case report is to review the management of a boy with Lesch-Nyhan syndrome with deep-brain stimulation who had remission of self-injurious behaviors as a result. This patient was treated with intrathecal baclofen and, later, with deep-brain stimulation to reduce hypertonia. Goals were to improve wheelchair positioning for school attendance and to reduce the use of restraints for comfort.

Measuring care and comfort in children with cerebral palsy: the care and comfort caregiver questionnaire.

Objective: To evaluate the psychometric properties of the Care and Comfort Caregiver Questionnaire (CareQ), which was developed to measure the perceived effort of caregivers in providing care for children with moderate to severe cerebral palsy (CP).

Design: Cross-sectional data collection from a representative sample of a large racially/ethnically diverse geographic region.

Setting: Outpatient CP clinics at a metropolitan rehabilitation institution.

Quantitative evaluations of ankle spasticity and stiffness in neurological disorders using manual spasticity evaluator.

Spasticity and contracture are major sources of disability in people with neurological impairments that have been evaluated using various instruments: the Modified Ashworth Scale, tendon reflex scale, pendulum test, mechanical perturbations, and passive joint range of motion (ROM). These measures generally are either convenient to use in clinics but not quantitative or they are quantitative but difficult to use conveniently in clinics. We have developed a manual spasticity evaluator (MSE) to evaluate spasticity/contracture quantitatively and conveniently, with ankle ROM and stiffness measured at a controlled low velocity and joint resistance and Tardieu catch angle measured at several higher velocities.

Efficacy of robotic rehabilitation of ankle impairments in children with cerebral palsy.

The current study introduces a novel rehabilitation robot for treatment of impaired ankle in children with cerebral palsy (CP). The treatment consisted of passive stretching under intelligent control and active movement training with motivating game-playing using the portable robot. After 18 sessions of training (3 sessions/week for 6 weeks), we found significant improvement in 12 children with CP in terms of improved passive and active ranges of motion, selective motor control and mobility functions.

Changes of calf muscle-tendon properties due to stretching and active movement of children with cerebral palsy--a pilot study.

A portable ankle rehabilitation robot with intelligent stretching and game-based active movement training was used to treat the spastic impaired ankle of children with cerebral palsy over six weeks. The subject's calf muscles and Achilles tendon properties were evaluated before and after treatment using ultrasonography and biomechanical measures. It was found that there were decreased Achilles tendon resting length (2.

Participation of the child with cerebral palsy in the home, school, and community: A review of the literature.

Improving participation of children with cerebral palsy is an important outcome in the practice of pediatric rehabilitation. Current knowledge of how a child's interactions with various environments influence participation can affect care provision to children with cerebral palsy. The literature was searched using electronic databases and reference lists from 1991 to 2008.

Measurement of ankle spasticity in children with cerebral palsy using a manual spasticity evaluator.

Spastic hypertonia involving spasticity and/or contracture is a major source of disability in cerebral palsy and other neurological impairments like stroke. Several measures have been used to assess the reflex hyperexcitability and hypertonus associated with spasticity, including the Ashworth scale, tendon reflex scale, pendulum test, mechanical perturbations and passive joint ROM. These measures generally are either convenient to use in clinics but not quantitative or they are quantitative but difficult to use conveniently in clinics.

Effects of neuromuscular electrical stimulation treatment of cerebral palsy on potential impairment mechanisms: a pilot study.

Purpose: This pilot study examined the effects of neuromuscular electrical stimulation (NMES) therapy on upper limb impairment in children with cerebral palsy, specifically addressing spasticity, heightened passive resistance to wrist rotation, coactivation, and weakness.

Methods: Eight subjects, aged five to 15 years, with spastic hemiparesis subsequent to brain injury, participated in three months of NMES therapy, targeting the wrist flexor and extensor muscles. Maximum voluntary wrist extension range of motion against gravity, spasticity, passive torque, maximum voluntary isometric torque, and coactivation were recorded prior to, during, and at the conclusion of the therapy.