Mental Health Diagnoses Risk Among Children and Young Adults With Cerebral Palsy, Chronic Conditions, or Typical Development.

Importance: Mental health (MH) issues in children with cerebral palsy (CP) are poorly understood compared with other pediatric populations.

Objective: To examine MH diagnosis code assignment among children and young adults with CP and compare with typically developing (TD) and chronic condition (CC) pediatric populations.

Design, Setting, And Participants: This case-control study used International Statistical Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes to create a CP case set and CC and TD control sets using electronic health record data of children and young adults from a large tertiary care children's hospital in the midwestern United States between 2010 and 2022.

White matter characteristics in children with cerebral palsy prior to selective dorsal rhizotomy: a multicenter diffusion tensor imaging study.

Objective: The aims of this study were to 1) assess and quantify white matter (WM) microstructural characteristics derived from diffusion tensor imaging (DTI) in children with cerebral palsy (CP) prior to selective dorsal rhizotomy (SDR), and 2) investigate potential associations between WM diffusion properties and gross motor function and spasticity in children with spastic CP who underwent SDR.

Methods: This study is a multisite study based on DT images acquired prior to SDR as well as postoperative outcome data. DTI data collected from two sites were harmonized using the ComBat approach to minimize intersite scanner difference.

TOT Collar Use in Complex Case of Congenital Muscular Torticollis With Persistent Head Tilt.

Purpose: The purposes of this case report were to (1) highlight the use and efficacy of the Tubular Orthosis for Torticollis (TOT) Collar in a prolonged and complex episode of care for an infant with congenital muscular torticollis (CMT) and (2) describe an infant with CMT receiving a physical therapy episode of care interrupted by the COVID-19 pandemic, leading to use of supplemental interventions.

Summary Of Key Points: The patient presented was an infant with CMT who received physical therapy treatment, including the TOT Collar, to resolve all symptoms.

Statement Of Conclusions: The TOT Collar helped achieve midline head position after all treatment options were exhausted at the end of a lengthy episode of care impacted by the COVID-19 pandemic.

Outpatient hospital utilization after single event multi-level surgery in children with cerebral palsy.

Purpose: This study aimed to examine outpatient hospital utilization (number of specialties seen and number of visits to each specialty) in the year after single event multi-level surgery (SEMLS) in children with cerebral palsy (CP), and to determine if utilization differs across the medical center in the year after compared to the year before SEMLS.

Methods: This retrospective cross-sectional study used electronic medical record data of outpatient hospital utilization in children with CP who underwent SEMLS.

Results: Thirty children with CP (Gross Motor Function Classification System Levels I-V, mean age of 9.

A big data approach to evaluate receipt of optimal care in childhood cerebral palsy.

Purpose: Through automated electronic health record (EHR) data extraction and analysis, this project systematically quantified actual care delivery for children with cerebral palsy (CP) and evaluated alignment with current evidence-based recommendations.

Methods: Utilizing EHR data for over 8000 children with CP, we developed an approach to define and quantify receipt of optimal care, and pursued proof-of-concept with two children with unilateral CP, Gross Motor Function Classification System (GMFCS) Level II. Optimal care was codified as a cluster of four components including physical medicine and rehabilitation (PMR) care, spasticity management, physical therapy (PT), and occupational therapy (OT).

Personal factors understood through the Ecological-Enactive Model of Disability and implications for rehabilitation research.

The International Classification of Functioning, Disability and Health (ICF) recognizes that disability arises from the interaction between an individual with a medical condition and the context in which they are embedded. Context in the ICF is comprised of environmental and personal factors. Personal factors, the background life and lifestyle of an individual, are poorly understood in rehabilitation.

Mobilization of Children with External Ventricular Drains: A Retrospective Cohort Study.

The implementation of early mobility programs for children with critical illnesses has been growing. Children with acute neurologic conditions that result in the requirement of an external ventricular drain (EVD) may be excluded from attaining the benefits of early mobility programs due to the fear of adverse events. The purpose of this study was to examine the implementation, safety, and outcomes of children with EVDs mobilized by physical therapists.

Neuromuscular electrical stimulation to augment lower limb exercise and mobility in individuals with spastic cerebral palsy: A scoping review.

Neuromuscular Electrical Stimulation (NMES) is an emerging assistive technology applied through surface or implanted electrodes to augment skeletal muscle contraction. NMES has the potential to improve function while reducing the neuromuscular impairments of spastic cerebral palsy (CP). This scoping review examines the application of NMES to augment lower extremity exercises for individuals with spastic CP and reports the effects of NMES on neuromuscular impairments and function in spastic CP, to provide a foundation of knowledge to guide research and development of more effective treatment.

Gross motor function prediction using natural language processing in cerebral palsy.

Aim: To predict ambulatory status and Gross Motor Function Classification System (GMFCS) levels in patients with cerebral palsy (CP) by applying natural language processing (NLP) to electronic health record (EHR) clinical notes.

Method: Individuals aged 8 to 26 years with a diagnosis of CP in the EHR between January 2009 and November 2020 (~12 years of data) were included in a cross-sectional retrospective cohort of 2483 patients. The cohort was divided into train-test and validation groups.

Infants With Congenital Muscular Torticollis Requiring Supplemental Physical Therapy Interventions.

Purpose: To describe supplemental intervention (SI) frequency in infants with congenital muscular torticollis (CMT) and compare groups of infants who received first-choice intervention only to infants who received SI.

Methods: Data were retrospectively extracted from a registry. Baseline and treatment variables were collected and analyzed.

Infants With Congenital Muscular Torticollis: Demographic Factors, Clinical Characteristics, and Physical Therapy Episode of Care.

Purpose: To describe demographic factors, baseline characteristics, and physical therapy episodes in infants with congenital muscular torticollis (CMT), examine groups based on physical therapy completion, and identify implications for clinical practice.

Methods: Retrospective data were extracted from a single-site registry of 445 infants with CMT.

Results: Most infants were male (57%), Caucasian (63%), and firstborn (50%), with torticollis detected by 3 months old (89%) with a left (51%), mild (72%) CMT presentation.

Infants With Torticollis Who Changed Head Presentation During A Physical Therapy Episode.

Purpose: The purpose of this study is to describe infants with congenital muscular torticollis (CMT) who changed head presentation during an episode of physical therapy.

Methods: Data were extracted from electronic medical records between January 2015 and December 2018 to describe infants with CMT who changed presentation.

Results: Eighty-nine infants met criteria (predominantly male, non-Hispanic, White, with private insurance).

Neuromuscular Electrical Stimulation to Immobilized Lower Extremities Directly Following Orthopaedic Surgery in Three Children with Cerebral Palsy: A Case Series.

Cerebral palsy (CP) is a non-progressive, neurological disorder often resulting in secondary musculoskeletal impairments affecting alignment and function which can result in orthopaedic surgery. Neuromuscular electrical stimulation (NMES) is a modality that can be used for rehabilitation; however, NMES immediately following orthopaedic surgery in children with CP using surface electrodes has not been previously reported. The purpose of this case series is to describe the novel use of NMES in the acute rehabilitation phase directly after orthopaedic surgery.

Describing the Delivery of Evidence-Based Physical Therapy Intervention to Individuals With Cerebral Palsy.

Purpose: To characterize by evidence grades and examine variation in type of physical therapy intervention delivered in routine clinical care in individuals with cerebral palsy (CP).

Methods: Retrospective data collection from the electronic record over 1 year at a tertiary care pediatric outpatient therapy division.

Results: Four hundred sixty-five individuals with CP received 28 344 interventions during 4335 treatment visits.

Electronic health record and patterns of care for children with cerebral palsy.

Aim: To characterize the patterns of care of children with cerebral palsy (CP) in a tertiary healthcare system.

Method: Electronic health record data from 2009 to 2019 were extracted for children with CP. Machine learning hierarchical clustering was used to identify clusters of care.

The effect of suit wear during an intensive therapy program in children with cerebral palsy.

Purpose: To examine the effects of suit wear during an intensive therapy program on motor function among children with cerebral palsy.

Method: Twenty children were randomized to an experimental (TheraSuit) or a control (control suit) group and participated in an intensive therapy program. The Pediatric Evaluation of Disability Inventory (PEDI) and Gross Motor Function Measure (GMFM)-66 were administered before and after (4 and 9 weeks).