Ventilation and swallowing interactions of normal children and children with cerebral palsy.

The respiratory inductance plethysmograph was used to analyse the ventilatory cycle during drinking, chewing and swallowing of normal and cerebral-palsied children aged between five and 12 years. 33 children were divided equally into three groups: normal, spastic CP and athetoid CP. A few of the children with spastic CP and over half of those with athetoid CP were unable to perform the 'big breath' task.

Restraint-review committee: a working model.

Initially, the goal of this committee was to reduce the number of unnecessary physical restraints (see Table 4). This was achieved by a team approach and a systematic process of assessment, monitoring, and evaluation. In addition, this process provided a means by which restraint use could be thoroughly documented and functionally monitored.

Dynamic monitoring of sitting posture for children with spastic cerebral palsy.

A dynamic postural monitoring technique was developed and implemented to determine the effects of a forward-inclined seat base on the sitting posture of both normal children and children with mild spastic cerebal palsy. With the seat base tilted forward there was a significant increase in the distance between the top of head and the seat base, and an increase in the normalized erector spinae muscle activity for both the normal and cerebral palsy subjects. This increase represents a longitudinal straightening of the spine and consequent reduction in kyphotic posture.

Comparative assessment of gait after limb-salvage procedures.

We performed metabolic studies of gait in eighteen patients who had had above-the-knee amputation, block resection and arthrodesis of the knee, or block resection and rotationplasty for a malignant tumor of the distal end of the femur or the proximal end of the tibia. According to the measurement of consumption of oxygen, the patients who had had rotationplasty walked most efficiently. Those who had had arthrodesis used more oxygen and walked at a slower rate.

The multidisciplinary feeding profile: a statistically based protocol for assessment of dependent feeders.

The development of the multidisciplinary feeding profile entailed a level of statistical analyses not commonly utilized in test development. This paper describes the statistical analyses and offers an explanation of why specific statistical tests were chosen. It also serves to identify where clinical knowledge and experience overrode specific statistical tests.

Development of a multidisciplinary feeding profile for children who are dependent feeders.

The multidisciplinary feeding profile (MFP) is the first statistically based protocol for the quantitative assessment of feeding disorders in severely disabled children. This assessment can be completed in 30-45 min with foods and facilities that are available in homes, hospitals, and chronic care units. This paper describes the state of current testing methods, the parameters of successful feeding activity, the development of the test protocol, and the results of statistical analyses.

Interface design for indirect calorimetry in children with cerebral palsy.

The purpose of this study was to design, construct, and validate an alternative subject/instrument interface to collect metabolic data for individuals who, because of impairment, are unable to use a mouthpiece. An industrial designer directed the development of an interface design which would facilitate subject acceptance. A total of 13 subjects (eight children with cerebral palsy and five nonneurologically impaired) participated in the validation study.

EMG Biofeedback Training to Promote Hand Function in a Cerebral Palsied Child with Hemiplegia.

This paper will describe how EMG biofeedback can be used in training a hemiplegic cerebral palsied child. Specifically will be described how EMG biofeedback will promote relaxation of spastic upper-extremity muscles and active movements of antagonistic muscles, for potential improvement in hand function. To illustrate the biofeedback approach used, a case study will be presented.

Biofeedback techniques and behaviour modification in the conservative remediation of drooling by children with cerebral palsy.

In an attempt to decrease the rates of drooling of 12 children with cerebral palsy, the authors investigated the effectiveness of EMG auditory feedback training of the orbicularis oris, of making the act of swallowing a conscious one, and of providing an auditory signal to cue swallowing by means of an Accularm interval timer. After biofeedback training there was a significant decrease in drooling rates and a small increase in swallowing rates. After the Accularm was used the children maintained the decreased drooling rates and there was a further small improvement in swallowing rates.

Oral motor functioning, frequency of swallowing and drooling in normal children and in children with cerebral palsy.

Attempts to eliminate drooling in children with cerebral palsy have ranged from speech therapy to radical surgery. Drooling primarily results from an overflow of saliva from the mouth due to dysfunctional voluntary oral motor activity, improper swallowing, or oral sphincter deficits and rarely from hypersalivation. A study was undertaken to determine typical orofacial electromyographic patterns and swallowing frequencies of normal children and children with cerebral palsy with oral involvement who do, and who do not drool, as well as to determine the correlation between swallowing frequency and drooling rate.

The drooling patient: team evaluation and management.

Drooling is a common problem in neurologically damaged individuals. A surgeon, speech pathologist, physiotherapist and dentist created a "team" to evaluate affected patients. Management by consensus involves both non-surgical and surgical modalities.

Joint position biofeedback facilitation of physical therapy in gait training.

This paper discusses and reviews the use of biofeedback techniques in various gait training applications, focusing particularly on the use of joint position biofeedback. The potential benefits of this approach are illustrated in a controlled case study using applied behavior analysis methodology. A standardized physical therapy regimen was compared with an identical treatment phase which included the addition of joint position feedback.