Predictors of Independent Walking in Young Children With Cerebral Palsy.

Background: The attainment of walking is a focus of physical therapy intervention in children with cerebral palsy (CP) and may affect their independence in mobility and participation in daily activities. However, knowledge of determinants of independent walking to guide physical therapists' decision making is lacking.

Objective: The aim of this study was to identify child factors (postural control, reciprocal lower limb movement, functional strength, and motivation) and family factors (family support to child and support to family) that predict independent walking 1 year later in young children with CP at Gross Motor Function Classification System (GMFCS) levels II and III.

The continuum of care for individuals with lifelong disabilities: role of the physical therapist.

Many individuals with lifelong disabilities (LLDs) of childhood onset are living longer, participating in adult roles, and seeking comprehensive health care services, including physical therapy, with greater frequency than in the past. Individuals with LLDs have the same goals of health and wellness as those without disabilities. Aging with a chronic LLD is not yet well understood; however, impairments such as pain, fatigue, and osteoporosis often present earlier than in adults who are aging typically.

The determinants of self-determined behaviors of young children with cerebral palsy.

The purpose of this study was to identify determinants of self-determined behaviors of young children with cerebral palsy. The participants were 429 children (56% boys, 18-60 months) and their parents. Structural equation modeling was used to test two models of self-determined behaviors, one for children with walking mobility (Gross Motor Function Classification System, GMFCS levels I-II) and the other for children with limited self-mobility (GMFCS levels III-V).

Determinants of social participation--with friends and others who are not family members--for youths with cerebral palsy.

Background: Social participation provides youths with opportunities to develop their self-concept, friendships, and meaning in life. Youths with cerebral palsy (CP) have been reported to participate more in home-based leisure activities and to have fewer social experiences with friends and others than youths without disabilities.

Objective: The objective of this study was to identify youth, family, and service determinants of the participation of youths with CP in leisure activities with friends and others who are not family members.

Family priorities for activity and participation of children and youth with cerebral palsy.

Background: Understanding family priorities for children and youth with cerebral palsy is essential for family-centered service.

Objective: The purposes of this study were: (1) to identify family priorities for activity and participation in children and youth with cerebral palsy and (2) to determine differences based on age and Gross Motor Functional Classification System (GMFCS) level.

Design: Five hundred eighty-five children and youth with cerebral palsy and their caregivers participated at regional children's hospitals.

Participation in home, extracurricular, and community activities among children and young people with cerebral palsy.

Aim: Participation in home, extracurricular, and community activities is a desired outcome of rehabilitation services for children and young people with cerebral palsy (CP). The purpose of this study was to investigate the effect of age and gross motor function on participation among children and young people with CP.

Method: Five hundred participants (277 males, 223 females) were grouped by age and Gross Motor Function Classification System (GMFCS) level.

Test-retest reliability of isokinetic dynamometry for the assessment of spasticity of the knee flexors and knee extensors in children with cerebral palsy.

Objective: To assess test-retest reliability of the peak resistance torque and slope of work methods of spasticity measurement of the knee flexors and extensors in children with cerebral palsy (CP).

Design: Test-retest reliability study.

Setting: Pediatric orthopedic hospital.

Immediate effect of percutaneous intramuscular stimulation during gait in children with cerebral palsy: a feasibility study.

The feasibility of percutaneous intramuscular functional electrical stimulation (P-FES) in children with cerebral palsy (CP) for immediate improvement of ankle kinematics during gait has not previously been reported. Eight children with CP (six with diplegia, two with hemiplegia; mean age 9 years 1 month [SD 1 y 4 mo; range 7 y 11 mo to 11 y 10 mo]) had percutaneous intramuscular electrodes implanted into the gastrocnemius (GA) and tibialis anterior (TA) muscles of their involved limbs. Stimulation was provided during appropriate phases of the gait cycle in three conditions (GA only, TA only, and GA/TA).

Comparison of percutaneous and surface functional electrical stimulation during gait in a child with hemiplegic cerebral palsy.

The purpose of this brief report was to compare the immediate effects of surface functional electrical stimulation (S-FES) and percutaneous functional electrical stimulation (P-FES) of the tibialis anterior applied during gait in a child with hemiplegic cerebral palsy. A three-dimensional gait analysis was conducted while an 11-yr-old girl with right hemiplegia walked with S-FES, P-FES, and no stimulation. The results indicated that both P-FES and S-FES increased dorsiflexion at initial contact, peak dorsiflexion in swing, and mean dorsiflexion in swing compared with walking without stimulation.

Muscle force and range of motion as predictors of standing balance in children with cerebral palsy.

Children with cerebral palsy frequently receive therapeutic intervention to remediate standing balance deficits. Evaluation of the impairments associated with poor balance could facilitate more effective treatment programs. This study evaluated the relationship between lower extremity force production, range of motion and standing balance in thirty-five children between the ages of 6 and 14 years of age with spastic cerebral palsy.

Recent advances in physical and occupational therapy for children with cerebral palsy.

Recent research and conceptual frameworks that emphasize family centered care and participation in family, school, and community life have contributed to advances in provision of health care by physical therapists and occupational therapists to children with cerebral palsy (CP) and their families. This article provides a contemporary perspective on physical and occupational therapy for children with CP. Topics include conceptual frameworks, early identification, prognosis for gross motor function, implications of impairment in motor control and muscle performance, and physical fitness and secondary prevention.

Direct effect of percutaneous electric stimulation during gait in children with hemiplegic cerebral palsy: a report of 2 cases.

The feasibility of using percutaneous intramuscular functional electric stimulation (FES) in children with cerebral palsy (CP) as a method to improve ankle kinematics and kinetics during gait was investigated. Two children with right hemiplegic CP had percutaneous intramuscular electrodes implanted into the gastrocnemius and tibialis anterior muscles of the involved limb. FES was provided during the gait cycle using force-sensing foot switches to detect gait phase transitions.