Application of early assessment and intervention in motor development of high-risk infants with cerebral palsy / 中华实用儿科临床杂志

Objective:To evaluate the clinical value of the General Movements (GMs) in predicting the neurological outcome of high-risk infants with cerebral palsy in the early stage, and to analyze the application of the Peabody Developmental Motor Scale-Gross Motor (PDMS-GM) and Gross Motor Function Measure Scale (GMFM) in the rehabilitation assessment and intervention of high-risk infants with cerebral palsy.Methods:The gross motor function of 64 high-risk infants with cerebral palsy before treatment and after 2 months of treatment in Department of Child Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2017 to December 2019 was evaluated using PDMS-GM and GMFM.The total percentage of PDMS-GM and GMFM before and after treatment, and the monthly relative percentage of PDMS-GM and GMFM were compared.The correlation between PDMS-GM and GMFM original scores in the writhing and fidgety movements period before treatment, and that between PDMS-GM and GMFM original scores before and after treatment were compared.High-risk infants with cerebral palsy were followed up to 1 year old, and their neurological outcome was determined according to the clinical diagnosis and evaluation results.The predictive value of GMs on the outcome of cerebral palsy was evaluated.Results:Compared with that before treatment, the total percentage of PDMS-GM and GMFM in high-risk infants with cerebral palsy increased significantly after treatment [PDMS-GM: (37.250±13.690)% vs.(20.992±10.273)%, t=-15.793, P<0.01; GMFM: (22.672±8.438)% vs.(10.601±7.890)%, t=-16.442, P<0.01]. PDMS-GM original scores in the writhing movements period and fidgety movements period before treatment were highly correlated with those of GMFM (writhing movements period: r=0.922, P<0.01; fidgety movements period: r=0.905, P<0.01). PDMS-GM original score before and after treatment were highly correlated with those of GMFM (before treatment: r=0.901, P<0.01; after treatment: r=0.801, P<0.01). There was no significant difference in the monthly relative percentage of PDMS-GM and GMFM [(97.286±88.330)% vs.(76.885±43.815)%, t=-1.656, P=0.103]. The sensitivity, specificity, positive predictive value and negative predictive value of the writhing movements period to the prediction of cerebral palsy outcome were 90.7%, 82.3%, 23.4%, and 95.8%, respectively, which were 98.3%, 88.1%, 27.6% and 96.8% in the fidgety movements period, respectively.At 1-year-old follow-up, 3 cases of spastic cerebral palsy were found in a high risk with cerebral palsy, and 1 case was cramped synchronized and 2 cases were absence of fidgety movements. Conclusions:Gross motor function of high-risk infants with cerebral palsy was significantly improved after treatment compared with that before treatment, and PDMS-GM and GMFM were consistent in the assessment of gross motor function of high-risk infants with cerebral palsy in the writhing and fidgety movements period before and after treatment.In the early screening of infants at high risk of cerebral palsy, absence of fidgety movements and cramped synchronized maybe predict spastic cerebral palsy more sensitively, and fidgety movements assessment was more sensitive to predict spastic cerebral palsy outcome than writhing movements assessment.

Cambios en la función motora en pacientes con distrofia muscular de Duchenne: estudio descriptivo / Progression of motor function disorders in patients with Duchenne muscular dystrophy: a descriptive study

Introduction: duchenne muscular dystrophy (DMD) is a neuromuscular disease inherited in an X-linked recessive pattern, characterized by progressive muscle weakness, affecting axial muscles in the first place, and then the rest of the body’s muscles. In our country there is no record of the progressive behavior of the disease in children with DMD. Objective: to describe the progression of motor function disorders per age group in DMD patients. Method: Descriptive, cross-sectional study with 26 patients diagnosed with DMD, classified in 4 groups according to the evolution of the disease, using Motor Function Measure (MFM), Brooke and Vignos scales in Instituto teletón in Santiago between April and october 2013. Results: Median values and interquartile range (IQR) according to total MFM percentages by group were: Group 1 (3-5 years): 88.3 (5.8); Group 2 (6-9 years): 76.0 (20.8); Group 3 (10-14 years): 36.4 (8.3), and Group 4 (≥ 15 years): 31.2 (15.1). According to Vignos scale, G1 reached level 2; G2 reached level 3 and G3 and G4, level 9. According to Brooke scale, G1 and G2 reached level 1 and G3 and G4, level 5. Conclusion: MFM allowed an objective assessment of motor function progression in DMD per age group; dimension 1 shows the progression of the disease at an early stage and dimension 3 is better preserved in later stages of the disease. these results could facilitate a multi and inter-disciplinary approach.

Introducción: la distrofia muscular de Duchenne (DMD) es una enfermedad neuromuscular de carácter hereditario recesivo ligado al cromosoma X, caracterizada por debilidad muscular progresiva, afectando inicialmente a los músculos de cintura pélvica y escapular para luego abarcar todo el cuerpo. En nuestro país no se cuenta con un registro del comportamiento progresivo de la enfermedad en niños con DMD. Objetivo: Describir los cambios en la función motora según grupo etario en pacientes con DMD. Metodología: Estudio descriptivo, transversal, en 26 pacientes, con diagnóstico confirmado de DMD, clasificados en 4 grupos según fase de evolución de la enfermedad, a quienes se aplicó las escalas Medición Evaluación Motora (MFM), Vignos y Brooke en el Instituto teletón Santiago entre abril y octubre de 2013. Resultados: Las medianas y rangos intercuartílicos, según porcentajes totales de MFM, por cada grupo fueron: Grupo 1 (3-5 años): 88,3 (5,8); Grupo 2 (6-9 años): 76,0 (20,8); Grupo 3 (10-14 años): 36,4 (8,3) y Grupo 4 (15 años y más): 31,2 (15,1). Según Escala de Vignos, G1 se situó en nivel 2; G2 en nivel 3 y G3 y G4 en nivel 9. En escala de Brooke, G1 y G2 se situaron en nivel 1 y G3 y G4 en nivel 5. Conclusión: La MFM permitió una evaluación objetiva de los cambios en la función motora de pacientes con DMD según grupos etarios; la Dimensión 1 informa tempranamente la progresión y la Dimensión 3 se preserva mejor en estadios tardíos de la enfermedad, resultados que direccionan el abordaje multi e interdisciplinario.

Effect of Cluster Needling at Scalp Acupoints plus Paraffin Therapy on Motor Function in Patients with Spastic Cerebral Palsy / 上海针灸杂志

Objective To observe the effect of cluster needling at scalp acupoints plus paraffin therapy on motor function in cerebral palsy patients.Method Forty eligible patients with spastic cerebral palsy were randomized into a control group and an experimental group, 20 cases in each group. The control group was intervened by cluster needling with long-time retaining of the needles plus Uyeda's approach and conventional rehabilitation trainings specifically for spastic cerebral palsy; the experimental group was intervened by paraffin therapy in addition to the treatment given to the control group. The interventions were conducted once a day, for a total of 8 weeks. The Gross Motor Function Measure-88 (GMFM-88) and Modified Ashworth Scale (MAS) were adopted to evaluate the motor function before and after the treatment.Result The GMFM-88 scores were significantly changed after the treatment in both groups (P0.05); there was a significant difference in comparing the MAS score between the two groups after the intervention (P<0.05).Conclusion On the basis of conventional rehabilitation trainings, cluster needling at scalp acupoints plus paraffin therapy can produce a significant efficacy in improving the muscular tension and motor function, and benefit the development of cerebral palsy patients.

Clinical Study on ZHU Lian's Acupuncture Activating Method for Hypotonic Cerebral Palsy / 上海针灸杂志

Objective To observe the clinical efficacy of ZHU Lian's acupuncture activating method with type 1 manipulations in treating hypotonic cerebral palsy.Method Sixty patients with hypotonic cerebral palsy, aged 9-59 months, were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened by ZHU Lian's acupuncture activating method with type 1 manipulations, while the control group was intervened by acupoint injection of vitamin B1 and B12. The two groups were treated once a day, 5 sessions as a treatment course. The Gross Motor Function Measure-88 (GMFM-88) was evaluated before the treatment and after 10 treatment courses.Result The GMFM-88 score was significantly changed after the treatment in both groups (P<0.05). After the intervention, the GMFM-88 score in the treatment group was significantly different from that in the control group (P<0.05).Conclusion ZHU Lian's acupuncture activating method is an effective approach in treating hypotonic cerebral palsy.

Clinical Observation of JIN's Three-needle Acupuncture plus Modern Nerve Facilitation Technique for Infantile Cerebral Palsy / 上海针灸杂志

Objective To observe the clinical efficacy of JIN'sthree needle acupuncture plus modern nerve facilitation technique in treating infantile cerebral palsy.Method Fifty-two patients were randomized into a treatment group of 26 cases and a control group of 26 cases. The treatment group was intervened by JIN'sthree-needle acupuncture plus modern nerve facilitation technique, while the control group was by bionic electrical stimulation. After 2 treatment courses, the treatment group and control group were compared with each other by the Gross Motor Function Measure (GMFM), time taken for 10 m walk, Berg Balance Scale (BBS), modified Barthel Index (MBI) and therapeutic efficacy.Result After the treatment, the GMFM, time taken for 10 m walk, BBS, and MBI scores were significantly improved in the two groups (P<0.05). There were significant differences in comparing the GMFM, time for 10 m walk, BBS, and MBI scores between the two groups (P<0.05). The total effective rates were respectively 92.3% and 76.9%in the treatment group and control group, and the difference was statistically significant (P<0.05).Conclusion JIN's three-needle acupuncture plus modern nerve facilitation technique can significantly boost the efficacy in treating cerebral palsy.

Myotonic dystrophy type 1: frequency of ophthalmologic findings / Distrofia miotônica tipo 1: frequência dos achados oftalmológicos

ABSTRACT The purpose of the study was to evaluate the frequency of ophthalmologic abnormalities in a cohort of myotonic dystrophy type 1 (DM1) patients and to correlate them with motor function. We reviewed the pathophysiology of cataract and low intraocular pressure (IOP). Method Patients were included after clinical and laboratory diagnosis and after signed informed consent. They were evaluated by Motor Function Measure scale, Portuguese version (MFM-P) and ophthalmic protocol. Results We evaluated 42 patients aged 17 to 64 years (mean 40.7 ± 12.5), 22 of which were men. IOP (n = 41) was reduced in all but one. We found cataract or positivity for surgery in 38 (90.48%) and ptosis in 23 (54.76%). These signs but not IOP were significantly correlated with severity of motor dysfunction. Abnormalities in ocular motility and stereopsis were observed. Conclusion Cataract and ptosis are frequent in DM1 and associated to motor dysfunction. Reduced IOP is also common, but appears not to be related with motor impairment.

RESUMO O objetivo do estudo foi avaliar a frequência das anormalidades oftalmológicas em uma coorte de pacientes com distrofia miotônica tipo 1 (DM1) correlacionando-as à função motora. Revisamos a fisiopatogenia da catarata e baixa pressão intraocular (PIO). Método Os pacientes foram incluídos após diagnóstico clínico-laboratorial de DM1. Aqueles que assinaram o termo de participação foram avaliados pela escala medida da função motora, versão em português (MFM-P) e protocolo oftalmológico. Resultados Avaliamos 42 pacientes de 17 a 64 anos (média 40,7 ± 12,5), 22 do sexo masculino. Encontramos catarata ou positividade de cirurgia em 38 (90,48%) e blefaroptose em 23 (54,76%) e esses sinais foram correlacionados significativamente à maior gravidade da disfunção motora. Baixa PIO também foi comum e não correlacionada à gravidade motora. Alterações da motilidade ocular e de estereopsia ocorreram. Conclusão Catarata e ptose palpebral são frequentes na DM1 e associadas à gravidade motora. Baixa PIO é comum e parece ser independente da evolução motora.

The grading diagnosis of the magnetic resonance imaging and magnetic resonance spectroscopy and gross motor rating scale for children with cerebral palsy / 国际儿科学杂志

Objective To investigate the grading diagnostic value of magnetic resonance spectroscopy and magnetic resonance imaging and gross motor rating scale for children with cerebral palsy.Methods Forty cases of healthy children under 1.0 ～ 2.0 years old and 42 cases of cerebral palsy children under 1.1 ～ 2.0 years old were enrolled in the study,and we compared the inspection reports on MRI and MRS statistical analysis.According to the results of MRI for dividing cerebral palsy,and MRS indexing of NAA/Cr,CHO/Cr,LAC/Cr levels were compared;different types of cerebral palsy by GMFM scores were examined.Results Nuclear magnetic resonance(MRI) and MRS could effectively distinguish typical pathological changes in the brain of children with cerebral palsy,the cerebral NAA,Cr,Cho could appear significant formant when the children detected by MRS,could be quantitatively detected with MRS.The levels of NAA/Cr、CHO/Cr、LAC/Cr of different MRS and MRI degree was different,and the difference of moderate CP and severe CP was significant (P ＜ 0.05).Compared with MRS,the accordant rates of the MRI was not ideal,But gross motor rating scale score suggested that there were differences between the cerebral palsy of the MRI and MRS degree (P ＜ 0.05).Conclusion The magnetic resonance imaging and magnetic resonance spectroscopy and gross motor rating scale can effectively improve the dividing diagnosis of cerebral palsy,and this method for different types of cerebral palsy in children has some guiding value.

Gross Motor Function Outcome After Intensive Rehabilitation in Children With Bilateral Spastic Cerebral Palsy

OBJECTIVE: To compare gross motor function outcomes in children with moderate to severe degrees of bilateral spastic cerebral palsy (CP) who received either intensive inpatient rehabilitation or intermittent rehabilitation on an outpatient basis. METHODS: A non-biased retrospective chart review was done for patients diagnosed with bilateral spastic CP who received rehabilitation therapy. The intensive rehabilitation group (inpatient group) agreed to be hospitalized to receive 22 sessions of physical and occupational therapy per week for 1 month. The intermittent rehabilitation group (outpatient group) received four sessions of physical and occupational therapy per week for 3 months in an outpatient setting. Changes in the total score on the Gross Motor Function Measure (GMFM) between baseline and the follow-up period were analyzed. RESULTS: Both groups showed significant improvements in total GMFM scores at the follow-up assessment compared to that at baseline (p=0.000 for inpatient group, p=0.001 for outpatient group). The increase in mean total GMFM score after 1 month was significantly greater in the inpatient group than that in the outpatient group (p=0.020). Higher increase in GMFM score was observed in younger subjects as revealed by the negative correlation between age and the increase in GMFM score after 1 month (p=0.002, r=-0.460). CONCLUSION: Intensive inpatient rehabilitation therapy for patients with bilateral spastic CP of moderate to severe degree was more effective for improving gross motor function than intermittent rehabilitation therapy on an outpatient basis.

Effect of Mild Moxibustion on the Rehabilitation Efficacy in Patients with Cerebral Palsy / 上海针灸杂志

ObjectiveTo observe the clinical effect of warm needling based on conventional rehabilitation in treating cerebral palsy.MethodSixty patients with cerebral palsy were randomized into an observation group and a control group, 30 in each group. The control group was intervened by physiotherapy (PT), occupational therapy (OT), speech therapy (ST), conductive education (CE), etc.; the observation group was by mild moxibustion at Baihui (GV20), Zusanli (ST36), and Guanyuan (CV4) in addition tothe above rehabilitation therapies.ResultThe rehabilitation result in the observation group was superior to that inthe control group (P<0.05).ConclusionMild moxibustion can significantly enhance the rehabilitation result in patients with cerebral palsy.

Effect of Manipulation to Du Channel and Jiaji Acupoints on Dyskinetic Cerebral Palsy / 中国康复理论与实践

@#Objective To observe the clinical effect of manipulation to Du channel and Jiaji acupoints on dyskinetic cerabral palsy.Methods 76 children with dyskinetic cerebral palsy were divided into control group (n=31) and treatment group (n=34). The control group received conventional therapy and the treatment group received the manipulation to Du channel and Jiaji acupoints in addition. Gross Motor Function Measure (GMFM), and the changes of reflection in lateral bending and muscle tension fluctuation were evaluated. Results There was no significant difference in the percentages of total GMFM, lateral bending reflex, and muscle tension fluctuation between 2 groups before treatment (P>0.05). After treatment, all these indexes were better in the treatment group than in the control group (P<0.05). Conclusion manipulation to Du Channel and Jiaji acupoints can promote the the lateral bending reflex disppear, reduce the fluctuation of musle tone, and improve the gross motor function.

Impact of the peripheral neurotomy method combined with rehabilitation exercise on gross motor function and balance function of children with cerebral palsy / 中华实用儿科临床杂志

Objective To study the impact of the peripheral neurotomy method combined with rehabilitation exercise on gross motor function and balance function of children with cerebral palsy.Methods Matched pair design was used in the study.Thirty children with spastic cerebral palsy hospitalized from May 2011 to Nov.2013 suffering from peripheral neurotomy were assigned as study group,who were conscious and treated by peripheral neurotomy com bined with rehabilitation exercise.In the meanwhile,30 children inpatients at the same time were employed as the control group,who were similar in age and symptoms,with the same gender and the same Gross motor function classification (GMFCS) grade,and the controls were treated only with ordinary rehabilitation exercise.Modified Ashworth score,Gross Motor Function Measure (GMFM) D and E regions scores,physicians rating scale score in the 2 groups were recorded after treatment for 2,4,6,8,10 weeks.Repeated measure analysis of variance method was introduced to analyze the differences between the 2 groups in improved Ashworth muscle tension,gait improvement,gross motor function and balance function.Results The study group was superior over the control group in muscle tension reduction (F =8.177,P =0.006) and gait improvement(F =24.284,P =0.000).The 2 groups were not different statistically in D region evaluation of GMEM (F =0.072,P =0.790) and E region evaluation of GMFM (F =0.000,P =0.985) ; For Berg balance scale,the 2 groups had also no difference(F =0.150,P =0.700).Conclusions Both peripheral neurotomy method combined with rehabilitation exercise and the ordinary rehabilitation exercise method both could improve the gross function and the balance function.Furthermore,the former was superior over the latter in muscle tension reduction and gait improvement.

Effectiveness of resistance training exercises in spastic diplegia cerebral palsy: a review

Cerebral Palsy presents itself in a clinical form of spastic diplegia, where neurological sequels are predominant in the lower limbs and substantially affects the capacity to walk. Traditional methods of physiotherapy intervention emphasize the techniques of neurological rehabilitation at the expense of progressive resistance exercises.The goal of the present research is to fulfill a bibliographic review concerning the period of 1985 to 2012 about studies that investigated the effect of resistance exercises applied to cerebral palsy children carrying spastics’ diplegia. The Scielo, MEDLINE, PubMed, EMBASE, CINAHL, Sports Discus, DARE, PsychInfo, ERIC, Ausport-Med, AMI, Cochrane and PEDro databases were used to conduct a literature search using keywords without restrictions. In this systematization, a search was conducted using the keywords: cerebral palsy, progressive resistance exercise, diplegia, gross motor function measure (GMFM). Literature have shown that the restrict capacity to generate force is as debilitating or more than it is the muscle spasticity, potentially causing more restriction to the movement than the spasticity itself. Children with normal motor development, as well as carrying spastic diplegia increase their capacity to generate strength when submitted to a resistive training, not only on lower limbs, but also on upper limbs. Furthermore, several studies have shown that diplegic cerebral palsy children improve their motor ability due to strength training, thought it still remains to be proved that strength training leads to a substantial change for the better allowing that there is ascension of category for functional capacity.

Motor assessment in patients with Duchenne muscular dystrophy / Avaliação motora em pacientes com distrofia muscular de Duchenne

OBJECTIVE: Evaluate muscle force and motor function in patients with Duchenne muscular dystrophy (DMD) in a period of six months. METHOD: Twenty children and adolescents with diagnosis of DMD were evaluated trough: measurement of the strength of the flexors and extensors of the shoulder, elbow, wrist, knee and ankle through the Medical Research Council (MRC), and application of the Motor Function Measure (MFM). The patients were evaluated twice within a six-month interval. RESULTS: Loss of muscle strength was identified in the MRC score for upper proximal members (t=-2.17, p=0.04). In the MFM, it was noted significant loss in the dimension 1 (t=-3.06, p=0.006). Moderate and strong correlations were found between the scores for muscular strength and the MFM dimensions. CONCLUSION: The MFM scale was a useful instrument in the follow up of patients with DMD. Moreover, it is a more comprehensive scale to assess patients and very good for conducting trials to evaluate treatment.

OBJETIVO: Avaliar a força muscular e função motora em pacientes com distrofia muscular de Duchenne (DMD) em intervalo de seis meses. MÉTODO: Vinte crianças e adolescentes com diagnóstico de DMD foram avaliados quanto às seguintes medidas: força de flexores e extensores de ombro, cotovelo, punho, quadril, joelho e tornozelo, por meio do Medical Research Council (MRC) e aplicação da Medida da Função Motora (MFM). Os pacientes foram analisados em dois momentos, com intervalo de seis meses. RESULTADOS: Observou-se perda de força muscular identificada por meio da MRC para membros superiores proximais (t=-2,17, p=0,04). Na MFM, observou-se perda significativa na dimensão 1 (t=-3,06, p=0,006). Foram registradas correlações médias a fortes entre os escores de força muscular e as dimensões da MFM. CONCLUSÃO: A escala MFM mostrou ser um instrumento útil no acompanhamento dos pacientes com DMD. É uma escala funcional, o que a torna boa candidata para o acompanhamento de pacientes com DMD em uso de novas drogas.

Motor function measure scale, steroid therapy and patients with Duchenne muscular dystrophy / Medida de função motora, corticoterapia e pacientes com distrofia muscular de Duchenne

OBJECTIVE: To assess the evolution of motor function in patients with Duchenne muscular dystrophy (DMD) treated with steroids (prednisolone or deflazacort) through the Motor Function Measure (MFM), which evaluates three dimensions of motor performance (D1, D2, D3). METHODS: Thirty-three patients with DMD (22 ambulant, 6 non-ambulant and 5 who lost the capacity to walk during the period of the study) were assessed using the MFM scale six times over a period of 18 months. RESULTS: All the motor functions remained stable for 14 months in all patients, except D1 for those who lost their walking ability. In ambulant patients, D2 (axial and proximal motor capacities) motor functions improved during six months; an improvement in D3 (distal motor capacity) was noted during the total follow-up. D1 (standing posture and transfers) and total score were useful to predict the loss of the ability to walk. CONCLUSIONS: The use of the MFM in DMD patients confirms the benefits of the steroid treatment for slowing the progression of the disease.

OBJETIVO: Avaliar a evolução da função motora de pacientes com distrofia muscular de Duchenne (DMD) em corticoterapia (predinisolona e deflazacort), por meio da escala Medida da Função Motora (MFM), que avalia três dimensões de funções motoras (D1, D2, D3). MÉTODOS: Trinta e três pacientes com DMD (22 deambulantes, seis cadeirantes e cinco que perderam a capacidade de andar ao longo do estudo) foram avaliados pela escala MFM em seis momentos durante 18 meses. RESULTADOS: Todas as funções motoras mantiveram-se estáveis durante 14 meses, exceto D1 para os pacientes que perderam a marcha. Nos pacientes deambulantes, a D2 (função motora axial e proximal) apresentou melhora durante seis meses. Melhora em D3 (função motora distal) também foi observada durante o seguimento. A D1 (postura em pé e transferências) e o escore total foram importantes para predizer a perda de marcha. CONCLUSÕES: O uso da MFM nos pacientes com DMD confirma os benefícios do tratamento com corticoides na diminuição da velocidade de progressão da doença.

Effects of Wrist Hand Orthoses on Cerebral Palsy Children with Adduction of Thumb / 中国康复理论与实践

@#ObjectiveTo observe the effects of wrist hand orthoses on cerebral palsy children with adduction of thumb. MethodsChildren with spastic hemiplegia were divided into experimental group （14 cases) and control group （15 cases）. Children in the both groups received routine rehabilitation for 3 months. Children in experimental group wore wrist hand orthoses 4～8 h/d in addition. ResultsThe passive range of motion (PROM) and scores of Fine Motor Function Measure Scale (FMFM) significantly increased in both groups after treatment. The PROM and FMFM scores in experimental groups increased more than those in the control group after treatment （P＜0.05).ConclusionWrist hand orthoses can improve the passive adduction angle of carpometacarpal joints of thumb and the fine motor function in spastic hemiplegia children after cerebral palsy.

Therapeutic Observation on Treatment of Infantile Cerebral Palsy with Integrative Chinese-Western Medicine: A Clinical Report of 104 Cases / 针灸推拿医学（英文版）

Objective: To study the therapeutic effects of combined treatment with Chinese and western medicine in children with cerebral palsy (CP). Methods: 104 CP children were treated mainly with physiotherapy and acupuncture, together with occupational therapy, sensory integration and electrical stimulation. Gross Motor Function Measure (GMFM) was used to assess the effects of treatment. Results: After treatment for 3.29±0.80 months, the majority of CP children improved their IQ and limb symptoms, with decreased abnormal posture, increased muscle strength and improved motor developmental function. GMFM88 and GMFM66 scores had significantly increased after treatment. Conclusions: Combined treatment with Chinese and Western Medicine has confirmed effects on CP children.

Estudo de transferência e locomoção em crianças de 4 a 6 anos com paralisia diparética espástica nível motor III / Study about transfer and locomotion in 4 to 6 years-old children with motor level III spastic diplegig cerebral palsy

Este estudo objetivou traçar o perfil funcional de crianças com paralisia cerebral diparética espástica nível motor III, quanto ao desempenho de atividades de mobilidade – transferência e locomoção –, a fim de direcionar estratégias terapêuticas de avaliação e de intervenção nesta população. O estudo teve a participação de oito crianças que frequentavam o Setor de Fisioterapia Infantil da Associação de Assistência à Criança Deficiente (AACD). As crianças foram avaliadas pelo teste funcional PEDI, sendo utilizada apenas a escala de mobilidade das três partes que o compõem, que teve como referencial de comparação o GMFM. Os resultados demonstraram maior dificuldade dessas crianças nas atividades de locomoção, comparadas com as de transferência. Há necessidade de adequar a assistência do cuidador e as modificações do ambiente para promover maior independência e funcionalidade às crianças.

Establishing the functional profile of children with motor level III spastic diplegic cerebral palsy, regarding the performance of mobility activities – transfer and locomotion – in order to direct therapeutic strategies for evaluating and intervening in this population was the goal of this study. Eight children who attended the Children’s Physical Therapy Department of the Associação de Assistência à Criança Deficiente (AACD) took part in this study. These children were evaluated by the functional test PEDI – only the mobility scale of the three parts that compose the test was used, and had the GMFM as a comparison reference. The results have showed that children have greater difficulty in locomotion compared to transfer. There is the need to adequate caretaker assistance and to adapt the environment to promote higher independency and functionality to the children.

Responsiveness and precision of Gross Motor Function Measure(66 items version) / 中国康复理论与实践

@#ObjectiveTo compare the responsiveness and precision between the 66 items version of Gross Motor Function Measure(GMFM-66) and 88 items version(GMFM-88).Methods173 children with cerebral palsy(male 126,female 47) who have received twice assessments were involved.All the second assessment were performed 3.8±4.3 months later.112 children received the third assessment 3.2±2.2 months after the second assessment.The effect size and relative precision between the GMFM-66 and GMFM-88 were analyzed.ResultsThe effect size of GMFM-66 between every two assessments was nearly the same as those of GMFM-88.The precision of GMFM-66 was not lower than that of GMFM-88.ConclusionThe interval-scale GMFM-66 has satisfying responsiveness and precision.It is more useful than GMFM-88 in measuring the treating effect of children with cerebral palsy.

Applications of Gross Motor Function Measure Scale and Peabody Developmental Measure Scale-Gross Motor in the evaluation of children with cerebral palsy / 中国康复理论与实践

@#Objective To compare the advantages of two gross motor measure scales, Peabody Developmental Measure Scale Gross Motor (PDMS-GM) and Gross Motor Function Measure Scale (GMFM), in the evaluation of children with cerebral palsy (CP).Methods The gross motor functions of 29 CP children, 0-3 years old, were evaluated three times using PDMS-GM and GMFM respectively. The improvement percentile each month of PDMS-GM and GMFM were compared by t test.Results There was significant difference between the improvement percentile each month of PDMS-GM and GMFM. Conclusion The GMFM was more sensitive than PDMS-GM in the evaluation of CP children especially in the evaluation of treatment effect.

Scoring of Norms of the Gross Motor Function Measure (GMFM) in Normal Children

OBJECTIVE: We performed to obtain the normal values of Gross Motor Function Measure (GMFM) in normally developed children. We designed this study to inform the degree of gross motor functional disability or delay in children with cerebral palsy, comparing with score values of GMFM in normal children. METHOD: One hundred-sixteen normally developed children who were in the age of 12 to 47 months were recruited. Their GMFM tests were performed by a pediatric physical therapist. They were grouped by age of 6 months and the scores were compared with all of each groups. Results: The GMFM scores in normal children increased with ages. The rates of increment in scores were fast till 35 months of age and inter-individual differences of GMFM scores were greater in younger age groups (less than 36 months of age) than older groups. Even the means of GMFM scores were higher in the girls than boys, the differences between sexes were insignificant statistically. CONCLUSION: Norms of GMFM obtained in normally developed children who were in the age of 12 to 47 months. It would be helpful to assess the degree of motor functional disabilities or delay in children with physical disabilities.