Research progress of nutritional intervention in children with cerebral palsy / 中华实用儿科临床杂志

Malnutrition and obesity are common in children with cerebral palsy, leading to growth retardation, anemia, brain dysplasia or increased risk of cardiovascular diseases.Nutritional status and energy demand of children with cerebral palsy are usually determined by physical examinations, detections of anthropometric parameters, bone mineral density and body composition, and laboratory tests, thus developing nutritional intervention programs to improve their nutritional problems and quality of life.This study aims to summarize the research progress of nutritional intervention in children with cerebral palsy.

The efficacy of an orthotic helmet in cranial remodeling of infants with deformational plagiocephaly / 中华物理医学与康复杂志

Objective:To observe the clinical effect of helmet therapy in cranial remodeling of infants with deformational plagiocephaly.Methods:A total of 114 infants with plagiocephaly received helmet therapy at the age of 4 to 12 months over the period from 2016 to 2018 and the results were analyzed retrospectively. Seventy-four were male and forty female. The average ages were (7.49±1.91) and (7.54±2.10) months, respectively. A Spectra scanner was used to quantify each head′s radial symmetry index (RSI), cranial vault asymmetry (CVA) and cranial vault asymmetry index (CVAI) before and after 100 days of treatment, and those data were related with age (4-6 months, 7-9 months and 10-12 months), gender and severity of deformity (levels III-V).Results:The average RSI, CVA and CVAI improved significantly for all of the infants studied. The average RSI, CVA and CVAI improved the most for those 4-6 months old. Those with level-IV deformity showed significantly better improvement than those with level III or V deformity.Conclusions:Helmet therapy is an effective way to improve deformities due to plagiocephaly among infants. The best age for treatment is 4-6 months. Patients with less malformation are more easily corrected.

Exercise intervention and strategies for early rehabilitation in critically ill children / 中国小儿急救医学

Recently, early rehabilitation of critically illness in children has been paid more and more attention.Moreover, early exercise rehabilitation is an important part of pediatric critical rehabilitation.It is very beneficial to prevent or minimize secondary musculoskeletal problems, reduce time of hospital stay, promote the recovery of cognitive function and growth, and improve long-term prognosis in critically ill children.In this study, we mainly introduced the techniques and related strategies of early exercise rehabilitation for critically ill children.

The efficacy of individualized swallowing training for premature infants with feeding disorders: A randomized controlled trial / 中华物理医学与康复杂志

Objective To observe the effect of individualized swallowing training in the neonatal intensive care unit on the swallowing function of premature infants with feeding disorders.Methods Sixty-two preterm (28 to 32 weeks) infants with feeding disorders were randomly divided into a treatment group (n=34) and a control group (n =28).Both groups were given routine gastric tube feeding,but the treatment group was additionally provided with individualized swallowing training twice a day for 2 weeks,including oral sensory and motor stimulation,milking,family participation,a better environment and a selection of feeding tools.The subjects' daily milk consumption and weight were recorded,along with the age when the gastric tube was removed and the total length of the hospital stay.Results The treatment group showed significantly greater improvement than the control group in their daily milk consumption and weight gain,though both groups showed significant improvements.The average time to removing the gastric tube and the average hospital stay were both significantly shorter for the treatment group than for the control group.Conclusion Individualized swallowing training can effectively improve sucking and swallowing skills and shorten the period of using a gastric tube and the total hospital stay for premature infants.

Study of characteristics and correlation of the head shape of infants with plagiocephaly / 中华实用儿科临床杂志

Objective To study the characteristics of the head shape and correlations among the shape parameters in infants at the plagiocephaly.Methods One hundred and four infants at the age of 4-12 months from Department of Rehabilitation,Guangzhou Women and Children's Medical Center with plagiocephaly or normal head shape from January to October 2016 were selected for head shape characteristic analysis.Seventy-four males and 30 females were included.Seventy-three infants (53 males and 20 females) with plagiocephaly were plagiocephaly group with age of (7.07 ±2.23) months.Thirty-one infants (21 males and 10 females) with normal head shape were control group with age for (8.29 ± 2.81) months.The Spectra scanner 2.0 was applied to acquire head shape parameters including cephalic ratio (CR),radial symmetry index (RSI),oblique diagonal difference (ODD),and cranial vault asymmetry index (CVAI).The correlation between the head shape characteristics and shape parameters of infants in different month ages and gender with plagiocephaly were analyzed through independent sample t-test and Pearson correlation analysis.Among all the enrolled infants,there were 46 infants in 4-7 months (36 cases with plagiocephaly and 10 cases with normal head shape),34 infants in ＞ 7-10 months (24 cases with plagiocephaly and 10 cases with normal head shape),and 24 infants in ＞ 10-12 months (13 cases with plagiocephaly and 11 cases with normal head shape).Results CR in 4-7 months group and ＞ 7-10 months of plagiocephaly group were all significantly higher than that in control group [(91.32 ± 5.60) ％ vs.(80.73 ± 2.68) ％,(90.31 ± 6.22) ％ vs.(84.14 ± 3.57) ％],and the differences were all statistically significant (t =-5.765,-2.924,all P ＜ 0.05).The difference was not significant of the CR in ＞ 10-12 months plagiocephaly group compared with that in control group (t =-1.917,P =0.060).RSI,ODD,and CVAI of plagiocephaly group in all ages were significantly higher than those in control group [(46.40 ± 13.59) mmvs.(16.13 ±4.18) mm,(11.84±3.58) mmvs.(3.44±1.59) mm,7.92±2.43 vs.2.34± 1.07],and the differences were all statistically significant (t =-17.210,-16.579,-16.304,all P ＜ 0.001).CR,RSI,ODD,and CVAI of males and females in plagiocephaly group were respectively higher than those of control group,and the differences were all statistically significant (all P ＜ 0.001).There was no statistical significance in CR,RSI,ODD,CVAI between males and females in plagiocephaly group or control group (all P ＞ 0.05).Pearson correlation analysis revealed that there was no correlation between CR and RSI,ODD,CVAI in any age of plagiocephaly group (all P ＞ 0.05).There was a positive correlation among RSI,ODD,and CVAI in the plagiocephaly group in any age (r =0.940,0.912,0.973,all P ＜ 0.001).Conclusions In the infants with plagiocephaly may exist asymmetric head shape and the shorter length of head at the same time.When one of the values of RSI,ODD and CVAI increases,the other two values increase too with more serious level of plagiocephaly.

Impacts on motor function in the children of cerebral palsy treated with acupuncture and acupoint embedding therapy / 中国针灸

<p><b>OBJECTIVE</b>To observe the efficacy difference on the motor function in the children of cerebral palsy between acupuncture combined with acupoint embedding therapy and simple acupuncture.</p><p><b>METHODS</b>One hundred and twenty children of cerebral palsy were randomized into an observation group and a control group, 60 cases in, each one. In the observation group, acupuncture was applied in combination with acupoint embedding therapy. For the acupoint embedding therapy, the main acupoints were Pishu (BL 20), Shenshu (BL 23); the supplementary points were Dazhui (GV 14), Mingmen (GV 4), Yaoyangguan (GV 3), Sanjiaoshu (BL 22), Xinshu (BL 15) and Ganshu (BL 18). The catgut was embedded to the acupoints. Acupuncture was applied to the acupoints on the head and four limbs and the needles were retained for 40 min after qi arrival. In the control group, the simple acupuncture was applied, except for the acupoint embedding therapy. The rest treatment was the same as the observation group. The treatment lasted continuously for 3 months in the two groups. Before and after treatment, the gross motor function measure (GMFM) and the gross motor function classification system (GMFCS) were used for the assessment and the efficacy was analyzed.</p><p><b>RESULTS</b>(1) After treatment, the total score of GMFM was increased in the two groups (both P<0. 01) and the score in the observation group was higher than that in the control group (P<0. 05). (2) The scores in A and B areas of GMFM were all improved in the two groups after treat ment (all P<0. 01) and the scores in the observation group were higher than those in the control group (P<0. 01 P<0. 05). (3) The total effective rate was 76. 7% (46/60) in the observation group, which was better than 55. 0% (33/60) in the control group (P<0. 01).</p><p><b>CONCLUSION</b>The combined therapy of acupuncture and acupoint embedding much better improves the motor function in the children of cerebral palsy as compared with the simple acupuncture.</p>

Characteristic surface myoelectric signals of maximum isometric voluntary contraction of the wrist flexors and extensors in children with hemiplegic cerebral palsy / 中华物理医学与康复杂志

Objective To study the characteristic surface myoelectric signals generated by children with hemiplegic cerebral palsy (HCP) during maximum isometric voluntary contraction (MIVC) of the wrist flexors and extensors.Methods Sixty-eight children with HCP 2 to 14 years of age were assessed with surface electromyography (sEMG).The electrodes were applied on the skin over the wrist flexors and extensors.The integrated EMG signals (iEMGs),root mean square amplitudes (RMSs) and co-contraction ratios during MIVC were recorded and analyzed.Results In a MIVC,the RMS,iEMG and co-contraction ratio were all significantly different between the involved and uninvolved hands,though the iEMGs of the wrists of the two hands were strongly correlated.The RMSs of the wrists of the involved and uninvolved hands were also strongly positively correlated when grasping maximally using the involved hand.Conclusions The involved hand of children with HCP has excessive co-activation of the wrist flexors,poor muscle recruitment and little isolated selective control of movement.It may be very important to facilitate wrist extensor contraction,inhibit wrist flexor co-activation and induce involved hand use to improve the hand function of children with HCP.

Effects of Electro-acupuncture and Functional Training on Gross Motor Function of Children with Cerebral Palsy / 中国康复理论与实践

@#Objective To observe the effects of electro-acupuncture and functional training on gross motor function of children with cerebral palsy. Methods 137 children with cerebral palsy were divided into observation group (n=81) and control group (n=56). The observation group received electro-acupuncture and functional training, and the control group received functional training only. Results The scores of Gross Motor Function Measure (GMFM) increased in both group after treatment (P<0.01), and it was significantly higher in the observation group than in the control group (P<0.01). Conclusion Electro-acupuncture and functional training is superior to functional training in gross motor function.