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.

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.

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.

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.