Improvements in children with cerebral palsy following intrathecal baclofen: use of the Rehabilitation Institute of Chicago Care and Comfort Caregiver Questionnaire (RIC CareQ).

Implantation of an intrathecal baclofen pump is recommended for children with cerebral palsy as a means to improve care and comfort when other options fail to control severe hypertonia. Making an assessment of a child's spasticity-related limitations in both routine care and activity is a necessary component of selection of intrathecal baclofen candidates. The Rehabilitation Institute of Chicago Care and Comfort Caregiver Questionnaire (RIC CareQ) is a validated, easy-to-use questionnaire that elicits information about the ease of daily activity and caregiving in patients with severe spasticity. Questionnaires completed by caregivers and patients at a pediatric physiatry spasticity clinic over an 11-year period were reviewed to evaluate whether the Rehabilitation Institute of Chicago Care and Comfort Caregiver Questionnaire captured improved caregiving and comfort of children with cerebral palsy and severe spasticity following intrathecal baclofen pump implantation. The Questionnaire scores showed improvement after intrathecal baclofen pump implantation, consistent with subjective reports of patient and caregiver satisfaction.

Participation of the child with cerebral palsy in the home, school, and community: A review of the literature.

Improving participation of children with cerebral palsy is an important outcome in the practice of pediatric rehabilitation. Current knowledge of how a child's interactions with various environments influence participation can affect care provision to children with cerebral palsy. The literature was searched using electronic databases and reference lists from 1991 to 2008. Studies included reports on one or more factors influencing a child's participation. Using the International Classification of Function, Disability, and Health (ICF) as a framework, factors that influence participation are summarized.

Pilot evaluation of functional questionnaire for predicting ability of patients with tetraplegia to self-catheterize after continent diversion.

BACKGROUND/OBJECTIVES: Creation of a continent catheterizable stoma has dramatically improved the ability of the patient with spinal cord injury to perform clean intermittent catheterization (CIC). However, not all patients are good candidates for this procedure. To aid in patient evaluation, we propose the use of a functional questionnaire to predict a candidate's ability to negotiate a continent catheterizable stoma. METHODS: A published functional questionnaire was adapted to assess the self-perceived ability to perform upper extremity tasks similar to those involved in the manipulation of catheter. Tetraplegic patients who had undergone creation of a content catheterizable stoma were given the questionnaire and asked to describe demographics, method of catheterization, motivational factors, and satisfaction with the procedure. RESULTS: Subjects varied in age (23-36 years) and level of impairment (C4-C6). Functional scores correlated with level of injury. Of the 4 women and 1 man who responded, only 2 were able to self-catheterize before diversion. Their catheterization times decreased significantly after creation of a continent stoma. Two patients unable to perform CIC preoperatively were able to perform CIC postoperatively. The patient with the lowest score was unable to perform CIC preoperatively or postoperatively. All were satisfied with outcome after diversion. CONCLUSIONS: In our small cohort, a low functional score was associated with inability to perform CIC after continent diversion. Administration of this questionnaire to a larger spinal cord injury population should aid in selecting appropriate candidates for the creation of a continent catheterizable stoma.