The use of functional electrical stimulation to improve upper limb function in children with hemiplegic cerebral palsy: A feasibility study.

BACKGROUND: Grasping and manipulating objects are common problems for children with hemiplegic cerebral palsy. Multichannel-functional electrical stimulation may help facilitate upper limb movements and improve function. OBJECTIVE: To evaluate the feasibility of multichannel-functional electrical stimulation to improve grasp and upper limb function in children with hemiplegic cerebral palsy to inform the development of a clinical trial. METHODS: A prospective pre-/post-test/follow-up (six months) design with three children, aged 6-13 years, was used. Multichannel-functional electrical stimulation (mFES) was applied to the hemiplegic upper limb for up to 48 sessions over 16 weeks. Feasibility indicators included recruitment of participants and adherence rates, safety, and discomfort/pain. Effectiveness was assessed using the grasp domain of the Quality of Upper Extremity Skills Test, and other secondary clinical outcome measures with "success" criteria set a priori. RESULTS: Participant recruitment target was not met but adherence was high, and multichannel-functional electrical stimulation was found to be safe and comfortable. Of the three participants, two improved in grasp at post-test, whereas one child's ability deteriorated. Only one child met success criteria on most outcomes at post-test. CONCLUSIONS: Feasibility indicators met success criteria, except for participant recruitment. Treatment effectiveness was mixed. A future case comparison investigation with a larger but more selected sample is suggested.

Birth weight and two possible types of maternal effects on male sexual orientation: a clinical study of children and adolescents referred to a Gender Identity Service.

This study tested predictions regarding two hypothesized maternal immune responses influencing sexual orientation: one affecting homosexual males with high fraternal birth order and another affecting firstborn homosexual individuals whose mothers experience repeated miscarriage after the birth of the first child. Low birth weight was treated as a marker of possible exposure to a maternal immune response during gestation. Birth weight was examined relative to sibship characteristics in a clinical sample of youth (N = 1,722) classified as heterosexual or homosexual based on self-reported or probable sexual orientation. No female sexual orientation differences in birth weight were found. Homosexual, compared to heterosexual, males showed lower birth weight if they had one or more older brothers--and especially two or more older brothers--or if they were an only-child. These findings support the existence of two maternal immune responses influencing male sexual orientation and possibly also cross-gender behavior and identity.