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Vascular access challenge on a patient with cerebral palsy and severe kyphoscoliosis.

Posted on January 27th 2010

We report a case of vascular assess challenge on a patient with severe kyphoscoliosis and joint contractures. Multiple internal jugular (IJ) central venous catheters (CVC) and a peripherally inserted central catheter (PICC) catheterization were attempted via ultrasound guidance and all resulted in malposition. The PICC attempt fortuitously pushed a malpositioned IJ into the correct position. Computed tomography (CT) demonstrated a narrow thoracic inlet with no definite venous stenoses. Therefore, severe chest wall deformity, a narrow thoracic inlet and inadequate positioning of the patient secondary to his contractures all contributed to the malposition of the PICC and CVCs.
PMID: 20119920 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)

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Characterization of spasticity in cerebral palsy: dependence of catch angle on velocity

Posted on January 27th 2010

Aim To evaluate spasticity under controlled velocities and torques in children with cerebral palsy (CP) using a manual spasticity evaluator.Method The study involved 10 children with spastic CP (six males, four females; mean age 10y 1mo, SD 2y 9mo, range 7[ndash]16y; one with quadriplegia, six with right hemiplegia, three with left hemiplegia; Gross Motor Function Classification System levels I [n=2], II [n=3], III [n=2], IV [n=2], and V [n=1]; Manual Ability Classification System levels II [n=5], III [n=4], and V [n=1]) and 10 typically developing participants (four males, six females; mean age 10y 3mo, SD 2y 7mo, range 7[ndash]15y). Spasticity and catch angle were evaluated using joint position, resistance torque, and torque rate at velocities of 90°, 180°, and 270° per second, contro…



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Effectiveness of functional progressive resistance exercise strength training on muscle strength and mobility in children with cerebral palsy: a randomized controlled trial

Posted on January 27th 2010

Aim To evaluate the effectiveness of functional progressive resistance exercise (PRE) strength training on muscle strength and mobility in children with cerebral palsy (CP).Method Fifty-one children with spastic uni- and bilateral CP; (29 males, 22 females; mean age 10y 5mo, SD 1y 10mo, range 6y 0mo[ndash]13y 10mo; Gross Motor Function Classification System levels I[ndash]III) were randomized to the intervention group (n=26) or the control group (n=25, receiving usual care). The intervention group trained for 12 weeks, three times a week, on a five-exercise circuit, which included a leg-press and functional exercises. The training load progressively increased based on the child’s maximum level of strength, determined by the eight-repetition maximum. Muscle strength (measured with hand-held…



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Rating scales for dystonia in cerebral palsy: reliability and validity

Posted on January 27th 2010

This study investigated the reliability and validity of the Barry[ndash]Albright Dystonia Scale (BADS), the Burke[ndash]Fahn[ndash]Marsden Movement Scale (BFMMS), and the Unified Dystonia Rating Scale (UDRS) in patients with bilateral dystonic cerebral palsy (CP).Method Three raters independently scored videotapes of 10 patients (five males, five females; mean age 13y 3mo, SD 5y 2mo, range 5[ndash]22y). One patient each was classified at levels I[ndash]IV in the Gross Motor Function Classification System and six patients were classified at level V. Reliability was measured by (1) intraclass correlation coefficient (ICC) for interrater reliability, (2) standard error of measurement (SEM) and smallest detectable difference (SDD), and (3) Cronbach’s alpha for internal consistency. Validity wa…



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Mechanical properties of the plantarflexor musculotendinous unit during passive dorsiflexion in children with cerebral palsy compared with typically developing children

Posted on January 27th 2010

Aim To examine the passive length[ndash]tension relations in the myotendinous components of the plantarflexor muscles of children with and without cerebral palsy (CP) under conditions excluding reflex muscle contraction.Method A cross-sectional, non-interventional study was conducted in a hospital outpatient clinic. Passive torque[ndash]angle characteristics of the ankle were quantified from full plantarflexion to full available dorsiflexion in 26 independently ambulant children with CP (11 females, 15 males; mean age: 6y 11mo, range 4y 7mo[ndash]9y 7mo) and 26 age-matched typically developing children (18 females, 8 males; mean age 7y 2mo, range 4y 1mo[ndash]10y 4mo). In the children with CP, the affected (hemiplegia; n=21) or more affected (diplegia; n=5) leg was tested; in typically dev…



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