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Selective Percutaneous Myofascial Lengthening of the Lower Extremities in Children with Spastic Cerebral Palsy

Posted on March 31st 2010

Children with spastic cerebral palsy commonly acquire lower extremity musculoskeletal deformities that at some point may need surgical correction. The authors present 58 children with spastic cerebral palsy who underwent selective percutaneous myofascial lengthening of the hip adductor group and the medial or the lateral hamstrings. All the patients were spastic diplegic, hemiplegic, or quadriplegic. The indications for surgery were a primary contracture that interfered with the patients’ walking or sitting ability or joint subluxation. Gross motor ability and gross motor function of the children were evaluated using the gross motor function classification system (GMFCS) and the gross motor function measure (GMFM), respectively. The mean time of the surgical procedure was 14 minutes (rang…



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Safety Considerations in the Use of Botulinum Toxins in Children With Cerebral Palsy

Posted on March 31st 2010

The use of botulinum toxins to decrease spasticity in children with cerebral palsy has become standard of care during the past decade. In 2008 reports of severe adverse events, including death, were reported in children who received injections of these medications. The following discussion focuses on the background of these reports, the response of the U.S. Food and Drug Administration, as well as the safety profile and pharmacokinetics of botulinum toxins. Finally, the authors will offer their perspective on the safe use of botulinum toxins. (Source: PM and R)



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Towards an Intelligent Wheelchair System for Users With Cerebral Palsy

Posted on March 31st 2010

This paper describes and evaluates an intelligent wheelchair, adapted for users with cognitive disabilities and mobility impairment. The study focuses on patients with cerebral palsy, one of the most common disorders affecting muscle control and coordination, thereby impairing movement. The wheelchair concept is an assistive device that allows the user to select arbitrary local destinations through a tactile screen interface. The device incorporates an automatic navigation system that drives the vehicle, avoiding obstacles even in unknown and dynamic scenarios. It provides the user with a high degree of autonomy, independent from a particular environment, i.e., not restricted to predefined conditions. To evaluate the rehabilitation device, a study was carried out with four subjects with co…



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Augmentative Communication Based on Realtime Vocal Cord Vibration Detection

Posted on March 31st 2010

A binary switch based on the detection of periodic vocal cord vibrations is proposed for individuals with multiple and severe disabilities. The system offers three major advantages over existing speech-based access technologies, namely, insensitivity to environment noise, increased robustness against user-generated artifacts such as coughs, and reduced exertion during prolonged usage periods. The proposed system makes use of a dual-axis accelerometer placed noninvasively in proximity of the vocal cords by means of a neckband. Periodic vocal cord vibrations are detected using the normalized cross-correlation function computed from anterior–posterior and superior–inferior accelerometry signals. Experiments with a participant with hypotonic cerebral palsy show the proposed syste…



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Compartment Syndrome After Serial Casting in Spastic Diplegic Cerebral Palsy: A Case Report

Posted on March 31st 2010

Abstract: Muchow RD, Flannery WD, Miedaner JA, Noonan KJ, McCarthy JJ. Compartment syndrome after serial casting in spastic diplegic cerebral palsy: a case report.We present the case of a 24-year-old woman with spastic diplegic cerebral palsy who developed left lower extremity compartment syndrome after serial casting to treat an equinus contracture. To our knowledge, this represents the first case of compartment syndrome that has occurred from cast application to treat a deformity. The cast was the second placed in the treatment series and was removed 18 hours later because of increased pain. The clinical picture progressed despite the cast being removed. Accordingly, the patient presented to the emergency department with uncontrollable pain and a peroneal nerve deficit. Compartment press…



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