Norrlin S, Strinnholm M, Carlsson M, Dahl M. Factors of significance for mobility in children with myelomeningocele. Acta Paediatr 2003; 92: 204-210. Stockholm. ISSN 0803-5253Aim: To investigate neurological impairment, hand function and cognitive function in a group of children with myelomeningocele, in order to identify factors of significance for independent mobility and the physical assistance required for mobility in daily activities. Methods: The study material comprised 32 children, aged 6-11 y and without mental retardation. Mobility was assessed with the Pediatric Evaluation of Disability Inventory, scored as caregiver assistance. Statistical differences and correlations between the caregiver assistance scores and the selected variables were analysed. Results: Nine children scored independent mobility. The independent children had better hand coordination ( p = 0.004) and walking ability ( p = 0.01), lower cele levels ( p = 0.011), higher performance IQ ( p = 0.027), better visuospatial function ( p = 0.029) and executive function ( p = 0.037) than the others. The caregiver assistance scores were lower for both the children with early and severe symptoms of brainstem dysfunction and the children with scoliosis. Statistically significant correlations were found between the need for caregiver assistance and reduced walking ability, high cele level, poor hand strength and coordination, visuospatial function, executive function and performance IQ. In the subgroup of children who needed a wheelchair or walking aids, hand strength was the only variable significantly correlated with caregiver assistance (r s = 0.703, p = 0.000).Conclusion: Most of the children were dependent on others in daily activities. Impaired hand function and cognitive function were significant for mobility, and this has implications for the therapy programme in children with myelomeningocele.

SUMMARY Ten children with cerebral palsy (CP) were videotaped and photographed after the introduction to a functional sitting position (FSP–defined as a position in which children with CP could gain head‐, trunk‐ and foot‐control and the maximum degree of independent function when performing arm and hand movements during tasks) and again five years later. Head‐, trunk‐ and foot‐control, and arm‐and hand‐function were assessed from video‐tapes by the Sitting Assessment Scale. The eight children who had been using the l‐'SP throughout this period showed slight but significant improvement; the remaining two had deteriorated. Since all 10 children had undergone similar rehabilitation programmes, it is concluded that sitting in an FSP contributed to their improvement in the ability to use the hand and arm. RÉSUMÉ Un suivi de cinq tins dcar;une position assise fonctionnelle chcz des enfants IMC Un examen video ct photographique a été effectue ehez dix enfants IMC apres la mise en place dcar;une position assise fonctionnelle (FSP définie comme une position oú les enfants IMC pouvaient acquérir un bon contrôle de la tête, du trone et des pieds, ct une fonclion indépendanle en réalisant des mouveinents des bras et des mains an cours dcar;une tâchc) et de même cinq ans plus tard. l.e contrôle de la tête, du trone et des pieds, et la fonclion des bras et des mains furent évalués a partir des bandes vidéo selon la Sitting Assesscment Scale, l.es huit enfants qui avaient utilisé la FSP tout au long de la période dcar;examen précsentefrent un progrès léger mais significant“; lcaron;etaat se deteriora pour les deux autres enfants. Puisque le programme de rééducation entrepris pour les dix enfants était identique. les auteurs concluent que la position assise en FSP contrbuc à leurs progrès dans lcar;utilisation du bras et de la main. ZUSAMMENFASSUNG Verlaufskontiolle einer funktioneUen Sitzposition bci Kiudern mit Cerebralparese über fünf Jalire Zehn Kinder mit Cerebralparese (CP) wurden auf Video aufgenommen und fotografiert. nachdem sie in cine funktionelle Sitz‐position (FSP) eingefuhrt waren diese ist definicrt als eine Position, in der Kinder mil CP Kopf. Runipf und Füße unter Kontrolle haben und ein Maximum an Freiraum haben, wenn sic bei der Ausführung von Aufgaben Arm‐ und Handbewegungen machen–und dann ein zweites Mai nach fünf Jahren. Kopf‐. Rumpf‐ und Fußkontrolle. sowic Arm‐ und Handfunktion wurden anhand der Videobänder gemäß der Sitting Assessment Scale beurteilt Bei den acht Kinder, die die FSP während der gesamten Zeit beibehalten batten, zeigte sich einer leichte. aber signifikante Besserung; die beiden anderen batten sich verseltlechtert. Da alio Kinder ähnliche Rehabilitationsprogramme mit‐gemacht hatten. wird der Schluß gezogen, daß das Sitzen in einer FSP dazu beitrug, den Bewegungsfrciraum von Händen und Armen zu verbessern. RESUMEN Seguimiento durante cinco anyos de la sedestacion funcional en niños con parálisis infantil Diez niños con parálisis cerebral (PC) fueron registrados en video y fotografiados ...

Both PCI and TCI were reliable methods when calculating energy cost in children with cerebral palsy, cystic fibrosis and controls. TCI seemed to be a suitable alternative in the evaluation of gait efficiency in children.

The aim of this study was to investigate reliability of Myotonometer measurements, by assessing muscle tone in muscle rectus femoris in children with cerebral palsy and children without disabilities. Differences in muscle tone between groups and conditions, contracted or relaxed, were also investigated. A total of 15 children with cerebral palsy and 15 children without disabilities participated. Intrarater reliability of Myotonometer measurements showed high to very high intraclass correlation, under both conditions and in both groups. Interrater reliability showed high to very high intraclass correlation under both conditions in the control group and in the cerebral palsy group under contracted condition and moderate under relaxed condition. There were slight differences in tissue displacement between groups, although not statistically significant. Myotonometer measurements are reliable when assessing muscle tone in children. However, there is still a need to investigate this method for objectively quantifying increased muscle tone in children with cerebral palsy.

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