Age at referral for diagnosis and rehabilitation services for cerebral palsy: a scoping review

Boychuck, Zachary; Bussières, André; Goldschleger, Jessica; Majnemer, Annette

doi:10.1111/dmcn.14034

Cited by 30 publications

(31 citation statements)

References 35 publications

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“…Foreign scholars have reported that in animal experiments, the position of the ACL tibial plateau on the tibial plateau was moved forward and backward, and the tibial plateau and knee stability were significantly different, suggesting the position of the tibial plateau and its restrictions [5]. e ability of the tibia to move forward and maintain the stability of the knee joint is closely related, but there is still no research report on the clear correspondence between the position of the ACL tibial stop and the ACL control force [6][7][8][9]. e connection point between the ligament and the bone is not a simple ligament bone connection, but a complex structure.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Exercise Rehabilitation of Knee Joint Anterior Cruciate Ligament Injury Based on 3D-CT Reconstruction

Zhang

Lv²

2020

Complexity

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The joint capsule of the knee joint is attached to the edges of various articular surfaces and is thin and loose. Therefore, ligament reinforcement is needed to protect the knee joint and increase the stability of the joint. It plays a vital role in human activities. In this paper, a 3D-CT three-dimensional reconstruction method is used to reconstruct the ACL natural femoral imprint and double-bone tract. The relative positional relationship between the two center points is compared, and the law is summarized to guide the improvement of ACL anatomic double-beam reconstruction under arthroscopy. The 3D reconstruction results suggest that the bone layer in the anterior medial portion is the thickest, forming a peak, and the thickness of the bone layer in the posterior medial portion gradually decreases in a stepwise manner. The entire bone tissue in the anterior medial portion and posterior medial portion is integrated into one body. The tissues are connected as a whole, and the thickness is relatively uniform. The two parts of the bone tissues are not connected. The CF tissue was inserted into the bone tissue in a zigzag pattern. The changes of CF tissues in the anterior medial and posteromedial CF tissues were similar, and they were distributed stepwise from the inside to the outside. According to the bone and CF spatial structure and changing rules, ACL is divided into medial and lateral beams. According to this study, it can be summarized that (1) 3D reconstruction can clearly reconstruct the natural footprint of ACL femoral stops and postoperative osseous position and (2) 3D reconstruction can be used to evaluate the position of osseous postoperative ACL anatomic double-beam reconstruction. Arthroscopy double-beam reconstruction of ACL is instructive.

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Section: Introductionmentioning

confidence: 99%

Diagnosis and Exercise Rehabilitation of Knee Joint Anterior Cruciate Ligament Injury Based on 3D-CT Reconstruction

Zhang

Lv²

2020

Complexity

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“…The clinical diagnosis of unilateral CP may be considered a less optimal external criterion for investigating the predictive validity of the HAI because it is a symptomatic diagnosis; nonetheless, it is based on international classification 12 . The diagnosis of unilateral CP was collected from medical records at about 2 years of age and was not verified by an additional clinical examination at later age, which could have contributed to extremely mild cases being missed 26,27 . As for any other study investigating the sensitivity and specificity of a method, the retrieved estimates may to some extent have been overestimated because estimation and evaluation of the cut‐off values was performed in the same study sample, and need to be externally validated in another similar sample 28…”

Section: Discussionmentioning

confidence: 99%

Predictive validity of the Hand Assessment for Infants in infants at risk of unilateral cerebral palsy

Ryll

Krumlinde‐Sundholm

Verhage

et al. 2020

Develop Med Child Neuro

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Aim To evaluate the sensitivity, specificity, and predictive value of the Hand Assessment for Infants (HAI) in identifying infants at risk of being diagnosed with unilateral cerebral palsy (CP), and to determine cut‐off values for this purpose. Method A convenience sample of 203 infants (106 females, 97 males) was assessed by the HAI at 3, 6, 9, and 12 months. Sensitivity, specificity, predictive values, and likelihood ratios were calculated using receiver operating characteristic curve analysis. Cut‐off values were derived for different ages. The clinical outcome (unilateral CP yes/no) at 24 months or more served as an external criterion to investigate the predictive validity of HAI. Results Half of the infants developed unilateral CP. The area under the curve ranged from 0.77 (95% CI [confidence interval] 0.63–0.91) to 0.95 (95% CI 0.90–1.00) across HAI scales and age intervals. Likewise, sensitivity ranged from 63% to 93%, specificity from 62% to 91%, and accuracy from 73% to 94%. Interpretation HAI scores demonstrated overall accuracy that ranged from very good to excellent in predicting unilateral CP in infants at risk aged between 3.5 and 12 months. This accuracy increased with age at assessment and the earliest possible prediction was at 3.5 months of age, when appropriate HAI cut‐off values for different ages were applied. The Hand Assessment for Infants (HAI) predicts unilateral cerebral palsy (CP) with high accuracy. HAI cut‐off values can guide clinical practice for early identification and diagnosis of unilateral CP.

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“…The importance of early diagnosis and intervention for children with CP has been understood for decades [ 2 ]. Nonetheless, children with CP are still identified late [ 2 , 5 , 16 – 18 ], and studies investigating how CP manifests during infancy and what factors affect access to intervention have been called for [ 17 , 21 , 22 ]. By retrospectively reviewing medical charts, we aimed to describe clinical characteristics of infants with CP as well as what factors enable early access to physiotherapy.…”

Section: Introductionmentioning

confidence: 99%

Early access to physiotherapy for infants with cerebral palsy: A retrospective chart review

Hekne¹,

Montgomery

Johansen

2021

PLoS ONE

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Aim This study aimed to investigate whether children with cerebral palsy (CP) had equal access to timely physiotherapy. Additionally, to learn more about clinical characteristics of infants with CP, we explored differences in neonatal clinical history and CP profile between children referred by a neonatologist or enrolled in neonatal follow-up and those referred by other healthcare professionals as well as those referred before and after 5 months corrected age. Methods We conducted a retrospective chart review study including children born in Uppsala County, Sweden, from 2010 to 2016, who had received a CP diagnosis by July 2019. Entries by doctors and physiotherapists working at Uppsala University Children’s Hospital were reviewed. Results Thirty-eight children were included (21 girls, 55.3%) in the study. Twenty-two (57.9%) were born at term. Twenty-five children (66%) had their first visit to a physiotherapist before 5 months corrected age, and this included all children (n = 22, 57.9%) referred by a neonatologist or enrolled in neonatal follow-up. The latter group had significantly earlier access to physiotherapy compared to children referred by other healthcare professionals, with a median of 1.9 (min-max: -1-4) and 7.6 (min-max: 1–24) months, respectively (p < 0.0001). Referral source explained unique variance in predicting time of referral to physiotherapist (R2 0.550, B 4.213, p < 0.0001) when controlling for both number of risk factors and severity of motor impairment. However, number of risk factor was vital for early access to physiotherapy for children referred by other health care professionals. Children referred by a neonatologist or enrolled in neonatal follow-up or referred before 5 months corrected age differed on all measured variables concerning neonatal clinical history and CP profile, compared to children referred by other healthcare professionals or after 5 months corrected age. The latter groups had milder forms of CP. In total, twenty-eight children (73.7%) were ambulatory at 2 years of age. Bilateral spastic CP was most common among those referred by a neonatologist or enrolled in neonatal follow-up or referred before 5 months corrected age, while unilateral spastic CP was most common among those referred by other healthcare professionals or after 5 months corrected age. Conclusion Infants with CP have unequal access to timely physiotherapy, and children considered at low risk for CP receive therapy later. Neonatal follow-up of infants considered at high risk for CP that involves an assessment of motor performance using an evidence-based method during the first months of life corrected age seems to be effective in identifying CP early. Conversely, measuring milestone attainment seems to be a less reliable method for early identification. To provide safe and equal care, all professionals performing developmental surveillance should receive proper training and use evidence-based assessment methods. Physiotherapy should be available prior to formal medical diagnosis.

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Age at referral for diagnosis and rehabilitation services for cerebral palsy: a scoping review

Cited by 30 publications

References 35 publications

Diagnosis and Exercise Rehabilitation of Knee Joint Anterior Cruciate Ligament Injury Based on 3D-CT Reconstruction

Diagnosis and Exercise Rehabilitation of Knee Joint Anterior Cruciate Ligament Injury Based on 3D-CT Reconstruction

Predictive validity of the Hand Assessment for Infants in infants at risk of unilateral cerebral palsy

Early access to physiotherapy for infants with cerebral palsy: A retrospective chart review

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