Clinical Examination of Children with Cerebral Palsy

Abstract

Cerebral palsy (CP), a heterogeneous disorder of movement and posture, is one of the most important causes of disability affecting children. With a wide variability in the clinical presentation and a paucity of reliable diagnostic tests, decision-making in CP is fraught with difficulties and challenges. The plethora of musculoskeletal manifestations includes poor muscle function, spasticity, rigidity, muscle weakness, poor selective motor control, soft-tissue and joint contractures, torsional malalignments, and lever arm dysfunctions. Children with CP are at a high risk of further worsening and progression of these musculoskeletal abnormalities with the natural course of the disease. A comprehensive assessment that includes a combination of detailed medical history, functional assessment, clinical examination, analysis of gait, and radiological assessment is required to provide a favorable treatment outcome in these children. A close surveillance is essential so as to identify risk factors for the development and progression of musculoskeletal problems so that early interventions can be carried out to circumvent them. This review article is to highlight the importance of clinical examination in the assessment of children with CP.

Design, Validity, and Reliability of a New Test, Based on an Inertial Measurement Unit System, for Measuring Cervical Posture and Motor Control in Children with Cerebral Palsy

“…In fact, ICC increases with higher between-individual variance [ 59 ]. The heterogeneity of the level of patients’ affectation, the variation of spasticity states [ 74 ], and the training effect between both assessments [ 75 ] could explain part of the variability. Further research should identify whether more homogeneous subgroups show lower MDC.…”

Does spasticity affect the postural stability and quality of life of children with cerebral palsy?

“…Forty-five children with spastic CP were selected from the outpatient clinic of faculty of physical therapy at Cairo University. The inclusion criteria were a) spastic CP, b) age of 4–6 years of both genders, and c) spasticity grades 1 and 1+ on the modified Ashworth scale, 20 while the exclusion criteria were a) permanent deformities or severe contractures of upper or lower limbs or vertebral column, b) breathing disorders, c) an epilepsy or seizure disorder that was resistant to treatment, or d) orthopedic surgery owing to pathology and Botox injections during the 12 months that preceded the study.…”

“…It is performed manually to determine the resistance of lower limb muscles to passive stretching as a measure of degree of spasticity. 20 All selected children were affected by spasticity classified with grades 1 and 1+. 21 Gross Motor Functional Measurement-88 (GMFM-88): is a standard principle-test aiming to evaluate alterations of function in different milestones for children diagnosed with CP.…”

“…23 The GMFCS has been successfully implemented worldwide in a range of settings including routine clinical management. 20 The pediatric quality of life inventory “TM” (PedsQL TM ): Health-related QOL was used to assess QOL by (PedsQL™) 4.0 generic core scale which measures HRQOL in normal children and adolescents as well as those with acute or chronic disorders. PedsQL™ is a reliable and valid measurement of the pediatric health outcome, as it enables the evaluation of risk.…”

“…It is performed manually to determine the resistance of lower limb muscles to passive stretching as a measure of degree of spasticity. 20 All selected children were affected by spasticity classified with grades 1 and 1+. 21 …”