Musculoskeletal problems in cerebral palsy

Quinby, Janice M.; Abraham, Alwyn

doi:10.1016/j.cupe.2004.10.002

Cited by 31 publications

(18 citation statements)

References 16 publications

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“…Furthermore, the muscular contractures alter the physical forces on the developing skeleton, leading to progressive dysplasia and dislocation of joints (5)(6)(7)(8)(9). These contractures are the primary driver of the need for rehabilitative and surgical therapies, assistive devices, and accommodations for daily functioning (10,11). However, no existing treatment strategies alter the actual contracture pathology, and instead can worsen function by further weakening already abnormal muscles (12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Proteasome inhibition preserves longitudinal growth of denervated muscle and prevents neonatal neuromuscular contractures

Nikolaou¹,

Cramer

Hu³

et al. 2019

JCI Insight

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Section: Introductionmentioning

confidence: 99%

Proteasome inhibition preserves longitudinal growth of denervated muscle and prevents neonatal neuromuscular contractures

Nikolaou¹,

Cramer

Hu³

et al. 2019

JCI Insight

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“…As the mature gait pattern develops by the age of 7 years, orthopaedic surgery should be avoided in ambulant children before that age [42]. Derotation osteotomies usually are not undertaken before the age of 8 years, due to high recurrence rate [42]. With the advent of less invasive treatments such as intrathecal baclofen, the need for such treatments is decreasing [22].…”

Section: Management Of Contractures -Orthopaedic Treatment (Tenotomiementioning

confidence: 98%

“…adductor tenotomy in the hip, hamstring lengthening for the knee), muscle release, tendon release, tendon transfers or even derotation osteotomies (usually of the femur) to modify the vectors of action of different muscles and improve function [11]. As the mature gait pattern develops by the age of 7 years, orthopaedic surgery should be avoided in ambulant children before that age [42]. Derotation osteotomies usually are not undertaken before the age of 8 years, due to high recurrence rate [42].…”

Section: Management Of Contractures -Orthopaedic Treatment (Tenotomiementioning

confidence: 99%

Surgical management of spasticity of cerebral origin in children

Sgouros

Operative Neuromodulation

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SummaryIn children, spasticity is commonly seen in the context of cerebral palsy (CP), but also following head injury, cerebral infarct or other brain insults. CP is a wide term used to describe a constellation of symptoms that characterise the physical impairment of movement due to abnormal brain development. The management of spasticity is tailored according to the clinical picture of the child. Ambulatory mild spastic diplegics tend to reach the maximum of their disability in the first few years of life, and change little after the age of 5-7 years. Such patients who are seen between 3-5 years and who attempt to mobilise with walking frames are often good candidates for either dorsal rhizotomy or intrathecal baclofen (ITB) administration with the implantation of an indwelling pump. Non-ambulatory mild spastic diplegics and spastic quadriplegics have more profound spasticity, painful spasms, orthopaedic deformities, and difficulties with daily care and posture. ITB has become established as the first line of surgical treatment for these patients. In the last decade, there has been a definite trend away from ablative treatments and towards reversible stimulation and infusion systems. Current pumps have practical limitations but, in the next decade, it is anticipated that technological improvements will render the pumps more patient friendly.

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“…As the individuals with CP grow, abnormal biomechanical situations affecting joints and static postures can cause pain formation. As the child grows old, chronic pain, social isolation, functional limitations and dependency can affect mental status negatively [7,14].…”

Section: Spasticitymentioning

confidence: 99%

How Does Botulinum Toxin Injection and Physiotherapy Complement Each Other in Cerebral Palsy?

Akbaş¹

2016

Botulinum Toxin Therapy Manual for Dystonia and Spasticity

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Cerebral Palsy (CP) is a clinical condition that describes impairments of motor and sensory systems due to a lesion in immature brain. CP-related disorders effect movements, balance and posture of the child. Spasticity is most frequent motor disorder seen in CP and effects 70-80% of the children with CP. Spasticity can lead to abnormalities in all motor system levels involving muscles, joints, bones and tendons. If spasticity exists for long period of time, immobilization of muscles in short position and changes in the connective tissue around joints lead to shortening of the muscles and connective tissue. Various methods are used for spasticity management in children with CP. Botulinum neurotoxin (BoNT) injections, oral medications, selective dorsal rhizotomy and intrathecal baclofen applications are the foremost among them. BoNT injections are most prevalently used one among these applications. BoNT, which is a neurotoxin obtained from Clostridium botulinum bacteria, is frequently used in children with CP to decrease muscle tone for a certain period in the selected muscles, prevent contractures, postpone surgery and decrease frequency of surgeries. During this time frame that muscle tone decreased, it is very important to increase activity and participation levels of children. For achieving better motor outcomes and functional independence, BoNT injections should be combined with physiotherapy (PT) and occupational therapy (OT).

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Musculoskeletal problems in cerebral palsy

Cited by 31 publications

References 16 publications

Proteasome inhibition preserves longitudinal growth of denervated muscle and prevents neonatal neuromuscular contractures

Proteasome inhibition preserves longitudinal growth of denervated muscle and prevents neonatal neuromuscular contractures

Surgical management of spasticity of cerebral origin in children

How Does Botulinum Toxin Injection and Physiotherapy Complement Each Other in Cerebral Palsy?

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