The functional muscle-bone unit in children with cerebral palsy

Duran, İbrahim; Schutz, Fabio A.B.; Hamacher, Stefanie; Semler, Oliver; Stark, Christina; Schulze, Jost; Rittweger, Jörn; Schöenau, Eckhard

doi:10.1007/s00198-017-4023-2

Cited by 18 publications

(3 citation statements)

References 42 publications

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“…The skeletal muscle plays an important role in daily life as it is the largest tissue component of the lean body mass in humans [43]. MM skeletal is crucial for movement and balance [44] and is positively correlated with gross motor function in children with CP [42,45]. Most previous studies have evaluated muscle strength or muscle size after training using magnetic resonance imaging (MRI) [46] or dynamometry [47].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Robot-Assisted Gait Training on Locomotor Function and Functional Capability for Daily Activities in Children with Cerebral Palsy: A Single-Blinded, Randomized Cross-Over Trial

et al. 2020

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Purpose: The effectiveness of robot-assisted gait training (RAGT) in children with cerebral palsy (CP), especially in terms of improving the performance of daily activities, remains unclear. Therefore, we aimed to investigate the effectiveness of RAGT in children with CP. Methods: In this single-center, single-blinded, randomized cross-over trial, we enrolled 20 children with CP with Gross Motor Function Classification System (GMFCS) levels II–IV (13 males; age range, 6.75 ± 2.15 years). The participants were randomized into the RAGT/standard care (SC) (n = 10) and SC/RAGT/SC sequence groups (n = 10). Using a Walkbot-K system, the RAGT program comprised 3 × 30-min sessions/week for 6 weeks with a continued SC program. The SC program comprised 2–4 conventional physiotherapy sessions/week for 6 weeks. The Gross Motor Function Measure-88 (GMFM-88), the pediatric functional independence measure (WeeFIM), and the Canadian occupational performance measure (COPM) scores were assessed pre- and post-RAGT or SC periods and treatment, period, follow-up, and carry-over effects were analyzed. Energy expenditure and body composition were measured pre- and post-RAGT. Results: Significant treatment effects were observed in dimensions D and E of the GMFM (D: p = 0.018; E: p = 0.021) scores, WeeFIM mobility subtotal (p = 0.007), and COPM performance (p < 0.001) and satisfaction (p = 0.001) measure scores. The period, follow-up, and carry-over effects were not statistically significant. The gross energy cost significantly decreased (p = 0.041) and the skeletal muscle mass increased (p = 0.014) at post-RAGT assessment. The factors associated with functional outcomes showed significant improvements in the GMFM D scores and were mainly observed in children with GMFCS levels II–III compared to those classified at level IV (p = 0.038). Conclusion: RAGT had training benefits for children with CP. Specifically, it improved locomotor function and functional capability for daily activities. These effects were better in ambulatory children with CP. However, as SC interventions continued during the RAGT period, these improvements may be also related to multiple treatment effects.

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Section: Discussionmentioning

confidence: 99%

The Effect of Robot-Assisted Gait Training on Locomotor Function and Functional Capability for Daily Activities in Children with Cerebral Palsy: A Single-Blinded, Randomized Cross-Over Trial

et al. 2020

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“…They reasoned that there was a need for other measures (in addition to BMD) because of the likely underestimation of the risk of fractures in patients with CP. Another study by Duran et al came to the opposite conclusion: they found that BMD could potentially overestimate the fracture risk 4 . However, as the patient group in their study was paediatric, bone development issues seen in puberty could account for the different bone trait integration.…”

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confidence: 90%

Should bone mineral content be part of the equation for assessing fracture risk in patients with cerebral palsy?

Szlachetka

Myint

2021

Develop Med Child Neuro

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Bone health is a common concern in patients with cerebral palsy (CP), who have increased prevalence of fractures due to combination of reduced mobility, ataxia, cognitive impairment, medication, and nutritional factors with the effects already seen in childhood. To put things into perspective, the prevalence of osteoporosis was reported in the United States as 4.8% in adults without CP, 8.4% in adults with CP insured privately, and 14.3% in adults with CP with public insurance. 1 Even after adjusting for cardiometabolic diseases and osteoporosis, the higher odds of fractures in patients with CP persist. 2 So far, bone mineral density (BMD) has been the main well-established way to assess fragility of the bone and risk of fractures.Whitney et al. argue that this widely used measurement method alone may not be adequate based on findings from their retrospective study involving analysis of the association of bone traits -BMD, bone mineral content (BMC), and areawith history of fractures in adults with CP. 3 The authors describe findings of the same or higher BMD in adults with CP who had a history of a fracture compared to those who did not. They reasoned that there was a need for other measures (in addition to BMD) because of the likely underestimation of the risk of fractures in patients with CP. Another study by Duran et al. came to the opposite conclusion: they found that BMD could potentially overestimate the fracture risk. 4 However, as the patient group in their study was paediatric, bone development issues seen in puberty could account for the different bone trait integration.

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“…Based on the progress of national and international research, different scholars also have some collaborative studies on kids with cerebral palsy: The aim of the Duran I research was to compare the prevalence of positive DXA-based markers of skeletal fitness deficits in kids with cerebral palsy with the application of a functional musculoskeletal unit assessment algorithm to account for the prevalence of positive findings following reduced muscle activity [1]. Keawutan P compared the walking status of children with cerebral palsy aged 4 to 5 years with their customary body movements and duration of sedentary activity and compared their activities with physical activity guidelines.…”

Section: Related Workmentioning

confidence: 99%

Clinical Nursing and Physical Rehabilitation Evaluation of Children with Cerebral Palsy

2022

IJHPM

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Cerebral hemiplegia refers to a persistent central movement and posture normal developmental dysfunction and active limitation syndrome. These syndromes are often caused by non-incurring brain damage in growing or normally developing neonates and infants. The aim of this paper is to analyze the evaluation of clinical care and the effectiveness of physical rehabilitation treatment in children with cerebral palsy. This paper first analyzes the necessity of combining education and recovery among kids suffering from cerebral paralysis. Rehabilitation training or intellectual education alone is far from enough for children with cerebral palsy. The two must be combined to truly improve the self-care ability of children with cerebral palsy. Then, the method of medical image segmentation was introduced, and finally, the experimental comparison and analysis of the conditions of the two groups of kids with cerebral palsy before and after treatment were conducted. The experimental findings revealed that after two courses of treatment to compare the two groups of kids with cerebral palsy, the overall efficacy rate was 87.5% for the treated group and 67.7% for the controlled group. The results of the experiment showed that the clinical efficacy of the control group was not as good as that of the treatment group by rank sum test. This shows that on the basis of the most basic comprehensive rehabilitation treatment, acupuncture to relieve the spinal points can be used to treat the symptoms of cerebral palsy. This can effectively enhance the motor function of the major muscles in children with cerebral palsy, and can promote their intellectual development, which is better than the most basic comprehensive rehabilitation treatment alone. Clinical Nursing and Physical Rehabilitation Evaluation Methods for Children with Cerebral Palsy

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The functional muscle-bone unit in children with cerebral palsy

Cited by 18 publications

References 42 publications

The Effect of Robot-Assisted Gait Training on Locomotor Function and Functional Capability for Daily Activities in Children with Cerebral Palsy: A Single-Blinded, Randomized Cross-Over Trial

The Effect of Robot-Assisted Gait Training on Locomotor Function and Functional Capability for Daily Activities in Children with Cerebral Palsy: A Single-Blinded, Randomized Cross-Over Trial

Should bone mineral content be part of the equation for assessing fracture risk in patients with cerebral palsy?

Clinical Nursing and Physical Rehabilitation Evaluation of Children with Cerebral Palsy

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