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Seizures in cerebral palsy
Nagabhushana Rao Potharaju
January-June 2016, 2(1):3-21
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Physical profile of children with cerebral palsy in Jalandhar district of Punjab India
Raju Sharma, AGK Sinha
January-June 2015, 1(1):9-20
Introduction: Cerebral palsy (CP) has emerged as one of the major causes of childhood disability in India. Physical and functional status of children with CP and their relation with various sociodemographic variables in the Indian context are not widely reported. Objective: This report describes the physical and functional status of children with CP in Jalandhar district of Punjab and examines its association with biological and social factors. Methodology: A survey using physical examination of child and schedule interview of parents has been conducted on 248 children with CP of age group 3-13 years. Descriptive analysis has been conducted with probability level set at 0.05. Results: Spastic CP (83.46%) has been observed the most prevalent type of motor impairment. In spastic type diplegia has been major presentation (43.5%), followed by quadriplegia (34.3%), majority of children fall in level V (57.7%,) of Gross Motor Function Classification System (GMFCS). Mental retardation (MR) is (42.3%) the most frequent associated disability and epilepsy are the most prevalent co-morbidity. About 69% subjects have been found nonambulatory and dependent in their -self-care domains. More than 70% of children have been observed with deformities of more than four joints. GMFCS levels were significantly associated with topography, MR, age of diagnosis, time constraint of parent, difficulty in arranging physiotherapy, ignorance of parents about condition and rehab services required, poor belief in rehabilitation methods. Conclusion: Lack of comprehensive rehabilitation facilities for children with CP was reflected in the poor physical and functional status of the children. Beside the primary impairments, social factors have played an important role in determining the functional status of these children.
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Effect of dynamic sitting balance on upper extremity motor skills in children having spastic diplegia: A correlational study
Indira Brundavanam, Lakshmana Prasad Gadde, Naveen Kumar Balne, AK Purohit
July-December 2015, 1(2):70-74
Introduction: Children having spastic diplegic cerebral palsy also have some impairment in upper extremity functions; hence, they have difficulty in performing certain activities such as pulling up to stand, support themselves to sit, and participate in surrounding environment. Trunk control is proposed to be a major contributing factor for voluntary upper limb motor functions including motor control. Objective: To study the effect of dynamic sitting balance on upper extremity skill in children having spastic diplegia. Material and Methods: Study Design - Randomized control trial. Participants - The children were randomly divided into experimental (n = 15) and control group (n = 15). Experimental group received dynamic sitting balance training for a period of two weeks, whereas control group received conventional physiotherapy for a period of two weeks. Results: A significant improvement was noted in dynamic sitting balance and upper extremity skill, and a positive correlation was found between these two parameters. Conclusion: This study showed that, for this cohort of children having spastic diplegic cerebral palsy, short duration of dynamic sitting balance training resulted in improvement in upper extremity function with improvement in dynamic sitting balance.
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One stage soft tissue release, open reduction, femoral shortening, osteotomy and peri acetabular augmentation for spastic dislocated hip-early results
Sakti Prasad Das, Sudhakar Pradhan, PK Sahoo, Shankar Ganesh, RN Mohanty, SK Das
January-June 2015, 1(1):28-34
Objectives: The goals of hip surgery in cerebral palsy are to maintain adequate reduction of the femoral head, prevent pain, improve sitting balance and maintain motion and the ambulatory status of the patient. It is now well accepted that soft tissue release, open reduction and femoral shortening were necessary for a stable hip along with some type of pelvic osteotomy. We evaluated the clinical and radiological results of one-stage correction of hip dislocation for cerebral palsy patients. Materials and Methods: We reviewed clinical outcomes and radiologic indices of 32 dislocated hips in 24 children with cerebral palsy (13 males, 11 females; mean age, 8.6 years). All 32 hips had dislocation. Preoperative Gross Motor Function Classification System (GMFCS) scores of the patients were as follows; level V (13 patients), level IV (9), and level III (2). The combined surgery included release of contracted muscles, (adductors, rectus femoris, iliopsoas) open reduction of the femoral head, femoral shortening varusderotation osteotomy and the modified Dega osteotomy along with shelf procedure. Hip range of motion, GMFCS level, acetabular index, center- edge angle, migration percentage, neck shaft angle, Sharp's angle was measured before and after surgery. The mean follow-up period was 38.1 months. Results: Hip abduction (median, 40°), sitting comfort and GMFCS level were improved after surgery, and pain was decreased. There were no femoral head avascular necrosis, no infection or nonunion. There was no redislocation. All radiologic indices showed improvement after surgery. Conclusions: So, we believe that a combined approach of muscle releases, open reduction, femoral shortening varus-derotation osteotomy, Dega osteotomy and penicapsularacetabular augmentation was a highly effective method for the treatment of spastic dislocated hips in our patients.
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Results of selective motor fasciculotomy in spastic upper limbs due to cerebral palsy (a review of 30 children and adults)
Srikanth Reddy, Aneel Kumar Puligopu, Aniruddh Kumar Purohit
January-June 2015, 1(1):21-27
Objectives: To assess the outcome of selective motor fasciculotomy in relieving upper limb harmful resistant spasticity and thereby to improve motor functions in persons with cerebral palsy. Materials and Methods: Thirty people having cerebral palsy (16 males and 14 females) age ranging from 5-35 (mean age = 12.66) years with upper limb resistant spasticity were studied. The participants having spastic hemiplegia (N = 11), triplegia (N = 9) and quadriplegia (N = 10) were assessed using Modified Ashworth Scale (MAS), Selective Voluntary Control Grade (SVC), WeeFIM Scale and hand function evaluation. Selective motor fasciculotomy (SMF) was performed on musculocutaneous nerve (N = 15), median nerve (N = 35) and ulnar nerves (N = 3) for elbow flexors, pronators and radial wrist flexors and ulnar wrist flexors spasticity respectively. Pre and post op therapeutic exercises were performed. Results: Statistical analysis using Wilcoxon Signed Ranks test showed significant reduction in spasticity and improvement in selective voluntary control, hand functions (grasp to hold a rod) and WeeFIM self care domain. There was no recurrence in spasticity and no complications following surgery. Conclusions: The SMF of musculocutaneous, median and ulnar nerves significantly reduces spasticity in the affected muscle groups and thereby improves the self care (motor) functions in selected people with cerebral palsy who have harmful resistant spasticity without any organic shortening of the muscles. The procedure is safe and the spasticity does not recur.
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A study on available support systems in inclusive setting for the students with mental retardation
Jayanti Pujari, M Annapurna
January-June 2015, 1(1):35-41
The present study is an exploratory study to find out the existing support system in the primary schools of two Districts of Telengana. The study primarily focused on identifying the available support system in the primary schools which facilitate the learning of children with mental retardation. The objective of the study was to find out the support system available for the students with mental retardation in terms of academic support, social support, emotional support and physical support in inclusive setting in the primary schools. A total number of 100 teachers (both regular and resource teacher), 50 students and 20 primary school were selected by purposive sampling procedure. The data was generated with the help of 4 type of questionnaire. The major findings of the study show that the academic and social support as perceived by regular teacher was in average level where as academic and social support perceived by resource teacher are in high level. The emotional support provided by peer is high level. The physical support was studied under three catogerise i.e. toilet and sanitation facilities, mobility and barrier free environment are in low level. The study concludes that adequate support system is key to the success of inclusive education.
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Cerebral palsy field indeed needs scientific deeds
AK Purohit
January-June 2015, 1(1):1-3
  1,221 5 -
A study of audiological profile of children with cerebral palsy
Mohammad Shamim Ansari, MA Hafiz Ansari
July-December 2015, 1(2):80-83
Background: Hearing is critical for the full development of language skills. Even a mild hearing impairment can interfere with speech and language development. Hearing impairment has the highest incidence rate for any pediatric disability, since several risk factors in infants with cerebral palsy (CP) are the same risk factors to develop hearing impairment. Thus, it should come as no surprise that hearing impairment occurs more frequently among children with cerebral palsy than in the general population. Recent studies have shown that up to 25% of children with cerebral palsy also suffer from a hearing impairment. However, no data of hearing impairment in cerebral palsy is available in India. Objective: The goal of this study was to determine the frequency and profile of hearing impairment in children with cerebral palsy. Methodology: This was a retrospective study involving 117 children of 2-10 years of age of both genders who were diagnosed with cerebral palsy. The audiometry, tympanometry, otoacoustic emission, and auditory brain stem response hearing tests were employed to categorize the hearing impairment. Results: Hearing impairment was observed in 39% of children. Sensorineural, conductive, and mixed hearing impairment was present in 48%, 41%, and 31% of the children, respectively. Among them, there was mild, moderate, and severe degree of hearing impairment in 52%, 26%, and 22% of the children with cerebral palsy, respectively. Conclusions: Prevalence of hearing impairment in children with cerebral palsy is alarming. This warrants early identification and diagnosis of hearing impairment, especially for medically treatable forms of hearing impairment such as secretory otitis media, Eustachian tube dysfunction, and presence of wax. This early identification may facilitate better development of speech and language as well as positive outcomes. Therefore audiological assessment should be incorporated into the diagnostic and therapeutic plan of all children with cerebral palsy.
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Single event multi level orthopedic surgery in a teenager having spastic triplegic cerebral palsy
Jitender Jain, Varidmala Jain, Vinai Shrivastav
January-June 2015, 1(1):45-48
An 18-year-old boy with spastic triplegic cerebral palsy was not able to stand or walk without support (GMF Score: Level-4) and even not able to hold things with his right hand. He had undergone orthopedic surgeries previously twice in both the lower limbs and right upper limb. He also underwent static magnetic field (SMF) of median nerve for pronator and wrist flexor spasticity in right upper limb. Single Event Multilevel Orthopedic Surgeries (SEMLOS) were performed in both the lower limbs and in right upper limb with derotational osteotomy on right proximal femur and fixation with DHS. On complete reassessment 1 month after the surgery it was found that he also had lots of trouble in sensory feedback. He was given first sensory integration followed by other therapeutic exercises. Now, he is fully independent and is able to walk with elbow crutches as well as two stick support for a long distance (GMF Score- level 3). Grip as well as release of fingers in right hand have also improved.
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Feasibility of multisensory training and its effects on balance control in school going children with cerebral palsy
Bhakti Patel, S Karthikbabu, Nafeez Syed
July-December 2015, 1(2):101-107
Context: Involvement of sensory system affects the motor performance of children with cerebral palsy, and the literature on sensory-based balance training is scarce in such children. Aim: To test the feasibility of administering multisensory training in school going children with cerebral palsy and its effects on balance control as measured by Balance Evaluation - Systems Test (BESTest). Settings and Design: School setting and a baseline-pre-post feasibility trial. Subjects and Methods: Seventeen children with cerebral palsy (gross motor function classification system level 1-3) aged between 6 and 16 years participated in sensory-based balance training encompassing inputs from visual, vestibular, and proprioceptive systems. Children with mental delay, hearing, and visual impairments and those who underwent treatments such as BOTOX, tendon lengthening, derotation surgery, or selective rhizotomy in the past 6 months were excluded. Following 2 months run-in period, each child underwent 45 min of training per session; a total of 18 sessions over 2 months duration. Statistical Analysis and Results: Repeated measures ANOVA and post-hoc test was done to analyze within-subject changes and with respect to time. P < 0.05 was statistically significant. After training, all the components of BESTest showed statistically significant change (P < 0.05). Conclusion: Multisensory training is a feasible mode of practice in a school setting and is beneficial in improving balance control in children with cerebral palsy.
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Journey of a child with spastic diplegic cerebral palsy from doldrums to hope
Divya Midha, Manisha Uttam, Megha Neb
July-December 2015, 1(2):127-130
This case study describes the physical therapy of a 9-year-old male child with spastic diplegic cerebral palsy with the aim to improve his gross motor function and social skills. The child had severe impairments across the full spectrum of developmental functions, especially affecting the gross motor and self-care functions at Stage V of gross motor function classification system (GMFCS) in spastic diplegic cerebral palsy. His body was completely stiff with marked asymmetrical spasticity in lower limbs, truncal dystonia, and chest deformity with cardio respiratory complications. The physical therapy was performed by giving sessions of Roods approach, sensory integration, and static weight-bearing exercise for a period of 9 months. Pre- and post-therapy evaluation of child was done using GMFCS. There was an improvement in the child with his social skills, transitional activities, activities of daily living, and gross motor skills, reaching to Stage IV with the 9 months physiotherapy intervention given by a neurological physical therapist.
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Acquired cryptorchidism with spastic cerebral palsy
Ibrahim Aliyu
January-June 2015, 1(1):42-44
Cryptorchidism may have significant impact on the psycho-social wellbeing of a child that if not detected could result in low self-esteem and poor scholastic achievement. It may be congenital or acquired; in acquired cryptorchidism the testes would have descended into the scrotum and then subsequently ascended into the inguinal canal or abdomen. Although congenital cryptorchidism is commonly associated with prematurity and diseases such as prune-belly syndrome, Smith-Lemli-Opitz syndrome, Laurence-Moon-Biedl syndromes; acquired cryptorchidism (unlike retractile testes) is rare. Therefore, the case of an 11-year-old boy with acquired cryptorchidism associated with spastic cerebral palsy, which was omitted, is reported. This affected his relationship with his peers and also resulted in poor school attendance.
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Developmental disability in the 21 st century: New ideas for a new millennium
Peter Rosenbaum
January-June 2015, 1(1):4-8
  1,041 3 -
Dr. PK Mullaferoze motivational biography (3 October 1910-24 November 2008)
Dhruv Mehta, Nadir Bharucha, GS Chawra, Rakesh R Bhansali, Ella D'Souza, PC Shastri, GS Shashikala, Asha Dangarwalla, Fatema Jetpurwalla, AK Purohit
January-June 2015, 1(1):54-60
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Perinatal risk factors in cerebral palsy: A rehab center based study
Varidmala Jain, Jitendra Kumar Jain, Gyanendra Singh, Amit pandey
July-December 2015, 1(2):75-79
Introduction: The etiology of cerebral palsy (CP) is very diverse and multifactorial including prenatal, natal, and postnatal factors. Objective: This study is an attempt to describe the distribution of risk factors among children with cerebral palsy. Materials and Methods: This study was conducted to explore perinatal risk factors among 307 children having cerebral palsy. Results: Major risk factors found in this study were history of spontaneous abortions in 33 (10.7%), anemia during pregnancy in 53 (17.3%), hypertension in 26 (8.5%), and history of infection in 22 (6.2%) mothers. In total, 141 (45%) children were born preterm and 28 (9.1%) were born in multiple births. Further, it was also found that 12 (3.9%) deliveries were forceps delivery. Out of the total 307 respondents, 208 (67.8%) reported a history of delayed crying of their child at birth. Out of the available record of 278 children, 108 (38.8%) had birth weights of <1.5 kg. The most frequent risk factors in the postnatal period were high fever in 82 (26.7%), convulsion in 81 (26.4%), and jaundice in 99 (32.2%). Conclusions: In this study, factors related to poor antenatal care as well as other unavoidable risk factors were found; therefore, there is a need to prevent avoidable causes that lead to CP through strict standard practices, mass awareness programs, etc.
  956 9 -
Participation restrictions in a teenager with down syndrome: A nine year follow up case study
Asha Chitnis, Reena Mody, Gajanan Vithalrao Bhalerao, Sujata Noronha, Madhavi Kelapure, Kruti Shah
January-June 2015, 1(1):49-53
This is a case report of Aadyant, a child with Down syndrome, [1] across his life so far from age 8-17 years. Although Aadyant (name changed) had a sound immediate postnatal period, he was diagnosed with Down syndrome at birth. He suffered from convulsions at the age of 6 months. He had subluxation of the right hip joint. Sensory motor cognitive developmental therapies with perseverance and participation by the family do improve the condition of the person.
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My journey into the world of treating children with cerebral palsy
Warwick J Peacock
July-December 2015, 1(2):65-69
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Efficacy of supracondylar knee ankle foot orthosis for hyperextended knee and heel rise in spastic cerebral palsy: A pilot clinical trial
Rajesh Kumar Mohanty, Ullas Chandra Sahoo, Smruti Prava Sahoo
January-June 2016, 2(1):22-26
Background: Guidelines to assist with decision making for orthotic management of gait dysfunction in individual with cerebral palsy (CP) is difficult to derive and remain controversial. The research question is whether supracondylar knee ankle foot orthosis (SKAFO) is one of best options for knee hyperextension and heel rise for spastic diaplegic Cerebral palsy. Aim: The purpose of this study was to check the efficacy of bilateral molded SKAFO for knee hyperextension and heel rise for Cerebral palsy in terms of gait parameters and energy expenditure. Materials and Methods: Five individuals (mean age 3.5 years) were diagnosed as spastic diplegic and one with hemiplegic (age 5 years old) Cerebral palsy with delayed milestone presented with knee hyperextension and heel rise during mid-stance and were fitted with bilateral molded SKAFO with pair of shoes. Observational gait analysis by video recording was performed and gait parameters by 10 m walk test and energy expenditure using physiological cost index was recorded in bracing and non-bracing conditions. Results: The orthosis controlled knee hyperextension by not allowing the knee to go beyond neutral position. The gait was more natural with proper heel strike and better push off. There was improvement in temporal-spatial gait parameters and gait was energy efficient. Conclusion: The SKAFO was found to be effective in controlling knee hyperextension and resulted in stable, natural, satisfactory and energy efficient gait in spastic Cerebral palsy with knee hyperextension and heel rise. Similar study involving case series can be used to set the prognosis of ambulation and the kind of orthotic interventions needed to optimize the walking ability.
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Relation of quality of upper limb to independent gross motor and manual ability function in children with spastic diplegia
Rajashree Fadnavis, Gajanan Bhalerao, Vivek Kulkarni, Nilima Bedekar
July-December 2015, 1(2):94-100
Background: Most of the children having spastic diplegia show variability in upper limb and upper trunk functions. Due to this variation in upper limb and upper trunk, the quality of upper limb function may affect and limit the independence of functional activities in these children. Hence, this study aimed to find the relation of the quality of upper limb function to independent gross motor and manual ability function in children with spastic diplegia. Materials and Methods: Overall, 30 children (both girls and boys) who were diagnosed with spastic diplegia (age ranged 4 to 8 years) were included. Children having any musculoskeletal deformity of upper limb or fracture or who had undergone administration of botulinum toxin or soft tissue release surgery in last 6 months or who were unable to follow commands were excluded from this study. Included children were classified in gross motor function classification system (GMFCS) and manual ability classification system (MACS) level. The outcome measures used were quality of upper limb function, which was assessed using quality of upper extremity skills test, and self care was assessed using self care domain of functional skills with its caregiver assistance of pediatric evaluation of disability inventory (PEDI). The data were analyzed. Results: Spearman coefficient of correlation was calculated. The quality was found having moderate correlation with GMFCS (−0.459) and MACS (−0.589), while it strongly correlated with self care domain of functional skills (0.647) and caregiver assistance of PEDI (0.666). Conclusion: The quality of upper limb functions was affected in children with spastic diplegia. This was reflected on self care domain along with caregiver assistance of PEDI.
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Low tech clinical research: A minimum must
AK Purohit
July-December 2015, 1(2):63-64
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Coupling effect of neuromuscular electrical stimulation on glutei and transcutaneous electrical nerve stimulation on hip adductors in scissoring gait
Khurshid Shaik, Lakshmana Prasad Gadde, Naveen Kumar Balne, Aniruddh Kumar Purohit
January-June 2016, 2(1):27-31
Introduction: Spasticity and weakness are the two most important factors effecting gait in children with spastic diplegia. Spasticity in hip adductors and associated weakness in hip extensors and abductors leads to scissoring gait pattern. Proximal muscle stability is essential for distal mobility; this study focuses more on proximal muscle group facilitation for correction of deviations in scissoring gait. Objective: The objective of this study was to study the coupled effect of neuromuscular electrical stimulation (NMES) on glutei and transcutaneous electrical nerve stimulation (TENS) on hip adductors in improving gait parameters. Materials and Methods: The experimental group received NMES to hip extensors and hip abductors followed by TENS to hip adductors as an adjunct to conventional therapy for a period of 3 weeks whereas the control group received only conventional therapy. In experimental group, NMES was applied to gluteus maximus and medius for 10 min each and were asked them to perform the muscle action voluntarily. Later, TENS was applied to hip adductors for 10 min with passive hip abduction (HAB). Both the group received home program for the next 2 months. Results: A significant improvement was noted in spasticity, active range of motion (AROM) to HAB, extension, and gait parameters with P < 0.05. Conclusion: The coupled effect of NMES on glutei and TENS on hip adductors in children with scissoring gait gives rise changes in muscle tone, AROM, and gait parameter. All these contribute in improving the gait. These gains persist atleast for 3 months compared to the individuals who receive only conventional therapy. The improvement is seen within a short period of 3 weeks time compared to conventional therapy alone group which takes longer period of 12 weeks time.
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Evaluation of functional performance assessment in preterm infants with Infant Neurological International Battery
G Shinde Krishna, S Ganvir Suvarna
July-December 2015, 1(2):84-87
Context: Many studies have found that there is an increased risk of neurodevelopmental impairments in preterm and low birth weight (LBW) infants, so it is desirable to make early predictions with regard to outcome. This is important for the family, for the researchers designing appropriate follow-up and intervention programs, and for the pediatric neurologist who has to give meaningful feedback to obstetricians and neonatologists. Several studies have tried to identify infants at particularly high risk of neurological damage. In 1972, Drillien described transitory dystonia of the LBW premature infant as a common developmental deviation of motor function during the 1 st year of life. Aims: To evaluate the functional performance (age specific motor development) in preterm infants using Infant Neurological International Battery (INFANIB). Settings and Design: Observational study design conducted at physiotherapy OPD. Subjects and Methods: An observational study was carried out in 100 infants who were born at 24-31 weeks gestation with age group from 4 to 9 months with a mean age of 4.3 months. The sample selection was based on convenient sampling method. The infants were evaluated according to their gestational age. The study was approved by Institutional Ethical Committee. The guardians signed an informed consent form allowing the infant's participation. INFANIB was administered on 100 preterm infants, and collected data were compared with standard values of INFANIB. Statistical Analysis Used: Unpaired t-test was used for between group comparisons. Results: The present study shows that premature infants have high risk of delayed pattern of motor development which is different from those infants born at term. Conclusions: The premature infants show delayed pattern of motor development that is different from those born at term.
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Comparison of postural instability between the spastic diplegic and hemiplegic children with cerebral palsy
Mahima Shroff, Sachin Gawande, Nilima Bedekar, Ashok Shyam, Parag Sancheti
July-December 2015, 1(2):113-116
Context: Cerebral palsy (CP) is known as a sensory and neuromuscular deficit, which is caused by nonprogressive brain defect that occurs during infancy or early childhood. Children with cerebral palsy are a heterogeneous group, varying considerably in movement abilities. Balance and postural control are the fundamental components of movement. Children with many types of motor dysfunction have complications in maintaining postural stability, as maintenance of postural stability is an integral part of all movements. These children exhibit clumsiness and frequent falls during regular activities. Aim: To compare the postural instability between the children with cerebral palsy having spastic diplegia and hemiplegia. Materials and Methods: Hundred age-matched children with cerebral palsy from the age group of 5 to 12 years were included in this study, with 50 children in each group of spastic diplegic and hemiplegic, respectively. They were asked to perform 2 tests for testing their postural instability. The tests were Early Clinical Assessment and Balance (ECAB) scale and Pediatric Reach Test (PRT). The total scores were then statistically compared between the groups using Mann-Whitney U-test. Results: (A) The " P" value for ECAB was found to be 0.434 (B). The " P" value for the PRT was found to be as follows - Age group: 5-6 years: 0.68, age group: 7-8 years: 0.61, age group: 9-10: 0.28, and age group: 11-12 years: 0.58. Conclusion: The study showed no significant difference in postural instability between the two groups.
  580 1 -
Comparison of self-concept of children with cerebral palsy and children without impairments
Sharwari Mutsaddi, Ravinder Kaur Mahapatra
January-June 2016, 2(1):32-36
Introduction: Self-esteem or self-concept is a feeling of self-appreciation. A positive self-concept is essential to maintain normal psychological health. Cerebral palsy results in functional impairments that limit the individual's activities. This could lead to a negative self-concept among these children. Aim: To compare the self-concept of children having cerebral palsy with the children having no impairment. Material and Methods: The study was an observational case-control type of study with n = 56 (28 in each group). The self-concept of the children (age 10-16 years) was assessed using Harter's Self Perception Profile for Children. The mean of each subscale was compared between the two groups using the Mann-Whitney U-test on SPSS version 20. The males and females were compared in each group. Results: There was a significant difference in the two graphs with respect to the aspects of physical appearance (P = 0.000), behavioral conduct (P = 0.024), social competence (P = 0.001), and athletic competence (P = 0.000). Males with cerebral palsy showed a lower sense of self-concept in the field of social competence (P = 0.002), athletic competence (P = 0.00), and physical appearance (P = 0.016). On the other hand, females with cerebral palsy showed comparatively lower self-concept in the fields of athletic competence (P = 0.000) and physical appearance (P = 0.000). Conclusion: Children having cerebral palsy showed reduced self-concept in the domains of social competence, behavioral conduct, physical appearance, and athletic competence. Gender-based differences were observed in the two groups.
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Parents' expectations from rehabilitation services for their children with cerebral palsy: A retrospective study
Seshagiri Rao Joshi, G Srikrishna, Binapani Mohapatra
July-December 2015, 1(2):121-126
Background: Early identification and intervention has brought change in the societies towards disability and its management. However, dependency on drug-cure (medical model) has influenced the community expectations on the outcomes of rehabilitation process. The psychosocial rehabilitation process has been sparsely studied in Indian context. Aim: The present study aims to study whether the expectations of the parents change across the age, as recorded in chief complaints, in a way that psychological disorders are late to be detected and are generally not recognized by parents and medical professionals. The study also found some interesting findings such as ratio of males and females registered and the mean age range of the children registered. Methodology: The present study has examined and analyzed the documentation of case history files of children brought by their parents and caregivers to the National Institute for the Mentally Handicapped, Bowenpally, General services (n = 3,960) for male and female ratio, mean age of registration, developmental and social age (DA and SA) for 3-36, 36-72, and 72-120 month age ranges, respectively. Results: As the age increases psychosocial difficulties also increases with psychomotor problems. Registered male cases were more than female cases. The visits to the Psychology department for the behavior problems have increased across the age range. Conclusions: Psycho-social rehabilitation and family counseling in managing the person with cerebral palsy is effective than behavior modification programs. A mobile Rehabilitation Services team must visit area wise for offering in-the-neighborhood services along with psycho-education for remote areas. Schools need to be sensitized that if motor and speech are the only disabilities in a child, he should not be refused admission. Parents counseling is necessary for vulnerability of psychological problems in this population due to restrictive environment and explain Medical Model VS Bio-Psycho-Social Model.
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