Laboratory-instrumental diagnostics and individual rehabilitation program for children with cerebral palsy
DOI:
https://doi.org/10.15574/SP.2025.1(145).5763Keywords:
cerebral palsy, diagnostics, physical rehabilitation, multidisciplinary approach, early intervention, postural disorders, pain, comorbidity, emotional-volitional disorders, neuropsychological rehabilitation, vitamin D, calcium, subluxation of the hip jointsAbstract
Cerebral palsy (CP) is one of the most frequent causes of childhood disability in the world and in Ukraine. CP affects posture, balance, and the ability to move, which leads to varying degrees of impaired activity and functioning in children. Reducing the risk of secondary complications in children with CP is possible with early diagnosis and rehabilitation at an early age. The early intervention service (EI), which provides support and rehabilitation according to an individual program for children with cerebral palsy from birth to 4 years, contributes to improving the functional capabilities of the child.
Aim - to carry out a comparative analysis of disorders in children aged 4 to 14 years with spastic CP, depending on whether they underwent an individual rehabilitation program within the framework of the EI service from birth to 4 years of age.
Materials and methods. The study involved 105 children aged 4-14 years, divided into two groups: the Group A (43 children who received EI) and the Group B (62 children who did not). The level of violations in children was assessed using standardized international scales and laboratory-instrumental methods.
Results. Children in the Group A had less pronounced orthopedic complications (scoliosis, hip dislocations, etc.). Children in the Group A had higher vitamin D levels (24.98±1.164 ng/ml versus 20.85±1.194 ng/ml). Electrocardiogram and complete blood count parameters did not reveal statistically significant differences between the groups.
Conclusions. EI service from birth to 4 years with the use of an individual rehabilitation program has a positive effect on the prevention of secondary complications in children with CP, contributing to the improvement of activities, functioning and participation of children with CP.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
References
Alenazi KA, Alanezi AA. (2024). Prevalence of Vitamin D Deficiency in Children with Cerebral Palsy: A Meta-Analysis. Pediatric neurology. 159: 56-61. https://doi.org/10.1016/j.pediatrneurol.2024.03.021; PMid:39137591
Altman DG. (1991). Practical statistics for medical research. London: Chapman and Hall: 632. https://doi.org/10.1201/9780429258589
Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N, Dan B et al. (2005). Proposed definition and classification of cerebral palsy. Developmental Medicine & Child Neurology. 47(8): 571-6. https://doi.org/10.1017/S001216220500112X; PMid:16108461
Brehher K, Kampoy K, Kolomb V, Deksi T, Domellof M, Fʹyutrell M et al. (2013). Vitamin D in the Healthy European Pediatric Population. Zhurnal dytyachoyi hastroenterolohiyi ta kharchuvannya. 56: 692-701. https://doi.org/10.1097/MPG.0b013e31828f3c05; PMid:23708639
Cloake T, Gardner A. (2016). The management of scoliosis in children with cerebral palsy: a review. Journal of spine surgery (Hong Kong). 2(4): 299-309. https://doi.org/10.21037/jss.2016.09.05; PMid:28097247 PMCid:PMC5233861
Davis E, Shelly A, Waters E, Davern M. (2010). Measuring the quality of life of children with cerebral palsy: comparing the conceptual differences and psychometric properties of three instruments. Developmental Medicine & Child Neurology. 52(2): 174-180. https://doi.org/10.1111/j.1469-8749.2009.03382.x; PMid:19549193
Eliasson AC, Krumlinde-Sundholm L, Rösblad B, Beckung E, Arner M, Ohrvall AM et al. (2006). The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Developmental Medicine & Child Neurology. 48(7): 549-54. PMID: 16780622. https://doi.org/10.1111/j.1469-8749.2006.tb01313.x
Fisher RA. (1992). Statistical Methods for Research Workers. In: Kotz, S., Johnson, N.L. (eds) Breakthroughs in Statistics. Springer Series in Statistics. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-4380-9_6
Gray L, Ng H, Bartlett D. (2010). The gross motor function classification system: an update on impact and clinical utility. Pediatric Physical Therapy. 22(3): 315-320. https://doi.org/10.1097/PEP.0b013e3181ea8e52; PMid:20699783
Hidecker MJ, Paneth N, Rosenbaum PL, Kent RD, Lillie J, Eulenberg JB et al. (2011). Developing and validating the Communication Function Classification System for individuals with cerebral palsy. Developmental Medicine & Child Neurology. 53(8): 704-710. https://doi.org/10.1111/j.1469-8749.2011.03996.x; PMid:21707596 PMCid:PMC3130799
Kyryk OV. (2023). Current trends in individual rehabilitation programs for children with cerebral palsy: a crucial step towards improving quality of life (literature review). Modern Pediatrics. Ukraine. 7(135): 94-104. https://doi.org/10.15574/SP.2023.135.94
Kyryk OV, Nazar OV. (2024). International practices in diagnosing the level of functioning of children with cerebral palsy (literature review). Modern Pediatrics. Ukraine. 4(140): 83-92. https://doi.org/10.15574/SP.2024.140.83
Kyryk OV, Nazar OV. (2024). Comparative assessment of quality of life and functional status of children with cerebral palsy according to their early treatment. Modern Pediatrics. Ukraine. 6(142): 79-87. https://doi.org/10.15574/SP.2024.6(142).7987
McConnell D, Savage A. (2015). Stress and Resilience Among Families Caring for Children with Intellectual Disability: Expanding the Research Agenda. Current Developmental Disorders Reports. 2: 100-109. https://doi.org/10.1007/s40474-015-0040-z
Morgan C, Fetters L, Adde L, Badawi N, Bancale A, Boyd RN et al. (2021). Early Intervention for Children Aged 0 to 2 Years With or at High Risk of Cerebral Palsy: International Clinical Practice Guideline Based on Systematic Reviews. JAMA Pediatrics. 175(8): 846-858. https://doi.org/10.1001/jamapediatrics.2021.0878; PMid:33999106 PMCid:PMC9677545
Nazar OV. (2012). Quality of Life Assessment in Children with Cerebral Palsy. Ukrainian Journal of Psychoneurology. 20(3): 125.
Novak I, McIntyre S, Morgan C, Campbell L, Dark L, Morton N et al. (2013). A systematic review of interventions for children with cerebral palsy: state of the evidence. Developmental Medicine & Child Neurology. 55(10): 885-910. https://doi.org/10.1111/dmcn.12246; PMid:23962350
Novak I, Morgan C, Adde L, Blackman J, Boyd RN, Brunstrom-Hernandez J et al. (2017). Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy: Advances in Diagnosis and Treatment. JAMA Pediatrics. 171(9): 897-907. https://doi.org/10.1001/jamapediatrics.2017.1689; PMid:28715518 PMCid:PMC9641643
Novak I, Morgan C, Fahey M, Finch-Edmondson M, Galea C, Hines A et al. (2020). State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy. Current Developmental Disorders Reports. 20(2): 3. https://doi.org/10.1007/s11910-020-1022-z; PMid:32086598 PMCid:PMC7035308
Palisano RJ, Rosenbaum P, Bartlett D, Livingston MH. (2008). Content validity of the expanded and revised Gross Motor Function Classification System. Developmental Medicine & Child Neurolog. 50(10): 744-750. https://doi.org/10.1111/j.1469-8749.2008.03089.x; PMid:18834387
Rosenbaum P, Stewart D. (2004). The World Health Organization International Classification of Functioning, Disability, and Health: a model to guide clinical thinking, practice and research in the field of cerebral palsy. Seminars in Pediatric Neurology. 11(1): 5-10. https://doi.org/10.1016/j.spen.2004.01.002; PMid:15132248
Shapiro SS, Wilk MB. (1965). An analysis of variance test for normality (complete samples). Biometrika. 52(3-4): 591-611. https://doi.org/10.1093/biomet/52.3-4.591
Shrader MW, Wimberly L, Thompson R. (2019). Hip Surveillance in Children With Cerebral Palsy. The Journal of the American Academy of Orthopaedic Surgeons. 27(20): 760-768. https://doi.org/10.5435/JAAOS-D-18-00184; PMid:30998565
Sullivan PB, Juszczak E, Bachlet AM, Lambert B, Vernon-Roberts A, Grant HW et al. (2005). Gastrostomy tube feeding in children with cerebral palsy: a prospective, longitudinal study. Developmental Medicine & Child Neurology. 47(2): 77-85. https://doi.org/10.1017/S0012162205000162; PMid:15707230
Varni JW, Seid M, Rode CA. (1999). The PedsQL: measurement model for the pediatric quality of life inventory. Medical Care. 37(2): 126-139. https://doi.org/10.1097/00005650-199902000-00003; PMid:10024117
Verkhovna Rada Ukrayiny. (2021). Pro reabilitatsiyu u sferi okhorony zdorovya. Zakon Ukrayiny 2021 Hruden 15, No. 1962-IX. URL: https://zakon.rada.gov.ua/laws/show/1053-20#Text.
World Health Organization & United Nations Children's Fund (UNICEF) (2012). Early childhood development and disability: a discussion paper. Geneva: World Health Organization. URL: https://iris.who.int/handle/10665/75355.
World Health Organization. (2007). International Classification of Functioning, Disability, and Health: Children & Youth Version: ICF-CY. Geneva: WHO: 351.
World Medical Association (2013). World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 310(20): 2191-4. https://doi.org/10.1001/jama.2013.281053; PMid:24141714
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