Assessment of the functional capacity of patients with cerebral palsy secondary to a treatment with botulinum A toxin and post-surgical rehabilitation treatment
Keywords:
Cerebral palsy, botulinum toxin, postoperative rehabilitation, functional capacity, PEDI-CAT, GMFCSAbstract
Cerebral palsy is the leading cause of disability in children and care in the Division of Pediatric Rehabilitation at the National Institute of Rehabilitation. Objective: To evaluate changes programs. Methodology: Hospitalized children were enrolled in the study in the Hospitalization in functional capacity of patients with cerebral palsy enrolled in two intensive rehabilitation Unit for Pediatric Rehabilitation divided into two treatment groups: after application of botulinum toxin A and post-orthopedic surgical treatment, functional capacity was evaluated by applying the instrument Evaluation of Disability Inventory Computerized Adaptive Test, hospital admission, at discharge and three weeks after discharge, the effects of the rehabilitation program were analyzed. Results: 85 patients were studied, with an average age of 7.5 years, found that spastic diparesis was the most frequent topographical, patients classified as outpatients in the group of intensive rehabilitative postsurgical treatment scored better on the PEDICAT in 3 times evaluative, with statistically significant changes in activities of social/cognitive daily life and mobility. Conclusions: The pedi-CAT instrument showed high intraobserver and interobserver reliability, to assess changes in functional capacity in children with cerebral palsy. Significant improvements in the domains of pedi-CAT were tested only in outpatients incorporated into postsurgical intensive rehabilitative treatment.
References
Prevención y rehabilitación de discapacidades, PreveR- Dis, Programa Nacional de Salud (2001-2006).
García D. Instrumentos de funcionalidad en niños con discapacidad: Una comparación descriptiva entre The Functional Independence Measure of Children
(WeeFIM) y The Pediatric Evaluation of Disability Inven-
tory (PEDI). Rehabil Integral. 2011; 6: 79-86.
Haley SM, Raczek AE, Coster WJ, Dumas HM, Fragala- Pinkham MA. Assessing mobility in children using a com- puter adaptive testing version of the pediatric evaluation of disability inventory. Arch Phys Med Rehabil. 2005; 86
(5): 932-939.
Berg M, Jahnsen R, Frøslie KF, Hussain A. Reliability
of the pediatric evaluation of disability inventory (PEDI).
Phys Occup Ther Pediatr. 2004; 24 (3): 61-77.
Sánchez R, Echevery J. Validación de escalas de medición en salud. Rev Salud Pública. 2004; 6: 302-318. 6. García de Yebebes MJ, Rodríguez-Salvanes F, Ortells- Loreto C. Validación de cuestionarios. Reumatol Clin.
; 5: 171-177.
Haley SM, Coster WI, Kao YC, Dumas HM, Fragala-
Pinkham MA, Kramer JM et al. Lessons from use of the Pediatric Evaluation of Disability Inventory: where do we go from here? Pediatr Phys Ther. 2010; 22 (1): 69-75.
Krigger KW. Cerebral palsy: an overview. Am Fam Physician. 2006; 73 (1): 91-100.
Santamaría-Vázquez M, Guijo-Blanco V. Evaluación de la discapacidad en la infancia. International Journal of Developmental and Educational Psychology. 2012; 1: 133-140.
Wassenberg-Severijnen JE, Custers JW, Hox JJ, Ver- meer A, Helders PJ. Reliability of the Dutch pediatric evaluation of disability inventory (PEDI). Clin Rehabil. 2003; 17 (4): 457-462.
Feldman AB, Haley SM, Coryell J. Concurrent and construct validity of the Pediatric Evaluation of Disability Inventory. Phys Ther. 1990; 70 (10): 602-610.
Dumas HM, Fragala-Pinkham MA, Feng T, Haley SM. A preliminary evaluation of the PEDI-CAT Mobility item bank for children using walking aids and wheelchairs. J Pediatr Rehabil Med. 2012; 5 (1): 29-35.
KramerJM,LiljenquistK,CosterWJ.Validity,reliability, and usability of the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test for autism spectrum disorders. Dev Med Child Neurol. 2016; 58 (3): 255-261.
Berg MM, Dolva AS, Kleiven J, Krumlinde-Sundholm L. Normative scores for the pediatric evaluation of disability inventory in Norway. Phys Occup Ther Pediatr. 2016; 36 (2): 131-143.
Mancini MC, Coster WJ, Amaral MF, Avelar BS, Freitas R, Sampaio RF. New version of the Pediatric Evaluation of Disability Inventory (PEDI-CAT): trans-
lation, cultural adaptation to Brazil and analyses of
psychometric properties. Braz J Phys Ther [Internet].
[cited 2016 June 29]. Available from: http://www. scielo.br/scielo.php?script=sci_arttext&pid=S1413- 35552016005008105&lng=en. In press 2016. Epub June 16, 2016. http://dx.doi.org/10.1590/bjpt-rbf.2014.0166.
Coster WJ, Haley SM, Ni P, Dumas HM, Fragala- Pinkham MA. Assessing self-care and social function using a computer adaptive testing version of the pedi-
atric evaluation of disability inventory. Arch Phys Med
Rehabil. 2008; 89 (4): 622-629.
Kramer JM, Coster WJ, Kao YC, Snow A, Orsmond
GI. A new approach to the measurement of adaptive behavior: development of the PEDI-CAT for children and youth with autism spectrum disorders. Phys Occup Ther Pediatr. 2012; 32 (1): 34-47.
pedicat.com [Internet]. Boston: CRE Care; 2010 [Actu- alizado 2013, citado 1 junio 2013]. Disponible en: www. pedicat.com.
Haley SM, Coster WJ, Dumas HM, Fragala-Pinkham MA, Moed R. PEDI-CAT Standardization and Admin- istration Manual [Internet]. Versión 1.3.6: Trustees of Boston University, under license to CREcare; 2011 [Actualizado octubre 2012, citado 1 de junio 2013]. Disponible en: http://pedicat.com/ordering/pedicat- 1-3-6-manual/
Haley SM, Coster WJ, Dumas HM, Fragala-Pinkham MA, Kramer J, Ni P, et al. Accuracy and precision of the Pediatric Evaluation of Disability Inventory computer- adaptive tests (PEDI-CAT). Dev Med Child Neurol. 2011; 53 (12): 1100-1106.
Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N, Dan B et al. Proposed definition and classification of cerebral palsy, April 2005. Dev Med Child Neurol. 2005; 47 (8): 571-576.
development of cerebral palsy. BJOG. 2003; 110 Suppl
: 124-127.
İçağasıoğlu A, Mesci E, Yumusakhuylu Y, Turgut ST,
Murat S. Rehabilitation outcomes in children with cere- bral palsy during a 2 year period. J Phys Ther Sci. 2015; 27 (10): 3211-3214.
Berker AN, Yalçin MS. Cerebral palsy: orthopedic as- pects and rehabilitation. Pediatr Clin North Am. 2008; 55 (5): 1209-1225.
Tseng MH, Chen KL, Shieh JY, Lu L, Huang CY. The determinants of daily function in children with cerebral palsy. Res Dev Disabil. 2011; 32 (1): 235-245.
Scholtes VA, Dallmeijer AJ, Knol DL, Speth LA, Maathuis CG, Jongerius PH et al. Effect of multilevel botulinum toxin a and comprehensive rehabilitation on gait in ce- rebral palsy. Pediatr Neurol. 2007; 36 (1): 30-39.
Strobl W, Theologis T, Brunner R, Kocer S, Viehweger E, Pascual-Pascual I et al. Best clinical practice in botu- linum toxin treatment for children with cerebral palsy. Toxins (Basel). 2015; 7 (5): 1629-1648.
Friedman BC, Goldman RD. Use of botulinum toxin A in management of children with cerebral palsy. Can Fam Physician. 2011; 57 (9): 1006-1073.
Delalic A. Assessment of functional independence according to the WeeFIM score in children with cere- bral palsy after postoperative rehabilitation. Annals of Physical and Rehabilitation Medicine. 2011: 54: 185-
Mutlu A, Akmese PP, Gunel MK, Karahan S, Livanelio-
glu A. The importance of motor functional levels from
the activity limitation perspective of ICF in children with
cerebral palsy. Int J Rehabil Res. 2010; 33 (4): 319-324.
Yoon BH, Romero R, Park JS, Kim CJ, Kim SH, Choi JH, Han TR. Fetal exposure to an intra-amniotic inflam- mation and the development of cerebral palsy at the age
of three years. J Perinat Med. 2002;30:301-306.
Moon JB, Kim JC, Yoon BH, Romero R, Kim G, Oh SY et al. Amniotic fluid matrix metalloproteinase-8 and the
development of cerebral palsy. BJOG. 2003; 110 Suppl
: 124-127.
İçağasıoğlu A, Mesci E, Yumusakhuylu Y, Turgut ST,
Murat S. Rehabilitation outcomes in children with cere- bral palsy during a 2 year period. J Phys Ther Sci. 2015; 27 (10): 3211-3214.
Berker AN, Yalçin MS. Cerebral palsy: orthopedic as- pects and rehabilitation. Pediatr Clin North Am. 2008; 55 (5): 1209-1225.
Tseng MH, Chen KL, Shieh JY, Lu L, Huang CY. The determinants of daily function in children with cerebral palsy. Res Dev Disabil. 2011; 32 (1): 235-245.
Scholtes VA, Dallmeijer AJ, Knol DL, Speth LA, Maathuis CG, Jongerius PH et al. Effect of multilevel botulinum toxin a and comprehensive rehabilitation on gait in ce- rebral palsy. Pediatr Neurol. 2007; 36 (1): 30-39.
Strobl W, Theologis T, Brunner R, Kocer S, Viehweger E, Pascual-Pascual I et al. Best clinical practice in botu- linum toxin treatment for children with cerebral palsy. Toxins (Basel). 2015; 7 (5): 1629-1648.
Friedman BC, Goldman RD. Use of botulinum toxin A in management of children with cerebral palsy. Can Fam Physician. 2011; 57 (9): 1006-1073.
Delalic A. Assessment of functional independence according to the WeeFIM score in children with cere- bral palsy after postoperative rehabilitation. Annals of Physical and Rehabilitation Medicine. 2011: 54: 185-204
Vasconcelos RK, Moura TL, Campos TF, Lindquist ARR, Guerra RO. Functional performance assessment of chil- dren with cerebral palsy according to motor impairment levels. Rev Bras Fisioter. 2009; 13 (5): 390-397.
Badía-Corbella M. Tendencias actuales de investigación ante el nuevo concepto de parálisis cerebral. Revista Española sobre Discapacidad Intelectual. 2007; 223: 25-38.
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