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Clinical Diagnosis and Personalized Treatment of Cerebral Palsy
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Clinical Diagnosis and Personalized Treatment of Cerebral Palsy

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Methodology, Drug and Device Discovery".

Deadline for manuscript submissions: closed (1 June 2021) | Viewed by 17280

Special Issue Editors

Dr. Robert E. Akins

E-Mail Website
Guest Editor
Nemours Biomedical Research, Center for Pediatric Clinical Research & Development, 200 Powder Mill Road, Wilmington, DE, USA
Interests: bioengineering/biomedical engineering; cardiology; cell biology; diagnostics development; genomics/metabolomics/proteomics; imaging/applied physics; materials science, polymers, plastics, implants; cerebral palsy; spasticity; motor function; neuroscience physiology stem cells and regenerative medicine
Prof. Dr. M. Wade Shrader

E-Mail Website
Guest Editor
Department of Orthopedic Surgery, Alfred I. Dupont Institute, Wilmington, DE 19803, USA
Interests: cerebral palsy; neuromuscular; scoliosis; hip osteotomy; single event multi-level surgery; posterior spine fusion
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The clinical management of patients with cerebral palsy (CP) is often challenging due to the complex nature of the condition and difficulties in identifying affected children early in life. Recent advances in genomics, cell and tissue physiology, biomechanics, imaging technologies, and integrated therapeutic approaches have opened dramatic new possibilities for improving diagnosis, clinical care, and quality of life for individuals with CP. For this Issue of the Journal of Personalized Medicine, we seek articles from a broad range of disciplines that address the early identification of CP, targeted medical and surgical care, personalized therapeutic and rehabilitative pathways, and precision medical approaches for all types of cerebral palsy. We are particularly interested in findings that expand the potential for targeted care early in life and personalized interventions across the lifespan.

Prof. Robert E. Akins
Prof. M. Wade Shrader
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cerebral palsy (CP)
  • personalized therapeutic
  • rehabilitative pathways

Published Papers (5 papers)

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Research

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10 pages, 580 KiB  
Article
The Ability to Run in Young People with Cerebral Palsy before and after Single Event Multi-Level Surgery
by Roman Rethwilm, Harald Böhm, Leonhard Döderlein, Peter A. Federolf and Chakravarthy U. Dussa
J. Pers. Med. 2021, 11(7), 660; https://doi.org/10.3390/jpm11070660 - 14 Jul 2021
Viewed by 1994
Abstract
The objective of the study is to identify and evaluate possible factors that influence the ability to run before and after single event multi-level surgery (SEMLS). Young patients (6–25 years) with spastic cerebral palsy (GMFCSI-II) were retrospectively included. Type and number of surgical [...] Read more.
The objective of the study is to identify and evaluate possible factors that influence the ability to run before and after single event multi-level surgery (SEMLS). Young patients (6–25 years) with spastic cerebral palsy (GMFCSI-II) were retrospectively included. Type and number of surgical procedures, time for recovery and 3D gait analysis variables were analyzed with respect to the ability to run. In total, 98 patients (38 females; 60 males) who received SEMLS (12 years, SD 3.4) were included and compared to a control group of 71 conservatively treated patients. Of 60 runners pre-surgery, 17 (28%) lost the ability, while gained in 8 of 38 (21%) non-runners. The number of surgical procedures was a significant predictor and those who lost their ability to run had significantly more (mean = 5.9, SD = 1.7), compared to the patients who gained the ability (mean = 3.5, SD = 0.9). Further, pre-surgical function (e.g., gait speed) was significantly different (p < 0.001). Pre-surgical function and the number of surgical procedures seem to play an important role for the gain or loss of the ability to run after surgery. Caution is warranted in patients with lower pre-surgical function and the ability to run, as they seem at a higher risk to lose the ability. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Personalized Treatment of Cerebral Palsy)
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23 pages, 453 KiB  
Article
Needs of Families with Children with Cerebral Palsy in Latvia and Factors Affecting These Needs
by Dace Bertule and Anita Vetra
J. Pers. Med. 2020, 10(3), 139; https://doi.org/10.3390/jpm10030139 - 22 Sep 2020
Cited by 1 | Viewed by 2504
Abstract
In order to provide targeted support to families who are raising children with developmental disorders, it is important to study the family needs and to understand circumstances that may affect them. The aim of this study was to identify the needs of the [...] Read more.
In order to provide targeted support to families who are raising children with developmental disorders, it is important to study the family needs and to understand circumstances that may affect them. The aim of this study was to identify the needs of the families with preschool children with cerebral palsy, and study how these needs relate to factors associated with families, children and rehabilitation services. Descriptive analysis showed that families living in Latvia most often need information, social and financial support and coordination of services, and they also need financial support to cover the costs of child care and treatment. The results of the data analysis support the hypothesis that factors characterising families, children with cerebral palsy and rehabilitation services affect the needs of the families with preschool children with cerebral palsy living in Latvia, and the unique impact of these factors depends on the type of needs. Regression analysis revealed that the most important factors affecting the needs of families were related with the socio-economic situation, as well as the support of peers and professionals. The availability and regularity of rehabilitation services, limitations to the child’s functions and health impairments were factors that affected family needs to a lesser extent. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Personalized Treatment of Cerebral Palsy)
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Review

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21 pages, 389 KiB  
Review
An Emerging Role for Epigenetics in Cerebral Palsy
by Brigette Romero, Karyn G. Robinson, Mona Batish and Robert E. Akins
J. Pers. Med. 2021, 11(11), 1187; https://doi.org/10.3390/jpm11111187 - 12 Nov 2021
Cited by 7 | Viewed by 2757
Abstract
Cerebral palsy is a set of common, severe, motor disabilities categorized by a static, nondegenerative encephalopathy arising in the developing brain and associated with deficits in movement, posture, and activity. Spastic CP, which is the most common type, involves high muscle tone and [...] Read more.
Cerebral palsy is a set of common, severe, motor disabilities categorized by a static, nondegenerative encephalopathy arising in the developing brain and associated with deficits in movement, posture, and activity. Spastic CP, which is the most common type, involves high muscle tone and is associated with altered muscle function including poor muscle growth and contracture, increased extracellular matrix deposition, microanatomic disruption, musculoskeletal deformities, weakness, and difficult movement control. These muscle-related manifestations of CP are major causes of progressive debilitation and frequently require intensive surgical and therapeutic intervention to control. Current clinical approaches involve sophisticated consideration of biomechanics, radiologic assessments, and movement analyses, but outcomes remain difficult to predict. There is a need for more precise and personalized approaches involving omics technologies, data science, and advanced analytics. An improved understanding of muscle involvement in spastic CP is needed. Unfortunately, the fundamental mechanisms and molecular pathways contributing to altered muscle function in spastic CP are only partially understood. In this review, we outline evidence supporting the emerging hypothesis that epigenetic phenomena play significant roles in musculoskeletal manifestations of CP. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Personalized Treatment of Cerebral Palsy)
14 pages, 579 KiB  
Review
Standardized Outcomes Measures in Physical Therapy Practice for Treatment and Rehabilitation of Cerebral PALSY: A Systematic Review
by Maria Dolores Apolo-Arenas, Aline Ferreira de Araújo Jerônimo, Alejandro Caña-Pino, Orlando Fernandes, Joana Alegrete and Jose Alberto Parraca
J. Pers. Med. 2021, 11(7), 604; https://doi.org/10.3390/jpm11070604 - 26 Jun 2021
Cited by 7 | Viewed by 5964
Abstract
Cerebral palsy (CP) treatment includes physical therapy and various complementary therapies to the standard clinical treatment. However, there are not many reviews that focus on the methods used and evaluation procedures. This study aims to analyze which tools are most suitable for the [...] Read more.
Cerebral palsy (CP) treatment includes physical therapy and various complementary therapies to the standard clinical treatment. However, there are not many reviews that focus on the methods used and evaluation procedures. This study aims to analyze which tools are most suitable for the evaluation and methodology of patients with CP treated with physical therapy. Following the PRISMA statement, through a PICOS strategy, PubMed/MEDLINE, Web of Science (WOS), Scopus, Science Direct, and Scielo were searched with the following terms: cerebral palsy AND (physical therapy modalities OR therapeutics) AND outcome assessment. The methodological quality of the RCTs was assessed with the Evidence Project risk of bias tool. Thirty-seven RCTs and six RCT protocols, comprising 1359 participants with different types of CP: spastic hemiplegia/paresis, spastic diplegia/paresis, and spastic CP, met the inclusion criteria, uncovering 21 variables measured through 77 different instruments and several interventions. The therapies most widely used in CP are gaming or technology-assisted therapies, aerobic training, hippotherapy, music therapy, gait training, and aquatic exercises. This study provides an overview of what the authors used in the neurorehabilitation field through procedure evaluation and checking the technological advance that began to be used. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Personalized Treatment of Cerebral Palsy)
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Other

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13 pages, 1275 KiB  
Case Report
Targeted Physical Therapy Combined with Spasticity Management Changes Motor Development Trajectory for a 2-Year-Old with Cerebral Palsy
by Corri L. Stuyvenberg, Shaaron E. Brown, Ketaki Inamdar, Megan Evans, Lin-ya Hsu, Olivier Rolin, Regina T. Harbourne, Sarah Westcott McCoy, Michele A. Lobo, Natalie A. Koziol and Stacey C. Dusing
J. Pers. Med. 2021, 11(3), 163; https://doi.org/10.3390/jpm11030163 - 27 Feb 2021
Cited by 2 | Viewed by 2898
Abstract
Therapies for children with cerebral palsy (CP) often fail to address essential components of early rehabilitation: intensity, child initiation, and an embodied approach. Sitting Together And Reaching To Play (START-Play) addresses these issues while incorporating intensive family involvement to maximize therapeutic dosage. While [...] Read more.
Therapies for children with cerebral palsy (CP) often fail to address essential components of early rehabilitation: intensity, child initiation, and an embodied approach. Sitting Together And Reaching To Play (START-Play) addresses these issues while incorporating intensive family involvement to maximize therapeutic dosage. While START-Play was developed and tested on children aged 7–16 months with motor delays, the theoretical construct can be applied to intervention in children of broader ages and skills levels. This study quantifies the impact of a broader START-Play intervention combined with Botulinum toxin-A (BoNT-A) and phenol on the developmental trajectory of a 24 month-old child with bilateral spastic CP. In this AB +1 study, A consisted of multiple baseline assessments with the Gross Motor Function Measure-66 and the Assessment of Problem Solving in Play. The research participant demonstrated a stable baseline during A and changes in response to the combination of BoNT-A/phenol and 12 START-Play sessions during B, surpassing the minimal clinically important difference on the Gross Motor Function Measure-66. The follow-up data point (+1) was completed after a second round of BoNT-A/phenol injections. While the findings suggest the participant improved his gross motor skills with BoNT-A/phenol and START-Play, further research is needed to generalize these findings. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Personalized Treatment of Cerebral Palsy)
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