Effect of VOJTA Therapy on Gross Motor Function in Children with Cerebral Palsy

Objective: To investigate the effect of VOJTA therapy on gross motor function in children with cerebral palsy. Methods: The 86 children with cerebral palsy were all from the First People’s Hospital of Jingzhou City from January 2023-December 2023, and were divided into the control group and the study group with 43 cases according to the principle of voluntariness. Results: In terms of total effective rate of treatment, the gross motor function scale-88 (GMFM-88) was used to evaluate the effective rate before and after treatment, and the effective rate of the study group was higher than that of the control group, and the difference was statistically significant, and the scores of gross motor items of GMFM-88 were better than those of the control group after treatment, and the difference was statistically significant (P 0.05). Conclusion: The application of VOJTA therapy in the treatment of children with cerebral palsy can not only promote the rehabilitation of gross motor function, but also help to improve the treatment effect, and the earlier the treatment, the better.

Precise Rehabilitation Strategies for Functional Impairment in Children with Cerebral Palsy

This paper explores the effect of precise rehabilitation strategies under the international classification of functioning,disability and health for children and youth(ICF-CY)on the motor function of children with cerebral palsy.Under the framework of ICF-CY,the observation team is designed and evaluated from physical functions,activities and participation,environmental factors,and devel-ops individualized rehabilitation strategies that are tailored to individual character-istics.The control group was assessed by traditional methods and treatment plans and measures were formulated and guided.The course of treatment was 12 months.The scores of GMFM-88,Peabody Motor Development Scale-2con-cluding fine motor quotient(PDMS-FM),WeeFIM and the ability of daily living(ADL)scale(Barthel index,BI)score were compared before and after treatment.The research shows that precise rehabilitation strategy mode for children with cer-ebral palsy under the ICF-CY framework can effectively improve the motor func-tion and the ability of daily living(ADL)in children with cerebral palsy.Rehabilitation evaluation and treatment mode of children with cerebral palsy under ICF-CY framework can effectively improve the gross motor function of children with cerebral palsy.Individualized evaluation and analysis and guidance of comprehensive rehabilitation treatment have certain advantages.The overall treatment effect is better than that of traditional rehabilitation evaluation.

Effect of Lumbar Spinal Point Injection on Sitting Function in Children with Cerebral Palsy

Objective: To observe the effect of lumbar spinal point injection on sitting function in children with cerebral palsy. Method: Sixty-two children with post-confirmed cerebral palsy were randomly divided into control group and treatment group, 31 each. The control group was given conventional rehabilitation treatment, and the treatment group was given lumbar chiropspinal acupoint injection on the basis of the treatment method of the control group. After 3 consecutive courses of treatment, the sitting score of the two groups before and after treatment (GMFM88) was used to evaluate the sitting score before and after treatment. Outcome: Before treatment, the two groups were evaluated and the differences were not statistically significant (p > 0.05), which was comparable. The two groups (GMFM88) after treatment had significantly increased the differential values, and the difference was statistically significant compared with the same group before treatment (p Conclusion: Conventional rehabilitation combined with lumbar spinal point injection can effectively improve the sitting motor function of children with cerebral palsy.

Application of core stability training in rehabilitation of motor function in children with cerebral palsy

Cerebral palsy is a syndrome caused by non-progressive brain injury and developmental defects from the start of conception until infancy. The main manifestations are dyskinesia and postural abnormalities in children. This article is to summarize the current application of core stability training in rehabilitation of children with cerebral palsy motor function, which aims to lay a foundation for clinical work and further related theoretical research.

Motor function outcomes of pediatric patients with hemiplegic cerebral palsy after rehabilitation treatment:a diffusion tensor imaging study

Previous diffusion tensor imaging(DTI) studies regarding pediatric patients with motor dysfunction have confirmed the correlation between DTI parameters of the injured corticospinal tract and the severity of motor dysfunction. There is also evidence that DTI parameters can help predict the prognosis of motor function of patients with cerebral palsy. But few studies are reported on the DTI parameters that can reflect the motor function outcomes of pediatric patients with hemiplegic cerebral palsy after rehabilitation treatment. In the present study, 36 pediatric patients with hemiplegic cerebral palsy were included. Before and after rehabilitation treatment, DTI was used to measure the fiber number(FN), fractional anisotropy(FA) and apparent diffusion coefficient(ADC) of bilateral corticospinal tracts. Functional Level of Hemiplegia scale(Fx L) was used to assess the therapeutic effect of rehabilitative therapy on clinical hemiplegia. Correlation analysis was performed to assess the statistical interrelationship between the change amount of DTI parameters and Fx L. DTI findings obtained at the initial and follow-up evaluations demonstrated that more affected corticospinal tract yielded significantly decreased FN and FA values and significantly increased ADC value compared to the less affected corticospinal tract. Correlation analysis results showed that the change amount of Fx L was positively correlated to FN and FA values, and the correlation to FN was stronger than the correlation to FA. The results suggest that FN and FA values can be used to evaluate the motor function outcomes of pediatric patients with hemiplegic cerebral palsy after rehabilitation treatment and FN is of more significance for evaluation.

Prevalence and predictors of urinary tract infections among children with cerebral palsy in Makurdi, Nigeria

Background: Children with cerebral palsy (CP) are prone to urinary tract infection (UTI), a common cause of childhood morbidity and mortality. However, there has been no report regarding the prevalence of UTI among this group of children inNigeria. Objectives: The study aims at determining the prevalence and the possible predictors of UTI in children with CP compared to age and sex matched children without CP. Methods: A prospective cross-sectional study was carried out among consecutive children with CP at the Neurologic Clinic in the Paediatric Department of the Federal Medical Centre, Makurdi, Nigeria, from December 2011 to May 2013. Results: The age range of the studied population was between 2 and 15 years with a mean age of 8.63 ± 3.83 years including 30 males and 22 females. UTI was confirmed in 20 (38.5%) children with cerebral palsy compared to 2 children (3.8%) without CP (p value 0.000). Among children with CP, Escherichia coli was the commonest organism isolated in 9 (9/20, 45.0%), Streptococcus faecalis in 4 (20.0%), Staphylococcus aureus in 3 (15%), while both Proteus spp., and Klebsiella spp., were isolated in 2 children (10.0%) each. Escherichia coli was also found in the 2 children without CP. All the organisms were resistant to co-trimoxazole, nalidixic acid, nitrofuratoin and amoxiclav, while they were 100% sensitive to ceftriazone and the quinolones. In a univariate regression, analysis only moderate to severe gross motor dysfunction predicted the risk of UTI (OR = 54.81, 95%CI, 2.27 - 1324.00, p value 0.014). Conclusion: Efforts should be put in place to aid mobility among children with CP in order to reduce risk of UT.

Gait analysis of children with spastic hemiplegic cerebral palsy

An experiment was carried out in the key laboratory for Technique Diagnosis and Function Assessment of Winter Sports of China to investigate the differences in gait characteristics between healthy children and children with spastic hemiplegic cerebral palsy.With permission of their parents,200 healthy children aged 3 to 6 years in the kindergarten of Northeastern University were enrolled in this experiment.Twenty children aged 3 to 6 years with spastic hemiplegic cerebral palsy from Shengjing Hospital,China were also enrolled in this experiment.Standard data were collected by simultaneously recording gait information from two digital cameras.DVracker was used to analyze the standard data.The children with hemiplegic cerebral palsy had a longer gait cycle,slower walking speed,and longer support phase than did the healthy children.The support phase was longer than the swing phase in the children with hemiplegic cerebral palsy.There were significant differences in the angles of the hip,knee,and ankle joint between children with cerebral palsy and healthy children at the moment of touching the ground and buffering,and during pedal extension.Children with hemiplegic cerebral palsy had poor motor coordination during walking,which basically resulted in a short stride,high stride frequency to maintain speed,more obvious swing,and poor stability.

Association of therapeutic occasion, gross motor function grading and developmental level with gross motor functional recovery in children with cerebral palsy

BACKGROUND: The abnormal posture and motor pattern have not stabilized in children with cerebral palsy at early period, thus timely treatment can establish normal postural reflex and motor pattern, and prevent complications of muscle contracture, ankylosis, skeletal deformity, etc. The clinical factors affecting the rehabilitative efficacy of gross motor function in children with cerebral palsy should be observed. OBJECTIVE: To observe the effects of therapeutic occasion, grading of gross motor function and developmental level on the rehabilitative efficacy in children with cerebral palsy. DESIGN: A case-controlled analysis. SETTING: Qilu Children's Hospital of Shandong University. PARTICIPANTS: Totally 138 children with cerebral palsy, who were hospitalized for 12 months in the Rehabilitation Center of Qilu Children's Hospital, Shandong University, were selected from April 2004 to September 2006, and all the children were diagnosed to be accorded with the standard set by the national seminar on cerebral palsy in 2004. There were 97 males and 41 females, including 55 cases of 0-2 years old, 47 cases of 2-4 years and 36 cases of 4-6 years. Informed contents were obtained from relatives of all the children. METHODS: ① Comprehensive rehabilitation treatment: Vojta method was to induce the children to turn over the body and crawl by stimulating reflective turn over and crawling on belly. Bobath method including trainings of head control, turning over body, keeping sitting position, keeping balance, crawling, keeping standing position, and walking, etc.; The children were massaged by using the maneuvers of push, press, rub, pull, wave, etc. according to the sites and types of palsy. Acupuncture was performed mainly at bilateral motor areas, the needle was retained for 1 hour per time, 6 days continuously every week, and followed by a 1-day interval. ② Prognosis assessment: The gross motor functional grading of the children with cerebral palsy at admission was assessed using the Chinese version of gross motor function classification system (GMFCS). The gross motor functions of the children with cerebral palsy were assessed before rehabilitation treatment and 12 months after rehabilitation treatment by using gross motor function measure (GMFM). The improved GMFM total score was calculated. Developmental quotient was evaluated using Gesell developmental schedules (GDS) after 12-month rehabilitation treatment. Univariate analysis of variance was performed using the improved GMFM total score with age, GMFCS grade and developmental level (developmental quotient). MAIN OUTCOME MEASURES: Effects of age started to accept rehabilitation treatment, GMFCS grade and developmental level on the recovery of gross motor function in children with cerebral palsy. RESULTS: All the 138 children with cerebral palsy were involved in the analysis of results. The improved GMFM total scores were significantly different among the children with cerebral palsy of different ages started to accept treatment, GMFCS grades and developmental levels (F=13.464, 37.283, 30.814, P < 0.01). The younger the children started to accept treatment, the lower the their GMFCS grades and the higher their developmental levels, then the higher their improved GMFM total scores. CONCLUSION: The recovery of gross motor function is better in younger children started to accepted treatment with cerebral palsy with lower GMFCS grades and higher developmental levels.

Analysis of orthopedic surgical procedures in children with cerebral palsy

BACKGROUND Orthopedic surgery in children with cerebral palsy(CP)aims to improve function and prevent deformities.Each child’s condition in CP is unique and many covariables influence surgical decision-making including a patient's age and their functional level.Little is known about the frequency of different types of orthopedic surgery in children with CP who have varied functional levels,particularly in countries from Latin America.AIM To assess the type of orthopedic surgical procedures in relation to age and gross motor function in children with CP.METHODS This retrospective study included all children with CP(n=245)treated with elective orthopedic surgery at a Uruguayan university hospital between October 2010 and May 2016 identified from a surgical database.Eighteen children(7%)were lost to follow-up due to missing medical charts.Demographics,gross motor function classification(GMFCS),and orthopedic surgeries were obtained from the medical records of 227 children.Chi-squared tests and analysis of variance were used to assess the frequency of surgery,accounting for GMFCS levels.Mean age for soft tissue vs bone surgery was compared with the independent samples t-test.RESULTS A total of 711 surgical procedures were performed between 1998 and 2016.On average,children had 3.1 surgical procedures and the mean age at first surgery was 8.0 years.There were no significant differences in age at first surgery among GMFCS levels(P=0.47).The most common procedures were lower leg soft tissue surgery(n=189,27%),hip tenotomy(n=135,19%),and hamstring tenotomy(n=104,14%).For children with GMFCS level Ⅰ,the mean number of surgeries per child[1.8(range 1-9)]differed significantly at P<0.05 in children with GMFCS levels Ⅱ[3.2(1-12)],Ⅲ[3.2(1-8)],Ⅳ[3.3(1-13)],and Ⅴ[3.6(1-11)].Within Ⅱ,Ⅲ,Ⅳ,and Ⅴ,there was no significant difference in mean number of surgeries per child when comparing across the groups.The proportion of soft tissue surgery vs bone surgery was higher in GMFCS levels Ⅰ-Ⅲ(80%-85%)compared to levels IV(68%)and V(55%)(P<0.05).CONCLUSION The frequency of surgical procedures per child did not increase with higher GMFCS level after level Ⅰ.However,the proportion of bone surgery was higher in GMFCS levels Ⅳ-Ⅴ compared to Ⅰ-Ⅲ.

Therapies for children with cerebral palsy A Web of Science-based literature analysis

OBJECTIVE: To identify global research trends in three therapies for children with cerebral palsy. DATA RETRIEVAL: We performed a bibliometric analysis of studies on therapies for children with cerebral palsy from 2002 to 2011 retrieved from Web of Science. SELECTION CRITERIA: Inclusion criteria: (a) peer-reviewed published articles on botulinum toxin, constraint-induced movement therapy, or acupuncture for children with cerebral palsy indexed in Web of Science; (b) original research articles, reviews, meeting abstracts, proceedings papers, book chapters, editorial material, and news items; and (c) publication between 2002 and 2011. Exclusion criteria: (a) articles that required manual searching or telephone access; (b) documents that were not published in the public domain; and (c) a number of corrected papers from the total number of articles. MAIN OUTCOME MEASURES: (1) Number of publications on the three therapies; (2) annual publication output, distribution by journals, distribution by institution, and top-cited articles on botulinum toxin; (3) annual publication output, distribution by journal, distribution by institution, and top-cited articles on constraint-induced movement therapy; (4) annual publication, distribution by journal, distribution by institution, and top-cited articles on acupuncture. RESULTS: This analysis, based on Web of Science articles, identified several research trends in studies published over the past 10 years of three therapies for children with cerebral palsy. More articles on botulinum toxin for treating children with cerebral palsy were published than the articles regarding constraint-induced movement therapy or acupuncture. The numbers of publications increased over the 10-year study period. Most papers appeared in journals with a focus on neurology, such as Developmental Medicine and Child Neurology and Journal of Child Neurology.Research institutes publishing on botulinum toxin treatments for this population are mostly in the Netherlands, the United States of America, and Australia; those publishing on constraint-induced movement therapy are mostly in Australia and the United States of America; and those publishing on acupuncture are mostly in China, Sweden and the United States of America.CONCLUSION: Analysis of literature and research trends indicated that there was no one specific therapy to cure cerebral palsy. Further studies are still necessary.

Effects of the Neurodevelopmental Treatment (NDT) on the Mobility of Children with Cerebral Palsy

The purpose of the present study was to examine the effectiveness of the NDT method (Bobath) in children with CP. Twenty children with cerebral palsy (7 with quadriplegia, 6 with diplegia and 7 with right hemiplegia), with mean age of 4. 85 ± 2. 49 years, took part in the study. Materials-Method: The children participated in an intervention that consisted of an 8-week Bobath program. GMFM-88, PEDI and TUG scores were measured across three time points during the intervention (a baseline measurement, a second at the end of the intervention and a post-intervention measurement one month after the end of the intervention). Results: The results of the NDT intervention showed that the participant children significantly improved their GMFM-88 and TUG scores between initial and final measurement and maintained this one month later (F2,36 = 69,778, p 0.001), while in PEDI the intervention program had no statistically significant effect (F2,36 = 0.844, p = 0.438). In conclusion, there is strong evidence of the effectiveness of the NDT (Bobath) method in improving the mobility of children regardless of the frequency of its application.

Efficacy of Physiotherapy and Conductive Education in Improving Motor Skills and Mental Function in Children with Cerebral Palsy

Background: Children with Cerebral Palsy (CP) often receive physiotherapy to achieve maximum motor potential and prevent secondary conditions. Conductive Education (CE) is an education programme that combines special education and rehabilitation. Purpose: Study the effect of physiotherapy and conductive education in development of fine, gross motor skills and mental function in the children with CP. Subjects and Methods: This is a prospective case study that was carried out on 105 children with CP less than 4 years old selected from outpatient clinic in National Institute for Neuro Motor System. Cases were taken consecutively from February 2019 to September 2019. A written informed consent was taken from all participants after proper explanation of the study. They were classified into three groups (group I, group II and group III) according to their age. All children are subjected to complete history taking, clinical examination, use of developmental quotient (DQ) sheet before and after 6 months of regular physiotherapy and conductive education program. Results: There was statistically significant improvement in fine motor, cognation and gross motor in 3 groups after 6 months of regular physiotherapy and conductive education program. The maximum improvement was in group I, so children with cerebral palsy were achieved maximum improvement when physiotherapy and conductive education started as early as possible. Conclusion: Significant improvement has in fine motor, cognation and gross motor in 3 groups after 6 months of regular physiotherapy and conductive education program. Early start physiotherapy and conductive education program gave us better outcome.

Clinical Observation of Double Tube Laryngeal Mask in Fast-Track Anesthesia for Limb Orthopedic Surgery in Children with Cerebral Palsy

Objective: To compare and analyze the effect and safety of double tube laryngeal mask and endotracheal intubation general anesthesia in fast track anesthesia for limb orthopaedic surgery in children with cerebral palsy. Methods: 78 children with cerebral palsy undergoing limb orthopedic surgery were randomly divided into laryngeal mask group and intubation group, with 39 cases in each group. The perioperative hemodynamic indexes, anesthesia effect related indexes, anesthesia related complications or adverse reaction rates of the two groups were observed and compared between the two groups. Results: When the two groups of children entered the room, there was no significant difference in MAP and HR (P > 0.05);MAP and HR of children in the intubation group were higher than those in the laryngeal mask anesthesia group (P Conclusion: Laryngeal mask is used to establish the airway of intravenous general anesthesia in limb orthopaedic surgery of children with cerebral palsy, which is conducive to the stability of children’s circulatory and respiratory system, to reduce the impact of narcotic drugs on children, to reduce the incidence of postoperative anesthesia related complications, and to improve the anesthetic effect. It meets the requirements of fast track anesthesia, and can be widely used in clinical practice.

Research progress regarding the nutritional status and assessment methods of cerebral palsy patients

Cerebral palsy is a group of clinical disorders characterized by persistent central motor deficits and postural abnormalities due to non-progressive damage to the fetal or infant brain.Malnutrition is one of the most common clinical comorbidities in children with cerebral palsy and is the result of a combination of internal factors,such as the child’s structural and functional abnormalities,and external factors,such as the child’s feeding habits and family/social factors.The nutritional status of children with cerebral palsy is closely related to their development,quality of life,social participation,and life expectancy;thus,an objective and accurate understanding of the nutritional status of these children through rehabilitation assessment is essential for their growth and development.The current nutritional assessments include routine measurements of human nutritional parameters,scale-based assessments,and instrumental assessments.It is important to detect malnutrition in children with cerebral palsy at an early stage,reduce the prevalence of malnutrition,and improve the quality of survival.Therefore,this review aimed to analyze and summarize the nutritional status and assessment methods of children with cerebral palsy,to assess the nutritional status of children with cerebral palsy from multiple perspectives,indicators and directions,and to provide reference for the early detection of co-morbid malnutrition in children with cerebral palsy.

Design of a DSLM-based cerebral palsy action rehabilitation training system

Based on domain specified language mechanism(DSLM),the architecture of the robotic training system for the rehabilitation of children with cerebral palsy(CP)is designed.Application of human-computer interaction(HCI)motion recognition technology is combined with Kinect to improve the effect of cerebral palsy rehabilitation training.In this system,Kinect's bone recognition method is used to judge the patient's training movements,and the collected bone movement information is judged.The human-computer interaction function is based on the Microsoft foundation classes function of Visual Studio based on DSLM development,which can realize real-time interactive training and evaluation of people and actions,and record the training information of patients.The system combines the designed small game to train the upper limb movement ability and reaction ability of the cerebral palsy patient,and provides key technology for improving the cerebral palsy rehabilitation training system.

Ultrasound guided neural stem cell transplantation through the lateral ventricle for treatment of cerebral palsy in children

A total of 24 children with cerebral palsy were enrolled in this study and underwent ultrasound guided transplantation of neural stem cells through the lateral ventricle. Neural stem cells (3.8 × 106-7.3 × 107) were injected into the lateral ventricles. Mild injury of lateral ventricular blood vessels occurred in only two cases (8.3%). Seven cases (29.2%) experienced a fever. Clinical manifestations were improved to varying degrees in eight cases (28.0%) within 3 months after transplantation. Patient condition did not worsen, and no patient experienced severe adverse reactions.

Addition of respiratory exercises to conventional rehabilitation for children and adolescents with cerebral palsy:a systematic review and meta-analysis

Background Respiratory dysfunctions are an important cause of morbidity and death in cerebral palsy(CP)populations.Respiratory exercises in addition to conventional rehabilitation have been suggested to improve respiratory status in CP patients.The objective of this systematic review and meta-analysis was to verify the effects of the addition of respiratory exercises to conventional rehabilitation on pulmonary function,functional capacity,respiratory muscle strength,gross motor function and quality of life in children and adolescents with CP.Methods We searched for randomized controlled clinical trials in PubMed/Medline,Lilacs,SciELO,EMBASE and Physi-otheraphy Evidence(PEDro)from their inception until July 2022 without language restrictions.Studies that included respiratory exercises(breathing exercise program;feedback respiratory training;incentive spirometer exercise;inspiratory muscle training;and combination of respiratory exercises+incentive spirometer exercise)in combination with conventional rehabilitation for children and adolescents with CP were evaluated by two independent reviewers.The mean difference(MD)and 95%confidence interval(CI)were estimated by random effect models.Results Ten studies met the eligibility criteria,including 324 children aged from 6 to 16 years.The meta-analysis showed an improvement in inspiratory muscle strength of 22.96 cmH2O(18.63-27.27,n=55)and pulmonary function of 0.60(0.38-0.82,n=98)for forced vital capacity(L);0.22(0.06-0.39,n=98)for forced expiratory volume at 1 second(L);and 0.50(0.05-0.04,n=98)for peak expiratory flow(L/min).Functional skills in daily living activities improved in the intervention group.Caregivers'assistance of daily living activities,functional capacity,gross motor function and expiratory muscle strength showed a nonsignificant improvement.Social well-being and acceptance and functioning domains improved in only one study.Conclusions Emerging data show significant enhancements in inspiratory muscle strength and pulmonary function in CP patients after respiratory training in addition to conventional rehabilitation.There is no consensus on the frequency,type or intensity of respiratory exercises for children with and adolescents with CP.

Acupuncture for cerebral palsy: a meta-analysis of randomized controlled trials

OBJECTIVE: To evaluate the efficacy and safety of acupuncture therapy for children with cerebral palsy. DATA SOURCES: We conducted electronic searches of PUBMED(1950/2017), EMBASE(1974/2017), Science Direct(1986/2017), Academic Source Premier(1887/2017), the Cochrane Library(Issue 4, April 2017), Science Citation Index Expanded(1900/2017), China National Knowledge Infrastructure(1915/2017), China Biological Medicine(1990/2017-04), Wan Fang(1980/2017), VIP(1989/2017), and Chinese Science Citation Database(1989/2017). DATA SELECTION: We included randomized controlled trials that aimed to compare the effect of acupuncture plus rehabilitation training versus rehabilitation training alone. Data about functional motor abilities, daily activity/social participation, effective rate, intellectual development, and adverse effects were included. We used Revman 5.2 software for statistical analysis. OUTCOME MEASURES: The primary outcomes included functional motor abilities, daily activity, and effective rate. The secondary outcomes included intellectual development and adverse effects.RESULTS: Twenty-one studies with a total of 1718 participants met the inclusion criteria. The effect size of gross motor function(SMD = 0.64, 95% CI: 0.52 to 0.76, P < 0.00001; I^2 = 0%, P = 0.69; in 13 studies with 1144 patients) and the total effective rate(RR = 1.28, 95% CI: 1.20 to 1.37, P < 0.00001; I^2 = 18%, P = 0.27; in 12 studies with 1106 patients) suggested that acupuncture plus rehabilitation produced a significant improvement in gross motor function and a high total effective rate. The pooled fine motor function(SMD = 3.48, 95% CI: 2.62 to 4.34, P < 0.00001; I^2 = 64%, P = 0.10; in 2 studies with 193 patients), modified Ashworth scale scores(SMD = –0.31, 95% CI: –0.52 to –0.11, P = 0.003; I^2 = 74%, P = 0.004; in 5 studies with 363 patients) and activities of daily living(SMD = 1.45, 95% CI: 1.20 to 1.71, P < 0.00001; I^2 = 78%, P = 0.004; in 4 studies with 313 patients) also indicated improvements in children with cerebral palsy. Publication bias was not observed. Only mild adverse events related to acupuncture were reported. CONCLUSION: Acupuncture plus rehabilitation training improved gross motor function, reduced muscle spasms, and enhanced daily life activities in children with cerebral palsy. However, this conclusion should be interpreted with caution due to the small number of randomized controlled trials available and the small sample sizes. More high-quality and large-scale studies are needed.

Mothers’challenges and experiences of children with cerebral palsy:a qualitative meta-synthesis

Objective:To examine what challenges and experiences a mother faces in caring for children with cerebral palsy(CP).As the main caregiver of children with CP,mothers are under multiple pressures.Even though mothers’challenges and experiences of children with CP will affect their quality of life and the rehabilitation of the children,little is known about their challenges and experiences during the whole care.Methods:A qualitative meta-synthesis was conducted to extract and analyze qualitative research from the PubMed,CINAHL,PsycINFO,Web of Science,Ovid and MEDLINE databases.Thirteen articles were selected and analyzed using thematic syntheses.Results:From 2522 screened abstracts,84 texts were reviewed,and 13 studies met the inclusion criteria.Mothers’challenges and experiences of children with CP include 4 themes,both positive and negative.Conclusions:The mothers of children with CP suffer from physical burden,as well as psychological pressure,in the care experience;social and healthcare support are their main challenges.Interventions to help them face the difficulties and adapt to the role of caregivers as soon as possible should target multiple aspects in order to maximize effectiveness,to promote the healthy growth of children with CP.