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.

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.

Clinical Study on Improving Articulation Clarity in Spastic Cerebral Palsy with 120 Cases of Oral-Facial Acupressure Combined with Oral Placement Therapy

Objective:To observe the efficacy of oral-facial acupressure combined with oral placement therapy(OPT)in improving articulation clarity in 120 children with spastic cerebral palsy,and to explore effective therapeutic solutions for speech disorders associated with spastic cerebral palsy.Methods:A total of 120 children with spastic cerebral palsy and speech disorders,meeting the inclusion criteria,were randomly assigned into two groups:60 cases in the treatment group and 60 cases in the control group.The treatment group received orofacial acupressure combined with OPT,while the control group received only OPT.The Oral Motor Function Assessment Scale(OMFAS),developed by the China Rehabilitation Research Centre(CRRC),was used to evaluate the treatment outcomes before and after the intervention.Results:After the treatment,both the treatment and control groups showed improved mobility of the mandible,lips,and tongue.However,the treatment group exhibited significantly better improvement than the control group,with the difference between the two groups being statistically significant(P<0.05).Conclusion:Oral-facial acupressure combined with OPT can effectively improve articulation clarity in children with spastic cerebral palsy.This combined therapy is recommended for clinical promotion and application.

Genetic pathways in cerebral palsy:a review of the implications for precision diagnosis and understanding disease mechanisms

Ce rebral palsy is a diagnostic term utilized to describe a group of permanent disorders affecting movement and posture.Patients with cerebral palsy are often only capable of limited activity,resulting from non-progressive disturbances in the fetal or neonatal brain.These disturbances severely impact the child’s daily life and impose a substantial economic burden on the family.Although cerebral palsy encompasses various brain injuries leading to similar clinical outcomes,the unde rstanding of its etiological pathways remains incomplete owing to its complexity and heterogeneity.This review aims to summarize the current knowledge on the genetic factors influencing cerebral palsy development.It is now widely acknowledged that genetic mutations and alterations play a pivotal role in cerebral palsy development,which can be further influenced by environmental fa ctors.Des pite continuous research endeavors,the underlying fa ctors contributing to cerebral palsy remain are still elusive.However,significant progress has been made in genetic research that has markedly enhanced our comprehension of the genetic factors underlying cerebral palsy development.Moreove r,these genetic factors have been categorized based on the identified gene mutations in patients through clinical genotyping,including thrombosis,angiogenesis,mitochondrial and oxidative phosphorylation function,neuronal migration,and cellular autophagy.Furthermore,exploring targeted genotypes holds potential for precision treatment.In conclusion,advancements in genetic research have substantially improved our understanding of the genetic causes underlying cerebral palsy.These breakthroughs have the potential to pave the way for new treatments and therapies,consequently shaping the future of cerebral palsy research and its clinical management.The investigation of cerebral palsy genetics holds the potential to significantly advance treatments and management strategies.By elucidating the underlying cellular mechanisms,we can develop to rgeted interventions to optimize outcomes.A continued collaboration between researchers and clinicians is imperative to comprehensively unravel the intricate genetic etiology of cerebral palsy.

Allogeneic mesenchymal stem cells may be a viable treatment modality in cerebral palsy

BACKGROUND Cerebral palsy(CP)describes a group of disorders affecting movement,balance,and posture.Disturbances in motor functions constitute the main body of CP symptoms.These symptoms surface in early childhood and patients are affected for the rest of their lives.Currently,treatment involves various pharmacotherapies for different types of CP,including antiepileptics for epilepsy and Botox A for focal spasticity.However,none of these methods can provide full symptom relief.This has prompted researchers to look for new treatment modalities,one of which is mesenchymal stem cell therapy(MSCT).Despite being a promising tool and offering a wide array of possibilities,mesenchymal stem cells(MSCs)still need to be investigated for their efficacy and safety.AIM To analyze the efficacy and safety of MSCT in CP patients.METHODS Our sample consists of four CP patients who cannot stand or walk without external support.All of these cases received allogeneic MSCT six times as 1×106/kg intrathecally,intravenously,and intramuscularly using umbilical cord-derived MSCs(UC-MSC).We monitored and assessed the patients pre-and post-treatment using the Wee Functional Independence Measure(WeeFIM),Gross Motor Function Classification System(GMFCS),and Manual Ability Classification Scale(MACS)instruments.We utilized the Modified Ashworth Scale(MAS)to measure spasticity.RESULTS We found significant improvements in MAS scores after the intervention on both sides.Two months:Rightχ^(2)=4000,P=0.046,leftχ^(2)=4000,P=0.046;four months:Rightχ^(2)=4000,P=0.046,leftχ^(2)=4000,P=0.046;12 months:Rightχ^(2)=4000,P=0.046,leftχ^(2)=4000,P=0.046.However,there was no significant difference in motor functions based on WeeFIM results(P>0.05).GMFCS and MACS scores differed significantly at 12 months after the intervention(P=0.046,P=0.046).Finally,there was no significant change in cognitive functions(P>0.05).CONCLUSION In light of our findings,we believe that UC-MSC therapy has a positive effect on spasticity,and it partially improves motor functions.

An overview of acupuncture for the treatment of limb spasticity in cerebral palsy-A mini review

Cerebral palsy is a common chronic disabling disease in children with special needs,and rehabilitation for cerebral palsy is characterized by a long period,multiple methods and limited efficacy.Due to the limited motor function of cerebral palsy patients,the quality of life of patients is reduced,and their ability to participate in society is reduced,so the improvement of patients’motor function has become an important goal of cerebral palsy rehabilitation.The motor function of cerebral palsy has become an important goal of cerebral palsy rehabilitation.Limb spasticity is one of the main clinical signs of cerebral palsy patients,and the more severe the limb spasticity is,the greater the impact on the patient's motor function,so improving limb spasticity in patients with cerebral palsy is particularly important.Acupuncture,as a Chinese medicine treatment method,has been widely used in the clinical treatment of cerebral palsy in China,and has shown certain efficacy.To promote the clinical application of acupuncture technique in cerebral palsy limb spasticity,this paper analyses and summarizes the relevant literature on acupuncture treatment of cerebral palsy limb spasticity summarizes the current status of the clinical application of acupuncture in cerebral palsy limb spasticity,and provides clinical references for the reasonable application of acupuncture in cerebral palsy limb spasticity.

Effects of video game-based therapy in an adolescent with cerebral palsy: A case report

BACKGROUND Herein,we report the case of a 13-year-old boy with spastic quadriplegia cerebral palsy(CP)at Gross Motor Function Classification System(GMFCS)level II,en-gaging in a 6-wk video game-based therapy(VBT)program.This study aimed to offer essential insights regarding VBT’s impact on enhancing the physical function and improving the quality of life(QoL)of adolescents diagnosed with CP.This report provides a distinctive viewpoint that can inform and direct future clinical practices and research endeavors.CASE SUMMARY The boy presented with moderate mobility,balance,and overall well-being.He faced challenges with diminished lower limb strength,which affected his daily living and physical fitness capabilities.Our participant was diagnosed with spas-tic quadriplegic CP at GMFCS level II.He participated in a 6-wk program of VBT using a play station.This innovative approach incorporates warm-up exercises,interactive activities,and cool-down routines,targeting various movements,in-cluding single-leg stance,weight shifting,kicking,jumping,marching,and squatting.After VBT,the strength of the left hip extensor significantly increased from 199.3 N to 541.3 N.Distance covered as part of a 6-min walk test increased by 82 m.His Paediatric QoL Inventory score increased dramatically by 25.9%.CONCLUSION VBT is an innovative,individualized therapy that enhances physical function and QoL in CP,emphasizing its role in ambulatory patients.

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.

Systematic evaluation of the efficacy and safety of botulinum toxin type A in the treatment of spastic cerebral palsy

Background:Botulinum toxin type A(BTX-A)is a neuromuscular blocking agent.BTX-A inhibits acetylcholine release,causes neuromuscular transmission impairment,and decreases muscle spasms.Objective:To explore the efficacy and safety of BTX-A injection in the treatment of spastic cerebral palsy through systematic evaluation and to provide a reference for the clinical use of BTX-A.Methods:We used“Cerebral palsy”and“BTX-A”as the subject terms and used a combination of subject terms and free words for the search.We searched 7 databases,including CNKI,Wanfang,VIP,Sinomed,PubMed,Embase,and Web of science.Based on the inclusion and exclusion criteria,we screened the articles by reading their titles,abstracts,and full texts and finally included relevant literature for systematic evaluation.Result:A total of 93 papers were systematically evaluated,revealing that BTX-A injection treatment can effectively reduce muscle tone,increase joint mobility,improve gait and motor posture,and enhance gross motor movements in patients with spastic cerebral palsy.The benefits of BTX-A treatment can be sustained for 3–6 months,with motor ability improvement lasting up to 1 year.Combining BTX-A treatment with rehabilitation or external fixation therapy can enhance its efficacy.However,the effectiveness of BTX-A treatment is influenced by several factors,such as the dosage,number of injections,and patient age.Adverse reactions to BTX-A treatment are typically mild and can be relieved within 1–2 weeks.Conclusion:BTX-A injection is relatively safe but reversible.

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.

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.

Therapeutic effects on spastic cerebral palsy in children Acupuncture and massage at the Shu and He acupoints versus routine acupoints

BACKGROUND： Based on clinical findings and syndromes, it has been previously shown that therapeutic methods for cerebral palsy can be greatly improved by selecting fewer, but more accurate acupoints. Therefore, greater therapeutic efficacy for cerebral palsy could be obtained by selecting the five Shu acupoints, which are located at the qi-intersecting point of the twelve meridians below the elbow and knee. OBJECTIVE： To treat children with spastic cerebral palsy using acupuncture and massage at the Shu and He points through a combination of rehabilitative training, and to compare the effects with routine acupuncture and massage. DESIGN： A randomized controlled clinical trial. SETTING： Rehabilitation Center for Cerebral Palsy, Department of Pediatrics, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine. PARTICIPANTS： Sixty children with spastic cerebral palsy were selected from the Rehabilitation Center for Cerebral Palsy, Department of Pediatrics, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from May 2003 to February 2006. There were 38 boys and 22 girls, aged 10 months to 4 years old, muscle strength ranging from grade I to grade IV. The children were randomly divided into a treatment group （n =30） and a control group （n =30）. Informed consent for the therapeutic program was obtained from the relatives of all enrolled children. The study was approved by the Hospital＇s Ethical Committee. METHODS： All children were given exercise and occupational therapy based on standard treatments. （1） In the control group, the children were additionally treated with routine acupuncture and massage during the one-month basic rehabilitative training. The acupuncture needles were manipulated alternately at the acupoints of Jianyu, Shousanli, Binao, Hegu, Huantiao, Xuanzhong, and Biguan. They were treated once per day, 6 days a week, followed by one day of rest. The children＇s limbs were first massaged by pressing, stretching, rolling, and kneading. Then, the same acupuncture points were pressed with the thumb for 30 minutes each time, once a day, 6 days a week, followed by one day of rest. The treatment continued for 1 month. （2） In the treatment group, the children were administered acupuncture and massage at the Shu and He points during the one-month basic rehabilitative treatment. For acupuncture of the upper limbs, the following acupoints were used： Sanjian and Quchi of the Large Intestine Meridian of Hand-Yangming, and Houxi and Xiaohai of the Small Intestine Meridian of Hand-Taiyang. The acupoints were acupunctured alternately every other day. For acupuncture of the lower limbs, the following acupoints were used; Zulinqi and Yanglingquan of the Gall bladder Meridian of Foot-Shaoyang, Taibai and Yinlingquan of the Spleen Meridian of Foot-Taiyang, or Xiangu and Zusanli of the Stomach Meridian of Foot-Yangming. The acupoints were acupunctured alternately every other day. Three needles were for the medial malleolus and three needles for the lateral malleolus. They were treated once a day, 6 days a week, followed by one day of rest. The children＇s limbs were first massaged by means of pressing, stretching, rolling, and kneading. The same acupuncture points were then pressed with the thumb for 0.5-1 minute at each point, 30 minutes each time, once a day, 6 days a week, followed by one day of rest. MAIN OUTCOME MEASURES： Therapeutic efficacy was evaluated using gross motor function measurements, as well as activity of daily living scale before and after treatment. RESULTS： All 60 enrolled children with spastic cerebral palsy were included in the final analysis of results. （1） Comparison of gross motor function scores： The gross motor function score after treatment was significantly higher in both the treatment group and control group than before treatment （t = -3.86 and -8.882, respectively, P 〈 0.05）. The scores in the treatment group were significantly higher than the control group scores （t = -7.166, P 〈 0.01）. （2） Changes in activity of daily living scores： The scores for activity of daily living in the treatment group was significantly higher after treatment than before treatment （t = -3.933, P 〈 0.01）, and was also significantly higher than the control group （t = -0.671, P 〈 0.05）. CONCLUSION： Acupuncture and massage at the Shu and He acupoints can significantly ameliorate motor function deficits and movement disabilities in children with spastic cerebral palsy. The therapeutic efficacy at these acupoints is better than routine acupuncture and massage.

Mononuclear cells from the cord blood and granulocytecolony stimulating factor-mobilized peripheral blood:is there a potential for treatment of cerebral palsy?

To investigate a possible therapeutic mechanism of cell therapy in the field of cerebral palsy using granulocyte-colony stimulating factor（G-CSF）-mobilized peripheral blood mononuclear cells（m PBMCs）,we compared the expression of inflammatory cytokines and neurotrophic factors in PBMCs and m PBMCs from children with cerebral palsy to those from healthy adult donors and to cord blood mononuclear cells donated from healthy newborns.No significant differences in expression of neurotrophic factors were found between PBMCs and m PBMCs.However,in cerebral palsy children,the expression of interleukin-6 was significantly increased in m PBMCs as compared to PBMCs,and the expression of interleukin-3 was significantly decreased in m PBMCs as compared to PBMCs.In healthy adults,the expression levels of both interleukin-1βand interleukin-6 were significantly increased in m PBMCs as compared to PBMCs.The expression of brain-derived neurotrophic factors in m PBMC from cerebral palsy children was significantly higher than that in the cord blood or m PBMCs from healthy adults.The expression of G-CSF in m PBMCs from cerebral palsy children was comparable to that in the cord blood but significantly higher than that in m PBMCs from healthy adults.Lower expression of pro-inflammatory cytokines（interleukin-1β,interleukin-3,and-6）and higher expression of anti-inflammatory cytokines（interleukin-8 and interleukin-9）were observed from the cord blood and m PBMCs from cerebral palsy children rather than from healthy adults.These findings indicate that m PBMCs from cerebral palsy and cord blood mononuclear cells from healthy newborns have the potential to become seed cells for treatment of cerebral palsy.

Progress in clinical trials of stem cell therapy for cerebral palsy

Cerebral palsy is the most common disease in children associated with lifelong disability in many countries.Clinical research has demonstrated that traditional physiotherapy and rehabilitation therapies cannot alone cure cerebral palsy.Stem cell transplantation is an emerging therapy that has been applied in clinical trials for a variety of neurological diseases because of the regenerative and unlimited proliferative capacity of stem cells.In this review, we summarize the design schemes and results of these clinical trials.Our findings reveal great differences in population characteristics, stem cell types and doses, administration methods, and evaluation methods among the included clinical trials.Furthermore, we also assess the safety and efficacy of these clinical trials.We anticipate that our findings will advance the rational development of clinical trials of stem cell therapy for cerebral palsy and contribute to the clinical application of stem cells.

Combined treatment using acupuncture and music therapy on children with cerebral palsy Gross motor function measure comparison in 60 cases

BACKGROUND： The use of acupuncture has received recognition to effectively treat cerebral palsy. Moreover, music therapy can be used to modify treatment of cerebral palsy. OBJECTIVE： To study the effects of combined treatment using acupuncture and music therapy on gross motor function measure （GMFM） of children with cerebral palsy, compared with acupuncture treatment alone. DESIGN, TIME AND SETTING： Randomized, controlled, clinical study. The experiment was conducted in Shenzhen Hospital of Traditional Chinese Medicine between January 2007 and September 2007. PARTICIPANTS： All children with cerebral palsy in the trial were from the outpatient department of Shenzhen Hospital of Traditional Chinese Medicine. The children were randomly divided into two groups： 30 children in Group B received acupuncture and music therapy, while 30 children in Group A received only acupuncture therapy. METHODS： Subjects in Groups A and B received acupuncture based on syndrome differentiation. The main acupoints were necessary for all participants. At first, flash needling was applied to the acupoints. For the remaining acupoints, the technique of transverse needling was applied to the head acupoints, and perpendicular needling was used for the other points. The inserted needles were twirled and then maintained for 30 minutes. The needle was twirled for one second every other 10 minutes, without reinforcing-reducing techniques. The therapy was performed every other day. The trial consisted of three periods each, and lasted for 84 days. Subjects in Group B received music therapy. They listened to music that they preferred while acupuncture was being performed. Following acupuncture, they were allowed to perform musical activities, such as percussion, singing, and dancing. The music therapy was scheduled for one hour, including listening to music for 30 minutes and music activities for 30 minutes. MAIN OUTCOME MEASURES： The comprehensive functional evaluation scale of cerebral palsy and the GMFM were applied to test symptoms before and after respective treatment. RESULTS： All 60 children were included in final analysis. The general function of all children with cerebral palsy improved, but the general efficiency in Group B was obviously higher than in Group A （93% and 73%, Х^2 = 4.32, P 〈 0.05）. GMFM evaluation showed that the function of crawling and kneeling, standing, and walking improved more significantly in Group B than in Group A （P 〈 0.05）, while the function of lying down, rolling, and sitting remained similar between the two groups （P 〉 0.05）. CONCLUSION： The combination of acupuncture and music therapy on the treatment of cerebral palsy is more effective than acupuncture alone. The various activities in music therapy may affect treatment of cerebral palsy.

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.

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.

Autologous Stem Cell Therapy for Cerebral Palsy

Introduction: We describe treatment of Cerebral Palsy with adult stem cells derived from bone marrow and fat of the same patient. Adult stem cells are of two types, the mesenchymal and haemopoietic stem cells which have potential to duplicate, indefinitely produce 50 types of growth factors that repair and regenerate tissues in an epigenetic manner. Every organ has its own stem cells, for example kidney stem cells, liver stem cells, etc. When specialized cells in an organ get damaged, the local stem cells come forward and get differentiated into specialized cells and the tissue damage is replenished. But when the stock of this reserve of local stem cell is over, the organ starts failing. In autologous stem cell therapy, we harvest stem cells from other healthy organs like fat and bone marrow which have abundant stem cells and put them into the diseased organ. Adult stem cells differentiate into neurons in vitro when added with nerve growth factor which is present in every nerve tissue. Our stem cell research was done by following all the guidelines set at national and international level. In India the incidence of cerebral palsy is around 5/1000 live births. In cerebral Palsy the upper motor neuron is weak, hence the lower motor neuron becomes hyper active leading to spasticity. The treatment involves mainly physiotherapy and prognosis is poor. Physiotherapy is a palliation and does not repair damage in the brain. The conventional therapy has failed to give any satisfactory results in these children hence something new needs to be done. Materials and Methods: In last 2 years we did stem cell therapy for 21 cases of CP in our center with age of 9 months to 17 years. Out of 21 cases of CP, 7 (33.3%) cases had quadriplegia, 6 (28.57%) paraplegia and 1 (4.76%) monoplegia, 2 (9%) hypotonic, 5 (23.8%) hemiplegia, 4 (19.04%) with mental retardation and 3 (14.28) had features of ADHD and Autism. 18 patients had squint in the eyes, 8 patients had food regurgitation and drooling of saliva, 2 patients had audiovisual impairment, 3 patients had bronchial asthma and one patient had menstrual irregularity. 26 cases were put as control with age range of 9 months to 19 years. 9 (34.61%) patients had quadriplegia, 8 (30.76%) paraplegia and 3 (11.53) had monoplegia, 3 (11.53%) hypotonic, 5 (19.23) with mental retardation and 6 (23.07) had features of ADHD and autism. 21 patients had squint in the eyes, 11 patients had food regurgitation and drooling of saliva, 4 patients had audiovisual impairment, 5 patients had bronchial asthma in the control group. 11 patients were subjected to adipose tissue derived stem cell therapy and 10 with bone marrow derived stem cell therapy. All patients were examined at 3 monthly intervals. Maximum follow up was 2.5 years and minimum of one year. Results: The results of bone marrow derived stem cells and adipose tissue derived stem cells were almost the same. Results took 3 months to appear and positive outcome came till one year since therapy. The spasticity was significantly reduced in 15 out of 18 patients in 6 months. Out of 18 patients who had squint, it was regressed completely in 12 (66.66%) patients and partially in 3 (16.66%) in 6 months’ time. 8 patients had faulty deglutition and 75% of them had 90%

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.

ACUPUNCTURE THERAPY AND POINT-INJECTION OF MEDICINE FOR TREATMENT OF 32 CASES OF INFANTILE CEREBRAL PALSY

In the present study, 32 cases of infantile cerebral palsy were treated with acupunc-ture and point-injection therapies. Among them, 15 cases were cured basicaly, 7 markedly efec-tive, 9 improved and 2 failed, with a total effective rate being 93. 8%. The results showed thatthe therapies both could improve the microcirculation of the brain tissues in favour of recovery ofcerebral functions.