Verificação das habilidades funcionais e necessidades de auxílio do cuidador em crianças com paralisia cerebral nos primeiros meses de vida
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INTRODUÇÃO: Paralisia Cerebral é uma desordem do movimento e da postura, persistente, porém variável, surgida nos primeiros anos de vida pela interferência no desenvolvimento do sistema nervoso central, causada por uma desordem cerebral não progressiva ¹. Tem como principal característica a inabilidade do corpo em enfrentar com eficiência os efeitos da gravidade. Devido às alterações motoras é importante a participação do Fisioterapeuta na equipe interdisciplinar. Para tanto, deve-se realizar avaliações das dificuldades na paralisia cerebral para possibilitar uma melhor organização do programa fisioterapêutico. OBJETIVO: Avaliar as habilidades funcionais e a necessidade de auxílio do cuidador em crianças com até 18 meses de idade, e com paralisia cerebral. Método: Foram avaliadas 7 crianças com diagnóstico médico de paralisia cerebral, entre 10 e 18 meses de idade, com média de idade correspondente a um ano e dois meses. A avaliação ocorreu por meio do P.E.D.I. e foram analisados os escores bruto e normativo nas áreas de habilidades funcionais e assistência do cuidador. RESULTADOS: Verificou-se maior dificuldade nas crianças com paralisia cerebral na área de mobilidade e, desta forma, a necessidade de maior assistência em movimentos e posturas. CONCLUSÃO: Apesar das alterações nos componentes neuromotores observadas em crianças de risco, as mesmas acabam desenvolvendo estratégias motoras que lhes permitem desempenhar atividades funcionais, como por exemplo as situações citadas na área de auto-cuidado. Os cuidadores orientados pelo fisioterapeuta podem propor facilitações que beneficiarão a função da criança, sua participação na atividade e desenvolvimento da comunicação.ABSTRACT. Of 1200 people randomly sampled from the total Finnish population, cerebral palsy was known to 95.4% and its meaning to 60.7%. Nine of ten (88.4%) would let their children play with a child suffering from cerebral palsy. A total of 48% stated that they would, other circumstances being equal, hire persons with cerebral palsy. Half (47.5%) of the subjects regarded it as possible and a further 28.0% as fully possible for individuals with cerebral palsy to make and maintain a family of their own. A good knowledge of cerebral palsy was independently related to a good basic education, age of more than 24 years, female sex and Finnish as native language. A positive attitude toward people with cerebral palsy was independently related to Finnish as native language and a good basic education. A good knowledge of cerebral palsy fostered a positive attitude toward people with this disease.
Public education
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Objective To investigate the families with cerebral palsy high-risk infants on knowledge,attitudes and behavior of cerebral palsy and early intervention.Methods 200 family members of cerebral palsy high-risk infants were investigated with their knowledge,atti-tudes and behavior on cerebral palsy and early Intervention.Results Their knowledge of cerebral palsy,including related risk factors and early features,was poor;the attitude to early intervention was not positive and the behavior is not reasonable.Conclusion The education to the families with cerebral palsy high-risk infants is important for the prevention and treatment of cerebral palsy.
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Objectives: Negative attitudes toward people with disabilities, including cerebral palsy, may be related to misunderstandings or lack of knowledge about the disability. If held by medical practitioners, they can have detrimental implications for the care of people with disabilities. The purposes of this study were to examine the knowledge and attitudes of medical students regarding cerebral palsy and to examine the effects of the videotape ‘Understanding Cerebral Palsy’ on these two areas. Methods: The attitudes and knowledge regarding cerebral palsy of 54 medical students in their penultimate year were measured before and after watching a video produced to educate health professionals about cerebral palsy. They were assessed using a self‐administered questionnaire constructed specifically for the study, adapted from previously validated questionnaires. Results: These medical students generally had limited knowledge about cerebral palsy and displayed negative attitudes toward people with cerebral palsy. It was also found that males had less positive attitudes than females ( P = 0.014) and that students educated mainly in Asia had less positive attitudes than students educated mainly in Australia ( P = 0.012). The videotape was shown to be effective in improving the students’ knowledge about cerebral palsy. A small but significant improvement in attitudes was also shown ( P = 0.014), with the attitudes of some students improving dramatically. However, negative attitudes remained in many. Conclusions: Based on the findings, structured teaching about cerebral palsy is necessary within the medical curriculum at the University of Melbourne. Greater promotion of positive attitudes toward people with cerebral palsy and other disabilities is required.
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Parenting a child with cerebral palsy is at least as challenging as parenting a child with typical development. Caregivers of children with cerebral palsy are strongly influenced by the needs of their children.1 Although the body of literature addressing parent stress in families with a child with cerebral palsy is not large, the growing evidence has been supplemented and illuminated by the work of Parkes et al.2 Working with data gathered through SPARCLE (Study of Participation of Children with Cerebral Palsy in Europe), the authors present the most convincing data to date regarding this subject. Among the strengths of the study are the size and the composition of the study group, arguably representative of the overall population of European children with cerebral palsy. While it is reassuring to learn that most parents of children with cerebral palsy have normal levels of stress, it is not surprising that very high levels are more prevalent in parents of children with cerebral palsy than in the general population. Similarly, an association between high stress and having a child with cerebral palsy who has intellectual disability, communication impairment, or pain is intuitive. Less intuitive is the absence of a relationship between the Gross Motor Function Classification System (GMFCS) level and parent stress. Other investigators have demonstrated relationships between motor disability and parent stress, but often have not had a sufficient sample size to pursue multivariate regression models. Parkes et al.2 demonstrate that GMFCS level is not a significant contributor when other associated factors are included. Even so, their model, like others reported to date3, accounts for only a fraction of the determinants. An array of issues undoubtedly impacts on the levels of stress for parents of children with cerebral palsy. While the severity of motor impairment may not be a direct contributor, complications and comorbidities of cerebral palsy including pain and intellectual disability do appear to increase parent stress. Other factors may not be as easily defined, but have similar effects. Beyond the immediate manifestations of cerebral palsy, innate qualities of the child including temperament and behavior are also important. Extrinsic to the child with cerebral palsy, parent function, parent coping, family resources, as well as community and societal influences are additional contributors to well-being and stress. It is good to recognize the known risk factors for increased parent stress. At the same time, we must remain alert to diverse and presently unquantified threats to optimal family functioning and well-being. Children with cerebral palsy deserve truly family-centered care. As we acknowledge several substantiated risk factors for parent stress, we must also respond to multifaceted needs of children with cerebral palsy and their families. The status of children with cerebral palsy – and, indeed, the status of their parents – is highly intertwined with parent stress. Directing efforts to maximize the function or wellness of children with cerebral palsy may help to reduce this. Conversely, employing mechanisms for stress reduction may result in improvements for their children. Research to date has not evaluated causation in these arenas, but there is no reason to delay in offering support to families of children with cerebral palsy. Integrated, family-centered services that focus on maximizing the child's function and supporting parents should be expected to produce superior outcomes for the family as a whole.
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This study surveys parents of children with cerebral palsy. The purpose of the study is to report the parents' opinions concerning possible causes of cerebral palsy. All parents of children with cerebral palsy who attended the United Cerebral Palsy centers in North Carolina were asked to respond to a survey concerning their opinions of possible causative factors related to cerebral palsy. Parents of children with cerebral palsy participating in this study reported agreement with several possible causative factors of cerebral palsy. Though the opinions of these parents largely reflect knowledge that is consistent with the literature, there is also confusion concerning some factors that have been associated with cerebral palsy. There is a need for more study of causative factors related to cerebral palsy.
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Cerebral palsy is one of the commonest children's physical handicaps with frequency of 1.5-3/1000. Beside many other disturbances, these children may have serious disorders caused by dental diseases. Concerning this fact, the objective of our study was to examine children with cerebral palsy in our country and determine condition of dental health and suggest adequate protective measures. A total of 116 children, 3-18 years old, with cerebral palsy were examined and the results were compared to the control group of healthy children of the same age. Among healthy children, 7-10 years old, 66.3% had healthy parodontium, while none of children with cerebral palsy had healthy parodontium. Children, 11-14 years old with cerebral palsy had higher percentage of untreated caries, but lower percentage of filled teeth (18.7%) compared to healthy children (55.0%). Children, 15-18 years old with cerebral palsy had significantly higher percentage of extracted teeth (10.6%) than healthy children (4.1%) and more often orthodontic anomalies (70.6%), compared to healthy children (46.9%). Results of these study indicate that children with cerebral palsy need special and planned dental care.
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Background Cerebral palsy (CP) is the most common cause of childhood motor disability. However, there is limited guidance on training of child neurologists and neurodevelopmental disability specialists in the care of individuals with cerebral palsy. We sought to determine training program directors’ impressions of the importance and adequacy of training in the diagnosis and management of cerebral palsy. Methods In this cross-sectional study, all 82 child neurology and neurodevelopmental disability program directors were asked to complete a survey querying program characteristics, aspects of training in cerebral palsy, importance of cerebral palsy training, and perceived competence at graduation in cerebral palsy care. Results There were 35 responses (43% response rate). Nearly all program directors (91%) reported “learning to diagnose cerebral palsy” as very important, and most (71%) felt that “learning to manage cerebral palsy” was very important. Although most program directors reported trainees to be very or extremely competent in cerebral palsy diagnosis (77%), only 43% of program directors felt that trainees were very or extremely competent in cerebral palsy management. Time spent with cerebral palsy faculty was associated with higher reported competence in cerebral palsy diagnosis ( P = .03) and management ( P < .01). The presence of a cerebral palsy clinic was associated with higher reported competence in cerebral palsy management ( P = .03). Conclusions Child neurology and neurodevelopmental disability program directors reported that training in cerebral palsy is important for residents; however, a significant proportion felt that residents were not very well prepared to manage cerebral palsy. The development of cerebral palsy curricula and exposure to cerebral palsy clinics may improve training, translating to better care of individuals with cerebral palsy.
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The care of the hip in children with cerebral palsy is an ongoing challenge. Interventions need to be physiologically based and well timed. Early management will prevent future complications in both the ambulatory and nonambulatory child with cerebral palsy. Evaluation management and treatment of the hips in cerebral palsy will be discussed in this article.
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