1/30. Syntax PAL: a system to improve the written syntax of language-impaired users.In our work with children who have difficulty with spelling or with the physical action of writing, we have found a number of children who also have difficulty with written grammar. As an extension of PAL, an existing predictive spelling and typing aid, we have developed a writing aid to help these children with sentence construction. The enhanced system uses the syntax of the initial part of a sentence to enhance the position in the prediction list of syntactically correct words. It was postulated that this would discourage the use of incorrect syntax and encourage the use of correct syntax. In two case studies, the use of Syntax PAL significantly improved the quality and quantity of one child's written output, but had little effect on the other child's work.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/30. independent living and the physical environment: aspects that matter to residents.Field interviews were conducted with seven clients with disabilities for the purpose of developing design guidelines for apartments suitable for independent living. Analysis of these data generated six factors that were highly valued and felt to contribute to the success of these individuals' venture into community living. Control appears to be the central construct and to subsume the other concepts: safety/security, accessibility/mobility, function, flexibility and privacy. These findings are presented and discussed here as a working model of environmental control. These ideas are suggested as hypotheses which would need to be tested and refined further before being used as a model to guide clinical interventions.- - - - - - - - - - ranking = 4keywords = physical (Clic here for more details about this article) |
3/30. Spinal deformity after selective dorsal rhizotomy in patients with cerebral palsy.Selective dorsal rhizotomy is used widely as a means of treating spasticity associated with cerebral palsy. Little is known regarding the effect of the procedure on the development or progression of spinal deformity. The authors reviewed six patients with progressive deformity after rhizotomy. Prerhizotomy and postrhizotomy records of physical examinations and radiographs were reviewed retrospectively in an attempt to identify risk factors for development of and/or rapid progression of, spinal deformity. Detailed preoperative and postoperative evaluation of spinal alignment should be undertaken, particularly in those patients who may be at risk of rapidly progressive deformity.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/30. Treatment of self-induced trauma in a patient with cerebral palsy.Factitious illness can be a problem for disabled patients who experience recurrent trauma or irritation to a particular part of the body. In this case, the patient's recurring lip trauma combined with his overlying physical disability presented a problem not easily solved with prior methods of treating lip trauma. Modifying the standard orthodontic appliance solved the problem; after a short period of use, the patient dropped the harmful habit that caused the lip trauma. The appliance was no longer needed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/30. Desensitization of the gag reflex in an adult with cerebral palsy: a case report.Severe oral hypersensitivity and aversive oral behaviors present a significant barrier to dental treatment and compromise oral health status. Although several authors have addressed the reduction of oral hypersensitivity and aversive behaviors (such as gagging, retching, and vomiting) in the otherwise well dental patient, treatment for patients with severe disability has not been explored. The successful management of oral hypersensitivity and aversive behavior can have significant health benefits. These can be described via an outcomes paradigm as physical and social benefits for the patient, psychological benefits for the patient, carer, and practitioner, and organizational benefits for the institutions providing dental care and medical management. This paper summarizes the management of a severely disabled patient whose aversive behaviors were eliminated with non-invasive therapy techniques. oral hygiene was facilitated and health benefits were identified across a number of domains following successful multi-disciplinary management.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/30. Studies of malformation syndromes of man XXXVIII: The BD syndrome. A "new" multiple congenital anomalies/mental retardation syndrome with athetoid cerebral palsy.Two patients with a virtually identical physical examination syndrome are reported. Both had severe microbrachycephaly, profound mental retardation and athetoid cerebral palsy. The anomalies include prominence of forehead, hypoplastic midface, mandibular prognathism, apparent midline "cleft" of mandible with absence of lower central incisors, ear and eye anomalies, growth failure, and various similar secondary anomalies due to hypotonia, cerebral palsy and immobilisation. The patients probably represent a "new" MCA/MR syndrome, the etiology of which is still unknown. A genetic cause, i.e., a gene mutation with pleiotropic effects, is suggested. This may involve an autosomal recessive trait, an autosomal dominant new mutation, or an X-linked dominant-hemizygous lethal trait.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/30. Correlation between physical functioning and gait measures in children with cerebral palsy.The primary aim of this investigation was to assess the correlation between the POSNA Musculoskeletal Functional Health Questionnaire (POSNA) and gait analysis in children with cerebral palsy (CP). POSNA and computerized gait analysis were used to evaluate individuals with CP. Correlations were investigated between POSNA scales, gait parameters, and the Gillette Functional Assessment Questionnaire (FAQ) in 63 children (31 males, 32 females; mean age 9.17 years [SD 3.06], age range 3.75 to 16.44 years) with spastic CP. Twelve participants had hemiplegia, 29 diplegia, 12 quadriplegia, and 10 triplegia. The result of backwards stepwise multiple regression analysis indicated that the Log normalcy index (NI) was a significant predictor of the POSNA Global Function and Comfort scale. Energy expenditure (EE) did not add significantly to the prediction. The POSNA scales differentiated between the different topographical types of CP. The POSNA scale is a valid and useful clinical measure. Used in conjunction with the NI, EE, and FAQ, the POSNA scale provides a more complete appraisal of change in functioning.- - - - - - - - - - ranking = 4keywords = physical (Clic here for more details about this article) |
8/30. Use of modafinil in spastic cerebral palsy.After an initial patient with cerebral palsy had an apparent dramatic reduction in spasticity when placed on modafinil, a pilot study was undertaken in 10 pediatric patients to confirm or refute the benefit of modafinil in cerebral palsy. Nine of 10 patients completed the 1-month treatment period. The study patients were treated with 50 or 100 mg of modafinil once daily in the morning. An assessment was made at baseline and at 1 month on treatment. All patients had a clinical examination, Modified Ashworth Scale scores (spasticity) determined by a physical therapist, and videotaping of ambulation. In comparing visit 1 (baseline) and visit 2 (on treatment), statistically significant improvement in the modified Ashworth Scale scores was noted in seven of the nine patients completing the study (P = .0080). A blinded review of the videotapes did not show statistically significant differences in ambulation, but the speed (ft/sec) of gait improved in six of the nine patients (P = .0192). In this study, modafinil, a newly released central stimulant for narcolepsy, showed benefit in treating spasticity in patients with cerebral palsy. A second larger, placebo-controlled, double-blinded trial is planned to confirm these initial results and observations. Modafinil appears to benefit spastic cerebral palsy by a yet to be determined mechanism; however, a primary effect of modafinil on brainstem structures is hypothesized to reduce spasticity of central origin.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/30. A child with spina bifida, cerebral palsy and juvenile rheumatoid arthritis: rehabilitation challenge.PURPOSE: A child with spina bifida, cerebral palsy and juvenile rheumatoid arthritis is presented, and strategies to approach a patient with multiple paediatric onset disabling conditions with possible overlaps are discussed. CONCLUSION: The value of multidisciplinary team approach including physiatrist, physical therapist, occupational therapist, rehabilitation nurse, prosthetist-orthotist, psychologist, speech-language pathologist, paediatric rheumatologist, social worker, kinesiotherapist, dietitian, recreation therapist, dentist and other disciplines as required is emphasized.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/30. Constraint-induced therapy for a child with hemiplegic cerebral palsy: a case report.A 12-year-old boy with hemiplegic cerebral palsy (CP) presented with decreased function in his left upper extremity. He was treated with a 3-week protocol of constraint-induced therapy (CIT) consisting of six 2-hour sessions of physical and occupational therapy, plus home practice. Improvements in upper-extremity function were found in the mean and median time for completion of the Wolf Motor Function Test immediately posttreatment and at 8-month follow-up. Also, improvements in functional use of the arm were documented with the Assessment of Motor and Process Skills and by patient self-report of use of the upper extremity at home. The results suggest that CIT may be useful in the treatment of upper-extremity dysfunction in hemiplegic CP. Larger, experimentally controlled investigations of the efficacy of CIT and the mechanism of recovery in patients with CP are warranted. The effects of the duration and intensity of CIT protocols need additional study to increase its clinical application.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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