[Truncated abstract] This thesis consists of five experimental studies from seven data collection periods. The first two studies quantitatively analyse children with and without cerebral palsy using upper limb three dimensional (3D) motion analysis. Upper limb angular kinematics and sub-structures were measured and analysed, both of which were utilised during subsequent studies. The final three studies assess the efficacy of lycra® arm splints using clinical assessments, 3D dimensional upper limb kinematics and 3D sub-structures. Study 1 analysed 3D movement sub-structures in children with and without cerebral palsy ... The aim of the study was to quantitatively analyse movement sub-structures in children with and without cerebral palsy during four functional tasks taken from the Melbourne Assessment of Unilateral Upper Limb Function (Melbourne Assessment - Randall, Johnson & Reddihough, 1999) ... Results demonstrated significant differences in angular kinematics in children with and without cerebral palsy, while the methodology developed in this study provided improved insight into the movement of the upper limb and trunk during functional tasks. Study 3 reported a randomised controlled trial of lycra® arm splints in children with cerebral palsy across all levels of the International Classification of Functioning Disability and Health (ICF) ... Lycra® arm splints were shown to have a statistically significant impact at the level of participation, whereas no significant difference was seen at the level of impairment and activity. Study 4 reported a randomised controlled trial of the effects of lycra® arm splints on 3D movement sub-structures during functional tasks in children with cerebral palsy ... This research demonstrated that movement sub-structures (including movement time) can be quantified and are amenable to change with intervention. Study 5 reported a randomised controlled trial of the effects of lycra® arm splints on angular kinematics (thorax, shoulder and elbow) during functional tasks in children with cerebral palsy ... The benefits of the splint on angular kinematics were only apparent when worn for the 3 month period, as minimum evidence was established for the short-term (1hour) and long term (3 month post splint wear) carry-over effects.

Univ., Diss.--Göteborg, 2005.

Made available in DSpace on 2015-06-17T19:34:30Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-08-21. Added 1 bitstream(s) on 2015-06-18T12:48:42Z : No. of bitstreams: 1 000831088.pdf: 668106 bytes, checksum: c2d5b05ff722c695000319add3971dba (MD5) / Paralisia Cerebral (PC) é uma das principais causas de incapacidade crônica na infância tendo como sequela desordens motoras que vêm acompanhadas de distúrbios de sensibilidade, percepção, cognição comunicação e comportamento, e secundariamente por desordens musculoesqueléticas. O presente estudo transversal teve como objetivo avaliar a qualidade de vida (QV) das crianças portadoras de Paralisia Cerebral (PC) e sua relação com o nível funcional (Gross Motor Function Classification System GMFCS), características sociodemográficas e frequência a fisioterapia além de sua idade de início. A amostra foi constituída de 71 cuidadores primários e 45 crianças. Para avaliação da qualidade de vida foram utilizados os instrumentos Child Health Questionnaire - Parent Form 50 (CHQ PF50) e Autoquestionaire Qualité de Vie Efant Imagé (AUQEI) Nível funcional, dados sociodemográficos e relacionados a reabilitação (frequência e idade de início na fisioterapia) foram utilizados com o objetivo de verificar o quanto eles interferem na qualidade de vida do indivíduo portador de paralisia cerebral. Crianças e cuidadores primários foram avaliados na Unidade de Apoio de Reabilitação do Hospital Estadual de Bauru (HEB). Foi realizada análise descritiva dos dados sociodemográficos, tais como idade, escolaridade, renda familiar entre outros. Para as variáveis categóricas foi aplicado o Teste de Tukey quando houve significância. A correlação de Pearson foi utilizada para correlacionar dados sociodemográficos com os escores obtidos pela avaliação da qualidade de vida. A média de idade das crianças foi de 9,83 (DP 1,5) e a maioria das crianças era do sexo masculino (54,9%). Como resultado o escore físico foi o mais prejudicado principalmente na forma mais grave de PC quando comparado aos outros níveis. Sob o ponto de vista das crianças não houve diferença significativa entre os níveis. Em relação à fisioterapia foi ... / Cerebral Palsy (CP) is a major cause of chronic disability in childhood as having sequel motor disorders that are accompanied by disturbances of sensation, perception, cognition, communication and behavior, and secondarily by musculoskeletal disorders. This cross-sectional study aimed to evaluate the quality of life (QOL) of children with Cerebral Palsy (CP) and its relation to the functional level (Gross Motor Function Classification System GMFCS), sociodemographic characteristics and frequency physiotherapy beyond his years start. The sample consisted of 71 primary caregivers and 45 children. To assess quality of life instruments Child Health Questionnaire were used - Parent Form 50 (CHQ PF50) and Autoquestionaire Qualité de Vie Efant image (AUQEI) functional level, demographic data and related rehabilitation (frequency and age of onset in physiotherapy) were used in order to check how much they affect the quality of life of the individual with cerebral palsy. Children and primary caregivers were assessed at Rehabilitation Support Unit Hospital Estadual de Bauru (HEB). Descriptive analysis of demographic data such as age, education, household income and other was performed. For categorical variables we used the Tukey test when significance was found. The Pearson correlation was used to correlate demographic data with the scores obtained by assessing the quality of life. The mean age of children was 9.83 (SD 1.5) and the majority of children were male (54.9%). As a result the physical score was the most affected mainly the most severe form of PC when compared to other levels. From the point of view of the children there was no significant difference between the levels. Regarding physical therapy was observed that the higher the frequency in physiotherapy, better quality of life indices. Conclusion: in the present study it was concluded that the quality of life evaluated from the point of view ...

O presente trabalho teve como objetivo principal identificar o benefício do uso da comunicação alternativa como recurso facilitador para a construção da linguagem em crianças com paralisia cerebral. Os objetivos específicos foram os de descrever os meios comunicativos mais usados pela criança; identificar o perfil comunicativo funções comunicativas, utilizadas pela criança em situação de interação com a mãe, para acompanhar evolução no uso de um sistema alternativo de comunicação e o de analisar se houve alteração na relação entre a competência lingüística e o nível de interação após a intervenção terapêutica. Para tanto uma abordagem qualitativa e quantitativa, longitudinal, do tipo Estudo de Caso foi empregada. Participou deste estudo uma díade mãe-criança, este último com o diagnóstico neurológico de Paralisia Cerebral com quadro clínico de diplegia espástica com um dimídio esquerdo mais comprometido (MSE) Nível motor III. A constituição do corpus foi feita em três etapas: Inicialmente, foi realizada a coleta de informações da criança (anamnese) seguida da avaliação fonoaudiológica através de dois encontros com a díade. Em seguida, o primeiro registro videográfico de uma interação livre da díade. E na última etapa, o segundo e último registro videográfico de uma interação livre da díade após 4 meses de intervenção fonoaudiológica. Os resultados evidenciam que a criança utilizou, na sua interação com a mãe, predominantemente, funções de interação agrupadas em: aquelas utilizadas para regular o comportamento do outro e o ambiente (Pedidos de: Informação, Objeto, de Ação, Consentimento e de Rotina Social e Protesto); para a interação social (Comentário, Expressão de Protesto, Performativo e Narrativa) e aquelas utilizadas para estabelecer a atenção compartilhada (Exibição, Jogo Compartilhado e Reconhecimento do Outro). O meio comunicativo mais utilizado foi o gestual/vocal havendo um aumento na gestualidade, onde a criança além de apontar mais e utilizar gestos, também fez uso da sua pasta de comunicação. Este trabalho aponta dados relevantes de que a comunicação da criança teve a função de regulação e interação. Esses dados mostram que a criança comunica mais com o objetivo de interação social. Aponta também para eventuais dificuldades na mediação da atenção com o outro que pode ser uma dificuldade da criança diante de sua patologia, sugerindo variações na conduta do profissional em orientações aos familiares/cuidadores, por exemplo, na introdução de um sistema alternativo de comunicação / This study had the main purpose to identify the benefits of using the alternative communication as an assistant resource for language construction in children with cerebral palsy. The specific goals were to describe the most used communicative means by the child investigated; identify the communicative profile communicative functions, used by the child in situations of interaction with the mother, in order to follow the progress in using an Alternative System of Communication (ASC); and analyzing if happened any variation in the relation between the linguistic competence and the level of interaction after the therapeutic intervention. For that, it was adopted a qualitative, quantitative and longitudinal approach, of the type Study of Case. Participated, from this study, one mother-child dyad. The child has the neurological diagnosis of Cerebral Palsy, with a clinical frame of spastic diplegia with the left dimidium more damaged (MSE) motor level III. The constitution of the corpus had three stages: initially, it was made a collect of informations about the child (anamnesis) and a speech evaluation, through two meetings with the dyad. Afterward, it was recorded the first video during the dyads free interaction And, in the last stage of collect, it was made a second and last video recorder of a dyads free interaction, after four months of speech therapy intervention. The results reveal that the child used, in the interaction with the mother, largely, interactive functions grouped as: those used to control or regulate the others behavior and the background (asks of: information, object, action, assent, social routine and protest); for the social interaction (comment, protest expression, performative and narrative) and those used to establish the shared attention (exhibition, shared game and others recognizing). The most used communicative means was the gestual/vocal, displaying an increase in the gestuality, so the child, further than pointing more and using gestures, the child also used the folder of communication. The results indicate that the childs communication had the functions of control and interaction. These data show that the child uses the communication with the aim of social interaction. These data point, also, to difficulties in the attention mediation with the other, that may be a childs difficulty because of the pathology, suggesting variations in the professional approach about assistance to the family, for example, introducing an alternative System of Communication (ASC)

Doctorat en sciences psychologiques / info:eu-repo/semantics/nonPublished

M.Ed. / Riglyne kan ontwerp en beskryfword vir opvoedkundige sielkundiges om die ouers van serebraalgestremde kinders te help om die opvoedingsverhouding tussen die ouers en die betrokke kinders te probeer herstel, indien die behoeftes en verwagtings van 'n ouerbegeleidingsprogram van die ouers van hulle serebraal-gestremde kinders verken en beskryf word. Verder kan die aspekte wat opvoedkundige sielkundiges as suksesvol beskou in hulle begeleiding van ouers van serebraalgestremde kinders ook verken en beskryf word. Navorsing oor die behoeftes van ouers van serebraal-gestremde kinders, die ouers se vewagtings van 'n ouerbegeleidingsprogram, asook die bepaling van riglyne vir die opvoedkundige sielkundige om hierdie ouers te help om die opvoedingsverhouding te probeer herstel, kan as 'n integrale deel van die opvoedkundig-sielkundige paradigma gesien word. Van Niekerk (1986:43) onderskei die volgende aspekte as deel van die opvoedkundige sielkundige se terrein, nl. Die gee van voorkomende begelleiding aan ouers en onderwysers ten aansien van die opvoeding, onderwys en ontwikkeling van die kind as persoon. Intervensie, veral ten aansien van die kind en vroee volwassene wie se persoonsvoltrekking probleme openbaar, met die oog op harmoniering van die disharmoniese en die opheffing van sodanige probleme. Hierdie probleme kan in 'n uiteenlopende verskeidenheid simptome manifesteer, wat as verhoudingsprobleme, gesinsprobleme, skoolprobleme, gedragsprobleme, leerprobleme, waaronder onderprestasie, spesifieke leergeremdhede; beroepskennis- en keuseprobleme geopenbaar word. â ienslewering aan onderwysdepartemente se skoolklinieke en hulpdienste, skole vir buitengewone onderwys; in privaatpraktyke of ander instansies waar by lid is van 'n interdissiplinere en transprofessionele span. Die samestelling van 'n begeleidingsprogram vir ouers van serebraal-gestremde kinders behoort betrekking te he op al hierdie aspekte. Eerstens kan so 'n program gesien word as voorkomemde begeleiding aan die ouers en onderwysers van serebraal-gestremde kinders. Ouers van leerlinge in skole vir buitengewone onderwys kan so 'n begeleidingsprogram, wat aangebied word deur die opvoedkundige sielkundige by die skool, volg as deel van 'n orientasieprogram. Onderwysers kan op hierdie wyse bewus gemaak word van die dinamiek in 'n gesin met 'n serebraal-gestremde kind.

Children with dysarthria due to cerebral palsy (CP) often face barriers to accessing speech research participation and clinical speech services. Utilizing at-home online videoconferencing may be a practical solution to these accessibility barriers if the speech signal yielded from online recordings is valid. This study aimed to determine the validity of acoustic and perceptual measures obtained from speech data collected (remotely) online from children with dysarthria due to CP. The speech of 17 children with dysarthria was recorded by means of two data collection methods performed simultaneously: 1) via Zoom video communications and 2) via a professional audio recording device sent to the children's parents. A calibration procedure permitted the children’s original vocal sound pressure level (SPL) to be represented in the speech signal. Acoustic and perceptual measures extracted from the two recordings were compared in order to determine the validity of speech data collected online from the children. The acoustic measures, obtained from 1,690 tokens of words and 605 tokens of sentences, were the second formant (F2) range of diphthongs, F2 slope of diphthongs, fricative-affricate duration difference, word duration/articulation rate, mean fundamental frequency (F0), F0 variation, SPL, shimmer, signal-to-noise ratio (SNR), and cepstral peak prominence (CPP). Perceptual measures were 187 adult listeners’ orthographic transcription accuracy and visual analog scale (VAS) ratings of the children’s speech, collected via an online crowdsourced platform. Acoustic measures of F2 range of diphthongs, fricative-affricate duration difference, word duration, and mean F0 reached the validity criterion of rrm-value .75 and demonstrated good agreement within the predetermined clinical criterion at both word and sentence levels. Moreover, SPL met the validity criterion and exhibited good agreement at the word level; however, it failed to meet the validity criterion and demonstrated agreement outside the clinical criterion at the sentence level. The F2 slope of diphthongs showed a strong correlation between online and audio-device recordings and reached the validity criterion; however, it did not show agreement within the clinical criterion at either word or sentence level. Perturbation-based, noise-based, and cepstral measures (i.e., F0 variation, shimmer, SNR, CPP) showed a wide range of correlation and agreement outside of clinical criteria between online and audio-device recordings. Both perceptual measures showed strong correlations between the two recording methods, reaching the validity criterion. Findings suggest that measures that reflect physiological aspects of speech production may be valid and appropriate to extract from online recordings. However, measures capturing noise and variability within the signal may not be valid when obtained from online recordings. Additionally, the results suggest that perceptual measures of listeners’ transcription and ratings from online recordings may be valid to use for research and clinical purposes. Therefore, careful consideration of the appropriate measures and their limitations is essential to obtaining accurate results when extracting measures from online recordings. These findings provide a valuable foundation of evidence supporting the use of online videoconferencing platforms for several acoustic and perceptual measures commonly implemented in speech research, clinical assessment, and treatment.

Through literature and personal experience it became apparent that cerebral palsy is a condition that poses physical challenges to the everyday lives of children diagnosed with this condition. Negative feedback from society and significant others in the lives of these children may lead to an emotional imbalance in these children. Although various models for addressing emotional issues in children with cerebral palsy exist, their needs within a therapeutic setting are not addressed. The purpose of this study was to investigate the use of the Schoeman model in therapy with the child with cerebral palsy. The Schoeman model is a therapeutic model that is based on the Gestalt philosophy and is used in conjunction with Gestalt play therapy. Through applying the different aspects of this model the study sheds light on the usefulness of the Schoeman model in therapy with the child diagnosed with cerebral palsy. / Social Work / M. Diac. (Spelterapie)

Thesis (MScPhysio (Physiotherapy))--Stellenbosch University, 2008. / Cerebral palsy (CP) is a common neurological condition seen in children which results in childhood disability. Damage to the developing brain results in abnormal muscle tone and decreased force generation, which leads to loss of independent function. Previous studies investigating interventions targeting the typical equinus gait pattern seen in spastic CP have reported inconclusive and widespread outcomes. Objectives The objectives of the study were to determine (1) the effect of functional electrical stimulation (FES) after a single botulinum toxin injection into the triceps surae muscle as a functional orthosis on various gait parameters and economy of movement; (2) caregivers’ perceptions of the impact of the intervention on their child’s function and participation, and (3) optimal timing intervals for introducing FES after a botulinum toxin injection. Method Single-subject research with a multiple baseline approach was conducted on five ambulant subjects (average age 5.1 years, SD=1.4) in the Cape Metropole with a dynamic equinus gait due to hemiplegic CP. Two-dimensional gait analysis, isometric dynamometry, Energy Expenditure Index (EEI), and a caregiver questionnaire were used to gather data on walking speed, ankle angles at initial contact of gait, isometric plantarand dorsiflexior muscle strength, energy expenditure during gait, as well as caregiver perception on participation changes. Statistical analysis was conducted by means of ANOVA tests and graphic data illustrations. Results A statistically significant pre- to post intervention (FES after botulinum toxin) change was found for plantarflexor muscle strength. This effect was partially maintained over the withdrawal phase. Caregivers felt the intervention to have a positive influence on their children’s walking speeds, as well as on age-appropriate function and participation. Selfselected walking speed, dorsiflexor muscle strength, and ankle angles at initial contact did not change significantly. A 32-day interval between between botulinum toxin and the FES programme resulted in the most pronounced improvements in terms of walking speed, EEI scores, and plantarflexor muscle strength. Conclusion FES to the lower limb, 32 days after botulinum toxin into the triceps surae, applied for 30 minutes per day, five times a week over a total of four weeks, seemed to improve selected gait parameters as well as caregiver perception of impact on function and activities of daily living. However, further research is needed.

This study attempted to ascertain whether the under-representation of black, disadvantaged learners with cerebral palsy in biology and related careers is linked in any way to the method and content of teaching and learning in special education. In addition this study also attempted to identify and uncover the barriers that prevent learners with cerebral palsy from pursuing careers in science and technology related professions.