The aim of this study was to determine the effects of an eight-week weight bearing exercise program coupled with whole body vibration (WBV) on gross motor function, functional mobility and spasticity in hemiplegic type cerebral palsied school going children. The experimental group was compared to a control group undergoing the same exercise program. The control group excluded WBV training. Fifteen children participated in the study nine females and six males. There were eight children with right hemiplegia and seven with left hemiplegia; all children had gross motor classification (GMFCS) of Level 1. Significant improvements were seen in both groups for gross motor function. There was no difference in the amount of change seen between the two groups. A decline was noticed in the functional mobility assessment. The findings of this study demonstrated that both the children in the control and the experimental groups showed significant improvements in the GMFM scores after a weight bearing exercise program. The children in the experimental group who received WBV while exercising showed significant improvement from baseline to completion of the study compared to the group that did weight bearing exercise alone; better carry over effect in this group from WBV. Time up and down stairs (TUDS) and modified ashworth scale (MAS) scores showed less convincing results and need further investigation. Further research is required to determine the most effective and efficient way of managing children with cerebral palsy in a resource poor area.

Motor deficits are debilitating in that they affect everyday function in human beings (Zillmer & Spiers, 2001). Cerebral Palsy (CP) is one particular disorder that is primary characterised by motor deficits, more specifically gross motor function deficits. As a result, people with CP are restricted in their everyday function and lack independence and self-sufficiency. With other factors such as stigmatisation and prejudice, social participation becomes limited which leads to isolation and loneliness, which may further lead to psychological disorders such as depression, anxiety, low self esteem and poor quality of life. These assumptions are based on the application of the mental health model, and one could assume the poorer the level of functioning the more likely a person’s psychological well-being will suffer. Thus, the study attempted to investigate these assumptions by exploring the relationship between levels of gross motor function and psychological well-being. A sample of 43 participants based in a care centre in Johannesburg completed a demographic questionnaire, the Major Depression Inventory (MDI), The Becks Anxiety Inventory (BAI), The Rosenburg Self Esteem Scale (RSE) and the Comprehensive Quality of Life Scale (COMQOL – A5). In addition, through observation, the level of gross motor function was determined by utilising the Gross Motor Function Classification System (GMFCS). The data that was gathered and was statistically manipulated to explore three main questions. Before the relationship between gross motor function and psychological well-being could be explored it was necessary to examine the suitability of the use of psychological measure on an adult with CP sample. Results indicated that the MDI (r = 0.78), BAI (r = 0.76). RSE (0.77), and COMQOL (r = 0.99) had high internal constancy reliability. The relationship between demographical variables, namely, age, gender, years of residency, experience of motor deterioration and presence of epilepsy, were tested against the level of gross motor function. No significant results were found apart from motor PDF created with pdfFactory trial version www.softwarelabs.com 4 deterioration. More participants with a higher level of gross motor function experienced motor deterioration (77%) than those with a lower level of gross motor function (44%). Lastly, the relationship between psychological variables and gross motor function was investigated as well as difference between the levels. Correlations revealed very weak positive relationships, with the exception of depression having a very weak negative relationship. All relationship were non significant. Although slight differences were seen between levels, they were non significant. 7% of participants were diagnosed with depressive disorders, and 47% with anxiety disorders. Problems with certain questions pertaining to the BAI raised concerns over the suitability of its use in CP adult samples. The study concluded that psychological measures, excluding the BAI, were suitable for use on a sample of adults with CP. It also highlighted that the level of motor functioning is not related to or determines psychological well-being in adults with CP. PDF created with pdfFactory trial version www.softwarelabs.com

A research report submitted to the Faculty of Health Sciences, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Science in Occupational Therapy Johannesburg, April 2017 / The study sought to compare the caregivers’ evaluation of the occupational performance and assistance needed by children with cerebral palsy (CP) to that of treating therapists to ascertain agreement about the children’s strengths/weaknesses so goals for intervention can be set. The Paediatric Evaluation of Disability Inventory (PEDI) parent/caregiver and therapist scores of 50 children with CP in Harare aged four to six and half years were analysed. The association between PEDI scores and the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) levels as well as the internal consistency of the PEDI for this sample were also determined. Correlations for the caregivers’ and therapists’ scores on the PEDI were strong to excellent. A marked decrease in functional skills on the PEDI was noted in relation to the GMFCS and MACS levels with a negative moderate correlation between the PEDI scores and the GMFCS levels for self care, a negative strong correlation for mobility but a negative weak correlation for social function. The similarity of scores indicates positive correlation that allows for collaborative goal setting and Family Centred Therapy with these children. Internal consistency was excellent for all functional skills domains and caregiver assistance. / MT2017

Background Cerebral palsy has been identified as the most common, chronic childhood disability that causes appreciable motor deficit. Building the capacity of caregivers and improving children’s functional capacities through rehabilitation programs could reduce the physical and psychological burden imposed by the caregiving process. There is paucity of information about the experiences of caregivers of children with cerebral palsy in Ghana especially those who are not receiving any form of care. The purpose of this study was to explore the experiences and perception of caregivers living in rural communities. Methodology A descriptive phenomenological approach as proposed by Husserl was used to explore the experiences of 12 caregivers of children with cerebral palsy aged between 2 years 9 months to 14 years. The caregivers’ interviews were analysed using Colaizzi’s phenomenological method of data analysis framework. Findings Two main themes emerged from the narratives of the caregivers. The first theme ‘Developing personal beliefs to support the caregiving role’ revealed that caregivers developed religious and spiritual beliefs to interpret their children’s condition, perceive the standard of care and negatively their beliefs caused feeling of despair and sorrow. The second main theme ‘Demands that shaped the experience of caring’ revealed the demands included physical, financial and social demands. The essential structure of the phenomenon demonstrated the complex interaction of personal and environmental factors in harmony with the actual demands to influence the experiences of caregivers positively or negatively. Positively caregivers achieve coping, committed to caring, hope for the future and acceptance of the condition of their children. However negatively caregivers described the triggering factors of feeling of despair and sorrow as frustration, lack of understanding of the condition, felt stigmatised and perceived that the child was going through pain and suffering. Conclusion Caregivers derived strength from their religious and spiritual beliefs to balance the demands of caregiving. The new findings could be used as a basis for developing interventions to support caregivers, inform new strategies for rehabilitation care delivery and sensitisation of community members about inclusion of children with disabilities in the future.

The study explored the experiences of young adults who have a sibling with cerebral palsy living in Nairobi, Kenya in order to establish how they made sense out of the experience of growing up with a sibling with CP. The study used a qualitative approach with an Interpretative Phenomenological Analysis (IPA) whereby six participants all young adults aged between eighteen and twenty four years, were interviewed using semi-structured interviews. Data analysis was undertaken according to IPA guidelines. The findings generated four super ordinate themes namely: increased sense of reward, emotional impact, family relationships and public relations. The findings revealed that there was a direct impact on sense of psychological well-being both negatively and positively. On one hand, the young adults experienced feelings of stigma, fear about the future, anger and a sense of responsibility. While on the other hand they experienced personal growth in terms of a sense of personal development and some concrete rewards. In conclusion, the study demonstrated the potential for personal development in the group studied and made a contribution to understanding the disabling impact of society on the lives of sibling due to disability by association.

Cyberlink:Brainfingers is a human computer user interface that supports hands free computer access. This is especially valuable technology for disabled individuals who lack the motor skills necessary to use a keyboard and mouse easily. Over the course of two months, four students with cerebral palsy, a motor disorder, used Brainfingers to play a variety of spatial software. The primary aims were to see if use of Brainfingers with spatial software could improve the spatial motor abilities of students with cerebral palsy, as well as to assess any apparent behavioral changes. Two of the students showed a large increase in spatial abilities when assessed, and all students displayed improvement or no change in positive behavioral attributes. All students improved their control of Brainfingers over time, and expressed their desire to use Brainfingers in the future over other methods of accessing a computer. The implications of these results are discussed, as well as issues for further study.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

The purpose of this thesis was to investigate the psychometric properties and clinical utility of the Functional Mobility Scale (FMS) for children with cerebral palsy (CP). The FMS quantifies mobility according to the need for assistive devices in different environmental settings. Initially a systematic review was conducted on the psychometric properties and clinical utility of existing evaluative outcome measures that assessed activity limitation in children with CP. Good to excellent reliability was found for all tools. In contrast, the validity and responsiveness of many tools required further investigation. The FMS was the only tool to quantify activity with different assistive devices for a range of environmental settings. A key objective of this thesis was to investigate the reliability, construct, concurrent and discriminative validity, as well as the responsiveness to change of the FMS. (For complete abstract open document)

Diss. (sammanfattning) Göteborg : Univ. , 2006. / Härtill 4 uppsatser.

Thesis (Ph.D.)--University of Melbourne, School of Physiotherapy, 2008. / Typescript. Includes bibliographical references.