No description available.

Thesis (Ph. D.)--University of Wisconsin--Madison, 2000. / Includes bibliographical references (p. 281-286). Also available on the Internet.

No description available.

Objectives: To describe the 'activities and participation' of children with cerebral palsy, as defined by the International Classification of Functioning, Disability and Health (ICF), using family-assessed instruments. Methods: A structured review of family assessed instruments appropriate for measuring children's activities and participation was undertaken to identify questionnaires for use in a postal survey. The survey involved a geographically-defined population of children with cerebral palsy between 6 and 12 years old, identified from the 4Child database in Oxford. Indices of children's 'activities and participation' were families' assessment of the Gross Motor Function (GMFCS) and Manual Ability (MACS) Classification Systems, the Activities Scale for Kids (ASK) and Lifestyle Assessment Questionnaire (LAQ-CP). To determine the reliability of families' assessments their classifications of the GMFCS and MACS were compared to ratings made professionals; the response frequencies and internal consistency of the ASK and LAQ-CP scales were also examined. Details of children's impairments and abilities were then used as explanatory variables in multiple regression analyses to identify the effect of disability on children's activities and participation. Results: Families of 129/314 (41%) of the children fully participated in the survey and 175/314 (56%) provided a classification using the GMFCS. These children did not differ from children who did not take part by age, gender or characteristics of their cerebral palsy and associated impairments. Although there was not always perfect agreement the families' classifications of children's movement and manual abilities using the GMFCS and MACS were highly reliable compared to those of health professionals (ICC>0.9). Analysis of the ASK and LAQ-CP showed these also to be reliable. Scores for the ASK and LAQ-CP were generally best predicted by children movement, manual and intellectual disability. Conclusions: Family assessment of children's movement and manual abilities using the GMFCS and MACS was highly reliable compared to health professionals. In concordance with similar studies that used professionally-assessed measures, children's activities and participation were most adversely affected by movement, manual and intellectual disabilities. Family assessment offers a highly reliable method for measuring activities and participation; however currently available instruments do not fully represent all the domains in the ICF.

Complex orthopaedic surgery is often indicated in the management of deformity in children with spastic diplegic cerebral palsy (CP) and a long rehabilitation programme is important for a successful outcome. However, the frequency and content of physiotherapy treatment following surgery varies between centres. This thesis aimed at providing a scientific basis for post-operative rehabilitation following multi-level surgery in children with CP. The effect of muscle weakness on function in patients with CP is recognised. However, the short and long-term impact of multi-level orthopaedic surgery on muscle strength is unclear. Strength changes would have implications for both surgical and conservative treatment planning. The objectives of this study were to establish a better understanding of the impact of surgery on muscle strength, gait and function, as well as the natural history of weakness in CP. Furthermore, the study aimed to clarify whether physiotherapy, focused on resistance strengthening techniques, was more effective than routine physiotherapy. The reliability of a protocol for measuring muscle strength in lower limb muscle groups in this population was firstly established. A pilot study of 10 children with a diagnosis of spastic diplegic CP and healthy counterparts demonstrated a reliable strength testing protocol. The main study of 20 diplegic children who underwent multi-level surgery showed that despite improvements in gait parameters, significant loss of strength in lower limb muscle groups and gross motor function persisted at six months. The value of intensive physiotherapy was assessed in a randomised controlled trial six months after surgery. Advantages of resistance training over active exercise were demonstrated. Assessment at one year showed that surgical patients preserved the post-physiotherapy strength and function gains but these did not reach the pre-operative values. Another group of 10 diplegic children who received routine physiotherapy but no surgical treatment for 12 months showed significant deterioration of their gait. The rate of deterioration demonstrated in conservatively treated diplegic patients and the degree of weakness caused by surgery, should inform parents and clinicians during decisions regarding surgery. Future research in multi-level surgery should include specific strength assessment protocols. The results from the randomised clinical trial showed that overall intensive strengthening regimes after multi-level surgery are beneficial. This finding would have significant implications on managing resources and designing appropriate rehabilitation programmes after multi-level orthopaedic surgery.

The thesis consists of seven Sections. Each Section contains a set of published papers, reports or chapters which describe epidemiological aspects of the Cerebral Palsies (CPs). These have, in the main, made use of of the Western Australian Cerebral Palsy Register. Several of the chapters are from a recent book (Stanley and Alberman, 1984), which was an invited monograph in a series published jointly by Spastics International Medical Publications and Blackwells, Oxford. The published work in each Section is introduced and moulded together by text with the aim of making it flow as a composite whole. The numbers and rates differ between papers as the register is continually being updated and recent figures are more accurate and complete than in earlier publications. The Register was established in 1977, with the aims of being basically descriptive: to provide accurate numerator data on the major cause of childhood motor handicap. In addition it was planned to utlisie the data base as a population sampling frame for epidemiological studies searching for causes of the CPs. It is now an ongoing collection and it is the only population-based Cerebral Palsy Register in Australia. Four others exist in the world, one in Denmark (Hansen, 1960; Glenting, 1976), one in Sweden (Hagberg et al., 1975a, 1975b, 1976), one in County Cork, Ireland (Cussen et al., 1978), and one in Newcastle-Upon-Tyne in UK (Hey, personal communication). It is of considerable current interest, as paediatric research is expanding into the causes of childhood handicaps generally, and perinatal researchers are keen to monitor the trends of major handicap in relation to changes in perinatal care.

Thesis (M.S.)--University of Delaware, 2007. / Principal faculty advisor: Nancy Getchell, Dept. of Health, Nutrition, and Exercise Sciences. Includes bibliographical references.

Thesis (Ph.D.)--Drexel University, 2009. / Includes abstract. Includes bibliographical references (leaves 110-114).

Thesis (B.Sc)--University of Hong Kong, 2000. / "A dissertation submitted in partial fulfilment of the requirements for the Bachelor of Science (Speech and Hearing Sciences), The University of Hong Kong, May 10, 2000." Also available in print.

Orientador: Fausto Viterbo / Banca: José Carlos Marques de Faria / Banca: Amilton Antunes Barreira / Banca: José Antonio Garbino / Banca: Susana Fabíola Müller / Resumo: Várias técnicas são utilizadas para o tratamento da paralisia facial, entre elas o enxerto de nervo transfacial e a transposição muscular. Estas técnicas foram associadas utilizando neurorrafia término-terminal (NTT) para tornar o músculo temporal duplamente inervado, porém, a secção de nervos saudáveis pode levar à atrofia ou enfraquecimento muscular. Os objetivos deste trabalho foram analisar a ocorrência da dupla inervação muscular através da neurorrafia término-lateral (NTL), avaliar a imediata inervação muscular através da NTL, evitando atrofia muscular e avaliar a ocorrência de degeneração Walleriana no segmento distal à NTL no nervo receptor. Foram utilizados 140 ratos Wistar divididos em sete grupos experimentais. O G1 foi o grupo controle de normalidade e o G2 o controle de desnervação. Em 80 ratos foi realizada a dupla inervação muscular (DIM) suturando o segmento proximal do nervo tibial (NT) na lateral intacta do nervo fibular comum (NFC). Estes ratos foram divididos em quatro grupos: G3 no qual os animais foram sacrificados após 120 dias; G4 onde 120 dias após a realização da DIM, o NFC foi seccionado proximal à NTL, estes animais foram sacrificados após 30 dias da secção; no G5 os animais foram sacrificados após 150 dias; no G6 120 dias após a realização da DIM, o NFC e o NT foram seccionados proximalmente à NTL e os animais foram sacrificados após 30 dias das secções; e no G7 o nervo fibular comum foi seccionado e, após 30 dias, o segmento proximal do NT foi suturado à lateral do coto distal do NFC e os animais foram sacrificados 120 dias após a NTL. Após realização dos testes da marcha e eletrofisiológico, os músculos tibiais craniais direitos (MTCD) foram removidos e pesados e os segmentos de nervo de interesse também foram coletados. Foram realizadas análises histomorfométricas das fibras do MTCD e fibras nervosas... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Among several techniques for facial palsy treatment, we have the transfacial nerve graft and the muscular transposition. Nowadays, these methods were associated using end-to-end neurorraphy (EEN). Even though the temporalis muscle became double innervated, the health nerve section possibly leads the muscular atrophy or even its weakness. The aim of this study was to analyze, through end-to-side neurorrhaphy (ESN), the double innervation of the muscle, the immediately muscular innervation and also evaluate the Wallerian degeneration occurrence in the distal segment of receptor nerve. One hundred forty Wistar rats were divided in seven experimental groups, 20 animals per group. The G1 was the sham group; G2 the control dennervation group. In 80 rats the double muscular innervations (DMI) was performed, the proximal segment of tibial nerve (TN) was sutured laterally to the intact peroneal nerve (PN). These 80 rats were divided in four groups: in G3 the animals were killed after 120 days; in G4, post 120 days, the peroneal nerve was cut proximal the ESN and after more 30 days the animals were killed; in the group G5 the rats were killed after 150 days; in G6 post 120 days, the peroneal and also the tibial nerves were cut proximal to the ESN and the animals were killed 30 days after the second surgery. Finally in the G7 the fibular nerve was sectioned and after 30 days, the proximal end of tibial nerve was sutured laterally to the peroneal distal stump. These rats (G7) were killed 120 days post ESN. The animals were submitted to walking track analysis and electrophysiological tests. After that, the right tibial cranial muscle (RTCM) was removed and the aim nerve segments were collected and weighted. The rats were killed with high doses of intraperitoneal sodium pentobarbital. Histomorphometrical analysis of TCM and nervous fiber was performed... (Complete abstract click electronic access below) / Doutor