Conditions like cerebral palsy, which are often the result of a birth injury, affect a person’s motor abilities, making it difficult, and sometimes nearly impossible, to walk or talk correctly.

The medical care and other treatments used to reduce the effects of cerebral palsy are a diverse and widely debated topic. In addition to medical methods of preventing and treating the condition, many parents turn to alternative treatments in order to increase flexibility and muscle strength, as well as to alleviate pain.

Lokomat robot-assisted walking therapy is one method that many have found to be effective. This method has the patient use a treadmill with the help of a harness and robotic legs. A computer monitors the speed and natural motion of the legs, creating a repetitive walking pattern that seems to help strengthen the muscles, improve circulation and teach the brain to use and recognize walking motions.

CBS recently broadcasted the story of MacKenzie Maher, a young girl born with cerebral palsy. When her inability to walk became apparent, MacKenzie’s parents worked with numerous doctors and ended up using the Lokomat method in a clinical trial. Now, MacKenzie can walk on her own.

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A study whose conclusions were published in the medical journal Pediatrics postulates a possible link of the increased incidence of twinning in society to the increased incidence of cerebral palsy.

Based on examining the birth outcomes of over 155,000 children, the researchers from the National Institute of Neurological Disorders and Stroke (NINDS) and the California Birth Defects Monitoring Program (CBDMP) saw that twin pregnancies led to the development of cerebral palsy ten times more often than what is seen among singleton births.

“With the number of twin births on the rise in this country and others, it is vital for us to increase our base of scientific knowledge about this very special population,” said Patricia A. Grady, Ph.D., acting director of the NINDS. “Twins accounted for 10 percent of all cases of CP in this study, and we need to explore the reasons behind that number.”

The study was led by Judith K. Grether, Ph.D, and epidemiologist at the CBDMP, which is part of the California Department of Health Services. Joining her was Karin B. Nelson, MD, acting chief of the NINDS Neuroepidemiolgy Branch. The scientists looked at 2,985 individuals from 1,537 twin pairs born between the years 1983 and 1985 in four counties in Northern California who lived to at least age three. Their findings showed that out of the close to 3,000 children from twinned pregnancies, 20 children from 18 pairs had cerebral palsy. The study found that about seven children out of every one thousand twin children had either moderate or severe CP. In addition, more than 10 twin pairs out of every thousand twin pregnancies had CP in either one or both members.

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Michael Kutcher, brother to famous actor Ashton Kutcher, has been sharing his story of struggling with cerebral palsy. While talking to kids at Ottumwa High School in Iowa, Kutcher explained how his brother “Jabba the Hutt” was born 10.5 pounds, while he weighed only 4 pounds and was over-oxygenated.

Kutcher recounted that he was diagnosed with mild cerebral palsy at the age of three and that he has impaired walking ability, difficulty using his right side, and hearing loss in his left ear.

Kutcher told a story about playing basketball with Ashton and being told to us his “right hand.” Mike walked away, complaining that it wasn’t fair since his right hand was impaired. Ashton said, “You can do anything you want. I can’t make that shot for you. Mom’s not here; she can’t do it for you. It’s your challenge. Stop using your disability as a crutch. This is your obstacle.”

These words stayed with him for the rest of his life. At the age of 13, he needed a heart transplant and experienced cardiac arrest. He received a donor heart just 24 hours before the doctors told his parents that his time would run out, and he was given a life expectancy of seven years with the new heart. It’s now been 20.

Michael explained that, at that point, “I decided to stop being Ashton’s brother and start being Michael Kutcher.

Michael now spends his time employed in sales for a company in Cedar Rapids and Los Angeles, but he also speaks to young people about disability awareness and overcoming obstacles they face.

Certainly a story worth listening to.

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Monitoring fetal heart rates during delivery is a routine practice performed in all hospitals in order to ensure the infant’s health during the ordeal. A new method, called ‘STAN’, is part of a nationwide study that allows nurses and doctors to follow the infant’s oxygen levels as well. Lack of oxygen during birth can cause severe brain damage, and is one of the main causes of conditions like cerebral palsy.

“The STAN monitor interacts with the fetus exactly the same (as the traditional heart rate trackers), but it offers a different way of looking at the information,” explained Nikki Dekker, a specialist on the method’s trials.

The STAN is attached to the baby’s head after dilation, and presents readings on the fetus’s oxygen use throughout the labor.

Dr. Bill Grobman of the Northwestern Medical Faculty Foundation, one of the facilities participating in the monitor project, explained that the monitor significantly reduces the guessing games that often ensue when there is only a heart monitor present. With oxygen intake on the screen, doctors are able to identify dangers, as well as increase or reduce intervention, lowering the risk of brain damage and cerebral palsy.

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A new medical imaging tool created by Simon Fraser University associate professor James Wakeling may help orthopaedic surgeons working with tendon-transfers for cerebral palsy patients and those with other conditions. The new invention is a medical imaging tool that includes a new signal-processing method for looking at muscle activation details.

Wakeling’s method for looking at muscle movement includes a new way of looking at ultrasound imaging, 3D motion-capture technology and proprietary data-processing software. The ultimate product is a 3D map of the muscle structure that can be produced in only 90 seconds.

Previous methods for medical-imaging of the muscles took 15 minutes to produce – which is far too long to ask people to hold one muscle contraction. Now, with the new technology, surgeons will, hopefully, have new software programs that will help them to predict the outcome of orthopaedic surgeries for treating cerebral palsy in children and other muscle conditions.

Wakeling developed the software with graduate student Manku Rana. As Wakeling explained, “Now, we can get people to do muscle contractions and we can actually see how the internal structure of the muscle changes.”

At the moment, software packages leave out important information about muscle contractions, and these are details that the new software can capture. The new software can now show how the muscle shape changes, how it bulges at times, and even how the internal muscle fibres might curve.

As Wakeling said, “We’re poised to start making new observations and insights,” he says, “and to do new experiments that haven’t been possible before.”

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Cerebral palsy is a condition that affects muscle control, inhibiting movement and speech. Cerebral palsy patients often require lifelong medical treatments to improve their quality of life, with limited success. Alternative therapies are becoming more popular as parents learn about their various options.

One of these options is acupuncture. Though there are limited studies to prove the full effectiveness of the treatment, new research has implied that the practice may in fact have a positive effect on patients. Most acupuncture treatments for cerebral palsy patients are aimed at reducing pain and boosting flexibility and strength of the muscles.

In 2010, a research paper studying 3,286 children with cerebral palsy revealed that acupuncture does in fact improve patients’ day-to-day quality of life. The therapy also appears to “increase independence and verbal ability.” Similar studies have shown that acupuncture can improve speech as well as strengthen bone density. Other studies have found that combining music therapy with acupuncture is even more effective than acupuncture alone.

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For parents of children with cerebral palsy, it’s always a very important and difficult decision to make when placing a child in the educational framework.  The Center for Disease Control and Prevention estimates that about 10,000 children are diagnosed with cerebral palsy each year; the good news for parents is that cerebral palsy symptoms are often noticed between birth and three years of age, allowing parents a decent amount of time to figure out the right educational answers.

 
Children with cerebral palsy often receive a large basket of extra assistance which includes occupational therapy, physical therapy, speech therapy and other techniques.  They can be educated either in a general education setting with addition help on the side, or in a special education classroom.  While focusing on strengthening skills with the child, educators also focus for cerebral palsy children on life skills. These include self-care skills that enable the child to be more independent as she grows.

Certainly, just as no two children are the same in their educational needs, no two children with cerebral palsy are. This means that the professional team needs to consult with each other and to overlap services to best provide for the cerebral palsy child’s needs.  A child with fine motor skills issues may also have speech issues, sensory needs and beyond.

Similarly, the classroom where the child learns needs to be physically arranged to suit the child.  The child needs to be able to move about freely and without hindrance.  The child may need to be seated near the front of the room, and may need FM audio amplification systems, modified writing paper, oral assessments and other modifications that the school team can identify.

Parents of the cerebral palsy child should search for the best fit for their child before starting the educational process.  They should consult with any therapists the child is already working with, with the educational school choices in the area, and with doctors to find the right fit and the best location for the child’s needs.

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Researchers from Case Western Reserve University have found that mothers who integrate the care needs of their technology-dependent child into the larger family life have families that then function more productively.  Valerie Toly was the lead researcher on the study, “A Longitudinal Study of Family with Technology–Dependent Children” published in the journal of Research in Nursing & Health.

Studying 82 mothers with technology-dependent children who had issues like cerebral palsy, the researchers interviewed the mothers during visits to a hospital’s specialty clinic and then gave them six surveys after they left the hospital. They were then interviewed again 12 months after the first set of interviews.

Toly explained that the study included children who “are in high risk, vulnerable group.” She said that “3 children died in the one year span of time between interviews and one mother died. This is much higher than the general population.”

Toly explained that the perception of the child’s illness is of paramount importance. The researchers found that integrating the technology-dependent child into regular family events is critically important. As Toly explained, “Mothers integrate technology-dependent child into the family by being flexible about when to give medications or food.”

Certainly, it’s a detailed juggling act to keep the needs of the entire family in mind, and to juggle that along with the needs of the cerebral palsy child.  Interestingly enough, Toly explained that, “A mother’s depression plays a greater role in family functioning than the child’s severity of illness.”

Toly said that there is still much work to be done to understand how families deal with their everyday lives in the face of such hurdles, but researchers are beginning to uncover tools to help parents to cope and to integrate these children into the family picture.

Source

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A new treatment for infants who have experienced birth asphyxia, one of the causes of cerebral palsy, is the subject of research at the Sahlgrenska Academy at the University of Gothenburg.

When a newborn is deprived of oxygen at birth, the brain is vulnerable to damage; but because the brain damage happens over time, during a period of anywhere from hours to days, there is a window of opportunity to prevent, or at the least, reduce that damage. Doctors take advantage of this chance to improve the infant’s outcome by cooling the newborn, which slows down the process of cell death in the brain. Unfortunately this cooling therapy only shows results in one out of nine babies treated this way; and furthermore there are many infants, such as those born prematurely, who cannot be safely subjected to cooling therapy.

Ylva Carlsson, the researcher leading the new study in Sweden, looked for an alternative method of slowing down the process of cell death. The focus of her research was on an enzyme which controls the components of apoptosis, (cell death) which is the cause of the brain damage which can lead to cerebral palsy. Carlsson, who conducted the research for her doctoral thesis,explained the role of this enzyme in the development of brain damage.

 
“We’ve mapped the role this enzyme plays in the development of brain damage in newborns who suffer from birth asphyxia,” says Carlsson. “The results show that a reduction in the amount of this enzyme also reduces the extent of the brain damage. Added protection is given if cooling therapy is used too.”

 
Carlsson’s thesis also examined the relationship of age to brain damage. Using mice, she was able to show that treatments that protect fully grown individuals from brain damage can actually make the brain damage worse in infants and newborns.

“This may mean that some drugs developed for brain damage in adults should probably not be given to newborn babies,” says Carlsson. “Tailor-made treatments targeting specific brain damage mechanisms and combination treatments for children may therefore be the way forward. But first we need to look more closely at how best to control these proteins without disrupting other key functions in the growing brain.”

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Though the procedure is very expensive, many people around the world are taking note of the possible advantages to storing their child’s cord blood. Natalie Lopez, a mother in Beverly Hills, learned of the practice by chance and decided to donate the blood. “If anything was going to happen to Gabriela, then I would like to tap into that resource one day,” she explained.

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