Tuesday, September 10, 2013

Two Studies on Cerebral Palsy Advance Our Knowledge of Children with This Disorder

Children with cerebral palsy (CP), while often requiring input from neurologic, orthopedic, rehabilitative or other specialists, also need to have their longitudinal care needs coordinated and met by the medical home established by their primary care pediatrician.  Thus, the more we can learn about the longitudinal trajectory of these patients, the more we can be poised to initiate appropriate supportive services as needed to maintain and enhance the quality of life in these patients.  It is for this reason that we are sharing two studies this week that provide some new insight on the natural history of children with cerebral palsy.

The first study by Vohr et al. (doi: 10.1542/peds.2012-3915) examines growth failure along with cognitive impairment up to 6-7 years of age in children who experienced severe hypoxic ischemic encephalopathy (HIE) in early infancy.  They report results of growth parameters and neurodevelopmental status in 115 of 122 infants surviving in a hypothermia trial for neonatal HIE.  The results demonstrate a need to closely monitor growth in these patients and adjust nutritional needs and other treatments that may help prevent the lower percentiles of growth in these patients from occurring as well as perhaps improve cognitive outcomes.

The second study by Vos et al. (doi: 10.1542/peds.2013-0499) looked at the mobility performance of more than 400 patients with CP ages 1-20 years in terms of their ability to perform daily activities of life over time based on their gross motor function with or without intellectual disability.  Both gross motor function and intellectual disability play particular roles in mobility performance and/or daily activity performance, which in turn can affect the implementation of appropriate rehabilitation strategies.

If you follow a child with CP, both these articles provide insight into the long-term management you need to consider in enhancing the quality of life for these patients.  Read them both and learn more that can, in turn, be shared with the families of your CP patients.