The potential of cell therapies for cerebral palsy: where are we today?

Iona Novak, Madison Cb Paton, Alexandra R Griffin, Michelle Jackman, Remy K Blatch-Williams, Megan Finch-Edmondson

• PMID: 37428111
• DOI: 10.1080/14737175.2023.2234642

No abstract available

Keywords: Cerebral palsy; efficacy; inflammation; mesenchymal stem cells; safety; stem cells; umbilical cord blood.

Professor Novak is the Cerebral Palsy Alliance Chair of Allied Health, and co-founder of the Cerebral Palsy Alliance Research Institute, affiliated with the Brain and Mind Centre and Faculty of Medicine and Health at The University of Sydney.

Tune in to hear a touching story about a mother and her son’s old wheelchair. God always has a plan and purpose for everything. Giving the gift of something as simple as a wheelchair and the gospel of Jesus Christ can truly change a child’s life.

This Christmas, you can give the Perfect Gift!

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Thank you for listening! Your support of Joni and Friends helps make this show possible.

Joni and Friends envisions a world where every person with a disability finds hope, dignity, and their place in the body of Christ. Become part of the global movement today at www.joniandfriends.org.

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F-words and early intervention ingredients for non-ambulant children with cerebral palsy: A scoping review

Ana Carolina De Campos, Álvaro Hidalgo-Robles, Egmar Longo, Claire Shrader, Ginny Paleg

Abstract

Aim: To explore the ingredients of early interventions provided to young children with cerebral palsy (CP) who are classified in Gross Motor Function Classification System (GMFCS) levels IV and V, and to identify the 'F-words' addressed by the interventions.

Method: Searches were completed in four electronic databases. Inclusion criteria were the original experimental studies that fitted the following PCC components: population, young children (aged 0-5 years, at least 30% of the sample) with CP and significant motor impairment (GMFCS levels IV or V, at least 30% of the sample); concept, non-surgical and non-pharmacological early intervention services measuring outcomes from any of the International Classification of Functioning, Disability and Health domains; and context, studies published from 2001 to 2021, from all settings and not limited to any specific geographical location.

Results: Eighty-seven papers were included for review, with qualitative (n = 3), mixed-methods (n = 4), quantitative descriptive (n = 22), quantitative non-randomized (n = 39), and quantitative randomized (n = 19) designs. Fitness (n = 59), family (n = 46), and functioning (n = 33) ingredients were addressed by most experimental studies, whereas studies on fun (n = 6), friends (n = 5), and future (n = 14) were scarce. Several other factors (n = 55) related to the environment, for example, service provision, professional training, therapy dose, and environmental modifications, were also relevant.

Interpretation: Many studies positively supported formal parent training and use of assistive technology to promote several F-words. A menu of intervention ingredients was provided, with suggestions for future research, to incorporate them into a real context within the family and clinical practice.

A roundtable discussion about the clinical application of Mobility as a Human Right!

Mobility is a fundamental human right and is supported by the United Nations and the ON Time Mobility framework.

W Logan, Bethany M Sloane, Lisa K Kenyon, Heather A Feldner 

PMID: 37232636 
PMCID: PMC10215286 
DOI: 10.3390/bs13050399 

Free PMC article 

Abstract 

Mobility is a fundamental human right and is supported by the United Nations and the ON Time Mobility framework. The purpose of this study was to understand the effect of a powered mobility intervention on developmental changes of children with cerebral palsy (CP). 

This study was a randomized, crossover clinical trial involving 24 children (12-36 months) diagnosed with CP or with high probability of future CP diagnosis based on birth history and current developmental status. Children received the Explorer Mini and a modified ride-on car in randomized order, each for 8 weeks. 

The Bayley Scales of Infant and Toddler Development-4th Edition was administered at baseline, mid-study, and end-of-study. Raw change scores were used for analysis. 

Total minutes of use per device was categorised as low or high use for analysis based on caregiver-reported driving diaries. 

Explorer Mini: The high use group exhibited significantly greater positive change scores compared to the low use group on receptive communication, expressive communication, and gross motor sub scales (p less than 0.05). 

Modified ride-on car: No significant differences between low and high use groups. Regardless of device, low use was associated with no significant developmental change and high use was associated with positive developmental changes. Mobility access is critical to maximize the development of children with CP and may be augmented by using powered mobility devices. 

Results may have implications for the development of evidence-based guidelines on dosage for powered mobility use. 

Keywords: cerebral palsy; disability; mobility; technology.

Powered Mobility Device Use and Developmental Change of Young Children with Cerebral Palsy

Mobility is a fundamental human right and is supported by the United Nations and the ON Time Mobility framework.

The purpose of this study was to understand the effect of a powered mobility intervention on developmental changes of children with cerebral palsy (CP).

This study was a randomized, crossover clinical trial involving 24 children (12-36 months) diagnosed with CP or with high probability of future CP diagnosis based on birth history and current developmental status. Children received the Explorer Mini and a modified ride-on car in randomized order, each for 8 weeks. The Bayley Scales of Infant and Toddler Development-4th Edition was administered at baseline, mid-study, and end-of-study. Raw change scores were used for analysis. Total minutes of use per device was categorized as low or high use for analysis based on caregiver-reported driving diaries.

Explorer Mini: The high use group exhibited significantly greater positive change scores compared to the low use group on receptive communication, expressive communication, and gross motor subscales (p < 0.05). 

Modified ride-on car: No significant differences between low and high use groups. Regardless of device, low use was associated with no significant developmental change and high use was associated with positive developmental changes. 

Mobility access is critical to maximize the development of children with CP and may be augmented by using powered mobility devices. 

Results may have implications for the development of evidence-based guidelines on dosage for powered mobility use.

Brain activation changes following motor training in children with unilateral cerebral palsy: An fMRI study

Rodrigo Araneda, Laurance Dricot, Daniela Ebner-Karestinos, Julie Paradis, Andrew M Gordon, Kathleen M Friel, Yannick Bleyenheuft

Free article

Abstract

Background: Intensive motor-learning-based interventions have demonstrated efficacy for improving motor function in children with unilateral spastic cerebral palsy (USCP). Although this improvement has been associated mainly with neuroplastic changes in the primary sensori-motor cortices, this plasticity may also involve a wider fronto-parietal network for motor learning.

Objective: To determine whether hand-arm bimanual intensive therapy including lower extremities (HABIT-ILE) induces brain activation changes in an extensive network for motor skill learning and whether these changes are related to functional changes observed after HABIT-ILE.

Methods: In total, 25 children with USCP were behaviourally assessed in manual dexterity and everyday activities before and after HABIT-ILE. Functional imagery monitored brain activity while participants manipulated objects using their less-affected, more-affected or both hands. Two random-effects-group analyses performed at the whole-brain level assessed the brain activity network before and after therapy. Three other random-effects-group analyses assessed brain activity changes after therapy. Spearman's correlations were used to evaluate the correlation between behavioural and brain activity changes.

Results: The same fronto-parietal network was identified before and after therapy. After the intervention, the more-affected hand manipulation elicited a decrease in activity on the motor cortex of the non-lesional hemisphere and an increase in activity on motor areas of the lesional hemisphere. The less-affected hand manipulation generated a decrease in activity of sensorimotor areas in the non-lesional hemisphere. Both-hands manipulation elicited an increase in activity of both hemispheres. Furthermore, we observed an association between brain activity changes and changes in everyday activity assessments.

Conclusion: Brain activation changes were observed in a fronto-parietal network underlying motor skill learning with HABIT-ILE in children with USCP. Two different patterns were observed, probably related to different phases of motor skill learning, representing an increased practice-dependent brain recruitment or a brain activation refinement by more efficient means. CLINICALTRIALS.GOV: NCT01700777 &NCT02667613.

Keywords: Cerebral palsy; FMRI; HABIT-ILE; Intensive therapy; Neuroplasticity.

Eye movements and stress during eye-tracking gaming performance in children with dyskinetic cerebral palsy

Saranda Bekteshi, Petra Karlsson, Lieselot De Reyck, Karen Vermeerbergen, Marco Konings, Patrick Hellin, Jean-Marie Aerts, Hans Hallez, Bernard Dan, Elegast Monbaliu

Affiliations expand

• PMID: 35393636
• DOI: 10.1111/dmcn.15237

Abstract

Aim: This study aimed to explore eye movements and stress during eye-tracking gaming performance in children with dyskinetic cerebral palsy (CP) compared with typically developing children, and associations between eye-tracking performance, eye movements, stress, and participants' characteristics.

Method: This cohort study included 12 children with dyskinetic CP aged 5 to 12 years (mean age 8 years 7 months, standard deviation [SD] 2 years 3 months) and 23 typically developing children aged 5 to 13 years (mean age 9 years 0 months, SD 2 years 7 months). Participants played 10 eye-tracking games. Tobii X3-120 and Tobii Pro Lab were used to record and analyse eye movements. Stress was assessed through heart rate variability (HRV), recorded during rest, and eye-tracking performance using the Bittium Faros360° ECG Holter device. Eye-tracking performance was measured using gaming completion time. Fixation and saccade variables were used to quantify eye movements, and time- and frequency-domain variables to quantify HRV. Non-parametric statistics were used.

Results: Gaming completion time was significantly different (p < 0.001) between groups, and it was negatively correlated with experience (rs = -0.63, p = 0.029). No significant differences were found between groups in fixation and saccade variables. HRV significantly changed from rest to eye-tracking performance only in typically developing children and not in children with dyskinetic CP.

Interpretation: Children with dyskinetic CP took longer to perform the 10 games, especially the inexperienced users, indicating the importance of the early provision of eye-tracking training opportunities. It seems that eye-tracking tasks are not a source of increased stress and effort in children with dyskinetic CP.

What this paper adds: Participants with dyskinetic cerebral palsy (CP) took twice as long to perform 10 eye-tracking games than typically developing peers. Participants with dyskinetic CP with previous eye-tracking experience performed the games faster. Fixation and saccade variables were not significantly different between children with and without dyskinetic CP. Heart rate variability showed no differences between rest and performance in participants with dyskinetic CP. Gross Motor Function Classification System, Manual Ability Classification System, and Viking Speech Scale levels were not correlated to the eye movements or stress variables.

In this episode, Arnie and Fred begin by discussing Jesus' transfiguration. We note where this occurred, who was there and what was said. All of the accounts by Matthew, Mark and Luke mention the transfiguration. That being the case, we look at that term and what is meant by it. Peter was among those who were there, and he discussed it in his second letter. We look at that account. We then move on to talking about several of the over 50 miracles that Jesus performed. We note the different people who benefitted from His actions and why these miracles were performed. Take about 30-minutes to listen in on our discussion. Have your Bible handy so you can verify what we are saying. There is a transcript provided of this Buzzsprout episode for your convenience. 

Assistant Professor Sudarshan Dayanidhi 

Shirley Ryan Ability Lab, NorthWestern University

Presentation title: Mitochondrial energetics in impaired muscle growth and across functional levels in children with cerebral palsy 

Lize Kleeren (PhD  Candidate) and Lisa Decraene (PhD Candidate)

KU Leuven

Presentation titles

1: Proximal proprioception in children with and without unilateral cerebral palsy, measured with state-of-the-art robotics.

2: Robotic evaluation of bimanual coordination in children with unilateral cerebral palsy with different manual abilities.

Dr Lisa Mailleux 

University of Leuven

Presentation: The assessment of grip strength and stereognosis in preschool aged children with and without unilateral cerebral palsy

Professor Roslyn Boyd 

Queensland Cerebral Palsy and Rehabilitation Research Centre, University of Queensland

Presentation title: Efficacy of infant friendly Baby-CIMT and Baby-BIM in a randomised trial of home-based parent delivered early intervention for infants at risk of unilateral cerebral palsy

Ms Atefeh Taghizadeh, PhD Candidate 

LaTrobe University

Presentation title: Development and psychometric properties of the Upper Limb-Motor Learning Strategy Tool (UL-MLST) for children with cerebral palsy

Professor Sylvain Brochard

(Co-chair of the technological task force for EACD)  and BEaCHiLD (Breizh Research and Innovation Centre for Child Development and Rehabilitation) and 

Niek De Taeye:

Head of family user forum of EACD and parent of daughter with CP.

Presentation title: Building technologies for children with disabilities: how to start from their needs?