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cerebral palsy and Stroke—Early and Late Brain Lesion Present Differences in Systemic Biomarkers and Gene Expression Related to Muscle Contractures

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World Journal of Neuroscience 2021年第1期11卷 34-47页

作者： Jessica Pingel Camille Potts Theis Wolter Petersen Jens Bo Nielsen Department of Neuroscience University of Copenhagen Copenhagen Denmark The Elsass Foundation Research Unit Charlottenlund Denmark

Background: CNS lesions that are acquired early in life e.g. cerebral palsy (CP) disturb muscle development and growth, while CNS injuries acquired later in life e.g. stroke, affect fully matured muscles and cause paresis and atrophy. These differences may result in different contracture phenotypes. Aim: The purpose of this study was to compare systemic biomarkers and gene expression levels in muscle of individuals with CNS lesions acquired early and later in life. Methods: Blood samples and muscle biopsies were analyzed using Enzyme-linked immunosorbent assay and Real-time PCR from n = 24 control participants, n = 14 individuals with cerebral palsy, and n = 12 stroke survivors. Results: Systemic markers: Myostatin was significantly decreased in both the cerebral palsy (p = 0.0051), and the stroke group (p = 0.036). Creatine Kinase-MB and C-Reactive Protein were significantly elevated in stroke patients only (p 0.034 respectively). Gene expressions: The expression of myostatin (MSTN) was significantly lower in both the ST and the CP group when compared to Ctrl (p = 0.02). In addition, collagen type 4A1 (COL4A1) was significantly lower in the CP group compared to the other groups (p = 0.015). Finally, the troponin 1 slow skeletal muscle type was significantly increased in the ST group when compared to both CP and Ctrl (p = 0.03). Conclusion: The downregulation of myostatin in individuals with both early and late CNS injury is likely a compensatory reaction to muscle weakness, reduced muscle mass and/or muscle atrophy. Changes in gene expression may reflect a specific alteration depending on when in life the CNS lesions were acquired.

关键词： cerebral palsy Stroke Biomarkers Creatin Kinase Myostatin C-Reactive Protein

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cerebral palsy 2005

Critical Analysis of Children’s Drawings as a Diagnostic Tool for Body Schema and Body Image Disorder in cerebral palsy

2005年

作者： Freeman Miller

来源：畅想之星图书光盘版（南... 评论

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Neuroscience & Medicine 2016年第4期7卷 133-148页

作者： Renée Lampe Ines Lützow Tobias Blumenstein Varvara Turova Ana Alves-Pinto Markus Würth Foundation Orthopedics Department Clinic “rechts der Isar” Technical University of Munich Munich Germany Research Unit of Buhl-Strohmaier-Foundation for Children Neuro-Orthopedics and cerebral palsy Clinic “rechts der Isar” Technical University of Munich Munich Germany Stiftung ICP München Munich Germany

cerebral palsy is a multiple disability manifested by motor deficits and impairments of cognition, language, and body perception. To assess if body schema and body image distortion in children and youth with cerebral palsy can be represented through draw-a-person-test, outcome measure of conscious and subconscious body awareness, visual perception and cognition in two age-matched groups, one with cerebral palsy and other with developmental disability, were collected. The outcome was compared within the two groups and with reference data (healthy population) and correlated with the outcome of draw-a-person test. Decreased scores in the draw-a-person test in subjects with cerebral palsy compared both to subjects with developmental disorders and to healthy population had strongly correlated with decreased scores in visual perception. This suggests that draw-a-person test may provide a preliminary guidance for the assessment of visual perception. No statistically significant effect of cognitive abilities on performance in the draw-a-person test was found. The influence of both conscious and subconscious body awareness on the scores in the draw-a-person test was not significant, which confirms that this test alone is not fully reliable to detect the body schema and body image disorder in cerebral palsy.

关键词： cerebral palsy Draw-a-Person-Test Body Perception Body Representation Disorder

Effects of scalp acupuncture plus acupuncture exercise therapy on walking ability in children with spastic cerebral palsy

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Journal of Acupuncture and Tuina Science 2022年第3期20卷 181-186页

作者： ZHAO Yong JIN Bingxu ZHAO Wenjian CHENG Jixiang HUANG Yinying GUO Jiankun HAN Yu ZHANG Chuntao FU Jianmei Nanhai Maternity and Child Hospital Affiliated to Guangzhou University of Chinese Medicine Foshan 528200China Panyu Hospital of Chinese Medicine GuangzhouGuangdong ProvinceGuangzhou 511400China

Objective:To compare the effect of scalp acupuncture and scalp acupuncture plus acupuncture exercise therapy(AET)on walking ability in children with spastic cerebral palsy(CP).Methods:A total of 60 spastic CP children with gross motor function classification system(GMFCS)gradesⅠ-Ⅲwere divided into a control group and an observation group by the random number table method,with 30 cases in each *** groups were treated with the same conventional rehabilitation and scalp acupuncture therapy for *** control group received conventional rehabilitation first and then scalp *** observation group received AET,which was to receive the conventional rehabilitation and scalp acupuncture *** and after treatment,the clinical efficacy was evaluated by the modified Ashworth scale(MAS)score,scores of dimensions D and E of the gross motor function measure(GMFM)scale,walking speed,and walking ***:During treatment,there were 2 dropouts in the observation *** 3 courses of treatment,the MAS scores in both the control group and observation group decreased compared with the same group before treatment(P<0.05),and the scores of dimensions D and E of the GMFM,walking speed,and walking distance were increased(P<0.05);the between-group comparison showed that the MAS score in the observation group was lower than that in the control group(P<0.05),and the scores of dimensions D and E of the GMFM,walking speed,and walking distance in the observation group were higher or longer than those in the control group(P<0.05).Conclusion:W ith the same treatments,scalp acupuncture combined with AET is superior to the conventional scalp acupuncture method in reducing lower-limb muscle tone,improving standing balance ability,and walking stability in children with spastic CP.

关键词： Acupuncture Therapy Scalp Acupuncture Scalp Stimulation Areas Acupuncture Exercise Therapy cerebral palsy Myospasm Movement Disorders Child,Preschool

Effect of acupuncture on improving the quality of life in children with cerebral palsy and their parents

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Journal of Acupuncture and Tuina Science 2016年第3期14卷 225-230页

作者：刘永锋于海波李志峰杨颖黄杏贤韩丑萍(译) Shenzhen Hospital of Traditional Chinese Medicine Guangdong ProvinceShenzhen 518033China Luohu District Hospital of Traditional Chinese Medicine ShenzhenGuangdong ProvinceShenzhen 518000China 不详

Objective： To observe the spleen-strengthening and mind-regulating acupuncture method on the quality of life of children with cerebral palsy （CP） and their parents. Methods： A total of 76 CP children were randomly allocated into a treatment group （n=38） and a control group （n=38） according to their vJsJt sequence. The CP chJJdren and theJr parents Jn both groups receJved the same psychologJcaJ counselling. The CP children in the treatment group were intervened with spleen-strengthening and mind-regulating acupuncture method, versus routine acupuncture method in the control group. The parents of CP children in the treatment group were intervened with three mind-regulating points, versus placebo in the control group. The developmental quotients were evaluated using the Gesell scale before and after treatment. The anxieties of parents were assessed using the self-rating anxiety scale （SAS） before and after treatment. The efficacies were evaluated using the comprehensive functional assessment of CP children. Results： After 6 months of treatment, the Gesell scores of CP children and SAS scores of the parents were significantly improved in both groups, and there were intra-group and inter-group statistical differences （both P〈0.05）. In addition, the scores of comprehensive functional assessment of CP children in the treatment group were significantly higher than those in the control group （P〈0.05）. Conclusion： The spleen-strengthening and mind-regulating acupuncture method can effectively improve the comprehensive ability of CP children, alleviate the anxiety in parents of CP children, improve the quality of life of CP children and their parents, and play an active role in rehabilitative care of CP children.

关键词： Acupuncture Therapy cerebral palsy Rehabilitation Anxiety Quality of Life

Clinical observation on muscle regions of meridians needling method in improving upper limb function for children with cerebral palsy of spastic hemiplegia type

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Journal of Acupuncture and Tuina Science 2020年第4期18卷 295-301页

作者： Li Nuo Jin Bing-xu Zhao Yong Fu Wen-jie Liu Zhen-huan Liang Bi-qi Pang Bi-hui Nanhai Maternity and Children's Hospital Affiliated to Guangzhou University of Chinese Medicine Foshan 528200China

Objective:To observe the improving effect of muscle regions of meridians needling method on the upper limb function in children with cerebral palsy of spastic hemiplegic ***:A total of 100 children with cerebral palsy of spastic hemiplegia type were divided into a treatment group and a control group according to the visiting sequence,with 50 cases in each *** control group was treated with conventional rehabilitation plus conventional acupuncture *** treatment group was treated with conventional rehabilitation plus muscle regions of meridians needling *** electromyography(EMG)signal values of triceps brachii and pronator teres were detected before treatment,and 3 months and 6 months after *** clinical efficacy was evaluated by Peabody developmental motor scale-fine motor(PDMS-FM)and fine motor function measure(FMFM).Results:Three and six months after treatment,the EMG signal values of triceps brachii and pronator teres,grasping scores and visual-motor integrated scores of PDMS-FM and the FMFM scores in both groups increased to varying degrees compared with the same group before treatment,and the intra-group differences were all statistically significant(all Pcerebral palsy of spastic hemiplegia *** efficacy is superior to that of the conventional rehabilitation plus conventional acupuncture treatment.

关键词： Acupuncture Therapy Musculature of 12 Meridians Rehabilitation cerebral palsy Hemiplegia Myospasm Movement Disorders Child,Preschool

Deep brain stimulation for the treatment of cerebral palsy: A review

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Brain Science Advances 2020年第1期6卷 20-29页

作者： Hongjie Jiang Rui Wang Zhe Zheng Junming Zhu Department of Neurosurgery Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009China

Deep brain stimulation(DBS)has been used as a safe and effective neuromodulation technique for treatment of various diseases.A large number of patients suffering from movement disorders such as dyskinesia may benefit from *** palsy(CP)is a group of permanent disorders mainly involving motor impairment,and medical interventions are usually unsatisfactory or temporarily active,especially for dyskinetic *** may be another approach to the treatment of *** this review we discuss the targets for DBS and the mechanisms of action for the treatment of CP,and focus on presurgical assessment,efficacy for dystonia and other symptoms,safety,and risks.

关键词： deep brain stimulation(DBS) cerebral palsy dyskinesia

Therapeutic efficacy of acupuncture plus Tuina for spastic cerebral palsy and discussion of its mechanism

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Journal of Acupuncture and Tuina Science 2022年第2期20卷 111-118页

作者： XU Yan SHAO Zheng YU Yunyang XIAO Yao LUO Yujun YANG Jin Department of Rehabilitation Hubei Provincial Hospital of Traditional Chinese MedicineWuhan430061China Department of Children Rehabilitation Huangshi Central HospitalAffiliated Hospital of Hubei Polytechnic UniversityEdong Healthcare GroupHuangshi435000China

Objective To discuss the effects of acupuncture plus Tuina(Chinese therapeutic massage)in intervening the mental development,motor function,cerebral hemodynamics,and muscle tone in kids with spastic cerebral palsy(CP).Methods A retrospective analysis was conducted on 87 kids with spastic *** were divided into a control group and an observation group based on their original treatment *** in the control group received symptomatic treatment,motor development therapy,and Tuina *** observation group was additionally given acupuncture *** month was taken as a treatment *** six courses,the efficacy,change in muscle tone,mental development,gross motor function,fine motor function,and the systolic velocity(Vs),mean velocity(Vm),and pulsatility index(PI)of the anterior cerebral artery(ACA),middle cerebral artery(MCA),and posterior cerebral artery(PCA)were compared between the two *** After treatment,the muscle tone score dropped in both groups(Pcerebral hemodynamics.

关键词： Acupuncture Therapy Tuina Massage cerebral palsy Motor Disorders Cerebrovascular Circulation Hemodynamics

Introducing an Innovative Method to Treat Spastic cerebral palsy with Faster Recovery Time: Post-Achilles Tendon Lengthening with Bandaging

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Journal of Biosciences and Medicines 2021年第12期9卷 30-39页

作者： Hamed Yazdanshenas Firoozeh Madadi Kevin Perez Eleby Rudolph Washington III Arya Nick Shamie Firooz Madadi Department of Orthopedic Surgery College of Medicine Charles R. Drew University of Medicine and Science (CDU) Los Angeles USA Department of Orthopedic Surgery David Geffen School of Medicine University of California Los Angeles (UCLA) Los Angeles USA Department of General Surgery College of Medicine Charles R. Drew University of Medicine and Science Los Angeles (CDU) Los Angeles USA Department of Family Medicine David Geffen School of Medicine University of California Los Angeles (UCLA) Los Angeles USA Department of Family Medicine College of Medicine Charles R. Drew University of Medicine and Science Los Angeles (CDU) Los Angeles USA Department of Anesthesiology Anesthesiology Research Center Shabid Beheshti University of Medical Sciences (SBMU) Tehran Iran College of Medicine Charles R. Drew University of Medicine and Science (CDU) Los Angeles USA David Geffen School of Medicine University of California Los Angeles (UCLA) Los Angeles USA Department of Orthopedic Surgery Akhtar Hospital Shabid Beheshti University of Medical Sciences (SBMU) Tehran Iran

Equinus deformity is one of the most common musculoskeletal deformities of cerebral palsy (CP) which is defined as an abnormality in ankle dorsiflexion that can cause severe walking disability. The standard surgical intervention for Equinus deformity is Achilles Tendon Lengthening (ATL) with post-operative leg casting, however in some cases, it requires months of recovery post-operation to regain movement. The objective of this study was to find an alternative to leg casting that would provide a safe and faster time course to recovery. Therefore, we conducted a semi-experimental clinical trial study of a population that included 62 CP patients between the ages of 6 - 15 years of age with diplegia, hemiplegia, or quadriplegia that randomly underwent ATL followed by subsequent leg casting (control, 32 patients) or bandage and ankle-foot orthosis (AFO;experimental, 30 patients). Patients were periodically evaluated for mobility and walking ability pre-operation and at 2 weeks post- operation, 6 weeks post-operation, and then every month for 6 months. We found that all 32 patients in the experimental group regained their walking ability within two weeks (100%), while majority of patients in the control group (84%) regained their walking ability after 4 - 6 weeks, regardless of CP type. We also found that on 6-month follow-up, progression of walking abilities was similar in both groups. Rupture of the repaired tendon was not observed in any of the participants in either group. This study suggests applying a bandage with a foot or ankle orthosis as an alternative to long leg cast in children of 15 years of age or younger with CP treated with ATL for Equinus deformity to facilitate faster post-operative recovery. It also recommends follow-up studies on confounding factors, categorization of pre- and post-operative range of movement, and post-op complications with longer follow up while treating CP patient with ATL followed by AFO.

关键词： cerebral palsy Equinus Deformity Recovery