New Clinical and Research Trends in Lower Extremity Management for Ambulatory Children with Cerebral Palsy - 05/08/11

Doi : 10.1016/j.pmr.2009.04.005

Diane L. Damiano, PhD, PT ^a,^⁎ , Katharine E. Alter, MD ^a,^b, Henry Chambers, MD ^c
^a Functional & Applied Biomechanics Section, Clinical Center, National Institutes of Health, 10 Center Drive, Room 1-1469, Bethesda, MD 20892, USA
^b Rehabilitation Medicine Department, National Institute for Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
^c Department of Orthopedic Surgery, University of California at San Diego, Rady Children’s Hospital, 3030 Children’s Way, San Diego, CA 92123, USA

Corresponding author. Functional & Applied Biomechanics Section, Clinical Center, National Institutes of Health, 10 Center Drive, Room 1-1469, Bethesda, MD 20892, USA.

Résumé

Cerebral palsy (CP) is the most prevalent physical disability in childhood and includes a group of disorders with varying manifestations. This article focuses on current and future intervention strategies for improving mobility and participation during the lifespan for ambulatory children with CP. The provision and integration of physical therapy and medical and orthopedic surgery management focused primarily on the lower extremities are discussed here. Some of the newer trends are more intense and task-related exercise strategies, greater precision in tone identification and management, and a shift towards musculoskeletal surgery that focuses more on promoting dynamic bony alignment and less on releasing or lengthening tendons. Advances in basic and clinical science and technology development are changing existing paradigms and offering renewed hope for improved functioning for children with CP who face a lifelong disability with unique challenges at each stage in life.

Le texte complet de cet article est disponible en PDF.

Keywords : Physical therapy, Medication, Botulinum toxin, Gait, Orthopedic surgery, Training, Spasticity