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Participation in everyday activities of Thai children with cerebral palsy and factors associated with the frequency of participation
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Oral abstracts / Annals of Physical and Rehabilitation Medicine 61S (2018) e1–e102
Patients with closed spinal dysraphism had higher success rate vs. patients with myelomeningocele (48.2% vs. 17.4%; P = 0.02). Patients in whom the first IDBTX-A succeeded urodynamically had higher baseline bladder compliance (15.5 ml/cm H2 O vs. 7 ml/cm H2 O; P = 0.02). Maximum cystometric capacity (P < 0.0001) and compliance (P = 0.01) significantly improved after the first IDBTXA. After a mean follow up of 3.7 years, 23 patients (43.4%) required augmentation cystoplasty. Conclusion Despite IBTX-A enabled clinical improvement in most patients (66%), urodynamic outcomes were poor, resulting in a low global success rate (30%). Keywords Botulinum toxin A; Dysraphisms; Neurogenic bladder Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.rehab.2018.05.121 ISPR8-0047
Oxygen equimolar mixture of nitrous oxide during post-operative physiotherapy in patients with cerebral palsy: A randomised double-blind placebo-controlled study A. Delafontaine 1,2,3,∗ , A. Presedo 4 , D. Mohamed 5 , D. Lopes 4 , C. Wood 6 , C. Alberti 5 1 STAPS Orsay, laboratoire CIAMS, université Paris-Sud, Université Paris-Saclay, 91405 Orsay cedex, France 2 CIAMS, université d’Orléans, 45067 Orléans, France 3 CIAMS laboratory, Rungis, France 4 AP–HP, hôpital Robert-Debré, service de chirurgie orthopédique, 75019 Paris, France 5 AP–HP, hôpital Robert-Debré, URC, UEC, unité de recherche clinique, 75019 Paris, France 6 Centre de la douleur chronique, service de rhumatologie, CHU Dupuytren, Limoges, France ∗ Corresponding author. E-mail address: arnaud [email protected] (A. Delafontaine) Introduction/Background The administration of an equimolar mixture of nitrous oxide-oxygen (N2 O) is recommended during painful procedures. However, the evaluation of its use during physiotherapy after surgery has not been reported, although pain may hamper physiotherapy efficiency. This study investigated whether the use of N2 O improves the efficacy of post-operative physiotherapy after multilevel surgery in patients with cerebral palsy. Material and method It was a randomised 1:1, double-blind, placebo-controlled study. Sixty-four patients were enrolled. All patients had post-operative physiotherapy starting the day after surgery. Patients received either N2 O or placebo gas during the rehabilitation sessions. All patients had post-operative pain management protocol, including pain medication as needed for acute pain. The primary objective was to reach angles of knee flexion of 110◦ combined with hip extension of 10◦ , with the patient lying prone, within 6 or less physiotherapy sessions. Secondary evaluation criteria were the number of sessions required to reach the targeted angles, the session-related pain intensity, and the analgesics consumption for managing post-operative pain. Results Targeted angles were achieved more often in the N2 O group (23/32, 72%, vs. Placebo: 13/32, 41%; P = 0.01). Patients treated with N2 O tended to require less often level III analgesic agents for managing post-operative pain, compared to those receiving placebo: 18/32 (58%) vs. 24/32 (75%).
Conclusion The administration of N2 O during post-operative physiotherapy can help to achieve more quickly an improved range of motion, and, although not significant in our study, to alleviate the need for pain medication. Further studies evaluating the administration of N2 O in various settings are warranted. Keywords Post-operative physiotherapy; Oxygen-nitrous oxide; Cerebral palsy Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.rehab.2018.05.122 ISPR8-0247
Participation in everyday activities of Thai children with cerebral palsy and factors associated with the frequency of participation
T. Ploypetch ∗ , C. Buasuk , K. Pajareya Faculty of Medicine Siriraj Hospital, Mahidol University, Department of Rehabilitation Medicine, Bangkok, Thailand ∗ Corresponding author. E-mail address: teerada [email protected] (T. Ploypetch) Introduction/Background Different culture and socioeconomic possibly influence the level of participation, while limited information was available in developing countries. The study aims to explore participation of children with cerebral palsy (CP) in Thailand and factors associated with the frequency of participation. Material and method A survey descriptive research was done in 80 children with CP, aged 6–18 years, who visited outpatient clinics of a university hospital in Thailand. Family caregivers reported Thai-version questionnaires: the frequency of participation (FPQ), Gross Motor Function Classification System (GMFCS-ER), attitude of caregivers and socioeconomic information. Disease severity and comorbidities were reviewed. Factors were analyzed for the association with the frequency of participation. Results Children with CP, a mean age 9.7 (SD 3.3) years and 46 (57.5%) males were participated. Most subjects were spastic (88.8%) and quadriplegic (41.2%) types. Various levels of motor function were included: GMFCS level I-8 (10%), II-27 (33.8%), III6 (7.5%), IV-13 (16.2%), V-26 (32.5%). Within 14 activities, the most-frequently-participated activity was “helping with housework” that 59 (73.8%) children with CP participated in a few times/week, followed by going to shops (41.3%) and riding bike (36.3%). The least-participated activity was “taking part in community activities”, 32 (40%) children had never participated in, even though the attitude of almost caregivers (96.3%) was good. The multivariate analysis found that better GMFCS level (P = 0.014) and communication ability (P = 0.015) significantly correlated with higher frequency of participation. The children with positive family income more frequently participated in leisure activities (P = 0.031) and art/cultural events (P = 0.018). Conclusion Thai children with CP tended to participate more frequently in family activities such as housework, shopping and riding bike, whereas rarely participated in community activities. Participation in leisure activity and art/cultural events, which seemed to need free time and money associated with family income. The children with higher level of motor function and communication ability had higher frequency of participation in everyday activities. Keywords Frequency of participation; Cerebral palsy; Factors associated participation Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.rehab.2018.05.123
Oral abstracts / Annals of Physical and Rehabilitation Medicine 61S (2018) e1–e102
Patients with closed spinal dysraphism had higher success rate vs. patients with myelomeningocele (48.2% vs. 17.4%; P = 0.02). Patients in whom the first IDBTX-A succeeded urodynamically had higher baseline bladder compliance (15.5 ml/cm H2 O vs. 7 ml/cm H2 O; P = 0.02). Maximum cystometric capacity (P < 0.0001) and compliance (P = 0.01) significantly improved after the first IDBTXA. After a mean follow up of 3.7 years, 23 patients (43.4%) required augmentation cystoplasty. Conclusion Despite IBTX-A enabled clinical improvement in most patients (66%), urodynamic outcomes were poor, resulting in a low global success rate (30%). Keywords Botulinum toxin A; Dysraphisms; Neurogenic bladder Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.rehab.2018.05.121 ISPR8-0047
Oxygen equimolar mixture of nitrous oxide during post-operative physiotherapy in patients with cerebral palsy: A randomised double-blind placebo-controlled study A. Delafontaine 1,2,3,∗ , A. Presedo 4 , D. Mohamed 5 , D. Lopes 4 , C. Wood 6 , C. Alberti 5 1 STAPS Orsay, laboratoire CIAMS, université Paris-Sud, Université Paris-Saclay, 91405 Orsay cedex, France 2 CIAMS, université d’Orléans, 45067 Orléans, France 3 CIAMS laboratory, Rungis, France 4 AP–HP, hôpital Robert-Debré, service de chirurgie orthopédique, 75019 Paris, France 5 AP–HP, hôpital Robert-Debré, URC, UEC, unité de recherche clinique, 75019 Paris, France 6 Centre de la douleur chronique, service de rhumatologie, CHU Dupuytren, Limoges, France ∗ Corresponding author. E-mail address: arnaud [email protected] (A. Delafontaine) Introduction/Background The administration of an equimolar mixture of nitrous oxide-oxygen (N2 O) is recommended during painful procedures. However, the evaluation of its use during physiotherapy after surgery has not been reported, although pain may hamper physiotherapy efficiency. This study investigated whether the use of N2 O improves the efficacy of post-operative physiotherapy after multilevel surgery in patients with cerebral palsy. Material and method It was a randomised 1:1, double-blind, placebo-controlled study. Sixty-four patients were enrolled. All patients had post-operative physiotherapy starting the day after surgery. Patients received either N2 O or placebo gas during the rehabilitation sessions. All patients had post-operative pain management protocol, including pain medication as needed for acute pain. The primary objective was to reach angles of knee flexion of 110◦ combined with hip extension of 10◦ , with the patient lying prone, within 6 or less physiotherapy sessions. Secondary evaluation criteria were the number of sessions required to reach the targeted angles, the session-related pain intensity, and the analgesics consumption for managing post-operative pain. Results Targeted angles were achieved more often in the N2 O group (23/32, 72%, vs. Placebo: 13/32, 41%; P = 0.01). Patients treated with N2 O tended to require less often level III analgesic agents for managing post-operative pain, compared to those receiving placebo: 18/32 (58%) vs. 24/32 (75%).
Conclusion The administration of N2 O during post-operative physiotherapy can help to achieve more quickly an improved range of motion, and, although not significant in our study, to alleviate the need for pain medication. Further studies evaluating the administration of N2 O in various settings are warranted. Keywords Post-operative physiotherapy; Oxygen-nitrous oxide; Cerebral palsy Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.rehab.2018.05.122 ISPR8-0247
Participation in everyday activities of Thai children with cerebral palsy and factors associated with the frequency of participation
T. Ploypetch ∗ , C. Buasuk , K. Pajareya Faculty of Medicine Siriraj Hospital, Mahidol University, Department of Rehabilitation Medicine, Bangkok, Thailand ∗ Corresponding author. E-mail address: teerada [email protected] (T. Ploypetch) Introduction/Background Different culture and socioeconomic possibly influence the level of participation, while limited information was available in developing countries. The study aims to explore participation of children with cerebral palsy (CP) in Thailand and factors associated with the frequency of participation. Material and method A survey descriptive research was done in 80 children with CP, aged 6–18 years, who visited outpatient clinics of a university hospital in Thailand. Family caregivers reported Thai-version questionnaires: the frequency of participation (FPQ), Gross Motor Function Classification System (GMFCS-ER), attitude of caregivers and socioeconomic information. Disease severity and comorbidities were reviewed. Factors were analyzed for the association with the frequency of participation. Results Children with CP, a mean age 9.7 (SD 3.3) years and 46 (57.5%) males were participated. Most subjects were spastic (88.8%) and quadriplegic (41.2%) types. Various levels of motor function were included: GMFCS level I-8 (10%), II-27 (33.8%), III6 (7.5%), IV-13 (16.2%), V-26 (32.5%). Within 14 activities, the most-frequently-participated activity was “helping with housework” that 59 (73.8%) children with CP participated in a few times/week, followed by going to shops (41.3%) and riding bike (36.3%). The least-participated activity was “taking part in community activities”, 32 (40%) children had never participated in, even though the attitude of almost caregivers (96.3%) was good. The multivariate analysis found that better GMFCS level (P = 0.014) and communication ability (P = 0.015) significantly correlated with higher frequency of participation. The children with positive family income more frequently participated in leisure activities (P = 0.031) and art/cultural events (P = 0.018). Conclusion Thai children with CP tended to participate more frequently in family activities such as housework, shopping and riding bike, whereas rarely participated in community activities. Participation in leisure activity and art/cultural events, which seemed to need free time and money associated with family income. The children with higher level of motor function and communication ability had higher frequency of participation in everyday activities. Keywords Frequency of participation; Cerebral palsy; Factors associated participation Disclosure of interest The authors have not supplied their declaration of competing interest. https://doi.org/10.1016/j.rehab.2018.05.123