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Clinical Examination of Children with Cerebral Palsy
Kailash Sarathy1, Chintan Doshi1, Alaric Aroojis1
1Department of Paediatric Orthopaedics, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India.
Insights
Clinical examination is crucial for assessing children with cerebral palsy (CP). Early identification and intervention for musculoskeletal issues in CP can improve treatment outcomes.
Area of Science:
- Pediatrics
- Neurology
- Orthopedics
Background:
- Cerebral palsy (CP) is a complex neurological disorder causing movement and posture impairments in children.
- Musculoskeletal issues like spasticity, contractures, and malalignments are common and can worsen over time in children with CP.
- Accurate diagnosis and management of CP are challenging due to varied presentations and limited diagnostic tools.
Purpose of the Study:
- To emphasize the critical role of clinical examination in evaluating children with cerebral palsy (CP).
- To highlight the importance of comprehensive assessment for effective CP management.
- To underscore the need for early identification of musculoskeletal problems in CP.
Main Methods:
- Review of current literature on cerebral palsy assessment.
- Focus on the components of a comprehensive clinical examination for CP.
- Discussion of musculoskeletal manifestations and their progression.
Main Results:
- Clinical examination is a cornerstone in assessing children with CP.
- A thorough assessment combines history, functional evaluation, physical examination, gait analysis, and imaging.
- Early detection of risk factors for musculoskeletal problems is vital.
Conclusions:
- Clinical examination is indispensable for accurate CP assessment and management.
- Comprehensive and regular assessments are necessary to address the evolving musculoskeletal challenges in CP.
- Timely interventions based on clinical findings can lead to better treatment outcomes for children with CP.
Abstract:
Cerebral palsy (CP), a heterogeneous disorder of movement and posture, is one of the most important causes of disability affecting children. With a wide variability in the clinical presentation and a paucity of reliable diagnostic tests, decision-making in CP is fraught with difficulties and challenges. The plethora of musculoskeletal manifestations includes poor muscle function, spasticity, rigidity, muscle weakness, poor selective motor control, soft-tissue and joint contractures, torsional malalignments, and lever arm dysfunctions. Children with CP are at a high risk of further worsening and progression of these musculoskeletal abnormalities with the natural course of the disease. A comprehensive assessment that includes a combination of detailed medical history, functional assessment, clinical examination, analysis of gait, and radiological assessment is required to provide a favorable treatment outcome in these children. A close surveillance is essential so as to identify risk factors for the development and progression of musculoskeletal problems so that early interventions can be carried out to circumvent them. This review article is to highlight the importance of clinical examination in the assessment of children with CP.
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