Related Experiment Video
Updated: May 26, 2025
Enhancing the Development and Growth of Infant Cerebral Palsy Rats Using Selective Spinal Manipulations
Published on: February 2, 2024
Outpatient Management of Clinical Comorbidities in Children With Cerebral Palsy in Low- and Middle-Income Countries
Bruno Leonardo Scofano Dias1, Lenamaris Mendes Rocha Duarte1, Daniela Fava1
1SARAH Network of Rehabilitation Hospitals, Brasília, Brazil.
Insights
Cerebral palsy (CP) management in low- and middle-income countries (LMICs) needs context-specific solutions. This review synthesizes evidence for common comorbidities in children with CP in LMICs, emphasizing adapted interventions and professional empowerment.
Area of Science:
- Pediatric Neurology
- Global Health
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) is the most common childhood physical disability, with higher prevalence and mortality in low- and middle-income countries (LMICs).
- Children with CP often experience multiple health conditions (multimorbidity), with limited research evidence originating from LMIC settings.
- There is an urgent need for research and management strategies tailored to the unique challenges faced in LMICs.
Purpose of the Study:
- To conduct a scoping review identifying and synthesizing current evidence on managing clinical comorbidities in children with CP in LMICs.
- To determine common comorbidities, their gold standard diagnoses/treatments, and available alternatives for LMIC contexts.
Main Methods:
- A comprehensive literature search was conducted, identifying 22,188 citations.
- Data extraction and analysis followed Joanna Briggs Institute guidelines.
- 194 articles met eligibility criteria, covering key comorbidities.
Main Results:
- The review identified and synthesized evidence for numerous comorbidities including respiratory impairments, dysphagia, gastroesophageal reflux, malnutrition, epilepsy, spasticity, pain, and orthopedic conditions.
- The findings address diagnosis and treatment options relevant to LMIC resource limitations.
- Key morbidities covered include respiratory impairments, dysphagia, GERD, drooling, OSA, malnutrition, constipation, epilepsy, sleep disorders, spasticity, dystonia, pain, hip disorders, scoliosis, and osteoporosis.
Conclusions:
- Interventions for CP comorbidities must be adapted to the realities of LMICs.
- Empowering local pediatricians and healthcare professionals is vital for early diagnosis and proactive management.
- Developing specific guidelines for LMICs will enhance the management of complex conditions in children with CP.
Background:
Cerebral palsy (CP) is the most common physical disability of childhood. Its prevalence in low-and middle-income countries (LMICs) is over 3/1000 live births, about double the 1.6/1000 in high income countries (HICs). Multimorbidity is highly prevalent in CP. In LMICs, there are higher rates of prevalence, severity, comorbidities and mortality in children with CP. The evidence base for the recommendations in CP emanates overwhelmingly from studies conducted in HICs. Research conducted in LMICs settings, involving local clinicians, considering local context and investigating local solutions are urgently needed.
Methods:
This scoping review aimed to identify and synthesise current evidence on management of clinical comorbidities in children with CP in LMICs. The Joanna Briggs Institute guidelines were followed for the data extraction and analysis phases. The following questions guided the scoping review: What are the main clinical comorbidities in children with CP? What are the gold standards for diagnosis and treatment of these comorbidities? What options do we have to diagnose and treat these comorbidities in LMICs when gold standards are not available?
Results:
A total of 22 188 citations were identified by our search strategy, with 21 380 remaining after the removal of 808 duplicates. After screening titles and abstracts, 1918 citations progressed to full text review. A total of 194 articles met the eligibility criteria and were included in the review. The guiding questions of the review were answered for the following morbidities: respiratory impairments, dysphagia and aspiration, gastroesophageal reflux disease, drooling, obstructive sleep apnea syndrome, malnutrition, constipation, epilepsy, sleep disorders, spasticity, dystonia, pain, hip disorders, scoliosis and osteoporosis.
Conclusion:
This article highlights the need for interventions adapted to the realities of LMICs. Empowering paediatricians and healthcare professionals in LMICs is crucial for early diagnosis and proactive interventions. Specific guidelines for LMICs can better guide professionals in managing these complex conditions.
More Related Videos
Related Concept Videos
01:29Chronic Obstructive Pulmonary Disease-V: Management
Smoking Cessation
01:30Chronic Obstructive Pulmonary Disease-V: Nursing Management
Assessment
01:26COPD: Management Using Bronchodilators and Corticosteroids
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:24Cystic Fibrosis: Management
Sinus disease and chronic...
01:30Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...