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Position as a cause of deformity in children with cerebral palsy
Insights
Asymmetrical deformities in children with cerebral palsy (CP) and
Area of Science:
- Pediatric Orthopedics
- Developmental Pediatrics
- Neurology
Background:
- Asymmetrical deformities are observed in children with cerebral palsy (CP) and also in infants with 'squint' baby syndrome.
- These deformities include plagiocephaly, unilateral bat ear, facial and thoracic asymmetry, pelvic obliquity, and apparent leg length discrepancy.
Purpose of the Study:
- To compare asymmetrical deformities in children with CP and those with 'squint' baby syndrome.
- To investigate the underlying causes of these deformities.
- To propose a unified understanding of related syndromes and suggest appropriate interventions.
Main Methods:
- Comparative analysis of asymmetrical deformities in two groups of children: 20 with CP and 20 with 'squint' baby syndrome.
- Clinical observation and assessment of specific deformities.
Main Results:
- The 'squint' baby syndrome and the 'windswept' child syndrome in CP are suggested to be stages of the same underlying condition.
- Deformities in both groups are hypothesized to result from the effect of gravity on immobile growing children, not spasticity or muscle imbalance.
Conclusions:
- Asymmetrical deformities in children with CP may be preventable and treatable through physiotherapy.
- Intervention should focus on managing external factors like gravity rather than solely on modifying brain development.
Abstract:
The asymmetrical deformities in 20 children with various types of cerebral palsy are compared with 20 children without cerebral palsy who have the so-called 'squint' baby syndrome (asymmetrical deformities of plagiocephaly, unilateral bat ear, facial and thoracic asymmetry, pelvic obliquity and apparent shortening of one leg). It is suggested that the 'squint' baby syndrome and the 'windswept' child syndrome in children with cerebral palsy are stages of the same syndrome and that in both the deformities are caused by the effect of gravity on an immobile growing child, rather than spasticity or muscle imbalance. Asymmetrical deformity should therefore be amenable to physiotherapeutic intervention, rather than trying to modify maturation of the damaged brain. As the 'windswept' cerebralpalsied child can develop some of the most severe deformities seen in cerebral palsy, it is important that asymmetrical deformities should be prevented.