Cerebral Palsy in Infancy targeted activity to optimize early growth and development 1st Edition by Roberta Shepherd 0702050997 9780702050992

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ISBN 10: 0702050997

ISBN 13: 9780702050992

Author: Roberta B. Shepherd

Cerebral Palsy in Infancy is a thought-provoking book which introduces a new way of thinking on the development and use of interventions. Relevant to current practice, it advocates early, targeted activity that is focused on increasing muscle activation, training basic actions and minimizing (or preventing) mal-adaptive changes to muscle morphology and function. The authors present recent scientific findings in brain science, movement sciences (developmental biomechanics, motor control mechanisms, motor learning, exercise science) and muscle biology. This knowledge provides the rationale for active intervention, underpinning the need for an early referral to appropriate services. The book features methods for promoting relatively intensive physical activity in young infants without placing a burden on parents which include assistive technologies such as robotics, electronic bilateral limb trainers and baby treadmills.

Cerebral Palsy in Infancy begins by specifying the guidelines for training and exercise, outlining the rationale for such intervention. It goes on to cover the fundamentals of neuromotor plasticity and the development and negative effects of limited motor activity on brain organization and corticospinal tract development. Neuromuscular adaptations to impairments and inactivity are discussed along with the General Movement assessment that can provide early diagnosis and prognosis, facilitating very early referral from paediatric specialists to training programs. The book ends with a section featuring various methods of training with the emphasis on preventing/minimizing muscle contracture, stimulating biomechanically critical muscle activity and joint movement.

Cerebral Palsy in Infancy targeted activity to optimize early growth and development 1st Table of contents:

Part 1: Introduction

Chapter 1: The changing face of intervention in infants with cerebral palsy

Historical view

Background

Annotation A: Aspects of motor training

Targeted training and exercise

Specificity and transfer

Preservation of soft tissue compliance

Driving limb use

The organization of intervention: methods of delivery

Part 2: Neuromotor Plasticity and Development

Chapter 2: Corticospinal tract development and activity-dependent plasticity

Corticospinal tract development and plasticity in sub-primate mammals

Corticospinal development and plasticity in sub-human primates

Corticospinal development in humans

Corticospinal system reorganization in man

Summary

Chapter 3: Re-thinking the brain: new insights into early experience and brain development

Early development

Experience and the development of target structures

Perinatal injury

Experience and brain development

Interventions

Summary

Part 3: Impairments and Neuromuscular Adaptations to Impairments and Inactivity

Chapter 4: Functional effects of neural impairments and subsequent adaptations

Introduction

Motor impairments and muscle adaptations

Clinical implications

Conclusions and statement of the problem

Annotation B: Findings from a series of studies of passive mechanical properties of muscle in young children with cerebral palsy

Methodology

Study 1: Non-reflex stiffness in children with CP

Study 2: Distinguishing between reflex and non-reflex stiffness in children with CP in a clinical scale

Study 3: Non-reflex stiffness can influence the motor performance of children with CP

Study 4: Effect of botulinum injections on non-reflex stiffness in children with CP

Suggestions for future studies

Conclusion

Chapter 5: The syndrome of deforming spastic paresis: pathophysiology, assessment and treatment

Phenomenology and taxonomy in deforming spastic paresis

Clinical evaluation of deforming spastic paresis

Management of deforming spastic paresis in children

Conclusion

Chapter 6: Skeletal muscle changes due to cerebral palsy

Review of skeletal muscle structure and function as related to cerebral palsy

Biomechanical and neurophysiological studies of limb mechanics in spasticity

Skeletal muscle in vivo morphology in cerebral palsy

Skeletal muscle tissue properties in cerebral palsy

Chapter 7: Early muscle development in children with cerebral palsy: the consequences for further muscle growth, muscle function, and long-term mobility

Skeletal muscle structure and function

Skeletal muscle changes in children with CP

Normal skeletal muscle development and growth

Possible mechanisms leading to altered muscle development and growth in CP

Implications for early intervention

Conclusion

Part 4: Early and Active Intervention to Optimize Growth, Development and Functional Motor Performance

Chapter 8: Early diagnosis and prognosis in cerebral palsy

Techniques for the clinical assessment of the neonatal nervous system

Prechtl’s method on the qualitative assessment of general movements

GM features that can predict dyskinetic CP

Motor optimality scores and the prediction of CP severity

Integrating GM assessment with traditional neurological examination and neuroimaging techniques

Conclusion

Chapter 9: Effects of motor activity on brain and muscle development in cerebral palsy

Infancy is a unique period of neural development and plasticity

Interaction of brain and muscle injury and plasticity

Muscle plasticity in infants with cerebral palsy

Efficacy and effectiveness of early intervention: study design considerations

Types and amounts of interventions that have been delivered

The future of physiotherapy for infants with CP

Summary and conclusions

Chapter 10: The consequences of independent locomotion for brain and psychological development

Brief historical perspective on motor activity and psychological functioning

Independent mobility and psychological development in the human infant

Mobility and psychological development: implications for infants with disabilities

Conclusions and future directions

Part 5: Specific Methods of Motor Training for Infants

Chapter 11: Training lower limb performance in early infancy: Support, balance and propulsion

Introduction

Part 1: support, balance, propulsion

Development of lower limb motor skills

Part 2: guidelines for activity-based intervention in infancy

Optimizing support and balance

Functional activities for the lower limbs

Concluding comments

Annotation C: Kick start: using the mobile infant learning paradigm to promote early leg action

Infants are dynamically changing

Development requires exploration

Altered development for the infant and child with cerebral palsy

Early intervention is essential

Early intervention through contingency learning

Contingency learning in prematurely born infants

Understanding the dynamics

Intervention programmes and future research using contingency-based learning

Chapter 12: Treadmill training in early infancy: sensory and motor effects

The birth of the infant treadmill stepping paradigm

Plasticity and adaptability of the stepping pattern

Continuity from stepping to walking

Constraints on the development of walking

When should interventions start?

Can treadmill interventions promote independent walking in clinical populations?

Treadmill interventions can have lasting effects

Can infants with cerebral palsy benefit from treadmill training?

A more ecological approach to treadmill training

Conclusions

Chapter 13: Very early upper limb interventions for infants with asymmetric brain lesions

The problem

Definitive diagnosis of hemiplegia

Critical periods of typical upper limb motor development

Cortical reorganization after an early brain lesion: a critical window

Current evidence for early upper limb interventions for infants with hemiplegia

Potential early interventions for infants with asymmetric brain lesions

Future directions

Chapter 14: Constraint-induced therapy and bimanual training in children with unilateral cerebral palsy

Task-oriented training

Constraint-induced movement therapy

Bimanual therapy in children with unilateral CP

Alternative models of training delivery

When should CIMT or bimanual training be used?

Conclusions

Acknowledgements

Chapter 15: Interactive technologies for diagnosis and treatment in infants with cerebral palsy

Early diagnosis: a role for technology?

Early treatment: a role for interactive technologies?

Delivering and monitoring training by satellite: going small and interactive with smartphone technology

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