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Background: Most adults with cerebral palsy encounter newly developing physical health problems and premature functional decline with aging. These physical and functional losses along with the characteristic symptoms of cerebral palsy may heighten the risk of sarcopenia., Objective: To determine the prevalence of sarcopenia among a selected group of adults with cerebral palsy and to identify the factors associated with their sarcopenia among them., Design: Cross-sectional study., Setting: University hospitals and communities for persons with disabilities., Participants: A total of 80 adults with cerebral palsy (46 men and 34 women with mean age of 42.8 ± 8.86 years) were included., Method: Muscle mass, strength, and physical performance were measured to diagnose sarcopenia. Participants also completed a structured questionnaire for physical, psychological, or socioeconomic attributes and health-related quality of life., Main Outcome Measures: Prevalence of sarcopenia in adults with cerebral palsy., Results: The prevalence of sarcopenia was 47.9%. Sarcopenia was significantly associated with sex, the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), body mass index (BMI), and trunk fat. Male, higher GMFCS and lower BMI were significant risk factors of sarcopenia. Sarcopenic adults with cerebral palsy showed significantly lower health-related quality of life., Conclusion: The prevalence of sarcopenia in adults with cerebral palsy was higher than that of general population despite the young age of the selected group. Modifiable risk factor was a low BMI., Level of Evidence: III., (© 2019 American Academy of Physical Medicine and Rehabilitation.)

Objectives: To investigate the characteristics of oropharyngeal dysphagia in adults with dyskinetic cerebral palsy (DCP) and cervical dystonia (CD)., Design: Exploratory observational cross-sectional study., Setting: University hospital., Participants: Seventeen patients with DCP (8 men, 9 women; age, 45.7±6.3y) enrolled in a randomized controlled trial on the effects of botulinum toxin injection on CD., Interventions: Not applicable., Main Outcome Measures: Baseline clinical assessments and videofluoroscopic swallowing studies (VFSSs) were conducted. VFSS findings were evaluated using the videofluoroscopic dysphagia scale (VDS) and the penetration-aspiration scale (PAS). The Gross Motor Function Classification System (GMFCS) and Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) scores were also assessed. Relationships between outcomes were evaluated using Spearman's rank correlation., Results: The clinical assessment revealed abnormalities in chewing (n=10, 58.8%), tongue movement (n=10, 58.8%), and laryngeal elevation (n=8, 47.1%). The most common abnormality on the VDS was inadequate mastication (n=13, 76.5%), followed by premature bolus loss, vallecular residue, and penetration/aspiration (all: n=10, 58.8%). A maximum PAS score of 8 was observed in 8 of 17 patients (47.1%). Total and pharyngeal VDS scores were significantly correlated with TWSTRS scores (ρ=0.543, P=.024 and ρ=0.539, P=.026, respectively); the VDS oral score did not correlate with the TWSTRS score (ρ=0.446, P=.073). There was no significant correlation between VDS score and GMFCS level (ρ=0.212, P=.414)., Conclusions: This preliminary observational study presents the characteristics of oropharyngeal dysphagia in adults with DCP and CD. Pharyngeal stage difficulties were negatively correlated with severity of CD, but not with GMFCS level. Screening for dysphagia may be recommended in adults with DCP and severe CD., (Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Cervical dystonia is a common issue in patients with athetoid cerebral palsy. Botulinum toxin injection to dystonic cervical muscles is a well-recognized treatment option, but it is known to be associated with dysphagia. Previously reported cases of dysphagia after botulinum toxin injection to the sternocleidomastoid muscle were related to the regional spread of toxin to the pharyngeal muscles. We report a unique case of posture-dependent dysphagia due to preactivation of the suprahyoid and infrahyoid muscles to compensate for impaired head stabilization by the weakened sternocleidomastoid muscle while swallowing. This case suggests a possible mechanism of dysphagia in patients with athetoid cerebral palsy.

Background: Most adults with cerebral palsy encounter newly developing physical health problems and premature functional decline with aging. These physical and functional losses along with the characteristic symptoms of cerebral palsy may heighten the risk of sarcopenia.Objective: To determine the prevalence of sarcopenia among a selected group of adults with cerebral palsy and to identify the factors associated with their sarcopenia among them.Design: Cross-sectional study.Setting: University hospitals and communities for persons with disabilities.Participants: A total of 80 adults with cerebral palsy (46 men and 34 women with mean age of 42.8 ± 8.86 years) were included.Method: Muscle mass, strength, and physical performance were measured to diagnose sarcopenia. Participants also completed a structured questionnaire for physical, psychological, or socioeconomic attributes and health-related quality of life.Main Outcome Measures: Prevalence of sarcopenia in adults with cerebral palsy.Results: The prevalence of sarcopenia was 47.9%. Sarcopenia was significantly associated with sex, the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), body mass index (BMI), and trunk fat. Male, higher GMFCS and lower BMI were significant risk factors of sarcopenia. Sarcopenic adults with cerebral palsy showed significantly lower health-related quality of life.Conclusion: The prevalence of sarcopenia in adults with cerebral palsy was higher than that of general population despite the young age of the selected group. Modifiable risk factor was a low BMI.Level Of Evidence: III. [ABSTRACT FROM AUTHOR]

We aimed to evaluate the efficacy and safety of injecting botulinum toxin A (BoNT-A) into the neck muscles to treat cervical dystonia (CD) in patients with dyskinetic cerebral palsy (CP). This was a randomized, double-blinded, placebo-controlled trial with cross-over design. We prospectively enrolled adults with dyskinetic CP who were over 20 years old and had been clinically diagnosed with CD for more than one year. The primary outcome measure was the change in Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) at four weeks from the baseline TWSTRS. Seventeen patients were initially enrolled, but one patient was excluded after the final evaluation because of a violation of the study protocol. At four weeks, the BoNT-A injections showed significant improvement in TWSTRS total scores compared to the saline injections (p = 0.0286 for ANCOVA). At 12 weeks, the BoNT-A injections resulted in greater improvements in TWSTRS total scores than the saline injections without statistical significance (p = 0.0783 for ANCOVA). Dysphagia occurred in three out of 16 patients: two after BoNT-A and one after saline. The dysphagia was transient and improved naturally within two weeks without any special treatment. BoNT-A injection for CD in adults with dyskinetic CP is relatively safe and improves pain and disability. [ABSTRACT FROM AUTHOR]