Search

AbstractPurposeMaterials and MethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONIdentify priorities for adult cerebral palsy (CP) research by engaging individuals with lived experience, clinical investigators, and community leaders.Qualitative descriptive study using iterative focus groups, followed by inductive thematic analysis. Participants included adults with CP and caregivers, clinical investigators, and community leaders in the CP and disability spaces. We explored research priorities among three research areas identified a priori– bone health, kidney health, and preventive care.We conducted four focus groups (20 participants with lived experience; 10 clinical investigators; 9 community leaders). Most participants felt all topic areas were very important, though preventive care emerged as the top priority. We identified three overarching themes that cut across the various research areas discussed: patient and provider knowledge gaps; a precision medicine approach for adult CP care; and the need to address ableism.Adults with CP face unique healthcare needs and risks as they age, and the evidence base to guide their care lags significantly behind. Our study identified preventive care as the top research priority for the adult CP research agenda. Next steps in this line of research should focus on interventions to facilitate primary and preventive care interactions for adults with CP.Participants identified preventive care as the top research priority for the adult cerebral palsy (CP) research agenda.Ableism is a barrier to care for adults with CP, and rehabilitation professionals should provide and advocate for equitable care and access for adults with CP.Adults with CP, caregivers, clinical investigators, and community leaders highlighted significant knowledge gaps among patients and providers alike regarding the unique health risks and needs facing adults with CP.When possible, rehabilitation professionals should use a precision medicine approach to adult CP care, which takes into account an individual’s risk factors to guide care.Participants identified preventive care as the top research priority for the adult cerebral palsy (CP) research agenda.Ableism is a barrier to care for adults with CP, and rehabilitation professionals should provide and advocate for equitable care and access for adults with CP.Adults with CP, caregivers, clinical investigators, and community leaders highlighted significant knowledge gaps among patients and providers alike regarding the unique health risks and needs facing adults with CP.When possible, rehabilitation professionals should use a precision medicine approach to adult CP care, which takes into account an individual’s risk factors to guide care. [ABSTRACT FROM AUTHOR]

Aim: To increase understanding regarding the experiences and values of young adults with cerebral palsy (CP), and their caregivers, regarding pediatric rehabilitation‐related care, including perceived barriers and potential facilitators to transition to adult care. Method: This was a qualitative descriptive study that used 20 semi‐structured interviews (13 caregivers and seven patient–caregiver dyads). Results: We identified four major themes: (1) the value and security of long‐term relationships; (2) feeling 'rudderless' navigating the logistics of transition; (3) differences in pediatric versus adult models of care; and (4) perceived lack of provider expertise and comfort in adult care settings. Young adults with CP who had not yet transitioned to adult rehabilitation care and their caregivers placed high value on provider relationships and expertise, advanced planning, communication, and coordination of care. Interpretation: Identified barriers and potential facilitators to the transition to adult rehabilitation care reflected the uncertainty that accompanies leaving an established healthcare relationship. Challenges related to the logistics of this transition, differences in models of care, and perceived lack of provider comfort and expertise in adult care settings were also noted. Our findings could be used to develop and study patient‐centered and family‐centered transition processes for individuals with CP to promote age‐appropriate and developmentally appropriate lifespan care. [ABSTRACT FROM AUTHOR]

Objectives: People with childhood-onset disabilities are living into adulthood, and the prevalence of smoking and illicit drug use among adults with disabilities is high. We evaluated the relationship between disability status and age of disability onset, current cigarette smoking status, and heavy alcohol drinking. Methods: We conducted a secondary data analysis of the National Health Interview Survey (NHIS), a US survey on illness and disability. Among 2020 NHIS participants aged 22-80 years (n = 28 225), we compared self-reported prevalence of current cigarette smoking and heavy alcohol drinking among those with and without disabilities and among those with childhood- versus adult-onset disabilities. We used adjusted logistic regression analysis to calculate the adjusted odds ratios (AORs) of current smoking and heavy alcohol drinking based on disability status and age of disability onset. Results: Compared with adults without disabilities, adults with disabilities were significantly more likely to report current smoking (23.5% vs 11.2%; P <.001) and significantly less likely to report heavy alcohol drinking (5.3% vs 7.4%; P =.001). The prevalence of these behaviors did not vary significantly by age of disability onset. In adjusted logistic regression models, adults with disabilities had significantly higher odds of current smoking (AOR = 1.76; 95% CI, 1.53-2.03) and similar odds of heavy alcohol drinking (AOR = 0.82; 95% CI, 0.65-1.04) compared with adults without disabilities. The odds of these health behaviors did not vary significantly by age of disability onset. Conclusions: Adults with disabilities overall may be at high risk for these unhealthy behaviors, particularly smoking, regardless of age of disability onset. Routine screening and cessation counseling related to smoking and unhealthy alcohol use are important for all people with disabilities. [ABSTRACT FROM AUTHOR]

Objective: A systematic review of the literature was conducted to identify measures used to evaluate developmental outcomes after abusive head trauma (AHT), as well as describe outcomes among those with AHT, and explore factors and interventions influencing such outcomes. Design: This systematic review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. The protocol is in PROSPERO, registration number CRD42020179592. On April 17, 2020, OVID Medline, Embase, OVID PsycINFO, Web of Science, CINAHL, Cochrane Library, and Google Scholar were searched (since inception). Inclusion criteria included original, peer-reviewed study data; AHT exposure; infants younger than 24 months at time of AHT; and evaluation of developmental outcomes. Reviewers independently evaluated studies for inclusion and assessed risk of bias using the Effective Public Health Practice Project quality assessment tool for quantitative studies. A descriptive synthesis approach was utilized as variability of study designs, follow-up periods, and outcome assessment tools precluded a meta-analytic approach. Results: Fifty-nine studies were included; 115 assessment tools were used to evaluate developmental outcomes; and 42 studies examined factors influencing outcomes. Two studies evaluated interventions. Five percent of studies (n = 3) were rated low risk of bias. Conclusions: Notable variation was observed in terms of case ascertainment criteria. Developmental outcomes after AHT have been assessed in a manner that limits understanding of how AHT impacts development, as well as the efficacy of interventions intended to improve outcomes. Researchers and clinicians are encouraged to adopt consistent diagnostic and assessment approaches. [ABSTRACT FROM AUTHOR]

Spinal cord infarction accounts for 0.3% to 1% of all strokes.[1] The anterior spinal artery (ASA) territory is more often affected because the posterior cord is protected by a pial collateral network and dual posterior spinal arteries (PSA).[[2]] Concomitant ischemia can lead to varied clinical manifestations, especially with cardinal sensory symptoms.[4] Etiology is variable as traditional stroke risk factors are less applicable. Repeated magnetic resonance imaging (MRI) (13 hours after initial imaging) of her cervical spine showed diffusion restriction involving the posterior and left aspect of the spinal cord from C1 to C7 suggestive of dorsal cord syndrome (Figure). 18 Richard S, Abdallah C, Chanson A, Foscolo S, Baillot P-A, Ducrocq X. Unilateral posterior cervical spinal cord infarction due to spontaneous vertebral artery dissection. 25 Wang C-M, Tsai W-L, Lo Y-L, Chen J-Y, Wong AM-K. Unilateral right occipital condyle to C2 level spinal cord infarction associated with ipsilateral vertebral artery stenosis and contralateral vertebral artery dissection: a case report. [Extracted from the article]

Hydrocephalus is a common comorbidity associated with brain injuries, including cerebral palsy (CP). In CP, hydrocephalus typically presents in infancy or early childhood. This report describes a patient in their mid 20 s with mixed dyskinetic-spastic CP with adult-onset hydrocephalus of unknown cause initially presenting with new-onset bilateral lower extremity spasms. Multiple interventions were trialed, including ischial bursal steroid injections, botulinum toxin injections, trigger point injections, multiple oral medications, and physical and massage therapies without benefit. Given lack of treatment response, imaging of the neuraxis was obtained. Magnetic resonance imaging (MRI) of the brain demonstrated new diffuse moderate ventriculomegaly compared to prior MRI. Ophthalmologic evaluation demonstrated papilledema, and opening pressure on lumbar puncture was elevated to 44 mmHg H2O. The patient underwent ventriculoperitoneal shunt placement with rapid and near-resolution of their spasms and pain. This patient represents a unique case of new-onset hydrocephalus in an adult with CP. To ensure appropriate and timely diagnosis and treatment, individuals with neurologic conditions such as CP should have ongoing surveillance and comprehensive evaluation for any neurologic or functional changes, including changes in baseline tone. Future research is needed to better understand if adults with CP are at higher risk for the development of hydrocephalus in adulthood. [ABSTRACT FROM AUTHOR]

Purpose/objective: The transition from childhood to adulthood often involves emotional challenges. These problems may be especially prominent for transition-age adults (TAA) with pediatric-onset disabilities, although there are currently few studies that speak to this. The aim of this study is to characterize depressive symptoms and the association with family functioning in a sample of TAA with pediatric-onset disabilities., Research Method/design: This sample is comprised of 55 TAA (18-28 years of age, M = 20.88, SD = 2.49) who were followed by pediatric rehabilitation medicine clinics. Participants have childhood acquired brain injury ( n = 17), spina bifida ( n = 10), or neuromuscular disorders ( n = 28). Participants completed the Center for Epidemiological Studies-Depression scale and the Family Assessment Device Short Form., Results: Clinically elevated depressive symptoms were endorsed by 65.4% of the sample. Forty-five percent of those with elevated depressive symptoms were not currently receiving psychotherapy services. Poorer family functioning on the Family Assessment Device Short Form and older age were independently associated with more depressive symptoms, controlling for medical condition, mobility status, and other relevant sociodemographic factors., Conclusions/implications: Emotional problems are quite common in TAA with a history of acquired brain injury, spina bifida, and neuromuscular disorders, yet are seemingly inadequately managed. In view of the results of this study, TAA with pediatric-onset disabilities are likely to benefit from interventions that bolster emotional well-being and target risk factors related to their family system. (PsycInfo Database Record (c) 2025 APA, all rights reserved).