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Hip subluxation in Italian cerebral palsy children and its determinants: a retrospective cohort study

The study’s aim was two-fold: to describe the trend of hip subluxation in the largest sample of Italian nonambulatory cerebral palsy (CP) children ever published; to investigate its determinants. This single-centre retrospective cohort study included patients with spastic or dyskinetic CP, Gross Mot...

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Autores principales: Faccioli, Silvia, Sassi, Silvia, Ferrari, Adriano, Corradini, Elena, Toni, Francesca, Kaleci, Shaniko, Lombardi, Francesco, Benedetti, Maria Grazia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9631781/
https://www.ncbi.nlm.nih.gov/pubmed/36059222
http://dx.doi.org/10.1097/MRR.0000000000000545
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author Faccioli, Silvia
Sassi, Silvia
Ferrari, Adriano
Corradini, Elena
Toni, Francesca
Kaleci, Shaniko
Lombardi, Francesco
Benedetti, Maria Grazia
author_facet Faccioli, Silvia
Sassi, Silvia
Ferrari, Adriano
Corradini, Elena
Toni, Francesca
Kaleci, Shaniko
Lombardi, Francesco
Benedetti, Maria Grazia
author_sort Faccioli, Silvia
collection PubMed
description The study’s aim was two-fold: to describe the trend of hip subluxation in the largest sample of Italian nonambulatory cerebral palsy (CP) children ever published; to investigate its determinants. This single-centre retrospective cohort study included patients with spastic or dyskinetic CP, Gross Motor Function Classification System (GMFCS) level IV or V, age 0–18 years, having been referred to our unit before March 2020. The hip subluxation was measured by means of the migration percentage (MP). Other data were gathered such as sex, CP subtype, GMFCS level, presence of drug-resistant epilepsy, age, use of walkers with weight relief or standing devices, previous botulinum injection or hip surgery, oral or intrathecal baclofen and hip pain. Multiple linear stepwise regression was performed and descriptive statistics are provided. Spastic CP had MP maximum increase in early ages, with GMFCS level V values persistently higher than level IV. The dyskinetic subtype showed a slower increase of the MP, with GMFCS level IV presenting similar or higher values, compared to level V. Age, CP severity and spastic subtype are the main determinants. The stepwise multiple regression analysis demonstrated that weight relief walking and standing assistive devices, combined with botulinum contributed to reduce the MP progression. Dyskinetic CP showed overall lower MP values and a more variable behaviour relative to age and GMFCS level, compared to the spastic subtype. Standing and walking assistive devices, with partial or total weight relief, combined with individually targeted botulinum injections, should be considered in the management of bilateral nonambulatory CP patients, to prevent hip subluxation or its recurrence after surgery.
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spelling pubmed-96317812022-11-04 Hip subluxation in Italian cerebral palsy children and its determinants: a retrospective cohort study Faccioli, Silvia Sassi, Silvia Ferrari, Adriano Corradini, Elena Toni, Francesca Kaleci, Shaniko Lombardi, Francesco Benedetti, Maria Grazia Int J Rehabil Res Original Articles The study’s aim was two-fold: to describe the trend of hip subluxation in the largest sample of Italian nonambulatory cerebral palsy (CP) children ever published; to investigate its determinants. This single-centre retrospective cohort study included patients with spastic or dyskinetic CP, Gross Motor Function Classification System (GMFCS) level IV or V, age 0–18 years, having been referred to our unit before March 2020. The hip subluxation was measured by means of the migration percentage (MP). Other data were gathered such as sex, CP subtype, GMFCS level, presence of drug-resistant epilepsy, age, use of walkers with weight relief or standing devices, previous botulinum injection or hip surgery, oral or intrathecal baclofen and hip pain. Multiple linear stepwise regression was performed and descriptive statistics are provided. Spastic CP had MP maximum increase in early ages, with GMFCS level V values persistently higher than level IV. The dyskinetic subtype showed a slower increase of the MP, with GMFCS level IV presenting similar or higher values, compared to level V. Age, CP severity and spastic subtype are the main determinants. The stepwise multiple regression analysis demonstrated that weight relief walking and standing assistive devices, combined with botulinum contributed to reduce the MP progression. Dyskinetic CP showed overall lower MP values and a more variable behaviour relative to age and GMFCS level, compared to the spastic subtype. Standing and walking assistive devices, with partial or total weight relief, combined with individually targeted botulinum injections, should be considered in the management of bilateral nonambulatory CP patients, to prevent hip subluxation or its recurrence after surgery. Lippincott Williams & Wilkins 2022-09-05 2022-12 /pmc/articles/PMC9631781/ /pubmed/36059222 http://dx.doi.org/10.1097/MRR.0000000000000545 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Original Articles
Faccioli, Silvia
Sassi, Silvia
Ferrari, Adriano
Corradini, Elena
Toni, Francesca
Kaleci, Shaniko
Lombardi, Francesco
Benedetti, Maria Grazia
Hip subluxation in Italian cerebral palsy children and its determinants: a retrospective cohort study
title Hip subluxation in Italian cerebral palsy children and its determinants: a retrospective cohort study
title_full Hip subluxation in Italian cerebral palsy children and its determinants: a retrospective cohort study
title_fullStr Hip subluxation in Italian cerebral palsy children and its determinants: a retrospective cohort study
title_full_unstemmed Hip subluxation in Italian cerebral palsy children and its determinants: a retrospective cohort study
title_short Hip subluxation in Italian cerebral palsy children and its determinants: a retrospective cohort study
title_sort hip subluxation in italian cerebral palsy children and its determinants: a retrospective cohort study
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9631781/
https://www.ncbi.nlm.nih.gov/pubmed/36059222
http://dx.doi.org/10.1097/MRR.0000000000000545
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