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AACPDM 67th Annual Meeting

Get revved up for Milwaukee!

Mac Keith Press Update
Mac Leith Press Update
October 2013
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67th Annual Meeting

67th Annual Meeting

We look forward to an outstanding Annual Meeting in Milwaukee!

President's Welcome Reception
at the Milwaukee Art Museum!

The Milwaukee Art Museum is an architectural landmark, comprised of three buildings designed by three legendary architects: Eero Saarinen, David Kahler, and Santiago Calatrava. The Milwaukee Art Museum contains 30,000 works of art and hosts 350,000+ visitors a year. From its roots in Milwaukee's first art gallery in 1888, the Museum has grown today to be an icon for Milwaukee and a resource for the entire state.

New to the meeting and the art museum… submissions from our first annual Lifeshots Photo Gallery! This is why we do what we do!

67th Annual Meeting Celebration
at the Harley-Davidson Museum®!

Harley Davidson just celebrated its 110th Anniversary and the history roars to life at the Harley-Davidson Museum®. It's the best of American design and culture – seasoned with freedom and rebellion, showcased in a landmark building. See why the Museum is one of Milwaukee’s top tourist destinations!

In addition to touring the museum, you will be able to try a "ride" on a stationary Harley-Davidson® motorcycle plus there will be plenty of food with music and dancing to follow.

Shuttle buses will be available at the Milwaukee Hilton City Center for transportation. There are still tickets available to attend this event! Tickets are $50 each. Get yours today!

Missing the Meeting? You don’t have to!

If you cannot get away to attend the meeting this year and attend the most-popular educational offerings… The AACPDM will have audio recordings of all the proceedings! Stay tuned for details and discounted offerings for members.

Strides in Research

Selected Abstracts from Developmental Medicine and Child Neurology

Magnetic resonance diffusion tractography of the preterm infant brain: a systematic review.  
Kerstin Pannek,  Simon M Scheck,  Paul B Colditz,  Roslyn N Boyd, Stephen E Rose    
Article first published online: 16 SEP 2013

Preterm birth is associated with an increased risk of adverse neurodevelopmental outcomes. Diffusion magnetic resonance imaging (dMRI) combined with tractography can be used to assess non-invasively white matter microstructure and brain development in preterm infants. Our aim was to conduct a systematic review of the current evidence obtained from tractography studies of preterm infants in whom MRI was performed up to term-equivalent age.

Databases were searched for dMRI tractography studies of preterm infants.

Twenty-two studies were assessed. The most frequently assessed tracts included the corticospinal tract, the corpus callosum, and the optic radiations. The superior longitudinal fasciculus, and the anterior and superior thalamic radiations were investigated less frequently. A clear relationship exists between diffusion metrics and postmenstrual age at the time of scanning, although the evidence of an effect of gestational age at birth and white matter injury is conflicting. Sex and laterality may play an important role in the relationship between diffusion metrics, early clinical assessment, and outcomes.

Studies involving infants of all gestational ages are required to elucidate the relationship between gestational age and diffusion metrics, and to establish the utility of tractography as a predictive tool. There is a need for more robust acquisition and analysis methods to improve the accuracy of assessing development of white matter pathways.

Practice considerations for the introduction and use of power mobility for children.
Roslyn Livingstone and Ginny Paleg
Article first published online: 2 SEP 2013

The aim of the study was to support clinicians in recommending and justifying power mobility for children of different ages and abilities, and with different needs. The study comprised three distinct parts: a literature review; a Delphi consensus; and clinical practice considerations.

A scoping review of eight electronic databases and manual searches carried out in February 2011 identified 15 themes or transferable messages among 27 articles meeting initial inclusion criteria and these formed the basis of a draft paper. Informal consensus at two international conference presentations refined and modified the paper to include 10 messages supported by 24 articles. The literature review was updated in May 2012 and a modified Delphi process sought to formalize the consensus process with an international panel of 16 expert clinicians and researchers using a priori criteria of 80% agreement.

Evidence from studies was classified using the American Academy of Cerebral Palsy and Developmental Medicine guidelines, with evidence from most studies being classified as either level IV or level V, apart from one study each with evidence classified as level II and level III. Expert consensus on the content and wording of nine transferable messages may raise evidence overall to level III.

This paper suggests that power mobility may reasonably be considered as an effective and appropriate intervention for children lacking efficient, independent mobility from around 12 months of age including children who may never become competent drivers and children lacking independent mobility only in early childhood.

Did you know you can subscribe to a weekly digest of research concerning cerebral palsy? Sign up here!

Here are a few examples from the most recent edition.

Eur J Paediatr Neurol. 2013 Sep 16. pii: S1090-3798(13)00129-3. doi: 10.1016/j.ejpn.2013.08.001. [Epub ahead of print]

Comparing contents of outcome measures in cerebral palsy using the international classification of functioning (ICF-CY): A systematic review.

Schiariti V, Klassen AF, Cieza A, Sauve K, O'Donnell M, Armstrong R, Mâsse LC.

Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: vschiariti@cw.bc.ca.

The International Classification of Functioning children and youth version (ICF-CY) provides a universal framework for defining and classifying functioning and disability in children worldwide. To facilitate the application of the ICF in practice, ICF based-tools like the "ICF Core Sets" are being developed. In the context of the development of the ICF-CY Core Sets for children with Cerebral Palsy (CP), the aims of this study were as follows: to identify and compare the content of outcome measures used in studies of children with CP using the ICF-CY coding system; and to describe the most frequently addressed areas of functioning in those studies. We searched multiple databases likely to capture studies involving children with CP from January 1998 to March 2012. We included all English language articles that studied children aged 2-18 years and described an interventional or observational study. Constructs of the outcome measures identified in studies were linked to the ICF-CY by two trained professionals. We found 231 articles that described 238 outcome measures. The outcome measures contained 2193 concepts that were linked to the ICF-CY and covered 161 independent ICF-CY categories. Out of the 161 categories, 53 (33.5%) were related to body functions, 75 (46%) were related to activities/participation, 26 (16.1%) were related to environmental factors, and 7 (4.3%) were related to body structures. This systematic review provides information about content of measures that may guide researchers and clinicians in their selection of an outcome measure for use in a study and/or clinical practice with children with CP.

Copyright © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

PMID: 24051208 [PubMed - as supplied by publisher]

Res Dev Disabil. 2013 Sep 11;34(11):4017-4024. doi: 10.1016/j.ridd.2013.08.032. [Epub ahead of print]

A physical fitness follow-up in children with cerebral palsy receiving 12-week individualized exercise training.

Jeng SC, Yeh KK, Liu WY, Huang WP, Chuang YF, Wong AM, Lin YH.

Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan 333, Taiwan.

Physical fitness in children with cerebral palsy (CP) is lower than in their peers. A 12-week individualized home-based exercise program completed by 11 children with CP 10 years earlier showed a favorable effect on physical fitness performance. We follow-up the physical fitness of those 11 children with CP, and compare their physical fitness and health-related quality of life (HRQoL) to children with CP without exercise training matched with age and motor levels. Eleven children with CP in the 2003 program as a follow-up group (FUG) and 12 volunteers recruited as a control group (CG) participated in this study. Physical fitness measures, including cardiopulmonary endurance, muscle strength, body mass index (BMI), flexibility, agility, balance, and the SF-36 Taiwan version, were assessed in both groups. After 10 years, the FUG showed better physical fitness in cardiopulmonary endurance and muscle strength (p<.05). Compared to the CG, the FUG demonstrated better muscle strength, agility, and balance (p<.05). However, the HRQoL did not show a significant difference between the FUG and the CG. Individualized home-based exercise training is beneficial for children with CP. Over 10 years, the FUG was more devoted to physical activity than was the CG. Physical exercise may not directly affect the HRQoL in this study.

Copyright © 2013 Elsevier Ltd. All rights reserved.

PMID: 24036390 [PubMed - as supplied by publisher]

J Perinatol. 2013 Sep 19. doi: 10.1038/jp.2013.116. [Epub ahead of print]

Adverse neurodevelopmental outcomes after exposure to phenobarbital and levetiracetam for the treatment of neonatal seizures.

Maitre NL, Smolinsky C, Slaughter JC, Stark AR.

Department of Pediatrics, Vanderbilt University, Nashville, TN, USA.

Objective: Compare neurodevelopment after levetiracetam (LEV) and phenobarbital (PB) for neonatal seizures. Study design: Retrospective study of infants who received antiepileptic drugs (AEDs) for neonatal seizures. Effect of cumulative exposure to LEV and PB on outcomes of death, cerebral palsy (CP) and Bayley Scales of Infant Development (BSID) scores were evaluated at 24 months corrected age. Analyses were adjusted for number of electrographic seizures and gestational age. Result: In 280 infants with comparable seizure etiology and cranial imaging results, increased exposure to PB was associated with worse BSID cognitive and motor scores (8.1- and 9-point decrease per 100 mg kg-1; P=0.01). The effect was less with LEV (2.2- and 2.6-point decrease per 300 mg kg-1 LEV (P=0.01)). CP probability increased by 2.3-fold per 100 mg kg-1 PB and was not associated with increasing LEV. Conclusion: Increased exposure to PB is associated with worse neurodevelopmental outcomes than LEV. Prospective studies of outcomes of neonatal exposure to AEDs are essential.

PMID: 24051577 [PubMed - as supplied by publisher]

And from our partner Pediatric Physical Therapy

Fall 2013 - Volume 25 - Issue 3 - p 232-247

Systematic Review and Evidence-Based Clinical Recommendations for Dosing of Pediatric Supported Standing Programs

Paleg, Ginny S. PT, MPT, DScPT; Smith, Beth A. PT, DPT, PhD; Glickman, Leslie B. PT, PhD

Abstract Purpose: There is a lack of evidence-based recommendations for effective dosing of pediatric supported standing programs, despite widespread clinical use.

Methods: Using the International Classification of Functioning, Disability, and Health (Child and Youth Version) framework, we searched 7 databases, using specific search terms.

Results: Thirty of 687 studies located met our inclusion criteria. Strength of the evidence was evaluated by well-known tools, and to assist with clinical decision-making, clinical recommendations based on the existing evidence and the authors’ opinions were provided.

Conclusions and recommendations for clinical practice: Standing programs 5 days per week positively affect bone mineral density (60 to 90 min/d); hip stability (60 min/d in 30° to 60° of total bilateral hip abduction); range of motion of hip, knee, and ankle (45 to 60 min/d); and spasticity (30 to 45 min/d).

Committee Updates

Social Media

Please follow us on twitter @aacpdm, like us on Facebook (AACPDM) and go to your website (www.aacpdm.org). If you have something you think the membership would like or need to know, send it to us. loganl@upstate.edu (newsletter or tweets  @LRlogan), kmurphy@gillettechildrens.com (tweets), susan@voicedoctor.net(webmistress Susan Sienko Thomas).

Recent tweets:
https://twitter.com/DisabledWorld Disabled World ‏@DisabledWorld 21 Sep Stephen #Hawking tells extraordinary tale of how he overcame #disability –

‏@LRlogan 20 Sep Check out this great poster! http://on.wfmy.com/1eYInKThttp://en.worldcpday.org/assets/Uploads/about/WorldCPDayCP-Infographic.pdf

AACPDM ‏@aacpdm 12 Jun Fashion photographer focuses on those with genetic conditions to reframe beauty - PhotoBlog http://nbcnews.to/194n5VV

Follow some of our members: Hank Chambers has a great Facebook page; Southern California Cerebral Palsy Center  https://www.facebook.com/groups/90311749318/ with photos like this:

Website Sub-committee

Be on the lookout for a new website design! In the meantime visit our website www.aacpdm.org and use the Amazon link for your holiday purchases.

Our Amazing Patients

Check out this link for a story of a little girl who likes to "go fast"!


And this one of a very brave and inspiring young woman sailor.

And a video http://www.bbc.co.uk/news/uk-england-hampshire-19571826

Note from the Editor

I've been thinking lately of the communities that support all of us as I look forward to the annual meeting in Milwaukee. Certainly my professional community is immensely enriched by all of you and the opportunities made available by participating in this organization. I never would have guessed I'd get so involved with evidence based practice (thanks Outcomes committee), professional foreign travel (thanks Indian CP Association), tweeting (thanks Multimedia committee) and now web design (thanks Susan Sienko Thomas). Every committee or group of which I’ve been a member has offered multiple opportunities for personal and professional development and of course being the ever curious type, I’ve tried to take advantage of many of them. I've co-authored articles, reviewed books and many articles and learned so much. I urge each of you to sign up for something out of your comfort zone this year and make a contribution. We need you to help make our Academy reflect the diversity of our membership and I promise you will learn something and we will learn from you.

Personally, it has been a great summer for sailboat racing; we mostly managed to miss the daily rains and brought home hardware (trophies) and flags this year. One more regatta this weekend and then the boat will be for sale. Not to worry, there will be more sailing stories; we already bought another J 24!

My gardens have been lovely this year with all the rain.

If you would like me to highlight your article in the next newsletter, send me an email! I’d love to let everyone know of your success. loganl@upstate.edu