ORCID Profile
0000-0002-5221-9800
Current Organisations
University of Ulster
,
Queen's University Belfast
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Publisher: Swansea University
Date: 25-08-2022
Publisher: Informa UK Limited
Date: 26-03-2020
Publisher: Wiley
Date: 11-08-2022
DOI: 10.1111/DMCN.15346
Abstract: To determine trends and current estimates in regional and global prevalence of cerebral palsy (CP). A systematic analysis of data from participating CP registers/surveillance systems and population‐based prevalence studies (from birth year 1995) was performed. Quality and risk of bias were assessed for both data sources. Analyses were conducted for pre‐ erinatal, postnatal, neonatal, and overall CP. For each region, trends were statistically classified as increasing, decreasing, heterogeneous, or no change, and most recent prevalence estimates with 95% confidence intervals (CI) were calculated. Meta‐analyses were conducted to determine current birth prevalence estimates (from birth year 2010). Forty‐one regions from 27 countries across five continents were represented. Pre‐ erinatal birth prevalence declined significantly across Europe and Australia (11 out of 14 regions), with no change in postneonatal CP. From the limited but increasing data available from regions in low‐ and middle‐income countries (LMICs), birth prevalence for pre‐ erinatal CP was as high as 3.4 per 1000 (95% CI 3.0–3.9) live births. Following meta‐analyses, birth prevalence for pre‐ erinatal CP in regions from high‐income countries (HICs) was 1.5 per 1000 (95% CI 1.4–1.6) live births, and 1.6 per 1000 (95% CI 1.5–1.7) live births when postneonatal CP was included. The birth prevalence estimate of CP in HICs declined to 1.6 per 1000 live births. Data available from LMICs indicated markedly higher birth prevalence. • Birth prevalence of pre‐ erinatal cerebral palsy (CP) in high‐income countries (HICs) is decreasing. • Current overall CP birth prevalence for HICs is 1.6 per 1000 live births. • Trends in low‐ and middle‐income countries (LMICs) cannot currently be measured. • Current birth prevalence in LMICs is markedly higher than in HICs. • Active surveillance of CP helps to assess the impact of medical advancements and social/economic development. • Population‐based data on prevalence and trends of CP are critical to inform policy.
Publisher: BMJ
Date: 16-03-2021
DOI: 10.1136/ARCHDISCHILD-2020-320441
Abstract: Cerebral palsy (CP) is a non-progressive disorder of posture and movement caused by prenatal or perinatal lesions of the brain. Children with CP are also at increased risk of other disabilities, for ex le, intellectual disability. Previous studies suggest the risk of intellectual disability varies in complex ways according to the type of motor impairment and perinatal factors such as gestational age. To determine the patterns of risk of intellectual disability in children with spastic CP. Cross-sectional, population-based study using the Northern Ireland Cerebral Palsy Register. Persons born in 1981–2008 with congenital bilateral or unilateral spastic CP (N=1452). The outcome measure was severe intellectual disability (IQ ), as reported by clinicians known to the child. Data pertaining to CP subtype, sex, gestational age, birth weight and functional level were included in analyses. Severe intellectual disability was significantly more prevalent in children with bilateral spastic CP (BSCP) compared with children with unilateral spastic CP (χ² (2)=162.60, p .001). Compared with very preterm infants with BSCP, the risk of intellectual disability increased in moderately preterm (OR=3.97, 95% CI 1.04 to 15.23) and at-term (OR=2.51, 95% CI 1.16 to 5.44) children with BSCP. Children with BSCP are at increased risk of intellectual disability, with those born at term at the highest risk. The findings highlight the importance of early screening, particularly for children with BSCP born at term.
Publisher: Swansea University
Date: 25-08-2022
Publisher: Frontiers Media SA
Date: 17-11-2022
Publisher: Informa UK Limited
Date: 22-06-2012
DOI: 10.3109/17518423.2012.692124
Abstract: To establish perceived severity of upper limb (UL) impairments and their therapeutic management in children with cerebral palsy (CP). A cross-sectional questionnaire survey was mailed to all 208 paediatric physiotherapists (PTs) and occupational therapists (OTs) working in a region of the UK. Data analysis included descriptive statistics, frequency counts and chi-square tests. A 74% response rate was achieved, of which 94 questionnaires were valid for analysis. Many impairments were rated as affecting the UL to a moderate or great extent. Goniometry and manual muscle testing were frequently reported for measuring UL impairment and by significantly more PTs than OTs. UL activity measures were rarely reported as being available or used by therapists. Participants frequently reported using positioning, neurodevelopmental therapy and task practice to treat UL dysfunction. UL management in children with CP could be enhanced by application of standardized measurement tools and evidence-based interventions.
Publisher: Informa UK Limited
Date: 17-12-2013
DOI: 10.3109/01942638.2013.866611
Abstract: Assess efficacy and acceptability of reduced intensity constraint-induced movement therapy (CIMT) in children with cerebral palsy (CP). Single-subject research design and semi-structured interviews. Children (9-11y) with hemiplegia underwent five baseline assessments followed by two weeks CIMT. Six further assessments were performed during treatment and follow-up phases. The primary outcome was the Melbourne Assessment of Unilateral Upper Limb Function (MUUL). Quantitative data were analysed using standard single-subject methods and qualitative data by thematic analysis. Four of the seven participants demonstrated statistically significant improvements in MUUL (3-11%, p < .05). Two participants achieved significant improvements in active range of motion but strength and tone remained largely unchanged. Qualitative interviews highlighted limitations of the restraint, importance of family involvement, and coordination of treatment with education. Reduced intensity CIMT may be effective for some children in this population however it is not suitable for all children with hemiplegia.
Publisher: Swansea University
Date: 25-08-2022
Publisher: Springer Science and Business Media LLC
Date: 11-01-2022
DOI: 10.1186/S12887-021-03093-1
Abstract: Research suggests electrical Vestibular Nerve Stimulation (VeNS) may improve balance for people with neurological impairments. This study aimed to assess the feasibility and acceptability of a VeNS headset protocol in children with cerebral palsy (CP). Children aged 5–18 years with ambulant CP, their parents, and healthcare professionals were recruited via social media. Children completed a battery of balance tests and wore a sham VeNS headset one hour per day for four weeks. Perspectives on the balance tests and headset were ascertained from children, parents and healthcare professionals using semi-structured interviews. Interview data were analysed thematically. Two families and four healthcare professionals participated. Balance outcome measures were fully completed and deemed acceptable. Adherence with wearing the headset was 89–100% but discomfort with self-adhesive electrodes was reported. Four themes emerged from interview data: headset issues, perceptions about VeNS, the importance of balance, and modifications for future study. Although the VeNS headset had high acceptability, the volunteer s le was small, potentially suggesting limited interest in VeNS as a treatment for children with CP, or reluctance to trial a ‘non-active’ headset. Recruitment via clinicians known to the family and use of an ‘active’ headset may increase participation in future research.
Publisher: BMJ
Date: 2021
DOI: 10.1136/BMJOPEN-2020-044614
Abstract: This study aimed to report the prevalence and clinical characteristics of adults with cerebral palsy (CP) in a geographically defined region of the UK. Cross-sectional study using the Northern Ireland Cerebral Palsy Register (NICPR). All validated cases known to the NICPR, born 1981–2001 and alive and resident in Northern Ireland at age 19 years were included. The study included 1218 persons with CP aged 19–39 years, 46 of whom died in adulthood. The prevalence of CP was 2.38 per 1000. The majority of cases had spastic CP (n=1132/1218, 93%) and could walk (n=949/1218, 78%). Those that died in adulthood typically had bilateral spastic CP (n=39/46) and used a wheelchair (n=40/46). The prevalence of CP in adults is similar to other common neurological conditions such as multiple sclerosis and Parkinson’s disease. The needs of adults with CP vary widely with almost half having two or more associated impairments that may require multiprofessional and multiagency coordination. Results from this study can be used to inform transformation of health and care services for adults with CP.
Publisher: Wiley
Date: 24-03-2011
DOI: 10.1111/J.1469-8749.2011.03953.X
Abstract: To review classification systems for the upper limb in children with cerebral palsy (CP), and evaluate their validity, reliability, and clinical utility to make recommendations for clinical practice and future research. We comprehensively searched electronic databases to identify upper limb classification tools and associated evidence of psychometric testing. Two independent reviewers assessed the quality of the psychometric studies, and rated the clinical utility of each system using previously published tools. Eighteen classification systems were eligible for inclusion, with two primary functions: classification of function or deformity. Published evidence of psychometric testing was available for fewer than half of the identified systems. Reliability studies were frequently limited by s le size, rater blinding, representativeness, and the number of observers. The Manual Ability Classification System (MACS) demonstrated content validity and interrater reliability. The original and modified House functional, House thumb, swan-neck, and Zancolli systems had evidence of reliability the modified House functional system also demonstrated criterion-related validity. This review supports the use of the MACS and modified House functional system to classify upper limb function in children with CP. Similarly, the House thumb and Zancolli systems are recommended to classify thumb, and hand and wrist deformity respectively.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Karen McConnell.