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Multiple Impairments (multiple + impairment)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Developing Good Practice in the Clinical Assessment of People With Profound Intellectual Disabilities and Multiple Impairment

JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 2 2007
Steve Carnaby
Abstract, The task of assessing people with profound intellectual disabilities and multiple impairments can be a daunting one, for experienced and newly qualified clinicians and practitioners alike. Difficulties with definitions in the context of challenging, excluding service delivery models can sometimes lead to incoherent and inconsistent approaches. The author examines a number of issues, including the paucity of adequately sensitive, standardized assessment tools, the importance of collaborative working, and the acknowledgment that services can be ill-equipped to face the challenges presented by people with such complex and chronic support needs. The role of an overly generic service philosophy in potentially limiting the work of clinicians is noted, and the author notes that evaluating development is a crucial factor in any overall assessment. The author concludes with a number of recommendations for developing good practice in this crucial area of the support process, including: agree on terminology and inclusion criteria; take a transdisciplinary approach; use a developmental model; consider the impact of neurological conditions; select measures and informants carefully; and consider the assessment as an intervention. [source]

Lower-extremity selective voluntary motor control in patients with spastic cerebral palsy: increased distal motor impairment

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 3 2010
EILEEN G FOWLER
Aim, Multiple impairments contribute to motor deficits in spastic cerebral palsy (CP). Selective voluntary motor control (SVMC), namely isolation of joint movement upon request, is important, but frequently overlooked. This study evaluated the proximal to distal distribution of SVMC impairment among lower extremity joints. Method, Using a recently developed tool, the Selective Control Assessment of the Lower Extremity (SCALE), we evaluated the SVMC of the hip, knee, ankle, subtalar joint, and toes in a cross-sectional, observational study of 47 participants with spastic, diplegic, hemiplegic, and quadriplegic CP (22 males, 25 females; mean age 11y 9mo, SD 4y 8mo; Gross Motor Function Classification System levels I,IV). Results, Statistically significant decreases in SCALE scores from hip to toes were found using the Page statistical test for trend (p<0.001). Statistically significant differences (p<0.05) were found between all joint pairs, except toes versus subtalar, toes versus ankle, and right ankle versus subtalar joints. Cross-tabulation of score frequencies for all pairs revealed that proximal joint scores were higher or equal to distal ones 81 to 100% of the time. Excluding toes versus subtalar joints, proximal scores exceeded distal ones 94 to 100% of the time. Interpretation, We confirmed increasing proximal to distal SVMC impairment, which may have implications for treatment and research. [source]

Developing Good Practice in the Clinical Assessment of People With Profound Intellectual Disabilities and Multiple Impairment

JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 2 2007
Steve Carnaby
Abstract, The task of assessing people with profound intellectual disabilities and multiple impairments can be a daunting one, for experienced and newly qualified clinicians and practitioners alike. Difficulties with definitions in the context of challenging, excluding service delivery models can sometimes lead to incoherent and inconsistent approaches. The author examines a number of issues, including the paucity of adequately sensitive, standardized assessment tools, the importance of collaborative working, and the acknowledgment that services can be ill-equipped to face the challenges presented by people with such complex and chronic support needs. The role of an overly generic service philosophy in potentially limiting the work of clinicians is noted, and the author notes that evaluating development is a crucial factor in any overall assessment. The author concludes with a number of recommendations for developing good practice in this crucial area of the support process, including: agree on terminology and inclusion criteria; take a transdisciplinary approach; use a developmental model; consider the impact of neurological conditions; select measures and informants carefully; and consider the assessment as an intervention. [source]

Medical problems in adolescents with myelomeningocele (MMC): an inventory of the Swedish MMC population born during 1986,1989

ACTA PAEDIATRICA, Issue 3 2007
I Olsson
Abstract Aim: To describe the prevalence of myelomeningocele (MMC) and the medical needs of adolescents, 15,18 years, with MMC in Sweden, at a time when they are on the threshold of adulthood, leaving paediatrics. Methods: In a retrospective study, we identified all adolescents with MMC, born during 1986,1989 and living in Sweden on July 1, 2004. An inventory was agreed upon with questions concerning their medical problems and need for medical care. Results: There were 175 persons 15,18 years of age, born with MMC or lipoMMC (prevalence 3.8 per 10 000). Hydrocephalus was seen in 86%, 31% had been operated because of tethered cord syndrome, and 6% for Chiari malformation symptoms. The majority had motor impairments. Clean intermittent catheterisation for bladder emptying was used by 85%, and 59% used enemas on a regular basis because of the neurogenic bowel dysfunction. Renal dysfunction was seen in 1.7% of the adolescents. Conclusion: Lifelong follow-up by many specialists, among others neurologists and neurosurgeons, urotherapists and urologists, orthopaedic surgeons and orthotists, is necessary for individuals with MMC. The complex medical situation, often in combination with cognitive difficulties, makes it necessary to coordinate medical services for this increasing group of adults with multiple impairments. [source]