Interest of early management of children with cerbral palsy within a specialized network
Prof Sameh GHROUBIa, Dr Wafa ELLEUCHa, Dr Samar ALILAa, Prof Fatma KAMMOUNb, Prof Nedia HMIDAc, Prof Chahinez TRIKIb, Prof Mohamed Habib ELLEUCHa
a Service de Médecine Physique et de Réadaptation, CHU Habib Bourguiba, Sfax, Tunisie, et Unité de recherche de l’évaluation des pathologies de l’appareil locomoteur UR12ES18, université de Sfax, b Service de neuropédiatrie, CHU Hedi Chaker, Sfax, Tunisie, c Service de néonatologie, CHU Hedi Chaker, Sfax, Tunisie
To show the superiority of early specialized management of children with cerebral palsy (CP) in specific structures.
Materials and methods:
This was a prospective study including 100 newborns with risk of PC recognized on clinical and radiological criteria and followed since the age of 4 months. They were divided into 2 groups according to the type of management and the place of habitat: G1 included children who received a specialized management since an early age in specialized centers and G2 included children with an external and irregular management. All these children have been regularly assessed, especially at 2 years old.
The diagnosis of PC was retained in 62 children who were divided into 30 children in G1 and 32 children in the G2. These two groups were comparable according to the different risk factors: the gestational age, follow-up and complications of pregnancy, circumstances of birth, postnatal complications and clinical assessment at output of service. Evaluation at 2 years old showed that the number of walking children in G1 was more important with a younger age of walk acquisition. These differences were not significant. The language development was better in G1 (p = 0.01): The absence of language was 13.4% in G1 versus 28.1% in G2. The number of children with difficulties in cognitive development was higher in G2 (p = 0.02). Behavior problems were more frequent in G2 with a significant difference for hyperactivity (p = 0.014).
The management of children with risk of neurosensory impairments remains today an ethical and public health priority. Early interventions take a special place.
According to the European Academy for Childhood Disability, although its effectiveness is not scientifically proven and the appropriate assessment methods are lacking, it is now accepted as a right . The results of this study confirm clearly the interest of early treatment in a specialized structure.
Bax M. Does “therapy” have a future? Dev Med Child Neurol 2001; 43:3.
Keywords : Cerebral palsy, children, management, specialized network, development