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Toward Improved Evaluation, Treatment, and Management of Movement Disorders and...
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Toward Improved Evaluation, Treatment, and Management of Movement Disorders and Cognitive Impairments in People with Cerebral Palsy

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 2534

Special Issue Editors

Prof. Dr. Elegast Monbaliu

E-Mail Website
Guest Editor
Department of Rehabilitation Sciences, Neurorehabilitation Technology Lab, KU Leuven, Bruges, Belgium
Interests: cerebral palsy; complex movement disorders; rehabilitation technology; instrumented measurements; rehabilitation interventions; powered wheelchair mobility; computer accessibility; eye tracking
Dr. Saranda Bekteshi

E-Mail Website
Guest Editor
Department of Rehabilitation Sciences, Neurorehabilitation Technology Lab, KU Leuven, Bruges, Belgium
Interests: cerebral palsy; neurorehabilitation; assistive technology; eye tracking; powered wheelchair mobility; executive functions

Special Issue Information

Dear Colleagues,

Cerebral palsy is one of the most common childhood-onset disabilities, characterized by motor and non-motor impairments of varying severity. Due to its heterogeneity, evaluating, treating and managing the myriad of symptoms associated with cerebral palsy remains challenging. Evidence-based knowledge to inform clinical practice is paramount to the quest of facilitating a fulfilling life with the greatest independence possible.

This Special Issue aims to report a collection of high-quality research in the field of cerebral palsy, conducted in the last 5-years, using state-of-the-art methodology to explore questions associated with evaluation, treatment and/or management. Topics of interest include, among others, novel methods to reliably assess motor- and non-motor impairments, medical and rehabilitation interventions in paediatric and adult populations, technology solutions to increased activity and participation levels, telehealth, wearables, neuroimaging techniques and artificial intelligence.

Prof. Dr. Elegast Monbaliu
Dr. Saranda Bekteshi
Guest Editors

Manuscript Submission Information

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Keywords

  • cerebral palsy
  • movement disorders
  • cognition
  • technology
  • artificial intelligence
  • wearables
  • neuroimaging
  • telehealth

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Published Papers (4 papers)

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10 pages, 987 KiB  
Article
Socioeconomic Disadvantage, Residential Remoteness and Access to Specialised Interventions in Cerebral Palsy: A Cross-Sectional Study
by Simon P. Paget, Kirsty Stewart, Lisa Copeland, Emma Waight, Nadine Smith, Felicity Baker, Jennifer Lewis and on behalf of the Australian Selective Dorsal Rhizotomy Research Group and Australian Paediatric Intrathecal Baclo-fen Research Group
J. Clin. Med. 2025, 14(10), 3579; https://doi.org/10.3390/jcm14103579 (registering DOI) - 20 May 2025
Abstract
Aim: Socioeconomic factors are known to influence access to health services, including for children with cerebral palsy (CP). This study aims to determine whether socioeconomic disadvantage and/or geographical remoteness influence access to specialised CP interventions: selective dorsal rhizotomy (SDR) and intrathecal baclofen [...] Read more.
Aim: Socioeconomic factors are known to influence access to health services, including for children with cerebral palsy (CP). This study aims to determine whether socioeconomic disadvantage and/or geographical remoteness influence access to specialised CP interventions: selective dorsal rhizotomy (SDR) and intrathecal baclofen (ITB). Methods: This was a cross-sectional study of children with CP from (i) the Australian SDR Research Registry and (ii) an Australian ITB audit study. Socioeconomic disadvantage was grouped (quintiles) using the Index of Relative Socioeconomic Disadvantage (IRSD). Geographical remoteness was determined using the Australian Statistical Geographical Standard. IRSD quintiles and remoteness were compared with the Australian CP Register (ACPR) (birth years 1995–2016). Results: A total of 64 children (31.3% female) had received SDR surgery and 52 children (48.1% female) had received ITB therapy. Of these, 7 (11.1%) (SDR) and 7 (13.5%) (ITB) lived in the most disadvantaged neighbourhoods (IRSD quintile 1); 41 children (65.1%) (SDR) and 42 (82.4%) (ITB) lived in major cities. In comparison, 1630 (18.8%) of children on the ACPR resided in IRSD quintile 1; 6122 (70.4%) resided in major cities. There were no statistical differences in IRSD distribution between ACPR, SDR, and ITB groups. More children in major cities received ITB therapy (p = 0.03) and more children in outer regional/remote areas had received SDR (p = 0.03). Conclusions: Access to SDR and ITB in Australia varies by geographical remoteness. Equity of access is important to monitor, and interventions should be considered to reduce inequity. Full article
(This article belongs to the Special Issue Toward Improved Evaluation, Treatment, and Management of Movement Disorders and Cognitive Impairments in People with Cerebral Palsy)
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13 pages, 521 KiB  
Article
Between Anxiety and Adaptation: Children’s and Parents’ Experiences with Botulinum Toxin Treatment in Cerebral Palsy
by Rannei Sæther, Siri Merete Brændvik and Ann-Kristin Gunnes Elvrum
J. Clin. Med. 2025, 14(9), 3164; https://doi.org/10.3390/jcm14093164 - 2 May 2025
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Abstract
Background/Objectives: This study explores how children with cerebral palsy (CP) and their parents experience botulinum toxin type A (BoNT-A) treatment, focusing on emotional and procedural challenges and communication within the triad of children, parents, and healthcare providers. Methods: This qualitative sub-study [...] Read more.
Background/Objectives: This study explores how children with cerebral palsy (CP) and their parents experience botulinum toxin type A (BoNT-A) treatment, focusing on emotional and procedural challenges and communication within the triad of children, parents, and healthcare providers. Methods: This qualitative sub-study was conducted within the WE-study, a randomized controlled trial on BoNT-A effects in children with CP. Semi-structured interviews with 20 parents and 18 children (aged 4–15 years, GMFCS I–II) were thematically analyzed. Results: Three themes were identified: Preparing for the treatment, Being in the moment, and Adapting after treatment. Pre-procedural anxiety was common, with children describing nervousness or physical discomfort in the days before the treatment. During the procedure, pain management and sedation choices influenced children’s experiences, with healthcare providers being the primary source of information. After treatment, some children experienced temporary walking instability, but most quickly resumed daily activities. Communication primarily occurred between healthcare providers and each party individually, rather than through a triadic interaction. Conclusions: BoNT-A treatment involves both emotional distress and adaptation. Strengthening child-inclusive communication, structured preparation, and collaboration within the triad may improve treatment experiences and better align care with child-centered principles. Future research should explore strategies to enhance child involvement in repeated treatments. Full article
(This article belongs to the Special Issue Toward Improved Evaluation, Treatment, and Management of Movement Disorders and Cognitive Impairments in People with Cerebral Palsy)
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22 pages, 983 KiB  
Article
Assessment of Gaze Fixations and Shifts in Children with Cerebral Palsy: A Comparison of Computer- and Object-Based Approaches
by Tom Griffiths, Michael T. Clarke and John Swettenham
J. Clin. Med. 2025, 14(7), 2326; https://doi.org/10.3390/jcm14072326 - 28 Mar 2025
Viewed by 357
Abstract
Background/Objectives: Gaze behaviours, such as fixation on single objects, and switching gaze between two objects are important for signaling messages, making choices or controlling a computer for children with cerebral palsy (CP) and similar movement disabilities. Observing these behaviours can be challenging [...] Read more.
Background/Objectives: Gaze behaviours, such as fixation on single objects, and switching gaze between two objects are important for signaling messages, making choices or controlling a computer for children with cerebral palsy (CP) and similar movement disabilities. Observing these behaviours can be challenging for clinicians, with a lack of agreement on how they can be objectively quantified or rated. Methods: This study compares two methods of eliciting and observing gaze behaviours: a computer presentation using an eye tracker and an object presentation scored by two independent observers in order to explore the utility of each to clinicians working in this area. Children with CP (n = 39) attempted single-target fixation (STF) and target–target fixation shift (TTFS) tasks using both presentations and the results were compared. Results: Six children were unable to calibrate the eye tracker to the accuracy level required. Significantly higher scores for both STF (81.3% object presentation and 30.3% computer presentation, p < 0.01) and TTFS (70.1% and 26.9%, p < 0.01) were seen on the object presentation, with children’s performance not predicted by developmental age, severity of CP or presence or absence of strabismus. It is not possible to definitively state which method gives the “correct” result; however, the difference in reported success rate merits further discussion. Conclusions: Whilst eye tracking may present an “entry barrier” for some children in terms of its accuracy and calibration requirements, object presentation carries with it the risk of over-interpreting children as having fixated. Conversely, eye tracking may be better at recording fixations in children with strabismus, where object-based paradigms may offer more flexible administration for clinicians. The variability in children’s performance on both presentations underlines the risk of assuming these skills to be present and the importance of assessing gaze behaviours in individual children. Full article
(This article belongs to the Special Issue Toward Improved Evaluation, Treatment, and Management of Movement Disorders and Cognitive Impairments in People with Cerebral Palsy)
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15 pages, 1622 KiB  
Case Report
Is Whole-Body Cryostimulation Useful in Modulating Spasticity in Adults with Cerebral Palsy? A Case Study
by Paolo Piterà, Matteo Bigoni, Elisa Prina, Boris Barrera, Duru Ceren Yavuz, Federica Verme, Jacopo Maria Fontana, Lorenzo Priano, Alessandro Mauro and Paolo Capodaglio
J. Clin. Med. 2024, 13(24), 7674; https://doi.org/10.3390/jcm13247674 - 16 Dec 2024
Viewed by 1059
Abstract
Background: This case study investigates the effect of a five-session whole-body cryostimulation (WBC) cycle on a 55-year-old female patient with cerebral palsy (CP) and lower limb spasticity (LLS) with a typical diplegic gait pattern. CP is a common physical disability characterized by [...] Read more.
Background: This case study investigates the effect of a five-session whole-body cryostimulation (WBC) cycle on a 55-year-old female patient with cerebral palsy (CP) and lower limb spasticity (LLS) with a typical diplegic gait pattern. CP is a common physical disability characterized by motor impairments, including spasticity, which significantly impacts mobility and quality of life. The current treatments for spasticity often have limited efficacy and considerable side effects, making alternative therapies like WBC an area of interest. Methods: The patient underwent a 10-day inpatient rehabilitation program integrated with five WBC sessions at −110 °C for 2 min. The treatment effects were assessed immediately before and after the five WBC sessions using the Ashworth Scale, Fugl-Meyer Assessment, H-reflex test, and gait analysis. Psychosocial outcomes were measured with the SF-36, WHO-5, PSQI, ESS, and BDI questionnaires. Results: Immediately after the WBC cycle, gait analysis showed increased walking speed (0.48 to 0.61 m/s left; 0.49 to 0.57 m/s right) and step length (0.30 to 0.38 m left; 0.30 to 0.35 m right). The H/M ratio in the H-reflex test improved, indicating a better neuromuscular efficiency. Psychosocial assessments revealed a 42.5% reduction in pain and a 24% improvement in overall quality of life and well-being. Discussion and Conclusions: The objective improvements in gait parameters and neuromuscular modulation, along with the subjectively reported enhancements in functional abilities, highlight the potential of WBC as a valuable addition to rehabilitation strategies for this population. Further research is needed to confirm these findings and assess long-term outcomes. Full article
(This article belongs to the Special Issue Toward Improved Evaluation, Treatment, and Management of Movement Disorders and Cognitive Impairments in People with Cerebral Palsy)
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