Ibolya Túri

Objectives: Special care dentistry provides essential, customized oral health care for individuals with significant disabilities, addressing higher rates of dental issues and enhancing overall well-being. The aim of this pilot study was to evaluate the effect of an eight-week dental prevention program on oral health outcomes and cooperation during dental treatment in children with special needs. Methods: The study targeted 97 children from Pető András Conductive Practical Primary School. A total of 16 children participated in the program, which consisted of eight weeks of education sessions focusing on oral hygiene practices and dental cooperation strategies. Dental assessments were conducted at baseline, weeks 8, 16, 52 and 104 using WHO protocols. Results: Significant improvements were observed following the 8-week preventive education program. OHI-S, DI-S, and CI-S values showed significant reductions at both week 8 and week 16 compared to baseline (p < 0.05). Patient cooperation, assessed using the Frankl scale, also improved significantly during the intervention period. Accommodation type demonstrated a significant association with OHI-S values, while diagnosis did not significantly influence the measured outcomes. Long-term follow-up demonstrated sustained improvements in oral hygiene and cooperation scores at both week 52 and week 104, indicating the potential long-term effectiveness of the preventive education program in children with special needs. Conclusions: The specific prevention program significantly improved oral health outcomes and cooperation among children with special needs.

Cerebral palsy (CP) manifests with abnormal posture and impaired selective motor control, notably affecting trunk control and dynamic balance coordination, leading to inadequate postural control. Previous research has indicated the benefits of pulsed electromagnetic field (PEMF) therapy for various musculoskeletal and neurological conditions. Therefore, we conducted a randomized pilot study to assess the feasibility of our preliminary research design and examine the effect of the PEMF treatment among children with CP. Methods: Twelve children with spastic CP participated, with the study group undergoing PEMF treatment three times a week for four weeks. The treatment involved sine signal form, 20/200 Hz frequencies at an amplitude of 150 μT, initially administered for 8, 12, and 16 min per session. The control group received a sham treatment. Dynamic postural balance was evaluated using a force platform at baseline and post-intervention, and the data were analyzed. Data were processed using IBM SPSS 27 by repeated factorial analysis of variance. The significance level was α = 0.05. Results: No side effects of PEMF therapy were detected; this is important, because this intervention has not yet been applied among CP patients. The treatment group demonstrated a positive trend in fine balance coordination tests (p = 0.049); however, the small sample size and variability in control group performance suggest caution in interpreting these findings. Other test domains did not show significant differences. Conclusions: Our pilot study reveals the safety, feasibility, and potential efficacy of pulsed electromagnetic field (PEMF) therapy for children with cerebral palsy. With no observed side effects, the significant improvement in fine balance coordination suggests a promising avenue.

Background: Children with CP show deficits in executive function compared to their typically developing peers, based on the majority of the available evidence. However, the magnitude of these deficits, as well as the proportions of the shortfalls in the three main components, have not yet been examined. This is the first meta-analysis to synthesize evidence on the magnitude of differences between patients with cerebral palsy (CP) and typically developing populations in different components of executive function skills (working memory, inhibitory control and cognitive flexibility), and thus makes recommendations on which areas of executive functioning are in greatest need of intervention. Methods: We conducted a systematic literature search of four databases for studies that measured executive functions in these two groups until 31 August 2023. We calculated the standardized mean difference (Hedges’ g), an average effect size overall, and for the three components of executive function skills separately, we used several moderator analyses, including methodological differences between the primary studies. Results: Fifteen articles were included in the meta-analysis. The average mean difference in executive functioning overall was large (g+ = −0.82). Furthermore, large significant differences were found in working memory (g+ = −0.92) and inhibitory control (g+ = −0.82) and a moderate difference was identified in cognitive flexibility (g+ = −0.57). In addition, results of moderator analyses reveal the importance of a rigorous matching of control group participants and CP patients. Conclusions: The results demonstrate a severe impairment in all executive functions among CP patients compared to typically developing peers, which do not decrease over time.

Background: Despite medical advances, individuals with cerebral palsy (CP) face significant respiratory challenges, leading to heightened hospitalization rates and early mortality among this population. We hypothesize that integrating supplementary respiratory therapy into standard rehabilitation will result in significant improvements in pulmonary function, enhanced respiratory muscle strength, and an overall increase in the quality of life among pediatric patients with CP. Methods: A systematic search of literature across five databases was conducted, and random-effects meta-analyses were performed to assess the impact of supplementary respiratory therapy on (a) pulmonary function: forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FVC/FEV1 ratio, peak expiratory flow (PEF), and (b) respiratory muscle strength: maximal inspiratory and expiratory pressure (MIP, MEP), and (c) quality of life. Certainty of evidence was determined by the GRADE assessment. Results: Analysis of data from 11 eligible randomized controlled trials revealed clinically meaningful changes in pulmonary function. We found a relevant mean difference (MD) in absolute PEF of 0.50 L/s (95% confidence interval (CI): 0.19; 0.82 p = 0.0107). The certainty of the evidence ranged from moderate to high. Conclusions: This study presents current evidence on the impact of various supplementary respiratory therapies for CP patients classified under gross motor function classification level I–IV, demonstrating clinically meaningful improvements in pulmonary function and respiratory muscle strength. These improvements suggest the potential for an enhanced quality of life. Our findings hold the promise of serving as a foundational reference for potential revisions to conventional rehabilitation care, incorporating supplementary respiratory therapy.

Nowadays, whole-body vibration (WBV) has become increasingly popular as an additional therapy in the intervention of patients with cerebral palsy (CP). However, the impact of WBV remains a subject of debate. Consequently, a systematic review and meta-analysis were undertaken to evaluate the effects of WBV on the musculoskeletal system in children with CP. Randomized controlled trials (RCTs) were sought in the most frequent databases. The intervention studied was WBV combined with conventional physiotherapy (PT) compared with conventional PT as the control; the main outcomes were changes in the musculoskeletal system. Weighted mean differences with 95%CIs were calculated. A random-effects model was applied, and the publication bias was checked using funnel plots. On the basis of the inclusion and exclusion criteria, 16 articles, including 414 patients, were considered in the final analysis. The improvement in walking performance (speed and step length) was statistically significant (p < 0.05), and although there were no significant differences in the further outcomes, a clear positive tendency was visible in the case of improved muscle strength, decreased spasticity, enhanced gross motor functions, and overall stability. Based on the findings, a clear assessment of the usefulness of this intervention cannot be made; nonetheless, due to the promising results, it would be worthwhile to conduct additional RCTs to enhance the available evidence in this field. Due to the wide range of vibration configurations, including varying durations and intensities, it is suggested to establish guidelines and a strategy for the incorporation of this additional treatment.