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• W3204274650 abstract "<h3>Background</h3> In the first lockdown period community services were quick to move to virtual assessments and this was seen as a huge success in the use of technology. It became clear that there was significantly above expected deterioration in function and ability in our children with Cerebral Palsy. Whilst there is a desire amongst some within the service to maintain this virtual approach, there is a question as to whether virtual assessment is in fact good enough for the long term care of these young people. We have used the Cerebral Palsy Integrated Pathway (CPIP) UK for 3 years. This is an evidence based tool for hip surveillance and monitoring of contracture/deformity in the lower limbs of children with cerebral palsy. Children and young people are seen at regular intervals dependent on their age and severity of cerebral palsy (based on gross motor functional classification system GMFCS). Joint measurement is colour-coded in a traffic light system where green is ‘no concern’, amber suggests an ‘area of concern which may require intervention’ and red ‘needs action or intervention’. <h3>Objectives</h3> To examine the impact of Covid related operational changes (reduction in face-to-face services) on pre- and post-Covid measurements extracted from CPIP data. <h3>Methods</h3> A retrospective study of 97 patients aged 3–20 years (mean=10.33) registered under our Trust CPIP UK Registry. Paired-sample t-tests or Wilcoxon Signed Rank tests were performed using SPSS Software. Statistical significance was indicated at 0.05. <h3>Results</h3> Of the 97 patients, 54 were male. 43 children had hemiplegic cerebral palsy (20 left sided and 23 right sided), 32 were diplegic distribution, and 22 were quadriplegic. The GMFCS score of severity was also recorded: 42 Level I, 25 Level II, 8 Level III, 13 Level IV and 9 Level V. The CPIP database pre- and post-lockdown measurements were compared. A significant difference was found between pre- and post-scores for Knee Popliteal Angle on the Right (t=-2.42, p=0.02). Where the mean score for 90 Children was pre 36.14 and post 39.24 degrees. A significant difference was also found between pre- and post-scores for Knee Popliteal on the Left (t=-2.78, p=0.01). The mean score for 88 children was 36.23 degrees pre and 40.09 post. Also significantly deteriorated was Ankle Dorsiflexion on the Right, (t=2.79, p=0.01), where 85 children showed a mean dorsiflexion to 9.6 degrees above neutral pre and 6.91 post. Ankle Dorsiflexion on the Left also significantly deteriorated (asymptotic sig=0.01). 88 children had a mean pre-value of 7.95 degrees above neutral and 5.47 post. Therefore, hamstrings and gastrocnemius muscle groups showed significant deterioration during lockdown. Of note, 4 children received interventions: 2 had intramuscular Botulinum Toxin injections, 2 had orthopaedic surgery. Children receiving interventions did not deteriorate. <h3>Conclusions</h3> The CPIP database is an excellent resource for comparison studies in cerebral palsy. The children who received interventions seemed to be protected from deterioration. This study demonstrates the importance of face-to-face consultations and interventions in preventing deterioration in children with spastic cerebral palsy. Virtual medicine is inadequate for this patient group." @default.
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• W3204274650 date "2021-09-30" @default.
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• W3204274650 title "1116 Examining the impact of virtual consultations during the Covid pandemic on children with cerebral palsy using the cerebral palsy integrated pathway (CPIP) data" @default.
• W3204274650 doi "https://doi.org/10.1136/archdischild-2021-rcpch.409" @default.
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