Publicação
Impact of Visual Stimulation Therapy in the Management of Cerebral Visual Impairment in Paediatric Cerebral Palsy
| Resumo: | INTRODUCTION: Cerebral visual impairment (CVI) is a common yet underdiagnosed cause of visual dysfunction in paediatric cerebral palsy (CP) for which there is not an approved therapy available. The aim of our study was to present our experience in CVI management in paediatric CP subjects involved in a visual stimulation therapy (VST) program. METHODS: A group of paediatric CP patients with severe CVI was selected and submitted to a VST program between February 2022 and September 2023. Median number of VST sessions was 1 per week, conducted over an average follow-up period of 12 months. Visual Assessment Scale - Cerebral Visual Impairment in persons with Profound Intellectual and Multiple Disabilities (VAS CVI-PIMD) was applied for standardized and objective assessment of two parameters: 1) visual functioning level (VFL), and 2) total characteristics of CVI. Assessment was conducted by the same multidisciplinary team of occupational therapists and an ophthalmologist. VAS CVI-PIMD was re-measured after the intervention period to evaluate the effect of VST in the VFL, characteristics, and severity of CVI. A questionnaire was also administered to parents. A related samples Wilcoxon Signed Rank test was used to compare initial pre-VST scores with post-VST scores. p-values <0.05 were considered statistically significative. RESULTS: Eight children with CP and severe CVI (age range, 1 - 14 years) were selected. Initial median VFL was 3, corresponding to an exogenous attention system. After the VST program, 7/8 subjects improved at least one level, reaching a median VFL of 4 corresponding to a basic recognition and active visual attention system (p=0.014). Total number of CVI characteristics in each patient decreased from a median score of 9 on the initial evaluation to a median score of 6 after the follow up period (p=0.013). Parent questionnaire revealed a perception of improvement in eye-hand coordination skills and social functioning in everyday life. CONCLUSION: In the present cohort, visual rehabilitation with appropriate stimuli for each stage of visual development leads to measurable gains in the visual performance of children with CVI. |
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| Autores principais: | Figueiredo, Inês |
| Outros Autores: | Ramos, Andreia; Carmo, Marisa; Martins, Inês; Almeida, Luís; Silva, Catarina; Murta, Joaquim; Paiva, Catarina |
| Assunto: | Artigos Originais |
| Ano: | 2024 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Sociedade Portuguesa de Oftalmologia |
| Idioma: | inglês |
| Origem: | Revista Sociedade Portuguesa de Oftalmologia |
| Resumo: | INTRODUCTION: Cerebral visual impairment (CVI) is a common yet underdiagnosed cause of visual dysfunction in paediatric cerebral palsy (CP) for which there is not an approved therapy available. The aim of our study was to present our experience in CVI management in paediatric CP subjects involved in a visual stimulation therapy (VST) program. METHODS: A group of paediatric CP patients with severe CVI was selected and submitted to a VST program between February 2022 and September 2023. Median number of VST sessions was 1 per week, conducted over an average follow-up period of 12 months. Visual Assessment Scale - Cerebral Visual Impairment in persons with Profound Intellectual and Multiple Disabilities (VAS CVI-PIMD) was applied for standardized and objective assessment of two parameters: 1) visual functioning level (VFL), and 2) total characteristics of CVI. Assessment was conducted by the same multidisciplinary team of occupational therapists and an ophthalmologist. VAS CVI-PIMD was re-measured after the intervention period to evaluate the effect of VST in the VFL, characteristics, and severity of CVI. A questionnaire was also administered to parents. A related samples Wilcoxon Signed Rank test was used to compare initial pre-VST scores with post-VST scores. p-values <0.05 were considered statistically significative. RESULTS: Eight children with CP and severe CVI (age range, 1 - 14 years) were selected. Initial median VFL was 3, corresponding to an exogenous attention system. After the VST program, 7/8 subjects improved at least one level, reaching a median VFL of 4 corresponding to a basic recognition and active visual attention system (p=0.014). Total number of CVI characteristics in each patient decreased from a median score of 9 on the initial evaluation to a median score of 6 after the follow up period (p=0.013). Parent questionnaire revealed a perception of improvement in eye-hand coordination skills and social functioning in everyday life. CONCLUSION: In the present cohort, visual rehabilitation with appropriate stimuli for each stage of visual development leads to measurable gains in the visual performance of children with CVI. |
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