For the past couple of weeks I’ve been indulging in some hard core geekdom and my “nerd file”, filled with research papers is getting fatter and fatter. Horrifyingly enough, it makes me yearn to go back to college for a—gasp—4th degree. Because, you know, the perfect compliment to an English BA, a creative writing masters and a library science masters is a degree in exercise physiology. Relax, Mom and Dad, I won’t be quitting my job any time soon. I suck too much at math to study anything technical. But to indulge my nerdy side, I’m resurrecting a research feature here in my own virtual fifedom. The goal is to spread the word about research relevant to this blog—CP research, exercise research, obesity research, etc., and to allow me to pontificate and gush about the geeky stuff I read. It’s my soapbox, after all. 
So this week’s read was: Neural plasticity and treatment across the lifespan in motor deficits in cerebral palsy by George F. Wittenberg, MD, PhD.
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So I’m still going through my contemplative quiet time—yeah, I know, ME quiet? Something must be out of sync in the universe. I have about three volume settings: not-so loud, let-me-make-sure-everybody-noticed-me loud, and yeah-just-try-to-ignore-me-I-dare-you loud. This is particularly true if I’ve got a bee in my bonnet about something—and clearly I’ve got a swarm going about CP, fitness, access to care, etc. Actually, truth be told I’m spending this time using my mad librarian skills to build a bibliography. It’s a list of studies and resources on CP research (particularly CP and exercise), disability and obesity, barriers to fitness/patient treatment compliance, and muscle growth in folks with brain injuries. So I promise I haven’t abandoned this blog or this project. And of course, my personal fitness quest continues, as do the Botox treatments—I feel great for the most part, I’ve got zero acute pain 99% of the time. Some days I feel so grateful it hurts—and I spontaneously burst into tears.
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Today the American Academy of Neurology released new guidelines regarding the use of drugs, including Botox, to reduce spasticity in children with CP.
AAN Guideline Evaluates Treatments For Kids With Cerebral Palsy
This is great news for a number of reasons, including that it will make it more difficult for insurance companies to deny coverage for Botox injections, citing that the treatment is “experimental.” But I have to admit to being disappointed–and beating my head against the desk– because adults have been excluded from the guidelines. (This means that denial of coverage can still take place in the adult population.) The guidelines, though, were generated after a review of existing literature on the subject of pharmacologic interventions for spasticity–most of which only looks at children. As I’ve worked on this blog and sought treatment for myself, I’ve been routinely appalled and frustrated by the lack of academic study and funding devoted to treating adults with CP. It seems that no one is looking at the long-term benefits of treatments administered over a patient’s life span from childhood to adulthood, either.
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Below you’ll find a cool article about a very small study on the use of customized virtual reality “games” to improve hand function in teenagers with hemiplegic cerebral palsy. I think it’s awesome on two fronts–a.) it’s an innovative application of a technology that teenagers would be self- motivated to use; and b.) it studies teenagers as opposed to young children.
Virtual Reality Tele-rehab Improves Hand Function: Playing Games For Real Recovery
The article also mentions that the use of remotely controlled virtual reality games offers a new way for patients to receive low-cost, effective treatment at home. The idea being that as the patient’s hand/arm motor function improves, a physical therapist could monitor their progress and increase the duration/level of difficulty. The remote monitoring system, while of course not a replacement for manual physical therapy, would decrease the stress, hassle and cost of traveling to a clinic regularly for rehab .
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Although Botox injections have been used in the treatment for cerebral palsy for over a decade, they didn’t really arrive on my radar as a possibility until about 5 years ago. And I didn’t consider actively pursuing it as a treatment until I began working with PTE (personal trainer extraordinaire) about 2 1/2 years ago. Now, I’m determined never to miss out on a promising treatment due to my own ignorance, so I’m signed up for all kinds of neurology news RSS feeds.
New Tools Use Light To Turn Off Brain Cells And Possibly Treat Brain Disorders
Although cerebral palsy isn’t mentioned specifically here, it is a type of brain injury, usually suffered before, during, or in the two years after birth. CP is characterized by “inappropriate brain activity” similar, I think, to what’s described here. So it seems to me–although like I said, I speak only remedial “neurologist”– that this might eventually be an applicable treatment for CP too.
Anyway, very cool.