The Cerebral Palsy Research Network has been established to conduct several types of clinical research and quality improvement projects to improve healthcare for people with cerebral palsy.

Dr. Kristie Bjornson in a bright green CPRN shirt and holding an orthotic.

CP Research Network Hires Scientific Director

Kristie Bjornson, PT, PhD. A smiling woman with blond hair, wearing a black vest over maroon turtleneck in a hospital hallway.

Kristie Bjornson, PT, PhD, MS, has been hired by the CP Research Network to be the Scientific Director.

The Cerebral Palsy Research Network hired Kristie Bjornson, PT, PhD, MS to lead its scientific direction. Dr. Bjornson, featured in our CP Stories in April 2021, is a leader in the field of research for cerebral palsy. In her new role, Dr. Bjornson will lead the network’s effort to pursue public funding from granting agencies such as the National Institutes of Health, the Patient-Centered Outcomes Research Institute and the National Institute on Disability Independent Living and Rehabilitation Research. Dr. Bjornson brings multi-center clinical trial experience for various interventions for CP (i.e. surgery, injections, orthoses, and rehabilitation).

“I’m excited to merge my experience in clinical research in cerebral palsy with the power of the network,” said Dr. Bjornson. “There are so many important to questions to answer for our community and the network is a highly efficient way to conduct this research.”

In addition to her role as Scientific Director, Dr. Bjornson will continue as a site principal investigator for Seattle Children’s Hospital (SCH) where her first-hand experience with our registry will be invaluable to our future research endeavors as she has real world experience with how the registry can be used to make clinical research more effective. Under her leadership, SCH has become a significant contributor to the richness of data in the network’s cerebral palsy registry as SCH has enrolled its entire CP population. Understanding and leveraging the registry to plan new research studies is a great strength that Dr. Bjornson brings to the network.

Webinar: Intrathecal Baclofen Pump Complications

Robert Bollo, MD, with a shaved head and a smile, in a dark suit, white shirt and red striped tie

Dr. Robert Bollo will present on the CP Research Network’s efforts to reduce the most common complication with intrathecal baclofen pumps.

Our next MyCP webinar is Thursday, January 27, at 8 PM ET and will be about our efforts to improve outcomes for intrathecal baclofen pumps (ITB). ITB pumps are commonly used to treat spasticity in people with cerebral palsy. Our featured speaker will be Robert Bollo, MD, a pediatric neurosurgeon from the University of Utah. The webinar and open Q&A with Dr. Bollo will last one hour.

Dr. Bollo will present an overview of the use of ITB pumps in the management of spasticity and common post-surgical complications with ITB pumps. He is leading a quality improvement (QI) initiative (study to improve outcomes) in the CP Research Network to monitor the most common complication of baclofen pumps – post surgical infections. ITB pump infections are common but estimates of infection rates in the literature vary widely with an average of 10%[refs] of all implantations.

Interested participants need to register in advance. Members of the MyCP webinar series will be emailed a link for this webinar. It is free and open to the public. It will also be recorded for future viewing.


References

  1. Fjelstad AB, Hommelstad J, Sorteberg A. Infections related to intrathecal baclofen therapy in children and adults: frequency and risk factors. J Neurosurg Pediatr. 2009 Nov;4(5):487-93. doi: 10.3171/2009.6.PEDS0921. PMID: 19877786.
  2. Tyack L, Copeland L, McCartney L, Waugh MC. Adverse events associated with paediatric intrathecal baclofen in Australia: 5 years of data collection. J Paediatr Child Health. 2021 Feb;57(2):258-262. doi: 10.1111/jpc.15194. Epub 2020 Sep 25. PMID: 32975337.
  3. Imerci A, Rogers KJ, Pargas C, Sees JP, Miller F. Identification of complications in paediatric cerebral palsy treated with intrathecal baclofen pump: a descriptive analysis of 15 years at one institution. J Child Orthop. 2019 Oct 1;13(5):529-535. doi: 10.1302/1863-2548.13.190112. PMID: 31695821; PMCID: PMC6808077.
  4. Desai VR, Raskin JS, Mohan A, Montojo J, Briceño V, Curry DJ, Lam S. A standardized protocol to reduce pediatric baclofen pump infections: a quality improvement initiative. J Neurosurg Pediatr. 2018 Apr;21(4):395-400. doi: 10.3171/2017.10.PEDS17248. Epub 2018 Jan 26. PMID: 29372853.
  5. Desai VR, Raskin JS, Mohan A, Montojo J, Briceño V, Curry DJ, Lam S. A standardized protocol to reduce pediatric baclofen pump infections: a quality improvement initiative. J Neurosurg Pediatr. 2018 Apr;21(4):395-400. doi: 10.3171/2017.10.PEDS17248. Epub 2018 Jan 26. PMID: 29372853.
  6. Spader HS, Bollo RJ, Bowers CA, Riva-Cambrin J. Risk factors for baclofen pump infection in children: a multivariate analysis. J Neurosurg Pediatr. 2016 Jun;17(6):756-62. doi: 10.3171/2015.11.PEDS15421. Epub 2016 Feb 26. PMID: 26919315.
  7. Haranhalli N, Anand D, Wisoff JH, Harter DH, Weiner HL, Blate M, Roth J. Intrathecal baclofen therapy: complication avoidance and management. Childs Nerv Syst. 2011 Mar;27(3):421-7. doi: 10.1007/s00381-010-1277-9. Epub 2010 Sep 18. PMID: 20853002.
  8. Motta F, Antonello CE. Analysis of complications in 430 consecutive pediatric patients treated with intrathecal baclofen therapy: 14-year experience. J Neurosurg Pediatr. 2014 Mar;13(3):301-6. doi: 10.3171/2013.11.PEDS13253. Epub 2014 Jan 3. Erratum in: J Neurosurg Pediatr. 2014 May;13(5):588. PMID: 24404968.
  9. Borowski A, Littleton AG, Borkhuu B, Presedo A, Shah S, Dabney KW, Lyons S, McMannus M, Miller F. Complications of intrathecal baclofen pump therapy in pediatric patients. J Pediatr Orthop. 2010 Jan-Feb;30(1):76-81. doi: 10.1097/BPO.0b013e3181c6b257. PMID: 20032747.
  10. Gooch JL, Oberg WA, Grams B, Ward LA, Walker ML. Complications of intrathecal baclofen pumps in children. Pediatr Neurosurg. 2003 Jul;39(1):1-6. doi: 10.1159/000070870. PMID: 12784068.
Dr. Bhooma Aravamuthan, pictured in a white lab coat and dark rimmed glasses, will speak about dystonia in CP

Update on Dystonia in Cerebral Palsy

On Thursday, December 9, at 8 pm ET, the CP Research Network will hold its final MyCP webinar for 2021 to provide an update on our work in dystonia in cerebral palsy. Bhooma Aravamuthan, MD, DPhil, a pediatric movement disorders neurologist at St. Louis Children’s Hospital, and a leader in the network, will present an update on our progress in this important area of research and care.

In 2019, the Cerebral Palsy (CP) Research Network started an effort to build a community centered research agenda for dystonia in CP. Dr. Darcy Fehlings had found that dystonia was significantly under diagnosed in the CP population and that as much as 80% of the people with CP had some degree of dystonia in addition to spasticity.[ref] The presence of dystonia can be challenging and painful for people and often requires different approaches to treatment. Parents expressed frustration in getting an accurate diagnosis that allowed their children get relief from these symptoms. The CP Research Network developed Research CP Dystonia Edition to engage the extended community – caregivers, people with CP, and clinicians – in a dialogue about the most pressing issues needing research in dystonia in CP.

Dr. Aravamuthan leads our quality improvement effort focused on increasing practitioner awareness of dystonia screening for every person with CP. She will describe how this effort addresses a key priority set forth in Research CP Dystonia Edition. She will also describe research concepts that she is developing to directly engage the community to advance dystonia diagnosis. Please join us for the webinar next Thursday evening by signing up at https://cprn.org/mycp-webinar-series/.

A blond woman kneels while speaking with her daughter braided hair in a wheelchair.

Results: Communication and Participation in CP

Kristen Allison, PhD, CCC-SLP. A smiling woman with long blond hair wearing earrings and a light grey sweater.

Kristen Allison, PhD, CCC-SLP, an Assistant Professor at Northeastern, is this month’s featured speaker for the MyCP Webinar Series, presenting the results of her recent study in speech and language for children with CP.

Next Wednesday, November 17, at 8 pm, Kristen Allison, PhD, CCC-SLP, will present the results of her study of Speech and Language Predictors of Participation in Children with Cerebral Palsy, as part of the CP Research Network’s MyCP Webinar series. Dr. Allison received our Research CP grant award in 2019 for her study investigating how speech and language capability affect a child’s quality of life in terms of participation in activities. Attendees of this webinar will learn what she discovered and be able to participate in a live Q&A with Dr. Allison.

“We found that several aspects of a child’s speech and language skills affect how often they participate and how involved they are in social activities.” said Dr. Allison. “Our results highlight just how important effective communication is to quality of life for children with CP!”

Dr. Allison is an Assistant Professor in the Department of Communication Sciences & Disorders and the director of the Speech Motor Impairment & Learning (SMILe) Lab at Northeastern University. The study was hosted and distributed through th CP Research Network Community Registry and data collection was completed in 2020. Dr. Allison will not only share the results of the study but talk about its meaning for both parents of children with CP, but also how the data will be used to inform future research questions.

Community members interesting in learning about the results of Dr. Allison’s research can sign up to receive webinar login instructions. People who have already registered for the whole MyCP webinar series will be sent an invitation with login details prior to the webinar. Note: Our MyCP webinar series now require a Zoom account to sign in. You can get a free Zoom account here.

The MyCP webinar on assessing pain in adults with CP will be delivered by Drs Gannotti and Noritz

Assessing Pain for Adults with Cerebral Palsy

Drs. Gannotti and Noritz, dressed in business attire, at an informal meeting in Austin, TX

Drs Gannotti and Noritz, clinicians who treat both children and adults, will present on assessing pain in adults with cerebral palsy (CP).

This month’s MyCP webinar will focus on the CP Research Network’s Adult Care quality improvement (QI) initiative at 8 pm ET on Monday, October 25. CP Research Network leaders Garey Noritz, MD and Mary Gannotti, PT, PhD, will provide an overview of this initiative which is focused on pain for adults with CP. Quality improvement, like clinical research, is aimed at improving health outcomes but using a different methodology to achieve those outcomes. QI is exciting because it can change health outcomes much more rapidly than clinical research. The webinar will include a brief overview of how QI enables these faster changes in outcomes.

Our Adult Care QI initiative includes clinicians that treat adults with CP and community advocates working together with a global aim of improving the care that adults with CP receive. Supported by data from our Adult Wellbeing and Chronic Pain study, this initiative has narrowed it first efforts to uniformly assess pain in each clinic visit for adults with CP. In addition to support from our ongoing study, a recent MyCP focus group with several adults with CP helped shape initial assessments of pain used by the participating clinicians.

Dr. Gannotti is a professor of physical therapy at the University of Hartford and a PT affiliated with Shriners’ Hospital of Springfield and co-leads the adult study group of the CP Research Network. Dr. Noritz is the Director of the Complex Care program at Nationwide Children’s Hospital and an adult internist who treats adults with CP. Doctors Gannotti and Noritz will present for approximately 25 minutes before opening the webinar to questions and answers. Community members who wish to participate in the webinar can sign up on CPRN or to receive an email with a link to the recording after the webinar.

October 6 is World CP Day - Millioins of Reasons to Spread the Word

CP Research Network Featured at AACPDM

The Cerebral Palsy Research Network was invited alongside of the National Institutes of Health (NIH), the Patient Centered Outcomes Research Institute (PCORI), and C-Progress to teach early-stage investigators how to establish a successful research program at their institution during the annual meeting of the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM). The nine-hour pre-conference tutorial featured presentations from each of these research and funding organizations to emphasize key steps for an investigator to get funding. The CP Research Network is differentiated from its co-presenters by being an organization that facilitates and conducts research.

In addition to presenting the network’s programs, registries, and tools, CEO Paul Gross held a breakout session for Q&A with interested attendees. “It was an honor to present our mission and vision alongside the largest public funders for research – NIH and PCORI,” said Gross. “The attendees also heard from Dr. Michael Kruer about his experience working with the CP Research Network to gain $3M in funding from NIH for his genetic causes of CP study.”

This pre-conference session fell on October 6 – World CP Day – when the CP Research Network Board of Directors has offered to match donations two-fold! World CP Day creates awareness about CP and much needed research around the globe. We are excited to be part of accelerating that research by educating new investigators to the field.

A green page banner with a headshot of Dr. Wade Shrader. A smiling man with short brown hair and beard wearing a dark suit.

Webinar on Hip Surveillance and CP

Dr. Wade Shrader of Nemours/AI duPoint, smiling in a blue suit, is an orthopedic surgeon who leads the CP program at Nemours

Dr. Shrader, an orthopedic surgeon, leads the hip surveillance initiative for the CP Research Network.

After taking a break during the last month of summer, our MyCP webinar series will resume on Wednesday, September 29 at 8 pm ET with a presentation on our hip research program. Hip pain is the most frequent cause of pain in children with cerebral palsy and can cause problems with mobility and range of motion. We have begun a hip surveillance program at our the CP Research Network centers to proactively address this issue—a very challenging task to undertake. Our upcoming webinar will feature Dr. Wade Shrader, a pediatric orthopedic surgeon and Division Chief of Cerebral Palsy at Nemours/AI duPont Hospital in Wilmington, DE who leads this effort for the network. He is also the parent of four children, two of whom are adults with CP.

In order to protect the hips of children with CP, the American Academy for Cerebral Palsy and Development Medicine (AACPDM) released an updated “care pathway” recommending the frequency and techniques for monitoring the hip health of children with CP in June 2018. Care pathways combine the latest evidence-based medicine and expert opinion to provide guidance on how to treat complex conditions. Dr. Shrader will discuss the anatomy of childrens’ hips, the impact of CP, the importance of monitoring hips, and how parents and caregivers can advocate for their child’s hip health.

“I know first-hand as a Dad how tough recovery from hip reconstruction surgery can be, “ said Dr. Shrader. “I’m looking forward to talking with the CPRN community about hip issues in Cerebral Palsy, and to give my perspective as both a pediatric orthopedic surgeon and a family member.”

Community members and clinicians interested in the webinar can sign up on cprn.org. MyCP members and series registrants will receive the Zoom link automatically prior to the webinar. Join us!

Small preview image of Dr. Laura Gilbert linking to blog post

Dystonia Agenda Takes Center Stage at Child Neurology Society Meeting

Laura Gilbert, DO, a pediatric neurologist, with shoulder length brown hair and a dark green shirt, smiles broadly.

Laura Gilbert, DO, has won a Junior Member Award from the Child Neurology Society, for her abstract on a patient-centered dystonia research agenda.

Dr. Laura Gilbert, a pediatric neurologist at St. Louis Children’s Hospital, has been selected to present our Dystonia in Cerebral Palsy patient-centered research agenda at the Child Neurology Society (CNS) meeting in Boston, MA in September 2021.

Her talk, entitled, “Top 10 Areas of Research Need for People with Cerebral Palsy and Dystonia: A Novel Community-driven Agenda,” is based on collaborative work she carried out with the Network to engage the community in a research priority setting process for dystonia in CP in 2020.

“Dr. Gilbert played a significant role in the organization and analysis of our dystonia agenda setting process,” said Bhooma Aravamuthan, MD, DPhil, a pediatric movement disorders specialist from Washington University in St. Louis. “She is a smart and savvy burgeoning clinician researcher. It’s been a gift to see her interest bloom in dystonia in CP.”

The Child Neurology Society gathers neurologists annually to advance research and the treatment of pediatric neurological conditions. The live platform presentation has been selected as one of the top 20 abstracts submitted to the meeting. Further congratulations are in order for Dr. Gilbert who will be recognized as one of four Outstanding Junior Members for her work.

Her talk, and talks by her mentor Dr. Aravamuthan, will increase the focus on CP at this year’s CNS meeting. This increased focus will improve child neurologist awareness of issues faced by people with CP and promote research opportunities in the field.

A grey banner with ‘MyCP Webinar Series’ and a photo of Mary Gannotti, PT, PhD; smiling and wearing a brown blazer.

Join our Webinar on Adult Wellbeing and Pain in Cerebral Palsy

How does your lived experience align with the initial results from our chronic pain study?

Mary Gannotti, PT, PhD, smiles with brown shoulder length hair, a red blouse and a brown blazer.

Mary Gannotti, PT, PhD

Compiling information about the chronic pain and wellbeing challenges many adults with cerebral palsy experience, sometimes on a daily basis, is an important priority for the Cerebral Palsy Research Network as we work to improve health outcomes for our community.

On Monday, July 19, at 8 pm ET, Mary Gannotti, PT, PhD, co-principal investigator of the CP Research Network’s adult study group, will present an update on our adult study of wellbeing and chronic pain.

Dr. Gannotti’s study seeks to gather cross-sectional data from 500 adults with CP to demonstrate health differences between adults with CP and the adult population overall. This interim report includes data from approximately the first 200 participants in the study.

“Members of the community will find it valuable to see how their personal lived experience aligns with many other adults with CP,” says Paul Gross, President, CEO and Co-Founder of the CP Research Network. “Dr. Gannotti will discuss how we plan to use these findings to support additional adult research and to advocate for policy changes in healthcare to improve health outcomes for adults with CP.”

Prior to Tuesday’s virtual event, MyCP webinar series registrants and MyCP members will receive a reminder with a link to the webinar. If you are not subscribed to the series, you can sign up for this individual webinar on our MyCP Webinar Series page.

The presentation will last for approximately 30 minutes and be followed by an open Q&A with Dr. Gannotti. All of our webinars are recorded and posted on our YouTube channel subsequent to the live webinar. You can also view Dr. Gannotti’s inaugural presentation after we initially launched the study in 2019.

Adults with CP can still participate in the study which is hosted in our Community Registry on MyCP.

The diagram patient priority framework from PSCORE shows an interrelationship among different interests in cerebral palsy care.

A step forward in Standardizing Patient Reported Outcomes

Hospitals and clinicians in the Cerebral Palsy Research Network will be able to track, learn from, and compare outcomes for their patient populations thanks to our selection of standardized patient outcome measures. The CP Research Network has collaborated with Dr. Unni Narayanan, the subject of our recent CP Stories series, at the Hospital for Sick Children in Toronto, Canada, to standardize a validated set of patient-reported outcome measures (PROMs) across the network. Working closely with Nationwide Children’s Hospital in Columbus Ohio and Dr. Narayanan’s PRIORITY-BASED SCALES FOR CHILDREN’S OUTCOMES – RESEARCH & EVALUATION (PSCORE) Program, the CP Research Network has released electronic versions of two PROMs to collate patient information across sites in our network.

The Gait Outcomes Assessment List (GOAL) and the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) will ensure CP families can provide information and communicate their needs to clinicians in patient facing portals like Epic’s MyChart. On a wider scale this submitted data will also help improve treatment more widely in the CP community. Shared decision-making helps balance the input of doctors and experts with the priorities and preferences of patients and their families.

The patient priority framework from PSCORE shows an interrelationship among patient priorities, interventions and outcomes for people living with cerebral palsy.

The patient priority framework from PSCORE shows an interrelationship among patient priorities, interventions and outcomes for living with cerebral palsy.

In addition to these benchmarking capabilities, the PROMs allow patients and patient families to identify important goals, which clinicians can take into account as they make decisions about treatments. And the standardization of PROMs holds the promise to improve medical and surgical outcomes across the network.

Dr. Narayanan has been funded by the Canadian Institute for Health Research (CIHR) to study the impact of these tools in improving shared decision making.

Patient families can use these tools today in MyCP – the CP Research Network’s personalized platform for cerebral palsy resources. The CPCHILD and GOAL Questionnaires are available in the MyCP Community Registry that can be taken annually to track a child’s progress across numerous domains like activities of daily living, mobility or participation. Once a family takes the survey, they can download a PDF of their results which includes their important goals, and bring these results to an appointment with their CP focused physician or therapy team.

The CP Research Network will enhance these tools over time to provide summary reports that will include the scores and list of important goals to better support shared decision making. Parents of children under the age of 18 can sign up for MyCP and take these surveys now.