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针对患有脑瘫及其他神经发育障碍的成年人的预防性护理:我们是否抓错重点了?

Preventive Care for Adults With Cerebral Palsy and Other Neurodevelopmental Disabilities: Are We Missing the Point?

作者信息

Whitney Daniel G, Rabideau Michelle L, McKee Michael, Hurvitz Edward A

机构信息

Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, United States.

Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States.

出版信息

Front Integr Neurosci. 2022 Apr 7;16:866765. doi: 10.3389/fnint.2022.866765. eCollection 2022.

Abstract

Preventive care techniques are cornerstones of primary care for people with neurodevelopmental disabilities such as cerebral palsy (CP). However, well-established methods evaluating health constructs may not be applied in the same way for adults with CP, as compared to the general population, due to differences in anatomy/physiology, leading to missed opportunities for interventions, medication modifications, and other primary/secondary prevention goals. One barrier to care prevention comes from misinterpretation of values to capture health constructs, even when measurements are accurate. In this Perspective, we emphasize the need for differential interpretation of values from commonly used clinical measures that assess for well-known medical issues among adults with CP obesity risk, bone health, and kidney health. We provide technical, but simple, evidence to showcase why the underlying assumptions of how some measures relate to the health construct being assessed may not be appropriate for adults with CP, which may apply to other neurodevelopmental conditions across the lifespan.

摘要

预防保健技术是针对患有神经发育障碍(如脑瘫,CP)的人群进行初级保健的基石。然而,与普通人群相比,由于解剖学/生理学差异,成熟的健康指标评估方法可能无法以相同方式应用于成年脑瘫患者,这导致干预、药物调整及其他一级/二级预防目标的机会错失。护理预防的一个障碍源于对用于获取健康指标的数值的错误解读,即便测量是准确的。在本观点文章中,我们强调需要对常用临床测量值进行差异化解读,这些测量用于评估成年脑瘫患者中常见的医学问题——肥胖风险、骨骼健康和肾脏健康。我们提供了专业但简单的证据,以说明为何某些测量与所评估的健康指标之间的潜在假设可能不适用于成年脑瘫患者,这可能适用于整个生命周期中的其他神经发育状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4bc/9021436/7822782df25d/fnint-16-866765-g0001.jpg

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