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Castelli E, Beretta E, De Tanti A, Arduini F, Biffi E, Colazza A, Di Pede C, Guzzetta A, Lucarini L, Maghini I, Mandalà M, Nespoli M, Pavarelli C, Policastro F, Polverelli M, Rossi A, Sgandurra G, Boldrini P, Bonaiuti D, Mazzoleni S, Posteraro F, Benanti P, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzon S, Molteni F, Morone G, Petrarca M, Picelli A, Senatore M, Turchetti G, Saviola D, Turchetti G. Robot-assisted rehabilitation for children with neurological disabilities: Results of the Italian consensus conference CICERONE. NeuroRehabilitation 2022; 51:665-679. [PMID: 36530098 DOI: 10.3233/nre-220036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The use of robotic technologies in pediatric rehabilitation has seen a large increase, but with a lack of a comprehensive framework about their effectiveness. OBJECTIVE An Italian Consensus Conference has been promoted to develop recommendations on these technologies: definitions and classification criteria of devices, indications and limits of their use in neurological diseases, theoretical models, ethical and legal implications. In this paper, we present the results for the pediatric age. METHODS A systematic search on Cochrane Library, PEDro and PubMed was performed. Papers published up to March 1st, 2020, in English, were included and analyzed using the methodology of the Centre for Evidence-Based Medicine in Oxford, AMSTAR2 and PEDro scales for systematic reviews and RCT, respectively. RESULTS Some positives aspects emerged in the area of gait: an increased number of children reaching the stance, an improvement in walking distance, speed and endurance. Critical aspects include the heterogeneity of the studied cases, measurements and training protocols. CONCLUSION Many studies demonstrate the benefits of robotic training in developmental age. However, it is necessary to increase the number of trials to achieve greater homogeneity between protocols and to confirm the effectiveness of pediatric robotic rehabilitation.
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Affiliation(s)
| | - Elena Beretta
- IRCCS Eugenio Medea, La Nostra Famiglia, Ponte Lambro, Italy
| | - Antonio De Tanti
- KOS-CARE, Santo Stefano Rehabilitation, Cardinal Ferrari Center, Parma, Italy
| | | | - Emilia Biffi
- IRCCS Eugenio Medea, La Nostra Famiglia, Ponte Lambro, Italy
| | | | - Chiara Di Pede
- IRCCS Eugenio Medea, La Nostra Famiglia, Ponte Lambro, Italy
| | - Andrea Guzzetta
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, Italy.,Dipartimento di Neuroscienze dello Sviluppo, IRCCS Stella Maris, Pisa, Italy
| | | | - Irene Maghini
- Department of Women's and Children's Health, Pediatric Pain and Palliative Care Service, University of Padua, Padua, Italy
| | - Martina Mandalà
- IRCCS Santa Maria Nascente - Fondazione Don C. Gnocchi, Milan, Italy
| | | | - Claudia Pavarelli
- Servizio di Neuropsichiatria Infanzia e dell'Adolescenza (NPIA), Vignola, Italy
| | - Francesca Policastro
- Dipartimento Scienze Mediche e Chirurgiche, Università degli Studi di Trieste, Trieste, Italy
| | - Marco Polverelli
- Dipartimento Riabilitazione, Azienda Ospedaliera Nazionale SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Andrea Rossi
- ASST Spedali Civili di Brescia, Ospedale dei Bambini, Brescia, Italy
| | - Giuseppina Sgandurra
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, Italy.,Dipartimento di Neuroscienze dello Sviluppo, IRCCS Stella Maris, Pisa, Italy
| | - Paolo Boldrini
- Italian Society of Physical Medicine and Rehabilitation, (SIMFER), Rome, Italy
| | - Donatella Bonaiuti
- Italian Society of Physical Medicine and Rehabilitation, (SIMFER), Rome, Italy
| | - Stefano Mazzoleni
- Department of Electrical and Information Engineering, Politecnico di Bari, Bari, Italy
| | - Federico Posteraro
- Department of Rehabilitation, Versilia Hospital - AUSL12, Viareggio, Italy
| | | | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Rome, Italy
| | - Vincenzo Falabella
- Italian Federation of Persons with Spinal Cord Injuries (FAIP Onlus), Rome, Italy
| | | | - Francesca Gimigliano
- Department of Mental, Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mauro Grigioni
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, Rome, Italy
| | - Stefano Mazzon
- Rehabilitation Unit, ULSS (Local Health Autority) Euganea, Camposampietro Hospital, Padua, Italy
| | - Franco Molteni
- Department of Rehabilitation Medicine, Villa Beretta Rehabilitation Center, Valduce Hospital, Lecco, Italy
| | | | - Maurizio Petrarca
- Movement Analysis and Robotics Laboratory (MARlab), IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Alessandro Picelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Michele Senatore
- Associazione Italiana dei Terapisti Occupazionali (AITO), Rome, Italy
| | | | - Donatella Saviola
- KOS-CARE, Santo Stefano Rehabilitation, Cardinal Ferrari Center, Parma, Italy
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Picciolini O, Giannì ML, Messina L, Pesenti N, Fumagalli M, Gardon L, Squarza C, Mosca F, Fontana C, Porro M. Development of a new scoring method in the neurofunctional assessment of preterm infants. Sci Rep 2022; 12:16335. [PMID: 36175601 PMCID: PMC9522729 DOI: 10.1038/s41598-022-20754-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/19/2022] [Indexed: 11/09/2022] Open
Abstract
Infants born preterm are at high risk of presenting neurodevelopmental delay. The Neurofunctional Assessment (NFA) describes infants' neurodevelopment through the evaluation of six different domains. This study aimed to evaluate how, in a cohort of preterm infants, each NFA domain assessed at 3 months of corrected age (CA) was associated with neurodevelopment at 2 years of CA using the Griffiths Mental Developmental Scales Extended Revised (GMDS-ER). In addition, by introducing the NFA complexity score (CS), the study aimed to define a threshold that can help clinicians discriminate infants at higher risk of later neurodevelopmental delay. We conducted an observational, longitudinal study including 211 preterm infants. At 3 months of CA, infants who had normal scores in each domain showed a significantly higher GMDS-ER global quotient (GQ) at 2 years of CA. In addition, linear model results showed a significant negative relationship between the NFA CS and 2-year GMDS-ER GQ (estimate: - 0.27; 95% CI - 0.35, - 0.20; p value < 0.001). Each 10-point increase in the NFA CS was associated with an average 2.7-point decrease in the GMDS GQ. These results highlight how the NFA domains and NFA CS are compelling instruments for the early identification of children at risk for long-term adverse outcomes.
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Affiliation(s)
- Odoardo Picciolini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Physical Medicine & Rehabilitation Unit, Milan, Italy
| | - Maria Lorella Giannì
- University of Milan, Department of Clinical Sciences and Community Health, Milan, Italy.,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Laura Messina
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Physical Medicine & Rehabilitation Unit, Milan, Italy
| | - Nicola Pesenti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.,University of Milano-Bicocca, Division of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, Milan, Italy
| | - Monica Fumagalli
- University of Milan, Department of Clinical Sciences and Community Health, Milan, Italy.,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Laura Gardon
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Chiara Squarza
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Fabio Mosca
- University of Milan, Department of Clinical Sciences and Community Health, Milan, Italy.,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Camilla Fontana
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Matteo Porro
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Physical Medicine & Rehabilitation Unit, Milan, Italy.
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3
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Lugli L, Bedetti L, Guidotti I, Pugliese M, Picciolini O, Roversi MF, DellaCasa Muttini E, Lucaccioni L, Bertoncelli N, Ancora G, Gargano G, Mosca F, Sandri F, Corvaglia LT, Solinas A, Perrone S, Stella M, Iughetti L, Berardi A, Ferrari F. Neuroprem 2: An Italian Study of Neurodevelopmental Outcomes of Very Low Birth Weight Infants. Front Pediatr 2021; 9:697100. [PMID: 34589450 PMCID: PMC8474877 DOI: 10.3389/fped.2021.697100] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Despite the increased survival of preterm newborns worldwide, the risk of neurodevelopmental disabilities remains high. Analyzing the outcomes of the preterm population can identify risk factors and enable specific early interventions. Aims: Neuroprem is a prospective cohort study of very low birth weight (VLBW) infants that aims to evaluate the neurodevelopmental outcomes and risk factors for severe functional disability at 2 years of corrected age. Methods: Nine Italian neonatal intensive care units participated in the network. The Griffiths Mental Developmental Scales (GMDS-R) or the Bayley Scales of Infant and Toddler Development (BSDI III) and a neuro-functional evaluation (according to the International Classification of Disability and Health and Neuro-Functional Assessment, or NFA ICF-CY) were administered to VLBW infants at 24 months of corrected age. The primary outcome measure was severe functional disability, defined as cerebral palsy, bilateral blindness, deafness, an NFA ICF-CY of >2, a BSDI III cognitive composite score of <2 SD, or a GMDS-R global quotient score of <2 SD. Perinatal risk factors for severe functional disability were assessed through multivariate logistic regression analysis. Results: Among 502 VLBW survivors who completed the 24-month follow-up, 48 (9.6%) presented severe functional disability, of whom 27 had cerebral palsy (5.4%). Rates of severe functional disability and cerebral palsy were higher in neonates with a lower gestational age (p < 0.001). Overall, 147 infants (29.3%) were referred to neuromotor intervention. In the multivariate regression model, gestational age at birth OR 0.79; 95% CI 0.67-0.90; p = 0.001) and periventricular-intraventricular hemorrhage (OR 2.51; 95% CI 1.19-5.26; p = 0.015) were significantly associated with severe functional disability. Conclusion: Neuroprem 2 provides updated information on the neurodevelopmental outcomes of VLBW infants in a large Italian cohort. The overall rate of neurodevelopmental disabilities was quite lower than reported in the previous literature. These data indicate the need for structured follow-up programs from a national neonatal network perspective.
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Affiliation(s)
- Licia Lugli
- Neonatal Intensive Care Unit, University Hospital of Modena, Modena, Italy
| | - Luca Bedetti
- Neonatal Intensive Care Unit, University Hospital of Modena, Modena, Italy.,PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy.,Pediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Isotta Guidotti
- Neonatal Intensive Care Unit, University Hospital of Modena, Modena, Italy
| | - Marisa Pugliese
- Neonatal Intensive Care Unit, University Hospital of Modena, Modena, Italy.,Psychology Unit, University Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Odoardo Picciolini
- Physical and Rehabilitation Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | | | | | - Laura Lucaccioni
- Pediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Gina Ancora
- Neonatal Intensive Care Unit, Infermi Hospital of Rimini, Rimini, Italy
| | - Giancarlo Gargano
- Neonatal Intensive Care Unit, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy
| | - Fabio Mosca
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Fabrizio Sandri
- Neonatal Intensive Care Unit, Maggiore Hospital of Bologna, Bologna, Italy
| | - Luigi Tommaso Corvaglia
- Neonatal Intensive Care Unit, Sant'Orsola Malpighi University Hospital of Bologna, Bologna, Italy
| | - Agostina Solinas
- Neonatal Intensive Care Unit, Sant'Anna Hospital of Ferrara, Ferrara, Italy
| | - Serafina Perrone
- Neonatal Intensive Care Unit, University Hospital of Parma, Parma, Italy
| | - Marcello Stella
- Neonatal Intensive Care Unit, Bufalini Hospital of Cesena, Cesena, Italy
| | | | - Lorenzo Iughetti
- Pediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.,Department of Medical and Surgical Sciences of Mothers, Children and Adults, Pediatric Postgraduate School, University of Modena and Reggio Emilia, Modena, Italy
| | - Alberto Berardi
- Neonatal Intensive Care Unit, University Hospital of Modena, Modena, Italy
| | - Fabrizio Ferrari
- Neonatal Intensive Care Unit, University Hospital of Modena, Modena, Italy
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DA Fonseca Filho GG, Lopes AC, Bezerra RB, de M Candido A, Arrais N, Pereira SA, Lindquist AR. Assessment of child development in premature babies based on the ICF biopsychosocial model. Eur J Phys Rehabil Med 2020; 57:585-592. [PMID: 32975397 DOI: 10.23736/s1973-9087.20.06543-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The International Classification of Functionality (ICF) has been recommended to enable a broader and more holistic view of an individual's health condition. In addition, it works as an important reference for multiprofessional teams. In low-income countries, like Brazil, the attempts to systematize and incorporate the ICF model in health services has been a challenge. AIM The aim was to analyze the development of premature babies considering the biopsychosocial model of the ICF. DESIGN A longitudinal study. SETTING Maternity in the northeast Brazil. POPULATION Thirty-five premature babies were evaluated in the first stage and 20 in the second. METHODS Pre, perinatal, socioeconomic data and environmental factors were collected, and general movements assessed during the 38th (±1.79) week of corrected gestational age. The Age and Stages Questionnaire (ASQ-3) was used to assess child development, in the 13th (±1.50) month of life. The instruments were chosen with the objective of evaluating information necessary for the follow-up of premature infants and to represent the five domains of the ICF. RESULTS Of the 35 newborns initially evaluated, 20 were reassessed at 1 year of age and 70% were boys. In the function and structure domain, 55% exhibited altered general movements and 35% grade 1 intraventricular hemorrhage; in activity and participation, 15% displayed delayed communication, 20% delayed ample motor coordination, 40% fine motor coordination and problem resolution and 35% personal/social delay in the ASQ-3. Only one item of the personal factors (male sex) and function and structure domain (intraventricular hemorrhage) exhibited an association with atypical child development. CONCLUSIONS Given the susceptibility of premature newborn neurodevelopment and the magnitude of the biopsychosocial model of the ICF, even at this early stage of life, it was possible to observe the influence of personal factors, body function and structure domains on atypical child development. CLINICAL REHABILITATION IMPACT The care for the premature newborn with global look of the classification of functioning, disability and health.
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Affiliation(s)
| | - Ana C Lopes
- Department of Physiotherapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Ruth B Bezerra
- Department of Physiotherapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Amanda de M Candido
- Department of Physiotherapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Nívia Arrais
- Department of Pediatrics, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Silvana A Pereira
- Department of Physiotherapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Ana R Lindquist
- Department of Physiotherapy, Federal University of Rio Grande do Norte, Natal, Brazil -
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Neuroprem: the Neuro-developmental outcome of very low birth weight infants in an Italian region. Ital J Pediatr 2020; 46:26. [PMID: 32087748 PMCID: PMC7036238 DOI: 10.1186/s13052-020-0787-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 02/07/2020] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION The survival of preterm babies has increased worldwide, but the risk of neuro-developmental disabilities remains high, which is of concern to both the public and professionals. The early identification of children at risk of neuro-developmental disabilities may increase access to intervention, potentially influencing the outcome. AIMS Neuroprem is an area-based prospective cohort study on the neuro-developmental outcome of very low birth weight (VLBW) infants that aims to define severe functional disability at 2 years of age. METHODS Surviving VLBW infants from an Italian network of 7 neonatal intensive care units (NICUs) were assessed for 24 months through the Griffiths Mental Developmental Scales (GMDS-R) or the Bayley Scales of Infant and Toddler Development (BSDI III) and neuro-functional evaluation according to the International Classification of Disability and Health (ICF-CY). The primary outcome measure was severe functional disability at 2 years of age, defined as cerebral palsy, a BSDI III cognitive composite score < 2 standard deviation (SD) or a GMDS-R global quotients score < 2 SD, bilateral blindness or deafness. RESULTS Among 211 surviving VLBW infants, 153 completed follow-up at 24 months (72.5%). Thirteen patients (8.5%) developed a severe functional disability, of whom 7 presented with cerebral palsy (overall rate of 4.5%). Patients with cerebral palsy were all classified with ICF-CY scores of 3 or 4. BSDI III composite scores and GMDS-R subscales were significantly correlated with ICF-CY scores (p < 0.01). CONCLUSION Neuroprem represents an Italian network of NICUs aiming to work together to ensure preterm neuro-developmental assessment. This study updates information on VLBW outcomes in an Italian region, showing a rate of cerebral palsy and major developmental disabilities in line with or even lower than those of similar international studies. Therefore, Neuroprem provides encouraging data on VLBW neurological outcomes and supports the implementation of a preterm follow-up programme from a national network perspective.
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Stack DM, Matte-Gagné C, Dickson DJ. Persistence of Effects of VLBW/PT Birth Status and Maternal Emotional Availability (EA) on Child EA Trajectories. Front Psychol 2019; 9:2715. [PMID: 30761058 PMCID: PMC6361804 DOI: 10.3389/fpsyg.2018.02715] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 12/17/2018] [Indexed: 11/21/2022] Open
Abstract
Few studies have examined the longitudinal impact of birth status on the infant-mother relationship and on children's socio-emotional development. In the present study we investigated developmental patterns of such relationships [using the Emotional Availability (EA) Scales] in fullterm and VLBW/PT infants from infancy to emerging school age. Our objectives were to: (a) model the developmental trajectories of EA dimensions (maternal sensitivity, structuring, non-hostility; child responsiveness, involvement) in a VLBW/PT and fullterm sample, (b) identify potential effects of VLBW/PT status on these trajectories, and (c) determine whether the effects of VLBW/PT status on children's socio-emotional development (child EA) remained after accounting for the effect of maternal EA. Child-mother dyads (n = 109) were observed in home-based interactions (face-to-face and free play) when children were 6, 12, 18, and 57-months-old in fullterm (37-41 weeks, >2500 g; n = 48) and healthy VLBW/PT (26-32 weeks gestation, birth weight 800-1500 g, corrected for gestational age; n = 61) children. Developmental trajectories of maternal and child EA were assessed using multilevel growth modeling in Mplus. Results indicated that, even after controlling for maternal EA, there was a persistent negative effect of VLBW/PT birth status on child EA trajectories. Both initially and over time, VLBW/PT infants lagged behind their fullterm counterparts on levels of responsiveness and involvement with mothers. There was also a persistent positive effect of maternal EA (sensitivity and structuring) on child EA trajectories. Higher average levels of maternal sensitivity and structuring across time were also associated with higher and persistent levels of child responsiveness and involvement of their mothers. Importantly, results held after modeling both effects together, and after controlling for maternal education and child gender. Our results have implications for VLBW/PT children's development, the parent-child relationship, and integrating family level factors and relationship dimensions in early prevention and intervention programs.
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Affiliation(s)
- Dale M. Stack
- Centre for Research in Human Development, Department of Psychology, Concordia University, Montréal, QC, Canada
| | | | - Daniel J. Dickson
- Centre for Research in Human Development, Department of Psychology, Concordia University, Montréal, QC, Canada
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Towers K. What are the outcomes for children born preterm and how can interventions meet their needs? EDUCATIONAL PSYCHOLOGY IN PRACTICE 2018. [DOI: 10.1080/02667363.2018.1426557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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A longitudinal ICF-CY-based evaluation of functioning and disability of children born with very low birth weight. Int J Rehabil Res 2016; 39:296-301. [PMID: 27362970 DOI: 10.1097/mrr.0000000000000183] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This paper aims to describe the longitudinal changes in disability, defined by the International Classification of Functioning, Disability, and Health - Children and Youth version (ICF-CY) biopsychosocial model, and developmental outcomes in a cohort of 56 very low birth weight children over 14-20 months. We used a neurofunctional assessment, the Griffiths Mental Development Scales-Revised: 2-8 years (Griffiths 2-8) to evaluate psychomotor development and the ICF-CY questionnaire for ages 0-3 and 3-6 to address children's disability. Extension indexes on the basis of ICF-CY categories were computed, and longitudinal change was tested. Complete follow-up was available for 55 children (mean age 36.7 months, SD 6.7). Considering the sample as a whole, neurofunctional assessment, Griffiths score and disability were basically stable. When the subsample of children with the higher baseline functioning was taken into account, some degree of worsening, in terms of an increase in the number of impairments and limitations, was found. Our results show that disability profiles, neurofunctional assessment and global development were basically stable, except for the subgroup of children who were in the intermediate/high-functioning cluster at baseline. The increased disability among these children might be because of the possibility to observe a wider set of age-specific problems, such as emotional, regulation and social abilities that are not detectable at an early stage of development and that might lead to reduced participation in social activities.
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9
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Picciolini O, Montirosso R, Porro M, Giannì ML, Mosca F. Neurofunctional assessment at term equivalent age can predict 3-year neurodevelopmental outcomes in very low birth weight infants. Acta Paediatr 2016; 105:e47-53. [PMID: 26497156 DOI: 10.1111/apa.13248] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 07/23/2015] [Accepted: 10/19/2015] [Indexed: 12/31/2022]
Abstract
AIM Preterm infants are at high risk of developing motor delay, learning difficulties and behavioural problems and the availability of valid neurodevelopmental assessments is a major clinical issue. This study evaluated the relationship between preterm infants' neurofunctional assessment at term equivalent age and neurodevelopment outcome at three years of chronological age. METHODS Neurofunctional assessment was performed in 70 very low birth weight infants at term equivalent age and neurodevelopmental outcome was assessed at three years of chronological age with the Griffiths Mental Development Scale - Extended Revised. RESULTS At term equivalent age, 81% of the children had normal neurofunctional scores and 82.5% of those showed normal neurodevelopmental outcome at three years. Of the 19% who had impaired development at term equivalent age, 38.5% had neurodevelopmental delay at three years. Impaired neurofunctional status was associated with an increased risk of developmental delay in the global quotient (odds ratio 12.1) and locomotor sub-quotient (odds ratio 18.35) compared with normal neurofunctional status. Infants with sepsis or necrotising enterocolitis also faced a higher risk of neurodevelopmental delay. CONCLUSION Neurofunctional assessment performed at term equivalent age appeared to provide early identification of preterm infants at risk of neurodevelopmental delay at three years of chronological age.
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Affiliation(s)
- Odoardo Picciolini
- Pediatric Rehabilitation Unit; NICU; Department of Clinical Sciences and Community Health; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Università degli Studi di Milano; Milano Italy
| | - Rosario Montirosso
- Centre for the Study of Social Emotional Development of the At-Risk Infant - Scientific Institute; IRCCS Eugenio Medea; Bosisio Parini (LC) Italy
| | - Matteo Porro
- Pediatric Rehabilitation Unit; NICU; Department of Clinical Sciences and Community Health; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Università degli Studi di Milano; Milano Italy
| | - Maria L. Giannì
- NICU; Department of Clinical Sciences and Community Health; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Università degli Studi di Milano; Milano Italy
| | - Fabio Mosca
- NICU; Department of Clinical Sciences and Community Health; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Università degli Studi di Milano; Milano Italy
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10
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Psychiatric diagnoses, emotional-behavioral symptoms and functional outcomes in adolescents born preterm with very low birth weights. Child Psychiatry Hum Dev 2015; 46:358-66. [PMID: 24879118 DOI: 10.1007/s10578-014-0475-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Children born preterm with very low birth weight (VLBW; birth weight ≤1,500 g) run risks of neurodevelopmental disorders. Studies of adolescent outcome are relatively few. In this follow-up survey, we examined the emotional-behavioral symptoms, psychiatric diagnoses and functional status in a geographically-based birth cohort of VLBW adolescents (average 13.4 years) as registered in a level III center of a recently developed Asian country. Psychiatric interviews were conducted. Parents were asked to fill out the Child Behavioral Checklist and the Current Status Survey. Results revealed that neonatal survival rate was 75.7% (112/148). In the follow-up, 26.2% of the adolescents required individualized educational plan; 52.5% were with at least one neuropsychiatric diagnosis (e.g. cerebral palsy 24.6%, intellectual disabilities 21.3%, attention deficit/hyperactivity disorder 19.7%), and 32.8% of the participants were disabled. Logistic regression found that neonatal sepsis and grade III/IV intraventricular hemorrhage were most predictive of a disabled status in adolescence.
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