1
|
Colovic H, Zlatanovic D, Zivkovic V, Jankovic M, Radosavljevic N, Ducic S, Ducic J, Stojkovic J, Jovanovic K, Nikolic D. A Review of Current Perspectives on Motoric Insufficiency Rehabilitation following Pediatric Stroke. Healthcare (Basel) 2024; 12:149. [PMID: 38255037 PMCID: PMC10815565 DOI: 10.3390/healthcare12020149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 12/30/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
Pediatric stroke (PS) is an injury caused by the occlusion or rupture of a blood vessel in the central nervous system (CNS) of children, before or after birth. Hemiparesis is the most common motoric deficit associated with PS in children. Therefore, it is important to emphasize that PS is a significant challenge for rehabilitation, especially since the consequences may also appear during the child's growth and development, reducing functional capacity. The plasticity of the child's CNS is an important predecessor of recovery, but disruption of the neural network, specific to an immature brain, can have harmful and potentially devastating consequences. In this review, we summarize the complexity of the consequences associated with PS and the possibilities and role of modern rehabilitation. An analysis of the current literature reveals that Constraint-Induced Movement Therapy, forced-use therapy, repetitive transcranial magnetic stimulation, functional electrical stimulation and robot-assisted therapy have demonstrated at least partial improvements in motor domains related to hemiparesis or hemiplegia caused by PS, but they are supported with different levels of evidence. Due to the lack of randomized controlled studies, the optimal rehabilitation treatment is still debatable, and therefore, most recommendations are primarily based on expert consensuses, opinions and an insufficient level of evidence.
Collapse
Affiliation(s)
- Hristina Colovic
- Department for Physical Medicine and Rehabilitation, Faculty of Medicine, University of Niš, 18000 Niš, Serbia; (D.Z.); (V.Z.)
- Clinic for Physical Medicine and Rehabilitation, University Clinical Center Niš, 18000 Niš, Serbia
| | - Dragan Zlatanovic
- Department for Physical Medicine and Rehabilitation, Faculty of Medicine, University of Niš, 18000 Niš, Serbia; (D.Z.); (V.Z.)
- Clinic for Physical Medicine and Rehabilitation, University Clinical Center Niš, 18000 Niš, Serbia
| | - Vesna Zivkovic
- Department for Physical Medicine and Rehabilitation, Faculty of Medicine, University of Niš, 18000 Niš, Serbia; (D.Z.); (V.Z.)
- Clinic for Physical Medicine and Rehabilitation, University Clinical Center Niš, 18000 Niš, Serbia
| | - Milena Jankovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.J.); (S.D.); (J.D.); (J.S.); (D.N.)
- Neurology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Natasa Radosavljevic
- Department of Biomedical Sciences, State University of Novi Pazar, 36300 Novi Pazar, Serbia;
| | - Sinisa Ducic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.J.); (S.D.); (J.D.); (J.S.); (D.N.)
- Department of Pediatric Surgery, University Children’s Hospital, 11000 Belgrade, Serbia
| | - Jovan Ducic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.J.); (S.D.); (J.D.); (J.S.); (D.N.)
| | - Jasna Stojkovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.J.); (S.D.); (J.D.); (J.S.); (D.N.)
- Department of Physical Medicine and Rehabilitation, University Children’s Hospital, 11000 Belgrade, Serbia
| | - Kristina Jovanovic
- Department of Pediatrics, University Children’s Hospital, 11000 Belgrade, Serbia;
| | - Dejan Nikolic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.J.); (S.D.); (J.D.); (J.S.); (D.N.)
- Department of Physical Medicine and Rehabilitation, University Children’s Hospital, 11000 Belgrade, Serbia
| |
Collapse
|
2
|
Yousef BM, Bhaskar Raj N, Nadiah WA, Dhas BN, Mansour AM, Abd Alhadi SA, Rosal FV, Dizon MM. Integrated Life Skills Training and Executive Function Strategies in Children With Autism Spectrum Disorder in Qatar: A Pilot Study of a Randomized Controlled Trial. Cureus 2024; 16:e52809. [PMID: 38264179 PMCID: PMC10805505 DOI: 10.7759/cureus.52809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 01/25/2024] Open
Abstract
Background and aim Executive function (EF) impairment is common in children with autism spectrum disorder (ASD). EF strategies are considered effective in improving the therapeutic outcomes of children with ASD. This study primarily aimed to explore whether integrating EF strategies combined with regular occupational therapy intervention is more effective in improving daily life skills (DLS) and sensory integration/processing (SI/SP) skills than regular occupational therapy alone in children with ASD and secondarily aims to assess treatment outcomes on improving visual motor integration (VMI) skills. Methods A total of 17 participants (13 males, mean age 4.29 years, standard deviation 0.66) completed the study. Following the baseline assessments, the participants were randomly assigned to the treatment group (45-minute once-weekly individual occupational therapy plus EF strategies) or control group (45-minute once-weekly individual therapy sessions alone). All participants received one intervention per week for 14 weeks. All children were systematically evaluated using a pediatric functional independent measure (WeeFIM) and the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) to assess DLS, the Short Sensory Profile 2 (SSP2) to assess SP/SI, and the Beery VMI test (Beery VMI) to assess VMI. Assessments were conducted at baseline, seven weeks, and 14 weeks of treatment. Results The analysis of the results between the treatment and control groups revealed that the treatment group had greater gains and significant differences in the mean values of both the WeeFIM and SSP2. In addition, notable distinctions were observed in the VB-MAPP transition subscale; although these differences did not reach statistical significance, they were clinically significant. Minimal differences were noted in the VMI between the two groups. Nevertheless, both groups showed statistically significant improvements across all outcome measures. Conclusions Our study provides preliminary evidence of the efficacy of EF strategies combined with regular occupational therapy for DLS, SP/SI, and VMI in children with ASD. The differences between the groups support further evaluation of the effectiveness of EF strategies for the next stage of a larger randomized clinical trial.
Collapse
Affiliation(s)
- Bara M Yousef
- Rehabilitation, Hamad Medical Corporation, Doha, QAT
- Faculty of Health Sciences, University Sultan Zainal Abidin, Kuala Nerus, MYS
| | - Naresh Bhaskar Raj
- Faculty of Health Sciences, University Sultan Zainal Abidin, Kuala Nerus, MYS
| | - Wan-Arfah Nadiah
- Faculty of Health Sciences, University Sultan Zainal Abidin, Kuala Nerus, MYS
| | | | | | | | | | | |
Collapse
|
3
|
Gill I, Davidson SA, Stevenson PG, Robinson R, Pool D, Valentine J. Outcomes following intensive day rehabilitation for young people in Western Australia. J Pediatr Rehabil Med 2023:PRM220102. [PMID: 38108363 DOI: 10.3233/prm-220102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
PURPOSE Intensive rehabilitation aims to improve and maintain functioning in young people who experience disability due to illness or injury. Day rehabilitation may have advantages for families and healthcare systems over inpatient models of rehabilitation. METHODS This study evaluated the goals and outcomes of a cohort of young people in Western Australia who attended a specialist intensive day rehabilitation programme ("iRehab") at Perth Children's Hospital. Analysis of the iRehab service database was performed. Rehabilitation goals and outcomes were recorded as per the Canadian Occupational Performance Measure (COPM), Children's Functional Independence Measure (WeeFIM), and Goal Attainment Scale (GAS). RESULTS There were 586 iRehab admissions between August 11, 2011, and December 31, 2018. Admissions were divided by diagnosis: Cerebral Palsy (228, 38.5%), Acquired Brain Injury (125, 21.3%), Spinal Cord Disorders (91, 15.5%), and Other (141, 24.2%). Mean COPM Performance increased by 2.78 points from admission to discharge (95% CI 2.58 to 2.98, p < 0.001). Mean COPM Satisfaction was 3.29 points higher at discharge than admission (95% CI 3.07 to 3.51, p < 0.001). Mean total WeeFIM score improved by 6.51 points between admission and discharge (95% CI 5.56 to 7.45, p < 0.001), and by 3.33 additional points by six months post discharge (95% CI 2.14 to 4.53, p < 0.001). Mean GAS T-scores increased by 27.85 (95% CI 26.73 to 28.97, p < 0.001) from admission to discharge, and by 29.64 (95% CI 28.26 to 31.02, p < 0.001) from admission to six months post discharge, representing improvement consistent with team expectations. CONCLUSION This study describes a model by which intensive rehabilitation can be delivered in a day rehabilitation setting. A diverse population of young people who experienced disability achieved significant improvements in occupational performance, independence, and goal attainment after accessing intensive day rehabilitation. Improvements were measured in all diagnostic subgroups and were maintained six months after discharge.
Collapse
Affiliation(s)
- Irwin Gill
- Kids Rehab WA, Perth Children's Hospital, Perth, Australia
| | | | - Paul G Stevenson
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Rae Robinson
- Kids Rehab WA, Perth Children's Hospital, Perth, Australia
| | - Dayna Pool
- Kids Rehab WA, Perth Children's Hospital, Perth, Australia
| | - Jane Valentine
- Kids Rehab WA, Perth Children's Hospital, Perth, Australia
- Curtin University, Perth, Australia
| |
Collapse
|
4
|
Seyhan-Biyik K, Esen-AydinlI F, Sel SA, Incebay Ö, Özcebe E, Kerem-Günel M, Anlar FB, Pennington L. Psychometric properties of the Viking Speech Scale-Turkish version for children with cerebral palsy aged 4-18 years based on live and video-based observation. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:687-703. [PMID: 36426770 DOI: 10.1111/1460-6984.12810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 09/27/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND Speech is the most common method of communication. Video-based clinical communication evaluation is a requirement for children with speech-language impairments living in rural areas, and those who have limited mobility. AIMS To determine the validity and reliability of the Turkish version of the Viking Speech Scale (VSS-T) via live and video-based observation for children with cerebral palsy (CP) aged 4-18 years. METHODS & PROCEDURES A total of 142 children (mean age 8.18 ± 3.98 years; 68 female) with CP were included in this study. Their motor, communication, visual and eating-drinking function levels and comorbidities (dental, swallowing, cognitive impairments and epilepsy) were recorded. The Intelligibility in Context Scale (ICS), the Pediatric Evaluation of Disability Inventory-Social Function (PEDI-SF), and the Functional Independence Measure for Children-Communication (WeeFIM-C) were assessed to examine the concurrent validity of the VSS-T. The interrater reliability of the VSS-T was analysed between parents, physical therapists, and speech and language therapists from live and video-based observation. Intra-rater reliability was calculated from ratings made from live and video-based observations taken 3 weeks apart. OUTCOMES & RESULTS The VSS-T was strongly related to the ICS (r = -0.830), PEDI-SF (r = -0.819), WeeFIM-C (r = -0.643), other functional classifications (r > 0.432), and the comorbidities (Cramer's V > 0.284, p < 0.001). Good to excellent interrater reliability (κw ≥ 0.838) and intra-rater reliability (intraclass correlation coefficient (ICC) = 0.848-0.995) were found between parents and therapists. CONCLUSIONS & IMPLICATIONS Speech and language therapists, physical therapists, and parents can use the VSS-T as a valid and reliable classification system to describe speech intelligibility of 4-18-year-old children with CP. Both live and video-based observations can be used to administer the VSS-T. WHAT THIS PAPER ADDS What is already known on the subject The English version of the VSS has been shown to be a valid and reliable tool used to classify the speech of children with CP aged 4-13 years. The scale can be administered by means of live observation of the child or based on clinicians' notes on the case by parents, SLTs, physiotherapists and paediatricians. What this paper adds to existing knowledge The VSS-T is valid and reliable for children with CP aged 4-18 years. Video-based observation is a suitable method for evaluating the VSS-T levels. The VSS-T has a moderate association with the CFCS. What are the potential or actual clinical implications of this work? The VSS-T is a valid and reliable method of categorizing the severity of motor speech impairment for Turkish children with CP in clinical research studies, registry systems or epidemiological studies. Both experienced and inexperienced therapists can use either live or video-based observation methods to administer the VSS-T. This study extended the validity and reliability of the scale in children with CP aged up to 18 years. The VSS-T is also associated with the Visual Functional Classification System (VFCS), which has been recently developed for describing the visual abilities of children with CP in daily life. In addition, the VSS-T is associated with the presence of dental, swallowing, cognitive problems and epilepsy.
Collapse
Affiliation(s)
- Kübra Seyhan-Biyik
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Fatma Esen-AydinlI
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Sinem Asena Sel
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Önal Incebay
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Esra Özcebe
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Mintaze Kerem-Günel
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Fatma Banu Anlar
- Faculty of Medicine, Division of Neurology, Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Lindsay Pennington
- Population Health Sciences, Institute Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
5
|
Feldman SJ, Beslow LA, Felling RJ, Malone LA, Waak M, Fraser S, Bakeer N, Lee JEM, Sherman V, Howard MM, Cavanaugh BA, Westmacott R, Jordan LC. Consensus-Based Evaluation of Outcome Measures in Pediatric Stroke Care: A Toolkit. Pediatr Neurol 2023; 141:118-132. [PMID: 36812698 PMCID: PMC10042484 DOI: 10.1016/j.pediatrneurol.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/08/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
Following a pediatric stroke, outcome measures selected for monitoring functional recovery and development vary widely. We sought to develop a toolkit of outcome measures that are currently available to clinicians, possess strong psychometric properties, and are feasible for use within clinical settings. A multidisciplinary group of clinicians and scientists from the International Pediatric Stroke Organization comprehensively reviewed the quality of measures in multiple domains described in pediatric stroke populations including global performance, motor and cognitive function, language, quality of life, and behavior and adaptive functioning. The quality of each measure was evaluated using guidelines focused on responsiveness and sensitivity, reliability, validity, feasibility, and predictive utility. A total of 48 outcome measures were included and were rated by experts based on the available evidence within the literature supporting the strengths of their psychometric properties and practical use. Only three measures were found to be validated for use in pediatric stroke: the Pediatric Stroke Outcome Measure, the Pediatric Stroke Recurrence and Recovery Questionnaire, and the Pediatric Stroke Quality of Life Measure. However, multiple additional measures were deemed to have good psychometric properties and acceptable utility for assessing pediatric stroke outcomes. Strengths and weaknesses of commonly used measures including feasibility are highlighted to guide evidence-based and practicable outcome measure selection. Improving the coherence of outcome assessment will facilitate comparison of studies and enhance research and clinical care in children with stroke. Further work is urgently needed to close the gap and validate measures across all clinically significant domains in the pediatric stroke population.
Collapse
Affiliation(s)
- Samantha J Feldman
- Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lauren A Beslow
- Division of Neurology, Children's Hospital of Philadelphia, Departments of Neurology and Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ryan J Felling
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Laura A Malone
- Johns Hopkins University School of Medicine and the Kennedy Krieger Institute, Baltimore, Maryland
| | - Michaela Waak
- Pediatric Critical Care Research Group, Child Health Research Centre, The University of Queensland, Queensland, Australia; Pediatric Intensive Care Unit, Queensland Children's Hospital, South Brisbane, Australia
| | - Stuart Fraser
- Division of Vascular Neurology, Department of Pediatrics, University of Texas Health Science Center, Houston, Texas
| | - Nihal Bakeer
- Indiana Hemophilia and Thrombosis Center, Indianapolis, Indiana
| | - Jo Ellen M Lee
- Department of Neurology, Nationwide Children's Hospital, Columbus, Ohio
| | | | - Melissa M Howard
- Casa Colina Hospital and Centers for Healthcare, Pomona, California
| | - Beth Anne Cavanaugh
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee
| | - Robyn Westmacott
- Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lori C Jordan
- Division of Pediatric Neurology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
| |
Collapse
|
6
|
Amien R, Scott D, Verstraete J. The validity and reliability of the interviewer-administered EQ-5D-Y-3L version in young children. Health Qual Life Outcomes 2023; 21:19. [PMID: 36814254 PMCID: PMC9948371 DOI: 10.1186/s12955-023-02100-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 02/14/2023] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVES The aim of this study was to determine the validity and reliability of the EQ-5D-Y-3L interviewer-administered (IA) version in South African children aged 5-7-years compared to 8-10-years. METHODS Children aged 5-10-years (n = 388) were recruited from healthcare facilities, schools for learners with special educational needs and mainstream schools across four known condition groups: chronic respiratory illnesses, functional disabilities, orthopaedic conditions and the general population. All children completed the EQ-5D-Y-3L IA, Moods and Feelings Questionnaire (MFQ), Faces Pain Scale-Revised (FPS-R) and a functional independence measure (WeeFIM) was completed by the researcher. Cognitive debriefing was done after the EQ-5D-Y-3L IA to determine comprehensibility. Test-retest of the EQ-5D-Y-3L IA was done 48 h later and assessed using Cohen's kappa (k). RESULTS Results from children aged 5-7-years (n = 177) and 8-10-years (n = 211) were included. There were significantly higher reports of problems in the Looking After Myself dimension in the 5-7-year-olds (55%) compared to the 8-10-year-olds (28%) (x2 = 31.021; p = 0.000). The younger children took significantly longer to complete the measure (Mann-Whitney U = 8389.5, p < 0.001). Known-group validity was found at dimension level with children receiving orthopaedic management reporting more problems on physical dimensions across both age-groups. Convergent validity between Looking After Myself and WeeFIM items of self-care showed moderate to high correlations for both age-groups with a significantly higher correlation in the 8-10-year-olds for dressing upper (z = 2.24; p = 0.013) and lower body (z = 2.78; p = 0.003) and self-care total (z = 2.01; p = 0.022). There were fair to moderate levels of test-retest reliability across age-groups. CONCLUSION The EQ-5D-Y-3L IA showed acceptable convergent validity and test-retest reliability for measuring health in children aged 5-7-years. There was more report of problems with the dimension of Looking After Myself in the 5-7-year group due to younger children requiring help with dressing, including buttons and shoelaces due to their developmental age, rather than their physical capabilities. Therefore, it may be useful to include examples of age-appropriate dressing tasks. There was further some reported difficulty with thinking about the dimensions in the younger age-group, most notably for Usual Activities which includes a large number of examples. By decreasing the number of examples it may reduce the burden of recall for the younger age-group.
Collapse
Affiliation(s)
- Razia Amien
- Division of Physiotherapy, Faculty of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa.
| | - Desiree Scott
- grid.7836.a0000 0004 1937 1151Division of Physiotherapy, Faculty of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa
| | - Janine Verstraete
- grid.7836.a0000 0004 1937 1151Division of Pulmonology, Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
7
|
Aprasidze T, Shatirishvili T, Oesch G, Lomidze G, Tatishvili N. Outcome in Childhood Stroke: Comparing Functional Outcome by Modified Rankin Scale with Neurological Outcome by Pediatric Stroke Outcome Measure. JOURNAL OF PEDIATRIC NEUROLOGY 2023. [DOI: 10.1055/s-0043-1761620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
AbstractDifferent scales are used as outcome predictors following arterial ischemic stroke (AIS) in children. Pediatric stroke outcome measure (PSOM) gives information about neurological deficits and function and modified Rankin scale (mRS) about functional outcome. Research examining the relationship between the two measures is scarce. The aim of this study is to correlate the two different scales and to get some information on the long course of outcomes according to these outcome measures. Sixty-one children with the diagnosis of AIS and normal neurodevelopment prior to stroke were investigated. Results of outcome measures (PSOM and mRS) from ≥ 2 years of follow-up were analyzed. Changes of neurological deficits (subcategories of PSOM) over time (discharge, 6 months, and ≥2 years) and prognostic impact on the outcome of the Pediatric National Institutes of Health Stroke Scale and etiology/risk factors are presented.Cramer's V with a coefficient of 0.836 (df-1) indicates a strong association between dichotomized total PSOM and mRS scores. The correlation between the total scales was strong (rho = 0.983, p < 0.001). The correlation coefficient was highest for sensorimotor (rho = 0.949, p < 0.001), then for language (rho = 0.464, p < 0.001) and cognitive (rho = 0.363, p = 0.004) subscales. PSOM scores improved at 6 months compared to the discharge state in sensorimotor (p<0.001) and language (p<0.026) domains, however, there was no statistically significant difference between PSOM scores at 6 months and >2 years follow-up. There was no improvement in cognitive PSOM scores during the follow-up period.There was a high concordance level between the two scales, illustrating that long-term neurological deficits after stroke are related to poor functional outcome. Significant improvement of sensorimotor and language function happened within the period from onset to 6 months of follow-up. Thus, early mobilization of appropriate rehabilitative therapy might improve the outcome. We conclude that both outcome classifications are applicable for assessing outcome after childhood AIS.
Collapse
Affiliation(s)
- Tatia Aprasidze
- Department of Neurology, David Tvildiani Medical University, Tbilisi, Georgia
- Department of Neuroscience, M. Iashvili Children's Central Hospital, Tbilisi, Georgia
| | - Teona Shatirishvili
- Department of Neurology, David Tvildiani Medical University, Tbilisi, Georgia
- Department of Neuroscience, M. Iashvili Children's Central Hospital, Tbilisi, Georgia
| | - Gabriela Oesch
- Division of Child Neurology, Department of Pediatrics, University Children's Hospital Bern, University of Bern, Bern, Switzerland
| | - Giorgi Lomidze
- Department of Neurology, European University, Tbilisi, Georgia
| | - Nana Tatishvili
- Department of Neurology, David Tvildiani Medical University, Tbilisi, Georgia
- Department of Neuroscience, M. Iashvili Children's Central Hospital, Tbilisi, Georgia
| |
Collapse
|
8
|
Berg AT, Kaat AJ, Gaebler-Spira D. Measuring the inch stones for progress: Gross motor function in the developmental and epileptic encephalopathies. Epilepsy Behav 2022; 137:108953. [PMID: 36368092 DOI: 10.1016/j.yebeh.2022.108953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 09/30/2022] [Accepted: 10/10/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Developmental and epileptic encephalopathies (DEE) entail moderate to profound impairments in gross motor skills and mobility, which are poorly quantified with clinical outcomes assessments (COA) used in neuro-typical populations. We studied the motor domain of the Adaptive Behavior Assessment System-3 for ages 0-5 years (ABAS) used outside of its intended age range with a focus on raw scores. METHODS In a cross-sectional survey, 117 parents of children with a variety of DEEs (ages 1-35 years, median = 9) completed the motor domain section of the ABAS. Floor and ceiling effects and associations with epilepsy-related factors were assessed with appropriate parametric and nonparametric statistical techniques. The sensitivity of the ABAS and additional measures of mobility borrowed from the cerebral palsy literature (Functional Activities Questionnaire (FAQ-22) walking level (FAQ-WL)) to different levels of the Functional Mobility Scale was determined. RESULTS ABAS motor scores corresponded to a median age equivalent of 20.5 months (Inter-Quartile Range (IQR) 8-34). Most raw scores corresponded to standardized scores > 2 standard deviations below the ABAS standardization sample mean. ABAS raw scores demonstrated minimal floor and ceiling effects (<5%). In linear regression models, scores increased with age under 6 years (p < 0.0001) but flattened out thereafter. Scores varied substantially by DEE group (p < 0.001) and decreased with higher convulsive seizure frequency (<0.0001) and number of seizure medications (p < 0.001). ABAS and other motor scores were sensitive to important differences in mobility as represented by the FMS at 5 yards. Further, they correlated with declines in mobility function from 5 to 500 yards. SIGNIFICANCE An out-of-range COA with raw scores may provide a measure of motor ability and mobility sensitive within the range of moderate to profound impairment seen in patients with DEE. This approach could shorten the time to appropriate COA development and ensure timely clinical trial readiness for novel therapies for rare DEEs.
Collapse
Affiliation(s)
- Anne T Berg
- COMBINEDBrain, Nashville, TN, United States; Northwestern Feinberg School of Medicine, Department of Neurology, Chicago, IL, United States.
| | - Aaron J Kaat
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Deborah Gaebler-Spira
- Shirley Ryan Ability Lab, Chicago, IL, United States; Department of Physical Medicine and Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, IL, United States; Department of Pediatrics, Northwestern Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
9
|
Malone LA, Levy TJ, Peterson RK, Felling RJ, Beslow LA. Neurological and Functional Outcomes after Pediatric Stroke. Semin Pediatr Neurol 2022; 44:100991. [PMID: 36456032 DOI: 10.1016/j.spen.2022.100991] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/15/2022] [Accepted: 08/22/2022] [Indexed: 12/01/2022]
Abstract
Pediatric stroke results in life-long morbidity for many patients, but the outcomes can vary depending on factors such as age of injury, or mechanism, size, and location of stroke. In this review, we summarize the current understanding of outcomes in different neurological domains (eg, motor, cognitive, language) for children with stroke of different mechanisms (ie, arterial ischemic stroke, cerebral sinus venous thrombosis, and hemorrhagic stroke), but with a focus on World Health Organization International Classification for Functioning, Disability, and Health (ICF-CY) framework for measuring health and disability for children and youth. We describe outcomes for the population as a whole and certain factors that may further refine prognostication.
Collapse
Affiliation(s)
- Laura A Malone
- Kennedy Krieger Institute, Baltimore, MD; Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD; Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD.
| | - Todd J Levy
- The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Rachel K Peterson
- Kennedy Krieger Institute, Baltimore, MD; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
| | - Ryan J Felling
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Lauren A Beslow
- The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
10
|
Vostrý M, Lanková B, Pešatová I, Müllerová L, Vomáčková H. Assessment of the Functional Level of Independence in Individuals with Mental Disabilities as Part of Special Education Diagnostics: Case Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15474. [PMID: 36497547 PMCID: PMC9739072 DOI: 10.3390/ijerph192315474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
In this study we focus on the application of standardized tests aimed at evaluating the functional degree of independence in children (client 1, WeeFIM test; and client 2, FIM test) in special education diagnostics. The target group consisted of two clients with a diagnosis of mental functional diversity (n = 2; client 1: mild mental retardation, according to ICD-10: F70, aged 6.5 years; and client 2: moderate mental retardation, according to ICD-10: F71, aged 13.4 years). Special pedagogical intervention was primarily applied to the clients, focusing on identified deficits in the areas of cognitive, motor, and social skills. The presented results demonstrate the importance of the application of these tests in special pedagogy. An improvement in the observed indicators of the given tests was demonstrated for both probands after the intervention. The aim of this article was to draw attention to the suitability of using functional independence tests in special pedagogical practices. The authors discuss the further implications of this application for future practice.
Collapse
Affiliation(s)
- Michal Vostrý
- Research Centre, Faculty of Health Studies, Jan Evangelista Purkyně University in Ústí nad Labem, 400 96 Ústí nad Labem, Czech Republic
- Department of Special and Social Education, Faculty of Education, Jan Evangelista Purkyně University in Ústí nad Labem, 400 96 Ústí nad Labem, Czech Republic
| | - Barbora Lanková
- Department of Primary and Pre-Primary Education, Faculty of Education, Jan Evangelista Purkyně University in Ústí nad Labem, 400 96 Ústí nad Labem, Czech Republic
| | - Ilona Pešatová
- Department of Special and Social Education, Faculty of Education, Jan Evangelista Purkyně University in Ústí nad Labem, 400 96 Ústí nad Labem, Czech Republic
| | - Lenka Müllerová
- Department of Special and Social Education, Faculty of Education, Jan Evangelista Purkyně University in Ústí nad Labem, 400 96 Ústí nad Labem, Czech Republic
| | - Helena Vomáčková
- Department of Special and Social Education, Faculty of Education, Jan Evangelista Purkyně University in Ústí nad Labem, 400 96 Ústí nad Labem, Czech Republic
| |
Collapse
|
11
|
Ochandorena-Acha M, Terradas-Monllor M, Nunes Cabrera TF, Torrabias Rodas M, Grau S. Effectiveness of virtual reality on functional mobility during treadmill training in children with cerebral palsy: a single-blind, two-arm parallel group randomised clinical trial (VirtWalkCP Project). BMJ Open 2022; 12:e061988. [PMID: 36328390 PMCID: PMC9639079 DOI: 10.1136/bmjopen-2022-061988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Treadmill training and virtual reality have been investigated in children with cerebral palsy. However, few studies have assessed the effectiveness of the combination of both treatments on children's functional and balance activities. The project aims to compare the effects of treadmill training with and without virtual reality on walking endurance and speed, static and dynamic balance, gross motor function, functional independence, quality of life and occupational participation in children with spastic cerebral palsy between the ages of 4 and 12 years classified at levels I, II and III of the Gross Motor Function Classification System. METHODS AND ANALYSIS This study is a single-blind, two-arm parallel group, randomised, controlled clinical trial. Participants will be recruited at the Pediatric Department of the Vic Hospital Consortium, and the research will be conducted at the University of Vic - Central University of Catalonia. The participants will be randomly allocated into two groups: (1) the experimental group, which will receive the treadmill training at the same time as the virtual reality; and (2) the control group, which will undertake treadmill gait training alone. The training will be provided in 10 sessions over 2 weeks with 30 min for each session. Assessments will be performed on three occasions: 1 week before the intervention, 1 week following the intervention and 1 month after the end of the intervention. The evaluations will involve the 6 min walk test, stabilometry, the Berg Balance Scale, the 10 m walk test, the Gross Motor Function Measure, the Functional Independence Measure, the paediatric quality of life inventory and the Children Participation Questionnaire. For between-within group comparison, a mixed-effect linear model will be used. ETHICS AND DISSEMINATION The study has been approved by the Clinical Research Ethics Committee of the Osona Foundation for Health Research and Education (2021061). Results will be published in peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER NCT05131724.
Collapse
Affiliation(s)
- Mirari Ochandorena-Acha
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC), C.Sagrada Família, 7, 08500 Vic, Spain
- Neurology department, Sant Joan de Deu Barcelona Children's Hospital, Barcelona, Catalonia, Spain
| | - Marc Terradas-Monllor
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC), C.Sagrada Família, 7, 08500 Vic, Spain
- Pain Medicine Section, Anesthesiology Department, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
| | - Tania Fabiola Nunes Cabrera
- Neurology department, Sant Joan de Deu Barcelona Children's Hospital, Barcelona, Catalonia, Spain
- Pediatric Department, Consorci Hospitalari de Vic, Vic, Catalunya, Spain
| | | | - Sergi Grau
- Faculty of Science and Technology, University of Vic - Central University of Catalonia, Vic, Spain
| |
Collapse
|
12
|
Greve KR, Joseph CF, Berry BE, Schadl K, Rose J. Neuromuscular electrical stimulation to augment lower limb exercise and mobility in individuals with spastic cerebral palsy: A scoping review. Front Physiol 2022; 13:951899. [PMID: 36111153 PMCID: PMC9468780 DOI: 10.3389/fphys.2022.951899] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Neuromuscular Electrical Stimulation (NMES) is an emerging assistive technology applied through surface or implanted electrodes to augment skeletal muscle contraction. NMES has the potential to improve function while reducing the neuromuscular impairments of spastic cerebral palsy (CP). This scoping review examines the application of NMES to augment lower extremity exercises for individuals with spastic CP and reports the effects of NMES on neuromuscular impairments and function in spastic CP, to provide a foundation of knowledge to guide research and development of more effective treatment. Methods: A literature review of Scopus, Medline, Embase, and CINAHL databases were searched from 2001 to 2 November 2021 with identified inclusion and exclusion criteria. Results: Out of 168 publications identified, 33 articles were included. Articles on three NMES applications were identified, including NMES-assisted strengthening, NMES-assisted gait, and NMES for spasticity reduction. NMES-assisted strengthening included the use of therapeutic exercises and cycling. NMES-assisted gait included the use of NMES to improve gait patterns. NMES-spasticity reduction included the use of transcutaneous electrical stimulation or NMES to decrease tone. Thirteen studies investigated NMES-assisted strengthening, eleven investigated therapeutic exercise and demonstrated significant improvements in muscle structure, strength, gross motor skills, walking speed, and functional mobility; three studies investigated NMES-assisted cycling and demonstrated improved gross motor skills and walking distance or speed. Eleven studies investigated NMES-assisted gait and demonstrated improved muscle structure, strength, selective motor control, gross motor skills, and gait mechanics. Seven studies investigated NMES for spasticity reduction, and five of the seven studies demonstrated reduced spasticity. Conclusion: A growing body of evidence supports the use of NMES-assisted strengthening, NMES-assisted gait, and NMES for spasticity reduction to improve functional mobility for individuals with spastic CP. Evidence for NMES to augment exercise in individuals with spastic CP remains limited. NMES protocols and parameters require further clarity to translate knowledge to clinicians. Future research should be completed to provide richer evidence to transition to more robust clinical practice.
Collapse
Affiliation(s)
- Kelly R. Greve
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Rehabilitation, Exercise and Nutrition Sciences, University of Cincinnati, College of Allied Health Sciences, Cincinnati, OH, United States
- *Correspondence: Kelly R. Greve,
| | - Christopher F. Joseph
- Department of Physical Therapy, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Blake E. Berry
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Rehabilitation, Exercise and Nutrition Sciences, University of Cincinnati, College of Allied Health Sciences, Cincinnati, OH, United States
| | - Kornel Schadl
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, United States
- Motion and Gait Analysis Lab, Lucile Packard Children’s Hospital, Stanford Children’s Health, Stanford, CA, United States
| | - Jessica Rose
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, United States
- Motion and Gait Analysis Lab, Lucile Packard Children’s Hospital, Stanford Children’s Health, Stanford, CA, United States
| |
Collapse
|
13
|
Othman EM, Aly DA. To what extent the Arabic WeeFIM is reliable and feasible in Egyptian children with burns? An observational cross-sectional study. J Burn Care Res 2022; 44:590-598. [PMID: 35788852 DOI: 10.1093/jbcr/irac094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Indexed: 11/13/2022]
Abstract
This is an observational cross-sectional study design aimed to assess the feasibility and reliability of Arabic version of WeeFIM in Egyptian children with healed burns with two measurements within a 2-week time period in a sample of 53 patients with healed burns who were aged 3 to 16 years and treated in the outpatient burn clinic, Faculty of Physical Therapy, Cairo University and Om Elmisryeen Hospital. All patients met the inclusive criteria were enrolled in the study. The adaptation of the Arabic WeeFIM instrument to an interview format suitable for burned children with communicative and/or cognitive problems and evaluation of its feasibility and reliability. The reliability was assessed by a test-retest procedure. Feasibility was evaluated by the assessment of the frequency of missing answers per item and administration time. The Arabic Index of Content Validity (ICV) was used for content validity assessment. The Arabic version of WeeFIM has borderline reliability (Cronbach's Alpha = 0.619 and Pearson correlation coefficient: r = 0.986). There was an acceptable percent to have a feasible test as 83.963% of the filled questionnaires had no missing answers and the mean of administration time was 7.4, 5.5 for 1 st and 2 nd assessments, respectively. The ICV of adapted WeeFIM items showed that all the questions were relevant except for two questions only. The Arabic version of WeeFIM has high test-retest reliability, moderate internal consistency, and excellent feasibility in measuring and reporting the functional independence and burden of care for children with healed burns.
Collapse
Affiliation(s)
- Eman Mohamed Othman
- Department of Surgery, Faculty of Physical Therapy, Cairo University, Al Doqi, Giza, Egypt
| | - Doaa A Aly
- Department of Surgery, Faculty of Physical Therapy, Cairo University, Egypt
| |
Collapse
|
14
|
Concurrent Validity Between the AM-PAC “6-Clicks” Basic Mobility Short Form and the WeeFIM in the Pediatric Acute Care Population. JOURNAL OF ACUTE CARE PHYSICAL THERAPY 2022. [DOI: 10.1097/jat.0000000000000197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
15
|
Mandarano R, Danieli A, Petacchi E, Di Pede C, Mondani M, Armellin MT, Facchin D, Martinuzzi A. Deep Brain Stimulation in childhood-onset dystonia due to brain pathology. A long-term study. Eur J Paediatr Neurol 2022; 37:62-67. [PMID: 35124541 DOI: 10.1016/j.ejpn.2022.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 12/30/2021] [Accepted: 01/20/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Pallidal Deep Brain Stimulation (DBS) is an established treatment option for isolated, inherited or idiopathic dystonia, however data on its safety and efficacy in other forms of dystonia are more limited. OBJECTIVES Retrospective analysis of motor and non-motor outcomes in pediatric onset refractory dystonia due to static or progressive brain disorders in a cohort of patients with a DBS treatment duration ≥12 months. METHODS Multidisciplinary assessments including standardised scales/tests of motor function, pain, quality of life, cognition and language were carried out before implantation and longitudinally afterwards. RESULTS 9 patients were included, 7 had cerebral palsy. Mean age at implantation was 209 months ± 156, mean treatment duration 84 ± 37 months. DBS was well tolerated and positively affected both motor and non-motor functions. In particular, statistically significant improvements were documented in Burke-Fahn-Marsden Scale scores (- 19.9% p 0.01031) at 12 months and in long-term quality of life (+28.6%, p 0.0292). CONCLUSIONS DBS may be a useful treatment option in generalized dystonia associated with brain pathology. Even when the motor benefits are limited, improvements in quality of life and non-motor functions, or the possible prevention of serious dystonia-related complications, may have a significant impact on overall clinical status.
Collapse
Affiliation(s)
- Romina Mandarano
- Unit for Severe Disabilities in Developmental Age, Scientific Institute IRCCS E. Medea, Conegliano, Treviso, Italy.
| | - Alberto Danieli
- Unit of Epilepsy and Clinical Neurophysiology, Scientific Institute IRCCS E. Medea, Conegliano, Treviso, Italy
| | - Elisa Petacchi
- Unit for Severe Disabilities in Developmental Age, Scientific Institute IRCCS E. Medea, Conegliano, Treviso, Italy
| | - Chiara Di Pede
- Unit for Severe Disabilities in Developmental Age, Scientific Institute IRCCS E. Medea, Conegliano, Treviso, Italy
| | - Massimo Mondani
- Neurological Unit, S. Maria della Misericordia Universital Hospital, Udine, Italy
| | - Maria Teresa Armellin
- Unit for Severe Disabilities in Developmental Age, Scientific Institute IRCCS E. Medea, Conegliano, Treviso, Italy
| | - Dina Facchin
- Unit for Severe Disabilities in Developmental Age, Scientific Institute IRCCS E. Medea, Conegliano, Treviso, Italy
| | - Andrea Martinuzzi
- Unit for Severe Disabilities in Developmental Age, Scientific Institute IRCCS E. Medea, Conegliano, Treviso, Italy
| |
Collapse
|
16
|
Viehweger E, Kläusler M, Loucheur N. Paralytic dislocation of the hip in children. Orthop Traumatol Surg Res 2022; 108:103166. [PMID: 34871796 DOI: 10.1016/j.otsr.2021.103166] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 05/24/2021] [Accepted: 06/04/2021] [Indexed: 02/03/2023]
Abstract
Despite the progress made in the past decades, hip disorders are one of the most common orthopedic problems in the context of paralysis. The etiology can be congenital (malformation such as myelomeningoceles, genetic neuromuscular disorders) or acquired (cerebral palsy, post-traumatic). In these conditions, the orthopedic deformities are minimal at birth. They can develop as the child grows, at different ages, depending on the etiology, severity of the neuromuscular disorder and functional potential. Hip subluxation and dislocation can compromise standing and walking capacities, but also the quality of the seated position and the personal care. Daily life activities and participation are restricted and influence the disabled person's quality of life. Paralytic dislocation of the hip is the orthopedic deformity that has be biggest impact on day-to-day life, general health and the overall orthopedic result in adulthood. Neuro-orthopedic care is challenging. However, there are basic principles that one must know to ensure good long-term quality of life in patients suffering from paralytic dislocations of the hip. When planning the treatment strategy, it is essential to take into consideration the day-to-day life and to integrate the patient's experiences and needs, along with those of their caretakers. The objective of this review is to outline the differences in paralytic dislocations of the hip of diverse etiology, to present evaluation principles useful in daily clinical practice and to help practitioners in choosing a treatment strategy.
Collapse
Affiliation(s)
- Elke Viehweger
- Department of Orthopedic Surgery, Neuro-orthopedics Unit, Pediatric University Hospital of Both Basel (UKBB), Spitalstrasse 33, CH-4056 Basel, Switzerland.
| | - Michèle Kläusler
- Department of Orthopedic Surgery, Neuro-orthopedics Unit, Pediatric University Hospital of Both Basel (UKBB), Spitalstrasse 33, CH-4056 Basel, Switzerland
| | - Naima Loucheur
- Pediatric Orthopedic Surgery Unit, Hôpital Timone Enfants, 264 Rue Saint-Pierre, 13385 Marseille, France
| |
Collapse
|
17
|
Song EJ, Lee EJ, Kwon HY. The effects of sling exercise program on balance and body activities in children with spastic cerebral palsy. J Exerc Rehabil 2022; 17:410-417. [PMID: 35036390 PMCID: PMC8743608 DOI: 10.12965/jer.2142608.304] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 11/19/2021] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to investigate the static and dynamic balance and body activities after administering a trunk stability exercise program using a sling for children with spastic cerebral palsy of Gross Motor Function Classification System (GMFCS) levels III–IV. This study was conducted based on a quasi-experimental study design. Six of the study participants were assigned to the control group and six were assigned to the experimental group using simple random sampling. Both groups underwent a double-blind clinical trial study in which exercise therapy was performed for 40 min twice a week for 8 weeks. The experimental group underwent the sling exercise program and the control group underwent neuro-developmental treatment. The results showed that static and dynamic balance were significantly different before and after intervention in both the experimental and control groups (P<0.05), and there was also a statistically significant difference between the two groups (P<0.05). Gross motor function and activities of daily life showed significant improvement before and after intervention in the experimental group (P<0.05), but there was no statistically significant difference in the control group (P<0.05). There was a statistically significant difference between the two groups (P<0.05). Therefore, the sling exercise program can be used as an effective treatment for improving balance and physical activity in children with cerebral palsy of GMFCS levels III–IV who have difficulty walking. In addition, such exercise will have a positive impact on the independence of such children and help them to participate in social activities.
Collapse
Affiliation(s)
- Eun-Ju Song
- Busan Brain Lesion Welfare Center, Busan, Korea
| | - Eun-Jung Lee
- Ulsan Community Rehabilitation Center, Ulsan, Korea
| | - Hae-Yeon Kwon
- Department of Physical Therapy, College of Nursing and Healthcare Science, Dong-Eui University, Busan, Korea
| |
Collapse
|
18
|
Amien R, Scott D, Verstraete J. Performance of the EQ-5D-Y Interviewer Administered Version in Young Children. CHILDREN (BASEL, SWITZERLAND) 2022; 9:93. [PMID: 35053718 PMCID: PMC8775050 DOI: 10.3390/children9010093] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/03/2022] [Accepted: 01/07/2022] [Indexed: 06/14/2023]
Abstract
(1) Background: An estimated 78% of South African children aged 9-10 years have not mastered basic reading, therefore potentially excluding them from self-reporting on health-related outcome measures. Thus, the aim of this study was to compare the performance of the EQ-5D-Y-3L self-complete to the newly developed interviewer-administered version in children 8-10 years. (2) Methods: Children (n = 207) with chronic respiratory illnesses, functional disabilities, orthopaedic conditions and from the general population completed the EQ-5D-Y-3L self-complete and interviewer-administered versions, Moods and Feelings Questionnaire (MFQ) and Faces Pain Scale-Revised (FPS-R). A functional independence measure (WeeFIM) was completed by the researcher. (3) Results: The 8-year-olds had significantly higher missing responses (x2 = 14.23, p < 0.001) on the self-complete version. Known-group and concurrent validity were comparable across dimensions, utility and VAS scores for the two versions. The dimensions showed low to moderate convergent validity with similar items on the MFQ, FPS-R and WeeFIM with significantly higher correlations between the interviewer-administered dimensions of Mobility and WeeFIM mobility total (z = 1.91, p = 0.028) and Looking After Myself and WeeFIM self-care total (z = 3.24, p = 0.001). Children preferred the interviewer-administered version (60%) (x2 = 21.87, p < 0.001) with 22% of the reasons attributed to literacy level. (4) Conclusions: The EQ-5D-Y-3L interviewer-administered version is valid and reliable in children aged 8-10 years. The results were comparable to the self-complete version indicating that versions can be used interchangeably.
Collapse
Affiliation(s)
- Razia Amien
- Division of Physiotherapy, Faculty of Health and Rehabilitation Sciences, University of Cape Town, Cape Town 7701, South Africa;
| | - Desiree Scott
- Division of Physiotherapy, Faculty of Health and Rehabilitation Sciences, University of Cape Town, Cape Town 7701, South Africa;
| | - Janine Verstraete
- Division of Pulmonology, Department of Paediatric and Child Health, University of Cape Town, Cape Town 7701, South Africa;
| |
Collapse
|
19
|
Alnahdi AH, Alhusaini AA, Yousef B, Alshami A. The Arabic version of the ABILOCO-Kids scale is valid and reliable in children with cerebral palsy. Physiother Theory Pract 2022; 38:173-181. [DOI: 10.1080/09593985.2020.1736222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Ali H. Alnahdi
- Rehabilitation Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Adel A. Alhusaini
- Rehabilitation Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Bara Yousef
- Rehabilitation Program and Services, Sultan Bin Abdulaziz Humanitarian City, Riyadh, Saudi Arabia
| | - Abdullah Alshami
- Rehabilitation Program and Services, Sultan Bin Abdulaziz Humanitarian City, Riyadh, Saudi Arabia
| |
Collapse
|
20
|
Galeoto G, Mignolli E, Tofani M, Sogos C, Servadio A, Valente D, Berardi A. Evaluation of test-retest reliability and concurrent validity of the Italian version of the pediatric evaluation of disability inventory in children with down syndrome: A cross-sectional study. J Pediatr Rehabil Med 2022; 15:487-497. [PMID: 35723123 DOI: 10.3233/prm-190674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Down Syndrome (DS) is a common genetic disorder caused by trisomy 21. Due to cognitive challenges associated with DS, individuals often experience difficulty performing activities of daily living (ADLs), at levels that can range from mild to significant. This study aimed to measure psychometric properties of the Italian version of the Pediatric Evaluation of Disability Inventory (PEDI-I) in the DS population. METHODS The PEDI-I was administered to children with DS. The internal consistency was examined using Cronbach's Alpha. Test-retest reliability was demonstrated by intraclass correlation coefficient (ICC) and Bland-Altman plots. The concurrent validity was evaluated with the Italian version of the Barthel Index. RESULTS The PEDI-I was administered to 54 children with DS. Cronbach's Alpha showed statistically significant values (0.899 -0.986). The ICC confirmed the reproducibility of the scale with a range of (0.988 -1), while Bland-Altman plots showed a smallest detectable change of (0.18-1.63). The Pearson Correlation Coefficient with the Barthel Index showed statistically significant values for all PEDI-I subscales (range 0.75-0.95). CONCLUSION The study provides evidence of good test-retest reliability and convergent validity when used in children with DS. Other psychometric proprieties need to be investigated in future studies.
Collapse
Affiliation(s)
- Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Neuromed, Pozzilli, Italy
| | | | - Marco Tofani
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,Professional Development, Continuous Education and Research Service, Bambino Gesù Children's Hospital, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Rome, Italy
| | - Carla Sogos
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | - Donatella Valente
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Neuromed, Pozzilli, Italy
| | - Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
21
|
Teo JH, Shabhani S, Qiao F, Ng ZM, Chan DWS. Comparison of functional outcome scales in paediatric acute encephalitis: Responsiveness and outcome predictors. J Pediatr Rehabil Med 2022; 15:289-298. [PMID: 34744032 DOI: 10.3233/prm-200706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To compare scoring systems and their ability to capture short and long-term recovery of paediatric patients with acute encephalitis. To identify clinical predictors of short-term outcomes by correlating functional outcome measures at 1 month post diagnosis of acute encephalitis. METHODS Patients with encephalitis diagnosed between July 2011 and 2016 based on Granerod's criteria were studied in this retrospective cohort study. Functional outcome scores on WeeFIM, LOS, GOS-E, mRS and ICF at initial presentation and 1, 3, 6 and 12 months later were compared. RESULTS WeeFIM and LOS scores both showed maximum change in the first 3 months, reflecting highest recovery in this period. With WeeFIM, the greatest change occurred within the first month following diagnosis. On univariate analysis, seizure frequency in the first month, presence of movement disorder, presence of autonomic dysfunction and lower baseline functional score was associated with poorer WeeFIM scores at 1 month. The latter three variables remained statistically significant on multivariate analysis. CONCLUSION WeeFIM is a potentially preferred functional outcome assessment tool as it demonstrated greatest recovery within the first month due to a trend of high responsiveness and relatively low ceiling effect. Presence of autonomic dysfunction and movement disorders at diagnosis correlated with poorer outcome at 1 month post diagnosis.
Collapse
Affiliation(s)
- Jia Hui Teo
- Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore
| | | | - Fan Qiao
- Duke-NUS Medical School, Singapore
| | - Zhi Min Ng
- Neurology Service, KK Women's and Children's Hospital, Singapore
| | | |
Collapse
|
22
|
Hedrich UBS, Lauxmann S, Wolff M, Synofzik M, Bast T, Binelli A, Serratosa JM, Martínez-Ulloa P, Allen NM, King MD, Gorman KM, Zeev BB, Tzadok M, Wong-Kisiel L, Marjanovic D, Rubboli G, Sisodiya SM, Lutz F, Ashraf HP, Torge K, Yan P, Bosselmann C, Schwarz N, Fudali M, Lerche H. 4-Aminopyridine is a promising treatment option for patients with gain-of-function KCNA2-encephalopathy. Sci Transl Med 2021; 13:eaaz4957. [PMID: 34516822 DOI: 10.1126/scitranslmed.aaz4957] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
[Figure: see text].
Collapse
Affiliation(s)
- Ulrike B S Hedrich
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tuebingen, 72076 Tuebingen, Germany
| | - Stephan Lauxmann
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tuebingen, 72076 Tuebingen, Germany
| | - Markus Wolff
- Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital, 72076 Tuebingen, Germany.,Department of Pediatric Neurology, Vivantes-Klinikum Neukölln, 12351 Berlin, Germany
| | - Matthis Synofzik
- Department of Neurology and Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research, University of Tuebingen, 72076 Tuebingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen, Germany
| | - Thomas Bast
- Epilepsy Center Kork, 77694 Kehl-Kork, Germany.,Medical Faculty of the University of Freiburg, 79110 Freiburg, Germany
| | - Adrian Binelli
- Department of Pediatric Neurology, Elizalde Children's Hospital, C1270 Buenos Aires, Argentina
| | - José M Serratosa
- Neurology Laboratory and Epilepsy Unit, Department of Neurology, IIS- Fundacio'n Jime'nez Dı'az, UAM, 28040 Madrid, Spain.,Centro de Investigacio'n Biome'dica en Red de Enfermedades Raras (CIBERER), 28029 Madrid, Spain
| | - Pedro Martínez-Ulloa
- Neurology Laboratory and Epilepsy Unit, Department of Neurology, IIS- Fundacio'n Jime'nez Dı'az, UAM, 28040 Madrid, Spain
| | - Nicholas M Allen
- Department of Paediatrics, Clinical Sciences Institute, National University of Ireland Galway, Galway H91 TK33, Ireland
| | - Mary D King
- Department of Neurology and Neurophysiology, Children's Health Ireland at Temple Street, Dublin DO1 YC67, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin DO4 V1W8, Ireland
| | - Kathleen M Gorman
- Department of Neurology and Neurophysiology, Children's Health Ireland at Temple Street, Dublin DO1 YC67, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin DO4 V1W8, Ireland
| | - Bruria Ben Zeev
- Sackler School of Medicine Tel Aviv University, Tel Aviv 6997801, Israel.,Pediatric Neurology Unit, Edmond and Lilly Safra Pediatric Hospital, Sheba Medical Center, 5265601 Ramat Gan, Israel
| | - Michal Tzadok
- Sackler School of Medicine Tel Aviv University, Tel Aviv 6997801, Israel.,Pediatric Neurology Unit, Edmond and Lilly Safra Pediatric Hospital, Sheba Medical Center, 5265601 Ramat Gan, Israel
| | - Lily Wong-Kisiel
- Divisions of Child Neurology & Division of Epilepsy, Department of Neurology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA
| | | | - Guido Rubboli
- Danish Epilepsy Center, Filadelfia, 4293 Dianalund, Denmark.,University of Copenhagen, 1165 Copenhagen, Denmark
| | - Sanjay M Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.,Chalfont Centre for Epilepsy, Bucks SL9 0RJ, UK
| | - Florian Lutz
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tuebingen, 72076 Tuebingen, Germany
| | - Harshad Pannikkaveettil Ashraf
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tuebingen, 72076 Tuebingen, Germany
| | - Kirsten Torge
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tuebingen, 72076 Tuebingen, Germany
| | - Pu Yan
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tuebingen, 72076 Tuebingen, Germany
| | - Christian Bosselmann
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tuebingen, 72076 Tuebingen, Germany
| | - Niklas Schwarz
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tuebingen, 72076 Tuebingen, Germany
| | - Monika Fudali
- Department of Neurosurgery, University of Tuebingen, 72076 Tuebingen, Germany
| | - Holger Lerche
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tuebingen, 72076 Tuebingen, Germany
| |
Collapse
|
23
|
Santangelo L, Netti GS, Torres DD, Piscopo G, Carbone V, Losito L, Milella L, Lasorella ML, Conti P, Gagliardi D, Chironna M, Spadaccino F, Bresin E, Trabacca A, Ranieri E, Giordano M. Peripheral nervous system manifestations of Shiga toxin-producing E. coli-induced haemolytic uremic syndrome in children. Ital J Pediatr 2021; 47:181. [PMID: 34488831 PMCID: PMC8422760 DOI: 10.1186/s13052-021-01133-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 08/16/2021] [Indexed: 11/16/2022] Open
Abstract
Background The Neurological involvement is the most common extra-renal complication of Shiga toxin-producing E. coli-hemolytic uremic syndrome (HUS) or typical HUS. On brain magnetic resonance examination, main neurological signs encompass acute lesions of the basal ganglia and the white matter, which could usually regress after Eculizumab infusion. In contrast, peripheral nervous system (PNS) manifestations in typical HUS are very rare and, when occurring, they require a careful management of neurological sequelae and an intensive multidisciplinary neuro-rehabilitation program. Case presentation Here, we present two pediatric cases of severe and complicated typical HUS with PNS manifestations who required therapeutic treatment and an intensive multidisciplinary neuro-rehabilitation program. In both cases, PNS manifestations were followed by the recovery from typical HUS-related severe central neurological damage and manifested mainly with marked bilateral motor deficit and hyporeflexia/areflexia in the lower limbs. The peripheral polyneuropathy was treated with immunosuppressive therapy (methylprednisolone boluses, i.v. immunoglobulins, plasma exchange), followed by a prolonged intensive neuro-rehabilitation program. After 8 months of rehabilitation, both patients gained complete functional recovery. Conclusions PNS manifestations during typical HUS are a rare event and potentially leading to severe disability. A timely clinical assessment is mandatory to set up a prompt therapeutic and rehabilitation program and to obtain a complete clinical and functional recovery.
Collapse
Affiliation(s)
- Luisa Santangelo
- Pediatric Nephrology and Dialysis Unit, Pediatric Hospital 'Giovanni XXIII', Bari, Italy
| | - Giuseppe Stefano Netti
- Department of Medical and Surgical Sciences, Clinical Pathology Unit and Center for Molecular Medicine, University of Foggia, Viale Luigi Pinto -, 71122, Foggia, Italy.
| | | | - Giovanni Piscopo
- Pediatric Nephrology and Dialysis Unit, Pediatric Hospital 'Giovanni XXIII', Bari, Italy
| | - Vincenza Carbone
- Pediatric Nephrology and Dialysis Unit, Pediatric Hospital 'Giovanni XXIII', Bari, Italy
| | - Luciana Losito
- Scientific Institute I.R.C.C.S. "E. Medea"- Unit for Severe disabilities in developmental age and young adults (Developmental Neurology and Neurorehabilitation), Brindisi, Italy
| | - Leonardo Milella
- Intensive Care Unit, Pediatric Hospital "Giovanni XXIII", Bari, Italy
| | | | - Pasquale Conti
- Pediatric Neurology Unit, Pediatric Hospital "Giovanni XXIII", Bari, Italy
| | - Delio Gagliardi
- Pediatric Neurology Unit, Pediatric Hospital "Giovanni XXIII", Bari, Italy
| | - Maria Chironna
- Department of Biomedical Sciences and Human Oncology, Hygiene Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Federica Spadaccino
- Department of Medical and Surgical Sciences, Clinical Pathology Unit and Center for Molecular Medicine, University of Foggia, Viale Luigi Pinto -, 71122, Foggia, Italy
| | - Elena Bresin
- Clinical Research Center for Rare Diseases 'Aldo e Cele Daccò', Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Antonio Trabacca
- Scientific Institute I.R.C.C.S. "E. Medea"- Unit for Severe disabilities in developmental age and young adults (Developmental Neurology and Neurorehabilitation), Brindisi, Italy
| | - Elena Ranieri
- Department of Medical and Surgical Sciences, Clinical Pathology Unit and Center for Molecular Medicine, University of Foggia, Viale Luigi Pinto -, 71122, Foggia, Italy
| | - Mario Giordano
- Pediatric Nephrology and Dialysis Unit, Pediatric Hospital 'Giovanni XXIII', Bari, Italy
| |
Collapse
|
24
|
Pool D, Elliott C. Kindy Moves: a protocol for establishing the feasibility of an activity-based intervention on goal attainment and motor capacity delivered within an interdisciplinary framework for preschool aged children with cerebral palsy. BMJ Open 2021; 11:e046831. [PMID: 34389566 PMCID: PMC8365782 DOI: 10.1136/bmjopen-2020-046831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 08/03/2021] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Preschool aged children with cerebral palsy (CP) and like conditions are at risk of performing below their peers in key skill areas of school readiness. Kindy Moves was developed to support school readiness in preschool aged children with CP and like conditions that are dependent on physical assistance and equipment throughout the day. The primary aims are to determine the feasibility of motor-based interventions that are functional and goal directed, adequately dosed and embedded into a play environment with interdisciplinary support to optimise goal-driven outcomes. METHODS AND ANALYSIS Forty children with CP and like conditions aged between 2 and 5 years with a Gross Motor Function Classification System (GMFCS) level of III-V or equivalent, that is, dependent on physical assistance and equipment will be recruited in Western Australia. Participants will undertake a 4-week programme, comprised three, 2-hour sessions a week consisting of floor time, gross motor movement and play (30 min), locomotor treadmill training (30 min), overground walking in gait trainers (30 min) and table-top activities (30 min). The programme is group based with 3-4 children of similar GMFCS levels in each group. However, each child will be supported by their own therapist providing an interdisciplinary and goal directed approach. Primary outcomes of this feasibility study will be goal attainment (Goal Attainment Scale) and secondary outcomes will include Canadian Occupational Performance Measure, 10 metre walk test, Children's Functional Independence Measure, Sleep Disturbance Scale, Infant and Toddler Quality of Life Questionnaire, Peabody Developmental Motor Scale and Gross Motor Function Measure. Outcomes will be assessed at baseline, post intervention (4 weeks) and retention at the 4-week follow-up. ETHICS AND DISSEMINATION Ethical approval was obtained from Curtin University Human Ethics Committee (HRE2019-0073). Results will be disseminated through published manuscripts in peer-reviewed journals, conference presentations and public seminars for stakeholder groups. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12619000064101p).
Collapse
Affiliation(s)
- Dayna Pool
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
- The Healthy Strides Foundation, Perth, Western Australia, Australia
| | - Catherine Elliott
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Telethon Institute for Child Health Research, Nedlands, Western Australia, Australia
| |
Collapse
|
25
|
Caliendo ET, Kim N, Edasery D, Askin G, Nowak S, Gerber LM, Baum KT, Blackwell LS, Koterba CH, Hoskinson KR, Kurowski BG, McLaughlin M, Tlustos SJ, Watson WD, Niogi SN, Suskauer SJ, Shah SA. Acute Imaging Findings Predict Recovery of Cognitive and Motor Function after Inpatient Rehabilitation for Pediatric Traumatic Brain Injury: A Pediatric Brain Injury Consortium Study. J Neurotrauma 2021; 38:1961-1968. [PMID: 33504256 PMCID: PMC8418527 DOI: 10.1089/neu.2020.7437] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Traumatic brain injury (TBI) is a major cause of morbidity and mortality in children; survivors experience long-term cognitive and motor deficits. To date, studies predicting outcome following pediatric TBI have primarily focused on acute behavioral responses and proxy measures of injury severity; unsurprisingly, these measures explain very little of the variance following heterogenous injury. In adults, certain acute imaging biomarkers help predict cognitive and motor recovery following moderate to severe TBI. This multi-center, retrospective study, characterizes the day-of-injury computed tomographic (CT) reports of pediatric, adolescent, and young adult patients (2 months to 21 years old) who received inpatient rehabilitation services for TBI (n = 247). The study also determines the prognostic utility of CT findings for cognitive and motor outcomes assessed by the Pediatric Functional Independence Measure, converted to age-appropriate developmental functional quotient (DFQ), at discharge from rehabilitation. Subdural hematomas (66%), contusions (63%), and subarachnoid hemorrhages (59%) were the most common lesions; the majority of subjects had less severe Rotterdam CT scores (88%, ≤ 3). After controlling for age, gender, mechanism of injury, length of acute hospital stay, and admission DFQ in multivariate regression analyses, the highest Rotterdam score (β = -25.2, p < 0.01) and complete cisternal effacement (β = -19.4, p < 0.05) were associated with lower motor DFQ, and intraventricular hemorrhage was associated with lower motor (β = -3.7, p < 0.05) and cognitive DFQ (β = -4.9, p < 0.05). These results suggest that direct detection of intracranial injury provides valuable information to aid in prediction of recovery after pediatric TBI, and needs to be accounted for in future studies of prognosis and intervention.
Collapse
Affiliation(s)
| | - Nayoung Kim
- Department of Rehabilitation Medicine, Weill Cornell Medicine, New York, New York, USA
- Blythedale Children's Hospital, Valhalla, New York, USA
| | - David Edasery
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Gulce Askin
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Sophie Nowak
- Blythedale Children's Hospital, Valhalla, New York, USA
| | - Linda M. Gerber
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Katherine T. Baum
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Laura S. Blackwell
- Department of Neuropsychology, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Christine H. Koterba
- Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Kristen R. Hoskinson
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Brad G. Kurowski
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Departments of Pediatrics and Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Matthew McLaughlin
- Division of Pediatric Rehabilitation Medicine, Children's Mercy, Kansas City, Missouri, USA
- University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Sarah J. Tlustos
- Department of Rehabilitation, Children's Hospital Colorado and Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - William D. Watson
- Blythedale Children's Hospital, Valhalla, New York, USA
- Department of Rehabilitation and Regenerative Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Sumit N. Niogi
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Stacy J. Suskauer
- Kennedy Krieger Institute, Baltimore, Maryland, USA
- Departments of Physical Medicine & Rehabilitation and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sudhin A. Shah
- Department of Rehabilitation Medicine, Weill Cornell Medicine, New York, New York, USA
- Blythedale Children's Hospital, Valhalla, New York, USA
| |
Collapse
|
26
|
Watson WD, Suskauer SJ, Askin G, Nowak S, Baum KT, Gerber LM, Blackwell LS, Koterba CH, Hoskinson KR, Kurowski BG, Mclaughlin MJ, Tlustos SJ, Zimmerman KO, Shah SA. Cognitive Recovery During Inpatient Rehabilitation Following Pediatric Traumatic Brain Injury: A Pediatric Brain Injury Consortium Study. J Head Trauma Rehabil 2021; 36:253-263. [PMID: 33656473 DOI: 10.1097/htr.0000000000000650] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To characterize the demographics, clinical course, and predictors of cognitive recovery among children and young adults receiving inpatient rehabilitation following pediatric traumatic brain injury (TBI). DESIGN Retrospective observational, multicenter study. SETTING Eight acute pediatric inpatient rehabilitation facilities in the United States with specialized programs for treating patients with TBI. PARTICIPANTS Children and young adults (0-21 years) with TBI (n = 234) receiving inpatient rehabilitation. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Admission and discharge status assessed by the WeeFIM Cognitive Developmental Functional Quotient (DFQ) and Cognitive and Linguistic Scale (CALS). RESULTS Patients admitted to pediatric inpatient rehabilitation are diverse in cognitive functioning. While the majority of patients make improvements, cognitive recovery is constrained for those admitted with the most severe cognitive impairments. Age, time since injury to rehabilitation admission, and admission WeeFIM Cognitive DFQ are significant predictors of cognitive functioning at discharge from inpatient rehabilitation. CONCLUSIONS This work establishes a multicenter Pediatric Brain Injury Consortium and characterized the demographics and clinical course of cognitive recovery during inpatient rehabilitation of pediatric patients with TBI to aid in prospective study design.
Collapse
Affiliation(s)
- William D Watson
- Department of Rehabilitation and Regenerative Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York (Dr Watson); Blythedale Children's Hospital, Valhalla, New York (Drs Watson and Shah and Ms Nowak); Kennedy Krieger Institute, and Departments of Physical Medicine and Rehabilitation and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland (Dr Suskauer); Departments of Population Health Sciences (Ms Askin and Dr Gerber) and Rehabilitation Medicine (Dr Shah), Weill Cornell Medicine, New York, New York; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (Dr Baum); Department of Neuropsychology, Children's Hospital of Atlanta, Atlanta, Georgia (Dr Blackwell); Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio (Drs Koterba and Hoskinson); Department of Pediatrics, The Ohio State University College of Medicine, Columbus (Dr Hoskinson); Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, and Departments of Pediatrics and Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Ohio (Dr Kurowski); Division of Pediatric Rehabilitation Medicine, Children's Mercy-Kansas City, Kansas City, Missouri, and Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri (Dr Mclaughlin); Department of Rehabilitation, Children's Hospital Colorado, and Department of Physical Medicine and Rehabilitation, University of Colorado Anshutz Medical Campus, Aurora (Dr Tlustos); and Division of Critical Care Medicine, Department of Pediatrics, Duke University Medical Center, Duke Clinical Research Institute, Durham, North Carolina (Dr Zimmerman)
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Kurt M, Şimşek TT. Motivation and motivation-related factors in children with disabilities. J Pediatr Rehabil Med 2021; 14:127-132. [PMID: 33720861 DOI: 10.3233/prm-200711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Assessing motivation and motivation-related factors will contribute to a better understanding of motivation and the development of optimal rehabilitation conditions. The purpose of this study was to determine the motivation level and investigate the relationship of motivation level with socio-demographic characteristics (i.e., age, gender, comorbidities), functional level, and family satisfaction with rehabilitation centers in children with disabilities. METHODS Sixty-two children with disabilities were included in the study, and the socio-demographic characteristics were recorded. Children were assessed by the Pediatric Motivation Scale (PMOT) and the Pediatric Functional Independence Measure (WeeFIM). Also, parents were asked to complete a questionnaire titled, "A patient satisfaction instrument for outpatient physical therapy clinics." RESULTS The mean age of the children was 12.16 ± 3.19 years. Total PMOT and WeeFIM scores were found to be 93.71 ± 9.66 and 108.23 ± 22.14, respectively. There was a positive correlation between children's PMOT score and the satisfaction score of their families that was statistically significant (r= 0.602, p< 0.05). CONCLUSION The level of family satisfaction with rehabilitation centers was found to be positively correlated with the motivation level of children. Improving family satisfaction with rehabilitation centers, potentially through modifying the physical conditions of rehabilitation centers and focusing on the interest of the family, may increase the motivation level of children, and thus may improve rehabilitation outcomes.
Collapse
Affiliation(s)
- Merve Kurt
- Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Tülay Tarsuslu Şimşek
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| |
Collapse
|
28
|
Sahu PK, Singh G, Gupta DK, Mahapatra AK, Kale SS. Pre- and Postoperative Rehabilitation of Craniopagus Conjoined Twins: A Case Report. Phys Occup Ther Pediatr 2021; 41:637-654. [PMID: 33745416 DOI: 10.1080/01942638.2021.1899100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIMS Describe the pre-operative and post-operative stages of physical therapy examination, rehabilitation interventions and outcomes in craniopagus conjoined twins (CCT). METHODS 27-months old total vertical types III CCT were admitted for surgical treatment. A structured rehabilitation program (functional mobility, balance training, sensory stimulation, communication, orthotic management, and caregiver education) was delivered post-operatively at different stages of surgery. The total duration of post-separation rehabilitation was 15 months for Twin A and 23 months for Twin B. RESULTS Pre-operative WeeFIM was 67/126 for both the twins. Post-separation, Twin A improved to a state of complete independence in walking, step climbing, and hand function with a discharge WeeFIM score of 84/126. However, Twin B was completely dependent in bed mobility and transfer activities during discharge (WeeFIM-18/126). Minimal change in functional status was noted in Twin B (discharge FSS score-19/30). Both the twins were transferred to a regional hospital for long-term care. At 67 months of age, Twin B lost his life due to chest infection. CONCLUSIONS Vestibular based therapies, balance, and postural control may be prioritized in the rehabilitation process of CCT. Greater communication and coordination among physical, occupational therapists and other rehabilitation professionals are recommended for successful outcome in these unique cases.
Collapse
Affiliation(s)
- Pradeep Kumar Sahu
- Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Garima Singh
- Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Deepak Kumar Gupta
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | | | - Shashank Sharad Kale
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
29
|
Steinhart S, Raz-Silbiger S, Beeri M, Gilboa Y. Occupation Based Telerehabilitation Intervention for Adolescents with Myelomeningocele: A Pilot Study. Phys Occup Ther Pediatr 2021; 41:176-191. [PMID: 32856511 DOI: 10.1080/01942638.2020.1807448] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
AIMS This pilot study examined the impact of an occupation based intervention using a telerehabilitation format with adolescents with myelomeningocele (MMC). METHODS We conducted a nonrandomized pilot study including four adolescents ages 14-18 with MMC. The intervention program included 10-12 sessions of the Cognitive Orientation to daily Occupational Performance remotely delivered via videoconferencing. Outcome measures included the Canadian Occupational Performance Measure (COPM), Wee-Functional Independence Measure;(Wee-FIM), and the Pediatric Quality of Life Inventory (PedsQL). Assessments were administered at baseline, post intervention and at three-month follow-up. RESULTS Following intervention, participants rated their performance as having improved 2 points on the COPM for 8 out of 12 trained goals and on 2 out of 8 untrained goals. At 3-month follow-up improvement was reported on 9 out of 12 trained goals and 3 out of 8 untrained goals All participants made clinically significant improvements on the Wee-FIM total score following intervention and improvements were maintained at 3-month follow-up. The intervention effect on the PedsQL was inconclusive. Feedback interviews suggested that participants experience high satisfaction from the results and implementation of the intervention. CONCLUSIONS Our results demonstrate potential efficacy of occupation based teleintervention for adolescents with MMC.
Collapse
Affiliation(s)
- Shoshana Steinhart
- ALYN Hospital - Pediatric and Adolescent Rehabilitation Center, Jerusalem, Israel
| | - Shani Raz-Silbiger
- ALYN Hospital - Pediatric and Adolescent Rehabilitation Center, Jerusalem, Israel
| | - Maurit Beeri
- ALYN Hospital - Pediatric and Adolescent Rehabilitation Center, Jerusalem, Israel
| | - Yafit Gilboa
- School of Occupational Therapy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| |
Collapse
|
30
|
Blackwell LS, Shishido Y, Howarth R. Cognitive recovery of children and adolescents with moderate to severe TBI during inpatient rehabilitation. Disabil Rehabil 2020; 44:1035-1041. [PMID: 32649219 DOI: 10.1080/09638288.2020.1788176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Traumatic brain injury (TBI) is the leading cause of morbidity and mortality in children and adolescents. This study examines the early cognitive-linguistic recovery of pediatric patients who sustained TBI and required inpatient rehabilitation and investigates the contribution of various demographic, clinical, and preinjury factors to recovery. METHODS A retrospective chart review of children and adolescents, ages 3-20 years, admitted to an inpatient rehabilitation unit. Acute outcomes were assessed at admission and discharge using the WeeFIM and CALS. Premorbid measures of behavioral and emotional functioning were also collected. RESULTS One hundred and one children and adolescents (mean age = 12.31, SD = 4.46) diagnosed with TBI requiring inpatient rehabilitation were included. Patients displayed significant improvements on cognitive-linguistic skills and functional independence between admission and discharge, with medium to large effect sizes. Premorbid behavioral-emotional functioning was not found to be associated with early cognitive recovery. CONCLUSION Results suggest that significant functional improvements can be expected for pediatric patients with TBI during inpatient rehabilitation. Consistent with previous literature, injury severity was significantly related to acute outcomes. In conjunction with the WeeFIM, the CALS appears to be a meaningful complement for assessing and monitoring cognitive-linguistic skills during inpatient rehabilitation.Implications for RehabiliationOur study provides support for the utility of the CALS to assess cognitive recovery during inpatient rehabilitation following moderate to severe TBI.Injury severity and not pre-injury functioning or demographic variables was related to worse scores on the CALS at discharge.Using a measure sensitive to change over admission, such as the CALS, can inform treatment planning.
Collapse
Affiliation(s)
- Laura S Blackwell
- Department of Neuropsychology, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Yuri Shishido
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MA, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MA, USA
| | - Robyn Howarth
- Department of Neuropsychology, Children's Healthcare of Atlanta, Atlanta, GA, USA
| |
Collapse
|
31
|
Madi SM, Alraddadi NI. Association Between Pediatric Inpatient Rehabilitation Services and Children's Functional Outcomes: King Fahad Medical City Experience. Rehabil Process Outcome 2020; 9:1179572720928394. [PMID: 34497465 PMCID: PMC8282134 DOI: 10.1177/1179572720928394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 04/28/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Disability may affect children’s performance of functional activities. This may translate to difficulties in returning to home and/or school. It has been documented that intensive rehabilitation programs for children with disabilities lead to an improvement in their functional abilities. Wee-FIM is a valid and reliable outcome measure that is used commonly with children undergoing rehabilitation. Objectives: To study changes in the functional status of children admitted to a specialized pediatric inpatient rehabilitation unit. Design: A retrospective cohort study. Setting: King Fahad Medical City—Rehabilitation Hospital, Riyadh, Saudi Arabia. Methods: Investigators reviewed records of children admitted to a pediatric rehabilitation unit between January 1, 2012, and December 31, 2017. The outcome measures used were rehabilitation length of stay (LOS), Wee-FIM gain, and Wee-FIM efficiency. Results: The total number of records included in this study was 361 records. Sixty percent of the children were boys. The mean age was 8.7 ± 3.8 years (range, 3-17 years). Children with cerebral palsy accounted for 45.2% of the children. The mean LOS was 43 days. Children with brain tumors had the shortest LOS compared with children with other diagnoses. Mean (SD) Wee-FIM efficiency was 0.58 (±0.6). Highest Wee-FIM efficiency was observed in children with brain tumors. Average Wee-FIM gain was 20 (±15). The highest functional gain was 27 in children with brain tumors while the lowest was 16 in children with cerebral palsy. Conclusions: Intensive inpatient rehabilitation program is associated with improvement in functional performance in children with a variety of impairments and disabilities.
Collapse
|
32
|
Meier SBB, Uenver Y, Stooss A, Meyer-Heim A. Frequency, Characteristics and Risk Factors of Aggressive Incidents in a Paediatric Rehabilitation Setting: A Prospective Survey. Dev Neurorehabil 2020; 23:9-17. [PMID: 31055992 DOI: 10.1080/17518423.2019.1604579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aim: Aggressive incidents (AI) are a serious concern in health care and can have negative effects on the physical and emotional well-being staff. This study aimed to determine frequency, characteristics and risk factors for aggressive behavior.Methods: AI were recorded during six months by the staff in a pediatric rehabilitation clinic using the evaluation form for AI (EVA). Patients were divided into the study group (patients who were involved in AI) and controls.Results: 14/105 (13%) of patients were involved in 79 AI. 0.44 AI per day occurred. Most often AI occurred on Mondays and 98% included physical, 22% verbal aggression. Most frequent target (43%) were nurses, followed by therapists (31.6%).Significant risk factors for AI were: previous aggressive behavior (p = .038), lower cognitive and higher mobility sub-scores in the WeeFIM. Conclusion: Findings emphasize the magnitude of AI in pediatric rehabilitation and thus the importance of implement preventive strategies.Abbreviations: ADL: Activity of daily living; AI: Aggressive Incidents; CFCS: Communication Function Classification System; EVA: Recording aggressive incidents (Erfassung von Aggressionsereignissen); GMFCS: Gross Motor Function Classification System; MACS: Manual Ability Classification System; SOAS-R: Staff Observation of Aggression Scale-Revised; WeeFIM: Functional Independence Measure for Children; WPV: Workplace violence.
Collapse
Affiliation(s)
- S B B Meier
- Rehabilitation centre Affoltern am Albis, University Children's Hospital Zurich, Switzerland
| | - Y Uenver
- Rehabilitation centre Affoltern am Albis, University Children's Hospital Zurich, Switzerland
| | - A Stooss
- Rehabilitation centre Affoltern am Albis, University Children's Hospital Zurich, Switzerland
| | - A Meyer-Heim
- Rehabilitation centre Affoltern am Albis, University Children's Hospital Zurich, Switzerland
| |
Collapse
|
33
|
Zanon MA, Pacheco RL, Latorraca CDOC, Martimbianco ALC, Pachito DV, Riera R. Neurodevelopmental Treatment (Bobath) for Children With Cerebral Palsy: A Systematic Review. J Child Neurol 2019; 34:679-686. [PMID: 31179823 DOI: 10.1177/0883073819852237] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AIM To assess the effects of neurodevelopmental treatment for children with cerebral palsy. METHODS We conducted a systematic review following the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions and reported in accordance to PRISMA Statement. Through a comprehensive literature search we considered all randomized clinical trials that compared neurodevelopmental treatment with conventional physical therapy for children with cerebral palsy. We used the Cochrane Risk of Bias Table to assess the risk of bias of the included randomized clinical trial, and the GRADE approach to evaluate the certainty of the body of the evidence. RESULTS We found 3 randomized clinical trials (2 published and 1 ongoing) comprising 66 children. Published randomized clinical trials presented methodological and reporting limitations and only 1 provided data for outcomes of interest. No difference between neurodevelopmental treatment and conventional physical therapy was found for gross motor function (mean difference 1.40; 95% confidence interval -5.47 to 8.27, low certainty evidence). CONCLUSION This review found that the effects of neurodevelopmental treatment for children with cerebral palsy are still uncertain. Further studies are required to assess the efficacy and safety of neurodevelopmental treatment for this purpose and until there, current evidence do not support its routinely use in practice. Number of protocol registration in PROSPERO database: CRD42017082817 (available from https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=82817 ).
Collapse
Affiliation(s)
- Márcia Andréa Zanon
- 1 Maternal, Child and Adolescent Health Program, Universidade Estadual de Ciências da Saúde de Alagoas, Alagoas (AL), Brazil
| | - Rafael Leite Pacheco
- 2 Centro Universitário São Camilo, São Paulo, Brazil.,3 Evidence Based Health Program at Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Ana Luiza Cabrera Martimbianco
- 3 Evidence Based Health Program at Universidade Federal de São Paulo, São Paulo, Brazil.,5 Universidade Metropolitana de Santos (UNIMES), Santos, São Paulo, Brazil
| | | | - Rachel Riera
- 7 Evidence Based Health, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil.,8 Centre of Health Technology Assessment, Hospital Sirio-Libanês, Sao Paulo, Brazil
| |
Collapse
|
34
|
Hwang SY, Ong JW, Ng ZM, Foo CY, Chua SZ, Sri D, Lee JH, Chong SL. Long-term outcomes in children with moderate to severe traumatic brain injury: a single-centre retrospective study. Brain Inj 2019; 33:1420-1424. [PMID: 31314599 DOI: 10.1080/02699052.2019.1641625] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Traumatic brain injury (TBI) is a significant cause of mortality and disability in the pediatric population. Non-accidental trauma (NAT) has specifically been reported to result in more severe injury as compared to accidental mechanisms of injury. We aim to investigate the long-term neurological outcomes in children with moderate to severe traumatic brain injury. Our secondary aim is to evaluate the difference in outcomes between children presenting with NAT and non-NAT, in our study population. We performed a retrospective study in a tertiary pediatric hospital between January 2008 to October 2017 of all patients with TBI <16 years old with a Glasgow Coma Scale (GCS) ≤13. The dual primary outcomes were mortality and Paediatric Functional Independence Measure (WeeFIM) scores, recorded at the start of rehabilitation, discharge, 3 months and 6 months post-injury. The secondary outcome was the development of post-traumatic epilepsy. There were 68 patients with a median age of 4.5 [interquartile range (IQR) 1.0-9.0] years old. The most common presenting symptom was vomiting for children <2 years (11/20, 55.0%) while confusion and disorientation were common for those ≥2 years (27/48, 56.3%). WeeFIM scores at the start of rehabilitation [median 122.0, IQR 33.8-126.0] improved at 6 months post-injury (median 126.0, IQR 98.5-126.0). There was a greater incidence of post-traumatic epilepsy in age <2 years (6/20, 30.0%) compared to age ≥2 years (1/48, 2.1%) (p = .002). When comparing NAT versus non-NAT survivors, cognition WeeFIM scores were significantly different at the start of rehabilitation (p = .017) and at 3 months post-injury (p = .025). NAT predicts for poorer long-term outcomes, specifically in cognition, as measured by WeeFIM scores. Younger children <2 years had a higher incidence of post-traumatic epilepsy compared to older children.
Collapse
Affiliation(s)
- Shih Yao Hwang
- a Yong Loo Lin School of Medicine, National University of Singapore , Singapore , Singapore
| | - Jia Wei Ong
- a Yong Loo Lin School of Medicine, National University of Singapore , Singapore , Singapore
| | - Zhi Min Ng
- b Department of Paediatric Medicine, KK Women's and Children's Hospital , Singapore , Singapore
| | - Ce Yu Foo
- c Department of Rehabilitation, KK Women's and Children's Hospital , Singapore , Singapore
| | - Shu Zhen Chua
- c Department of Rehabilitation, KK Women's and Children's Hospital , Singapore , Singapore
| | - Dianna Sri
- d KK Research Centre, KK Women's and Children's Hospital , Singapore , Singapore
| | - Jan Hau Lee
- e Children's Intensive Care Unit, KK Women's and Children's Hospital , Singapore , Singapore
| | - Shu-Ling Chong
- f Department of Emergency Medicine, KK Women's and Children's Hospital , Singapore , Singapore
| |
Collapse
|
35
|
Cross-cultural selection and validation of instruments to assess patient-reported outcomes in children and adolescents with achondroplasia. Qual Life Res 2019; 28:2553-2563. [DOI: 10.1007/s11136-019-02210-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2019] [Indexed: 12/31/2022]
|
36
|
Alnahdi AH, Alhusaini AA, Alshami A, Yousef B, Melam G. Cross-cultural adaptation and measurement properties of the Arabic version of the ABILHAND-Kids scale. Disabil Rehabil 2019; 42:2224-2231. [PMID: 31067144 DOI: 10.1080/09638288.2018.1555622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To cross-culturally adapt the ABILHAND-Kids into Arabic and to examine its measurement properties in children with cerebral palsy.Materials and methods: The Cross-cultural adaption of the ABILHAND-Kids into Arabic language included forward translation, backward translation, expert committee followed by preliminary testing. Structural validity using Rasch analysis, internal consistency, test-retest reliability, measurement error, and construct validity of the Arabic ABILHAND-Kids were examined in children with cerebral palsy (N = 154; 54% male, mean age 7.4 years).Results: Rasch analysis did not support the structural validity of the Arabic ABILHAND-Kids mainly due to response dependency. Removal of two items addressed the issue of the response dependency and resulted in a unidimensional scale meeting the requirement of the Rasch model. The scale had excellent internal consistency (Person Separation Index = 0.93) and excellent test-retest reliability (intraclass correlation coefficient = 0.98). The results supported 86% of the predefined hypotheses regarding correlation of the Arabic ABILHAND-Kids with the manual ability classification system, gross motor function classification system and the functional independence measure for children.Conclusion: The Arabic ABILHAND-Kids demonstrated adequate evidence supporting its structural validity as a unidimensional measure along with evidence supporting its internal consistency, test-retest reliability and construct validity as a measure of manual ability in children with cerebral palsy.Implications for rehabilitationThe Arabic ABILHAND-Kids is a reliable and valid measure of manual ability in children with cerebral palsy.The Arabic ABILHAND-Kids can be used to quantify manual ability in children with cerebral palsy in clinical practice and for research purposes.
Collapse
Affiliation(s)
- Ali H Alnahdi
- Rehabilitation Sciences Department College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Adel A Alhusaini
- Rehabilitation Sciences Department College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | | | - Bara Yousef
- Sultan Bin Abdulaziz Humanitarian City, Riyadh, Saudi Arabia
| | - Ganeswararao Melam
- Rehabilitation Sciences Department College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
37
|
Zollars JA, Armstrong M, Whisler S, Williamson S. Visceral and Neural Manipulation in Children with Cerebral Palsy and Chronic Constipation: Five Case Reports. Explore (NY) 2019; 15:47-54. [DOI: 10.1016/j.explore.2018.09.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 08/21/2018] [Accepted: 09/03/2018] [Indexed: 12/18/2022]
|
38
|
Ammann-Reiffer C, Bastiaenen CHG, Klöti C, van Hedel HJA. Concurrent Validity of Two Gait Performance Measures in Children with Neuromotor Disorders. Phys Occup Ther Pediatr 2019; 39:181-192. [PMID: 29336642 DOI: 10.1080/01942638.2017.1420003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS To investigate the concurrent validity of two mobility performance measures, the Functional Mobility Scale (FMS) and the Gillette Functional Assessment Questionnaire - walking scale (FAQ) in an inpatient pediatric neurorehabilitation setting. METHODS Cross-sectional data were collected on 71 children (mean age 12.7 years) with neuromotor gait impairments who participated in an inpatient rehabilitation program to evaluate aspects of concurrent validity of the FMS and FAQ. Physiotherapists independently performed ratings. Comparator instruments included the walking item of the Functional Independence Measure for children, 10-m and 6-minute walking tests, and Gross Motor Function Measure-88 dimension E. All tests were completed within 7 days. Spearman correlation coefficients were calculated to test a priori formulated hypotheses regarding the strength and direction of the measures relationships. RESULTS The children had a broad spectrum of mobility levels, including all levels of FMS and levels 2-10 of FAQ. Spearman correlation coefficients with comparator measures varied between 0.58-0.79 for the FMS and 0.69-0.73 for the FAQ. Hypotheses concerning correlation strengths and directions were met for FMS and FAQ. CONCLUSIONS The findings demonstrate that the FMS and FAQ are valid to evaluate functional mobility in pediatric inpatient neurorehabilitation.
Collapse
Affiliation(s)
- Corinne Ammann-Reiffer
- a Pediatric Rehab Research Group, Rehabilitation Center for Children and Adolescents , University Children's Hospital Zurich , Affoltern am Albis , Zurich , Switzerland.,b CAPHRI Research Institute, Program Functioning and Rehabilitation, Department of Epidemiology , Maastricht University , Maastricht , Limburg , The Netherlands.,c Children's Research Center , University Children's Hospital Zurich , Zurich , Switzerland
| | - Caroline H G Bastiaenen
- b CAPHRI Research Institute, Program Functioning and Rehabilitation, Department of Epidemiology , Maastricht University , Maastricht , Limburg , The Netherlands
| | - Corina Klöti
- a Pediatric Rehab Research Group, Rehabilitation Center for Children and Adolescents , University Children's Hospital Zurich , Affoltern am Albis , Zurich , Switzerland
| | - Hubertus J A van Hedel
- a Pediatric Rehab Research Group, Rehabilitation Center for Children and Adolescents , University Children's Hospital Zurich , Affoltern am Albis , Zurich , Switzerland.,c Children's Research Center , University Children's Hospital Zurich , Zurich , Switzerland
| |
Collapse
|
39
|
The Effect of Admission Functional Independence on Early Recovery in Pediatric Traumatic and Nontraumatic Brain Injury. J Head Trauma Rehabil 2018; 33:E11-E18. [DOI: 10.1097/htr.0000000000000374] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
40
|
Çubukçu D, Güzel O, Arslan N. Effect of Ketogenic Diet on Motor Functions and Daily Living Activities of Children With Multidrug-Resistant Epilepsy: A Prospective Study. J Child Neurol 2018; 33:718-723. [PMID: 30062917 DOI: 10.1177/0883073818786558] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AIMS To investigate the effect of ketogenic diet on motor function and daily living activities in children with epilepsy. METHODS A total of 62 children (median age 5.0 years) were enrolled. Motor function was assessed using the Gross Motor Function Measure (GMFM), and daily living activities and cognitive functions were assessed using the Functional Independence Measure (WeeFIM) before treatment and 3, 6, and 12 months after ketogenic diet treatment. RESULTS Significant improvement in total GMFM and WeeFIM scores ( P < .001) were found during the 12 months of ketogenic diet treatment. There was a positive correlation between total GMFM scores and WeeFIM scores at baseline (r= 0.792, P = .0001), and at 3 (r= 0.780, P = .0001), 6 (r= 0.744, P = .0001), and 12 months (r= 0.692, P = .0001) of treatment. Both the responder (50 patients, 80.7%) and nonresponder (12 patients, 19.3%) patient groups showed significantly higher GMFM and WeeFIM scores at 12 months of treatment compared to baseline values. A ≥50% reduction in seizure frequency was observed in 77.4%, 72.6%, and 80.7% of the patients after 3, 6, and 12 months of treatment, respectively. CONCLUSION Ketogenic diet treatment improves motor functions and daily living activities in children with epilepsy during the 12 months of treatment.
Collapse
Affiliation(s)
- Duygu Çubukçu
- 1 Department of Physical Medicine and Rehabilitation, Behçet Uz Children Hospital, Izmir, Turkey
| | - Orkide Güzel
- 2 Division of Pediatric Neurology, Behçet Uz Children Hospital, Izmir, Turkey.,3 Mediterranean Ketogenic Diet Center, Izmir, Turkey
| | - Nur Arslan
- 4 Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Dokuz Eylul University, Izmir, Turkey.,5 Izmir Biomedicine and Genome Center (iBG-izmir), Dokuz Eylul University, Izmir, Turkey
| |
Collapse
|
41
|
Noh T, Vogt MS, Pruitt DW, Hummel TR, Mangano FT. Pediatric intramedullary spinal cord tumor outcomes using the WeeFIM scale. Childs Nerv Syst 2018; 34:1753-1758. [PMID: 29797065 DOI: 10.1007/s00381-018-3831-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 05/13/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE The Functional Independence Measure for children (WeeFIM) is a user-friendly functional outcomes tool that has been validated across other traditional functional scales. Historically, the significant neurologic and functional deficits of intramedullary spinal cord tumors (IMSCTs) have been monitored by coarse or overbearing functional outcomes tools that make it difficult to measure the slow improvement/decline seen in these patients. This study is the first to report WeeFIM outcomes on a series of IMSCTs with emphasis on an aggressive surgical strategy. METHODS A retrospective review from 2005 to 2014 was performed for nine patients who underwent resective surgery for intramedullary spinal cord tumors with intraoperative ultrasound and neurophysiologic monitoring. WeeFIM scales were assessed at admission and discharge to evaluate changes in severity of disability and need for assistance. RESULTS At the time of this submission, 7/9 patients are alive. The mean WeeFIM improvement was 27 points (8-50 points) with a mean WeeFIM efficiency of 2.0 points/day. CONCLUSIONS The WeeFIM scale is an appropriate and useful scale for measuring postoperative improvements in patients with IMSCTs undergoing aggressive resective surgery. Attention to intraoperative spinal cord monitoring and prevention of spinal column instability may prevent morbidity related to surgery, and functional outcomes do not appear to be compromised by an aggressive surgical approach.
Collapse
Affiliation(s)
- Thomas Noh
- Department of Neurological Surgery, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI, 48202, USA
| | - Manuel S Vogt
- Department of Neurosurgery, Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | - David W Pruitt
- Department of Rehabilitation, Division of Pediatric Rehabilitation, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | - Trent R Hummel
- Cancer and Blood Diseases Institute, Division of Oncology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | - Francesco T Mangano
- Department of Neurosurgery, Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA. .,Department of Neurological Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, MLC 2016, 3333 Burnet Avenue, Cincinnati, OH, 44529, USA.
| |
Collapse
|
42
|
Kilbride HW, Aylward GP, Carter B. What Are We Measuring as Outcome? Looking Beyond Neurodevelopmental Impairment. Clin Perinatol 2018; 45:467-484. [PMID: 30144850 DOI: 10.1016/j.clp.2018.05.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Outcomes of neonatal intensive care unit (NICU) graduates have been categorized by rates of neurodevelopmental impairment at 2 years old. Although useful as metrics for research, these early childhood assessments may underestimate or overestimate later functional capabilities. Often overlooked are less severe but more prevalent neurobehavioral dysfunctions seen later in childhood, and chronic health concerns that may impact the child's quality of life (QoL). Comprehensive NICU follow-up should include measures of less severe cognitive/learning delays, physical/mental well-being, and the promotion of resilience in children and families. Studies are needed to identify QoL measures that will optimize children's assessments and outcomes.
Collapse
Affiliation(s)
- Howard W Kilbride
- Division of Neonatology, Department of Pediatrics, Children's Mercy-Kansas City, University of Missouri-Kansas City School of Medicine, 2401 Gillham Road, Kansas City, MO 64108, USA.
| | - Glen P Aylward
- Division of Developmental and Behavioral Pediatrics, Southern Illinois University School of Medicine, PO Box 19658, Springfield, IL 62794-9658, USA
| | - Brian Carter
- Division of Neonatology, Department of Pediatrics, Children's Mercy-Kansas City, University of Missouri-Kansas City School of Medicine, 2401 Gillham Road, Kansas City, MO 64108, USA
| |
Collapse
|
43
|
Physiotherapy and Rehabilitation in a Child with Joubert Syndrome. Case Rep Pediatr 2017; 2017:8076494. [PMID: 29138705 PMCID: PMC5613706 DOI: 10.1155/2017/8076494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 07/09/2017] [Accepted: 07/20/2017] [Indexed: 11/17/2022] Open
Abstract
Objective Joubert syndrome (JS) is a rare autosomal recessive genetic disorder characterized by brain malformation, hypotonia, breathing abnormalities, ataxia, oculomotor apraxia, and developmental delay. The purpose of this study was to report the efficiency of the physiotherapy and rehabilitation program in a child with JS. Materials and Methods Our case is a 19-month-old female child with mild clinical signs of JS. The pretreatment and posttreatment motor functioning level of the case was evaluated through the Gross Motor Function Measure (GMFM), whereas the independence level was evaluated through the Pediatric Functional Independence Measure (WeeFIM). The case was included in the rehabilitation program by the physiotherapist for one hour for five days a week throughout the period of 13 months in accordance with the neurodevelopmental treatment principles. Results The case was able to turn around from the supine position to the reverse direction by oneself, and she was able to rise on her forearms facedown and was able to sit, crawl, and walk independently. The GMFM score was 210, whereas WeeFIM score was 65. Discussion In the direction of those findings, in Joubert Syndrome, physiotherapy and rehabilitation can be effective in coping with the symptoms causing developmental delay.
Collapse
|
44
|
Spangenberg K, Corten L, van Rensburg W, Kilian E, McKenzie J, Vorster H, Jelsma J. The validation of an educational database for children with profound intellectual disabilities. Afr J Disabil 2017; 5:237. [PMID: 28730055 PMCID: PMC5433460 DOI: 10.4102/ajod.v5i1.237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 07/13/2016] [Indexed: 11/08/2022] Open
Abstract
Background The Western Cape Forum for Intellectual Disability took the South African Government to court in 2010 on its failure to implement the right to education for Children with Severe and Profound Intellectual Disability. Subsequently, multidisciplinary teams were appointed by the Western Cape Education Department to deliver services to the Special Care Centres (SCCs). Initially, minimal information was available on this population. Objectives The purpose is to document the process of developing and validating a database for the collection of routine data. Method A descriptive analytical study design was used. A sample of convenience was drawn from individuals under the age of 18 years, enrolled in SCCs in the Western Cape. The team who entered and analysed the data reached consensus regarding the utility and feasibility of each item. Results Data were collected on 134 children. The omission of certain items from the database was identified. Some information was not reliable or readily available. Of the instruments identified to assess function, the classification systems were found to be reliable and useful, as were the performance scales. The WeeFIM, on the other hand, was lengthy and expensive, and was therefore discarded. Discussion and conclusions A list of items to be included was identified. Apart from an individual profile, it can be useful for service planning and monitoring, if incorporated into the central information system used to monitor the performance of all children. Without such inclusion, this most vulnerable population, despite court ruling, will not have their right to education adequately addressed.
Collapse
Affiliation(s)
- Karlien Spangenberg
- Children with Severe and Profound Intellectual Disabilities Inclusive Education Outreach Team, Western Cape Department of Education, South Africa
| | - Lieselotte Corten
- Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
| | - Winnie van Rensburg
- Children with Severe and Profound Intellectual Disabilities Inclusive Education Outreach Team, Western Cape Department of Education, South Africa
| | - Elizma Kilian
- Children with Severe and Profound Intellectual Disabilities Inclusive Education Outreach Team, Western Cape Department of Education, South Africa
| | - Judith McKenzie
- Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
| | - Hein Vorster
- Children with Severe and Profound Intellectual Disabilities Inclusive Education Outreach Team, Western Cape Department of Education, South Africa
| | - Jennifer Jelsma
- Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
| |
Collapse
|
45
|
Calder S, Ward R, Jones M, Johnston J, Claessen M. The uses of outcome measures within multidisciplinary early childhood intervention services: a systematic review. Disabil Rehabil 2017; 40:2599-2622. [PMID: 28715915 DOI: 10.1080/09638288.2017.1353144] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Purpose of the article: To review the use of outcome measures, across the domains of activity, participation, and environment, within multidisciplinary early childhood intervention services. MATERIALS AND METHODS A systematic literature search was undertaken that included four electronic databases: Medline, CINAHL, EMBASE, and the Cochrane Library and Cochrane Database of Systematic Review. Inclusion criteria were age 0-24 months, having or at risk of a developmental disability, in receipt of multidisciplinary early childhood intervention services, and included outcome measures across all domains of the International Classification of Functioning-Child & Youth (ICF-CY). Only peer-reviewed journal articles were considered. Eligible studies were coded using the Oxford Levels of Evidence. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) Scale for randomised controlled trials and the QualSyst for non-randomised control trials. RESULTS Of the total of 5764 records identified, 10 were considered to meet inclusion criteria. CONCLUSION Fourteen outcome measures were identified, addressing the domains of activity, participation, and environment. Of these, eight have been recommended in the early intervention literature. While the methodological quality of the 10 studies varied, these papers make a contribution to the body of research that acknowledges the role of routine and enriched environments. Implications for Rehabilitation Core practice elements of multidisciplinary early childhood intervention services indicate it is necessary to select outcome measures framed within the International Classification of Functioning-Child & Youth to inform clinical decision-making for measuring intervention effectiveness across the domains of activity, participation and environment. Of the identified measures, three (Canadian Occupational Performance Measure, Pediatric Evaluation of Disability Inventory, and Goal Attainment Scaling) are well-established and identified in the literature as multidisciplinary outcome measures for children with developmental disability. The selection of an appropriate outcome measure depends on the age of the child, individual goals of the family, and the type of intervention. This requires the combination of measures as no one measure alone will capture all components of the International Classification of Functioning-Child & Youth.
Collapse
Affiliation(s)
| | - Roslyn Ward
- b Department of Paediatric Rehabilitation , Princess Margaret Hospital for Children , Perth , WA , Australia.,c School of Paediatrics and Child Health , The University of Western Australia , Perth , WA , Australia
| | - Megan Jones
- d School of Psychology and Speech Pathology , Curtin University , Perth , WA , Australia
| | - Jenelle Johnston
- b Department of Paediatric Rehabilitation , Princess Margaret Hospital for Children , Perth , WA , Australia
| | - Mary Claessen
- d School of Psychology and Speech Pathology , Curtin University , Perth , WA , Australia
| |
Collapse
|
46
|
Öksüz Ç, Alemdaroglu I, Kilinç M, Abaoğlu H, Demirci C, Karahan S, Yilmaz O, Yildirim SA. Reliability and validity of the Turkish version of ABILHAND-Kids’ questionnaire in a group of patients with neuromuscular disorders. Physiother Theory Pract 2017; 33:780-787. [DOI: 10.1080/09593985.2017.1346026] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Çigdem Öksüz
- Occupational Therapy Department, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Ipek Alemdaroglu
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Muhammed Kilinç
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Hatice Abaoğlu
- Occupational Therapy Department, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Cevher Demirci
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Sevilay Karahan
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Oznur Yilmaz
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Sibel Aksu Yildirim
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| |
Collapse
|
47
|
Abstract
PURPOSE Describe the rehabilitation, including two episodes of inpatient rehabilitation, early intervention, and outpatient services, of conjoined twins. CASE DESCRIPTION The patients were 14-month-old female ischiopagus tripus twins that received 3 months of rehabilitation (mobility, feeding, communication, developmental skill training, developing adaptive equipment, educating caregivers) preseparation surgery. Surgery occurred at 24 months. At 27 months, the twins were admitted to inpatient rehabilitation, receiving 4 months of rehabilitation promoting strength, endurance, gait training, feeding, communication, developmental skill training, orthotics, adaptive equipment, and caregiver education. Presurgical WeeFIM was 18/126 (twin A) and 19/126 (twin B), and 28/126 (both twins A&B) postsurgical. Prior to surgery, patients performed supine to sit transfers with supervision. OUTCOMES Following surgery, each twin sat and performed bed mobility independently. Twin B performed wheelchair mobility and supported standing at anterior surface with assistance. Discharge WeeFIM was 42/126 (twin A) and 45/126 (twin B). Twins performed floor mobility by scooting, stood at an anterior surface with assistance (maximum for twin A, minimal for twin B), and propelled a manual wheelchair indoors (minimal assistance for both twins A & B). CONCLUSION Rehabilitation of conjoined twins improved presurgical functional status and addressed the unique functional needs of each twin postseparation.
Collapse
Affiliation(s)
- Maria Tozzi
- a The Children's Institute , Pittsburgh , Pennsylvania , USA
| | - R Scott Van Zant
- b Physical Therapy Program, The University of Findlay , Findlay , Ohio , USA
| |
Collapse
|
48
|
Wong SSN, Wong VCN. Functional Independence Measure for Children: A Comparison of Chinese and Japanese Children. Neurorehabil Neural Repair 2016; 21:91-6. [PMID: 17172559 DOI: 10.1177/1545968306290225] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Functional Independence Measure for Children (WeeFIM) is a simple-to-administer scale for assessing functional independence across 3 domains (self-care, mobility, cognition) in children. There are normative data from America and Japan. In 2001 to 2002, the authors created a normative Chinese WeeFIM profile and compared this with the American one. In this study, they aimed to compare their Chinese normative data with the Japanese one. Methods. A random sampling of 445 normal Chinese children from different social classes in Hong Kong was conducted in the community. It was conducted via face-to-face interviews with the mother, and a normative database was created. Results. Similar to the Japanese children, the WeeFIM total score and 3 main domain subscores (self-care, mobility, and cognition) increased progressively with age. In the self-care domain, Chinese children achieved modified independence or level 6 earlier in all items except toileting. For the mobility domain, the item chair transfer was achieved earlier in the Chinese children, whereas toilet transfer, stair, tub transfer, and locomotion were achieved later in Chinese children. As for cognition domain, the item problem solving was achieved earlier but comprehension, social interaction, and memory were achieved later in the Chinese children. The authors’ results showed the same pattern of increasing WeeFIM score with increasing chronological age, which is similar to the Japanese children. There are 3 patterns of WeeFIM score achievement in this Chinese cohort. As for the Japanese children, the 3 patterns of WeeFIM score achievement from independent to dependent are 1) rapid change, 2) gradual change, and 3) linear change. Conclusions. WeeFIM is a validated standardized tool for assessing the outcome of rehabilitation programs. It should be widely used to assess rehabilitative achievement in children from different ethnic origins. The authors’ previous study and this current study demonstrated that the authors’ normative WeeFIM profile showed similar results to the American and Japanese children. However, there are minor differences in the WeeFIM scoring in the 3 main domains, which might be due to cultural differences between ethnic groups. Thus, usage of the WeeFIM with a different age criteria in achieving independence according to local culture should be adopted.
Collapse
Affiliation(s)
- Sheila S N Wong
- Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Hong Kong
| | | |
Collapse
|
49
|
Mensch SM, Rameckers EAA, Echteld MA, Evenhuis HM. Instruments for the evaluation of motor abilities for children with severe multiple disabilities: A systematic review of the literature. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 47:185-198. [PMID: 26436614 DOI: 10.1016/j.ridd.2015.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 09/07/2015] [Accepted: 09/08/2015] [Indexed: 06/05/2023]
Abstract
Based on a systematic review, psychometric characteristics of currently available instruments on motor abilities of children with disabilities were evaluated, with the aim to identify candidates for use in children with severe multiple (intellectual and motor) disabilities. In addition, motor abilities are essential for independent functioning, but are severely compromised in these children. The methodological quality of all studies was evaluated with the Consensus Based Standards for the Selection of Health Status Measurement Instruments (COSMIN) Checklist; overall levels of evidence per instrument were based on the Cochrane Back Review Group strategy. As a result, 18 studies with a total of eight instruments, developed for children with cerebral palsy (CLA, GMFM-88 and LE85), spinal muscular atrophy (MHFMS), neuromuscular diseases (MFM), disabilities 0-6 years (VAB, WeeFIM), and one developed specifically for children with severe multiple disabilities (TDMMT) were found. Strong levels of evidence were found for construct validity of LE85 and MFM and for responsiveness of WeeFIM, but reliability studies of these instruments had a limited methodological quality. Up to now studies of the TDMMT resulted in limited and unknown evidence for structural validity due to the poor methodological quality of reliability studies. In a next step, the clinical suitability of the instruments for children with severe multiple disabilities will be evaluate.
Collapse
Affiliation(s)
- Sonja M Mensch
- Intellectual Disability Medicine, Department of General Practice, Erasmus Medical Centre, The Netherlands; Ipse de Bruggen Centre of Expertise in Intellectual Disabilities, The Netherlands; University for Professionals for Paediatric Physical Therapy, AVANSplus, Breda, The Netherlands.
| | - Eugène A A Rameckers
- Department of Rehabilitation Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, The Netherlands; Adelante Centre of Expertise in Rehabilitation and Audiology, The Netherlands; University for Professionals for Paediatric Physical Therapy, AVANSplus, Breda, The Netherlands
| | - Michael A Echteld
- Intellectual Disability Medicine, Department of General Practice, Erasmus Medical Centre, The Netherlands; Prisma Foundation, Waalwijk, The Netherlands
| | - Heleen M Evenhuis
- Intellectual Disability Medicine, Department of General Practice, Erasmus Medical Centre, The Netherlands
| |
Collapse
|
50
|
Zanon MA, Porfírio GJM, Riera R, Martimbianco ALC. Neurodevelopmental treatment approaches for children with cerebral palsy. Hippokratia 2015. [DOI: 10.1002/14651858.cd011937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Márcia A Zanon
- UNCISAL; Faculdade Estácio de Alagoas; Maternal, Child and Adolescent Health Program; Rua Dr. Jorge de Lima, 113 - Trapiche da Barra Maceió Alagoas Brazil 57010 300
| | - Gustavo JM Porfírio
- Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em Saúde; Cochrane Brazil; Rua Borges Lagoa, 564 cj 63 São Paulo SP Brazil 04038-000
| | - Rachel Riera
- Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em Saúde; Cochrane Brazil; Rua Borges Lagoa, 564 cj 63 São Paulo SP Brazil 04038-000
| | - Ana Luiza C Martimbianco
- Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em Saúde; Cochrane Brazil; Rua Borges Lagoa, 564 cj 63 São Paulo SP Brazil 04038-000
| |
Collapse
|