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Julien L, Moreau-Pernet G, Rochette E, Lemaire JJ, Pontier B, Bourrand S, Pereira B, Chassain C, Sontheimer A, Sarret C. Robot-assisted gait training improves walking and cerebral connectivity in children with unilateral cerebral palsy. Pediatr Res 2024:10.1038/s41390-024-03240-1. [PMID: 38769400 DOI: 10.1038/s41390-024-03240-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 02/13/2024] [Accepted: 04/03/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Robot-assisted gait training (RAGT) is promising to help walking rehabilitation in cerebral palsy, but training-induced neuroplastic effects have little been investigated. METHODS Forty unilateral cerebral palsy children aged 4-18 years were randomly allocated in a monocentric study to ten 20-minute RAGT sessions with the G-EO system, five days a week (n = 20) or to a control group (who continued conventional care with six 30-minute physiotherapy sessions, three days a week) (n = 20), two weeks running, from September 2020 to December 2021. Clinical and MRI outcomes were compared before and one month after therapy. The primary outcome was gait speed. Secondary outcomes were a 6-minute walking test distance, Gross Motor Function Measure-88 (GMFM-88) dimensions D and E, Patient Global Impression of Improvement, resting-state functional connectivity within the sensorimotor network, and structural connectivity in the corticospinal tracts. RESULTS Gait speed and the 6-minute walking test distance improved more after RAGT. Resting-state functional connectivity increased after RAGT but decreased in controls between superior and lateral healthy or lateral injured sensorimotor networks. GMFM-88 and structural connectivity in corticospinal tracts were unchanged. Impression of improvement in children was better after RAGT. CONCLUSION Short-term benefit of repetitive RAGT on walking abilities and functional cerebral connectivity was found in unilateral cerebral palsy children. IMPACT STATEMENT Short-term repetitive robot-assisted gait training improves gait speed and walking resistance and increases cerebral functional connectivity in unilateral cerebral palsy. GMFM dimensions D and E were unchanged after short-term repetitive robot-assisted gait training in unilateral cerebral palsy.
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Affiliation(s)
- Laura Julien
- Department of Pediatrics, CRECHE, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
- Clermont Auvergne University, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France
| | | | - Emmanuelle Rochette
- Department of Pediatrics, CRECHE, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Jean-Jacques Lemaire
- Clermont Auvergne University, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France
- Department of Neurosurgery, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Bénédicte Pontier
- Department of Pediatrics, CRECHE, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
- Clermont Auvergne University, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France
- Department of Neurosurgery, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Sacha Bourrand
- Clermont Auvergne University, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France
| | - Bruno Pereira
- Clinical Research Division, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Carine Chassain
- Clermont Auvergne University, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France
| | - Anna Sontheimer
- Clermont Auvergne University, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France
- Department of Neurosurgery, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Catherine Sarret
- Department of Pediatrics, CRECHE, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.
- Clermont Auvergne University, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France.
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Morales Mestre N, Reychler G, Moniotte S. Use of One-minute Sit-to-stand Test to Predict Functional Exercise Capacity in Patients With Congenital Heart Disease. Arch Bronconeumol 2024:S0300-2896(24)00169-8. [PMID: 38821777 DOI: 10.1016/j.arbres.2024.05.008] [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: 02/15/2024] [Revised: 04/08/2024] [Accepted: 05/10/2024] [Indexed: 06/02/2024]
Abstract
INTRODUCTION Field tests are commonly used as complements of cardiopulmonary exercise test (CPET) to evaluate the functional exercise capacity. The aims of this study were to validate the one-minute sit-to-stand test (STST) in congenital heart disease (CHD) children and to evaluate the possibility of predicting the peakVO2 using the STST in this paediatric population. METHODS Children (8- to 18-year-old) followed for a CHD and performing CPET were recruited prospectively. Concomitantly, they performed STST. The heart rate (HR), oxygen saturation (SpO2), muscular fatigue and dyspnoea were recorded before (t0), immediately after (t1) and 1min after the end of the STST (t2). RESULTS We observed a poor but significant correlation between the STST and the peakVO2 (r=0.306; p=0.013). A significant difference between girls and boys were observed for peakVO2 (p<0.001), HR t0 (p=0.030), HR t1 (p=0.002) and HR t2 (p<0.001). The proposed model of prediction, including the number of STST, weight, height and age explains 37% of the predicted peakVO2 variance. CONCLUSION The STST can provide relevant data on physical capacity in children with CHD. When CPET cannot be performed, we therefore propose an alternative equation using the STST as a surrogate of peakVO2 in CHD children.
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Affiliation(s)
- Natalia Morales Mestre
- Secteur de Kinésithérapie et Ergothérapie, St-Luc University Hospital, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium; Department of Critical Care Medicine, St-Luc University Hospital, Brussels, Belgium.
| | - Gregory Reychler
- Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium; Pneumology Department, St-Luc University Hospital, Brussels, Belgium
| | - Stephane Moniotte
- Pediatric and Congenital Department, St-Luc University Hospital, Brussels, Belgium
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Lagos M, Pousada T, Fernández A, Carneiro R, Martínez A, Groba B, Nieto-Riveiro L, Pereira J. Outcome measures applied to robotic assistive technology for people with cerebral palsy: a pilot study. Disabil Rehabil Assist Technol 2024:1-8. [PMID: 38618937 DOI: 10.1080/17483107.2024.2339425] [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: 01/02/2024] [Accepted: 04/01/2024] [Indexed: 04/16/2024]
Abstract
The application of robotic devices is being used as Assistive Technology (AT) for improving rehabilitation interventions. The purposes of this research were to (1) test a novel low-cost robotic AT to support interventions for people with Cerebral Palsy (CP); (2) determine its usability; and (3) analyze its impact. It was a pilot study with prospective, longitudinal and analytical cohorts was done. Intervention was developed in one association (NGO) of people with CP. Participants were 6 women and 3 men with CP, with a mean age of 51.67. Intervention with LOLA2 (a robotic platform, not wearable, equipped with artificial intelligence) was implemented for training some activities of daily life (ADL) of participants. Functional Independence Measure (FIM), Psychosocial Impact of Assistive Technology Scale (PIADS), and Assistive Technology Device Predisposition Assessment (ATPA) were used for outcome measures. Level of participants' independence was high (FIM = 98). Psychosocial impact of the robotic platform in terms of competence (M = 0.25), adaptability (M = 0.33), and self-esteem (M = 0.25), was positive, but low. The mean in ATDPA (M = 3) reflects a moderate match. No significant variations concerning the changes in functional independence were detected. The robotic platform is applicable and complementary AT for rehabilitation. This study leads to implementing some improvements in its design, proposed activities, human-robot interaction, and system for registering information.
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Affiliation(s)
- Manuel Lagos
- TALIONIS Research Group, University of A Coruña. CITIC, A Coruña, Spain
| | - Thais Pousada
- TALIONIS Research Group, University of A Coruña. CITIC, A Coruña, Spain
| | - Aroa Fernández
- Association of People with Cerebral Palsy of A Coruña (ASPACE Coruña), A Coruña, Spain
| | - Rubén Carneiro
- Association of People with Cerebral Palsy of A Coruña (ASPACE Coruña), A Coruña, Spain
| | - Alba Martínez
- Association of People with Cerebral Palsy of A Coruña (ASPACE Coruña), A Coruña, Spain
| | - Betania Groba
- TALIONIS Research Group, University of A Coruña. CITIC, A Coruña, Spain
| | | | - Javier Pereira
- TALIONIS Research Group, University of A Coruña. CITIC, A Coruña, Spain
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Di J, Tuttle PG, Adamowicz L, Lin W, Zhang H, Psaltos D, Selig J, Bai J, Karahanoglu FI, Sheriff P, Seelam V, Williams B, Ghafoor S, Demanuele C, Santamaria M, Cai X. Monitoring Activity and Gait in Children (MAGIC) using digital health technologies. Pediatr Res 2024:10.1038/s41390-024-03147-x. [PMID: 38514860 DOI: 10.1038/s41390-024-03147-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/22/2024] [Accepted: 03/02/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Digital health technologies (DHTs) can collect gait and physical activity in adults, but limited studies have validated these in children. This study compared gait and physical activity metrics collected using DHTs to those collected by reference comparators during in-clinic sessions, to collect a normative accelerometry dataset, and to evaluate participants' comfort and their compliance in wearing the DHTs at-home. METHODS The MAGIC (Monitoring Activity and Gait in Children) study was an analytical validation study which enrolled 40, generally healthy participants aged 3-17 years. Gait and physical activity were collected using DHTs in a clinical setting and continuously at-home. RESULTS Overall good to excellent agreement was observed between gait metrics extracted with a gait algorithm from a lumbar-worn DHT compared to ground truth reference systems. Majority of participants either "agreed" or "strongly agreed" that wrist and lumbar DHTs were comfortable to wear at home, respectively, with 86% (wrist-worn DHT) and 68% (lumbar-worn DHT) wear-time compliance. Significant differences across age groups were observed in multiple gait and activity metrics obtained at home. CONCLUSIONS Our findings suggest that gait and physical activity data can be collected from DHTs in pediatric populations with high reliability and wear compliance, in-clinic and in home environments. TRIAL REGISTRATION ClinicalTrials.gov: NCT04823650 IMPACT: Digital health technologies (DHTs) have been used to collect gait and physical activity in adult populations, but limited studies have validated these metrics in children. The MAGIC study comprehensively validates the performance and feasibility of DHT-measured gait and physical activity in the pediatric population. Our findings suggest that reliable gait and physical activity data can be collected from DHTs in pediatric populations, with both high accuracy and wear compliance both in-clinic and in home environments. The identified across-age-group differences in gait and activity measurements highlighted their potential clinical value.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Xuemei Cai
- Pfizer, Inc., Cambridge, MA, USA
- Tufts Medical Center, Boston, MA, USA
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Sulla-Torres J, Vidal-Espinoza R, Avendaño-Llanque C, Calla-Gamboa A, Zúñiga-Carnero M, Gomez-Campos R, Cossio-Bolaños M. Reference values for the 6-min walking test in children and adolescents living in a moderate altitude region of Peru. BMC Pediatr 2024; 24:141. [PMID: 38413925 PMCID: PMC10898062 DOI: 10.1186/s12887-023-04459-3] [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: 08/07/2023] [Accepted: 12/04/2023] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND The assessment of cardiorespiratory fitness is important because it allows the identification of subgroups with poor health status and the targeting of effective intervention strategies to improve health. OBJECTIVE To compare the cardiorespiratory capacity of children and adolescents living in a moderate altitude region of Peru with international studies and to develop reference values for the 6-min walk test (6MWT) according to age and sex. METHODOLOGY A descriptive cross-sectional study of schoolchildren from a region of moderate altitude in Peru was carried out. A total of 704 schoolchildren (400 males and 304 females) with an age range of 6 to 17 years were studied. Weight, standing height, waist circumference (WC), body mass index (BMI) and tri-ponderal mass index (TMI) were evaluated. The 6MWT was assessed in a straight line over a distance of 30 m. Percentiles were created through the LMS method [L (skewness: lambda), M (median: mu) and S (coefficient of variation: Mu)]. RESULTS There were discrepancies in cardiorespiratory fitness performance with international studies by age and sex. The schoolchildren in the study reached stability and the highest number of meters in the last two age ranges (14 to 15 years: 698.1 m and 16 to 17 years 686.3 m in males). While females (14 to 15 years: 698.1 m and 16 to 17 years: 686.3 m). The proposed percentile values show ascending values as age advances. The cut-off points adopted are: low cardiorespiratory fitness < p25, moderate p25 to p75 and high cardiorespiratory fitness p > 75. CONCLUSION We verified that the cardiorespiratory fitness evaluated by means of the 6MWT is ascending with the course of age. Even the performance with other countries is heterogeneous at early and middle ages, stabilizing during adolescence. The proposed reference values can be used to evaluate and monitor cardiorespiratory fitness during physical education classes.
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Affiliation(s)
- Jose Sulla-Torres
- Escuela de Ingeniería de Sistemas, Universidad Católica de Santa María, Arequipa, Perú
| | | | | | | | - Manuel Zúñiga-Carnero
- Escuela de Ingeniería de Sistemas, Universidad Católica de Santa María, Arequipa, Perú
| | - Rossana Gomez-Campos
- Ciencias de La Actividad Física y del Deporte, Facultad de Ciencias de La Salud, Universidad San Ignacio de Loyola, Lima, Perú
| | - Marco Cossio-Bolaños
- Ciencias de La Actividad Física y del Deporte, Facultad de Ciencias de La Salud, Universidad San Ignacio de Loyola, Lima, Perú.
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Beer SS, Wong Vega M. Malnutrition, sarcopenia, and frailty assessment in pediatric transplantation. Nutr Clin Pract 2024; 39:27-44. [PMID: 38088812 DOI: 10.1002/ncp.11105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 01/13/2024] Open
Abstract
Nutrition assessment can be challenging in children with end-stage organ disease and in those requiring an organ transplant. The effect of poor nutrition status can exert long-lasting effects on children with end-stage organ disease requiring transplantation. Malnutrition, sarcopenia, and frailty are conditions that require provision of optimal nutrition to prevent or support the treatment of these conditions. Unfortunately, the literature on the assessment of malnutrition, sarcopenia, and frailty in pediatric end-stage organ disease is scarce, thus leading to confusion on how to effectively identify them. Recently, the addition of a variety of validated nutrition and functional assessment techniques has assisted with appropriate assessment of these conditions. The objective of this narrative review is to provide an overview of the current literature for pediatric assessment of malnutrition, sarcopenia, and frailty in the setting of solid organ transplantation and provide practicing nutrition clinicians a solid foundation for learning how to effectively assess these conditions with the current literature available.
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Affiliation(s)
- Stacey Silver Beer
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Molly Wong Vega
- Renal Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Department of Health and Human Performance, University of Houston, Houston, Texas, USA
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Latorre Román PA, Salazar CM, Montilla JAP, Cabrera-Linares JC, Andrade-Lara KE, Fuentes AR, Silva JME. Reference Values in the 6-Minute Walk Test in Chilean Children Aged 3-10 Years and Relationship With Cardiometabolic Risk. Pediatr Exerc Sci 2024:1-8. [PMID: 38307014 DOI: 10.1123/pes.2023-0127] [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: 08/29/2023] [Revised: 11/17/2023] [Accepted: 11/29/2023] [Indexed: 02/04/2024]
Abstract
PURPOSE The aim of this study was to evaluate the performance of healthy Chilean children aged 3-10 years in the 6-minute walking test (6MWT) and cardiometabolic risk variables and to determine sex- and age-specific reference values. METHODS This study involved 1165 healthy children (age = 6.36 [1.70] y old). The 6MWT was used to evaluate exercise performance. Furthermore, anthropometric measures were collected, like weight, height, body mass index, waist circumference, and skin folds. Resting heart rate and blood pressure (BP) were also evaluated. RESULTS The prevalence of overweight and obesity was 35.0% and 25.4% in preschoolers and 29.0% and 36.2% in school-age children, respectively, showing significant differences (P < .05) between age groups. The distance walked (6-min walk distance) increased significantly year on year at ages from 3 to 10 years. According to the regression analysis, 6MWT performance was positively related to age, systolic BP, and height, whereas it was negatively related to ∑4 skinfold fat, resting heart rate, diastolic BP, and waist circumference. CONCLUSIONS This study provides a reference equation and an age- and sex-adjusted percentile curve to assess the predicted 6MWT performance in a cohort of prepubertal Chilean children. The 6-minute walk distance depends mainly on age; however, other variables, such as resting heart rate, BP, skinfold fat, and waist circumference, add significant information and should be taken into account.
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Affiliation(s)
- Pedro A Latorre Román
- Departamento Didáctica de la Expresión Musical, Plástica y Corporal, Universidad de Jaén, Spain
| | | | - Juan A Párraga Montilla
- Departamento Didáctica de la Expresión Musical, Plástica y Corporal, Universidad de Jaén, Spain
| | | | - Karina E Andrade-Lara
- Departamento Didáctica de la Expresión Musical, Plástica y Corporal, Universidad de Jaén, Spain
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Sonoda Y, Tobita R, Ikeda Y, Taga T. Effect of Early Physical Therapy on Children of School Age With Hematological Cancer: A Quasi-Randomized Controlled Pilot Study. Pediatr Phys Ther 2024; 36:80-86. [PMID: 37816168 DOI: 10.1097/pep.0000000000001061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
PURPOSE Although physical therapy (PT) positively impacts exercise capacity and health-related quality of life (HRQOL) in children with hematological cancers, the optimal time for intervention is unknown. We compared the effects of PT administered before and after initial cancer treatment on the exercise capacity and HRQOL of children with hematological cancer. METHODS The participants were allocated to early (before initiating treatment) and late PT (after initiating treatment) groups. We evaluated exercise capacity using the 6-min walking distance (6MWD) test and HRQOL using the Pediatric Quality of Life Inventory. RESULTS Thirteen school children (7-13 years) were included. The early PT cohort had significant improvements in Pediatric Quality of Life Inventory but not 6MWD scores from admission to the completion of initial treatment; however, both scores reduced significantly in the late PT cohort. CONCLUSIONS Early rather than late PT during hospitalization might prevent reduced exercise capacity and improve HRQOL in children with hematological cancers.
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Affiliation(s)
- Yuma Sonoda
- Advanced Research Center for Well-being (Dr Sonoda), Kobe University, Kobe University Graduate School of Health Sciences, Kobe, Hyogo, Japan; Rehabilitation Units (Mr Tobita), Shiga University of Medical Science Hospital, Otsu, Shiga, Japan; Department of Pediatrics (Drs Ikeda and Taga), Shiga University of Medical Science, Otsu, Shiga, Japan
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van der Zalm MM, Jongen VW, Swanepoel R, Zimri K, Allwood B, Palmer M, Dunbar R, Goussard P, Schaaf HS, Hesseling AC, Seddon JA. Impaired lung function in adolescents with pulmonary tuberculosis during treatment and following treatment completion. EClinicalMedicine 2024; 67:102406. [PMID: 38261903 PMCID: PMC10796966 DOI: 10.1016/j.eclinm.2023.102406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/08/2023] [Accepted: 12/14/2023] [Indexed: 01/25/2024] Open
Abstract
Background Little is known about post-tuberculosis lung disease in adolescents. We prospectively assessed lung function in adolescents with microbiologically confirmed pulmonary tuberculosis during treatment and after treatment completion. Methods In a prospective study, we enrolled adolescents diagnosed with microbiologically confirmed tuberculosis and healthy tuberculosis-exposed household controls, between October 2020 and July 2021 in Cape Town, South Africa. Spirometry, plethysmography, diffusion capacity lung function tests and 6-min walking test (6MWT) were completed according to international guidelines 2 months into treatment and following treatment completion. Abnormal lung function was defined as abnormal spirometry (z-score < -1.64 for forced expiratory volume in 1 s (FEV1) and/or forced vital capacity (FVC) and/or FEV1/FVC), plethysmography (total lung capacity (TLC) < 80% of predicted, residual volume over TLC of >45%) and/or diffusion capacity (DLCO z-score < -1.64). Findings One-hundred adolescents were enrolled; 50 (50%) with tuberculosis and 50 (50%) healthy tuberculosis-exposed controls. Of the 50 adolescents with tuberculosis, ten had multidrug-resistant tuberculosis. Mean age of the group was 14.9 years (SD 2.7), 6 (6.0%) were living with HIV and 9 (9.0%) were previously treated for tuberculosis. Lung function improved over time; during treatment abnormal lung function was found in 76% of adolescents with tuberculosis, compared to 65% after treatment completion. Spirometry indices were lower in adolescents with tuberculosis compared to controls, both at 2 months and after treatment completion. Plethysmography in adolescents with tuberculosis showed that air-trapping was more common during treatment than in controls (12% vs 0%, respectively, p = 0.017); which improved following treatment completion. Adolescents with tuberculosis both during and after treatment completion walked a shorter distance than controls. Interpretation Adolescents with tuberculosis have impaired lung function even after treatment completion. It is crucial to include adolescents in trials on the prevention and treatment of tuberculosis-associated respiratory morbidity. Funding EDCTP, National Institute of Health, Medical Research Council, BMBF.
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Affiliation(s)
- Marieke M. van der Zalm
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Vita W. Jongen
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
| | - Ruan Swanepoel
- Division of Pulmonology, Department of Internal Medicine, Tygerberg Academic Hospital, Cape Town, South Africa
| | - Klassina Zimri
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Brian Allwood
- Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, South Africa
| | - Megan Palmer
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rory Dunbar
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Pierre Goussard
- Paediatric Pulmonology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - H Simon Schaaf
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Anneke C. Hesseling
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - James A. Seddon
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Department of Infectious Disease, Imperial College London, London, United Kingdom
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Guo H, Zhou X, Li Y, Yang Y, Yu H, Li X, Yuan H, Chen Y, Feng Y, Huang J, Du Q. Application of the six-minute Walk Test in Assessment of the Cardiopulmonary Function of Children with Idiopathic Scoliosis. Spine (Phila Pa 1976) 2023; 49:00007632-990000000-00545. [PMID: 38158748 PMCID: PMC11132092 DOI: 10.1097/brs.0000000000004913] [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: 05/10/2022] [Accepted: 12/10/2023] [Indexed: 01/03/2024]
Abstract
STUDY DESIGN A retrospective observational study. OBSJECTIVE To assess whether the 6-minute walk test (6MWT) can predict cardiopulmonary function in children with idiopathic scoliosis (IS) as an alternative to the cardiopulmonary exercise test (CPET). SUMMARY OF BACKGROUND DATA Cardiopulmonary functional impairment in the setting of IS is a common health problem. A simple and convenient assessment method is needed. METHODS We recruited 65 children (eight male, 57 female) aged 10.70-14.84 years old with IS. Radiographic characteristics of the cohort were measured, including Risser's sign and Cobb angle. We measured cardiopulmonary exercise tolerance using both the 6MWT and CPET and their corresponding indicators, including six-minute walking distance (6MWD) and peak oxygen uptake (peak VO2), respectively. Pearson correlation analysis was used to determine the relationship between 6MWT indicators and IS parameters. Linear regression models were used to explore the relationship between 6MWT and CPET response indicators. RESULTS Over a third of the cohort (35.4%) had a Risser's sign grade of 0, with 21.5% in grade 2 and 3, respectively. The cohort's mean Cobb angle was 26.02 degrees. 6MWD was significantly positively correlated with Risser's sign (R=0.258; P=0.038) and change in respiratory rate (△RR) positively correlated with vertebral rotation (R=0.264; P=0.034). 6MWD positively correlated with peak VO2, peak VO2/heart rate (HR) and metabolic equivalents (METs), and negatively correlated with ventilation equivalent of carbon dioxide slope (VE/VCO2 slope) (P<0.05). These four CPET indicators were found to be predicted from 6MWD in the linear regression model (P<0.05). CONCLUSION CPET response indicators, especially peak VO2, can be predicted using 6MWD among other factors. The 6MWT can therefore be used to rapidly and efficiently predict the cardiorespiratory tolerance of children with IS. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Haibin Guo
- Department of Rehabilitation Medicine, Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuan Zhou
- Department of Rehabilitation Medicine, Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanyan Li
- Department of Rehabilitation Medicine, Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuqi Yang
- College of Global Public Health, New York University, New York, NY
| | - Hong Yu
- Department of Rehabilitation Medicine, Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Li
- Department of Rehabilitation Medicine, Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haiyan Yuan
- Chongming Hospital Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Yushan Chen
- Chongming Hospital Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Yufei Feng
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Jiaoling Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Du
- Department of Rehabilitation Medicine, Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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11
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Zeng J, Hao S, Wang Y, Liu Q. Neuromechanism, recovery effect and case study of swimming training intervention in children with cerebral palsy: A case report. Medicine (Baltimore) 2023; 102:e35223. [PMID: 38115343 PMCID: PMC10727662 DOI: 10.1097/md.0000000000035223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/12/2023] [Accepted: 08/24/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Cerebral palsy, hereinafter referred to as "cerebral palsy", refers to a non progressive injury that occurs during the development of brain tissue in fetuses or infants. The patients often have walking dysfunction, abnormal balance ability and abnormal body stability, which are mainly caused by Cranial nerves injury. PATIENT CONCERNS One child diagnosed with ataxia cerebral palsy by the hospital was recruited, aged 6 years and 9 months. The symptoms were: lower limb adduction and internal rotation, left neck tilt to the left due to insufficient muscle tension, and eyes squint to the right. The movement is clumsy and the coordination ability of limbs is poor; Its body balance function is poor, the sitting and standing position cannot keep the body upright and balanced for a long time, and the coordination of the random movement of hands and eyes is poor; Weak spatial cognition and orientation ability; Have persistent central motor dysfunction. When walking, the body leans forward and sideways, and the gait is staggered, which is easy to fall; In terms of expression, it shows vague language and unclear speech; Relatively retarded in intelligence. DIAGNOSIS AND INTERVENTION The study used swimming training intervention to report a twelve months training intervention program for a child with ataxic cerebral palsy, and evaluated it with Berg balance scale and modified Ashworth scale. OUTCOMES Swimming training has a significant effect on the rehabilitation of children with ataxic cerebral palsy; The forces from different directions in the water can improve the balance of children with cerebral palsy; Muscle endurance training with medium load intensity can help restore unilateral muscle tension deficiency to a certain extent, and make bilateral muscle tension gradually becomes.consistent, thus enhancing the balance ability, gait and body stability of children with cerebral palsy.
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Affiliation(s)
- Jing Zeng
- Chengdu Sport University, Chengdu, Sichuan, China
- Postdoctoral Research Station of Physical Education, Shanxi University, Taiyuan, Shanxi, China
| | - Shuang Hao
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yuxuan Wang
- Chengdu Sport University, Chengdu, Sichuan, China
| | - Qing Liu
- Chengdu Sport University, Chengdu, Sichuan, China
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12
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Malakan Rad E, Radmehr H, Taghizadeh A, Pouraliakbar H. Congenital anomalous drainage of the inferior vena cava and hepatic veins into the left atrium associated with long QT syndrome: Multimodality imaging, pitfalls, and caveats. Echocardiography 2023; 40:1127-1136. [PMID: 37589961 DOI: 10.1111/echo.15673] [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: 01/26/2023] [Revised: 07/16/2023] [Accepted: 08/06/2023] [Indexed: 08/18/2023] Open
Abstract
Isolated congenital anomalous drainage of the inferior vena cava (IVC) and partial hepatic veins (HV) into the left atrium (LA) via an interatrial communication (IAC), associated with the normal connection of the IVC to the right atrium is exceedingly rare. Therefore, there is a dearth of knowledge regarding the management of these cases. To date, there has been no report of abnormal IVC drainage caused by abnormal IVC-IAC alignment. Much more frequently, patients have an abnormal connection or abnormal drainage mediated by a persistent Eustachian valve that allows blood to pass from the inferior vena cava to the left atrium. Herein, we report an 8-year-old boy with anomalous IVC and hepatic vein drainage into the LA due to IVC-IAC malalignment. We describe the findings of multimodality imaging, including transthoracic, transesophageal, contrast, and speckle-tracking echocardiography, cardiac angiography, and cardiac magnetic resonance imaging. We go over the diagnostic and therapeutic pitfalls and caveats of this case that can apply to similar patients.
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13
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Fireman Klein E, Yaacoby-Bianu K, Orlin I, Zetser A, Purits N, Livnat G. Exhaled Breath Condensate and Respiratory Sequelae in Children Post-COVID-19. Respiration 2023; 102:479-486. [PMID: 37393889 DOI: 10.1159/000530971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 05/02/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes an acute respiratory illness. A substantial proportion of adults experience persistent symptoms. There is a paucity of data on respiratory sequelae in children. Exhaled breath condensate (EBC) is a non-invasive tool used to assess airway inflammation. OBJECTIVES This study aimed to evaluate EBC parameters, respiratory, mental and physical ability among children post COVID-19 infection. METHODS Observational study of confirmed SARS-CoV-2 infection cases among children, aged 5-18 years, evaluated once, 1-6 months post positive SARS-CoV-2 PCR testing. All subjects performed spirometry, 6-min walk test (6MWT), EBC (pH, interleukin-6), and completed medical history questionnaires, Depression, Anxiety, and Stress Scale (DASS-21), and physical activity scores. Severity of COVID-19 disease was classified according to WHO criteria. RESULTS Fifty-eight children were included and classified asymptomatic (n = 14), mild (n = 37), and moderate (n = 7) disease. The asymptomatic group included younger patients compared to the mild and moderate groups (8.9 ± 2.5y vs. 12.3 ± 3.6y and 14.6 ± 2.5y, respectively, p = 0.001), as well as lower DASS-21 total scores (3.4 ± 4 vs. 8.7 ± 9.4 and 8.7 ± 0.6 respectively, p = 0.056), with higher scores in proximity to positive PCR (p = 0.011). No differences were found between the 3 groups regarding EBC, 6MWT, spirometry, body mass index percentile, and activity scores. CONCLUSIONS COVID-19 is an asymptomatic-mild disease in most young healthy children, with gradually diminishing emotional symptoms. Children without prolonged respiratory symptoms revealed no significant pulmonary sequelae as evaluated by EBC markers, spirometry, 6MWT, and activity scores. Larger studies are required to assess long-term pediatric consequences of post SARS-CoV-2 infection, to assess the need for pulmonology surveillance.
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Affiliation(s)
- Einat Fireman Klein
- Pulmonology division, Carmel Medical Center, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Karin Yaacoby-Bianu
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Pediatric Pulmonology unit, Carmel Medical Center, Haifa, Israel
| | - Ido Orlin
- Department of Pediatrics, Carmel Medical Center, Haifa, Israel
| | - Anna Zetser
- Chemistry Laboratory, Carmel Medical Center, Haifa, Israel
| | - Nona Purits
- Pediatric Pulmonology unit, Carmel Medical Center, Haifa, Israel
| | - Galit Livnat
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Pediatric Pulmonology unit, Carmel Medical Center, Haifa, Israel
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14
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Dewandel I, van Niekerk M, Ghimenton-Walters E, Palmer M, Anthony MG, McKenzie C, Croucamp R, Alter G, Demers AM, van Zyl G, Claassen M, Goussard P, Swanepoel R, Hoddinott G, Bosch C, Dunbar R, Allwood B, McCollum ED, Schaaf HS, Hesseling AC, van der Zalm MM. UMOYA: a prospective longitudinal cohort study to evaluate novel diagnostic tools and to assess long-term impact on lung health in South African children with presumptive pulmonary TB-a study protocol. BMC Pulm Med 2023; 23:97. [PMID: 36949477 PMCID: PMC10032249 DOI: 10.1186/s12890-023-02329-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/17/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Despite a high paediatric tuberculosis (TB) burden globally, sensitive and specific diagnostic tools are lacking. In addition, no data exist on the impact of pulmonary TB on long-term child lung health in low- and middle-income countries. The prospective observational UMOYA study aims (1) to build a state-of-the-art clinical, radiological, and biological repository of well-characterised children with presumptive pulmonary TB as a platform for future studies to explore new emerging diagnostic tools and biomarkers for early diagnosis and treatment response; and (2) to investigate the short and long-term impact of pulmonary TB on lung health and quality of life in children. METHODS We will recruit up to 600 children (0-13 years) with presumptive pulmonary TB and 100 healthy controls. Recruitment started in November 2017 and is expected to continue until May 2023. Sputum and non-sputum-based samples are collected at enrolment and during follow-up in TB cases and symptomatic controls. TB treatment is started by routine care services. Intensive follow-up for 6 months will allow for TB cases to retrospectively be classified according to international consensus clinical case definitions for TB. Long-term follow-up, including imaging, comprehensive assessment of lung function and quality of life questionnaires, are done yearly up to 4 years after recruitment. DISCUSSION The UMOYA study will provide a unique platform to evaluate new emerging diagnostic tools and biomarkers for early diagnosis and treatment response and to investigate long-term outcomes of pulmonary TB and other respiratory events on lung health in children.
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Affiliation(s)
- Isabelle Dewandel
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Margaret van Niekerk
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Elisabetta Ghimenton-Walters
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Newcastle-Upon-Tyne National Health Service Hospitals Foundation Trust, Newcastle upon Tyne, UK
| | - Megan Palmer
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Michaile G Anthony
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Carla McKenzie
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rolanda Croucamp
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Galit Alter
- Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard, Cambridge, MA, USA
- Moderna Therapeutics, Cambridge, MA, USA
| | - Anne-Marie Demers
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Division of Microbiology, Department of Laboratory Medicine, Centre Hospitalier Universitaire Sainte-Justine, Quebec, Canada
- Department of Microbiology, Immunology and Infectious Diseases, Faculty of Medicine, University of Montreal, Quebec, Canada
| | - Gert van Zyl
- Division of Medical Virology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- National Health Laboratory Service, Tygerberg Business Unit, Cape Town, South Africa
| | - Mathilda Claassen
- Division of Medical Virology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Pierre Goussard
- Department of Paediatric Pulmonology, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
| | - Ruan Swanepoel
- Department of Pulmonology and Lung Function, Tygerberg Hospital, Cape Town, South Africa
| | - Graeme Hoddinott
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Corne Bosch
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rory Dunbar
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Brian Allwood
- Department of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Eric D McCollum
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Global Program in Pediatric Respiratory Sciences, Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins School of Medicine, Baltimore, USA
| | - H Simon Schaaf
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Anneke C Hesseling
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Marieke M van der Zalm
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
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15
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Swanepoel J, Zimri K, van der Zalm MM, Hoddinott G, Palmer M, Doruyter A, De Beer G, Kleynhans L, Johnson SM, Jongen V, Wademan D, Mcimeli K, Jacobs S, Swanepoel R, Van Zyl G, Allwood BW, Malherbe S, Heuvelings C, Griffith-Richards S, Whittaker E, Moore DAJ, Schaaf HS, Hesseling AC, Seddon JA. Understanding the biology, morbidity and social contexts of adolescent tuberculosis: a prospective observational cohort study protocol (Teen TB). BMJ Open 2022; 12:e062979. [PMID: 36600434 PMCID: PMC9772637 DOI: 10.1136/bmjopen-2022-062979] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION A considerable burden of the tuberculosis (TB) epidemic is found in adolescents. The reasons for increased susceptibility to TB infection and higher incidence of TB disease in adolescence, compared with the 5-10 years old age group, are incompletely understood. Despite the pressing clinical and public health need to better understand and address adolescent TB, research in this field remains limited. METHODS AND ANALYSIS Teen TB is an ongoing prospective observational cohort study that aims to better understand the biology, morbidity and social context of adolescent TB. The study plans to recruit 50 adolescents (10-19 years old) with newly diagnosed microbiologically confirmed pulmonary TB disease and 50 TB-exposed controls without evidence of TB disease in Cape Town, South Africa, which is highly endemic for TB. At baseline, cases and controls will undergo a detailed clinical evaluation, chest imaging, respiratory function assessments and blood collection for viral coinfections, inflammatory cytokines and pubertal hormone testing. At 2 weeks, 2 months and 12 months, TB disease cases will undergo further chest imaging and additional lung function testing to explore the patterns of respiratory abnormalities. At week 2, cases will complete a multicomponent quantitative questionnaire about psychological and social impacts on their experiences and longitudinal, in-depth qualitative data will be collected from a nested subsample of 20 cases and their families. ETHICS AND DISSEMINATION The study protocol has received ethical approval from the Stellenbosch University Health Research Ethics Committee (N19/10/148). The study findings will be disseminated through peer-reviewed publications, academic conferences and formal presentations to health professionals. Results will also be made available to participants and caregivers.
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Affiliation(s)
- Jeremi Swanepoel
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Klassina Zimri
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Marieke M van der Zalm
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Graeme Hoddinott
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Megan Palmer
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Alex Doruyter
- NuMeRI Node for Infection Imaging, Central Analytical Facilities, Stellenbosch University, Cape Town, South Africa
- Division of Nuclear Medicine, Department of Medical Imaging and Clinical Oncology, Stellenbosch University, Cape Town, South Africa
| | - Gezila De Beer
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Leanie Kleynhans
- South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, DSI-NRF Centre of Excellence, Stellenbosch University, Cape Town, Western Cape, South Africa
| | - Sarah M Johnson
- Department of Infectious Disease, Imperial College London, London, UK
| | - Vita Jongen
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, Netherlands
| | - Dillon Wademan
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Khanyisa Mcimeli
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Stephanie Jacobs
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Ruan Swanepoel
- Division of Pulmonology, Department of Internal Medicine, Tygerberg Hospital, Cape Town, Western Cape, South Africa
| | - Gert Van Zyl
- Division of Medical Virology, Department of Pathology, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa
| | - Brian W Allwood
- Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa
| | - Stephanus Malherbe
- South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, DSI-NRF Centre of Excellence, Stellenbosch University, Cape Town, Western Cape, South Africa
| | - Charlotte Heuvelings
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Stephanie Griffith-Richards
- Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa
| | | | - David A J Moore
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - H Simon Schaaf
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Anneke C Hesseling
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - James A Seddon
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Department of Infectious Disease, Imperial College London, London, UK
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16
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Nir V, Bentur L, Zucker-Toledano M, Gur M, Adler Z, Hanna M, Toukan Y, Masarweh K, Hakim F, Bar-Yoseph R. Functional capacity and quality of life in patients with vascular ring. Pediatr Pulmonol 2022; 57:2946-2953. [PMID: 35971243 DOI: 10.1002/ppul.26112] [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: 05/21/2022] [Revised: 08/02/2022] [Accepted: 08/09/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Vascular rings are congenital anomalies of the aortic arch that compress the trachea and esophagus and may require corrective surgery. Data about the long-term effects of vascular rings are scarce. We aimed to evaluate the long-term cardiorespiratory, exercise capacity, and quality of life of vascular ring patients. METHODS A single center prospective study evaluating spirometry, echocardiography, six-minute walk test (6MWT), cardiopulmonary exercise testing (CPET), and quality of life questionnaire (SF36) in patients with a diagnosis of vascular ring, with or without corrective surgery. RESULTS Twenty-seven patients participated (11.9 ± 6 years, 52% males). The most common diagnosis was double aortic arch (16 patients, 59%). Nineteen patients had corrective surgery (O) and 8 did not (NO). Pulmonary function tests were within normal range in both groups (FEV1 % predicted O = 87.6 ± 16.5, NO = 83 ± 10.8%). However, 11/27 had abnormal FEV1 , 5 had abnormal FVC, and 13 (48%) had flattening of the expiratory curve. 6MWD and oxygen uptake were similarly mildly reduced in both groups; (6MWD O = 80.1 ± 10.7% predicted, NO = 74.1 ± 10.9% and oxygen uptake O = 78.5 ± 23.2% predicted, NO = 73.4 ± 14.3%). Peak O2 pulse (V̇O2 /HR% predicted) was mildly reduced in the NO group (O = 88.4 ± 17.3%, NO = 75.8 ± 16.2%). Echocardiogram and SF36 scores were normal in all patients. CONCLUSIONS Long-term evaluation of patients born with vascular rings revealed mild pulmonary impairment, reduction in 6MWD, and oxygen uptake. The NO group had also mild reduced peak O2 pulse. Larger, long-term studies assessing functional parameters in operated and non-operated patients are needed to assess disease/surgery limitation in patients with vascular rings. Clinical trial registration number: NCT04781738.
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Affiliation(s)
- Vered Nir
- Pediatric Pulmonary Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Technion-Israel Institute of Technology, Bruce Rappaport Faculty of Medicine, Haifa, Israel
| | - Lea Bentur
- Pediatric Pulmonary Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Technion-Israel Institute of Technology, Bruce Rappaport Faculty of Medicine, Haifa, Israel
| | - Merav Zucker-Toledano
- Pediatric Cardiology Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Michal Gur
- Pediatric Pulmonary Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Technion-Israel Institute of Technology, Bruce Rappaport Faculty of Medicine, Haifa, Israel
| | - Zvi Adler
- Technion-Israel Institute of Technology, Bruce Rappaport Faculty of Medicine, Haifa, Israel.,Department of Cardiac Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Moneera Hanna
- Pediatric Pulmonary Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Yazeed Toukan
- Pediatric Pulmonary Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Technion-Israel Institute of Technology, Bruce Rappaport Faculty of Medicine, Haifa, Israel
| | - Kamal Masarweh
- Pediatric Pulmonary Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Fahed Hakim
- Pediatric Pulmonary Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Technion-Israel Institute of Technology, Bruce Rappaport Faculty of Medicine, Haifa, Israel
| | - Ronen Bar-Yoseph
- Pediatric Pulmonary Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Technion-Israel Institute of Technology, Bruce Rappaport Faculty of Medicine, Haifa, Israel
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17
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Oh W, An Y, Min S, Park C. Comparative Effectiveness of Artificial Intelligence-Based Interactive Home Exercise Applications in Adolescents with Obesity. SENSORS (BASEL, SWITZERLAND) 2022; 22:7352. [PMID: 36236451 PMCID: PMC9573710 DOI: 10.3390/s22197352] [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: 09/05/2022] [Revised: 09/23/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
The rate of obesity in adolescents has increased due to social distancing measures and school closures caused by the COVID-19 pandemic. These issues have caused adolescents to change their lifestyles and eating habits. Furthermore, the growth in inactive behavior and computer screen or watching TV time, as well as the reduction in physical activity, could similarly be related with obesity. To overcome this problem, we recently developed an artificial intelligence (AI)-based gesture recognition game application called Super Kids Adventure (SUKIA, Funrehab, Daejeon, Korea), which provides inexpensive and motivational game applications. This research is designed to assess the effects of SUKIA and Nintendo Switch (NINS) on calorie consumption, VO2 max, 6-minute walking test (6MWT) as well as body mass index (BMI), and the Borg rating of perceived exertion scale (RPE) in adolescents with obesity. A convenience sample of 24 adolescents with obesity were randomized into either the NINS or SUKIA groups 5 days/week for 3 weeks. Analysis of variance (ANOVA) and independent t-tests were presented with significant level at p < 0.05, and the analysis indicated that SUKIA showed superior effects on calorie consumption, VO2 max, and RPE compared to NINS. Our results provide evidence that SUKIA can more effectively improve cardiopulmonary function and calorie consumption than NINS in adolescents with obesity during COVID-19.
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Affiliation(s)
- Wonjun Oh
- Department of Physical Therapy, Yonsei University, Wonju 26493, Korea
| | | | | | - Chanhee Park
- Department of Physical Therapy, Yonsei University, Wonju 26493, Korea
- Funrehab Co., Ltd., Daejeon 35229, Korea
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18
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Ubuane PO, Ajiboye OA, Adekunle MO, Akinola AO, Akinyosoye G, Kayode-Awe MO, Ajayi OA, Ohagwu CI, Animasahun BA, Njokanma FO. Reference values and equations for the 6-minute walk distance of Nigerian children aged 6-11 years: A cross-sectional study. Pediatr Pulmonol 2022; 57:2103-2115. [PMID: 35581671 DOI: 10.1002/ppul.25986] [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: 02/18/2022] [Revised: 05/04/2022] [Accepted: 05/16/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The 6-minute walk test (6MWT), a simple, reliable, and valid test that uses the distance walked in 6 minute walk distance (6MWD) to quantify functional capacity, is widely used in the management of chronic disorders. However, the absence of reference standards from sub-Saharan African, including Nigerian, school-aged children limits its utility in this age group. OBJECTIVES To develop normative values and equations for the 6MWD of school-aged Nigerian children. METHODS In a cross-sectional study, healthy children aged 6-11 years in Lagos, Nigeria, completed the 6MWT on 20-m-long straight outdoor courses in their schools. The primary outcome was the 6MWD in meters while potential predictors included demographic (age, sex), anthropometric (height, weight, chest circumference, leg length) and physiologic variables (pre-walk, immediate post-walk, and fifth min-post-walk heart rate [HR], oxygen saturation [SpO2 ], systolic blood pressure [SBP], diastolic blood pressure [DBP], and rating of perceived exertion [RPE]; and the difference between pre-walk and post-walk HR [∆HR], SpO2 [∆SpO2 ], SBP [∆SBP], DBP [∆DBP], and RPE [∆RPE]). RESULTS Overall, 627 pupils (52.1% girls) walked 504.6 ± 66.6 m (95% CI: 499.4, 509.8; range: 326.6-673.0 m); 16 m longer in boys (p = 0.002). A stepwise linear regression model yielded: 6MWD (m) = 347.9 + 14(Ageyears ) + 1.6 (∆HRbeats/min ) + 17.6(Sexmale=1, female=0 ) + 1.2(∆SBPmmHg ); R2 = 0.25. Previously published reference equations mostly over-estimated Nigerian children's 6MWD. CONCLUSION These reference standards add to the global normative data on pediatric 6MWT and may be useful for the functional evaluation of Nigerian school-aged children with chronic childhood disorders.
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Affiliation(s)
- Peter Odion Ubuane
- Department of Pediatrics, Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos State, Nigeria
| | | | | | | | - Gbenga Akinyosoye
- Department of Pediatrics, Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos State, Nigeria
| | | | - Omotola Aderiyike Ajayi
- Department of Pediatrics, Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos State, Nigeria
| | - Chidimma Imma Ohagwu
- Department of Pediatrics, Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos State, Nigeria
| | - Barakat Adeola Animasahun
- Department of Pediatrics, Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos State, Nigeria.,Department of Pediatrics & Child Health, Lagos State University College of Medicine (LASUCOM)/Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria
| | - Fidelis Olisamedua Njokanma
- Department of Pediatrics, Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos State, Nigeria.,Department of Pediatrics & Child Health, Lagos State University College of Medicine (LASUCOM)/Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria
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Allado E, Poussel M, Albuisson E, Paysant J, Temperelli M, Hily O, Moussu A, Benhajji N, Gauchard GC, Chenuel B. Physical Activity Capacity Assessment of Patients with Chronic Disease and the Six-Minute Walk Test: A Cross-Sectional Study. Healthcare (Basel) 2022; 10:758. [PMID: 35627895 PMCID: PMC9141940 DOI: 10.3390/healthcare10050758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background: This study aimed to evaluate the efficacy of the Six-Minute Walk Test (6MWT) to determine the physical activity capacities of patients with chronic disease. Methods: For this cross-sectional study, we investigated 156 patients with chronic disease and no beta-blocker treatment. They systematically performed a maximal cardiopulmonary exercise test to determine their heart rate peak (HRPeak) and maximal oxygen uptake (V’O2max). We considered two groups of patients based upon the results of the functional evaluation of exercise performance: (1) No limitation in exercise performance (V’O2max greater or equal to 80% of the theoretical reference) and (2) limited exercise performance (V’O2max less than 80% of the theoretical value). All patients also received a 6MWT on the same day as the exercise test. Results: We found 68 (43.6%) patients with normal exercise capacities and 88 (56.4%) patients with limited exercise performance. In this sample, 6MWT mean distances were 510 (87) and 506 (86) m, respectively. There were no significant differences between the two groups for distance and end-test heart rate. The correlation between matrix V’O2max measured during the maximal incremental exercise test and the 6MWT distance displayed a positive slope (r = 0.549 CI95 [0.431−0.656]—p < 0.001). Conclusion: Our results showed a moderate relationship between 6MWT and physical activity capacity for patients with chronic disease.
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Affiliation(s)
- Edem Allado
- University Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, Université de Lorraine, F-54000 Nancy, France; (M.P.); (M.T.); (O.H.); (A.M.); (B.C.)
- DevAH, Université de Lorraine, F-54000 Nancy, France; (J.P.); (G.C.G.)
- OMEOS, F-54000 Nancy, France;
| | - Mathias Poussel
- University Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, Université de Lorraine, F-54000 Nancy, France; (M.P.); (M.T.); (O.H.); (A.M.); (B.C.)
- DevAH, Université de Lorraine, F-54000 Nancy, France; (J.P.); (G.C.G.)
| | - Eliane Albuisson
- Direction de la Recherche Clinique et de l’Innovation, CHRU-Nancy, F-54000 Nancy, France;
- IECL, CNRS, Université de Lorraine, F-54000 Nancy, France
- Département du Grand Est de Recherche en Soins Primaires (DEGERESP), Faculté de Médecine, Université de Lorraine, F-54000 Nancy, France
| | - Jean Paysant
- DevAH, Université de Lorraine, F-54000 Nancy, France; (J.P.); (G.C.G.)
- IECL, CNRS, Université de Lorraine, F-54000 Nancy, France
- Rehabilitation Medicine Department, CHRU-Nancy, Université de Lorraine, F-54000 Nancy, France
| | - Margaux Temperelli
- University Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, Université de Lorraine, F-54000 Nancy, France; (M.P.); (M.T.); (O.H.); (A.M.); (B.C.)
| | - Oriane Hily
- University Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, Université de Lorraine, F-54000 Nancy, France; (M.P.); (M.T.); (O.H.); (A.M.); (B.C.)
| | - Anthony Moussu
- University Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, Université de Lorraine, F-54000 Nancy, France; (M.P.); (M.T.); (O.H.); (A.M.); (B.C.)
- OMEOS, F-54000 Nancy, France;
| | - Noura Benhajji
- OMEOS, F-54000 Nancy, France;
- IECL, CNRS, Université de Lorraine, F-54000 Nancy, France
| | | | - Bruno Chenuel
- University Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, Université de Lorraine, F-54000 Nancy, France; (M.P.); (M.T.); (O.H.); (A.M.); (B.C.)
- DevAH, Université de Lorraine, F-54000 Nancy, France; (J.P.); (G.C.G.)
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20
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Sarcopenia in Children with Solid Organ Tumors: An Instrumental Era. Cells 2022; 11:cells11081278. [PMID: 35455957 PMCID: PMC9024674 DOI: 10.3390/cells11081278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/22/2022] [Accepted: 04/05/2022] [Indexed: 11/17/2022] Open
Abstract
Sarcopenia has recently been studied in both adults and children and was found to be a prognostic marker for adverse outcome in a variety of patient groups. Our research showed that sarcopenia is a relevant marker in predicting outcome in children with solid organ tumors, such as hepatoblastoma and neuroblastoma. This was especially true in very ill, high-risk groups. Children with cancer have a higher likelihood of ongoing loss of skeletal muscle mass due to a mismatch in energy intake and expenditure. Additionally, the effects of cancer therapy, hormonal alterations, chronic inflammation, multi-organ dysfunction, and a hypermetabolic state all contribute to a loss of skeletal muscle mass. Sarcopenia seems to be able to pinpoint this waste to a high degree in a new and objective way, making it an additional tool in predicting and improving outcome in children. This article focuses on the current state of sarcopenia in children with solid organ tumors. It details the pathophysiological mechanisms behind sarcopenia, highlighting the technical features of the available methods for measuring muscle mass, strength, and function, including artificial intelligence (AI)-based techniques. It also reviews the latest research on sarcopenia in children, focusing on children with solid organ tumors.
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21
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Zenginler Yazgan Y, Vural P, Ormen R, Akinci B, Tarakci E, Guler S, Saltik S. Six-Minute Walk Performance and Related Factors in Pediatric-Onset Multiple Sclerosis. J Child Neurol 2022; 37:351-358. [PMID: 35317699 DOI: 10.1177/08830738211072701] [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] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate functional exercise capacity and its relationship between physical activity levels, muscle strength, balance, fatigue, and quality of life in patients with pediatric-onset multiple sclerosis. METHODS Fifteen patients with pediatric-onset multiple sclerosis were included. The 6-minute walk test was used to determine functional exercise capacity and walking distance. The Godin Leisure-Time Exercise Questionnaire and pedometer were used to evaluate physical activity, Timed-Up and Go for dynamic balance, isokinetic testing for lower extremity muscle strength, Fatigue Severity Scale for fatigue, and the Pediatric Quality of Life Inventory (PedsQL) for quality of life. RESULTS The 6-minute walking distance was positively correlated with GLTEQ and the School-Work subgroup score of the PedsQL-Self-report, and negatively correlated with Timed-Up and Go and Fatigue Severity Scale. Dynamic balance, physical activity, and fatigue were significant predictors of 6-minute walking distance. CONCLUSIONS Our results showed that 6-minute walk test is influenced by physical activity, dynamic balance, and fatigue, and related to quality of life in patients with pediatric-onset multiple sclerosis.
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Affiliation(s)
- Yonca Zenginler Yazgan
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 532719Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Pelin Vural
- Department of Physiotherapy and Rehabilitation, Institute of Graduate Studies, 532719Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Recep Ormen
- Department of Physiotherapy and Rehabilitation, Institute of Graduate Studies, 532719Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Buket Akinci
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Biruni University, Istanbul, Turkey
| | - Ela Tarakci
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 532719Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Serhat Guler
- Cerrahpasa Faculty of Medicine, Department of Pediatric Neurology, 532719Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Sema Saltik
- Cerrahpasa Faculty of Medicine, Department of Pediatric Neurology, 532719Istanbul University-Cerrahpasa, Istanbul, Turkey
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22
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Qu J, Shi H, Guo Y, Chen X, Xiao X, Zheng X, Cui Y. Is the six-minute walk test still reliable compared to cardiopulmonary exercise test for exercise capacity in children with congenital heart disease? Front Pediatr 2022; 10:965739. [PMID: 36452347 PMCID: PMC9702990 DOI: 10.3389/fped.2022.965739] [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: 06/10/2022] [Accepted: 10/27/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES We aimed to assess the validity of the six-minute walk test (6MWT) to reflect the functional capacity of children with congenital heart disease (CHD), evaluate a possible correlation between the 6MWT distance with cardiopulmonary exercise test (CPET) variables, as well as to find a cutoff value to stratification the physical fitness in this population. METHODS We enrolled 459 children with CHD, 6-18 years old, who performed a complete CPET and 6MWT on the same day in a cross-sectional observational study. Correlations between variables of CPET and six-minute walking distance (6MWD) were analyzed and cutoff values of 6MWD were identified for the classification of the physical fitness in the population. RESULTS The mean distance ambulated during the 6MWT was 578 ± 65 m, 590 ± 65 m for boys, and 562 ± 62 m for girls (p < 0.001). Both VO2max and %predicted VO2max showed a correlation with the 6MWT distance (r = 0.35, p < 0.001 and r = 0.51, p < 0.001, respectively), and an inverse correlation was found between VE/VCO2 slope and the 6MWT distance (r = -0.31; p < 0.001). There appeared to be a linear association between 6MWD and VO2max up to a 6MWD of approximately 600 m. We divided the population into 4 subgroups (boys <130 cm; boys ≥130 cm; girls <130 cm; girls ≥130 cm), and get the cutoff values (554 m, 617 m, 549 m, 587 m) respectively equivalent to 80% of predicted VO2max. The 6MWT distances of another 102 patients were applied for external verification of the cutoff values. CONCLUSIONS Our study provided evidence on when a 6MWT should be considered as a convincing complementary test in the pediatric population with CHD and explored the classification of exercise tolerance using a 6MWD value. The cut-off values for 6MWD may be qualified as an intervention target for exercise rehabilitation.
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Affiliation(s)
- Jiangbo Qu
- Cardiac Intensive Care Unit, Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Hui Shi
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yugong Guo
- Cardiac Intensive Care Unit, Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xinxin Chen
- Cardiac Intensive Care Unit, Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xuwen Xiao
- Cardiac Intensive Care Unit, Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiaojuan Zheng
- Cardiac Intensive Care Unit, Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yanqin Cui
- Cardiac Intensive Care Unit, Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
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Barak S, Silberg T, Gerner M, Eisenstein E, Bardach CA, Yissar T, Landa J. Functional neurological symptom disorder: Preliminary findings of factors associated with walking ability post integrative pediatric rehabilitation. J Pediatr Rehabil Med 2022; 15:433-446. [PMID: 36031917 DOI: 10.3233/prm-210107] [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 The current study's aims were to (1) examine long-distance walking ability (6-minute walking test [6MWT]) and walking hemodynamic responses (i.e., heart rate) among youth with functional neurological symptom disorder (FNSD) before and after an integrative pediatric rehabilitation (IPR) program; and (2) explore factors predicting improvement in walking ability. METHODS Thirty-one youth with FNSD participating in an IPR program were recruited. The IPR program was activated biweekly in an ambulatory format. Study measures included the 6MWT, hemodynamic characteristics, rate of perceived exertion (RPE), pain-intensity perception, and Child's Somatization Inventory-24 (CSI-24). All measures were conducted upon admission to the IPR and discharge. RESULTS Findings indicated a significant increase in 6MWT distance, as well as decreases in heart rate, RPE, and pain-intensity perception from admission to discharge. At admission, CSI-24 and pain intensity predicted 6MWT distance (adjusted R2 = 0.68). Pain intensity predicted discharge 6MWT distance (adjusted R2 = 0.18). Initial 6MWT predicted changes in 6MWT distance from admission to discharge (adjusted R2 = 0.33). CONCLUSION Using an integrative rehabilitation approach increases walking distance and decreases pain-related symptoms in youth with FNSD, emphasizing the need for collaboration between physical therapists and pediatric psychologists. Moreover, changes in walking ability may increase participation and thus should be the focus of IPR.
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Affiliation(s)
- Sharon Barak
- Department of Nursing, College of Health Sciences, Ariel University, Ariel, Israel.,Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Tamar Silberg
- Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat-Gan, Israel.,Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - Maya Gerner
- Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Etzyona Eisenstein
- Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Chen Arzoni Bardach
- Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Tamar Yissar
- Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Jana Landa
- Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat-Gan, Israel.,The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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24
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Gielis M, Dirix V, Vanderhenst E, Uyttebroeck A, Feys H, Sleurs C, Jacobs S. Better detection of reduced motor functioning in brain tumor survivors based on objective motor assessments: an incentive for improved standardized follow-up. Eur J Pediatr 2022; 181:2731-2740. [PMID: 35476292 PMCID: PMC9192471 DOI: 10.1007/s00431-022-04472-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 03/15/2022] [Accepted: 04/09/2022] [Indexed: 11/03/2022]
Abstract
Long-term sequelae are well-known in childhood brain tumor survivors, but motor functioning remains poorly described. This cross-sectional study aimed to assess objective motor functioning, patient-specific risk factors, and parental perceptions. Fifty-two childhood brain tumor patients (pilocytic astrocytoma, medulloblastoma, and other types) who were at least 6 months out of treatment were evaluated. Mean age at testing was 11.7 years. Objective motor functioning was assessed with the Movement Assessment Battery for Children (MABC-2-NL) and/or Bruininks-Oseretsky test of motor proficiency (BOT-2). Functional walking capacity was assessed with the 6-min walk test (6MWT). Parent-reported motor functioning was addressed using the ABILHAND-Kids, ABILOCO-Kids questionnaires, and a standardized anamnesis. Patients showed impaired motor functioning in all domains (p < 0.001). Regarding risk factors, younger age at diagnosis (< 5 year) was significantly associated with lower scores on body coordination (p = 0.006). Adjuvant treatment resulted in lower scores for fine manual control of the BOT-2 (p = 0.024) and balance of MABC-2-NL (p = 0.036). Finally, questionnaires revealed an underestimation of motor problems as perceived by the parents. In conclusion, many children who are in follow-up for a brain tumor show impaired motor functioning on multiple aspects, with younger age at diagnosis and adjuvant treatment as specific risk factors. Based on the questionnaires and anamnesis, motor problems appear to be underestimated by the parents. Conclusion: These findings point to the need for timely prospective screening of motor functioning. Based on a screening assessment, adequate rehabilitation programs can be applied in childhood brain tumor survivors, aiming to reduce the adverse impact on their daily lives, both for functional activities and cardiovascular fitness. What is Known: • A pediatric brain tumor and its treatment are associated with potential long-term motor sequelae. • Test assessments could enable us to objectify motor functioning of these patients. What is New: • Pediatric brain tumors survivors show lower motor performance compared to the norm, which is often underestimated by parents. • Younger age at diagnosis and adjuvant treatment could be specific risk factors.
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Affiliation(s)
- Marjoke Gielis
- grid.410569.f0000 0004 0626 3338Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Veerle Dirix
- grid.410569.f0000 0004 0626 3338Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Ellen Vanderhenst
- grid.410569.f0000 0004 0626 3338Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Anne Uyttebroeck
- grid.410569.f0000 0004 0626 3338Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Oncology, KU Leuven, Leuven, Belgium
| | - Hilde Feys
- grid.5596.f0000 0001 0668 7884Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Charlotte Sleurs
- grid.5596.f0000 0001 0668 7884Department of Oncology, KU Leuven, Leuven, Belgium
| | - Sandra Jacobs
- Department of Pediatrics, Pediatric Hemato-Oncology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium. .,Department of Oncology, KU Leuven, Leuven, Belgium.
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The influence of body composition on the six-minute walk test in Chilean preschool and school children. NUTR HOSP 2021; 39:27-32. [PMID: 34816726 DOI: 10.20960/nh.03424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND the six minutes' walk test (6MWT) measures submaximal physical activity. OBJECTIVE this study determines the association of children´s nutritional status and body composition with the results of the 6MWT. METHODS a sample of 1419 Chilean children, 4 to 10 years of age, were assessed including anthropometry, body composition by validated equations, the 6MWT test, and in 50 % of the sample heart rate prior the test, at one minute into the test, and at one minute posttest with a Polar watch. RESULTS the distance walked ranged from 473.1 ± 47.8 m in preschool children to 584.2 ± 65.7 meters in school children. In heart rate there was a significant difference between obese and eutrophic children. The distance walked in the 6MWT was positively associated with fat-free mass (p < 0.05) and BMI (r2 = 0.49). Body composition influences 6MWT quartile distribution, as well as nutritional status. Age and height explained 49 % of the variance (R2 = 0.42 and 0.47, respectively) in the 6MWT, and there are significant differences in this variable by sex, body composition, and nutritional status. CONCLUSIONS body composition was associated with walking performance in children. Thus, it is important to evaluate height and body composition when assessing the six-minute walk test because of this important relationship.
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Ostergaard JR. Gait phenotype in Batten disease: A marker of disease progression. Eur J Paediatr Neurol 2021; 35:1-7. [PMID: 34547583 DOI: 10.1016/j.ejpn.2021.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 08/03/2021] [Accepted: 09/06/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Gait impairment and its etiologic correlate has not previously been subject of special attention in Batten disease. METHODS In the present review, the clinical picture of gait phenotype during Batten disease course accompanied by descriptions of the known concomitant patho-anatomical changes is presented. RESULTS In CLN1 a non-rhythmic gait is seen around 1-1½ years of age. Shortly after, postural hypotonia and exaggerated tendon reflexes develop. The disease reaches a burnt-out stage during the third year of age and subsequently the children are almost without voluntary movements. The existing literature indicates that gait phenotype in CLN1 is caused by early involvement of the spinal interneurons followed by impact of the cortex and the cortico-spinal tracts. The earliest walking abnormality in children with CLN2 is a clumsy, ataxic, and spastic gait, which is in accordance with the existing imaging and histologic studies showing early involvement of the cerebellum and the cortico-spinal pathways. In CLN3, a reduction in walking speed is present at the age of 7-8 years. It occurs simultaneously with a reduction in the white matter microstructure and brain connectivity networks. Functional impairment of the basal ganglia contributing to a parkinsonian gait phenotype occurs in the mid-teens. In the late teens and early twenties involvement of the peripheral nerves, neurogenic musculoskeletal atrophy, loss of tendon reflexes and postural control are seen. CONCLUSION The progressively impaired gait function in Batten disease is related to timing of damage of distinct areas of the nervous system depending on subtype and is a powerful marker of disease progression.
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Affiliation(s)
- John R Ostergaard
- Centre for Rare Diseases, Department of Children & Youth, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200, Aarhus N, Denmark.
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Muenzer J, Botha J, Harmatz P, Giugliani R, Kampmann C, Burton BK. Evaluation of the long-term treatment effects of intravenous idursulfase in patients with mucopolysaccharidosis II (MPS II) using statistical modeling: data from the Hunter Outcome Survey (HOS). Orphanet J Rare Dis 2021; 16:456. [PMID: 34717704 PMCID: PMC8557006 DOI: 10.1186/s13023-021-02052-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 09/20/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Mucopolysaccharidosis II (MPS II; Hunter syndrome) is a rare, life-limiting lysosomal storage disease caused by deficient iduronate-2-sulfatase activity. Enzyme replacement therapy (ERT) with intravenous (IV) idursulfase can stabilize or improve many somatic manifestations, but there remains a need for further analysis of long-term treatment outcomes. Using data from patients with MPS II enrolled in the Hunter Outcome Survey (HOS), mixed modeling was performed to evaluate and predict the effects of IV idursulfase treatment on selected clinical parameters for up to 8 years following treatment start. The modeling population comprised male patients followed prospectively in HOS who had received IV idursulfase for at least 5 years and who had data available for two or more time points (at least one post-ERT). Age at ERT start and time since ERT start were included as covariates. RESULTS In total, 481 patients were eligible for inclusion in at least one model. At 8 years post-ERT start, improvement from baseline was predicted for each age group (< 18 months, 18 months to < 5 years and ≥ 5 years at treatment start) in the following parameters: mean urinary glycosaminoglycan levels (percentage changes of > -75% in each group), mean left ventricular mass index (decreases of ~ 1 g/m2) and mean palpable liver size (decreases of > 2 cm). Improvements in mean 6-min walk test distance (increase of > 50 m) and stabilization in percent predicted forced vital capacity and forced expiratory volume in 1 s (decreases of ~ 4 and ~ 9 percentage points, respectively) at 8 years post-ERT start were predicted for patients aged ≥ 5 years at ERT start (these assessments are unsuitable for patients aged < 5 years). Predicted changes over time were similar across the three age groups; however, overall outcomes were most favorable in children aged < 18 months at ERT start. CONCLUSIONS These findings suggest that the previously reported positive effects of IV idursulfase on the somatic manifestations of MPS II are predicted to be maintained for at least 8 years following ERT initiation and highlight the value of statistical modeling to predict long-term treatment outcomes in patients with rare diseases.
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Affiliation(s)
- Joseph Muenzer
- University of North Carolina at Chapel Hill, 101 Manning Drive CB# 7487, Medical School Wing E Room 117, Chapel Hill, NC 27599-7487 USA
| | - Jaco Botha
- Takeda Pharmaceuticals International AG, Zurich, Switzerland
| | - Paul Harmatz
- UCSF Benioff Children’s Hospital Oakland, Oakland, CA USA
| | - Roberto Giugliani
- Department of Genetics, UFRGS, Medical Genetics Service, HCPA, and INAGEMP, Porto Alegre, Brazil
| | | | - Barbara K. Burton
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL USA
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Iturain Barrón A, Quintana Riera S, Reychler G. The 3 Minute Step Test is a validated field test to evaluate the functional exercise capacity in children aged 6 to 12. Respir Med Res 2021; 80:100833. [PMID: 34147867 DOI: 10.1016/j.resmer.2021.100833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/10/2021] [Accepted: 05/26/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Field tests are useful to assess the functional exercise capacity. The 6minute walking test (6MWT) is the most common field test even if alternatives are needed. The main aim of the study was to verify if the 3minute step test (3MST) is a valid tool to measure the functional exercise capacity and can surrogate the 6MWT in healthy children from 6- to 12-years-old. METHODS This randomized cross-over trial recruited 30 healthy children from 6 to 12 years. One 6MWT and two 3MST (3MST1 and 3MST2) were performed randomly on 3 consecutive days. The variables were the distance (6MWT), the number of steps (3MST) and the cardiorespiratory parameters. RESULTS The distance walked during 6MWT was very strongly correlated to the number of steps during the 3MST (3MST1: rho=0.833; P<0.001 and 3MST2: rho=0.868; P<0.001). Heart rate (HR) was lower than the theoretical maximal HR at the end of both tests. The change in HR and perceived fatigue were significantly higher after the 3MST. A learning effect was observed in the 3MST (+8 steps; P<0.001). CONCLUSIONS The 3MST is validated and can be a surrogate for the 6MWT in healthy children population between 6 and 12 years old. A training test is required in these children.
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Affiliation(s)
- A Iturain Barrón
- Escoles Universitàries Gimbernat, EUI Gimbernat, Universitat Autònoma de Barcelona, Sant Cugat del Vallès (Barcelona), Spain.
| | - S Quintana Riera
- Escoles Universitàries Gimbernat, EUI Gimbernat, Universitat Autònoma de Barcelona, Sant Cugat del Vallès (Barcelona), Spain.
| | - G Reychler
- Escoles Universitàries Gimbernat, EUI Gimbernat, Universitat Autònoma de Barcelona, Sant Cugat del Vallès (Barcelona), Spain; Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium; Service de Pneumologie, Cliniques universitaires Saint-Luc, Brussels, Belgium; Secteur de Kinésithérapie et Ergothérapie, Cliniques universitaires Saint-Luc, Brussels, Belgium.
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Abdeen HAA, Rodriguez-Sanz D, Ewidea M, Al-Hamaky DMA, Mohamed MAER, Elerian AE. Efficacy of Vitamin D Supplementation in Addition to Aerobic Exercise Training in Obese Women with Perceived Myalgia: A Single-Blinded Randomized Controlled Clinical Trial. Nutrients 2021; 13:nu13061819. [PMID: 34071781 PMCID: PMC8227578 DOI: 10.3390/nu13061819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/29/2021] [Accepted: 05/15/2021] [Indexed: 01/04/2023] Open
Abstract
Obese women were more susceptible to myalgia because of their significantly lower vitamin D concentrations; the present study investigated the efficacy of vitamin D in addition to an aerobic interval training in the management of obese women with myalgia. Forty-five obese women with vitamin D deficiency and myalgia (30 to 40 years old) were assigned randomly into three equal groups. Group A received an aerobic interval training with vitamin D supplementation, Group B received vitamin D supplementation only, and Group C received aerobic interval training only; participants in all groups were on calorie deficient diets. The study outcomes were the Visual Analog Scale (VAS) for Pain Evaluation, serum vitamin D level, and Cooper 12-Minute Walk Test for Functional Capacity Evaluation, while the Short-Form Health Survey (SF) was used for assessment of quality of life. We detected a significant improvement in pain intensity level, serum vitamin D level, and quality of life in all groups with significant difference between Group A and groups B and C. We also detected a significant improvement in functional capacity in groups A and C, with no significant change in Group B. Aerobic interval training with vitamin D supplementation was more effective for the management of obese women with perceived myalgia.
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Affiliation(s)
- Heba Ahmed Ali Abdeen
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Ad Doqi, Giza District, Giza Governorate 11432, Egypt
- Correspondence: (H.A.A.A.); (A.E.E.)
| | - David Rodriguez-Sanz
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - Mahmoud Ewidea
- Department of Basic Science for Physical Therapy, Faculty of Physical Therapy, Kafr Elshiekh University, Kafr Elsheikh Government 33511, Egypt;
| | - Dina Mohamed Ali Al-Hamaky
- Department of Physical Therapy for Musculoskeletal Disorders and Its Surgery, Faculty of Physical Therapy, Cairo University, Ad Doqi, Giza District, Giza Governorate 11432, Egypt;
| | - Marwa Abd El-Rahman Mohamed
- Department of Physical Therapy for Women Health, Faculty of Physical Therapy, Cairo University, Ad Doqi, Giza District, Giza Governorate 11432, Egypt;
| | - Ahmed Ebrahim Elerian
- Department of Basic Science for Physical Therapy, Faculty of Physical Therapy, Cairo University, Ad Doqi, Giza District, Giza Governorate 11432, Egypt
- Correspondence: (H.A.A.A.); (A.E.E.)
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Wang L, Sun B, Cui H, Wang W, Ren Q, Sun Y, Zhang M. Long-term effects of home-based pulmonary rehabilitation on idiopathic interstitial pneumonia patients. ALL LIFE 2021. [DOI: 10.1080/26895293.2021.1898051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Lingling Wang
- Department of Respiratory, Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, People’s Republic of China
| | - Bowen Sun
- Department of Respiratory, Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, People’s Republic of China
| | - Hanwen Cui
- Department of Respiratory, Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, People’s Republic of China
| | - Wenxiu Wang
- Department of Respiratory, Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, People’s Republic of China
| | - Qiu Ren
- Department of Respiratory, Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, People’s Republic of China
| | - Yong Sun
- Department of Respiratory, Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, People’s Republic of China
| | - Min Zhang
- Department of Respiratory, Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, People’s Republic of China
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Cardiorespiratory Fitness: Reference on the Six-Minute Walk Test and Oxygen Consumption in Adolescents from South-Central Chile. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052474. [PMID: 33802300 PMCID: PMC7967604 DOI: 10.3390/ijerph18052474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 02/22/2021] [Accepted: 02/22/2021] [Indexed: 11/16/2022]
Abstract
Cardiorespiratory fitness (CRF) provides oxygen to the exercising muscles and is related to body adiposity, with cardiometabolic variables. The aim was to develop reference values and a predictive model of CRF in Chilean adolescents. A total of 741 adolescents of both genders (15.7 years old) participated in a basic anthropometry, performance in the six-minute walk test (SMWT), and in Course Navette was measured. Percentiles were determined for the SMWT, for the V̇O2max, and an equation was developed to estimate it. The validity of the equation was checked using distribution assumptions and the Bland–Altman diagram. The STATA v.14 program was used (p < 0.05). The 50th percentile values for males and females in the SMWT and in the V̇O2max of Course Navette were, respectively, from 607 to 690 and from 630 to 641 m, and from 43.9 to 45 and from 37.5 to 31.5 mlO2·kg·min−1, for the range of 13 to 17 years. For its part, the model to predict V̇O2max incorporated gender, heart rate, height, waist-to-height ratio (WHR), and distance in the SMWT (R2 = 0.62; estimation error = 0.38 LO2·min−1; p <0.001). Reference values can guide physical fitness in Chilean adolescents, and V̇O2max was possible to predict from morphofunctional variables.
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Solomon M, Mallory GB. Lung transplant referrals for individuals with cystic fibrosis: A pediatric perspective on the cystic fibrosis foundation consensus guidelines. Pediatr Pulmonol 2021; 56:465-471. [PMID: 33300243 DOI: 10.1002/ppul.25215] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/10/2020] [Accepted: 12/05/2020] [Indexed: 11/08/2022]
Abstract
Lung transplant referral guidelines for individuals with cystic fibrosis (CF) were published recently. Most of the recommendations focus on the specific indications and barriers to transplantation in adults with CF. Although the number of children with CF and end-stage lung disease continues to decrease, the specific issues related to pediatric patients merit further elucidation. We address each recommendation from the recent publication with a pediatric perspective. Furthermore, we note some significant differences between the practice and policy related to lung transplantation between Canada and the United States.
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Affiliation(s)
- Melinda Solomon
- Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - George B Mallory
- Department of Pediatrics, Section of Pulmonology, Texas Children's Hospital, Houston, Texas, USA
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Makni E, Elloumi A, Ben Brahim M, Moalla W, Tabka Z, Chamari K, Elloumi M. Six-minute walk distance equation in children and adolescents with obesity. Acta Paediatr 2020; 109:2729-2737. [PMID: 32259303 DOI: 10.1111/apa.15286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 03/25/2020] [Accepted: 03/27/2020] [Indexed: 11/27/2022]
Abstract
AIM To develop a 6-minute walk-distance (6MWD) reference equation for children and adolescents with obesity, and to assess its determinant factors. METHODS A cross-sectional study using mixed linear and multiple regression models was conducted in 497 children (235 girls and 262 boys) aged 6-18 years with a body mass index (BMI) greater than 97th percentile. Anthropometrics and a 6-minute walk test (6MWT) were performed. RESULTS Mean 6MWD was 547 ± 86 m for girls and 575 ± 96 m for boys, which averaged ~80% of a reference normal-weight population matched for age and ethnicity. Age, weight and BMI were positively correlated with 6MWD whereas waist and hip circumferences (WC and HC, respectively) were negatively correlated with 6MWD for both genders. The combination of age, height, BMI and HC explained 69% of the 6MWD variability in the equation for the whole population. Moreover, the combination of age, height, HC as well as the combination of age, height, BMI and WC explained 67% and 75% of the variability in the girls' and boys' equations, respectively. CONCLUSION This 6MWD reference equation, which was influenced by abdominal obesity markers in a gender-specific way, extends and enhances scientific knowledge and provides useful predictive tools for the care of obese children.
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Affiliation(s)
- Emna Makni
- Respiratory, and Hormonal Adaptations to Muscular Exercise Faculty of Medicine Ibn El Jazzar Laboratory of Cardio‐circulatory University of Sousse Sousse Tunisia
| | - Anis Elloumi
- Respiratory, and Hormonal Adaptations to Muscular Exercise Faculty of Medicine Ibn El Jazzar Laboratory of Cardio‐circulatory University of Sousse Sousse Tunisia
| | - Mehdi Ben Brahim
- Health and Physical Education Department Prince Sultan University Riyadh Kingdom of Saudi Arabia
| | - Wassim Moalla
- UR15JS01. Education, Motricity, Sport and Health High Institute of Sport and Physical Education Sfax University Sfax Tunisia
| | - Zouhair Tabka
- Respiratory, and Hormonal Adaptations to Muscular Exercise Faculty of Medicine Ibn El Jazzar Laboratory of Cardio‐circulatory University of Sousse Sousse Tunisia
| | - Karim Chamari
- Research Laboratory ‘Sport Performance Optimization’ National Center of Medicine and Science in Sports Tunis Tunisia
| | - Mohamed Elloumi
- Health and Physical Education Department Prince Sultan University Riyadh Kingdom of Saudi Arabia
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Albergoni A, Hettinga FJ, Stut W, Sartor F. Factors Influencing Walking and Exercise Adherence in Healthy Older Adults Using Monitoring and Interfacing Technology: Preliminary Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6142. [PMID: 32846988 PMCID: PMC7503601 DOI: 10.3390/ijerph17176142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/06/2020] [Accepted: 08/07/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND Monitoring and interfacing technologies may increase physical activity (PA) program adherence in older adults, but they should account for aspects influencing older adults' PA behavior. This study aimed at gathering preliminary wrist-based PA adherence data in free-living and relate these to the influencing factors. METHODS Ten healthy older adults (4 females, aged 70-78 years) provided health, fatigue, activity levels, attitude towards pacing, and self-efficacy information and performed a 6 min-walk test to assess their fitness. After a baseline week they followed a two-week walking and exercise intervention. Participants saw their progress via a purposely designed mobile application. RESULTS Walking and exercise adherence did not increase during the intervention (p = 0.38, p = 0.65). Self-efficacy decreased (p = 0.024). The baseline physical component of the Short Form Health Survey was the most predictive variable of walking adherence. Baseline perceived risk of over-activity and resting heart rate (HRrest) were the most predictive variables of exercise adherence. When the latter two were used to cluster participants according to their exercise adherence, the fitness gap between exercise-adherent and non-adherent increased after the intervention (p = 0.004). CONCLUSIONS Risk of over-activity and HRrest profiled short-term exercise adherence in older adults. If confirmed in a larger and longer study, these could personalize interventions aimed at increasing adherence.
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Affiliation(s)
- Andrea Albergoni
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy;
- Centro Polifunzionale di Scienze Motorie, University of Genoa, 16132 Genoa, Italy
- Department of Neuroscience (DINOGMI), University of Genoa, 16148 Genoa, Italy
- Department of Patient Care and Measurements, Philips Research, 5656AE Eindhoven, The Netherlands
| | - Florentina J. Hettinga
- School of Sport Rehabilitation and Exercise Sciences, University of Essex, Colchester CO4 3WA, UK;
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle NE1 8ST, UK
| | - Wim Stut
- Department of Chronic Disease Management, Philips Research, 5656AE Eindhoven, The Netherlands;
| | - Francesco Sartor
- Department of Patient Care and Measurements, Philips Research, 5656AE Eindhoven, The Netherlands
- School of Sport Rehabilitation and Exercise Sciences, University of Essex, Colchester CO4 3WA, UK;
- College of Health and Behavioural Science, Bangor University, Bangor LL57 2EF, UK
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Lang RL, Stockton K, Wilson C, Russell TG, Johnston LM. Exercise testing for children with cystic fibrosis: A systematic review. Pediatr Pulmonol 2020; 55:1996-2010. [PMID: 32453897 DOI: 10.1002/ppul.24794] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 03/19/2020] [Accepted: 04/13/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Exercise testing is routinely used to measure exercise capacity in children with cystic fibrosis (CF). Various tests are available, however the psychometric properties of these measures have not been systematically reviewed for this population. METHOD A systematic search of electronic databases (PubMed, Web of Science, Medline, CINHAL, Cochrane, and PEDro) was performed to identify papers that: (a) reported original psychometric data, (b) examined a measure of exercise capacity, (c) examined children with CF aged eight to 18 years; and (d) were published in English after 1950. The level of psychometric evidence was evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. RESULTS Searches identified 1025 papers. Forty-six papers were included, covering 15 tests: incremental cardiopulmonary exercise test using a cycle ergometer (CPET(cycle)) or treadmill (CPET(treadmill)), 6 minute walk test (6MWT), modified shuttle test (MST), 3-minute step test (3MST), 2 minute walk test (2MWT), Bratteby walk test, intermittent sprint test, speed ramp test, incremental step test, forward-backwards jump test (FBJT), astride jump test (AJT), motor quotient test, Munich fitness test, and Glittre ADL test. CONCLUSION There is a plethora of exercise tests available with varying psychometric robustness. The CPET, 6MWT, and MST have fair to good psychometric properties, but each with their clinical advantages and limitations. Thus, a Selection Guide was developed to assist clinicians and researchers in selecting the most appropriate exercise test for various situations.
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Affiliation(s)
- Ray Lei Lang
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Kellie Stockton
- Department of Physiotherapy, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Services, South Brisbane, Australia
| | - Christine Wilson
- Department of Physiotherapy, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Services, South Brisbane, Australia
| | - Trevor Glen Russell
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Leanne Marie Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
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Progression of muscular co-activation and gait variability in children with Duchenne muscular dystrophy: A 2-year follow-up study. Clin Biomech (Bristol, Avon) 2020; 78:105101. [PMID: 32652381 DOI: 10.1016/j.clinbiomech.2020.105101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 05/09/2020] [Accepted: 06/26/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Duchenne muscular dystrophy is an X-linked muscle disease caused by dystrophin absence. Muscle weakness is a major determinant of the gait impairments in patients with Duchenne muscular dystrophy and it affects lower limbs more often than upper limbs. Monitoring progression of motor symptoms is key to plan treatments for prolonging ambulation. METHODS The progression of gait impairment in a group of ten patients with Duchenne muscular dystrophy was observed longitudinally three times over a period of 2 years by computerized gait analysis system. Spatio-temporal parameters of gait, and variability indicators were extracted from kinematics, while lower limb muscles coactivation were measured at the baseline and at each follow-up evaluation. The 6-min walk test was used to evaluate functional capacity at each time session. FINDINGS We found a significant increase in stride width and in both stride width and stride length variability at the 1-and 2-year follow-up evaluations. Furthermore, significant higher values in proximal muscle coactivation and significant lower values in both distal muscle coactivation and functional capacity were found at the 2-year follow-up evaluation. Significant negative correlations between muscle coactivation at proximal level and functional capacity and between muscle coactivation at distal level and gait variability were observed. INTERPRETATION Our findings suggest that patients with Duchenne muscular dystrophy exhibit decline in functional capacity after 2 years from the baseline. Moreover, to cope with disease progression, patients try to maintain an effective gait by changing the balance dynamic strategies (i.e. increase in proximal muscle coactivation) during the course of disease.
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Raghuveer G, Hartz J, Lubans DR, Takken T, Wiltz JL, Mietus-Snyder M, Perak AM, Baker-Smith C, Pietris N, Edwards NM. Cardiorespiratory Fitness in Youth: An Important Marker of Health: A Scientific Statement From the American Heart Association. Circulation 2020; 142:e101-e118. [PMID: 32686505 DOI: 10.1161/cir.0000000000000866] [Citation(s) in RCA: 204] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Cardiorespiratory fitness (CRF) refers to the capacity of the circulatory and respiratory systems to supply oxygen to skeletal muscle mitochondria for energy production needed during physical activity. CRF is an important marker of physical and mental health and academic achievement in youth. However, only 40% of US youth are currently believed to have healthy CRF. In this statement, we review the physiological principles that determine CRF, the tools that are available to assess CRF, the modifiable and nonmodifiable factors influencing CRF, the association of CRF with markers of health in otherwise healthy youth, and the temporal trends in CRF both in the United States and internationally. Development of a cost-effective CRF measurement process that could readily be incorporated into office visits and in field settings to screen all youth periodically could help identify those at increased risk.
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Damen KMS, Takken T, de Groot JF, Backx FJG, Radder B, Roos ICPM, Bloemen MAT. 6-Minute Push Test in Youth Who Have Spina Bifida and Who Self-Propel a Wheelchair: Reliability and Physiologic Response. Phys Ther 2020; 100:1852-1861. [PMID: 32671398 PMCID: PMC7530576 DOI: 10.1093/ptj/pzaa121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 10/21/2019] [Accepted: 06/09/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Despite the common occurrence of lower levels of physical activity and physical fitness in youth with spina bifida (SB) who use a wheelchair, there are very few tests available to measure and assess these levels. The purpose of this study was to determine reliability and the physiologic response of the 6-minute push test (6MPT) in youth with SB who self-propel a wheelchair. METHODS In this reliability and observational study, a sample of 53 youth with SB (5-19 years old; mean age = 13 years 7 months; 32 boys and 21 girls) who used a wheelchair performed 2 exercise tests: the 6MPT and shuttle ride test. Heart rate, minute ventilation, respiratory exchange ratio, and oxygen consumption were measured using a calibrated mobile gas analysis system and a heart rate monitor. For reliability, intraclass correlation coefficients (ICCs), SE of measurement, smallest detectable change for total covered distance, minute work, and heart rate were calculated. Physiologic response during the 6MPT was expressed as percentage of maximal values achieved during the shuttle ride test. RESULTS The ICCs for total distance and minute work were excellent (0.95 and 0.97, respectively), and the ICC for heart rate was good (0.81). The physiologic response during the 6MPT was 85% to 89% of maximal values, except for minute ventilation (70.6%). CONCLUSIONS For most youth with SB who use a wheelchair for mobility or sports participation, the 6MPT is a reliable, functional performance test on a vigorous level of exercise. IMPACT This is the first study to investigate physiologic response during the 6MPT in youth (with SB) who are wheelchair using. Clinicians can use the 6MPT to evaluate functional performance and help design effective exercise programs for youth with SB who are wheelchair using.
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Affiliation(s)
- Karlijn M S Damen
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Heidelberglaan 7, Postbus 12011, 3501 AA Utrecht, the Netherlands; and Master Program Physiotherapy, Specialisation Paediatric Physiotherapy, HU University of Applied Sciences Utrecht
| | - Tim Takken
- Child Development & Exercise Center, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Janke F de Groot
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht and Child Development & Exercise Center, Wilhelmina Children’s Hospital, University Medical Center Utrecht
| | - Frank J G Backx
- Department of Rehabilitation, Physiotherapy Science and Sports, University Medical Center Utrecht
| | - Bob Radder
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht; and Child Development & Exercise Center, Wilhelmina Children’s Hospital, University Medical Center Utrecht
| | - Irene C P M Roos
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht and Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht
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Miladi A, Ben Fraj S, Latiri I, Ben Saad H. Does Ramadan Observance Affect Cardiorespiratory Capacity of Healthy Boys? Am J Mens Health 2020; 14:1557988320917587. [PMID: 32475293 PMCID: PMC7263136 DOI: 10.1177/1557988320917587] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Studies raising the issue of the effects of Ramadan observance (RO) on boys' 6-min walk test (6MWT) data are rare. The studies, which did not include control groups of non-fasters, presented contradictory results. This study aimed to compare the 6MWT data (6-min walk distance [6MWD; m, %predicted], heart rate [HR; bpm, % of maximal predicted HR]), oxy-hemoglobin saturation (Oxy-sat; %), systolic and diastolic blood pressures (SBP and DBP, respectively; mmHg) determined at rest (Rest and at the end End of the test) of a group of 22 healthy fasting boys (age: 12 to 15 years) with an age-matched non-fasting group (n = 10). The 6MWTs were performed during three experimental conditions (ECs): Pre-Ramadan, Mid-Ramadan, and Post-Ramadan. The two groups' 6MWT data for each EC were compared, and repeated factorial analysis of variance (2 groups vs. 3 ECs) was performed. Both groups had similar values of 6MWD (m, %predicted), HRRest or HREnd (bpm, % of maximal predicted HR), Oxy-satRest, Oxy-satEnd, SBPRest, and DBPRest during the three ECs. Compared to the non-fasting group, the fasting group had significantly higher SBPEnd (121 ± 10 vs. 130 ± 11) and DBPEnd (72 ± 6 vs. 78 ± 7) determined during the Mid-Ramadan EC. No significant interactive effects of the groups (2) vs. ECs (3) was found for the 6MWD (%predicted; p = .809), HRRest (%, p = .555), HREnd (%, p = .964), Oxy-satRest (p = .336), Oxy-satEnd (p = .389), SBPRest (p = .708), SBPEnd (p = .548), DBPRest (p = .277), and DBPEnd (p = .096). To conclude, in boys, RO does not impact the 6MWD, HR, or Oxy-sat, but it has minimal impact on the SBPEnd and DBPEnd.
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Affiliation(s)
- Amira Miladi
- Université de Sousse, Faculté de Médecine de Sousse, Laboratoire de Physiologie et Explorations Fonctionnelles, Sousse, Tunisia
| | - Selma Ben Fraj
- Université de Sousse, Faculté de Médecine de Sousse, Laboratoire de Physiologie et Explorations Fonctionnelles, Sousse, Tunisia
| | - Imed Latiri
- Université de Sousse, Faculté de Médecine de Sousse, Laboratoire de Physiologie et Explorations Fonctionnelles, Sousse, Tunisia,Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED University Hospital, Sousse, Tunisia
| | - Helmi Ben Saad
- Université de Sousse, Faculté de Médecine de Sousse, Laboratoire de Physiologie et Explorations Fonctionnelles, Sousse, Tunisia,Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED University Hospital, Sousse, Tunisia,Helmi Ben Saad, MD, PhD, Laboratory of Physiology, Faculty of Medicine of Sousse, Rue Mohamed KAROUI, Sousse, Tunisia.
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Andrade de Medeiros Moreira R, Ricardo Moreira T, Dias da Costa G, Vidigal Castro LC, Minardi Mitre Cotta R. Multilevel analysis of factors that influence overweight in children: research in schools enrolled in northern Brazil School Health Program. BMC Pediatr 2020; 20:188. [PMID: 32345250 PMCID: PMC7187501 DOI: 10.1186/s12887-020-02096-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 04/20/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The study evaluates children in schools that participate in the School Health Program in the Northern region of Brazil with the objective of assessing whether their schools interfered in the development of overweight/obesity and how individual and school environment variables behave according to contextual analysis. METHODS The analyses were carried out with 1036 children from 25 municipal public schools in Northern Brazil that participated in the School Health Program. We evaluated both individual characteristics and scholar environment through univariate and multivariate logistic regressions to identify which of these factors were related to overweight/obesity as well as the effect of varying such associations. RESULTS The considered individuals had an median age of 8 years, being 54.9% female and 27.8% presenting overweight/obesity. In multivariate logistic regression, the overweight/obesity variance in schools was 0.386 (individual variables) and 0.102 (individual and school variables), explaining 23.7% of the variation, reduction of ICC and MOR. The Akaike Information Criterion between the models was reduced and the likelihood ratio indicated better adequacy of the latter model. The investigated children had a greater chance of developing overweight/obesity when they performed 2+ sedentary activities/day, depending on school location as well as whether or not candies were sold in the school surroundings. On the other hand, a lower chance of developing overweight/obesity was identified in children that ate 5+ meals/day and practiced dance at school. CONCLUSION We observed that the variables inherent to both individuals and schools favored the development of overweight/obesity in children. It is relevant that scholar curriculums incorporate healthy eating interventions and encourage body practices associated with policies that restrain the sale of ultra-processed food in schools as well as the development of intersectoral actions between education and health to control childhood obesity.
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Affiliation(s)
- Renata Andrade de Medeiros Moreira
- Curso de Nutrição, Câmpus de Palmas, Universidade Federal do Tocantins, Quadra 109 Norte, Avenida NS 15, ALCNO-14, Bloco de Apoio Logístico e Administrativo 1 (BALA1) 2º andar, sala 19, Curso de Nutrição. Bairro, Plano Diretor Norte, Palmas, Tocantins 77001-090 Brazil
| | - Tiago Ricardo Moreira
- Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Avenida PH Rolfs, s/n, Câmpus Universitário, Bairro Centro, Viçosa, Minas Gerais 36570-900 Brazil
| | - Glauce Dias da Costa
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Avenida PH Rolfs, s/n, Prédio CCBII, Câmpus Universitário, Bairro Centro, Viçosa, Minas Gerais 36570-900 Brazil
| | - Luiza Carla Vidigal Castro
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Avenida PH Rolfs, s/n, Prédio CCBII, Câmpus Universitário, Bairro Centro, Viçosa, Minas Gerais 36570-900 Brazil
| | - Rosângela Minardi Mitre Cotta
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Avenida PH Rolfs, s/n, Prédio CCBII, Câmpus Universitário, Bairro Centro, Viçosa, Minas Gerais 36570-900 Brazil
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Rinaldi M, Petrarca M, Romano A, Vasco G, D'Anna C, Schmid M, Castelli E, Conforto S. EMG-based Indicators of Muscular Co-Activation during Gait in Children with Duchenne Muscular Dystrophy. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:3845-3848. [PMID: 31946712 DOI: 10.1109/embc.2019.8856892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Muscular weakness is one of the main signs associated with the onset and progression of Duchenne Muscular Dystrophy. During motor functions, this disease also determines deviations in muscular activity, especially in terms of coordination and activation between muscles acting on the same joints. In this study, surface EMG activity of the lower limb muscles of 10 children with Duchenne Muscular Dystrophy at different times from disease onset were recorded along with kinematics during unconstrained gait. Muscular co-activation of muscle pairs was then evaluated by extracting different co-activation indicators, and linking them with kinematic markers of motor function. The combination of disease progression and pharmacological treatment resulted in a significant decrease in terms of co-activation indexes for two pairs of agonist-antagonist muscles, and for one of these two pairs the decrease in co-activation was correlated with a decrease in the motor function of gait.
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Goodwin AM, Cornett KMD, McKay MJ, Burns J, Garber CE, De Vivo DC, Montes J. Limitations of 6-minute walk test reference values for spinal muscular atrophy. Muscle Nerve 2020; 61:375-382. [PMID: 31884700 DOI: 10.1002/mus.26794] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 12/20/2019] [Accepted: 12/23/2019] [Indexed: 11/11/2022]
Abstract
INTRODUCTION The 6-minute walk test (6MWT) is a well-established clinical assessment of functional endurance, validated as a measure of walking ability in spinal muscular atrophy (SMA). The current availability of disease-modifying therapies for SMA indicates a growing need for normative reference data to compare SMA patients with healthy controls. METHODS The literature was searched in two scientific databases. Studies were evaluated and selected based on adherence to American Thoracic Society guidelines for administering the 6MWT. Reference equations from the selected studies were applied to 6MWT data collected from SMA patients to calculate and compare % predicted values. RESULTS Three pediatric and six adult studies were selected for comparison. The % predicted values using the pediatric and adult equations ranged from 47.7 ± 18.2% to 67.6 ± 26.2% and 43.0 ± 17.9% to 59.5 ± 26.2%, respectively, and were significantly different (P < 0.001). DISCUSSION Results suggest significant variability between % predicted values derived from published reference equations in children and adults, despite adherence to 6MWT standardization.
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Affiliation(s)
- Ashley M Goodwin
- Department of Rehabilitation and Regenerative Medicine, Program in Physical Therapy, Columbia University Irving Medical Center, New York, New York.,Teachers College, Columbia University, New York, New York
| | - Kayla M D Cornett
- Department of Neurology, Columbia University Irving Medical Center, New York, New York
| | - Marnee J McKay
- The University of Sydney & The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Joshua Burns
- The University of Sydney & The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | | | - Darryl C De Vivo
- Department of Neurology, Columbia University Irving Medical Center, New York, New York
| | - Jacqueline Montes
- Department of Rehabilitation and Regenerative Medicine, Program in Physical Therapy, Columbia University Irving Medical Center, New York, New York.,Department of Neurology, Columbia University Irving Medical Center, New York, New York
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Cabral LA, Pereira DAG, Oliveira CC, Carvalho EMD, Velloso M. Determinants of Work in the Six-Minute Walk Test in School-Age Children. FISIOTERAPIA EM MOVIMENTO 2020. [DOI: 10.1590/1980-5918.033.ao60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: The Six-Minute Walk Test (6MWT) is widely used to assess functional capacity in children. The measure of work during 6MWT can add important information to the 6MWT assessment in this population as it relates to walking efficiency. Objective: To verify the determinants of work during the Six-Minute Walk Test (6MWTwork) in school-aged children. Method: This is a cross-sectional and exploratory study that included healthy children recruited from the public and private schools of the cities of Belo Horizonte and Uberlândia, Brazil. The inclusion criteria were: children aged 7 to 12 years without diagnosis of chronic cardiorespiratory disease, cognitive, behavioral disorder or physical function impairment (information obtained through self-report of those responsible for children). Exclusion criteria were children who refused to perform the 6MWT; who did not understand the 6MWT or who did not answer the test commands. Three hundred and nineteen school-aged children were included in the study. Correlation analyses and multiple linear regression analysis were used to identify the variables associated with the 6MWTwork. Results: Age, height, nutritional status, physical activity and heart rate showed significant correlation with 6MWTwork (p <0.001) and explained 87% of its variation (p = 0.0001). Conclusion: Age, height, nutritional status and heart rate variation are determinants of 6MWTwork that is able to evaluate functional capacity of school-aged children.
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Abstract
Mucopolysaccharidoses (MPS) are inborn errors of metabolism produced by a deficiency of one of the enzymes involved in the degradation of glycosaminoglycans (GAGs). Although taken separately, each type is rare. As a group, MPS are relatively frequent, with an overall estimated incidence of around 1 in 20,000-25,000 births. Development of therapeutic options for MPS, including hematopoietic stem cell transplantation (HSCT) and enzyme replacement therapy (ERT), has modified the natural history of many MPS types. In spite of the improvement in some tissues and organs, significant challenges remain unsolved, including blood-brain barrier (BBB) penetration and treatment of lesions in avascular cartilage, heart valves, and corneas. Newer approaches, such as intrathecal ERT, ERT with fusion proteins to cross the BBB, gene therapy, substrate reduction therapy (SRT), chaperone therapy, and some combination of these strategies may provide better outcomes for MPS patients in the near future. As early diagnosis and early treatment are imperative to improve therapeutic efficacy, the inclusion of MPS in newborn screening programs should enhance the potential impact of treatment in reducing the morbidity associated with MPS diseases. In this review, we evaluate available treatments, including ERT and HSCT, and future treatments, such as gene therapy, SRT, and chaperone therapy, and describe the advantages and disadvantages. We also assess the current clinical endpoints and biomarkers used in clinical trials.
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ÖZCAN KAHRAMAN B, YÜKSEL E, NALBANT A, KOÇAK UZ, ÜNVER B. Reference values and prediction equation for the 6-minute walk test in healthy children aged 6–12 years old. Turk J Med Sci 2019; 49:1126-1131. [PMID: 31294244 PMCID: PMC7018300 DOI: 10.3906/sag-1901-232] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND/AIM The 6-minute walk test (6MWT) is the most commonly used and well-established test to measure functional exercise capacity in research and clinical settings. Country-specific reference values are important to interpret the results of 6MWT. However, no reference values have been reported for healthy Turkish children aged between 6 and 12 years old. The aim of this study was to determine normal reference values for the 6MWT test of healthy Turkish children aged between 6 and 12 years old. MATERIALS AND METHODS Two hundred and sixty-two healthy children aged between 6 and 12 years old were included in this cross-sectional study. Measures included height, weight, body mass index (BMI), leg length, and 6MWT distance (6MWD). RESULTS The mean 6MWD was 572.58 (SD = 117.72) m. There were significant correlations between 6MWD and age (r = 0.764, P < 0.001), height (r = 0.742, P < 0.001), weight (r = 0.605, P < 0.001), BMI (r = 0.234, P < 0.001), and lower extremity length (r = 0.708, P < 0.001). In the stepwise multiple linear regression model, age and height explained about 60% of the variability of the 6MWT distance for the total sample. CONCLUSION Reference values and prediction equation for the 6MWT in healthy Turkish children aged 6–12 years old have been reported for the first time in this study. Researchers and clinicians can use them to interpret the effectiveness of a treatment and/or to compare the results of disabled children with healthy ones.
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Affiliation(s)
- Buse ÖZCAN KAHRAMAN
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, İzmirTurkey
- * To whom correspondence should be addressed. E-mail:
| | - Ertuğrul YÜKSEL
- Graduate School of Health Science, Dokuz Eylül University, İzmirTurkey
| | | | - Umut Ziya KOÇAK
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, İzmir Katip Çelebi University, İzmirTurkey
| | - Bayram ÜNVER
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, İzmirTurkey
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Yaacoby-Bianu K, Plonsky MT, Gur M, Bar-Yoseph R, Kugelman A, Bentur L. Effect of late preterm birth on lung clearance index and respiratory physiology in school-age children. Pediatr Pulmonol 2019; 54:1250-1256. [PMID: 31091024 DOI: 10.1002/ppul.24357] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 04/06/2019] [Accepted: 04/26/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND We hypothesized that former late preterm (LP) children have abnormal pulmonary physiology parameters, including uneven ventilation distribution, due to premature disruption of normal lung development. METHODS A cross-sectional study evaluating former LP children at the age of 6 to 12 years as compared to term controls. Demographics and child's and family history of asthma/atopy/smoking were recorded. The outcome parameters were spirometry, multiple breath washout (MBW) measurement by lung clearance index (LCI), 6-minute walk test (6MWT), symptoms related to asthma and allergy, and Godin Leisure-Time Exercise Questionnaire. RESULTS Twenty-nine former LP were compared to 30 term-control children (mean age, 8.2 ± 1.7 and 8.8 ± 1.8 years, respectively). LP had reduced forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) compared to term controls (FEV1 1.59 ± 0.48 vs 1.80 ± 0.39 L, P = 0.005 and FVC 1.73 ± 0.45 vs 1.99 ± 0.49 L, P = 0.009). There were no differences between the two groups regarding FEV1/FVC, forced expiratory flow between 25 and 75 (FEF25-75), LCI (7.10 ± 0.79 vs 6.96 ± 0.75, P = 0.50), 6MW distance, and weekly leisure-activity score. Former LP children had more episodes of wheezing and greater use of asthma medication. CONCLUSIONS This pilot study suggests that LP have lower pulmonary function tests (PFTs) but not ventilation inhomogeneity measured by LCI or functional disturbance. It is unclear if the differences in PFTs are due to late prematurity by itself or are the consequence of maternal and neonatal factors associated with LP. Further larger studies are required to assess the long-term respiratory consequences of LP birth.
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Affiliation(s)
- Karin Yaacoby-Bianu
- Pediatric Pulmonary Institute and CF Center, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Moran T Plonsky
- Department of Pediatrics B, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Michal Gur
- Pediatric Pulmonary Institute and CF Center, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ronen Bar-Yoseph
- Pediatric Pulmonary Institute and CF Center, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Amir Kugelman
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Neonatal Intensive Care, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Lea Bentur
- Pediatric Pulmonary Institute and CF Center, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Kuper WF, van Alfen C, van Eck L, Huijgen BC, Nieuwenhuis EE, van Brussel M, van Hasselt PM. Motor function impairment is an early sign of CLN3 disease. Neurology 2019; 93:e293-e297. [DOI: 10.1212/wnl.0000000000007773] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 03/04/2019] [Indexed: 11/15/2022] Open
Abstract
ObjectiveTo delineate timing of motor decline in CLN3 disease.MethodsMotor function, assessed by the 6-Minute Walk Test (6MWT), was evaluated repeatedly in 15 patients with CLN3 disease, resulting in 65 test results and during one occasion in 2 control cohorts. One control cohort (n = 14) had isolated visual impairment; a second cohort (n = 12) exhibited visual impairment in combination with neurologic impairments. Based on 6MWT reference values in healthy sighted children, z scores of 6MWT results in patients with CLN3 disease and control cohort individuals were calculated. 6MWT results were correlated with age—including multilevel modeling analysis allowing assessment of imbalanced repeated measurements—and with Unified Batten Disease Rating Scale (UBDRS) scores.ResultsIn CLN3 disease, 6MWT scores were already impaired from first testing near diagnosis (mean z scores of −3.6 and −4.7 at 7 and 8 years of age, respectively). Afterwards, 6MWT scores continuously declined with age (r = −0.64, p < 0.0001) and with increasing UBDRS scores (r = −0.60, p = 0.0001), confirming correlation with disease progression. The decrease was more pronounced at a later age, as shown by the nonlinear multilevel model for 6MWT results in CLN3 disease (y = 409.18 − [0.52 × age2]). In contrast, an upward trend of 6MWT scores with age was observed in the control cohort with isolated visual impairment (r = 0.56; p = 0.04) similar to healthy, sighted children. The control cohort with additional neurologic impairments displayed a slightly decreased 6MWT walking distance independent of age.ConclusionsThe 6MWT unveils early onset of motor decline in CLN3 disease.
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Vandoni M, Correale L, Puci MV, Galvani C, Codella R, Togni F, La Torre A, Casolo F, Passi A, Orizio C, Montomoli C. Six minute walk distance and reference values in healthy Italian children: A cross-sectional study. PLoS One 2018; 13:e0205792. [PMID: 30321226 PMCID: PMC6188863 DOI: 10.1371/journal.pone.0205792] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 10/02/2018] [Indexed: 11/19/2022] Open
Abstract
The 6-minute walking test (6MWT) is a simple assessment tool to evaluate exercise capacity. The result of the test is the distance that a subject can walk at a constant and normal pace within 6 minutes (6MWD) and reflects the aerobic/fitness performance related to walking function. Use of 6MWT has been relevant to assess exercise tolerance either in healthy children or in patients with, heart, lung and metabolic diseases. Our aim was to find 6MWT reference values in healthy Italian children. The 6MWT was performed in 5614 children aged 6–11 years recruited from primary Italian schools. Age related reference percentiles of the covered distance were gender-modeled. A linear and quadratic regression model was used to predict 6MWT performance. Males walked longer distances than females, respectively 598.8±83.9 m vs 592.1±77.6 m (p = 0.0016). According to the regression analysis, 6MWD was positively related to age, gender and height, while it was negatively related to body weight [(6MWD = -160.16 + 93.35× age (years) -4.05× age2(years) +7.34× gender (m) +2.12× weight (kg) −2.50× height (cm)]. Reference values were established for the 6MWT in healthy children. The age related 6MWD percentiles provided a useful tool in the assessment of capacity in 6–11 year children, in fact they may be helpful to evaluate the effect of a given treatment or rehabilitation program and represent a feasible measure as to prevention within the primary school context. It was found a substantial difference from other countries for 6mwd values. In our study, factors such as age, weight and height were relevant for the prediction of 6MWD, similarly to other studies. Therefore, these variables should be taken into account in context of exercise performance.
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Affiliation(s)
- Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- * E-mail:
| | - Luca Correale
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Mariangela Valentina Puci
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Christel Galvani
- Applied Exercise Physiology Laboratory, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Roberto Codella
- School of Exercise Sciences, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Pedagogy, Exercise and Sport Science Degree Course, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
- Metabolism Research Center, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Fabio Togni
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Antonio La Torre
- School of Exercise Sciences, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Francesco Casolo
- Department of Pedagogy, Exercise and Sport Science Degree Course, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Alberto Passi
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Claudio Orizio
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Cristina Montomoli
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
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