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Azab AR, Elnaggar RK, Aloraini GS, Aldhafian OR, Alshahrani NN, Kamel FH, Basha MA, Morsy WE. Adolescents with hemophilic knee arthropathy can improve their gait characteristics, functional ability, and physical activity level through kinect-based virtual reality: A randomized clinical trial. Heliyon 2024; 10:e28113. [PMID: 38560162 PMCID: PMC10981017 DOI: 10.1016/j.heliyon.2024.e28113] [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: 05/09/2023] [Revised: 03/12/2024] [Accepted: 03/12/2024] [Indexed: 04/04/2024] Open
Abstract
Background Hemophilic arthropathy is caused by recurrent intra-articular bleeding, most commonly in the knee joints. In terms of physical impact, this arthropathy causes significant disability and hampers the physical activity and functionality of he affected individuals. Objective This study intended to examine the effect of a physical rehabilitation program incorporating Kinect-based virtual reality (KBVR) on gait characteristics, functional ability, and physical activity level in adolescents diagnosed with hemophilic knee arthropathy (HKA). Materials and methods In a randomized clinical trial, 56 boys, aged 10-14 years, with moderate HKA, were randomly allocated into two groups. The control group (n = 28) received conventional physical therapy (CPT), while the KBVR group (n = 52) received a 30-min KBVR exercise program in addition to the CPT. Training was conducted three times/week for 12 successive weeks. Gait characteristics (step length, cadence, velocity, peak knee extension moment during stance, and knee flexion amplitude during swing) were assessed using a gait analysis system, the functional ability was assessed through the 6-min walk test, and physical activity level assessed by the Adolescents' Physical Activity Questionnaire on the pre- and post-treatment occasions. Results The KBVR group achieved more favorable changes in the gait characteristics [step length (P = 0.015), cadence (P = 0.004), velocity (P = 0.024), peak knee extension moment during stance (P = 0.018), and Knee flexion amplitude during swing (P = 0.032)], functional capacity (P = 0.002), and physical activity levels (P = 0.007) compared to the control group. Conclusion The use of KBVR exercises within a rehabilitation program is a potentially effective therapeutic option for the total care of adolescents with HKA.
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Affiliation(s)
- Alshimaa R. Azab
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Ragab K. Elnaggar
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Ghfren S. Aloraini
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam University, Al-Kharj, Saudi Arabia
| | - Osama R. Aldhafian
- Department of Surgery, College of Medicine, Prince Sattam bin Abdulaziz University, Saudi Arabia
| | - Naif N. Alshahrani
- Orthopedic surgery Department, King Fahd medical City Riyadh, Ministry of Health, Saudi Arabia
| | - FatmaAlzahraa H. Kamel
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
- Department of Physical Therapy, College of Applied Medical Sciences, Qassim University, Buraidah, Qassim, Saudi Arabia
| | - Maged A. Basha
- Department of Physical Therapy, College of Applied Medical Sciences, Qassim University, Buraidah, Qassim, Saudi Arabia
- Department of Physical Therapy, El-Sahel Teaching Hospital, General Organization for Teaching Hospitals and Institutes, Cairo, Egypt
| | - Walaa E. Morsy
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, KSA
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Lanza FC, Santos J, Selman JP, Crispim AO, Nascimento KS, Souza GM, Cano DVB, Holland AE, Solé D, Corso SD. The PAY test: a new approach for assessing functional performance in children and adolescents with asthma. J Pediatr (Rio J) 2023; 99:597-603. [PMID: 37230151 PMCID: PMC10594023 DOI: 10.1016/j.jped.2023.05.002] [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: 06/27/2022] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE To develop, validate, and test the reproducibility of a new test capable of assessing functional performance in children and adolescents (PAY test: Performance Activity in Youth). METHODS participants without and with asthma were included in the development and validation phases, respectively. The PAY test includes five activities: transition from sitting to standing, walking 10 m, step climbing, shoulder extension and flexion, and star jumps. Participants underwent the Pediatric Glittre test (TGlittre-P test time), modified shuttle test (MST), and cardiopulmonary exercise test (CPET). OUTCOMES PAY test and TGlittre-P test times, oxygen uptake (VO2peak), and distance walked in the MST. RESULTS 8 healthy volunteers, aged 12 (7 - 15) years old were included in the development phase and 34 participants with asthma, aged 11 (7 -14) years old, in the validation phase. The PAY test elicited greater physiological responses (VO2peak 33.5 ± 6.9 mL/kg) than the TGlittre-P (VO2peak: 27.4 ± 9.0 mL/kg), but lower than the MST (VO2peak: 48.9 ± 14.2 mL/kg) and CPET (VO2peak: 42.0 ± 8.8 mL/kg), p < .05. Moderate correlation between the PAY test time and the TGlittre-P time (r = 0.70, p < .001) and distance walked in the MST (r = -0.72, p < .001). The PAY test time was longer in participants with asthma than in healthy participants (3.1 [3.0 - 3.3] min vs. 2.3 [2.1 - 2.4 min]), p < .001.; and the test was reproducible (ICC 0.78, CI 95% 0.55-0.90, p < .001). CONCLUSIONS The PAY test is a valid and reproducible tool for assessing functional performance in children and adolescents with asthma.
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Affiliation(s)
- Fernanda C Lanza
- Universidade Federal de Minas Gerais (UFMG), Departamento de Fisioterapia, Belo Horizonte, MG, Brazil; Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil.
| | - Jenifer Santos
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
| | - Jessyca P Selman
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
| | - Ariane O Crispim
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
| | - Karina S Nascimento
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
| | - Giovanna M Souza
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
| | - Danila V B Cano
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
| | - Anne E Holland
- Monash University, Central Clinical School, Department of Allergy, Clinical Immunology and Respiratory Medicine, Melbourne, Victoria, Australia; Alfred Health, Physiotherapy Department, Melbourne, Victoria, Australia
| | - Dirceu Solé
- Universidade Federal de São Paulo (UNIFESP), Departamento de Pediatria, Disciplina de Alergia, Imunologia Clínica e Reumatologia, São Paulo, SP, Brazil
| | - Simone Dal Corso
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
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Kraft M, Hansmann S. [Analysis of movement disorders in paediatric and adolescent rheumatology]. ORTHOPADIE (HEIDELBERG, GERMANY) 2023:10.1007/s00132-023-04406-1. [PMID: 37391675 DOI: 10.1007/s00132-023-04406-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 07/02/2023]
Abstract
Rheumatic diseases in childhood and adolescence like juvenile idiopathic arthritis can cause movement disorders due to pain, swelling and limited range of motion. This article describes different possibilities and results of movement analysis for rheumatic diseases. The influence of JIA on specific movements in individual joints and complex movements such as gait is examined. The results of gait analyses show a great influence of the disease on spatiotemporal parameters such as gait speed, cadence and stride length, on joint angles during walking and on torques and forces. Furthermore, the importance of gait analysis for estimating the efficacy of interventions like intra-articular steroids is described. This article provides a summary of current studies on the effects of rheumatic diseases on movement disorders in children and adolescents, as well as an outlook on the increasing importance of movement analysis for therapy monitoring and optimisation.
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Affiliation(s)
- Mareen Kraft
- Abteilung I - Allgemeine Pädiatrie, Hämatologie und Onkologie, Universitätsklinik für Kinder- und Jugendmedizin Tübingen, Tübingen, Deutschland
| | - Sandra Hansmann
- Abteilung III - Neuropädiatrie, Entwicklungsneurologie und Sozialpädiatrie, Universitätsklinik für Kinder- und Jugendmedizin Tübingen, Hoppe-Seyler-Str. 1, 72076, Tübingen, Deutschland.
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Räsänen K, Markula-Patjas K, Kantanen S, Sipilä K, Lakka TA, Arikoski P, Piippo-Savolainen E. Impaired cardiorespiratory and neuromuscular fitness in children and adolescents with juvenile idiopathic arthritis: a cross-sectional case-control study in the era of biologic drug therapies. Pediatr Rheumatol Online J 2023; 21:26. [PMID: 36932386 PMCID: PMC10022213 DOI: 10.1186/s12969-023-00808-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/11/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND In recent years, biologic drug therapies have altered the course of juvenile idiopathic arthritis (JIA) possibly also improving the patients' physical fitness. However, studies measuring both cardiorespiratory and muscular fitness in children with JIA are sparse and have failed to show consistent results. Our aim was to assess both cardiorespiratory and neuromuscular fitness and contributing factors in children and adolescents with JIA in the era of biologic drug therapies. METHODS This cross-sectional study consisted of 73 JIA patients (25 boys, 48 girls) aged 6.8- 17.5 years and 73 healthy age- and sex-matched controls, investigated in 2017-2019. Cardiorespiratory fitness was assessed by maximal ergospirometry and neuromuscular fitness by speed, agility, balance, and muscle strength tests. RESULTS Means (± SD) of maximal workload (Wmax/kg) and peak oxygen uptake (VO2peak/kg,) were lower in JIA patients than in controls (Wmax/kg: 2.80 ± 0.54 vs. 3.14 ± 0.50 Watts, p < 0.01; VO2peak/kg: 38.7 ± 7.53 vs. 45.8 ± 6.59 ml/min/kg, p < 0.01). Shuttle-run, sit-up and standing long jump test results were lower in JIA patients than in controls (p < 0.01). Mean (± SD) daily activity was lower (89.0 ± 44.7 vs. 112.7 ± 62.1 min/day, p < 0.05), and sedentary time was higher (427 ± 213 vs. 343 ± 211 min/day, p < 0.05) in JIA patients compared to controls. Physical activity and cardiorespiratory or neuromuscular fitness were not associated with disease activity. CONCLUSIONS JIA patients were physically less active and had lower cardiorespiratory and neuromuscular fitness than their same aged controls with no JIA. Therefore, JIA patients should be encouraged to engage in physical activities as a part of their multidisciplinary treatment protocols to prevent adverse health risks of low physical activity and fitness.
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Affiliation(s)
- Kati Räsänen
- Pediatric Research Unit, University of Eastern Finland and Kuopio University Hospital, Kuopio, PL100, 70029 KYS, Finland.
| | - Kati Markula-Patjas
- Center for Child Health Research, Tampere University and Department of Pediatrics, Tampere University Hospital, Tampere, Finland
| | - Saija Kantanen
- Center for Child Health Research, Tampere University and Department of Pediatrics, Tampere University Hospital, Tampere, Finland
| | - Kalle Sipilä
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Timo A Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio Campus, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Pekka Arikoski
- Pediatric Research Unit, University of Eastern Finland and Kuopio University Hospital, Kuopio, PL100, 70029 KYS, Finland
| | - Eija Piippo-Savolainen
- Pediatric Research Unit, University of Eastern Finland and Kuopio University Hospital, Kuopio, PL100, 70029 KYS, Finland
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New insights in the prevalence of scoliosis and musculoskeletal asymmetries in adolescents with esophageal atresia. J Pediatr Surg 2023; 58:412-419. [PMID: 36384939 DOI: 10.1016/j.jpedsurg.2022.10.002] [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: 03/16/2022] [Revised: 09/16/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Increased risk of scoliosis and musculoskeletal abnormalities in adolescents with esophageal atresia (EA) is reported, but the impact of these abnormalities on physical fitness and motor skills are not known. METHODS Scoliosis was assessed radiographically and shoulder and chest abnormalities by a standardized protocol. Physical fitness was evaluated with Grippit, Six-minute walk test, and International Physical Activity Questionnaire and motor skills by Motor Assessment Battery for Children. RESULTS Sixty-seven EA adolescents median 16 (13-20) years participated. The prevalence of significant scoliosis (≥ 20º) was 12% (8/67) whereas 22% (15/67) had mild scoliosis (10-19º). Vertebral anomalies occurred in 18/67 (27%), eight of them (44%) had scoliosis. The majority of adolescents (15/23) with scoliosis did not have vertebral anomalies. Musculoskeletal abnormalities were detected in 22-78%. Balance problems occurred three times more frequently than expected (44% vs. 15%, p = 0.004). Submaximal exercise capacity was significantly reduced compared to reference values (p < 0.001). Scoliosis ≥ 20º was related to reduced physical activity (p = 0.008), and musculoskeletal abnormalities to reduced physical activity and impaired motor skills (p = 0.042 and p < 0.038, respectively). CONCLUSIONS Significant scoliosis was diagnosed in 12% of the EA adolescents and related to reduced physical activity. Musculoskeletal abnormalities identified in more than half of the patients, were related to reduced physical activity and impaired motor skills, and exercise capacity was significantly below reference group. EA patients with and without vertebral anomalies need health-promoting guidance to prevent impaired motor skills and consequences of reduced physical activity. LEVEL OF EVIDENCE Prognostic Study, Level II.
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Gour-Provençal G, Costa C. Metabolic Syndrome in Children With Myelomeningocele and the Role of Physical Activity: A Narrative Review of the Literature. Top Spinal Cord Inj Rehabil 2022; 28:15-40. [PMID: 36017122 DOI: 10.46292/sci21-00032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objectives The purpose of this review is to describe the current scientific literature on the prevalence of metabolic syndrome in children with myelomeningocele and to gain insight into the baseline levels of aerobic fitness, endurance, and strength in this population in order to identify gaps in knowledge, suggest potential primary prevention strategies, and provide recommendations for future studies. Methods A literature review of articles published in English and French between 1990 and April 2020 was conducted. Results Obese adolescents with myelomeningocele have an increased prevalence of components of the metabolic syndrome. Children and adolescents with myelomeningocele have decreased aerobic fitness and muscular strength, decreased lean mass, and increased fat mass, all of which, when combined with higher levels of physical inactivity, put them at higher risk of developing metabolic syndrome and cardiovascular diseases. Conclusion Until more research is conducted, addressing weight-related challenges and promoting healthy habits (such as optimal activity levels) could be easily integrated into yearly myelomeningocele clinics. An actionable suggestion might be to systematically weigh and measure children in these clinics and utilize the results and trends as a talking point with the parents and children. The follow-up appointments could also be used to develop physical activity goals and monitor progress. We recommend that the health care practitioner tasked with this intervention (physician, nurse, etc.) should be aware of locally available accessible sports platforms and have knowledge of motivational interviewing to facilitate removal of perceived barriers to physical activity.
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Affiliation(s)
| | - Camille Costa
- Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada
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Cruz-Montecinos C, Núñez-Cortés R, Vasconcello-Castillo L, Solís-Navarro L, Carrasco-Alonso B, Calatayud J, Pérez-Alenda S, Torres-Castro R. Exercise capacity in people with haemophilia: A systematic review. Haemophilia 2022; 28:891-901. [PMID: 35896002 DOI: 10.1111/hae.14646] [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: 06/11/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Exercise capacity has been established as a protective factor against joint impairment in people with haemophilia (PWH). However, little is known about how exercise capacity is affected in PWH. AIM To analyse exercise capacity, as assessed by standardised laboratory or field tests in PWH. METHODS A systematic review was conducted to identify manuscripts investigating physical capacity in PWH. An electronic search of PubMed/MEDLINE, Embase, Web of Science, CENTRAL and CINAHL was conducted from inception to 13 April, 2022. Two independent reviewers performed data extraction and assessed study quality using the critical appraisal tools of the Joanna Briggs Institute. RESULTS Nineteen studies with 825 patients were included. Most studies used the six-min walk test (6MWT) or peak/maximal oxygen consumption (VO2 max). In children, the distance walked ranged from 274 ± 36.02 to 680 ± 100 m. In adults, the distance walked ranged from 457.5 ± 96.9 to 650.9 ± 180.3 m. VO2 max ranged from 37 ± 8 to 47.42 ± 8.29 ml kg-1 min-1 . Most studies reported lower values of exercise capacity compared to standardised values. Overall, the quality of the studies was moderate. CONCLUSION Most of the studies showed that PWH have lower exercise capacity compared to reference values of 6MWT or VO2 max. Based on these results, it is necessary to emphasise in both the promotion and the prescription of physical exercise in PWH.
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Affiliation(s)
- Carlos Cruz-Montecinos
- Departament of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.,Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain.,Section of Research, Innovation and Development in Kinesiology, Kinesiology Unit, San José Hospital, Santiago, Chile
| | - Rodrigo Núñez-Cortés
- Departament of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.,Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain.,International Physiotherapy Research Network (PhysioEvidence), Barcelona, Spain
| | - Luis Vasconcello-Castillo
- Departament of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.,International Physiotherapy Research Network (PhysioEvidence), Barcelona, Spain
| | - Lilian Solís-Navarro
- International Physiotherapy Research Network (PhysioEvidence), Barcelona, Spain.,Global Research on Wellbeing (GRoW), Facultat Ciències de la Salut Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | | | - Joaquín Calatayud
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Exercise Intervention for Health Research Group (EXINH-RG), Department of, Physiotherapy, University of Valencia, Valencia, Spain
| | - Sofía Pérez-Alenda
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain
| | - Rodrigo Torres-Castro
- Departament of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.,International Physiotherapy Research Network (PhysioEvidence), Barcelona, Spain
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Mian Q, Rumsey DG, Verschuren O, Moez EK, Roy M, Kaup C, Pritchard L. Reference Values for the Six Minute Walk Test in Children with Juvenile Idiopathic Arthritis. Phys Occup Ther Pediatr 2022; 42:187-197. [PMID: 34167453 DOI: 10.1080/01942638.2021.1934239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIMS To (1) describe six-minute walk test (6MWT) reference values for children with Juvenile Idiopathic Arthritis (JIA) and (2) explore predictors of 6MWT distance. A secondary objective was to determine how 6MWT distances of children with JIA compare to those of children without JIA reported in the literature. METHODS Demographic, clinical, height, weight and 6MWT data were extracted from clinical records of 120 children with JIA (70.8% female, mean age=12.4 ± 3.2 years) who attended a follow-up rheumatology clinic. A total of 272 6MWTs were included in the analyses. Linear mixed effects modeling was used to determine the relationship between predictive variables and 6MWT distance. 6MWT distances were compared to predicted values using published equations for estimating 6MWT distances in children without JIA. RESULTS Height, weight, and age were predictive of 6MWT distance (R2 = 0.62). Mean 6MWT distances for children with JIA were lower than those reported for children without JIA (p < 0.001). Mean 6MWT distance was 84% and 78% of predicted values for children without JIA. CONCLUSION The reference values and associated predictive model have application for assessing exercise capacity in children with JIA.
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Affiliation(s)
- Qaasim Mian
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Dax G Rumsey
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.,Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Olaf Verschuren
- UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine, Utrecht University, Utrecht, The Netherlands
| | - Elham K Moez
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle Roy
- Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Cara Kaup
- Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Lesley Pritchard
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
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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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Pritchard L, Verschuren O, Roy M, Kaup C, Rumsey DG. Reproducibility of the Six‐Minute Walk Test in Children and Youth with Juvenile Idiopathic Arthritis. Arthritis Care Res (Hoboken) 2020; 74:686-690. [DOI: 10.1002/acr.24492] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 09/25/2020] [Accepted: 10/20/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Lesley Pritchard
- Department of Physical Therapy Faculty of Rehabilitation Medicine University of Alberta Canada Edmonton Alberta
| | - Olaf Verschuren
- UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine Utrecht University Utrecht the Netherlands
| | - Michelle Roy
- Glenrose Rehabilitation Hospital Edmonton Alberta Canada
| | - Cara Kaup
- Glenrose Rehabilitation Hospital Edmonton Alberta Canada
| | - Dax G. Rumsey
- Glenrose Rehabilitation Hospital Edmonton Alberta Canada
- Department of Pediatrics Faculty of Medicine and Dentistry University of Alberta Canada Edmonton Alberta
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11
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Lumsden DE, Cadwgan J. Fifteen-minute consultation: A clinical approach to the management of the child with hypertonia. Arch Dis Child Educ Pract Ed 2020; 105:276-281. [PMID: 32051164 DOI: 10.1136/archdischild-2018-315978] [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: 07/17/2019] [Revised: 10/15/2019] [Accepted: 01/17/2020] [Indexed: 11/03/2022]
Abstract
Elevated tone (hypertonia) is a common problem seen in the paediatric clinic. For most children and young people, hypertonia is just one aspect of a broader disorder of movement and posture. This paper describes a clinical approach to the management of hypertonia in children, considering the contribution of high tone to the functional problems experienced by the child, the potential adverse effects of reducing tone, side effects of the intervention and the importance of setting objectives/goals for intervention which can be measured at follow-up. We describe this as the 'MOTOR' approach and provide some examples of how it can be used in practice.
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Affiliation(s)
- Daniel E Lumsden
- Children's Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Jill Cadwgan
- Children's Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
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12
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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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Scalco JC, Minsky RC, Mayer AF, Caputo F, Schivinski CIS. Comparison of the physiological responses induced by different pediatric exercise field tests in children. Pediatr Pulmonol 2019; 54:1431-1438. [PMID: 31276325 DOI: 10.1002/ppul.24423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 06/07/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to compare the physiological responses induced by the modified shuttle walk test (MSWT), the 6-minute walk test (6MWT), and the pediatric Glittre activities of daily living test for children (TGlittre-P) in healthy children. METHOD This was an analytical observational cross-sectional study. All subjects underwent an anthropometric evaluation, pulmonary function test, TGlittre-P, 6MWT, and MSWT using a portable gas analyzer. Each test was conducted on the same day, and a maximum period of 15 days was considered for completion of the 3 days of data collection. RESULTS Overall, 24 subjects were included (mean age, 9.78 ± 1.27 years). The peak oxygen consumption (VO2peak ) during the MSWT (1409.94 ± 285.13 mL/kg/min) was significantly higher than that during the TGlittre-P (982.19 ± 205.95 mL/kg/min) and 6MWT (982.85 ± 257.09 mL/kg/min) (P < .001 for both). There was no difference in VO2peak as well as most of the physiological variables between the 6MWT and TGlittre-P (P = .987). The MSWT VO2peak correlated with the 6MWT VO2peak (r = 0.67; P = .00) and the TGlittre-P VO2peak (r = 0.43; P = .04). The VO2peak values achieved in the 6MWT and TGlittre-P were also correlated (r = 0.68; P = .00). Unlike in the MSWT, in which the physiological measurements show an incremental response, the VO2 , heart rate, minute ventilation, and respiratory exchange ratio were stabilized in the TGlittre-P and 6MWT. CONCLUSION The TGlittre-P and 6MWT showed similar physiological responses and required less metabolic, respiratory, and cardiovascular overload than the MSWT. The performance measures and VO2peak values obtained in the three tests were correlated.
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Affiliation(s)
- Janaina C Scalco
- Group on Physiotherapy Applied to Pediatric Pulmonology (NUFIPP), Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Santa Catarina, Brazil.,Physical Therapy Graduate Program, Centro de Ciências da Saúde e do Esporte (CEFID), Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Santa Catarina, Brazil
| | - Rafaela C Minsky
- Group on Physiotherapy Applied to Pediatric Pulmonology (NUFIPP), Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Santa Catarina, Brazil.,Physical Therapy Graduate Program, Centro de Ciências da Saúde e do Esporte (CEFID), Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Santa Catarina, Brazil
| | - Anamaria F Mayer
- Brazil Human Movement Sciences Graduate Program, Centro de Ciências da Saúde e do Esporte (CEFID), Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Santa Catarina, Brazil.,Physical Therapy Graduate Program, Centro de Ciências da Saúde e do Esporte (CEFID), Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Santa Catarina, Brazil
| | - Fabrizio Caputo
- Brazil Human Movement Sciences Graduate Program, Centro de Ciências da Saúde e do Esporte (CEFID), Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Santa Catarina, Brazil
| | - Camila I S Schivinski
- Group on Physiotherapy Applied to Pediatric Pulmonology (NUFIPP), Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Santa Catarina, Brazil.,Physical Therapy Graduate Program, Centro de Ciências da Saúde e do Esporte (CEFID), Universidade do Estado de Santa Catarina (UDESC), Florianópolis, Santa Catarina, Brazil
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14
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Legeret C, Mählmann L, Gerber M, Kalak N, Köhler H, Holsboer-Trachsler E, Brand S, Furlano R. Favorable impact of long-term exercise on disease symptoms in pediatric patients with inflammatory bowel disease. BMC Pediatr 2019; 19:297. [PMID: 31455308 PMCID: PMC6710863 DOI: 10.1186/s12887-019-1680-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 08/20/2019] [Indexed: 12/11/2022] Open
Abstract
Background Evidence is growing that both short- and long-term physical exercise have the potential to positively impact on the physiological system related to inflammatory indices, though, such patterns are unknown for pediatric patients with Inflammatory Bowel Disease (IBD). The aim of the present intervention study was to investigate the influence of a single bout and chronic moderate-intensity exercise on IBD-related inflammatory indices and exercise capacity among pediatric individuals with IBD and healthy controls. Method Twenty-one pediatric patients with IBD, split into a “remission-group” (IBD-RE; n = 14) and an “active disease group” (IBD-AD; n = 7), were compared to 23 age matched healthy controls (HC). All participants completed a single bout of exercise at baseline and an 8-week exercise intervention. Before and after the single bout of exercise IBD-related inflammatory indices (erythrocyte sedimentation rate (ESR), albumin, C-reactive protein (CRP), cortisol, hemoglobin, hematocrit, thrombocytes and leukocytes) were assessed. Results At baseline, after a single bout of exercise, inflammation (albumin, hemoglobin, erythrocytes, hematocrit and leukocytes) increased in all three groups IBD-AD, IBD-RE and HC. CRP and thrombocytes were only elevated in IBD-AD and IBD-RE, compared to HC. After a longer-term exercise intervention, ESR, CRP and thrombocytes significantly decreased in all groups. The longer-term exercise intervention did not decrease acute immunopathologic responses after a single bout of exercise, compared to baseline. Conclusion Whereas a single bout of exercise increases albumin, erythrocytes and leukocytes, longer-term moderate-intensity exercise reduced inflammatory markers in pediatric patients with IBD. Children and teenagers with IBD should be encouraged to engage in regular moderate-intensity exercise activities, as such activities may contribute to inflammation suppression and improved disease management.
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Affiliation(s)
- Corinne Legeret
- Children's University Hospital of Basel, Spitalstrasse 33, 4056, Basel, Switzerland. .,Children's Hospital of Aarau, Aarau, Switzerland.
| | - Laura Mählmann
- Psychiatric Clinics of the University of Basel, Centre for Affective, Stress and Sleep Disorders, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland
| | - Nadeem Kalak
- Psychiatric Clinics of the University of Basel, Centre for Affective, Stress and Sleep Disorders, University of Basel, Basel, Switzerland
| | | | - Edith Holsboer-Trachsler
- Psychiatric Clinics of the University of Basel, Centre for Affective, Stress and Sleep Disorders, University of Basel, Basel, Switzerland
| | - Serge Brand
- Psychiatric Clinics of the University of Basel, Centre for Affective, Stress and Sleep Disorders, University of Basel, Basel, Switzerland.,Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland.,Psychiatry Department, Substance Abuse Prevention and Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Raoul Furlano
- Children's University Hospital of Basel, Spitalstrasse 33, 4056, Basel, Switzerland
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15
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Rauchenzauner M, Schneider J, Colleselli V, Ruepp M, Cortina G, Högler W, Neururer S, Geiger R. Comparing modalities of conducting the six-minute walk test in healthy children and adolescents. Minerva Pediatr 2019; 71:229-234. [PMID: 31017381 DOI: 10.23736/s0026-4946.18.05185-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The 6-minute walk test (6MWT) in children can be performed in the conventional way, or by using a measuring wheel. This study aimed to compare these test modalities and to determine influencing factors. METHODS The study included 317 healthy children (172 boys) between 6 and 15 years from elementary schools and high schools, who were randomly assigned to perform a 6MWT either with or without a measuring wheel according to the guidelines of the American Thoracic Society. The 6-minute walk distance (6MWD) was compared between the two measuring modalities as well as different school types. RESULTS The use of a measuring wheel during the 6MWT led to a significantly greater 6MWD compared to conventional walking. Students of sports schools walked substantially farther than those attending general high schools, irrespective of test modality. In multivariate regression analysis height, post-test heart rate, male sex and the measuring wheel itself were all independently associated with greater 6MWD. CONCLUSIONS The use of a measuring wheel during a 6MWT reflects physical performance in children and adolescents more accurately as it includes the stretch of way around the cones during lap turns. Test modalities and sports background should be taken into account, especially when performing longitudinal monitoring and multicenter studies.
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Affiliation(s)
- Markus Rauchenzauner
- Department of Pediatrics, Hospital Ostallgäu-Kaufbeuren, Kaufbeuren, Germany - .,Department of Pediatrics, Medical University Innsbruck, Innsbruck, Austria -
| | - Johanna Schneider
- Division of Cardiology, Pulmology, Allergology, and Cystic Fibrosis, Department of Pediatrics, Medical University Innsbruck, Innsbruck, Austria
| | | | - Monika Ruepp
- Medical University Innsbruck, Innsbruck, Austria
| | - Gerard Cortina
- Division of Cardiology, Pulmology, Allergology, and Cystic Fibrosis, Department of Pediatrics, Medical University Innsbruck, Innsbruck, Austria
| | - Wolfgang Högler
- Department of Endocrinology and Diabetes, Birmingham Children's Hospital, Birmingham, UK
| | - Sabrina Neururer
- Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria
| | - Ralf Geiger
- Division of Cardiology, Pulmology, Allergology, and Cystic Fibrosis, Department of Pediatrics, Medical University Innsbruck, Innsbruck, Austria.,Department of Pediatrics, Hospital Bruneck, Bruneck, Italy
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16
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Risum K, Edvardsen E, Selvaag AM, Dagfinrud H, Sanner H. Measurement properties and performance of an eight-minute submaximal treadmill test in patients with juvenile idiopathic arthritis: a controlled study. Pediatr Rheumatol Online J 2019; 17:14. [PMID: 30961626 PMCID: PMC6454717 DOI: 10.1186/s12969-019-0316-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 03/28/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor cardiorespiratory fitness is previously reported in patients with juvenile idiopathic arthritis (JIA) measured both by maximal and submaximal exercise tests, but a submaximal exercise test with acceptable measurement properties is currently lacking for both clinical and research purposes in this patient population. The objectives of this study were to evaluate the measurement properties and performance of a submaximal treadmill test in patients with JIA, and to compare the results with those obtained in controls. METHODS Fifty-nine patients (50 girls), aged 10-16 years, with oligo- (n = 30) and polyarticular (n = 29) JIA, and 59 age- and sex-matched controls performed an eight-minute submaximal treadmill test for estimating peak oxygen uptake (VO2peak) followed by a maximal treadmill test measuring VO2peak directly. During the submaximal treadmill test, the study participants walked with no inclination at a speed between 3.2-7.2 km/h for four minutes, and then continued to walk at the same speed for four minutes with five % inclination. VO2peak was directly measured during a continuous graded exercise test on treadmill until exhaustion. Thirty-seven patients participated in the evaluation of the reliability. Criterion validity and reliability were evaluated with interclass correlation coefficient (ICC); measurement errors by Bland-Altman plot, standard error of measurement and smallest detectable change. RESULTS In patients with JIA, the ICC (95% CI) for criterion validity was acceptable at group level 0.71 (0.51, 0.82), but not at individual level. The test-retest reliability and inter-rater reliability were acceptable at individual (0.84 (0.71, 0.91) and 0.92 (0.83, 0.96), respectively) and group levels (0.91 (0.83, 0.96) and 0.96 (0.91, 0.98), respectively). The measurement errors (for test-retest reliability/inter-rater reliability) were large. Bland-Altman plots showed no systematic differences, but a large variability for both the validity and reliability. The performance of and estimated VO2peak from the submaximal test were not associated with disease variables and were comparable between patients and controls. CONCLUSION The submaximal treadmill test is valid for use in patients with JIA on group level, but not on individual level. The reliability is acceptable. Due to large measurement errors, the submaximal treadmill test is not optimal for use in daily clinical practice to estimate VO2peak in individual patients.
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Affiliation(s)
- Kristine Risum
- Division of Orthopaedic Surgery, Section for Orthopaedic Rehabilitation, Oslo University Hospital, Rikshospitalet, Postboks 4950 Nydalen, 0424 Oslo, Norway
- Department of Health Sciences, Institute of Health and Society, Oslo, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Elisabeth Edvardsen
- Department of Pulmonary Medicine, Oslo University Hospital, Ullevål, Oslo, Norway
- Department of Physical Performance, Norwegian School of Sports Sciences, Oslo, Norway
| | - Anne M. Selvaag
- Department of Rheumatology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Hanne Dagfinrud
- Department of Health Sciences, Institute of Health and Society, Oslo, Faculty of Medicine, University of Oslo, Oslo, Norway
- National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Helga Sanner
- Department of Rheumatology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Bjørknes University College, Oslo, Norway
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17
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Van de Vijver E, Van Gils A, Beckers L, Van Driessche Y, Moes ND, van Rheenen PF. Fatigue in children and adolescents with inflammatory bowel disease. World J Gastroenterol 2019; 25:632-643. [PMID: 30774277 PMCID: PMC6371006 DOI: 10.3748/wjg.v25.i5.632] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/16/2018] [Accepted: 12/20/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To identify factors other than active disease and anemia that contribute to fatigue in pediatric inflammatory bowel disease (IBD).
METHODS We performed an electronic search in Medline and EMBASE from their inception to May 2017 using the search term “fatigue” or the related keywords “physical impairment” and “inflammatory bowel disease” with the filter “child” (age 0-18 years). Cross-sectional and case-control studies were included. We restricted our search to studies published in English. We used the PRISMA checklist and flow diagram. Duplicate articles were manually deleted in End Note. To identify further relevant studies, we checked the reference lists of the selected articles.
RESULTS We identified 149 papers, of which 19 were retrieved for full text review. Eleven studies were subsequently excluded because fatigue was not evaluated as an outcome measure. Eight papers focused on the desired topic and were discussed in the final analysis. A lack of uniformity of outcome measures made the pooling of data impossible. In all but one study, questionnaires were used to evaluate fatigue. In the remaining study, an accelerometer was used to measure daily activities, sleeping time and their relationships with fatigue in a more quantifiable manner. Adolescents with IBD are significantly more fatigued than healthy controls. In addition to active disease, increased anxiety or depression and disturbed family relationships were frequently reported predictors of fatigue. Quantitative measurement of physical activity in patients with Crohn’s disease showed a reduction in the number of steps per day, and patients with ulcerative colitis had a shorter duration of physical activity during the day.
CONCLUSION Fatigue in pediatric IBD is related to a combination of biological, functional and behavioral factors, which should all be taken into account when managing fatigue.
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Affiliation(s)
- Els Van de Vijver
- Department of Paediatric Gastroenterology, Hepatology and Nutrition, Antwerp University Hospital, Edegem B-2650, Belgium
| | - Ann Van Gils
- Department of Paediatric Gastroenterology, Hepatology and Nutrition, Antwerp University Hospital, Edegem B-2650, Belgium
| | - Laura Beckers
- Department of Anesthesiology, Antwerp University Hospital, Edegem B-2650, Belgium
| | | | - Nicolette Dorien Moes
- Department of Paediatric Gastroenterology, Hepatology and Nutrition, Antwerp University Hospital, Edegem B-2650, Belgium
| | - Patrick Ferry van Rheenen
- Department of Paediatric Gastroenterology, Hepatology and Nutrition, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands
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18
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Fouasson-Chailloux A, Maugars Y, Vinatier C, Trossaert M, Menu P, Rannou F, Guicheux J, Dauty M. Clinical relevance of 3D gait analysis in patients with haemophilia. Haemophilia 2018; 24:703-710. [DOI: 10.1111/hae.13563] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2018] [Indexed: 02/06/2023]
Affiliation(s)
- A. Fouasson-Chailloux
- CHU Nantes; Physical Medicine and Rehabilitation Center; Nantes France
- Inserm; UMR 1229; RMeS, Regenerative Medicine and Skeleton; Université de Nantes; ONIRIS; Nantes France
- UFR Odontologie; Université de Nantes; Nantes France
| | - Y. Maugars
- Inserm; UMR 1229; RMeS, Regenerative Medicine and Skeleton; Université de Nantes; ONIRIS; Nantes France
- UFR Odontologie; Université de Nantes; Nantes France
- CHU Nantes; Nantes France
- Rheumatologic Department; CHU Nantes; Nantes France
| | - C. Vinatier
- Inserm; UMR 1229; RMeS, Regenerative Medicine and Skeleton; Université de Nantes; ONIRIS; Nantes France
- UFR Odontologie; Université de Nantes; Nantes France
| | - M. Trossaert
- CHU Nantes Centre Régional de traitement de l'hémophilie; Nantes France
| | - P. Menu
- CHU Nantes; Physical Medicine and Rehabilitation Center; Nantes France
- Inserm; UMR 1229; RMeS, Regenerative Medicine and Skeleton; Université de Nantes; ONIRIS; Nantes France
- UFR Odontologie; Université de Nantes; Nantes France
| | - F. Rannou
- Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis; Hôpitaux Universitaires-Paris Centre; Groupe Hospitalier Cochin; Assistance Publique-Hôpitaux de Paris; Paris France
| | - J. Guicheux
- Inserm; UMR 1229; RMeS, Regenerative Medicine and Skeleton; Université de Nantes; ONIRIS; Nantes France
- UFR Odontologie; Université de Nantes; Nantes France
- CHU Nantes; Nantes France
| | - M. Dauty
- CHU Nantes; Physical Medicine and Rehabilitation Center; Nantes France
- Inserm; UMR 1229; RMeS, Regenerative Medicine and Skeleton; Université de Nantes; ONIRIS; Nantes France
- UFR Odontologie; Université de Nantes; Nantes France
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19
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Wallek S, Senn-Malashonak A, Vogt L, Schmidt K, Bader P, Banzer W. Impact of the initial fitness level on the effects of a structured exercise therapy during pediatric stem cell transplantation. Pediatr Blood Cancer 2018; 65. [PMID: 29049845 DOI: 10.1002/pbc.26851] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/24/2017] [Accepted: 09/06/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Before and after hematopoietic stem cell transplantation (HSCT), most patients suffer from psychophysical limitations due to the treatment. Exercise interventions demonstrate beneficial effects on, for example, strength, endurance, or health-related quality of life during and after HSCT, but with a great variation among patients concerning the response to exercise. This study examines the influence of the initial fitness on the effects of an exercise therapy in pediatric HSCT. PROCEDURE Fifty-three children and adolescents (10.9 ± 3.5 years) scheduled for HSCT were randomized into an exercise intervention group (IG) or a control group (CG). During hospitalization, the IG performed endurance, strength, and flexibility training three times per week. The CG included a nonexercise program. A 6-min walk test was completed before and after the inpatient period. Baseline results (6-min walking distance [6MWD]) were used to split both groups into the following: IGUNFIT , n = 14; IGFIT , n = 12; CGUNFIT , n = 16; CGFIT , n = 11. Differences in outcome changes between groups were analyzed with H-test. RESULT Intergroup comparison revealed significant differences between IGUNFIT and CGUNFIT (P < 0.05). The IGUNFIT increased their 6MWD by +8% (vs. IGFIT , +1%); both CGs presented a decline in 6MWD (CGUNFIT , -14%; CGFIT , -16%). At discharge, the IGFIT achieved 85.5 ± 10.3% of healthy reference values. CONCLUSIONS The current results indicate that exercise during pediatric HSCT is feasible and contributes to prevention of treatment-related loss of physical function. As seen in healthy persons, patients' benefits might depend on their initial fitness level. As a diminished physical capability may result in higher training effects, impaired especially patients should engage in exercise.
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Affiliation(s)
- Susanne Wallek
- Department of Pediatric Oncology, Hematology and Hemostaseology, Goethe University Hospital, Frankfurt am Main, Germany
| | - Anna Senn-Malashonak
- Department of Pediatric Oncology, Hematology and Hemostaseology, Goethe University Hospital, Frankfurt am Main, Germany
| | - Lutz Vogt
- Department of Sports Medicine, Goethe University, Frankfurt am Main, Germany
| | - Katharina Schmidt
- Department of Sports Medicine, Goethe University, Frankfurt am Main, Germany
| | - Peter Bader
- Department of Stem Cell Transplantation and Immunology, Goethe University Hospital, Frankfurt am Main, Germany
| | - Winfried Banzer
- Department of Sports Medicine, Goethe University, Frankfurt am Main, Germany
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20
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Mählmann L, Gerber M, Furlano RI, Legeret C, Kalak N, Holsboer-Trachsler E, Brand S. Psychological wellbeing and physical activity in children and adolescents with inflammatory bowel disease compared to healthy controls. BMC Gastroenterol 2017; 17:160. [PMID: 29233119 PMCID: PMC5727963 DOI: 10.1186/s12876-017-0721-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 11/30/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Children and adolescents with inflammatory bowel disease (IBD) report impairments in daily activities, social interactions and coping. Findings regarding psychological functioning are inconsistent, while limited information is available on objectively assessed physical activity (PA). The aims of the present study were therefore to compare anthropometric dimensions, blood values, psychological functioning and PA of children and adolescents with IBD with healthy controls. METHODS Forty-seven children and adolescents took part in the study. Of these, 23 were diagnosed with IBD (mean age: 13.88 years, 44% females). The IBD group was divided into a medically well adjusted "remission-group" (n = 14; IBD-RE) and a group with an "active state" of disease (n = 8; IBD-AD). Healthy controls (n = 24; HC) were age- and gender-matched. Participants' anthropometric data, blood values and objective PA were assessed. Further, participants completed questionnaires covering socio-demographic data and psychological functioning. RESULTS Participants with IBD-AD showed higher erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) values, haemoglobin, and leukocyte values. IBD-AD had poorer psychological functioning and lower PA (average steps per day) compared to IBD-RE and HC. No mean differences were found between IBD-RE and HC. CONCLUSIONS The pattern of results suggests that effective medical treatment of IBD in children and adolescents is associated with favorable physiological parameters, psychological dimensions and PA. Psychological counselling of children and adolescents in an active state of IBD seem to be advised in addition to standard treatment schedules. TRIAL REGISTRATION NCT NCT02264275 ; Registered 8 October 2014.
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Affiliation(s)
- Laura Mählmann
- Psychiatric Clinics of the University of Basel, Centre for Affective, Stress and Sleep Disorders, University of Basel, Wilhelm Klein-Strasse 27, Ch-4012 Basel, Switzerland
- United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (UNU-MERIT), Maastricht University, Maastricht, The Netherlands
| | - Markus Gerber
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland
| | - Raoul I. Furlano
- Pediatric Gastroenterology & Nutrition, University Children’s Hospital Basel, Basel, Switzerland
| | - Corinne Legeret
- Pediatric Gastroenterology & Nutrition, University Children’s Hospital Basel, Basel, Switzerland
| | - Nadeem Kalak
- Psychiatric Clinics of the University of Basel, Centre for Affective, Stress and Sleep Disorders, University of Basel, Wilhelm Klein-Strasse 27, Ch-4012 Basel, Switzerland
| | - Edith Holsboer-Trachsler
- Psychiatric Clinics of the University of Basel, Centre for Affective, Stress and Sleep Disorders, University of Basel, Wilhelm Klein-Strasse 27, Ch-4012 Basel, Switzerland
| | - Serge Brand
- Psychiatric Clinics of the University of Basel, Centre for Affective, Stress and Sleep Disorders, University of Basel, Wilhelm Klein-Strasse 27, Ch-4012 Basel, Switzerland
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland
- Substance Abuse Prevention Research Center; Sleep Disorders Research Center, Psychiatry Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
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21
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Predicting Peak Oxygen Uptake From the 6-Minute Walk Test in Patients With Pulmonary Hypertension. J Cardiopulm Rehabil Prev 2017; 36:203-8. [PMID: 26959496 DOI: 10.1097/hcr.0000000000000174] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE To determine whether the 6-minute walk test (6MWT) is a predictor of peak oxygen uptake ((Equation is included in full-text article.)O2) in patients with idiopathic pulmonary arterial hypertension (IPAH). METHODS A total of 157 patients treated for IPAH completed a 6MWT in accordance with American Thoracic Society standards. Heart rate, pulse oximetry, and Borg rating of perceived exertion were determined at baseline and posttest. A cardiopulmonary exercise test (CPET) was performed on a cycle ergometer using a ramp protocol. Participants were stratified post hoc by age into 3 groups: children (n = 26), adolescents (n = 49), and adults (n = 82). Multiple linear regression analysis was performed to predict peak (Equation is included in full-text article.)O2 from the 6MWT. RESULTS The regression equation generated for the children was the only model to strongly predict peak (Equation is included in full-text article.)O2 (r = 0.87; P < .001). Similar models for adolescent (r = 0.59; P < .001) and adult groups (r = 0.68; P < .001) did not achieve the same level of correlation. CONCLUSION Six-Minute Walk Test was able to accurately predict peak (Equation is included in full-text article.)O2 in children (6-12 years) with IPAH; however, the model was weaker for predicting peak (Equation is included in full-text article.)O2 in older populations. These findings suggest that 6MWT may be as valid a test for predicting peak (Equation is included in full-text article.)O2 in children with IPAH as CPET measured peak (Equation is included in full-text article.)O2. In older IPAH populations, CPET is the only reliable method for the evaluation of peak (Equation is included in full-text article.)O2.
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Timmer MA, Gouw SC, Feldman BM, Zwagemaker A, de Kleijn P, Pisters MF, Schutgens REG, Blanchette V, Srivastava A, David JA, Fischer K, van der Net J. Measuring activities and participation in persons with haemophilia: A systematic review of commonly used instruments. Haemophilia 2017; 24:e33-e49. [DOI: 10.1111/hae.13367] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2017] [Indexed: 11/30/2022]
Affiliation(s)
- M. A. Timmer
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht University; The Netherlands
- Physical Therapy Research; Department of Rehabilitation; Physical Therapy Science and Sport; Brain Center Rudolf Magnus; Utrecht University; The Netherlands
| | - S. C. Gouw
- Department of Pediatric Hematology; Academic Medical Center; Amsterdam The Netherlands
| | - B. M. Feldman
- Division of Rheumatology; Department of Paediatrics; The Hospital for Sick Children; Institute of Health Policy, Management and Evaluation; Dalla Lana School of Public Health; University of Toronto; Toronto ON Canada
| | - A. Zwagemaker
- Department of Pediatric Hematology; Academic Medical Center; Amsterdam The Netherlands
| | - P. de Kleijn
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht University; The Netherlands
- Physical Therapy Research; Department of Rehabilitation; Physical Therapy Science and Sport; Brain Center Rudolf Magnus; Utrecht University; The Netherlands
| | - M. F. Pisters
- Physical Therapy Research; Department of Rehabilitation; Physical Therapy Science and Sport; Brain Center Rudolf Magnus; Utrecht University; The Netherlands
- Center for Physical Therapy Research and Innovation in Primary Care; Julius Health Care Centers; Utrecht The Netherlands
| | - R. E. G. Schutgens
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht University; The Netherlands
| | - V. Blanchette
- Department of Pediatrics; Division of Hematology/Oncology Hospital for Sick Children; University of Toronto; Toronto ON Canada
| | - A. Srivastava
- Department of Haematology; Christian Medical College; Vellore India
| | - J. A. David
- Department of Physical Medicine and Rehabilitation; Christian Medical College; Vellore India
| | - K. Fischer
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht University; The Netherlands
| | - J. van der Net
- Department of Child Development and Exercise; University Medical Center Utrecht and Children's Hospital; Utrecht University The Netherlands
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Blitz J, Stern SM, Marzan K. Do pedometers with or without education on exercise increase functional walking capacity and physical activity level in adolescents with juvenile idiopathic arthritis? Physiother Theory Pract 2017; 34:359-366. [PMID: 29131689 DOI: 10.1080/09593985.2017.1401189] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To evaluate the impact of pedometer use on the physical activity (PA) and functional walking capacity (FWC) of adolescents with juvenile idiopathic arthritis (JIA) and lower extremity (LE) involvement. Twenty-seven adolescents, aged 11-19 years with JIA and LE involvement, participated in the three-phase pedometer study that introduced the use of a pedometer and an education seminar at 6 weeks. Measurements were taken at the baseline first visit and at weeks 6, 12, and 20. The primary outcome measure was the 6-minute walk test (6MWT). Thirteen completed the study. Six-minute walk distance (6MWD) significantly increased from baseline (458.0 ± 70.8 m) to the end of phase 1 (501.4 ± 59.8 m) (p = 0.035), prior to receiving the pedometer; and from baseline to the end of study (p = 0.0037). No significant changes in 6MWD were found between weeks 6 and 12 (intervention) (p = 0.77) or between weeks 12 and 20 (follow through phase) (p = 0.27). In adolescents with LE JIA, consistent guidance and support by rheumatology professionals appears to positively influence PA and measures of FWC as seen through improved 6MWD. There was insufficient evidence to show that pedometers further increased FWC or PA.
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Affiliation(s)
- Jill Blitz
- a Department of Pediatrics, Division of Pediatric Rehabilitation Medicine , Children's Hospital Los Angeles , Los Angeles , CA , USA
| | - Sara M Stern
- b Department of Pediatrics, Division of Pediatric Immunology, Rheumatology, and Allergy , University of Utah School of Medicine, Primary Children's Medical Center , Salt Lake City , UT , USA
| | - Katherine Marzan
- c Department of Pediatrics, Division of Rheumatology , Children's Hospital Los Angeles , Los Angeles , CA , USA.,d Keck School of Medicine of USC
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Six-Minute Walk Test in Evaluation of Children with Pulmonary Arterial Hypertension. Pediatr Cardiol 2017; 38:754-761. [PMID: 28239753 PMCID: PMC5388718 DOI: 10.1007/s00246-017-1575-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 01/19/2017] [Indexed: 12/31/2022]
Abstract
Six-minute walk test (6MWT) is a submaximal exercise test applied for evaluation of adults with pulmonary arterial hypertension (PAH). It was widely used as an endpoint in the clinical trials. The aim of the study was to assess the usefulness of 6MWT in management of children with PAH and to establish correlations with other clinical features. 164 6MWT were performed in 15 children between 5 and 18 years with PAH confirmed by right heart catheterization (102 in patients with shunt, 62 without shunt). Distance in 6MWT (6MWD)-% of predicted for age and gender, desaturation at the maximum effort, peak heart rate (HR)-% of maximal HR, were compared to the level of NTproBNP, WHO-FC, echocardiography parameters, and events of PAH treatment intensification. 6MWD had low negative correlation with peak HR (τ -0.1 p = 0,03), negative correlation with NTproBNP (τ -0.17 p = 0.002), and no dependence on echocardiography parameters. The presence of shunt was associated with lower 6MWD, lower blood saturation at rest, and higher desaturation after effort. Patients in III/IV WHO-FC achieved higher rest HR and maximal HR in comparison to patients in I/II WHO-FC (63.1 vs. 55.2% p < 0.01) and lower 6MWD (64.3 vs. 77.5% p < 0.01). In 14 out of 20 6MWT performed after treatment intensification, increase of distance was observed. The results of 6MWT were consistent with clinical status (WHO-FC, NTproBNP) but not with echocardiography parameters. 6MWT may be the source of additional information in management of children with PAH.
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Stephensen D, Taylor S, Bladen M, Drechsler WI. Relationship between physical function and biomechanical gait patterns in boys with haemophilia. Haemophilia 2016; 22:e512-e518. [PMID: 27785862 DOI: 10.1111/hae.13118] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2016] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The World Federation of Haemophilia recommends joint and muscle health is evaluated using X-ray and magnetic resonance imaging, together with clinical examination scores. To date, inclusion of performance-based functional activities to monitor children with the condition has received little attention. AIM To evaluate test-retest repeatability of physical function tests and quantify relationships between physical function, lower limb muscle strength and gait patterns in young boys with haemophilia. METHODS Timed 6-minute walk, timed up and down stairs, timed single leg stance, muscle strength of the knee extensors, ankle dorsi and plantar flexors, together with joint biomechanics during level walking were collected from 21 boys aged 6-12 years with severe haemophilia. RESULTS Measures of physical function and recording of muscle strength with a hand-held myometer were repeatable (ICC > 0.78). Distances walked in six minutes, time taken to go up and down a flight of stairs and lower limb muscle strength correlated closely with ankle range of motion, together with peak knee flexion and ankle dorsi and plantarflexion moments during walking (P < 0.05). CONCLUSION Alterations in gait patterns of boys with haemophilia appear to be associated with changes in performance of physical function and performance seems to depend on their muscle strength. Timed 6-minute walk test, timed up and down steps test and muscle strength of the knee extensors showed the strongest correlation with biomechanical joint function, and hence might serve as a basis for the clinical monitoring of physical function outcomes in children with haemophilia.
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Affiliation(s)
- D Stephensen
- Kent Haemophilia Centre, Kent and Canterbury Hospital, Canterbury, UK.,Haemophilia Centre, Royal London Hospital, London, UK
| | - S Taylor
- Oxford Haemophilia Centre, Churchill Hospital, Oxford, UK
| | - M Bladen
- Haemophilia Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, UK
| | - W I Drechsler
- Faculty of Health, Social Care & Education, Angela Ruskin University, Chelmsford, UK
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Wickerson L, Rozenberg D, Janaudis-Ferreira T, Deliva R, Lo V, Beauchamp G, Helm D, Gottesman C, Mendes P, Vieira L, Herridge M, Singer LG, Mathur S. Physical rehabilitation for lung transplant candidates and recipients: An evidence-informed clinical approach. World J Transplant 2016; 6:517-31. [PMID: 27683630 PMCID: PMC5036121 DOI: 10.5500/wjt.v6.i3.517] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/31/2016] [Accepted: 08/17/2016] [Indexed: 02/06/2023] Open
Abstract
Physical rehabilitation of lung transplant candidates and recipients plays an important in optimizing physical function prior to transplant and facilitating recovery of function post-transplant. As medical and surgical interventions in lung transplantation have evolved over time, there has been a demographic shift of individuals undergoing lung transplantation including older individuals, those with multiple co-morbidites, and candidates with respiratory failure requiring bridging to transplantation. These changes have an impact on the rehabilitation needs of lung transplant candidates and recipients. This review provides a practical approach to rehabilitation based on research and clinical practice at our transplant centre. It focuses on functional assessment and exercise prescription during an uncomplicated and complicated clinical course in the pre-transplant, early and late post-transplant periods. The target audience includes clinicians involved in pre- and post-transplant patient care and rehabilitation researchers.
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Fischer K, Poonnoose P, Dunn AL, Babyn P, Manco-Johnson MJ, David JA, van der Net J, Feldman B, Berger K, Carcao M, de Kleijn P, Silva M, Hilliard P, Doria A, Srivastava A, Blanchette V. Choosing outcome assessment tools in haemophilia care and research: a multidisciplinary perspective. Haemophilia 2016; 23:11-24. [DOI: 10.1111/hae.13088] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2016] [Indexed: 01/23/2023]
Affiliation(s)
- K. Fischer
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht The Netherlands
| | - P. Poonnoose
- Department of Orthopaedics; Christian Medical College; Vellore Tamil Nadu India
| | - A. L. Dunn
- Division of Hematology and Oncology; Nationwide Children's Hospital and The Ohio State University; Columbus OH USA
| | - P. Babyn
- Department of Medical Imaging; University of Saskatchewan and Saskatoon Health Region Royal University Hospital; Saskatoon SK Canada
| | - M. J. Manco-Johnson
- Section of Hematology/Oncology/Bone Marrow Transplantation; Department of Pediatrics; University of Colorado Anschutz Medical Campus and Children's Hospital; Aurora CO USA
| | - J. A. David
- Department of PMR; Christian Medical College; Vellore Tamil Nadu India
| | - J. van der Net
- Child Health Services; Child Development and Exercise Center; University Medical Center and Children's Hospital; Utrecht The Netherlands
| | - B. Feldman
- Division of Rheumatology; Department of Paediatrics and Child Health Evaluative Sciences; Research Institute; Hospital for Sick Children; University of Toronto; Toronto ON Canada
| | - K. Berger
- Division of Haematology/Oncology; University Hospital of Munich; Munich Germany
| | - M. Carcao
- Division of Haematology/Oncology; Department of Paediatrics and Child Health Evaluative Sciences; Research Institute; Hospital for Sick Children; University of Toronto; Toronto ON Canada
| | - P. de Kleijn
- Department of Rehabilitation, Nursing Science and Sports, and Van Creveldkliniek; University Medical Center Utrecht; Utrecht The Netherlands
| | - M. Silva
- Department of Orthopaedic Surgery; Orthopaedic Institute for Children; David Geffen School of Medicine at UCLA; Los Angeles CA USA
| | - P. Hilliard
- Department of Rehabilitation; Hospital for Sick Children; University of Toronto; Toronto ON Canada
| | - A. Doria
- Department of Diagnostic Imaging; Research Institute; Hospital for Sick Children; University of Toronto; Toronto ON Canada
| | - A. Srivastava
- Department of Haematology; Christian Medical College; Vellore Tamil Nadu India
| | - V. Blanchette
- Division of Haematology/Oncology; Department of Paediatrics and Child Health Evaluative Sciences; Research Institute; Hospital for Sick Children; University of Toronto; Toronto ON Canada
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Barón Ó, Díaz G. Caminata de seis minutos: propuesta de estandarización del protocolo y aplicación práctica para la evaluación de la hipertensión pulmonar con especial referencia a la de los niños. REVISTA COLOMBIANA DE CARDIOLOGÍA 2016. [DOI: 10.1016/j.rccar.2015.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Doeleman WR, Takken T, Bronsveld I, Hulzebos EHJ. Relationship between lung function and Modified Shuttle Test performance in adult patients with cystic fibrosis: a cross-sectional, retrospective study. Physiotherapy 2015; 102:184-8. [PMID: 27101722 DOI: 10.1016/j.physio.2015.10.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 10/23/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To investigate the relationship between lung function and exercise capacity in adults with cystic fibrosis (CF), and to develop a CF-specific equation to predict Modified Shuttle Test (MST) performance from baseline data. DESIGN Cross-sectional, retrospective study. SETTING Adult CF centre. PARTICIPANTS One hundred and twenty-seven patients with CF [61 male; mean age 25 years (range 17 to 52 years), mean forced expiratory volume in 1second (FEV1) 56% predicted (range 15 to 124%)]. MAIN OUTCOME MEASURES MST and FEV1. RESULTS Overall, a moderate-to-good relationship was found between lung function and MST performance (walking distance vs FEV1% predicted: r=0.64, P=0.01). This relationship between FEV1 and MST shows an obvious threshold at an FEV1 of 67% predicted. Above this threshold, no significant association was observed between FEV1 and MST performance. However, a strong relationship (MST vs FEV1% predicted: r≥0.74, P<0.01 for men and r=0.79, P<0.01 for women) was found below an FEV1 of 67% predicted. CONCLUSIONS This study suggests that a strong association exists between lung function (FEV1% predicted) and MST (walking distance) in adult patients with moderate-to-severe CF (FEV1<67% predicted). A reference equation for MST performance was developed for those patients with FEV1 ≤67% predicted, providing a tool to make an a-priori prediction of MST walking distance.
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Affiliation(s)
- W R Doeleman
- University Medical Centre Utrecht, Rehabilitation, Nursing Science and Sport, University Hospital Utrecht, Utrecht, The Netherlands.
| | - T Takken
- University Medical Centre Utrecht, Child Development and Exercise Centre, Wilhelmina Children's Hospital Utrecht, Utrecht, The Netherlands
| | - I Bronsveld
- University Medical Centre Utrecht, Department of Pulmonology, Utrecht, The Netherlands
| | - E H J Hulzebos
- University Medical Centre Utrecht, Child Development and Exercise Centre, Wilhelmina Children's Hospital Utrecht, Utrecht, The Netherlands
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Bisaro DL, Bidonde J, Kane KJ, Bergsma S, Musselman KE. Past and current use of walking measures for children with spina bifida: a systematic review. Arch Phys Med Rehabil 2015; 96:1533-1543.e31. [PMID: 25944500 DOI: 10.1016/j.apmr.2015.04.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 04/16/2015] [Accepted: 04/21/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To describe walking measurement in children with spina bifida and to identify patterns in the use of walking measures in this population. DATA SOURCES Seven medical databases-Medline, PubMed, Embase, Scopus, Web of Science, CINAHL, and AMED-were searched from the earliest known record until March 11, 2014. Search terms encompassed 3 themes: (1) children; (2) spina bifida; and (3) walking. STUDY SELECTION Articles were included if participants were children with spina bifida aged 1 to 17 years and if walking was measured. Articles were excluded if the assessment was restricted to kinematic, kinetic, or electromyographic analysis of walking. A total of 1751 abstracts were screened by 2 authors independently, and 109 articles were included in this review. DATA EXTRACTION Data were extracted using standardized forms. Extracted data included study and participant characteristics and details about the walking measures used, including psychometric properties. Two authors evaluated the methodological quality of articles using a previously published framework that considers sampling method, study design, and psychometric properties of the measures used. DATA SYNTHESIS Nineteen walking measures were identified. Ordinal-level rating scales (eg, Hoffer Functional Ambulation Scale) were most commonly used (57% of articles), followed by ratio-level, spatiotemporal measures, such as walking speed (18% of articles). Walking was measured for various reasons relevant to multiple health care disciplines. A machine learning analysis was used to identify patterns in the use of walking measures. The learned classifier predicted whether a spatiotemporal measure was used with 77.1% accuracy. A trend to use spatiotemporal measures in older children and those with lumbar and sacral spinal lesions was identified. Most articles were prospective studies that used samples of convenience and unblinded assessors. Few articles evaluated or considered the psychometric properties of the walking measures used. CONCLUSIONS Despite a demonstrated need to measure walking in children with spina bifida, few valid, reliable, and responsive measures have been established for this population.
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Affiliation(s)
- Derek L Bisaro
- School of Physical Therapy, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Julia Bidonde
- School of Physical Therapy, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Kyra J Kane
- School of Physical Therapy, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Shane Bergsma
- Department of Computer Science, College of Arts and Science, University of Saskatchewan, Saskatoon, SK, Canada
| | - Kristin E Musselman
- School of Physical Therapy, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada; Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada; Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
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Richter J, Svozil V, Král V, Rajnohová Dobiášová L, Vetvicka V. β-glucan affects mucosal immunity in children with chronic respiratory problems under physical stress: clinical trials. ANNALS OF TRANSLATIONAL MEDICINE 2015; 3:52. [PMID: 25861607 DOI: 10.3978/j.issn.2305-5839.2015.03.20] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 03/02/2015] [Indexed: 11/14/2022]
Abstract
BACKGROUND The role of β-glucan in children with respiratory problems is getting more and more attention. In this report we focused on the effects of 30 days oral supplementation with β-glucan on physical activity and immune status of children with respiratory problems. METHODS We measured the level of sIgA, eNO and physical activity [using a 6-minute walking test (6MWT)] in 77 children and evaluated the effect of 100 mg/day oral dose. RESULTS We found a significant difference between males and females in physical endurance. In the glucan group, the positive effects of glucan were significant in both age groups. In the glucan group, we found significant decrease of eNO levels and stabilization of the sIgA levels. CONCLUSIONS Short-term oral application of natural immunomodulator β-glucan stimulated physical endurance in children with respiratory problems and, via stabilization of the sIgA levels, helps their mucosal immunity.
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Affiliation(s)
- Josef Richter
- 1 Zdravotní ústav se sídlem v Ústí nad Labem, Czech Republic ; 2 Sanatorium Edel, Zlaté Hory, Czech Republic ; 3 Department of Pathology, University of Louisville, Louisville, KY 40202, USA
| | - Vladimir Svozil
- 1 Zdravotní ústav se sídlem v Ústí nad Labem, Czech Republic ; 2 Sanatorium Edel, Zlaté Hory, Czech Republic ; 3 Department of Pathology, University of Louisville, Louisville, KY 40202, USA
| | - Vlastimil Král
- 1 Zdravotní ústav se sídlem v Ústí nad Labem, Czech Republic ; 2 Sanatorium Edel, Zlaté Hory, Czech Republic ; 3 Department of Pathology, University of Louisville, Louisville, KY 40202, USA
| | - Lucie Rajnohová Dobiášová
- 1 Zdravotní ústav se sídlem v Ústí nad Labem, Czech Republic ; 2 Sanatorium Edel, Zlaté Hory, Czech Republic ; 3 Department of Pathology, University of Louisville, Louisville, KY 40202, USA
| | - Vaclav Vetvicka
- 1 Zdravotní ústav se sídlem v Ústí nad Labem, Czech Republic ; 2 Sanatorium Edel, Zlaté Hory, Czech Republic ; 3 Department of Pathology, University of Louisville, Louisville, KY 40202, USA
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Abd-Elmone AM, Hussein Di R, Atyea Ali H. Alteration of Muscle Function and Mobility after Russian Current Stimulation in Children with Knee Hemarthrosis. TRENDS IN APPLIED SCIENCES RESEARCH 2015; 10:183-194. [DOI: 10.3923/tasr.2015.183.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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The scope of pediatric physical therapy practice in health promotion and fitness for youth with disabilities. Pediatr Phys Ther 2015; 27:2-15. [PMID: 25521261 DOI: 10.1097/pep.0000000000000098] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this report is to discuss the scope of pediatric physical therapy practice in health promotion and fitness for youth with disabilities. SUMMARY OF KEY POINTS Evidence is provided that supports integration of health promotion and fitness strategies in physical therapy clinical management. Physical therapists' roles in community-based adapted sports and fitness interventions and reimbursement considerations are discussed. CONCLUSIONS Physical therapists are in a unique position to provide expertise in the design and implementation of health promotion and fitness programs for youth with disabilities. These programs are important to promote active, healthy lifestyles and reduce comorbidities associated with sedentary behaviors and unhealthy weight, which are often seen in youth with disabilities. RECOMMENDATIONS FOR CLINICAL PRACTICE Pediatric physical therapists should incorporate health promotion and fitness strategies into practice.
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Abstract
Although the main aim of clubfoot correction is to create a foot without limitations in daily activities and sport, studies on the walking capacity of children with corrected clubfeet are rare. In this cross-sectional study, the outcome of the six-minute walking test in 44 children with clubfeet (16 unilateral and 28 bilateral, mean age 8.57±2.45 years) was compared with the reference values of Geiger, clinical status measured with the Clubfoot Assessment Protocol (CAP), and regression analysis used to calculate which CAP subgroup predicts walking capacity. The mean walking capacity was decreased to 79% (P<0.001) and was not influenced by unilaterality or bilaterality (P=0.437). The subgroup CAP morphology was a significant predictor (R=0.103; P=0.034). Knowing that walking capacity is only slightly decreased can help adjust expectations and set goals for training.
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Maria da Silva R, Brunow de Carvalho W, Johnston C, Borba de Castro M, Manta Ferreira I, Patti CL, Anthero de Azevedo R, Miziara Gonzalez A, Moura Linhares M, Augusto Salzedas-Netto A. Functional capacity after pediatric liver transplantation: a pilot study. Pediatr Transplant 2014; 18:586-93. [PMID: 25039300 DOI: 10.1111/petr.12318] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/03/2014] [Indexed: 11/30/2022]
Abstract
The prospective cross-sectional study investigated the 6MWT performance in pediatric group of liver transplant recipients (6-17 yr, median post-transplantation time of 22 months) and compared to the normal values obtained in healthy children as well as evaluated the reproducibility of the 6MWT. We analyzed the relationship between walked distance and the 6MWw, distance walked × body weight) with the anthropometric, clinical, and pulmonary functions. In post-transplanted group, the average walked distance was significantly shorter compared with control (687 ± 80 m vs. 511 ± 72 m, p < 0.001). The calculated ICC coefficient confirmed the reproducibility among tests. The Pearson correlation revealed that only walked distance in the 6MWT was moderately correlated with tidal volume. Conversely, the 6MWw was significantly correlated with age, weight, height, BMI, FVC, PEF rate, and volume expiratory. According to multiple regression analysis, age, VE and FVC factors explained 80% of the variance in the 6MWw. In conclusion, the pediatric liver transplant recipients' performance in the 6MWT is significantly lower than the values for healthy children of the same age. Notably, the 6MWw may provide relevant information, constituting an additional parameter in the determination of functional capacity.
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36
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Eriksson M, Villard L, Bartonek Å. Walking, orthoses and physical effort in a Swedish population with arthrogryposis. J Child Orthop 2014; 8:305-12. [PMID: 24907777 PMCID: PMC4128944 DOI: 10.1007/s11832-014-0597-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 05/21/2014] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Excessive movements during walking have been observed by gait analysis in children with arthrogryposis (AMC) using orthoses compared to children using only shoes. The aim of this study was to evaluate energy expenditure and functional exercise capacity in children with AMC. METHODS Twenty-four children with AMC and 25 typically developing (TD) children underwent oxygen measurement and the 6-minute walk test (6MWT). Children were divided into AMC1 using knee-ankle-foot orthoses with locked knee joints (KAFO-LK); AMC2 KAFOs with open knee joints (KAFO-O) or ankle-foot orthoses (AFO); and AMC3 using shoes. RESULTS The net non-dimensional oxygen cost (NNcost) was lower in TD (0.308) than in AMC2 (0.455, n = 10) (p = 0.002). There were no differences in the net non-dimensional consumption (NNconsumption) or normalised walking velocity. The lowest NNconsumption (0.082), NNcost (0.385) and normalised walking velocity (0.214) were found in AMC1 (n = 3), but no statistical calculation was performed. In the 6MWT, both AMC2 (402.7, n = 11) and AMC3 (476.8, n = 10) walked shorter distances (m) than TD (565.1) (p < 0.001 and p = 0.043, respectively). AMC2 (0.435) had lower normalised walking velocity than TD (0.564) (p < 0.001). CONCLUSIONS Children with AMC using open KAFOs or AFOs (AMC2) had higher energy effort represented by significantly higher NNcost than TD, whereas AMC children requiring only shoes (AMC3) did not differ significantly from TD. To maintain the NNconsumption at an acceptable level, children using locked KAFOs (AMC1) slowed down their walking velocity. Compared to TD, the exercise capacity was lower in children with AMC using open KAFOs or AFOs and shoes, represented by lower walking velocity and shorter distance walked during the 6MWT.
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Affiliation(s)
- Marie Eriksson
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden ,Q2:07 MotorikLab, Astrid Lindgren Children’s Hospital, 171 76 Stockholm, Sweden
| | - Li Villard
- Department of Physiotherapy, Astrid Lindgren Children’s Hospital, Stockholm, Sweden
| | - Åsa Bartonek
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
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Halphen I, Elie C, Brousse V, Le Bourgeois M, Allali S, Bonnet D, de Montalembert M. Severe nocturnal and postexercise hypoxia in children and adolescents with sickle cell disease. PLoS One 2014; 9:e97462. [PMID: 24878576 PMCID: PMC4039516 DOI: 10.1371/journal.pone.0097462] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 04/21/2014] [Indexed: 01/26/2023] Open
Abstract
Hypoxia is a common feature in children with sickle cell disease (SCD) that is inconsistently associated with painful crises and acute chest syndrome. To assess the prevalence and risk factors of hypoxia, we recorded daytime, nocturnal, and postexercise pulse oximetry (SpO2) values in 39 SCD patients with a median age of 10.8 years. Median daytime SpO2 was 97% (range, 89%–100%), and 36% of patients had daytime hypoxia defined as SpO2<96%. Median nocturnal SpO2 was 94.7% (range, 87.7%–99.5%), 50% of patients had nocturnal hypoxia defined as SpO2≤93%, and 11(37%) patients spent more than 10% of their total sleep time with SpO2<90%. Median postexercise SpO2 was 94% (range, 72%–100%) and 44.7% of patients had postexercise hypoxia defined as an SpO2 decrease ≥3% after a 6-minute walk test. Among patients with normal daytime SpO2, 35% had nocturnal and 42% postexercise hypoxia. Compared to 9 patients without daytime, nocturnal, or postexercise hypoxia, 25 patients with hypoxia under at least one of these three conditions had greater anemia severity (P = 0.01), lower HbF levels (P = 0.04), and higher aspartate aminotransferase levels (P = 0.03). Males predominated among patients with postexercise hypoxia (P = 0.004). Hypoxia correlated neither with painful crises nor with acute chest syndrome. Of 32 evaluable patients, 6 (18.8%) had a tricuspid regurgitation velocity ≥2.6 m/s, and this feature was associated with anemia (P = 0.044). Median percentage of the predicted distance covered during a 6-minute walk test was 86% [46–120]; the distance was negatively associated with LDH (P = 0.044) and with a past history of acute chest syndrome (P = 0.009). In conclusion, severe episodes of nocturnal and postexercise hypoxia are common in children with SCD, even those with normal daytime SpO2.
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Affiliation(s)
- Isabelle Halphen
- Pediatric Emergency Department, Hospital Necker, APHP, Paris, France
| | - Caroline Elie
- Paris Descartes University, Paris, France
- Department of Biostatistics, Hospital Necker, APHP, Paris, France
| | - Valentine Brousse
- Pediatrics Department and Sickle Cell Clinic, Hospital Necker, AP-HP, Paris, France
| | - Muriel Le Bourgeois
- Pediatric Pneumology and Allergology Department, Hospital Necker, APHP, Paris, France
| | - Slimane Allali
- Pediatrics Department and Sickle Cell Clinic, Hospital Necker, AP-HP, Paris, France
| | - Damien Bonnet
- Paris Descartes University, Paris, France
- Pediatric Cardiology Department, M3C–Necker, AP-HP, Paris, Paris Descartes University, France
| | - Mariane de Montalembert
- Paris Descartes University, Paris, France
- Pediatrics Department and Sickle Cell Clinic, Hospital Necker, AP-HP, Paris, France
- * E-mail:
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Oliveira A, Jácome C, Marques A. Physical fitness and exercise training on individuals with spina bifida: a systematic review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:1119-1136. [PMID: 24612860 DOI: 10.1016/j.ridd.2014.02.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 02/01/2014] [Accepted: 02/03/2014] [Indexed: 06/03/2023]
Abstract
Spina Bifida (SB) is characterized by several physical impairments; however, data on physical fitness and on the benefits of exercise training in individuals with SB are dispersed in the literature. Thus, this systematic review aimed to describe (i) physical fitness components (cardiorespiratory endurance, muscle strength, body composition, flexibility and neuromotor) and (ii) exercise training effects on the physical fitness of individuals with SB. CINAHL, MEDLINE and EMBASE were searched from January to March 2013 and updated in December 2013. Twenty-three studies were included. A summary of the results was performed using a best-evidence synthesis. Participants with SB had lower cardiorespiratory endurance (-32 to 54% in VO2 peak) and muscle strength (-58 to 90%) and higher body fat (159%) than their healthy peers. Mobility restrictions were present in 26.3-61% of participants. No data on neuromotor fitness were found. Aerobic and strength training improved participants' cardiorespiratory endurance (effect sizes 0.78-1.4) and muscle strength (effect sizes 0-0.59). Individuals with SB have impaired cardiorespiratory endurance, muscle strength, body composition and flexibility when compared to healthy peers. Exercise training seems to improve two of these fitness components (cardiorespiratory endurance and muscle strength). Nevertheless, the heterogeneity of the studies' designs, methods and instruments used limits the establishment of firm conclusions and highlights the need for further research.
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Affiliation(s)
- Ana Oliveira
- School of Health Sciences, University of Aveiro (ESSUA), 3810-193 Aveiro, Portugal.
| | - Cristina Jácome
- School of Health Sciences, University of Aveiro (ESSUA), 3810-193 Aveiro, Portugal.
| | - Alda Marques
- School of Health Sciences, University of Aveiro (ESSUA), 3810-193 Aveiro, Portugal; Unidade de Investigação e Formação sobre Adultos e Idosos (UniFAI), 4050-313 Porto, Portugal.
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Eid MA, Ibrahim MM, Aly SM. Effect of resistance and aerobic exercises on bone mineral density, muscle strength and functional ability in children with hemophilia. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2014. [DOI: 10.1016/j.ejmhg.2013.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Functional capacity, strength, and quality of life in children and youth with familial Mediterranean fever. Pediatr Phys Ther 2014; 26:347-52. [PMID: 24979093 DOI: 10.1097/pep.0000000000000052] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To examine functional capacity and muscle strength in children and youth with familial Mediterranean fever (FMF) as compared with controls, and to assess whether these factors influence quality of life (QOL) in FMF. METHODS A total of 100 subjects with FMF and 55 control subjects (8-18 years old) without known health issues were enrolled in the study. The 6-Minute Walk Test (6MWT) was used to evaluate functional capacity. Quadriceps strength was measured with a hand-held dynamometer. Quality of life was evaluated with the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0). RESULTS Significant differences were found between subjects with FMF and controls in the 6MWT and strength test. PedsQL scores of subjects with FMF were significantly lower than the scores of the controls. The 6MWT and quadriceps strength were weakly correlated with the PedsQL. CONCLUSION Subjects with FMF displayed lower functional capacity and QOL than peers who are healthy. Decreased functional capacity was correlated with decreased QOL in those with FMF.
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Stephensen D, Drechsler WI, Scott OM. Outcome measures monitoring physical function in children with haemophilia: a systematic review. Haemophilia 2013; 20:306-21. [PMID: 24252123 DOI: 10.1111/hae.12299] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2013] [Indexed: 12/13/2022]
Abstract
Our objective was to provide a synthesis of measurement properties for performance-based outcome measures used to evaluate physical function in children with haemophilia. A systematic review of articles published in English using Medline, PEDro, Cinahl and The Cochrane Library electronic databases was conducted. Studies were included if a performance-based method, clinical evaluation or measurement tool was used to record an aspect of physical function in patients with haemophilia aged ≤ 18 years. Recording of self-perceived or patient-reported physical performance, abstracts, unpublished reports, case series reports and studies where the outcome measure was not documented or cross-referenced was excluded. Description of outcome measures, patient characteristics, measurement properties for construct validity, internal consistency, repeatability, responsiveness and feasibility was extracted. Data synthesis of 41 studies evaluating 14 measures is reported. None of the outcome measures demonstrated the requirements for all the measurement properties. Data on validity and test-retest repeatability were most lacking together with studies of sufficient size. Measurement of walking and muscle strength demonstrated good repeatability and discriminative properties; however, correlation with other measures of musculoskeletal impairment requires investigation. The Haemophilia Joint Health Score demonstrated acceptable construct validity, internal consistency and repeatability, but the ability to discriminate changes in physical function is still to be determined. Rigorous evaluation of the measurement properties of performance-based outcome measures used to monitor physical function of children with haemophilia in larger collaborative studies is required.
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Affiliation(s)
- D Stephensen
- School of Health, Sport and Bioscience, University of East London, London, UK; Kent Haemophilia Centre, Kent and Canterbury Hospital, Canterbury, UK
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Halliday M, Selvadurai H, Sherwood M, Fitzgerald DA. Exercise in children with common congenital heart lesions: balancing benefits with risks. J Paediatr Child Health 2013; 49:795-9. [PMID: 24131111 DOI: 10.1111/jpc.12388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Children with corrected common congenital heart lesions are often withheld from regular exercise by their parents. While there are some modest risks with exercise, they should be seen in perspective, and the life-long benefits of regular exercise on general health, mood and well-being should be emphasised.
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Affiliation(s)
- Melanie Halliday
- Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
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43
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Relationship between physical activity and functional ability in school-aged children with hemophilia. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.poamed.2013.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Oliveira AC, Rodrigues CC, Rolim DS, Souza AAL, Nascimento OA, Jardim JR, Rozov T. Six-minute walk test in healthy children: is the leg length important? Pediatr Pulmonol 2013; 48:921-6. [PMID: 23169476 DOI: 10.1002/ppul.22696] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Accepted: 10/08/2012] [Indexed: 12/21/2022]
Abstract
RATIONALE Measures as height, age, and weight influence the six-minute walk test (6MWT). It was shown that children's true leg length (TLL) influence the 6MWT distance but so far it has never been evaluated how much this variable could predict the distance walked related to height. Our hypothesis is that there should not have any significant difference between models including height or TLL. OBJECTIVE To establish and to compare the predicted walked distance of healthy children in the 6MWT by two distinct models, one including TLL and other including height. METHODS Observational cross sectional study. A total of 161 healthy children (84 girls, 52.2%), 6-13 years old from three local primary and secondary schools. Two 6MWT were performed following ATS guidelines. Weight, height, and TLL were measured. The longer walked distance was selected for statistical analysis. RESULTS Anthropometric data were similar for both genders into each group of age. Mean (±SD) walked distances in whole group were: boys 704.4 m (77.7); girls 681.6 m (67.9; P = 0.049). In the univariate regression to predict the distance walked, the adjusted coefficients to TLL and height were in boys: 0.46 and 0.39; and in girls: 0.35 and 0.29, respectively. After adjusting for age and weight, the residuals of the two equations were not significantly different (P = 0.998). CONCLUSION The model including TLL to predict the walked distance by healthy children explained more of the variation on the walked distance in the 6MWT than the model using the height but without significant difference between the models.
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Affiliation(s)
- Andréia C Oliveira
- Pulmonary Rehabilitation Center, Federal University of São Paulo/Associação de Assistência à Criança Deficiente, São Paulo, Brazil
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Hinckson EA, Dickinson A, Water T, Sands M, Penman L. Physical activity, dietary habits and overall health in overweight and obese children and youth with intellectual disability or autism. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:1170-1178. [PMID: 23400004 DOI: 10.1016/j.ridd.2012.12.006] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2012] [Revised: 12/10/2012] [Accepted: 12/12/2012] [Indexed: 06/01/2023]
Abstract
In children and youth with disability, the risk of obesity is higher and is associated with lower levels of physical activity, inappropriate eating behaviors, and chronic health conditions. We determined the effectiveness of a program in managing weight, through changes in physical activity and nutrition behaviors in overweight and obese New Zealand children and youth with intellectual disability or autism. Twenty-two children and youth 14±4 y (mean±SD) and their families participated in a 10-week school-based program. The program consisted of 18 sessions focusing on physical activity and nutrition. Changes were measured immediately after completion of the program (post 1) and at 24 weeks (follow up). Fitness was assessed with the six-minute walk-test (6MWT) and body fatness via waist circumference and BMI. Physical activity and nutrition changes were measured by means of proxy reporting and interviews with parents. Individual interviews were conducted with school teachers and program leaders at 24 weeks to gain feedback regarding the program. Most quantitative outcomes were either unclear or trivial. The only possible change was observed in the six-minute walk-test where 24 weeks post program where participants walked 51 m further. There was however, a substantial reduction in the consumption of confectionery and chocolate at the two measurement points. Parents commented that during the program there were less hospital visits and absences from school related to illness. The program assisted in the development of a supportive community network and participants' abilities to partake in family and community activities. This the first study to report on the results of a physical activity and nutrition program targeted in children and youth with intellectual disability and autism. The results of this study may support and inform future developments of an integrated weight management and prevention program to enhance the health and well being in children and youth with disabilities.
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Affiliation(s)
- Erica A Hinckson
- Centre for Child Health Research, Institute of Public Health and Mental Health, Auckland University of Technology, New Zealand.
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Negrier C, Seuser A, Forsyth A, Lobet S, Llinas A, Rosas M, Heijnen L. The benefits of exercise for patients with haemophilia and recommendations for safe and effective physical activity. Haemophilia 2013; 19:487-98. [DOI: 10.1111/hae.12118] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2013] [Indexed: 01/29/2023]
Affiliation(s)
- C. Negrier
- Unité d'Hémostase Clinique; Centre Régional de Traitement de l'Hémophilie; Lyon; France
| | | | - A. Forsyth
- Christiana Care Health System Hemophilia Program; Newark; DE; USA
| | - S. Lobet
- Haemostasis and Thrombosis Unit; Cliniques Universitaires Saint-Luc; Université Catholique de Louvain; Brussels; Belgium
| | - A. Llinas
- Department of Orthopedics and Traumatology; Fundación Santa Fe de Bogotá; University Hospital and Universidad de los Andes; School of Medicine; Bogotá; Colombia
| | - M. Rosas
- National Hemophilia Center; Banco Metropolitano de Sangre DC; Caracas; Venezuela
| | - L. Heijnen
- Van CreveldKliniek; UMC; Utrecht and Rehabilitation Centre De Trappenberg; Huizen; The Netherlands
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Okuro RT, Schivinski CIS. Teste de caminhada de seis minutos em pediatria: relação entre desempenho e parâmetros antropométricos. FISIOTERAPIA EM MOVIMENTO 2013. [DOI: 10.1590/s0103-51502013000100024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: Diferenças antropométricas podem influenciar o desempenho no teste de caminhada de seis minutos (TC6). OBJETIVO: Analisar publicações referentes ao TC6 realizado em crianças e adolescentes e identificar a influência de parâmetros antropométricos no desempenho do teste. MATERAIS E MÉTODOS: Pesquisa nas bases de dados eletrônicas SciELO e MEDLINE, utilizando as palavras-chave: six-minute walk test, children, adolescents, anthropometric measures/variables, growth e exercise tolerance, na busca de estudos envolvendo TC6 em crianças e adolescentes, que apresentem correlação entre dados antropométricos e variáveis do teste. Foram identificados 45 trabalhos relacionados à busca e, após análise dos títulos, resumos e artigos na íntegra, foram incluídos 13 estudos compatíveis com o tema proposto. RESULTADOS: O material elencado aborda o TC6 e sua aplicação em diferentes situações: análise de reprodutibilidade, correlação com teste cardiopulmonar máximo, indicação em diferentes doenças, valores de referência em saudáveis, parâmetro de efeito de programas de prevenção/reabilitação. Muitos trabalhos relacionam a distância percorrida no TC6 com idade e sexo, bem como com variáveis antropométricas, evidenciando frequente correlação com altura, além de idade, peso e índice de massa corporal. Outros dados como comprimento e força de membros inferiores, porcentagem de massas gorda/magra e força muscular respiratória, relacionados às mudanças do período de desenvolvimento infanto-juvenil, também parecem influenciar no desempenho do teste. CONCLUSÃO: Estudos indicam forte influência entre variáveis antropométricas e distância percorrida no TC6 em crianças e adolescentes, e a necessidade de que se esclareça essa associação para que não haja comprometimento do desfecho de estudos e de terapêuticas.
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48
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Groen W, van der Net J, Lacatusu AM, Serban M, Helders PJM, Fischer K. Functional limitations in Romanian children with haemophilia: further testing of psychometric properties of the Paediatric Haemophilia Activities List. Haemophilia 2013; 19:e116-25. [DOI: 10.1111/hae.12090] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2012] [Indexed: 11/28/2022]
Affiliation(s)
- W. Groen
- Child Development and Exercise Center, University Children's Hospital; University Medical Center Utrecht; Utrecht; The Netherlands
| | - J. van der Net
- Child Development and Exercise Center, University Children's Hospital; University Medical Center Utrecht; Utrecht; The Netherlands
| | - A. M. Lacatusu
- Clinical Center for Evaluation and Rehabilitation “Cristian Serban”; Buzias; Romania
| | | | - P. J. M. Helders
- Child Development and Exercise Center, University Children's Hospital; University Medical Center Utrecht; Utrecht; The Netherlands
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Yimlamai D, Freiberger DA, Gould A, Zhou J, Boyer D. Pretransplant six-minute walk test predicts peri- and post-operative outcomes after pediatric lung transplantation. Pediatr Transplant 2013; 17:34-40. [PMID: 23067306 DOI: 10.1111/petr.12010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2012] [Indexed: 12/12/2022]
Abstract
UNLABELLED The purpose of the pretransplant assessment in lung transplantation is to determine a patient's need for transplant as well as their potential survival post-procedure. In 2005, the UNOS introduced the LAS, a calculation based on multiple physiologic measures to determine need and likelihood for survival. Measures include NYHA class and the 6-MWT. Some adult studies indicate a positive correlation with 6-MWT and waiting list survival. In pediatric/adolescent patients, there are minimal data regarding the predictive value of physiologic markers in either wait list survival or post-transplant outcome. A retrospective cohort study of 60 consecutive lung transplantations from 1990 to 2008 was performed at a pediatric tertiary care facility. Functional pretransplant assessments were abstracted from the medical record and compared with outcomes after transplantation. RESULTS a 6-MWT of >1000 ft (305 m) prior to transplantation correlated with a shorter ICU stay (7 vs. 11 days, p = 0.046) and fewer days of mechanical ventilation (2 vs. 4, p = 0.04). A pretransplant 6-MWT greater than 750 ft (229 m) correlated with shorter overall hospitalization (37 vs. 20 days, p = 0.03). Measuring pretransplant 6-MWT tests for pediatric patients is valuable in predicting peri-operative outcomes after lung transplantation.
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Affiliation(s)
- Dean Yimlamai
- Division of Gastroenterology and Nutrition, Department of Medicine, Boston Children's Hospital, Boston, MA 02115, USA
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Rosipal NC, Mingle L, Smith J, Morris GS. Assessment of Voluntary Exercise Behavior and Active Video Gaming Among Adolescent and Young Adult Patients During Hematopoietic Stem Cell Transplantation. J Pediatr Oncol Nurs 2012; 30:24-33. [DOI: 10.1177/1043454212461071] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This pilot study sought to examine the exercise behavior and preferences among adolescent and young adult (AYA) hematopoietic stem cell transplant (HSCT) recipients. Eighteen patients aged 19 to 25 years were recruited to engage in unsupervised exercise activities lasting at least 60 minutes/week during hospitalization for HSCT. Enrolled patients had access to standard exercise activities (walking, resistance training, and basketball) and active video gaming equipment. Physical function (6-Minute Walk Test and Timed-Up-and-Go test) and quality of life (Behavioral, Affective, and Somatic Experiences Scale) were assessed at different time points during admission. Participants exercised an average of 76% of the days during admission and spent an average of 36.5 minutes per day exercising. The Nintendo Wii was the preferred active video gaming equipment, but standard exercises accounted for 73% of all exercise time. Neither functional capacity nor quality of life improved. Results suggest that AYAs voluntarily exercise during HSCT admission, prefer to use standard exercise activities, and may require supervision in order to derive maximum benefits from their efforts. These results provide guidance for developing rehabilitation interventions for AYA HSCT recipients.
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Affiliation(s)
| | | | - Janet Smith
- The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
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