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Tanel MR, Gupta C, Wilson KE, Murphy J, Wright FV, Reed N. The Concussion Challenge Assessment: Development and reliability of a novel gross motor assessment tool for paediatric concussion. Front Sports Act Living 2022; 4:1027339. [PMID: 36589783 PMCID: PMC9795185 DOI: 10.3389/fspor.2022.1027339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/16/2022] [Indexed: 12/15/2022] Open
Abstract
Aims The aim of this study was to develop a gross motor performance clinical assessment tool, the Concussion Challenge Assessment (CCA), for paediatric concussion populations. Methods An expert panel evaluated tasks from the Acquired Brain Injury Challenge Assessment to determine relevant tasks for a paediatric concussion population. These tasks were administered to a convenience sample of 854 healthy youth. An analysis of the response options for each task, considering task difficulty, was performed. The test-retest reliability of each task was considered to finalise the tool. Results The Acquired Brain Injury Challenge Assessment was reduced to six tasks (three coordination, two speed and agility, and one strength) to create the CCA. Population-specific 4-point response options were generated, which, upon examination of task difficulty, were revised as 5-point response sets to better capture performance differences. The test-retest reliability results led to acceptance of all six: three performance tasks and three exertion tasks. Conclusion This development of the CCA is an important step in creating a gross motor performance assessment tool that can assist in the determination of when youth are able to safely return to activity following a concussion.
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Affiliation(s)
- Michelle R. Tanel
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Christopher Gupta
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Katherine E. Wilson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - James Murphy
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - F. Virginia Wright
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, ON, Canada,Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nick Reed
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, ON, Canada,Correspondence: Nick Reed
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Barak S, Silberg T, Gerner M, Eisenstein E, Bardach CA, Yissar T, Landa J. Functional neurological symptom disorder: Preliminary findings of factors associated with walking ability post integrative pediatric rehabilitation. J Pediatr Rehabil Med 2022; 15:433-446. [PMID: 36031917 DOI: 10.3233/prm-210107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The current study's aims were to (1) examine long-distance walking ability (6-minute walking test [6MWT]) and walking hemodynamic responses (i.e., heart rate) among youth with functional neurological symptom disorder (FNSD) before and after an integrative pediatric rehabilitation (IPR) program; and (2) explore factors predicting improvement in walking ability. METHODS Thirty-one youth with FNSD participating in an IPR program were recruited. The IPR program was activated biweekly in an ambulatory format. Study measures included the 6MWT, hemodynamic characteristics, rate of perceived exertion (RPE), pain-intensity perception, and Child's Somatization Inventory-24 (CSI-24). All measures were conducted upon admission to the IPR and discharge. RESULTS Findings indicated a significant increase in 6MWT distance, as well as decreases in heart rate, RPE, and pain-intensity perception from admission to discharge. At admission, CSI-24 and pain intensity predicted 6MWT distance (adjusted R2 = 0.68). Pain intensity predicted discharge 6MWT distance (adjusted R2 = 0.18). Initial 6MWT predicted changes in 6MWT distance from admission to discharge (adjusted R2 = 0.33). CONCLUSION Using an integrative rehabilitation approach increases walking distance and decreases pain-related symptoms in youth with FNSD, emphasizing the need for collaboration between physical therapists and pediatric psychologists. Moreover, changes in walking ability may increase participation and thus should be the focus of IPR.
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Affiliation(s)
- Sharon Barak
- Department of Nursing, College of Health Sciences, Ariel University, Ariel, Israel.,Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Tamar Silberg
- Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat-Gan, Israel.,Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - Maya Gerner
- Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Etzyona Eisenstein
- Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Chen Arzoni Bardach
- Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Tamar Yissar
- Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Jana Landa
- Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat-Gan, Israel.,The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Köster P, Hohmann A, Niessner C, Siener M. Health-Related Motor Testing of Children in Primary School: A Systematic Review of Criterion-Referenced Standards. CHILDREN (BASEL, SWITZERLAND) 2021; 8:1046. [PMID: 34828759 PMCID: PMC8619070 DOI: 10.3390/children8111046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 01/03/2023]
Abstract
Being physically fit in younger years prevents several diseases in the presence as well as in the life course. Therefore, monitoring physical fitness and motor competence through motor testing is essential for determining developmental status and identifying health-related risks. The main objectives of this systematic review were (1) to identify currently available health-related criterion-referenced standards and cut-off points for physical fitness and motor competence test items, (2) to frame the methodological background on setting health-related criterion-referenced standards and (3) to give implications for a health-related evaluation system for physical fitness and motor competence tests. The electronic data base search (PubMed, Web of Science and SURF) yielded 2062 records in total and identified six empirical studies reporting cut-off points of motor test items for children (7-10 years), as well as 30 methodological papers discussing determination approaches to health-related criterion-referenced standards. Data collection, selection and analyses followed the PRISMA guidelines. Health-related motor test standards need to be gender- and age-specific but should refer to an absolute cut-off point rather than to relative performance in the reference group. Due to the lack of data on health-related criterion referenced standards, receiver-operating-characteristic (ROC) curves provide a tool for the determination of cut-off points and criterion referenced standards for physical fitness and motor competence tests. A standardized approach forms the fundamental base for a globally applicable evaluation of health-related fitness tests.
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Affiliation(s)
- Paulina Köster
- Institute of Sport Science, University of Bayreuth, Universitätsstraße 30, 95447 Bayreuth, Germany; (A.H.); (M.S.)
| | - Andreas Hohmann
- Institute of Sport Science, University of Bayreuth, Universitätsstraße 30, 95447 Bayreuth, Germany; (A.H.); (M.S.)
| | - Claudia Niessner
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany;
| | - Maximilian Siener
- Institute of Sport Science, University of Bayreuth, Universitätsstraße 30, 95447 Bayreuth, Germany; (A.H.); (M.S.)
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Weightman MM, McCulloch KL, Radomski MV, Finkelstein M, Cecchini AS, Davidson LF, Heaton KJ, Smith LB, Scherer MR. Further Development of the Assessment of Military Multitasking Performance: Iterative Reliability Testing. PLoS One 2017; 12:e0169104. [PMID: 28056045 PMCID: PMC5215871 DOI: 10.1371/journal.pone.0169104] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 12/12/2016] [Indexed: 11/24/2022] Open
Abstract
The Assessment of Military Multitasking Performance (AMMP) is a battery of functional dual-tasks and multitasks based on military activities that target known sensorimotor, cognitive, and exertional vulnerabilities after concussion/mild traumatic brain injury (mTBI). The AMMP was developed to help address known limitations in post concussive return to duty assessment and decision making. Once validated, the AMMP is intended for use in combination with other metrics to inform duty-readiness decisions in Active Duty Service Members following concussion. This study used an iterative process of repeated interrater reliability testing and feasibility feedback to drive modifications to the 9 tasks of the original AMMP which resulted in a final version of 6 tasks with metrics that demonstrated clinically acceptable ICCs of > 0.92 (range of 0.92–1.0) for the 3 dual tasks and > 0.87 (range 0.87–1.0) for the metrics of the 3 multitasks. Three metrics involved in recording subject errors across 2 tasks did not achieve ICCs above 0.85 set apriori for multitasks (0.64) and above 0.90 set for dual-tasks (0.77 and 0.86) and were not used for further analysis. This iterative process involved 3 phases of testing with between 13 and 26 subjects, ages 18–42 years, tested in each phase from a combined cohort of healthy controls and Service Members with mTBI. Study findings support continued validation of this assessment tool to provide rehabilitation clinicians further return to duty assessment methods robust to ceiling effects with strong face validity to injured Warriors and their leaders.
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Affiliation(s)
- Margaret M. Weightman
- Courage Kenny Research Center, Abbott Northwestern Hospital, Minneapolis, Minnesota, United States of America
- * E-mail:
| | - Karen L. McCulloch
- Division of Physical Therapy, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Mary V. Radomski
- Courage Kenny Research Center, Abbott Northwestern Hospital, Minneapolis, Minnesota, United States of America
| | - Marsha Finkelstein
- Courage Kenny Research Center, Abbott Northwestern Hospital, Minneapolis, Minnesota, United States of America
| | - Amy S. Cecchini
- Courage Kenny Research Center, Abbott Northwestern Hospital, Minneapolis, Minnesota, United States of America
- Defense and Veterans Brain Injury Center, Fort Bragg, North Carolina, United States of America
| | - Leslie F. Davidson
- Department of Clinical Research and Leadership, George Washington School of Medicine and Health Sciences, Washington, DC, United States of America
| | - Kristin J. Heaton
- United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States of America
- Boston University School of Public Health, Department of Environmental Health, Boston, Massachusetts, United States of America
| | - Laurel B. Smith
- United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States of America
| | - Matthew R. Scherer
- Clinical and Rehabilitative Medicine Research Program, Medical Research Materiel Command, Ft Detrick, Maryland, United States of America
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Wong RKY, McEwan J, Finlayson D, Chung S, Wan L, Salbach NM, Kirkwood G, Meschino C, Wright FV. Reliability and validity of the acquired brain injury challenge assessment (ABI-CA) in children. Brain Inj 2014; 28:1734-43. [DOI: 10.3109/02699052.2014.947620] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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