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Sogbossi ES, Arnould C, Kpadonou TG, Batcho CS, Bleyenheuft Y. Measuring global activity performance in children with cerebral palsy in West Africa: validation of an adapted version of the ACTIVLIM-CP questionnaire. Disabil Rehabil 2024; 46:170-179. [PMID: 36495153 DOI: 10.1080/09638288.2022.2154083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/26/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE To calibrate a West-African version of the ACTIVLIM-CP questionnaire (ACTIVLIM-CP-WA) for children with cerebral palsy (CP). MATERIALS AND METHODS We recruited 287 children with CP of various age range: 2-6 years (n = 117, preschoolers), 6-12 years (n = 96, children) and 12-19 years (n = 74, adolescents). Caregivers of children of each age range completed the experimental version of the ACTIVLIM-CP-WA including 76 (preschoolers), 78 (children) and 76 (adolescents) global daily life activities. Responses were analyzed using the Rasch RUMM2030 software. RESULTS The final West-African version of ACTIVLIM-CP including 31 items (both common and age-specific items) defined a unidimensional, linear scale with well-discriminated response categories. It presented a high internal consistency (R = 0.94). Moreover, all items were locally independent and the item difficulty hierarchy was invariant regarding caregivers' education, children's age and gender, MACS and GMFCS levels. The ACTIVLIM-CP-WA measures were significantly correlated (p < 0.05) with Gross Motor Function Classification System (ρ = -0.77), Manual Ability Classification System (ρ = -0.75), Box and Block test (dominant hand r = 0.51; non-dominant hand r = 0.49), One-minute walking test (r = 0.28), and Timed up and Go test (r = -0.40). CONCLUSIONS The ACTIVLIM-CP-WA questionnaire provides a valid and reliable tool that has the potential to follow children's evolution and quantify changes consecutive to neurorehabilitation in Sub-Saharan Africa.IMPLICATIONS FOR REHABILITATIONThe West-African version of the ACTIVLIM-CP questionnaire (ACTIVLIM-CP-WA) measures global activities requiring a combination of lower and upper extremities in children with cerebral palsy.As a Rasch-built scale, measures are unidimensional and linear to document changes in children with cerebral palsy from 2 to 19 years in Sub-Saharan Africa.Rehabilitation professionals are encouraged to use the ACTIVLIM-CP-WA questionnaire as a psychometrically robust assessment tool measuring the global performance in daily life activities in children with cerebral palsy in Sub-Saharan Africa.
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Affiliation(s)
- Emmanuel Segnon Sogbossi
- Motor Skill Learning and Intensive Neurorehabilitation Lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
- School of Physical Therapy, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - Carlyne Arnould
- Forme & Fonctionnement Humain Lab, Physical and Occupational Therapy Departments, Haute Ecole Louvain en Hainaut, Montignies-sur-Sambre, Belgium
| | - Toussaint G Kpadonou
- School of Physical Therapy, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
- Clinique Universitaire de Médecine Physique et Réadaptation, Centre National Hospitalier et Universitaire Hubert Koutoukou MAGA (CNHU-HKM) de Cotonou, Cotonou, Benin
| | - Charles Sebiyo Batcho
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Laval University, Quebec, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada
| | - Yannick Bleyenheuft
- Motor Skill Learning and Intensive Neurorehabilitation Lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
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Martinez AR, Turpin M, McGloon K, Coker-Bolt P. Rehabilitation for Pediatric Stroke in Low and Middle Income Countries: A Focused Review. Semin Pediatr Neurol 2022; 44:101000. [PMID: 36456036 DOI: 10.1016/j.spen.2022.101000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 09/10/2022] [Accepted: 09/12/2022] [Indexed: 10/14/2022]
Abstract
Rehabilitation for pediatric stroke survivors can maximize a child's potential through each developmental stage of life. Timely diagnosis and referral to a rehabilitation specialist may harness opportunities to maximize brain plasticity, to help children adapt and learn, and to participate in and enjoy daily life to their capability. The aim of this focused review is to explore current rehabilitation models and evidence-based interventions for pediatric stroke survivors in Low- and Middle- Income Countries (LMICs) and to provide recommendations for future research and focused areas of improvement.There are several published pediatric stroke guidelines from the American Heart Association (AHA), Canada, Australia, and the United Kingdom (UK) which provide specific recommendations for rehabilitation, although the suggested intervention and services vary. There are no current guidelines developed in or contextually adapted for LMICs, although the current pediatric stroke guidelines emphasize the need to develop interventions that fit the cultural and environmental contexts. The World Health Organization (WHO) Rehabilitation 2030 initiative acknowledges profound unmet rehabilitation needs around the world, especially in LMICs. According to the WHO, LMICs have less than ten skilled rehabilitation professionals per one million people. Enhancing the understanding of rehabilitation services in LMICs could lead to nationally supported workforce education initiatives targeted to expand the number of locally trained therapy providers. This could improve access to and delivery of quality rehabilitation interventions to pediatric stroke survivors in these settings.
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Kaboré PA, Zanga OB, Schepens B. Nonspecific chronic low back pain conditions and therapeutic practices in Burkina Faso. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2022; 78:1787. [PMID: 36262214 PMCID: PMC9575379 DOI: 10.4102/sajp.v78i1.1787] [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: 02/15/2022] [Accepted: 06/27/2022] [Indexed: 11/06/2022] Open
Abstract
Background The management of nonspecific chronic low back pain (NCLBP) is complex because of its multifactorial origin. Objectives To investigate NCLBP care by evaluating patients’ condition and therapeutic management of health practitioners. Method A cross-sectional survey was carried out among 92 patients with NCLBP, 30 medical practitioners (MP) and 20 physiotherapists (PT) from four public health institutions in Burkina Faso. Patients completed the Visual Analogue Scale, Roland Morris Disability Questionnaire and Fear-Avoidance Beliefs Questionnaire. Practitioners were asked about therapy and continuing professional training. Results Pain was moderate to intense for 80% of participants with NCLBP. They were functionally affected and showed fear-avoidance beliefs related to physical and work activities. The majority (97%) of medical practitioners prescribed analgesics and 53% prescribed nonsteroidal anti-inflammatory drugs (NSAIDs). Physiotherapy was the most frequently recommended nonpharmacological treatment. Forty-three per cent of medical practitioners referred to physiotherapy; 20% never did. Physiotherapists practised both passive treatments, such as massage (50%), electrotherapy (55%) and thermotherapy (50%), as well as active treatments, such as general exercises (55%), specific exercises (70%), functional revalidation (50%) and back school (40%). Having had recent continuing professional training and assessing risk factors for chronicity were associated with MPs’ and PTs’ therapeutic choices. Conclusion Participants with NCLBP showed fear-avoidance beliefs, correlated with their algo-functional status. Prescribing habits of MPs were drug-based. Treatments by PTs were passive and active. Continuing professional training of healthcare practitioners and assessment of risk factors had a positive impact on therapeutic choices. Clinical implications Our study is an invitation to the health care system to improve the relationship between a patient’s NCLBP and therapeutic choices.
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Affiliation(s)
- Pegdwendé A. Kaboré
- Laboratory of Physiology and Biomechanics of Locomotion, Institute of Neuroscience (IoNS), Faculty of Motor Sciences, Université Catholique de Louvain, Louvain-la-Neuve, Belgium,Centre National d’Appareillage Orthopédique du Burkina, Ouagadougou, Burkina Faso
| | - Orokiatou B. Zanga
- Department of Physical Medicine and Rehabilitation, Centre Hospitalier Universitaire de Bogodogo, Ouagadougou, Burkina Faso
| | - Bénédicte Schepens
- Laboratory of Physiology and Biomechanics of Locomotion, Institute of Neuroscience (IoNS), Faculty of Motor Sciences, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
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Demont A, Gedda M, Lager C, de Lattre C, Gary Y, Keroulle E, Feuillerat B, Caudan H, Sancelme Z, Isapof A, Viehweger E, Chatelin M, Hochard M, Boivin J, Vurpillat P, Genès N, de Boissezon X, Fontaine A, Brochard S. Evidence-based, Implementable Motor Rehabilitation Guidelines for Individuals With Cerebral Palsy. Neurology 2022; 99:283-297. [PMID: 35750497 DOI: 10.1212/wnl.0000000000200936] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/19/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Cerebral palsy is a life-long condition that causes heterogeneous motor disorders. Motor rehabilitation interventions must be adapted to the topography of the symptoms, ambulatory capacity and age of the individual. Current guidelines do not differentiate between the different profiles of individuals with cerebral palsy, which limits their implementation. OBJECTIVES To develop evidence-based, implementable guidelines for motor rehabilitation interventions for individuals with cerebral palsy according to the age, topography of the cerebral palsy and ambulatory capacity of the individual, and to determine a level of priority for each intervention. METHODS We used a mixed methods design that combined a systematic review of the literature on available motor rehabilitation interventions with expert opinions. Based on the French National Authority for Health methodology, recommendations were graded as strong, conditional or weak. Interventions were then prioritized by the experts according to both the evidence and their own opinions on relevance and implementability to provide a guide for clinicians. All recommendations were approved by experts who were independent from the working group. RESULTS Strong recommendations as first-line treatments were made for gait training, physical activities and hand-arm bimanual intensive therapy for all children and adolescents with cerebral palsy. Moderate recommendations were made against passive joint mobilizations, muscle stretching, prolonged stretching with the limb fixed, and neurodevelopmental therapies for all children and adolescents with cerebral palsy. Strong recommendations as first-line treatments were made for gait training for all adults with cerebral palsy and moderate recommendations as moderate importance interventions for strengthening exercises and ankle-foot orthoses for motor impairment of the feet and the ankles. DISCUSSION These guidelines, which combine research evidence and expert opinion, could help individuals with cerebral palsy and their families to co-determine rehabilitation goals with health professionals, according to their preferences.
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Affiliation(s)
- Anthony Demont
- French National Authority for Health, Saint-Denis, France .,University of Paris, ECEVE, Inserm, U1123, Paris, France
| | - Michel Gedda
- French National Authority for Health, Saint-Denis, France.,University of Paris, ECEVE, Inserm, U1123, Paris, France
| | - Céline Lager
- Occupational therapy Clinic, Mouans Sartoux, France
| | | | - Yann Gary
- Bourgès Clinic, Castelnau-le-lez, France
| | - Elisabeth Keroulle
- Société d'études et de soins pour les enfants paralysés et polymalformés, Antony, France
| | | | | | | | - Arnaud Isapof
- Neuropediatrics Department, Hôpital Armand Trousseau, CRMR Neuromuscular pathologies, APHP, Paris, France
| | - Elke Viehweger
- Orthopedic department, Neuro-orthopedics Unit and Movement Analysis Center, Université Bâle, Suisse
| | | | | | | | | | | | - Xavier de Boissezon
- Physical and Rehabilitation Medicine Department, Neurosciences, CHU, Toulouse, France.,ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France
| | | | - Sylvain Brochard
- Physical and medical rehabilitation department, CHRU Brest, Brest, France.,Paediatric physical and medical rehabilitation department, Fondation ILDYS, Brest, France.,University of Western Brittany, Laboratory of medical information processing, Inserm U1101, Brest, France
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