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García-Galant M, Blasco M, Moral-Salicrú P, Soldevilla J, Ballester-Plané J, Laporta-Hoyos O, Caldú X, Miralbell J, Alonso X, Toro-Tamargo E, Meléndez-Plumed M, Gimeno F, Leiva D, Boyd RN, Pueyo R. Understanding social cognition in children with cerebral palsy: exploring the relationship with executive functions and the intervention outcomes in a randomized controlled trial. Eur J Pediatr 2024; 183:3997-4008. [PMID: 38951253 PMCID: PMC11322257 DOI: 10.1007/s00431-024-05635-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 05/18/2024] [Accepted: 05/29/2024] [Indexed: 07/03/2024]
Abstract
Children with Cerebral Palsy (CP) experience Social Cognition (SC) difficulties, which could be related to executive functioning. While motor interventions are common, there is limited knowledge about the impact of cognitive interventions on SC in this population. This study examined the relationship between SC and Executive Function (EF) skills and the effectiveness of an EF intervention that included some SC tasks for improving SC in children with CP. SC and EF domains were assessed in 60 participants with CP (30 females; 8-12 years). The relationship between SC and EF baseline scores was analyzed by bivariate correlations and contingency tables. Participants were matched by age, sex, motor ability, and intelligence quotient and randomized into intervention or control groups. The intervention group underwent a 12-week home-based computerized EF intervention. Analysis of covariance was used to examine differences in SC components between groups at post-intervention and 9 months after. Significant positive correlations were found between the SC and EF scores. The frequencies of impaired and average scores in SC were distributed similarly to the impaired and average scores in EFs. The intervention group showed significant improvements in Affect Recognition performance post-intervention, which were maintained at the follow-up assessment, with a moderate effect size. Long-term improvements in Theory of Mind were observed 9 months after. CONCLUSIONS This study highlights the association between SC and EFs. A home-based computerized cognitive intervention program improves SC in children with CP. Including SC tasks in EF interventions may lead to positive short- and long-term effects for children with CP. CLINICAL TRIAL REGISTRATION NCT04025749 retrospectively registered on 19 July 2019. WHAT IS KNOWN • Executive functions and social cognition are associated with social and community participation in people with cerebral palsy. • A home-based computerized cognitive intervention can improve the executive functioning of children with cerebral palsy. WHAT IS NEW • Social cognition performance is related to core and higher-order executive functions. • A home-based computerized executive function intervention, including social cognition tasks, has positive short- and long-term effects on social cognition skills in children with cerebral palsy.
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Affiliation(s)
- María García-Galant
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
| | - Montse Blasco
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
| | - Paula Moral-Salicrú
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
| | - Jorge Soldevilla
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
| | - Júlia Ballester-Plané
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
- Facultat de Ciències de la salut i de la vida, Universitat Abat Oliba CEU, CEU Universities, Bellesguard 30, 08022, Barcelona, Spain
| | - Olga Laporta-Hoyos
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
- School of Medicine, University of California, 1550 Fourth Street, 94158, San Francisco, CA, USA
| | - Xavier Caldú
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
| | - Júlia Miralbell
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
| | - Xènia Alonso
- Servei de Neurologia, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Esther Toro-Tamargo
- Servei de Traumatologia i Rehabilitació, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Mar Meléndez-Plumed
- Servei de Traumatologia i Rehabilitació, Hospital Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Francisca Gimeno
- Associació de Paràlisi Cerebral (ASPACE), Servei de Salut i Rehabilitació, Camí Tres Pins 31-35, 08038, Barcelona, Spain
| | - David Leiva
- Departament de Psicologia Social i Psicologia Quantitativa, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Roslyn N Boyd
- Faculty of Medicine, Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, 62 Graham St, Brisbane, 4101, QLD, Australia
| | - Roser Pueyo
- Grup de Neuropsicologia, Departament de Psicologia Clínica i Psicobiologia, Institut de Neurociències, Universitat de Barcelona, Casanova 143, 08036, Barcelona, Spain.
- Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain.
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Adams SN, Bhorat R, Moosa A. Caregiver perspectives on the long-lasting impact of the COVID-19 pandemic on children with cerebral palsy in Johannesburg, South Africa. BMJ Paediatr Open 2024; 8:e002617. [PMID: 38918024 PMCID: PMC11202650 DOI: 10.1136/bmjpo-2024-002617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic exacerbated challenges faced by children with cerebral palsy (CP), including limited access to therapy services, financial strain and disruptions in schooling and social activities. However, the specific long-lasting impacts of the pandemic on families of children with CP in the South African context remain underexplored. AIM To explore the long-lasting impact of the COVID-19 pandemic on children with CP in South Africa. METHOD A qualitative exploratory approach was used. 14 caregivers of 12 children with CP (aged 4-12) were recruited from various CP-specific schools and organisations in urban Johannesburg, South Africa. Individual semistructured interviews were conducted, and each interview was audio recorded, transcribed verbatim and analysed using inductive thematic analysis. RESULTS Children experienced significant changes to their physical and emotional well-being during the pandemic that had long-lasting effects on their added weight gain and activities of daily living. Many children experienced regressions during the lockdown due to the closure of schools and therapy centres. However, increased screen time observed among children with CP during the pandemic yielded unexpected positive outcomes, such as the improvement of technological skills and enhanced confidence through activities like vlogging. IMPLICATIONS The pandemic has had long-lasting impacts on children with CP and addressing the multifaceted challenges faced by children with CP and their families in the post-COVID-19 era requires coordinated efforts from all stakeholders to ensure the holistic well-being and inclusion of this vulnerable population. Further research is warranted to assess the long-term impacts of the pandemic and evaluate the effectiveness of interventions aimed at mitigating its effects on this vulnerable population.
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Affiliation(s)
- Skye Nandi Adams
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Razina Bhorat
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Aneesah Moosa
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
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Shin J, Hong MJ, Park JB, Lee YJ. The impact of the COVID-19 pandemic on the rehabilitation therapy of children and adolescents with cerebral palsy: a nationwide, health insurance data-based study. Front Public Health 2024; 12:1374766. [PMID: 38873308 PMCID: PMC11169719 DOI: 10.3389/fpubh.2024.1374766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/03/2024] [Indexed: 06/15/2024] Open
Abstract
Introduction The coronavirus disease 2019 (COVID-19) pandemic has profoundly affected the utilization of rehabilitation services. Existing evidence investigating this issue at the nationwide level is lacking, and it is uncertain whether the effects of the COVID-19 pandemic on the use of rehabilitation therapy of children and adolescents with cerebral palsy. This study aimed to investigate the impact of COVID-19 on the rehabilitation therapy of children and adolescents with cerebral palsy. Methods We obtained data from South Korea's Health Insurance Review and Assessment Agency for 2017-2021. By analyzing the claims data, we focused on rehabilitation therapy in individuals with CP under 18 years of age. We categorized these according to therapy type (physical, occupational, or dysphagia), medical facility, hospital visits, and insurance. We calculated the patient counts and average claims per person and compared the average from before to during the COVID-19 pandemic. Results Over the 5 years, there was a significant decline in the number of patients undergoing rehabilitation therapy (trend p = 0.004), but the average claims per person remained stable (trend p = 0.971). During the COVID-19 pandemic, the average number of claims per person decreased significantly compared to the control period (p = 0.013). Both the physical (p = 0.049) and occupational therapy groups (p = 0.019) showed significant differences in claims. General hospitals and hospitals experienced a decrease in average cases by 2.2 (p < 0.001) and 2.4 (p < 0.001) respectively, while long-term care hospitals increased by 3.1 cases (p < 0.001). Outpatients showed a decline of 2.0 cases (p < 0.001), whereas inpatients showed an increase of 5.9 cases (p < 0.001). Individuals with health insurance decreased by 0.5 cases (p = 0.007), but the decrease of 0.08 cases among medical aid-covered individuals was not statistically significant (p = 0.898). Conclusion In 2020-2021, the average number of claims per person showed a significant decrease compared to the pre-COVID-19 pandemic period (2017-2019). Depending on the type of treatment, the number of claims for physical and occupational therapy significantly decreased.
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Affiliation(s)
- Jieun Shin
- Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Republic of Korea
| | - Mi Jin Hong
- Department of Rehabilitation Medicine, College of Medicine, Konyang University Hospital, Daejeon, Republic of Korea
| | - Jong Bum Park
- Department of Rehabilitation Medicine, College of Medicine, Konyang University Hospital, Daejeon, Republic of Korea
| | - Yung Jin Lee
- Department of Rehabilitation Medicine, College of Medicine, Konyang University Hospital, Daejeon, Republic of Korea
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Shpigelman CN, Araten-Bergman T. Adults With IDD in Supported Accommodation During COVID-19 Lockdown: The Families' Perspective. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2024; 129:215-230. [PMID: 38657961 DOI: 10.1352/1944-7558-129.3.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/21/2023] [Indexed: 04/26/2024]
Abstract
The present study aims to understand and describe family caregivers' perceptions and experiences regarding contact and relationships with their adult relatives with intellectual and developmental disabilities (IDD) living in supported accommodation during the COVID-19 lockdown. A qualitative phenomenological approach was applied in which 19 Israeli family caregivers (parents and siblings) were interviewed. Inductive thematic analysis revealed themes at the microsystem level (the resident, the caregiver, and their relationship), and at the mesosystem level (the caregivers' interactions with service providers and other residents' families). The findings highlight the pivotal role of family caregivers in times of uncertainty and the need to develop explicit policies and mechanisms to facilitate family engagement in the residents' lives.
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Affiliation(s)
- Carmit-Noa Shpigelman
- Carmit-Noa Shpigelman, Department of Community Mental Health, University of Haifa, Israel
| | - Tal Araten-Bergman
- Tal Araten-Bergman, Social Work and Social Policy, School of Allied Health, Human Services and Sport, and Living with Disability Research Centre, La Trobe University, Melbourne, Australia
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Harris C, Sumy MSA, Feygin YB, Huxol H, Tejuoso A, Kluthe T, Bickel S. Changes in Psychiatric Medication Use During the COVID-19 Pandemic in a Pediatric Long-Term Care Facility. J Child Adolesc Psychopharmacol 2024; 34:210-213. [PMID: 38682450 DOI: 10.1089/cap.2023.0067] [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] [Indexed: 05/01/2024]
Abstract
Background: Coronavirus disease 2019 (COVID-19) caused a global pandemic that dramatically altered infection control procedures in long-term care facilities. Mental health decline among residents of geriatric facilities during the pandemic has been described (Ferro Uriguen et al., 2022). Our study aims to evaluate psychological effects of the pandemic on residents of a pediatric long-term care facility, a population comprised of medically complex children. To characterize this, we compared patterns of psychotropic medication use during the COVID-19 pandemic to those of the prepandemic period among residents of a 76-bed pediatric long-term care facility. Methods: We conducted a retrospective study of psychotropic medication use from January 2019 to August 2022 using de-identified monthly facility medication refill data. Linear multivariable regression models were used to estimate the level and trends in the monthly rates of medication refills per 10,000 bed days among resident children before and after the pandemic onset. Six classes of psychotropic medications were analyzed including antipsychotics, antidepressants and anxiety medications, trazodone, clonidine, mood stabilizers, and gabapentin. Results: The pandemic onset was associated with a significant increase in the monthly prescribing rates of antidepressant and anxiety medications (20.83; 95% CI, 3.96-37.71; p = 0.017), mood stabilizers (10.44; 95% CI, 5.79-15.09; p < 0.001), and trazodone (-27.66; 95% CI, -40.44 to 14.88; p < 0.001) above those expected by prepandemic trends. The trend in trazodone use changed significantly during the pandemic from decreasing prepandemic to increasing (2.21; 95% CI, 1.28-3.14; p < 0.001). Antidepressant, anxiety medication, and gabapentin use increased throughout the study. Antidepressant and anxiety medication use surged early in the pandemic, but then continued growth at their prior rates of use. Discussion: Increased use of antidepressant and anxiety medications and trazodone suggests a possible impact of the COVID-19 pandemic on rates of anxiety, depression, sleep disturbance, and agitation among children with severe intellectual and developmental disabilities living in long-term care.
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Affiliation(s)
- Corrie Harris
- Division of Pediatric Hospitalist Medicine, Norton Children's and University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Mst Sharmin Akter Sumy
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky, USA
| | - Yana B Feygin
- Norton Children's Research Institute, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Heather Huxol
- Division of Pediatric Hospitalist Medicine, Norton Children's and University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Ademilola Tejuoso
- University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Theresa Kluthe
- Norton Children's Research Institute, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Scott Bickel
- Division of Pediatric Pulmonology, Allergy and Immunology, Norton Children's and University of Louisville School of Medicine, Louisville, Kentucky, USA
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Naidoo L, Pillay M, Naidoo U. Who really decides? Feeding decisions 'made' by caregivers of children with cerebral palsy. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2024; 71:e1-e14. [PMID: 38572900 PMCID: PMC11019338 DOI: 10.4102/sajcd.v71i1.1001] [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: 07/01/2023] [Revised: 10/30/2023] [Accepted: 11/09/2023] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND There are no definitive guidelines for clinical decisions for children with cerebral palsy (CP) requiring enteral feeds. Traditionally, medical doctors made enteral feeding decisions, while patients were essentially treated passively within a paternalistic 'doctor knows best' approach. Although a more collaborative approach to decision-making has been promoted globally as the favoured model among healthcare professionals, little is known about how these decisions are currently made practically. OBJECTIVES This study aimed to identify the significant individuals, factors and views involved in the enteral feeding decision-making process for caregivers of children with CP within the South African public healthcare sector. METHOD A single-case research design was used in this qualitative explorative study. Data were collected using semi-structured interviews and analysed using reflexive thematic analysis. RESULTS Four primary individuals were identified by the caregivers in the decision-making process: doctors, speech therapists, caregivers' families and God. Four factors were identified as extrinsically motivating: (1) physiological factors, (2) nutritional factors, (3) financial factors and (4) environmental factors. Two views were identified as intrinsically motivating: personal beliefs regarding enteral feeding tubes, and feelings of fear and isolation. CONCLUSION Enteral feeding decision-making within the South African public healthcare sector is currently still dominated by a paternalistic approach, endorsed by a lack of caregiver knowledge, distinct patient-healthcare provider power imbalances and prescriptive multidisciplinary healthcare dialogues.Contribution: This study has implications for clinical practice, curriculum development at higher education training facilities, and institutional policy changes and development, thereby contributing to the current knowledge and clinical gap(s) in the area.
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Affiliation(s)
- Lavanya Naidoo
- Discipline of Speech-Language Therapy, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; and Department of Speech Language Pathology, Faculty of Humanities, University of the Witwatersrand, Johannesburg.
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Evangelou G, Adams SN. "Tremendous burdens often unveil enormous gifts": The experiences of South African caregivers implementing speech and language teletherapy for children with cerebral palsy during COVID-19. J Pediatr Rehabil Med 2024; 17:85-96. [PMID: 38251071 PMCID: PMC10977356 DOI: 10.3233/prm-220118] [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: 11/07/2022] [Accepted: 09/20/2023] [Indexed: 01/23/2024] Open
Abstract
PURPOSE In accordance with South Africa's restrictions to mitigate the spread of COVID-19, some speech-language pathologists (SLPs) attempted to engage in novice teletherapy regimes to ensure continuity of care for children with cerebral palsy (CP). This study aimed to explore the experiences of caregivers of children with CP implementing SLP teletherapy during COVID-19 in South Africa. The goal was to shed light on how these families can be better supported and how teletherapy practices can be adjusted for this population. METHODS This study employed a qualitative phenomenological research design using in-person and virtual semi-structured interviews with 18 purposively sampled participants with children with CP who received speech and language teletherapy during COVID-19. The data was evaluated using an inductive thematic analysis approach whereby themes elicited from the caregivers' narratives were analyzed. RESULTS Interviews (n = 18) unveiled the significant understanding caregivers gained by becoming integral and active stakeholders in the provision of teletherapy. Caregivers were able to meaningfully communicate and bond with their children with CP. However, caregivers also assumed the burden that teletherapy placed on them, as they had to renegotiate their role during the pandemic in order to provide routine teletherapy. CONCLUSION Findings indicated the need for person-centered SLP teletherapy interventions that utilize contextually and culturally responsive techniques and resources.
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Affiliation(s)
- Gabriela Evangelou
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Skye Nandi Adams
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
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Fong VC, Baumbusch J, Khan K. "Can you hear me OK?": Caregivers of Children With Medical Complexity and Their Perspectives of Virtual Care During COVID-19. J Pediatr Health Care 2024; 38:30-38. [PMID: 37725030 DOI: 10.1016/j.pedhc.2023.08.008] [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: 05/28/2023] [Revised: 07/25/2023] [Accepted: 08/23/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION The rapid and widespread shift to virtual care during COVID-19 created new opportunities and unique challenges for families of children with medical complexity (CMC). However, few studies have examined perceptions of virtual care during the pandemic in this population. METHOD To address this gap, the current study used a qualitative approach and semistructured interviews via Zoom to explore parent perspectives of virtual care. Purposive sampling was used to recruit 30 parents residing with their CMC (aged 0-18 years) in British Columbia, Canada. RESULTS The findings identified from the data included (1) advantages and opportunities, (2) concerns and challenges, and (3) parent choice and preference. DISCUSSION Our findings indicate the need for healthcare professionals to receive training to use virtual care in their practice effectively. In addition, policies about standards for virtual care and ensuring families have access to the necessary technology will help reduce barriers and improve equity and inclusion for this population.
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García-Galant M, Blasco M, Laporta-Hoyos O, Berenguer-González A, Moral-Salicrú P, Ballester-Plané J, Caldú X, Miralbell J, Alonso X, Medina-Cantillo J, Povedano-Bulló E, Leiva D, Boyd RN, Pueyo R. A randomized controlled trial of a home-based computerized executive function intervention for children with cerebral palsy. Eur J Pediatr 2023; 182:4351-4363. [PMID: 37462799 PMCID: PMC10587273 DOI: 10.1007/s00431-023-05072-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/27/2023] [Accepted: 06/17/2023] [Indexed: 10/20/2023]
Abstract
Children with cerebral palsy (CP) often show executive function (EF) impairments that are key to quality of life. The aim of this study was to assess whether a home-based computerized intervention program improves executive functions (EFs) compared to usual care. Sixty participants (30 females) with CP (8-12 years old) were paired by age, sex, motor ability, and intelligence quotient score and then randomized to intervention and waitlist control groups. The intervention group received a 12-week home-based computerized EF intervention (5 days/week, 30 min/day, total dose 30 h). Core and higher-order EFs were assessed before, immediately after, and 9 months after completing the intervention. The intervention group performed better than the waitlist control group in the three core EFs (immediately and 9 months after the intervention): inhibitory control (F = 7.58, p = 0.13 and F = 7.85, p = 0.12), working memory (F = 8.34, p = 0.14 and F = 7.55, p = 0.13), and cognitive flexibility (F = 4.87, p = 0.09 and F = 4.19, p = 0.08). No differences were found between the groups in higher-order EFs or EF manifestations in daily life. CONCLUSIONS A home-based computerized EF intervention improved core EFs in children with CP, but further research is needed to identify strategies that allow the transfer of these improvements to everyday life. TRIAL REGISTRATION NCT04025749 retrospectively registered on 19 July 2019. WHAT IS KNOWN • One in two children with cerebral palsy has an intellectual impairment. Visual perception and executive functions are the most reported specific cognitive deficits. • The majority of interventions for cerebral palsy focus on motor impairments, but only a few randomized controlled trials have explored the effect of interventions on executive functions. WHAT IS NEW • A home-based computerized cognitive intervention can improve the core executive functions of children with cerebral palsy. • Short- and long-term effects on core executive functions have been found.
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Affiliation(s)
- María García-Galant
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Montse Blasco
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Olga Laporta-Hoyos
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Alba Berenguer-González
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Paula Moral-Salicrú
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Júlia Ballester-Plané
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Xavier Caldú
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Júlia Miralbell
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Xènia Alonso
- Servei de Neurologia, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Julita Medina-Cantillo
- Servei de Rehabilitació i Medicina Física, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08035, Barcelona, Spain
| | - Elsa Povedano-Bulló
- Servei de Rehabilitació i Medicina Física, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08035, Barcelona, Spain
| | - David Leiva
- Departament de Psicologia Social i Psicologia Quantitativa, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Roslyn N Boyd
- Faculty of Medicine, Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, 62 Graham St, Brisbane, QLD, 4101, Australia
| | - Roser Pueyo
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain.
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10
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Nguyen HB, Mulpuri N, Cook D, Greenberg M, Shrader MW, Sanborn R, Mulpuri K, Shore BJ. The Impact of COVID-19 on Multidisciplinary Care Delivery to Children with Cerebral Palsy and Other Neuromuscular Complex Chronic Conditions. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1555. [PMID: 37761516 PMCID: PMC10529915 DOI: 10.3390/children10091555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/29/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
The COVID-19 pandemic has caused unprecedented challenges in the care of children with cerebral palsy (CP) and other neuromuscular complex chronic conditions (NCCCs). The purpose of this study is to explore the direct impact of the COVID-19 pandemic on healthcare delivery. From May to August 2020, medical professionals caring for CP and NCCC patients across multiple countries and disciplines completed a self-administered cross-sectional survey comparing practices before and during the COVID-19 pandemic. Of the 79 healthcare workers from eight countries who participated-predominantly pediatric orthopedic surgeons (32%), pediatricians (30%), and pediatric physiatrists (23%)-most of them felt that caring for NCCC patients during the pandemic presented unique difficulties, and they reported a significant decrease in the in-person NCCC clinic volume (p < 0.001), multidisciplinary appointments (p < 0.001), surgical cases (p = 0.008), and botulinum toxin/phenol injections. Most providers affirmed that institutional guidelines for perioperative emergent/urgent and elective procedures, workplace settings, and technology were modified to accommodate the ongoing public health crisis. The usage of telemedicine significantly increased for NCCC patient visits (p < 0.001). During the COVID-19 pandemic, many children with NCCCs lost access to routine, multidisciplinary care. Telemedicine became an integral part of communication and management. In the setting of the COVID-19 pandemic and with the threat of future healthcare disruptions, these data lay the foundation for trending the evolution of healthcare delivery and accelerating best practice guidelines for children with CP and NCCCs.
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Affiliation(s)
- Hillary Brenda Nguyen
- Harvard Medical School, Boston, MA 02115, USA;
- Boston Children’s Hospital, Department of Orthopedic Surgery, Boston, MA 02115, USA; (D.C.); (R.S.)
| | - Neha Mulpuri
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Danielle Cook
- Boston Children’s Hospital, Department of Orthopedic Surgery, Boston, MA 02115, USA; (D.C.); (R.S.)
| | - Michael Greenberg
- Boston Children’s Hospital, Department of Orthopedic Surgery, Boston, MA 02115, USA; (D.C.); (R.S.)
| | - M. Wade Shrader
- Department of Orthopedic Surgery, Alfred I. Dupont Institute, Wilmington, DE 19803, USA
| | - Ryan Sanborn
- Boston Children’s Hospital, Department of Orthopedic Surgery, Boston, MA 02115, USA; (D.C.); (R.S.)
| | - Kishore Mulpuri
- Department of Orthopaedics, BC Children’s Hospital, University of British Columbia, Vancouver, BC V6H3NA, Canada
| | - Benjamin J. Shore
- Harvard Medical School, Boston, MA 02115, USA;
- Boston Children’s Hospital, Department of Orthopedic Surgery, Boston, MA 02115, USA; (D.C.); (R.S.)
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11
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Celikel R, Ramazanoglu E, Talu B. The effect of motor learning-based telerehabilitation on quality of life of children with cerebral palsy during the COVID-19 pandemic. Arch Pediatr 2023:S0929-693X(23)00086-6. [PMID: 37321948 DOI: 10.1016/j.arcped.2023.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/04/2023] [Accepted: 04/29/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND During the pandemic, the access of children with cerebral palsy (CP) to rehabilitation services was adversely affected due to the significant risk of infection. AIMS We assessed whether the effect of a motor learning-based treatment provided via a telerehabilitation method on the quality of life of children with cerebral palsy during the COVID-19 period was equivalent to face-to-face treatment. METHODS Distance exercises were explained by a physiotherapist to the patients in the telerehabilitation group, and motor learning-based treatment was applied by their families; the physiotherapist followed the sessions with video conferencing. Motor learning-based treatment was offered to the face-to-face group by a physiotherapist in the clinic. RESULTS In the comparison between the groups, there was a significant difference in the parameters of play activities, pain-hurt, fatigue, eating activities, and speech communication activities after treatment (p<0.05). However, in the test performed by considering the nonhomogeneous parameters before the treatment, no time-dependent difference was found in the repeated measurements before and after the treatment in all parameters (p>0.05). CONCLUSION Motor learning-based treatment provided using the telerehabilitation method has a positive effect on the quality of life of children with CP, but the results are similar to face-to-face treatment.
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Affiliation(s)
- Rabia Celikel
- Inonu University, Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Malatya, Turkey
| | - Engin Ramazanoglu
- Inonu University, Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Malatya, Turkey.
| | - Burcu Talu
- Inonu University, Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Malatya, Turkey
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12
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Pizzighello S, Uliana M, Martinuzzi M, Vascello MGF, Cipriani M, Breda M, De Polo G, Martinuzzi A. The perceived impact of Covid-19 pandemic on the children with cerebral palsy: the parents' perspective explored within the "6-F words" framework. Child Adolesc Psychiatry Ment Health 2023; 17:24. [PMID: 36793119 PMCID: PMC9930050 DOI: 10.1186/s13034-023-00569-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND In 2020 the world faced the spread of the coronavirus infection disease (Covid-19). This was a general public health emergency but many people with disabilities might have been particularly affected. OBJECTIVE This paper aims to investigate the impact of the Covid-19 pandemic on children with Cerebral Palsy (CP) and their families. METHODS 110 parents of children with CP (aged 2 to 19) who completed a questionnaire were included. These children were under the care of one of the Italian Children Rehabilitation Centers. Socio-demographic and clinical information about patients and their families were collected. In addition, difficulties on adopting protective measures and in respecting lockdown rules by children were explored. We adopted the ICF (International Classification of Functioning, Disability and Health) framework to create multiple choice questions. Descriptive statistics were reported and logistic regression analyses were run in order to identify the predictors of perceived impairment in motor, speech, manual and behavioral abilities. RESULTS Daily activities of children, as well as rehabilitation and fitness sessions, underwent a change during the pandemic. Spending more time with family due to lockdown measures, has had, in some cases a positive effect however there was a perceived decrease in rehabilitation support and school activities. The age range (between 7 and 12 years) and difficulty in respecting rules emerged as significant predictors of the perceived impairment due to Covid-19 pandemic. CONCLUSIONS The pandemic has had different impacts on children and their families on the basis of children's characteristics. Rehabilitation activities during a hypothetic lockdown should consider these characteristics.
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Affiliation(s)
- Silvia Pizzighello
- Department of Conegliano, Scientific Institute IRCCS E. Medea, Via Costa Alta, 37, 31015, Conegliano, Treviso, Italy.
| | - Marianna Uliana
- grid.420417.40000 0004 1757 9792Department of Conegliano, Scientific Institute IRCCS E. Medea, Via Costa Alta, 37, 31015 Conegliano, Treviso Italy
| | - Michela Martinuzzi
- grid.13097.3c0000 0001 2322 6764King’s College London GKT School of Medical Education, London, UK
| | - Matteo G. F. Vascello
- grid.460094.f0000 0004 1757 8431Clinical Psychology Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Martina Cipriani
- grid.420417.40000 0004 1757 9792Department of Conegliano, Scientific Institute IRCCS E. Medea, Via Costa Alta, 37, 31015 Conegliano, Treviso Italy
| | - Martina Breda
- grid.420417.40000 0004 1757 9792Department of Conegliano, Scientific Institute IRCCS E. Medea, Via Costa Alta, 37, 31015 Conegliano, Treviso Italy
| | - Gianni De Polo
- grid.420417.40000 0004 1757 9792Department of Conegliano, Scientific Institute IRCCS E. Medea, Via Costa Alta, 37, 31015 Conegliano, Treviso Italy
| | - Andrea Martinuzzi
- grid.420417.40000 0004 1757 9792Department of Conegliano, Scientific Institute IRCCS E. Medea, Via Costa Alta, 37, 31015 Conegliano, Treviso Italy
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13
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Chu Y, Wang X, Dai H. Prevalence and risk factors for anxiety and depression among community dwelling patients with cervical spondylosis during the COVID-19 pandemic. Heliyon 2023; 9:e13497. [PMID: 36776911 PMCID: PMC9899124 DOI: 10.1016/j.heliyon.2023.e13497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 01/24/2023] [Accepted: 01/31/2023] [Indexed: 02/06/2023] Open
Abstract
Background The emergence of COVID-19 and its unfavorable consequences lead to disease fear and other related mental health problems for individuals worldwide. This study aimed to analyze the prevalence and relevant factors of anxiety and depression among community dwelling cervical spondylosis (CS) patients, and to explore the relationship between fear of COVID-19 and anxiety and depression, so as to provide scientific basis for improving their mental health. Methods A community-based cross-sectional study was conducted among a cohort of 556 CS patients by using convenient sampling. These participants were asked to complete a demographic questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the Fear of COVID-19 Scale (FCV-19S). The Chi-square test was used to determine the differences among categorical variables. Binary stepwise logistic regression was used to determine predictors of anxiety and depression. Results The median HADS-A score was 5 (interquartile interval 2-7), and the median HADS-D score was 4 (interquartile interval 2-8). In this study, the prevalence of anxiety and depression was 25.0% and 26.6%, respectively. Gender and comorbid chronic diseases were predictors of depressive symptoms. In addition, fear of COVID-19 was related to depression and anxiety among community dwelling CS patients. Conclusion Approximately one quarter of community dwelling CS patients were suffering depression or anxiety. Our findings could provide a basis for the development of psychological crisis intervention strategies for CS patients under public health emergencies in the future.
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Affiliation(s)
| | | | - Hongliang Dai
- Corresponding author. School of Nursing, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Jinzhou, Liaoning, China.
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14
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Gama GL, Salvino AS, Tavares JDS, Gregorio JGR, Moreira KMA, Amorim MMR, Melo A. The Impact of COVID-19 Pandemic and Social Distancing on Motor Function and Growth of Children with Congenital Zika Syndrome: A Prospective Cohort Study. Dev Neurorehabil 2023; 26:123-129. [PMID: 36463499 DOI: 10.1080/17518423.2022.2154399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
This article describes the impact of social distancing during the COVID-19 pandemic on the motor function and growth of children with congenital Zika syndrome (CZS). Children's motor function, weight, height and joint range of movement (ROM) were evaluated before the onset of the pandemic and soon after their return to face-to-face activities at a rehabilitation center. Fifty-two children (Mean 46.07 months, SD 3.76 months) were assessed. Results showed a reduction in proportion of children with adequate body mass index (p = .04), an increase in proportion with adequate height (p < 0.001), deterioration in gross motor function in children with severe motor impairment (p < .01), and a reduction in the maximum ROM for shoulder (p < .01) and wrist flexion (p = .046), elbow (p = .01), knee (p = .03) and ankle extension (p < .01), and an increase in hip flexion (p = .04). The social distancing period appears to have contributed to important losses in motor function and joint mobility of children with CZS; however, this period of time appeared to have less impact on their growth.
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Affiliation(s)
- Gabriela Lopes Gama
- Instituto de Pesquisa Professor Joaquim Amorim Neto (IPESQ), Campina Grande, Brazil.,UNIFACISA University Center, Campina Grande, Brazil
| | - Ana Stela Salvino
- Instituto de Pesquisa Professor Joaquim Amorim Neto (IPESQ), Campina Grande, Brazil
| | | | | | | | | | - Adriana Melo
- Instituto de Pesquisa Professor Joaquim Amorim Neto (IPESQ), Campina Grande, Brazil.,UNIFACISA University Center, Campina Grande, Brazil
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15
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Ghazy RM, Sallam M, Fadl N, Bouraad E, Youssef N, Ghoneim OSA. Attitude of Parents of Children with Cerebral Palsy Towards COVID-19 Vaccination. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20031909. [PMID: 36767281 PMCID: PMC9915268 DOI: 10.3390/ijerph20031909] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/14/2023] [Accepted: 01/18/2023] [Indexed: 05/26/2023]
Abstract
Children with cerebral palsy (CP) are at a greater risk of respiratory complications from coronavirus disease 2019 (COVID-19). Therefore, this study aimed to assess COVID-19 vaccine hesitancy (VH) among parents of CP children in Egypt, using the Arabic version of the Parental Attitude about Childhood Vaccination (PACV) questionnaire. This cross-sectional survey study was conducted at the outpatient clinics of two hospitals in Cairo, Egypt. Parents of children with CP were recruited using a simple random sampling technique. A total of 321 parents were enrolled; more than half of them were mothers of the children (61.37%); and the majority were Egyptians (87.23%) and living in urban areas (84.42%). Nearly 70% of the parents were hesitant to administer the COVID-19 vaccine to their children. A multiple linear regression model revealed that the PACV mean scores were lower among the following categories: (1) parents who could pay back loans, compared to those who could not pay back loans and who reported insufficient income (β = -2.39, p = 0.030); (2) non-Egyptian parents (β = -1.54, p = 0.002); (3) those who were fully vaccinated against COVID-19 themselves or had the intention to receive the complete COVID-19 vaccination (β = -6.28, p < 0.001); (4) those who had the intention to give the COVID-19 vaccination to their children (β = -3.04, p < 0.001); and (5) parents whose children received routine vaccines (β = -2.86, p < 0.045). After adjusting for other covariates, the parental COVID-19 vaccine status (β = -6.28, p < 0.001) and parents who experienced a COVID-19-related death in the family (β = -1.75, p < 0.001) showed significantly lower mean PACV scores. However, higher mean PACV scores were reported among parents who had a COVID-19 infection (β = 2.77, p < 0.001) or who were not sure (β = 2.94, p < 0.001). Our findings suggest the need to increase COVID-19 vaccine acceptance among parents of vulnerable children to reduce the negative consequences of COVID-19.
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Affiliation(s)
- Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
| | - Noha Fadl
- Family Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
| | - Etwal Bouraad
- Department of Epidemiology and Population Health, American University of Beirut, Beirut 961, Lebanon
- School of Pharmacy, Lebanese International University, Beirut 961, Lebanon
| | - Naglaa Youssef
- Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Omnya Samy A. Ghoneim
- Department of Physical Therapy for Pediatrics and Pediatric Surgery, Faculty of Physical Therapy, Badr University in Cairo, Cairo 11829, Egypt
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16
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Zonneveld E, van Schelven F, Boeije H. Effects of the COVID-19 pandemic on quality of life among relatives of individuals with intellectual disabilities: A longitudinal study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 36:68-77. [PMID: 36134473 PMCID: PMC9539069 DOI: 10.1111/jar.13035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 08/31/2022] [Accepted: 09/06/2022] [Indexed: 11/30/2022]
Abstract
Background The COVID‐19 pandemic poses risks to the quality of life (QoL) of relatives of individuals with intellectual disabilities. This paper investigates relatives' QoL and associated risk and buffering factors before and during the pandemic. Method Surveys were administered to three samples of relatives in the Netherlands in 2019 (N = 105) and during the first waves of COVID‐19 in June (N = 207) and October 2020 (N = 332). Associations between QoL and care burden, care competence, social support, and resilience, and changes over time were analysed using (logistic) regressions. Results No significant changes in overall QoL nor its domains were found. Care burden was negatively associated with QoL and increased during the pandemic. Care competence was lower than in 2019. Competence, social support, and resilience were positively associated with QoL. Conclusions Although relatives' QoL remained stable, the pandemic poses non‐negligible risks to their wellbeing. It is, therefore, crucial to provide relatives with adequate support.
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Affiliation(s)
- Ellen Zonneveld
- Department Perspective of patients and clients in healthcare, Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
| | - Femke van Schelven
- Department Perspective of patients and clients in healthcare, Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
| | - Hennie Boeije
- Department Perspective of patients and clients in healthcare, Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
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17
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Portillo-Aceituno A, Calderón-Bernal A, Pérez-Corrales J, Fernández-de-Las-Peñas C, Palacios-Ceña D, Güeita-Rodríguez J. The impact of digital physical therapy during COVID-19 lockdown in children with developmental disorders: A qualitative study. Braz J Phys Ther 2022; 26:100445. [PMID: 36179573 PMCID: PMC9477961 DOI: 10.1016/j.bjpt.2022.100445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 09/04/2022] [Accepted: 09/12/2022] [Indexed: 12/03/2022] Open
Abstract
Digital physical therapy may be a solution for continuity during lockdown, yet its development appears complex. Implementation difficulties seem to relate to physical, attentional, and training factors. Technological accessibility, adaptation of the therapist and involvement of the whole family appear to be facilitators. Future possibilities may support a better follow-up with fluid communication between families and therapists.
Background Digital physical therapy was performed within early intervention sessions for children with developmental disorders during the COVID-19 pandemic. There is no known qualitative study that addresses the perspectives of parents with digital practice for early intervention. Objective To describe the parents' experiences with digital physical therapy for early intervention in children during COVID-19 lockdown. Methods A qualitative phenomenological study. Purposive sampling was conducted, including 16 parents of the children participating in the early intervention program. Data were collected through semi-structured interviews and researchers' field notes. An inductive analysis was performed. Results Four themes emerged: a) ambivalent experiences about digital physical therapy: telehealth can be a good solution in times of COVID-19, however, it was also perceived as difficult and insufficient; b) barriers encountered for its implementation: describing factors related to physical aspects, training, and time, and difficulties maintaining the child's attention; c) perceived facilitators during its use: based on digital accessibility, availability, and adaptability of the therapist and the rest of the family; d) future possibilities of digital physical therapy: suggested uses for after the lockdown, such as a complement that facilitates communication and as a follow-up with older children. Conclusions Our findings help shed light on the possible benefits of digital physical therapy in children with developmental disorders, considering the perspectives of families. However, there are several difficulties to be overcome to successfully implement this type of therapy and optimize its future possibilities.
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Affiliation(s)
| | - Andrea Calderón-Bernal
- COVID-19 Tracer Service, Primary care management of the Community of Madrid, Madrid, Spain
| | - Jorge Pérez-Corrales
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Health Science Faculty, Alcorcón, Spain; Research Group of Humanities and Qualitative Research in Health Science (Hum&QRinHS), Universidad Rey Juan Carlos, Health Science Faculty, Alcorcón, Spain.
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Health Science Faculty, Alcorcón, Spain
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Health Science Faculty, Alcorcón, Spain; Research Group of Humanities and Qualitative Research in Health Science (Hum&QRinHS), Universidad Rey Juan Carlos, Health Science Faculty, Alcorcón, Spain
| | - Javier Güeita-Rodríguez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Health Science Faculty, Alcorcón, Spain; Research Group of Humanities and Qualitative Research in Health Science (Hum&QRinHS), Universidad Rey Juan Carlos, Health Science Faculty, Alcorcón, Spain
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18
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Urizar GG, Ramírez I, Caicedo BI, Mora C. Mental health outcomes and experiences of family caregivers of children with disabilities during the COVID-19 pandemic in Bolivia. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:2682-2702. [PMID: 34845739 PMCID: PMC9015286 DOI: 10.1002/jcop.22763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/03/2021] [Indexed: 05/15/2023]
Abstract
This study examined whether certain demographic characteristics, caregiver strain, and coping behaviors were associated with the mental health outcomes of family caregivers of children with disabilities in Bolivia during the COVID-19 pandemic. A mixed-methods convergent study design was used with virtual interviews to quantitatively assess caregivers' demographic characteristics, caregiver strain, coping behaviors, and mental health outcomes, as well as qualitatively assess how the pandemic affected their family. Approximately 32%-71% of caregivers experienced poor mental health outcomes (stress, anxiety, and depression), especially among those experiencing poor health, high caregiver strain, and those using maladaptive coping strategies. Qualitative responses revealed that they experienced several unique stressors during the pandemic that affected them and their children. These findings highlight the need for culturally tailored prevention and treatment interventions to help offset the adverse effects of the COVID-19 pandemic on the mental health outcomes of this at-risk population.
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Affiliation(s)
- Guido G. Urizar
- Department of PsychologyCalifornia State UniversityLong BeachCaliforniaUSA
| | - Ivonne Ramírez
- Instituto de Investigaciones en NeurodesarrolloUniversidad Mayor, Real y Pontificia de San Francisco Xavier de ChuquisacaSucreBolivia
| | - Brianna I. Caicedo
- Department of PsychologyCalifornia State UniversityLong BeachCaliforniaUSA
| | - Cindy Mora
- Department of PsychologyCalifornia State UniversityLong BeachCaliforniaUSA
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19
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Lim Y, Han A, Lee M, Kim M. The Effects of an Online-Offline Hybrid Exercise Program on the Lives of Children with Cerebral Palsy Using Wheelchairs during the COVID-19 Pandemic in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7203. [PMID: 35742452 PMCID: PMC9223063 DOI: 10.3390/ijerph19127203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 06/05/2022] [Accepted: 06/11/2022] [Indexed: 12/10/2022]
Abstract
Due to the ongoing COVID-19 pandemic, many online programs for social meetings, education, leisure, and physical activities have been developed and provided; however, children with cerebral palsy (CP) cannot enjoy online programs in the same way that those without disabilities can. The aim of this study was to investigate the differences in reintegration to normal living (RNL), social interaction, and quality of life among school-age children with CP after participation in a game-based online−offline hybrid group exercise program. The current study was conducted on 26 children with CP who participated in a hybrid exercise program. The RNL, social interaction, and quality of life were measured before and after the six-week program. The scores of RNL and quality of life were improved (p < 0.05) after program participation. Online or hybrid exercise programs incorporating interactive methods (i.e., competition and cooperating) could enhance RNL and quality of life of children with CP. Thus, well-designed online or hybrid exercise programs should be developed and provided for children with CP to enhance overall quality of life during the pandemic.
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Affiliation(s)
- Youngshin Lim
- Department of Physical Education, College of Education, Korea University, Seoul 02841, Korea;
| | - Areum Han
- Department of Sport Sciences, College of Energy and Biotechnology, Seoul National University of Science & Technology, Seoul 01811, Korea;
| | - Mingoo Lee
- College of Medicine, Korea University, Seoul 02841, Korea;
| | - May Kim
- Department of Physical Education, College of Education, Korea University, Seoul 02841, Korea;
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20
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Jung YG, Chang HJ, Jo ES, Kim DH. The Effect of a Horse-Riding Simulator with Virtual Reality on Gross Motor Function and Body Composition of Children with Cerebral Palsy: Preliminary Study. SENSORS 2022; 22:s22082903. [PMID: 35458888 PMCID: PMC9029300 DOI: 10.3390/s22082903] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/30/2022] [Accepted: 04/07/2022] [Indexed: 11/29/2022]
Abstract
This study aimed to evaluate the effect of a horse-riding simulator (HRS) with virtual reality (VR) on gross motor function, balance control, and body composition in children with spastic cerebral palsy (CP). Seventeen preschool and school-aged children with spastic CP were included; 10 children in the intervention group (HRS group) received 30 min of HRS with VR training twice a week for a total of 16 sessions in addition to conventional physiotherapy. Seven children in the control group were instructed to perform home-based aerobic exercises twice a week for 8 weeks in addition to conventional physiotherapy. Gross motor function measure (GMFM) and body composition were evaluated before the first session and after the last session. Before and after the 2-month intervention, Pediatric Balance Scale and Timed Up and Go test were evaluated for the HRS group. GMFM scores and body composition changed significantly in the HRS group (p < 0.05). However, no significant differences were observed in the control group. Changes in the GMFM total scores, GMFM dimension D scores, and skeletal muscle mass significantly differed between the HRS and control groups (p < 0.05). HRS with VR may be an effective adjunctive therapeutic approach for the rehabilitation of children with CP.
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Affiliation(s)
- Yong Gi Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Korea;
| | - Hyun Jung Chang
- Department of Physical Medicine and Rehabilitation, Samsung Changwon Hospital, School of Medicine, Sungkyunkwan University, Changwon 51353, Korea; (E.S.J.); (D.H.K.)
- Correspondence: ; Tel.: +82-55-233-5996
| | - Eun Sol Jo
- Department of Physical Medicine and Rehabilitation, Samsung Changwon Hospital, School of Medicine, Sungkyunkwan University, Changwon 51353, Korea; (E.S.J.); (D.H.K.)
| | - Da Hye Kim
- Department of Physical Medicine and Rehabilitation, Samsung Changwon Hospital, School of Medicine, Sungkyunkwan University, Changwon 51353, Korea; (E.S.J.); (D.H.K.)
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21
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Palomo-Carrión R, Romero-Galisteo RP, Romay-Barrero H, Cortés-Vega MD, Casuso-Holgado MJ, Pinero-Pinto E. Impact of lack of face-to-face schooling during COVID-19 confinement on family quality of life of children with disabilities and typical development. Ther Adv Chronic Dis 2022; 13:20406223221078091. [PMID: 35237399 PMCID: PMC8883405 DOI: 10.1177/20406223221078091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/13/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: The aim of this study was to analyze the impact of the lack of face-to-face schooling during the COVID-19 confinement on the family quality of life of children aged 3–6 years with hemiplegia, obstetrical brachial palsy, and typical development. Materials and Methods: An observational and cross-sectional study, using an online survey hosted in Google Forms from October to December 2020, was performed in families with children with infantile hemiplegia, obstetrical brachial palsy, and typical development aged 3–6 years living in Spain. The quality of life and family impact (measured through Pediatric Quality of Life Questionnaires, PedsQL™) were evaluated, as well as the affected upper limb side, the presence of other associated problems, the parents’ job, lack of use of the affected upper limb, and the type of online intervention using different channels: phone calls, emails, and video calls. Family expectations on the treatment and on their acquired capacity to solve problems related to their children were also measured. Results: A total of 93 families participated in the study and the children’s quality of life and family impact obtained a strong correlation in three populations: infantile hemiplegia (r = 0.844), obstetrical brachial palsy (r = 0.513), and typical development (r = 0.904). There was no association between quality of life and online intervention (phone calls and emails were selected), p > 0.05. Conclusion: The deprivation of schooling coupled with home confinement due to the COVID-19 pandemic had a greater impact on the quality of life of children with disabilities: infantile hemiplegia and obstetrical brachial palsy than on typically developing children and on their families. However, the online intervention did not produce improvements in quality of life, which could be a consequence of using emails or phone calls instead of video calls to interact with the families.
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Affiliation(s)
- Rocío Palomo-Carrión
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, Toledo, Spain
- Pediatric Unit, Hemi-Child-Research [Group of Research in Physiotherapy of Toledo (GIFTO)], Toledo, Spain
| | - Rita-Pilar Romero-Galisteo
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, Arquitecto Francisco Peñalosa St., 3 (Campus Teatinos), 29014 Málaga, Spain
- Institute of Biomedicine of Málaga (IBIMA), Málaga, Spain
| | - Helena Romay-Barrero
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, Toledo, Spain
| | - María-Dolores Cortés-Vega
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - María-Jesús Casuso-Holgado
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
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22
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Lo Moro G, Cugudda E, Bert F, Raco I, Siliquini R. Vaccine Hesitancy and Fear of COVID-19 Among Italian Medical Students: A Cross-Sectional Study. J Community Health 2022; 47:475-483. [PMID: 35138490 PMCID: PMC9160103 DOI: 10.1007/s10900-022-01074-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 11/29/2022]
Abstract
Medical students are in close contact with patients and should adhere to the same recommendations as healthcare workers. The study aimed to explore medical students' hesitancy towards COVID-19 vaccine and evaluate fear of COVID-19 and its relationship with hesitancy. A cross-sectional survey was conducted amongst a sample of medical students attending clinical years (November 2020–February 2021, Italy). Multivariable regressions were performed (p < 0.05 as significant). A total of 929 students participated (58.6% of eligible students). Hesitancy was reported by 6.7%; extreme fear of COVID-19 by 42.0%. Among hesitancy predictors, there were the survey completion before COVID-19 vaccine authorisation (adjOR = 6.43), adverse reactions after a vaccination (adjOR = 3.30), and receiving advice against COVID-19 vaccination from a relative (adjOR = 2.40). Students who received the recommended paediatric vaccinations (adjOR = 0.10), students with higher adherence to preventive measures (adjOR = 0.98), and students with fear of contracting COVID-19 with regard to the health of loved ones (adjOR = 0.17) were less likely to be hesitant. Females (adjOR = 1.85), students with poor health (adjOR = 1.64), students who had a loved one severely affected by COVID-19 (adjOR = 1.68), and students with fear of contracting flu (adjOR = 3.06) had a higher likelihood of reporting extreme fear. Hesitancy was remarkably lower than in similar studies. However, there is room for improvement in university activities that could deepen the competence in vaccines. Our focus on fear should not be overlooked, since the extent of extreme fear that we found might represent a substantial burden, considering the associations between fear and other health outcomes.
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Affiliation(s)
- Giuseppina Lo Moro
- Department of Public Health Sciences, University of Turin, Via Santena 5 bis, 10126, Turin, Italy
| | - Eleonora Cugudda
- Department of Public Health Sciences, University of Turin, Via Santena 5 bis, 10126, Turin, Italy
| | - Fabrizio Bert
- Department of Public Health Sciences, University of Turin, Via Santena 5 bis, 10126, Turin, Italy.
| | - Immacolata Raco
- Department of Public Health Sciences, University of Turin, Via Santena 5 bis, 10126, Turin, Italy
| | - Roberta Siliquini
- Department of Public Health Sciences, University of Turin, Via Santena 5 bis, 10126, Turin, Italy
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23
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Bhaskar AR, Gad MV, Rathod CM. Impact of COVID Pandemic on the Children with Cerebral Palsy. Indian J Orthop 2022; 56:927-932. [PMID: 35068545 PMCID: PMC8764506 DOI: 10.1007/s43465-021-00591-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/07/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The COVID pandemic has been raging across the world for the past 18 months and has severely impacted healthcare and resources. Children with special needs have been adversely affected by the COVID pandemic, due to lack of formal schooling, access to rehabilitation and limited physical and social activity. The aim of this online survey was to understand the effect of the pandemic on the children with Cerebral Palsy (CP). METHODS An online survey was conducted using a nine parts questionnaire comprising 26 questions. Survey included questions pertaining to demographic data, ambulatory status, lack of access to physiotherapy, orthotic adjustment, surgery, deterioration of function, and behaviour. A simple binary answer was sought to cover all social strata of society. RESULTS Responses were received from 101 caregivers who participated in an online questionnaire. 25.7% had no therapy sessions, 74.2% were on therapy of which 23.7% had online sessions. The lockdown restrictions coupled with lack of rehabilitation and orthotic support led to deterioration in physical function in 54 children and worsening of deformity in 34. Changes in behavioural pattern was observed in 45 children. CONCLUSION The survey revealed major disruptions in the care of Children with CP. The parents reported difficulties in managing the child therapy at home. There is always a possibility that the pandemic will result in a lockdown again, and hence our approach toward physical therapy assessment and rehabilitation needs to be towards home-based and family-centred care.
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Affiliation(s)
- Atul R. Bhaskar
- Department of Orthopaedics, Children Orthopaedic Clinic, Andheri, Mumbai, India
| | | | - Chasanal M. Rathod
- grid.511852.aDepartment of Orthopaedics, SRCC Children’s Hospital, Haji Ali, Mumbai, India
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24
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Ismail A, Sk Abd Razak R, Suddin LS, Mahmud A, Kamaralzaman S, Yusri G. The Economic Burden and Determinant Factors of Parents/Caregivers of Children with Cerebral Palsy in Malaysia: A Mixed Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010475. [PMID: 35010732 PMCID: PMC8744799 DOI: 10.3390/ijerph19010475] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/09/2021] [Accepted: 12/14/2021] [Indexed: 02/04/2023]
Abstract
The economic burden is a major concern for parents/caregivers of children with cerebral palsy (CP). This study used the sequential explanatory mixed-method approach to explorethe economic burden on parents/caregivers with a CP child in Malaysia and the factors associated with the economic burden. The study period spanned April 2020 and December 2020. A total of 106 questionnaire respondents were selected for the quantitative part, and 15 were interviewed to obtain qualitative input. A retrospective costing analysis was conducted based on the cost data obtained from the questionnaire. The majority of the children were GrossMotor Function Classification System (GMFCS) Level 5 (71%), quadriplegic (63%), and aged >4 years (90%). The estimated annual median total economic burden on the parents/caregivers per child in 2020 was RM52,540.00 (~USD12,515.03), with indirect cost being the greatest cost (RM28,800.00, ~USD6860.16), followed by developmental cost (RM16,200.00, ~USD3858.84), direct healthcare cost (RM4540.00, ~USD1081.43) and direct non-healthcare cost (RM3000.00, ~USD714.60). The annual household income was identified as a significant determinant factor (p=0.019, 95% CI: 0.04, 0.40) of the economic burden. The participants’ responses during the in-depth interview in the qualitative part of the study supported the premise that socioeconomic factors play a substantial role in determining the total economic burden. Our findings may aid local policymakers when planning the greater provision of support to the affected families in the future, especially for the parents/caregivers of children with CP, who are facing socioeconomic challenges.
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Affiliation(s)
- Aniza Ismail
- Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | - Ruhana Sk Abd Razak
- Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
- Correspondence: ; Tel.: +60-193009537
| | - Leny Suzana Suddin
- Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh 47000, Malaysia;
| | - Aidalina Mahmud
- Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia;
| | - Sazlina Kamaralzaman
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia;
| | - Ghazali Yusri
- Academy of Language Studies, Universiti Teknologi MARA, Shah Alam 40450, Malaysia;
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25
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Valderas C, Méndez G, Echeverría A, Suarez N, Julio K, Sandoval F. COVID-19 and neurologic manifestations: a synthesis from the child neurologist's corner. World J Pediatr 2022; 18:373-382. [PMID: 35476245 PMCID: PMC9044375 DOI: 10.1007/s12519-022-00550-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/29/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Since December 2019, the SARS-CoV-2 virus has been a global health issue. The main clinical presentation of this virus is a flu-like disease; however, patients with diverse neurologic manifestations have also been reported. In this review, we attempt to summarize, discuss and update the knowledge of the neurologic manifestations in the pediatric population affected by SARS-CoV-2 infection and the pandemic's effects in children with neurologic diseases. DATA SOURCES This review analyzes studies found on the PubMed database using the following keywords: Neurologic manifestations COVID-19, Neurological COVID-19, coronavirus, SARS-CoV-2, pediatric COVID-19, COVID-19 in children, MIS-C, Pediatric Inflammatory Multisystem Syndrome, Guillain Barré Syndrome, Stroke, ADEM, and Anti-NMDA encephalitis. All studies cited were published between 2004 and 2022, and represent the most relevant articles in the field. The World Health Organization COVID-19 online dashboard was assessed to obtain updated epidemiological data. RESULTS The most common neurologic symptoms in the pediatric population are headache, seizures, encephalopathy, and muscle weakness. These can be present during COVID-19 or weeks after recovering from it. Children who presented with multi-system inflammatory syndrome had a higher incidence of neurologic manifestations, which conferred a greater risk of morbidity and mortality. Several neuro-pathophysiological mechanisms have been proposed, including direct virus invasion, hyper-inflammatory reactions, multi-systemic failure, prothrombotic states, and immune-mediated processes. On the other hand, the COVID-19 pandemic has affected patients with neurologic diseases, making it challenging to access controls, treatment, and therapies. CONCLUSIONS Various neurologic manifestations have been associated with children's SARS-CoV-2 infection. It is important to identify and give them proper and opportune treatment because they can be potentially grave and life-threatening; some can lead to long-lasting sequelae. Different neuro-pathophysiological mechanisms have been proposed, however, a causal relationship between SARS-CoV-2 infection and neurologic manifestations remains to be proven. Patients with neurologic diseases are especially affected by COVID-19, not only by the disease itself but also by its complications and pandemic management measures.
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Affiliation(s)
- Carolina Valderas
- Department of Neurology, Hospital Dr. Exequiel González Cortés, Gran Avenida José Miguel Carrera 3300, 8900085 Santiago, Región Metropolitana Chile
| | - Gastón Méndez
- Department of Neurology, Hospital Dr. Exequiel González Cortés, Gran Avenida José Miguel Carrera 3300, 8900085 Santiago, Región Metropolitana Chile
| | - Alejandra Echeverría
- Department of Neurology, Hospital Dr. Exequiel González Cortés, Gran Avenida José Miguel Carrera 3300, 8900085 Santiago, Región Metropolitana Chile
| | - Nelson Suarez
- Department of Neurology, Hospital Dr. Exequiel González Cortés, Gran Avenida José Miguel Carrera 3300, 8900085 Santiago, Región Metropolitana Chile
| | - Katherin Julio
- Department of Neurology, Hospital Dr. Exequiel González Cortés, Gran Avenida José Miguel Carrera 3300, 8900085 Santiago, Región Metropolitana Chile
| | - Francisca Sandoval
- Department of Neurology, Hospital Dr. Exequiel González Cortés, Gran Avenida José Miguel Carrera 3300, 8900085, Santiago, Región Metropolitana, Chile.
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26
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Lai B, Wen H, Sinha T, Davis D, Swanson-Kimani E, Wozow C, Young R, Powell D, Rimmer JH. The impact of COVID-19 on the lifestyles of adolescents with cerebral palsy in the Southeast United States. Disabil Health J 2021; 15:101263. [PMID: 35000878 PMCID: PMC8677427 DOI: 10.1016/j.dhjo.2021.101263] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/01/2021] [Accepted: 12/13/2021] [Indexed: 11/26/2022]
Abstract
Background The impact of COVID-19 on adolescents with cerebral palsy (CP) and their families is underinvestigated, particularly in the Southeastern United States. Objective/Hypothesis The objective of this study was to examine the impact of COVID-19 on lifestyle activities, general and mental health, and basic needs among a cohort of adolescents with CP in the Southeast U.S. The second purpose was to identify key factors that impacted their lifestyles. Methods This was a cross-sectional survey of adolescents with CP (aged 10–19 years) who completed a child-modified version of the Coronavirus Disability Survey. Health and behavior items were associated with the perceived lifestyle impact of COVID-19. Results A total of 101 respondents completed the survey (mean age: 14 ± 2 years). Respondents reported minimal to no change in general health since the COVID-19 outbreak. Basic needs were met for most families. Nearly all participants (94.1%) reported a mental health concern that resulted from COVID-19: 32.7% felt down or depressed; 47.5% felt little pleasure in doing things; and 64.4% felt isolated. Moreover, 74.3% reported decreased socialization, 51.5% reported reduced exercise participation, and 43.6% reported difficulties in obtaining medical care. Most participants (90.1%) were negatively affected by COVID-19, and key associated factors were reduced interactions with friends and family (p = 0.001), exercise participation (p = 0.016), interest in doing things (p = 0.005), worsened depression (p = 0.015), increased isolation from others (p = 0.02) and at home (p = 0.006), technological communication (p = 0.00), and virus exposure (p = 0.008). Conclusions Study findings highlight problem areas that warrant urgent intervention among adolescents with CP located within the Southeast U.S.
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Affiliation(s)
- Byron Lai
- Department of Pediatrics, Division of Pediatric Rehabilitation Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, USA.
| | - Huacong Wen
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Tanvee Sinha
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Drew Davis
- Department of Pediatrics, Division of Pediatric Rehabilitation Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Erin Swanson-Kimani
- Department of Pediatrics, Division of Pediatric Rehabilitation Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Cynthia Wozow
- Department of Pediatrics, Division of Pediatric Rehabilitation Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Raven Young
- Department of Pediatrics, Division of Pediatric Rehabilitation Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Danielle Powell
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - James H Rimmer
- School of Health Professions, Dean's Office, University of Alabama at Birmingham, Birmingham, USA
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27
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The Quality of Medical Care in the Conditions of the COVID-19 Pandemic, with Particular Emphasis on the Access to Primary Healthcare and the Effectiveness of Treatment in Poland. J Clin Med 2021; 10:jcm10163502. [PMID: 34441798 PMCID: PMC8396893 DOI: 10.3390/jcm10163502] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/29/2021] [Accepted: 08/04/2021] [Indexed: 02/01/2023] Open
Abstract
Health has a significant influence on the quality of life of a society. The COVID-19 pandemic has forced many countries to implement restrictive measures to prevent its wider spread, including, inter alia, the introduction of remote healthcare in the form of teleconsultations. Therefore, there is the question of how such a change affects the quality of treatment and the primary healthcare of patients during the COVID-19 pandemic. The article aims to examine patient satisfaction with the access to primary healthcare and the effectiveness of treatment in a condition of remote medical care caused by the COVID-19 pandemic. We also analyse the impact of access to primary healthcare on the treatment effectiveness. Patient satisfaction was measured using a questionnaire assessing the quality of primary medical care. Of the 36 items studied, seven were related to the accessibility dimension and four were related to the treatment effectiveness dimension. Our results suggest that the treatment effectiveness and the access to primary healthcare services during the COVID-19 pandemic through telemedicine are quite highly rated by patients. Hence, further implementation of telemedicine in primary healthcare should improve the quality of lives of the wide society. We have also identified the access to primary healthcare has a considerable impact on the treatment effectiveness. Therefore, we recommend increasing the contact between patients and GPs via telemedicine under lockdown conditions.
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