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Santana CAS, Rosenbaum P, van der Kemp J, de Campos AC. Looking beyond Body Structure and Function: ICF Foci and Who Is Being Assessed in Research about Adolescents and Young Adults with Cerebral Palsy-A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:670. [PMID: 38928917 PMCID: PMC11203594 DOI: 10.3390/ijerph21060670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/12/2024] [Accepted: 05/15/2024] [Indexed: 06/28/2024]
Abstract
PURPOSE The purpose of this study is to summarize the ICF foci, looking beyond body structures and function, and to analyze who has been assessed in research about adolescents and young adults (AYAs) with CP in the phase of transition to adulthood. METHOD Medline, EMBASE, PsycINFO, and CINAHL databases were searched using terms related to cerebral palsy, adolescents/young adults, health development, participation, and independence. Studies including youth with CP (13-30 years old) published in English from 2014 to 2021 were considered. The methods of assessment reported in the included studies were used to identify the ICF foci and who was assessed. RESULTS In this study, 86 studies were reviewed. The main ICF foci are activity and participation (51% of the studies), personal factors (23%), ICF not covered (14%), ICF not defined (9%), with environmental factors being the least focused ICF component (3%). Most studies assessed AYAs directly (49% of studies). CONCLUSIONS Activity- and participation-related constructs are the leading research focus of studies, and more attention is needed concerning environmental factors. AYAs are the main source of information, and the perspectives of other key figures are also being valued. To bridge the gap between child and adult health care, a broader view of health development and approaches to explore AYA developmental issues must be taken.
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Affiliation(s)
- Camila Araújo Santos Santana
- Physiotherapy Department, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil;
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Jet van der Kemp
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, 3584 Utrecht, The Netherlands
| | - Ana Carolina de Campos
- Physiotherapy Department, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil;
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Marcilla-Jorda M, Grande C, Coelho V, Rubio-Belmonte C, Moro-Ipola M. Sensory Profile-2 in Autism Spectrum Disorder: An Analysis within the International Classification of Functioning, Disability and Health Framework. J Autism Dev Disord 2024:10.1007/s10803-024-06337-y. [PMID: 38613593 DOI: 10.1007/s10803-024-06337-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2024] [Indexed: 04/15/2024]
Abstract
Autism spectrum disorder (ASD) is characterized by impairments in many functional areas requiring long-term interventions to promote autonomy. This study aims to map The Sensory Profile™ 2 (SP-2), one of the most widely used assessment tools in children with ASD, with the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY), developed by the World Health Organization (WHO). This will allow the identification of the functional dimensions covered by this instrument and the comparison with the ICF shortlist proposed for autism (ICF Core Set [ICF-CS]). The deductive content analysis described in the ICF Linking Rules was followed, along with a systematized process including statistical and reasoning techniques that could contribute to the improvement of ICF linking studies (Cohen's Kappa and percentage of agreement). 218 codes were identified, 71% of them were codes related to the body functions chapters, mainly linked to perceptual functions (b160), emotional functions (b152), and temperament and personality functions (b126). Concerning activities and participation chapters (29%) the most frequently used codes were: focusing attention (d160), carrying out daily routine (d230), and walking (d450). Even though the SP-2 items do not assess most of the functional features regarded as essential in the ASD ICF-CS, SP-2 encompasses a majority of problems concerning body functions. This instrument may be considered as part of a multidimensional assessment approach, to complement other sources that are more likely to assess activity and participation dimensions and guide a functional intervention.
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Affiliation(s)
| | - Catarina Grande
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Center for Psychology at University of Porto, University of Porto, Porto, Portugal
| | - Vera Coelho
- Department of Social and Behavioral Sciences, Universidade da Maia, Maia, Portugal
- Center for Psychology at University of Porto, University of Porto, Porto, Portugal
| | | | - Micaela Moro-Ipola
- Faculty of Health Sciences, Universitat Jaume I, Castello de la Plana, Spain.
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D'Arcy E, Evans K, Afsharnejad B, Milbourn B, Bölte S, Girdler S. Assessing functioning for individuals with neurodevelopmental conditions: Current clinical practice in Australia. Aust Occup Ther J 2023; 70:43-60. [PMID: 35934786 PMCID: PMC10087051 DOI: 10.1111/1440-1630.12834] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND In the disability sector globally, and specifically in Australia, assessments of functioning have become key to diagnostic processes, and accessing therapy and funding. Over half of all individuals accessing support through Australia's National Disability Insurance Scheme have a neurodevelopmental condition diagnosis. Little is known about assessments of functioning for this population. METHODS A mixed methods online survey was designed to understand the current assessment of functioning practices (including clinical contexts, concepts being assessed, and assessment methods) and barriers and facilitators to clinicians using best practice. Results were analysed descriptively, and differences between professions calculated where possible. Content analysis was used to explore qualitative comments. RESULTS Clinicians from various medical and allied health backgrounds completed the survey (n = 93), with varying ranges of age, experience, and education. Clinicians reported that they assessed functioning across age, setting, sector, funding body, and individuals with a wide variety of diagnoses. Missing from current practice is a clear transdisciplinary conceptualisation of functioning. The largest barriers to best practice were limited time, large caseloads, availability of appropriate tools, and lack of clarity from funding bodies. CONCLUSIONS Missing from current practice is a clear transdisciplinary conceptualisation of functioning.These results will help inform steps forward to improve assessment of functioning practices to ensure that all individuals receive appropriate and sufficient support.
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Affiliation(s)
- Emily D'Arcy
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Telethon Kids Institute, Nedlands, Western Australia, Australia.,Cooperative Research Centre for Living with Autism, Indooroopilly, Queensland, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia
| | - Kiah Evans
- Telethon Kids Institute, Nedlands, Western Australia, Australia.,Cooperative Research Centre for Living with Autism, Indooroopilly, Queensland, Australia.,School of Allied Health, University of Western Australia, Perth, Western Australia, Australia
| | - Bahareh Afsharnejad
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia
| | - Benjamin Milbourn
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Telethon Kids Institute, Nedlands, Western Australia, Australia.,Cooperative Research Centre for Living with Autism, Indooroopilly, Queensland, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia
| | - Sven Bölte
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Department of Women's and Children's Health, Karolinska Institutet, Solna, Sweden.,Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Sonya Girdler
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Telethon Kids Institute, Nedlands, Western Australia, Australia.,Cooperative Research Centre for Living with Autism, Indooroopilly, Queensland, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia.,School of Allied Health, University of Western Australia, Perth, Western Australia, Australia.,Department of Women's and Children's Health, Karolinska Institutet, Solna, Sweden
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Finch-Edmondson M, Paton MCB, Honan I, Karlsson P, Stephenson C, Chiu D, Reedman S, Griffin AR, Morgan C, Novak I. Are We Getting It Right? A Scoping Review of Outcomes Reported in Cell Therapy Clinical Studies for Cerebral Palsy. J Clin Med 2022; 11:jcm11247319. [PMID: 36555936 PMCID: PMC9786692 DOI: 10.3390/jcm11247319] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/01/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Cell therapies are an emergent treatment for cerebral palsy (CP) with promising evidence demonstrating efficacy for improving gross motor function. However, families value improvements in a range of domains following intervention and the non-motor symptoms, comorbidities and complications of CP can potentially be targeted by cell therapies. We conducted a scoping review to describe all outcomes that have been reported in cell therapy studies for CP to date, and to examine what instruments were used to capture these. Through a systematic search we identified 54 studies comprising 2066 participants that were treated with a range of cell therapy interventions. We categorized the reported 53 unique outcome instruments and additional descriptive measures into 10 categories and 12 sub-categories. Movement and Posture was the most frequently reported outcome category, followed by Safety, however Quality of Life, and various prevalent comorbidities and complications of CP were infrequently reported. Notably, many outcome instruments used do not have evaluative properties and thus are not suitable for measuring change following intervention. We provide a number of recommendations to ensure that future trials generate high-quality outcome data that is aligned with the priorities of the CP community.
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Affiliation(s)
- Megan Finch-Edmondson
- Cerebral Palsy Alliance Research Institute, Speciality of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
- Correspondence: ; Tel.: +61-2-8052-2068
| | - Madison C. B. Paton
- Cerebral Palsy Alliance Research Institute, Speciality of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Ingrid Honan
- Cerebral Palsy Alliance Research Institute, Speciality of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Petra Karlsson
- Cerebral Palsy Alliance Research Institute, Speciality of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Candice Stephenson
- Cerebral Palsy Alliance Research Institute, Speciality of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Darryl Chiu
- Cerebral Palsy Alliance Research Institute, Speciality of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Sarah Reedman
- Cerebral Palsy Alliance Research Institute, Speciality of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Alexandra R. Griffin
- Cerebral Palsy Alliance Research Institute, Speciality of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Catherine Morgan
- Cerebral Palsy Alliance Research Institute, Speciality of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Iona Novak
- Cerebral Palsy Alliance Research Institute, Speciality of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
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Zh Chia A, Hua Tan Y, Hong Yeo T, Teoh OH, Min Ng Z. Epidemiology and risk factors for sleep disturbances in children and youth with cerebral palsy: An ICF-based approach. Sleep Med 2022; 96:93-98. [DOI: 10.1016/j.sleep.2022.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 03/14/2022] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
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Noten S, Selb M, Troenosemito LAA, Thorpe DE, Rodby‐Bousquet E, van der Slot WMA, Roebroeck ME. ICF Core Sets for the assessment of functioning of adults with cerebral palsy. Dev Med Child Neurol 2022; 64:569-577. [PMID: 34800032 PMCID: PMC9299033 DOI: 10.1111/dmcn.15104] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 09/17/2021] [Accepted: 09/25/2021] [Indexed: 01/19/2023]
Abstract
AIM To report on the results of the online international consensus process to develop the comprehensive and brief International Classification of Functioning, Disability and Health (ICF) Core Sets for adults with cerebral palsy (CP). METHOD An online iterative decision-making and consensus process involved 25 experts, including clinicians and researchers working with adults with CP, an adult with CP, and the parents of adults with CP from all six regions of the World Health Organization. The most relevant categories were selected from a list of 154 unique second-level candidate categories to develop the ICF Core Sets for adults with CP. This list resulted from evidence gathered during four preparatory studies, that is, a systematic literature review, a qualitative study, an expert survey, and an empirical study. RESULTS The consensus process resulted in the comprehensive ICF Core Set containing 120 second-level ICF categories: 33 body functions; eight body structures; 50 activities and participation; and 29 environmental factors, from which the most essential categories, 33 in total, were selected for the brief ICF Core Set. For body functions, most of the categories were mental functions and neuromusculoskeletal and movement-related functions. Body structures were mostly related to movement. All the chapters of the activities and participation component were represented, with mobility and self-care as the most frequently covered chapters. For environmental factors, most of the categories addressed products and technology and services, systems, and policies. INTERPRETATION The comprehensive and brief ICF Core Sets for adults with CP were created using a new online version of an established ICF Core Set consensus process. These Core Sets complement the age-specific ICF Core Sets for children and young people with CP and will promote standardized data collection worldwide.
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Affiliation(s)
- Suzie Noten
- Department of Rehabilitation MedicineErasmus MC University Medical CenterRotterdamthe Netherlands,Rijndam RehabilitationRotterdamthe Netherlands.
| | - Melissa Selb
- ICF Research BranchNottwilSwitzerland,Swiss Paraplegic ResearchNottwilSwitzerland.
| | - Lorenzo A A Troenosemito
- Department of Rehabilitation MedicineErasmus MC University Medical CenterRotterdamthe Netherlands
| | - Deborah E Thorpe
- Division of Physical TherapySchool of MedicineUniversity of North Carolina at Chapel HillChapel HillNCUSA.
| | - Elisabet Rodby‐Bousquet
- Centre for Clinical ResearchUppsala University – Region VästmanlandVästeråsSweden,Department of Clinical SciencesOrthopaedicsLund UniversityLundSweden
| | - Wilma M A van der Slot
- Department of Rehabilitation MedicineErasmus MC University Medical CenterRotterdamthe Netherlands,Rijndam RehabilitationRotterdamthe Netherlands.
| | - Marij E Roebroeck
- Department of Rehabilitation MedicineErasmus MC University Medical CenterRotterdamthe Netherlands,Rijndam RehabilitationRotterdamthe Netherlands.
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MacDermid JC. ICF Linking and Cognitive Interviewing Are Complementary Methods for Optimizing Content Validity of Outcome Measures: An Integrated Methods Review. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:702596. [PMID: 36188847 PMCID: PMC9397968 DOI: 10.3389/fresc.2021.702596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/10/2021] [Indexed: 12/18/2022]
Abstract
Content validity is a fundamental requirement of outcome measures. After reviewing operational needs and existing definitions, content validity we as defined as: the extent to which a measure provides a comprehensive and true assessment of the key relevant elements of a specified construct or attribute across a defined range, clearly and equitably for a stated target audience and context. ICF linkage rules from 2002, 2005, and 2019 have provide increasingly clear processes for describing and evaluating content of outcome measures. ICF Core Sets provide international reference standards of the core constructs of importance for different health conditions. Both are important as reference standards during content validation. To summarize their use as reference standards, the following summary indicators were proposed: (1) Measure to ICF linkage, (2) Measure to (Brief or Comprehensive) Core Set Absolute Linkage, (3) Measure to (Brief or Comprehensive) Core Set Unique Linkage, (4) Core Set Representation, and (5) Core Set Unique Disability Representation. Methods to assess how respondents engage with content are needed to complement ICF-linking. Cognitive interviewing is an ideal method since it used to explore how respondents interpret and calibrate response to individual items on an outcome measure. We proposed a framework for classifying these responses: Clarity/Comprehension, Relevance, Inadequate response definition, Reference Point, Perspective modification, and Calibration Across Items. Our analysis of 24 manuscripts that used ICF linking for content validation since updated linking rules were published found that authors typically used linking to validate existing measures, involved multiple raters, used 2005 linking rules, summarized content at a concept level (e.g., impairment, activity, participation) and/or use core sets as a reference standard. Infrequently, ICF linking was used to create item pools/conceptual frameworks for new measures, applied the full scope of the 2019 linking rules, used summary indicators, or integrated ICF-linking with qualitative methods like cognitive interviews. We conclude that ICF linkage is a powerful tool for content validity during development or validation of PROM. Best practices include use of updated ICF linking rules, triangulation of ICF linking with participant assessments of clarity and relevance preferably obtained using cognitive interview methods, and application of defined summary indicators.
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Affiliation(s)
- Joy C. MacDermid
- Department of Surgery, School of Physical Therapy, Western University, London, ON, Canada
- Hand and Upper Limb Centre, St. Joseph's Health Centre, London, ON, Canada
- *Correspondence: Joy C. MacDermid
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8
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Kim H, Kolaski K. Is botulinum toxin type A more effective and safer than other treatments for the management of lower limb spasticity in children with cerebral palsy? A Cochrane Review summary with commentary. NeuroRehabilitation 2021; 49:161-164. [PMID: 34366300 DOI: 10.3233/nre-218003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Botulinum toxin A (BoNT-A) is a well-accepted treatment for the medical management of spasticity in children with cerebral palsy (CP). OBJECTIVE To assess the efficacy and safety of BoNT-A compared with other treatment options in managing lower limb spasticity in children with CP. METHODS A summary of the Cochrane Review update by Blumetti et al. (2019), with comments. RESULTS This review included 31 randomized controlled trials (1508 participants). Compared with usual care/physiotherapy, the evidence is very uncertain about the effect of BoNT-A on gait, function, ankle joint range of motion (ROM), satisfaction, and ankle spasticity in children with CP. Compared with placebo/sham, BoNT-A probably benefits these same outcomes, although the results for function are contradictory. BoNT-A may not be more effective than serial casting at improving gait, function, ankle ROM and spasticity at any time point. However, it may be more effective than an orthosis at medium-term follow-up for hip ROM and adductor spasticity, but not function. The rate of adverse events with BoNT-A is similar to placebo/sham and serial casting. CONCLUSIONS Evidence for the effectiveness and safety of BoNT-A for the management of lower limb spasticity in children with CP is uncertain, with better quality evidence available from studies of placebo/sham than non-placebo controls. To produce high-quality evidence, future studies need to improve their methodological quality and increase sample sizes.
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Affiliation(s)
- Heakyung Kim
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Kat Kolaski
- Departments of Orthopedics and Pediatrics, Wake Forest Baptist Health, Comp Rehab, Winston-Salem, NC, USA
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Gimeno H, Polatajko HJ, Cornelius V, Lin JP, Brown RG. Rehabilitation in childhood-onset hyperkinetic movement disorders including dystonia: Treatment change in outcomes across the ICF and feasibility of outcomes for full trial evaluation. Eur J Paediatr Neurol 2021; 33:159-167. [PMID: 34052114 DOI: 10.1016/j.ejpn.2021.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 04/27/2021] [Accepted: 04/29/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Childhood-onset hyperkinetic movement disorders (HMD), including dystonia are notoriously difficult to treat and there are limited studies showing successful medical, surgical or non-pharmacological interventions. METHODS This prospective study used grouped data (n = 22) from two studies of the Cognitive Orientation to daily Occupational Performance (CO-OP) Approach for patient-selected goals. Eligibility included aged 6-21 years, deep brain stimulation in place, with manual ability classification system level I-IV. Outcome was assessed on a range of patient-reported and clinician-rated measures across the International Classification of Function at end-treatment (10 weekly sessions) (series 1 and 2) and 3-month follow-up (series 1). Feasibility of outcomes to be used in a full trial were explored. FINDINGS Nineteen participants completed the intervention and were included in the analysis. Of the primary outcome measures, the self-reported Canadian Occupational Performance Measure showed improvement in goal performance (mean change 4.08, 95% CI [3.37,4.79] post-; 4.18 [5.10,5.26] follow-up), and satisfaction (4.03 [3.04,5.03) post-; 4.44 [3.07,5.82] follow-up]. The Assessment of Motor and Process Skills showed improved motor score (0.52 [0.01,1.03] at follow-up only, while the process score did not change. Objective blind-rated pooled data using the Performance Quality Rating Scale-individualized indicated significant change for trained goals (3.79 [3.37,4.21] post-; (4.01,5.10) follow-up] and untrained goals (1.90 [1.24,2.55] post 1.91 [0.23,3.60] follow-up]. Motor impairment assessed by the Burke-Fahn Motor Disability Rating Scale was unchanged (-3.26 [-6.62,0.09] post-; -1.11 [-8.05,5.82] follow-up). Improvement was also observed in self-efficacy (0.97 [0.47,1.47] post-; 1.37 [1.91-0.83] follow-up) and Quality of Life (0.12 [0.03-0.22] follow-up). Goal improvement; self-efficacy and quality of life captured significant change post-intervention. This improvement was shown despite no change on impairment-related measures and were shown to be feasible measures to use in a larger study of CO-OP for this population.
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Affiliation(s)
- Hortensia Gimeno
- Complex Motor Disorders Service, Paediatric Neurosciences, Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK; Department of Psychology, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK.
| | - Helene J Polatajko
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Victoria Cornelius
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, London, UK
| | - Jean-Pierre Lin
- Complex Motor Disorders Service, Paediatric Neurosciences, Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Richard G Brown
- Department of Psychology, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
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Zanella LW, Valentini NC, Copetti F, Nobre GC. Peabody Developmental Motor Scales - Second Edition (PDMS-2): Reliability, content and construct validity evidence for Brazilian children. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 111:103871. [PMID: 33571789 DOI: 10.1016/j.ridd.2021.103871] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/07/2021] [Accepted: 01/19/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The Peabody Developmental Motor Scales - Second Edition (PDMS-2) has been used by health and educational professionals to assess the gross and fine motor skills of children with typical development, motor and/or cognitive delays, and disabilities. AIM Investigate the validity and reliability of PDMS-2 for use in Brazil. METHODS For content validity, 13 professionals participated in the study. For construct validity, a sample of 637 children from birth until 71 months (0-23 months: n = 399; 24-71 months: n = 238) was assessed with the PDMS-2. RESULTS The PDMS-2 administered to the Brazilian population has psychometric characteristics equivalent to the original version. CONCLUSION PDMS-2 is a valid and reliable tool for evaluating Brazilian children's motor development and providing appropriate support for clinical and educational intervention plans and follow-ups.
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Affiliation(s)
- Larissa Wagner Zanella
- Federal Institute of Education, Science and Technology of Rio Grande do Sul, Campus Sertão, Rodovia RS-135, KM 25 - District Eng. Luiz, Sertão, Rio Grande do Sul, 99170-000, Brazil.
| | - Nadia Cristina Valentini
- Human Movement Sciences Graduate Program at School of Physical Education, Physiotherapy and Dance in Federal University of Rio Grande do Sul, Felizardo Street, 750 - Jardim Botânico, Porto Alegre, Rio Grande do Sul, 90690-200, Brazil.
| | - Fernando Copetti
- Physical Education Graduate Program at Physical Education and Sports Center in Universidade Federal de Santa Maria, Brazil.
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Ng ZM, Lin JB, Khoo PC, Rajadurai VS, Chan DWS, Ong HT, Wong J, Choong CT, Lim KW, Lim KBL, Yeo TH. Causes, functional outcomes and healthcare utilisation of people with cerebral
palsy in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2021. [DOI: 10.47102/annals-acadmedsg.2020489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Introduction: A voluntary cerebral palsy (CP) registry was established in 2017 to describe the clinical
characteristics and functional outcomes of CP in Singapore.
Methods: People with CP born after 1994 were recruited through KK Women’s and Children’s Hospital,
National University Hospital and Cerebral Palsy Alliance Singapore. Patient-reported basic demographics,
service utilisation and quality of life measures were collected with standardised questionnaires. Clinical
information was obtained through hospital medical records.
Results: Between 1 September 2017 and 31 March 2020, 151 participants were recruited. A majority
(n=135, 89%) acquired CP in the pre/perinatal period, where prematurity (n=102, 76%) and the need
for emergency caesarean section (n=68, 50%) were leading risk factors. Sixteen (11%) of the total
participants had post-neonatally acquired CP. For predominant CP motor types, 109 (72%) had a spastic
motor type; 32% with spastic mono/hemiplegia, 41% diplegia, 6% triplegia and 21% quadriplegia.
The remaining (42, 27.8%) had dyskinetic CP. Sixty-eight (45.0%) participants suffered significant
functional impairment (Gross Motor Functional Classification System levels IV–V). Most participants
(n=102, 67.5%) required frequent medical follow-up (≥4 times a year).
Conclusion: Optimisation of pre- and perinatal care to prevent and manage prematurity could reduce the
burden of CP and their overall healthcare utilisation.
Keywords: Cerebral palsy, functional outcomes, neonatal, registry
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Affiliation(s)
- Zhi Min Ng
- KK Women’s and Children’s Hospital, Singapore
| | - Jeremy B Lin
- National University of Singapore and Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore
| | | | | | | | - Hian Tat Ong
- National University of Singapore and Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore
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Almoajil H, Wilson N, Theologis T, Hopewell S, Toye F, Dawes H. Outcome domains and measures after lower limb orthopaedic surgery for ambulant children with cerebral palsy: an updated scoping review. Dev Med Child Neurol 2020; 62:1138-1146. [PMID: 32567044 DOI: 10.1111/dmcn.14599] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 05/07/2020] [Indexed: 11/30/2022]
Abstract
AIM To determine the reported outcome domains and measures used to assess lower limb orthopaedic surgery of ambulant children and young people with cerebral palsy (CP) and map these outcomes to the International Classification of Functioning, Disability and Health - Children and Youth (ICF-CY) framework. METHOD This updated scoping review included studies published between January 2016 and July 2019 in five databases: MEDLINE, PubMed, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials. Studies were included if participants were ambulant individuals with CP aged between 0 and 20 years who had undergone lower limb orthopaedic surgery. Health outcome domains and measures were identified and classified using the ICF-CY framework. RESULTS Forty-four eligible studies were identified with a total of 40 different outcome domains recorded. Among eligible studies, 44 (100%) measured body function and structural impairment and seven (16%) measured activity limitation and participation restriction. The most frequently reported outcome was gait pattern (n=37, 84%). Few studies reported adverse effects of surgery (n=13, 30%). Twenty-nine different outcome measures were identified. Patient-reported outcomes measures were used in 10 studies (23%). INTERPRETATION The review highlights a heterogeneity in the reported outcome domains and measures used in CP studies. The majority of the reported outcomes focus on the ICF-CY domain of body function and structure. The review also highlights a notable shift towards patient-reported outcomes in recent years. Development of a core outcome set for lower limb orthopaedic surgery would guide researchers to use more consistent and complete measurement sets.
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Affiliation(s)
- Hajar Almoajil
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Department of Physical Therapy, College of Applied Medical Science, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nichola Wilson
- Department of Surgery, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Tim Theologis
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Paediatric Orthopaedic Surgery, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Sally Hopewell
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Francine Toye
- Physiotherapy Research Unite, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Helen Dawes
- Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK.,Oxford Health NHS Foundation Trust, Oxford, UK
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Colomera JA, Nahuelhual P. [Effectiveness of robotic assistance for gait training in children with cerebral palsy. a systematic review]. Rehabilitacion (Madr) 2020; 54:107-115. [PMID: 32370825 DOI: 10.1016/j.rh.2019.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 12/10/2019] [Accepted: 12/17/2019] [Indexed: 06/11/2023]
Abstract
INTRODUCTION In recent years, the use of gait training using robotic assistance systems has progressively increased in the paediatric population with cerebral palsy. OBJECTIVE To systematically assess the effects of robotic assistance for gait training compared with physical rehabilitation therapy in children with cerebral palsy (CP), based on the International Classification of Functioning, Health and Disability (ICF). MATERIALS AND METHODS A systematic review was carried out according to the recommendations of the Cochrane Collaboration. We included randomised or quasi-randomised clinical trials that analysed children with CP classified according to The Gross Motor Function Classification System (GMFCS) I-III. The search was carried out in PubMed, PEDro, CENTRAL, CINALH, Cochrane, Embase, Europe PMC, LILACS and Science Direct. The selection and extraction of data from the studies was carried out by two independent researchers. Disagreements were resolved by consensus. A descriptive analysis of the selected studies was performed. Assessment of risk of bias was performed with the Cochrane Collaboration tool. RESULTS Four studies met the eligibility criteria. Most of the temporal-spatial, kinetic and kinematic parameters of gait were evaluated, all corresponding to the activity component of the ICF. CONCLUSIONS Due to the methodological variability of the studies, it is not possible to determine whether robot-assisted gait training is effective for treatment in children with CP.
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Affiliation(s)
- J A Colomera
- Unidad de Kinesiología, Instituto Teletón Temuco, Temuco, Chile.
| | - P Nahuelhual
- Subdirección de investigación Teletón Santiago, Chile; Facultad de Medicina CAS UDD, Santiago, Chile
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Lewis J, Scott K, Pan X, Heathcock J. The Relationship between Parent-reported PEDI-CAT Mobility and Gross Motor Function in Children with Cerebral Palsy: Brief Report. Dev Neurorehabil 2020; 23:140-144. [PMID: 31726912 DOI: 10.1080/17518423.2019.1687601] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: The PEDI-CAT mobility domain (PEDI-mob) is a parent-reported measure of mobility for children up to 21 years of age. The purpose of this research is to investigate the relationship between the PEDI-mob and Gross Motor Function Measure (GMFM)-66 and Gross Motor Function Classification Scale (GMFCS) levels.Methods: Fifty-seven children (N = 57), ages 2-8.8 years participated. PEDI-mob and GMFM were administered and GMFCS was confirmed during the same session. A Pearson correlation coefficient was calculated for PEDI-mob and GMFM-66 scores to evaluate the association between these two measures. An ANOVA was used to analyze PEDI-mob across GMFCS levels.Results: Large, statistically significant correlation was found between PEDI-mob and GMFM-66 scores (r = 0.894, p-value<0.001). Differences in PEDI-mob scores were found across GMFCS levels (p-value <0.001), where patients with higher GMFCS levels had lower PEDI-mob scores.Conclusion: These results support a strong relationship between parent-reported and clinically measured motor function.
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Benner JL, McPhee PG, Gorter JW, Hurvitz EA, Peterson MD, Obeid J, Wright M, Balemans AC, Verschuren O, van den Berg-Emons RH, van der Slot WM, Roebroeck ME. Focus on Risk Factors for Cardiometabolic Disease in Cerebral Palsy: Toward a Core Set of Outcome Measurement Instruments. Arch Phys Med Rehabil 2019; 100:2389-2398. [DOI: 10.1016/j.apmr.2019.04.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/02/2019] [Accepted: 04/12/2019] [Indexed: 01/05/2023]
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16
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Outcome Assessment and Function in Cerebral Palsy. Phys Med Rehabil Clin N Am 2019; 31:131-141. [PMID: 31760986 DOI: 10.1016/j.pmr.2019.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Care and research in childhood cerebral palsy (CP) continue to evolve. As our understanding of CP grows more nuanced, so grows our need to describe function, activities, challenges, adaptations of children with CP. In CP, robust means of measuring outcomes are vital to understanding utility of treatments. Research must accurately measure meaningful constructs of children with CP as a reliable ruler to establish if interventions produce useful effects. This article addresses the challenges of outcome measurement in CP, current status of outcome measurement in CP, and issues of understanding change in childhood CP.
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Content Comparison of Aquatic Therapy Outcome Measures for Children with Neuromuscular and Neurodevelopmental Disorders Using the International Classification of Functioning, Disability, and Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214263. [PMID: 31684043 PMCID: PMC6862466 DOI: 10.3390/ijerph16214263] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/30/2019] [Accepted: 10/31/2019] [Indexed: 11/25/2022]
Abstract
Currently, aquatic exercise is among the most common physical activity modalities for children with neuromuscular and neurodevelopmental disorders. However, the outcome measures that should be routinely used by therapists working in this specific health-care context have not been widely studied. The purpose of the study was to identify and compare the content of outcome measures used in aquatic physiotherapy for children, employing the International Classification of Functioning, Disability and Health (ICF) as a framework. A literature review was used to identify aquatic functioning outcome measures for children with neuromuscular and neurodevelopmental disorders. Content comparison of outcome measures identified was linked to the ICF following the linking guidelines, and content-related metrics were used to analyze them. Four outcome measures were identified (HAAR, Conatser, WOTA 1 and 2, and SWIM), which contained a total of 116 meaningful concepts and were linked to 35 ICF 2nd level categories. The greatest number of items assessed activity and participation categories. Large differences were found in reference to the density of content. For content diversity, the measures were all below 0.5. The identified outcome measurements showed homogeneity with respect to the theoretical foundation; however, some differences were found in terms of content analysis.
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18
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Yi YG, Jung SH, Bang MS. Emerging Issues in Cerebral Palsy Associated With Aging: A Physiatrist Perspective. Ann Rehabil Med 2019; 43:241-249. [PMID: 31311245 PMCID: PMC6637058 DOI: 10.5535/arm.2019.43.3.241] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 10/17/2018] [Indexed: 11/16/2022] Open
Abstract
The population of adults diagnosed with cerebral palsy (CP) is increasing along with the survival rate of children born with the disability. Adults with CP need health services for the continued monitoring and management of their condition. Moreover, the development of additional health problems in adulthood increases the need for ongoing access to health services. Adults with CP manifest a higher rate of chronic health conditions and eventual decline in strength and functional reserve, deterioration in physical activity, increased risk of musculoskeletal complications, and gradual changes in swallowing ability. They are also reported to exhibit difficulty engaging socially and have a low health-related quality of life (QOL). However, there are a large number of adults with CP who cannot access medical services adequately and are therefore not effectively treated. To overcome these apparent challenges, we need to fully comprehend the healthcare needs of adults with CP to develop adult-focused health services. Further research is needed regarding the impact of physical activity, nutrition, sarcopenia, myeloradiculopathy, and swallowing function on QOL.
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Affiliation(s)
- You Gyoung Yi
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul University College of Medicine, Seoul, Korea
| | - Se Hee Jung
- Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Moon Suk Bang
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul University College of Medicine, Seoul, Korea
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19
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Affiliation(s)
- Michael M Green
- Physical Medicine and Rehabilitation, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Deborah Gaebler-Spira
- Physical Medicine and Rehabilitation and Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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20
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Liao HF, Hwang AW, Schiariti V, Yen CF, Chi WC, Liou TH, Hung HC, Hsieh YH. Validating the ICF core set for cerebral palsy using a national disability sample in Taiwan. Disabil Rehabil 2018; 42:642-650. [PMID: 30451019 DOI: 10.1080/09638288.2018.1504328] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To validate the activities and participation (d) codes of two age-specific brief International Classification of Functioning, Disability, and Health (ICF) core sets for school-aged children with cerebral palsy (CP), using national dataset of the child version of the Functioning Scale of the Disability Evaluation System (FUNDES) in Taiwan.Methods: Students with CP aged 6-17.9 years (n = 546) in the national dataset were analyzed. Items of the child version of the FUNDES were linked to the ICF d-codes and matched to two brief ICF core sets for CP. The restriction rate of the linked d-codes were calculated. Random Forest regression was applied to select the important linked d-codes for predicting school participation frequency.Results: The vast majority of the content of the Taiwanese dataset was covered by two core sets. The matched d-codes represent high restriction rates (80%) and most were important for predicting school participation. One important code, d740 (formal relationships, such as relationship with teachers), identified in this study were not included in two ICF core sets.Conclusions: Two brief ICF core sets for CP capture the majority of relevant functional information collected by the child version of the FUNDES. Some additional codes not covered in the international ICF core sets should be considered for inclusion in the revised Taiwanese version.Implications for rehabilitationCerebral palsy (CP) is the most common cause of severe physical disability in childhood. ICF core sets for CP promote a comprehensive assessment and service provision.To ensure applicability, ICF core sets for CP were validated in Taiwan using the child and youth national dataset of the child version of the Functioning Scale of the Disability Evaluation System. This study shows content validity and proposes new ICF codes additions for the Taiwanese version.Among top five ICF-based predictors for school participation frequency, four of them were consistent in both children and youth groups as d310-d350 (basic communication), d750 (informal social relationships), d820 (school education), and d710-d720, d880 and d920 (social play), which could be taken into consideration in clinical application.
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Affiliation(s)
- Hua-Fang Liao
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Taiwan Society of International Classification of Functioning, Disability and Health, TSICF, New Taipei City, Taiwan
| | - Ai-Wen Hwang
- Taiwan Society of International Classification of Functioning, Disability and Health, TSICF, New Taipei City, Taiwan.,Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.,Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Veronica Schiariti
- Division of Medical Sciences, University of Victoria, British Columbia, Canada
| | - Chia-Feng Yen
- Taiwan Society of International Classification of Functioning, Disability and Health, TSICF, New Taipei City, Taiwan.,Department of Public Health, Tzu Chi University, Hualien City, Taiwan
| | - Wen-Chou Chi
- Taiwan Society of International Classification of Functioning, Disability and Health, TSICF, New Taipei City, Taiwan.,Department of Occupational Therapy, Chung Shan Medical University, Taichung, Taiwan
| | - Tsan-Hon Liou
- Taiwan Society of International Classification of Functioning, Disability and Health, TSICF, New Taipei City, Taiwan.,Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital Taipei Medical University, New, Taipei City, Taiwan
| | - Hsiu-Chuan Hung
- Taiwan Society of International Classification of Functioning, Disability and Health, TSICF, New Taipei City, Taiwan
| | - Yu-Hsin Hsieh
- Taiwan Society of International Classification of Functioning, Disability and Health, TSICF, New Taipei City, Taiwan
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21
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Schiariti V, Fowler E, Brandenburg JE, Levey E, Mcintyre S, Sukal-Moulton T, Ramey SL, Rose J, Sienko S, Stashinko E, Vogtle L, Feldman RS, Koenig JI. A common data language for clinical research studies: the National Institute of Neurological Disorders and Stroke and American Academy for Cerebral Palsy and Developmental Medicine Cerebral Palsy Common Data Elements Version 1.0 recommendations. Dev Med Child Neurol 2018. [PMID: 29542813 DOI: 10.1111/dmcn.13723] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
UNLABELLED To increase the efficiency and effectiveness of clinical research studies, cerebral palsy (CP) specific Common Data Elements (CDEs) were developed through a partnership between the National Institute of Neurological Disorders and Stroke (NINDS) and the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM). International experts reviewed existing NINDS CDEs and tools used in studies of children and young people with CP. CDEs were compiled, subjected to internal review, and posted online for external public comment in September 2016. Guided by the International Classification of Functioning, Disability and Health framework, CDEs were categorized into six domains: (1) participant characteristics; (2) health, growth, and genetics; (3) neuroimaging; (4) neuromotor skills and functional assessments; (5) neurocognitive, social, and emotional assessments; and (6) engagement and quality of life. Version 1.0 of the NINDS/AACPDM CDEs for CP is publicly available on the NINDS CDE and AACPDM websites. Global use of CDEs for CP will standardize data collection, improve data quality, and facilitate comparisons across studies. Ongoing collaboration with international colleagues, industry, and people with CP and their families will provide meaningful feedback and updates as additional evidence is obtained. These CDEs are recommended for NINDS-funded research for CP. WHAT THIS PAPER ADDS This is the first comprehensive Common Data Elements (CDEs) for children and young people with CP for clinical research. The CDEs for children and young people with CP include common definitions, the standardization of case report forms, and measures. The CDE guides the standardization for data collection and outcome evaluation in all types of studies with children and young people with CP. The CDE ultimately improves data quality and data sharing.
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Affiliation(s)
- Verónica Schiariti
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Eileen Fowler
- University of California Los Angeles, Los Angeles, CA, USA
| | - Joline E Brandenburg
- Department of Physical Medicine and Rehabilitation, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Eric Levey
- Health Services for Children with Special Needs, Inc., Washington, DC, USA
| | - Sarah Mcintyre
- Cerebral Palsy Alliance, University of Sydney, Sydney, NSW, Australia
| | - Theresa Sukal-Moulton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Sharon L Ramey
- Virginia Tech Carilion Research Institute, Virginia Polytechnic Institute, Roanoke, VA, USA
| | - Jessica Rose
- Stanford University School of Medicine, Stanford, CA, USA
| | - Susan Sienko
- Shriners Hospitals for Children, Portland, OR, USA
| | | | - Laura Vogtle
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - James I Koenig
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
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Standardised assessment of functioning in ADHD: consensus on the ICF Core Sets for ADHD. Eur Child Adolesc Psychiatry 2018; 27:1261-1281. [PMID: 29435654 DOI: 10.1007/s00787-018-1119-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 02/03/2018] [Indexed: 01/29/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is associated with significant impairments in social, educational, and occupational functioning, as well as specific strengths. Currently, there is no internationally accepted standard to assess the functioning of individuals with ADHD. WHO's International Classification of Functioning, Disability and Health-child and youth version (ICF) can serve as a conceptual basis for such a standard. The objective of this study is to develop a comprehensive, a common brief, and three age-appropriate brief ICF Core Sets for ADHD. Using a standardised methodology, four international preparatory studies generated 132 second-level ICF candidate categories that served as the basis for developing ADHD Core Sets. Using these categories and following an iterative consensus process, 20 ADHD experts from nine professional disciplines and representing all six WHO regions selected the most relevant categories to constitute the ADHD Core Sets. The consensus process resulted in 72 second-level ICF categories forming the comprehensive ICF Core Set-these represented 8 body functions, 35 activities and participation, and 29 environmental categories. A Common Brief Core Set that included 38 categories was also defined. Age-specific brief Core Sets included a 47 category preschool version for 0-5 years old, a 55 category school-age version for 6-16 years old, and a 52 category version for older adolescents and adults 17 years old and above. The ICF Core Sets for ADHD mark a milestone toward an internationally standardised functional assessment of ADHD across the lifespan, and across educational, administrative, clinical, and research settings.
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Schiariti V, Mahdi S, Bölte S. International Classification of Functioning, Disability and Health Core Sets for cerebral palsy, autism spectrum disorder, and attention-deficit-hyperactivity disorder. Dev Med Child Neurol 2018; 60:933-941. [PMID: 29845609 DOI: 10.1111/dmcn.13922] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2018] [Indexed: 12/27/2022]
Abstract
AIM Capturing functional information is crucial in childhood disability. The International Classification of Functioning, Disability and Health (ICF) Core Sets promote assessments of functional abilities and disabilities in clinical practice regarding circumscribed diagnoses. However, the specificity of ICF Core Sets for childhood-onset disabilities has been doubted. This study aimed to identify content commonalities and differences among the ICF Core Sets for cerebral palsy (CP), and the newly developed Core Sets for autism spectrum disorder (ASD) and attention-deficit-hyperactivity disorder (ADHD). METHOD The categories within each Core Set were aggregated at the ICF component and chapter levels. Content comparison was conducted using descriptive analyses. RESULTS The activities and participation component of the ICF was the most covered across all Core Sets. Main differences included representation of ICF components and coverage of ICF chapters within each component. CP included all ICF components, while ADHD and ASD predominantly focused on activities and participation. Environmental factors were highly represented in the ADHD Core Sets (40.5%) compared to the ASD (28%) and CP (27%) Core Sets. INTERPRETATION International Classification of Functioning, Disability and Health Core Sets for CP, ASD, and ADHD capture both common but also unique functional information, showing the importance of creating condition-specific, ICF-based tools to build functional profiles of individuals with childhood-onset disabilities. WHAT THIS PAPER ADDS The International Classification of Functioning, Disability and Health (ICF) Core Sets for cerebral palsy (CP), autism spectrum disorder (ASD), and attention-deficit-hyperactivity disorder (ADHD) include unique functional information. The ICF-based tools for CP, ASD, and ADHD differ in terms of representation and coverage of ICF components and ICF chapters. Representation of environmental factors uniquely influences functioning and disability across ICF Core Sets for CP, ASD and ADHD.
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Affiliation(s)
- Verónica Schiariti
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - Soheil Mahdi
- Division of Neuropsychiatry, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden.,Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Sven Bölte
- Division of Neuropsychiatry, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden.,Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden.,Child and Adolescent Psychiatry, Stockholm County Council, Stockholm, Sweden
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Schiariti V, Longo E, Shoshmin A, Kozhushko L, Besstrashnova Y, Król M, Neri Correia Campos T, Náryma Confessor Ferreira H, Verissimo C, Shaba D, Mwale M, Amado S. Implementation of the International Classification of Functioning, Disability, and Health (ICF) Core Sets for Children and Youth with Cerebral Palsy: Global Initiatives Promoting Optimal Functioning. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091899. [PMID: 30200412 PMCID: PMC6163506 DOI: 10.3390/ijerph15091899] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 08/11/2018] [Accepted: 08/16/2018] [Indexed: 12/21/2022]
Abstract
Background: The International Classification of Functioning, Disability, and Health (ICF) Core Sets for children and youth with cerebral palsy (CP) offer service providers and stakeholders a specific framework to explore functioning and disability for assessment, treatment, evaluation, and policy purposes in a global context. Objective: Describe global initiatives applying the ICF Core Sets for children and youth with CP, with a focus on contributions to clinical practice and challenges in their implementation. Methods: This is a descriptive cross-sectional study. Ongoing initiatives applying the ICF Core Sets for CP in Russia, Poland, Malawi, and Brazil are included. Results: The main contributions of applying the ICF Core Sets for children and youth with CP include: (1) an objective description of abilities and limitations in everyday activities; (2) a consistent identification of facilitators and barriers influencing functioning; (3) a practical communication tool promoting client-centered care and multidisciplinary teamwork; and, (4) a useful guideline for measurement selection. The main challenges of adopting the ICF Core Sets are related to lack of ICF knowledge requiring intense training and translating results from standardized measures into the ICF qualifiers in a consistent way. Conclusions: Global initiatives include research and clinical applications at the program, service and system levels. The ICF Core Sets for CP are useful tools to guide service provision and build profiles of functioning and disability. Global interprofessional collaboration, capacity training, and informatics (e-records) will maximize their applications and accelerate adoption.
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Affiliation(s)
- Verónica Schiariti
- Division of Medical Sciences, University of Victoria, Victoria, BC V8W 2Y2, Canada.
| | - Egmar Longo
- Postgraduate Program in Collective Health, Faculty of Health Sciences of Trairi (UFRN-FACISA), Federal University of Rio Grande do Norte, Santa Cruz 59200-000, Brazil.
| | - Alexander Shoshmin
- Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, Saint Petersburg 195067, Russia.
| | - Ludmila Kozhushko
- Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, Saint Petersburg 195067, Russia.
| | - Yanina Besstrashnova
- Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, Saint Petersburg 195067, Russia.
| | - Maria Król
- The Step by Step Association for Help of Disabled Children, Zamość 22-400, Poland.
| | - Taynah Neri Correia Campos
- Postgraduate Program in Collective Health, Faculty of Health Sciences of Trairi (UFRN-FACISA), Federal University of Rio Grande do Norte, Santa Cruz 59200-000, Brazil.
| | - Haryelle Náryma Confessor Ferreira
- Postgraduate Program in Collective Health, Faculty of Health Sciences of Trairi (UFRN-FACISA), Federal University of Rio Grande do Norte, Santa Cruz 59200-000, Brazil.
| | - Cláudia Verissimo
- Health School Science, Polytechnic Institute of Leiria, Leiria 2411-901, Portugal.
| | | | - Matilda Mwale
- RIPPLE Africa, Limbe 431136, Malawi, Africa.
- Department of Education, Catholic University of Malawi, Limbe 431136, Malawi, Africa.
| | - Sandra Amado
- Health School Science, Polytechnic Institute of Leiria, Leiria 2411-901, Portugal.
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Ferreira HNC, Schiariti V, Regalado ICR, Sousa KG, Pereira SA, Fechine CPNDS, Longo E. Functioning and Disability Profile of Children with Microcephaly Associated with Congenital Zika Virus Infection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1107. [PMID: 29844290 PMCID: PMC6025082 DOI: 10.3390/ijerph15061107] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/23/2018] [Accepted: 05/23/2018] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The increase in the number of cases of microcephaly in Brazil and its association with the Zika virus (ZIKV) is a global public health problem. The International Classification of Functioning Disability and Health (ICF) model is a powerful tool and extremely relevant in managing disability. OBJECTIVE Describe the functioning profile of children with microcephaly associated with ZIKV in two states of northeastern Brazil. METHODS This is a descriptive cross-sectional study. The sociodemographic characteristics, head circumference, and other clinical data were collected from medical charts, physical examinations, measuring instruments, and interviews with the children and their parents. The Brazilian Portuguese version of the Brief Common ICF Core Set for cerebral palsy (CP) was used. Each ICF category was assigned a qualifier, which ranged from 0 to 4 (no problem, mild problem, moderate problem, severe problem, complete problem). For environmental factors, 0 represents no barrier and 4 represents complete barrier; +0, no facilitator and +4, complete facilitator. RESULTS A total of 34 children with microcephaly caused by ZIKV were recruited (18 girls and 16 boys) at four rehabilitation facilities in Rio Grande do Norte and Paraíba states, Brazil. The average age of the participants was 21 months, monthly income was ≈USD 300.00, and head circumference z-scores ranged between 0.92 and -5.51. The functioning profile revealed complete disability in most of the body function categories (b). The activity and participation areas (d) were highly impacted, particularly in mobility-related categories. With respect to environmental factors (e), most of the sample reported a complete facilitator for the immediate family, friends, and health services, systems, and policies, as well as a complete barrier to societal attitudes. CONCLUSION This is the first study that describes the functioning profile of children with microcephaly associated with ZIKV, using a tool based on the ICF in Brazil. Our findings reinforce the need to maximize health care and access to information, based on the ICF, for multiprofessional teams, administrators, family members, and children.
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Affiliation(s)
- Haryelle Náryma Confessor Ferreira
- Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte-Faculty of Health Sciences of Trairi (UFRN-FACISA), Santa Cruz 59200-000, Brazil.
| | - Veronica Schiariti
- Division of Medical Sciences, University of Victoria, BC V8W 2Y2, Canada.
| | | | - Klayton Galante Sousa
- Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte-Faculty of Health Sciences of Trairi (UFRN-FACISA), Santa Cruz 59200-000, Brazil.
| | - Silvana Alves Pereira
- Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte-Faculty of Health Sciences of Trairi (UFRN-FACISA), Santa Cruz 59200-000, Brazil.
| | | | - Egmar Longo
- Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte-Faculty of Health Sciences of Trairi (UFRN-FACISA), Santa Cruz 59200-000, Brazil.
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Self-reported upper limb functioning of pupils with cerebral palsy by the International Classification of Functioning, Disability, and Health. Int J Rehabil Res 2018; 41:262-266. [PMID: 29664754 DOI: 10.1097/mrr.0000000000000289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
International Classification of Functioning, Disability, and Health: Children and Youth Version has shown an increasing role in the assessment of children with cerebral palsy (CP), but just a few researchers use it for individuals' self-assessment. In this study, we present the self-assessment of functioning of students with CP and changes by the end of a school year. Thirty-seven pupils with spastic CP involving upper limbs, 24 pupils with typical development, and 20 pupils with speech and language disorders were studied by International Classification of Functioning, Disability, and Health core sets for CP. The CP group reported limitations in sensory functions (P<0.05), movement-related functions (P<0.001), and mobility (P<0.001) as well as products and technology and support and relationships as supportive (P<0.05). Correlation between expert and self-evaluation was weak to moderate. The CP core set may appropriately serve in the self-assessment of pupils' functioning in longitudinal studies.
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Büğüşan S, Kahraman A, Elbasan B, Mutlu A. Do adolescents with cerebral palsy agree with their caregivers on their participation and quality of life? Disabil Health J 2018; 11:287-292. [DOI: 10.1016/j.dhjo.2017.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 09/28/2017] [Accepted: 10/12/2017] [Indexed: 10/18/2022]
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Bölte S, Mahdi S, de Vries PJ, Granlund M, Robison JE, Shulman C, Swedo S, Tonge B, Wong V, Zwaigenbaum L, Segerer W, Selb M. The Gestalt of functioning in autism spectrum disorder: Results of the international conference to develop final consensus International Classification of Functioning, Disability and Health core sets. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:449-467. [PMID: 29378422 PMCID: PMC6376609 DOI: 10.1177/1362361318755522] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Autism spectrum disorder is associated with diverse social, educational, and
occupational challenges. To date, no standardized, internationally accepted
tools exist to assess autism spectrum disorder–related functioning. World Health
Organization’s International Classification of Functioning, Disability and
Health can serve as foundation for developing such tools. This study aimed to
identify a comprehensive, a common brief, and three age-appropriate brief autism
spectrum disorder Core Sets. Four international preparatory studies yielded in
total 164 second-level International Classification of Functioning, Disability
and Health candidate categories. Based on this evidence, 20 international autism
spectrum disorder experts applied an established iterative decision-making
consensus process to select from the candidate categories the most relevant ones
to constitute the autism spectrum disorder Core Sets. The consensus process
generated 111 second-level International Classification of Functioning,
Disability and Health categories in the Comprehensive Core Set for autism
spectrum disorder—one body structure, 20 body functions, 59 activities and
participation categories, and 31 environmental factors. The Common Brief Core
Set comprised 60 categories, while the age-appropriate core sets included 73
categories in the preschool version (0- to 5-year-old children), 81 in the
school-age version (6- to 16-year-old children and adolescents), and 79 in the
older adolescent and adult version (⩾17-year-old individuals). The autism
spectrum disorder Core Sets mark a milestone toward the standardized assessment
of autism spectrum disorder–related functioning in educational, administrative,
clinical, and research settings.
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Affiliation(s)
- Sven Bölte
- 1 Karolinska Institutet, Sweden.,2 Stockholm County Council, Sweden
| | - Soheil Mahdi
- 1 Karolinska Institutet, Sweden.,2 Stockholm County Council, Sweden
| | | | | | | | | | | | | | | | | | | | - Melissa Selb
- 11 Swiss Paraplegic Research, Switzerland.,12 ICF Research Branch, Switzerland
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Editorial commentary on 'Toolbox of multi-item measures aligning with ICF core sets for children and youth with cerebral palsy'. Eur J Paediatr Neurol 2017; 21:250-251. [PMID: 28187822 DOI: 10.1016/j.ejpn.2017.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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