Development of stratified normative data and reference equations for the timed up and down stairs test for healthy children 6-14 years of age

Physical capacity in children and adolescents with newly diagnosed cancer: A systematic review and meta-analysis

OBJECTIVE

To review the body of evidence on cardiorespiratory fitness, muscle strength, and physical performance in children with newly diagnosed cancer, five databases (MEDLINE, Embase, CINAHL, CENTRAL, and Web of Science) were searched on December 19, 2022.

METHODS

Thirteen studies, embodying 594 participants within 1 month of cancer diagnosis and 3674 healthy controls were included. Eighteen different outcomes on cardiorespiratory fitness (n = 2), muscle strength (n = 5), physical performance (n = 10), and adverse events (n = 1) were analyzed.

RESULTS

Fifteen out of 17 outcomes on physical capacity showed severe impairments compared with healthy controls. Where possible, random-effects meta-analysis was conducted to synthesize the results. No adverse events were reported related to testing.

CONCLUSION

Children with cancer have impaired cardiorespiratory fitness, muscle strength, and physical performance within the first month after diagnosis. However, the evidence is based on a small number of studies with large clinical heterogeneity, limiting the certainty of evidence.

Muscle Properties, Gross Motor Performance, and Quality of Life in Children With Sickle Cell Disease

PURPOSE

To explore muscle properties, gross motor performance, and quality of life (QoL) in children with sickle cell disease (SCD) compared with controls and to assess relationships among these outcomes.

METHODS

A cross-sectional study of 24 children assessed muscle properties including: knee extension strength by dynamometry; vastus lateralis (VL) and rectus femoris (RF) muscle thickness by ultrasonography; and VL and RF neuromuscular activation (rate of muscle activation [RoA]) by electromyography (EMG). Gross motor performance and QoL were assessed by standardized tests and questionnaires.

RESULTS

Children with SCD had impaired knee extension strength, VL EMG RoA, gross motor performance, and QoL compared with children without SCD. Relationships among muscle properties, gross motor performance, and QoL were identified.

CONCLUSIONS

These findings indicate that comprehensive muscle properties, gross motor performance, and QoL assessments should be considered to support and develop individualized physical therapy plans for children with SCD.

Pediatric pain rehabilitation during the COVID-19 pandemic: exploring the effectiveness of a hybrid intensive interdisciplinary pain treatment model

PURPOSE

This study aimed to (1) examine improvements in rehabilitation outcomes after participation in a pediatric hybrid intensive interdisciplinary pain treatment model (50% in-person and 50% video-based telehealth) and (2) compare magnitude of hybrid model improvements to patients treated in a traditional, 100% in-person model prior to the pandemic.

MATERIALS AND METHODS

Rehabilitation outcomes for 33 youth with chronic pain from the model were compared to 33 youth with chronic pain who completed a traditional, in-person model. Improvements between admission and discharge in both models were examined using paired student t-tests. Independent samples t-tests compared change scores for the hybrid and traditional models.

RESULTS

Participants in both models experienced significant improvements on all rehabilitation outcomes, including cardiovascular endurance, pain interference, functional disability, and occupational performance (p < 0.001), except for pain intensity (p = 0.15). Change scores for rehabilitation outcomes did not significantly differ between models.

CONCLUSIONS

Quantitatively, hybrid model rehabilitation outcomes appeared clinically equivalent to the traditional, in-person model. Qualitative and psychosocial outcome comparisons of each model are warranted to better understand challenges and barriers associated with hybrid pain treatment models. The feasibility and impact of tools to enhance telehealth, such as actigraphy or virtual reality, should also be explored.IMPLICATIONS FOR REHABILITATIONThis study supports the efficacy of video-based telehealth interventions for children and adolescents with chronic pain syndromes.Disability outcomes for a hybrid (50% in-person, 50% video-based telehealth) intensive interdisciplinary pain treatment program appear to be equivalent to patients treated within a fully in-person program.

Reliability of the TUDS test for children with cerebral palsy

Background

The timed up and down stairs (TUDS) test is widely used to assess the time required by a patient to climb up and down stairs as a measure of functional mobility.

Aim

This cross-sectional study was conducted to examine test-retest, intra-rater, and inter-rater reliability of TUDS test in children with cerebral palsy (CP).

Subjects

Forty children (22 boys and 18 girls) with unilateral and bilateral spastic CP were selected from the Cairo University Hospitals to participate in this study. The age range was 3–9 years. Subjects classified according to Gross Motor Function Classification System-Expanded and Revised (GMFCS-E&R) in categories 1 or 2 only were included. All subjects with muscle tone above normal (spasticity) were included.

Methods

The TUDS test was performed at two testing sessions on the same day to determine test-retest reliability; the main investigator scored all children at real time using a stopwatch and then rescored them later from video recording to determine intra-rater reliability. Another research team member scored all children from video recording to determine inter-rater reliability. Scoring was carried out at real time and from video recordings of the trials. Reliability was estimated using intra-class correlation coefficients (ICC).

Results

The TUDS test showed excellent reliability for all measured types of reliability. ICC score for test-retest reliability was 0.978, ICC score for intra-rater reliability was 0.999, while ICC score for inter-rater reliability was 0.998 and 0.999.

Conclusion

The TUDS test is a reliable outcome measure for children with spastic CP. It can be measured at real time or later from video recording of the performance trials. The TUDS test is an important tool in the re-evaluation process of children with CP.

Mucopolysaccharidosis type VI (Maroteaux-Lamy syndrome): defining and measuring functional impacts in pediatric patients

BACKGROUND

Research about pediatric patients' perspective on mucopolysaccharidosis type VI (MPS VI) and its impact on daily life is limited. We aimed to identify the disease concepts of interest that most impact function and day-to-day life of pediatric patients with MPS VI, and to consider clinical outcome assessments (COAs) that may potentially measure meaningful improvements in these concepts.

METHODS

Potential focus group participants were identified by the National MPS Society (USA) and invited to participate if they self-reported a clinician-provided diagnosis of MPS VI and were 4 to 18 years, receiving enzyme replacement therapy (ERT), and available to attend a 1-day focus group with their caregiver in Dallas, TX, USA. The focus group consisted of a series of polling and open-ended concept elicitation questions and a cognitive debriefing session. The discussion was audio recorded, transcribed verbatim, and analyzed to identify disease concepts of interest and functional impacts most relevant to participants.

RESULTS

Overall, caregivers (n = 9) and patients with MPS VI (n = 9) endorsed that although their children/they receive ERT, residual symptoms exist and impact health-related quality of life. The key disease concepts of interest identified were impaired mobility, upper extremity and fine motor deficits, pain, and fatigue. Pain was unanimously reported by all patients across many areas of the body and impacted daily activity. Key disease concepts were mapped to a selection of pediatric COAs including generic measures such as PROMIS®, PODCI, CHAQ, and PedsQL™. Caregivers endorsed the relevance of PODCI and PROMIS Upper Extremity, Mobility, and Pain items and all patients completed the NIH Toolbox Pegboard Dexterity Test. Additional COAs that aligned with the disease concepts included range of motion, the 2- and 6-min walk tests, timed stair climbs, Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition, grip strength, pain visual analog scale, and the Faces Pain Scale-Revised.

CONCLUSION

An MPS VI focus group of pediatric patients and their caregivers identified impaired mobility, upper extremity and fine motor deficits, pain, and fatigue as key disease concepts of interest. These disease concepts were mapped to existing pediatric COAs, which were provided to the group for endorsement of their relevance.

Motor Skills are Associated with Participation of Children with Autism Spectrum Disorder

Children with autism spectrum disorder (ASD) generally have a delay in the development of motor skills when compared to typical children, however, to date, no study has investigated whether motor limitations can interfere in the participation of these children. The objectives of this study were: verify if the motor skills can explain the frequency, the percentage of number of activities, the involvement and the desire to change in participation at home, school and community of children with autism spectrum disorder (ASD) and; identify if contextual factors would modify the association between motor skills and participation outcomes. The participation and the motor skills were evaluated in 30 children with ASD between 5 and 10 years old. Participation outcomes were measured by the Participation and Environment Measure-Children and Youth (PEM-CY) and the motor skills were assessed by the Timed Up and Go, Timed Up and Down Stairs, Test of Gross Motor Development-2nd edition and Pediatric Balance Scale. The results of the study demonstrated that the motor skills of the locomotion, objects control, change position and balance explained participation outcomes of children with ASD classified from mild to moderate, between 5 and 10 years old. Moreover, the sex variable modified the association between the motor skills and the school participation, with girls performing less activities at this setting.