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Sudnawa KK, Li W, Calamia S, Kanner CH, Bain JM, Abdelhakim AH, Geltzeiler A, Mebane CM, Provenzano FA, Sands TT, Fee RJ, Montes J, Shen Y, Chung WK. Heterogeneity of comprehensive clinical phenotype and longitudinal adaptive function and correlation with computational predictions of severity of missense genotypes in KIF1A-associated neurological disorder. Genet Med 2024; 26:101169. [PMID: 38785164 PMCID: PMC11298291 DOI: 10.1016/j.gim.2024.101169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/15/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
PURPOSE Pathogenic variants in kinesin family member 1A (KIF1A) are associated with KIF1A-associated neurological disorder. We report the clinical phenotypes and correlate genotypes of individuals with KIF1A-associated neurological disorder. METHODS Medical history and adaptive function were assessed longitudinally. In-person evaluations included neurological, motor, ophthalmologic, and cognitive assessments. RESULTS We collected online data on 177 individuals. Fifty-seven individuals were also assessed in-person. Most individuals had de novo heterozygous missense likely pathogenic/pathogenic KIF1A variants. The most common characteristics were hypotonia, spasticity, ataxia, seizures, optic nerve atrophy, cerebellar atrophy, and cognitive impairment. Mean Vineland adaptive behavior composite score (VABS-ABC) was low (M = 62.9, SD = 19.1). The mean change in VABS-ABC over time was -3.1 (SD = 7.3). The decline in VABS-ABC was associated with the age at first assessment and abnormal electroencephalogram/seizure. There was a positive correlation between evolutionary scale model (ESM) score for the variants and final VABS-ABC (P = .003). Abnormal electroencephalogram/seizure, neuroimaging result, and ESM explain 34% of the variance in final VABS-ABC (P < .001). CONCLUSION In-person assessment confirmed caregiver report and identified additional visual deficits. Adaptive function declined over time consistent with both the neurodevelopmental and neurodegenerative nature of the condition. Using ESM score assists in predicting phenotype across a wide range of unique variants.
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Affiliation(s)
- Khemika K Sudnawa
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Pediatrics, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Wenxing Li
- Department of Systems Biology, Columbia University Irving Medical Center, New York, NY
| | - Sean Calamia
- Department of Pediatrics, Columbia University, New York, NY
| | - Cara H Kanner
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY
| | - Jennifer M Bain
- Departments of Neurology and Pediatrics, Columbia University Irving Medical Center, New York, NY
| | - Aliaa H Abdelhakim
- Harkness Eye Institute, Department of Ophthalmology, Columbia University Irving Medical Center, New York, NY
| | - Alexa Geltzeiler
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | | | - Frank A Provenzano
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University Medical Center, New York, NY
| | - Tristan T Sands
- Departments of Neurology and Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | - Robert J Fee
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, NY
| | - Jacqueline Montes
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY
| | - Yufeng Shen
- Department of Systems Biology, Columbia University Irving Medical Center, New York, NY; Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY
| | - Wendy K Chung
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA.
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Zreibe K, Kanner CH, Uher D, Beard G, Patterson M, Harris M, Doerger J, Calamia S, Chung WK, Montes J. Characterizing ambulatory function in children with PPP2R5D-related neurodevelopmental disorder. Gait Posture 2024; 110:77-83. [PMID: 38547676 PMCID: PMC11056288 DOI: 10.1016/j.gaitpost.2024.03.012] [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: 09/22/2023] [Revised: 01/29/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Individuals with PPP2R5D-related neurodevelopmental disorder have an atypical gait pattern characterized by ataxia and incoordination. Structured, quantitative assessments are needed to further understand the impact of these impairments on function. RESEARCH QUESTION How do gait parameters and ambulatory function of individuals with PPP2R5D-related neurodevelopmental disorder compare to age and sex matched healthy norms? METHODS Twenty-six individuals with PPP2R5D pathogenic genetic variants participated in this observational, single visit study. Participants completed at least one of the following gait assessments: quantitative gait analysis at three different speeds (preferred pace walking (PPW), fast paced walking (FPW) and running, six-minute walk test (6MWT), 10-meter walk run (10MWR), and timed up and go (TUG). Descriptive statistics were used to summarize gait variables. Percent of predicted values were calculated using published norms. Paired t-tests and regression analyses were used to compare gait variables. RESULTS The median age of the participants was 8 years (range 4-27) and eighteen (69.2 %) were female. Individuals with PPP2R5D-related neurodevelopmental disorder walked slower and with a wider base of support than predicted for their age and sex. Stride velocity ranged from 48.9 % to 70.1 % and stride distance from 58.5 % to 81.9 % of predicted during PPW. Percent of predicted distance walked on the 6MWT ranged from 30.6 % to 71.1 % representing varied walking impairment. Increases in stride distance, not cadence, were associated with changes in stride velocity in FPW (R2 = 0.675, p =< 0.001) and running conditions (R2 = 0.918, p =< 0.001). SIGNIFICANCE We quantitatively assessed the abnormal gait in individuals with PPP2R5D-related neurodevelopmental disorder. These impairments may affect ability to adapt to environmental changes and participation in daily life. Rehabilitative interventions targeting gait speed and balance may improve function and safety for individuals with PPP2R5D-related neurodevelopmental disorder.
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Affiliation(s)
- Kyle Zreibe
- Department of Rehabilitation, UHealth-Jackson Holtz Children's Hospital, Miami, FL, USA; Department of Rehabilitation & Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA.
| | - Cara H Kanner
- Department of Rehabilitation & Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - David Uher
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Gabriella Beard
- Department of Rehabilitation & Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Madison Patterson
- Department of Rehabilitation & Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Matthew Harris
- Department of Rehabilitation & Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Jerome Doerger
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
| | - Sean Calamia
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
| | - Wendy K Chung
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA USA
| | - Jacqueline Montes
- Department of Rehabilitation & Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA
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Sudnawa KK, Garber A, Cohen R, Calamia S, Kanner CH, Montes J, Bain JM, Fee RJ, Chung WK. Clinical phenotypic spectrum of CTNNB1 neurodevelopmental disorder. Clin Genet 2024; 105:523-532. [PMID: 38247296 DOI: 10.1111/cge.14487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/03/2024] [Accepted: 01/08/2024] [Indexed: 01/23/2024]
Abstract
Pathogenic heterozygous loss of function variants in CTNNB1 are associated with CTNNB1 neurodevelopmental disorder. We report the clinical phenotype of individuals with CTNNB1 neurodevelopmental disorder using both caregiver-reported data (medical history, adaptive function, quality of life, and behavior issues) and in-person clinical assessments (neurological, motor, and cognitive function) in 32 individuals with likely pathogenic or pathogenic CTNNB1 variants. Most individuals had truncal hypotonia, muscle weakness, hypertonia, dystonia, microcephaly, and many had a history of tethered cord. Visual problems included strabismus, hyperopia, and familial exudative vitreoretinopathy. Half of individuals walked without an assistive device. The mean Gross Motor Functional Measure-66 score was 56.6 (SD = 14.8). Average time to complete Nine-Hole Peg Test was slower than norms. Mean general conceptual ability composite scores from Differential Ability Scales Second Edition were very low (M = 58.3, SD = 11.3). Fifty-five percent of individuals had low adaptive functioning based on the Vineland Adaptive Behavioral Scales. Based upon the Child Behavior Checklist total problems score, the majority (65%) of individuals had behavioral challenges. The mean overall Quality of Life Inventory-Disability score was 81.7 (SD = 11.9). These data provide a detailed characterization of clinical features in individuals with CTNNB1 neurodevelopmental disorder.
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Affiliation(s)
- Khemika K Sudnawa
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Pediatrics, Pramongkutklao Hospital and Pramongkutklao College of Medicine, Bangkok, Thailand
| | - Alison Garber
- Department of Pediatrics, Columbia University, New York, New York, USA
| | - Ryan Cohen
- Department of Pediatrics, Columbia University, New York, New York, USA
| | - Sean Calamia
- Department of Pediatrics, Columbia University, New York, New York, USA
| | - Cara H Kanner
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Jacqueline Montes
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Jennifer M Bain
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Robert J Fee
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, New York, USA
| | - Wendy K Chung
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Beer SS, Wong Vega M. Malnutrition, sarcopenia, and frailty assessment in pediatric transplantation. Nutr Clin Pract 2024; 39:27-44. [PMID: 38088812 DOI: 10.1002/ncp.11105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 01/13/2024] Open
Abstract
Nutrition assessment can be challenging in children with end-stage organ disease and in those requiring an organ transplant. The effect of poor nutrition status can exert long-lasting effects on children with end-stage organ disease requiring transplantation. Malnutrition, sarcopenia, and frailty are conditions that require provision of optimal nutrition to prevent or support the treatment of these conditions. Unfortunately, the literature on the assessment of malnutrition, sarcopenia, and frailty in pediatric end-stage organ disease is scarce, thus leading to confusion on how to effectively identify them. Recently, the addition of a variety of validated nutrition and functional assessment techniques has assisted with appropriate assessment of these conditions. The objective of this narrative review is to provide an overview of the current literature for pediatric assessment of malnutrition, sarcopenia, and frailty in the setting of solid organ transplantation and provide practicing nutrition clinicians a solid foundation for learning how to effectively assess these conditions with the current literature available.
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Affiliation(s)
- Stacey Silver Beer
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Molly Wong Vega
- Renal Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Department of Health and Human Performance, University of Houston, Houston, Texas, USA
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Schmidt-Andersen P, Stage A, Pouplier A, Bastholm LH, Müller KG, Larsen A, Ness KK, Larsen HB, Christensen J, Fridh MK. Physical capacity in children and adolescents with newly diagnosed cancer: A systematic review and meta-analysis. Pediatr Blood Cancer 2024; 71:e30746. [PMID: 37877893 PMCID: PMC10842329 DOI: 10.1002/pbc.30746] [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: 09/05/2023] [Revised: 09/28/2023] [Accepted: 10/15/2023] [Indexed: 10/26/2023]
Abstract
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.
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Affiliation(s)
- Peter Schmidt-Andersen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital—Rigshospitalet, Denmark
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital—Rigshospitalet, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Anna Stage
- Center for Clinical Research and Prevention, Copenhagen University Hospital—Bispebjerg and Frederiksberg, Denmark
| | - Anna Pouplier
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital—Rigshospitalet, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Louise H. Bastholm
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital—Rigshospitalet, Denmark
| | - Klaus G. Müller
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital—Rigshospitalet, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Denmark
| | - Anders Larsen
- University Hospitals Centre for Health Research (UCSF), Copenhagen University Hospital—Rigshospitalet, Denmark
| | - Kirsten K. Ness
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Hanne B. Larsen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital—Rigshospitalet, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Denmark
| | - Jan Christensen
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital—Rigshospitalet, Denmark
| | - Martin K. Fridh
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital—Rigshospitalet, Denmark
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Pennell A, Fisher J, Patey M, Miedema ST, Stodden D, Lieberman L, Webster C, Brian A. Measurement properties of Brief-BESTest scores from children, adolescents, and youth with visual impairments. Disabil Rehabil 2023:1-10. [PMID: 38037853 DOI: 10.1080/09638288.2023.2288935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 11/23/2023] [Indexed: 12/02/2023]
Abstract
Purpose: This study aimed to vet the measurement properties of Brief-BESTest scores in children, adolescents, and youth with visual impairment and blindness (YVI). Methods: A cross-sectional sample of YVI (N = 101) completed the Brief-BESTest, a modified version of the Y-Balance Test, the 360-degree turn test, bipedal quiet stance, and Activity-Specific Balance Confidence Scales. Thirty-seven YVI completed test-retest of the Brief-BESTest using a one-year interval. Using classical test theory, various forms of total and item-level Brief-BESTest score reliability and validity were investigated in YVI. Results: All inter-rater reliability coefficients were ≥ .80. When considering the eight items of the Brief-BESTest, 27 of the 28 possible correlations were statistically significant (p<.05). Various internal consistency and item difficulty results were strong. When taking total Brief-BESTest scores and their association with the complementary balance tasks/metrics into account, 11 of 13 associations were statistically significant (p<.05) providing strong convergent validity evidence. Being multimorbid and degree of vision significantly predicted total Brief-BESTest scores (p<.001) suggesting construct (i.e. known groups) validity. Numerous test-retest results (e.g. coefficients, limits of agreement) following the one-year interval were indicative of score stability. Conclusion: Practitioners and researchers should have confidence in, and consider adopting, the Brief-BESTest to examine multidimensional balance in YVI.
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Affiliation(s)
- Adam Pennell
- Natural Science Division, Pepperdine University, Malibu, CA, USA
| | - Jenna Fisher
- Department of Secondary Education and K-12 Health and Physical Education, West Chester University of Pennsylvania, West Chester, PA, USA
| | - Matthew Patey
- Department of Health & Kinesiology, Bridgewater State University, Bridgewater, MA, USA
| | - Sally Taunton Miedema
- Department of Educational and Developmental Science, University of South Carolina, Columbia, SC, USA
| | - David Stodden
- Department of Educational and Developmental Science, University of South Carolina, Columbia, SC, USA
| | - Lauren Lieberman
- Department of Kinesiology, Sports Studies & Physical Education, SUNY Brockport, Brockport, NY, USA
| | - Collin Webster
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham Dubai, Dubai, UAE
| | - Ali Brian
- Department of Educational and Developmental Science, University of South Carolina, Columbia, SC, USA
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Wolan-Nieroda A, Wojnarska A, Mańko G, Kiper A, Guzik A, Maciejczak A. Assessment of rehabilitation effects in children with mild intellectual disability. Sci Rep 2023; 13:15541. [PMID: 37730865 PMCID: PMC10511505 DOI: 10.1038/s41598-023-42280-1] [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: 03/28/2023] [Accepted: 09/07/2023] [Indexed: 09/22/2023] Open
Abstract
Research on effectiveness of rehabilitation programmes continues to investigate impact of therapeutic interventions on various motor parameters in children with intellectual disability (ID). This study compared the effectiveness of rehabilitation, reflected by physical fitness, static balance, and dynamic balance measurements, in children with mild ID. A total of 70 children with mild ID were enrolled for the study and were divided into two equal groups based on their body mass index (BMI) percentile, reflecting obesity or normal weight. Physical fitness was assessed using the Eurofit Special Test, whereas balance was evaluated with single-leg stance and timed up and go tests. The examinations were performed twice: At the beginning and at the end of a six-month therapy programme. Improvements were shown in the muscle strength of the upper limbs (p < 0.001) and lower limbs (p = 0.001), flexibility (p = 0.005), and static balance (p < 0.001) for the entire cohort. The effects of rehabilitation did not differ significantly between the children with obesity and those with a normal weight. These results may be important from the viewpoint of clinical practice and preventive measures, as they present evidence showing that rehabilitation is equally effective in both obese and normal weight children with mild ID. Therefore, these findings may be of assistance to those designing therapeutic programmes in special education centres.
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Affiliation(s)
- Andżelina Wolan-Nieroda
- Department of Physiotherapy, College of Medical Sciences, Institute of Health Sciences, University of Rzeszów, Rzeszów, Poland
| | - Anna Wojnarska
- Students Scientific Club for Physiotherapy in Adults' and Children's Neurology, Medical College of the University of Rzeszów, Rzeszów, Poland
| | - Grzegorz Mańko
- Department of Biomechanics and Kinesiology, Institute of Physiotherapy, Jagiellonian University Collegium Medicum, Krakow, Poland
- ORNR "Krzeszowice", Rehabilitation Center, Krzeszowice, Poland
| | | | - Agnieszka Guzik
- Department of Physiotherapy, College of Medical Sciences, Institute of Health Sciences, University of Rzeszów, Rzeszów, Poland.
| | - Andrzej Maciejczak
- Institute of Medical Sciences, College of Medical Sciences, University of Rzeszów, Rzeszów, Poland
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Almass BA, Algabbani MF, Shaheen AA, Alqabbani S. Normative reference values for Obstacles Test and Curb Test and their correlation with demographic characteristics: a cross-sectional study in Saudi children. Int J Rehabil Res 2023; 46:70-76. [PMID: 36538585 PMCID: PMC9907697 DOI: 10.1097/mrr.0000000000000562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
The Obstacles Test and Curb Test have been used to measure gait speed and functional balance in adults. Recently, they have been modified for use in children but the normative values have not been established. This requires correlating the sex, age, height, weight, and BMI% of children with the test results and developing prediction equations. In this cross-sectional study, the Obstacles Test and Curb Test were administered to a convenience sample of 240 typically developing children aged 6-11 years. The factors associated with the time to complete each test were studied and prediction equations were established. The completion times were 5.27 ± 0.81 s for the Obstacles Test and 2.82 ± 0.45 s for the Curb Test. The Obstacles Test showed a fair negative relationship with height (Pearson's r = -0.41, P < 0.001), age ( r = -0.35, P < 0.001), and weight ( r = -0.32, P < 0.05). The Curb Test also had fair negative correlations with height ( r = -0.42, P < 0.001), age ( r = -0.39, P < 0.001), and weight ( r = -0.31, P < 0.001). Both tests showed poor correlations with the sex [eta ( η ) = 0.15 and 0.12, respectively]. Nonetheless, age and sex emerged as the main predictors of both test scores, accounting for 14% and 17% of the total variance in the Obstacles Test and Curb Test times, respectively. Normative values and prediction equations for both tests in typically developing children may be used for individual comparisons and in clinical research for the evaluation of interventions targeting disabled children.
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Affiliation(s)
- Banan A. Almass
- Department of Physical Therapy, College of Applied Medical Sciences, Majmaah University, Al-Majmaah
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Maha F. Algabbani
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Afaf A.M. Shaheen
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
- Basic Sciences Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Samiah Alqabbani
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, P.O. Box: 84428, Riyadh 11433, Saudi Arabia
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Lifestyle and physical fitness in adolescents with type 1 diabetes and obesity. Heliyon 2023; 9:e13109. [PMID: 36711296 PMCID: PMC9880399 DOI: 10.1016/j.heliyon.2023.e13109] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/17/2023] [Accepted: 01/17/2023] [Indexed: 01/23/2023] Open
Abstract
Background The association between Type 1 Diabetes Mellitus (T1DM) and obesity (Ob) is no longer unexpected due to unhealthy lifestyle mostly in adolescents. We compared clinical-biochemical characteristics, adherence to the Mediterranean Diet (MD), lifestyle habits and physical fitness across different weight categories of T1DM adolescents from Campania Region. As second aim, we assessed the relationship among lifestyle and physical fitness in these patients. Methods 74 adolescents (35M; 39F; 13-18 y), with T1DM diagnosed at least 6 mo before the study, were enrolled at the Regional Center for Pediatric Diabetology of Vanvitelli University of Naples. Height, weight, Body Mass Index (BMI), BMI z-score, and Clinical Biochemical health-related parameters were determined. MD adherence, physical activity (PA) amount and sedentary habits were assessed by questionnaires. Handgrip strength, 2-Min Step test (2-MST) cardiorespiratory endurance and Timed up and go test (TUG) for agility and balance were used for physical fitness evaluation. Results Our sample included 22 normal weight (NW), 37 overweight (OW) and 15 with Obese (Ob) adolescents. Across the three groups, adolescents showed similar Clinical-Biochemical parameters, MD adherence, PA amount, mostly walking (9.3 h/w), daily video exposure (8.5 h/d) and similar handgrip or 2-MST performance. Better performance was observed in NW compared to OW or Ob for TUG (7 vs 8 vs 9 s; p < 0.05). A positive correlation was found between TUG test and BMI, while no correlation was found between HbA1c (glycated haemoglobin) and BMI z score or 2-MST. Conclusions T1DM adolescents did not meet the recommendations for active lifestyle, despite a medium/good adherence to MD, in particular in NW and OW youths. Sedentary habits correlated with a poor HbA1c. Further, reduced agility and balance were observed in adolescents with obesity compared to NW participants.Future research should be aimed to examine wider samples and to design health promotion interventions for T1DM adolescents.
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Psychometric properties of functional postural control tests in children: A systematic review. Ann Phys Rehabil Med 2023; 66:101729. [PMID: 36669385 DOI: 10.1016/j.rehab.2022.101729] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/10/2022] [Accepted: 11/04/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND Postural control deficits are one of the most common impairments treated in pediatric physiotherapeutic practice. Adequate evaluation of these deficits is imperative to identify postural control deficits, plan treatment and assess efficacy. Currently, there is no gold standard evaluation for postural control deficits. However, the number of studies investigating the psychometric properties of functional pediatric postural control tests has increased significantly. OBJECTIVE To facilitate the selection of an appropriate pediatric functional postural control test in research and clinical practice. METHODS Systematic review following the PRISMA guidelines. PubMed, Web of Science and Scopus were systematically searched (last update: June 2022; PROSPERO: CRD42021246995). Studies were selected using the PICOs-method (pediatric populations (P), functional assessment tools for postural control (I) and psychometric properties (O). The risk of bias was rated with the COSMIN checklist and the level of evidence was determined with GRADE. For each test, the postural control systems were mapped, and the psychometric properties were extracted. RESULTS Seventy studies investigating 26 different postural control tests were included. Most children were healthy or had cerebral palsy. Overall, the evidence for all measurement properties was low to very low. Most tests (95%) showed good reliability (ICC>0.70), but inconsistent validity results. Structural validity, internal consistency and responsiveness were only available for 3 tests. Only the Kids-BESTest and FAB covered all postural control systems. CONCLUSION Currently, 2 functional tests encompass the entire construct of postural control. Although reliability is overall good, validity results depend on task, age and pathology. Future research should focus on test batteries and should particularly explore structural validity and responsiveness in different populations with methodologically strong study designs.
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Hulteen RM, Terlizzi B, Abrams TC, Sacko RS, De Meester A, Pesce C, Stodden DF. Reinvest to Assess: Advancing Approaches to Motor Competence Measurement Across the Lifespan. Sports Med 2023; 53:33-50. [PMID: 35997861 DOI: 10.1007/s40279-022-01750-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2022] [Indexed: 01/12/2023]
Abstract
Measurement of motor competence is a vital process to advancing knowledge in the field of motor development. As motor competence is being more widely linked to research in other academic domains (e.g., public health, neuroscience, behavioral health), it is imperative that measurement methodology and protocols are reproducible with high degrees of validity and reliability. When addressing the plethora of available assessments, mostly developed for youth populations, there are potential questions and concerns that need to be addressed and/or clarified. One of the most prominent issues is the lack of a lifespan measure of motor competence, which is at odds with the premise of the field of motor development-studying changes in motor behavior across the lifespan. We address six areas of concern in lifespan assessment which include: (1) lack of assessment feasibility for conducting research with large samples, (2) lack of accountability for cultural significance of skills assessed, (3) limited sensitivity and discriminatory capabilities of assessments, (4) developmental and ecological validity limitations, (5) a problematic definition of 'success' in skill performance, and (6) task complexity and adaptability limitations. It is important to critically analyze current assessment methodologies as it will help us to envision the development and application of potential new assessments through a more comprehensive lens. Ultimately, we propose that reinvesting in how we think about assessment will be highly beneficial for integrating motor development from a holistic perspective, impact scientific advancements in other developmental domains, and increase global and lifespan surveillance of motor competence.
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Affiliation(s)
- Ryan M Hulteen
- School of Kinesiology, Louisiana State University, 2229 Pleasant Hall, Baton Rouge, LA, 70809, USA.
| | - Bryan Terlizzi
- College of Education, University of South Carolina, 1300 Wheat Street, Columbia, SC, 29208, USA
| | - T Cade Abrams
- College of Education, University of South Carolina, 1300 Wheat Street, Columbia, SC, 29208, USA
| | - Ryan S Sacko
- Department of Health and Human Performance, The Citadel, 171 Moultrie Street, Charleston, SC, 29409, USA
| | - An De Meester
- College of Education, University of South Carolina, 1300 Wheat Street, Columbia, SC, 29208, USA
| | - Caterina Pesce
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - David F Stodden
- College of Education, University of South Carolina, 1300 Wheat Street, Columbia, SC, 29208, USA
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12
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Smith J, DiVito M, Fergus A. Reliability and discriminant validity of the quantitative timed up and go in typically developing children and children with cerebral palsy GMFCS levels I-II. J Pediatr Rehabil Med 2022; 16:25-35. [PMID: 36031915 DOI: 10.3233/prm-210034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The purpose of this study was to examine the reliability, and discriminant validity of the Quantitative Timed up and Go (QTUG) in typically developing (TD) children and children with cerebral palsy (CP). METHODS Twenty-eight TD children and 8 with CP (GMFCS I-II) completed 3 TUG trials while wearing QTUG sensors. Test-retest reliability and discriminative ability were examined for the 57 constituent parameters of the TUG. Relationships between age and these parameters were also examined. RESULTS Forty-four of the parameters demonstrated moderate to excellent test-retest reliability, with measures of angular velocity being the most reliable. Twenty-six parameters were different between TD children and those with CP, and twenty-eight gait parameters demonstrated correlations with age, further supporting its discriminative ability. CONCLUSION The QTUG is a clinically feasible tool that is capable of both reliably measuring and discriminating many of the movement parameters with the TUG mobility task in TD children and those with CP GMFCS I-II. The results of the present study provide preliminary evidence that the QTUG can discriminate between children on several of the gait parameters within the TUG.
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Affiliation(s)
- Julianna Smith
- Shenandoah University Division of Physical Therapy Winchester, VA, USA
| | - Michelle DiVito
- Shenandoah University Division of Physical Therapy Winchester, VA, USA
| | - Andrea Fergus
- Shenandoah University Division of Physical Therapy Winchester, VA, USA
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Choi KY, Wong HY, Cheung HN, Tseng JK, Chen CC, Wu CL, Eng H, Woo GC, Cheong AMY. Impact of visual impairment on balance and visual processing functions in students with special educational needs. PLoS One 2022; 17:e0249052. [PMID: 35486663 PMCID: PMC9053808 DOI: 10.1371/journal.pone.0249052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 03/05/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Vision is critical for children's development. However, prevalence of visual impairment (VI) is high in students with special educational needs (SEN). Other than VI, SEN students are prone to having functional deficits. Whether visual problems relate to these functional deficits is unclear. This study aimed to assess the impact of vision on visual processing functions and balance in SEN students through a community service. METHODS Visual acuity (VA) and contrast sensitivity were measured in a total of 104 (aged 14.3±4.3) SEN students as the visual outcomes, followed by retinoscopy. Visual processing function assessment included facial expression recognition by card matching examiner's facial expression matching, and visual orientation recognition. Dynamic balance, by Timed Up and Go test, and static standing balance (postural sway in double-legged standing with feet-together and tandem-stance for open-eye and closed-eye conditions) were assessed. Static balance was presented in terms of the maximal medial-lateral and antero-posterior sways. RESULTS Of the 104 students, 62 (59.6%) were classified as visually impaired according to WHO classification of visual impairment based on presenting distance acuity. Ocular problems (e.g. optic nerve anomaly, uncorrected/ under-corrected refractive errors) and neurological anomalies were the major causes of vision loss. VA was positively associated with visual processing functions (all p ≤ 0.01), as SEN students with better vision tended to perform better in visual orientation and facial expression recognition tasks, as well as dynamic balance function (p = 0.04). For the static balance, postural sway and VA showed a positive relationship under open-eye and tandem stance conditions. However, the relationship between postural sway and VA became negative under closed-eye and tandem stance conditions. CONCLUSION This study found a high prevalence of SEN students with visual impairment, in which many of them were undetected. Optometric examination is important to improve their visual function to minimize the effect of vision on functional performance. Vision is critical in visual processing as well as playing an important role in maintaining balance in SEN students.
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Affiliation(s)
- Kai Yip Choi
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Ho Yin Wong
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Hoi Nga Cheung
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Jung Kai Tseng
- Department of Optometry, Asia University, Taichung, Taiwan
| | | | - Chieh Lin Wu
- Department of Optometry, Asia University, Taichung, Taiwan
| | - Helen Eng
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - George C. Woo
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- Center for Eye and Vision Research (CEVR), Sha Tin, Hong Kong
| | - Allen Ming Yan Cheong
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- Center for Eye and Vision Research (CEVR), Sha Tin, Hong Kong
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Sukal-Moulton T, Egan T, Johnson L, Lein C, Gaebler-Spira D. Use of Frame Running for Adolescent Athletes With Movement Challenges: Study of Feasibility to Support Health and Participation. Front Sports Act Living 2022; 4:830492. [PMID: 35356095 PMCID: PMC8959752 DOI: 10.3389/fspor.2022.830492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/28/2022] [Indexed: 12/18/2022] Open
Abstract
Children and adolescents with movement challenges have lower instances of physical activity and longer time spent in sedentary behaviors compared to children with typical development. The purpose of this study was to investigate the feasibility of a sport-based youth development running program modified for accessibility using a running frame and to evaluate initial evidence for its efficacy on endurance and functional strength. We completed four 8-week seasons (2–3 times per week) in a combination of 3 different formats by season: online remote (winter and spring), in person in a community park (winter, spring, and summer), and in person in an afterschool setting (autumn). Participants included 13 athletes (average age 14.46 years, range 8–18 years, 4 females), who collectively completed 22 season blocks. Diagnoses included cerebral palsy (n = 10), arthrogryposis (n = 1), Dandy-Walker malformation (n = 1), and transverse myelitis (n = 1). In all settings, participants engaged in activities of social emotional learning, cardiovascular endurance, and muscle strengthening in a progressive manner. We found that each season format was feasible to administer with high attendance rates (76–97%) and positive qualitative feedback from athletes. In addition, promising average improvements in motor performance across a season (6 min frame running test, 170 m; timed up and go test, 8.44 s; five times sit to stand, 14.1 s; and Goal Attainment Scale, t = 65.01) were identified in the pilot data of this non-randomized cohort. Training in any of the proposed settings with an overall goal of completing a community race in a running frame is feasible and warrants further study.
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Affiliation(s)
- Theresa Sukal-Moulton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- *Correspondence: Theresa Sukal-Moulton
| | - Tara Egan
- Office of Diverse Learner Supports and Services, Chicago Public Schools, Chicago, IL, United States
| | | | | | - Deborah Gaebler-Spira
- Shirley Ryan AbilityLab, Chicago, IL, United States
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Lurie Children's Hospital, Chicago, IL, United States
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Al-Toaimi NS, Shaheen AAM, Algabbani MF, Gawad RFM. Reference values for the Modified Timed Up and Go Test in Saudi children aged 4-12 years old in Riyadh city: cross-sectional study. Ann Med 2021; 53:1905-1913. [PMID: 34727799 PMCID: PMC8567941 DOI: 10.1080/07853890.2021.1986638] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 09/22/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE The study aimed to report within-session reliability, estimate the reference values for the Modified Timed Up and Go (mTUG) test in typically developing (TD) Saudi children aged 4-12 years old, develop a reference equation for the estimated mTUG, and compare the measured mTUG in the present study with the predicted mTUG obtained from the previous regression equation. METHODS In this cross-sectional observational study, anthropometric measurements and mTUG test were investigated in 805 child. The association between the mTUG test and predictive variables was studied. RESULTS Average mTUG speed was 4.63 ± 0.68 s. Within-session reliability was excellent with intraclass correlation coefficient of 0.90. The test was significantly and negatively correlated with age, height, and weight (r = -0.66, p = .00), (r = -0.54, p = .01), and (r = -0.33, p = .01) respectively. According to the stepwise regression analysis, age and weight were the predictors and explained 47% of total variance of mTUG scores. CONCLUSION This study provided the mTUG reference values that can be used clinically to evaluate functional mobility and dynamic balance in TD Saudi children aged 4-12 years. The mTUG scores can be predicted as a function of age and weight.KEY MESSAGESModified Timed Up and Go test used to assess the functional mobility and dynamic balance for children with or without developmental abnormalities.Availability of reference values according to age is helpful to compare the performance of children at same ages.
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Affiliation(s)
- Nora Saleh Al-Toaimi
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Afaf A. M. Shaheen
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
- Basic Science Department, Cairo University, Cairo, Egypt
| | - Maha Fahad Algabbani
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Rehab F. M. Gawad
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
- Physical Therapy Department, National Heart Institute, Giza, Egypt
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Denlinger K, Young DL, Beier M, Friedman M, Quinn J, Hoyer EH, Kudchadkar SR. Psychometric Testing of the Activity Measure for Post-Acute Care (AM-PAC) in the Pediatric Acute Care Setting. Pediatr Phys Ther 2021; 33:149-154. [PMID: 34086622 DOI: 10.1097/pep.0000000000000807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine interrater reliability and construct validity of the Activity Measure for Post-Acute Care (AM-PAC) Inpatient "6-clicks" Short Forms for children in acute care. METHODS Eight physical therapists (PTs) scored the AM-PAC Basic Mobility, 30-second walk test (30SWT), and Timed Up and Go (TUG) for 54 patients (4-17 years); 6 occupational therapists (OTs) scored the AM-PAC Daily Activity and handgrip dynamometry for 50 patients (5-17 years). Correlations between the AM-PAC Basic Mobility, 30SWT, and TUG and between the Daily Activity AM-PAC and handgrip dynamometry were calculated for evidence of construct validity. RESULTS Interrater reliability for the AM-PAC was excellent for PTs and OTs. Validity was strong to moderate for Basic Mobility when compared with the 30SWT and TUG. Daily Activity had weak correlation with mean left handgrip strength and no correlation with mean right handgrip strength. CONCLUSIONS AM-PAC Short Forms have acceptable psychometrics for use among children in acute care.
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Affiliation(s)
- Katherine Denlinger
- Department of Physical Therapy (Dr Denlinger and Ms Quinn), Johns Hopkins Children's Center, Baltimore, Maryland; Departments of Physical Medicine and Rehabilitation (Drs Young, Beier, Hoyer, and Kudchadkar and Mr Friedman), Division of General Internal Medicine, Department of Medicine (Dr Hoyer), Outcome After Critical Illness and Surgery (OACIS) Group (Drs Hoyer and Kudchadkar), Anesthesiology and Critical Care Medicine (Dr Kudchadkar), and Pediatrics (Dr Kudchadkar), Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Physical Therapy (Dr Young), University of Nevada Las Vegas, Las Vegas, Nevada
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de Valle K, Dobson F, Woodcock I, Carroll K, Ryan MM, Heatwole C, Eichinger K, McGinley JL. Reliability and validity of the FSHD-composite outcome measure in childhood facioscapulohumeral dystrophy. Neuromuscul Disord 2021; 31:706-715. [PMID: 34210539 DOI: 10.1016/j.nmd.2021.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/09/2021] [Accepted: 05/26/2021] [Indexed: 11/25/2022]
Abstract
This study aims to investigate intra-rater reliability and construct validity of the Facioscapulohumeral Dystrophy Composite Outcome Measure (FSHD-COM), in childhood FSHD. Participants included eighteen children with FSHD, and matched healthy controls. Reliability data were collected from 15 participants with FSHD over two testing sessions. Validity data were collected from all participants. Participants with FSHD completed; the FSHD-COM (and modified pediatric version), Motor Function Measure-32 (MFM-32), FSHD Severity Scales, Performance of the Upper Limb 2.0, Pediatric Quality of Life™ Neuromuscular Module and pediatric FSHD Health-Index Questionnaire. Both versions of the FSHD-COM showed excellent intra-rater reliability (ICC1,2 > 0.99, lower 95%CI > 0.98) with a Minimal Detectable Change (MDC95%) of ≤14.5%. The FSHD-COM had robust and widespread correlations with other related outcome measures. The FSHD-COM versions and 6 min walk test effectively discriminated between children with and without FSHD; the MFM-32 and 10 m walk/run test did not. Ceiling effects were not observed on either version of the FSHD-COM. Reliability and validity findings in this childhood FSHD study concord with estimates in adults. Both versions of the FSHD-COM were effective in discriminating disease in children with mild FSHD symptoms. The FSHD-COM has the potential to be a useful measure of function across the life span.
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Affiliation(s)
- K de Valle
- Department of Neurology, The Royal Children's Hospital, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia; Department of Physiotherapy, The University of Melbourne, Australia.
| | - F Dobson
- Department of Physiotherapy, The University of Melbourne, Australia
| | - I Woodcock
- Department of Neurology, The Royal Children's Hospital, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Australia
| | - K Carroll
- Department of Neurology, The Royal Children's Hospital, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia
| | - M M Ryan
- Department of Neurology, The Royal Children's Hospital, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Australia
| | - C Heatwole
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA; Center for Health and Technology, Outcomes Division, University of Rochester Medical Center, Rochester, NY, USA
| | - K Eichinger
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
| | - J L McGinley
- Department of Physiotherapy, The University of Melbourne, Australia
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Reliability and concurrent validity of a modified timed up and go test for healthy preschoolers. Eur J Pediatr 2020; 179:1579-1586. [PMID: 32338296 DOI: 10.1007/s00431-020-03638-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 03/16/2020] [Accepted: 03/18/2020] [Indexed: 12/17/2022]
Abstract
The purpose of this study was to assess the interrater and test-retest reliability and the concurrent validity of the modified timed up and go test for preschoolers. As such, we aim to determine the most suited outcome of the modified timed up and go test: the best or the average performance. Thirty-two children (age 3-5) performed three timed up and go test trials as fast as possible on two separate occasions. During the first session, two researchers recorded the time to perform the task simultaneously. For reliability analyses, intra-class correlation coefficients (ICCs) and the minimal detectable change were determined. A Pearson correlation coefficient was calculated to determine concurrent validity between the timed up and go test and the balance subscale of the Movement Assessment Battery for Children, 2nd edition. Interrater (ICC > 0.97) and test-retest (ICC > 0.75) reliability were good both for the average and the best timed up and go test performance. A minimal detectable change of 1.86 s was found for the best performance, and 2.30 s for the average performance. Only the best timed up and go test performance correlated significantly with the balance subscale of the Movement Assessment Battery for Children, 2nd edition, though fair (r = -0.347, p = 0.007).Conclusion: The modified timed up and go test for preschoolers using the best performance is reliable and recommended to reduce standard and measurement error. What is Known: • A large variety of timed up and go test protocols is available for children • The protocols differ in the instructions on walking speed (self-selected/fastest), the use of an extra motivation (e.g., touch a star on the wall) and the applied outcome (average/best performance) What is New: • The best timed up and go test performance induces more consistent test results between raters and sessions and also less standard and measurement error in 3- to 5-year-old children • The best timed up and go test performance should be preferred over the average performance to achieve both reliable and valid test results in 3- to 5-year-old children.
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Feasibility and Reliability of Functional Mobility Measures in Children With Cri du Chat (5P-) Syndrome. Pediatr Phys Ther 2020; 32:161-167. [PMID: 32218082 DOI: 10.1097/pep.0000000000000681] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate feasibility and reliability of functional mobility measures in children with Cri du Chat syndrome (CdCS). METHODS Nine children with CdCS and 9 children with typical development (TD) completed the Timed Up and Go, 5 times sit-to-stand test, Timed Floor to Stand, and 4 Square Step Test. Feasibility was determined using testing time and need for modifications. Intraclass correlation coefficients were calculated for intrarater and interrater reliability. RESULTS Children with CdCS required modifications to complete all tests. One child with CdCS completed the 4 Square Step Test. Good reliability was found for both groups. CONCLUSIONS The Timed Up and Go, 5 times sit-to-stand test, and Timed Floor to Stand are feasible and reliable tools for children with TD between ages of 5 and 15 years; however, may require modifications to the protocols to be feasible in children with CdCS. The 4 Square Step Test is not a feasible tool for children with CdCS.
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Bustam IG, Suriyaamarit D, Boonyong S. Timed Up and Go test in typically developing children: Protocol choice influences the outcome. Gait Posture 2019; 73:258-261. [PMID: 31382232 DOI: 10.1016/j.gaitpost.2019.07.382] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 07/26/2019] [Accepted: 07/29/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND The Timed Up and Go (TUG) test is one of the most popular functional dynamic balance tests in children with typical and atypical development. However, the TUG protocol varies in terms of turning-point markers and verbal commands. RESEARCH QUESTION Would the outcomes of TUG be different if a different TUG protocol, especially turning-point markers and verbal commands, was used in different age and gender? METHODS Two hundred and ten typically developing children aged 6-12 years participated in the study. They were separated into 7 groups according to age. All participants were randomly selected to perform the TUG test in 6 conditions of a cone, a line, and a picture as turning-point markers under nonqualitative and qualitative verbal instructions in terms of the walking speed. The best TUG score (in seconds) of 3 trials in each condition was obtained for analysis. RESULTS The time to complete the TUG test was decreased by age. The fastest time was found in the picture condition under qualitative and nonqualitative verbal instructions in all age groups. Additionally, using qualitative verbal instruction resulted in faster times than nonqualitative verbal instruction for all turning-point markers and in all age groups. SIGNIFICANCE This study provided evidence that the outcome of the TUG test was influenced by turning-point markers and verbal instructions in all age groups. Therefore, a reliable TUG test protocol should be considered in order to measure the change in functional dynamic balance of children.
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Affiliation(s)
- Ika Guslanda Bustam
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand; STIKes Muhammadiyah Palembang, South Sumatera, Indonesia
| | - Duangporn Suriyaamarit
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Sujitra Boonyong
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.
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Schedler S, Kiss R, Muehlbauer T. Age and sex differences in human balance performance from 6-18 years of age: A systematic review and meta-analysis. PLoS One 2019; 14:e0214434. [PMID: 30964877 PMCID: PMC6456289 DOI: 10.1371/journal.pone.0214434] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 03/11/2019] [Indexed: 11/20/2022] Open
Abstract
Background The process of growing leads to inter-individual differences in the timing of growth, maturational, and developmental processes during childhood and adolescence, also affecting balance performance in youth. However, differences in balance performance by age and sex in youth have not been systematically investigated yet. Objective The objective of the present study was to characterize and quantify age- and sex-related differences in balance performance in healthy youth. Methods A computerized systematic literature search was performed in the electronic databases PubMed, Web of Science, and SPORTDiscus. To be applicable for analysis, studies had to report at least one measure of static steady-state, dynamic steady-state, proactive or reactive balance in healthy children (6–12 years) and/or adolescents (13–18 years). Coding of the studies was done according to the following criteria: age, sex, and balance outcome. Study quality was assessed using the Appraisal tool for Cross-Sectional Studies. Weighted standardized mean differences were calculated and classified according to their magnitude. Results Twenty-one studies examined age-related differences in balance performance. A large effect for measures of static steady-state balance (SMDba = 1.20) and small effects for proxies of dynamic steady-state (SMDba = 0.26) and proactive balance (SMDba = 0.28) were found; all in favor of adolescents. Twenty-five studies investigated sex-related differences in balance performance. A small-sized effect was observed for static steady-state balance (SMDbs = 0.33) in favor of girls and for dynamic steady-state (SMDbs -0.02) and proactive balance (SMDbs = -0.15) in favor of boys. Due to a lack of studies, no analysis for measures of reactive balance was performed. Conclusions Our systematic review and meta-analysis revealed better balance performances in adolescents compared to children, irrespective of the measure considered. Sex-related differences were inconsistent. These findings may have implications for example in terms of trainability of balance in youth that should be investigated in future studies.
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Affiliation(s)
- Simon Schedler
- Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Essen, Germany
- * E-mail:
| | - Rainer Kiss
- Department of Health and Social Affairs, FHM Bielefeld—University of Applied Sciences, Bielefeld, Germany
| | - Thomas Muehlbauer
- Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Essen, Germany
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Abstract
PURPOSE Results on reliability and normative data for the Timed Up and Go test (TUG) in children who are developing typically are systematically reviewed. SUMMARY OF KEY POINTS Six different TUG protocols are presented for which normative data are available for ages 3 to 18 years. TUG time is consistent within and between raters and sessions and is influenced by age. The choice of protocol, self-selected versus fastest walking speed, and use of a motivational aspect and of the outcome calculation affect TUG time as well as its consistency within and between sessions. CONCLUSIONS A standard protocol for the TUG is lacking and should be developed with attention to reliability. RECOMMENDATIONS FOR CLINICAL PRACTICE If the TUG is to be used as a screening tool for dynamic balance control, clinicians need to apply protocols that include fastest walking speed motivation.
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Abstract
PURPOSE To determine test-retest reliability and minimal detectable change of the Timed Up and Go (TUG) and Timed Up and Down Stairs (TUDS) for Down syndrome. SUBJECTS Twelve children with Down syndrome (DS) aged 3 to 17 years. METHODS Two sessions, 1 week apart, with 3 trials of the TUG and 2 trials of the TUDS. Test-retest reliability was estimated using intraclass correlation coefficients and the standard error of measurement. The minimal detectable changes (MDCs) for both tests were calculated. RESULTS The TUG and TUDS tests both had high test-retest reliability. The MDC was 1.26 seconds for the TUG and 12.52 seconds for the TUDS test. CONCLUSIONS Both tests were reliable in this population, but the MDC results suggest only the TUG is clinically useful.
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