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Ferrer-Mallol E, Matthews C, Aziza R, Mendoza A, Sahota N, Komarzynski S, Lakshminarayana R, Davies EH. Video-based assessments of activities of daily living: generating real-world evidence in pediatric rare diseases. Expert Rev Pharmacoecon Outcomes Res 2024; 24:713-721. [PMID: 38789406 DOI: 10.1080/14737167.2024.2360201] [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: 02/11/2024] [Accepted: 05/22/2024] [Indexed: 05/26/2024]
Abstract
INTRODUCTION Preserving function and independence to perform activities of daily living (ADL) is critical for patients and carers to manage the burden of care and improve quality of life. In children living with rare diseases, video recording ADLs offer the opportunity to collect the patients' experience in a real-life setting and accurately reflect treatment effectiveness on outcomes that matter to patients and families. AREAS COVERED We reviewed the measurement of ADL in pediatric rare diseases and the use of video to develop at-home electronic clinical outcome assessments (eCOA) by leveraging smartphone apps and artificial intelligence-based analysis. We broadly searched PubMed using Boolean combinations of the following MeSH terms 'Rare Diseases,' 'Quality of Life,' 'Activities of Daily Living,' 'Child,' 'Video Recording,' 'Outcome Assessment, Healthcare,' 'Intellectual disability,' and 'Genetic Diseases, Inborn.' Non-controlled vocabulary was used to include human pose estimation in movement analysis. EXPERT OPINION Broad uptake of video eCOA in drug development is linked to the generation of technical and clinical validation evidence to confidently assess a patient's functional abilities. Software platforms handling video data must align with quality regulations to ensure data integrity, security, and privacy. Regulatory flexibility and optimized validation processes should facilitate video eCOA to support benefit/risk drug assessment.
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Toomer-Mensah N, O'Neil M, Blacutt M, Quinn L. Measuring Physical Activity in Children Who Do Not Walk and With Cerebral Palsy: An Exploratory Case Series. Pediatr Phys Ther 2024; 36:353-362. [PMID: 38758603 DOI: 10.1097/pep.0000000000001113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
AIM The purpose of this case series was to describe physical activity (PA) amount and intensity in the home and school environment. Accelerometers and heart rate (HR) monitors are reliable and valid measures of PA in children with cerebral palsy (CP) who can walk. There is limited research on PA measures in children with CP who cannot walk. METHODS Three 9-year-old boys with CP, Gross Motor Function Classification System levels IV and V, participated in a 1-week measurement period wearing waist- and wrist-worn triaxial accelerometers to measure PA counts and a wrist-worn HR monitor to measure PA intensity. PA intensity was calculated using an estimated HR max. Accelerometer counts were reported. Parents and school staff completed activity and eating journals. RESULTS Six days of PA and HR data were analyzed. Two participants spent more time in moderate/vigorous PA intensity during school compared to at home. Activities with greatest PA intensity included oral eating, communication, and social engagement. Higher activity counts were recorded from the wrist compared with the waist accelerometers. PA and eating journal adherence were high in both settings. CONCLUSION The findings provide preliminary data to evaluate PA amount and intensity in children with CP who have little walking ability. It is important to consider PA levels in daily activity for youth with CP when designing plans of care.
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Affiliation(s)
- Nia Toomer-Mensah
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York (Drs Toomer-Mensah and Quinn); Program in Physical Therapy, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, Massachusetts (Dr O'Neil); Department of Physical Therapy, Long Island University, Brooklyn, New York (Dr Toomer-Mensah).; Department of Psychology, Doctoral Program, Notre Dame, Notre Dame, Indiana (Mr Blacutt)
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Hwang Y, Kwon JY. Filtering walking actigraphy data in children with unilateral cerebral palsy: A preliminary study. PLoS One 2024; 19:e0303090. [PMID: 38722902 PMCID: PMC11081346 DOI: 10.1371/journal.pone.0303090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 04/15/2024] [Indexed: 05/13/2024] Open
Abstract
This study aimed to determine whether filtering out walking-related actigraphy data improves the reliability and accuracy of real-world upper extremity activity assessment in children with unilateral cerebral palsy. Twenty-two children aged 4-12 years diagnosed with unilateral cerebral palsy were included in this study, which was drawn from a two-phase randomized controlled trial conducted from July 2021 to December 2022. Data were collected from a tertiary hospital in Seoul, Republic of Korea. Participants were monitored using tri-axial accelerometers on both wrists across three time points (namely, T0, T1, and T2) over 3 days; interventions were used between each time point. Concurrently, an in-laboratory study focusing on walking and bimanual tasks was conducted with four participants. Data filtration resulted in a reduction of 8.20% in total data entry. With respect to reliability assessment, the intra-class correlation coefficients indicated enhanced consistency after filtration, with increased values for both the affected and less-affected sides. Before filtration, the magnitude counts for both sides showed varying tendencies, depending on the time points; however, they presented a consistent and stable trend after filtration. The findings of this research underscore the importance of accurately interpreting actigraphy measurements in children with unilateral cerebral palsy for targeted upper limb intervention by filtering walking-induced data.
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Affiliation(s)
- Youngsub Hwang
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jeong-Yi Kwon
- Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
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Niedzwecki C, Barbuto A, Mitchell K, Wirt S, Seymour M, Thomas S, Schwabe A. Comparison of outcomes following surgical intervention and inpatient rehabilitation stays in children with cerebral palsy. PM R 2024; 16:449-461. [PMID: 37801614 DOI: 10.1002/pmrj.13075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/28/2023] [Accepted: 09/01/2023] [Indexed: 10/08/2023]
Abstract
INTRODUCTION Literature is limited on functional outcomes in children with cerebral palsy (CP) following surgical procedures and a subsequent inpatient rehabilitation unit (IRU) stay. OBJECTIVE To compare functional outcomes and length of stay (LOS) in children with CP following a surgical procedure and IRU stay based on the surgical procedure performed, pattern of involvement, etiology, and Gross Motor Function Classification System (GMFCS) level. DESIGN Retrospective cohort study. SETTING Tertiary care pediatrics. PARTICIPANTS Pediatric patients with CP who underwent one of three surgical procedures followed by an IRU stay. INTERVENTIONS Selective dorsal rhizotomy (SDR), single-event multilevel orthopedic surgery (SEMLS), or intrathecal baclofen (ITB) pump implantation and subsequent IRU stay. MAIN OUTCOME MEASURES IRU LOS, Functional Independence Measure for Children (WeeFIM) total score, sub-scores, and efficiency. RESULTS Children undergoing SDR had a longer LOS (p ≤ .015). Children with spastic diplegia, GMFCS level II, and prematurity-based CP had higher WeeFIM efficiency scores (p ≤ .046, ≤.021, and .034 respectively). Greater changes in WeeFIM™ scores were associated with spastic diplegia, SDR, GMFCS level II, longer LOS, and higher admission scores (p ≤ .045). CONCLUSIONS Although statistically and functionally significant improvements in children with CP following surgical interventions and an IRU stay were seen, those with higher WeeFIM change scores tended to have spastic diplegia, to have undergone SDR, GMFCS level II, longer LOS, and higher admission scores.
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Affiliation(s)
- Christian Niedzwecki
- Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, Texas, USA
| | - Amy Barbuto
- Department of Physical and Occupational Therapy, Texas Children's Hospital-The Woodlands, The Woodlands, Texas, USA
| | - Katy Mitchell
- Department of Physical Therapy, Texas Woman's University-Houston, Houston, Texas, USA
| | - Steven Wirt
- Department of Physical and Occupational Therapy, Texas Children's Hospital-Main Campus, Houston, Texas, USA
| | - Michelle Seymour
- Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, Texas, USA
| | - Sruthi Thomas
- Departments of Physical Medicine & Rehabilitation and Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Aloysia Schwabe
- Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, Texas, USA
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Lorås H, Haga M, Hagen RV, Bjerke Ø, Timler A, Sando OJ. Psychometric properties of the Adolescent Motor Competence Questionnaire for Norwegian adolescents. Front Psychol 2024; 15:1296923. [PMID: 38328374 PMCID: PMC10848321 DOI: 10.3389/fpsyg.2024.1296923] [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: 09/19/2023] [Accepted: 01/10/2024] [Indexed: 02/09/2024] Open
Abstract
The objective of this study was to examine the psychometric properties of the Adolescent Motor Competence Questionnaire (AMCQ) for Norwegian adolescents. To this end, a sample of 349 Norwegian-speaking adolescents (13-16 years old) were recruited and completed the AMCQ. Initial results showed that confirmatory factor analysis (CFA) did not indicate statistical support for previous statistical models reported in the literature. Further analysis indicated factorial validity for a novel three-factor model identified through exploratory factor analysis, encompassing measures of fine motor skill (α = 0.65), gross motor skill (α = 0.74), and activities of daily living (ADL; α = 0.79) with acceptable internal consistency coefficients. Subsequent analysis indicated indices of measurement invariance in the study sample, as males rated their competence higher compared to females in 19 of the 27 items, and better model fit was obtained for the female adolescents. Strong invariance was tenable, and no factor mean differences were found across older and younger adolescents or across BMI scores. Overall results thus suggested that the AMCQ has acceptable psychometric properties and can be confidently used in further work with perceived motor competence in Norwegian 13-16 years-old adolescents.
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Affiliation(s)
- Håvard Lorås
- Department of Teacher Education, Faculty of Social and Educational Sciences, NTNU, Trondheim, Norway
| | - Monika Haga
- Department of Teacher Education, Faculty of Social and Educational Sciences, NTNU, Trondheim, Norway
| | - Ruben Vist Hagen
- Department of Teacher Education, Faculty of Social and Educational Sciences, NTNU, Trondheim, Norway
| | - Øyvind Bjerke
- Department of Teacher Education, Faculty of Social and Educational Sciences, NTNU, Trondheim, Norway
| | - Amanda Timler
- School of Health Sciences and Physiotherapy, Faculty of Medicine, Nursing, Midwifery and Health Sciences, The University of Notre Dame, Fremantle, WA, Australia
| | - Ole Johan Sando
- Department of Physical Education and Health, Queen Maud University College of Early Childhood Education, Trondheim, Norway
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Matsumoto Y, Yoshii Y, Ikutomo A, Yagi M, Nishimura M, Kawasaki Y, Sarafian A, Kim H, Roye DP, Matsumoto H. Improvement in a post-stroke pediatric patient with hemiplegia: Use of a hand-arm bimanual intensive therapy with hybrid assistive limb. Brain Dev 2024; 46:68-72. [PMID: 37652813 DOI: 10.1016/j.braindev.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 07/04/2023] [Accepted: 08/11/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Pediatric stroke is a rare medical condition that often leads to long-lasting motor and cognitive impairments. Although therapies for adults after a stroke are well described, treatments for motor deficits following a pediatric stroke are yet to be investigated. We report a case of pediatric stroke in the chronic phase, in which a combination of novel treatments resulted in a significant improvement in physical function. CASE REPORT A seven-year-old girl with a left hemispheric cerebral infarction lost almost all right upper extremity motor function. Following onabotulinumtoxinA treatment, she underwent hand-arm bimanual intensive therapy augmented with a hybrid assistive limb for 90 h over 15 days. Evaluation after the training revealed significant improvements in physical function, daily activities, and occupational performance. CONCLUSIONS This report highlights the importance of innovative combinations of techniques in the treatment of pediatric stroke.
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Affiliation(s)
- Yoko Matsumoto
- NikoNiko House Medical and Welfare Center, Kobe, Japan; Department of Public Health and Health Science, Kobe University Graduate School of Health Sciences, Kobe, Japan; Tokyo Metropolitan Fuchu Rehabilitation Center, Tokyo, Japan.
| | - Yuji Yoshii
- PorePore-no-Ki, Children Development Support Center, Himeji, Japan
| | - Akiyo Ikutomo
- NikoNiko House Medical and Welfare Center, Kobe, Japan
| | - Mariko Yagi
- NikoNiko House Medical and Welfare Center, Kobe, Japan; Department of Childhood Development and Education, Faculty of Human Science, Konan Women's University, Kobe, Japan
| | - Mio Nishimura
- NikoNiko House Medical and Welfare Center, Kobe, Japan
| | - Yoko Kawasaki
- NikoNiko House Medical and Welfare Center, Kobe, Japan
| | | | - Heakyung Kim
- Physical Medicine & Rehabilitation, The University of Texas Southwestern Medical Center, TX, USA
| | - David P Roye
- Department of Orthopaedic Surgery, Columbia University Irving Medical Center, MA, USA
| | - Hiroko Matsumoto
- Department of Orthopaedic Surgery and Sports Medicine, Boston Children's Hospital, MA, USA; Department of Orthopaedic Surgery, Harvard Medical School, MA, USA
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Hadar-Frumer M, Ten-Napel H, Yuste-Sánchez MJ, Rodríguez-Costa I. Feasibility of Using the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) as a Framework for Aquatic Activities: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1856. [PMID: 38136058 PMCID: PMC10741913 DOI: 10.3390/children10121856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/23/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023]
Abstract
(1) Background: In recent years, reviewing studies of aquatic activities for children with developmental delays has been a complex task due to the multitude of indices and professional languages. (2) Aim: To determine if the ICF-CY framework can be used as the unifying language in AA studies of children with DD. (3) Methods: Part One-A systematic review of selected studies focusing on goals that were found to be positive. These goals were linked to the ICF-CY categories. Part Two-Review of all studies using the ICF-CY's functioning components. (4) Results: Most of the positive goals were properly linked to ICF-CY and made it possible to review the 71 articles in a uniform language. (5) Conclusions: It is feasible to use the ICF framework as a universal structure and language.
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Affiliation(s)
- Merav Hadar-Frumer
- Israel Sport Centre for the Disabled (ISCD) Ilan Spivak, Ramat Gan 52535, Israel;
- Faculty of Medicine and Health Sciences, University of Alcalá, 28807 Alcalá de Henares, Spain;
| | - Huib Ten-Napel
- WHO-FIC Collaborating Centre RIVM, 3720 Bilthoven, The Netherlands;
- Department of Primary and Community Care, Radboud University Medical Centre, 6500 Nijmegen, The Netherlands
| | | | - Isabel Rodríguez-Costa
- Faculty of Medicine and Health Sciences, University of Alcalá, 28807 Alcalá de Henares, Spain;
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Li B, Cunha AB, Lobo MA. Effectiveness and Users' Perceptions of Upper Extremity Exoskeletons and Robot-Assisted Devices in Children with Physical Disabilities: Systematic Review. Phys Occup Ther Pediatr 2023; 44:336-379. [PMID: 37635151 DOI: 10.1080/01942638.2023.2248241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 07/26/2023] [Accepted: 08/02/2023] [Indexed: 08/29/2023]
Abstract
AIM Systematically determine the effectiveness and users' perceptions of upper extremity (UE) exoskeletons and robot-assisted devices for pediatric rehabilitation. METHODS PubMed/Medline, Web of Science, Scopus, and Cochrane Library were searched for studies with "exoskeletons"/"robot-assisted devices", children with disabilities, effectiveness data, and English publication. Intervention effectiveness outcomes were classified within components of the International Classification of Functioning, Disability, and Health, Children and Youth Version (ICF-CY). Secondary data (users' perceptions; implementation setting) were extracted. Risk of bias and methodological quality were assessed. Descriptive analyses were performed. RESULTS Seventy-two articles were included. Most evaluated body structure and function and activity outcomes with less emphasis on participation. Most effects across all ICF-CY levels were positive. Devices were primarily evaluated in clinical or laboratory rather than natural environments. Perceptions about device effectiveness were mostly positive, while those about expression, accessibility, and esthetics were mostly negative. A need for increased rigor in research study design was detected. CONCLUSIONS Across populations, devices, settings, interventions, and dosing schedules, UE exoskeletons and robot-assisted devices may improve function, activity, and perhaps participation for children with physical disabilities. Future work should transition devices into natural environments, design devices and implementation strategies to address users' negative perceptions, and increase research rigor.
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Affiliation(s)
- Bai Li
- Department of Physical Therapy, Biomechanics & Movement Science Program, University of Delaware, Newark, DE, USA
| | - Andrea B Cunha
- Department of Physical Therapy, Biomechanics & Movement Science Program, University of Delaware, Newark, DE, USA
- Department of Physical Therapy, Munroe Meyer Institute, University of Nebraska Medical Center, Omaha, NE, USA
| | - Michele A Lobo
- Department of Physical Therapy, Biomechanics & Movement Science Program, University of Delaware, Newark, DE, USA
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Collange-Grecco LA, Cosmo C, Silva ALS, Rizzutti S, Oliveira CS, Muszkat M. Effects of Dual Task Training and Transcranial Direct Current Stimulation in Children with Spastic Cerebral Palsy: A Pilot Randomized Control Trial. Dev Neurorehabil 2023; 26:279-286. [PMID: 37352444 DOI: 10.1080/17518423.2023.2228400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/28/2023] [Accepted: 06/19/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE Compare the effectiveness of active and sham transcranial direct current stimulation (tDCS) during the training of a dual task in children with spastic cerebral palsy (CP). METHODS Thirty children with CP were submitted to ten sessions of either active (n = 15) or sham (n = 15) tDCS over the motor cortex for 20 minutes during the training of a dual task. Pre-intervention, post-intervention and follow-up evaluations involved measures of functional performance, intellectual performance, functional mobility and cortical excitability. RESULTS The combination of active tDCS and dual task training led to improvements in functional mobility as well as functional and intellectual performances one month after the end of the intervention. CONCLUSION The combination of active tDCS and dual task training demonstrated promising effects for children with spastic CP.
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Affiliation(s)
- Luanda André Collange-Grecco
- Center of Pediatric Neurostimulation, Sao Paulo, SP, Brazil
- Education and health in childhood and adolescence, Federal University of São Paulo, São Paulo, SP, Brazil
- Human movement analysis laboratory, University Center of Anápolis, Anápolis, GO, Brazil
| | - Camila Cosmo
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Brown University, Providence, RI, USA
- Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, USA
| | | | - Sueli Rizzutti
- Education and health in childhood and adolescence, Federal University of São Paulo, São Paulo, SP, Brazil
| | | | - Mauro Muszkat
- Education and health in childhood and adolescence, Federal University of São Paulo, São Paulo, SP, Brazil
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Irie K, Mukaiyama K, Yamashita R, Zeidan H, Bandara A, Nagai-Tanima M, Aoyama T. Investigating Subtypes of Motor Skills and Activities of Daily Living among Young Children with Motor Delay. Occup Ther Int 2023; 2023:4031372. [PMID: 37360553 PMCID: PMC10287527 DOI: 10.1155/2023/4031372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/15/2023] [Accepted: 06/02/2023] [Indexed: 06/28/2023] Open
Abstract
The purpose of this study was to classify preschool children into subtypes based on motor skills and to characterize the activities of daily living for each subtype. The subjects were 45 preschool children whose scores on the Movement Assessment Battery for Children-Second Edition (MABC-2) and the Functional Independence Measure for Children (WeeFIM) were measured. The fine score and gross score were calculated from the MABC-2, and a cluster analysis was performed. The difference between the fine score and the gross score was evaluated for each subtype, and multiple comparisons among subtypes were performed for the fine, gross, and WeeFIM scores. Subtype analysis showed that the fine score was significantly lower than the gross score for subtype I (p < 0.001), and the gross score was significantly lower than the fine score for subtype III (p = 0.018). Subtype II had a significantly lower score than subtype I and subtype III (p < 0.001). Children with subtype II had more difficulty dressing movements and less communication skills than subtype III (p < 0.05). Classification into three subtypes according to motor ability and some of the characteristics of ADLs were identified.
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Affiliation(s)
- Keisuke Irie
- Department of Occupational Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kohei Mukaiyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Reika Yamashita
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Anuradhi Bandara
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Momoko Nagai-Tanima
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Moon I, An Y, Min S, Park C. Therapeutic Effects of Metaverse Rehabilitation for Cerebral Palsy: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1578. [PMID: 36674332 PMCID: PMC9864535 DOI: 10.3390/ijerph20021578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/04/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Metaverse physical therapy (MPT), an adjuvant technology for the rehabilitation of children with cerebral palsy (CP), has gained notoriety in the clinical field owing to its accessibility and because it provides motivation for rehabilitation. The aim is to compare the gross motor function and cardiopulmonary function, the activities of daily living, quality of life (QOL), and the perceived risk of coronavirus disease (COVID)-19 transmission between MPT and conventional physical therapy (CPT). A convenience sample of 26 children with CP (mean age, 11.23 ± 3.24 years, 14 females) were randomized into either the MPT or CPT group and received therapy three days/week for four weeks. Clinical outcomes included gross-motor-function measure 66 (GMFM-66), heart rate (HR), Borg-rating perceived exertion (BRPE), functional independence measure (FIM), pediatric QOL, and the risk of COVID-19 transmission. An analysis of variance showed that compared with CPT, MPT exerted positive effects on GMFM, HR, and BRPE. An independent t-test showed that compared with CPT, MPT exerted positive effects on the perceived transmission risk of COVID-19 but not on FIM and QOL. Our results provide promising therapeutic evidence that MPT improves gross motor function, cardiopulmonary function, and the risk of COVID-19 in children with CP.
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Affiliation(s)
- Ilyoung Moon
- Department of Physical Therapy, Yonsei University, Wonju 26493, Republic of Korea
| | - Yeongsang An
- Funrehab Co., Ltd., Daejeon 35229, Republic of Korea
| | - Seunghwa Min
- Funrehab Co., Ltd., Daejeon 35229, Republic of Korea
| | - Chanhee Park
- Department of Physical Therapy, Yonsei University, Wonju 26493, Republic of Korea
- Funrehab Co., Ltd., Daejeon 35229, Republic of Korea
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Nielsen CG, Thomsen BL, Als-Nielsen B, Conyers R, Jeha S, Mateos MK, Mlynarski W, Pieters R, Rathe M, Schmiegelow K, Andrés-Jensen L. Physician-defined severe toxicities occurring during and after cancer treatment: Modified consensus definitions and clinical applicability in the evaluation of cancer treatment. Front Pediatr 2023; 11:1155449. [PMID: 37181427 PMCID: PMC10171426 DOI: 10.3389/fped.2023.1155449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/27/2023] [Indexed: 05/16/2023] Open
Abstract
Overall survival after cancer is increasing for the majority of cancer types, but survivors can be burdened lifelong by treatment-related severe toxicities. Integration of long-term toxicities in treatment evaluation is not least important for children and young adults with cancers with high survival probability. We present modified consensus definitions of 21 previously published physician-defined Severe Toxicities (STs), each reflecting the most serious long-term treatment-related toxicities and representing an unacceptable price for cure. Applying the Severe Toxicity (ST) concept to real-world data required careful adjustments of the original consensus definitions, translating them into standardized endpoints for evaluating treatment-related outcomes to ensure that (1) the STs can be classified uniformly and prospectively across different cohorts, and (2) the ST definitions allow for valid statistical analyses. The current paper presents the resulting modified consensus definitions of the 21 STs proposed to be included in outcome reporting of cancer treatment.
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Affiliation(s)
- Camilla Grud Nielsen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Birthe Lykke Thomsen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark
- Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Bodil Als-Nielsen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Rachel Conyers
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Pharmacogenomics, Stem Cell Biology, Murdoch Children’s Research Institute, Melbourne, VIC, Australia
- Children’s Cancer Centre, The Royal Children’s Hospital, Melbourne, VIC, Australia
| | - Sima Jeha
- Department of Oncology, St Jude Children’s Research Hospital, Memphis, TN, United States
| | - Marion K. Mateos
- Kids Cancer Centre, Sydney Children’s Hospital Randwick, Sydney, NSW, Australia
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine & Health, UNSW, Sydney, NSW, Australia
- Children’s Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia
| | - Wojciech Mlynarski
- Department of Pediatrics, Oncology & Hematology, Medical University of Lodz, Lodz, Poland
| | - Rob Pieters
- Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Mathias Rathe
- Department of Pediatric Hematology and Oncology, Hans Christian Andersen’s Children’s Hospital, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Liv Andrés-Jensen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark
- Correspondence: Liv Andrés-Jensen
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Systematic review of reviews on Activities of Daily Living measures for children with developmental disabilities. Heliyon 2022; 8:e09698. [PMID: 35761927 PMCID: PMC9233222 DOI: 10.1016/j.heliyon.2022.e09698] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/11/2022] [Accepted: 06/07/2022] [Indexed: 12/12/2022] Open
Abstract
Background There seems to be a lack of consensus on the concept and domains of Activities of Daily Living (ADL) measured among children and adolescents with developmental disabilities (DD), despite a significant number of existing measures of ADL and associated constructs, and two prevailing theoretical frameworks (i.e., the cognitive-social-practical framework, and the activity-and-participation framework). Aims This systematic review (SR) aims to identify articles that systematically reviewed measures of ADL for children and adolescents aged 7–18 years with DD to evaluate the quality of included articles, and describe the measures and domains identified. Methods and Procedures: Searches were conducted in PubMed®, Academic Search Complete® (EBSCOhost), Education Source Search® (EBSCOhost), ERIC® (EBSCOhost), and PsychInfo® (EBSCOhost). 14,931 articles were identified, and two researchers completed title screening, abstract screening, and full-text screening, with disagreements resolved. Out of these 14,931 articles, fourteen were included, which resulted in a total of 163 ADL measures. Out of the 163 ADL measures, forty-eight met the criteria and were included for analysis. PRISMA and COSMIN checklists were used to appraise the methodological quality of the included articles. Outcomes and results Results indicated that most of the 14 systematic review articles did not provide information on instrument development and content validity of their included measures. Analysis of the identified 48 measures of ADL and its associated constructs revealed heterogeneity in domains covered, although there were seven domains that were most often included. Conclusions and implications Implications in terms of practice, research, and policy are further discussed.
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Elvrum AKG, Johansen GO, Vik T, Krumlinde-Sundholm L. External validity of the Both Hands Assessment for evaluating bimanual performance in children with bilateral cerebral palsy. Dev Med Child Neurol 2022; 64:586-592. [PMID: 34907525 DOI: 10.1111/dmcn.15127] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 09/11/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022]
Abstract
AIM To investigate the external validity of the Both Hands Assessment (BoHA), a new test evaluating bimanual performance in children with bilateral cerebral palsy (CP), by analysing its relationship to established measurements of hand function and self-care skills. METHOD In this cross-sectional study, we recruited children with bilateral CP and manual ability corresponding to Manual Ability Classification System (MACS) levels I to III attending three habilitation units in Norway. All participants completed the BoHA. Unimanual capacity was assessed using the Bimanual Fine Motor Function (BFMF) classification, the Box and Block Test (BBT), and the Melbourne Assessment 2 (MA2). Self-care skills were assessed with the Pediatric Evaluation of Disability Inventory (PEDI). RESULTS Thirty-nine children (19 males, 20 females; mean age 8y 2mo, SD 2y 8mo; age range 2y 8mo-12y 6mo) were included. Spearman's correlation coefficient (ρ) suggested high correlation between the BoHA and MACS (p=0.89; 95% confidence interval [CI] 0.79-0.94), BFMF classification (p=0.84; 95% CI 0.71-0.91), and BBT for the non-dominant (p=0.85; 95% CI 0.68-0.95) and dominant hand (p=0.72; 95% CI 0.53-0.85). The Spearman's ρ between the BoHA and the MA2 subscales varied between 0.48 and 0.83, while the PEDI's ρ was 0.51 (95% CI 0.33-0.67). INTERPRETATION The BoHA provides valid measures of hand use as suggested by its high correlation with other activity-based measures of hand function.
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Affiliation(s)
- Ann-Kristin G Elvrum
- Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gøril Okkenhaug Johansen
- Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Torstein Vik
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lena Krumlinde-Sundholm
- Neuropediatric Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Jang JS, Jeon JY, Kim H, Kim GW. Validity and Reliability of Functional Independence Measure for Children (WeeFIM) for Children With Cerebral Palsy. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580211072454. [PMID: 35199570 PMCID: PMC8883382 DOI: 10.1177/00469580211072454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: This study was conducted to verify the validity and reliability of the Functional Independence Measure for Children (WeeFIM) for children with cerebral palsy by verifying the construct validity, difficulty, suitability, and cultural differences using Rasch analysis. Methods: From May 1, 2015, to February 27, 2020, 105 children with cerebral palsy aged 6 months–95 months (7 years and 11 months old) from Hospital Y located in Korea were included. In WeeFIM, 18 items were divided into 3 areas: Self-care 8 items, Motor 5 items, and Cognition 5 items. Analysis and separation reliability were analyzed. Results: In the Self-care area, the Grooming item and in the Motor area, the Transfer (Tub, Shower) item were judged as inappropriate items, and the order of difficulty was arranged without excluding the unsuitable items. In Self-acre, the most difficult item was Bathing, the easiest items were Eating and Bladder management, and the separation reliability was .87, the most difficult item in Motor was Stair, and the easiest item was Locomotion, and the separation reliability was .99. In Cognition, the most difficult item was Problem Solving, the easiest item was Communication, and the separation reliability was .95. Conclusion: The reliability and validity of WeeFIM was verified for children with cerebral palsy by applying Rasch Analysis. In future research, it is thought that additional research should be conducted by dividing the children by age and type so that they can be generalized.
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Affiliation(s)
- Jong-Sik Jang
- Department of Occupational Therapy, Kangwon National University, Chuncheon, South Korea
| | - Ju-Yeong Jeon
- Department of Occupational Therapy, College of Health Science, Yonsei University, Seodaemun-Gu, South Korea
| | - Hyub Kim
- Department of Emergency Medical Rehabilitation, Kangwon National University, Chuncheon, South Korea
| | - Geon-Woo Kim
- Department of Emergency Medical Rehabilitation, Kangwon National University, Chuncheon, South Korea
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de Leeuw MJ, Schasfoort FC, Spek B, van der Ham I, Verschure S, Westendorp T, Pangalila RF. Factors for changes in self-care and mobility capabilities in young children with cerebral palsy involved in regular outpatient rehabilitation care. Heliyon 2021; 7:e08537. [PMID: 34950787 PMCID: PMC8671866 DOI: 10.1016/j.heliyon.2021.e08537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 06/14/2021] [Accepted: 11/29/2021] [Indexed: 11/23/2022] Open
Abstract
Background Assessing prognosis of self-care and mobility capabilities in children with cerebral palsy (CP) is important for goal setting, treatment guidance and meaningful professional-caregiver conversations. Aims Identifying factors associated with changes in self-care and mobility capabilities in regular outpatient multidisciplinary paediatric CP rehabilitation care. Methods and procedures Routinely monitored longitudinal data, assessed with the Paediatric Evaluation of Disability Inventory (PEDI-Functional-Skills-Scale, FSS 0–100) was retrospectively analysed. We determined contributions of age, gross-motor function, bimanual-arm function, intellectual function, education type, epilepsy, visual function, and psychiatric comorbidity to self-care and mobility capability changes (linear-mixed-models). Outcomes and results For 90 children (53 boys), in all Gross-Motor-Function-Classification-System (GMFCS) levels, 272 PEDI's were completed. Mean PEDI–FSS–scores at first measurement (median age: 3,2 years) for self-care and mobility were 46.3 and 42.4, and mean final FSS-scores respectively were 55.1 and 53.1 (median age: 6,5 years). Self-care capability change was significantly associated with age (2.81, p < 0.001), GMFCS levels III-V (-9.12 to -46.66, p < 0.01), and intellectual impairment (-6.39, p < 0.01). Mobility capability change was significantly associated with age (3.25, p < 0.001) and GMFCS levels II-V (-6.58 to -47.12, p < 0.01). Conclusions and implications Most important prognostic factor for self-care and mobility capabilities is GMFCS level, plus intellectual impairment for self-care. Maximum capability levels are reached at different ages, which is important for individual goal setting and managing expectations. Capabilities of children with CP improve modestly over time in outpatient rehabilitation. Children with more severe CP reach maximum mobility and self-care levels at an earlier age. After this maintaining capabilities is more realistic than improvement. Important prognostic factors are GMFCS level and intellectual impairment. Routine monitoring can aid goal setting and expectation management in communication with families.
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Affiliation(s)
- Marleen J de Leeuw
- Rijndam Rehabilitation, P.O. Box 23181, 3001 KD, Rotterdam, the Netherlands.,Department of General Practice, Intellectual Disability Medicine, Erasmus MC University Medical Centre, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Fabienne C Schasfoort
- Rijndam Rehabilitation, P.O. Box 23181, 3001 KD, Rotterdam, the Netherlands.,Department of Rehabilitation Medicine, Erasmus MC University Medical Centre, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Bea Spek
- Department of Clinical Epidemiology, Biostatistics & Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, the Netherlands
| | - Inez van der Ham
- Rijndam Rehabilitation, P.O. Box 23181, 3001 KD, Rotterdam, the Netherlands
| | - Stella Verschure
- Rijndam Rehabilitation, P.O. Box 23181, 3001 KD, Rotterdam, the Netherlands
| | - Tessa Westendorp
- Rijndam Rehabilitation, P.O. Box 23181, 3001 KD, Rotterdam, the Netherlands
| | - Robert F Pangalila
- Rijndam Rehabilitation, P.O. Box 23181, 3001 KD, Rotterdam, the Netherlands.,Department of Rehabilitation Medicine, Erasmus MC University Medical Centre, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
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Costi S, Filippi MC, Braglia L, Beccani L, Corradi I, Bruzzi E, Signorelli C, Pelosin E. Reliability and construct validity of the Activities Scale for Kids in Italian children with cerebral palsy. Disabil Rehabil 2021; 44:6445-6451. [PMID: 34415225 DOI: 10.1080/09638288.2021.1966519] [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] [Indexed: 01/12/2023]
Abstract
PURPOSE To investigate internal consistency and construct validity of the of the Activities Scale for Kids performance (ASKp) in Italian children with cerebral palsy (CP). METHODS This cross-sectional study was conducted from 2014 up to 2019 and consisted in the single self-administration of the Italian ASKp to 206 children aged 5-15, with unilateral or bilateral CP, classified on the basis of the Gross Motor Function Classification System (GMFCS). RESULTS The ASKp showed good internal consistency (Chronbach's α 0.91, 95% CI 0.89-0.93). It distinguished between children and adolescents (70.3 ± 16.6 versus 83.0 ± 18.0, respectively; p < 0.001), unilateral and bilateral CP clinical manifestations (82.5 ± 13.6 versus 72.4 ± 19.0, respectively; p = 0.002), children with and without intellectual disability (60.3 ± 18.3 versus 77.2 ± 17.3, respectively; p < 0.001). It also distinguished children using assistive devices for indoor mobility from children who did not use devices or those who use devices only for outdoor mobility (66.1 ± 18.3 versus 83.6 ± 12.8 and versus 80.4 ± 17.4, respectively; both p < 0.001). CONCLUSIONS The ASKp could help integrate the perspective of children with CP in their rehabilitation process. Trial registration: ClinicalTrials.gov Identifier: NCT03325842IMPLICATIONS FOR REHABILITATIONThe ASKp is a valid and widely used measure for several ICF domains of activities and participation in pediatrics.It has never been formally validated in children with CP, although this disorder causes restrictions in everyday activities.Recently, the culturally adapted Italian version of the ASKp has been tested in typically developing Italian children, confirming its high acceptability and providing evidence of construct validity.This study confirms the internal consistency reliability and the construct validity of the Italian ASKp when applied to the population with CP.The ASKp can support rehabilitation professionals in planning therapeutic intervention targeted to relevant goals.
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Affiliation(s)
- Stefania Costi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genova, Genova, Italy.,Scientific Directorate, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Maria Cristina Filippi
- Children Rehabilitation Unit for Severe Developmental Disabilities, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luca Braglia
- Research and Statistics Infrastructure, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Laura Beccani
- Children Rehabilitation Unit for Severe Developmental Disabilities, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Isabella Corradi
- Casa della Salute Pintor Molinetto, Azienda Unità Sanitaria Locale di Parma, Parma, Italy
| | - Elena Bruzzi
- Ospedale di Cles, Azienda Provinciale per i Servizi Sanitari di Trento, Trento, Italy
| | - Chiara Signorelli
- Specialization School in Physical Medicine and Rehabilitation, University of Parma, Parma, Italy
| | - Elisa Pelosin
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genova, Genova, Italy
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Kusumoto Y, Takaki K, Matsuda T, Nitta O. Relevant factors of self-care in children and adolescents with spastic cerebral palsy. PLoS One 2021; 16:e0254899. [PMID: 34288946 PMCID: PMC8294482 DOI: 10.1371/journal.pone.0254899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 07/06/2021] [Indexed: 11/19/2022] Open
Abstract
Objective Manual ability is considered one of the factors that can predict functional independence in activities of daily living. For evaluating personal tasks such as self-care, the Pediatric Evaluation of Disability Inventory (PEDI) comprises/introduces/offers a set of useful measures that assist in enhancing the capability for self-care among children and adolescents with cerebral palsy (CP). The aim of this study was to investigate the relevant factors of self-care capability and performance in children and adolescents with spastic CP. Methods This was a cross-sectional study. Seventy-six children and adolescents with spastic CP (between 5 and 18 years of age), representing levels I to IV of the Gross Motor Function Classification System-Expanded & Revised version (GMFCS), were analyzed. Multiple linear regression analysis with forward stepwise selection was conducted to examine which determinants were related to self-care capability and performance. Independent variables were age, CP type, GMFCS, Manual Ability Classification System, Box and Block Test, and grip strength in the dominant and non-dominant hands. Dependent variables were scores for the PEDI Functional Skills Scale and the PEDI Caregiver Assistance Scale. Results Results of the multiple regression analysis showed that the PEDI Functional Skills scale scores were correlated with the Box and Block Test in the dominant hand and GMFCS (Adjusted R2 = 0.69). The PEDI Caregiver Assistance Scale scores were correlated with the Box and Block Test in the dominant hand, GMFCS, and age (adjusted R2 = 0.71). Conclusion When considering self-care of children and adolescents with spastic CP, it is necessary to consider the evaluation of upper limb dysfunction in addition to GMFCS.
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Affiliation(s)
- Yasuaki Kusumoto
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima city, Fukushima, JP
- * E-mail:
| | - Kenji Takaki
- Faculty of Health Sciences, Department of Physical Therapy, Tokyo University of Technology, Ohta-ku, Tokyo, JP
| | - Tadamitsu Matsuda
- Faculty of Health Sciences, Department of Physical Therapy, Juntendo University, Bunkyo-ku, Tokyo, JP
| | - Osamu Nitta
- Faculty of Health Sciences, Department of Physical Therapy, Tokyo Metropolitan University, Arakawa-ku, Tokyo, JP
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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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Irwin LN, Soto EF, Chan ES, Miller CE, Carrington-Forde S, Groves NB, Kofler MJ. Activities of daily living and working memory in pediatric attention-deficit/hyperactivity disorder (ADHD). Child Neuropsychol 2021; 27:468-490. [PMID: 33459154 PMCID: PMC8035253 DOI: 10.1080/09297049.2020.1866521] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 12/15/2020] [Indexed: 10/22/2022]
Abstract
Most children with ADHD have impaired working memory abilities. These working memory deficits predict impairments in activities of daily living (ADLs) for adults with ADHD. However, our understanding of the relation between pediatric ADHD and ADLs is limited. Thus, this study aimed to examine (1) the extent to which pediatric ADHD is associated with ADL difficulties; and if so (2) the extent to which these difficulties are related to their well-documented working memory difficulties and/or core ADHD inattentive and hyperactive/impulsive symptom domains. A well-characterized, clinically evaluated sample of 141 children ages 8-13 years (M = 10.36, SD = 1.46; 51 girls; 70% White/non-Hispanic) were administered a battery of well-validated working memory tests and assessed for ADHD symptoms (teacher-ratings) and ADL difficulties (parent-ratings); cross-informant reports were used to control for mono-informant bias. Children with ADHD exhibited medium magnitude difficulties with ADLs (d = 0.61, p < .005, 38% impaired). Results of the bias-corrected, bootstrapped conditional effects model indicated that lower working memory predicted reduced performance of age-expected ADLs (β =0.28) and greater ADHD inattentive (β = -0.40) and hyperactive/impulsive symptoms (β = -0.16). Greater inattentive, but not hyperactive/impulsive, symptoms predicted greater ADL difficulties (β = -0.36) even after controlling for working memory. Interestingly, working memory exerted a significant indirect effect on ADLs via inattentive (indirect effect: β = 0.15, effect ratio = .54) but not hyperactive/impulsive symptoms. These findings implicate ADHD inattentive symptoms as a potential mechanism underlying ADL difficulties for children with ADHD, both independently and via working memory's role in regulating attention.
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Affiliation(s)
| | - Elia F. Soto
- Florida State University, Department of Psychology
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Amaral MF, Sampaio RF, Coster WJ, Souza MP, Mancini MC. Functioning of young patients with cerebral palsy: Rasch analysis of the pediatric evaluation of disability inventory computer adaptive test daily activity and mobility. Health Qual Life Outcomes 2020; 18:369. [PMID: 33208162 PMCID: PMC7672984 DOI: 10.1186/s12955-020-01624-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 11/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with cerebral palsy experience limitations in performing activities of daily living. Rehabilitation practitioners seek valid instruments to measure changes in the performance of those activities. The Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) is a new tool to assess functioning in children and youth with various health conditions. Its validity needs to be evaluated in a way that is consistent with the theoretical model on which it was based. We aimed to evaluate the fit of daily activity and mobility items and children with CP to the Rasch model and to compare the performance in daily activities and mobility of older children, adolescents, and young adults with CP based on manual function and gross motor function limitations. METHODS Eighty-three parents of children and youth of 8-20 years old (mean age: 11.6) with different severity levels of cerebral palsy participated in this study. Ninety-one items of the PEDI-CAT Daily Activities and Mobility domains were analyzed through Rasch analysis to evaluate relative item difficulty and participant ability. Participants were described according to the Manual Ability (MACS) (level I: 21.7%; II: 32.5%; III: 24.1%; IV: 7.2% and V: 3.6%) and the Gross Motor Function (GMFCS) (level I: 37.3%; II: 26.5%; III: 6%; IV: 18.1%; and V: 7.2%) classification systems levels. RESULTS Our data fit the Rasch Model. Parents had difficulty distinguishing some PEDI-CAT response categories. Participants from MACS and GMFCS levels IV and V showed lower ability to perform relatively more difficult items. There was a floor effect in both domains. Only 7.7% of the items presented differential item functioning when individuals with mild MACS and GMFCS levels (I, II) and moderate level (III) and individuals with moderate (III) and severe levels (IV, V) were compared. CONCLUSIONS PEDI-CAT daily activities and mobility domains are valid to evaluate children, adolescents and youth with CP of different severities, but the addition of items to these domains is recommended in order to address their floor effect.
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Affiliation(s)
- Maíra Ferreira Amaral
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais (UFMG), Avenida Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31270-010, Brazil.,Department of Occupational Therapy, Universidade Federal do Triângulo Mineiro (UFTM), Avenida Getúlio Guaritá, 159, Nossa Senhora da Abadia, Uberaba, MG, 38025-440, Brazil
| | - Rosana Ferreira Sampaio
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais (UFMG), Avenida Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31270-010, Brazil
| | - Wendy Jane Coster
- Department of Occupational Therapy, College of Health and Rehabilitation Sciences: Sargent College, Boston University, 635 Commonwealth Avenue, Boston, MA, 02215, USA
| | - Mariana Peixoto Souza
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais (UFMG), Avenida Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31270-010, Brazil
| | - Marisa Cotta Mancini
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais (UFMG), Avenida Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31270-010, Brazil.
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Geijen M, Rameckers E, Bastiaenen C, Gordon A, Smeets R. Construct Validity of a Task-Oriented Bimanual and Unimanual Strength Measurement in Children With Unilateral Cerebral Palsy. Phys Ther 2020; 100:2237-2245. [PMID: 32936866 PMCID: PMC7720643 DOI: 10.1093/ptj/pzaa173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 05/14/2020] [Accepted: 08/28/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purposes of this study were to (1) investigate aspects of construct validity of peak force measurements of crate-and-pitcher tasks using the Task-oriented Arm-hAnd Capacity (TAAC), an instrument designed to measure task-oriented arm and hand strength for cross-sectional and evaluation purposes, and (2) compare TAAC measurements with those of comparative measures using COSMIN guidelines. METHODS In this cross-sectional validity study, participants were 105 children (mean age = 12 years 10 months; number of boys = 66) diagnosed with unilateral cerebral palsy (UCP). Ten a priori hypotheses were formulated with peak force of the TAAC as index measure and compared with measures on body functions and structure and activity level of the International Classification of Functioning, Disability and Health for Children and Youth. Strength and direction of the relationship between the TAAC and comparative measures were investigated by calculating Pearson correlation coefficients (r). RESULTS On body functions and structures level, low-to-moderate positive correlations (0.493-0.687) were found. On activity level, low negative and positive correlations (-0.271 to 0.387) were found. CONCLUSION The construct of peak force measurement of the TAAC is in line with the a priori hypotheses with comparators on body function and structures and activity level, indicating a partial overlap of the construct of the TAAC with both International Classification of Functioning levels. The TAAC appears to be valuable, as it measures functional strength that differs from the constructs of the comparators. More research with a larger population and more comparators is needed. IMPACT Clinically relevant information is lacking about the use of strength and strength measurement during daily activities in children with UCP. This study shows that the TAAC provides unique information about functional strength in children with UCP.
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Affiliation(s)
| | - Eugene Rameckers
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University; Centre of Expertise in Rehabilitation and Audiology, Adelante, Hoensbroek, the Netherlands; and Rehabilitation Science, Pediatric Physical Therapy, Hasselt University, Hasselt, Belgium
| | | | - Andrew Gordon
- Department of Biobehavioral Science, Teachers College, Columbia University, New York, New York
| | - Rob Smeets
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University
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Assistive spectacles: A vision for the future. SOCIAL THEORY & HEALTH 2020. [DOI: 10.1057/s41285-020-00140-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Stadskleiv K. Cognitive functioning in children with cerebral palsy. Dev Med Child Neurol 2020; 62:283-289. [PMID: 32010976 DOI: 10.1111/dmcn.14463] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/06/2019] [Indexed: 01/24/2023]
Abstract
Children with cerebral palsy (CP) have an increased risk of cognitive impairments. This narrative review of the literature discusses assessment of cognition in children with CP, presents the most salient characteristics of cognitive functioning pertaining to each subtype, and discusses the relationships between brain injury, functioning, and intervention from a developmental perspective. A search for original studies of cognitive functioning in children with different subtypes of CP was performed. The search resulted in 81 unique hits. There were few studies with a representative sample of children with CP where all participants were individually assessed. Cognitive functioning in children with the most severe motor impairments were often assumed and not assessed. Furthermore, there was a confounding of IQ below 70 and intellectual disability, possibly leading to an overestimation of the prevalence of intellectual disability. Longitudinal neuropsychological studies, including also very young children and those with the most severe speech and motor impairments, as well as intervention studies, are called for. WHAT THIS PAPER ADDS: Few studies have assessed cognition in a representative sample of children with cerebral palsy. Cognition in children with severe motor impairment is often assumed, not assessed. Lack of assessment may lead to overestimating the prevalence of intellectual disability. Lowered cognitive functioning in older children highlights the need for longitudinal studies.
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Affiliation(s)
- Kristine Stadskleiv
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway.,Department of Educational Science, University of South-Eastern Norway, Vestfold, Norway
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Rast FM, Labruyère R. Letter to the editor on "Relationship between changes in motor capacity and objectively measured motor performance in ambulatory children with spastic cerebral palsy". Child Care Health Dev 2020; 46:247-248. [PMID: 32017230 DOI: 10.1111/cch.12742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 01/04/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Fabian M Rast
- Swiss Children's Rehab, University Children's Hospital, Zurich, Affoltern am Albis, Switzerland.,Children's Research Center, University Children's Hospital, Zurich, Switzerland
| | - Rob Labruyère
- Swiss Children's Rehab, University Children's Hospital, Zurich, Affoltern am Albis, Switzerland.,Children's Research Center, University Children's Hospital, Zurich, Switzerland
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26
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Kusumoto Y, Tsuchiya J, Watanabe Y, Umeda M, Matsuda T, Takaki K, Nitta O. Characteristics of dynamic standing balance with and without an insole in patients with spastic diplegia cerebral palsy. J Phys Ther Sci 2020; 32:23-26. [PMID: 32082023 PMCID: PMC7008017 DOI: 10.1589/jpts.32.23] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/17/2019] [Indexed: 01/17/2023] Open
Abstract
[Purpose] This study examined characteristics of dynamic standing balance, with an without an insole, in patients with spastic diplegia cerebral palsy (CP). [Participants and Methods] This cross-sectional study used a crossover design. Eleven patients with spastic diplegia CP and gross motor levels between I and III with spastic diplegia CP (according to the Gross Motor Function Classification System expanded and revised version) were randomly allocated to either the barefoot or insole groups. The Index of postural stability (IPS) was evaluated while each patient was barefoot and while wearing insoles. The Pediatric Evaluation of Disability Inventory (PEDI) was used to measure functional self-care and mobility domains. [Results] While wearing the insoles, the center movement distance between right and left positions was significantly higher. While barefoot, IPS and area of postural sway correlated with the PEDI subscales for mobility and self-care. [Conclusion] Insoles promote standing balance and dynamic balance to move the center of pressure within the base of support. Such improvements may enhance activities of daily living in patients with spastic diplegia CP.
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Affiliation(s)
- Yasuaki Kusumoto
- Department of Physical Therapy, Division of Health Science, Tokyo University of Technology: 5-23-22 Nishikamata, Ohta-ku, Tokyo 144-8635, Japan
| | - Junko Tsuchiya
- Department of Physical Therapy, Division of Health Science, Tokyo University of Technology: 5-23-22 Nishikamata, Ohta-ku, Tokyo 144-8635, Japan
| | - Yoshiteru Watanabe
- Department of Physical Therapy, Division of Health Science, Tokyo University of Technology: 5-23-22 Nishikamata, Ohta-ku, Tokyo 144-8635, Japan
| | - Masaru Umeda
- Department of Physical Therapy, Division of Health Science, Tokyo University of Technology: 5-23-22 Nishikamata, Ohta-ku, Tokyo 144-8635, Japan
| | - Tadamitsu Matsuda
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Japan
| | - Kenji Takaki
- Department of Physical Therapy, Faculty of Health Sciences, Mejiro University, Japan
| | - Osamu Nitta
- Tokyo Metropolitan University, Department of Physical Therapy, Faculty of Health Sciences, Tokyo Metropolitan University, Japan
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Kuo FL, Lee HC, Hsiao HY, Lin JC. Robotic-assisted hand therapy for improvement of hand function in children with cerebral palsy: a case series study. Eur J Phys Rehabil Med 2020; 56:237-242. [PMID: 31939267 DOI: 10.23736/s1973-9087.20.05926-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Most types of robot-assisted training (RT) have been used in Cerebral Palsy (CP) patients only focus on proximal upper extremity. Few of study investigated the effect of distal upper extremity training. CASE REPORT Pediatric CP patients (N.=7) participated the RT sessions for 6 weeks (12 60-min sessions 2 times a week). Performance was assessed at 3 time points (pretest, posttest, and 1-month follow-up). RT significantly improved in body structure and function domains: FMA-UE scores (P=0.002). On electromyography, significant improvements in the mean brachioradialis muscle amplitude (P=0.015) and electrical agonist-antagonist muscle ratio (P=0.041) in the 1-inch cube-grasping task. The effects were maintained after 1 month. CLINICAL REHABILITATION IMPACT RT using a Gloreha device which focuses on the distal part of the upper limb benefit on body structure and function, including upper-extremity motor function, brachioradialis muscle recruitment, and coordination in children with cerebral palsy.
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Affiliation(s)
- Fen-Ling Kuo
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsin-Chieh Lee
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Han-Yun Hsiao
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Jui-Chi Lin
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan -
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Wang J, Shi W, Khiati D, Shi B, Shi X, Luo D, Wang Y, Deng R, Huang H, Li J, Yan W, Yang H. Acupuncture treatment on the motor area of the scalp for motor dysfunction in children with cerebral palsy: study protocol for a multicenter randomized controlled trial. Trials 2020; 21:29. [PMID: 31907027 PMCID: PMC6945653 DOI: 10.1186/s13063-019-3986-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 12/11/2019] [Indexed: 01/09/2023] Open
Abstract
Background Scalp acupuncture has been widely used as treatment for motor dysfunction in children with cerebral palsy in China. Previous studies have failed to provide high-quality evidence to demonstrate the effectiveness of this treatment in children with cerebral palsy. No high-quality randomized controlled trials on scalp acupuncture have been published. The aim of this study is to evaluate the effectiveness of Jiao’s scalp acupuncture when combined with routine rehabilitation treatment versus routine rehabilitation treatment alone for motor dysfunction in children with cerebral palsy. Methods/Design This is a four-centre randomized controlled trial. One hundred cerebral palsy patients with motor dysfunction were enrolled. Patients will be allocated in a 1:1 ratio into either an acupuncture treatment group or a control group. Cerebral palsy patients in the control group will receive conventional rehabilitation treatment, whereas patients in the acupuncture group will receive a combination of scalp acupuncture and conventional rehabilitation treatment. Thirty-six treatment sessions will be performed over a 12-week period. The Gross Motor Function Measure and the Fine Motor Function Measure Scale will be assessed as the primary outcome measures. The Paediatric Evaluation of Disability Inventory and the Cerebral Palsy Quality of Life Questionnaire for Children will be selected as secondary outcome measures. All assessments will be conducted at baseline, week 4 (treatment 12), week 8 (treatment 24), week 12 (treatment 36) and week 24 (follow-up). Discussion This is the first trial evaluating the efficacy and safety of scalp acupuncture as a treatment for motor dysfunction in children with cerebral palsy. The results of this trial are expected to provide relevant evidence demonstrating that scalp acupuncture can be used as an effective rehabilitation treatment method for improving motor dysfunction in children with cerebral palsy. Trial registration ClinicalTrials.gov, NCT03921281. Registered on 19 April 2019.
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Affiliation(s)
- Jun Wang
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China
| | - Wei Shi
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China
| | - Dhiaedin Khiati
- School of Medicine, Royal College of Surgeons in Ireland - Medical University of Bahrain, Adilya, 15503, Bahrain
| | - Bingpei Shi
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China
| | - Xiaojuan Shi
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China
| | - Dandan Luo
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China
| | - Yin Wang
- Clinical Trial Unit, Children's Hospital, Fudan University, Shanghai, 201102, China
| | - Rencai Deng
- Department of Rehabilitation, The 445th Hospital of Chinese People's Liberation Army, Shanghai, 200052, China
| | - Huayu Huang
- Department of Rehabilitation, Huajing Community Health Service Centre of Xuhui District, Shanghai, 200231, China
| | - Jian Li
- Department of Rehabilitation, Jiangchuan Community Health Service Centre of Minhang District, Shanghai, 201100, China
| | - Weili Yan
- Clinical Trial Unit, Children's Hospital, Fudan University, Shanghai, 201102, China.
| | - Hong Yang
- Department of Rehabilitation, Children's Hospital, Fudan University, Shanghai, 201102, China.
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Abstract
PURPOSE To review the level of evidence of the psychometric properties of outcome measures for motor or functional skills for children with cerebral palsy classified across I to V levels of the Gross Motor Function Classification System. METHODS A systematic search was completed in PubMed/MEDLINE, ISI Web of Science, CINAHL, and 4 complementary databases. The COSMIN Risk of Bias checklist and the updated criteria for good measurement properties were applied to assess the quality. RESULTS Four outcome measures were identified from 12 articles: Gross Motor Function Measure, Gross Motor Performance Measure, Pediatric Evaluation of Disability Inventory, and Functional Independence Measure for Children. Evidence levels for validity, reliability, and responsiveness varied among measures. CONCLUSIONS Gross Motor Function Measure in all versions was the most investigated measure providing the best results, with the strongest evidence for validity and responsiveness properties. Reliability evidence should be improved to determine stability.
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30
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Russo RN, Skuza PP, Sandelance M, Flett P. Upper limb impairments, process skills, and outcome in children with unilateral cerebral palsy. Dev Med Child Neurol 2019; 61:1080-1086. [PMID: 30775778 PMCID: PMC6850156 DOI: 10.1111/dmcn.14185] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/26/2018] [Indexed: 11/28/2022]
Abstract
AIM To examine the relationships between upper limb impairments and independence in self-care (ISC) in children with unilateral cerebral palsy (CP). METHOD One hundred and eight children with unilateral CP (46 females, 62 males; mean age 8y 7mo, SD 3y 9mo) recruited from a population register were assessed for upper limb muscle power, spasticity, sensation, motor control, and process skills, and for ISC as the functional outcome using structural equation modelling. RESULTS The model showed good fit indices and explained 90% of the variance in ISC. Direct effects were significant between manual ability and ISC (β=0.47), and process skills and ISC (β=0.63). Sensation had a significant positive indirect effect on ISC through manual ability (β=0.24) and a positive but marginally non-significant indirect effect through process skills (β=0.21, bootstrapped 95% confidence interval -0.05 to 0.55). Spasticity had a significant negative indirect effect on ISC through its effect on manual ability (β=-0.21). Age had a significant positive indirect effect on ISC, as did intellect, through their effect on process skills (β=0.34 and 0.21 respectively). INTERPRETATION ISC is affected by upper limb impairments and process skill. Sensation influences ISC through its effects on manual and process skill abilities. Both sensation and process skills require further evaluation to assist ISC in children with unilateral CP. WHAT THIS PAPER ADDS Process skills and manual ability most strongly positively influence independence in self-care (ISC) in children with unilateral cerebral palsy. Sensation influences ISC through manual ability and process skill.
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Affiliation(s)
- Remo N Russo
- Paediatric Rehabilitation DepartmentWomen's and Children's Health NetworkWomen's and Children's HospitalNorth AdelaideSAAustralia,School of MedicineFlinders UniversityBedford ParkSAAustralia
| | - Pawel P Skuza
- Central LibraryFlinders UniversityBedford ParkSAAustralia
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31
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Schulze C, Meichtry A, Page J, Kottorp A. Psychometric properties of the German Version of the Pediatric Evaluation of Disability Inventory (PEDI-G): A factor analysis. Scand J Occup Ther 2019; 28:621-630. [PMID: 31155987 DOI: 10.1080/11038128.2019.1618392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Activities of daily living (ADL) are crucial for children because they enable them to participate in everyday life. For the evaluation of children`s ADL performance, health professionals such as occupational therapists use standardized ADL assessments. To implement assessments into practice it is important that the score generated from an assessment can be viewed as a unidimensional measure. AIM To investigate the factor structure of the German Pediatric Evaluation of Disability Inventory (PEDI-G) in a sample of typically developing children and children with an impairment. MATERIAL AND METHODS An exploratory factor analysis (EFA) with factor rotation was performed to assess the factor structure for the PEDI-G domains (self-care, mobility and social function) of the Functional Skills Scale and the Caregiver Assistance Scale. RESULTS 262 children (118 (45%) girls and 144 (55%) boys) participated in this study. Their mean age (SD) was 4 years (SD 1.91). Results suggest that the PEDI domains of the Functional Skills Scale and the Caregivers Assistance Scale can be used as unidimensional measures to evaluate child`s ability to perform activities of daily living. CONCLUSION The results of this study support the use of the PEDI-G for research and practice in Austria, Germany and Switzerland.
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Affiliation(s)
- Christina Schulze
- School of Health Professions, Zurich University of Applied Science, Winterthur, Switzerland.,Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Malmö University, Faculty of Health and Society, Malmö, Sweden
| | - André Meichtry
- School of Health Professions, Zurich University of Applied Science, Winterthur, Switzerland
| | - Julie Page
- School of Health Professions, Zurich University of Applied Science, Winterthur, Switzerland
| | - Anders Kottorp
- School of Health Professions, Zurich University of Applied Science, Winterthur, Switzerland.,Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Malmö University, Faculty of Health and Society, Malmö, Sweden
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Hoare BJ, Wallen MA, Thorley MN, Jackman ML, Carey LM, Imms C. Constraint-induced movement therapy in children with unilateral cerebral palsy. Cochrane Database Syst Rev 2019; 4:CD004149. [PMID: 30932166 PMCID: PMC6442500 DOI: 10.1002/14651858.cd004149.pub3] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Unilateral cerebral palsy (CP) is a condition that affects muscle control and function on one side of the body. Children with unilateral CP experience difficulties using their hands together secondary to disturbances that occur in the developing fetal or infant brain. Often, the more affected limb is disregarded. Constraint-induced movement therapy (CIMT) aims to increase use of the more affected upper limb and improve bimanual performance. CIMT is based on two principles: restraining the use of the less affected limb (for example, using a splint, mitt or sling) and intensive therapeutic practice of the more affected limb. OBJECTIVES To evaluate the effect of constraint-induced movement therapy (CIMT) in the treatment of the more affected upper limb in children with unilateral CP. SEARCH METHODS In March 2018 we searched CENTRAL, MEDLINE, Embase, CINAHL, PEDro, OTseeker, five other databases and three trials registers. We also ran citation searches, checked reference lists, contacted experts, handsearched key journals and searched using Google Scholar. SELECTION CRITERIA Randomised controlled trials (RCTs), cluster-RCTs or clinically controlled trials implemented with children with unilateral CP, aged between 0 and 19 years, where CIMT was compared with a different form of CIMT, or a low dose, high-dose or dose-matched alternative form of upper-limb intervention such as bimanual intervention. Primarily, outcomes were bimanual performance, unimanual capacity and manual ability. Secondary outcomes included measures of self-care, body function, participation and quality of life. DATA COLLECTION AND ANALYSIS Two review authors independently screened titles and abstracts to eliminate ineligible studies. Five review authors were paired to extract data and assess risk of bias in each included study. GRADE assessments were undertaken by two review authors. MAIN RESULTS We included 36 trials (1264 participants), published between 2004 and 2018. Sample sizes ranged from 11 to 105 (mean 35). Mean age was 5.96 years (standard deviation (SD) 1.82), range three months to 19.8 years; 53% male and 47% participants had left hemiplegia. Fifty-seven outcome measures were used across studies. Average length of CIMT programs was four weeks (range one to 10 weeks). Frequency of sessions ranged from twice weekly to seven days per week. Duration of intervention sessions ranged from 0.5 to eight hours per day. The mean total number of hours of CIMT provided was 137 hours (range 20 to 504 hours). The most common constraint devices were a mitt/glove or a sling (11 studies each).We judged the risk of bias as moderate to high across the studies. KEY RESULTS Primary outcomes at primary endpoint (immediately after intervention)CIMT versus low-dose comparison (e.g. occupational therapy)We found low-quality evidence that CIMT was more effective than a low-dose comparison for improving bimanual performance (mean difference (MD) 5.44 Assisting Hand Assessment (AHA) units, 95% confidence interval (CI) 2.37 to 8.51).CIMT was more effective than a low-dose comparison for improving unimanual capacity (Quality of upper extremity skills test (QUEST) - Dissociated movement MD 5.95, 95% CI 2.02 to 9.87; Grasps; MD 7.57, 95% CI 2.10 to 13.05; Weight bearing MD 5.92, 95% CI 2.21 to 9.6; Protective extension MD 12.54, 95% CI 8.60 to 16.47). Three studies reported adverse events, including frustration, constraint refusal and reversible skin irritations from casting.CIMT versus high-dose comparison (e.g. individualised occupational therapy, bimanual therapy)When compared with a high-dose comparison, CIMT was not more effective for improving bimanual performance (MD -0.39 AHA Units, 95% CI -3.14 to 2.36). There was no evidence that CIMT was more effective than a high-dose comparison for improving unimanual capacity in a single study using QUEST (Dissociated movement MD 0.49, 95% CI -10.71 to 11.69; Grasp MD -0.20, 95% CI -11.84 to 11.44). Two studies reported that some children experienced frustration participating in CIMT.CIMT versus dose-matched comparison (e.g. Hand Arm Bimanual Intensive Therapy, bimanual therapy, occupational therapy)There was no evidence of differences in bimanual performance between groups receiving CIMT or a dose-matched comparison (MD 0.80 AHA units, 95% CI -0.78 to 2.38).There was no evidence that CIMT was more effective than a dose-matched comparison for improving unimanual capacity (Box and Blocks Test MD 1.11, 95% CI -0.06 to 2.28; Melbourne Assessment MD 1.48, 95% CI -0.49 to 3.44; QUEST Dissociated movement MD 6.51, 95% CI -0.74 to 13.76; Grasp, MD 6.63, 95% CI -2.38 to 15.65; Weightbearing MD -2.31, 95% CI -8.02 to 3.40) except for the Protective extension domain (MD 6.86, 95% CI 0.14 to 13.58).There was no evidence of differences in manual ability between groups receiving CIMT or a dose-matched comparison (ABILHAND-Kids MD 0.74, 95% CI 0.31 to 1.18). From 15 studies, two children did not tolerate CIMT and three experienced difficulty. AUTHORS' CONCLUSIONS The quality of evidence for all conclusions was low to very low. For children with unilateral CP, there was some evidence that CIMT resulted in improved bimanual performance and unimanual capacity when compared to a low-dose comparison, but not when compared to a high-dose or dose-matched comparison. Based on the evidence available, CIMT appears to be safe for children with CP.
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Affiliation(s)
- Brian J Hoare
- Monash Children's HospitalVictorian Paediatric Rehabilitation Service246 Clayton RdClaytonVictoriaAustralia3168
| | - Margaret A Wallen
- Australian Catholic UniversitySchool of Allied Health, Faculty of Health SciencesNorth SydneyAustralia
| | - Megan N Thorley
- Royal Children's HospitalRehabilitationHerston RoadBrisbaneQueenslandAustralia4006
| | - Michelle L Jackman
- John Hunter Children's HospitalPaediatric Occupational TherapyLambton RoadNew LambtonNew South WalesAustralia2310
| | - Leeanne M Carey
- Florey Institute of Neuroscience and Mental Health, The University of MelbourneNeurorehabilitation and Recovery, Stroke DivisionMelbourneVictoriaAustralia3081
| | - Christine Imms
- Australian Catholic UniversityCentre for Disability & Development ResearchLevel 2, Daniel Mannix Building17 Young StreetMelbourneVictoriaAustralia3065
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Romli MH, Wan Yunus F, Mackenzie L. Overview of reviews of standardised occupation-based instruments for use in occupational therapy practice. Aust Occup Ther J 2019; 66:428-445. [PMID: 30821362 DOI: 10.1111/1440-1630.12572] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Using standardised instruments is one approach to support evidence-based practice. Referring to systematic reviews is an option to identify suitable instruments. However, with an abundance of systematic reviews available, therapists are challenged to identify an appropriate instrument to use. Therefore, this overview of reviews aimed to summarise relevant systematic review findings about standardised occupation-based instruments relevant for occupational therapy practice. METHODS An overview of reviews was conducted. A systematic search was performed on four databases up to March 2018. Included systematic reviews were analysed for quality using A MeaSurement Tool to Assess systematic Reviews (AMSTAR). RESULTS A total of 2187 articles were identified after removing duplicates. Ultimately, 58 systematic reviews were identified that yielded 641 instruments. From those, 45 instruments were selected for appraisal as they met the inclusion criteria of being developed mainly by occupational therapists and were recommended in the summarised findings from the systematic reviews. The instruments were classified according to the following occupation domains: (i) multidimensional, (ii) activities of daily living, (iii) productivity, (iv) social, (v) sleep/rest, (vi) sexuality and (vii) spirituality. No systematic review was identified that specifically focussed on occupations related to school/education, leisure and play. DISCUSSION Certain occupation domains such as activities of daily living, social and sleep/rest received high attention amongst researchers. There is a need for systematic reviews of instruments to measure education/school, play and leisure. Limited numbers of instruments were developed by occupational therapists outside the occupation domain of activities of daily living, and in areas of practice other than children and older people. Nevertheless, this overview can give some guidance for occupational therapists in selecting a suitable occupational therapy instrument for practice.
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Affiliation(s)
- Muhammad Hibatullah Romli
- Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.,Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Farahiyah Wan Yunus
- Occupational Therapy Programme, Faculty of Health Sciences, Centre for Rehabilitation and Special Needs, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus, University of Sydney, Lidcombe, New South Wales, Australia
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Interrater Reliability of Activity Questionnaires After an Intensive Motor-Skill Learning Intervention for Children With Cerebral Palsy. Arch Phys Med Rehabil 2019; 100:1655-1662. [PMID: 30790557 DOI: 10.1016/j.apmr.2018.12.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 12/07/2018] [Accepted: 12/17/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the reliability of parents-reported activity questionnaires after a motor-skill learning intervention for children with cerebral palsy (CP). We hypothesize that the intervention process might influence parental judgment. DESIGN Double-blind randomized trial. SETTING Conventional therapy was delivered in the usual context while intensive intervention was provided at the Catholic University of Louvain. PARTICIPANTS Children with CP (N=41; age range 5-18y, Gross Motor Function Classification System I-IV) were randomized to a control group (CG) (n=21, 2 dropouts) receiving conventional therapy or an intervention group (IG) (n=20) receiving hand-arm bimanual intensive therapy-including lower extremities (HABIT-ILE). INTERVENTIONS Conventional therapy (mostly neurodevelopmental) was delivered as ongoing treatment (1-5 times/wk). HABIT-ILE, based on motor-skill learning, was delivered over 2 weeks. All children were assessed at T1 (baseline), T2 (3wk after baseline) and T3 (4mo after baseline). MAIN OUTCOMES MEASURES ABILHAND-Kids and ACTIVLIM-CP questionnaires rated by parents (perception) and 2 examiners (videotapes). RESULTS Agreement (level/range) between examiners was systematically almost perfect (P≤.001). At baseline, moderate to almost perfect agreement (level/range) was observed between parents and examiners (P≤.001). At T2 and T3, a similar agreement (level/range) was observed for the CG. For the IG, a similar level of agreement was observed, but the range of agreement varied from poor to almost perfect (P≤.001), with parents estimating higher performance measures compared to examiners after intervention. Higher performance was associated with higher satisfaction scores of the child's functional goals at T3. CONCLUSION Parents and examiners have a similar perception of the child's performance at baseline and during conventional therapy. Their perceptions are less congruent after a motor-skill learning intervention, probably due to the goal-oriented process of the intervention. Therefore, our results favor the use of blind observations of home-videotaped items after intensive motor-skill learning interventions.
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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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Elad D, Barak S, Silberg T, Brezner A. Sense of autonomy and daily and scholastic functioning among children with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 80:161-169. [PMID: 30029069 DOI: 10.1016/j.ridd.2018.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 04/17/2018] [Accepted: 06/19/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND There is growing evidence that children's sense of autonomy is an important psychological need closely linked with the development of self-esteem and motivation. Among children with physical disabilities, motor or cognitive limitations may negatively affect child's sense of autonomy (CSA) and competency. PURPOSE To examine how sense of autonomy among children with cerebral palsy (CP) directly and indirectly relates to their activity of daily living (ADL) and scholastic performance. METHODS Seventy-three children with CP and their mothers participated in this study. Child's ADL skills and scholastic performance were assessed using the Pediatric Evaluation Disability Inventory (PEDI) and the Scholastic Skills Rating Scale (SSRS), respectively. Level of impairment was assessed using the Gross Motor Function Measure-66 (GMFM-66). CSA was established via videotaped mother-child interactions. Regression analyses were conducted to examine factors predicting child's functional level (ADL and scholastic). The overall model was tested for goodness-of-fit and test of mediation. RESULTS GMFM and CSA significantly predicted child's ADL and scholastic functioning. GMFM explained 15% of the variance for CSA, 84% for PEDI, and 24% for scholastic functioning. CSA positively mediated the association between GMFM and child's ADL skills. GMFM was positively associated with CSA. CONCLUSION Motor impairment has a substantial impact on child's level of functioning. However, child's functioning is a complex construct that is also affected by her or his sense of autonomy. Therefore, sense of autonomy can serve as a potential point of intervention to improve functioning among children with CP.
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Affiliation(s)
- Dina Elad
- The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Sharon Barak
- The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat Gan, Israel; Kaye Academic College of Education, Ber-Sheva, Ramat Gan, Israel.
| | - Tamar Silberg
- The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat Gan, Israel; The Department of Psychology, Bar Ilan University, Ramat Gan, Israel
| | - Amichai Brezner
- The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat Gan, Israel
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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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Kramer JM, Schwartz AE. Development of the Pediatric Disability Inventory-Patient Reported Outcome (PEDI-PRO) measurement conceptual framework and item candidates. Scand J Occup Ther 2018; 25:335-346. [PMID: 30280615 PMCID: PMC6377807 DOI: 10.1080/11038128.2018.1502344] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 02/19/2018] [Accepted: 03/15/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND To address the gap in patient reported outcome measures (PROMs) of functional performance appropriate for youth and young adults with developmental disabilities (DD) we developed the Pediatric Evaluation of Disability Inventory-Patient Reported Outcome (PEDI-PRO). AIM/OBJECTIVE We used a participatory process to: (1) Develop the measurement conceptual framework; (2) Identify discrete functional tasks to include in the PEDI-PRO; and (3) Refine item candidates. METHODS We collaborated with eight youth with DD over 33 months. These youth and university researchers explored the construct of functional performance, developed and refined items, and collected and analyzed data. We also conducted focus groups with youth with DD (n = 62) and rehabilitation professionals (n = 26), and consulted with PEDI measurement experts (n = 3). RESULTS Youth's understanding of their functional performance is embedded in their experiences participating in everyday life situations. We developed 78 Daily Activities, 65 Social/Cognitive, and 52 Mobility item candidates that are linked to 11 everyday life situations to assess discrete functional tasks important to youth with DD and rehabilitation professionals. CONCLUSION AND IMPLICATIONS As a result of our participatory development process, the PEDI-PRO's proposed conceptual framework and item candidates are grounded in the lived experience of youth with DD.
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Affiliation(s)
- Jessica M Kramer
- a Department of Occupational Therapy, College of Health and Rehabilitation Sciences, Sargent College , Boston University , Boston , MA , USA
| | - Ariel E Schwartz
- a Department of Occupational Therapy, College of Health and Rehabilitation Sciences, Sargent College , Boston University , Boston , MA , USA
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Schwartz AE, Kramer JM, Longo AL. Patient-reported outcome measures for young people with developmental disabilities: incorporation of design features to reduce cognitive demands. Dev Med Child Neurol 2018; 60:173-184. [PMID: 29171008 PMCID: PMC5771952 DOI: 10.1111/dmcn.13617] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/11/2017] [Indexed: 11/29/2022]
Abstract
UNLABELLED Use of patient-reported outcome measures (PROMs) may increase the involvement of young people with developmental disabilities in their healthcare decisions and healthcare-related research. Young people with developmental disabilities may have difficulty completing PROMs because of extraneous assessment demands that require additional cognitive processes. However, PROM design features may mitigate the impact of these demands. We identified and evaluated six pediatric PROMs of self-care and domestic life tasks for the incorporation of suggested design features that can reduce cognitive demands. PROMs incorporated an average of 6 out of 11 content, 7 out of 14 layout, and 2 out of 9 administration features. This critical review identified two primary gaps in PROM design: (1) examples and visuals were not optimized to reduce cognitive demands; and (2) administration features that support young people's motivation and self-efficacy and reduce frustration were underutilized. Because assessment demands impact the validity of PROMs, clinicians should prospectively consider the impact of these demands when selecting PROMs and interpreting scores. WHAT THIS PAPER ADDS Patient-reported outcome measure (PROM) design features can reduce assessment demands related to cognitive processes. Pediatric PROMs underutilize design features that decrease cognitive demands of self-reporting.
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Affiliation(s)
- Ariel E. Schwartz
- PhD Program in Rehabilitation Sciences, Boston University, Boston, MA
| | - Jessica M. Kramer
- Department of Occupational Therapy, Boston University, Boston, MA, USA
| | - Angela L. Longo
- Department of Occupational Therapy, Boston University, Boston, MA, USA
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Goh YR, Choi JY, Kim SA, Park J, Park ES. Comparisons of severity classification systems for oropharyngeal dysfunction in children with cerebral palsy: Relations with other functional profiles. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 72:248-256. [PMID: 29223113 DOI: 10.1016/j.ridd.2017.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 10/02/2017] [Accepted: 12/01/2017] [Indexed: 05/28/2023]
Abstract
This study aimed to investigate the relationships between various classification systems assessing the severity of oropharyngeal dysphagia and communication function and other functional profiles in children with cerebral palsy (CP). This is a prospective, cross-sectional, study in a university-affiliated, tertiary-care hospital. We recruited 151 children with CP (mean age 6.11 years, SD 3.42, range 3-18yr). The Eating and Drinking Ability Classification System (EDACS) and the dysphagia scales of Functional Oral Intake Scale (FOIS), Swallow Function Scales (SFS), and Food Intake Level Scale (FILS) were used. The Communication Function Classification System (CFCS) and Viking Speech Scale (VSS) were employed to classify communication function and speech intelligibility, respectively. The Pediatric Evaluation of Disability Inventory (PEDI) with the Gross Motor Function Classification System (GFMCS) and the Manual Ability Classification System (MACS) level were also assessed. Spearman correlation analysis to investigate the associations between measures and univariate and multivariate logistic regression models to identify significant factors were used. Median GMFCS level of participants was III (interquartile range II-IV). Significant dysphagia based on EDACS level III-V was noted in 23 children (15.2%). There were strong to very strong relationships between the EDACS level with the dysphagia scales. The EDACS presented strong associations with MACS, CFCS, and VSS, a moderate association with GMFCS level, and a moderate to strong association with each domain of the PEDI. In multivariate analysis, poor functioning in EDACS were associated with poor functioning in gross motor and communication functions.
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Affiliation(s)
- Yu-Ra Goh
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ja Young Choi
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seon Ah Kim
- Department of Pediatric Occupational Therapy, Severance Rehabilitation Hospital, Seoul, Republic of Korea
| | - Jieun Park
- Department of Rehabilitation Speech-Language Therapy, Severance Rehabilitation Hospital, Seoul, Republic of Korea
| | - Eun Sook Park
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Tatla SK, Holsti L, Andrews GS, Feichtinger L, Steele R, Siden H. Charting the territory: Describing the functional abilities of children with progressive neurological conditions. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 71:191-199. [PMID: 29054023 DOI: 10.1016/j.ridd.2017.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 09/15/2017] [Accepted: 10/02/2017] [Indexed: 06/07/2023]
Abstract
AIMS Little is known about the functional abilities of children with progressive genetic, metabolic, or neurological conditions (PNCs). In this study, children with PNCs were followed over a 2-year period to assess their functional abilities over time. Specific aims were to: 1) describe the changes in functional skills and the effects of age for children with PNCs, 2) assess changes in these children's need for caregiver assistance over time, and 3) examine relationships between these children's functional skills and need for caregiver assistance. METHODS This study involved a longitudinal, descriptive design with three assessments occurring at Baseline, Year 1, Year 2. Functional skills and caregiver assistance were assessed by the Pediatric Evaluation of Disability Inventory (PEDI). The PEDI questionnaire was completed at baseline and then yearly by parents, along with the assistance of a trained research assistant (RA). RESULTS The study was completed with 83 children (mean age at Baseline=7.1yrs, SD=4.6). Mean Functional skills scores were in the low ranges at Baseline and did not change significantly across time points (F(2, 71)=0.437, p=0.58). Time point had no effect on caregiver assistance ratings (p<0.2); however, children required greater amounts of help with self-care at later time points than for other functional domains. Statistically significant correlations were found between PEDI-Functional skills and caregiver assistance ratings (r=0.80-0.90, p<0.01). CONCLUSIONS Functional skills were low for these children overall, irrespective of age. In children with PNCs: 1) mean functional skills did not change significantly over time; 2) caregiver assistance scores remained stable and 3) functional skills and levels of caregiver assistance were strongly positively correlated. Further research to explore the long-term functional trajectory in children with a PNC is recommended.
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Affiliation(s)
- Sandy K Tatla
- BC Children's and Women's Health Centre, BC Children's Hospital Research Institute, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada.
| | - Liisa Holsti
- Department of Occupational Science and Occupational Therapy, University of British Columbia and BC Children's Hospital Research Institute, Clinical Support Building, V3-327, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada.
| | - Gail Stephanie Andrews
- University of British Columbia, BC Children's Hospital Research Institute, F611-4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.
| | - Leanne Feichtinger
- University of British Columbia, BC Children's Hospital Research Institute, F611-4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.
| | - Rose Steele
- School of Nursing, Faculty of Health, York University, Room 342 HNES Building, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
| | - Harold Siden
- Department of Pediatrics, University of British Columbia, BC Children's Hospital Research Institute, F612a-4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.
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Zhang B, Zhu Y, Jiang C, Li C, Li Y, Bai Y, Wu Y. Effects of Transcutaneous Electrical Acupoint Stimulation on Motor Functions and Self-Care Ability in Children with Cerebral Palsy. J Altern Complement Med 2017; 24:55-61. [PMID: 28767271 DOI: 10.1089/acm.2016.0111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To observe the effects of transcutaneous electrical acupoint stimulation (TEAS) in improving motor functions and self-care abilities in children with cerebral palsy in their early childhood. DESIGN A preliminary, prospective, cohort study. SETTINGS/LOCATION Multicenter. SUBJECTS Children aged 2-6 years old. INTERVENTIONS Twenty-three children were included in the study and randomly assigned to a control group ([CG] N = 11) or a therapeutic group ([TG] N = 12). In the TG, children were treated with TEAS (Shousanli [LI10] and Waiguan [SJ5]) plus the exercise therapy, while in the control group, they were treated with sham TEAS plus exercise therapy. Therapies were performed five days per week for eight weeks. OUTCOME MEASURES The Gross Motor Function Measure (GMFM) and the Functional Independent Measurement for children (WeeFIM) were used to evaluate motor functions and self-care abilities before and after the therapies. RESULTS Greater improvements were observed in the TG concerning all the measurements, although without statistical differences. The increments of the GMFM score and the WeeFIM motor, self-care and total scores were 36.08 ± 18.34 (26%), 16.17 ± 8.21 (33%), 7.67 ± 3.42 (40%) and 20.33 ± 10.08 (28%) in the TG, while 22.73 ± 16.54 (17%), 9.09 ± 9.43 (19%), 5.64 ± 6.73 (29%) and 12.82 ± 11.77 (18%) in the CG, respectively. No statistically significant correlations were shown between functional improvements and the demographics in the TG or the CG. The GMFM improvement was not statistically correlated with the improvements of the WeeFIM motor, self-care or total scores. However, the WeeFIM motor, self-care and total score were significantly positively correlated with one another in both groups (P < 0.01). No adverse effect was recorded during the study. CONCLUSION TEAS may be effective in improving motor functions and self-care abilities in children with cerebral palsy, in addition to conventional exercise therapy. Larger samples are required to confirm the efficacies.
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Affiliation(s)
- Bei Zhang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University , Shanghai, People's Republic of China
| | - Yulan Zhu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University , Shanghai, People's Republic of China
| | - Congyu Jiang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University , Shanghai, People's Republic of China
| | - Ce Li
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University , Shanghai, People's Republic of China
| | - Yingying Li
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University , Shanghai, People's Republic of China
| | - Yulong Bai
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University , Shanghai, People's Republic of China
| | - Yi Wu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University , Shanghai, People's Republic of China
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Schiariti V, Tatla S, Sauve K, O'Donnell M. Toolbox of multiple-item measures aligning with the ICF Core Sets for children and youth with cerebral palsy. Eur J Paediatr Neurol 2017; 21:252-263. [PMID: 27864012 DOI: 10.1016/j.ejpn.2016.10.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 10/06/2016] [Accepted: 10/20/2016] [Indexed: 10/20/2022]
Abstract
Selecting appropriate measure(s) for clinical and/or research applications for children and youth with Cerebral Palsy (CP) poses many challenges. The newly developed International Classification of Functioning, Disability and Health (ICF) Core Sets for children and youth with CP serve as universal guidelines for assessment, intervention and follow-up. The aims of this study were: 1) to identify valid and reliable measures used in studies with children and youth with CP, 2) to characterize the content of each measure using the ICF Core Sets for children and youth with CP as a framework, and finally 3) to create a toolbox of psychometrically sound measures covering the content of each ICF Core Set for children and youth with CP. All clearly defined multiple-item measures used in studies with CP between 1998 and 2015 were identified. Psychometric properties were extracted when available. Construct of the measures were linked to the ICF Core Sets. Overall, 83 multiple-item measures were identified. Of these, 68 measures (80%) included reliability and validity testing. The majority of the measures were discriminative, generic and designed for school-aged children. The degree to which measures with proven psychometric properties represented the ICF Core Sets for children and youth with CP varied considerably. Finally, 25 valid and reliable measures aligned highly with the content of the ICF Core Sets, and as such, these measures are proposed as a novel ICF Core Sets-based toolbox of measures for CP. Our results will guide professionals seeking appropriate measures to meet their research and clinical needs worldwide.
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Affiliation(s)
- Verónica Schiariti
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, V6H 3V4, Canada; Division of Medical Sciences, University of Victoria, PO Box 1700 STN CSC, Victoria, British Columbia, V8W 2Y2, Canada.
| | - Sandy Tatla
- BC Children's Hospital, 4480 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada
| | - Karen Sauve
- BC Children's Hospital, 4480 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada
| | - Maureen O'Donnell
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, V6H 3V4, Canada; BC Children's Hospital, 4480 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada
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Park MO. Effects of gross motor function and manual function levels on performance-based ADL motor skills of children with spastic cerebral palsy. J Phys Ther Sci 2017; 29:345-348. [PMID: 28265171 PMCID: PMC5333002 DOI: 10.1589/jpts.29.345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 11/14/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to determine effects of Gross Motor Function
Classification System and Manual Ability Classification System levels on performance-based
motor skills of children with spastic cerebral palsy. [Subjects and Methods] Twenty-three
children with cerebral palsy were included. The Assessment of Motor and Process Skills was
used to evaluate performance-based motor skills in daily life. Gross motor function was
assessed using Gross Motor Function Classification Systems, and manual function was
measured using the Manual Ability Classification System. [Results] Motor skills in daily
activities were significantly different on Gross Motor Function Classification System
level and Manual Ability Classification System level. According to the results of multiple
regression analysis, children categorized as Gross Motor Function Classification System
level III scored lower in terms of performance based motor skills than Gross Motor
Function Classification System level I children. Also, when analyzed with respect to
Manual Ability Classification System level, level II was lower than level I, and level III
was lower than level II in terms of performance based motor skills. [Conclusion] The
results of this study indicate that performance-based motor skills differ among children
categorized based on Gross Motor Function Classification System and Manual Ability
Classification System levels of cerebral palsy.
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Affiliation(s)
- Myoung-Ok Park
- Department of Occupational Therapy, Division of Health Science, Baekseok University: 76 Munam-ro, Dongnam-gu, Cheonan-si, Chungcheongnam-do, Republic of Korea
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Abstract
Orthopedic surgery (OS) plays an important role in the management of cerebral palsy (CP). The objectives of OS are to optimize functions and prevent deformity. Newer developments in OS for CP include emphasis on hip surveillance, minimally invasive procedures, use of external fixators instead of plates and screws, better understanding of lever arm dysfunctions (that can only be corrected by bony OS), orthopedic selective spasticity-control surgery, and single-event multilevel lever arm restoration and anti spasticity surgery, which have led to significant improvements in gross motor function and ambulation, especially in spastic quadriplegia, athetosis, and dystonia. The results of OS can be dramatic and life altering for the person with CP and their caregivers if it is performed meticulously by a specialized surgical team, at the appropriate age, for the correct indications, employing sound biomechanical principles and is followed by physician-led, protocol based, intensive, multidisciplinary, institutional rehabilitation, and long term followup. However, OS can be a double-edged sword, and if performed less than optimally, and without the supporting multidisciplinary medical and rehabilitation team, expertise and infrastructure, it often leads to significant functional worsening of the person with CP, including irretrievable loss of previous ambulatory capacity. OS must be integrated into the long term management of the person with CP and should be anticipated and planned at the optimal time and not viewed as a "last resort" intervention or failure of rehabilitation. This instructional course lecture reviews the relevant contemporary principles and techniques of OS in CP.
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Affiliation(s)
- Deepak Sharan
- Department of Pediatric Orthopedics and Rehabilitation, RECOUP Neuromusculoskeletal Rehabilitation Centre, Bengaluru, Karnataka, India,Address for correspondence: Dr. Deepak Sharan, Department of Pediatric Orthopedics and Rehabilitation, RECOUP Neuromusculoskeletal Rehabilitation Centre, 312, Further Extension of Anjanapura Layout, 10th Block, Bengaluru - 560 108, Karnataka, India. E-mail:
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Schulze C, Page J, Lilja M, Kottorp A. Cross-cultural validity of the German version of the Pediatric Evaluation of Disability Inventory (PEDI-G)-a Rasch model application. Child Care Health Dev 2017; 43:48-58. [PMID: 27592707 DOI: 10.1111/cch.12401] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 07/17/2016] [Accepted: 08/01/2016] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to evaluate the cross-cultural validity of the German version of the Pediatric Evaluation of Disability Inventory (PEDI-G) when used in Austria, Germany and Switzerland. METHOD A total of 118 girls and 144 boys participated in this study; 198 of the children (75.6%) had a developmental disability and 64 (24.4%) were without a known disability. The mean age was four years (range 11 months to 10 years and six months, SD 1.91). Item goodness of fit, differential item functioning (DIF) and differential test functioning (DTF) were evaluated by use of a Rasch model. RESULTS Twenty-four (11.6%) out of 206 items of the Functional Skills Scale and one (5%) out of 20 items of the Caregiver Assistance Scale demonstrated misfit according to the Rasch model. Thirty-four (16.5%) out of 206 items of the Functional Skills Scale and no item from the Caregiver Assistance Scale demonstrated DIF. Almost half (46%) of the items demonstrating misfit also demonstrated DIF, indicating an association between them. The DIF by country only demonstrated a minimal impact on the person measures of the PEDI-G. INTERPRETATION Even though some items did not meet the statistical and clinical criteria set, the PEDI-G can be used, on a preliminary basis as a valid tool to measure activities of daily living of children with and without a disability in these countries. Further larger studies are needed to evaluate more psychometric item properties of the PEDI-G in relation to context.
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Affiliation(s)
- C Schulze
- Zurich University of Applied Science, School of Health Professions, Institute of Occupational Therapy, Research and Development, Winterthur, Switzerland.,Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Stockholm, Sweden
| | - J Page
- Zurich University of Applied Science, School of Health Professions, Institute of Occupational Therapy, Research and Development, Winterthur, Switzerland
| | - M Lilja
- Luleå University of Technology, Department of Health Sciences, Luleå, Sweden
| | - A Kottorp
- Zurich University of Applied Science, School of Health Professions, Institute of Occupational Therapy, Research and Development, Winterthur, Switzerland.,Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Stockholm, Sweden.,University of Illinois at Chicago, Department of Occupational Therapy, Chicago, IL, USA
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Sakzewski L, Lewis M, Ziviani J. Test-retest reproducibility of the Assessment of Motor and Process Skills for school-aged children with acquired brain injuries. Scand J Occup Ther 2016; 24:161-166. [PMID: 26980287 DOI: 10.3109/11038128.2016.1152296] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background Persistent impairments resulting from childhood acquired brain injury (ABI) can impact performance of activities of daily living (ADL). Objective and reliable measures of ADL skills are required for treatment planning and research. Aim To evaluate test-retest reproducibility of the Assessment of Motor and Process Skills (AMPS) for children with ABI. Methods Twenty-eight children with ABI (mean age 11 years 7 months, SD 2 years 4 months; males = 11) were recruited. Two AMPS tasks were performed over two consecutive days, as per standardized AMPS procedures. Intraclass correlation coefficients (ICC; 2,1), standard error of measurement (SEM), smallest detectable difference (SDD), and 95% limits of agreement (Bland-Altman) were calculated. Results Test-retest reliability was fair to good for AMPS ADL motor (ICC 0.55) and ADL process (ICC 0.58) measures. The SEM was 0.36 and 0.34 logits for AMPS ADL motor and ADL process measures respectively. The SDD was 1.0 (motor) and 0.93 logits (process) measures. A learning effect was evident. Conclusion Test-retest reproducibility of the AMPS was fair to good for children with ABI, which is poorer than previously published data. Administration of the AMPS in an unfamiliar environment, fatigue, and the small time interval between testing sessions may have contributed to poorer results. The AMPS remains a useful measure of ADL, contributing to our understanding of task execution processes.
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Affiliation(s)
- Leanne Sakzewski
- a Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland , Brisbane , Australia
| | - Melinda Lewis
- b Lady Cilento Children's Hospital , Brisbane , Australia
| | - Jenny Ziviani
- c School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Australia.,d Children's Allied Health Research, Children's Health Queensland , Brisbane , Australia
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Cordier R, Chen YW, Speyer R, Totino R, Doma K, Leicht A, Brown N, Cuomo B. Child-Report Measures of Occupational Performance: A Systematic Review. PLoS One 2016; 11:e0147751. [PMID: 26808674 PMCID: PMC4726555 DOI: 10.1371/journal.pone.0147751] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 01/07/2016] [Indexed: 11/18/2022] Open
Abstract
Introduction Improving occupational performance is a key service of occupational therapists and client-centred approach to care is central to clinical practice. As such it is important to comprehensively evaluate the quality of psychometric properties reported across measures of occupational performance; in order to guide assessment and treatment planning. Objective To systematically review the literature on the psychometric properties of child-report measures of occupational performance for children ages 2–18 years. Methods A systematic search of the following six electronic databases was conducted: CINAHL; PsycINFO; EMBASE; PubMed; the Health and Psychosocial Instruments (HAPI) database; and Google Scholar. The quality of the studies was evaluated against the COSMIN taxonomy of measurement properties and the overall quality of psychometric properties was evaluated using pre-set psychometric criteria. Results Fifteen articles and one manual were reviewed to assess the psychometric properties of the six measures–the PEGS, MMD, CAPE, PAC, COSA, and OSA- which met the inclusion criteria. Most of the measures had conducted good quality studies to evaluate the psychometric properties of measures (PEGS, CAPE, PAC, OSA); however, the quality of the studies for two of these measures was relatively weak (MMD, COSA). When integrating the quality of the psychometric properties of the measures with the quality of the studies, the PAC stood out as having superior psychometric qualities. Conclusions The overall quality of the psychometric properties of most measures was limited. There is a need for continuing research into the psychometric properties of child-report measures of occupational performance, and to revise and improve the psychometric properties of existing measures.
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Affiliation(s)
- Reinie Cordier
- School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia
- * E-mail:
| | - Yu-Wei Chen
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Renée Speyer
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia
| | - Rebekah Totino
- School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia
| | - Kenji Doma
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia
| | - Anthony Leicht
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia
| | - Nicole Brown
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia
| | - Belinda Cuomo
- School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia
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49
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James S, Ziviani J, Ware RS, Boyd RN. Test-retest Reproducibility of the Assessment of Motor and Process Skills in Children with Unilateral Cerebral Palsy. Phys Occup Ther Pediatr 2016; 36:144-54. [PMID: 26606274 DOI: 10.3109/01942638.2015.1076555] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS To examine test-retest reproducibility of the Assessment of Motor and Process Skills (AMPS) in children aged 8-16 years with unilateral cerebral palsy (UCP). METHODS Thirty children with mild to moderate UCP (mean age = 11y 7m, SD 2y 4m; males = 18; Manual Ability Classification System level I = 10, II = 20; Gross Motor Function Classification System level I = 9, II = 21) enrolled in a large randomized controlled trial were recruited via consecutive series sampling. Children carried out two AMPS tasks over two consecutive days according to standardized AMPS administration procedures. The standard error of measurement (SEM), smallest detectable change (SDC), 95% limits of agreement using the Bland-Altman method, and intraclass correlation coefficients (ICC; 2,1) were calculated. RESULTS The SDC was 0.23 logits for the AMPS motor scale and 0.30 logits for the AMPS process scale. Test-retest reliability was excellent for both the AMPS motor scale (ICC = 0.93) and the AMPS process scale (ICC = 0.86). Intra-rater reliability (n = 10) was excellent for AMPS motor scale (ICC = 0.96) and AMPS process scale (ICC = 0.98). CONCLUSIONS The AMPS can be used by therapists with 8- to 16-year-old children with UCP as an outcome measure with changes in scores reflecting real changes in performance or capacity.
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Affiliation(s)
- Sarah James
- a Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Royal Children's Hospital , Brisbane , QLD , Australia
| | - Jenny Ziviani
- b Children's Allied Health Research, Queensland Health , Brisbane , QLD , Australia.,c School of Health and Rehabilitation Sciences, The University of Queensland , Brisbane , QLD , Australia
| | - Robert S Ware
- d School of Population Health, The Univers of Queensland , Brisbane , QLD , Australia.,e Queensland Children's Medical Research Institute, The University of Queensland , Brisbane , QLD , Australia
| | - Roslyn N Boyd
- a Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Royal Children's Hospital , Brisbane , QLD , Australia
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50
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Terwee CB, Prinsen CAC, Ricci Garotti MG, Suman A, de Vet HCW, Mokkink LB. The quality of systematic reviews of health-related outcome measurement instruments. Qual Life Res 2015; 25:767-79. [PMID: 26346986 PMCID: PMC4830864 DOI: 10.1007/s11136-015-1122-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Systematic reviews of outcome measurement instruments are important tools for the selection of instruments for research and clinical practice. Our aim was to assess the quality of systematic reviews of health-related outcome measurement instruments and to determine whether the quality has improved since our previous study in 2007. METHODS A systematic literature search was performed in MEDLINE and EMBASE between July 1, 2013, and June 19, 2014. The quality of the reviews was rated using a study-specific checklist. RESULTS A total of 102 reviews were included. In many reviews the search strategy was considered not comprehensive; in only 59 % of the reviews a search was performed in EMBASE and in about half of the reviews there was doubt about the comprehensiveness of the search terms used for type of measurement instruments and measurement properties. In 41 % of the reviews, compared to 30 % in our previous study, the methodological quality of the included studies was assessed. In 58 %, compared to 55 %, the quality of the included instruments was assessed. In 42 %, compared to 7 %, a data synthesis was performed in which the results from multiple studies on the same instrument were somehow combined. CONCLUSION Despite a clear improvement in the quality of systematic reviews of outcome measurement instruments in comparison with our previous study in 2007, there is still room for improvement with regard to the search strategy, and especially the quality assessment of the included studies and the included instruments, and the data synthesis.
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Affiliation(s)
- C B Terwee
- Department of Epidemiology and Biostatistics and the EMGO+ Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - C A C Prinsen
- Department of Epidemiology and Biostatistics and the EMGO+ Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | | | - A Suman
- Department of Public Health and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - H C W de Vet
- Department of Epidemiology and Biostatistics and the EMGO+ Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - L B Mokkink
- Department of Epidemiology and Biostatistics and the EMGO+ Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
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