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Dinsdale A, Thomas L, Forbes R, Treleaven J. Factors associated with patient-reported mouth opening activity limitations in individuals with persistent intra-articular temporomandibular disorders: A cross-sectional study exploring physical and self-reported outcomes. Musculoskelet Sci Pract 2024; 73:103166. [PMID: 39167861 DOI: 10.1016/j.msksp.2024.103166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 08/15/2024] [Accepted: 08/16/2024] [Indexed: 08/23/2024]
Abstract
BACKGROUND Individuals living with intra-articular temporomandibular disorders (IA-TMDs) often report limitations with mouth opening activities. While clinical measures such as active range of motion (AROM) and movement quality are often used to assess mouth opening function, it is unclear if and how these relate to patient-reported limitations and whether other factors such as kinesiophobia influence mouth opening activities in those with IA-TMDs. OBJECTIVES Compare clinical measures of mouth opening function in those with IA-TMDs to asymptomatic controls. In those with an IA/TMD, explore relationships between patient-reported mouth opening limitations, and mouth opening function and kinesiophobia. DESIGN Cross-sectional study. METHOD Clinical mouth opening function (AROM, movement quality, pain on movement/10, stiffness on movement/10) was compared between groups (n = 30 IA-TMD, n = 30 controls). Within the IA-TMD group, correlations between patient-reported mouth opening limitations (Patient specific functional scale), kinesiophobia (Tampa Scale for Kinesiophobia for Temporomandibular Disorders) and clinical measures of mouth opening function were explored. RESULTS Impairments in AROM (-4 mm, p = 0.04, d = 0.5), movement quality (p < 0.01, φ = 0.6), pain on movement (p < 0.01, d = 0.8) and stiffness on movement (p < 0.01, d = 1.6) were observed in the IA-TMD group compared to controls. Patient-reported mouth opening limitations and kinesiophobia were significantly correlated (r = -0.48, p < 0.01); no correlation was found between patient-reported limitations and clinical mouth opening measures (r < 0.3, p > 0.05). CONCLUSIONS Mouth opening function is impaired in IA-TMD. However, kinesiophobia appears more related to patient-reported mouth opening limitations than clinical impairments. Consideration of clinical, kinesiophobia and patient-reported limitation measures are necessary to direct management of IA-TMD in those presenting for care.
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Affiliation(s)
- Alana Dinsdale
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia.
| | - Lucy Thomas
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| | - Roma Forbes
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| | - Julia Treleaven
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
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2
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Rubsam M, Hohl K, Smaller K, Lopez G, Rafferty M. Integrating Heart Rate Monitoring Into a Camp for Children With Neuromotor Disorders: A Case Series. Pediatr Phys Ther 2024:00001577-990000000-00103. [PMID: 39074207 DOI: 10.1097/pep.0000000000001134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
PURPOSE This case series investigated the implementation fidelity, feasibility, and effectiveness of integrating continuous heart rate monitoring with visual feedback into an established, intensive physical therapy camp for children with neuromotor disorders. SUMMARY OF KEY POINTS The provision of continuous visual feedback through color-coded, individually calculated heart rate zones was a feasible and effective intervention, encouraging pediatric gait camp participants to exercise at intensities that produced aerobic and functional gains. The use of technology facilitated participation with peers, an outcome equally as important as their endurance and functional improvements. CONCLUSIONS AND RECOMMENDATIONS FOR CLINICAL PRACTICE Pediatric physical therapists play a crucial role in enhancing the well-being and physical fitness of children with disabilities. Encouraging regular exercise in a social environment fosters enjoyable, inclusive experiences while promoting overall health. It is important for clinicians in various pediatric rehabilitation settings to establish programs that offer such opportunities for children with neuromotor disorders.
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Affiliation(s)
- Meaghan Rubsam
- Shirley Ryan AbilityLab (Dr Rubsam, Dr Hohl, Mr Smaller, Dr Lopez, and Dr Rafferty), Chicago, Illinois; Ph.D. Program in Rehabilitation Sciences, Department of Physical Therapy, College of Applied Health Sciences (Dr Rubsam), University of Illinois, Chicago, Illinois; Department of Physical Medicine and Rehabilitation, Department of Psychiatry and Behavioral Science (Dr Rafferty), Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Dimakopoulos R, Vakalaki T, Spinou A, Michopoulos I, Papadopoulou Μ. Effectiveness of therapeutic interventions on participation in children with cerebral palsy: A systematic review and meta-analysis. Child Care Health Dev 2024; 50:e13301. [PMID: 38958263 DOI: 10.1111/cch.13301] [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] [Received: 06/15/2023] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Participation in life activities is an integral part of health and a main outcome of rehabilitation services for children and adolescents with disabilities. However, there is still no consensus on the most effective way to improve participation. The aim of this systematic review is to determine the effectiveness of therapeutic interventions on participation outcomes of children with cerebral palsy (CP). METHODS A systematic review was conducted, searching the databases PubMed, Cochrane Library, Science Direct, Web of Science and Scopus for randomized controlled trials (RCTs), between 2001 and 2023. Studies were eligible for inclusion if they evaluated children with CP undergoing any intervention and using any tool measuring participation as an outcome measure. A meta-analysis of treatment effect was conducted. A sensitivity analysis was conducted to identify the effect on participation when intervention targeted different International Classification of Functioning (ICF) domains. RESULTS A total of 1572 records were identified. Eight RCTs including 384 children (195 in the intervention group and 189 in the control group) were included in the systematic review and in the meta-analysis. A sensitivity analysis showed that interventions focusing on participation significantly improved participation; standardized mean difference (1.83; 95% CI: 1.33-2.32; Z = 7.21; P < 0.00001). When other types of interventions, that is, focusing on body functions and structures or activities, were used, then participation was not favourably affected. INTERPRETATION Interventions primarily targeting barriers to participation across several ICF domains have a greater influence on enhancing participation. Interventions aimed at enhancing specific motor skills, including gross and fine motor function or strength, do not necessarily have a positive impact on participation.
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Affiliation(s)
| | - Theodora Vakalaki
- Department of Physiotherapy, University of West Attica, Athens, Greece
| | - Arietta Spinou
- Population Health Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Ioannis Michopoulos
- Second Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
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Fonvig CE, Troelsen J, Halekoh U, Holsgaard-Larsen A. Limited associations between passive range of motion and gross motor function in ambulant/semi-ambulant children and adolescents with cerebral palsy: A cross-sectional study. J Bodyw Mov Ther 2024; 39:170-175. [PMID: 38876622 DOI: 10.1016/j.jbmt.2024.02.030] [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: 11/28/2022] [Revised: 12/12/2023] [Accepted: 02/25/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND AND AIM Cerebral palsy (CP) is the most common childhood motor disability, and the Cerebral Palsy Follow-Up Program (CPUP) in Nordic countries uses a traffic light system for passive range of motion (ROM) assessment to aid interpretation and guide decisions regarding interventions. However, the arbitrary chosen ROM threshold values and their potential clinical impact are uncertain. We investigated whether lower extremity ROM values were positively associated with gross motor function and whether gross motor function scores differ between the CPUP ROM thresholds. METHODS This was a cross-sectional analysis of CPUP data for 841 ambulatory children and adolescents with CP, at a mean (SD) age of 9 (3). Regression analyses were employed to explore the relationship between gross motor capacity and performance (using the Gross Motor Function Measure (GMFM-66) and the Functional Mobility Scale (FMS) 5/50/500 m, respectively) and lower extremity ROM, measured with a goniometer. ROM was assessed both as continuous and categorical variables. RESULTS We found that two out of ten continuous ROM measures were positively associated with gross motor function. Limited differences in gross motor function between the ROM thresholds were seen for seven out of ten ROM measures. The CPUP traffic light thresholds primarily differentiated gross motor function between the red and green categories, predominantly for the subgroup of participants with bilateral spastic CP. CONCLUSION Limited associations between passive ROM and gross motor function in children and adolescents with CP were observed, indicating that there is more to consider than ROM when identifying whether interventions are needed.
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Affiliation(s)
- Christina Esmann Fonvig
- Orthopaedic Research Unit, Department of Orthopaedics and Traumatology, Odense University Hospital, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Jens Troelsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Ulrich Halekoh
- Department of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, Denmark
| | - Anders Holsgaard-Larsen
- Orthopaedic Research Unit, Department of Orthopaedics and Traumatology, Odense University Hospital, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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5
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Rosenbaum P. Child development: The foundation of 'childhood disability'? Dev Med Child Neurol 2023; 65:1538. [PMID: 37592404 DOI: 10.1111/dmcn.15738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/19/2023]
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Kwok EYL, Rosenbaum P, Cunningham BJ. Speech-language pathologists' treatment goals for preschool language disorders: An ICF analysis. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:885-892. [PMID: 36416180 DOI: 10.1080/17549507.2022.2142665] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE The World Health Organization's International Classification of Functioning, Disability and Health (ICF) provides a comprehensive framework to conceptualise clinical services. This study explored how speech-language pathologists (SLPs) conceptualised therapy goals for preschoolers with language difficulties and disorders within the ICF framework. METHOD An online survey was distributed to SLPs practising in a publicly funded Preschool Speech and Language program in Ontario, Canada. SLPs rated their familiarity with the ICF framework, and then reported all therapy goals for one child with language difficulty/disorder on their caseload. For each reported goal, SLPs indicated the ICF component(s) they felt the goal addressed. Researchers then independently categorised SLPs' reported goals into the ICF components. RESULT Ninety-three SLPs completed the survey, and 81% reported they were at least "somewhat" familiar with the ICF framework. On average, SLPs reported three therapy goals per child, and felt the Activities and Participation components were most frequently targeted (73% and 72% of all reported goals, respectively). Researchers categorised SLPs' reported goals differently, and identified 57% of goals addressing the Activities component, and 21% the Participation component. CONCLUSION There is a need to better understand how SLPs and researchers conceptualise the ICF framework, particularly the Participation component.
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Affiliation(s)
- Elaine Y L Kwok
- Department of Pediatrics, McMaster University, Hamilton, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada, and
| | - Peter Rosenbaum
- Department of Pediatrics, McMaster University, Hamilton, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada, and
| | - Barbara J Cunningham
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada, and
- School of Communication Sciences and Disorders, Faculty of Health Sciences, Western University, London, Canada
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Kerem-Günel M, Arslan UE, Seyhan-Bıyık K, Özal C, Numanoğlu-Akbaş A, Üneş S, Tunçdemir M, Çankaya Ö, Özcebe H, Green D. Evaluation of daily and social participation of children with Cerebral Palsy across different age groups with a focus on the 'F'-words: Function, family, fitness, fun, friends and future. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 140:104588. [PMID: 37562097 DOI: 10.1016/j.ridd.2023.104588] [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: 09/12/2022] [Revised: 06/09/2023] [Accepted: 07/29/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND The impact of disability differs across cultures. This study aimed to determine the predictors of participation in children with cerebral palsy (CP) in Turkey, based on the six F-words. METHODS Cross-sectional study exploring participation profiles of 450 children with CP, aged between 2 and 18 years. Pediatric Evaluation of Disability Inventory (PEDI) evaluated functional skills, and Assessment of Life Habits (LIFE-H) version 3.0 assessed daily and social participation. Hierarchical linear regression models were done to determine the predictors of participation in daily activities (PDA) and social roles (PSR) in three age groups (2-4, 5-13 and 14-18 years) based on the 6 F-words (mobility of PEDI for 'fitness'; four classification systems and self-care of PEDI for 'functioning'; social functions of PEDI for 'friends'; demographic information by parents for 'family'; the recreation of LIFE-H for 'fun'; and different stages of development for 'future'). RESULTS The most important predictors for total PDA by age group were: self-care (p = 0.012) of PEDI in 2-4 y; self-care (p = 0.001) and mobility (p = 0.005) of PEDI in 5-13 y; GMFCS (p = 0.006) and mobility (p = 0.002) of PEDI in 14-18 y. Significant predictors for PSR differed by age group: self-care (p = 0.001) of PEDI in 2-4 y; self-care (p = 0.023) and mobility (p = 0.006) of PEDI in 5-13 y; and GMFCS (p = 0.004) and MACS (p = 0.003) in 14-18 y. CONCLUSIONS Six F-words of function and fitness focussed on self-care in younger children with an increasing emphasis on mobility and ability levels according to age. Therefore, rehabilitation for different aspects of the functional levels is needed to improve participation in life across the six F-words framework; plus take into consideration context, age-differences, family's expectations, life requirements, environmental needs, and cultural differences.
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Affiliation(s)
- Mintaze Kerem-Günel
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Umut Ece Arslan
- Department of Health Research, Institue of Public Health, Hacettepe University, Ankara, Turkey
| | - Kübra Seyhan-Bıyık
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Cemil Özal
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ayşe Numanoğlu-Akbaş
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey
| | - Sefa Üneş
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Merve Tunçdemir
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Özge Çankaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Kütahya Health Sciences University, Kütahya, Turkey
| | - Hilal Özcebe
- Department of Public Health, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Dido Green
- Department of Rehabilitation, Oxford Brookes University, Oxford, England, UK
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8
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Shetty T, Ganesan S, Johari A, Mullerpatan R. Gross motor function profile of children with cerebral palsy in a low-resource setting: A call for reflection on the model of care. J Pediatr Rehabil Med 2023; 16:211-218. [PMID: 36872801 DOI: 10.3233/prm-220039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
PURPOSE The current study aimed to explore Gross Motor Function Measure (GMFM) profiles among children with cerebral palsy (CP) at various Gross Motor Function Classification System (GMFCS) levels in a low-resource setting. Seventy-one ambulatory children with CP (61% males), were studied after signed informed consent was obtained from parents and assent from children older than 12 years. METHODS Ambulatory capacity of children with CP was classified using GMFCS levels. Functional ability of all participants was measured using GMFM-88. RESULTS Children with CP in a low-resource setting had 12-44% lower GMFM scores in dimensions of standing, walking, running, and jumping with reference to children from high-resource settings with similar ambulatory capacity reported previously. The most affected components across various GMFCS levels were 'sitting on a large and small bench from floor,' 'arm-free squatting,' 'half-kneeling,' 'kneel-walking,' and 'single-limb hop'. CONCLUSION Knowledge of GMFM profiles can guide clinicians and policymakers in low-resource settings for strategic rehabilitation planning and extend the focus of rehabilitation from restoration of body structure and function to the wider domain of social participation in leisure, sport, work, and the community at large. Additionally, providing tailored rehabilitation based on a profile of motor function can ensure an economically, environmentally, and socially sustainable future.
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Affiliation(s)
- Triveni Shetty
- Department of Neurophysiotherapy, MGM School of Physiotherapy, MGM Institute of Health Sciences, Navi Mumbai, Maharashtra, India
| | - Sailakshmi Ganesan
- Department of Neurophysiotherapy, MGM School of Physiotherapy, MGM Institute of Health Sciences, Navi Mumbai, Maharashtra, India
| | | | - Rajani Mullerpatan
- MGM School of Physiotherapy, MGM Institute of Health Sciences, Navi Mumbai, Maharashtra, India
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9
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Hilderley AJ, Wright FV, Taylor MJ, Chen JL, Fehlings D. Functional Neuroplasticity and Motor Skill Change Following Gross Motor Interventions for Children With Diplegic Cerebral Palsy. Neurorehabil Neural Repair 2023; 37:16-26. [PMID: 36524254 PMCID: PMC9896542 DOI: 10.1177/15459683221143503] [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] [Indexed: 12/23/2022]
Abstract
BACKGROUND Gross motor intervention designs for children with diplegic cerebral palsy (DCP) require an improved understanding of the children's potential for neuroplasticity. OBJECTIVE To identify relations between functional neuroplasticity and motor skill changes following gross motor interventions for children with DCP. METHODS There were 17 participants with DCP (ages 8-16 years; 6 females; Gross Motor Function Classification System Level I [n = 9] and II [n = 8]). Each completed a 6-week gross motor intervention program that was directed toward achievement of individualized motor/physical activity goals. Outcomes were assessed pre/post and 4 to 6 months post-intervention (follow-up). An active ankle dorsiflexion task was completed during functional magnetic resonance imaging. The ratio of motor cortical activation volume in each hemisphere was calculated using a laterality index. The Challenge was the primary gross motor skill measure. Change over time and relations among outcomes were evaluated. RESULTS Challenge scores improved post-intervention (4.57% points [SD 4.45], P = .004) and were maintained at follow-up (0.75% [SD 6.57], P = 1.000). The laterality index for dominant ankle dorsiflexion increased (P = .033), while non-dominant change was variable (P = .534). Contralateral activation (laterality index ≥+0.75) was most common for both ankles. Challenge improvements correlated with increased ipsilateral activity (negative laterality index) during non-dominant dorsiflexion (r = -.56, P = .045). Smaller activation volume during non-dominant dorsiflexion predicted continued gross motor gains at follow-up (R2 = .30, P = .040). CONCLUSIONS Motor cortical activation during non-dominant ankle dorsiflexion is a modest indicator of the potential for gross motor skill change. Further investigation of patterns of neuroplastic change will improve our understanding of effects. CLINICALTRIALS.GOV REGISTRY NCT02584491 and NCT02754128.
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Affiliation(s)
- Alicia J. Hilderley
- Bloorview Research Institute, Holland
Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - F. Virginia Wright
- Bloorview Research Institute, Holland
Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada,Department of Physical Therapy,
University of Toronto, Toronto, ON, Canada
| | - Margot J. Taylor
- Diagnostic Imaging, The Hospital for
Sick Children, Toronto, ON, Canada,Department of Medical Imaging,
University of Toronto, Toronto, ON, Canada,Department of Psychology, University of
Toronto, Toronto, ON, Canada
| | - Joyce L. Chen
- Faculty of Kinesiology and Physical
Education, University of Toronto, Toronto, ON, Canada,Hurvitz Brain Sciences Program,
Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto,
ON, Canada
| | - Darcy Fehlings
- Bloorview Research Institute, Holland
Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada,Department of Paediatrics, Faculty of
Medicine, University of Toronto, Toronto, ON, Canada,Darcy Fehlings, Holland Bloorview Kids
Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON M4G 1R8, Canada.
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10
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Ryan JL, Zhou C, Levac DE, Fehlings DL, Beal DS, Hung R, Wright FV. Gross motor change after inpatient rehabilitation for children with acquired brain injury: A 10-year retrospective review. Dev Med Child Neurol 2022. [PMID: 36404436 DOI: 10.1111/dmcn.15471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 09/16/2022] [Accepted: 10/25/2022] [Indexed: 11/22/2022]
Abstract
AIM To estimate gross motor change in inpatient school-aged children with subacute acquired brain injury (ABI), identify factors associated with gross motor change, and describe inpatient physiotherapy focus. METHOD This retrospective chart review involved inpatient children (5-18 years) with subacute ABI who had either two Gross Motor Function Measure (GMFM-88) assessments or one GMFM-88 with another pre/post gross motor outcome measure. Outcome change scores and Goal Attainment Scaling (GAS) T scores were calculated. Regression analyses examined factors predicting gross motor change. GAS goal areas were analysed to determine physiotherapy focus. RESULTS Of the 546 charts screened, 266 (118 female) met study criteria. The GMFM-88 was generally administered first, followed by other measures. GMFM-88 (n = 202), Community Balance and Mobility Scale (n = 89), and Six-Minute Walk Test (6MWT) (n = 98) mean change scores were 18.03% (SD 19.34), 17.85% (SD 10.77), and 142.3 m (SD 101.8) respectively. The mean GAS T score was 55.06 (SD 11.50). Lower baseline scores and increased time between assessments were most predictive of greater GMFM-88 change (r ≥ 0.40). Twenty-five percent of GAS goals were ambulation-based. INTERPRETATION Appropriate outcome measure selection is integral to detecting gross motor change in pediatric inpatient ABI rehabilitation. Mean change score estimates can be used to compare standard inpatient rehabilitation with new treatment approaches.
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Affiliation(s)
- Jennifer L Ryan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Chuanlin Zhou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Danielle E Levac
- School of Rehabilitation, University of Montreal, Montreal, Canada
| | - Darcy L Fehlings
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Deryk S Beal
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Ryan Hung
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - F Virginia Wright
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Canada
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11
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Oh W, Park C. Relationship between clinical outcome measurements and muscle thickness in cerebral palsy. ISOKINET EXERC SCI 2022. [DOI: 10.3233/ies-220058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: The World Health Organization (WHO) uses the International Classification of Functioning, Disability, and Health (ICF) model to provide physical therapy diagnoses and interventions. However, the relationship between clinical assessment and imaging remains unclear. OBJECTIVE: This study aimed to determine the relationships between body function/structure, activity, and participation outcomes following neurorehabilitation in children with cerebral palsy (CP). METHODS: Nineteen children (9 girls mean age 8.8 ± 1.8 years) with CP participated in this study. Clinical motor function tests included the quality of upper extremity skills test (QUEST), Wolf motor function test (WMFT), Functional Independence Measure for Children (WeeFIM), and the Jebsen-Taylor Hand Function Test (JTHFT). Ultrasound imaging was used to measure muscle thickness, which characterizes the body structure, and activity domain variables. RESULTS: The correlations between body structure domain (muscle thickness), activity domain (QUEST, WMFT, WeeFIM) and participants variable (JTHFT) were significant, ranging from r=-0.484 to 0.893, P< 0.05. CONCLUSIONS: These novel findings suggest that muscle thickness ultrasound imaging is closely associated with WMFT, WeeFIM, and QUEST variables. This finding provides important clinical insights when using broad clinical assessment and imaging in children with CP.
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12
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Associations between Time Processing Ability, Daily Time Management, and Dementia Severity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073928. [PMID: 35409618 PMCID: PMC8997539 DOI: 10.3390/ijerph19073928] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 12/04/2022]
Abstract
This study investigated associations between time processing ability (TPA), daily time management (DTM), and dementia severity. Persons with dementia (PwDs) (n = 53) and their significant others (n = 49) participated in this cross-sectional study. Bivariate analyses were used to investigate associations between TPA and DTM and the dementia severity. Linear regression models were used to further predict the contribution of the subtests in the Mini Mental State Examination (MMSE) for TPA results. The results showed significant correlations between TPA and dementia severity, where visuospatial functions were the most highly correlated. TPA also showed a significant correlation to proxy-rated DTM. In addition, proxy-rated DTM was significantly correlated with dementia severity and PwDs' own self-ratings of their DTM. Knowledge of the association between TPA, dementia severity, and visuospatial functions can enable early detection of TPA impairments. For a comprehensive assessment of TPA and DTM, objective measures should be used in combination with self-ratings and proxy-ratings. The findings can be used in clinical research and healthcare settings to develop methods to compensate for impaired TPA and support DTM in PwDs.
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13
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Cameron KL, McDonald CE, Allison K, McGinley JL, Cheong JL, Spittle AJ. Acceptability of Dance PREEMIE (a Dance PaRticipation intervention for Extremely prEterm children with Motor Impairment at prEschool age) from the perspectives of families and dancer teachers: a reflexive thematic analysis. Physiother Theory Pract 2022; 39:1224-1236. [PMID: 35114903 DOI: 10.1080/09593985.2022.2036280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Physical activity (PA) participation is important for children born extremely preterm or extremely low birthweight as it provides opportunities to improve motor skills and cardiovascular fitness; however there is little evidence on interventions promoting PA participation for this group, particularly at preschool age. OBJECTIVE This study aims to explore the acceptability, a critical component of intervention feasibility, of a novel dance participation intervention. METHODS Semi-structured interviews explored the acceptability of Dance PREEMIE, a Dance PaRticipation intervention for Extremely prEterm children with Motor Impairment at prEschool age (trial registration ACTRN12619001266156), from the perspectives of dance teachers delivering the intervention (n = 6), and parents of participating children (n = 6). Data were analyzed using reflexive thematic analysis. RESULTS Five themes were developed: 1) placing the child center-stage: a shared motivation to promote child wellbeing and development; 2) Dance PREEMIE as a catalyst for participation; 3) child development takes time, practice and exposure; 4) the value of being informed; and 5) dance teachers as architects of the learning environment. CONCLUSION Dance PREEMIE was acceptable to both parents of participating children and dance teachers. Findings from this study may inform future interventions aiming to improve PA participation for children with motor impairment at preschool age.
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Affiliation(s)
- Kate L Cameron
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia.,Department of Physiotherapy, University of Melbourne, Parkville, Australia
| | - Cassie E McDonald
- Department of Physiotherapy, University of Melbourne, Parkville, Australia.,Department of Physiotherapy, Royal Melbourne Hospital, Parkville, Australia
| | - Kim Allison
- Department of Physiotherapy, University of Melbourne, Parkville, Australia
| | | | - Jeanie L Cheong
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia.,Newborn Research, Royal Women's Hospital, Parkville, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Alicia J Spittle
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia.,Department of Physiotherapy, University of Melbourne, Parkville, Australia.,Newborn Research, Royal Women's Hospital, Parkville, Australia
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14
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Bingöl H, Günel MK. Comparing the effects of modified constraint-induced movement therapy and bimanual training in children with hemiplegic cerebral palsy mainstreamed in regular school: A randomized controlled study. Arch Pediatr 2022; 29:105-115. [PMID: 35039189 DOI: 10.1016/j.arcped.2021.11.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 09/07/2021] [Accepted: 11/30/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of this study was to compare the effects of modified constraint-induced movement therapy (mCIMT) and bimanual training (BIT) based on the International Classification of Functioning, Disability, and Health, Children and Youth (ICF-CY) conceptual framework. RESEARCH METHOD A total of 32 children (mean age 10.43 years [SD 2.9 years]; 15 girls, 17 boys) whose functional motor and communication levels, according to the Manual Ability Classification System, Gross Motor Function Classification System, and Communication Function Classification System, changed between level I and III were randomly distributed to one of the mCIMT or BIT groups with equivalent dosing frequencies and intensities (10 weeks, 3 days/week, 2.5 h/day). Upper extremity body function outcomes (handheld dynamometer), activity outcomes (Quality of Upper Extremity Skills Test, The Children's Hand-use Experience Questionnaire, ABILHAND-Kids, Pediatric Upper Extremity Motor Activity Log), and participation outcomes (Child and Adolescent Scale of Participation) were assessed before and after treatment, and at 16 weeks postintervention. The clinical trial number of the study is NCT04577391. RESULTS mCIMT resulted in more significant improvements in all outcomes than BIT at the immediate postintervention period (T2), which were maintained in the mCIMT group throughout the 16-week postintervention period (p<0.001; dmCIMT > dBIT). CONCLUSION The potential advantage of mCIMT versus BIT is the larger short-term effect sizes (ESs) and the more sustainable improvements.
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Affiliation(s)
- Hasan Bingöl
- Department of Therapy and Rehabilitation, Vocational School of Health Service, Muş Alparslan University, 49250-Güzeltepe, Mus, Turkey; Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Hacettepe University, 06100-Samanpazarı, Ankara, Turkey.
| | - Mintaze Kerem Günel
- Department of Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06100-Samanpazarı, Ankara, Turkey.
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15
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Elnaggar RK, Mahmoud WS, Alsubaie SF, Abd El-Nabie WA. Effectiveness of a Multi-Modal Exercise Program Incorporating Plyometric and Balance Training in Children With Hemiplegic Cerebral Palsy: A Three-Armed Randomized Clinical Trial. Phys Occup Ther Pediatr 2022; 42:113-129. [PMID: 34396891 DOI: 10.1080/01942638.2021.1964674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM To evaluate the effectiveness of a multimodal exercise program incorporating plyometric and balance training on muscle strength and postural stability in children with spastic hemiplegic cerebral palsy (SHCP). METHODS A total of 57 children with SHCP were enrolled in the study and randomly allocated into three treatment-based groups: plyometric exercises (PLYO group; n = 19), balance exercises (BAL group, n = 19), and combined plyometric and balance exercises (PLYO-BAL group; n = 19). The maximum isometric muscle strength (IMSmax) and postural stability [anterior-posterior stability index (AP-SI), mediolateral stability index (ML-SI), and overall stability index (O-SI)] were measured pre- and post-intervention. RESULTS By applying the intention-to-treat analysis, the PLYO-BAL group showed greater post-treatment IMSmax than the PLYO and BAL groups for the quadriceps (p=.03 and p=.0002 respectively), hamstrings (p=.018 and p<.0001 respectively), and dorsiflexors (p=.006 and p<.0001 respectively). Also, the PLYO-BAL group achieved better post-intervention stability scores as compared to PLYO and BAL groups regarding AP-SI (p<.0001 and p=.0001 respectively), ML-SI (p=.001 and p=.015 respectively), and O-SI (p=.011 and p=.04 respectively). CONCLUSIONS Incorporation of plyometric and balance exercises in a multimodal rehabilitation program could be an important consideration for enhancing muscle strength and boosting postural stability in children with SHCP.
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Affiliation(s)
- Ragab K Elnaggar
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia.,Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Waleed S Mahmoud
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia.,Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Saud F Alsubaie
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Walaa A Abd El-Nabie
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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16
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17
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Katchburian LR, Oulton K, Main E, Morris C, Carr LJ. Protocol for The Toxin Study: Understanding clinical and patient reported response of children and young people with cerebral palsy to intramuscular lower limb Botulinum neurotoxin-A injections, exploring all domains of the ICF. A pragmatic longitudinal observational study using a prospective one-group repeated measures design. BMJ Open 2021; 11:e049542. [PMID: 33883158 PMCID: PMC8061828 DOI: 10.1136/bmjopen-2021-049542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Botulinum neurotoxin-A (BoNT-A) is an accepted treatment modality for the management of hypertonia in children and young people with cerebral palsy (CYPwCP). Nevertheless, there are concerns about the long-term effects of BoNT-A, with a lack of consensus regarding the most meaningful outcome measures to guide its use. Most evidence to date is based on short-term outcomes, related to changes at impairment level (restrictions of body functions and structures), rather than changes in adaptive skills (enabling both activity and participation). The proposed study aims to evaluate clinical and patient reported outcomes in ambulant CYPwCP receiving lower limb BoNT-A injections over a 12-month period within all domains of the WHO's International Classification of Functioning, Disability and Health and health-related quality of life (HRQoL). METHODS AND ANALYSIS This pragmatic prospective longitudinal observational study will use a one-group repeated measures design. Sixty CYPwCP, classified as Gross Motor Function Classification System (GMFCS) levels I-III, aged between 4 and 18 years, will be recruited from an established movement disorder service in London, UK. Standardised clinical and patient reported outcome measures within all ICF domains; body structures and function, activity (including quality of movement), goal attainment, participation and HRQoL, will be collected preinjection and at 6 weeks, 6 months and up to 12 months postinjection. A representative subgroup of children and carers will participate in a qualitative component of the study, exploring how their experience of BoNT-A treatment relates to clinical outcome measures. ETHICS AND DISSEMINATION Central London Research Ethics Committee has granted ethics approval (#IRAS 211617 #REC 17/LO/0579). Findings will be disseminated in peer-reviewed publications, conferences and via networks to participants and relevant stakeholders using a variety of accessible formats including social media.
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Affiliation(s)
- Lesley R Katchburian
- Neuroscience Unit,The Wolfson Neurodisability Movement Disorder Service, Great Ormond Street Hospital For Children, London, UK
- Physiotherapy, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Kate Oulton
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children, London, UK
| | - Eleanor Main
- Physiotherapy, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Christopher Morris
- Peninsula Childhood Disability Research Unit (PenCRU), University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Lucinda J Carr
- Neuroscience Unit,The Wolfson Neurodisability Movement Disorder Service, Great Ormond Street Hospital For Children, London, UK
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18
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Flodström C, Viklund Axelsson SA, Nordström B. A pilot study of the impact of the electro-suit Mollii® on body functions, activity, and participation in children with cerebral palsy. Assist Technol 2021; 34:411-417. [PMID: 33151822 DOI: 10.1080/10400435.2020.1837288] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Electrical stimulation has been used to treat spasticity in children with cerebral palsy. Building on the benefits of electrical stimulation, a new assistive device, electro-suit Mollii® with imbedded electrodes has been tested. The aim of the study was to evaluate the possible effect of Mollii® on body function, activity and participation in self-selected activities. Six children, five to ten years of age, used the electro-suit for one hour, every other day for three months. The impact was evaluated after four weeks and after three months by measuring passive range of motion (ROM), muscle tone, pain, gross motor function and participation. All participants improved in the total score for Canadian Occupational Performance Measure (COPM), three of them showed significant clinical improvements. Pain was reduced for children who estimated pain when the study started. There were also small changes in Electro-suit Mollii® had a positive impact on activity and participation in self-selected activities among the children in this study. Further studies with more children over a longer time are necessary to evaluate the impact and usefulness over time.
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Affiliation(s)
- Camilla Flodström
- Department of Research and Development, Region Norrbotten, Luleå, Sweden
| | - Sari-Anne Viklund Axelsson
- Department of Research and Development, Region Norrbotten, Luleå, Sweden.,Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Birgitta Nordström
- Department of Research and Development, Region Norrbotten, Luleå, Sweden.,Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
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Cunningham BJ, Thomas-Stonell N, Rosenbaum P. Assessing communicative participation in preschool children with the Focus on the Outcomes of Communication Under Six: a scoping review. Dev Med Child Neurol 2021; 63:47-53. [PMID: 32909263 DOI: 10.1111/dmcn.14665] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/30/2020] [Indexed: 12/12/2022]
Abstract
AIM To describe uses of the Focus on the Outcomes of Communication Under Six (FOCUS) in research with children with and without various communication disorders since its publication in 2010. METHOD Six databases were searched for the term 'Focus on the Outcomes of Communication Under Six'. With additional searches we ascertained 70 articles, of which 25 met inclusion criteria for full review and data extraction. RESULTS The FOCUS has been used in research across multiple countries, purposes, populations, contexts, and versions. Evaluative studies have described: the development of children's communicative participation skills and factors that impact the development of communicative participation; the impact of specific interventions on communicative participation; how FOCUS captures change relative to measures of impairment; and how FOCUS performs when used at different intervals. Adaptations have included: use of the FOCUS as a descriptive or discriminative tool; use with children outside the validated age range; use of select items; and use with typically developing children. INTERPRETATION The FOCUS is used worldwide in research and practice, and much has been learned about children's communicative participation. Future research is needed to explore the relationship between children's impairments and their communicative participation, develop a FOCUS App, and develop and validate a FOCUS for school-age children.
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Affiliation(s)
- Barbara Jane Cunningham
- School of Communication Sciences and Disorders, Western University, Elborn College, London, Ontario, Canada.,CanChild, McMaster University, Hamilton, Ontario, Canada
| | | | - Peter Rosenbaum
- CanChild, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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20
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Rosenbaum P. Challenges of Guidelines: A Look at the Systematic Review of Clinical Guidelines Related to the Care of Individuals With Cerebral Palsy. Arch Phys Med Rehabil 2020; 102:796-798. [PMID: 33373598 DOI: 10.1016/j.apmr.2020.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 11/15/2022]
Abstract
This essay is an invited commentary on the report "Systematic Review of Clinical Guidelines Related to Care of Individuals With Cerebral Palsy as Part of the World Health Organization Efforts to Develop a Global Package of Interventions for Rehabilitation" published in this journal. As a blinded reviewer of the original and revised versions of this interesting article, I was stimulated to reflect on several ideas about "clinical guidelines" and to take the opportunity to share concerns I have long held and that this article identified. Having said that, the thoughts expressed are mine alone and should not be ascribed to the authors of the article that provoked them. The case I offer is that guidelines may in some ways risk being outdated, insofar as they are crafted based on what we already know from research done in "earlier" times and with different conceptual frameworks than we now apply. I use the example of 20th century concerns about spasticity to illustrate my argument. I also suggest that they may be too prescriptive and restrictive. Instead, I raise for consideration the idea that we should turn the guidelines process on its head and use best available valid data to build toward contextualized problem-focused approaches to issues that are relevant to the individuals for whom they are meant to be useful- in this case, individuals with cerebral palsy, their families, and the service providers who work with them. It is my hope that these ideas stimulate discussion and reflection.
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Affiliation(s)
- Peter Rosenbaum
- Department of Paediatrics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
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21
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Rosenbaum PL, Silva M, Camden C. Let's not go back to 'normal'! lessons from COVID-19 for professionals working in childhood disability. Disabil Rehabil 2020; 43:1022-1028. [PMID: 33355010 DOI: 10.1080/09638288.2020.1862925] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE The worldwide COVID-19 pandemic has changed almost all aspects of our lives, and the field of childhood disability is no exception. METHODS This article is based on an invited lecture by the first author at a conference-the eHealth Summit ("Pediatric Rehabilitation in a Digital Space")-organized by the other authors and their colleagues in May 2020. RESULTS The first author offers his own experiences and perspectives, supplemented by comments and observations contributed by many of the 9000+ attendees at this talk, as curated by the second and third authors. The basic messages are that while life for families of children with developmental disabilities, and for service providers who work with them, is significantly altered, many important lessons are being learned. CONCLUSIONS The comments from participants support the currency of the ideas that were presented, and encourage childhood disability professionals to reflect on what we are learning, so that we can seize the opportunities they afford to do things differently-and we believe better-moving forward.IMPLICATIONS FOR REHABILITATIONIdeas generated by colleagues and parents suggest that there may be alternatives to "business as usual" in childhood disability services after the COVID pandemic is over.People are recognizing opportunities, and benefits, to offering services virtually, including being able to see children in their natural environments, saving parents time, money and hassles to attend clinics in person, and perhaps increasing the availability of services.Many issues remain to be investigated systematically, including, among others, what services (assessments and interventions) require hands-on connections, what payment structures can accommodate new models of services, how professionals can work together in a virtual world, and what families will want.Regardless of the final answers to these issues, we believe that we should not simply "go back to normal"; rather, we should expand the range, nature and locations of our services for children with developmental disabilities and their families.
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Affiliation(s)
| | | | - Chantal Camden
- Sherbrooke University, CRCHUS, IUPLSSS, CanChild, Sherbrooke, Canada
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22
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Rosenbaum P. How do we know if interventions in developmental disability are effective? Dev Med Child Neurol 2020; 62:1344. [PMID: 33146437 DOI: 10.1111/dmcn.14673] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 08/20/2020] [Indexed: 12/01/2022]
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23
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Childhood disability: can people implement the F-words in low and middle-income countries - and how? Braz J Phys Ther 2020; 25:1-3. [PMID: 32763088 DOI: 10.1016/j.bjpt.2020.07.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 07/22/2020] [Indexed: 11/24/2022] Open
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24
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Cameron KL, Albesher RA, McGinley JL, Allison K, Cheong JLY, Spittle AJ. Movement-based interventions for preschool-age children with, or at risk of, motor impairment: a systematic review. Dev Med Child Neurol 2020; 62:290-296. [PMID: 31713851 DOI: 10.1111/dmcn.14394] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/10/2019] [Indexed: 12/11/2022]
Abstract
AIM To explore the efficacy of movement-based interventions to improve motor skills in preschool-age children with, or at risk of, motor impairment, including those with a diagnosis of cerebral palsy, autism spectrum disorder, and developmental coordination disorder. METHOD Relevant electronic databases were searched for randomized or quasi-randomized controlled trials. Outcomes were classified using domains of the International Classification of Functioning, Disability and Health: Children & Youth version. Quality was assessed using the Physiotherapy Evidence Database scale. Risk of bias was assessed using the Cochrane Risk of Bias tool. Effect sizes were calculated using Cohen's d. RESULTS Seventeen articles exploring a heterogeneity of intervention types, population groups, and outcome measures met the inclusion criteria. Movement-based interventions did not significantly improve outcomes in either the body structure and function or activity domains in most studies. No studies used a participation outcome measure. INTERPRETATION There is a paucity of evidence exploring movement-based interventions in the preschool-age group. Although movement-based interventions showed potential for improving body structure and function and activity outcomes for children with motor impairment, results were mostly not significant. Small sample sizes, variable study quality, and risk of bias limit confidence in the results. WHAT THIS PAPER ADDS The evidence is inconclusive to support movement-based interventions in this group. No studies used outcome measures assessing participation. Variability in intervention type and study quality limit confidence in results.
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Affiliation(s)
- Kate L Cameron
- Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Reem A Albesher
- Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Jennifer L McGinley
- Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia
| | - Kim Allison
- Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia
| | - Jeanie L Y Cheong
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Neonatal Research, Royal Women's Hospital, Melbourne, VIC, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia
| | - Alicia J Spittle
- Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Neonatal Research, Royal Women's Hospital, Melbourne, VIC, Australia
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25
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Abdel Malek S, Rosenbaum P, Gorter JW. Perspectives on cerebral palsy in Africa: Exploring the literature through the lens of the International Classification of Functioning, Disability and Health. Child Care Health Dev 2020; 46:175-186. [PMID: 31856343 PMCID: PMC7028076 DOI: 10.1111/cch.12733] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 12/14/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND The prevalence of cerebral palsy (CP) in countries in Africa is suggested to be higher than in Western countries. Research in Western resource-rich contexts has demonstrated the importance of environmental factors in the activities and participation of individuals with CP, as illustrated by the International Classification of Functioning, Disability and Health (ICF). Although the domains of the ICF are often acknowledged in research on CP in western contexts, the extent to which these domains have been explored in resource-limited areas is unknown. The current review aims to describe the nature of the current published literature on CP in African countries and how it aligns with the domains of the ICF. METHODS Key informants familiar with the literature on CP in Africa were consulted, and a literature search was conducted to identify articles on CP originating from countries in Africa. Identified articles were assessed to determine the ICF domains that align with the studies. Themes relating to each domain were identified. RESULTS Twenty-seven studies were included. The majority of studies were quantitative (70.3%) and focused on children or caregivers. Most studies included a body functions and structures component (70.4%), focusing on impairment rather than functioning. Activities and participation domains were addressed, but often focused solely on mobility. Environmental factors typically related to resources and policies and personal factors were often unexplored. CONCLUSIONS Research on CP in Africa tends to be grounded in a biomedical approach to disability and does not explicitly use the ICF as a guiding framework. Studies exploring body function and structures tend to be descriptive in nature, whereas activities and participation, and environmental and personal factors, represent modifiable factors that may be addressed with interventions. Knowledge translation activities that promote the ideas of the ICF in an African context should therefore be considered.
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Affiliation(s)
- Sandra Abdel Malek
- School of Rehabilitation ScienceMcMaster UniversityHamiltonOntarioCanada,CanChild Centre for Childhood Disability ResearchMcMaster UniversityHamiltonOntarioCanada
| | - Peter Rosenbaum
- School of Rehabilitation ScienceMcMaster UniversityHamiltonOntarioCanada,CanChild Centre for Childhood Disability ResearchMcMaster UniversityHamiltonOntarioCanada,Department of PaediatricsMcMaster UniversityHamiltonOntarioCanada
| | - Jan Willem Gorter
- School of Rehabilitation ScienceMcMaster UniversityHamiltonOntarioCanada,CanChild Centre for Childhood Disability ResearchMcMaster UniversityHamiltonOntarioCanada,Department of PaediatricsMcMaster UniversityHamiltonOntarioCanada
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26
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Cameron KL, McGinley JL, Allison K, Fini NA, Cheong JLY, Spittle AJ. Dance PREEMIE, a Dance PaRticipation intervention for Extremely prEterm children with Motor Impairment at prEschool age: an Australian feasibility trial protocol. BMJ Open 2020; 10:e034256. [PMID: 31988234 PMCID: PMC7044943 DOI: 10.1136/bmjopen-2019-034256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Children born extremely preterm (EP: <28 weeks gestation) and/or extremely low birth weight (ELBW: <1000 g) are at increased risk of motor impairment compared with children born at term. Children with motor impairment have lower rates of physical activity (PA) participation compared with their typically developing peers. PA participation is an important outcome for children with motor impairment, however, there is limited evidence available to support interventions that improve PA participation in this population. The aim of this study is to assess the feasibility, including the recruitment and retention, acceptability and fidelity, of a preschool dance participation intervention for children born EP/EBLW with motor impairment called Dance PaRticipation intervention for Extremely prEterm children with Motor Impairment at prEschool age. METHODS AND ANALYSIS This feasibility case series trial will recruit EP/ELBW children with motor impairment (n=10) from the Victorian Infant Collaborative Study 2016/2017 cohort, a prospective longitudinal cohort study. Up to 10 community-based dance teachers will be recruited and provided with physiotherapy-led training and support to facilitate the participation of EP/ELBW children in community dance classes. A mixed-methods approach (quantitative and qualitative) will be used to analyse the primary aim, to determine the feasibility of the intervention from the perspectives of families and dance teachers. ETHICS AND DISSEMINATION This study is approved by the Human Research Ethics Committees of The Royal Children's Hospital and The Royal Women's Hospital, Melbourne. Study outcomes will be disseminated through conference presentations, peer-reviewed publications and social media. TRIAL REGISTRATION NUMBER ACTRN12619001266156.
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Affiliation(s)
- Kate L Cameron
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Physiotherapy, University of Melbourne, Parkville, Victoria, Australia
| | | | - Kim Allison
- Physiotherapy, University of Melbourne, Parkville, Victoria, Australia
| | - Natalie A Fini
- Physiotherapy, University of Melbourne, Parkville, Victoria, Australia
- Physiotherapy, Alfred Health, Melbourne, Victoria, Australia
| | - Jeanie L Y Cheong
- Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia
- Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
| | - Alicia J Spittle
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Physiotherapy, University of Melbourne, Parkville, Victoria, Australia
- Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia
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27
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Jackman M, Novak I, Lannin N, Galea C. Immediate effect of a functional wrist orthosis for children with cerebral palsy or brain injury: A randomized controlled trial. J Hand Ther 2020; 32:10-16. [PMID: 29089196 DOI: 10.1016/j.jht.2017.09.006] [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: 11/27/2016] [Revised: 04/23/2017] [Accepted: 09/24/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Two-group randomized controlled trial. INTRODUCTION Upper limb orthoses worn during functional tasks are commonly used in pediatric neurologic rehabilitation, despite a paucity of high-level evidence. PURPOSE OF THE STUDY The purpose of this study was to investigate if a customized functional wrist orthosis, when placed on the limb, leads to an immediate improvement in hand function for children with cerebral palsy or brain injury. METHODS A 2-group randomized controlled trial involving 30 children was conducted. Participants were randomized to either receive a customized functional wrist orthosis (experimental, n = 15) or not receive an orthosis (control, n = 15). The box and blocks test was administered at baseline and repeated 1 hour after experimental intervention, with the orthosis on if randomized to the orthotic group. RESULTS After intervention, there were no significant differences on the box and blocks test between the orthotic group (mean, 10.13; standard deviation, 11.476) and the no orthotic group (mean, 14.07; standard deviation, 11.106; t[28], -0.954; P = .348; and 95% confidence interval, -12.380 to 4.513). DISCUSSION In contrast to the findings of previous studies, our results suggest that a functional wrist orthosis, when supporting the joint in a 'typical' position, may not lead to an immediate improvement in hand function. CONCLUSIONS Wearing a functional wrist orthosis did not lead to an immediate improvement in the ability of children with cerebral palsy or brain injury to grasp and release. Further research is needed combining upper limb orthoses with task-specific training and measuring outcomes over the medium to long term.
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Affiliation(s)
- Michelle Jackman
- School of Medicine, University of Notre Dame, Sydney, Australia; Occupational Therapy Department, John Hunter Children's Hospital, Newcastle, New South Wales, Australia; Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia.
| | - Iona Novak
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, Australia
| | - Natasha Lannin
- Department of Occupational Therapy, Faculty of Health Sciences, La Trobe University, Melbourne, Australia; Occupational Therapy Department, Alfred Health, Melbourne, Australia
| | - Claire Galea
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, Australia
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Halma E, Bussmann JBJ, van den Berg‐Emons HJG, Sneekes EM, Pangalila R, Schasfoort FC. Relationship between changes in motor capacity and objectively measured motor performance in ambulatory children with spastic cerebral palsy. Child Care Health Dev 2020; 46:66-73. [PMID: 31756281 PMCID: PMC7004060 DOI: 10.1111/cch.12719] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 10/21/2019] [Accepted: 10/23/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND Different interventions are offered to children with cerebral palsy (CP) to improve the activity domain of the international classification of functioning (ICF). In therapy settings, the focus is mostly on motor capacity, but the ultimate goal is to improve motor performance. We therefore examined if changes in motor capacity outcomes are accompanied by changes in objectively measured motor performance after a 3-month intensive treatment period in ambulatory children with CP. METHODS A secondary analysis on prospective clinical trial data was performed using multivariate linear regression. Sixty-five children (37 boys and 28 girls) with spastic CP, mean age 7 years and 3 months, Gross Motor Function Classification System (GMFCS) levels I-III were involved in a distinct 3-month intensive treatment period. Motor capacity (Gross Motor Function Measure [GMFM], functional muscle strength [FMS], and walking speed [WS]) and motor performance (using three Actigraph-GT3X+-derived outcome measures) were measured at baseline, 12 and 24 weeks. RESULTS No significant associations were found for any of the change scores (∆12 ) between motor capacity and motor performance after a 12-week intensive treatment period. After 24 weeks, ∆24 FMS (p = .042) and ∆24 WS (p = .036) were significantly associated with changes in motor performance outcome measure percentage of time spent sedentary (∆24 %sedentary). In this model, 16% of variance of ∆24 %sedentary was explained by changes in motor capacity (p = .030). CONCLUSIONS Changes in motor capacity are mostly not accompanied by changes in objectively measured motor performance after an intensive treatment period for ambulatory children with CP. These findings should be taken into account during goal setting and are important to manage expectations of both short- and longer term effects of treatment programmes.
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Affiliation(s)
- Elisabeth Halma
- Libra Rehabilitation and AudiologyEindhovenThe Netherlands,Department of Rehabilitation MedicineErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands,Rijndam RehabilitationRotterdamThe Netherlands
| | | | | | - Emanuel Maria Sneekes
- Department of Rehabilitation MedicineErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands,Rijndam RehabilitationRotterdamThe Netherlands
| | | | - Fabienne Carmen Schasfoort
- Department of Rehabilitation MedicineErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands,Rijndam RehabilitationRotterdamThe Netherlands
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Outcome Assessment and Function in Cerebral Palsy. Phys Med Rehabil Clin N Am 2019; 31:131-141. [PMID: 31760986 DOI: 10.1016/j.pmr.2019.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Care and research in childhood cerebral palsy (CP) continue to evolve. As our understanding of CP grows more nuanced, so grows our need to describe function, activities, challenges, adaptations of children with CP. In CP, robust means of measuring outcomes are vital to understanding utility of treatments. Research must accurately measure meaningful constructs of children with CP as a reliable ruler to establish if interventions produce useful effects. This article addresses the challenges of outcome measurement in CP, current status of outcome measurement in CP, and issues of understanding change in childhood CP.
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Rosenbaum PL, Dan B. The continuing evolution of "Cerebral Palsy". Ann Phys Rehabil Med 2019; 63:387-388. [PMID: 31669162 DOI: 10.1016/j.rehab.2019.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/20/2019] [Accepted: 09/26/2019] [Indexed: 11/25/2022]
Affiliation(s)
| | - Bernard Dan
- Université Libre de Bruxelles, Bruxelles, Belgium; Inkendaal Rehabilitation Hospital, Vlezenbeek, Belgium
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31
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Heppe ECM, Willemen AM, Kef S, Schuengel C. Improving social participation of adolescents with a visual impairment with community-based mentoring: results from a randomized controlled trial. Disabil Rehabil 2019; 42:3215-3226. [PMID: 31066313 DOI: 10.1080/09638288.2019.1589587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: The efficacy of a community-based mentoring program for adolescents with a visual impairment vs. care-as-usual was tested on social participation including satisfaction with social support.Materials and methods: Adolescents (15-22 years; 46% boys) were randomized to an intervention group with mentors with visual impairment (N = 25), an intervention group with mentors without visual impairment (N = 26), or care-as-usual (N = 25). One-on-one mentoring activities regarded school/work, leisure activities, and social relationships.Results and conclusions: Multilevel growth modelling revealed no effect of mentoring on changes in social participation compared to the care-as-usual group (participation [95% CI -0.30, 0.21, d = 0.1]; social participation composite [95% CI -0.24, 0.26, d = 0.24]). Mentees matched to mentors with visual impairments increased more on satisfaction with their social support compared to mentees matched to mentors without impairments and the care-as-usual group [95% CI 0.02, 0.49, d = 0.38]. Age, characteristics of the impairment, and number of match meetings were not associated with change in social participation during the mentoring program. This evaluation showed no benefit of mentoring for social participation of adolescents with a visual impairment. The value of mentors and mentees sharing the same disability needs further investigation. This trial is registered in the Netherlands Trial Register NTR4768.Implications for rehabilitationA community-based mentoring program resulted in no benefits for adolescents with a visual impairment on their social participation.A community-based mentoring program should not replace care-as-usual provided to young people with a visual impairment in the Netherlands. It could only be thought of as an additional service within rehabilitation.Matching mentees and mentors based on sharing the same disability could strengthen the effect of a community-based mentoring program. However, these benefits are rather small.Providing additional support for the social participation of young people with a visual impairment might be especially helpful for those with a progressive impairment and with comorbid problems.
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Affiliation(s)
- Eline C M Heppe
- Faculty of Behavioural and Movement Sciences, Section of Clinical Child and Family Studies, Vrije Unviersiteit Amsterdam, Amsterdam, The Netherlands
| | - Agnes M Willemen
- Faculty of Behavioural and Movement Sciences, Section of Clinical Child and Family Studies, Vrije Unviersiteit Amsterdam, Amsterdam, The Netherlands
| | - Sabina Kef
- Faculty of Behavioural and Movement Sciences, Section of Clinical Child and Family Studies, Vrije Unviersiteit Amsterdam, Amsterdam, The Netherlands.,Bartimeus, Rehabilitation Centre for People with Visual Impairments, Zeist, The Netherlands
| | - Carlo Schuengel
- Faculty of Behavioural and Movement Sciences, Section of Clinical Child and Family Studies, Vrije Unviersiteit Amsterdam, Amsterdam, The Netherlands
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Savant D, Telang V. Sensory-motor impairments of ipsilesional extremities and its impact on activity limitations following stroke. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2019. [DOI: 10.12968/ijtr.2017.0131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims Stroke can result in various motor and sensory impairments on contralesional as well as ipsilesional limbs. This study examined the impact on activity limitations as a result of sensory and motor impairments of ipsilesional limbs following stroke. Methods A cross-sectional study was used to assess 50 adults with stroke (acute: n=6, subacute: n=10, chronic: n=34) and 50 age- and gender-matched typically healthy adults. The Modified Ashworth Scale, the Brunnstrom Approach, Nottingham Sensory Assessment, Star Cancellation Test, Right-Left Orientation Test, Trunk Impairment Scale, Single Leg Stance Test, and the Fugl Mayer Assessment were used to measure outcomes for ipsilesional side impairments. Activity limitations were scored using the Wisconsin Gait Scale and the Motor Assessment Scale. Results A comparison of all impairments: tonal, voluntary control, sensation, perception, sitting and standing balance, and coordination of the ipsilesional extremity of persons with hemiparesis with corresponding extremity of typically healthy adults using unpaired t-test, showed significant impairment (P<0.05). Every participant with stroke had at least one impairment on their ipsilesional side, with 8% of participants having only one impairment, 36% had two impairments, 28% had three impairments, 18% had four impairments, 8% had five impairments and 2% had all six impairments on their ipsilesional side. The percentage of participants with stroke presenting with trunk impairment was highest (100%) and that of voluntary control impairment was lowest (24%) on their ipsilesional side. The relationship between identified impairments and activity limitations was calculated using Pearson’s correlation at 0.05 level, which showed a moderate negative correlation with the Wisconsin Gait Scale and a moderate positive correlation with the Motor Assessment Scale. Conclusions Ipsilesional impairments present in people with hemiparesis have a significant impact on the activity limitation; hence it is necessary to address ipsilesional impairments along with contralesional impairments.
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Affiliation(s)
- Divyarani Savant
- Physiotherapy Department, All India Institute of Physical Medicine & Rehabilitation, Keshavrao Khade Marg, Mumbai, India
| | - Vimal Telang
- Physiotherapy Department, All India Institute of Physical Medicine & Rehabilitation, Keshavrao Khade Marg, Mumbai, India
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Gross PH, Bailes AF, Horn SD, Hurvitz EA, Kean J, Shusterman M. Setting a patient-centered research agenda for cerebral palsy: a participatory action research initiative. Dev Med Child Neurol 2018; 60:1278-1284. [PMID: 30132826 DOI: 10.1111/dmcn.13984] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2018] [Indexed: 11/29/2022]
Abstract
AIM To establish a patient-centered research agenda for cerebral palsy (CP). METHOD We engaged a large cross-section of the extended community of people living with CP and those providing healthcare to people with CP ('the community') in an educational series and collaborative survey platform to establish an initial list of prioritized research ideas. After online workshops, a facilitated Delphi process was used to select the 20 highest priorities. Select participants attended an in-person workshop to provide comment and work toward consensus of research priorities. RESULTS A research agenda for CP was developed by the community, which included consumers, clinicians, and researchers interested in advancing the established research agenda. The results included the top 16 research concepts produced by the process to shape and steward the research agenda, and an engaged cross-section of the community. INTERPRETATION It has been shown that proactively engaging consumers with clinical researchers may provide more meaningful research for the community. This study suggests that future research should have more focus on interventions and outcomes across the lifespan with increased emphasis on the following outcome measures: function, quality of life, and participation. WHAT THIS PAPER ADDS A patient-centered research agenda for cerebral palsy was established. Comparative effectiveness of interventions, physical activity, and understanding ageing were leading themes. Longitudinal studies across the lifespan, clinical spectrum, and ages were highly ranked. Participants reported high value for participation outcomes. Participants reported great appreciation for the engagement between consumers and clinician researchers.
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Affiliation(s)
- Paul H Gross
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Amy F Bailes
- Division of Occupational Physical Therapy, Cincinnati Children's Hospital and Medical Center, Cincinnati, OH, USA
| | - Susan D Horn
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Edward A Hurvitz
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Jacob Kean
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
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Factors in the Efficacy, Safety, and Impact on Quality of Life for Treatment of Drooling with Botulinum Toxin Type A in Patients with Cerebral Palsy. Am J Phys Med Rehabil 2017; 96:68-76. [PMID: 28099276 DOI: 10.1097/phm.0000000000000525] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess the efficacy and safety of botulinum toxin A (BoNT-A) injected in both submandibular and parotid versus only in parotid glands as a treatment for drooling in patients with spastic and dyskinetic cerebral palsy (CP), including an assessment of impact on quality of life (QoL) based on items from the International Classification of Functioning, Disability, and Health (ICF) core set. DESIGN Forty patients with CP 18 years or older (mean, 21.8 years) participated in a prospective, single-center, randomized controlled interventional study. All participants were classified as Gross Motor Function Classification System level III or higher and all had significant drooling as defined in prior studies. One group (group A) was treated with 100 U of BoNT-A, and another group (group B) served as control. In the treatment group, all patients first received combined parotid and submandibular injections, and then parotid injections only. The main outcome variables were a postinjection decrease in the drooling quotient (DQ) of 50% or more, total flow of 30% or more, and QoL as assessed by a set of 10 items related to drooling from the ICF. RESULTS The proportion of patients who achieved at least 50% reduction in DQ was 45% in group A versus 0.0% in group B; 0.0% (P = 0.0012); and of those who achieved at least 30% reduction in total flow was 90% in group A versus 10% in group B (P < 0.0001). Within group A, 42.1% of the dyskinetic patients versus 58.0% of the spastic ones showed 50% or better response in DQ, which is not a statistically significant difference (P = 0.8045). With regard to ICF questions, group A showed statistically significant improvements in several related items. There did not seem to be a significant difference in overall response for providing parotid-only injections. Additional correlations and uncommon adverse effect experiences are also reviewed. CONCLUSION Botulinum toxin A injection of the salivary glands is frequently effective and generally safe for the treatment of drooling in patients with either spastic or dyskinetic CP, both in objective measurement of saliva production and subjective symptoms related to the condition. There does not seem to be a significant advantage of injecting both submandibular and parotid glands over injecting parotid glands alone.
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Löwing K, Thews K, Haglund-Åkerlind Y, Gutierrez-Farewik EM. Effects of Botulinum Toxin-A and Goal-Directed Physiotherapy in Children with Cerebral Palsy GMFCS Levels I & II. Phys Occup Ther Pediatr 2017; 37:268-282. [PMID: 27058177 DOI: 10.3109/01942638.2016.1150384] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS To evaluate short and long-term effects of botulinum toxin-A combined with goal-directed physiotherapy in children with cerebral palsy (CP). METHOD A consecutive selection of 40 children, ages 4-12 years, diagnosed with unilateral or bilateral CP, and classified in GMFCS levels I-II. During the 24 months, 9 children received one BoNT-A injection, 10 children two injections, 11 children three injections, and 10 children received four injections. 3D gait analysis, goal-attainment scaling, and body function assessments were performed before and at 3, 12, and 24 months after initial injections. RESULTS A significant but clinically small long-term improvement in gait was observed. Plantarflexor spasticity was reduced after three months and remained stable, while passive ankle dorsiflexion increased after 3 months but decreased slightly after 12 months. Goal-attainment gradually increased, reached the highest levels at 12 months, and levels were maintained at 24 months. CONCLUSION The treatments' positive effect on spasticity reduction was identified, but did not relate to improvement in gait or goal-attainment. No long-term positive change in passive ankle dorsiflexion was observed. Goal attainment was achieved in all except four children. The clinical significance of the improved gait is unclear. Further studies are recommended to identify predictors for positive treatment outcome.
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Affiliation(s)
- Kristina Löwing
- a Department of Women's and Children's Health , Karolinska Institutet , Stockholm , Sweden
| | - Karin Thews
- a Department of Women's and Children's Health , Karolinska Institutet , Stockholm , Sweden
| | | | - Elena M Gutierrez-Farewik
- a Department of Women's and Children's Health , Karolinska Institutet , Stockholm , Sweden.,b KTH Mechanics, Royal Institute of Technology , Stockholm , Sweden.,c KTH BioMEx Center, Royal Institute of Technology , Stockholm , Sweden
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36
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Fay D, Wilkinson T, Wagoner M, Brooks D, Quinn L, Turnell A. Effect of Group Setting on Gross Motor Performance in Children 3-5 Years Old with Motor Delays. Phys Occup Ther Pediatr 2017; 37:74-86. [PMID: 26913487 DOI: 10.3109/01942638.2015.1129387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS The purpose of this study was to evaluate differences in gross motor performance of children 3-5 years of age with motor delays when assessed individually compared to assessment in a group setting among peers with typical development (TD). METHODS Twenty children with motor delays and 42 children with TD were recruited from a preschool program. A within-subject repeated measures design was used; each child with delay was tested both in an individual setting and in a group setting with two to four peers with TD. Testing sessions were completed 4-8 days apart. Ten different motor skills from the Peabody Developmental Motor Scales-2 were administered. Performance of each item was videotaped and scored by a blinded researcher. RESULTS Overall gross motor performance was significantly different (p < .05) between the two settings, with 14 of 20 children demonstrating better performance in the group setting. In particular, children performed better on locomotion items (p < .05). CONCLUSIONS The higher scores for locomotion in the group setting may be due to the influence of competition, motivation, or modeling. Assessing a child in a group setting is recommended as part of the evaluation process.
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Affiliation(s)
- Deanne Fay
- a A. T. Still University , Still Circle, Mesa , Arizona , USA
| | - Tawna Wilkinson
- a A. T. Still University , Still Circle, Mesa , Arizona , USA
| | | | - Danna Brooks
- a A. T. Still University , Still Circle, Mesa , Arizona , USA
| | - Lauren Quinn
- a A. T. Still University , Still Circle, Mesa , Arizona , USA
| | - Andrea Turnell
- a A. T. Still University , Still Circle, Mesa , Arizona , USA
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Imms C, Granlund M, Wilson PH, Steenbergen B, Rosenbaum PL, Gordon AM. Participation, both a means and an end: a conceptual analysis of processes and outcomes in childhood disability. Dev Med Child Neurol 2017; 59:16-25. [PMID: 27640996 DOI: 10.1111/dmcn.13237] [Citation(s) in RCA: 291] [Impact Index Per Article: 41.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/14/2016] [Indexed: 02/04/2023]
Abstract
This review outlines a conceptual approach to inform research and practice aimed at supporting children whose lives are complicated by impairment and/or chronic medical conditions, and their families. 'Participation' in meaningful life activities should be an essential intervention goal, to meet the challenges of healthy growth and development, and to provide opportunities to help ensure that young people with impairments reach their full potential across their lifespan. Intervention activities and research can focus on participation as either an independent or dependent variable. The proposed framework and associated hypotheses are applicable to children and young people with a wide variety of conditions, and to their families. In taking a fresh 'non-categorical' perspective to health for children and young people, asking new questions, and exploring issues in innovative ways, we expect to learn lessons and to develop creative solutions that will ultimately benefit children with a wide variety of impairments and challenges, and their families, everywhere.
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Affiliation(s)
- Christine Imms
- Centre for Disability and Development Research (CeDDR), Australian Catholic University, Melbourne, Vic, Australia.,CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada.,Murdoch Childrens Research Institute, Melbourne, Vic, Australia
| | - Mats Granlund
- CHILD Research Group, Swedish Institute of Disability Research, Jonkoping University, Jonkoping, Sweden
| | - Peter H Wilson
- Centre for Disability and Development Research (CeDDR), Australian Catholic University, Melbourne, Vic, Australia
| | - Bert Steenbergen
- Centre for Disability and Development Research (CeDDR), Australian Catholic University, Melbourne, Vic, Australia.,Behavioural Science Research Institute, Radboud University, Nijmegen, the Netherlands
| | - Peter L Rosenbaum
- Centre for Disability and Development Research (CeDDR), Australian Catholic University, Melbourne, Vic, Australia.,CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Andrew M Gordon
- Cerebral Palsy Research Centre, Teachers College, Columbia University, New York, NY, USA
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Ferreira HNC, Cirne GNDM, Pereira SA, Lima NMFV, Cacho RDO, Cacho EWA. Upper extremity motor quality evaluation in children with Cerebral Palsy. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.s01.ao27] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Cerebral Palsy (CP) is a non-progressive disorder that may compromise functional abilities of the upper limbs due to motor and sensitive loss, that are still poorly evaluated and described by reliable tools. Objective: This study aimed to evaluate motor quality and skills of the upper extremity in children with CP in regions of Trairi and Seridó from Rio Grande do Norte state (Brazil). Methods: It is a cross-sectional exploratory study, with a qualitative approach, with 17 children with CP, aged between four and eight years. The following instruments were used for upper extremity evaluation: Manual Ability Classification System (MACS), Quality of Upper Extremity Skills Test (QUEST) and Gross Motor Function Classification System (GMFCS). Results: Mean and standard deviation (sd) of QUEST total score and the domains dissociated movement, grasp, weight bearing and extensive protection were, respectively, 41.06/37.08; 53.12/34.50; 15.51/62.98; 37.76/37.52; 42.48/47.26. MACS and GMFCS median scores were, respectively, 3 (three) and 5 (five); high positive correlation was observed between MACS and GMFCS (rs=0.83) and high negative correlation between GMFCS and total QUEST (rs=-0.83), as well as between MACS and QUEST (rs=-0.84); and MACS and all QUEST domains (rs=-0.73; rs=-0.82; rs=-0.76; rs=-0.79), p<0.001. Conclusion: Children with CP showed deficit in motor quality and skills of the upper limb, allowing to infer functional limitations regarding manipulation of objects and consequent dependence during life activities.
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Lee K, Jeong D, Schindler RC, Short EJ. SIG-Blocks: Tangible game technology for automated cognitive assessment. COMPUTERS IN HUMAN BEHAVIOR 2016. [DOI: 10.1016/j.chb.2016.08.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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40
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Jeevanantham D. Application of the International Classification of Functioning, Disability and Health - Children and Youth in Children With Cerebral Palsy. Indian Pediatr 2016; 53:805-810. [PMID: 27395840 DOI: 10.1007/s13312-016-0935-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The International Classification of Functioning, Disability and Health (ICF) is a framework for describing health status; however, there is a gap in literature for supporting its use as a classification tool. The purpose of this paper is to provide a perspective on its use in describing children with cerebral palsy. The interconnected concepts of the ICF are more important than the classification elements itself. Further research is required to prove its use as a classification tool in clinical practice.
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Affiliation(s)
- Deepa Jeevanantham
- Health and Rehabilitation Sciences Graduate Program, Western University, London, Ontario, Canada. Correspondence to: Deepa Jeevanantham, Health and Rehabilitation Sciences Graduate Program, Western University, London, Ontario, Canada.
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Sköld A, Janeslätt GK. Self-rating of daily time management in children: psychometric properties of the Time-S. Scand J Occup Ther 2016; 24:178-186. [DOI: 10.1080/11038128.2016.1185465] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lorin K, Forsberg A. Treatment with botulinum toxin in children with cerebral palsy: a qualitative study of parents' experiences. Child Care Health Dev 2016; 42:494-503. [PMID: 27198886 DOI: 10.1111/cch.12350] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 03/30/2016] [Accepted: 04/24/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND In children with cerebral palsy everyday movements such as walking, standing and using one's hands can be difficult to perform because of spasticity. Botulinum neurotoxin type A (BoNT-A) are often used to reduce spasticity. The aim of this study was to describe how parents of children with cerebral palsy experienced the child's treatment with BoNT-A, how the child was affected by the treatment and how spasticity affected the child. METHODS A qualitative study in which 15 parents of children (6-13 years old) with cerebral palsy were interviewed about their experiences of the BoNT-A treatment. The children had received several BoNT-A treatments. An interview guide was used with topics: the child's functions before and after the treatment, the outcomes of the treatment and how they valued the BoNT-A treatment. Content analysis was used to analyse the interviews. RESULTS The analyses resulted in two themes: 'When softness comes and goes' and 'Both want and do not want'. The reduction of spasticity - softness - was described to promote motor functions, and facilitate the next step in motor development. The children were described as being more active out of their own initiative and having a happier mood. Spasticity, described as stiffness, was described to make walking more strenuous as well as interfering with activities. The BoNT-A injection procedure was perceived as troublesome and painful for the child, and sometimes traumatic for both children and parents. CONCLUSIONS Treatment with BoNT-A was described as facilitating motor development and activity. The children's and the parents' negative experiences of the injection procedure should be addressed.
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Affiliation(s)
- K Lorin
- Child and Youth Habilitation Centre, Region Örebro County, Örebro, Sweden
| | - A Forsberg
- Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Wiart L, Rosychuk RJ, Wright FV. Evaluation of the effectiveness of robotic gait training and gait-focused physical therapy programs for children and youth with cerebral palsy: a mixed methods RCT. BMC Neurol 2016; 16:86. [PMID: 27255908 PMCID: PMC4890515 DOI: 10.1186/s12883-016-0582-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 04/29/2016] [Indexed: 12/31/2022] Open
Abstract
Background Robot assisted gait training (RAGT) is considered to be a promising approach for improving gait-related gross motor function of children and youth with cerebral palsy. However, RAGT has yet to be empirically demonstrated to be effective. This knowledge gap is particularly salient given the strong interest in this intensive therapy, the high cost of the technology, and the requirement for specialized rehabilitation centre resources. Methods This is a research protocol describing a prospective, multi-centre, concurrent mixed methods study comprised of a randomized controlled trial (RCT) and an interpretive descriptive qualitative design. It is a mixed methods study designed to determine the relative effectiveness of three physical therapy treatment conditions (i.e., RAGT, a functional physical therapy program conducted over-ground (fPT), and RAGT + fPT) on gait related motor skills of ambulatory children with cerebral palsy. Children with cerebral palsy aged 5–18 years who are ambulatory (Gross Motor Function Classification System Levels II and III) will be randomly allocated to one of four treatment conditions: 1) RAGT, 2) fPT, 3) RAGT and fPT combined, or 4) a maintenance therapy only control group. The qualitative component will explicate child and parent experiences with the interventions, provide insight into the values that underlie their therapy goals, and assist with interpretation of the results of the RCT. Discussion n/a. Trial Registration NCT02391324 Registered March 12, 2015.
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Affiliation(s)
- Lesley Wiart
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-60 Corbett Hall, Edmonton, Alberta, T5G 2G4, Canada. .,Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada.
| | - Rhonda J Rosychuk
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.,Edmonton Clinic Health Academy (ECHA), Rm 3-524, 11405 87 Avenue NW, Edmonton, Alberta, T6G 1C9, Canada
| | - F Virginia Wright
- Bloorview Children's Hospital Foundation, Bloorview Research Institute, Rm4W-270, 150 Kilgour Rd, Toronto, Ontario, M4G 1R8, Canada.,Department of Physical Therapy and Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
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44
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Ward R, Reynolds JE, Bear N, Elliott C, Valentine J. What is the evidence for managing tone in young children with, or at risk of developing, cerebral palsy: a systematic review. Disabil Rehabil 2016; 39:619-630. [DOI: 10.3109/09638288.2016.1153162] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Roslyn Ward
- Department of Paediatric Rehabilitation, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Jess E. Reynolds
- Department of Paediatric Rehabilitation, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- School of Sport, Science, Exercise and Health, the University of Western Australia, Perth, Western Australia, Australia
| | - Natasha Bear
- Department of Paediatric Rehabilitation, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- Telethon Kids Institute, Perth, Western Australia, Australia
- Department of Physiotherapy, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- Department of Clinical Research, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | - Catherine Elliott
- Department of Paediatric Rehabilitation, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- School of Occupational Therapy and Social Work, Curtin University, Western Australia, Australia
| | - Jane Valentine
- Department of Paediatric Rehabilitation, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
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Imms C, Adair B, Keen D, Ullenhag A, Rosenbaum P, Granlund M. 'Participation': a systematic review of language, definitions, and constructs used in intervention research with children with disabilities. Dev Med Child Neurol 2016; 58:29-38. [PMID: 26411643 DOI: 10.1111/dmcn.12932] [Citation(s) in RCA: 216] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/18/2015] [Indexed: 01/13/2023]
Abstract
AIM Improving participation of children with disabilities is a priority; however, the participation construct lacks clarity. This systematic review investigated how researchers defined 'participation' and the language used in participation intervention research. METHOD Nine health and education databases were searched for intervention studies of children with disabilities that included a participation outcome. Quantitative data were extracted using a customized form, and participation text data were extracted verbatim. Themes were derived using a thematic coding approach. These participation themes were applied to the outcome measures used in the included studies to compare participation language with the methods used to quantify participation changes. RESULTS Of the 2257 articles retrieved, 25 were included in this review. Five participation themes and nine subthemes were developed. Two themes, attendance and involvement, were directly related to the participation construct. Three additional themes described related concepts: preferences, activity competence, and sense of self. INTERPRETATION Attendance and involvement seem to describe the essence of the participation concept. The related themes may provide important avenues to enhance participation outcomes. This review highlighted the need for researchers to define the construct under investigation clearly and select measures carefully, as measurement choice is the mechanism through which the concept is operationalized in research.
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Affiliation(s)
- Christine Imms
- School of Allied Health and Centre for Disability and Development Research, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Vic., Australia
| | - Brooke Adair
- School of Allied Health and Centre for Disability and Development Research, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Vic., Australia
| | - Deb Keen
- Autism Centre of Excellence, Griffith University, Mt Gravatt, Qld, Australia
| | - Anna Ullenhag
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Peter Rosenbaum
- School of Allied Health and Centre for Disability and Development Research, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Vic., Australia.,Department of Pediatrics and CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Mats Granlund
- CHILD, SIDR, School of Health Sciences, Jönköping University, Jönköping, Sweden
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46
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Adair B, Ullenhag A, Keen D, Granlund M, Imms C. The effect of interventions aimed at improving participation outcomes for children with disabilities: a systematic review. Dev Med Child Neurol 2015; 57:1093-104. [PMID: 26010935 DOI: 10.1111/dmcn.12809] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/17/2015] [Indexed: 11/29/2022]
Abstract
AIM Enhancement of participation has been described as the ultimate outcome for health and educational interventions. The goal of this systematic review was to identify and critically appraise studies that aimed to improve the participation outcomes of children with disabilities. METHOD Nine databases that index literature from the fields of health, psychology, and education were searched to retrieve information on research conducted with children with disabilities aged between 5 years and 18 years. Articles were included if the author(s) reported that participation was an intended outcome of the intervention. The articles included were limited to those reporting high-level primary research, as defined by Australia's National Health and Medical Research Council evidence hierarchy guidelines. No restrictions were placed on the type of intervention being investigated. RESULTS Seven randomized controlled or pseudo-randomized studies were included. Only three of these studies identified participation as a primary outcome. Both individualized and group-based approaches to enhancing participation outcomes appeared to be effective. Studies of interventions with a primary focus on body function or activity level outcomes did not demonstrate an effect on participation outcomes. INTEPRETATION Few intervention studies have focused on participation as a primary outcome measure. Approaches using individually tailored education and mentoring programmes were found to enhance participation outcomes, while exercise programmes, where participation was a secondary outcome, generally demonstrated little effect.
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Affiliation(s)
- Brooke Adair
- School of Allied Health, Australian Catholic University, Fitzroy, Vic., Australia
| | - Anna Ullenhag
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Deb Keen
- Autism Centre of Excellence, Griffith University, Mt Gravatt, Qld, Australia
| | - Mats Granlund
- CHILD, School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Christine Imms
- School of Allied Health, Australian Catholic University, Fitzroy, Vic., Australia
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Imms C, Mathews S, Nicola Richmond K, Law M, Ullenhag A. Optimising leisure participation: a pilot intervention study for adolescents with physical impairments. Disabil Rehabil 2015. [DOI: 10.3109/09638288.2015.1068876] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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48
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de Castro Magalhães L, Cardoso AA, Guimarães MAP, Van Petten AMVN. How Can We Make Our Assessment of Motor AbilityRelevant Cross-Culturally? CURRENT DEVELOPMENTAL DISORDERS REPORTS 2015. [DOI: 10.1007/s40474-015-0047-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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49
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Law M, Anaby D, Imms C, Teplicky R, Turner L. Improving the participation of youth with physical disabilities in community activities: An interrupted time series design. Aust Occup Ther J 2015; 62:105-15. [PMID: 25678151 DOI: 10.1111/1440-1630.12177] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIM Youth with physical disabilities experience restrictions to participation in community-based leisure activities; however, there is little evidence about how to improve their involvement. This study examined whether an intervention to remove environmental barriers and develop strategies using a coaching approach improved youth participation in leisure activities. METHODS An Interrupted Time Series design was employed, where replication of the intervention effect was examined across individualised participation goals and across participants. Six adolescents with a physical disability participated in a 12-week intervention. An occupational therapist worked with each youth and his/her family to set three leisure goals based on problems identified using the Canadian Occupational Performance Measure (COPM). A coaching approach was used to collaboratively identify and implement strategies to remove environmental barriers. Interventions for each goal were introduced at different time points. Outcomes were evaluated using the COPM. RESULTS Improvements in COPM performance scores were clinically significant for 83% of the identified activities; an average change of 4.5 points in the performance scale (SD = 1.95) was observed. Statistical analysis using the celeration line demonstrated that the proportion of data points falling above the line increased in the intervention phase for 94% of the activities, indicating a significant treatment effect. CONCLUSIONS This study is the first to examine an intervention aimed at increasing leisure participation by changing only the environment. The results indicate that environment-focussed interventions are feasible and effective in promoting youth participation. Such findings can inform the design of a larger study and guide occupational therapy practice.
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Affiliation(s)
- Mary Law
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
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50
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Wu KP, Chuang YF, Chen CL, Liu IS, Liu HT, Chen HC. Predictors of participation change in various areas for preschool children with cerebral palsy: a longitudinal study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 37:102-111. [PMID: 25460224 DOI: 10.1016/j.ridd.2014.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 11/09/2014] [Accepted: 11/09/2014] [Indexed: 06/04/2023]
Abstract
This study identifies potential predictors of participation changes in various areas for preschool children with cerebral palsy (CP). Eighty children with CP (2-6 years) were enrolled. Seven potential predictors were identified: age; sex; socioeconomic status, CP subtype; cognitive function, Function Independence Measure for Children (WeeFIM), and motor composite variable from 5 motor factors (gross motor function classification system (GMFCS) level; bimanual fine motor function level; selective motor control score; Modified Ashworth Scale score; and Spinal Alignment and Range of Motion Measure). Outcome was assessed at baseline and at 6-month follow-up using the Assessment of Preschool Children's Participation (APCP) including diversity and intensity scores in the areas of play (PA), skill development (SD), active physical recreation, social activities (SA), and total areas. Dependent variables were change scores of APCP scores at baseline and 6-month follow-up. Regression analyses shows age and sex together predicted for APCP-total, APCP-SD diversity and APCP-total intensity changes (r(2)=0.13-0.25, p<0.001); cognitive function and WeeFIM were negative predictors for APCP-SA and APCP-PA diversity changes, respectively. CP subtype, motor composite variable, and socioeconomic status predicted for APCP changes in some areas. Findings suggest that young boys with poor cognitive function and daily activity predicted most on participation changes.
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Affiliation(s)
- Katie P Wu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, 5 Fu-Hsing St., Kwei-Shan, Tao-Yuan 333, Taiwan.
| | - Yu-fen Chuang
- Department of Physical Therapy, Chang Gung University, 259 Wen-Hwa 1st Rd, Kwei-Shan, Tao-Yuan 333, Taiwan.
| | - Chia-ling Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, 5 Fu-Hsing St., Kwei-Shan, Tao-Yuan 333, Taiwan; Graduate Institute of Early Intervention, Chang Gung University, 259 Wen-Hwa 1st Rd, Kwei-Shan, Tao-Yuan 333, Taiwan.
| | - I-shu Liu
- Graduate Institute of Early Intervention, Chang Gung University, 259 Wen-Hwa 1st Rd, Kwei-Shan, Tao-Yuan 333, Taiwan.
| | - Hsiang-tseng Liu
- Graduate Institute of Early Intervention, Chang Gung University, 259 Wen-Hwa 1st Rd, Kwei-Shan, Tao-Yuan 333, Taiwan.
| | - Hsieh-ching Chen
- Department of Industrial Engineering and Management, National Taipei University of Technology, 1, Sec. 3, Zhongxiao E. Rd., Taipei 106, Taiwan.
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