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Rossi F, Valle M, Galeoto G, Tofani M, Berchialla P, Sciannameo V, Bertin D, Calcagno A, Casalaz R, Cerboneschi M, Cervo M, Cornelli A, Di Pede C, Esposito M, Ferrarese M, Imazio P, Lorenzon M, Longo L, Martinuzzi A, Naretto G, Orsini N, Panzeri D, Pellegrini C, Peranzoni M, Picone F, Rabusin M, Ricci F, Zigrino C, Zucchetti G, Fagioli F. Internal Consistency and Floor/Ceiling Effects of the Gross Motor Function Measure for Use with Children Affected by Cancer: A Cross-Sectional Study. Curr Oncol 2024; 31:5291-5306. [PMID: 39330018 PMCID: PMC11430713 DOI: 10.3390/curroncol31090390] [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: 06/28/2024] [Revised: 09/02/2024] [Accepted: 09/03/2024] [Indexed: 09/28/2024] Open
Abstract
Children/adolescents with cancer can develop adverse effects impacting gross motor function. There is a lack of gross motor function assessment tools that have been validated for this population. The aim of this multicenter cross-sectional study was to preliminary validate the 88-item Gross Motor Function Measure (GMFM-88) for use in children/adolescents with cancer, exploring internal consistency and floor/ceiling effect. Inclusion criteria regarded children/adolescents diagnosed with cancer on treatment or <1 year off therapy. The internal consistency was assessed using Cronbach's α, and the floor-ceiling effects were calculated through percentage. This study involved 217 participants with heterogeneous neoplasm conditions. Internal consistency was good, with a Cronbach's α of 0.989. Floor-ceiling effect analysis reveals that several items obtained a dichotomous scoring distribution in each of the five sub-scales of the GMFM-88. This can be explained by the heterogeneous clinical characteristics of the target population. The preliminary validation of GMFM-88 in a group of children/adolescents affected by cancer suggests that some items are not able to discriminate between different gross motor function levels, and therefore it does not represent an informative tool to measure gross motor function in children with cancer. Future research is needed to define which ones could be more useful for clinical practice.
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Affiliation(s)
- Francesca Rossi
- Rehabilitation Service, Public Health and Paediatric Sciences Department, A.O.U. Città della Salute e della Scienza-Regina Margherita Children Hospital, 10126 Turin, Italy
| | - Monica Valle
- Department of Public Health and Pediatrics Sciences, University of Turin, 10124 Turin, Italy
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Marco Tofani
- Department of Life Sciences, Health and Allied Healthcare Professions, Università degli Studi "Link Campus University", Via del Casale di San Pio V 44, 00165 Rome, Italy
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Professional Development, Continuous Education and Research Service, IRCCS, Bambino Gesù Children's Hospital, 00165 Rome, Italy
| | - Paola Berchialla
- Epidemiology and Public Health, Department of Clinical and Biological Sciences, University of Turin, 10124 Turin, Italy
| | - Veronica Sciannameo
- Epidemiology and Public Health, Department of Clinical and Biological Sciences, University of Turin, 10124 Turin, Italy
| | - Daniele Bertin
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza-Regina Margherita Children's Hospital, 10126 Turin, Italy
| | - Annalisa Calcagno
- Physical Therapy and Rehabilitation Department, Children's Hospital Giannina Gaslini, 16147 Genoa, Italy
| | - Roberto Casalaz
- Paediatric Oncohematology Unit, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34137 Trieste, Italy
| | | | - Marta Cervo
- Rehabilitation Department, IRCCS, Meyer Children's Hospital, 50139 Firenze, Italy
| | - Annalisa Cornelli
- Pediatric Oncology Department, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
| | - Chiara Di Pede
- Neuromotor Rehabilitation Unit, Scientific Institute, IRCCS E. Medea, 31015 Conegliano, Italy
| | - Maria Esposito
- Department of Public Health and Pediatrics Sciences, University of Turin, 10124 Turin, Italy
| | - Miriana Ferrarese
- Health Professions of Rehabilitation Sciences Master's Degree, Clinical and Biological Sciences Department, University of Turin, 10124 Turin, Italy
| | - Paola Imazio
- Rehabilitation Department of Pediatric Orthopedics Unit, A.O.U. Città della Salute e della Scienza-Regina Margherita Children's Hospital, 10126 Turin, Italy
| | - Maria Lorenzon
- Neuromotor Rehabilitation Unit, Scientific Institute, IRCCS E. Medea, 31015 Conegliano, Italy
| | - Lucia Longo
- Health Professions of Rehabilitation Sciences Master's Degree, Clinical and Biological Sciences Department, University of Turin, 10124 Turin, Italy
| | - Andrea Martinuzzi
- Neuromotor Rehabilitation Unit, Scientific Institute, IRCCS E. Medea, 31015 Conegliano, Italy
| | - Gabriella Naretto
- Rehabilitation Department of Pediatric Orthopedics Unit, A.O.U. Città della Salute e della Scienza-Regina Margherita Children's Hospital, 10126 Turin, Italy
| | - Nicoletta Orsini
- Physical Therapy and Rehabilitation Department, Children's Hospital Giannina Gaslini, 16147 Genoa, Italy
| | - Daniele Panzeri
- Neuro-Oncological Rehabilitation Unit, Scientific Institute IRCCS E. Medea, 23842 Bosisio Parini, Italy
| | - Chiara Pellegrini
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Michela Peranzoni
- Department of Physiotherapy, Hospital of Bolzano, 39100 Bolzano, Italy
| | - Fabiola Picone
- Rehabilitation Department, IRCCS, Meyer Children's Hospital, 50139 Firenze, Italy
| | - Marco Rabusin
- Paediatric Oncohematology Unit, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34137 Trieste, Italy
| | - Federica Ricci
- Department of Public Health and Pediatrics Sciences, University of Turin, 10124 Turin, Italy
| | - Claudia Zigrino
- Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Scientific Institute IRCCS "Eugenio Medea", 72100 Brindisi, Italy
| | - Giulia Zucchetti
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza-Regina Margherita Children's Hospital, 10126 Turin, Italy
| | - Franca Fagioli
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza-Regina Margherita Children's Hospital, 10126 Turin, Italy
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Inotani T, Horaguchi A, Morishita Y, Yoshida A, Otomo M, Suzuki M, Inui T, Okubo Y, Komatsu S, Mizuno C, Takahashi Y, Ochiai T, Kinjo T, Asato T, Takayama J, Tamiya G, Saijo N, Kikuchi A, Haginoya K. Treatment of ZC4H2 Variant-Associated Spastic Paraplegia with Selective Dorsal Rhizotomy and Intensive Postoperative Rehabilitation: A Case Report. TOHOKU J EXP MED 2024; 262:239-244. [PMID: 38267061 DOI: 10.1620/tjem.2024.j004] [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] [Indexed: 01/26/2024]
Abstract
Selective dorsal rhizotomy (SDR) has been used to treat children with spastic cerebral palsy (CP), and its beneficial effect on quality of life and ambulation has been confirmed in long-term follow-up studies. However, the role of SDR in the treatment of spasticity in patients with hereditary spastic paraplegia (HSP) and related disorders is not well-established. Here, we report the first patient with the ZC4H2 variant who underwent SDR to treat spastic paraplegia. Abnormal gait was discovered during a regular checkup at the age of 3 years and 9 months, and she was diagnosed with spastic paraplegia. She was heterozygous for the ZC4H2 variant and underwent SDR at the age of 5 years and 11 months, which alleviated the spasticity. The patient underwent inpatient postoperative rehabilitation for 4 months and continued outpatient physiotherapy after discharge. The Gross Motor Function Measure-88 score and maximum walking speed decreased transiently 1 month postoperatively, but gradually recovered, and continuously improved 6 months postoperatively. SDR and postoperative intensive rehabilitation were effective in improving motor and walking functions up to 6 months after surgery, although long-term follow-up is needed to draw conclusions.
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Affiliation(s)
- Toshiki Inotani
- Department of Rehabilitation and Developmental Support, Miyagi Children's Hospital
| | - Akira Horaguchi
- Department of Rehabilitation and Developmental Support, Miyagi Children's Hospital
| | - Yuko Morishita
- Department of Rehabilitation and Developmental Support, Miyagi Children's Hospital
| | - Ayuko Yoshida
- Department of Rehabilitation and Developmental Support, Miyagi Children's Hospital
| | - Misaki Otomo
- Department of Rehabilitation and Developmental Support, Miyagi Children's Hospital
| | - Makoto Suzuki
- Graduate School of Health and Environment Sciences, Tohoku Bunka Gakuen University
| | - Takehiko Inui
- Department of Pediatric Neurology, Miyagi Children's Hospital
| | - Yukimune Okubo
- Department of Pediatric Neurology, Miyagi Children's Hospital
| | - Shigemasa Komatsu
- Department of Pediatric Orthopedic Surgery and Rehabilitation, Miyagi Children's Hospital
| | - Chika Mizuno
- Department of Pediatric Orthopedic Surgery and Rehabilitation, Miyagi Children's Hospital
| | - Yuko Takahashi
- Department of Pediatric Orthopedic Surgery and Rehabilitation, Miyagi Children's Hospital
| | - Tatsuhiro Ochiai
- Department of Pediatric Orthopedic Surgery and Rehabilitation, Miyagi Children's Hospital
| | - Takeshi Kinjo
- Department of Orthopedic Surgery and Rehabilitation, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center
| | - Takashi Asato
- Department of Orthopedic Surgery and Rehabilitation, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center
| | - Jun Takayama
- Department of AI and Innovative Medicine, Tohoku University Graduate School of Medicine
- Tohoku Medical Megabank Organization, Tohoku University
- Statistical Genetics Team, RIKEN Center for Advanced Intelligence Project
- Department of Rare Disease Genomics, Tohoku University Graduate School of Medicine
| | - Gen Tamiya
- Department of AI and Innovative Medicine, Tohoku University Graduate School of Medicine
- Tohoku Medical Megabank Organization, Tohoku University
- Statistical Genetics Team, RIKEN Center for Advanced Intelligence Project
- Department of Rare Disease Genomics, Tohoku University Graduate School of Medicine
| | - Naoya Saijo
- Department of Pediatrics, Tohoku University School of Medicine
| | - Atsuo Kikuchi
- Department of Pediatrics, Tohoku University School of Medicine
- Department of Rare Disease Genomics, Tohoku University Graduate School of Medicine
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Kato C, Uemura O, Sato Y, Tsuji T. Functional Outcome Prediction After Spinal Cord Injury Using Ensemble Machine Learning. Arch Phys Med Rehabil 2024; 105:95-100. [PMID: 37714506 DOI: 10.1016/j.apmr.2023.08.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/13/2023] [Accepted: 08/10/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVES To establish a machine learning model to predict functional outcomes after SCI with Spinal Cord Independence Measure (SCIM) using features present at the time of rehabilitation admission. STUDY DESIGN A retrospective, single-center study. The following data were collected from the medical charts: age, sex, acute length of stay (LOS), level of injury, American Spinal Injury Association Impairment Scale (AIS), motor scores of each key muscle, Upper Extremity Motor Score (UEMS), Lower Extremity Motor Score (LEMS), SCIM total scores, and subtotal scores on admission and discharge. Based on the multivariate linear regression analysis, age, acute LOS, UEMS, LEMS, and SCIM subtotal scores were selected as features for machine learning algorithms. Random forest, support vector machine, neural network, and gradient boosting were used as the base models and combined using ridge regression as a metamodel. SETTING A spinal center in Tokyo, Japan. PARTICIPANTS Participants were individuals with SCI admitted to our hospital from March 2016 to October 2021 for the first rehabilitation after the injury. They were divided into 2 groups: training (n=140) and testing (n=70). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The root-mean-square error (RMSE), R2, and Mean Absolute Error (MAE) were used as accuracy measures. RESULTS RMSE, R2, and MAE of the meta-model using the testing group were 9.7453, 0.8835, and 7.4743, respectively, outperforming any other single base model. CONCLUSIONS Our study revealed that functional prognostication could be achieved using machine-learning methods with features present at the time of rehabilitation admission. Goals can be set at the beginning of rehabilitation. Moreover, our model can be used to evaluate advanced medical treatments, such as regenerative medicine.
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Affiliation(s)
- Chihiro Kato
- National Hospital Organization Murayama Medical Center, Tokyo, Japan; Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Osamu Uemura
- National Hospital Organization Murayama Medical Center, Tokyo, Japan.
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
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Verheyen K, Wyers L, Lambrecht E, Schoonjans AS, Ceulemans B, van de Walle P, Hallemans A. Functional mobility in children and young adults with Dravet syndrome. Dev Med Child Neurol 2023; 65:1343-1356. [PMID: 36852703 DOI: 10.1111/dmcn.15561] [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: 03/22/2022] [Revised: 12/29/2022] [Accepted: 01/30/2023] [Indexed: 03/01/2023]
Abstract
AIM This cohort study aimed to describe functional mobility in Dravet syndrome, a developmental and epileptic encephalopathy. METHOD Functional mobility was assessed in individuals (aged 3-25 years), diagnosed with Dravet syndrome, using the Functional Mobility Scale (FMS), Mobility Questionnaire 28 (MobQues28), and estimated walking distance. Secondary outcome variables were Gait Profile Score (GPS), walking velocity, age at independent walking, intellectual disability, seizure frequency, genetic variant type, and body mass index (BMI). RESULTS Forty participants aged 3 years to 24 years 2 months (mean = 12 years 2 months) had a median MobQues28 of 79%, median scores of 5, 5, and 4 for the FMS 5 m, 50 m, and 500 m and a median estimated walking distance of 1 km to 3 km. Most difficulties were seen in walking up and down the stairs, walking over obstacles, kicking a ball, and running. MobQues28 scores showed a significant decrease (-6.6%, p = 0.016) in the age category of young adults (≥18 years). After correcting for age, MobQues28 was correlated to age at independent walking (-0.485, p = 0.002), GPS (-0.460, p = 0.003), and walking velocity (0.334, p = 0.038). Analysis of variance showed a significant effect of intellectual disability and BMI on MobQues28 (p = 0.029, p = 0.049). No effect of seizure frequency or genetic variant was found (p = 0.579, p = 0.337). INTERPRETATION Functional mobility limitations were observed mainly in dual tasks and activities requiring stability, with limitations increasing from the age of 18 years. Age at independent walking, gait impairments, intellectual disability, and BMI can impact functional mobility in Dravet syndrome. WHAT THIS PAPER ADDS Most limitations were seen in dual task activities and activities that required more stability. Deterioration in functional mobility occurred in young adults. The more gait impairments, the more functional mobility limitations. Age at independent walking, intellectual disability, and body mass index can impact functional mobility.
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Affiliation(s)
- Karen Verheyen
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
- Multidisciplinary Motor Centre Antwerp (M2Ocean), University of Antwerp, Belgium
| | - Lore Wyers
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
- Multidisciplinary Motor Centre Antwerp (M2Ocean), University of Antwerp, Belgium
| | - Eugénie Lambrecht
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
- Multidisciplinary Motor Centre Antwerp (M2Ocean), University of Antwerp, Belgium
| | - An-Sofie Schoonjans
- Department of Pediatric Neurology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Berten Ceulemans
- Department of Pediatric Neurology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Patricia van de Walle
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
- Multidisciplinary Motor Centre Antwerp (M2Ocean), University of Antwerp, Belgium
| | - Ann Hallemans
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
- Multidisciplinary Motor Centre Antwerp (M2Ocean), University of Antwerp, Belgium
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Albalwi AA, Saleh MN, Alharbi AA, Al-Bakri Q, Alatawi SF. Translation and cross-cultural adaptation of the functional mobility scale in children with cerebral palsy into Arabic. Front Public Health 2023; 11:1199337. [PMID: 37645707 PMCID: PMC10461045 DOI: 10.3389/fpubh.2023.1199337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/17/2023] [Indexed: 08/31/2023] Open
Abstract
Introduction Cerebral palsy (CP) is a lifelong disorder of posture and movement which often leads to a myriad of limitations in functional mobility. The Functional Mobility Scale (FMS) is a parent-report measure of functional mobility for children with CP at three different distances (5 m, 50 m, and 500 m). This is a cross-sectional study which sought to translate and culturally adapt the FMS into Arabic and to validate the translated version. Functional mobility for children and adolescents with CP in Saudi Arabia was examined. Methods The translation methodology complied with the World Health Organization Disability Assessment Schedule 2.0 translation package. A total of 154 children with CP were recruited (mean age 8.16 ± 3.32 years). Parents were interviewed to rate the usual walking ability of their children on the Arabic FMS. The re-test assessment was done with 34 families. The mean time interval between the first and second sessions was 14.3 days (SD = 8.5), with a range of 6-37 days. Results Concurrent validity was explored using Spearman's rank correlation coefficient between scores of the Arabic FMS with their corresponding score on the Gross Motor Function Classification System (GMFCS). Spearman's r values ranged between (-0.895 and -0.779), indicating strong to very strong correlations. The Test-retest reliability was examined using Cohen's weighted kappa, which showed almost perfect agreements. There was greater limitation for functional mobility at longer distances as 55.2% of children could not complete 500 meters (FMS score N). Overall, there was limited use of wheelchairs for all distances (ranging from 9.1% to 14.3%). Levels IV and V on the GMFCS had less variation in FMS scores and most of the children in these levels either did not complete the distances (no functional mobility at all distances) or used a wheelchair for mobility. Discussion The Arabic FMS was shown to be a reliable and valid measure of functional mobility for children with CP in their environment based on the parental reports. Functional mobility varied at different distances and within each GMFCS level. The use of both the GMFCS and FMS when assessing children with CP is recommended.
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Affiliation(s)
- Abdulaziz A. Albalwi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia
| | - Maysoun N. Saleh
- Department of Physical Therapy, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Ahmad A. Alharbi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia
| | - Qais Al-Bakri
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Salem F. Alatawi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia
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Saleh M, Almasri NA, Abu-Dahab SMN. Determinants of functional mobility in children with cerebral palsy in three different environments: A registry-based study. Physiother Theory Pract 2023; 39:840-850. [PMID: 35114901 DOI: 10.1080/09593985.2022.2027583] [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 Functional mobility in children with cerebral palsy (CP) varies widely and is affected by many factors related to the child and environment. Understanding this variability in child's natural environments: home, school, and community; and its determinants are important for effective child management. METHODS This cross-sectional study aims to investigate the functional mobility of children with CP within home, school, and community, and explore its determinants. Participants were 107 children with CP (aged 6.4 ± 2.9 years). Functional Mobility Scale was the outcome variable. Potential determinants included child-associated impairments and interventions. Three ordinal logistic regression analyses were conducted. RESULTS Children in Gross Motor Functional Classification System-Expanded and Revised level I walked without assistive devices in all environments, while children in levels II/III used different mobility methods in different environments. Children in levels IV/V used a wheelchair or had no form of functional mobility in all environments. Determinants of mobility varied across different environments but included impairments (visual impairments, scoliosis) and interventions (Botox, medications for spasticity, orthoses). CONCLUSIONS Child impairments and interventions received should be considered when exploring mobility options for children with CP in different environments. Further research is needed to examine other environmental and personal factors affecting mobility.
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Affiliation(s)
- Maysoun Saleh
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
- Department of Physical Therapy, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Kingdom of Saudi Arabia
| | - Nihad A Almasri
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Sana M N Abu-Dahab
- Department of Occupational Therapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
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von Elling-Tammen L, Stark C, Wloka KR, Alberg E, Schoenau E, Duran I. Predicting Gross Motor Function in Children and Adolescents with Cerebral Palsy Applying Artificial Intelligence Using Data on Assistive Devices. J Clin Med 2023; 12:jcm12062228. [PMID: 36983229 PMCID: PMC10051803 DOI: 10.3390/jcm12062228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/26/2023] [Accepted: 03/07/2023] [Indexed: 03/15/2023] Open
Abstract
Data obtained from routine clinical care find increasing use in a scientific context. Many routine databases, e.g., from health insurance providers, include records of medical devices and therapies, but not on motor function, such as the frequently used Gross Motor Function Measure-66 (GMFM-66) score for children and adolescents with cerebral palsy (CP). However, motor function is the most common outcome of therapeutic efforts. In order to increase the usability of available records, the aim of this study was to predict the GMFM-66 score from the medical devices used by a patient with CP. For this purpose, we developed the Medical Device Score Calculator (MDSC) based on the analysis of a population of 1581 children and adolescents with CP. Several machine learning algorithms were compared for predicting the GMFM-66 score. The random forest algorithm proved to be the most accurate with a concordance correlation coefficient (Lin) of 0.75 (0.71; 0.78) with a mean absolute error of 7.74 (7.15; 8.33) and a root mean square error of 10.1 (9.51; 10.8). Our findings suggest that the MDSC is appropriate for estimating the GMFM-66 score in sufficiently large patient groups for scientific purposes, such as comparison or efficacy of different therapies. The MDSC is not suitable for the individual assessment of a child or adolescent with CP.
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Affiliation(s)
- Lisa von Elling-Tammen
- Center of Prevention and Rehabilitation, University Hospital, Medical Faculty, University of Cologne, 50931 Cologne, Germany
| | - Christina Stark
- Department of Neurology, University Hospital, Medical Faculty, University of Cologne, 50931 Cologne, Germany
| | - Kim Ramona Wloka
- Center of Prevention and Rehabilitation, University Hospital, Medical Faculty, University of Cologne, 50931 Cologne, Germany
| | - Evelyn Alberg
- Center of Prevention and Rehabilitation, University Hospital, Medical Faculty, University of Cologne, 50931 Cologne, Germany
| | - Eckhard Schoenau
- Center of Prevention and Rehabilitation, University Hospital, Medical Faculty, University of Cologne, 50931 Cologne, Germany
- Department of Pediatrics, University Hospital, Medical Faculty, University of Cologne, 50931 Cologne, Germany
| | - Ibrahim Duran
- Center of Prevention and Rehabilitation, University Hospital, Medical Faculty, University of Cologne, 50931 Cologne, Germany
- Department of Pediatrics, University Hospital, Medical Faculty, University of Cologne, 50931 Cologne, Germany
- Correspondence: ; Tel.: +49-22147887627; Fax: +49-22147888696
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Duong T, Kishnani PS, An Haack K, Foster MC, Gibson JB, Wilson C, Hahn SH, Hillman R, Kronn D, Leslie ND, Peña LD, Sparks SE, Stockton DW, Tanpaiboon P, Day JW. Motor Responses in Pediatric Pompe Disease in the ADVANCE Participant Cohort. J Neuromuscul Dis 2022; 9:713-730. [DOI: 10.3233/jnd-210784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: ADVANCE (NCT01526785) presented an opportunity to obtain a more nuanced understanding of motor function changes in treatment-experienced children with Pompe disease receiving 4000L-production-scale alglucosidase alfa for 52 weeks. Objective: To estimate minimal detectable change (MDC) and effect size on Gross Motor Function Measure-88 (GMFM-88) after 52 weeks of 4000L alglucosidase alfa (complete data N = 90). Methods: The GMFM-88 mean total % score changes, MDC, and effect size were analyzed post hoc by Pompe Motor Function Level at enrollment, age groups at enrollment, and fraction of life on pre-study 160L-production-scale alglucosidase alfa. Results: Overall, participants aged < 2 years surpassed MDC at Week 52 (change [mean±standard deviation] 21.1±14.1, MDC range 5.7–13.3, effect size 1.1), whereas participants aged≥2 years did not attain this (change –0.9±15.3, MDC range 10.8–25.2, effect size –0.03). In participants aged < 2 years, improvements surpassed the MDC for walkers (change 17.1±13.3, MDC range 3.0–6.9, effect size 1.7), supported standers (change 35.2±18.0, MDC range 5.9–13.7, effect size 1.8) and sitters (change 24.1±12.1, MDC range 2.6–6.2, effect size 2.7). Age-independent MDC ranges were only attained by walkers (change 7.7±12.3, MDC range 6.4–15.0, effect size 0.4) and sitters (change 9.9±17.2, MDC range 3.3–7.7, effect size 0.9). Conclusions: These first GMFM-88 minimal-detectable-change estimates for alglucosidase alfa-treated Pompe disease offer utility for monitoring motor skills. Trial registration: ClinicalTrials.gov; NCT01526785; Registered 6 February 2012; https://clinicaltrials.gov/ct2/show/NCT01526785
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Affiliation(s)
- Tina Duong
- Department of Neurology, Division of Neuromuscular Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Priya S. Kishnani
- Department of Pediatrics, Duke University Medical Center, GSRB1, Durham, NC, USA
| | | | | | - James B. Gibson
- Clinical and Metabolic Genetics, DellChildren’s Medical Group, Barbara Jordan Boulevard, Suite, Austin, TX, USA
| | | | - Si Houn Hahn
- Departments of Pediatrics and Medicineand Biochemical Genetics Program, Seattle Children’s Hospital/University of Washington, Sand Point Way, MB, Seattle, WA, USA
| | - Richard Hillman
- University of Missouri Child Health, Hospital Drive, Columbia, MO, USA
| | - David Kronn
- Departments of Pathology and Pediatrics, New York Medical College, Valhalla, NY, USA
| | - Nancy D. Leslie
- Division of Human Genetics, Cincinnati Children’sHospital Medical Center, MC, Cincinnati, OH, USA
| | - Loren D.M. Peña
- Department of Pediatrics, Duke University Medical Center, GSRB1, Durham, NC, USA
- Current address: Division of Human Genetics, Cincinnati Children’s Hospital Medical Center, MC, Cincinnati, OH, USA
- Current address: University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - David W. Stockton
- Division of Genetic, Genomic, and Metabolic Disorders, Central Michigan University and Children’s Hospital ofMichigan, Detroit, MI, USA
| | - Pranoot Tanpaiboon
- Rare Disease Institute, Children’s National Hospital, Michigan Avenue NW, Washington, DC, USA
- Current address: Division of Medical Genetics, Child Health Research Center, Torrance, CA, USA
| | - John W. Day
- Department of Neurology, Division of Neuromuscular Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
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Hong J, Lee J, Choi T, Choi W, Kim T, Kwak K, Kim S, Kim K, Kim D. Feasibility of Overground Gait Training Using a Joint-Torque-Assisting Wearable Exoskeletal Robot in Children with Static Brain Injury. SENSORS (BASEL, SWITZERLAND) 2022; 22:3870. [PMID: 35632279 PMCID: PMC9144762 DOI: 10.3390/s22103870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/08/2022] [Accepted: 05/17/2022] [Indexed: 02/04/2023]
Abstract
Pediatric gait disorders are often chronic and accompanied by various complications, which challenge rehabilitation efforts. Here, we retrospectively analyzed the feasibility of overground robot-assisted gait training (RAGT) using a joint-torque-assisting wearable exoskeletal robot. In this study, 17 children with spastic cerebral palsy, cerebellar ataxia, and chronic traumatic brain injury received RAGT sessions. The Gross Motor Function Measure (GMFM), 6-min walk test (6 MWT), and 10-m walk test (10 MWT) were performed before and after intervention. The oxygen rate difference between resting and training was performed to evaluate the intensity of training in randomly selected sessions, while the Quebec User Evaluation of Satisfaction with assistive Technology 2.0 assessment was performed to evaluate its acceptability. A total of four of five items in the GMFM, gait speed on the 10 MWT, and total distance on the 6 MWT showed statistically significant improvement (p < 0.05). The oxygen rate was significantly higher during the training versus resting state. Altogether, six out of eight domains showed satisfaction scores more than four out of five points. In conclusion, overground training using a joint-torque-assisting wearable exoskeletal robot showed improvement in gross motor and gait functions after the intervention, induced intensive gait training, and achieved high satisfaction scores in children with static brain injury.
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Affiliation(s)
- Juntaek Hong
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (T.C.); (T.K.); (S.K.); (D.K.)
| | - Jongweon Lee
- Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang 10444, Korea; (J.L.); (W.C.)
| | - Taeyoung Choi
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (T.C.); (T.K.); (S.K.); (D.K.)
| | - Wooin Choi
- Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang 10444, Korea; (J.L.); (W.C.)
| | - Taeyong Kim
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (T.C.); (T.K.); (S.K.); (D.K.)
| | - Kyuwan Kwak
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul 03722, Korea; (K.K.); (K.K.)
| | - Seongjun Kim
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (T.C.); (T.K.); (S.K.); (D.K.)
| | - Kyeongyeol Kim
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul 03722, Korea; (K.K.); (K.K.)
| | - Daehyun Kim
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (T.C.); (T.K.); (S.K.); (D.K.)
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Intra- and Interrater Reliability of the Spanish Version of the Gross Motor Function Measure (GMFM-SP-88). Pediatr Phys Ther 2022; 34:193-200. [PMID: 35184079 DOI: 10.1097/pep.0000000000000874] [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: 11/25/2022]
Abstract
PURPOSE To assess intra- and interrater reliability of the Spanish version of the 88-item Gross Motor Function Measure (GMFM-SP-88), and its correlation to age and severity of children with cerebral palsy. METHODS Six raters assessed 50 videotapes and 4 viewed 50 recordings to determine intra- and interrater reliability, respectively. Intraclass correlation coefficients (ICCs), standard error of measurement (SEm), smallest real difference (SRD), and limits of agreement (LoA) were calculated. RESULTS Intra- and interrater reliability were excellent for both total (ICC2,1 = 1.00, 95% confidence interval [CI] 0.99-1.00) and dimension scores (ICC2,1 = 0.99, 95% CI 0.99-1.00). The SEm and the SRD for the total score were acceptable (1.60 and 3.14, respectively). The average differences in dimension scores were below 1 and 0.1 points (95% LoA: -1.65 to 1.94, -1.06 to 0.86 for intra- and interrater reliability, respectively). CONCLUSIONS The results support the potential use of the GMFM-SP-88 as a reliable tool, having correlation with age and severity. WHAT THIS ADDS TO THE EVIDENCE The GMFM-SP-88 is a reliable outcome measure to assess gross motor function in cerebral palsy. The GMFM-SP is the only tool available in Spanish to assess gross motor function in children and adolescents with cerebral palsy. The GMFM-SP-88 is a valuable resource for both Spanish physical therapists and researchers.
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Jain PD, Nayak A, Karnad SD, Doctor KN. Gross motor dysfunction and balance impairments in children and adolescents with Down syndrome: a systematic review. Clin Exp Pediatr 2022; 65:142-149. [PMID: 34126707 PMCID: PMC8898616 DOI: 10.3345/cep.2021.00479] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/30/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Individuals with Down syndrome present with several impairments such as hypotonia, ligament laxity, decreased muscle strength, insufficient muscular cocontraction, inadequate postural control, and disturbed proprioception. These factors are responsible for the developmental challenges faced by children with Down syndrome. These individuals also present with balance dysfunctions. PURPOSE This systematic review aims to describe the motor dysfunction and balance impairments in children and adolescents with Down syndrome. METHODS We searched the Scopus, ScienceDirect, MEDLINE, Wiley, and EBSCO databases for observational studies evaluating the motor abilities and balance performance in individuals with Down syndrome. The review was registered on PROSPERO. RESULTS A total of 1,096 articles were retrieved; after careful screening and scrutinizing against the inclusion and exclusion criteria, 10 articles were included in the review. Overall, the children and adolescents with Down syndrome showed delays and dysfunction in performing various activities such as sitting, pulling to stand, standing, and walking. They also presented with compensatory mechanisms to maintain their equilibrium in static and dynamic activities. CONCLUSION The motor development of children with Down syndrome is significantly delayed due to structural differences in the brain. These individuals have inefficient compensatory strategies like increasing step width, increasing frequency of mediolateral center of pressure displacement, decreasing anteroposterior displacement, increasing trunk stiffness, and increasing posterior trunk displacement to maintain equilibrium. Down syndrome presents with interindividual variations; therefore, a thorough evaluation is required before a structured intervention is developed to improve motor and balance dysfunction.
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Affiliation(s)
- Preyal D Jain
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Akshatha Nayak
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shreekanth D Karnad
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Kaiorisa N Doctor
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
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12
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Shearer C, Goss HR, Boddy LM, Knowles ZR, Durden-Myers EJ, Foweather L. Assessments Related to the Physical, Affective and Cognitive Domains of Physical Literacy Amongst Children Aged 7-11.9 Years: A Systematic Review. SPORTS MEDICINE-OPEN 2021; 7:37. [PMID: 34046703 PMCID: PMC8160065 DOI: 10.1186/s40798-021-00324-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 04/29/2021] [Indexed: 11/21/2022]
Abstract
Background Over the past decade, there has been increased interest amongst researchers, practitioners and policymakers in physical literacy for children and young people and the assessment of the concept within physical education (PE). This systematic review aimed to identify tools to assess physical literacy and its physical, cognitive and affective domains within children aged 7–11.9 years, and to examine the measurement properties, feasibility and elements of physical literacy assessed within each tool. Methods Six databases (EBSCO host platform, MEDLINE, PsycINFO, Scopus, Education Research Complete, SPORTDiscus) were searched up to 10th September 2020. Studies were included if they sampled children aged between 7 and 11.9 years, employed field-based assessments of physical literacy and/or related affective, physical or cognitive domains, reported measurement properties (quantitative) or theoretical development (qualitative), and were published in English in peer-reviewed journals. The methodological quality and measurement properties of studies and assessment tools were appraised using the COnsensus-based Standards for the selection of health Measurement INstruments risk of bias checklist. The feasibility of each assessment was considered using a utility matrix and elements of physical literacy element were recorded using a descriptive checklist. Results The search strategy resulted in a total of 11467 initial results. After full text screening, 11 studies (3 assessments) related to explicit physical literacy assessments. Forty-four studies (32 assessments) were relevant to the affective domain, 31 studies (15 assessments) were relevant to the physical domain and 2 studies (2 assessments) were included within the cognitive domain. Methodological quality and reporting of measurement properties within the included studies were mixed. The Canadian Assessment of Physical Literacy-2 and the Passport For Life had evidence of acceptable measurement properties from studies of very good methodological quality and assessed a wide range of physical literacy elements. Feasibility results indicated that many tools would be suitable for a primary PE setting, though some require a level of expertise to administer and score that would require training. Conclusions This review has identified a number of existing assessments that could be useful in a physical literacy assessment approach within PE and provides further information to empower researchers and practitioners to make informed decisions when selecting the most appropriate assessment for their needs, purpose and context. The review indicates that researchers and tool developers should aim to improve the methodological quality and reporting of measurement properties of assessments to better inform the field. Trial registration PROSPERO: CRD42017062217 Supplementary Information The online version contains supplementary material available at 10.1186/s40798-021-00324-8.
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Affiliation(s)
- Cara Shearer
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 5 Primrose Hill, Liverpool, UK
| | - Hannah R Goss
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 5 Primrose Hill, Liverpool, UK.,School of Health & Human Performance, Dublin City University, Dublin, Ireland
| | - Lynne M Boddy
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 5 Primrose Hill, Liverpool, UK
| | - Zoe R Knowles
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 5 Primrose Hill, Liverpool, UK
| | - Elizabeth J Durden-Myers
- Faculty of Education, The University of Gloucestershire, Francis Close Hall, Swindon Road, Cheltenham, UK
| | - Lawrence Foweather
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 5 Primrose Hill, Liverpool, UK.
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The relationship between gross motor function impairment in cerebral palsy and sleeping issues of children and caregivers. Sleep Med 2021; 81:261-267. [PMID: 33743473 DOI: 10.1016/j.sleep.2021.02.055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 11/22/2022]
Abstract
AIM To investigate, among children and adolescents with cerebral palsy (CP), the relationship between impairment of the gross motor function and: (i) child sleep disorders; (ii) the need for nocturnal support; and (iii) the quality of sleep of their caregivers. METHODS For children, we considered their scores on the gross motor function measure (GMFM-88) and on the sleep disturbance scale for children (SDSC), besides analyzing qualitative features about their sleep. For caregivers, we considered their scores in the Pittsburgh sleep quality index (PSQI). RESULTS Our sample was comprised of 87 participants with mean age of 11.4 years old (±3.4). We observed correlations between GMFM-88 and disorders of initiating and maintaining sleep (DIMS) (r = -0.22; p = 0.039), sleep-wake transition disorders (SWTD) (r = 0.26; p = 0.017) and disorders of arousal (DA) (r = 0.23; p = 0.033). Children receiving nocturnal support presented lower scores in the GMFM-88 (p = 0.001) and higher scores in the SDSC (p = 0.029). For the caregivers, we found no correlation between GMFM-88 and PSQI. Nonetheless, their PSQI scores correlated with the SDSC scores (r = 0.24; p = 0.027). CONCLUSION Impairment of the gross motor function correlated with DIMS and the need for nocturnal support but might not have an impact on the caregivers' sleep, which in turn correlated with child sleep disorders.
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14
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Dumas HM, Fragala-Pinkham MA, Moed R. Scoping Review of Judgment-Based Measures of Ambulation with Assistive Devices for Children and Youth. Phys Occup Ther Pediatr 2021; 41:120-137. [PMID: 32423367 PMCID: PMC7875468 DOI: 10.1080/01942638.2020.1766639] [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: 10/24/2022]
Abstract
AIM To identify available judgment-based measures of ambulation with assistive devices for the purpose of examining item content and responses to aid in the expansion of the Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) Mobility Domain. METHODS PubMed and CINAHL databases were used to identify measures meeting the following criteria: 1) applicable for children/youth; 2) self-report, proxy-report, or interview administration; and 3) assistive device (walker, cane, crutches, gait trainer) use specified or considered with responses. Population, administration, respondent(s), items, and responses were compiled. Item content was categorized and response scales grouped by type. RESULTS Fifteen measures met inclusion criteria. Measures included child and proxy-report. Item categories included Surfaces, Steps/Stairs, Dual Tasks, Negotiation of Environment, Distance, and Time. Only two measures distinguished between device type within items. One measure specified gait trainers. "Difficulty" and "Assistance" were the most frequently used response scales. CONCLUSIONS Available measures have content examining device use; however, none of the measures are comprehensive, devices are not consistently specified, and responses are imprecise. Items with well-defined responses for measuring a child's ambulation with an assistive device are needed for clinical practice, research, and program evaluation.
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Affiliation(s)
- Helene M Dumas
- Medical-Rehabilitation Research Center, Franciscan Children's Hospital, Boston, MA, USA
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15
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Kashoo FZ, Ahmad M. Comment to “The effects of Kinesio taping of lower limbs on functional mobility, spasticity, and range of motion of children with spastic cerebral palsy” by Mirjavad Tabatabaee et al. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00169-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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16
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Bouça‐Machado R, Duarte GS, Patriarca M, Castro Caldas A, Alarcão J, Fernandes RM, Mestre TA, Matias R, Ferreira JJ. Measurement Instruments to Assess Functional Mobility in Parkinson's Disease: A Systematic Review. Mov Disord Clin Pract 2020; 7:129-139. [PMID: 32071930 PMCID: PMC7011644 DOI: 10.1002/mdc3.12874] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/28/2019] [Accepted: 11/20/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Functional mobility (FM) is a person's ability to move to accomplish activities of daily living; it bridges the concepts of mobility and functional ability. There is frequently a loss of FM in Parkinson's disease (PD). Several instruments have been used to assess this concept in PD; however, there is no consensus on which are the most appropriate. OBJECTIVE We aimed to identify and critically appraise which measurement instruments have been used to assess FM. METHODS A systematic review was conducted using the databases CENTRAL, MEDLINE, Embase, and PEDro from their inception to January 2019 to identify all observational and experimental studies conducted in PD or atypical parkinsonism that included an FM assessment. Two reviewers independently screened citations, extracted data, and assessed clinimetric properties. RESULTS We included 95 studies that assessed FM in PD. Fifty-five (57.9%) studies mentioned FM in the article, and 39 (41.1%) specified the measurement tools used to evaluate FM. FM was the primary outcome in 12 (12.6%) studies. The Timed Up and Go test was the most frequently used measurement tool. Only one study presented a definition of FM. Several overlapping terms were used, the most common being mobility. CONCLUSION Several studies reported the use of FM measurement tools in PD, though with frequent misconceptions, an inadequate context of use, or suboptimal assessment. We propose the establishment of the concept of FM applied to PD, followed by the adequate clinimetric validation of existing measurement tools to provide a comprehensive and reliable evaluation of FM in PD.
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Affiliation(s)
- Raquel Bouça‐Machado
- Instituto de Medicina Molecular, Faculdade de MedicinaUniversidade de LisboaLisbonPortugal
- CNS–Campus Neurológico SéniorTorres VedrasPortugal
| | - Gonçalo S. Duarte
- Instituto de Medicina Molecular, Faculdade de MedicinaUniversidade de LisboaLisbonPortugal
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de MedicinaUniversidade de LisboaLisbonPortugal
| | | | | | - Joana Alarcão
- Center for Evidence‐Based Medicine, Faculdade de MedicinaUniversidade de LisboaLisbonPortugal
| | - Ricardo M. Fernandes
- Instituto de Medicina Molecular, Faculdade de MedicinaUniversidade de LisboaLisbonPortugal
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de MedicinaUniversidade de LisboaLisbonPortugal
- Department of PediatricsSanta Maria HospitalLisbonPortugal
| | - Tiago A. Mestre
- Parkinson's disease and Movement Disorders Center, Division of Neurology, Department of Medicine, The Ottawa Hospital Research InstituteUniversity of Ottawa Brain and Research InstituteOttawaOntarioCanada
| | - Ricardo Matias
- Champalimaud Research and Clinical CentreChampalimaud Centre for the UnknownLisbonPortugal
- Human Movement Analysis LabEscola Superior Saúde–Instituto Politécnico de SetúbalSetúbalPortugal
| | - Joaquim J. Ferreira
- Instituto de Medicina Molecular, Faculdade de MedicinaUniversidade de LisboaLisbonPortugal
- CNS–Campus Neurológico SéniorTorres VedrasPortugal
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Shank J, Chamorro-Viña C, Guilcher GMT, Langelier DM, Schulte F, Culos-Reed SN. Evaluation Tools for Physical Activity Programs for Childhood Cancer: A Scoping Review. J Pediatr Oncol Nurs 2019; 37:163-179. [PMID: 31847707 DOI: 10.1177/1043454219891987] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Research on the benefits of physical activity (PA) in childhood cancer has been translated into a handful of community-based programs. However, to foster further translation, an understanding of how to evaluate participant outcomes would be beneficial to provide feedback to participants and stimulate future research. Such a review would provide a summary of acceptable tools for work in this area. The purpose of this scoping review was to identify the evaluation tools that have been used in PA/exercise studies or programs for childhood cancer. This review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies included in the review used physical and psychosocial evaluation tools within PA and exercise programs or research for childhood cancer. In addition, studies with measures of health behavior such as PA levels and activities of daily living were included. Tools that assessed physical fitness and physical performance were excluded. Information on the types of evaluation tools used, mean age of participants, and type of cancer was extracted. Psychometric properties of each evaluation tool are reported. The most commonly assessed patient outcomes were motor performance, fatigue, well-being, functional mobility, and quality of life. Less commonly reported patient outcomes were hope, self-efficacy, and self-perception. None of the evaluation tools reported in the PA/exercise and pediatric oncology literature assess physical literacy. This review was the first step in a knowledge translation process, identifying evaluation tools that have been used in PA/exercise programs in childhood cancer survivors, that will guide the development and evaluation of current and future community-based programs.
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Affiliation(s)
- Jena Shank
- University of Calgary, Calgary, Alberta, Canada
| | - Carolina Chamorro-Viña
- University of Calgary, Calgary, Alberta, Canada.,Kids Cancer Care Foundation of Alberta, Calgary, Alberta, Canada
| | - Gregory M T Guilcher
- University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital, Calgary, Alberta, Canada
| | | | | | - S Nicole Culos-Reed
- University of Calgary, Calgary, Alberta, Canada.,Alberta Health Services, Calgary, Alberta, Canada
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18
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Belluscio V, Bergamini E, Salatino G, Marro T, Gentili P, Iosa M, Morelli D, Vannozzi G. Dynamic balance assessment during gait in children with Down and Prader-Willi syndromes using inertial sensors. Hum Mov Sci 2019; 63:53-61. [DOI: 10.1016/j.humov.2018.11.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 02/07/2023]
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19
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Himuro N, Nishibu H, Abe H, Mori M. Cross-Cultural Validation Study of the Japanese Version of the ABILOCO-Kids in Ambulatory Children With Cerebral Palsy Using Rasch Analysis. Phys Occup Ther Pediatr 2019; 39:679-691. [PMID: 31164026 DOI: 10.1080/01942638.2019.1609150] [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: 10/26/2022]
Abstract
Aims: To determine the structural validity, construct validity, cross-cultural validity, internal consistency and test-retest reliability of the Japanese version of the ABILOCO-Kids in children with cerebral palsy. Methods: One-hundred sixteen parents of children with cerebral palsy (Gross Motor Function Classification System level I [n = 66], II [n = 32], and III [n = 18]) reported on walking ability using the Japanese version of the ABILOCO-Kids. For test-retest reliability, 23 participants were evaluated. Results: The mean ABILOCO-Kids logit score was 2.48 (range -7.44 to 5.83). Rasch analysis and principal component analysis were used to determine the structural validity. The construct validity was confirmed on the basis of differences in the ABILOCO-Kids scores among the Gross Motor Function Classification System levels. Cronbach's α and the item-to-total correlation coefficient supported the internal consistency. The intra-class correlation coefficient was 0.96, standard error of measurement 0.56 and minimal detectable change 1.55. The cross-cultural validity analyses showed differential item functioning according to the analyses of the invariance of item difficulty and person's ability estimates. Conclusions: The ABILOCO-Kids is a reliable and valid measure of walking ability in children with cerebral palsy in Japan. The lack of evidence on cross-cultural validity indicates we should interpret results cautiously in cases of international comparison.
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Affiliation(s)
- Nobuaki Himuro
- Department of Public Health, School of Medicine, Sapporo Medical University , Sapporo , Japan
| | - Hisato Nishibu
- Division of Rehabilitation Medicine, Hokkaido Medical Center for Child Health and Rehabilitation , Sapporo , Japan
| | - Hirokazu Abe
- Department of Health Care and Child Development, Saitama Children's Medical Center , Saitama , Japan
| | - Mitsuru Mori
- Hokkaido Chitose College of Rehabilitation, Chitose , Japan
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20
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Abstract
OBJECTIVE Gross motor assessment tools have a critical role in identifying, diagnosing and evaluating motor difficulties in childhood. The objective of this review was to systematically evaluate the psychometric properties and clinical utility of gross motor assessment tools for children aged 2-12 years. METHOD A systematic search of MEDLINE, Embase, CINAHL and AMED was performed between May and July 2017. Methodological quality was assessed with the COnsensus-based Standards for the selection of health status Measurement INstruments checklist and an outcome measures rating form was used to evaluate reliability, validity and clinical utility of assessment tools. RESULTS Seven assessment tools from 37 studies/manuals met the inclusion criteria: Bayley Scale of Infant and Toddler Development-III (Bayley-III), Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2), Movement Assessment Battery for Children-2 (MABC-2), McCarron Assessment of Neuromuscular Development (MAND), Neurological Sensory Motor Developmental Assessment (NSMDA), Peabody Developmental Motor Scales-2 (PDMS-2) and Test of Gross Motor Development-2 (TGMD-2). Methodological quality varied from poor to excellent. Validity and internal consistency varied from fair to excellent (α=0.5-0.99). The Bayley-III, NSMDA and MABC-2 have evidence of predictive validity. Test-retest reliability is excellent in the BOT-2 (intraclass correlation coefficient (ICC)=0.80-0.99), PDMS-2 (ICC=0.97), MABC-2 (ICC=0.83-0.96) and TGMD-2 (ICC=0.81-0.92). TGMD-2 has the highest inter-rater (ICC=0.88-0.93) and intrarater reliability (ICC=0.92-0.99). CONCLUSIONS The majority of gross motor assessments for children have good-excellent validity. Test-retest reliability is highest in the BOT-2, MABC-2, PDMS-2 and TGMD-2. The Bayley-III has the best predictive validity at 2 years of age for later motor outcome. None of the assessment tools demonstrate good evaluative validity. Further research on evaluative gross motor assessment tools are urgently needed.
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Affiliation(s)
- Alison Griffiths
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia
- Department of Physiotherapy, The Royal Children's Hospital, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Rachel Toovey
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia
| | - Prue E Morgan
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia
| | - Alicia J Spittle
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia
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Himuro N, Nishibu H, Abe H, Mori M. The criterion validity and intra-rater reliability of the Japanese version of the Functional Mobility Scale in children with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 68:20-26. [PMID: 28735158 DOI: 10.1016/j.ridd.2017.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 05/21/2017] [Accepted: 07/11/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The purpose of this study was to develop a Japanese version of the Functional Mobility Scale (FMS), and examine the criterion validity and intra-rater reliability of the FMS in Japan. METHODS The translation of the FMS was performed according to international standards for the translation of measurements. For criterion validity, 111 children with cerebral palsy (mean age; 12year 1mo±3year 7mo; range 5-18) were rated the Japanese version of the FMS and Gross Motor Function Classification System (GMFCS). For intra-rater reliability, the Japanese version of the FMS was rated twice by 24 parents of children with cerebral palsy by interview and/or telephone with a one- to two-week interval between assessments. RESULTS The criterion validity was confirmed with a strong correlation between GMFCS level and FMS scores (r2=-0.71 to -0.75). For intra-rater reliability, there was a substantial to excellent level of agreement (kappa=0.72-0.87). CONCLUSION The study provides evidence of the criterion validity and intra-rater reliability of the Japanese version of the FMS as a measurement of mobility in children with cerebral palsy.
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Affiliation(s)
- Nobuaki Himuro
- Department of Public Health, School of Medicine, Sapporo Medical University, Sapporo, Japan.
| | - Hisato Nishibu
- Division of Rehabilitation Medicine, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Japan
| | - Hirokazu Abe
- Department of Health Care and Child Development, Saitama Children's Medical Center, Saitama, Japan
| | - Mitsuru Mori
- Department of Public Health, School of Medicine, Sapporo Medical University, Sapporo, Japan
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22
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Affiliation(s)
- Adrienne R Harvey
- Developmental Disability and Rehabilitation Research, Murdoch Children's Research Institute, Australia
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Aizawa CYP, Morales MP, Lundberg C, Moura MCDSD, Pinto FCG, Voos MC, Hasue RH. Conventional physical therapy and physical therapy based on reflex stimulation showed similar results in children with myelomeningocele. ARQUIVOS DE NEURO-PSIQUIATRIA 2017; 75:160-166. [PMID: 28355323 DOI: 10.1590/0004-282x20170009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 11/21/2016] [Indexed: 11/22/2022]
Abstract
We aimed to investigate whether infants with myelomeningocele would improve their motor ability and functional independence after ten sessions of physical therapy and compare the outcomes of conventional physical therapy (CPT) to a physical therapy program based on reflex stimulation (RPT). Twelve children were allocated to CPT (n = 6, age 18.3 months) or RPT (n = 6, age 18.2 months). The RPT involved proprioceptive neuromuscular facilitation. Children were assessed with the Gross Motor Function Measure and the Pediatric Evaluation of Disability Inventory before and after treatment. Mann-Whitney tests compared the improvement on the two scales of CPT versus RPT and the Wilcoxon test compared CPT to RPT (before vs. after treatment). Possible correlations between the two scales were tested with Spearman correlation coefficients. Both groups showed improvement on self-care and mobility domains of both scales. There were no differences between the groups, before, or after intervention. The CPT and RPT showed similar results after ten weeks of treatment.
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Affiliation(s)
- Carolina Y P Aizawa
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Fisioterapia, Terapia Ocupacional e Fonoaudiologia, São Paulo SP, Brasil
| | - Mariana P Morales
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Fisioterapia, Terapia Ocupacional e Fonoaudiologia, São Paulo SP, Brasil
| | - Carolina Lundberg
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Fisioterapia, Terapia Ocupacional e Fonoaudiologia, São Paulo SP, Brasil
| | - Maria Clara D Soares de Moura
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Fisioterapia, Terapia Ocupacional e Fonoaudiologia, São Paulo SP, Brasil
| | - Fernando C G Pinto
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Fisioterapia, Terapia Ocupacional e Fonoaudiologia, São Paulo SP, Brasil
| | - Mariana C Voos
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Fisioterapia, Terapia Ocupacional e Fonoaudiologia, São Paulo SP, Brasil
| | - Renata H Hasue
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Fisioterapia, Terapia Ocupacional e Fonoaudiologia, São Paulo SP, Brasil
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Champagne D, Corriveau H, Dugas C. Effect of Hippotherapy on Motor Proficiency and Function in Children with Cerebral Palsy Who Walk. Phys Occup Ther Pediatr 2017; 37:51-63. [PMID: 26930110 DOI: 10.3109/01942638.2015.1129386] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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 the effects of hippotherapy on physical capacities of children with cerebral palsy. METHODS Thirteen children (4-12 years old) with cerebral palsy classified in Gross Motor Function Classification System Level I or II were included in this prospective quasi-experimental ABA design study. Participants received 10 weeks of hippotherapy (30 min per week). Gross motor function and proficiency were measured with the Bruininks-Oseretski Motor Proficiency short form [BOT2-SF]) and the Gross Motor Function Measure-88 [GMFM-88] (Dimension D and E) twice before the program (T1 and T1'), immediately after (T2), and 10 weeks following the end of the program (T3). RESULTS Mean scores for dimensions D and E of the GMFM-88 Dimension scores (p = .005) and three out of the eight items of the BOT2-SF (fine motor precision (p = .013), balance (p = .025), and strength (p = .012) improved between baseline and immediately after intervention; mean scores immediately following and 10 weeks following intervention did not differ. CONCLUSIONS Hippotherapy provided by a trained therapist who applies an intense and graded session for 10 weeks can improve body functions and performance of gross motor and fine motor activities in children with cerebral palsy.
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Affiliation(s)
- Danielle Champagne
- a Faculty of Medicine and Health Sciences , Université de Sherbrooke , Sherbrooke , Québec , Canada
| | - Hélène Corriveau
- a Faculty of Medicine and Health Sciences , Université de Sherbrooke , Sherbrooke , Québec , Canada.,b Research Centre on Aging , University Institute of Geriatrics of Sherbrooke , Sherbrooke , Québec , Canada
| | - Claude Dugas
- c Department of Physical Activity Sciences , Université du Québec à Trois-Rivières , Trois-Rivières , Québec , Canada
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25
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Pham HP, Eidem A, Hansen G, Nyquist A, Vik T, Sæther R. Validity and Responsiveness of the Trunk Impairment Scale and Trunk Control Measurement Scale in Young Individuals with Cerebral Palsy. Phys Occup Ther Pediatr 2016; 36:440-52. [PMID: 26890372 DOI: 10.3109/01942638.2015.1127867] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM This study examines construct validity and responsiveness of the Trunk Impairment Scale (TIS) and Trunk Control Measurement Scale (TCMS) in individuals with cerebral palsy (CP). METHODS Twenty-six individuals with CP (nine males), 8-29 years (mean age 17.6) with gross motor function corresponding to GMFCS I-IV, participated in three weeks of intensive and varied physical training at a health sports center. Trunk control was assessed with the TIS (includes three subscales) and TCMS (includes three subscales), and gross motor function with the Gross Motor Function Measure 66 item set (GMFM-66-IS), before and after the training period. The GMFM-66-IS was used as a comparison measure. RESULTS The median score of the TCMS subscale dynamic sitting balance, reaching (DSB-R), increased from 6 to 7 (range: 1-10; p = .031), and there was a median change of 3 points in GMFM-66-IS score (p = .036). There were no significant changes in the TIS. The correlations (Spearman's rho), between the TIS, TCMS, and the GMFM-66-IS (pre-scores), ranged between 0.57 and 0.75 (p< .003). Correlations between change scores (pre- and post-scores) were low, and not statistically significant. However, the TCMS DSB-R change score correlated significantly with hours spent on "trunk-targeted training" like paddling/rowing (rho = 0.66; p = .003) and horseback riding (rho = 0.54; p = .011). CONCLUSIONS Our results support construct validity of the TIS and TCMS in young individuals with CP, whereas responsiveness could not be documented. However, the correlations between the TCMS DSB-R change score and hours spent on ''trunk-targeted training'' suggest that this subscale may have the potential to be used in intervention studies.
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Affiliation(s)
- Hong Phi Pham
- a Department of Laboratory Medicine, Children's and Women's Health , Norwegian University of Science and Technology , Trondheim , Norway
| | - Anita Eidem
- b Clinic for Clinical Services , St. Olavs University Hospital , Trondheim , Norway
| | - Gry Hansen
- c Department of Pediatrics , St. Olavs Hospital, University Hospital of Trondheim , Trondheim, Norway
| | - Astrid Nyquist
- d Beitostølen Healthsports Center , Øystre Slidre , Norway
| | - Torstein Vik
- a Department of Laboratory Medicine, Children's and Women's Health , Norwegian University of Science and Technology , Trondheim , Norway.,c Department of Pediatrics , St. Olavs Hospital, University Hospital of Trondheim , Trondheim, Norway
| | - Rannei Sæther
- a Department of Laboratory Medicine, Children's and Women's Health , Norwegian University of Science and Technology , Trondheim , Norway.,c Department of Pediatrics , St. Olavs Hospital, University Hospital of Trondheim , Trondheim, Norway
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26
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Himuro N, Abe H, Nishibu H, Seino T, Mori M. Easy-to-use clinical measures of walking ability in children and adolescents with cerebral palsy: a systematic review. Disabil Rehabil 2016; 39:957-968. [DOI: 10.1080/09638288.2016.1175036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Nobuaki Himuro
- Department of Public Health, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Hirokazu Abe
- Department of Health Care and Child Development, Saitama Children’s Medical Center, Saitama, Japan
| | - Hisato Nishibu
- Division of Rehabilitation Medicine, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Japan
- Master Course of Health Sciences, Department of Physical Therapy, Graduate School, Sapporo Medical University, Sapporo, Japan
| | - Tsugumi Seino
- Master Course of Health Sciences, Department of Physical Therapy, Graduate School, Sapporo Medical University, Sapporo, Japan
| | - Mitsuru Mori
- Department of Public Health, School of Medicine, Sapporo Medical University, Sapporo, Japan
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Condliffe EG, Jeffery DT, Emery DJ, Gorassini MA. Spinal inhibition and motor function in adults with spastic cerebral palsy. J Physiol 2016; 594:2691-705. [PMID: 26842905 DOI: 10.1113/jp271886] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 02/01/2016] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS Abnormal activation of motoneurons in the spinal cord by sensory pathways is thought to contribute to impaired movement control and spasticity in individuals with cerebral palsy. Here we use single motor unit recordings to show how individual motoneurons in the spinal cord respond to sensory inputs in a group of participants with cerebral palsy having different degrees of motor dysfunction. In participants who had problems walking independently and required assistive devices such as wheelchairs, sensory pathways only excited motoneurons in the spinal cord. In contrast, in participants with cerebral palsy who walked independently for long distances, sensory inputs both inhibited and excited motoneurons in the spinal cord, similar to what we found in uninjured control participants. These findings demonstrate that in individuals with severe cerebral palsy, inhibitory control of motoneurons from sensory pathways is reduced and may contribute to motor dysfunction and spasticity. ABSTRACT Reduced inhibition of spinal motoneurons by sensory pathways may contribute to heightened reflex activity, spasticity and impaired motor function in individuals with cerebral palsy (CP). To measure if the activation of inhibitory post-synaptic potentials (IPSPs) by sensory inputs is reduced in CP, the tonic discharge rate of single motor units from the soleus muscle was plotted time-locked to the occurrence of a sensory stimulation to produce peri-stimulus frequencygrams (PSFs). Stimulation to the medial arch of the foot was used to activate cutaneomuscular afferents in 17 adults with bilateral spastic CP and 15 neurologically intact (NI) peers. Evidence of IPSP activation from the PSF profiles, namely a marked pause or reduction in motor unit firing rates at the onset of the cutaneomuscular reflex, was found in all NI participants but in only half of participants with CP. In the other half of the participants with CP, stimulation of cutaneomuscular afferents produced a PSF profile indicative of a pure excitatory post-synaptic potential, with firing rates increasing above the mean pre-stimulus rate for 300 ms or more. The amplitude of motoneuron inhibition during the period of IPSP activation, as measured from the surface EMG, was less in participants with poor motor function as evaluated with the Gross Motor Functional Classification System (r = 0.72, P < 0.001) and the Functional Mobility Scale (r = -0.82, P < 0.001). These findings demonstrate that in individuals with CP, reduced activation of motoneuron IPSPs by sensory inputs is associated with reduced motor function and may contribute to enhanced reflexes and spasticity in CP.
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Affiliation(s)
- E G Condliffe
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada.,Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada.,Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, Alberta, Canada
| | - D T Jeffery
- Department of Radiology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - D J Emery
- Department of Radiology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - M A Gorassini
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada.,Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
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28
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Safety and efficacy of alternative alglucosidase alfa regimens in Pompe disease. Neuromuscul Disord 2015; 25:321-32. [DOI: 10.1016/j.nmd.2014.12.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 11/21/2014] [Accepted: 12/16/2014] [Indexed: 11/21/2022]
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29
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Anthoine E, Moret L, Regnault A, Sébille V, Hardouin JB. Sample size used to validate a scale: a review of publications on newly-developed patient reported outcomes measures. Health Qual Life Outcomes 2014; 12:176. [PMID: 25492701 PMCID: PMC4275948 DOI: 10.1186/s12955-014-0176-2] [Citation(s) in RCA: 563] [Impact Index Per Article: 56.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 11/20/2014] [Indexed: 12/26/2022] Open
Abstract
PURPOSE New patient reported outcome (PRO) measures are regularly developed to assess various aspects of the patients' perspective on their disease and treatment. For these instruments to be useful in clinical research, they must undergo a proper psychometric validation, including demonstration of cross-sectional and longitudinal measurement properties. This quantitative evaluation requires a study to be conducted on an appropriate sample size. The aim of this research was to list and describe practices in PRO and proxy PRO primary psychometric validation studies, focusing primarily on the practices used to determine sample size. METHODS A literature review of articles published in PubMed between January 2009 and September 2011 was conducted. Three selection criteria were applied including a search strategy, an article selection strategy, and data extraction. Agreements between authors were assessed, and practices of validation were described. RESULTS Data were extracted from 114 relevant articles. Within these, sample size determination was low (9.6%, 11/114), and were reported as either an arbitrary minimum sample size (n = 2), a subject to item ratio (n = 4), or the method was not explicitly stated (n = 5). Very few articles (4%, 5/114) compared a posteriori their sample size to a subject to item ratio. Content validity, construct validity, criterion validity and internal consistency were the most frequently measurement properties assessed in the validation studies. Approximately 92% of the articles reported a subject to item ratio greater than or equal to 2, whereas 25% had a ratio greater than or equal to 20. About 90% of articles had a sample size greater than or equal to 100, whereas 7% had a sample size greater than or equal to 1000. CONCLUSIONS The sample size determination for psychometric validation studies is rarely ever justified a priori. This emphasizes the lack of clear scientifically sound recommendations on this topic. Existing methods to determine the sample size needed to assess the various measurement properties of interest should be made more easily available.
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Affiliation(s)
- Emmanuelle Anthoine
- Public Health Department, University Hospital of Nantes, 85, rue Saint Jacques, 44093, Nantes Cedex 1, France. .,EA 4275 SPHERE "bioStatistics, Pharmacoepidemiology and Human sciEnces Research tEam", University of Nantes, 1, rue Gaston Veil, 44035, Nantes Cedex 1, France. .,Biometry Platform, University Hospital of Nantes, 5, Allée de l'Ile Gloriette, 44093, Nantes Cedex 1, France.
| | - Leïla Moret
- Public Health Department, University Hospital of Nantes, 85, rue Saint Jacques, 44093, Nantes Cedex 1, France. .,EA 4275 SPHERE "bioStatistics, Pharmacoepidemiology and Human sciEnces Research tEam", University of Nantes, 1, rue Gaston Veil, 44035, Nantes Cedex 1, France.
| | - Antoine Regnault
- EA 4275 SPHERE "bioStatistics, Pharmacoepidemiology and Human sciEnces Research tEam", University of Nantes, 1, rue Gaston Veil, 44035, Nantes Cedex 1, France. .,Mapi HEOR & Strategic Market Access, 27 rue de la Villette, 69003, Lyon, France.
| | - Véronique Sébille
- EA 4275 SPHERE "bioStatistics, Pharmacoepidemiology and Human sciEnces Research tEam", University of Nantes, 1, rue Gaston Veil, 44035, Nantes Cedex 1, France. .,Biometry Platform, University Hospital of Nantes, 5, Allée de l'Ile Gloriette, 44093, Nantes Cedex 1, France.
| | - Jean-Benoit Hardouin
- EA 4275 SPHERE "bioStatistics, Pharmacoepidemiology and Human sciEnces Research tEam", University of Nantes, 1, rue Gaston Veil, 44035, Nantes Cedex 1, France. .,Biometry Platform, University Hospital of Nantes, 5, Allée de l'Ile Gloriette, 44093, Nantes Cedex 1, France.
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Measurement properties of gait-related outcomes in youth with neuromuscular diagnoses: a systematic review. Phys Ther 2014; 94:1067-82. [PMID: 24786947 DOI: 10.2522/ptj.20130299] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Sound measurement properties of outcome tools are essential when evaluating outcomes of an intervention, in clinical practice and in research. PURPOSE The purpose of this study was to review the evidence on reliability, measurement error, and responsiveness of measures of gait function in children with neuromuscular diagnoses. DATA SOURCES The MEDLINE, CINAHL, EMBASE, and PsycINFO databases were searched up to June 15, 2012. STUDY SELECTION Studies evaluating reliability, measurement error, or responsiveness of measures of gait function in 1- to 18-year-old children and youth with neuromuscular diagnoses were included. DATA EXTRACTION Quality of the studies was independently rated by 2 raters using a modified COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. Studies with a fair quality rating or better were considered for best evidence synthesis. DATA SYNTHESIS Regarding the methodological quality, 32 out of 35 reliability studies, all of the 13 measurement error studies, and 5 out of 10 responsiveness studies were of fair or good quality. Best evidence synthesis revealed moderate to strong evidence for reliability for several measures in children and youth with cerebral palsy (CP) but was limited or unknown in other diagnoses. The Functional Mobility Scale (FMS) and the Gross Motor Function Measure (GMFM) dimension E showed limited positive evidence for responsiveness in children with CP, but it was unknown or controversial in other diagnoses. No information was reported on the minimal important change; thus, evidence on measurement error remained undetermined. LIMITATIONS As studies on validity were not included in the review, a comprehensive appraisal of the best available gait-related outcome measure per diagnosis is not possible. CONCLUSIONS There is moderate to strong evidence on reliability for several measures of gait function in children and youth with CP, whereas evidence on responsiveness exists only for the FMS and the GMFM dimension E.
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31
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Bañas BB, Gorgon EJR. Clinimetric properties of sitting balance measures for children with cerebral palsy: a systematic review. Phys Occup Ther Pediatr 2014; 34:313-34. [PMID: 24490854 DOI: 10.3109/01942638.2014.881952] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Assessment of sitting balance in children and youth with cerebral palsy (CP) is critical in order to design appropriate interventions to enhance activities and participation. This systematic review synthesized research evidence on the reliability, validity, responsiveness to change, and clinical utility of sitting balance measures for children and youth with CP. A two-tiered search in August 2012 using nine peer-reviewed electronic databases yielded nine articles with relevant information on seven clinical measures. Four of seven clinical measures: the Pediatric Reach Test (PRT), Sitting Assessment for Children with Neuromotor Dysfunction (SACND), Segmental Assessment of Trunk Control (SATCo), and Trunk Control Measurement Scale (TCMS), demonstrate acceptable overall applicability (at least one study supporting clinical utility, reliability, and validity) and are thus recommended for use in practice. Ongoing research on responsiveness to change, however, is warranted to support validity for outcomes measurement.
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32
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Ko J. Sensitivity to functional improvements of GMFM-88, GMFM-66, and PEDI mobility scores in young children with cerebral palsy. Percept Mot Skills 2014; 119:305-19. [PMID: 25153757 DOI: 10.2466/03.25.pms.119c14z1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study assessed the sensitivity to functional change of the total score on age- and severity-relevant dimensions (Goal Total score) of the Gross Motor Function Measure (GMFM)-88 compared with GMFM-88 Total, GMFM-66, and Pediatric Evaluation of Disability Inventory (PEDI) Mobility scores in children with cerebral palsy (CP). Correlations among the four parameters were calculated to assess how sensitivity may differ according to the severity of CP. 64 children with CP (M age = 43.8 mo., SD = 16.5, range = 21 to 84 mo.; 36 boys, 28 girls) were recruited. The GMFM and PEDI assessments were performed over an interval of 6 mo. The effect sizes for changes over time were large (0.88 to 1.26) for the selected GMFM-88 Goal Total scores. The minimally important differences of the GMFM-88 Goal Total scores were within the mean range of change, with CP severity categorized as GMFCS Levels I/II, Level III, and Levels IV/V. The selected GMFM-88 Goal Total scores showed from poor to good correlations with GMFM-88 Total, GMFM-66, and PEDI Mobility scores. The results indicated that age- and severity-relevant GMFM-88 Goal Total scores were the optimal parameter to detect meaningful change in children with CP for clinical and research use.
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Affiliation(s)
- Jooyeon Ko
- 1 Department of Rehabilitation Medicine CHA Bundang Medical Center
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33
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Morris ME, Adair B, Ozanne E, Kurowski W, Miller KJ, Pearce AJ, Santamaria N, Long M, Ventura C, Said CM. Smart technologies to enhance social connectedness in older people who live at home. Australas J Ageing 2014; 33:142-52. [DOI: 10.1111/ajag.12154] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Meg E Morris
- Department of Physiotherapy; School of Allied Health; La Trobe University; Melbourne Victoria Australia
| | - Brooke Adair
- Department of Physiotherapy; School of Allied Health; La Trobe University; Melbourne Victoria Australia
- School of Allied Health; Australian Catholic University; Melbourne Victoria Australia
| | - Elizabeth Ozanne
- Department of Social Work; Melbourne School of Health Sciences; University of Melbourne; Melbourne Australia
| | - William Kurowski
- Department of Social Work; Melbourne School of Health Sciences; University of Melbourne; Melbourne Australia
| | - Kimberly J Miller
- Department of Physical Therapy; University of British Columbia; Vancouver Canada
| | - Alan J Pearce
- Cognitive Neuroscience Unit; School of Psychology; Deakin University; Melbourne Victoria Australia
| | | | - Maureen Long
- Department of Social Work; School of Allied Health; La Trobe University; Melbourne Victoria Australia
| | - Cameron Ventura
- Department of Physiotherapy; School of Allied Health; La Trobe University; Melbourne Victoria Australia
| | - Catherine M Said
- Department of Physiotherapy; School of Allied Health; La Trobe University; Melbourne Victoria Australia
- Department of Physiotherapy; Melbourne School of Health Sciences; University of Melbourne; Melbourne Victoria Australia
- Physiotherapy Department; Austin Health; Melbourne Victoria Australia
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34
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Bialocerkowski A, O'shea K, Pin TW. Psychometric properties of outcome measures for children and adolescents with brachial plexus birth palsy: a systematic review. Dev Med Child Neurol 2013; 55:1075-88. [PMID: 23808952 DOI: 10.1111/dmcn.12194] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/17/2013] [Indexed: 02/01/2023]
Abstract
AIM The aim of this review was to evaluate the psychometric properties of outcome measures used to quantify upper limb function in children and adolescents with brachial plexus birth palsy (BPBP). METHOD Eleven electronic databases were searched to identify studies on the effects of conservative management to improve upper limb function in young people with BPBP. Outcome measures used in these studies were extracted and used in a subsequent search to identify studies that evaluated the psychometric properties of these measures. The methodological quality of these studies was rated using a standardized critical appraisal tool. RESULTS Thirty-three outcome measures and 12 psychometric studies were identified. Nine outcome measures had some psychometric evidence, which was variable in quality. The outcome measures which seem to have the most robust psychometric properties include the Active Movement Scale, Assisting Hand Assessment, Pediatric Evaluation of Disability Index, and the Pediatric Outcomes Data Collection Instrument. INTERPRETATION Further research is required to determine the psychometric properties of outcome measures used for children and adolescents with BPBP. Caution is required when interpreting the results of commonly used outcome measures in this population owing to their relatively unknown psychometric properties.
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35
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Avery LM, Russell DJ, Rosenbaum PL. Criterion validity of the GMFM-66 item set and the GMFM-66 basal and ceiling approaches for estimating GMFM-66 scores. Dev Med Child Neurol 2013; 55:534-8. [PMID: 23448693 DOI: 10.1111/dmcn.12120] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/08/2012] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to compare the accuracy of two abbreviated approaches for estimating Gross Motor Function Measure 66 (GMFM-66) scores against the full GMFM-66 and to explore their strengths and limitations. METHOD An existing dataset (n=224) comprising children aged 1 to 13 years (mean age 6y 11mo, SD 4y 6mo; 132 males, 92 females) with cerebral palsy (CP) of all Gross Motor Function Classification System (GMFCS) levels was used to compare the validity of the item set version (GMFM-66-IS) and the basal and ceiling version (GMFM-66-B&C) with the full GMFM-66 scores. Follow-up assessment at 1 year (n=109) allowed evaluation of change scores and accuracy at a single point in time. RESULTS The cross-sectional agreement was excellent for both abbreviated measures (all intraclass correlation coefficients [ICCs] >0.98). When measuring change over time, both the GMFM-66-IS and the GMFM-66-B&C showed good agreement for children with bilateral CP (ICCs >0.9). However, the GMFM-66-IS assessed change over 1 year more accurately than the GMFM-66-B&C in children with unilateral CP (ICC=0.89 vs ICC=0.58; 95% confidence intervals do not overlap). INTERPRETATION Both approaches for estimating GMFM-66 scores are accurate at a single point in time. If the primary goal of assessment is to measure change, the full GMFM-66 should still be regarded as the criterion standard. The GMFM-66-IS should be the preferred shortened measure for children with unilateral CP.
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Affiliation(s)
- Lisa M Avery
- CanChild Centre for Childhood Disability Research, McMaster University, Canada
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