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Knight Lozano R, Shannon H, Gilby J, Goddard S, Turner L, Marsden J. Community-based respiratory health measures in children and young people with cerebral palsy: A scoping review. Dev Med Child Neurol 2024; 66:849-862. [PMID: 38269611 DOI: 10.1111/dmcn.15854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 12/05/2023] [Accepted: 12/19/2023] [Indexed: 01/26/2024]
Abstract
AIM To identify, map, and describe outcome measurement domains and instruments used within a community setting to assess respiratory health in children and young people aged 1 to 18 years, diagnosed with cerebral palsy (CP). METHOD A scoping review methodology informed structured searches in nine databases, grey literature, and registries, conducted in August 2021 (updated in February 2023). Articles were screened for eligibility by two independent researchers. Any outcome measurement instruments used to assess respiratory health or associated impact were extracted, categorized, and mapped to health and health-related domains of the International Classification of Functioning, Disability, and Health. RESULTS Seventy-six outcome measurement instruments were identified across 78 articles worldwide between 1970 and 2023. These were categorized into 'Body functions and structures' (n = 20), 'Activity and performance' (n = 22), and 'Participation and quality of life' (n = 19), with a further 15 mapped to 'Health care resources use'. INTERPRETATION No consensus of 'what' to measure and 'how' to measure respiratory health in children and young people with CP was found. Moreover, many measures were not replicable in individuals with more severe forms of CP, excluding those at increased risk of respiratory-related morbidity and mortality. Further research is required to agree important outcome domains and associated measures in research and clinical practice. WHAT THIS PAPER ADDS A limited number and size of experimental designs were found. Seventy-six measures were identified to assess respiratory health in cerebral palsy. No consensus was found in 'what' or 'how' to measure respiratory health. Many measures were not replicable in children and young people at risk of poorer respiratory health outcomes. Children and young people with comorbidities and learning disability were frequently excluded from studies.
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Affiliation(s)
| | - Harriet Shannon
- UCL Great Ormond Street Institute of Child Health, London, UK
| | | | - Sian Goddard
- Faculty of Health, University of Plymouth, Plymouth, UK
| | - Leanne Turner
- Cheshire and Wirral Partnership NHS Foundation Trust, Chester, UK
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Avci D. Mental Health Problems Among Adolescents With Mild Intellectual Disability and Relation to Sleep Quality and Perceived Social Support: A Comparative Study. J Psychosoc Nurs Ment Health Serv 2024; 62:39-50. [PMID: 37646605 DOI: 10.3928/02793695-20230821-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
The current cross-sectional study sought to determine the mental health problems of adolescents with mild intellectual disability (ID) and influencing factors. This study, which used a comparison group, was performed with 188 adolescents (91 with mild ID and 97 without ID) between January 2019 and June 2019 in Turkey. Data were collected using a Personal Information Form, the Strengths and Difficulties Questionnaire, Pittsburgh Sleep Quality Index, and Perceived Social Support Scale. Adolescents with mild ID were at higher risk for mental health problems compared to those without ID. According to linear regression analysis, sex, age, birth order, maternal age, parents' educational level, sleep quality, and perceived social support were statistically significant predictive factors of mental health problems in adolescents with mild ID. Results of this study indicate that adolescents with mild ID are at greater risk for mental health problems and that effective prevention/intervention strategies are needed. [Journal of Psychosocial Nursing and Mental Health Services, 62(3), 39-50.].
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O'Sullivan R, Bissell S, Hamilton A, Bagshaw A, Richards C. Concordance of objective and subjective measures of sleep in children with neurodevelopmental conditions: A systematic review and meta-analysis. Sleep Med Rev 2023; 71:101814. [PMID: 37422998 DOI: 10.1016/j.smrv.2023.101814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/30/2023] [Accepted: 06/27/2023] [Indexed: 07/11/2023]
Abstract
The purpose of this systematic review and meta-analysis is to delineate the concordance of objective and subjective measures of sleep in children with neurodevelopmental conditions (NDCs). A systematic literature search identified 31 studies that compare objective and subjective estimates of sleep parameters in autism, ADHD or rare genetic syndromes associated with intellectual disability. The meta-analyses revealed smaller mean differences and larger correlations indicative of greater concordance for parameters associated with sleep scheduling compared to parameters associated with sleep duration and night awakenings. Relative to objective measures, subjective measures produced: 1) greater estimates of total sleep time, sleep efficiency and time in bed; and 2) lower estimates of wake after sleep onset and number of night awakenings. Subgroup analyses also revealed differences in concordance between measurement comparison types (e.g., stronger correlations between actigraphy and sleep diaries, compared to actigraphy and questionnaires) and NDC diagnostic groups. The results predominantly replicate concordance trends observed in typically-developing samples, although some NDC-specific patterns of concordance were identified. This indicates that objective and subjective sleep measures retain broadly similar properties across populations, although researchers and clinicians should be cautious of the impact of NDC-related characteristics on sleep parameter estimates. These findings should inform sleep assessment design and the interpretation of sleep parameter estimates in NDCs, increasing the rigour of sleep parameter description across research and clinical settings.
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Affiliation(s)
- Rory O'Sullivan
- School of Psychology, University of Birmingham, UK; Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, UK.
| | - Stacey Bissell
- School of Psychology, University of Birmingham, UK; Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, UK
| | - Anna Hamilton
- School of Psychology, University of Birmingham, UK; Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, UK
| | - Andrew Bagshaw
- School of Psychology, University of Birmingham, UK; Centre for Human Brain Health, University of Birmingham, UK
| | - Caroline Richards
- School of Psychology, University of Birmingham, UK; Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, UK
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Harper L, McAnelly S, Walshe I, Ooms A, Tuffrey-Wijne IM. Behavioural sleep problems in children and adults with intellectual disabilities: An integrative literature review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:916-928. [PMID: 37177858 DOI: 10.1111/jar.13116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 04/27/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND People with intellectual disabilities are more likely to experience sleep problems, which can affect quality of life, physical health, mental health and well-being. METHODS An integrative literature review was conducted to investigate what is known about behavioural sleep disturbances in people with an intellectual disability. The search used the following databases: Scopus, PsycInfo and Cinahl, to find papers published since 2015. RESULTS Within intellectual disability research, sleep appears as a common issue due to its high prevalence, negative relationships with an individual's physical and mental health, their quality of life, and impact of sleep problems on family or carers. The growing evidence base appears to support the use of behavioural, lifestyle and pharmacological interventions to improve sleep in people with an intellectual disability. CONCLUSION A wide array of literature provides evidence that people with intellectual disabilities are affected by and need support with their sleep.
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Affiliation(s)
- Lynette Harper
- Health and Life Sciences, Northumbria University, London, UK
| | - Su McAnelly
- Health and Life Sciences, Northumbria University, London, UK
| | - Ian Walshe
- Health and Life Sciences, Northumbria University, London, UK
| | - Ann Ooms
- Faculty of Health, Science, Social Care and Education, Kingston University, London, UK
| | - Irene M Tuffrey-Wijne
- Faculty of Health, Science, Social Care and Education, Kingston University, London, UK
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Giambersio D, Marzulli L, Margari L, Matera E, Nobili L, De Grandis E, Cordani R, Barbieri A, Peschechera A, Margari A, Petruzzelli MG. Correlations between Sleep Features and Iron Status in Children with Neurodevelopmental Disorders: A Cross-Sectional Study. J Clin Med 2023; 12:4949. [PMID: 37568350 PMCID: PMC10420017 DOI: 10.3390/jcm12154949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
A high prevalence of sleep disturbances has been reported in children with neurodevelopmental disorders (NDDs), such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and intellectual disability (ID). The etiology of sleep disorders in these children is heterogeneous and, recently, iron deficiency has received increasing attention. This study aims to investigate sleep features in children with NDDs and to explore a possible correlation between serum iron status biomarkers and qualitative features of sleep. We included 4- to 12-year-old children with a diagnosis of ASD, ADHD, or ID and assessed their sleep features through the children's sleep habits questionnaire (CSHQ). Venous blood samples were collected to investigate ferritin, transferrin, and iron levels. The mean CSHQ total score exceeds the cut-off in all groups of children. In the ASD group, the Parasomnias subscale negatively correlated with serum ferritin levels (Rho = 0.354; p = 0.029). Our findings may suggest the existence of an association between iron status, sleep quality, and neurodevelopmental processes. In clinical practice, sleep assessment should be included in the routine assessment for patients with NDDs. Furthermore, a routine assessment of iron status biomarkers should be recommended for children with NDDs who have sleep disturbances.
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Affiliation(s)
- Donatella Giambersio
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy; (D.G.); (E.D.G.); (R.C.)
- Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Studies of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Lucia Marzulli
- Department of Translational Biomedicine and Neuroscience (DIBRAIN), University of Studies of Bari “Aldo Moro”, 70124 Bari, Italy (M.G.P.)
| | - Lucia Margari
- Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Studies of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Emilia Matera
- Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Studies of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Lino Nobili
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy; (D.G.); (E.D.G.); (R.C.)
- Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Elisa De Grandis
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy; (D.G.); (E.D.G.); (R.C.)
- Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Ramona Cordani
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy; (D.G.); (E.D.G.); (R.C.)
- Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Antonella Barbieri
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy; (D.G.); (E.D.G.); (R.C.)
- Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Antonia Peschechera
- Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Studies of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Anna Margari
- Interdisciplinary Department of Medicine (DIM), University of Studies of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Maria Giuseppina Petruzzelli
- Department of Translational Biomedicine and Neuroscience (DIBRAIN), University of Studies of Bari “Aldo Moro”, 70124 Bari, Italy (M.G.P.)
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Downs J, Blackmore AM, Wong K, Buckley N, Lotan M, Elefant C, Leonard H, Stahlhut M. Can telehealth increase physical activity in individuals with Rett syndrome? A multicentre randomized controlled trial. Dev Med Child Neurol 2023; 65:489-497. [PMID: 36284370 DOI: 10.1111/dmcn.15436] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 12/01/2022]
Abstract
AIM To evaluate the effects of a physical activity programme on sedentary behaviour and physical activity in ambulant individuals with Rett syndrome (RTT). METHOD In this multicentre randomized waitlist-controlled trial, we recruited 43 ambulatory individuals with RTT in Australia and Denmark. Adequate baseline data were obtained from 38 participants (mean age 20 years, range 6-41, SD 10 years 6 months, one male). All completed the trial. Participants received 12 weeks of usual care (n = 19) or a goal-based, telehealth-supported programme in which activities occurred in their familiar environments (n = 19). Sedentary time and daily steps were assessed at baseline, post-test, and 12-week follow-up. The data analyst was blinded to group allocation. RESULTS Sedentary time decreased in the intervention group by 2.7% (95% confidence interval [CI] -6.0 to 0.6) and increased in the control group by 1.3% (95% CI -4.8 to 7.4). Intervention and control groups increased the number of their steps per day by 264.7 (95% CI -72.2 to 601.5) and 104.8 (95% CI -178.1 to 387.7) respectively. No significant differences were found on any outcomes at post-test. There were three minor adverse events. INTERPRETATION A goal-based telehealth intervention seemed to produce small improvements in physical activity for individuals with RTT. Families require more support to increase these individuals' extremely low physical activity levels. WHAT THIS PAPER ADDS A telehealth-supported intervention may produce small changes in physical activity in Rett syndrome (RTT). Increasing physical activity in individuals with RTT is challenging for caregivers. Families require substantial out-of-home support to increase their children's activity levels.
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Affiliation(s)
- Jenny Downs
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - A Marie Blackmore
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Kingsley Wong
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Nicholas Buckley
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Meir Lotan
- Department of Physiotherapy, Ariel University, Ariel, Israel
- Rett Syndrome National Clinic, Sheba Hospital, Ramat-Gan, Israel
| | - Cochavit Elefant
- School of Creative Arts Therapies, University of Haifa, Haifa, Israel
| | - Helen Leonard
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Michelle Stahlhut
- Department of Paediatrics and Adolescent Medicine, Center for Rett Syndrome, Rigshospitalet, Copenhagen, Denmark
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Hagebeuk EEO, Smits A, de Weerd A. Long time polysomnographic sleep and breathing evaluations in children with CDKL5 deficiency disorder. Sleep Med 2023; 103:173-179. [PMID: 36812861 DOI: 10.1016/j.sleep.2023.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/29/2023] [Accepted: 02/05/2023] [Indexed: 02/10/2023]
Abstract
STUDY OBJECTIVES CDKL5 deficiency disorder (CDD) is a rare developmental and epileptic encephalopathy, developing in the first months of life, caused by a mutation in the cyclin-dependent kinase-like 5 (CDKL5) gene. Children with CDD often have sleep (90%) and breathing disorders in wake (50%). Sleep disorders may have a significant impact emotional wellbeing and quality of life of caregivers of children with CDD and are challenging to treat. The outcomes of these features are unknown in children with CDD. METHODS We retrospectively evaluated sleep and respiratory function changes over 5-10 years in a small cohort of Dutch children with CDD, using video-EEG and/or polysomnography (3 × 24 h) and a parental questionnaire, the Sleep Disturbance Scale for Children (SDSC). The present study is a follow-up sleep and PSG study to evaluate if sleep and breathing disturbances persist in children with CDD previously studied. RESULTS Sleep disturbances persisted during the study period (5.5-10 years). All five individuals had long sleep latency (SL, range 32-174.5 min) and frequent arousals and awakenings (14-50/night), unrelated to apneas/seizures, corresponding to the SDSC findings. Low sleep efficiency (SE, 41-80%) was present and did not improve. In our participants, total sleep time (TST, 3h52min-7h52min) was short and remained so. Time in bed (TIB) was typical for children aged 2-8 years, but did not adjust with ageing. Low duration (4.8-17.4%) or even absent REM sleep persisted over time. No sleep apneas were noted. Central apneas due to episodic hyperventilation were reported during wakefulness in two of the five. CONCLUSION Sleep disturbances were present and persisted in all. The decreased REM sleep and sporadic breathing disturbances in wake may indicate failure of brainstem nuclei. Sleep disturbances can severely affect the emotional wellbeing and quality of life of the caregivers and the individuals with CDD and are challenging to treat. Hopefully our polysomnographic sleep data contribute to find the optimal treatment of the sleep problems in CDD patients.
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Affiliation(s)
- Eveline E O Hagebeuk
- Stichting Epilepsie Instellingen Nederland (SEIN), Achterweg 3, 2103 SW, Heemstede, the Netherlands.
| | - Annelies Smits
- Sleep Wake Centre Stichting Epilepsie Instellingen Nederland (SEIN) Dr Denekampweg 20, 8025BV, Zwolle, the Netherlands
| | - Al de Weerd
- Sleep Wake Centre Stichting Epilepsie Instellingen Nederland (SEIN), Dr Denekampweg 20, 8025BV, Zwolle, the Netherlands
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Downs J, Jacoby P, Saldaris J, Leonard H, Benke T, Marsh E, Demarest S. Negative impact of insomnia and daytime sleepiness on quality of life in individuals with the cyclin-dependent kinase-like 5 deficiency disorder. J Sleep Res 2022; 31:e13600. [PMID: 35415902 PMCID: PMC9489598 DOI: 10.1111/jsr.13600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/15/2022] [Accepted: 03/21/2022] [Indexed: 12/30/2022]
Abstract
Cyclin-dependent kinase-like 5 (CDKL5) gene pathogenic variants result in CDKL5 deficiency disorder (CDD). Early onset intractable epilepsy and severe developmental delays are prominent symptoms of CDD. Comorbid sleep disturbances are a major concerning symptom for families. We aimed to explore the relationship between insomnia, daytime sleepiness, sleep medications and quality of life in children with CDD. Caregivers of 129 children with CDD in the International CDKL5 Disorder Database completed the Quality-of-Life Inventory-Disability (QI-Disability) questionnaire and "Disorders of Maintaining Sleep" (DIMS) and the "Disorders of Excessive Somnolence" (DOES) items of the Sleep Disturbance Scale for Children. Adjusting for covariates, a unit increase in DOES score was associated with reduced quality of life total (coefficient -3.06, 95% confidence interval [CI] 1.35-7.80), physical health (coefficient -7.20, 95% CI -10.64, -3.76) and negative emotions (coefficient -3.90, 95% CI -7.38, -0.42) scores. Adjusting for covariates, a unit increase in DIMS score was associated with reduced negative emotions (coefficient -6.02, 95% CI -10.18, -2.86). Use of sleep medications had small influences on the effect sizes. This study highlights the importance of sleep problems as a determinant of quality of life in children with CDD, consistent with effects observed for other groups of children with intellectual disability. Excessive daytime sleepiness was particularly associated with detrimental effects on quality of life. Further research in optimal behavioural and pharmaceutical management of sleep problems for this population is required.
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Affiliation(s)
- Jenny Downs
- Telethon Kids Institute, Centre for Child Health ResearchThe University of Western AustraliaPerthAustralia,Curtin School of Allied HealthCurtin UniversityPerthAustralia
| | - Peter Jacoby
- Telethon Kids Institute, Centre for Child Health ResearchThe University of Western AustraliaPerthAustralia
| | - Jacinta Saldaris
- Telethon Kids Institute, Centre for Child Health ResearchThe University of Western AustraliaPerthAustralia
| | - Helen Leonard
- Telethon Kids Institute, Centre for Child Health ResearchThe University of Western AustraliaPerthAustralia
| | - Tim Benke
- Children's Hospital Colorado, Paediatric NeurologyUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Eric Marsh
- Division of Neurology, Children's Hospital of Philadelphia, School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Scott Demarest
- Children's Hospital Colorado, Paediatric NeurologyUniversity of Colorado School of MedicineAuroraColoradoUSA
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Amiri A, Kalantari M, Gharebashloo F. Association between leisure activities and sleep disturbances among children with and without cerebral palsy. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2022. [DOI: 10.12968/ijtr.2021.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background/Aims Sleep disturbances are common among children with cerebral palsy, resulting in adverse consequences. Investigating the association between leisure activities and sleep disturbances could help to develop ways to promote their sleep quality. This study primarily aimed to investigate the association between leisure activities and sleep disturbances among children with and without cerebral palsy. The secondary aim was to study the prevalence of sleep disturbances and some of its associated factors. Methods A total of 75 children with cerebral palsy (study group) (mean age 10.0 ± 2.5 years) and 75 typically developing children (control group) (mean age 10.5 ± 2.9 years) were randomly selected to completed the Children's Assessment of Participation and Enjoyment. Sleep disturbances were assessed using the Sleep Disturbance Scale for Children. Factors associated with sleep disturbances (age, gender, school attendance, bedroom sharing, type of cerebral palsy, motor functions, eating and drinking ability and communication functions) were statistically analysed and the prevalence of sleep disturbances was calculated. Results Overall frequency of leisure participation was strongly correlated with overall sleep disturbances (P<0.001) among both groups. The prevalence of overall sleep disturbances was 17.1% and 10.6% among the study and the control groups respectively. Eating and drinking ability and spastic quadriplegia emerged as the strongest predictors of overall negative scores on the Sleep Disturbance Scale for Children. Conclusions Greater participation in leisure activities is associated with better sleep. Occupational therapists are encouraged to consider this association when planning for occupation-based interventions aimed at enhancing occupational performance.
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Affiliation(s)
- Alireza Amiri
- Physiotherapy Research Centre, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Minoo Kalantari
- Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Gharebashloo
- Physiotherapy Research Centre, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Molecular Organization and Patterning of the Medulla Oblongata in Health and Disease. Int J Mol Sci 2022; 23:ijms23169260. [PMID: 36012524 PMCID: PMC9409237 DOI: 10.3390/ijms23169260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 11/17/2022] Open
Abstract
The medulla oblongata, located in the hindbrain between the pons and the spinal cord, is an important relay center for critical sensory, proprioceptive, and motoric information. It is an evolutionarily highly conserved brain region, both structural and functional, and consists of a multitude of nuclei all involved in different aspects of basic but vital functions. Understanding the functional anatomy and developmental program of this structure can help elucidate potential role(s) of the medulla in neurological disorders. Here, we have described the early molecular patterning of the medulla during murine development, from the fundamental units that structure the very early medullary region into 5 rhombomeres (r7–r11) and 13 different longitudinal progenitor domains, to the neuronal clusters derived from these progenitors that ultimately make-up the different medullary nuclei. By doing so, we developed a schematic overview that can be used to predict the cell-fate of a progenitor group, or pinpoint the progenitor domain of origin of medullary nuclei. This schematic overview can further be used to help in the explanation of medulla-related symptoms of neurodevelopmental disorders, e.g., congenital central hypoventilation syndrome, Wold–Hirschhorn syndrome, Rett syndrome, and Pitt–Hopkins syndrome. Based on the genetic defects seen in these syndromes, we can use our model to predict which medullary nuclei might be affected, which can be used to quickly direct the research into these diseases to the likely affected nuclei.
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