1
|
Tofani M, Mustari M, Tiozzo E, Dall'Oglio I, Morelli D, Gawronski O, Salata M, Cantonetti L, Castelli E, Di Lallo D, Raponi M. The development of the International Classification of Functioning, Disability and Health for Child and Youth (ICF-CY) Core Sets: a systematic review. Disabil Rehabil 2023; 45:3951-3960. [PMID: 36271731 DOI: 10.1080/09638288.2022.2136269] [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: 06/16/2022] [Revised: 10/05/2022] [Accepted: 10/09/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE The aim of this systematic review is to verify the development of the International Classification of Functioning, Disability and Health for Child and Youth (ICF-CY), investigating methodology and how many core sets have been created. METHODS Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to carry out the systematic review. Six bibliographic databases were searched: MEDLINE, SCOPUS, Web of Sciences, CINHAL, PEDro, and OT Seeker. Papers included in the study have the following characteristics: (a) pediatric population with different health conditions, (b) assessment of ICF domains, (c) development of ICF-CY core set in different health conditions, and (d) recommendation for clinical uses. RESULTS Search strategies allowed to identify 270 research papers. After the elimination of duplicates, 154 articles were analyzed. Finally, 28 records were included for qualitative synthesis. Twelve different ICF-CY Core Sets were identified. Autism spectrum disorder, attention-deficit/hyperactivity disorder, and cerebral palsy were the main health conditions studied at international level. Most of the studies involved international experts using Cieza' methodology to inform ICF-CY Core Set. CONCLUSIONS After 15 years since the adoption of ICF-CY, it still finds some barriers to use. Concrete actions should be taken to develop further core sets following a rigorous methodology and to contribute implementing the ICF framework.Implication for rehabilitationIn 15 years since the implementation of International Classification of Functioning, Disability and Health for Child and Youth (ICF-CY), only 12 core sets have been developed.To develop ICF-CY Core Set, health professionals should follow methodology described by Cieza et al.Strong collaboration between low- and middle-income countries and high-income countries are recommended.
Collapse
Affiliation(s)
- Marco Tofani
- Professional Development, Continuous Education and Research Service, Bambino Gesù Children Hospital IRCCS, Rome, Italy
| | - Martina Mustari
- Professional Development, Continuous Education and Research Service, Bambino Gesù Children Hospital IRCCS, Rome, Italy
| | - Emanuela Tiozzo
- Professional Development, Continuous Education and Research Service, Bambino Gesù Children Hospital IRCCS, Rome, Italy
| | - Immacolata Dall'Oglio
- Professional Development, Continuous Education and Research Service, Bambino Gesù Children Hospital IRCCS, Rome, Italy
| | - Daniela Morelli
- Professional Development, Continuous Education and Research Service, Bambino Gesù Children Hospital IRCCS, Rome, Italy
| | - Orsola Gawronski
- Professional Development, Continuous Education and Research Service, Bambino Gesù Children Hospital IRCCS, Rome, Italy
| | - Michele Salata
- Center for Pediatric Palliative Care, Bambino Gesù Children Hospital IRCCS, Rome, Italy
| | - Laura Cantonetti
- Department of Intensive Neurorehabilitation and Robotics, Bambino Gesù Children Hospital, Rome, Italy
| | - Enrico Castelli
- Department of Intensive Neurorehabilitation and Robotics, Bambino Gesù Children Hospital, Rome, Italy
| | - Domenico Di Lallo
- Medical Directorate, Bambino Gesù Children Hospital IRCCS, Rome, Italy
| | | |
Collapse
|
2
|
Leung T, Balzer J, Keller JW, van Hedel HJA. Playfully Assessing Lower Extremity Selective Voluntary Motor Control in Children With Cerebral Palsy: Psychometric Study. JMIR Rehabil Assist Technol 2022; 9:e39687. [PMID: 36525299 PMCID: PMC9804089 DOI: 10.2196/39687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Objective measures specifically assessing selective voluntary motor control are scarce. Therefore, we have developed an interval-scaled assessment based on accelerometers. OBJECTIVE This study provided a preliminary evaluation of the validity and reliability of this novel gamelike assessment measuring lower limb selective voluntary motor control in children with cerebral palsy (CP). METHODS Children with CP and their neurologically intact peers were recruited for this psychometric evaluation of the assessgame. The participants played the assessgame and steered an avatar by selective hip, knee, or ankle joint movements captured with accelerometers. The assessgame's scores provide information about the accuracy of the selective movement of the target joint and the amplitude and frequency of involuntary movements occurring in uninvolved joints. We established discriminative validity by comparing the assessgame scores of the children with CP with those of the neurologically intact children, concurrent validity by correlations with clinical scores and therapists' opinions, and relative and absolute test-retest reliability. RESULTS We included 20 children with CP (mean age 12 years and 5 months, SD 3 years and 4 months; Gross Motor Function Classification System levels I to IV) and 31 neurologically intact children (mean age 11 years and 1 month, SD 3 years and 6 months). The assessgame could distinguish between the children with CP and neurologically intact children. The correlations between the assessgame's involuntary movement score and the therapist's rating of the occurrence of involuntary movements during the game were moderate (Spearman ρ=0.56; P=.01), whereas the correlations of the assessgame outcomes with the Selective Control Assessment of the Lower Extremity and Gross Motor Function Classification System were low and not significant (|ρ|≤0.39). The intraclass correlation coefficients were >0.85 and indicated good relative test-retest reliability. Minimal detectable changes amounted to 25% (accuracy) and 44% (involuntary movement score) of the mean total scores. The percentage of children able to improve by the minimal detectable change without reaching the maximum score was 100% (17/17) for the accuracy score and 94% (16/17) for the involuntary movement score. CONCLUSIONS The assessgame proved reliable and showed discriminative validity in this preliminary evaluation. Concurrent validity was moderate with the therapist's opinion but relatively poor with the Selective Control Assessment of the Lower Extremity. We assume that the assessment's gamelike character demanded various other motor control aspects that are less considered in current clinical assessments.
Collapse
Affiliation(s)
| | - Julia Balzer
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern a.A., Switzerland.,Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jeffrey W Keller
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern a.A., Switzerland.,Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland.,Doctoral Program Clinical Science, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Hubertus J A van Hedel
- Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern a.A., Switzerland.,Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| |
Collapse
|
3
|
Validity and reliability of an electromyography-based similarity index to quantify lower extremity selective voluntary motor control in children with cerebral palsy. Clin Neurophysiol Pract 2022; 7:107-114. [PMID: 35372733 PMCID: PMC8967969 DOI: 10.1016/j.cnp.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/14/2022] [Accepted: 03/06/2022] [Indexed: 11/26/2022] Open
Abstract
The SISCALE is a new electromyography-based measure to quantify selective voluntary motor control. There is a need for precise, interval-scaled measures of selective voluntary motor control in children with cerebral palsy. Concurrent and discriminative validity of the new measure was affirmed and test–retest reliability was acceptable.
Objective To quantify selective voluntary motor control (SVMC) objectively and more precisely, we combined the “Selective Control Assessment of the Lower Extremity” (SCALE) with surface electromyography. The resulting Similarity Index (SI) measures the similarity of muscle activation patterns. This study evaluated the preliminary validity and reliability of this novel SISCALE measure in children with cerebral palsy (CP). Methods We investigated concurrent validity by correlating the SISCALE of 24 children with CP (median age 10.6 years) with comparator assessments. For discriminative validity, the patients’ SISCALE scores were compared to 31 neurologically intact age-matched peers. Test-retest reliability was quantified using intraclass correlation coefficients (ICC) and minimal detectable change (MDC) values. Results The SISCALE correlated strongly with the SCALE (ρ = 0.90, p < .001) and the Gross Motor Function Classification System (ρ = −0.74, p < .001). SISCALE scores were significantly lower in children with CP compared to healthy peers. Test-retest reliability appeared good (for the more and less affected leg, ICC ≥ 0.84, and MDC ≤ 0.17). Conclusions Validity and reliability of the SISCALE leg and total scores lay within clinically acceptable ranges. Further clinimetric analyses should include responsiveness. Significance A neurophysiology-based assessment could contribute to a more refined assessment of SVMC impairments.
Collapse
|
4
|
Almoajil H, Toye F, Dawes H, Pierce J, Meaney A, Baklouti A, Poverini L, Hopewell S, Theologis T. Outcomes of importance to children and young adults with cerebral palsy, their parents and health professionals following lower limb orthopaedic surgery: A qualitative study to inform a Core Outcome Set. Health Expect 2022; 25:925-935. [PMID: 35083830 PMCID: PMC9122398 DOI: 10.1111/hex.13428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 12/21/2021] [Accepted: 12/24/2021] [Indexed: 12/27/2022] Open
Abstract
Introduction Although several outcomes are commonly measured to assess the effect of surgery for young people with cerebral palsy (CP), these are selected mainly by health professionals and researchers. Including the perspectives of a broader range of stakeholders is an essential step towards determining important outcomes for assessment. This qualitative study involves the development of a core outcome set (COS) for lower limb orthopaedic surgery for ambulant children with CP. Objective This study aimed to identify outcomes that matter to children and young people with CP, their parents and healthcare professionals following lower limb orthopaedic surgery. Methods Semi‐structured interviews were conducted with 10 healthcare professionals, 10 children and young people with CP and 8 parents. Interview data were analysed by content analysis supported by the International Classification of Functioning, Disability and Health (ICF‐CY) supplemented by thematic analysis. Findings Thirty‐one outcomes were identified in total, which were linked to eleven second‐level ICF‐CY categories. There were differences between stakeholder groups in preferences and expectations from surgical outcomes. Healthcare professionals and children with their parents identified 31 and 25 outcomes, respectively. Health outcomes valued by participants were lower limb alignment and symmetry, flexibility and muscle strength, mental health, fatigue, pain, function in life, mobility, participation, being independent, quality of life and adverse events. Compared to previous published trials, 10 new outcomes were revealed by this study. Conclusion The researchers identified outcomes that are important to all stakeholders following lower limb orthopaedic surgery for ambulant CP. Including these outcomes in future studies would promote patient‐centred care for children and young adults with CP. Findings will be used to inform an international Delphi survey and develop a COS in this field. Patient and Public Contribution This study was informed by an advisory group including a young adult with CP and a parent of a child with CP. This group engaged in the design of the study and the information material to support the interview (information sheet and interview topic guide).
Collapse
Affiliation(s)
- Hajar Almoajil
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Department of Physical Therapy, College of Applied Medical Science, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Francine Toye
- Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Helen Dawes
- Centre for Movement, Occupation and Rehabilitation Sciences, Faculty of Health and Life Science, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK.,Oxford Health NHS Foundation Trust, Oxford, UK
| | - Jo Pierce
- Faculty of Health and Life Sciences, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK
| | - Andrew Meaney
- Centre for Movement, Occupation and Rehabilitation Sciences, Faculty of Health and Life Science, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK
| | - Aziz Baklouti
- Centre for Movement, Occupation and Rehabilitation Sciences, Faculty of Health and Life Science, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK
| | - Lara Poverini
- Centre for Movement, Occupation and Rehabilitation Sciences, Faculty of Health and Life Science, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK
| | - Sally Hopewell
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Tim Theologis
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| |
Collapse
|
5
|
Fahr A, Kläy A, Coka LS, van Hedel HJA. Game-based training of selective voluntary motor control in children and youth with upper motor neuron lesions: protocol for a multiple baseline design study. BMC Pediatr 2021; 21:505. [PMID: 34763681 PMCID: PMC8582135 DOI: 10.1186/s12887-021-02983-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/29/2021] [Indexed: 11/29/2022] Open
Abstract
Background Impairments of selective control of joint movements can have consequences for many activities of daily life, but there are only a few interventions to improve selective voluntary motor control (SVMC). We have developed a treatment option to specifically enhance SVMC exploiting the advantages of interactive computer play technology. It targets SVMC by training selective activation of a muscle or a selective joint movement while it provides immediate feedback about involuntary muscle activations/movements at an (unwanted) joint. This study aims to investigate the effectiveness of this game-based intervention to enhance SVMC in children and youth with upper motor neuron lesions. Methods We will conduct a randomized, non-concurrent, multiple baseline design study. Patients aged between 6 and 20 years with reduced SVMC due to an upper motor neuron lesion will be included. During the baseline phase of random length, participants will attend their regular intensive rehabilitation program, and in the intervention phase, they will additionally complete 10 therapy sessions (à 40 min) of the game-based SVMC training. The primary outcome will be a short SVMC assessment conducted repeatedly throughout both phases, which quantifies movement accuracy and involuntary movements. Changes in clinical SVMC measures, muscle strength, cortical excitability, motor control of the inhibited/unwanted movement, and functional independence will be assessed as secondary outcomes. We will use a mixed-effect model to determine the change in the course of the primary outcome when the intervention is introduced, and we will compare changes between phases for secondary outcomes with paired tests. Discussion This study will provide first evidence whether SVMC can be improved with our game-based training. The single-case design takes into account the individualization required for this intervention, and it can help to address the challenges of intervention trials in our setting. Trial registration German Clinical Trials Register: DRKS00025184, registered on 28.04.2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02983-8.
Collapse
Affiliation(s)
- Annina Fahr
- Swiss Children's Rehab, University Children's Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern am Albis, Switzerland. .,Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zürich, Switzerland. .,Institute for Biomechanics, ETH Zurich, Leopold-Ruzicka-Weg 4, 8093, Zurich, Switzerland.
| | - Andrina Kläy
- Swiss Children's Rehab, University Children's Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern am Albis, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zürich, Switzerland
| | - Larissa S Coka
- Swiss Children's Rehab, University Children's Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern am Albis, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zürich, Switzerland
| | - Hubertus J A van Hedel
- Swiss Children's Rehab, University Children's Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern am Albis, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zürich, Switzerland
| |
Collapse
|
6
|
van der Linden ML, Corrigan O, Tennant N, Verheul MHG. Cluster analysis of impairment measures to inform an evidence-based classification structure in RaceRunning, a new World Para Athletics event for athletes with hypertonia, ataxia or athetosis. J Sports Sci 2020; 39:159-166. [PMID: 33337948 DOI: 10.1080/02640414.2020.1860360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
RaceRunning enables athletes with limited or no walking ability to propel themselves independently using a three-wheeled frame that has a saddle, handle bars and a chest plate. For RaceRunning to be included as a para athletics event, an evidence-based classification system is required. This study assessed the impact of trunk control and lower limb impairment measures on RaceRunning performance and evaluated whether cluster analysis of these impairment measures produces a valid classification structure for RaceRunning. The Trunk Control Measurement Scale (TCMS), Selective Control Assessment of the Lower Extremity (SCALE), the Australian Spasticity Assessment Scale (ASAS), and knee extension were recorded for 26 RaceRunning athletes. Thirteen male and 13 female athletes aged 24 (SD = 7) years participated. All impairment measures were significantly correlated with performance (rho = 0.55-0.74). Using ASAS, SCALE, TCMS and knee extension as cluster variables in a two-step cluster analysis resulted in two clusters of athletes. Race speed and the impairment measures were significantly different between the clusters (p < 0.001). The findings of this study provide evidence for the utility of the selected impairment measures in an evidence-based classification system for RaceRunning athletes.
Collapse
Affiliation(s)
| | - Orla Corrigan
- Centre for Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, UK
| | - Nicola Tennant
- Cerebral Palsy International Sports and Recreation Association, Glasgow, UK
| | - Martine H G Verheul
- Human Performance Science Research Group, Institute for Sport, Physical Education & Health Sciences, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
7
|
Dey NEY, Dziwornu E, Frimpong-Manso K, Duah HO, Agbadi P. Correlates of child functional difficulties status in Ghana: A further analysis of the 2017/18 multiple indicator cluster survey. Heliyon 2020; 6:e05727. [PMID: 33364496 PMCID: PMC7750366 DOI: 10.1016/j.heliyon.2020.e05727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/06/2020] [Accepted: 12/10/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Functional difficulties have long-term implications for children's physical, cognitive, emotional, social, and academic growth and development. Although the subject of functional difficulties has received enough scholarly attention in the developed world, few studies have addressed the issue in Ghana. Therefore, the study aimed to regress child, maternal and household and geographical level factors associated with the functional difficulty of children in Ghana. METHOD We analysed the 2017/18 multiple indicator cluster survey dataset. The study sample consists of weighted cases of 21,871 children within the ages of 5-17 years. Summary statistics were produced for the study variables. Bivariate analyses were performed to select significant correlates for the multivariate analysis. We accounted for sample design and weight before using Poisson regression techniques to do the bivariate and multivariate analysis. RESULTS These factors were significantly associated with functional difficulties among 5-17 years old children in Ghana: not covered with health insurance, mothers who have a functional difficulty and those without information on their functional difficulty status, and children who dwelt in richer households compared to the richest households. Compared to the northern region, children from the remaining nine regions in Ghana were more likely to have had a child functional difficulty. CONCLUSION Given the results, the government of Ghana and other development partners should promote policies and programs to reduce the consequences of disability or functional difficulties in children by taking into consideration factors like mothers' functional difficulty, access to health insurance, and regional and economic disparities in Ghana.
Collapse
Affiliation(s)
| | - Emmanuel Dziwornu
- University of Health and Allied Sciences, Department of Psychological Medicine and Mental Health, School of Medicine, PMB 31, HO, Volta Region, Ghana
| | | | | | - Pascal Agbadi
- Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, PMB, Kumasi, Ghana
| |
Collapse
|
8
|
I Want to Play: Children With Cerebral Palsy Talk About Their Experiences on Barriers and Facilitators to Participation in Leisure Activities. Pediatr Phys Ther 2020; 32:190-200. [PMID: 32604358 DOI: 10.1097/pep.0000000000000719] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To explore how children with cerebral palsy (CP) experience participation in leisure activities and to describe the environmental barriers and facilitators. METHODS Sixteen children with cerebral palsy aged 7 to 17 years participated in 3 focus groups. Data were analyzed thematically by 3 researchers on the basis of the International Classification of Functioning, Disability and Health. RESULTS A total of 38 International Classification of Functioning, Disability and Health categories were identified (4 linked to Body functions; 2 linked to Body structures; 8 linked to Activities & Participation, and 24 to Environmental factors: 10 facilitators and 14 barriers). The most mentioned categories were Voluntary movement control functions, Functions related to gait pattern, Structure of upper arm, Recreation and leisure, Nuclear family and finally, and Individual attitudes of acquaintances. CONCLUSIONS The main barriers identified by children with cerebral palsy highlight aspects of the physical, social, and attitudinal environment that could be modified to enhance participation in leisure activities.
Collapse
|
9
|
Almoajil H, Dawes H, Hopewell S, Toye F, Jenkinson C, Theologis T. Development of a core outcome set for lower limb orthopaedic surgical interventions in ambulant children and young people with cerebral palsy: a study protocol. BMJ Open 2020; 10:e034744. [PMID: 32139490 PMCID: PMC7059521 DOI: 10.1136/bmjopen-2019-034744] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Musculoskeletal deformities and gait deviations are common features in ambulatory cerebral palsy (CP). Deformity correction through lower limb orthopaedic surgery is the standard form of care aimed at improving or preserving motor function. Current research on CP care does not always take into account individual patients' expectations and needs. There is a wide range of outcome domains and outcome measures used to assess outcome from treatment. This can lead to reporting bias and make it difficult to compare and contrast studies. A core outcome set (COS) would enhance the efficiency, relevance and overall quality of CP orthopaedic surgery research. The aim of this study is to establish a standardised COS for use in evaluating lower limb orthopaedic surgery for ambulatory children and young people with CP. METHODS/ANALYSIS A set of outcomes domains and outcome measures will be developed as follows: (1) a qualitative evidence synthesis to identify relevant outcomes from children and young people and family perspective; (2) a scoping review to identify relevant outcomes and outcome measures; (3) qualitative research to explore the experience of key stakeholders; (4) prioritisation of outcome domains will be achieved through a two-round Delphi process with key stakeholders; (5) a final COS will be developed at a consensus meeting with representation from key stakeholder groups. ETHICS AND DISSEMINATION Ethical approval for this study was granted in the UK by the Oxfordshire Research Ethics Committee B (REC reference 19/SC/0357). Informed consent will be obtained from participants taking part in the qualitative research and Delphi process. Study findings will be published in an open access journal and presented at relevant national and international conferences. Charities and associations will be engaged to promote awareness of the project COS results. TRIAL REGISTRATION NUMBER COMET registration: 1236. PROSPERO REGISTRATION NUMBER CRD42018089538.
Collapse
Affiliation(s)
- Hajar Almoajil
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Department of Physical Therapy, College of Applied Medical Science, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Helen Dawes
- Centre for Movement, Occupational and Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
- Department of Clinical Neurology, University of Oxford, Oxford, UK
| | - Sally Hopewell
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Francine Toye
- Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Crispin Jenkinson
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Tim Theologis
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Paediatric Orthopaedic Surgery, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| |
Collapse
|
10
|
Benner JL, Noten S, Limsakul C, Van Der Slot WMA, Stam HJ, Selb M, Van Den Berg-Emons RJG, Roebroeck ME. Outcomes in adults with cerebral palsy: systematic review using the International Classification of Functioning, Disability and Health. Dev Med Child Neurol 2019; 61:1153-1161. [PMID: 30985004 DOI: 10.1111/dmcn.14247] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/04/2019] [Indexed: 11/30/2022]
Abstract
AIM In the context of the development of an International Classification of Functioning, Disability and Health (ICF) Core Set for adults with cerebral palsy (CP), this systematic review sought to identify the outcome measures used in studies on adults with CP, to examine their content using the ICF as a reference, and to demonstrate the most studied areas in this population. METHOD Embase, MEDLINE, Web of Science, PsycINFO, CINAHL, Cochrane, and Google Scholar were searched for studies on adults with CP published between 2000 and 2017. Meaningful concepts of commonly used outcome measures were linked to the ICF, and frequencies of resultant ICF categories were explored. RESULTS In 274 included articles, 332 outcome measures were identified of which 155 were commonly used. In total, 4409 meaningful concepts were linked to the ICF. The component 'Activities and participation' included the most frequent categories, followed by 'Body functions'. The most frequent categories were b280 'Sensation of pain' (37.6%), d450 'Walking' (33.3%), and d850 'Remunerative employment' (27.5%). INTERPRETATION The broad range of ICF categories identified in this systematic review emphasizes the heterogeneity of functioning and disability in adults with CP. The current results specifically reflect the researchers' perspective and will serve as candidate categories to consider in the development of an ICF Core Set for adults with CP. WHAT THIS PAPER ADDS Outcomes studied in adults with cerebral palsy are captured in varying International Classification of Functioning, Disability and Health (ICF) categories. Activities and participation were studied more frequently than body functions and structures. Mobility, employment, and self-care were most frequent within ICF's 'Activities and participation' component. Pain and neuromusculoskeletal and movement-related functions were most frequent within 'Body functions'.
Collapse
Affiliation(s)
- Joyce L Benner
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Suzie Noten
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Chonnanid Limsakul
- Department of Orthopedic Surgery and Physical Medicine, Prince of Songkla University, Songkhla, Thailand
| | | | - Henk J Stam
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Melissa Selb
- ICF Research Branch, a Cooperation Partner within the WHO-FIC Collaborating Centre in Germany (at DIMDI), Nottwil, Switzerland
| | | | - Marij E Roebroeck
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
11
|
An International Clinical Study of Ability and Disability in Autism Spectrum Disorder Using the WHO-ICF Framework. J Autism Dev Disord 2019; 48:2148-2163. [PMID: 29423605 PMCID: PMC5948258 DOI: 10.1007/s10803-018-3482-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This is the fourth international preparatory study designed to develop International Classification of Functioning, Disability and Health (ICF, and Children and Youth version, ICF-CY) Core Sets for Autism Spectrum Disorder (ASD). Examine functioning of individuals diagnosed with ASD as documented by the ICF-CY in a variety of clinical settings. A cross-sectional study was conducted, involving 11 units from 10 countries. Clinical investigators assessed functioning of 122 individuals with ASD using the ICF-CY checklist. In total, 139 ICF-CY categories were identified: 64 activities and participation, 40 body functions and 35 environmental factors. The study results reinforce the heterogeneity of ASD, as evidenced by the many functional and contextual domains impacting on ASD from a clinical perspective.
Collapse
|
12
|
Kane KJ, Lanovaz JL, Musselman KE. Physical Therapists' Use of Evaluation Measures to Inform the Prescription of Ankle-Foot Orthoses for Children with Cerebral Palsy. Phys Occup Ther Pediatr 2019; 39:237-253. [PMID: 29702012 DOI: 10.1080/01942638.2018.1463586] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Aims: To examine how physical therapists (PTs) use evaluation measures to guide prescription and re-assessment of ankle-foot orthoses (AFOs) for children with CP. Methods: PTs in Canada who work with children with CP were invited to complete an online survey. Survey questions examined PT evaluation and interpretation of findings at initial AFO prescription and re-assessment. Closed-ended responses were analyzed using descriptive statistics, and a conventional content analysis examined responses to open-ended questions. Results: Sixty responses from ten provinces were analyzed. Three themes emerged from the open-ended responses, which were supported by closed-ended responses. (1) Focus on impairment-level measures. Although evaluation primarily involved observational, non-standardized measures of impairments and gait pattern, most respondents also considered participation-level constructs. (2) Lack of confidence/knowledge. Respondents reported a moderate level of confidence concerning decision-making about AFO type and characteristics. 3) Inconsistent practices between therapists, possibly reflecting the paucity of available evidence or individualization of the prescription. Conclusions: Non-standardized, observational assessment methods, and impairment-level constructs appear to guide AFO prescription decisions. Integrating current knowledge into practice, developing best practice guidelines, and developing standardized tools to assess the effects of AFOs on participation may promote confidence, consistency, and improved outcomes.
Collapse
Affiliation(s)
- Kyra J Kane
- a School of Rehabilitation Science, College of Medicine, University of Saskatchewan , Saskatoon , Canada.,b Saskatchewan Health Authority, Children's Program , Regina , Canada
| | - Joel L Lanovaz
- c College of Kinesiology, University of Saskatchewan , Saskatoon , Canada
| | - Kristin E Musselman
- a School of Rehabilitation Science, College of Medicine, University of Saskatchewan , Saskatoon , Canada.,d Toronto Rehabilitation Institute, University Health Network , Toronto , Canada.,e Department of Physical Therapy, Faculty of Medicine , University of Toronto , Toronto , Canada
| |
Collapse
|
13
|
Angeli JM, Harpster KL, Hanson E, Sheehan A, Schwab SM. Patient- and caregiver-identified preferences: Dimensions of change in developmental therapy treatment goals. Dev Neurorehabil 2019; 22:39-46. [PMID: 29370557 DOI: 10.1080/17518423.2018.1425754] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To describe patterns in preferred dimensions of change in therapy goals identified by individuals with developmental disability and their caregivers. METHODS A retrospective chart review of Goal Attainment Scaling (GAS) goals for patients aged 2-32 years (n = 124) participating in a program of episodic care was conducted. Dimensions of change were analyzed through a mixed-methods study design. Co-occurrence rates and descriptor-to-code comparisons were computed in order to relate the dimension of change to diagnosis, International Classification of Functioning, Disability, and Health (ICF) goal domain, gender, age, and goal setter. RESULTS Decreased level of assistance was the most commonly identified preferred dimension of change, cited in 31.0% of goals. Decreased level of assistance remained the most frequently reported dimension of change in multiple subgroup analyses. CONCLUSION Independence is highly valued by parents and individuals with developmental disability. This finding should help guide therapy plans or program development addressing task performance.
Collapse
Affiliation(s)
- Jennifer M Angeli
- a Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA.,b Department of Rehabilitation Sciences , University of Cincinnati , Cincinnati , OH , USA
| | - Karen L Harpster
- a Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA.,b Department of Rehabilitation Sciences , University of Cincinnati , Cincinnati , OH , USA
| | - Elizabeth Hanson
- a Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA.,b Department of Rehabilitation Sciences , University of Cincinnati , Cincinnati , OH , USA
| | - Amber Sheehan
- a Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA
| | - Sarah M Schwab
- a Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA.,b Department of Rehabilitation Sciences , University of Cincinnati , Cincinnati , OH , USA
| |
Collapse
|
14
|
Güeita-Rodríguez J, García-Muro F, Rodríguez-Fernández ÁL, Lambeck J, Fernández-de-Las-Peñas C, Palacios-Ceña D. What areas of functioning are influenced by aquatic physiotherapy? Experiences of parents of children with cerebral palsy. Dev Neurorehabil 2018; 21:506-514. [PMID: 28933572 DOI: 10.1080/17518423.2017.1368728] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To explore the experiences regarding aquatic physiotherapy among parents of children with cerebral palsy and to identify a list of relevant intervention categories for aquatic physiotherapy treatments. METHODS We conducted semi-structured interviews and focus groups using the components of the International Classification of Functioning, Disability and Health (ICF) as a frame of reference to explore and code experiences regarding aquatic physiotherapy. A non-probabilistic purposive sampling strategy was used. Content analysis methods and ICF linking processes were used to analyze data. RESULTS From the parents' perspective (n = 34), both the Body Functions and Activities and Participation components were mainly influenced by aquatic physiotherapy. Also, parents described Environmental Factors acting as barriers affecting progress during therapy. CONCLUSIONS Parents identified a wide range of categories influenced by aquatic physiotherapy. Social and contextual aspects were highlighted, as well as a series of changes related to the illness as a result of treatment.
Collapse
Affiliation(s)
- Javier Güeita-Rodríguez
- a Department of Physiotherapy , Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University , Alcorcón , Madrid , Spain
| | - Francisco García-Muro
- b Department of Nursing and Physiotherapy , School of Medicine, CEU-San Pablo University , Madrid , Spain
| | | | - Johan Lambeck
- c International Aquatic Therapy Faculty , Valens , Switzerland
| | - Cesar Fernández-de-Las-Peñas
- a Department of Physiotherapy , Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University , Alcorcón , Madrid , Spain
| | - Domingo Palacios-Ceña
- a Department of Physiotherapy , Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University , Alcorcón , Madrid , Spain
| |
Collapse
|
15
|
Mahdi S, Ronzano N, Knüppel A, Dias JC, Albdah A, Chien-Ho L, Almodayfer O, Bluschke A, Karande S, Huang HL, Christiansen H, Granlund M, de Vries PJ, Coghill D, Tannock R, Rohde L, Bölte S. An international clinical study of ability and disability in ADHD using the WHO-ICF framework. Eur Child Adolesc Psychiatry 2018; 27:1305-1319. [PMID: 29455340 DOI: 10.1007/s00787-018-1124-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 02/09/2018] [Indexed: 01/27/2023]
Abstract
This is the fourth and final study designed to develop International Classification of Functioning, Disability and Health (ICF, and children and youth version, ICF-CY) core sets for attention-deficit hyperactivity disorder (ADHD). To investigate aspects of functioning and environment of individuals with ADHD as documented by the ICF-CY in clinical practice settings. An international cross-sectional multi-centre study was applied, involving nine units from eight countries: Denmark, Germany, India, Italy, Portugal, Saudi Arabia, Sweden and Taiwan. Clinicians and clinical researchers rated the functioning level of 112 children, adolescents and adults with ADHD using the extended ICF-CY checklist version 2.1a. The ratings were based on a variety of information sources, such as medical records, medical history, clinical observations, clinical questionnaires, psychometric tests and structured interviews with participants and family members. In total, 113 ICF-CY categories were identified, of which 50 were related to the activities and participation, 33 to environmental factors and 30 to body functions. The clinical study also yielded strengths related to ADHD, which included temperament and personality functions and recreation and leisure. The study findings endorse the complex nature of ADHD, as evidenced by the many functional and contextual domains impacted in ADHD. ICF-CY based tools can serve as foundation for capturing various functional profiles and environmental facilitators and barriers. The international nature of the ICF-CY makes it possible to develop user-friendly tools that can be applied globally and in multiple settings, ranging from clinical services and policy-making to education and research.
Collapse
Affiliation(s)
- Soheil Mahdi
- Division of Neuropsychiatry, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), CAP Research Center, Karolinska Institutet, Gävlegatan 22, 11330, Stockholm, Sweden
- Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Nadia Ronzano
- Child and Adolescent Neuropsychiatric Unit, Department of Biomedical Science, University of Cagliari and "A. Cao" Microcitemico Paediatric Hospital, Cagliari, Italy
| | - Ane Knüppel
- Research Unit for Child and Adolescent Psychiatry, Aalborg University Hospital, Aalborg, Denmark
| | - José Carlos Dias
- Childhood and Adolescence Psychiatry Department, Oporto Hospital Centre, Porto, Portugal
| | - Ayman Albdah
- Child Psychiatry Division, King Abdullah Specialist Children Hospital, Riyadh, Saudi Arabia
| | - Lin Chien-Ho
- Department of Psychiatry, Chimei Medical Center, Tainan, Taiwan
| | - Omar Almodayfer
- Mental Health Department, KAMC-R, MNGHA, Riyadh, Saudi Arabia
| | - Annet Bluschke
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technical University, Dresden, Germany
| | - Sunil Karande
- Learning Disability Clinic, Department of Paediatrics, Seth GS Medical College and KEM Hospital, Parel, Mumbai, India
| | - Huei-Lin Huang
- Institute of Behavioral Medicine, Institute of Clinical Medicine, Department of Psychiatry, National Chen Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hanna Christiansen
- Department of Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
| | - Mats Granlund
- CHILD, SIDR, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Petrus J de Vries
- Division of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - David Coghill
- Departments of Paediatrics and Psychiatry, University of Melbourne, Melbourne, Australia
| | - Rosemary Tannock
- Research Institute of the Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Luis Rohde
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Development Psychiatry for Children and Adolescents, São Paulo, Brazil
| | - Sven Bölte
- Division of Neuropsychiatry, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), CAP Research Center, Karolinska Institutet, Gävlegatan 22, 11330, Stockholm, Sweden.
- Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden.
- Child and Adolescent Psychiatry, Stockholm County Council, 11330, Stockholm, Sweden.
| |
Collapse
|
16
|
MacIntosh A, Lam E, Vigneron V, Vignais N, Biddiss E. Biofeedback interventions for individuals with cerebral palsy: a systematic review. Disabil Rehabil 2018; 41:2369-2391. [PMID: 29756481 DOI: 10.1080/09638288.2018.1468933] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Purpose: The purpose of this study is to evaluate the quality of evidence of biofeedback interventions aimed at improving motor activities in people with Cerebral Palsy (CP). Second, to describe the relationship between intervention outcomes and biofeedback characteristics. Methods: Eight databases were searched for rehabilitation interventions that provided external feedback and addressed motor activities. Two reviewers independently assessed and extracted data. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was used to evaluate quality of evidence for outcome measures related to two International Classification of Functioning, Disability and Health (ICF) chapters. Results: Fifty-seven studies were included. There were 53 measures related Activities and Participation and 39 measures related to Body Functions. Strength of evidence was "Positive, Very-Low" due to the high proportion of non-controlled studies and heterogeneity of measures. Overall, 79% of studies and 63% of measures showed improvement post-intervention. Counter to motor learning theory recommendations, most studies provided feedback consistently and concurrently throughout the intervention regardless of the individual's desire or progress. Conclusion: Heterogeneous interventions and poor study design limit the strength of biofeedback evidence. A thoughtful biofeedback paradigm and standardized outcome toolbox can strengthen the confidence in the effect of biofeedback interventions for improving motor rehabilitation for people with CP. Implications for Rehabilitation Biofeedback can improve motor outcomes for people with Cerebral Palsy. If given too frequently, biofeedback may prevent the client from learning autonomously. Use consistent and concurrent feedback to improve simple/specific motor activities. Use terminal feedback and client-directed feedback to improve more complex/general motor activities.
Collapse
Affiliation(s)
- Alexander MacIntosh
- a Institute of Biomaterials and Biomedical Engineering , University of Toronto , Toronto , Canada.,b Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital , Toronto , Canada
| | - Emily Lam
- b Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital , Toronto , Canada
| | - Vincent Vigneron
- c Informatique, Biologie Intégrative et Systèmes Complexes (IBISC) laboratoire, Université d'Evry-Val-d'Essonne , Evry , France
| | - Nicolas Vignais
- d Complexity, Innovation, Sports & Motor Activities (CIAMS) laboratoire, Université Paris-Sud , Orsay , France
| | - Elaine Biddiss
- a Institute of Biomaterials and Biomedical Engineering , University of Toronto , Toronto , Canada.,b Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital , Toronto , Canada
| |
Collapse
|
17
|
Büğüşan S, Kahraman A, Elbasan B, Mutlu A. Do adolescents with cerebral palsy agree with their caregivers on their participation and quality of life? Disabil Health J 2018; 11:287-292. [DOI: 10.1016/j.dhjo.2017.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 09/28/2017] [Accepted: 10/12/2017] [Indexed: 10/18/2022]
|
18
|
Kane K, Manns P, Lanovaz J, Musselman K. Clinician perspectives and experiences in the prescription of ankle-foot orthoses for children with cerebral palsy. Physiother Theory Pract 2018; 35:148-156. [PMID: 29465276 DOI: 10.1080/09593985.2018.1441346] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Physiotherapists, orthotists, and physicians are involved in the prescription of ankle-foot orthoses (AFOs) for children with cerebral palsy (CP); however, little is known about how prescription decisions are made in practice. Therefore, the study objective was to identify current AFO prescription and clinical decision-making practices for children with CP in Canada. METHODS Focus groups were conducted in five pediatric rehabilitation facilities, with 32 clinicians. Semi-structured interviews focused on the goals and types of AFOs used, referral and follow-up processes, and clinical evaluation measures. Interpretive Description was used as a framework for analysis. Transcribed dialogue was imported into NVivo 11 for data coding and analysis. Three researchers participated in coding to establish categories and themes. RESULTS Categories included: what is made, how it is used, and factors that either support or challenge outcomes. Strengths and challenges of the current prescription process were discussed, including funding, communication, and technology to enhance clinical evaluation. Throughout the interviews, the theme of prescription as a collaborative, iterative, and individualized process emerged. CONCLUSIONS Processes, strengths, and challenges associated with AFO prescription in Canada were identified. This is a first step toward the development of guidelines to help clinicians improve AFO prescription for children with CP.
Collapse
Affiliation(s)
- Kyra Kane
- a School of Physical Therapy, College of Medicine , University of Saskatchewan , Saskatoon , Canada.,b Saskatchewan Health Authority , Children's Program , Regina , Canada
| | - Patricia Manns
- c Department of Physical Therapy, Faculty of Rehabilitation Medicine , University of Alberta , Edmonton , Canada
| | - Joel Lanovaz
- d College of Kinesiology , University of Saskatchewan , Saskatoon , Canada
| | - Kristin Musselman
- a School of Physical Therapy, College of Medicine , University of Saskatchewan , Saskatoon , Canada.,e Toronto Rehabilitation Institute - University Health Network , Toronto , Canada.,f Department of Physical Therapy, Faculty of Medicine , University of Toronto , Toronto , Canada
| |
Collapse
|
19
|
Nguyen L, Mesterman R, Gorter JW. Development of an inventory of goals using the International Classification of Functioning, Disability and Health in a population of non-ambulatory children and adolescents with cerebral palsy treated with botulinum toxin A. BMC Pediatr 2018; 18:1. [PMID: 29301539 PMCID: PMC5755464 DOI: 10.1186/s12887-017-0974-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 12/14/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the management of hypertonicity in children with cerebral palsy (CP), goals should be clearly identified in order to evaluate the effectiveness of botulinum toxin A (BoNT-A) treatment, specifically in non-ambulatory children and adolescents, Gross Motor Function Classification System (GMFCS), level IV or V. A retrospective chart review (Mesterman et al., 2013) identified the need for the development of a set of specific and meaningful goals linked to the International Classification of Functioning, Disability and Health (ICF) for future goal setting and evaluation in this population. Our objective is to create an inventory of goals based on the ICF framework that captures the needs and values of families with children with CP. METHODS This cross-sectional observational study recruited parents of twenty children and youths with CP in GMFCS levels IV or V (mean age 11.2 years, SD 4.3, 13 males) who were assessed for BoNT-A treatment at the Spasticity Management Clinic at McMaster Children's Hospital (Hamilton, ON). A previous inventory of goals was developed by a group of experts at a national botulinum toxin conference held in January 2014 (Montreal, Canada). The inventory of goals was further refined by asking the parents to select goals from the inventory list that they would like their child to accomplish after receiving BoNT-A treatment, and asking healthcare professionals for clarity and phrasing of goals in the inventory list. RESULTS All parents identified body structure and function goals, with more than 75% of parents selecting reduction in muscle tone and increased range of movements in the upper and lower extremities. More than 50% of parents identified activity goals related to ease of caregiving. Two activity goals and three participation goals were missing from the inventory. Participation goals were identified by less than 5% of parents. CONCLUSION The inventory may be a helpful tool to facilitate a discussion about goal setting between healthcare professionals and families in the context of BoNT-A treatment. A future study is needed to conduct qualitative interviews to better understand the information that families may require about setting goals during BoNT-A treatment and to evaluate the usefulness of the inventory.
Collapse
Affiliation(s)
- Linda Nguyen
- CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, 1400 Main Street West, Room 408, Hamilton, ON, L8S 1C7, Canada
| | - Ronit Mesterman
- CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, 1400 Main Street West, Room 408, Hamilton, ON, L8S 1C7, Canada
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, 1400 Main Street West, Room 408, Hamilton, ON, L8S 1C7, Canada.
| |
Collapse
|
20
|
Balzer J, van der Linden ML, Mercer TH, van Hedel HJA. Selective voluntary motor control measures of the lower extremity in children with upper motor neuron lesions: a systematic review. Dev Med Child Neurol 2017; 59:699-705. [PMID: 28272744 DOI: 10.1111/dmcn.13417] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/18/2017] [Indexed: 12/18/2022]
Abstract
AIM Recovery and trainability of impaired selective voluntary motor control (SVMC) of the lower extremity in children with upper motor neuron lesions has received little attention. To facilitate an evidence-based debate about this topic, this review evaluates the evidence level of the psychometric properties of SVMC measures. METHOD MEDLINE, Embase, CINAHL, PsycINFO, Scopus, Cochrane and PEDro databases were systematically searched up to July 2016. Two independent raters scored the methodological quality in accordance to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. The overall level of evidence was scored according to Cochrane criteria. RESULTS We identified 3590 studies, of which 17 were included. COSMIN scores ranged from 'poor' to 'excellent' for studies investigating measurement properties of the Selective Motor Control test, modified Trost test, Gillette's Selective Motor Control test, Selective Control Assessment of the Lower Extremity (SCALE), kinematic measures, electromyography, and torque steadiness. Studies assessing the SCALE scored highest on COSMIN items. Evidence levels for SCALE's validity and reliability properties were moderate, while for the other SVMC measures these ranged from unknown to moderate. Responsiveness was not assessed. INTERPRETATION Further psychometric studies of SVMC measures are needed to provide a scientific contribution to the ongoing debate of SVMC trainability.
Collapse
Affiliation(s)
- Julia Balzer
- Pediatric Rehabilitation Research Group, Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich, Affoltern am Albis, Switzerland
| | | | - Thomas H Mercer
- Centre for Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, UK
| | - Hubertus J A van Hedel
- Pediatric Rehabilitation Research Group, Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich, Affoltern am Albis, Switzerland
| |
Collapse
|
21
|
Schiariti V, Tatla S, Sauve K, O'Donnell M. Toolbox of multiple-item measures aligning with the ICF Core Sets for children and youth with cerebral palsy. Eur J Paediatr Neurol 2017; 21:252-263. [PMID: 27864012 DOI: 10.1016/j.ejpn.2016.10.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 10/06/2016] [Accepted: 10/20/2016] [Indexed: 10/20/2022]
Abstract
Selecting appropriate measure(s) for clinical and/or research applications for children and youth with Cerebral Palsy (CP) poses many challenges. The newly developed International Classification of Functioning, Disability and Health (ICF) Core Sets for children and youth with CP serve as universal guidelines for assessment, intervention and follow-up. The aims of this study were: 1) to identify valid and reliable measures used in studies with children and youth with CP, 2) to characterize the content of each measure using the ICF Core Sets for children and youth with CP as a framework, and finally 3) to create a toolbox of psychometrically sound measures covering the content of each ICF Core Set for children and youth with CP. All clearly defined multiple-item measures used in studies with CP between 1998 and 2015 were identified. Psychometric properties were extracted when available. Construct of the measures were linked to the ICF Core Sets. Overall, 83 multiple-item measures were identified. Of these, 68 measures (80%) included reliability and validity testing. The majority of the measures were discriminative, generic and designed for school-aged children. The degree to which measures with proven psychometric properties represented the ICF Core Sets for children and youth with CP varied considerably. Finally, 25 valid and reliable measures aligned highly with the content of the ICF Core Sets, and as such, these measures are proposed as a novel ICF Core Sets-based toolbox of measures for CP. Our results will guide professionals seeking appropriate measures to meet their research and clinical needs worldwide.
Collapse
Affiliation(s)
- Verónica Schiariti
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, V6H 3V4, Canada; Division of Medical Sciences, University of Victoria, PO Box 1700 STN CSC, Victoria, British Columbia, V8W 2Y2, Canada.
| | - Sandy Tatla
- BC Children's Hospital, 4480 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada
| | - Karen Sauve
- BC Children's Hospital, 4480 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada
| | - Maureen O'Donnell
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, V6H 3V4, Canada; BC Children's Hospital, 4480 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada
| |
Collapse
|
22
|
Schiariti V, Mâsse LC. Identifying relevant areas of functioning in children and youth with Cerebral Palsy using the ICF-CY coding system: from whose perspective? Eur J Paediatr Neurol 2014; 18:609-17. [PMID: 24813657 DOI: 10.1016/j.ejpn.2014.04.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 02/27/2014] [Accepted: 04/06/2014] [Indexed: 10/25/2022]
Abstract
AIMS A standardized methodology endorsed by the World Health Organization was used to select the most relevant International Classification of Functioning, Disability and Health for children and youth (ICF-CY) categories to inform the development of the ICF Core Sets for CY with Cerebral Palsy (CP). The aim of this study was to appraise comparatively the results of the four studies included in the preparatory phase of the project exploring relevant areas of functioning in CY with CP. METHODS ICF-CY categories identified in the preparatory studies - systematic review, global expert survey, qualitative study, and clinical study - were ranked. We compared the ranking percentile scores of the categories across studies. RESULTS Each study emphasized different ICF-CY components and provided unique categories. Professionals from the health, education and social sectors described areas of functioning that were well distributed across the ICF-CY components (global expert survey), CY with CP and caregivers highlighted areas within the components activity and participation (a & p) and environmental factors (qualitative study), while the research community and clinical encounters mainly focused on body functions and a & p (systematic review and clinical study). INTERPRETATION This study highlights the need to consider all relevant perspectives when describing the functional profile of CY with CP.
Collapse
Affiliation(s)
- Veronica Schiariti
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Louise C Mâsse
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|