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Psychometric properties of functional postural control tests in children: A systematic review. Ann Phys Rehabil Med 2023; 66:101729. [PMID: 36669385 DOI: 10.1016/j.rehab.2022.101729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/10/2022] [Accepted: 11/04/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND Postural control deficits are one of the most common impairments treated in pediatric physiotherapeutic practice. Adequate evaluation of these deficits is imperative to identify postural control deficits, plan treatment and assess efficacy. Currently, there is no gold standard evaluation for postural control deficits. However, the number of studies investigating the psychometric properties of functional pediatric postural control tests has increased significantly. OBJECTIVE To facilitate the selection of an appropriate pediatric functional postural control test in research and clinical practice. METHODS Systematic review following the PRISMA guidelines. PubMed, Web of Science and Scopus were systematically searched (last update: June 2022; PROSPERO: CRD42021246995). Studies were selected using the PICOs-method (pediatric populations (P), functional assessment tools for postural control (I) and psychometric properties (O). The risk of bias was rated with the COSMIN checklist and the level of evidence was determined with GRADE. For each test, the postural control systems were mapped, and the psychometric properties were extracted. RESULTS Seventy studies investigating 26 different postural control tests were included. Most children were healthy or had cerebral palsy. Overall, the evidence for all measurement properties was low to very low. Most tests (95%) showed good reliability (ICC>0.70), but inconsistent validity results. Structural validity, internal consistency and responsiveness were only available for 3 tests. Only the Kids-BESTest and FAB covered all postural control systems. CONCLUSION Currently, 2 functional tests encompass the entire construct of postural control. Although reliability is overall good, validity results depend on task, age and pathology. Future research should focus on test batteries and should particularly explore structural validity and responsiveness in different populations with methodologically strong study designs.
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Graff K, Szczerbik E, Kalinowska M, Kaczmarczyk K, Stępień A, Syczewska M. Using the TUG Test for the Functional Assessment of Patients with Selected Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084602. [PMID: 35457472 PMCID: PMC9025107 DOI: 10.3390/ijerph19084602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/05/2022] [Accepted: 04/09/2022] [Indexed: 12/10/2022]
Abstract
One of the tests used for quantitative diagnostics is Timed Up-and-Go (TUG), however, no reports were found regarding the percentage share of individual test components, which seems to have a greater diagnostic value in differentiating the functional status of the patients. The aim of the study was to analyze the percentage of the individual components of the TUG test in functional assessment in a population of healthy children and in clinical trials patients with various diseases. Material and Methodology. The material consisted of patients with orthopedic (n = 165), metabolic (n = 116) and neurological dysfunctions (n = 96). Results. The components of the TUG test that differentiated the studied groups of patients to the greatest extent were in the order: relapse tug3%, initial transition tug2%, sitting tug5% and standing up tug1%, while during the final transition tug4% statistically significant differences were found only between healthy children and the studied groups of patients. Conclusions. The TUG test turned out to be a good diagnostic tool, differentiating the studied groups of patients. The analysis of the percentage of the components of the TUG test can help in assessing the mobility of children and adolescents, monitor the effects of physiotherapy or the effects of surgical procedures.
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Affiliation(s)
- Krzysztof Graff
- Department of Pediatric Rehabilitation, Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (K.G.); (E.S.); (M.K.); (M.S.)
| | - Ewa Szczerbik
- Department of Pediatric Rehabilitation, Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (K.G.); (E.S.); (M.K.); (M.S.)
| | - Małgorzata Kalinowska
- Department of Pediatric Rehabilitation, Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (K.G.); (E.S.); (M.K.); (M.S.)
| | - Katarzyna Kaczmarczyk
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, 00-968 Warsaw, Poland;
- Correspondence: ; Tel.: +48-604777670
| | - Agnieszka Stępień
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, 00-968 Warsaw, Poland;
| | - Małgorzata Syczewska
- Department of Pediatric Rehabilitation, Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (K.G.); (E.S.); (M.K.); (M.S.)
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del Corral T, Tapia-Castañeda J, Ríos-Pérez G, Triviño-López P, Sastre-Moreno N, Fernández PG, López-de-Uralde-Villanueva I. Assessment of the determinants of changes and test–retest reliability in the 6-min walk test performance over a 4-month period in healthy 6–12-year-old children. Eur J Appl Physiol 2022; 122:935-944. [DOI: 10.1007/s00421-022-04890-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 01/09/2022] [Indexed: 11/03/2022]
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Takaki K, Nitta O, Kusumoto Y. Factors influencing the participation of children with disabilities in the community. J Phys Ther Sci 2021; 33:229-235. [PMID: 33814709 PMCID: PMC8012188 DOI: 10.1589/jpts.33.229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 12/01/2020] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To promote community involvement in children, the factors that influence and limit their participation must be well understood. The purpose of this study was to clarify the factors that limit the community participation of children with disabilities. [Participants and Methods] In total, 235 questionnaires were distributed to parents at special support schools, pediatric hospitals, home-visit nursing stations, and after-school daycare services in Tokyo, Gunma, Hiroshima, and Saga prefectures in Japan. Data related to the Participation and Environment Measure for Children and Youth, age, height, weight, gross motor function, presence of medical care, diagnosis, and parental age were recorded for school-aged children. [Results] Multiple regression analysis using the 100 valid questionnaire responses revealed that the number of community activities that the children participated in depended on the children's need for medical care (standardized partial regression coefficient: -0.20). The frequency was affected by gross motor function (standardized partial regression coefficient: -0.24). When respiratory, feeding, and excretion-related medical care were required, the children tended to participate in fewer community activities. [Conclusion] Community participation is influenced by the different factors in each aspect analyzed (number of activities, frequency, and degree of involvement). The factors that should be considered when promoting children's participation in rehabilitation must be identified.
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Affiliation(s)
- Kenji Takaki
- Graduate School of Human Health Sciences, Tokyo Metropolitan University: 7-2-10 Higashi-Ogu, Arakawa-ku, Tokyo 116-8551, Japan.,Department of Physical Therapy, Faculty of Health Sciences, Mejiro University, Japan
| | - Osamu Nitta
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Japan
| | - Yasuaki Kusumoto
- Department of Physical Therapy, Faculty of Health Sciences, Tokyo University of Technology, Japan
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Kohler BE, Baque E, Sandler CX, Brookes DSK, Terranova CO, Rixon M, Hassall T, Trost SG. Physical ACTivity in Survivorship (PACTS): study protocol for a randomized controlled trial evaluating a goal-directed therapeutic exercise program in pediatric posterior fossa brain tumor survivors. BMC Pediatr 2021; 21:105. [PMID: 33648474 PMCID: PMC7919081 DOI: 10.1186/s12887-021-02566-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 02/22/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Posterior fossa brain tumors (PFBT) are the most common solid tumor in children. Recent increases in survival rates are encouraging; however, survivors may experience a plethora of disease- and treatment-related complications that can persist into adulthood. Therapeutic exercise interventions have been shown to improve quality of survivorship in other pediatric cancer diagnoses. There is also evidence that goal-directed interventions are effective at improving motor activities, function, and self-care in children with complex health conditions. Yet, there is currently no evidence on the efficacy of goal-directed therapeutic exercise in pediatric PFBT survivors. The Physical ACTivity in Survivorship (PACTS) study aims to investigate the effects of a novel goal-directed therapeutic exercise program on cardiorespiratory fitness and physical activity-related goal attainment in pediatric survivors of PFBT. METHOD PFBT survivors, aged five to 17 years, who underwent surgery at least 12 months earlier and completed radiation therapy and/or chemotherapy at least 6 months prior will be recruited from the Queensland Children's Hospital (Brisbane, Australia) (target n = 48). Following baseline assessment, participants are randomized into either the intervention or usual care group. The intervention group will receive weekly individualized, goal-directed exercise therapy delivered face-to-face for 12 weeks, along with an accompanying home-based program (three sessions per week). Outcomes will be assessed at baseline, immediately post-intervention, and at 6- and 12-months post-intervention. The primary outcomes are cardiorespiratory fitness (Peak VO2) and physical activity-related goal attainment. Secondary outcomes are cardiorespiratory endurance, high-level mobility skills, functional muscle strength, habitual physical activity, gait, balance, quality of life, fatigue, participation, perceived movement skill competence and parameters of body composition. DISCUSSION PACTS is the first study to investigate the efficacy of goal-directed therapeutic exercise in children with PFBT and provide evidence needed to inform clinical practice recommendations for managing quality of survivorship in PFBT survivors. TRIAL REGISTRATION ACTRN12619000841178 .
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Affiliation(s)
- Brooke E Kohler
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Emmah Baque
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Carolina X Sandler
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- UNSW Fatigue Research Program, Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Denise S K Brookes
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Caroline O Terranova
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Matthew Rixon
- School of Clinical Sciences, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Tim Hassall
- Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Stewart G Trost
- Institute of Health and Biomedical Innovation at the Queensland Centre for Children's Health Research, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
- School of Exercise and Nutrition Science, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
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Martakis K, Stark C, Rehberg M, Semler O, Duran I, Schoenau E. Reference Centiles to Monitor the 6-minute-walk Test in Ambulant Children with Cerebral Palsy and Identification of Effects after Rehabilitation Utilizing Whole-body Vibration. Dev Neurorehabil 2021; 24:45-55. [PMID: 32564635 DOI: 10.1080/17518423.2020.1770891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Children with cerebral palsy present age-driven development in gross motor skills and walking capacity. Aims: To precisely monitor the 6-minute walk test (6MWT) in children with CP, GMFCS levels 1 and 2 over 6 months and to assess the effect of a 6-month rehabilitation program including whole-body vibration. Methods: Retrospective analysis of data of 157 children with CP who received standardized rehabilitation (DRKS00011331). 6MWT was assessed at the start (M0) and end of the training (M6), as well as at a 6-month follow-up (M12). Centiles were created using the lambda-mu-sigma (LMS) method. Results: We created 6MWT percentiles using data of all 157 children (M0 data). A medium treatment effect size (Cohen's d = 0.69) was found (M6 and M12 data). Conclusions: The generated centiles may help monitor 6MWT changes over 6 months. Combining WBV and conventional physiotherapy can significantly improve 6MWT in children with CP. Abbreviations: 6MWT: 6-Minute Walk Test; CP: Cerebral palsy; ES: effect size; GMFCS: Gross Motor Function Classification System; GMFM-66: Gross Motor Function Measure 66; LOESS: locally weighted scatterplot smoothing; LMS: lambda-mu-sigma; MCID: minimal clinical important difference; SD: standard deviation; SRM: standardized response mean; WBV: whole-body vibration.
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Affiliation(s)
- Kyriakos Martakis
- Medical Faculty and University Hospital, Centre of Prevention and Rehabilitation , Cologne, Germany.,Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne , Cologne, Germany.,Faculty of Health, Medicine and Life Sciences, Department of International Health, Care and Public Health Research Institute, School CAPHRI, Maastricht University , Maastricht, The Netherlands.,Department of Pediatric Neurology, Social Pediatrics and Epileptology, Justus-Liebig-University Giessen and UKGM , Giessen, Germany
| | - Christina Stark
- Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne , Cologne, Germany.,Cologne Centre for Musculoskeletal Biomechanics (CCMB), University of Cologne , Cologne, Germany
| | - Mirko Rehberg
- Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne , Cologne, Germany.,Centre for Rare Skeletal Diseases in Childhood, University of Cologne , Cologne, Germany
| | - Oliver Semler
- Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne , Cologne, Germany.,Centre for Rare Skeletal Diseases in Childhood, University of Cologne , Cologne, Germany
| | - Ibrahim Duran
- Medical Faculty and University Hospital, Centre of Prevention and Rehabilitation , Cologne, Germany
| | - Eckhard Schoenau
- Medical Faculty and University Hospital, Centre of Prevention and Rehabilitation , Cologne, Germany.,Medical Faculty and University Hospital, Department of Pediatrics, University of Cologne , Cologne, Germany.,Cologne Centre for Musculoskeletal Biomechanics (CCMB), University of Cologne , Cologne, Germany
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Pritchard L, Verschuren O, Roy M, Kaup C, Rumsey DG. Reproducibility of the Six‐Minute Walk Test in Children and Youth with Juvenile Idiopathic Arthritis. Arthritis Care Res (Hoboken) 2020; 74:686-690. [DOI: 10.1002/acr.24492] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 09/25/2020] [Accepted: 10/20/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Lesley Pritchard
- Department of Physical Therapy Faculty of Rehabilitation Medicine University of Alberta Canada Edmonton Alberta
| | - Olaf Verschuren
- UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine Utrecht University Utrecht the Netherlands
| | - Michelle Roy
- Glenrose Rehabilitation Hospital Edmonton Alberta Canada
| | - Cara Kaup
- Glenrose Rehabilitation Hospital Edmonton Alberta Canada
| | - Dax G. Rumsey
- Glenrose Rehabilitation Hospital Edmonton Alberta Canada
- Department of Pediatrics Faculty of Medicine and Dentistry University of Alberta Canada Edmonton Alberta
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8
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Reliability and concurrent validity of a modified timed up and go test for healthy preschoolers. Eur J Pediatr 2020; 179:1579-1586. [PMID: 32338296 DOI: 10.1007/s00431-020-03638-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 03/16/2020] [Accepted: 03/18/2020] [Indexed: 12/17/2022]
Abstract
The purpose of this study was to assess the interrater and test-retest reliability and the concurrent validity of the modified timed up and go test for preschoolers. As such, we aim to determine the most suited outcome of the modified timed up and go test: the best or the average performance. Thirty-two children (age 3-5) performed three timed up and go test trials as fast as possible on two separate occasions. During the first session, two researchers recorded the time to perform the task simultaneously. For reliability analyses, intra-class correlation coefficients (ICCs) and the minimal detectable change were determined. A Pearson correlation coefficient was calculated to determine concurrent validity between the timed up and go test and the balance subscale of the Movement Assessment Battery for Children, 2nd edition. Interrater (ICC > 0.97) and test-retest (ICC > 0.75) reliability were good both for the average and the best timed up and go test performance. A minimal detectable change of 1.86 s was found for the best performance, and 2.30 s for the average performance. Only the best timed up and go test performance correlated significantly with the balance subscale of the Movement Assessment Battery for Children, 2nd edition, though fair (r = -0.347, p = 0.007).Conclusion: The modified timed up and go test for preschoolers using the best performance is reliable and recommended to reduce standard and measurement error. What is Known: • A large variety of timed up and go test protocols is available for children • The protocols differ in the instructions on walking speed (self-selected/fastest), the use of an extra motivation (e.g., touch a star on the wall) and the applied outcome (average/best performance) What is New: • The best timed up and go test performance induces more consistent test results between raters and sessions and also less standard and measurement error in 3- to 5-year-old children • The best timed up and go test performance should be preferred over the average performance to achieve both reliable and valid test results in 3- to 5-year-old children.
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9
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Eldridge BJ, Galea MP, Kissane AL, Broder JC, Brilleman SL, Wolfe R, Williams G. High-Level Mobility Assessment Tool Normative Values for Children. Phys Ther 2020; 100:324-331. [PMID: 31742357 DOI: 10.1093/ptj/pzz168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 03/20/2019] [Accepted: 08/13/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Physical therapists need to be able to evaluate high-level gross motor skills of children to determine their capacity to engage in activities such as running, jumping, hopping, and stair climbing. The High-Level Mobility Assessment Tool (HiMAT) has excellent interrater and retest reliability and is less susceptible to a ceiling effect than existing mobility scales in children who are 6 to 17 years old and have traumatic brain injury. OBJECTIVE The purposes of this study were to develop normative HiMAT score ranges for Australian children and to investigate the relationship between children's HiMAT scores and their age, height, weight, and body mass index (BMI). DESIGN This study used a cross-sectional design. METHODS Children included in this study were 5 to 12 years old, had no condition affecting their mobility, could follow 2-stage instructions, and had written informed consent from their parent or guardian. A total 1091 children were assessed at their local school, where their height, weight, and HiMAT score were recorded. The relationships between children's age, height, weight, and BMI were summarized using Spearman rank correlations. Truncated regression models were used to determine the most appropriate predictor variable for developing sex-specific normative ranges. RESULTS There was a positive correlation between children's HiMAT scores and their age, height, weight, and BMI. Age explained the most variability in HiMAT scores for both boys and girls. LIMITATIONS The reliability, validity, and responsiveness of the HiMAT have not been tested across a broad range of children with mobility limitations. Normative data reported in this study are for Australian children only. CONCLUSIONS HiMAT scores for children in this study increased with age, height, weight, and BMI. Age was the most appropriate variable for developing a normative dataset of HiMAT scores for children of primary school age.
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Affiliation(s)
- Beverly J Eldridge
- Department of Allied Health, La Trobe University, Level 4, The Alfred Centre, Melbourne, Victoria, Australia
| | - Mary P Galea
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Anne L Kissane
- Victorian Paediatric Rehabilitation Service, North Geelong, Victoria, Australia
| | - Jonathan C Broder
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | - Rory Wolfe
- Department of Epidemiology and Preventive Medicine, Monash University
| | - Gavin Williams
- Department of Physiotherapy, Epworth Healthcare; and Department of Physiotherapy, The University of Melbourne, Victoria, Australia
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Fadida Y, Shapira-Vadler O, Spasser R, Frenkel-Toledo S. Reproducibility and smallest real differences of walking and Energy Expenditure Index in children and adolescents with an acquired brain injury. NeuroRehabilitation 2019; 45:19-24. [PMID: 31403952 DOI: 10.3233/nre-192716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Reliable evaluation is of utmost importance to the therapist and the patient. There is no data about the test-retest reproducibility of 6-Minute Walk Test (6MWT) and Energy Expenditure Index (EEI) for children and adolescents with an Acquired Brain Injury (ABI) in the sub-acute phase. OBJECTIVE To determine test-retest reproducibility and smallest real differences (SRDs) of the 6MWT and EEI in children and adolescents with an ABI during rehabilitation in the sub-acute phase. Our second aim was to assess the correlation between the objective measure, the EEI, and the subjective perception of physical exertion obtained by using the pictorial children's effort rating scale (PCERT). METHODS Twenty eight participants (12.5±4.3 years; 10 females) with an ABI in the sub-acute phase were asked to perform the 6MWT twice during their hospitalization. Heart rate was monitored during rest and throughout the 6MWT to calculate the EEI. Intra-class correlation coefficients (ICCs) and SRDs of the 6MWT and EEI were determined. RESULTS Test-retest reproducibility was excellent for the 6MWT (ICC = 0.98, SRD = 65.73 m) and EEI tests (ICC = 0.99, SRD = 0.65 beats/m). Excluding one participant who walked extremely slowly resulted in ICC = 0.97, SRD = 67.01 m for the 6MWT, and ICC = 0.91, SRD = 0.25 beats/m for the EEI. No significant correlations were found between the EEI and PCERT. CONCLUSIONS 6MWT and EEI are reliable measures in children and adolescents with an ABI during hospitalization in the sub-acute phase.
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Affiliation(s)
- Yahaloma Fadida
- Department of Physical Therapy, Loewenstein Rehabilitation Hospital, Raanana, Israel.,Department of Pediatric and Youth Rehabilitation, Loewenstein Rehabilitation Hospital, Raanana, Israel
| | - Orit Shapira-Vadler
- Department of Physical Therapy, Loewenstein Rehabilitation Hospital, Raanana, Israel.,Department of Pediatric and Youth Rehabilitation, Loewenstein Rehabilitation Hospital, Raanana, Israel
| | - Raluca Spasser
- Department of Pediatric and Youth Rehabilitation, Loewenstein Rehabilitation Hospital, Raanana, Israel
| | - Silvi Frenkel-Toledo
- Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel.,Department of Physical Therapy, Loewenstein Rehabilitation Hospital, Raanana, Israel
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11
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Newman MA, Hirsch MA, Peindl RD, Habet NA, Tsai TJ, Runyon MS, Huynh T, Zheng N. Reliability of the sub-components of the instrumented timed up and go test in ambulatory children with traumatic brain injury and typically developed controls. Gait Posture 2018; 63:248-253. [PMID: 29778065 DOI: 10.1016/j.gaitpost.2018.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/03/2018] [Accepted: 05/10/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Studies have evaluated the test-re-test reliability of subcomponents of the timed up and-go test in adults by using body-worn inertial sensors. However, studies in children have not been reported in the literature. RESEARCH QUESTION To evaluate the within-session reliability of subcomponents of a newly developed electronically augmented timed 'upand-go' test (EATUG) in ambulatory children with traumatic brain injury (TBI) and children with typical development (TD). METHOD The timed up and go test was administered to twelve consecutive ambulatory children with moderate to severe TBI (6 males and 6 females, age 10.5 ± 1.5 years, range 8-13 years, during inpatient rehabilitation at 27.0 ± 11.8 days following injury) and 10 TD age and sex-matched children (5 males and 5 females, 10.4 ± 1.3 years, range 8-11 years). Participants wore a single chest-mounted inertial measurement sensor package with custom software that measured angular and acceleration velocity and torso flexion and extension angles, while they performed 6 trials of the EATUG test. Measures were derived from the overall time to complete the TUG test, angular velocity and angular displacement data for torso flexion and extension during sit-to-stand and stand-to-sit segments and both mean and peak angular velocities for two turning segments (i.e. turning around a cone and turning-before-sitting). RESULTS Within-session reliability of the subcomponents of the TUG test for children with TBI assessed by the intra-class correlation coefficient was ICC (1,1) = 0.84, (range 0.82-0.96), and for TD children ICC (1,1) = 0.73, (range 0.53-0.89). Scores on Total Time, maximum torso flexion/extension angle and peak flexion angular velocity during sit-tostand, and peak turn angular velocity for both turns around the cone and turns before sitting were lower for children with TBI than for TD children (p ≤ 0.05). SIGNIFICANCE The EATUG test is a reliable measure of physical function in children with TBI who are being discharged from inpatient rehabilitation.
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Affiliation(s)
- Mark A Newman
- Carolinas Medical Center, Carolinas Rehabilitation, Department of Physical Medicine and Rehabilitation, 1100 Blythe Blvd., Charlotte, NC 28203, United States.
| | - Mark A Hirsch
- Carolinas Medical Center, Carolinas Rehabilitation, Department of Physical Medicine and Rehabilitation, 1100 Blythe Blvd., Charlotte, NC 28203, United States
| | - Richard D Peindl
- Atrium Health Musculoskeletal Institute, 1000 Blythe Blvd., Charlotte, NC 28203, United States
| | - Nahir A Habet
- Atrium Health Musculoskeletal Institute, 1000 Blythe Blvd., Charlotte, NC 28203, United States
| | - Tobias J Tsai
- Carolinas Medical Center, Carolinas Rehabilitation, Department of Physical Medicine and Rehabilitation, 1100 Blythe Blvd., Charlotte, NC 28203, United States
| | - Michael S Runyon
- Carolinas Medical Center, Department of Emergency Medicine, 1000 Blythe Blvd., Charlotte, NC 28203, United States
| | - Toan Huynh
- Carolinas Medical Center, Department of Surgery, Division of Acute Care Surgery, 1000 Blythe Blvd., Charlotte, NC 28203, United States
| | - Nigel Zheng
- Center for Biomedical Engineering and Science, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC 28223, United States
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12
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Towns M, Rosenbaum P, Palisano R, Wright FV. Should the Gross Motor Function Classification System be used for children who do not have cerebral palsy? Dev Med Child Neurol 2018; 60:147-154. [PMID: 29105760 DOI: 10.1111/dmcn.13602] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2017] [Indexed: 12/11/2022]
Abstract
UNLABELLED This literature review addressed four questions. (1) In which populations other than cerebral palsy (CP) has the Gross Motor Function Classification System (GMFCS) been applied? (2) In what types of study, and why was it used? (3) How was it modified to facilitate these applications? (4) What justifications and evidence of psychometric adequacy were used to support its application? A search of PubMed, MEDLINE, and Embase databases (January 1997 to April 2017) using the terms: 'GMFCS' OR 'Gross Motor Function Classification System' yielded 2499 articles. 118 met inclusion criteria and reported children/adults with 133 health conditions/clinical descriptions other than CP. Three broad GMFCS applications were observed: as a categorization tool, independent variable, or outcome measure. While the GMFCS is widely used for children with health conditions/clinical description other than CP, researchers rarely provided adequate justification for these uses. We offer recommendations for development/validation of other condition-specific classification systems and discuss the potential need for a generic gross motor function classification system. WHAT THIS PAPER ADDS The Gross Motor Function Classification System should not be used outside cerebral palsy or as an outcome measure. The authors provide recommendations for development and validation of condition-specific or generic classification systems.
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Affiliation(s)
- Megan Towns
- Bloorview Research Institute, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada.,Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Robert Palisano
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada.,Physical Therapy and Rehabilitation Science Department, Drexel University, Philadelphia, PA, USA
| | - F Virginia Wright
- Bloorview Research Institute, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada.,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
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Baque E, Barber L, Sakzewski L, Ware R, Boyd RN. Characteristics associated with physical activity capacity and performance in children and adolescents with an acquired brain injury. Brain Inj 2017; 31:667-673. [PMID: 28421820 DOI: 10.1080/02699052.2017.1291990] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM To examine characteristics associated with physical activity capacity and performance in children with acquired brain injury (ABI). METHODS 58 children (32 men; age 11 years 11 months ± 2 years 6 months; Gross motor function classification system [GMFCS] equivalent I = 29, II = 29) >12 months post ABI were recruited. Physical activity capacity measures included: (i) combined score of three 30-second repetition maximum functional strength exercises; (ii) timed up and go; (iii) 6-minute walk test and (iv) high-level mobility assessment tool (HiMAT). Physical activity performance determined time spent in sedentary, light and moderate to vigorous physical activity (MVPA). Full scale intelligence quotient (FSIQ) was assessed using the Wechsler intelligence scale for Children-IV. Regression models were constructed with functional strength score (n = 56), activity counts/minutes and time spent in MVPA and sedentary (n = 37). RESULTS The HiMAT and FSIQ explained 69% of the variance in functional strength. Age explained 12% of the variance in counts/min and 14% of the variance in time spent sedentary. GMFCS explained 10% of the variance in time spent in MVPA. CONCLUSIONS The ability to perform functional strength exercises is associated with mobility beyond independence and adequate intellectual ability for children with ABI. Age was the most significant factor associated with physical activity performance, and interventions should target adolescents with ABI.
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Affiliation(s)
- Emmah Baque
- a Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland , Brisbane , Australia
| | - Lee Barber
- a Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland , Brisbane , Australia
| | - Leanne Sakzewski
- a Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland , Brisbane , Australia
| | - Robert Ware
- b Child Health Research Centre, Faculty of Medicine, The University of Queensland , Brisbane , Australia.,c School of Public Health, The University of Queensland , Brisbane , Australia
| | - Roslyn N Boyd
- a Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland , Brisbane , Australia
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