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Lee HM, Mercimek-Andrews S, Horvath G, Marchese D, Poulin RE, Krolick A, Tierney KL, Turna J, Wei J, Hwu WL. A position statement on the post gene-therapy rehabilitation of aromatic I-amino acid decarboxylase deficiency patients. Orphanet J Rare Dis 2024; 19:17. [PMID: 38238766 PMCID: PMC10797739 DOI: 10.1186/s13023-024-03019-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/11/2024] [Indexed: 01/22/2024] Open
Abstract
Aromatic L-amino acid decarboxylase (AADC) deficiency is a rare genetic disorder of monoamine neurotransmitter synthesis that presents with a range of symptoms, including motor dysfunction and limited attainment of developmental motor milestones. The approval of eladocagene exuparvovec, a gene therapy for AADC deficiency with demonstrated efficacy for motor improvements, now expands the range of motor outcomes possible for patients with this disorder. However, recommendations and guidelines for therapy following treatment with gene therapy are lacking. To ensure patients can reach their full potential following treatment with gene therapy, it is essential they receive rehabilitation therapies designed specifically with their impairments and goals in mind. Therefore, we highlight specific rehabilitative needs of patients following gene therapy and propose a set of recommendations for the post-treatment period based on collective experiences of therapists, physicians, and caregivers treating and caring for patients with AADC deficiency who have been treated with gene therapy. These recommendations include a focus on periods of intensive therapy, facilitating active movements, training for functional abilities, cognitive and communication training, parent/caregiver empowerment, collaboration between therapists and caregivers to develop in-home programs, and the incorporation of supplemental forms of therapy that patients and their families may find more enjoyable and engaging. Many of these rehabilitative strategies may be employed prior to gene therapy. However, these recommendations will be valuable for therapists, caregivers, and wider treatment teams as they prepare for the post-treatment journey with these patients. Furthermore, the considerations and recommendations presented here may prove beneficial outside the AADC deficiency community as gene therapies and other treatments are developed and approved for other rare diseases.
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Affiliation(s)
- Hui-Min Lee
- Department of Medical Genetics and Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 8, Chung-Shan South Road, Taipei, 100226, Taiwan
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Linong St. Beitou Dist, No. 155, Sec. 2, Taipei, 112304, Taiwan
| | - Saadet Mercimek-Andrews
- Department of Medical Genetics, University of Alberta, 8613 114 Street, Edmonton, AB, T6G 2H7, Canada
| | - Gabriella Horvath
- Division of Biochemical Genetics, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada
| | - Diana Marchese
- Department of Pediatric Rehabilitation, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA
- Department of Pediatrics, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO, 64108, USA
| | - Richard E Poulin
- Thai-Chinese International School, 101/177 Moo 7 Soi Mooban Bangpleenives, Prasertsin Road, Bangplee Yai, Samut Prakan, 10540, Thailand
| | - Alexis Krolick
- PTC Therapeutics Inc, 100 Corporate Ct #2400, South Plainfield, NJ, 07080, USA
| | - Kati-Lyn Tierney
- Texas Children's Hospital, 6621 Fannin Street, Houston, TX, 77030, USA
| | - Jasmine Turna
- PTC Therapeutics Inc, 100 Corporate Ct #2400, South Plainfield, NJ, 07080, USA
| | - Judy Wei
- Ruamrudee International School, 6 Soi Ramkhamhaeng 184, Khwaeng Min Buri, Min Buri, Bangkok, 10510, Thailand
| | - Wuh-Liang Hwu
- Department of Medical Genetics and Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 8, Chung-Shan South Road, Taipei, 100226, Taiwan.
- Center for Precision Medicine, China Medical University Hospital, 2 Yude Road, 404, Taichung City, Taiwan.
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Serrada-Tejeda S, Pérez-de-Heredia-Torres M, Knox SH, Sánchez-Herrera-Baeza P, Martínez-Piédrola RM, Obeso-Benítez P, Santos-Del-Riego S. Spanish Cultural Adaptation and Inter-Rater Reliability of the Revised Knox Preschool Play Scale. CHILDREN (BASEL, SWITZERLAND) 2023; 10:965. [PMID: 37371197 DOI: 10.3390/children10060965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND The Revised Knox Preschool Play Scale (RKPPS) is a comprehensive assessment test that observes the level of play development; however, there is no culturally adapted version available with stable psychometric values that would allow its widespread use and provide objective information during clinical evaluations. METHODS Cross-cultural adaptation included direct and retrospective translations, along with cognitive interviews with pediatric occupational therapists to analyze the comprehensibility of the translation. In addition, a final phase of linguistic revision was carried out to determine the grammatical and semantic fit of the adapted version. Finally, inter-rater reliability was analyzed in a sample of typically developing children aged four to six years old. RESULTS The processes of translation and back-translation, cognitive interview, and linguistic review determined an adequate grammatical and semantic equivalence to the Spanish cultural context. Almost perfect agreement, with values between 0.82 and 0.94, was obtained for items and play dimensions, indicating that the precision of the measurements between both evaluators was excellent. CONCLUSIONS The cross-culturally adapted version of the RKPPS meets the necessary adjustments for the sociocultural context and can be used in the clinical practice of occupational therapy.
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Affiliation(s)
- Sergio Serrada-Tejeda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Avenida de Atenas s/n., 28922 Alcorcón, Spain
| | - Marta Pérez-de-Heredia-Torres
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Avenida de Atenas s/n., 28922 Alcorcón, Spain
| | | | - Patricia Sánchez-Herrera-Baeza
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Avenida de Atenas s/n., 28922 Alcorcón, Spain
| | - Rosa M Martínez-Piédrola
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Avenida de Atenas s/n., 28922 Alcorcón, Spain
| | - Paula Obeso-Benítez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Avenida de Atenas s/n., 28922 Alcorcón, Spain
| | - Sergio Santos-Del-Riego
- Department of Physical Therapy, Medicine and Biomedical Sciences, Universidade da Coruña, 15001 A Coruña, Spain
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A Comprehensive Analysis of the Relationship between Play Performance and Psychosocial Problems in School-Aged Children. CHILDREN 2022; 9:children9081110. [PMID: 35892613 PMCID: PMC9329709 DOI: 10.3390/children9081110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 11/17/2022]
Abstract
During childhood, play contributes to the physical, emotional, cognitive and social development of infants and children and may enhance future mental health. The aim of this study was to examine the relationship between play performance factors and psychosocial problems in school-aged children. A total of 142 typical Spanish children aged 5 to 9 years were included. Play performance was measured with the My Child’s Play questionnaire, while the Strengths and Difficulties Questionnaire was used to evaluate internalizing and externalizing problems. The findings showed that personal, environmental and activity factors of play performance were associated with psychosocial problems and prosocial behavior in children. Moreover, children with high psychosocial difficulties reported significantly poorer play performance. As executive functioning during play was the factor that was most strongly associated with internalizing and externalizing psychosocial difficulties, it is possible that executive functions have a decisive role on both social cognition and self-regulation during play performance.
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Patellofemoral Pain Syndrome in Young Female Athletes: A Case-Control Study. Adv Orthop 2022; 2022:1907975. [PMID: 35465126 PMCID: PMC9033388 DOI: 10.1155/2022/1907975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 11/18/2022] Open
Abstract
Background Patellofemoral pain syndrome (PFPS) is the most common cause of anterior knee pain in children and adolescents, and it is characterized by highly limiting, recurrent, frontal pain. Objectives The purpose of the study is to assess the incidence and onset of PFPS in the young female athletes and to compare it to healthy individuals. Methods Between 2017 and 2019, 51 subjects were reviewed and divided in three groups: rhythmic gymnastics athletes (RG; 21 individuals, mean age: 13.8 ± 3.6 years), basketball athletes (BG; 17 individuals, mean age: 14.2 ± 3.1 years), and control group (CG; 13 individuals, mean age: 14.5 ± 4.3 years). All patients underwent physical examination including patellar glide, tilt, grind and apprehension tests, tiptoe and jack tests, Coleman block, and navicular drop tests. The clinical and functional outcomes of the subjects were assessed using the Kujala patellofemoral score (KPS). Results In RG patients were recorded 66.7% of normal footprint (NF), 9.5% of cavus feet (FCF), and 23.8% of flatfeet (FFF); 14.8% patellar positive tests, KS = 98.6 ± 13.7. BG patients had 70.6% of NF, 11.8% FCF, and 17.6% of FFF; 23.5% patellar positive tests, KS = 98.3 ± 12.4. CG patients had 61.5% of NF, 7.7% of FCF and 30.8% of FFF; 15.4% patellar positive tests, KPS = 98,9 ± 15.3. No statistically significance was found between the three cohorts of patients. Conclusions PFPS is a common pathology; muscular imbalance and overuse could exacerbate pain and discomfort in young female athletes. Our findings show high type and level of sport activity are not related to increase frequency of clinical symptoms related to PFPS.
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Sport Ability during Walking Age in Clubfoot-Affected Children after Ponseti Method: A Case-Series Study. CHILDREN-BASEL 2021; 8:children8030181. [PMID: 33804306 PMCID: PMC8001402 DOI: 10.3390/children8030181] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 01/08/2023]
Abstract
Background: The Ponseti method (PM) of manipulative treatment for congenital talipes equinovarus (CTEV) or clubfoot became widely adopted by pediatric orthopedic surgeons at the beginning of the mid-1990s with reports of long-term successful outcomes. Sports are crucial for children’s development and for learning good behavior. This study aimed to evaluate the sports activity levels in children treated with PM and to assess the different outcomes, according to gender and bilaterality. Methods: A total of 25 patients (44 feet) with CTEV treated by the PM were included in the study. The patients were clinically evaluated according to the Clubfoot Assessment Protocol, American Orthopedic Foot and Ankle Society, Ankle–Hindfoot score, the Foot and Ankle Disability Index (CAP, AOFAS, and FADI, respectively), and FADI Sport scores. Results: The overall mean CAP, AOFAS, FADI, and FADI Sport scores were 97.5 ± 6.4 (range 68.75–100), 97.5 ± 5.8 (range 73.00–100), 99.9 ± 0.6 (range 97.1–100), and 100, respectively. Gender and bilaterality did not affect outcome (p > 0.05). Conclusions: The data confirmed good-to-excellent outcomes in children with CTEV managed by PM. No limitations in sport performance or activity could be observed. In particular, male and female patients and patients with unilateral or bilateral involvement performed equally well.
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