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McGloon K, Humanitzki E, Brennan J, Summers P, Brennan A, George MS, Badran BW, Cribb AR, Jenkins D, Coker-Bolt P. Pairing taVNS and CIMT is feasible and may improve upper extremity function in infants. Front Pediatr 2024; 12:1365767. [PMID: 38415207 PMCID: PMC10896996 DOI: 10.3389/fped.2024.1365767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 01/29/2024] [Indexed: 02/29/2024] Open
Abstract
In this study we combined non-invasive transcutaneous auricular vagal nerve stimulation (taVNS) with 40 h of constraint induced movement therapy (CIMT) in infants. All infants completed the full intervention with no adverse events. Therapists were able to maintain high treatment fidelity and reported high ratings for ease of use and child tolerance. Preliminary results show promising gains on motor outcomes: Mean QUEST increase 19.17 (minimal clinically important difference, MCID 4.89); Mean GMFM increase 13.33 (MCID 1%-3%). Infants also exceeded expectations on Goal Attainment Scores (+1). Early data is promising that taVNS paired with intensive motor CIMT is feasible, reliable, and safe in young infants with hemiplegia, and may help harness activity-dependent plasticity to enhance functional movement.
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Affiliation(s)
- Kelly McGloon
- Department of Rehabilitation Science, College of Health Professions, Medical University of South Carolina, Charleston, SC, United States
| | - Elizabeth Humanitzki
- Department of Health Science and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, United States
| | - Julia Brennan
- Department of Health Science and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, United States
| | - Philip Summers
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Alyssa Brennan
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States
| | - Mark S. George
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- Ralph H. Johnson VA Medical Center, Charleston, SC, United States
| | - Bashar W. Badran
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Anne R. Cribb
- College of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Dorothea Jenkins
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States
| | - Patricia Coker-Bolt
- Department of Rehabilitation Science, College of Health Professions, Medical University of South Carolina, Charleston, SC, United States
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Hart E, Humanitzki E, Schroeder J, Woodbury M, Coker-Bolt P, Dodds C. Neuromotor Rehabilitation Interventions After Pediatric Stroke: A Focused Review. Semin Pediatr Neurol 2022; 44:100994. [PMID: 36456037 PMCID: PMC9976625 DOI: 10.1016/j.spen.2022.100994] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 01/16/2023]
Abstract
Pediatric stroke is a condition that often results in life-long motor, cognitive, or sensory deficits for children. The purpose of this focused review is to compile the most recent literature on pediatric stroke neuromotor interventions and summarize evidence for use by rehabilitation providers and researchers. Terms including stroke, pediatric, and neuromotor were searched with appropriate MeSH terms. Information was collected regarding interventions conducted and outcome measures used for each article. Interventions and outcome measures were organized based on ICF components (Body Structure and Function, Activity, Participation, and Environmental Factors). 16 articles were included after full-text screens. From these 16 articles, a large majority of them included some form of neuromodulation as a part of intervention. Results identified a potentially problematic gap between domains addressed by interventions and measured by outcomes, with a need to include more expansive outcome measures in research studies. There are several areas of potential growth in pediatric stroke literature. Research studies should be precise when describing included samples. As interventions for pediatric stroke shift toward neuromodulation and other neurologic treatments, there is a need for well-defined populations, both clinically in the community as well as in research studies. There is also a need for US guidelines for rehabilitation after pediatric stroke. Overall, the trend in the literature seems to suggest that combining some form of neuromodulatory technique with existing recommended rehabilitation technique (ex: CIMT) may promote overall recovery for children after stroke, though further research is needed.
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Affiliation(s)
- Emerson Hart
- College of Health Professions, Medical University of South Carolina, Charleston, SC.
| | - Elizabeth Humanitzki
- College of Health Professions, Medical University of South Carolina, Charleston, SC
| | - Julia Schroeder
- College of Health Professions, Medical University of South Carolina, Charleston, SC
| | - Michelle Woodbury
- College of Health Professions, Medical University of South Carolina, Charleston, SC
| | - Patty Coker-Bolt
- College of Health Professions, Medical University of South Carolina, Charleston, SC
| | - Cindy Dodds
- College of Health Professions, Medical University of South Carolina, Charleston, SC
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