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Inotani T, Horaguchi A, Morishita Y, Yoshida A, Otomo M, Suzuki M, Inui T, Okubo Y, Komatsu S, Mizuno C, Takahashi Y, Ochiai T, Kinjo T, Asato T, Takayama J, Tamiya G, Saijo N, Kikuchi A, Haginoya K. Treatment of ZC4H2 Variant-Associated Spastic Paraplegia with Selective Dorsal Rhizotomy and Intensive Postoperative Rehabilitation: A Case Report. TOHOKU J EXP MED 2024; 262:239-244. [PMID: 38267061 DOI: 10.1620/tjem.2024.j004] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Selective dorsal rhizotomy (SDR) has been used to treat children with spastic cerebral palsy (CP), and its beneficial effect on quality of life and ambulation has been confirmed in long-term follow-up studies. However, the role of SDR in the treatment of spasticity in patients with hereditary spastic paraplegia (HSP) and related disorders is not well-established. Here, we report the first patient with the ZC4H2 variant who underwent SDR to treat spastic paraplegia. Abnormal gait was discovered during a regular checkup at the age of 3 years and 9 months, and she was diagnosed with spastic paraplegia. She was heterozygous for the ZC4H2 variant and underwent SDR at the age of 5 years and 11 months, which alleviated the spasticity. The patient underwent inpatient postoperative rehabilitation for 4 months and continued outpatient physiotherapy after discharge. The Gross Motor Function Measure-88 score and maximum walking speed decreased transiently 1 month postoperatively, but gradually recovered, and continuously improved 6 months postoperatively. SDR and postoperative intensive rehabilitation were effective in improving motor and walking functions up to 6 months after surgery, although long-term follow-up is needed to draw conclusions.
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Affiliation(s)
- Toshiki Inotani
- Department of Rehabilitation and Developmental Support, Miyagi Children's Hospital
| | - Akira Horaguchi
- Department of Rehabilitation and Developmental Support, Miyagi Children's Hospital
| | - Yuko Morishita
- Department of Rehabilitation and Developmental Support, Miyagi Children's Hospital
| | - Ayuko Yoshida
- Department of Rehabilitation and Developmental Support, Miyagi Children's Hospital
| | - Misaki Otomo
- Department of Rehabilitation and Developmental Support, Miyagi Children's Hospital
| | - Makoto Suzuki
- Graduate School of Health and Environment Sciences, Tohoku Bunka Gakuen University
| | - Takehiko Inui
- Department of Pediatric Neurology, Miyagi Children's Hospital
| | - Yukimune Okubo
- Department of Pediatric Neurology, Miyagi Children's Hospital
| | - Shigemasa Komatsu
- Department of Pediatric Orthopedic Surgery and Rehabilitation, Miyagi Children's Hospital
| | - Chika Mizuno
- Department of Pediatric Orthopedic Surgery and Rehabilitation, Miyagi Children's Hospital
| | - Yuko Takahashi
- Department of Pediatric Orthopedic Surgery and Rehabilitation, Miyagi Children's Hospital
| | - Tatsuhiro Ochiai
- Department of Pediatric Orthopedic Surgery and Rehabilitation, Miyagi Children's Hospital
| | - Takeshi Kinjo
- Department of Orthopedic Surgery and Rehabilitation, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center
| | - Takashi Asato
- Department of Orthopedic Surgery and Rehabilitation, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center
| | - Jun Takayama
- Department of AI and Innovative Medicine, Tohoku University Graduate School of Medicine
- Tohoku Medical Megabank Organization, Tohoku University
- Statistical Genetics Team, RIKEN Center for Advanced Intelligence Project
- Department of Rare Disease Genomics, Tohoku University Graduate School of Medicine
| | - Gen Tamiya
- Department of AI and Innovative Medicine, Tohoku University Graduate School of Medicine
- Tohoku Medical Megabank Organization, Tohoku University
- Statistical Genetics Team, RIKEN Center for Advanced Intelligence Project
- Department of Rare Disease Genomics, Tohoku University Graduate School of Medicine
| | - Naoya Saijo
- Department of Pediatrics, Tohoku University School of Medicine
| | - Atsuo Kikuchi
- Department of Pediatrics, Tohoku University School of Medicine
- Department of Rare Disease Genomics, Tohoku University Graduate School of Medicine
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Park M, Kim J, Yu C, Lim H. The Effects of Neurodevelopmental Treatment-Based Trunk Control Exercise on Gross Motor Function and Trunk Control in Children with Developmental Disabilities. Healthcare (Basel) 2023; 11:healthcare11101446. [PMID: 37239732 DOI: 10.3390/healthcare11101446] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Good trunk control is essential for higher developmental stages as the trunk is activated first when movement occurs, providing stability for the head and extremities. PURPOSE To determine if neurodevelopmental treatment-based trunk control exercise (NDT-TCE) is effective in improving gross motor function and trunk control in children with developmental disabilities (DD). MATERIALS AND METHODS Twenty children with developmental disabilities were randomly assigned to the NDT-TCE (12 children) and control (8 children) groups. RESULTS After the intervention; the NDT-TCE group showed improvement in GMFM (Gross Motor Function Measure; except for the GMFM-E dimension) and SATCo scores. The control group showed improvement in GMFM-A; B; C; and total scores; as well as static and active control of SATCo. The NDT-TCE group had a significant improvement in the GMFM B dimension and total score compared to the control group. The NDT-TCE group showed a significant improvement in static and active control of SATCo compared to the control group, but there was no significant difference in reactive control. CONCLUSIONS The NDT-TCE intervention specifically improved GMFM-B and trunk control scores. Therefore, NDT-TCE can be applied as a trunk-focused intervention for children with DD who have difficulty controlling their trunk.
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Affiliation(s)
- Miho Park
- Department of Physical Therapy, Graduate School, Dankook University, Cheonan 31116, Republic of Korea
| | - Jeongseon Kim
- Department of Physical Therapy, Gangdong University, Eumseong-gun 27600, Republic of Korea
| | - Changseon Yu
- Department of Rehabilitation Medicine, Dongguk University Ilsan Hospital, Goyang 10326, Republic of Korea
| | - Hyoungwon Lim
- Dankook University Disabled Rehabilitation Research Institute, Department of Physical Therapy, Dankook University, Cheonan 31116, Republic of Korea
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Abe H, Koyanagi S, Kusumoto Y, Himuro N. Intra-rater and inter-rater reliability, minimal detectable change, and construct validity of the Edinburgh Visual Gait Score in children with cerebral palsy. Gait Posture 2022; 94:119-123. [PMID: 35279565 DOI: 10.1016/j.gaitpost.2022.03.004] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 02/11/2022] [Accepted: 03/06/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The Edinburgh Visual Gait Score (EVGS) has been used for observational gait assessment in children with cerebral palsy (CP). However, the measurement error of the EVGS and its detailed relationship with gross motor function remain unclear. RESEARCH QUESTIONS This study aimed to confirm the intra-rater and inter-rater reliability as well as the minimal detectable change (MDC) values for the EVGS with the use of the video analysis software and examine the relationship between the EVGS and the Gross Motor Function Measure 66 (GMFM-66) with regard to construct validity. METHODS This cross-sectional study was conducted for 62 children (mean age 11.3 ± 3.9 years) with spastic CP at Gross Motor Function Classification System (GMFCS) level I (32 children), II (25 children) or III (5 children). Three raters independently scored the EVGS using Kinovea video analysis software. The intra-rater and inter-rater reliability were calculated using intra-class correlation coefficients (ICC2,1), and the MDC90 was calculated using standard error of measurement. The construct validity was examined by correlating the EVGS with the GMFM-66. RESULTS The EVGS showed good or excellent reliability within each rater (ICC2,1 = 0.90-0.97) and between raters (ICC2,1 = 0.91). The MDC90 of the EVGS ranged from 3.6 to 6.0. There was a significant correlation between the EVGS and the GMFM-66 (r = - 0.69 to - 0.73, p < 0.001). SIGNIFICANCE The intra-rater and inter-rater reliability of the EVGS is sufficient for observational gait assessment. The high correlation between the EVGS and the GMFM-66 supports its construct validity. The authors propose an MDC of 6.0 for the EVGS. These results can help in the application of EVGS to children with CP at GMFCS level I-II with mild to moderate gait pathology, as there were few children with CP at GMFCS level III.
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Affiliation(s)
- Hirokazu Abe
- Department of Health Care and Child Development, Saitama Children's Medical Center, Saitama, Japan.
| | - Shotaro Koyanagi
- Department of Rehabilitation, Visiting Nursing Station Asuka, Hiroshima, Japan
| | - Yasuaki Kusumoto
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima, Japan
| | - Nobuaki Himuro
- Department of Public Health, School of Medicine, Sapporo Medical University, Sapporo, Japan
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Scott KS, Barbosa GO, Pan J, Heathcock JC. Using the PODCI to Measure Motor Function and Parent Expectations in Children With Cerebral Palsy. Phys Ther 2021; 101:pzab215. [PMID: 34529078 PMCID: PMC8651067 DOI: 10.1093/ptj/pzab215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 07/12/2021] [Accepted: 07/31/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Involving parents in the evaluation of their child with cerebral palsy (CP) is associated with enhanced neurodevelopmental outcomes. The pediatric outcomes data collection instrument (PODCI) is a patient-reported outcome measure primarily used to assess motor function following orthopedic surgical intervention or for older children with more independent motor function. The PODCI expectations scale has infrequently been reported in previous studies. This study aims to determine the relationship between parent-reported motor performance using the PODCI and motor capacity assessed by pediatric therapists for young children with CP across all ability levels and to explore the use of the PODCI expectations scale for quantifying therapy-related parent expectations. METHODS This prospective cohort study included 108 participants with CP, 2 to 8 years of age, gross motor function classification systems (GMFCS) levels I to V. Measures included the PODCI, gross motor function measure (GMFM), and GMFCS. RESULTS There were moderate (r = 0.513) to large (r = 0.885) relationships between PODCI and GMFM scores. PODCI scores were significantly different across GMFCS levels. Weak, significant relationships (r = -0.28) were found between function expectations scores and measures of function. CONCLUSION The PODCI, GMFM, and GMFCS provide different, but strongly related, information about the abilities of young children. The GMFM measures motor capacity. Parents report daily function and health-related quality of life for their child using the PODCI. Parent expectations for intervention outcomes may relate to a child's motor function. IMPACT These study results are consistent with those for older children with greater independent mobility, indicating an opportunity for expanded use of the PODCI for measuring motor performance for younger children with CP across all ability levels. A strategy is provided for using the PODCI expectations scale to quantify parent therapy-related expectations in future research and clinical settings. Therapy-related expectations may relate to child outcomes.
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Affiliation(s)
- Kimberley S Scott
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Gardenia O Barbosa
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Jeff Pan
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio, USA
| | - Jill C Heathcock
- Pediatric and Rehabilitation Laboratory, School of Health and Rehabilitation Sciences, Division of Physical Therapy, The Ohio State University, Columbus, Ohio, USA
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Reddy S, Balaji GK. Dynamic Surface Exercise Training in Improving Trunk Control and Gross Motor Functions among Children with Quadriplegic Cerebral Palsy: A Single Center, Randomized Controlled Trial. J Pediatr Neurosci 2021; 15:214-219. [PMID: 33531934 PMCID: PMC7847094 DOI: 10.4103/jpn.jpn_88_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 11/18/2019] [Indexed: 11/14/2022] Open
Abstract
Background: Dynamic surface provides proprioceptive and vestibular feedback with optimal level of arousal. The activities on unstable environment have greater sensorimotor experiences. There is a lack of evidence examining the benefits of dynamic surface exercise training (DSET) among the children with spastic quadriplegic cerebral palsy (CP). Aim: The aim of the study was to analyze the effect of dynamic surface exercises on trunk control and gross motor functions in children with quadriplegic CP. Materials and Methods: A total of 30 children with spastic quadriplegic CP with Gross Motor Function Classification System of levels III and IV were recruited by the simple random sampling method (random number generator) to participate in this randomized controlled study. Recruited children were randomly divided into two groups, DSET group and standard physiotherapy training group. Both the groups received active training program lasting for 60 min, 4 days/week for 6 weeks. Gross Motor Function Measure (GMFM)-88 and Pediatric Balance Scale (PBS) scores were recorded at baseline, and at the end of 6-week post-intervention. Results: Total 30 children with quadriplegic CP with mean age 6.64 ± 2.15 years in experimental group and 6.50 ±1.59 years in control group participated in the study. Experimental group showed a significant difference for GMFM and PBS scores between pre- and post-intervention with P < 0.005. A significant difference was observed in GMFM scores between experimental and control group with P < 0.005. Conclusion: Six-week dynamic surface exercise therapy along with standard physiotherapy was effective in improving trunk control and gross motor function performance among children with spastic quadriplegic CP aged 6–12 years.
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Affiliation(s)
- Sravan Reddy
- Chitkara School of Health Sciences, Chitkara University, Punjab, India
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Mukhopadhyay R, Lenka PK, Biswas A, Mahadevappa M. Evaluation of Functional Mobility Outcomes Following Electrical Stimulation in Children With Spastic Cerebral Palsy. J Child Neurol 2017; 32:650-656. [PMID: 28393668 DOI: 10.1177/0883073817700604] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated the clinical feasibility of electrical stimulation in enhancing ankle dorsiflexion of the tibialis anterior muscle to improve mobility in children with spastic cerebral palsy. The intervention group received electrical stimulation therapy for 30 minutes and physiotherapy for another 30 minutes for 5 days a week, up to 12 weeks. Gait parameters, Gross Motor Function Measure, Physiological Cost Index, surface electromyogram, and electroencephalogram (EEG) data were recorded pre- and posttreatment. Data were compared with the control group, which received only conventional physiotherapy for 60 minutes. There was an increase in walking speed (17.67%) and Gross Motor Function Measure scores (2.1%) while the Physiological Cost Index value was decreased (19.7%). The analysis of features extracted from the surface electromyogram showed an increase in muscle strength and that of EEG showed increased motor activities. Hence, electrical stimulation combined with conventional physiotherapy improve gait, muscle strength, and motor activities in children with spastic cerebral palsy.
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Affiliation(s)
- Rupsha Mukhopadhyay
- 1 School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, India
| | | | - Abhishek Biswas
- 2 National Institute for Locomotor Disabilities, Kolkata, India
| | - Manjunatha Mahadevappa
- 1 School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, India
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Abstract
PURPOSE Robot-assisted gait training (RAGT) can complement conventional therapies in children with cerebral palsy. We investigated changes in walking-related outcomes between children with different Gross Motor Function Classification System (GMFCS) levels and the dose-response relationship. METHODS Data from 67 children (3.9-19.9 years) with GMFCS levels II-IV were evaluated retrospectively. Every child received RAGT with the Lokomat complementing a multidisciplinary rehabilitation program. Changes in various walking-related outcomes were assessed. RESULTS Walking-related outcomes did not improve differently between GMFCS level groups. Significant within-group improvements were mainly observed in children with GMFCS level IV. A dose-response relationship was present for children with GMFCS levels III and IV. CONCLUSIONS Our results indicated that, although children with a GMFCS level IV walked less during an average Lokomat session, they experienced significant improvements in walking-related outcomes. Further, training dose correlated with changes in walking-related outcomes. However, between-group differences in changes in walking-related outcomes were not significant.
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Affiliation(s)
- Hubertus J A van Hedel
- a Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich , Affoltern am Albis , Zurich , Switzerland.,b Children's Research Center, University Children's Hospital Zurich , Affoltern am Albis , Zurich , Switzerland , and.,c Neuroscience Center Zurich (ZNZ) , Zurich , Switzerland
| | - Andreas Meyer-Heim
- a Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich , Affoltern am Albis , Zurich , Switzerland.,b Children's Research Center, University Children's Hospital Zurich , Affoltern am Albis , Zurich , Switzerland , and.,c Neuroscience Center Zurich (ZNZ) , Zurich , Switzerland
| | - Christina Rüsch-Bohtz
- a Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich , Affoltern am Albis , Zurich , Switzerland.,b Children's Research Center, University Children's Hospital Zurich , Affoltern am Albis , Zurich , Switzerland , and
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Tao W, Lu Z, Wen F. The Influence of Neurodevelopmental Treatment on Transforming Growth Factor-β1 Levels and Neurological Remodeling in Children With Cerebral Palsy. J Child Neurol 2016; 31:1464-1467. [PMID: 27364738 DOI: 10.1177/0883073816656402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 05/24/2016] [Indexed: 01/16/2023]
Abstract
Neurodevelopmental treatment is an advanced therapeutic approach for the neural rehabilitation of children with cerebral palsy. Cerebral palsy represents a spectrum of neurological disorders primarily affecting gross motor function. The authors investigated the effects of neurodevelopmental treatment on serum levels of transforming growth factor-β1 (TGF-β1), a neuroprotective cytokine, and improvements to motor skills. Serum TGF-β1 levels and total score of the Gross Motor Function Measure-88 (GMFM-88) were significantly higher in children with cerebral palsy who underwent neurodevelopmental treatment compared to untreated patients (P < .01). Furthermore, the improved GMFM-88 total scores after neurodevelopmental treatment were significantly higher in children under the age of 3 with cerebral palsy than in older patients (P < .01). The authors demonstrate that the integration of TGF-β1 levels and GMFM-88 total score could be used to assess the efficacy of neurodevelopmental treatment. Moreover, the findings provide further scientific support for the early intervention and neurological rehabilitation of young children with cerebral palsy.
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Affiliation(s)
- Weiyuan Tao
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan Hubei Province, PR China
| | - Zuneng Lu
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan Hubei Province, PR China
| | - Fang Wen
- Institute Neuopsychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, PR China
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Kim MR, Lee BH, Park DS. Effects of combined Adeli suit and neurodevelopmental treatment in children with spastic cerebral palsy with gross motor function classification system levels I and II. Hong Kong Physiother J 2015; 34:10-18. [PMID: 30931022 PMCID: PMC6385137 DOI: 10.1016/j.hkpj.2015.09.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Children with cerebral palsy (CP) exhibit diverse gait patterns depending on their neurological deficits and musculoskeletal problems. The Adeli suit treatment (AST) has been proposed as an intensive exercise protocol in the management of CP. Objectives: The aim of this study was to compare the effects of a 6-week programme of combined AST and neurodevelopment treatment (NDT) with those of NDT alone on Gross Motor Function Measure (GMFM), balance, and gait in children with CP. Methods: Twenty children with CP of Gross Motor Function Classification System levels I and II were randomly assigned to one of the following two groups: (1) NDT or (2) AST/NDT. The participants were assessed using the GMFM, Pediatric Balance Scale (PBS), Timed Up and Go (TUG) test, and spatiotemporal gait parameters. Results: The GMFM, PBS, and TUG test for both groups showed a statistically significant increase (p < 0.05). Three children were excluded. Compared to the NDT group (n = 9), the AST/NDT group (n = 8) demonstrated a significant increase in spatiotemporal gait parameters (p < 0.05). Conclusion: These results provide evidence for the greater effectiveness of combined AST/NDT than NDT alone in improving spatiotemporal gait parameters but not GMFM, PBS, and TUG test.
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Affiliation(s)
- Mi-Ra Kim
- Department of Physical Therapy, Graduate School, Sahmyook University, Seoul, Republic of Korea
| | - Byoung-Hee Lee
- Department of Physical Therapy, Graduate School, Sahmyook University, Seoul, Republic of Korea
| | - Dae-Sung Park
- Department of Physical Therapy, Konyang University, Daejeon, Republic of Korea
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Lee BH, Kim YM, Jeong GC. Mediating effects of the ICF domain of function and the gross motor function measure on the ICF domains of activity, and participation in children with cerebral palsy. J Phys Ther Sci 2015; 27:3059-62. [PMID: 26644643 PMCID: PMC4668134 DOI: 10.1589/jpts.27.3059] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 07/06/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to evaluate the mediating effect of gross motor function,
measured using the Gross Motor Function Measure (GMFM) and of general function, measured
using the International Classification of Functioning, Disability and Health-Child and
Youth Check List (ICF-CY), on the ICF domains of activity and participation in children
with cerebral palsy (CP). [Subjects] Ninety-five children with CP, from Seoul, Korea,
participated in the study. [Methods] The GMFM was administered in its entirety to patients
without orthoses or mobility aids. The ICF-CY was used to evaluate the degree of
disability and health of subjects. [Results] GMFM score and ICF-CY function were
negatively correlated to ICF-CY activity and participation. ICF-CY partially mediated the
effects of the GMFM on activity and participation. [Conclusion] When establishing a
treatment plan for a child with CP, limitations in activity and participation, as
described by the ICF-CY, should be considered in addition to the child’s physical
abilities and development. In addition, the treatment plan should focus on increasing the
child’s activity and participation level, as well as his/her physical level.
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Affiliation(s)
- Byoung-Hee Lee
- Department of Physical Therapy, Sahmyook University, Republic of Korea
| | - Yu-Mi Kim
- Graduate School of Physical Therapy, Sahmyook University, Republic of Korea
| | - Goo-Churl Jeong
- Department of Counseling Psychology, Sahmyook University, Republic of Korea
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Roth LA, Marra JD, LaMarca NH, Sproule DM. Measuring disease progression in giant axonal neuropathy: implications for clinical trial design. J Child Neurol 2015; 30:741-8. [PMID: 25186661 DOI: 10.1177/0883073814542946] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Accepted: 06/01/2014] [Indexed: 11/16/2022]
Abstract
As part of a natural history study of giant axonal neuropathy, we hypothesized that the Friedreich Ataxia Rating Scale and the Gross Motor Function Measure would show a significant change over 6 months, reflecting subjects' decline in motor function. The Friedreich Ataxia Rating Scale was performed on 11 subjects and the Gross Motor Function Measure was performed on 10 subjects twice with a six-month interval. A paired two-tailed t-test was used to assess the difference in each subject's score. Significant changes were found over six months of 11.7 ± 11.0 (P = 0.006) for the Friedreich Ataxia Rating Scale and -10.0 ± 13.5 (P = 0.043) for the Gross Motor Function Measure, reflecting subjects' decline in motor function on examination and by report. These standardized assessments of clinical function are the first to be validated in giant axonal neuropathy and will be used in an upcoming gene therapy clinical trial.
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Affiliation(s)
- Lisa A Roth
- Division of Pediatric Neurology, Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Jonathan D Marra
- Division of Pediatric Neurology, Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Nicole H LaMarca
- Division of Pediatric Neurology, Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Douglas M Sproule
- Division of Pediatric Neurology, Department of Neurology, Columbia University Medical Center, New York, NY, USA
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Roth LA, Johnson-Kerner BL, Marra JD, LaMarca NH, Sproule DM. The absence of curly hair is associated with a milder phenotype in Giant Axonal Neuropathy. Neuromuscul Disord 2013; 24:48-55. [PMID: 23890932 DOI: 10.1016/j.nmd.2013.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 05/29/2013] [Accepted: 06/11/2013] [Indexed: 01/23/2023]
Abstract
Giant Axonal Neuropathy is a pediatric neurodegenerative disorder caused by autosomal recessive mutations in the GAN gene on chromosome 16q24.1. Mutations in the GAN gene lead to functional impairment of the cytoskeletal protein gigaxonin and a generalized disorder of intermediate filaments, including neurofilaments in axons. Tightly curled hair is a common but not universal feature of Giant Axonal Neuropathy. The pathogenesis of curly hair is unknown, although disruption of keratin architecture is thought to play a role. As part of a broader natural history study of Giant Axonal Neuropathy, we found that the absence of curly hair is correlated with superior motor function (p=0.013) when controlling for age, as measured by the Gross Motor Function Measure. Theoretically, higher levels of functional gigaxonin protein or compensatory mechanisms could produce fewer abnormalities of neurofilaments and keratin, accounting for this phenotype. We suggest that straight-haired patients with Giant Axonal Neuropathy are potentially underdiagnosed due to their divergence from the classic phenotype of the disease. Due to their non-specific features of an axonal neuropathy, these patients may be misdiagnosed with Charcot-Marie-Tooth Disease type 2. Genetic testing for Giant Axonal Neuropathy should be considered in relevant cases of Charcot-Marie-Tooth Disease type 2.
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Affiliation(s)
- Lisa A Roth
- College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, United States.
| | - Bethany L Johnson-Kerner
- College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, United States
| | - Jonathan D Marra
- Division of Pediatric Neurology, Department of Neurology, Columbia University Medical Center, New York, NY, United States
| | - Nicole H LaMarca
- Division of Pediatric Neurology, Department of Neurology, Columbia University Medical Center, New York, NY, United States
| | - Douglas M Sproule
- Division of Pediatric Neurology, Department of Neurology, Columbia University Medical Center, New York, NY, United States
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Bjornson KF, Zhou C, Stevenson R, Christakis DA. Capacity to participation in cerebral palsy: evidence of an indirect path via performance. Arch Phys Med Rehabil 2013; 94:2365-72. [PMID: 23835350 DOI: 10.1016/j.apmr.2013.06.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 04/30/2013] [Accepted: 06/13/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To examine the hypothesis that the influence of physical activity capacity on participation is mediated through activity performance. DESIGN Secondary analysis of a prospective cross-sectional study sample. SETTING Regional pediatric specialty care hospital. PARTICIPANTS Children (N=128; 59% boys; age range, 2-9y) with cerebral palsy with Gross Motor Function Classification System levels I to III; 49% had hemiplegia, and 72% had spasticity. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Activity capacity was measured with the Gross Motor Function Measure-66, performance was measured with the Activities Scale for Kids, and participation was measured with the Assessment of Life Habits. Children's Assessment of Participation and Enjoyment and the Assessment of Preschool Children's Participation assessed diversity participation. Regression equations and Sobel z test were used to examine the mediated effect via performance. RESULTS Physical activity performance mediates 74.9% (β=.83, P<.001) of the effect of activity capacity on total participation levels and 52.8% (β=.47, P=.001) of the effect of capacity on diversity participation. CONCLUSIONS The relation between what an ambulatory child with cerebral palsy is able to perform in a clinical setting and their participation in life is significantly mediated by what they actually do motorically in day-to-day life. Results suggest that interventions focusing on improving what they actually do every day, regardless of their capacity to perform (what they can do when tested), may positively influence participation.
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