Journal of Pediatric Rehabilitation Medicine - Volume Pre-press, issue Pre-press

Authors: Lohiya, Nirali | Srivastava, Leena | Lohiya, Nikhil | Kalrao, Vijay

Article Type: Research Article

Abstract: PURPOSE: Parenting a child with special health care needs (SHCN) is often stressful. This study aimed to measure and compare stress among mothers of children with (a) Autism Spectrum Disorder (ASD) - ASD group, (b) Developmental delay without ASD group, (c) SHCN without developmental delay group, and (d) Typically developing group. To assess factors associated with maternal stress in children with developmental disorders. METHODS: A cross-sectional analytical study was performed with children aged 2–12 years and their mothers. The study population was classified into four groups as defined above help of detailed history, developmental & behavioral assessments, psychological …assessments, and Child Special Health Care Needs Screener (CSHCN). Parental Stress Scale (PSS) Questionnaire was administered. The main outcome measurement was the PSS and various factors affecting it. RESULTS: The mothers of the ASD group reported a high stress score (50.4±11.4) compared to SHCN without developmental delay group (38.2±8.8) and the Typically developing group (22.3±3.3) (p  < 0.05) and higher but not significant stress than Developmental delay without ASD group (45.3±9.6, p  > 0.05). Maladaptive behavioral issues and irregular interventions were the factors contributing to higher parental stress in the ASD group (p  < 0.05). A moderate positive correlation was observed in rewarding and challenging scores of PSS among mothers of the ASD group, Developmental delay without ASD group, and SHCN without developmental delay group. CONCLUSION: Mothers of the ASD group perceived higher stress as compared to SHCN without developmental delay group and Typically developing group. Evaluation of stress and stressors is crucial for holistic management of ASD. Show more

Keywords: Autism spectrum disorder, special health care needs, maternal stress, maternal child relationship

DOI: 10.3233/PRM-220014

Citation: Journal of Pediatric Rehabilitation Medicine, vol. Pre-press, no. Pre-press, pp. 1-9, 2023

Authors: Mortazavi, Mo | Lucini, Francesca Arese | Joffe, David | Oakley, David S.

Article Type: Research Article

Abstract: PURPOSE: Numerous studies have reported electrophysiological differences between concussed and non-concussed groups, but few studies have systematically explored recovery trajectories from acute concussion to symptom recovery and the transition from acute concussion to prolonged phases. Questions remain about recovery prognosis and the extent to which symptom resolution coincides with injury resolution. This study therefore investigated the electrophysiological differences in recoveries between simple and complex concussion. METHODS: Student athletes with acute concussion from a previous study (19(2) years old) were tracked from pre-injury baseline, 24–48 hours after concussion, and through in-season recovery. The electroencephalography (EEG) with P300 evoked response …trajectories from this acute study were compared to an age-matched population of 71 patients (18(2) years old) with prolonged post-concussive symptoms (PPCS), 61 (SD 31) days after concussion. RESULTS: Acute, return-to-play, and PPCS groups all experienced a significant deficit in P300 amplitude compared to the pre-injury baseline group. The PPCS group, however, had significantly different EEG spectral and coherence patterns from every other group. CONCLUSION: These data suggest that while the evoked response potentials deficits of simple concussion may persist in more prolonged stages, there are certain EEG measures unique to PPCS. These metrics are readily accessible to clinicians and may provide useful parameters to help predict trajectories, characterize injury (phenotype), and track the course of injury. Show more

Keywords: Acute concussion, prolonged post-concussion syndrome, return to play, electroencephalogram, event related potentials

DOI: 10.3233/PRM-210114

Citation: Journal of Pediatric Rehabilitation Medicine, vol. Pre-press, no. Pre-press, pp. 1-13, 2023

Authors: Nguyen, Alan T. | Hemphill, Sydney | Donahue, Bridgette | Menendez, Maria | Rodriguez, Samuel | Caruso, Thomas J.

Article Type: Case Report

Abstract: Virtual reality (VR) technology has seen increasing use in physical rehabilitation and in the management of acute and chronic pain. Functional movement disorders (FMDs) are a source of disability with no known association to neurologic pathology, and patients are generally offered multidisciplinary treatment approaches to improve functional movement. However, patients who are not compliant with rehabilitation may have persistent FMD and long-term disability. Given VR’s use in physical rehabilitation, it may serve as a useful adjunct for the management of FMD. Utilizing an application called MovementTM to create a playlist of targeted applications for the restoration of motor function …and balance, this case study presents the application of VR as a tool to engage patients in physical therapy for the management of FMD. The VR games were selected to encourage movement while customization of levels within the games facilitated achievement of physical therapy goals. Physical rehabilitation aided by VR, when used in collaboration with a multidisciplinary care team, may be used to facilitate recovery from FMD. Show more

Keywords: Functional movement disorder, functional neurologic disorder, psychogenic movement disorder, conversion disorder, dyskinesias, virtual reality

DOI: 10.3233/PRM-210009

Citation: Journal of Pediatric Rehabilitation Medicine, vol. Pre-press, no. Pre-press, pp. 1-9, 2022

Authors: Michielsen, Anka | van Es, Maxine | Verschuren, Olaf | van Wijk, Iris

Article Type: Research Article

Abstract: PURPOSE: The primary aim was to describe sports participation of Dutch children and adolescents with lower limb deficiencies (LLD). The secondary aim was to explore perceived limitations concerning sports participation. METHODS: A total of 103 children and adolescents with LLD, aged 8–18 years (mean 11.7 years), were asked about their sports participation using a study-specific self-report questionnaire. RESULTS: Children and adolescents with LLD frequently (78%) participated in sports activities, and most of them (68%) participated in the sport of their preference. Just over half of all children (52%) perceived an inability to participate in specific sports. …Physical performance (running) and endurance were mentioned as the most limiting factors in participating in certain sports. CONCLUSION: Children and adolescents with LLD in the Netherlands participate in a variety of sports. Despite dependency on lower limb prostheses in most cases, children and adolescents with LLD have a high potentiality of participating in sports. Show more

Keywords: Sports participation, lower limb deficiency, lower limb prostheses, children and adolescents

DOI: 10.3233/PRM-210066

Citation: Journal of Pediatric Rehabilitation Medicine, vol. Pre-press, no. Pre-press, pp. 1-10, 2022

Authors: Juneja, Hemant | Frandsen, Christian | Nielsen, Nina Odgaard | Larsen, Kim | Praestegaard, Jeanette

Article Type: Research Article

Abstract: PURPOSE: The Wii Balance Board (WBB) can be used for assessment of steady state balance (SSB), but its reliability has not been studied in children aged 6–9 years. This study aimed to determine the test-retest reliability of the WBB for measuring SSB in this population. A secondary aim was to determine the minimum detectable change (MDC) and standard error of measurement (SEM) of the WBB in children aged 6–9 years. METHODS: 52 children between 6–9 years of age participated. “One leg stand balance” was used to assess center of pressure velocity (COPV) and center of pressure area (COPA) …on three occasions by the same tester. Two tests were conducted on the same day (Day 1) and the third test was performed on another day (Day 2), with a period of 5–13 days between the two test days. Intraclass correlation coefficient (ICC 3,1 ), SEMs, and MDC were calculated. RESULTS: Intra-day test-retest reliability of COPA was found to be good (ICC3,1 =0.86; 95% confidence interval [CI]: 0.75, 0.92) and that of COPV was also found to be good (ICC3,1 =0.87; 95% CI: 0.77, 0.92). Inter-day test-retest reliability was found to be good for COPA (ICC3,1 = 0.87; 95% CI: 0.75, 0.93) and COPV (ICC3,1 = 0.89; 95% CI: 0.81, 0.94). SEM for COPA in intra-day testing was 18.90 mm2 (15.78%), and in inter-day testing it was 16.44 mm2 (13.61%). SEM for COPV in intra-day testing was 1.12 mm/s (7.6%), and in inter-day testing it was 1.01 mm/s (6.9%). MDC for COPA in intra-day testing was 52.41mm2 (42.75%), and in inter-day testing was 45.58 mm2 (35.75%). MDC for COPV in intra-day testing was 3.11 mm/s (21.2%), and in inter-day testing it was 2.80 mm/s (18.9%). CONCLUSION: The WBB has good test-retest reliability for assessing SSB of children between 6-9 years. COPA measurements appear to be less sensitive to clinical changes in SSB when compared to COPV. Assessment of validity of the WBB in this age group is recommended before it can be considered as a potential balance assessment tool in children. Show more

Keywords: Wii Balance Board, center of pressure, reliability, steady state balance

DOI: 10.3233/PRM-210106

Citation: Journal of Pediatric Rehabilitation Medicine, vol. Pre-press, no. Pre-press, pp. 1-12, 2022

Authors: Bonarrigo, Kelly | McGuire, Michelle | Dorich, Jenny M. | Bolger, Ashlee | Lambert, Joshua | Horn, Paul S. | Tian, Cuixia

Article Type: Research Article

Abstract: PURPOSE: This study aimed to explore stander use in individuals with Duchenne Muscular Dystrophy (DMD). METHODS: This mixed method research study employed a survey with categorical and open-ended questions related to stander use. Categorical responses were analyzed quantitatively. Qualitative analysis of open-ended responses was linked to the International Classification of Function. Qualitative and quantitative results were merged to derive meta-inferences. RESULTS: Of 147 respondents, 28.6% (n  = 42) reported stander use. Equipment used included sit-to-stand stander (n  = 27), power standing feature in a wheelchair (n  = 13), and unspecified equipment (n  = 2). Economic services were the most common …barrier to stander obtainment. Age of loss of ambulation (LOA) and age of start of stander use were positively correlated (r  = 0.61, p  <  0.0001, n  = 36), with 59.5% initiating stander use after LOA. Twenty-nine respondents reported standing less than the recommended dose of 60–90 minutes at least five days a week, with frequency directionally less than five days per week (p  = 0.06) and time significantly less than 60–90 minutes (p  = 0.002). Respondents’ total dose was significantly lower than the recommended 300 minutes (p  = 0.02). Lack of time and presence of contractures contributed to decreased duration of use. CONCLUSION: This study provides a greater understanding of stander use among individuals with DMD and can assist with decision making about stander use prior to complications of disease progression to promote optimal health despite reported barriers. Show more

Keywords: Duchenne muscular dystrophy, stander, standing, dosing

DOI: 10.3233/PRM-220026

Citation: Journal of Pediatric Rehabilitation Medicine, vol. Pre-press, no. Pre-press, pp. 1-17, 2022

Authors: Schiariti, Verónica | de Campos, Ana Carolina | Sudati, Isabella Pessóta | Seal, Arnab K. | Springer, Priscilla E. | Thomson, Heather | Wamithi, Susan | Wei, Guorong | Spittle, Alicia | Gillick, Bernadette

Article Type: Research Article

Abstract: PURPOSE: The International Alliance of Academies of Childhood Disability created a COVID-19 Task Force with the goal of understanding the global impact of COVID-19 on children with disabilities and their families. The aim of this paper is to synthesize existing evidence describing the impact of COVID-19 on people with disabilities, derived from surveys conducted across the globe. METHODS: A descriptive environmental scan of surveys was conducted. From June to November 2020, a global call for surveys addressing the impact of COVID-19 on disability was launched. To identify gaps and overlaps, the content of the surveys was compared to …the Convention on the Rights of the Child and the International Classification of Functioning, Disability and Health. RESULTS: Forty-nine surveys, involving information from more than 17,230 participants around the world were collected. Overall, surveys identified that COVID-19 has negatively impacted several areas of functioning - including mental health, and human rights of people with disabilities and their families worldwide. CONCLUSION: Globally, the surveys highlight that impact of COVID-19 on mental health of people with disabilities, caregivers, and professionals continues to be a major issue. Rapid dissemination of collected information is essential for ameliorating the impact of COVID-19 across the globe. Show more

Keywords: COVID-19, disability, ICF, survey, human rights

DOI: 10.3233/PRM-220035

Citation: Journal of Pediatric Rehabilitation Medicine, vol. Pre-press, no. Pre-press, pp. 1-12, 2023

Authors: Inal, Busra | Ozengin, Nuriye | Bakar, Yesim | Ankaralı, Handan | Ozturk, Yusuf

Article Type: Research Article

Abstract: PURPOSE: This study aimed to examine symptom severity, posture, and balance of children with primary monosymptomatic nocturnal enuresis (PMNE) and compare to a healthy control group. METHODS: Thirty-five children with PMNE and 34 healthy children were included in this study. Physical and sociodemographic characteristics of the children were recorded. Symptom severity was assessed with a Vancouver Non-Neurogenic Lower Urinary Tract Dysfunction/Dysfunctional Elimination Syndrome Questionnaire (NLUTD/DES), a four-day bladder diary and a seven-day bowel diary. Standing postural alignment was assessed with the Spinal Mouse device, and the sensory integration of static balance and dynamic standing balance was assessed with …the Biodex Balance System SD. RESULTS: Compared to healthy controls, children with PMNE demonstrated increased symptom severity (p  = 0.001), increased upright lumbar lordosis (p  = 0.018) and sacral-hip angles (p  = 0.029), decreased static balance in the sensory condition of unstable surface with eyes closed (p  = 0.001), and decreased mediolateral dynamic balance (p  = 0.049). CONCLUSION: Children with PMNE demonstrate altered postural alignment, static and dynamic postural instability, and greater symptom severity on the Vancouver NLUTD/DES than age-matched controls. Show more

Keywords: Nocturnal enuresis, posture, postural balance, quality of life

DOI: 10.3233/PRM-210105

Citation: Journal of Pediatric Rehabilitation Medicine, vol. Pre-press, no. Pre-press, pp. 1-9, 2022

Authors: Toopchizadeh, Vahideh | Nezamoleslami, Elaheh | Rafeey, Mandana | Jahanjoo, Fatemeh | Khabbaz, Mohammad Sadegh | Jafari-Rouhi, Amir Hossein

Article Type: Research Article

Abstract: PURPOSE: This study aimed to compare the result of the six-minute walk test (6MWT) in patients with cystic fibrosis (CF) aged <  20 years old and individuals without CF. METHODS: In this cross-sectional study, 50 children and adolescents with CF and 20 children and adolescents without CF underwent the 6MWT. Vital signs before and immediately after the 6MWT and six-minute walk distance (6MWD) were evaluated. RESULTS: The mean change in heart rate, percentage of peripheral oxygen saturation (SpO2%), systolic blood pressure, respiratory rate, and dyspnea severity during the 6MWT was significantly higher in patients with CF. In …the case group, 6MWD was associated with regular chest physical therapy (CPT) and forced expiratory volume (FEV)>  80% . Patients with CF receiving regular CPT or mechanical vibration and with FEV in the first second >  80% showed better physical capacity during the 6MWT (smaller Sp02% decline and lower dyspnea perception). CONCLUSION: Children and adolescents with CF have lower physical capacity compared to individuals without CF. CPT and mechanical vibration could be used to increase physical capacity in this population. Show more

Keywords: Cystic fibrosis, physical capacity, six-minute walk test, chest physical therapy

DOI: 10.3233/PRM-210089

Citation: Journal of Pediatric Rehabilitation Medicine, vol. Pre-press, no. Pre-press, pp. 1-12, 2023

Authors: Biagioni, Jenny | Easley, Tricia | DeAlmeida, Mary L. | Vova, Joshua | Fujimoto, Akane B. | Graessle, Shelby | Nelson, Jennifer

Article Type: Research Article

Abstract: PURPOSE: The purpose of this study was to examine the relationship between early mobility (EM) of pediatric patients mechanically ventilated and functional outcomes in rehabilitation using WeeFIM scores, as well as hospital length of stay (LOS), ICU LOS, and rehabilitation LOS. METHODS: A retrospective chart review of 189 patients was completed to compare those who received EM interventions to those who did not in the ICU. Data extracted from the years 2015-2019 included: all patients who were between zero and 21 years, were mechanically ventilated via endotracheal tube (ETT) for >  48 hours, and then transferred to the comprehensive …inpatient rehabilitation unit (IRU). RESULTS: For respiratory patients, the EM group had higher WeeFIM scores in all categories at admission to IRU compared to the comparison group. Neurosurgery patients had higher cognition and total WeeFIM scores in the EM group at admission to IRU. All diagnoses demonstrated longer hospital, ICU, and IRU LOS for the comparison group versus the EM group. CONCLUSION: EM of mechanically ventilated pediatric patients with a primary respiratory diagnosis demonstrated improved function at admission to IRU compared to those who did not participate in EM. Prospective research needs to be done to examine this relationship further. Show more

Keywords: Early mobility, pediatric intensive care unit, physical and/or occupational therapy, critical care, rehabilitation, WeeFIM

DOI: 10.3233/PRM-220043

Citation: Journal of Pediatric Rehabilitation Medicine, vol. Pre-press, no. Pre-press, pp. 1-9, 2023