Journal of pediatric rehabilitation medicine最新文献

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.

Music is an art form that strongly affects people and can elicit many different emotions at the same time, including happiness, anxiety, sadness, and even ecstasy. What is it about music that causes such a strong reaction from each of us? Music engages many senses, which in turn can produce a multiplicity of responses and help create more extensive neuronal connections, as well as influence behaviour through structural and functional changes in the brain. Music-based interventions as a therapeutic tool in rehabilitation are becoming more common. It is said that the impact of music on the human body is positive. However, what impact does music have on the young nervous system, especially the affected one? This review presents the advantages and disadvantages of the use of music in paediatric neurology to treat dyslexia, cerebral palsy, and stroke, among others. Potential negative impacts such as musicogenic epilepsy and hallucinations will be discussed.

Purpose: Obesity prevalence and the relationship between obesity and motor function in children with ambulatory cerebral palsy (CP) were investigated.

Methods: This was a cross-sectional study. The obesity profile of 75 children aged 2-18 years with ambulatory CP was investigated. GMFCS levels were recorded, and BMI was calculated using height and weight data and converted into Z-scores. Age- and gender-specific growth charts were used for children and adolescents.

Results: The mean BMI of the participants was 17.78, with an obesity rate of 18.67% and an overweight rate of 16%. Gross motor function was found to be associated with height, weight, and BMI (p < 0.05). No relationship was found between obesity + overweight and gender and CP subtype (p > 0.05).

Conclusion: Turkish children with CP had a higher rate of obesity compared to typically developing peers and also their counterparts in other countries. There is a need for studies to identify the causes of obesity and to develop effective intervention programs for prevention of it in children with CP.

Purpose: This exploratory study demonstrates the application of functionally relevant physical exercises (FRPE) to objectively assess physical functioning among children with chronic pain. Intensive interdisciplinary pain treatment (IIPT) focuses on functional improvements as a primary outcome. FRPEs aim to enhance clinical assessments and monitoring by providing relevant data for physical and occupational therapies.

Methods: Children enrolled in three weeks of IIPT provided data for study. They completed two self-report measures of functioning (Lower Extremity Functioning Scale [LEFS] and Upper Extremity Functioning Index [UEFI]), measure of pain intensity, and six separate FRPEs (box carry, box lifts, floor to stand, sit to stand, step ups, and modified six-minute walk test). Data from 207 participants aged 8-20 years old were analyzed.

Results: Upon admission, over 91% of children could perform each FRPE at some level to provide clinicians with a baseline assessment of functional strength. Following IIPT, all children were able to complete FRPEs. Overall, children reported statistically significant gains in functioning on all subjective reports and FRPEs (p's < 0.001). Spearman correlations demonstrated that LEFS and UEFI were weakly to moderately correlated to all FRPEs at admission (r's between.43-.64, p's < 0.001 and.36-.50, p's < 0.01 respectively). Correlations between all subjective and objective measures were comparatively lower at discharge.

Conclusion: FRPEs appear to serve as good objective measures of strength and mobility for children with chronic pain, measuring variability across patients and change over time, which is unique from subjective data gathered via self-report. Due to face validity and objective measurement of functioning, from a clinical practice perspective, FRPEs provide meaningful information to support initial assessment, treatment planning, and patient monitoring. This study offers initial support for a novel measurement method that is easily administered and replicated to effectively measure functional improvement in children with chronic pain.

Purpose: In children with cerebral palsy (CP), gastrocnemius muscle spasticity may lead to pes equinus posture which causes insufficient ankle joint dorsiflexion for normal gait. The aim of this study was to analyze the stiffness of gastrocnemius and tibialis anterior muscles by shear wave elastography (SWE) in children with pes equinus deformity due to spastic CP.

Methods: 24 legs of 12 children (6 females and 6 males, mean age 45.8 months) with CP were prospectively included in the study. Tissue stiffness quantification with shear-wave velocity (SWV) was analyzed.

Results: The mean SWVs of the gastrocnemius and tibialis anterior muscles were 3.91±0.26 m/s and 2.67±0.18 m/s, respectively. The stiffness of the gastrocnemius muscle was significantly higher than the stiffness of the tibialis anterior muscle (p < 0.0001). There was no correlation between the stiffness of these muscles (r = 0.129, p > 0.05).

Conclusion: Gastrocnemius muscles were stiffer than tibialis anterior muscles in patients with spastic CP. But stiffness between these muscles was not correlated with each other. Pes equinus may be related to stiff gastrocnemius in these patients. This study demonstrates the clinical potential for SWE as a non-invasive tool for analyzing calf muscle stiffness.

Purpose: Existing evidence identifies racial and ethnic disparities impacting the prevalence and severity of cerebral palsy (CP). There is a paucity of literature examining the impact on associated treatment.

Methods: In this retrospective cohort study, an institutional database search identified outpatient encounters for pediatric patients with spastic CP. Additional filters were used to determine treatments received. For each treatment, the proportion of African American (AA) patients receiving treatment was compared to the proportion of Caucasian (C) patients receiving the same treatment.

Results: 3,686 children with spastic CP were seen in outpatient clinics associated with an academic tertiary hospital over a 21-year period. There was no significant difference between the proportion of any treatment compared to the entire sample for AA or C patients.

Conclusion: In this sample, there was no significant evidence of a racial disparity for AA patients receiving treatments for spasticity. This data is limited by several factors. Further research is needed to determine whether pediatric patients with disabilities are receiving equitable care. Clinicians should consider systematically monitoring their practices to identify areas of bias or inequity in accessing care.

Acute flaccid myelitis (AFM) is a "polio-like" neurologic disorder of the spinal cord gray matter characterized by asymmetric, flaccid limb weakness of rapid onset following prodromal viral illness. It has affected the pediatric population of the United States since 2014, but there is a paucity of literature describing the post-acute comprehensive rehabilitation management that maximizes functional outcomes for patients. This case series attempts to mitigate this by describing the complete acute and post-acute care course of six children diagnosed with AFM in Western Pennsylvania. It is critical that pediatric rehabilitation medicine providers be knowledgeable about the complex medical and rehabilitation management for patients with AFM.

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.