Developmental Neurorehabilitation最新文献

Aim: The aim of this study was to investigate validity, reliability and feasibility of the Four Square Step Test (FSST) in children with Duchenne Muscular Dystrophy (DMD).

Methods: The study included 44 children with DMD aged 5-12 years. The functional level of the children was determined by using the Brooke Lower Extremity Functional Classification (BLEFC). The concurrent validity of the FSST, a dynamic balance assessment, was investigated by analyzing the association between FSST and Timed Up and Go Test (TUG), North Star Ambulatory Assessment (NSAA) and Six-Minute Walk Test (6MWT) distance. The intra- and inter-rater reliability of the FSST was determined by using the Intra Class Correlation Coefficient (ICC) while the feasibility of the test was determined by calculating the percentage of children who successfully completed the test in accordance with the test instructions.

Results: The FSST score of the children (mean age 9.25 ± 2.14 years) was 11.91 ± 3.43 and the BLEFC level ranged from Level 1 (65.9%) to Level 3 (9.1%). FSST had positive, moderate relation with BLEFC (r = 0.447; p = .002); positive, strong relation with TUG (r_s = 0.623), and negative, moderate correlations with NSAA (r_s = -0.529) and 6MWT distance (r_s = -0.592) (p < .001). Intra-rater (ICC: 0.965) and inter-rater (ICC: 0.991) reliability was "excellent," and the test was feasible with successful performance of 88% children.

Discussion: The FSST is a valid, reliable and feasible instrument to assess dynamic balance as well as having the ability to reflect falling risk and different functional levels of children with DMD.

Background: Children and youth with severe motor and communication impairment (SMCI) have difficulty providing self-expression through typical speech, writing with a paper and pencil, or using a standard keyboard. Their emotional expressions can be missed by peers and novel caregivers.

Purpose: To describe the indicators and components of emotional experiences for children/youth with SMCI.

Methods: Primary guardians of nine children/youth with SMCI were involved in photo/video data collection and follow-up qualitative interviews. Twenty-one familiar people (e.g., friends, family members, and/or care team) participated in semi-structured qualitative interviews.

Results: A conceptual understanding of emotional well-being specific to the population has been developed consisting of nine themes, encompassed by four domains i) Core Attributes, ii) Personal Experiences, iii) Surroundings, iv) Expression and Reception.

Conclusions: Emotional experiences of children/youth with SMCI are diversely expressed. Primary guardian and familiar person insight can be amplified to positively impact care and participation.

Objective: In this study, we examined feasibility, acceptability, and preliminary efficacy of a telepsychological positive parenting intervention (I-InTERACT-North, Internet-basedInteracting Together Everyday: Recovery After Childhood Traumatic Brain Injury) during the COVID-19 pandemic among Canadian families of children at-risk for neurodevelopmental challenges given congenital or neonatal conditions. I-InTERACT-North was developed to improve behavioral and emotional outcomes in children with neurological conditions by utilizing and adapting parenting strategies from several established family-focused programmes.

Methods: A pragmatic prospective pre-post single-site pilot study design was used to assess feasibility, acceptabilty, and preliminary efficacy of I-InTERACT North during the COVID-19 pandemic.

Results: Thirty-five families of children ages three to nine years were referred between March 2020 and January 2021. Eighteen families enrolled, and 12 (67% adherence) completed the programme. Parents reported strong therapeutic alliance and programme acceptability with barriers due to competing time demands. Therapists reported high acceptability but perceived parental burnout. Parenting confidence (d = 0.70), and child behavior (d = 1.30) improved following the intervention.

Conclusions: Results demonstrate the programme's value to families during the pandemic, while underscoring unique participation barriers. Future research and clinicial implications are discussed.

Objective: To understand the perspectives of key stakeholder clinicians in implementing inpatient cycling-based exergames for children with cerebral palsy (CP) into pediatric rehabilitation.

Methods: Sixteen clinicians (nurses, physiotherapists, recreational therapists) that participated in a study exploring the feasibility of implementing cycling-based exergames for inpatient children with CP were interviewed. Clinicians' responses were coded using the Theoretical Domains Framework (TDF). Beliefs were generated from each response and relevant domains were identified.

Results: Ten domains from the TDF were identified as relevant. Key enablers to clinician participation in future implementation included revision of clinician roles and responsibilities, the belief that children with CP will benefit from exergames, and the belief in potential applicability to other pediatric populations. Barriers included clinician limited time and exergame responsibilities not aligning with perceived clinician roles.

Conclusions: This study identifies key barriers and enablers that future inpatient pediatric rehabilitation settings should consider when incorporating exergames into rehabilitation practice.

Mind understanding allows for the adaptation of expressive language to a listener and is a core element when communicating new information to a communication partner. There is limited knowledge about the relationship between aided language and mind understanding. This study investigates this relationship using a communication task. The participants were 71 aided communicators using graphic symbols or spelling for expression (38/33 girls/boys) and a reference group of 40 speaking children (21/19 girls/boys), aged 5;0-15;11 years. The task was to describe, but not name, drawings to a communication partner. The partner could not see the drawing and had to infer what was depicted from the child's explanation. Dyads with aided communicators solved fewer items than reference dyads (64% vs 93%). The aided spellers presented more precise details than the symbol users (46% vs 38%). In the aided group, number of correct items correlated with verbal comprehension and age.

Purpose: Fatigue in patients with acquired brain injury (ABI) is common. However, to better target fatigue, clear ways to categorize/interpret fatigue-severity in individual patients are lacking. This study aims to determine/categorize fatigue severity among children, adolescents, and young adults with ABI.

Methods: This cross-sectional study included young patients admitted to outpatient rehabilitation and their parents. To determine fatigue, the PedsQL™Multidimensional-Fatigue-Scale was used (MFS, scores 0-100, lower scores = higher fatigue, patient-/parent-reported). Based on scores from a reference population, four categories were formed: "1 = no/little fatigued" to "4 = severely-more fatigued."

Results: All scores were lower than those from the reference population, with comparisons in the adolescent and young adult groups reaching statistical significance (p < .05). The proportions of patients in category 4 were: 9%/50%/58% among children/adolescents/young adults, showing that many patients were "severely-more fatigued"-than the reference population.

Conclusions: Measuring fatigue and categorizing fatigue severity looks promising for clinical practice and could help to better target fatigue.

Background: The purpose of this study is to investigate whether wearing a functional hand splint adds benefit to carrying out a task-specific home program.

Methods: Thirty-three children were randomly assigned to the Specific Task and Splint Group or to a comparison group. Participants were evaluated before and after 6 weeks of intervention and at 14 weeks of follow-up.

Results: Both groups improved on the Assisting Hand Assessment and the Children's Hand-use Experience Questionnaire (AHA Units p = .000; CHEQ bimanual tasks p = .000; CHEQ grasp efficacy p = .000 and CHEQ time utilization p = .018). No differences were found between the groups after the intervention or after the follow-up.

Conclusions: Hand skills improved in both groups who received a task-specific home program. Wearing a functional hand splint did not appear to improve effectiveness in addition to the home program. This study is registered in ClinicalTrials.gov (NCT03282422).

Rule-governed behavior (RGB) is behavior that is controlled by verbal descriptions of contingencies rather than by direct contact or a history of direct contact with the contingencies. Humans rely on RGB to navigate a multitude of life experiences, and in doing so, we avoid direct contact with destructive or harmful contingencies or contingencies that would be inefficient to contact. However, individuals with autism spectrum disorders (ASDs) frequently struggle with RGB, leaving them at increased risk of contacting aversive consequences. As a result, acquiring RGB can be a valuable developmental outcome for individuals with ASD. The current study examined the effectiveness of an intervention program designed to promote acquisition and generalization of rule-governed social skills in children with ASD. Multiple exemplar training (MET) resulted in increased performance of the target behavior as well as successful discrimination.

Objective: The aim of this study was to compare exercise intensity of active video games (AVGs) between hip- and wrist-worn accelerometer data in cerebral palsy (CP).

Methods: Twenty children and adolescents (9.35 ± 3.71 years) with CP performed two exercise sessions, completing a standardized series of AVGs. Exercise intensity was collected, while one accelerometer was fitted to wrist and hip in separate, counterbalanced sessions.

Results: Accelerometer counts per minute and cut-points determined were significantly different between the wrist- and hip-worn outputs (p < .001). Metabolic equivalents (METs) of performing AVGs exceeded the three METs moderate intensity threshold in wrist-worn (3.12 ± 0.86) accelerometer and hip-worn data tend to underestimate intensity (1.16 ± 0.08).

Conclusions: Previous studies showed METs required to perform AVGs were related to moderate intensity (3-6 METs) in CP with mild deficits. Wrist-worn accelerometer, exceeding 3 METs, seem to have higher accuracy in measuring exercise intensity of AVGs than hip-worn.

This study was designed to extend research on motor skill development in autism spectrum disorder using a dual-task skill. Nine autistic and 18 non-autistic youths walked without grasping or while reaching to grasp a small or large object. Step extremity ratio, percent time in double support, and normalized speed were quantified. We hypothesized that gait would differ between autistic and non-autistic youth and that differences would be moderated by the phase (approach and grasp) and the complexity of the task (walking and grasping versus walking alone). Although gait parameters were similar during the walking-only trials, the combined task resulted in slower speed and shorter steps in autistic youth, particularly during the grasp phase. These findings, while in a small sample, offer preliminary evidence that autistic youth who show typical gait during simple assessments of motor ability may have difficulties in more complex tasks that require the coordination of movements.