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Use of the Physical Abilities and Mobility Scale (PAMS) in Children Receiving Inpatient Rehabilitation for Spinal Cord Related Paralysis. 使用身体能力和活动量表(PAMS)在接受脊髓相关性麻痹住院康复的儿童。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-04-01 DOI: 10.1080/17518423.2021.1962424
Cynthia Salorio, Kelsey Rogers, Erin Neuland, Julie Cagney, Cristina Sadowsky

Objectives: To investigate the performance of the Physical Abilities and Mobility Scale (PAMS) in children receiving inpatient rehabilitation for paralysis related to spinal cord disease and injury (SCD/SCI).

Methods: Participants were 146 children with paralysis related to SCD/SCI, aged 2-21, admitted between January 2010 and 2017 for inpatient rehabilitation at a single free-standing academically affiliated pediatric rehabilitation hospital. Retrospective chart review was performed to obtain admission and discharge scores on the PAMS and the functional independence measure for children (WeeFIM®), collected as part of clinical care. Internal consistency was evaluated using Cronbach's alpha. Inter-rater reliability was evaluated through overall agreement, Pearson correlations, and intraclass correlations. Construct validity was examined through exploratory factor analysis. Criterion validity was explored through correlations of PAMS overall and item scores with WeeFIM® total and subscale scores. Sensitivity to change was tested using paired t-tests examining differences between admission and discharge scores for each item and for the total score on the PAMS.

Results: Internal consistency and inter-rater reliability were high (0.94 at admission and 0.95 at discharge). Total PAMS scores are highly correlated with total WeeFIM®, mobility, self-care, and cognitive subscores at admission and discharge. Correlations with the WeeFIM® ranged from low (cognitive) to strong (mobility). Total PAMS score and all individual items increased significantly between admission and discharge.

Conclusions: The PAMS is a useful measure capturing incremental and granular functional motor skills changes occurring during inpatient rehabilitation for children with spinal cord-related paralysis.

目的:探讨脊髓疾病及损伤相关瘫痪(SCD/SCI)住院康复患儿身体能力与活动能力量表(PAMS)的表现。方法:研究对象为2010年1月至2017年1月在一家独立学术附属儿科康复医院住院康复的146名SCD/SCI相关瘫痪儿童,年龄2-21岁。进行回顾性图表回顾,以获得儿童PAMS和功能独立性测量(WeeFIM®)的入院和出院评分,作为临床护理的一部分收集。内部一致性采用Cronbach’s alpha评价。通过总体一致性、Pearson相关性和类内相关性来评估评分者之间的信度。通过探索性因子分析检验构念效度。通过PAMS总分和项目得分与WeeFIM®总分和子量表得分的相关性来探讨标准效度。对变化的敏感性使用配对t检验来检验每个项目的入院和出院分数以及PAMS总分之间的差异。结果:内部一致性和评估间信度高(入院时0.94,出院时0.95)。PAMS总分与患者入院和出院时WeeFIM总分、活动能力、自我保健和认知评分高度相关。与WeeFIM®的相关性从低(认知)到强(移动性)不等。PAMS总得分和各单项得分在入院和出院期间显著增加。结论:PAMS是一种有用的测量方法,可以捕捉脊髓相关性麻痹儿童住院康复期间发生的渐进式和颗粒状功能性运动技能变化。
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引用次数: 1
Botulinum Toxin Type A in the Spasticity of Cerebral Palsy Related to Congenital Zika Syndrome: An Observational Study. A型肉毒毒素在先天性寨卡综合征相关脑瘫痉挛中的作用:一项观察性研究。
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-04-01 Epub Date: 2021-08-13 DOI: 10.1080/17518423.2021.1960917
Giulia Armani-Franceschi, Cleber Luz, Pedro H Lucena, Danilo d'Afonseca, Henrique Sales, Alessandra L Carvalho, Isadora C Siqueira, Karine Silva, Sandra Portuense, Larissa Monteiro, Igor D Bandeira, Ailton Melo, Rita Lucena

Purpose: Investigate the effect of botulinum toxin type-A (BoNT-A) on spasticity and motor performance in children with Cerebral Palsy (CP) related to Congenital Zika Syndrome (CZS).

Methods: Prospective longitudinal observational study of 34 children with CP referred for BoNT-A treatment. Outcomes were evaluated with a muscle tone assessment scale (Modified Ashworth Scale - MAS) and the Patients' Global Impression of Improvement (PGI-I) scale.

Results: Mean age was 32.06 ± 3.07 months and 85% were classified as Gross Motor Function Classification System (GMFCS) V. Primitive reflexes were present in 56% of the sample. The majority of the parents (97.9%) reported improvement in range of motion or reduction in spasticity after treatment with botulinum toxin. No side effects were recorded. When compared to the baseline, median reduction in the MAS was 0.5 (IQR = 0).

Conclusions: The findings of this study suggest that BoNT-A may effectively promote functional improvements and reduce muscle tone, improving the child's and family's quality of life.

目的:探讨a型肉毒毒素(BoNT-A)对先天性寨卡综合征(CZS)相关脑瘫(CP)患儿痉挛和运动能力的影响。方法:对34例CP患儿行BoNT-A治疗的前瞻性纵向观察研究。采用肌张力评估量表(改良Ashworth量表- MAS)和患者整体改善印象量表(PGI-I)对结果进行评估。结果:平均年龄32.06±3.07个月,85%的患者属于大运动功能分类系统(GMFCS), 56%的患者存在原始反射。大多数父母(97.9%)报告用肉毒杆菌毒素治疗后活动范围改善或痉挛减少。无副作用记录。与基线相比,MAS的中位降低为0.5 (IQR = 0)。结论:本研究结果表明BoNT-A可以有效促进功能改善,降低肌肉张力,改善儿童和家庭的生活质量。
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引用次数: 0
Relationship between Comorbid Psychopathology in Children and Adolescents with Autism Spectrum Disorder and Parental Well-being. 儿童和青少年自闭症谱系障碍共病精神病理与父母幸福感的关系
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-04-01 Epub Date: 2021-05-15 DOI: 10.1080/17518423.2021.1922529
Julia Lanyi, Arlene Mannion, June L Chen, Geraldine Leader

Aim: Frequency and relationship between child comorbid psychopathology and parental stress, quality of life (QoL), anxiety, depression, and social support were examined in parents of children and adolescents with autism spectrum disorder (ASD).

Method: Parents of 152 children and adolescents with ASD completed the Autism Spectrum Disorder-Comorbid for Children, Parenting Stress Index-Short Form, World Health Organization Quality of Life Abbreviated Version, Hospital Anxiety and Depression Scale, and the Multidimensional Scale of Perceived Social Support.

Results: A series of one-way multivariate analysis of variance was conducted to examine the relationship between child comorbid psychopathology and parental well-being. A relationship was found between parental QoL, depression and anxiety and child comorbid psychopathology. Results showed a relationship between parental stress and the severity of child conduct, and repetitive behaviors.

Conclusion: This study adds to existing literature by demonstrating the relationship between comorbid psychopathology in children and adolescents in ASD and parental well-being.

目的:探讨儿童及青少年自闭症谱系障碍(ASD)患儿父母共病精神病理与父母压力、生活质量、焦虑、抑郁、社会支持的关系及其发生频率。方法:对152例ASD儿童和青少年家长填写《儿童自闭症谱系障碍-共病》、《父母压力指数简表》、《世界卫生组织生活质量简表》、《医院焦虑抑郁量表》和《感知社会支持多维度量表》。结果:对儿童共病精神病理与父母幸福感的关系进行了一系列的单因素多因素方差分析。父母生活质量、抑郁、焦虑与儿童共病精神病理存在相关性。结果显示,父母的压力与孩子行为的严重程度和重复行为之间存在关系。结论:本研究补充了现有文献,证明了儿童和青少年ASD共病精神病理与父母幸福感之间的关系。
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引用次数: 7
Reducing fatigue following acquired brain injury: A feasibility study of high intensity interval training for young adults 减轻获得性脑损伤后的疲劳:年轻人高强度间歇训练的可行性研究
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-03-26 DOI: 10.1080/17518423.2022.2052374
F. L. Dornonville de la Cour, Michelle Barner Bærentzen, Birgit Forchhammer, Sigrid Tibæk, A. Norup
ABSTRACT The aim was to evaluate feasibility of high-intensity interval training (HIIT) in fatigued adults (20–40 years old) with acquired brain injury (ABI). A prospective pre-post single-arm intervention trial was conducted, including 6–8 months follow-up assessment and interview. Intervention was 18 sessions of intermittent exercise on a cycle ergometer over six weeks. Six out of ten participants without motor impairments completed the intervention (all females, mean age = 30.2 years, months post-injury = 22). On average, participants attended 88% of sessions and achieved high intensity (93% of max heart rate). VO2max improved by 0.53 l/min (SD = 0.29), and participants continued exercising post-intervention. All participants were satisfied with HIIT, were more inclined to exercise, and reported positive effects of exercising for self-management of fatigue. Three sessions a week were demanding to some participants. Findings support feasibility of HIIT as a promising intervention for young adults with post-ABI fatigue.
摘要:目的是评估高强度间歇训练(HIIT)在患有获得性脑损伤(ABI)的疲劳成年人(20-40岁)中的可行性。进行了一项前瞻性的单臂干预前后试验,包括6-8个月的随访评估和访谈。干预是在六周内用自行车测力计进行18次间歇性运动。十分之六没有运动障碍的参与者完成了干预(均为女性,平均年龄30.2岁,受伤后数月=22)。平均而言,参与者参加了88%的会议,并达到了高强度(93%的最大心率)。VO2max提高了0.53 l/min(SD=0.29),参与者在干预后继续锻炼。所有参与者都对HIIT感到满意,更倾向于锻炼,并报告了锻炼对疲劳自我管理的积极影响。对一些参与者来说,一周三次会议要求很高。研究结果支持HIIT作为一种有前途的干预措施对患有ABI后疲劳的年轻人的可行性。
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引用次数: 0
Does music induce interbrain synchronization between a non-speaking youth with cerebral palsy (CP), a parent, and a neurologic music therapist? A brief report 音乐是否能诱导不会说话的脑瘫青年、父母和神经音乐治疗师之间的脑间同步?简短的报告
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-03-26 DOI: 10.1080/17518423.2022.2051628
K. Kang, S. Orlandi, N. Lorenzen, T. Chau, M. Thaut
ABSTRACT Shared emotional experiences during musical activities among musicians can be coupled with brainwave synchronization. For non-speaking individuals with CP, verbal communication may be limited in expressing mutual empathy. Therefore, this case study explored interbrain synchronization among a non-speaking CP (female, 18 yrs), her parent, and a music therapist by measuring their brainwaves simultaneously during four music and four storytelling sessions. In only the youth-parent dyad, we observed a significantly higher level of interbrain synchronization during music rather than story-telling condition. However, in both the youth-parent and youth-therapist dyad, regardless of condition type, significant interbrain synchronization emerged in frontal and temporal lobes in the low-frequency bands, which are associated with socio-emotional responses. Although interbrain synchronization may have been induced by multiple factors (e.g., external stimuli, shared empathetic experiences, and internal physiological rhythms), the music activity setting deserves further study as a potential facilitator of neurophysiological synchrony between youth with CP and caregivers/healthcare providers.
音乐家在音乐活动中共同的情感体验可以与脑波同步相结合。对于不说话的CP个体,言语交流在表达相互共情方面可能受到限制。因此,本案例研究通过在四次音乐和四次讲故事的过程中同时测量一名不会说话的CP(女性,18岁)、她的父母和一名音乐治疗师的脑电波,探讨了他们的脑间同步。我们观察到,只有在年轻父母二人组中,在听音乐而不是讲故事的情况下,大脑间同步的水平显著提高。然而,在青年父母和青年治疗师二人组中,无论病情类型如何,在与社会情绪反应相关的低频波段,额叶和颞叶都出现了显著的脑间同步。虽然脑间同步可能是由多种因素引起的(例如,外部刺激、共情经历和内部生理节奏),但音乐活动设置作为CP青年与照顾者/医疗保健提供者之间神经生理同步的潜在促进因素值得进一步研究。
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引用次数: 5
Agreement Between Alberta Infant Motor Scale Assessment and Maternal Perception of Motor Development in Full-Term Infants 艾伯塔省婴儿运动量表评估与足月婴儿运动发育知觉的一致性
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-03-20 DOI: 10.1080/17518423.2022.2052373
Rosana Silva Dos Santos, Amanda Otília Oliveira de Lima Barreto, Maria Carolina Chapellem P Barbosa da Silva, Hugo Ormond Vianna Sá Nogueira, R. Peres, Márcia Gonçalves Ribeiro, H. C. Ferreira
ABSTRACT Objectives To verify the agreement between the Alberta Infant Motor Scale assessment and maternal perception of the motor development in full-term infants. Methods This is a cross-sectional study involving 161 infants and mothers. Children were assessed with the Alberta Infant Motor Scale (AIMS) for motor developmental classification. Mothers completed questionnaires aiming to identify maternal profiles and impressions about their children’s development. The kappa test was used to analyze the concordance between AIMS and mother perceptions. Results A total of 83.2% of the sample was classified as typically developing and 16.8% as suspected or delayed development. The maternal impression indicates that 77% of infants are developing typically, 19.9% perceived their infants’ development as advanced, and 3.1% delayed development. There was low agreement between the mothers’ perceptions and AIMS classifications (kappa = 0.153) Conclusions Maternal perception of their infant’s development was unsatisfactory for evaluation of motor development because their perceptions did not agree with the findings of the AIMS.
摘要目的验证阿尔伯塔省婴儿运动量表评估和母亲对足月婴儿运动发育的认知之间的一致性。方法这是一项涉及161名婴儿和母亲的横断面研究。使用艾伯塔省婴儿运动量表(AIMS)对儿童进行运动发育分类评估。母亲们完成了问卷调查,旨在确定母亲对孩子发展的概况和印象。kappa检验用于分析AIMS和母亲认知之间的一致性。结果83.2%的样本被归类为典型发育,16.8%的样本被分类为疑似或延迟发育。母体印象表明,77%的婴儿发育正常,19.9%的婴儿认为婴儿发育迟缓,3.1%的婴儿发育迟缓。母亲的认知与AIMS分类之间的一致性较低(kappa=0.153)。结论母亲对婴儿发育的认知不符合运动发育的评估,因为她们的认知不与AIMS的结果一致。
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引用次数: 0
Relationship among four functional classification systems and parent interpredicted intelligence level in children with different clinical types of cerebral palsy 不同临床类型脑瘫患儿四种功能分类系统与父母预测智力水平的关系
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-03-18 DOI: 10.1080/17518423.2022.2051629
Sefa Unes, M. Tunçdemir, Cemil Ozal, Ozge Cankaya, Kübra Seyhan Bıyık, K. Delioğlu, C. Gunbey, M. Kerem Gunel, B. Anlar
ABSTRACT Objective To investigate the relationships between four functional classification systems in children with cerebral palsy (CP) and parent-interpredicted intelligence level, and the functional status in clinical types of CP. Methods Two hundred and twenty-five children with CP ages between 2 and 18 (mean age 6.5 ± 4.4) years included using the Surveillance of CP in Europe (SCPE) database in Turkey. Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS) and Eating and Drinking Classification System (EDACS) levels were classified by clinical observation, and intelligence quotient (IQ) was determined by parent reports. Results Correlations were found between all functional levels; the strongest were between GMFCS-MACS (r = 0.784, p < .001), CFCS-EDACS (r = 0.772, p < .001). Strong correlations were found for the IQ-CFCS (r = 0.762, p < .001) and IQ-EDACS (r = 0.634, p < .001). Correlations were stronger in children with bilateral CP and IQ level <70. Conclusions Taken together, these four classification systems and reported IQ levels can adequately describe overall functioning for children with CP. Our results can guide clinicians in the rehabilitation of children with CP.
摘要目的探讨脑瘫患儿的四种功能分类系统与父母智力水平的关系,以及脑瘫临床分型的功能状况。方法使用土耳其欧洲CP监测(SCPE)数据库,纳入225名年龄在2至18岁(平均年龄6.5±4.4)岁之间的CP儿童。通过临床观察对总运动功能分类系统(GMFCS)、手动能力分类系统(MACS)、沟通功能分类系统和饮食分类系统(EDACS)水平进行分类,并通过家长报告确定智商。结果各功能水平之间存在相关性;GMFCS-MACS(r=0.784,p<.001)、CFCS-EDACS(r=0.772,p<0.001)之间的相关性最强。IQ-CFCS(r=0.762,p<-001)和IQ-EDACS(r=0.634,p<001)之间存在强相关性。双侧CP和IQ水平<70的儿童的相关性更强。结论综合来看,这四个分类系统和报告的智商水平可以充分描述儿童脑瘫的整体功能。我们的研究结果可以指导临床医生对儿童脑瘫的康复。
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引用次数: 3
Walking and Fatigue in People with Cerebral Palsy: Brief Report 脑瘫患者的步行与疲劳
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-03-15 DOI: 10.1080/17518423.2022.2053222
Sarrah Husain, J. Wrightson, Erika Johnson, L. Brunton, E. Condliffe
ABSTRACT The aim of this study was to examine the relationship between perceived fatigue and perceptions of walking abilities and difficulty in people with cerebral palsy (CP). Twenty individuals with CP (range 10–21y; mean age 14.8y) who usually walk in the community were recruited. Community mobility was assessed using the Functional Mobility Scale. Participants were asked about their walking ability and frequency, perceived effort during walking (using the Children’s Effort Rating Table), and perceived fatigue (using the Fatigue Impact and Severity Self-Assessment). Community mobility, frequency, and perceived effort during walking were significantly related to fatigue. No relationship was found between time spent walking (maximum walking time) and fatigue. Here we demonstrate that perceived fatigue is related to walking in people with CP.
摘要本研究旨在探讨脑瘫患者的疲劳感与行走能力和困难感之间的关系。招募了20名CP患者(年龄10-21岁;平均年龄14.8岁),他们通常在社区中行走。社区流动性采用功能流动量表进行评估。参与者被问及他们的行走能力和频率、行走过程中感知到的努力(使用儿童努力评分表)和感知到的疲劳(使用疲劳影响和严重程度自我评估)。社区流动性、频率和行走过程中感知到的努力与疲劳显著相关。步行时间(最长步行时间)与疲劳之间没有关系。在这里,我们证明了CP患者的感知疲劳与行走有关。
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引用次数: 0
Selecting assessment tools to characterize upper limb function of children with cerebral palsy: A mega-review of systematic reviews 选择评估工具表征脑瘫儿童上肢功能:系统评价的大型综述
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-03-12 DOI: 10.1080/17518423.2022.2046656
Leonardo Vinícius Thomé Teixeira da Silva, Milena Vegas, N. Aquaroni Ricci, Cristina S Cardoso de Sá, S. Alouche
ABSTRACT Aim A mega-review of published systematic reviews without restriction on year of publication was implemented to summarize available assessment tools of upper limb (UL) function in children with Cerebral Palsy (CP). Method A multi-prong search strategy was used to identify 12 systematic literature reviews for inclusion in the mega-review. Included reviews were coded by descriptive analyses, which included methodological and reported measurement property description. Methodological quality of the selected systematic reviews was evaluated with the AMSTAR-2. We synthetized the measurement properties of the revised assessment tools and their coverage within the International Classification of Functioning, Disability and Health (ICF) domains. Results The 12 systematic reviews addressed 84 assessment tools. Systematic reviews’ methodological quality varied between critically low to moderate. Suggested assessment tools covered ICF domains of body structure and function, and activities and participation. Measurement property data analysis was based mostly on reliability and validity. Interpretation Based on the findings of the mega-review, the ABILHAND-Kids, Assisting Hand Assessment (AHA) and Melbourne Assessment of Unilateral Upper Limb Function (MUUL) are the most suitable tools to evaluate children between 6 and 12 years of age with unilateral CP.
【摘要】目的对已发表的不受发表年份限制的系统综述进行大型综述,总结脑瘫(CP)患儿上肢(UL)功能的可用评估工具。方法采用多管齐下的检索策略,筛选出12篇系统性文献综述纳入大综述。纳入的评审通过描述性分析进行编码,其中包括方法学和报告的测量属性描述。采用AMSTAR-2评价所选系统评价的方法学质量。我们综合了修订后的评估工具的测量特性及其在国际功能、残疾和健康分类(ICF)领域中的覆盖范围。结果12项系统评价涉及84种评价工具。系统评价的方法学质量在极低到中等之间变化。建议的评估工具包括身体结构和功能以及活动和参与的ICF领域。测量性能数据分析主要基于信度和效度。基于大型综述的结果,ABILHAND-Kids、辅助手评估(AHA)和单侧上肢功能墨尔本评估(MUUL)是评估6 - 12岁单侧CP儿童最合适的工具。
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引用次数: 0
Examination of multiple birth as a predictor of autism symptom severity and developmental functioning in an early intervention sample 早期干预样本中多胞胎检查作为自闭症症状严重程度和发育功能的预测指标
IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-03-06 DOI: 10.1080/17518423.2022.2047120
Esther Hong, Abigail Issarraras, J. Matson, Joshua J. Montrenes, Paige A. Weir
ABSTRACT Multiple birth is one of several perinatal factors associated with increased risk for autism spectrum disorder (ASD); however, complexity in its relationship to ASD symptoms and developmental functioning remains. The present study investigated perinatal risk factors for ASD, primarily focusing on birth status, within a large early intervention sample. In particular, the relationship between ASD, perinatal factors, and the effect of birth status on developmental functioning and ASD symptom severity were examined in youth with and without ASD classification who were born singly or were the product of a multiple birth. Overall, the presence of other perinatal risk factors, including prematurity, low birth weight, and advanced parental age, was primarily related to birth status and not to ASD classification, while severity of ASD symptoms and developmental impairments were primarily related to ASD classification and not to birth status. Study findings and implications for early screening of children with developmental delays are discussed.
多胞胎是与自闭症谱系障碍(ASD)风险增加相关的几个围产期因素之一;然而,它与ASD症状和发育功能之间的关系仍然很复杂。本研究在大量早期干预样本中调查了ASD的围产期危险因素,主要关注出生状况。特别是,研究了ASD、围产期因素以及出生状态对发育功能和ASD症状严重程度的影响之间的关系,研究对象是患有和不患有ASD分类的单独出生或多胞胎的青年。总的来说,其他围产期风险因素的存在,包括早产、低出生体重和父母高龄,主要与出生状态有关,而与ASD分类无关,而ASD症状和发育障碍的严重程度主要与ASD分级有关,而非出生状态。讨论了研究结果和对发育迟缓儿童早期筛查的意义。
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引用次数: 0
期刊
Developmental Neurorehabilitation
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