Activities Scale For Kids Performance Research Articles

Muscle power is associated with higher levels of walking capacity and self-reported gait performance and physical activity in individuals with cerebral palsy.

The purpose of this study was to investigate the relationships between a Power Leg Press test (PLP) with walking capacity and self-reported performance and participation in individuals with Cerebral Palsy (CP), and to compare the strength of the associations between two power tests (PLP and isokinetic (IsoK)) with walking capacity. Ambulatory individuals with CP (n = 33; age 17.89 ± 7.52 years) performed five inclined power leg presses at 40%-50% of their 1-repetition maximum "as fast as possible". A linear position transducer was attached to the weight bar, and the displacement, total load, and angle of the sled were used to calculate peak power for each trial. Isokinetic knee extensor power was measured at 60 deg/sec. Walking capacity was measured using the 10-m walk test fast (FS) and self-selected (SS) speeds and the 1-min walk test (1MWT). Self-reported performance and participation measures were the Activities Scale for Kids-performance (ASKp), Patient-Reported Outcomes Measurement Information System (PROMIS®), and the Gait Outcomes Assessment List (GOAL). Pearson's correlation coefficients determined relationships between power measures with walking capacity and self-report measures (α < 0.05). PLP and IsoK power were significantly correlated to SS (r = 0.361, r = 0.376), FS (r = 0.511, r = 0.485), and 1MWT (r = 0.583. r = 0.443), respectively (p < 0.05). There was no significant difference between the strength of the associations between walking capacity and each test of power (PLP and Isok) (p > 0.05). PLP power was significantly correlated to composite scores on the ASKp (r = 0.690) and GOAL (r = 0.577) and to four components of the PROMIS, including physical function (r = 0.588) (p < 0.01). The Gait and Mobility subscale of the GOAL (r = 0.705) and the Locomotion (r = 0.636), Transfers (r = 0.547), and Standing (r = 0.521) subscales of the ASKp had strong relationships to peak power produced during the PLP test (p < 0.01). PLP power was significantly correlated with walking capacity and self-reported walking performance and mobility-based participation in ambulatory individuals with CP. Higher movement velocities associated with the PLP test may explain the significant associations of power with faster gait speeds. Self-reported mobility performance and physical activity also showed moderate to strong relationships with lower extremity power. Overall, these results suggest a strong link between decreased muscle power generation and walking limitations in individuals with CP.

Psychometric properties of the Spanish version of the Activities Scale for Kids (ASK): reliability, validity and the Rasch model

AimsTo evaluate the psychometric properties of the Spanish version of the Activities Scale for Kids capability (ASKc) and ASK performance (ASKp) questionnaires.DesignIt includes an analysis of different types of reliability...

The applications of wearable devices in the rehabilitation of ankle injuries: A systematic review and meta-analysis

Wearable devices have been used in the treatment and rehabilitation of ankle injuries. This article systematically reviewed the trials that summarize and evaluate the effectiveness of rehabilitation treatment after an ankle injury. Three databases, PubMed (1974–2021), Embase, and Web of Science (1950–2021), were searched. The intervention was any wearable device, and the outcome measures were Activities Scale for Kids performance (ASKp), Foot and Ankle Outcome Score (FAOS), American Orthopaedic Foot and Ankle Society (AOFAS), Olerud-Molander Ankle Score (OMAS), and Circumference as measured by any validated outcome measure. Two independent authors evaluated the studies with the Cochrane risk-of-bias tool. Four papers were included, involving 476 participants, with a mean age of 29.3 ​± ​6.7 years. The mean duration of wearable devices was 3.83 weeks, and the mean length of training was 3.75 weeks. Wearable devices achieved better results compared with control on the functional performance (standardized mean difference [SMD] 0.66; 95% confidence interval [CI] 0.29 to 1.04; I2 ​= ​76%; P ​< ​0.001), as well as ankle score (SMD 0.78; 95% CI 0.22 to 1.35; I2 ​= ​82%; P ​< ​0.001). The definitive judgment could not be made due to the variability in training, training duration, and outcomes measurement. Wearable devices are a promising approach that has positive effects on ankle injuries in terms of functional performance and reducing the extent of swelling. There is insufficient evidence from randomized controlled trials (RCTs) to support this for ankle injury patients using wearable devices. Therefore, there is an need for well-conducted randomized controlled trials investigating more adaptive orthoses to achieve more effective strategies for early functional rehabilitation. PROSPERO registration number: CRD42021246289.

Can a pathological model improve the abilities of the paretic hand in hemiplegic children? The PAM-AOT study protocol of a randomised controlled trial

IntroductionAction Observation Treatment (AOT) is an innovative therapeutic approach consisting in the observation of actions followed by subsequent repetition. In children with unilateral cerebral palsy (UCP), it improves upper limb...

Reliability and construct validity of the Activities Scale for Kids in Italian children with cerebral palsy

Purpose To investigate internal consistency and construct validity of the of the Activities Scale for Kids performance (ASKp) in Italian children with cerebral palsy (CP). Methods This cross-sectional study was conducted from 2014 up to 2019 and consisted in the single self-administration of the Italian ASKp to 206 children aged 5–15, with unilateral or bilateral CP, classified on the basis of the Gross Motor Function Classification System (GMFCS). Results The ASKp showed good internal consistency (Chronbach’s α 0.91, 95% CI 0.89–0.93). It distinguished between children and adolescents (70.3 ± 16.6 versus 83.0 ± 18.0, respectively; p < 0.001), unilateral and bilateral CP clinical manifestations (82.5 ± 13.6 versus 72.4 ± 19.0, respectively; p = 0.002), children with and without intellectual disability (60.3 ± 18.3 versus 77.2 ± 17.3, respectively; p < 0.001). It also distinguished children using assistive devices for indoor mobility from children who did not use devices or those who use devices only for outdoor mobility (66.1 ± 18.3 versus 83.6 ± 12.8 and versus 80.4 ± 17.4, respectively; both p < 0.001). Conclusions The ASKp could help integrate the perspective of children with CP in their rehabilitation process. Trial registration: ClinicalTrials.gov Identifier: NCT03325842 IMPLICATIONS FOR REHABILITATION The ASKp is a valid and widely used measure for several ICF domains of activities and participation in pediatrics. It has never been formally validated in children with CP, although this disorder causes restrictions in everyday activities. Recently, the culturally adapted Italian version of the ASKp has been tested in typically developing Italian children, confirming its high acceptability and providing evidence of construct validity. This study confirms the internal consistency reliability and the construct validity of the Italian ASKp when applied to the population with CP. The ASKp can support rehabilitation professionals in planning therapeutic intervention targeted to relevant goals.

Outcomes reported in trials of childhood fractures: a systematic review.

AimsTo analyze outcomes reported in trials of childhood fractures.MethodsOVID MEDLINE, Embase, and Cochrane CENTRAL databases were searched on the eighth August 2019. A manual search of trial registries, bibliographic review and internet search was used to identify additional studies. 11,476 studies were screened following PRISMA guidelines. 100 trials were included in the analysis. Data extraction was completed by two researchers for each trial. Study quality was not evaluated. Outcomes reported by trials were mapped onto domains in the World Health Organization (WHO) International Classification of Function framework.ResultsIn all, 525 outcomes were identified representing 52 WHO domains. Four domains were reported in more than 50% of trials: structure of upper/lower limb, sensation of pain, mobility of joint function, and health services, systems and policies. The Activities Scale for Kids performance (ASK-p) score was the most common outcome score reported in 6/72 upper limb and 4/28 lower limb trials.ConclusionThere is a diverse range of outcomes reported in trials of childhood fractures covering all areas in the International Classification of Functioning, Disability and Health (ICF) framework. There were three common upper limb and three common lower limb outcomes. In the absence of a core outcome set, we recommend that upper limb trials report pain, range of movement and radiograph appearance of the arm and lower limb trials report pain, radiograph appearance of the leg and healthcare costs to improve consistency of reporting in future trials.Cite this article: Bone Joint Open 2020;1-5:167–174.

Outcomes reported in trials of childhood fractures

Aims To analyze outcomes reported in trials of childhood fractures. Methods OVID MEDLINE, Embase, and Cochrane CENTRAL databases were searched on the eighth August 2019. A manual search of trial registries, bibliographic review and internet search was used to identify additional studies. 11,476 studies were screened following PRISMA guidelines. 100 trials were included in the analysis. Data extraction was completed by two researchers for each trial. Study quality was not evaluated. Outcomes reported by trials were mapped onto domains in the World Health Organization (WHO) International Classification of Function framework. Results In all, 525 outcomes were identified representing 52 WHO domains. Four domains were reported in more than 50% of trials: structure of upper/lower limb, sensation of pain, mobility of joint function, and health services, systems and policies. The Activities Scale for Kids performance (ASK-p) score was the most common outcome score reported in 6/72 upper limb and 4/28 lower limb trials. Conclusion There is a diverse range of outcomes reported in trials of childhood fractures covering all areas in the International Classification of Functioning, Disability and Health (ICF) framework. There were three common upper limb and three common lower limb outcomes. In the absence of a core outcome set, we recommend that upper limb trials report pain, range of movement and radiograph appearance of the arm and lower limb trials report pain, radiograph appearance of the leg and healthcare costs to improve consistency of reporting in future trials. Cite this article: Bone Joint Open 2020;1-5:167–174.

It is not just comfort: waterproof casting increases physical functioning in children with minimally angulated distal radius fractures.

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Interventions for treating ankle fractures in children.

Interventions for treating ankle fractures in children.

A Comparison of Two Approaches for the Closed Treatment of Low-Energy Tibial Fractures in Children

Many orthopaedic surgeons treat tibial shaft fractures in children with a period of non-weight-bearing after application of a long leg cast, presumably to prevent fracture angulation and shortening. We hypothesized that allowing children to immediately bear weight as tolerated in a cast with the knee in 10° of flexion would lessen disability, without increasing the risk of unacceptable shortening or angulation. We divided eighty-one children, between the ages of four and fourteen years, with a low-energy, closed tibial shaft fracture into two groups. One group (forty children) received a long leg cast with the knee flexed 60° and were asked not to bear weight. The second group (forty-one children) received a long leg cast with the knee flexed 10° and were encouraged to bear weight as tolerated. All patients were switched to short leg walking casts at four weeks. We compared time to healing, overall alignment, shortening, and physical disability as determined by the Activities Scale for Kids-Performance (ASK-P) questionnaire. The mean time to fracture union was 10.8 weeks in both groups (p = 0.47). At the time of healing, mean coronal alignment was within 1.3° in both groups, mean sagittal alignment was within 1°, and mean shortening was <0.5 mm, with no significant differences. The ASK-P scores showed that both groups had overall improvement in physical functioning over time. However, at six weeks, the children who were allowed to bear weight as tolerated had better overall scores (p = 0.03) and better standing skills (p = 0.01) than those who were initially instructed to be non-weight-bearing. Children with low-energy tibial shaft fractures can be successfully managed by immobilizing the knee in 10° of flexion and encouraging early weight-bearing, without affecting the time to union or increasing the risk of angulation and shortening at the fracture site.

Functional Outcome After Air-Stirrup Ankle Brace or Fiberglass Backslab for Pediatric Low-Risk Ankle Fractures

Pediatric ankle fractures are usually treated by immobilization with either a posterior splint, cast, or ankle brace. We set out to determine if the below-knee fiberglass posterior splint was as effective as the Air-Stirrup ankle brace in returning children with a low risk ankle fracture to their normal level of activity. This was a randomized, single-blinded, noninferiority, controlled trial at the Royal Children's Hospital, Melbourne. Children aged 5 to 15 years presenting acutely with a low-risk ankle fracture were randomized to the Air-Stirrup ankle brace or fiberglass posterior splint. A validated self-reported outcome tool, the Activities Scale for Kids performance (ASKp), was used to measure physical functioning over the 4 week period. Main outcome was ASKp scores at 2 and 4 weeks with secondary outcomes including pain, weight-bearing ability, and acceptability of device. Forty-five patients were randomized: 23 in the posterior splint group and 22 in the Air-Stirrup ankle brace. Study groups were similar in terms of age, fracture type, and baseline pain. More of the posterior splint group were non-weight bearing "at enrollment" (96%) compared with the ankle brace group (77%). The median ASKp score at 4 weeks was 91.9 in the brace group and 84.2 in the posterior splint group. Scores on the ASKp as well as ASKp differences were favorable toward the brace in the 11- to 15-year age group at 2 weeks (69.6 vs 55.6) and 4 weeks (97.5 vs 90.2) but trended toward the posterior splint in the 5- to 10-year age group (47.5 vs 56). There was no difference between the Air-Stirrup ankle brace and the fiberglass posterior splint in returning children to their normal levels of activity.

Hippotherapy—An Intervention to Habilitate Balance Deficits in Children With Movement Disorders: A Clinical Trial

Clinical observations have suggested that hippotherapy may be an effective strategy for habilitating balance deficits in children with movement disorders. However, there is limited research to support this notion. The purposes of this study were to assess the effectiveness of hippotherapy for the management of postural instability in children with mild to moderate balance problems and to determine whether there is a correlation between balance and function. A repeated-measures design for a cohort of children with documented balance deficits was used. Sixteen children (9 boys and 7 girls) who were 5 to 16 years of age and had documented balance problems participated in this study. Intervention consisted of 45-minute hippotherapy sessions twice per week for 6 weeks. Two baseline assessments and 1 postintervention assessment of balance, as measured with the Pediatric Balance Scale (PBS), and of function, as measured with the Activities Scale for Kids-Performance (ASKp), were performed. With the Friedman analysis of variance, the PBS and the ASKp were found to be statistically significant across all measurements (P<.0001 for both measures). Post hoc analysis revealed a statistical difference between baseline and postintervention measures (P≤.017). This degree of difference resulted in large effect sizes for PBS (d=1.59) and ASKp (d=1.51) scores after hippotherapy. A Spearman rho correlation of .700 indicated a statistical association between PBS and ASKp postintervention scores (P=.003). There was no correlation between the change in PBS scores and the change in ASKp scores (r(s)=.13, P>.05). Lack of a control group and the short duration between baseline assessments are study limitations. The findings suggest that hippotherapy may be a viable strategy for reducing balance deficits and improving the performance of daily life skills in children with mild to moderate balance problems.

Factor- and item-level analyses of the 38-item Activities Scale for Kids-performance

Children and adolescents highly value their ability to participate in relevant daily life and recreational activities. The Activities Scale for Kids-performance (ASKp) instrument measures the frequency of performance of 30 common childhood activities, and has been shown to be valid and reliable. A revised and expanded 38-item ASKp (ASKp38) version has been reported in recent literature and is currently used in clinical research. The aim of this paper is to assess the factor structure and item-level statistics of the ASKp38. Our study used factor analyses and Rasch analyses to determine the item-set dimensionality and to calculate item-level statistics respectively, for existing ASKp38 data from 200 children (104 males; 96 females; mean age 12y 7mo; SD 2y 8mo; range 6-20y) with physical disabilities. The children had a variety of physical impairments including cerebral palsy (n = 105; range 8-13 y), limb salvage (n = 18; range 11-20y), arthrogryposis (n = 13; 6-17y), and other, including individuals with spina bifida and spinal cord injury (n = 64; 8-19 y). A two-factor model, with components of activities of daily living and play, most optimally fit the data. Item-fit statistics based on this two-factor model demonstrated adequate fit and content coverage. The ASKp38 appears to consist of two factors, defined as (1) activities of daily living and (2) play, and may be used to measure the frequency of activity performance on two corresponding subscales.

ASKing the Kids: How Children View Their Abilities After Perinatal Stroke

A total of 19 children with a history of perinatal stroke were asked how they saw their own motor abilities and disabilities using the Activities Scale for Kids (ASK) performance and capability questionnaires. The median ASK performance score was significantly lower (86.7) than the median ASK capability score (93.4; P = .03), suggesting children felt they were not doing everything they were capable of doing. Performance and capability total scores were not associated with gender or stroke type; lower performance and capability scores were associated with cerebral palsy. Within groups, performance scores were significantly lower than capability scores in girls (P = .02), children with presumed perinatal stroke (P = .02), children with unilateral stroke (P = .02), and children with large versus small branch unilateral middle cerebral artery stroke (P = .03). Further work is needed to understand why these children's performance does not match perceived capability.