Functional Status Of Children Research Articles

A Cross-Sectional Study Assessing the Functional Status in Children With Juvenile Idiopathic Arthritis and Its Correlation With Their Quality of Life and Burden on Caregivers.

Background Juvenile idiopathic arthritis (JIA) is a common rheumatic disease in children, significantly impacting their functional status and quality of life (QoL), as well as imposing a burden on caregivers. This study aims to assess the functional status of children with JIA, their QoL, and the associated caregiver burden while exploring the correlations between these factors. Methodology A prospective, cross-sectional, observational study was conducted over 18 months. A total of 33 children diagnosed with JIA were evaluated using the Childhood Health Assessment Questionnaire (CHAQ), and Euro Quality of Life-5 Dimension-Youth (EQ-5D-Y). Caregiver burden was assessed using the Family Burden Interview Schedule (FBIS). Data were analyzed using descriptive statistics, regression analysis, and Spearman's rank correlation. Results A total of 33 consecutive children with JIA were prospectively enrolled. The mean age was 10.1 ± 3.7 years, with a male predominance (63.6%, n = 21). Enthesitis-related arthritis was the most common subtype (42%, n = 14). The CHAQ scores indicated moderate disability, with profound impacts on walking and arising. Most children reported "some problems" in all EQ-5D-Y domains, with a mean health status visual analog scale score of 60.97 ± 23.43. The mean FBIS score was 9.64 ± 5.78, indicating a moderate caregiver burden. The majority of caregivers reported moderate financial, family routine, and family leisure disruptions. Significant correlations were found between CHAQ and EQ-5D-Y scores in several domains (p ≤ 0.040), as well as between specific CHAQ domains and FBIS scores (p ≤ 0.037). Conclusions Children with JIA experience significant functional limitations and reduced QoL, which also impacts their caregivers. Early rehabilitation and comprehensive care strategies are crucial for improving functional outcomes and QoL, as well as alleviating caregiver burden.

STUDY OF THE EFFECT OF THE COMBINATION OF HALOTHERAPY AND BREATHING GYMNASTICS IN CHILDREN WITH BRONCHIAL ASTHMA

Purpose. To date, there is no developed program and in-depth analysis of the complex impact of the effect of the combination of halotherapy and respiratory gymnastics in children with bronchial asthma, and the effect of its application on the disease has not been tracked. For this reason, referring to the successful results of the combined application of physiotherapeutic techniques, natural and reshaped physical factors in the recovery process in bronchial asthma in childhood, the following research goal was set: to implement the combined application of respiratory gymnastics and halotherapy for more effective rehabilitation program and optimal functional recovery in children with bronchial asthma and to track the effect of its impact. Material/Methods. The study was conducted from October 2018 to March 2020 in the city of Razgrad, Bulgaria, in the Resonance after-school training center. Results. The results show that properly conducted respiratory rehabilitation, combining the application of respiratory gymnastics and aerosol therapy, can contribute to the improvement of clinical indicators, reducing the frequency and severity of paroxysmal conditions, improving ventilation indicators, some gas parameters, physical capacity and quality of life. Conclusions. There are objective grounds for asserting that the tested physiotherapy program with an emphasis on respiratory gymnastics and halotherapy has a positive effect on the functional status of children with bronchial asthma and contributes to achieving independence in daily activities and improving their quality of life.

Echocardiographic assessment of right ventricular function status in children with congenital heart disease with irreversible and reversible pulmonary hypertension compared to normal children

Background: Right ventricular (RV) dysfunction is prevalent in children with congenital heart disease (CHD), particularly in association with pulmonary hypertension (PH). Transthoracic echocardiography (TTE) is crucial for detecting, assessing severity, and monitoring CHD patients with PH. The current study aimed to compare RV function assessed by TTE between CHD patients with PH and healthy children. Methods: The case group comprised CHD patients diagnosed with PH via TTE and confirmed by cardiac catheterization. The control group included children with normal echocardiograms. A total of 40 patients were enrolled based on predefined criteria. Results: The study included 20 cases and 20 controls. Echocardiographic parameters revealed significant differences between the case and control groups, with increased RV dimensions in the case group, except for RV subcostal wall thickness. RV systolic function parameters, including tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular systolic velocity (S'), were significantly lower in the case group. RV diastolic function parameters, including E/A ratio, E/e', and deceleration time (DT), were also significantly different between the groups. The RV global function parameter, tissue Doppler imaging-derived myocardial performance index (TD MPI), was significantly higher in the case group. Conclusions: Echocardiographic evaluation of RV function, including TAPSE, S', TD MPI, E/A ratio, E/e', and DT, in CHD children with PH correlates with PH severity. This assessment can aid in early detection of PH severity before irreversible changes occur and serve as an alternative to right heart catheterization.

The Effect of Combination of Healthy Sleep Education and Music Therapy on the Functional Status of Children with Cancer

Introduction:Cancer refers to the uncontrolled growth and reproduction of abnormal cells in the body as a whole. Sufferers will experience physical and psychological disorders in the form of feelings of sadness and depression, which cause a loss of ability to live daily life. The prevalence of cancer patients on chemotherapy at Dr. M. Djamil Padang Hospital has increased from 135 in 2019 to 170 in 2020 (21% increase). The side effects of chemotherapy are sleep disturbances, fatigue, and decreased functional status. Objective:This study aims to determine the effect of the combination of providing healthy sleep education and music therapy on the functional status of children with cancer to minimize the side effects of chemotherapy. Methods:The research design was a quasi-experimental pre-post-test with the control group. The sample consisted of 60 children, who were divided into a control group (n = 30) and an intervention group (n = 30). Three consecutive days were devoted to the intervention. Measurement of functional status scores using the Activity Daily Living Barthel Index questionnaire. Differences in functional status scores of each group were tested with a dependentT-test, and differences in functional status between the control and intervention groups were tested with independent T-tests used in this study. Results:The results of statistical tests showed that there was a significant difference in the mean score of functional status before and after giving sleep education and music therapy between the intervention group and the control group (p= 0.0005). Conclusion:Combining healthy sleep therapy and music therapy can be an option for independent nursing care for children with cancer as a way to combat the side effects of chemotherapy

Functional status of children and adolescents with COVID-19 in a reference hospital in southern Brazil

Functional status of children and adolescents with COVID-19 in a reference hospital in southern Brazil

Parental Perception and Measured Functional Status Following Pediatric Critical Illness: A Secondary Analysis of the Survivor Outcomes Study.

We evaluated the concordance between parent/guardian perception of child long-term function and objectively scored long-term functional status using the Functional Status Scale (FSS) among PICU survivors. Secondary analysis of prospective cohort study. Urban, tertiary, academic PICU. PICU patients less than 18 years old were admitted between June and August 2012. None. We conducted telephone interviews of parents/guardians of PICU survivors ( n = 77) 6 months post-PICU discharge. We asked parents/guardians to characterize their child's functional status, and we determined FSS scores using scripted interview questions. Concordance between parent/guardian perceptions and FSS scores was assessed, revealing that parent/guardian perceptions of their child's functional status aligned poorly with FSS scores at 6 months (kappa coefficient 0.16). These findings shed light on a critical disconnect between parent/guardian perspective and our current tools to measure a child's functional status following critical illness. In an era of decreased PICU mortality and increased long-term morbidity, the discordance between parent/guardian perception and available scoring tools in the assessment of long-term functional status highlights a key opportunity to improve communication and anchor expectations for long-term outcomes among PICU survivors.

Evaluation of Testicular Growth Percentage Ratio after Orchidopexy in Different Age Group in Unilateral Palpable Undescended Testis

Background: Undescended testis (UDT) means absent of testis in the scrotum but present its normal path of descend. In recent decades, the recommended age for orchiopexy for undescended testis has decreased, in the expectation that this might improve subsequent fertility. Currently recommended age for Orchidopexy between 6-12 and 6-18 months. Whatever the underlying cause UDT deserves treatment early in life to prevent loss of spermatogenic potential and to allow early detection of malignancy. The accurate measurement of testicular size and determination of testicular volume has a great importance in assessing the testicular functional status in children. Ultrasonograpically measured testicular volume is standard and more accurate than obtained by non-radiological clinical method. Objective: To evaluate the testicular growth after orchidopexy in different age group in unilateral palpable undescended testis. Materials and Methods: This Quasi Experimental study was carried in the Department of Pediatric Surgery, BSMMU, Dhaka, Bangladesh without interrupting standard care practiced in the department during October 2020 to September 2022.A total of 30 pediatric patients with unilateral palpable undescended testis. Proper clinical history, physical examinations, and initial investigation reports were recorded in a standard data sheet. All the patients were categorized according to age at operation as ≤2years and >2years. Unilateral palpable undescended testes from 6 months to 12 years were enrolled in this study. Ultrasonography of both inguino scrotal region were performed for every sample to see the length, width and location of testis. Ultrasonography was done before and after orchiopexy by single experienced radiologist. Statistical analyses of the results were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-22). Results: A total of 30 patients with unilateral palpable undescended testis underwent ........

Clinical and Functional Characteristics of a New Phenotype of SMA Type I among a National Sample of Spanish Children: A Cross-Sectional Study.

Spinal Muscular Atrophy (SMA) type I has classically presented extremely severe clinical features. New pharmacological treatments have led to a new phenotype of SMA. The aim of this study was to describe the current health and functional status of children with SMA. A cross-sectional study was conducted based on the STROBE guidelines. Patient questionnaires and standardized tools were used. A descriptive analysis was conducted establishing the proportions of subjects for each of the characteristics of interest. In total, 51 genetically confirmed SMA type I subjects were included. Fifty-seven percent received oral feeding, 33% received tube feeding and 10% combined both. Moreover, 21.6% had tracheostomies, and 9.8% needed more than 16 h/d ventilatory support. Regarding orthopedic status, 66.7% had scoliosis, and 68.6% had hip subluxation or dislocation. Up to 67% were able to sit independently, 23.5% walked with support and one child walked independently. Current SMA type I is a different entity from the classic phenotype but also from types II and III. In addition, no differences were found between SMA type I subgroups. These findings may enable the professionals involved in the care of these patients to improve their interventions in terms of prevention and rehabilitation measures for these children.

The impact of the COVID-19 pandemic on children with disabilities and their parents or caregivers.

The study aimed to determine the impact of the pandemic on parents/caregivers and children with neurologic disabilities. This multi-center cross-sectional study was conducted with 309 parents/caregivers (57 males, 252 females) and their 309 children (198 males, 111 females) with disabilities between July 5, 2020, and August 30, 2020. The parents/caregivers were able to answer the questions and had internet access. The survey included questions on the utilization of educational and health care services (whether they could obtain medicine, orthosis, botulinum toxin injection, or rehabilitation) during the pandemic. A Likert scale was used to evaluate the effect of the specific health domains, including mobility, spasticity, contractures, speech, communication, eating, academic, and emotional status. The Fear of COVID-19 Scale was used to assess fear of COVID-19. Among the children, 247 needed to visit their physician during the pandemic; however, 94% (n=233) of them could not attend their physician appointment or therapy sessions. The restricted life during the first wave of the pandemic in Türkiye had negatively affected 75% of the children with disabilities and 62% of their parents. From the perspective of the parents/caregivers, mobility, spasticity, and joint range of motion of the children were affected. Forty-four children required repeated injections of botulinum toxin; however, 91% could not be administered. The Fear of COVID-19 Scale scores were significantly higher in the parents who could not bring their children to the routine physician visit (p=0.041). During the pandemic, access to physical therapy sessions was disrupted in children with neurological disabilities, and this may have harmful consequences on the functional status of children.

Does Physical Activity Moderate the Relationship between Myopia and Functional Status in Children 9-11 Years of Age?

Although previous studies have reported an association between physical activity (PA) and myopia in school-aged children, little is known about the link between myopia and children’s functional status. The purpose of this study was to investigate dynamic balance control in relation to the daily PA levels of myopic schoolchildren aged 9–11 years (n = 52) versus a non-myopic control group (n = 53). A single leg stance test performed on the instability platform of the Biodex Balance System was used to assess balance control. The overall stability index (OSI), anterior-posterior stability index (APSI) and medial-lateral stability index (MLSI) were analyzed. PA levels were calculated using the World Health Organization European Childhood Obesity Surveillance Initiative family record form. Myopes and non-myopes were separated into three subgroups based on PA level (low, moderate and high). Myopia significantly affected OSI (F = 40.46, p < 0.001), APSI (F = 33.93, p < 0.001) and MLSI (F = 49.51, p < 0.001). There were significant differences (p < 0.001) between myopic and non-myopic children with low and moderate levels of PA, whilst there were no differences between compared children with high levels of PA. High PA levels had a positive impact on balance control in myopes. Our results showed that PA levels moderate the relationship between myopia and children’s functional status.

Global and regional prevalence of disabilities among children and adolescents: Analysis of findings from global health databases.

ObjectiveThe United Nations' Sustainable Development Goals (SDGs) require population-based data on children with disabilities to inform global policies and intervention programs. We set out to compare the prevalence estimates of disabilities among children and adolescents younger than 20 years as reported by the world's leading organizations for global health statistics.MethodsWe purposively searched the disability reports and databases of the United Nations Children's Fund (UNICEF), the World Health Organization (WHO), the World Bank and the Global Burden of Diseases (GBD) Study. We analyzed the latest disability data reported by these organizations since 2015. We examined the methodologies adopted in generating the reported prevalence estimates and evaluated the degree of agreement among the data sources using Welch's test of statistical difference, and the two one-sided t-test (TOST) for statistical equivalence.ResultsOnly UNICEF and GBD provided the most comprehensive prevalence estimates of disabilities in children and adolescents. Globally, UNICEF estimated that 28.9 million (4.3%) children aged 0–4 years, 207.4 million (12.5%) children aged 5–17 years and 236.4 million (10.1%) children aged 0–17 years have moderate-to-severe disabilities based on household surveys of child functional status. Using the UNICEF estimated prevalence of 10.1%, approximately 266 million children aged 0–19 years are expected to have moderate-to-severe disabilities. In contrast, GBD 2019 estimated that 49.8 million (7.5%) children aged under 5 years, 241.5 million (12.6%) children aged 5–19 years and 291.3 million (11.3%) children younger than 20 years have mild-to-severe disabilities. In both databases, Sub-Saharan Africa and South Asia accounted for more than half of children with disabilities. A comparison of the UNICEF and GBD estimates showed that the overall mean prevalence estimates for children under 5 years were statistically different and not statistically equivalent based on ±3 percentage-point margin. However, the prevalence estimates for children 5–19 years and < 20 years were not statistically different and were statistically equivalent.ConclusionPrevalence estimates of disabilities among children and adolescents generated using either functional approach or statistical modeling appear to be comparable and complementary. Improved alignment of the age-groups, thresholds of disability and the estimation process across databases, particularly among children under 5 years should be considered. Children and adolescents with disabilities will be well-served by a variety of complementary data sources to optimize their health and well-being as envisioned in the SDGs.

Current Profile of Physical Impairments in Children with Cerebral Palsy in Inclusive Education Settings: A Cross-Sectional Study.

Introduction Cerebral palsy (CP) excerpts a heterogeneous corral of neurological disorders occurring due to injury to the developing brain leading to motor dysfunctions. The CP children enjoy success and progress in normal school education and curriculum program. The principle of inclusive education has been acknowledged over recent decades in all countries supporting the schooling of children with disabilities into mainstream settings for constructing an inclusive society. Objective The objective of this study was to determine the current status of physical impairments in children with CP in inclusive education settings in district Mandi, Himachal Pradesh. Materials and Methods A survey using the physical examination of all CP children ( n = 20) between the age group of 6 and 12 years in inclusive education settings with an organized interview of special educators in school settings was conducted. Descriptive analysis was conducted by using SPSS IBM 22. Results A total of 20 CP children (11 boys and 9 girls, with the mean age of 9.8 ± 1.69) were enrolled in the study. Mean and standard deviation of Visual Analog Scale (6.5 ± 0.82), Pediatric Balance Scale (21.4 ± 17.1), Gross Motor Function Classification System, Expanded and Revised (2.8 ± 1.46), Manual Ability Classification System (2.5 ± 1.1), Gross Motor Function Measurement-88 (36.40 ± 22.94), and Goal Attainment Scale (35.9 ± 0.40) with the total WeeFIM score (75.7 ± 3.4) were analyzed as the score of all outcome measures. Conclusion Right to Education act promotes the compulsory education of such children, and limiting disability by knowing the current profile of impairments could help in improving physical and functional status in children.

Assessment of Renal and Liver Function Tests Before and After Induction of Chemotherapy in Newly Diagnosed Acute Lymphoblastic Leukemia in Children

A prospective study was done in the Department of Paediatric Hematology &amp; Oncology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, between January and June of 2012, to observe the renal and liver function status in children suffering from acute lymphoblastic leukemia (ALL) before and after induction of chemotherapy. A total of 30 diagnosed patients of acute lymphoblastic leukemia were enrolled in the study. Renal and liver function tests were done before and after induction of chemotherapy. All the patients of the study were within 2-11 years range. Mean age was 5.12±2.53 years. Maximum 43.3% patients were within 3-6 years of age followed by 33.3% up to 3 years of age,13.3% within 6-9 year of age range and 10% above 9-year age range. 73.3% were male and 26.7% were female. Among the liver functions tests, mean bilirubin level of the patients before induction of chemotherapy was 2.31±4.71 mg/dl and after induction of chemotherapy was 1.12±2.15 mg/dl (P=0.122). Mean SGPT levels were 35.33±15.82 IU/L and 75±57.12 IU/l respectively (P=0.001). Mean total protein levels were 67.05±6.99 gm/dl and 64.47±7.51 gm/dl respectively (P=0.06). All the patients were HBsAg negative. Among the renal function tests, mean blood urea level of the respondents before induction was 28.89±7.95 mg/dl and after induction was 30.67±9.39 mg/dl (P=0.429). Mean serum uric acid levels were 4.63±1.18 mg/dl and 5.12±0.44 mg/dl respectively (P=0.044). Mean serum creatinine levels were 0.74±0.27 mg/dl and 0.67±0.22 mg/dl respectively (P=0.168). Mean GFR was 99.77±37.38 ml/1.732/min. before induction of chemotherapy and 108.57±37.29 ml/1.732/min. following chemotherapy (P=0.177). Kidney and liver functions may be affected in ALL in children. Recognition of hepatic and renal impairment at the onset of illness helps judicious chemotherapy in management of ALL.&#x0D; CBMJ 2022 January: vol. 11 no. 01 P: 21-26

Low vision in school aged children- associated factors and effect of low vision aids on functional status

Low vision is defined as significant reduction of vision that cannot be corrected to normal by standard optical correction, medical treatment or surgery. Global prevalence of low vision in paediatric age group is over 10 times that of paediatric blindness. Low vision aids (LVAs) are optical devices which enhance residual vision by magnifying image of object at the retinal level. Early intervention with LVAs can strengthen the vision of children with low vision, by reducing visual stimulus deprivation at an early age, and hence it improves their quality of life. Aim of this study was to identify factors associated with low vision and to assess functional status of children after using LVAs. This is a descriptive study conducted among 56 children, between 5 to 15 years age group, attended who visited in a tertiary centre with low vision during a period of 11 years. After taking history, general, systemic and ocular examination, LVAs were prescribed for near and distant vision and were assessed after 2 months. Data analysis was done by using Graphpad quickcalcs internet software. Out of 56 children included in this study, 71% accepted and 29% denied LVAs for distant vision. 58.5% accepted and 12.5% denied LVAs for near vision. 28.5% did not require LVAs for vision. In older children acceptance of LVAs is found to be significantly higher compared to younger age group. Majority of patients are satisfied with LVAs and frequently use them. Adequate LVAs are major factors in improving quality of life. There can be deterioration of vision due to ongoing disease, so regular follow-up examinations are also necessary part of management of low vision patient.

Concordance between patient-centered and adaptive behavior outcome measures after applied behavior analysis for autism

BackgroundApplied behavior analysis (ABA) is an evidence-based approach to autism spectrum disorder that has been shown in clinical trials to improve child functional status. There is substantial focus in ABA on setting and tracking individualized goals that are patient-centered, but limited research on how to measure progress on such patient-centered outcomes.PurposeThe purpose of this investigation was to assess concordance between patient-centered and standard outcome measures of treatment progress in a real-world clinical sample of children receiving ABA for autism spectrum disorder.MethodsThis observational study used a clinical sample of children ages 3 to 16 years (N = 154) who received 24 months of ABA from an integrated health system. Concordance between three outcome measures after ABA was assessed using a correlation matrix: (1) patient-centered measures of progress on individualized treatment goals, (2) caregiver-centered measure of progress on treatment participation goals, and (3) the Vineland Adaptive Behavior Scales adaptive behavior composite.ResultsThere was limited concordance among measures at both 12 and 24 months of ABA. None of the patient-centered measures showed significant positive correlation with adaptive behavior composite difference scores at either 12 or 24 months, nor did the caregiver measure. The percentage of children achieving clinically meaningful gain on patient-centered goal measures increased between 12 and 24 months of ABA, while the percentage of children achieving clinically meaningful gains in adaptive behavior declined during the same time period.ConclusionsIn a health system implementation of ABA, there was limited concordance between patient-centered and standard measures of clinically meaningful treatment progress for children with ASD. Clinicians should have ongoing dialogue with patients and parents/caregivers to ensure that interventions for ASD are resulting in progress towards outcomes that are meaningful to patients and families.

Self-Reported Health Outcomes of Children and Youth with 10 Chronic Diseases

To identify pediatric patient-reported outcomes (PROs) that are associated with chronic conditions and to evaluate the effects of chronic disease activity on PROs. Participants (8-24years old) and their parents were enrolled into 14 studies that evaluated Patient-Reported Outcome Measurement Information SystemPROs across 10 chronic conditions-asthma, atopic dermatitis, cancer, cancer survivors, chronic kidney disease, Crohn's disease, juvenile idiopathic arthritis, lupus, sickle cell disease, and type 1 diabetes mellitus. PRO scores were contrasted with the US general population of children using nationally representative percentiles. PRO-specific coefficients of variation were computed to illustrate the degree of variation in scores within vs between conditions. Condition-specific measures of disease severity and Cohen d effect sizes were used to examine PRO scores by disease activity. Participants included 2975 child respondents and 2392 parent respondents who provided data for 3409 unique children: 52% were 5-12years old, 52% female, 25% African American/Black, and 14% Hispanic. Across all 10 chronic conditions, children reported more anxiety, fatigue, pain, and mobility restrictions than the general pediatric population. Variation in PRO scores within chronic disease cohorts was equivalent to variation within the general population, exceeding between-cohort variation by factors of 1.9 (mobility) to 5.7 (anxiety). Disease activity was consistently associated with poorer self-reported health, and these effects were weakest for peer relationships. Chronic conditions are associated with symptoms and functional status in children and adolescents across 10 different disorders. These findings highlight the need to complement conventional clinical evaluations with those obtained directly from patients themselves using PROs.

Functional Status of the Children with Cerebral PalsyAnd Their Mothers’ Psychological Status: A Cross-sectional Study

Objective: The aims of this study were to assess the demographic characteristics and functional status of children with cerebral palsy (CP) and to evaluate the psychological status of their mothers.Results: A total of 101 patients were included in the study (%57,4% boys, %42,6% girls). Their mean age was 6,79±4,48 (1,5-18) years. Mothers’ mean age was 33,31±7,72 (20-53) years. The neurologic classification were as follows: diplegia 27,7%, tetraplegia 45,5%, hemiplegia 19,8%, dyskinetic or ataxic 6,9%. The GMFCS levels were as follows: level 1 11,9%, level 2 14,9%, level 3 17,8%, level 4 25.7%, level 5 29,7%. SCL-90-R outcomes were as follows: 38,6% somatization, 18,8% anxiety, 37,6% obsessive-compulsive, 36,6% depression, 32,7% interpersonal-sensitivity, 21,8% eating-sleeping disorder. We didn’t detect any significant correlation between the GMFCS levels of children and mothers’ physicological status. Childrens’ low WeeFIM scores were related with anxiety, obsessive-compulsive, depression, interpersonalsensitivity, paranoid ideation and eating-sleeping disorder. (p=0,009, p=0,017, p=0,009, P=0,0001, p=0,021, p=0,001 respectively). The presence of chronic disease was related with somatization, anxiety and depression (p=0,001, p=0,024, p=0,008 respectively). The presence of pain was related with somatization (p=0,0001).Conclusion: Lower WeeFIM scores of children with CP and chronic disease and pain presence in their mothers were detected as the factors that negatively affect psychological status of mothers.International Journal of Human and Health Sciences Vol. 06 No. 01 January’22 Page: 17-23

Prognosis in the Functional Status of Children with Duchenne Muscular Dystrophy with Physiotherapy and Yoga Exercise Protocols – A Randomized Controlled Trial

Context: Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disease leading to destruction of the skeletal muscles, causing limitations in the activities of daily living, and ambulation at a later stage. Aims: The present study intended to identify the effect of add-on yoga with physiotherapy intervention compared to physiotherapy exercise program on the functional status of children with DMD. Settings and Design: A randomized controlled study was conducted at the physiotherapy center of a tertiary care hospital. Subjects and Methods: The study recruited 124 boys diagnosed with DMD who were randomly divided into two groups. Group I received home-based physiotherapy exercise program and was advised to perform twice daily for all days of the week. Group II was advised to perform physiotherapy and yoga at home. Functional status of the participants was assessed using muscular dystrophy functional rating scale (MDFRS) and timed functional test (TFT), taken at baseline, and on regular intervals of 3 months, up to 1 year. Statistical Analysis Used: Repeated measures ANOVA, Fisher's least significant difference analysis, and t-test analysis were used for statistical analysis. P &lt; 0.05 was considered statistically significant. Results: Eighty-eight participants completed the entire study with 45 in Group I and 43 in Group II. Significant time effect was demonstrated in both the groups for MDFRS (P &lt; 0.05) and TFT (P &lt; 0.01) measures, demonstrating beneficial effects of treatment protocols of both groups. Conclusions: The study identified that the combined yoga and physiotherapy interventions were as effective as physiotherapy alone.

Effects of critical illness on the functional status of children with a history of prematurity

Effects of critical illness on the functional status of children with a history of prematurity

Prevalence and functional status of children with complex chronic conditions in Brazilian PICUs during the COVID-19 pandemic

ObjectiveThe proportion of children with complex chronic conditions is increasing in PICUs around the world. We determined the prevalence and functional status of children with complex chronic conditions in Brazilian PICUs during the COVID-19 pandemic. MethodsThe authors conducted a point prevalence cross-sectional study among fifteen Brazilian PICUs during the COVID-19 pandemic. The authors enrolled all children admitted to the participating PICUs with complex chronic conditions on three different days, four weeks apart, starting on April 4th, 2020. The authors recorded the patient's characteristics and functional status at admission and discharge days. ResultsDuring the 3 study days from March to June 2020, the authors enrolled 248 patients admitted to the 15 PICUs; 148 had CCC (prevalence of 59.7%). Patients had a median of 1 acute diagnosis and 2 chronic diagnoses. The use of resources/devices was extensive. The main mode of respiratory support was conventional mechanical ventilation. Most patients had a peripherally inserted central catheter (63.1%), followed by a central venous line (52.5%), and 33.3% had gastrostomy or/and tracheostomy. The functional status score was significantly better at discharge compared to admission day due to the respiratory status improvement. ConclusionsThe prevalence of children with CCC admitted to the Brazilian PICUs represented 59.7% of patients during the COVID-19 pandemic. The functional status of these children improved during hospitalization, mainly due to the respiratory component.