Functional Abilities Of Children Research Articles

The Role of Immersive Virtual Reality Interventions in Pediatric Cerebral Palsy: A Systematic Review across Motor and Cognitive Domains.

Background: In recent years, new technologies have been applied in cerebral palsy. Among these, immersive virtual reality is one with promising motor and cognitive effects along with the reduced costs of its application. The level of immersion of the subject in the illusional world gives the feeling of being a real part of the virtual environment. This study aims to investigate the safety and the efficacy of immersive virtual reality in children affected by cerebral palsy. Methods: PubMed, Embase, Cochrane Database of Systematic Reviews, RehabData, and Web of Science were screened up to February 2023 to identify eligible clinical studies. Results: Out of 788, we included 15 studies involving CP patients. There was high heterogeneity in the outcomes considered, and the results showed non-inferiority to conventional therapy and initial additional benefits in comparison with conventional rehabilitation. Conclusions: Immersive virtual reality emerges as a pivotal technological tool in rehabilitation, seamlessly integrating with conventional therapy within CP rehabilitation programs. Indeed, it not only enhances motivation but significantly increases children's functional capacity and abilities.

The processes and outcomes related to 'family-centred care' in neuromotor and functional rehabilitation contexts for children with cerebral palsy: A scoping review.

The aim of this study is to identify the main processes and outcomes related to family-centred care (FCC) in neuromotor and functional rehabilitation of preschool children with cerebral palsy (CP). FCC is considered a reference for best practices in child rehabilitation. CP is the most common cause of physical disability in childhood with repercussions on functionality. There is a gap in knowledge of the practical principles of FCC, and it is necessary to develop a reference model for the practice of child rehabilitation professionals. In this scoping review, the main databases selected were as follows: LILACS; Pubmed; Embase; The Cochrane Library; CINAHL (EBSCO); Scopus; Web of Science; PEDro (Physiotherapy Evidence Database); Open Gray and other banks of thesis. The terms combined in the search strategy were as follows: 'Family-centered', 'Family-centred' and 'CP'. Inclusion criteria are as follows: studies on preschool-aged children with CP, undergoing family-centred functional therapeutic interventions (FCFTI) with outcomes on bodily structures and functions and/or activities and/or participation. The main participatory care methods identified were home intervention, environmental enrichment, collaborative realistic goal setting, planning of home-based activities and routine, child assessment feedback, family education/training, family coaching, encouraging discussion, observation of therapist and supervised practice. The main relational care qualities identified were as follows: respect, active listening, treat parents as equals, clear language, respect parents' ability to collaborate, demonstrate genuine care for the family, appreciate parents' knowledge and skills, demonstrate competence, experience and commitment. The main outcomes identified in children were improvement in motor and cognitive function and the child's functional ability. The main parentaloutcomes identified were empowerment, feeling of competence, self-confidence, motivation and engagement. The main differences in FCFTI programs refer to the parental education/guidance component and the amount of intervention carried out by parents. It is possible that the elements chosen by the therapist in a FCFTI depend on characteristics of the child and caregivers.

Caregivers' perspectives of community acceptance before and after surgical treatment for their child's disability.

In Tanzania, about 600 000 youth between 5 and 24 years old have a disability. Individuals with disabilities face numerous obstacles due to social stigma. The aim of this formative evaluation is to assess how caregivers of children with correctable disabilities (e.g., cleft lip/palate, club foot, and burn scar contractures) in Tanzania perceive their community's acceptance of their child before and after surgical treatment. Semi-structured interviews were conducted with 80 caregivers of children with disabilities treated at Kafika House in Arusha, Tanzania. The constant comparative method identified themes regarding the caregivers' feelings on their child's functional abilities and experiences of stigma in their community. Caregiver perceptions of stigma before and after surgical treatment were categorized and quantified as 'positive', 'neutral' and 'negative'. Thematic analysis of the 80 interviews resulted in five major themes: (1) stigma and acceptance (pre-treatment) and (2) post-treatment; (3) functional abilities (pre-treatment) and (4) post-treatment; and (5) emotional impact (pre- and post-treatment). These themes indicate caregivers and their children experience a range of emotional impacts before and after treatment, more severe stigma before treatment, and overall better social, emotional and functional status after treatment. Frequency analysis of caregiver experiences indicated that stigma experienced by children and their families decreased from 75% before surgical treatment to 2.5% after surgery. Surgical intervention and rehabilitation of physical disabilities mitigated experiences of social stigma for both children and their caregivers. Findings support the need for expanded treatment of correctable disabilities, larger investments in community-based rehabilitation programmes and further interventions to support stigmatized parents and their children.

THE INFLUENCE OF ATHLETIC EXERCISES ON THE DEVELOPMENT OF PRESCHOOL CHILDREN MOTOR ABILITIES

The bases of athletic exercises are natural human movements. Their use in the educational process will contribute to the child’s health comprehensive physical development and strengthening. Athletic exercises improve the skills of walking, running, jumping and other movements that the child needs in his future daily life. The integrated use of athletic exercises teaches the child to feel and control the capabilities of his own body and to enjoy it. Athletic exercises stimulate the activity of each child, taking into consideration his individual characteristics. The aim of the research is the development of motor qualities in the educational process of preschool children using various athletic exercises. The objectives of the research are to increase the motor and functional abilities of children with the help of general developing and special athletic exercises, developing strength, speed, endurance, agility, etc., using various athletic exercises, and instilling love and interest in athletics. We used the method of study, analysis, comparison and synthesis of scientific and methodological literature, pedagogical experiment, methods of empirical analysis (observation, demonstration, etc.) The experiment carried out indicates that athletic exercises have the most effective impact on the process of development of preschool children motor abilities. This confirms the peculiarity and necessity of the quantitative and qualitative use of athletic exercises in improving the physical development of the younger generation.

Profile of functioning of Brazilian children with congenital Zika syndrome: a longitudinal study applying the common brief ICF core set for cerebral palsy

ABSTRACT To use the International Classification of Functioning, Disability and Health (ICF) to investigate whether children with congenital Zika Syndrome (CZS) show changes in their functioning and disability profile after nine months. This study included children with CZS recruited from a support centre for children with microcephaly in Brazil. The children's functional abilities and limitations were classified using ICF Core Set for children with cerebral palsy. Each ICF category was quantified in two moments with a mean interval of nine months. The study included 81children (mean age = 38.4 ± 3.3mo). Most children showed changes between assessments. Categories that presented improvements were in body functions (five categories), environmental factors (two categories), and activity and participation (one category) sections. Most children with CZS evaluated improved their functioning and disability profile over time, mainly in body functions. These changes can be related to the course of the disease or to the health programmes that children had access.

The feasibility of an upper limb strength test protocol in children with Duchenne muscular dystrophy

Question This study aimed to develop and assess a protocol for evaluating upper limb strength and its association with functional abilities in children and adolescents diagnosed with Duchenne muscular dystrophy (DMD). Design A cross-sectional study. Participants Eleven male individuals diagnosed with DMD (aged 11 to 18 years). Intervention A systematic protocol for assessing the maximum voluntary isometric contraction (MVIC) of the upper limbs using grip and pull dynamometers was developed and conducted in conjunction with the Performance of Upper Limb (PUL) scale. Outcome measures Feasibility was evaluated by appraising the number of participants capable of successfully executing the strength test protocol. Correlations were conducted to examine the relationship between upper limb strength and PUL scores. Results The grip strength assessment was feasible for all participants, while the complete strength testing protocol was feasible for nine, excluding two individuals with non-ambulatory mobility. Significant correlations were found between overall upper limb strength and total PUL scores (rs = 0.742, p = 0.022), grip strength and distal PUL scores (rs=0.733, p = 0.010), shoulder abduction strength and PUL shoulder scores (rs=0.905, p = 0.005), and grip strength and overall PUL scores (rs=0.794, p = 0.004). The middle-level correlation was not statistically significant (rs=0.590, p = 0.094). Conclusion The established strength test protocol demonstrated feasibility among ambulatory participants. However, alternative approaches are essential for those with limited ambulation. The study identified a robust correlation between upper limb strength and functional abilities. Further extensive studies are required to validate these findings. Trial registration The present study is a part of a longitudinal intervention study registered at the ClinicalTrials.gov (NCT03963453).

Diagnostic Utility of Parent Ratings on the Behavior Assessment System for Children-Third Edition in Children who are Deaf and Hard of Hearing and Diagnosed with Autism Spectrum Disorder.

Between 1 to 2 of every 1,000 children are born deaf or hard of hearing (DHH) and, of those, 30-50% have additional disabilities, including Autism Spectrum Disorder (ASD). Most measures assessing ASD characteristics rely on some degree of behavioral response to sound (e.g., responding to name, listening response), and may not be appropriate for use with children who are DHH. Further, ASD specific measures do not provide information on a child's functional abilities across developmental domains. We conducted a cross-sectional analysis comparing mean T-scores on a standardized multidimensional measure, the Behavior Assessment System for Children, Third Edition, Parent Rating Scale (BASC-3 PRS), across three groups matched for age and sex: children who are DHH and diagnosed with ASD (DHH + ASD; n = 16); children who are DHH without ASD (DHH-ASD; n = 16); and children who are typically hearing with ASD (H + ASD; n = 16). Analyses revealed statistically significant differences across scales of Attention Problems, Atypicality, Withdrawal, Behavioral Symptoms Index, Social Skills, Leadership, Functional Communication, Activities of Daily Living, Adaptive Skills, Autism Probability Indices, and Developmental Social Disorders. Pairwise comparisons showed DHH + ASD and H + ASD mean T-scores were statistically similar and distinct from DHH-ASD mean T-scores on all these scales except for Withdrawal, Leadership, Functional Communication, and Activities of Daily Living, where pairwise comparisons varied. The findings add to the literature on ASD and DHH childrenand call for further exploration of the BASC-3 as a tool for both evaluation of ASD and the development of individualized treatment plans in this unique population.

Using adaptive behavior scores to convey level of functioning in children with autism spectrum disorder: Evidence from the Study to Explore Early Development.

Autistic people are often described as "low-" or "high-functioning" based on their scores on cognitive tests. These terms are common in publications and in everyday communication. However, recent research and feedback from the autistic community suggests that relying on cognitive ability alone to describe functioning may miss meaningful differences in the abilities of autistic children and adults and in the kinds of support they may need. Additional methods are needed to describe "functioning" in autistic children. We examined whether scores from a test measuring adaptive behaviors would provide information on the functional abilities of children with autism that is different from cognitive ability and autism symptom severity. Adaptive behaviors include age-appropriate skills that allow people to function in their everyday lives and social interactions. We found that a large amount of the variation in adaptive behavior scores was not explained by cognitive development, autism symptom severity, and behavioral and emotional problems. In addition, there was a wide range of adaptive ability levels in children with autism in our study, including in those with low, average, or high cognitive scores. Our results suggest that adaptive behavior scores could provide useful information about the strengths and support needs of autistic children above and beyond measures of cognitive ability and autism symptom severity. Adaptive behavior scores provide important information on the needs of autistic people.

Improving Functional Abilities in Children and Adolescents with Autism Spectrum Disorder Using Non-Invasive REAC Neuro Psycho Physical Optimization Treatments: A PEDI-CAT Study.

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder that affects communication, social interaction, and behavior. Non-invasive neuromodulation techniques, such as radioelectric asymmetric conveyer (REAC) technology, have gained attention for their potential to improve the endogenous bioelectric activity (EBA) and neurobiological processes underlying ASD. Neuro Postural Optimization (NPO) and Neuro Psycho Physical Optimization (NPPO) treatments are non-invasive and painless neuromodulation treatments that utilize REAC technology and have shown promising results in improving the symptoms of ASD. This study aimed to evaluate the effects of NPO and NPPO treatments on functional abilities in children and adolescents with ASD using the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT). The study consisted of 27 children and adolescents with ASD who underwent a single session of NPO followed by 18 sessions of NPPO treatment over a period of one week. The results showed significant improvements in the children's and adolescents' functional abilities across all domains of the PEDI-CAT. These findings suggest that NPO and NPPO may be effective treatments for improving functional abilities in children and adolescents with ASD.

Physiotherapy Modalities and Physiotherapy Modalities and its Effect on The Development of Functional Ability in Children with Cerebral Palsyits Effect on The Development of Functional Ability in Children with Cerebral Palsy

In Indonesia, currently there are various physiotherapy intervention modalities for children with special needs, especially in cerebral palsy. The Bobath concept is a holistic approach to solving the problems of individuals with movement disorders and postural control as a result of lesions in the central nervous system. The purpose of this study was to determine the effect of physiotherapy modalities on functional abilities in children with cerebral palsy. This research was an experimental type that had a control variable with a nonequivalent control group design, but in this design the experimental group and the control group were not randomly selected, functional ability measuring tool used gross motor functional movement (GMFM). All respondents received treatment 16 times (2 times per week), measured as fisrt post-test, followed by treatment 16 times (2 times per week) measured as second post-test. The first post-test (16 times) and the second post-test (32 times), these data were compared. The results of the repeated measured ANOVA test in the control group revealed that there was a significant difference in functional ability after the bobath concept treatment (p=0.060; x1=-0.714; x2=-2.714) and after the bobath concept and taping treatment (p=0.027; x1=-2.400; x2=-6.000). But, there was found not significant after the bobath concept and stretching treatment (p =0.071; x1=-0.333; x2=-3.667), and after the bobath concept and infrared treatment (p=0.126; x1=-1.000; x2=-2.500). The results of the Freadman test there was a significant difference in functional ability after the bobath concept and massage treatment (p=0.023). The conclusion, there was a significant difference in functional ability improvement after being given treatment by the bobath concept, bobath concept plus taping, and/or bobath concept plus massage.

Relationship Between Functional Classification Systems in Children With Cerebral Palsy

Objective: Cerebral palsy refers to a group of postural and movement disorders that limit movements and can be related to a non-progressive disorder in the developing brain. The international classification of disability emphasizes the child's functional abilities and routine performance. Some classification tools have been developed to describe and evaluate child's functions in daily activities such as walking, manipulating objects, and everyday communication. The present study aimed to investigate the relationship between classification systems (gross motor function, manual ability, communication function, and eating and drinking ability) in children with cerebral palsy. Materials & Methods: This study was performed by cross-sectional correlation method and of descriptive analytical type. Children with cerebral palsy aged 12-144 months were recruited by convenience sampling from patients referred to clinics and public and private rehabilitation centers in Tehran and Arak cities, Iran, in 2019-2020. After completing the demographic information questionnaire by the child's primary caregiver, the gross motor function classification system (GMFCS), manual ability classification system (MACS), Communication function classification system (CFCS), and eating and drinking ability classification system (EDACS) were completed by a child therapist. Results: In the present study, 154 children with a Mean±SD age of 49.45±32.22 months participated. also, 87 children (56.5%) were boys, and 67(43.5%) were girls. According to GMFCS, the highest percentage distributions at levels II and IV were 31.2% and 26%, respectively. In other words, more than 57% of children were distributed in these two levels. According to MACS, the distributions of the highest percentages at levels II, III, and IV were 28.6%, 22.1%, and 20.8%, respectively. In other words, more than 70% of the children were distributed in these three levels. According to EDACS, the distribution of almost all levels was equal except the V level, with 4.3% having the lowest percentage. According to CFCS, the distribution of the highest percentage at levels V and IV was 23.5%. In examining the relationship between functional systems, significant relationships were observed in all cases: MACS and GMFCS, r=0.672; CFCS and GMFCS, r=0.581; EADCS and GMFCS, r=0.593; CFCS and MACS, r=0.555; EADCS and MACS, r=664; EADCS and CFCS, r=0. 547 (P<0.01). Conclusion: It seems that children with more motor function limitations show more limitations in other performance classification systems, too. Of course, the number of studies in this field is limited and needs further investigation.

Effect of a structured aqua-plyometric exercise program on postural control and functional ability in children with hemiparetic cerebral palsy: A two-arm randomized controlled trial.

Individuals with hemiparetic cerebral palsy (h-CP) encounter postural control issues that largely interfere with activity and participation. So, there might be a need for improved, clearly effective rehabilitation protocols that target postural control dysfunction, which may, then, reduce activity limitations and participation restrictions. This trial was undertaken to examine the effect of a structured, 12-week aqua-plyometric (Aqua-PLYO) exercise program on postural control and functional ability in children with h-CP. Fifty-six children with h-CP took part in a two-arm, randomized single-blind controlled trial. They were randomly assigned to either receive the standard physical therapy (Control group; n = 28) or the Aqua-PLYO training program (Aqua-PLYO group; n = 28), three times/week over 12 consecutive weeks. The dynamic limit of stability [i.e., movement directional control (M-DC), reaction time (ReT), movement velocity (M-Vel), endpoint excursion (EP-Exc), and maximum excursion (M-Exc)] and functional ability [i.e., 30-second sit-to-stand test (30sec-STS), timed up and down stairs test (TUDS), and the dynamic gait index (DGI)] were assessed pre- and post-treatment. From the pre- to post-treatment occasion, the Aqua-PLYO group achieved greater improvement for the M-DC (P = 0.013), ReT (P = 0.004), M-Vel (P = 0.03), EP-Exc (P = 0.002), and M-Exc (P = 0.006), compared to controls. Besides, the Aqua-PLYO group showed more conducive changes in functional ability [as evidenced by the 30sec-STS (P = 0.005), TUDS (P = 0.002), and DGI (P = 0.004) scores]. Aqua-PLYO training is likely an effective training paradigm for enhancing postural control and functional ability in children with h-CP. Further studies are, however, recommended to substantiate the current evidence.

Functional progressive resistance exercise versus eccentric muscle control in children with hemiplegia: a randomized controlled trial

BackgroundHistorically, strength exercise in children with CP is not recommended, because it may develop spasticity, which results in difficulty with walking. But, recently increasing studies and systemic reviews have reported that strength exercise can promote muscle strength in children with CP with no negative impact on spasticity. The study is aiming to compare the effect of functional resistance exercise and functional eccentric training on dynamic balance and functional ability in children with hemiplegia. For this purpose, forty participating children diagnosed with spastic hemiplegia were included and their ages ranged from 6 to 13 years. They were randomly allocated into two groups: functional resistance exercise (group I) or eccentric muscle control exercise (group II). The training was conducted three times a week for 6 weeks for both groups. Each group received one of the interventions in addition to designed physical therapy programs. Functional ability and dynamic balance were measured before and after 6 weeks of the intervention by gross motor function measure and functional reach test.ResultsComparison between the two groups before treatment revealed no significant difference in all values of functional ability and dynamic balance. But comparison after treatment in values showed significant improvement in both groups with greater improvements in favor of group I (p < 0.01).ConclusionAdding both functional resistance exercise and eccentric muscle control exercise is beneficial for improving functional ability and dynamic balance with more recommendation for adding functional resistance exercise that showed more significant improvement than eccentric muscle control in children with hemiplegia.

Quality Of Life of Children with Thalassemia in Indonesia: Review

Background: Thalassemia is an inherited disorder of hemoglobin (Hb) synthesis. Treatment of thalassemia has not yet reached the level of cure. Globally, the management of thalassemia is symptomatic in the form of lifelong blood transfusions. Data on children with thalassemia major in Indonesia has not been widely published. However, various studies clearly showed growth and development disorders and behavior that greatly affected the quality of life of children with thalassemia. Blood transfusions and lifelong use of drugs often lead to feelings of boredom of treatment, not to mention physical changes and the feeling of being different from relatives or friends that will cause the feeling of inferiority. They often drop out of school and do not find work, which causes highly severe psychosocial effects. Objective: This paper aims to provide an overview of the quality of life of children with thalassemia in Indonesia so that it can be used as a reference in providing appropriate management regarding the quality of life of children with thalassemia. Methods: This literature search used google scholar and pubmed for complete publications in 2010-2020 with the keywords "quality of life", "thalassemia children," and "Indonesia”. Result: There were six research articles related to this search. Indonesia's average quality of life for children with thalassemia ranged from 50% to 67.2%.Conclusion: Of the four domains assessed, school function had the lowest average, followed by emotional, physical and social function. Child health services need to optimize children's functional abilities and quality of life.

Effect of power training on locomotion capacities in children with cerebral palsy with GMFCS level III–IV

Purpose Power training (PT) is a promising training modality to improve functional abilities in children with cerebral palsy (CP). This study aimed to implement PT in an adapted school and to assess its effect on locomotion capacities in children with Gross Motor Function Classification System (GMFCS) level III–IV. Materials and methods Nine children with CP (GMFCS level III–IV) were trained three times/week for 12 weeks. The training sessions took place during the 50-minute physical activity classes and included high intensity exercise. The outcome measures were the performance on the 10-meter comfortable and fast walking tests, the 50-meter sprint test (50M-ST), and the energy expenditure index (EEI). Results Participants spent 12 ± 7 and 7 ± 9 min per session at an intensity superior to 40% and 60% of the heart rate reserve, respectively. Performance in the 10-meter walking test (13.5 ± 7.8 to 9.9 ± 4.6 s, p < 0.05), the 10-meter fast walking test (8.8 ± 3.1 to 7.0 ± 3.2 s, p < 0.05), the 6-minute walking exercise (199.0 ± 48.6 to 316.6 ± 107.2 m, p < 0.05), and in 50M-ST (53.8 ± 29.5 to 42.3 ± 16.2 s, p < 0.05) increased after training. The EEI was reduced after training (p = 0.01), resulting in a more efficient gait. Conclusions PT was successfully implemented in children with CP with GMFCS level III–IV. Results suggest that PT increases walking capacities. Implications for rehabilitation Power training (PT) is feasible with children with bilateral cerebral palsy with GMFCS level III and IV. Physical education course in specialist school is a valuable environment to implement PT in children with poor gross motor function. Power training results in locomotion capacities improvement.

Developmental profiles of children at risk for autism spectrum disorder at school entry.

Functional abilities in children with autism spectrum disorder (ASD) are highly heterogenous, and impairments can overlap with non‐ASD neurodevelopmental disorders. We compared the profiles of children assessed for ASD with and without an ASD diagnosis using a retrospective cohort study of 101,739 children born in British Columbia (2000–2008). The children were grouped into the following five comparison groups: (1) ASD− (n = 1131), (2) ASD+ (n = 1583), (3) Ministry of Education designated ASD+ (n = 654), (4) special need other than ASD (n = 11,663), and (5) typically developing (n = 86,708). Five developmental domains were assessed using the Early Development Instrument. ANCOVA was used to control for covariates, Tukey's HSD test for multiple comparisons, and Cohen's d for effect size. The ASD− group had slightly higher scores than the ASD+ group with small to medium effect sizes in all domains (d = 0.20–0.48). The ASD− group had slightly higher scores than the Ministry of Education ASD+ group in only three domains with small effect sizes (d = 0.21–0.25). The ASD− group had lower scores in all domains compared to the typically developing group with large effect sizes in all domains (d = 1.12–1.77). The ASD− group received less education funding at school entry than both ASD+ groups. Overall, only small to medium differences in development were detected between the ASD− and ASD+ groups. While these children differ diagnostically, they share similar functional profiles and have substantially more difficulties than typically developing children. Therefore, differences in levels of support at school entry raise critical questions of equity.Lay SummaryComparison of children in British Columbia who have been referred for an autism assessment, with or without a diagnosis, shows similarities in their functional and developmental profiles in kindergarten. Furthermore, both groups of children have more difficulties than typically developing children. However, children who have been referred for assessment without an autism diagnosis receive less financial support at school entry, raising important questions on equity.

Modelling quality of life in children with intellectual disability using regression trees.

AimTo identify factors associated with quality of life (QoL) in children with intellectual disability. We aimed to identify patterns of association not observable in previous hypothesis‐driven regression modelling using the same data set from a cross‐sectional observational study.MethodA questionnaire was completed by 442 caregivers of children with confirmed intellectual disability and a diagnosis of autism spectrum disorder, cerebral palsy, Down syndrome, or Rett syndrome. The Quality of Life Inventory‐Disability (QI‐Disability) questionnaire was used to assess child QoL. Independent variables described the child's health, functional abilities, community participation, and sociodemographics. The R package rpart was used to build the regression trees.ResultsThe mean total QI‐Disability score was 69.2 out of a maximum 100. The subgroup with the lowest QoL scores comprised children with a high degree of daytime sleepiness (n=74, mean 57.5) while the subgroup with the highest QoL scores (n=91, mean 80.3) comprised children with little daytime sleepiness who participated more frequently in community activities and displayed good eye contact while listening.InterpretationRegression tree analysis provides insights into the relative importance of associated factors. Sleep problems and community participation were more important than functional abilities in accounting for differences in QoL.What this paper adds A hypothesis‐free regression tree analysis enables examination of multiple factors potentially influencing quality of life (QoL) in children with intellectual disability.Functional abilities were less strongly associated with QoL than sleep problems and community participation.

Pengaruh Postural Control Exercise Pada Anak Cerebral Palsy Spastik Hemiplegi

ABSTRACT&#x0D; Cerebral palsy is a motor problem as a result of non-progressive brain lesions in impaired brain development. In children who suffer from Cerebral Palsy experience damage to the brain that is permanent. The characteristic of Cerebral Palsy with the Spastic Hemiplegic type is characterized by the appearance of problems in the upper and lower limbs of one side of the body. The intervention given in this case is a postural control exercise which aims to improve the child's ability to control body position with the aim of stability and orientation. This research method is experimental, the research design uses case studies and data collection techniques use Pre and Post Tests. The sampling technique used was accidental sampling. Examination of posture using a posture assessment scale and functional examination of activities using the GMFM form. After six sessions of therapy, the results showed an improvement in posture and an increase in the functional score of children's activities, although not significant. Postural control exercise programmed to patients is able to improve posture and increase the functional ability of children's activities.

Association between Postural Stability and Functional Abilities in Children with Spastic Cerebral Palsy

Association between Postural Stability and Functional Abilities in Children with Spastic Cerebral Palsy

P069 Assessment of diagnostic delay for hip disorders in the pediatric population

Abstract Background Hip disorders are highly common among pediatric patients. The diagnosis is based primarily on the clinical findings, the context and the personal and family history of the child. It is in most cases steered by the biological and imaging findings. The latter are usually derived from radiographs, ultrasound imaging and, in some cases, MRI. The main purpose of this study is to evaluate assess the diagnostic delay for hip disorders in the pediatric population. Methods We conducted a retrospective study including pediatric patients from the rheumatology and the orthopedics department, who consulted or were referred to orthopeadics for a suspected hip disorder. For all patients, we collected the following data: age, clinical findings, imaging findings, the number of consultations in general medicine or emergency medicine and the number of consultations in orthopedics department before the diagnosis is made, the final retained diagnosis and, ultimately, the diagnostic delay since onset of symptoms and first consultation. Results We included 81 children (48 boys and 33 girls) with a mean age of 9.9 years old [1.5–16]. Sixty-two patients were symptomatic at admission. The pain was located in the hip in 55.5% of patients (n = 45), in the groin in 7.4% of patients (n = 6) and in the knee in 12.34% of patients (n = 10). One child reported unilateral buttock pain. The other reasons for consultation were limping in 3.7% of cases (n = 3), deformity of the lower limb in 1.23% of cases (n = 1), a crying baby in 1.23% of cases (n = 1) and swelling of the knee in 1.23% of cases (n = 1). On clinical examination, 58 patients had a limitation of the hip motion. Twenty-nine percent of the children had a biological inflammatory syndrome at admission. In total, over one hundred and seventy-one imaging examinations were performed in order to adjust the diagnosis; among them, 7 CT pelvic scan and 23 MRI. The different retained diagnoses of hip involvement are summarized in Table 1. The mean number of consultations in general medicine or emergency medicine before the diagnosis is made was 0,58 ranging from 0 to 2. The mean diagnostic delay since the onset of symptoms was 9,12 months ranging from 3 days to 13 years. The mean diagnostic delay since the first medical check -up was 3,5 months ranging from 0 to 10 years. Conclusion Our study showed that the patient lost an average of 9 months from symptom onset to retaining the final diagnosis. The hip being a prognosis joint, this delay could alter the child's future functional abilities.