Handicap Inventory Research Articles

Virtual reality rehabilitation in children with brain injury: a randomized controlled trial.

To investigate the efficacy of a virtual reality rehabilitation system of wearable multi-inertial sensors to improve upper-limb function in children with brain injury. Eighty children (39 males, 41 females) with brain injury including cerebral palsy aged 3 to 16 years (mean age 5y 8mo, SD 2y 10mo) were assessed as part of a multicentre, single-blind, randomized controlled trial. The intervention group received a 30-minute virtual reality intervention and a 30-minute session of conventional occupational therapy while the control group received 60 minutes of conventional occupational therapy per session, with 20 sessions over 4 weeks. The virtual reality rehabilitation system consisted of games promoting wrist and forearm articular movements using wearable inertial sensors. The Melbourne Assessment of Unilateral Upper Limb Function-2 (MA-2), Upper Limb Physician's Rating Scale, Pediatric Evaluation of Disability Inventory Computer Adaptive Test, and computerized three-dimensional motion analysis were performed. Both groups (virtual reality, n=40; control, n=38) significantly improved after treatment compared to baseline; however, the virtual reality group showed more significant improvements in upper-limb dexterity functions (MA-2, virtual reality group: Δ=10.09±10.50; control: Δ=3.65±6.92), performance of activities of daily living, and forearm supination by kinematic analysis (p<0.05). In the virtual reality group, children with more severe motor impairment showed significant improvements compared to those with less severe impairment. The virtual reality rehabilitation system used in this study, which consists of wearable inertial sensors and offers intensive, interactive, and repetitive motor training, is effective in children with brain injury. Both virtual reality rehabilitation and conventional occupational therapy were effective for upper-limb training. Virtual reality training was superior in improving dexterity, performance of activities of daily living, and active forearm supination motion. The effect of virtual reality training was significant in children with more severe motor impairments.

Development and initial validation of self-report measures of general health, preoperative anxiety, and postoperative pain in young children using computer-administered animation.

For young children, existing measures of children's health-related quality of life must be parent-reported or interviewer-administered for those who cannot read or complete measures independently. Parents' and childrens' reports about the child's health have been shown to disagree. (a) To test the reliability and validity of an animated, computer-administered Child Health Rating Inventories (CHRIS2.0) among children aged 4-12 undergoing surgery; and (b) to develop and test two CHRIS measures of preoperative anxiety and postoperative pain management. We conducted a longitudinal cohort study of a diverse group of 542 children aged 4-12 undergoing surgery. We compared the CHRIS measures to Pediatric Quality of Life Inventory (PedsQL), the Functional Disabilities Inventory (FDI), State-Trait Anxiety Inventory for children (STAI-CH), and the Parent Postoperative Pain Measure (PPPM). Factor analyses supported the construct validity of the 12-item general physical health and the 8-item mental health CHRIS scales, as well as a composite 20-item scale, and the CHRIS preoperative anxiety and postoperative pain scales. Internal consistency reliability for all CHRIS scales exceeded the standard for group comparisons (Cronbach's α ≥0.70). The CHRIS general health composite was significantly correlated with composite PedsQL and FDI (r=0.28, P<.001 and r=0.43, P<.001, respectively). The CHRIS peri-operative anxiety measure was significantly correlated with the STAI-CH (r=0.44, P<.001), as was the CHRIS postoperative pain scale with the PPPM (r=0.52, P<.001). The CHRIS measures were reliable and valid in this diverse sample of young children (4-12). Because CHRIS measures are self-administered, scored in real time, and run on multiple different platforms, this approach provides a feasible method for the collection of health-related quality of life in young children and those with limited literacy. Our data indicate that this approach is psychometrically sound and has the potential for adding the child's voice to pediatric outcomes.

Child pain-related injustice appraisals mediate the relationship between just-world beliefs and pain-related functioning.

Research among adult and paediatric samples suggests that pain-related injustice appraisals contribute to adverse pain-related functioning. However, a singular focus on pain-related injustice appraisals carries the risk of underestimating the role of broader concepts of justice. This study examined the unique roles of child pain-related injustice appraisals and just-world beliefs in understanding disability and physical, emotional, social and academic functioning, as well as the mediating role of injustice appraisals in the relationship between just-world beliefs and functioning. Participants comprised a school sample of 2,174 children (Study 1) and a clinical sample of 146 paediatric chronic pain patients (Study 2) who completed the Injustice Experience Questionnaire (IEQ), Personal and General Belief in a Just World scales (JWB-P/G), Functional Disability Inventory (FDI), Pain Catastrophizing Scale for Children (PCS-C) and Pediatric Quality of Life Inventory (PEDSQL). For both samples, child pain-related injustice appraisals were associated with poorer functioning, after controlling for just-world beliefs, catastrophizing, pain intensity, age and sex. In the school sample, injustice appraisals mediated the associations of both personal and general just-world beliefs with functioning. In the clinical sample, injustice appraisals mediated the association of personal, but not general, just-world beliefs with all functioning scales. The current findings attest to the unique role of pain-related injustice appraisals in understanding child pain-related functioning and their explanatory value in understanding the relationship between fundamental just-world beliefs and child pain-related functioning. The present study adds to emerging literature on the adverse effects of child pain-related injustice appraisals in the context of pain, through showing that pain-related injustice appraisals are uniquely associated with pain-related functioning and mediate the relationship between just-world beliefs and pain-related functioning. These findings suggest that interventions may target pain-related injustice appraisals as a mechanism for change in children.

Pola Asuh Orang Tua Mempengaruhi Kemampuan Self Care Pada Anak Autisme

Background: Autism is one of the serious development disorders of a child, which causes problem in the ability of daily life, one of which is self care. The role of parents, especially of parenting parents is very influential for self care ability in autistic children.Aims of this study is to analize corelation betwen parenting parents to self care ability in autism. Methods: The study design uses Descriptive Correlation, that is a correlation between two variables is parenting and ability self care in autistic children. With a Cross-Sectional approach. The amount of samples used was 47respondents, using the Purposive sampling technique and collecting data using The Pediatric Evaluation of Disability Inventory with the test results using the contingency coefficient. That tested whether there is a correlation between two variables is parenting and ability self care in autistic children. Results: The results of study found the majority of parents implementing democratic parenting as many as 25 people (53,2%) and 24 children (51,1%) with the ability to self care quite capable. The test results using the contingency coefficient obtained of p value of 0,000 (p&lt;0,05) which means that these results indicate a correlation of parenting with ability self care in autistic children, a correlation strength value of 0,659 (strong power). Conclusion: The researcher suggests that parents provide many positive activities in terms of eating and drinking, dreesing, personal hygiene, and toileting so that children can independently do self care.

'Dual Sensory Loss Protocol' for Communication and Wellbeing of Older Adults With Vision and Hearing Impairment - A Randomized Controlled Trial.

ObjectivesMany older adults with visual impairment also have significant hearing loss. The aim was to investigate the effectiveness of a newly developed Dual Sensory Loss (DSL) protocol on communication and wellbeing of older persons with DSL and their communication partners (e.g., spouse or child) in the Netherlands and Belgium.MethodsParticipants (N = 131) and their communication partners (n = 113) were randomized in the “DSL-protocol” intervention group or a waiting-list control group. The intervention took 3 to 5 weeks. Occupational therapists focused on optimal use of hearing aids, home-environment modifications and effective communication strategies. The primary outcome was the Communication Strategies domain of the Communication Profile for the Hearing Impaired (CPHI). Secondary outcomes measured in participants were the Low Vision Quality Of Life Adjustment subscale, the Center for Epidemiological Studies - Depression Scale, De Jong Gierveld Loneliness Scale and the Fatigue Assessment Scale. The Hearing Handicap and Disability Inventory (HHDI) - Reaction of Others subscale and the Care-related Quality of Life - 7 Dimensions was measured in communication partners. Measurements were taken at baseline and 3-month follow-up. Linear mixed models (LMM) were used to analyze effects between groups over time for every outcome measure.ResultsIntention-to-treat analyses showed a significant effect of the DSL-protocol on the use of verbal strategies (effect size SMD = 0.60, 95% CI: 0.25 to 0.95) in favor of the control group, however, this effect was non-significant after adjustment for confounding. Effect sizes of other outcomes varied between −0.23 [−0.57, 0.12] and 0.30 [−0.05, 0.64]. The LMM showed a significant effect on the HHDI-Reaction of others scale in favor of communication partners in the treatment group, however, the effect did not remain significant at a 0.01 significance level and the effect size was very small and non-significant 0.12, 95% CI [−0.27 to 0.51]. Adjusted analyses did not reveal treatment effects.ConclusionThe DSL-protocol did not clearly contribute to the enhancement of communication and wellbeing in DSL-patients. Possible reasons for the lack of effects are OTs not being comfortable giving advice on communication and psychosocial issues or the short-term treatment and follow-up period. Further study is warranted to find out how the protocol may be adapted or whether it is necessary to involve mental healthcare professionals.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NTR2843.

Mechanically assisted walking training for walking, participation, and quality of life in children with cerebral palsy.

Mechanically assisted walking training for walking, participation, and quality of life in children with cerebral palsy.

Functioning of young patients with cerebral palsy: Rasch analysis of the pediatric evaluation of disability inventory computer adaptive test daily activity and mobility

BackgroundPeople with cerebral palsy experience limitations in performing activities of daily living. Rehabilitation practitioners seek valid instruments to measure changes in the performance of those activities. The Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) is a new tool to assess functioning in children and youth with various health conditions. Its validity needs to be evaluated in a way that is consistent with the theoretical model on which it was based. We aimed to evaluate the fit of daily activity and mobility items and children with CP to the Rasch model and to compare the performance in daily activities and mobility of older children, adolescents, and young adults with CP based on manual function and gross motor function limitations.MethodsEighty-three parents of children and youth of 8–20 years old (mean age: 11.6) with different severity levels of cerebral palsy participated in this study. Ninety-one items of the PEDI-CAT Daily Activities and Mobility domains were analyzed through Rasch analysis to evaluate relative item difficulty and participant ability. Participants were described according to the Manual Ability (MACS) (level I: 21.7%; II: 32.5%; III: 24.1%; IV: 7.2% and V: 3.6%) and the Gross Motor Function (GMFCS) (level I: 37.3%; II: 26.5%; III: 6%; IV: 18.1%; and V: 7.2%) classification systems levels.ResultsOur data fit the Rasch Model. Parents had difficulty distinguishing some PEDI-CAT response categories. Participants from MACS and GMFCS levels IV and V showed lower ability to perform relatively more difficult items. There was a floor effect in both domains. Only 7.7% of the items presented differential item functioning when individuals with mild MACS and GMFCS levels (I, II) and moderate level (III) and individuals with moderate (III) and severe levels (IV, V) were compared.ConclusionsPEDI-CAT daily activities and mobility domains are valid to evaluate children, adolescents and youth with CP of different severities, but the addition of items to these domains is recommended in order to address their floor effect.

A Pilot Study of Two Different Constraint-Induced Movement Therapy Interventions in Children With Hemiplegic Cerebral Palsy After Botulinum Toxin Injection During Preschool Education.

Introduction: To establish a pilot study on applying two low dose (40 h) constraint-induced movement therapy (CIMT) interventions in children with hemiplegic cerebral palsy (CP) after botulinum toxin (BoNT-A) injection during preschool education.Methods: Five children with spastic CP (mean age: 5.31 years; Gross Motor Function Classification System level I and II) undergoing regular BoNT-A injections and rehabilitation programs were included. Participants were randomly allocated to one of two CIMT programs (40 h): a 2-week 4-hours/day CIMT program and a 4-week 2-hours/day CIMT program. One CIMT program was performed 1 month after a BoNT-A injection, and then the second program was implemented with the next injection. The outcomes were measured by changes in Goal Attainment Scaling (GAS), the grasp and Visual-Motor Integration (VMI) test in Peabody-Developmental Motor Scales (PDMS), the self-care scale on the Functional Skill Scale, and the Caregiver Assistance in Chinese Version of Pediatric Evaluation of Disability Inventory (PEDI-C), Anxiety and Oppositional Defiance Problems of Achenbach System of Empirically-Based Assessment before and after the CIMT interventions, and at every 2 months' follow-up thereafter.Results: The mean age of the participants was 5.31 years, BMI was 16.7 (kg/m2), VIQ was 86.4 ± 8.5, and dose of BoNT-A injection in the upper limb was 42 ± 26.6 units. Grasp, VMI, and self-care on the Functional Skill Scale were significantly better in the 4-week 2-hours/day CIMT program (p < 0.001, p = 0.001, p < 0.001). GAS, grasp, VMI, two 2 self-care scales of PEDI were significantly improved after the CIMT programs, and improvement continued for up to 4 months after the programs. There was no clinical evidence showing changes in the scores for anxiety and oppositional defiance problems during the study period.Conclusions: The preliminary findings, although limited, suggest a potential therapeutic role for the school-based CIMT program after BoNT-A injection. The 4-week 2-hours/day CIMT program might be better than a 2-week 4-hours/day program in terms of self-care and hand function when performed in kindergarten in this pilot study. Furthermore, this pilot study provides valuable information; therefore, it is crucial to include more CP children and blinded assessors for hand function and ADL in the future study.

Analysis of a Group-Based Treadmill Program for Children with Neuromotor Delay Who Are Pre-Ambulatory

Purpose To analyze data from a prospective cohort study, a group-based treadmill program, administered twice weekly for 14 weeks, in regard to gross motor skills related to walking and walking attainment in young children with neuromotor delay who are pre-ambulatory. Methods Seventy children (F = 29), mean age 25.6 (SD 10.1) months participated in the program 2×/week for 14 weeks. The Gross Motor Function Measure-88 Dimensions D and E (GMFM D/E), Functional Mobility Scale for 5, 50, and 500 meters (FMS 5, 50, 500), the timed 10-m walk test (10MWT), and the Pediatric Evaluation of Disability Inventory Caregiver Mobility Scale (PEDI) were administered before and after the program. Results Statistically significant improvements were found in the GMFM D, GMFM E, FMS 5, 50, 500 and PEDI, but not in 10MWT. Conclusions A group-based treadmill program was associated with improvements in motor skills related to walking in young children when administered in adjunct to ongoing physical therapy.

The spectrum of pediatric amplified musculoskeletal pain syndrome

BackgroundChildren presenting with musculoskeletal pain to pediatric rheumatology clinics are very heterogeneous and on a continuum from those with localized pain to total body pain. Many report intermittent, rather than constant, pain. We examined clinical and psychological characteristics of these children at presentation and specifically those who fulfilled the criteria for fibromyalgia.MethodsWe performed a retrospective, cross-sectional cohort study of children under ≤18 years old presenting to the pediatric rheumatology pain clinic between January 2015 and July 2019 and enrolled in a patient registry. We included children diagnosed with amplified pain, excluding those fulfilling criteria for complex regional pain syndrome. ed data included clinical characteristics, pain symptoms, functional disability inventory (FDI), widespread pain index, and symptom severity scale.ResultsWe analyzed 636 subjects, predominantly non-Hispanic Caucasian females. Using median split method, 54% had diffuse pain (≥ 5 body regions involved), but, of these, only 58% met criteria for fibromyalgia. Subjects with diffuse pain, compared to those with localized pain had a longer duration of pain (24 vs 12 months, p < 0.01), reported greater pain intensity (6/10 vs 5/10, p < 0.001), greater mental health burden, and poorer function (FDI 25 vs 19, p < 0.0001). Subjects with limited pain more often reported a history of trigger event (34% vs 24%, p < 0.01) but not autonomic changes (14% vs 14%, p = 0.94). The presence of adverse childhood experiences did not differ among those with limited versus diffuse pain except for parental divorce (16% vs 23%, p = 0.03). Intermittent pain was reported in 117 children (18%) and, compared to subjects with constant pain, they reported less pain (0/10 vs 6/10) and were more functional (FDI 13 vs 25) (both p < 0.0001).ConclusionsThere exists a wide spectrum of pain manifestations among children with amplified pain including limited or diffuse and constant or intermittent pain. Most children who presented to our clinic did not fulfill criteria for fibromyalgia but nonetheless had significant symptoms and disability. Studies focusing on fibromyalgia may miss the full extent of childhood amplified pain. Additionally, research limited to those meeting the fibromyalgia criteria likely underestimate the significant impact of amplified pain among the pediatric population.

Effects of Virtual Reality-Based Rehabilitation on Upper Extremity Function among Children with Cerebral Palsy.

Background: Deterioration in upper extremity function has been a common problem among children with cerebral palsy (CP). The present study evaluated the effects of virtual reality (VR)-based rehabilitation combined with conventional occupational therapy (COT) on upper extremity function and caregiver assistance among children with CP. Methods: Medical records of 17 children with CP who regularly participated in a rehabilitation program at Samsung Changwon Hospital were retrospectively reviewed. Ten children received VR-based rehabilitation, which utilized RAPAEL Smart Kids and video games combined with COT. Seven children received COT alone, which was provided by a trained occupational therapist and focused on their upper extremities. Clinical outcomes were determined using the Quality of Upper Extremity Skills Test (QUEST) and Pediatric Evaluation of Disability Inventory (PEDI), which were administered before and 8 weeks after the first intervention session. Results: The smart glove (SG) group showed significant improvements in all QUEST domains and five PEDI domains (p < 0.05), whereas the COT group showed a significant change only in total QUEST scores. A comparison between both groups revealed that the SG group had significantly greater improvements in five QUEST domains and two PEDI domains (p < 0.05). Conclusions: Our results suggest that VR-based rehabilitation combined with COT may improve the upper extremity functions and decrease caregiver burden among children with CP.

Response to Mindfulness-Based Cognitive Therapy Differs Between Chronic and Episodic Migraine.

Evaluate whether the benefits of Mindfulness-Based Cognitive Therapy for Migraine (MBCT-M) on headache disability differs among people with episodic and chronic migraine (CM). This is a planned secondary analysis of a randomized clinical trial. After a 30-day baseline, participants were stratified by episodic (6-14 d/mo) and CM (15-30 d/mo) and randomized to 8 weekly individual sessions of MBCT-M or wait list/treatment as usual (WL/TAU). Primary outcomes (Headache Disability Inventory; Severe Migraine Disability Assessment Scale [scores ≥ 21]) were assessed at months 0, 1, 2, and 4. Mixed models for repeated measures tested moderation with fixed effects of treatment, time, CM, and all interactions. Planned subgroup analyses evaluated treatment*time in episodic and CM. Of 60 participants (MBCT-M N = 31, WL/TAU N = 29), 52% had CM. CM moderated the effect of MBCT-M on Severe Migraine Disability Assessment Scale, F(3, 205) = 3.68, p = 0.013; MBCT-M vs WL/TAU reduced the proportion of people reporting severe disability to a greater extent among people with episodic migraine (-40.0% vs -14.3%) than CM (-16.4% vs +8.7%). Subgroup analysis revealed MBCT-M (vs WL/TAU) significantly reduced Headache Disability Inventory for episodic (p = 0.011) but not CM (p = 0.268). MBCT-M is a promising treatment for reducing headache-related disability, with greater benefits in episodic than CM. ClinicalTrials.gov Identifier: NCT02443519. This study provides Class III evidence that MBCT-M reduces headache disability to a greater extent in people with episodic than CM.

Measures of Juvenile Fibromyalgia.

Juvenile fibromyalgia (JFM) is a chronic and debilitating noninflammatory musculoskeletal pain syndrome that is typically diagnosed in adolescence. There are no specific medical tests or disease markers to diagnose the condition, and classification is based on patient report of pain and other associated symptoms after ruling out other underlying medical causes. JFM can be disabling in multiple life domains and therefore, a multidimensional assessment of JFM is recommended to gain a full picture of the extent of JFM symptoms along with their impact on physical and emotional functioning and quality of life. The following updated review outlines evidence-based measures useful in the assessment of school-age children and adolescents with JFM. New measures include 1) the Pain and Symptom Assessment Tool (PSAT) that offers a standardized tool for the classification of fibromyalgia in pediatric patients and 2) the Patient-Reported Outcomes Measurement Information System (PROMIS®) Pediatric Pain Interference, Anxiety, and Depression Scales. Updated information is presented on previously established measures that assess the impact of JFM on functioning and quality of life - the Functional Disability Inventory (FDI) and the Pediatric Quality of Life Inventory (PedsQL) 3.0 Rheumatology Module Pain and Hurt Scale, are also discussed. In general, there are increasing options for validated patient-reported outcome measures available to measure the spectrum of symptoms in JFM and assess impact on daily life. Greater consistency in identification of JFM and use of standardized assessment tools will undoubtedly lead to higher quality research much needed in this relatively understudied musculoskeletal pain condition.

Construct-concurrent validity and reliability of the European Child Environment Questionnaire (ECEQ) in a sample of Turkish children with cerebral palsy

Purpose To investigate the construct-concurrent validity and reliability of the Turkish version of the European Child Environment Questionnaire (ECEQ-T) in children with cerebral palsy (CP). Methods Mean age 9.53 ± 4.45 years 306 children with CP and their parents participated in the study. While construct validity was assessed using confirmatory factor analysis, concurrent validity was investigated using the correlation between ECEQ-T and Pediatric Evaluation of Disability Inventory (PEDI) with Spearman’s correlation analysis. For test–retest reliability, ECEQ-T was administered twice to 65 parents with an interval of two weeks. Cronbach’s alpha (α) and Intraclass Correlation Coefficient (ICC) were used for reliability. Results Construct validity (RMSEA > 0.080; GFI ≥ 0.90) and concurrent validity (r: −0.533 to −0.293; p < 0.05) were confirmed as acceptable. Eight items were dropped out as they did not fit the model and finally ECEQ-T contains 54 items in three domains. High Cronbach’s α and ICC values were found (Cronbach α PE: 0.960/ICCPE: 0.959, Cronbach α SS: 0.955/ICCSS: 0.954), Cronbach α A: 0.822/ICCA: 0.802, Cronbach α T: 0.957/ICCT: 0.955). Conclusion ECEQ-T has demonstrated good psychometric properties and can be used as a reliable and valid measure to assess environmental factors. We believe that ECEQ-T is a useful and detailed questionnaire to determine barriers-facilitators for increasing activity and participation in Turkish children with CP. IMPLICATIONS FOR REHABILITATION The Turkish version of ECEQ has acceptable construct validity and moderate concurrent validity for evaluating environmental factors in children with cerebral palsy. The Turkish version of ECEQ provides valuable information, which could be helpful to guide public health services and government policies in order to optimize the participation of children with CP. Environmental factors may play an important role in activity and participation in children with cerebral palsy. Turkish version of the ECEQ can be used for evaluating the environmental factors to determine barriers of activity and participation.

Long-Term Neurodevelopmental and Functional Outcomes of Normally Developing Children Requiring PICU Care for Bronchiolitis

Bronchiolitis is a common pediatric intensive care unit (PICU) illness and often affects generally healthy children, making it a promising disease in which to study long-term neurodevelopmental outcomes. We previously found that approximately 15% of critical bronchiolitis patients have evidence of post-PICU morbidity using coarse definitions available in administrative data sets. In this study, we measured neurodevelopmental outcomes using four more precise tools. Children who had previously been admitted to our PICU with bronchiolitis were included; those with evidence of developmental delay at PICU admission were excluded. Approximately 1 to 2 years after PICU discharge, the parent of each subject completed two questionnaires (Ages and Stages Questionnaire and Pediatric Evaluation of Disability Inventory Computer Adaptive Test). Each subject also underwent two in-person assessments administered by a certified examiner (Bayley Scales of Infant and Toddler Development, 3rd edition, and the Amiel-Tison neurological assessment). For each domain of each test, a score of > 1 standard deviation below the norm for the subject's age defined "moderate" disability and a score ≥ 2 standard deviations below the norm defined "severe" disability. Eighteen subjects (median ages of 3.7 months at PICU admission and 2.3 years at testing) were enrolled, 17 of whom were supported by high-flow nasal cannula and/or mechanical ventilation. Fifteen children (83%) scored abnormally on ≥ 1test. Eight children (44%) had disabilities in ≥ 3 domains and/or ≥ 1 severe disability identified. Our findings that motor, language, and cognitive disabilities are commonly observed months to years after critical bronchiolitis require larger studies to confirm this finding, assess causality, and identify modifiable risk factors.

Relationship Between the Performance of Self-Care and Visual Perception Among Young Children With Autism Spectrum Disorder and Typical Developing Children.

Studies investigating the performance of self-care and visual perception in young children with autism spectrum disorder (ASD) are limited. The relationship between self-care performance and visual perception ability in young children with ASD is not yet clearly understood. Here, self-care performance was evaluated by the caregivers and therapists of children with ASD. The differences in self-care performance and visual perception ability were investigated in 66 children with ASD and 66 typically developing (TD) children between the ages of 48-83 months. The relationships between self-care and visual perception were tested in both two groups. The Assessment of Motor and Process Skills (AMPS) and the Chinese version of the Pediatric Evaluation of Disability Inventory (PEDI-C) were used to assess the children's self-care performance. The Test of Visual Perceptual Skills-Third Edition (TVPS-3) and the Developmental Test of Visual Perception-Third Edition (DTVP-3) were used to evaluate visual perception ability. Young children with ASD obtained significantly lower scores for self-care performance (AMPS and PEDI-C) and visual perception ability (TVPS-3 and DTVP) compared with TD children. Additionally, positive correlations were found between self-care performance and visual perception ability in young children with ASD. The results provide a valuable contribution to our understanding about self-care and visual perception performance of young children with ASD. The findings of this research highlight the need for pediatric practitioners to include self-care and visual-motor integration evaluations for young children with ASD. LAY SUMMARY: Young children with ASD obtained significantly lower scores for self-care performance and visual perception ability compared with TD children. Positive correlations were found between self-care performance and visual perception ability in young children with ASD. The results provide a valuable contribution to our understanding about self-care and visual perception performance of young children with ASD.

Cross-Cultural Adaptation and Psychometric Properties of the Spanish Version of the Tampa Scale for Kinesiophobia for Temporomandibular Disorders.

The aim was to perform a translation, cross-cultural adaptation, and psychometric evaluation of the Spanish version of the Tampa Scale of Kinesiophobia for Temporomandibular Disorders (TSK-TMD-S). The study sample included 110 patients with TMD. We translated and cross-culturally adapted the TSK-TMD-S using standard methodology and analysed its internal consistency, test-retest reliability, construct validity, floor and ceiling effects, and discriminant validity. Confirmatory factor analysis extracted two factors and 10 items deemed essential for the scale. The TSK-TMD-S demonstrated good internal consistency (Cronbach’s α of 0.843, 0.938, and 0.885 for the entire scale, activity avoidance subscale, and somatic focus subscale, respectively; intraclass correlation coefficient, 0.81–0.9). No floor or ceiling effects were identified for this final version of the scale. The TSK-TMD-S total score showed moderate positive correlation with the craniofacial pain and disability inventory, visual analogue scale, general TSK and pain catastrophizing scale, and a moderate negative correlation with maximal mouth-opening. The receiver operating characteristic curve analysis showed that the subclassification employed for the TSK-TMD-S discriminates different kinesiophobia levels with a diagnostic accuracy between sufficient and good. The optimal cut-off point for considering kinesiophobia is 23 points. TSK-TMD-S appears to be a valid and reliable instrument for measuring kinesiophobia in patients with TMD.

A public health concern: Chronic low back pain and the relationship between pain, quality of life, depression, anxiety, and sleep quality

Aim: Chronic low back pain (CLBP) is a common condition of the musculoskeletal system and a public health concern. CLBP patients suffer from conditions such as muscle weakness and numbness, resulting in diminished quality of life (QoL), poor functioning, psychological disorders and sleep disorders related to disabling pain. The aim of the current study was to reveal relationship between CLBP and patients’ health related QoL, anxiety, depression, and sleep disturbances. Methods: Seventy-three patients with CLBP and 73 healthy controls participated in this questionnaire-based cross-sectional study. The Short form McGill Pain Questionnaire, Roland-Morris disability, Short form-36 (SF-36), Beck Depression (BDI) and anxiety inventory (BAI) and the Pittsburgh Sleep Quality Index (PSQI) were used in the study group, and SF-36, BDI, BAI and PSQI were used in the control group. The relationships between QoL, depression, anxiety, and sleep disorders were examined in the two groups. Results: Two groups did not differ in terms of demographic characteristics (P>0.05). In the sub-scales of SF-36, except vitality and mental health, a significant difference was detected between the study and control groups (P<0.001). The depression, anxiety and PSQI scores did not differ between the two groups (P>0.05). Conclusion: CLBP affects QoL negatively. This should be considered when managing CLBP.

Brazilian Portuguese version of the Headache Disability Inventory: Cross-cultural adaptation, validity, and reliability.

The Headache Disability Inventory assesses the dimensions of headache disability, but it is not available in Brazilian Portuguese yet. We aimed to translate the Headache Disability Inventory into Brazilian Portuguese and analyze its measurement properties. Consecutive patients with headaches diagnosed by expert neurologists as per the International Classification of Headache Disorders were included. For the cross-cultural adaptation, 30 individuals answered the translated Headache Disability Inventory version. The internal consistency was evaluated, and the structural validity was assessed through exploratory factor analysis. For the construct validity assessment, 132 individuals answered the Headache Disability Inventory-Brazil, 12-item Short Form Survey (SF-12), and Headache Impact Test (HIT-6). After 1-3 weeks, 67 individuals again answered the Headache Disability Inventory-Brazil for the reliability assessment. The Pearson's correlation test, the intraclass correlation coefficient and the standard error of measurement were analyzed. The pre-stage version of the questionnaire was considered as the final version. The Headache Disability Inventory-Brazil had an internal consistency of 0.84 and consisted of a functional, emotional and social participation domain (factor loads > 0.3). The internal consistency ranged from 0.81 to 0.93 for each of the three domains. For the construct validity, the Headache Disability Inventory-Brazil presented moderate correlation with the SF-12 (r = -0.70, p < 0.05) and with the HIT-6 (r = 0.67, p ≤ 0.05). Its test-retest reliability was considered to be excellent (intraclass correlation coefficient = 0.95) and the standard error of measurement was 2.26 points. The Headache Disability Inventory-Brazil was successfully translated and culturally adapted to the Brazilian population. It can be used for the impact assessment of primary and secondary headaches with validity and reliability equivalent to its original version.

Pain Experience, Physical Function, Pain Coping, and Catastrophizing in Children With Sickle Cell Disease Who Had Normal and Abnormal Sensory Patterns

ContextSickle cell disease (SCD) is associated with recurrent pain that could lead to abnormal sensory patterns (ASPs). ObjectivesThe purpose of this study is to compare children with SCD who had normal sensory patterns (NSPs) and ASPs in pain experience, physical function, pain coping, and pain catastrophizing. MethodsChildren with quantitative sensory testing data were selected from a larger study that examined pain and symptoms in children with SCD. Comparisons were made between children with NSP (n = 35; 13.9 ± 1.9 years) and ASP (n = 13; 12.8 ± 1.9 years). Children completed the Adolescent Pediatric Pain Tool, Functional Disability Inventory, Pain Coping Questionnaire, and Pain Catastrophizing Scale. ResultsNo significant differences were found in pain intensity (2.9 ± 3.0 vs. 2.6 ± 2.8 on 0–10 Visual Analogue Scale) between the NSP and ASP, respectively. The most common marked pain sites for both groups were lower extremities (22.9%), head and neck (20.8%), and upper extremities (20.8%). Functional Disability Inventory scores were significantly worse in ASP (38.5%) compared with NSP (11.4%). The ASP group had significantly worse scores in emotion-focused pain coping subscales. ConclusionChildren with SCD with ASP had worse functional disability, were expressing more affective pain quality, and had emotion-focused pain coping compared with NSP. Future studies are needed to examine the effectiveness of physical activities on the physical function as well as psychosocial interventions such as peer support and creative arts expression to minimize development of ASP in children with SCD.