Require Patient Compliance Research Articles

Treatment with TOPS for short femoral stump

Treatment with transcutaneous osseointegrated prosthesis systems (TOPS) for short femoral amputation stumps aims to restore independent walking ability after proximal femoral amputation by direct bone-guided prosthesis anchorage. This cannot be safely achieved with conventional socket prostheses due to the mechanically inadequate socket contact surface. Treatment of patients with short transfemoral stumps who cannot be mobilized sufficiently with conventional socket prostheses. Known contraindications as with standard TOPS fittings. Special features already arise during positioning with correct orthograde adjustment of the short femoral stump under X‑ray fluoroscopy. The prosthesis is anchored using the specified technique, taking into account the central insertion of the femoral neck screw with the aid of the aiming arm under X‑ray fluoroscopy in two planes. In most cases, step1 and2treatment is primarily possible, i.e., insertion of the double-cone adapter and passing through the skin by the intraoperatively created stoma (skin opening on the amputation stump). This requires patient compliance and hygiene with twice daily showering of the stoma and dressing. After the exoprosthesis components have been fitted by the patient's orthopedic technician, weight-bearing with the new adapted prosthesis is possible. Atotal of 14TOPS procedures were performed at Rostock University Medical Center between 2022 and 2024, including 9patients with short femoral stumps. Aprolonged rehabilitation phase compared to patients with "standard" TOPS restorations is not recognizable, but asignificant gain in quality of life is evident.

Novel Surface Topographic Assessment of Lung Volume and Pulmonary Function Tests in Idiopathic Scoliosis: A Preliminary Study.

Severe spinal deformity results in restrictive pulmonary disease from thoracic distortions and lung-volume limitations. Though spirometry and body plethysmography are widely accepted tests for pulmonary function tests (PFTs), they are time-consuming and require patient compliance. This study investigates whether surface topographic [surface topography (ST)] measurements of body volume difference (BVD) and torso volume difference between maximum inhale and exhale correlate to values determined on PFTs. This study included patients with idiopathic scoliosis and thoracic/thoracolumbar curves ≥40 degrees. Patients received ST scans, clinical examinations, and EOS biplanar radiographs on the same day. PFTs were performed within 3 months of ST/radiographic analysis. Univariate linear regression analysis was used to examine relationships between BVD, PFT values, and mean curves. Sixteen patients (14.6 ± 2.2 y, 69% females) with idiopathic scoliosis and mean thoracic/thoracolumbar curves of 62 degrees ± 15˚ degrees (45 degrees to 93 degrees) were assessed. BVD displayed statistically high-positive positive correlations with forced vital capacity ( R = 0.863, P < 0.0001), forced expiratory volume in 1 second ( R = 0.870, P < 0.001), vital capacity ( R = 0.802, P < 0.0001), and TLC ( R = 0.831, P < 0.0001. Torso volume difference showed similarly high positive correlations to forced vital capacity, forced expiratory volume in 1 second, vital capacity, and TLC, but not residual volume. No correlations emerged between the mean thoracic/thoracolumbar curve and BVD or PFT values. This study strongly endorses further investigation into ST scanning as an alternative to traditional PFTs for assessing pulmonary volumes. The noncontact and noninvasive nature of ST scanning presents a valuable alternative method for analyzing thoracic volume, particularly beneficial for patients unable to cooperate with standard PFTs. Level II-prognostic.

Orthodontic Relapse after Fixed or Removable Retention Devices: A Systematic Review

Retention constitutes a fundamental phase of orthodontic treatment, of which the patient must be made aware from the outset. Retention, which can be fixed or movable, has the task of maintaining over time and stabilising the results obtained during treatment. This study assessed the efficacy of using removable restraints versus fixed solutions for maintaining long-term outcomes. A comprehensive search across major databases—Pubmed, Web of Science, Scopus—used ‘relapse’ and ‘orthodontic’ as keywords to gather articles on relapse discussions. The primary focus was relapsed cases in post-fixed orthodontic therapy. Both fixed and removable retainer systems prove effective in preserving orthodontic achievements. While fixed devices require regular wire integrity checks, mobile devices require patient compliance, proper usage, and a recommended wear time. Studies indicate that fixed retainers are generally successful, with relapse rates varying based on the retainer type. Full-time use of removable devices surpasses night-only wear. Vacuum-formed and Hawley retainers offer similar effectiveness. Fixed retainers excel in long-term alignment stability, whereas removable ones have higher failure rates yet remain beneficial.

ANALISIS BIAYA DAN INDEKS UTILITAS YANG DIUKUR MENGGUNAKAN SF-6D PADA PASIEN GAGAL GINJAL KRONIS DENGAN HEMODIALISIS DI RSUD ADJI BATARA AGUNG DEWA SAKTI KUTAI KARTANEGARA

Hemodialysis (HD) patients with chronic kidney disease takes a long time and requires patient compliance. This will give the patient a psychological stressor which will then affect the quality of life. Apart from having an effect on quality of life, therapy hemodialysis also used a high cost, especially if the patient has complications. The purpose of this study was to determine the amount of hemodialysis costs, utility index, and the effect of complications on costs and utility index in hemodialysis patients. This study was a cross-sectional analytical research with the perspective of hospital. The research subjects were outpatient CKD who underwent hemodialysis at the HD Unit of Adji Batara Agung Dewa Sakti Hospital in September-Oktober 2020. Data were obtained use the SF-6D instrument, medical records, and financial financing. Data analysis used independent sample t-test and Kruskal-Wallis.The results showed that the average real cost of therapy in hemodialysis patients for a month was Rp. 12,014,488±0, while the real cost per hemodialysis episode is Rp. 1,316,722±273,989. The mean value of patient utility index as measured by the SF-6D was 0.717±0.143. The statistical test results show a significant value of 0.049 &lt;0.05 on the utility index, which means that there is a relationship between complications on the utility index and a significant value of 0.125&gt; 0.05 on costs, which means that there is no relationship between complications and costs in CKD patients with hemodialysis

THE NONCOMPLIANT PATIENT WITH THE BROKEN STENT

THE NONCOMPLIANT PATIENT WITH THE BROKEN STENT

SIMULTANEOUS RETRACTION AND INTRUSION OF MAXILLARY ANTERIOR TEETH: A REVIEW

Simultaneous retraction and intrusion of anterior segment are required in the patients who have deep overbite along with ared incisors. During the retraction of anterior segment, there is some bite deepening, which also requires intrusion. So there are various conventional methods which are used from many last years to achieve simultaneous retraction and intrusion, but these methods require patient compliance and have some undesirable side effects like anchorage loss. With the advent in technology, Orthodontic mini-implants (OMI) broaden the scope of orthodontic therapy by allowing treatment to proceed with little or no anchoring loss and require less patient participation than traditional procedures. Mini implants can be used to offer good anchorage for anterior tooth retraction and intrusion, and they can be inserted in almost any desirable site. There are various conventional methods as well as mini implant supported methods with which simultaneous retraction and intrusion can be achieved. This review article presents the various methods for achieving simultaneous retraction and intrusion of anterior segment either with conventional techniques or with the help of mini implants.

Calcium-phosphate homeostasis in secondary progressive multiple sclerosis patients during mitoxantrone therapy

ABSTRACT Objectives To assess calcium-phosphate parameters in SPMS patients treated with mitoxantrone (MTX). Methods Thirty eight SPMS patients eligible for MTX therapy in the Department of Neurology in Zabrze, Poland were enrolled in a prospective study from March 2016 to November 2019. The parameters of serum calcium-phosphate metabolism and the neurological status according to the Expanded Disability Status Scale (EDSS) were assessed. In patients with hypovitaminosis D, vitamin D (VitD) supplementation was introduced (4000 IU/day for 1 month and later 2000 IU /day). Results Most patients were women [57.89%]. The mean age [years] was 56.11 (±7.74). The median time from diagnosis to inclusion day (ID) was 7.50 [4.00–14.00] [years]. Due to VitD supplementation, an increase in serum VitD was observed during the study. 84.21% of patients presented with hypovitaminosis D before MTX treatment compared to 47.37% after treatment. Before MTX therapy, none of the patients underwent surgical repair of the fracture compared to 42.11% of patients after MTX treatment (p < 0.01). Discussion Deficiency of VitD was observed at the baseline in most SPMS patients eligible for MTX therapy. Due to adverse reactions to MTX treatment, this therapy requires patient compliance, cautious drug administration and monitoring during the therapy.

Plausibility of patient-centred care in high-intensity methadone treatment: reflections of providers and patients

BackgroundPatients with opioid use disorder (OUD) often have complex health care needs. Methadone is one of the medications for opioid use disorder (MOUD) used in the management of OUDs. Highly restrictive methadone treatment—which requires patient compliance with many rules of care—often results in low retention, especially if there is inadequate support from healthcare providers (HCPs). Nevertheless, HCPs should strive to offer patient-centred care (PCC) as it is deemed the gold standard to care. Such an approach can encourage patients to be actively involved in their care, ultimately increasing retention and yielding positive treatment outcomes.MethodsIn this secondary analysis, we aimed to explore how HCPs were applying the principles of PCC when caring for patients with OUD in a highly restrictive, biomedical and paternalistic setting. We applied Mead and Bower’s PCC framework in the secondary analysis of 40 in-depth, semi-structured interviews with both HCPs and patients.ResultsWe present how PCC's concepts of; (a) biopsychosocial perspective; (b) patient as a person; (c) sharing power and responsibility; (d) therapeutic alliance and (e) doctor as a person—are applied in a methadone treatment program. We identified both opportunities and barriers to providing PCC in these settings.ConclusionIn a highly restrictive methadone treatment program, full implementation of PCC is not possible. However, implementation of some aspects of PCC are possible to improve patient empowerment and engagement with care, possibly leading to increase in retention and better treatment outcomes.

Cost variation analysis of different brands of antifungal drugs available in India

Background: Most fungal infections require long-term therapy significantly increasing cost of therapy. High medical care cost should be of concern for policy makers and service providers. Hence, a study was planned to analyze cost ratio and percentage (%) cost variations of antifungal drugs available in India. Aim and Objectives: The aim of the study was to evaluate cost of different brands of antifungal drugs available in India and to analyze cost ratio and cost variations of different brands of antifungal drugs. Materials and Methods: Maximum and minimum price of each drug was noted in Indian Rupee, using “CIMS” April to July 2021; “Drug Today” April to July 2021 Vol - 1 and 2; and “Indian Drug Review” 2021. Percentage cost variation and cost ratio for individual drugs were compared. Results: Among oral antifungal drugs, Terbinafine 250 mg has highest cost ratio 89.071 and 8807.1% price variation. Griseofulvin 250 mg has lowest cost ratio 1.169 and 16.98% price variation. Among parenteral antifungal drugs, Amphotericin B 50 mg has highest cost ratio 17.088 and 1608.83% price variation. Caspofungin (50 and 70 mg) has least cost ratio and % price variation. Among single drug topical preparations, Clotrimazole 1% powder formulation has highest cost ratio and % price variation 22.48 and 2144.89%, respectively. Ketoconazole 2% solution formulation has least cost ratio and % price variation 1.233 and 23.33%, respectively. Conclusions: Long-term antifungal therapy requires patient compliance and thereby increased adherence to treatment which is achieved by switching to cost-effective regimen and by making Pharmacoeconomics an integral part of Undergraduate and Postgraduate Curriculum.

Ten years of miniscrew use in a U.S. orthodontic residency program

Orthodontic miniscrews have become popular not only because they can provide an absolute form of anchorage, but also because they can reduce the required patient compliance when compared with traditional orthodontic anchorage. The objective of this study was to examine success rates of miniscrews placed by orthodontic residents and to evaluate which factors may affect insertion outcomes. The sample consisted of 109 consecutive miniscrews placed in 60 patients (27 males and 33 females). Miniscrews were placed at 4 different insertion sites (anterior palate [n=31], palatal alveolar process [n=25], maxillary buccal alveolar process [n=15], and mandibular buccal alveolar process [n=38]). Analysis of variance tests were used to evaluate the influence of insertion sites and anchorage type (direct vs indirect) on the success rate. The overall success rate for miniscrews was 72.5%. The success rate was 83.9% in the anterior palate, 76% in the palatal alveolar process, 60% in the maxillary buccal alveolar process, and 65.8% in the mandibular buccal alveolar process. The success rate was significantly higher in indirect anchorage (84.2%) compared with direct anchorage (58.8%). Palatal miniscrews were more successful than buccal miniscrews. Indirect anchorage mechanics had a higher success rate than direct anchorage mechanics.

Sealants and White Spot Lesions in Orthodontics: A Review

This literature review aims to update the evidence for prevention of white spot lesion (WSL) using orthodontic sealants among patients with fixed orthodontic appliances. As a major issue among orthodontists, prolonged treatment duration increases the risk of plaque development around orthodontic brackets and bands. In consequence, this can lead to heightened risk for caries development and higher possibility of WSL development around fixed orthodontic brackets. Increased prevalence of WSLs generally occurs during orthodontic treatment. This review explored various products of orthodontic sealants used to prevent WSL. Orthodontic sealants do not require patient compliance and thus will further lessen the burden among orthodontists as well as support enamel surface for a long period of time during treatment. Certain factors, however, are considered important in the efficacy of these sealants, such as antibacterial activity, color stability, resistance to acid and brush abrasion, and their effect on shear bond strength (SBS). The review showed that the use of orthodontic sealants in preventing WSLs during and after fixed orthodontic treatment is significantly effective. However, the bioactive glass is deemed more effective against WSL development due to its ability to immediately repair enamel surface, low cytotoxicity, and high biocompatibility. Moreover, clinical studies on bioactive glass are still needed to determine its acceptability among patients with fixed orthodontic appliance. Development of WSL around the orthodontic brackets during treatment is a difficult task among orthodontists. As such, this review explored various strategies to effectively combat WSL development for good oral health and esthetics during orthodontic treatment.

An efficient and noncompliant method for forced eruption with microimplants that is bracket free, and its long-term stability

Background and OverviewThe authors describe a bracket-free forced eruption technique using microimplants that does not require patient compliance and report relapse after long-term observation. Case DescriptionIn 2 patients who needed to undergo forced eruption of carious and fractured roots of anterior teeth, the authors erupted the roots forcefully with a cantilever wire and microimplants as an anchorage. The microimplants provided sufficient anchorage by approximately 6 to 7 millimeters for forced eruption of the roots. The authors observed minor relapse of approximately 0.5 mm in both cases at the 1.5-year follow-up. Conclusions and Practical ImplicationsThe forced eruption method using microimplants and a sectional wire is simple and does not require patient compliance, but it does provide precise tooth movement. Clinicians can consider using long retention, overcorrection, and delayed cementation of prosthetic crowns to manage relapse.

Endoscopic Bariatric Therapies: Intragastric Balloons, Tissue Apposition, and Aspiration Therapy.

Endoscopic bariatric therapies (EBTs) have been identified as a group of procedures that can bridge the treatment gap between bariatric surgical procedures and non-procedural treatments such as pharmacotherapy and lifestyle therapy. We will review the recent progress that has been made in this important area in the past several years. Traditional intragastric balloons (IGB) that are both placed and removed endoscopically have been the fixture of IGB therapy. They have been shown to be safe and effective, when kept in place for 6months. Newer IGBs, both currently FDA approved and those in clinical trials, have unique features. The Obalon gastric balloon system is gas filled and does not require endoscopy for placement. The Elipse balloon system that is in clinical trials neither requires endoscopy for placement nor removal. The Spatz3 balloon is in clinical trials and can be adjusted endoscopically by adding or subtracting volume to titrate balloon volume to symptoms and weight loss. In addition to IGBs, several other promising therapies have continued to evolve. Endoscopic sleeve gastroplasty (ESG) is a promising gastric restriction technique that has efficacy and durability. POSE is a gastric plication technique that is available in Europe and in clinical trials in the USA. Aspiration therapy is a novel approach to weight loss that requires patient compliance but can be very effective and used long term. EBTs are an evolving effective and safe approach for patients who do not qualify for or do not want bariatric surgery. There are multiple EBTs currently FDA approved as well as prospective endoscopic therapies in clinical trials that appear promising.

Results of Scarf Osteotomy Without Implant Fixation in the Treatment of Hallux Valgus.

The main goal of the study was to evaluate the costs, clinical and radiologic results, and complications of hallux valgus surgery using scarf osteotomy, depending on the type of fixation (with or without screws). We evaluated 169 patients who underwent scarf osteotomy between January 2013 and August 2016. The patients were separated into 3 groups depending on the type of stabilization: A, 2 screws (50 patients); B, modified with 1 screw (55 patients); C, modified without implant (64 patients). We assessed duration of surgery, additional procedures, pre- and postoperative hallux valgus angle (HVA) and intermetatarsal angle (IMA) on anteroposterior and lateral foot weightbearing radiographs, the American Orthopaedic Foot & Ankle Society (AOFAS) hallux-metatarsophalangeal-interphalangeal scale for the clinical assessment preoperatively and at the 12-month follow-up. We recorded all the complications and compared the costs between the groups. Both the average HVA (A: from 33.7 to 12.6 degrees, B: 35.0 to 13.2 degrees, C: 34.7 to 12.4 degrees) and IMA (A: from 14.9 to 7.5 degrees, B: 15.2 to 6.9 degrees, C: 15.5 to 7.8 degrees) decreased in all groups without significant intergroup differences. The average AOFAS score improved in all the groups (A: from 40 to 88 points, B: 38 to 89 points, C: 42 to 91 points). A similar complication rate was observed (A: 9%, B: 10%, C: 11%). In group C, we noted a shorter time of surgery, and the procedure was the most cost-effective. Scarf osteotomy without implant stabilization was faster and cost-effective and gave comparable results. It was technically demanding and required patient compliance. Level III, retrospective comparative study.

P629 Impact of surgical treatment on quality of life in Crohn’s disease: Short-and longer-term follow-up

Symptoms of active CD have a substantial impact on health-related quality of life (HRQoL). Even in the absence of active disease, CD patients report worse HRQoL. Achievement of disease remission, whether by medical therapies or surgery, is associated with an improvement of quality of life (QoL). Medical management not rarely is associated to side effects, hospitalisation, long treatment period and requires patient compliance, with impact on QoL. Surgery is often required, in the form of ileo-colic resection (ICR), open or laparoscopic. Aim of the study was to assess changes of QoL following ICR, and to identify specific factors, patient and disease-related, impacting on QoL in the short- and longer term. We analysed data from a prospective database of patients undergoing ICR from 01/2009 to 08/2017. Data included duration of CD, disease features, demographics, habits and comorbidities. We assessed medical therapies before surgery (steroids/biologics), open and laparoscopic technique. Quality of life (QoL) was analysed with the Cleveland Global Quality of Life (CGQL) Score, recording the three items: Current Quality of Life (CQoL), Current Quality of Health (CQoH), Current Energy Level (CEL). In addition, the Overall Quality of Happiness (OQH) was recorded and patients answered the question if they would have surgery again and/or they recommend the treatment to others. CGQL Scores and OQH were compared according to timing of follow-up, surgical technique, medical treatment, and demographics. One hundred and thirteen patients were considered for analysis. Demographics and pre-operative data were similar among the groups. Fifty-two (46%) patients had laparoscopy and 61 (54%) laparotomy. Both at 30 days and 6 months after surgery we observed a significant increase of CGQL (p < 0.0001). Incremental values were also recorder at 1 and 3 years with a minor increase. Significant improvement was observed in all the three items composing the CGQL (p < 0.0001). This was also confirmed from the OQH. 88% of patients would undergo surgery again or recommend it. Laparoscopy was associated with better CGQL scores. Steroids before surgery showed a significant minor improvement in CGQL. Positive factors for QoL improvements were young age, female gender, penetrating disease. QoL of patients with CD is lower than normal ranges. Medical treatments often are not able to keep symptoms under control, and surgery is required. Surgical treatment is able to remove the diseased bowel, and is associated with a clear improvement of all the items related with QoL. Laparoscopy seems to guarantee greater results.

Oral and Dental Health in Head and Neck Cancer Patients.

A diagnosis of head and neck cancer (HNC) is typically followed by therapy that is associated with immediate and long-lasting toxic consequences. HNC patients' oral health needs may be complex and are best addressed in multidisciplinary collaborative teams including surgical, medical, and radiation oncologists, dental providers, nutrition, speech/swallow specialists, and physical therapists. Oral health maintenance also requires patient compliance and caregiver support. The role of dental providers begins prior to cancer diagnosis and continues through survivorship. This includes oral screening and health maintenance, management of common oral complications such as mucositis, pain, infection, salivary dysfunction, altered taste, and dental decay, as well as complex issues that include soft tissue fibrosis, osteoradionecrosis of the jaw, dysphagia, and recurrent/new primary malignancies. As the number of potential therapeutic interventions for HNC increase, so do the spectrum of side effects affecting the oral cavity, oropharynx, and dentition. Specific approaches to oral care must be tailored to the idiosyncrasies of the patient and his/her therapy and condition. Oral and dental care is impacted by the patient's oral and dental status prior to cancer therapy, as well as the specific cancer type, location, stage, and its treatment and potential comorbid conditions. Communication between the dental professional and the oncology team is required for appropriate therapy and is best accomplished by integrated healthcare teams.

Clinician Corner- A Simple and Efficient Modified Goshgarian Arch ("T" Arch) Appliance for Correcting Single Tooth Scissor Bite.

Scissor bite is a rare form of malocclusion that is often accompanied by varying degrees of facial asymmetry. Correction and treatment of scissor bite in posterior teeth is a challenging job for an orthodontist. There are several treatment options for correction of scissor bite in posterior teeth but some have their own ill-effects on the dentition thus contributing further to the problem and some require patient compliance which compromises the outcome of the treatment. Therefore to overcome these drawbacks we have designed a new appliance to correct the molar scissor bite.

A randomized clinical trial on the sealing of occlusal carious lesions: 3-4-year results.

This randomized clinical trial aimed to assess the efficacy of sealing occlusal carious lesions in permanent teeth. The sample consisted of 54 occlusal carious lesions in permanent molars and premolars of 49 patients aged 8-43 years (median: 19 years). The inclusion criteria comprised the presence of a cavity with no access allowing biofilm control. The maximum depth of the lesion was the middle third of the dentin thickness, as assessed by bitewing radiography. The teeth were randomly assigned to sealant treatment (n = 28) or restorative treatment (n = 26). Clinical and radiographic examinations were performed after 1 year and after 3-4 years. The outcomes depended on the clinical performance of the sealant/restoration and the control of caries progression observed radiographically. Survival analysis was performed to assess success rates. Over the 3-4 years of monitoring, 2 sealants were totally lost, 1 needed repair, and 1 showed caries progression, totaling 4 failures in the sealant group. In the restoration group, 1 failure was observed (in need of repair). The success rates were 76% and 94% in the sealant and the restoration groups, respectively (p > 0.05). The sealing of occlusal carious lesions in permanent teeth succeeded in controlling caries over a 3-4-year period. However, sealed carious lesions require patient compliance in attending regular follow-ups to control the occurrence of clinical failures of the sealants.

Facteurs prédictifs associés au statut de perdu de vue au cours du traitement antituberculeux à Brazzaville

The abandonment of TB treatment has consequences both individual by increasing the risk of drug resistance and collective seeding entourage. The aim of this study is to determine the risk factors to be lost sight of during TB treatment. He acted in a prospective cohort study of patients with microbiologically confirmed tuberculosis, beginning TB treatment and followed for six months. The comparative study between 75 patients lost (PL) and 108 no-patients lost (NPL). The presence of a large distance between the home center [OR=3.73 (1.21-11.05), P=0.022], to alcohol poisoning [OR=3.80 (3.80-11.3), P=0.031], the number of compressed high (depending on the patient) [OR=7.64 (1.96-29.8), P=0.007], stigma [OR=7.85 (1.87-33), P=0.004] were related to PL status. For against the implementation of the directly observed treatment by the community [OR=0.2 (0.03-0.92), P=0.04], be [OR=0.18 (0.05-0.63), P=0.07] were linked to reduced risk of being lost. Reducing the rate of PL requires patient compliance with good attitudes in post-education and ease of access to TB centers.

Cortical Activation Through Passive-Motion Functional MRI.

Functional brain mapping is an important technique for neurosurgical planning, particularly for patients with tumors or epilepsy; however, mapping has traditionally involved invasive techniques. Existing noninvasive techniques require patient compliance and may not be suitable for young children. We performed a retrospective review of our experience with passive-motion functional MR imaging in anesthetized patients to determine the diagnostic yield of this technique. A retrospective review of patients undergoing passive-motion fMRI under general anesthesia at a single institution over a 2.5-year period was performed. Clinical records were evaluated to determine the indication for fMRI, the ability to detect cortical activation, and, if present, the location of cortical activation. We identified 62 studies in 56 patients in this time period. The most common indication for fMRI was epilepsy/seizures. Passive-motion fMRI identified upper-extremity cortical activation in 105 of 119 (88%) limbs evaluated, of which 90 (86%) activations were in an orthotopic location. Lower-extremity cortical activation was identified in 86 of 118 (73%) limbs evaluated, of which 73 (85%) activations were in an orthotopic location. Passive-motion fMRI was successful in identifying cortical activation in most of the patients. This tool can be implemented easily and can aid in surgical planning for children with tumors or candidates for epilepsy surgery, particularly those who may be too young to comply with existing noninvasive functional measures.