Stability In Children Research Articles

Islam, Adat, and State: Examining the Phenomenon of Child Custody After Divorce in Padang Lawas Regency

This research is motivated by the phenomenon of childcare by fathers after divorce in Padang Lawas County. This phenomenon raises the interest of researchers to further examine child custody by fathers after divorce. The research method used is field research with a qualitative approach. Researchers collected primary data through interviews with traditional leaders and fathers caring for their children after divorce. The data obtained was then analyzed using descriptive analysis techniques, which involved collecting data through interviews and documentation and systematic data processing to describe and interpret existing phenomena. The results show that although customs in Padang Lawas County give custody to the father, it is essential to consider the provisions of the compilation of Islamic law and the broader principles of Islamic law. Child custody should focus on the best interests of the child, ensuring their physical, emotional, and mental development. Both parents have equal rights unless there are compelling reasons to the contrary, and they must work together to maintain the child's stability. Children have the right to adequate education and healthcare, as well as to maintain a good relationship with both parents, even if only one has primary custody.

Exploratory Investigation of Head Stability in Children with Cerebral Palsy and Typically Developing Children during a Targeted Stepping Task

Children with cerebral palsy (CP) exhibit head instability during simple overground walking, which may comprise sensory input and reduce stepping accuracy. Investigations of head stability during more challenging tasks, where fall risk may be increased, are limited. This study explored differences in head stability between ambulatory children with hemiplegic CP (N = 9) and diplegia (N = 9) (GMFCS I and II) and typically developing (TD) children (N = 8) during a targeted stepping task. All children completed five trials stepping into two successive rectangular floor-based targets whilst walking along an 8 m walkway. Three-dimensional motion capture enabled calculation of head stability and foot placement within and before each target. A two-way mixed-design ANOVA compared differences between all groups and target approach. Children with diplegic CP showed greater sagittal, frontal, and resultant head-to-laboratory and head-to-trunk head instability compared to children with hemiplegic CP and TD children. Anteroposterior foot placement error was significantly greater in children with hemiplegic CP (8.5 ± 5.0 cm) compared to TD children (3.8 ± 1.5 cm). Group differences in head instability were not consistent with group differences in foot placement error. To better understand how head instability might affect fall risk in children with CP, more challenging environments should be tested in future.

Postural Stability in Children with Cerebral Palsy.

Background: A lack of postural control is one of the key problems in children with cerebral palsy (CP). The goals of the present study were to assess static postural stability in children with mild CP using a force platform compared to that of typically developing peers and to identify differences in static stability between children with hemiplegic and diplegic CP. Methods: This study included 45 children with hemiplegic CP and 45 children with well-functioning diplegic CP (Gross Motor Function Classification System; GMFCS scores between I and II) who were patients of local paediatric rehabilitation centres. The testing procedure included two interrelated parts: (1) the analysis of the body weight distribution and (2) the posturometric test (the centre of pressure; CoP measurements) using the force platform. Results: The results of the present study show that children with CP, compared to their TD peers, demonstrated significantly higher values for all of the analysed indexes of postural stability. The obtained results indicate differences in disorders of static postural stability between children with hemiplegic and diplegic CP. Compared to their TD peers, children with hemiplegic CP showed greater body weight asymmetry between the affected and unaffected sides of the body and greater CoP sway in the medial-lateral direction. In contrast, children with diplegic CP exhibited greater CoP displacements in the anterior-posterior direction. Conclusions: The findings of the present study show that (1) children with CP have increased static postural instability compared to their TD peers and (2) children with diplegic CP exhibit weaker mediolateral stability in standing, whereas children with hemiplegic CP show reduced anterior-posterior stability.

Assessing dynamic stability in children with idiopathic toe walking in overground walking

Assessing dynamic stability in children with idiopathic toe walking in overground walking

The effectiveness of home-based video-game balance-training on gait stability in children with cerebral palsy

The effectiveness of home-based video-game balance-training on gait stability in children with cerebral palsy

Whole-body vibration versus gravity force stimulation on postural stability in children with Down syndrome: A randomized controlled trial

Purpose. To compare how functional walking ability and postural stability are affected in children with DS by whole-body vibration and gravity force stimulation. Methods. This study enrolled sixty DS children from both sexes into three groups at random. A structured physical therapy plan was given to the control and both study groups. Whole-body vibration (WBV) and gravity force stimulation (GFS) were given to the study groups (I) and (II) respectively. Postural stability indices (overall, mediolateral, and anteroposterior) and functional walking capacity were assessed by the Biodex balance system (BBS) and six-minute walk test (6MWT) respectively. The intervention session was conducted thrice/week for 12 consecutive weeks. Results. All stability indices at stability levels 8 and 5 significantly decreased after-intervention compared to before-intervention, but the 6MWT significantly increased in all three groups. All stability indices at stability levels 8 and 5 showed a significant decrease after-intervention, and the 6MWT in all three groups significantly increased in favor of study groups (WBV) and (GFS). However, there were no significant differences in all stability indices at stability levels 8 and 5 and in 6MWT between study groups (WBV) and (GFS) after-intervention. Conclusion. Whole-body vibration and gravity force stimulation both had a similar effect on postural stability and functional walking capacity among children who have Down syndrome.

Effect of Foot Posture on Limits of Stability in Children With Spastic Diplegic Cerebral Palsy.

Cerebral palsy (CP) is a neurological condition that affects musculoskeletal system causing altered balance control, which is governed by constant adjustments by muscular activity and joint positioning. Since the foot is the platform upon which we stand and balance, it is important to study and characterize foot posture abnormalities in CP to better understand their possible effect on multidirectional limits of stability (MDLS) in standing. Our aim was to find relation between foot posture and MDLS in diplegic children. Thirty diplegics (13 pes-planus and 17 pes-cavus) between the age of 6 to 14, gross motor function classification system (GMFCS) levels I and II, whose parents consented were included in this study. Diplegics unable to stand unsupported for < 2 minutes, undergone lower-limb surgeries in 6 months, having visual impairments were excluded. Foot posture was assessed with arch index, MDLS were measured by GEAMASTER stabilometer. There was significant positive correlation between foot posture and limits of stability. Diplegic children having pes-planus have better MDLS as compared with pes-cavus.

Comparison of Single Session Auditory Versus Visual Feedback on Performance and Postural Balance in Hemiplegic Children With Cerebral Palsy.

Cerebral palsy (CP) is a pediatric disorder characterized by a motor impairment resulting from a permanent, non-progressive lesion in the brain. Cerebral palsy is marked by movement and postural control impairments, which greatly affect body structure, function, daily activities, and participation. To compare the single-session auditory versus visual feedback on performance and postural balance in children with hemiplegic cerebral palsy. The study was a crossover clinical trialinvolving a group of 25 patients diagnosed with CP hemiplegia, aged between 6 and 12 years, including both genders. Each patient underwent conventional balance therapy followed by either auditory feedback or visual feedback intervention. After a 48-hour wash-out period, they received conventional balance therapy again before undergoing the alternative intervention initially assigned. The Modified Ashworth scale (MAS), pediatric balance scale (PBS), timed one-leg stance, time up and go test (TUG), and center of pressure (CoP) displacements were assessed as the outcome measures before and after the interventions. Based on the one-leg stand test, TUG, and CoP displacement outcome measures results, both interventions improved balance time, speed of movement, and postural stability in children with hemiplegic spastic cerebral palsy (P < 0.05). Moreover, after a single session of the intervention, the visual feedback group demonstrated a significantly greater improvement in the TUG test, one-leg stand test, and CoP displacement compared to the auditory group (P < 0.05). The results of the study suggest that combining auditory or visual feedback with conventional balance therapy is effective in treating children with hemiplegic spastic cerebral palsy; furthermore, the utilization of visual feedback would be more effective. Further research is needed to determine the long-term effects of visual and auditory feedback on the assessed outcome measures.

TRLS-15. “TAZNI”: A PHASE I/II COMBINATION TRIAL OF TAZEMETOSTAT WITH NIVOLUMAB AND IPILIMUMAB FOR CHILDREN WITH INI1-NEGATIVE OR SMARCA4-DEFICIENT TUMORS (NCT05407441)

Abstract BACKGROUND Recent pediatric trials with EZH2 inhibitor tazemetostat monotherapy have demonstrated efficacy and disease stabilization in children with relapsed INI1/SMARCA4-deficient tumors: overall response rate (ORR) 14% in all patients (dose expansion cohort), and 24%, 33% and 22% response rates in ATRT, chordoma and epithelioid sarcoma, respectively (NCT02601937); and prolonged disease stabilization &amp;gt;6 months (NCT03213665). Leveraging the role of EZH2 in tumor immunity and increased immune signaling by tazemetostat, we hypothesized that combining this EZH2 inhibitor with checkpoint inhibitors may benefit pediatric patients with these rare cancers. METHODS “TAZNI” is a phase 1/2, multi-center trial of tazemetostat, nivolumab and ipilimumab for children with INI1/ SMARCA4-deficient tumors, administered either after standard upfront therapy or in the relapsed setting. All patients will receive standard nivolumab and ipilimumab doses/dosing schedule, with continuous tazemetostat dosing determined by disease strata: Stratum A- subjects with ATRT; Stratum B- all other (non-ATRT) tumors. Each stratum is subdivided by disease status: A1/B1- refractory disease; A2/B2- relapsed disease; and A3/B3- no evidence of disease. Part 1 of the study consists of two concurrent “rolling six” phase 1 studies to identify the recommended phase 2 dose (RP2D) by disease stratum. Two dose levels are planned, with one dose de-escalation. Part 2 will consist of two phase 2 studies to estimate the ORRs in substrata A1 and A2, in a Simon’s 2-stage design at the RP2D. All other substrata will have descriptive analyses. Patients may receive up to 26 cycles of therapy. Key inclusion/exclusion criteria include INI1 or SMARCA4 loss (by immunohistochemistry or molecular confirmation); age 6 mo - 21 yo; no prior immunotherapy; limited corticosteroid usage; and no concern for hematologic malignancy. This trial is currently ongoing and open to accrual. To date, four patients have enrolled and additional sites across the US are anticipated to open for enrollment (NCT05407441).

Childhood Environmental Instabilities and Their Behavioral Implications: A Machine Learning Approach to Studying Adverse Childhood Experiences.

Adverse childhood experiences (ACEs) include a range of abusive, neglectful, and dysfunctional household behaviors that are strongly associated with long-term health problems, mental health conditions, and societal difficulties. The study aims to uncover significant factors influencing ACEs in children aged 0-17 years and to propose a predictive model that can be used to forecast the likelihood of ACEs in children. Machine learning models are applied to identify and analyze the relationships between several predictors and the occurrence of ACEs. Key performance metrics such as AUC, F1 score, recall, and precision are used to evaluate the predictive strength of different factors on ACEs. Family structures, especially non-traditional forms such as single parenting, and the frequency of relocating to a new address are determined as key predictors of ACEs. The final model, a neural network, achieved an AUC of 0.788, a precision score of 0.683, and a recall of 0.707, indicating its effectiveness in accurately identifying ACE cases. The model's ROC and PR curves showed a high true positive rate for detecting children with two or more ACEs while also pointing to difficulties in classifying single ACE instances accurately. Furthermore, our analysis revealed the intricate relationship between the frequency of relocation and other predictive factors. The findings highlight the importance of familial and residential stability in children's lives, with substantial implications for child welfare policies and interventions. The study emphasizes the need for targeted educational and healthcare support to promote the well-being and resilience of at-risk children.

Factors Associated With Stability for Children in Family Foster Care: A Study of Case Files in Six Municipalities in Sweden

ABSTRACTStability is vital for the development, health and relationships of children in family foster care. Instability can lead to social and school issues, low self‐esteem and diminished trust in caregivers. This article examines the risk and protective factors for stability for these children. Data, drawn from case files in six municipalities (n = 116), combine qualitative and quantitative analyses for a comprehensive understanding. Twenty children from each municipality were selected, with 10 in stable placements (lived in one family foster home for over a year) and 10 in unstable placements (lived in at least two different family foster homes). Quantitative results highlight the importance of factors like familiar placements, a child's age at the time of placement, behavioural challenges and the number of children in the foster home. Stable placements were more common in homes with fewer children (including foster and biological children). Qualitative findings show that in some instances, breakdowns in foster care placements could not be foreseen, often arising from stressful events within the foster family's life after the child's placement. Additionally, we observed that breakdowns sometimes resulted from foster parents lacking the necessary resources to address the child's requirements, particularly in cases involving children with behavioural challenges or extensive needs.

Time to Clinical Stability in Children With Community-Acquired Pneumonia.

Time to clinical stability (TCS) is a commonly used outcome in adults with community-acquired pneumonia (CAP), yet few studies have evaluated TCS in children. Our objective was to determine the association between TCS and disease severity in children with suspected CAP, as well as factors associated with reaching early stability. This is a prospective cohort study of children (aged 3 months to 18 years) hospitalized with suspected CAP. TCS parameters included temperature, heart rate, respiratory rate, and hypoxemia with the use of supplemental oxygen. TCS was defined as time from admission to parameter normalization. The association of TCS with severity and clinical factors associated with earlier TCS were evaluated. Of 571 children, 187 (32.7%) had at least 1 abnormal parameter at discharge, and none had ≥3 abnormal discharge parameters. A greater proportion of infants (90 [93%]) had all 4 parameters stable at discharge compared with 12- to 18-year-old youths (21 [49%]). The median TCS for each parameter was <24 hours. Younger age, absence of vomiting, diffusely decreased breath sounds, and normal capillary refill were associated with earlier TCS. Children who did not reach stability were not more likely to revisit after discharge. A TCS outcome consisting of physiologic variables may be useful for objectively assessing disease recovery and clinical readiness for discharge among children hospitalized with CAP. TCS may decrease length of stay if implemented to guide discharge decisions. Clinicians can consider factors associated with earlier TCS for management decisions.

The Effect of the Direction of Primary Lateral Spinal Curvature on Postural Stability in Children with Scoliosis.

Background: The purpose of the present study was to determine the impact of the direction and magnitude of primary lateral spinal curvature in children with scoliosis. Methods: Ninety-six children diagnosed with scoliosis were included in the study group, and fifty healthy peers were included in the control group. Posturographic measurements of body weight distribution and posturometric tests with eyes open and closed were performed. Results: Based on the symmetry index values, the study group was divided into children with symmetrical and asymmetrical body weight distributions on the basis of support. Then, taking into account the direction of the primary curvature, children with asymmetrical body weight distributions were divided into: (1) children with left-sided or right-sided scoliosis with overload on the same side of the body; and (2) children with left-sided or right-sided scoliosis with overload on the opposite side of the body. According to both posturometric tests, increased CoP spatial displacement was observed in the children with scoliosis compared to the healthy controls. The obtained results showed that increased asymmetry index and Cobb angle values significantly increase medial-lateral postural instability in children with scoliosis. Conclusions: These findings suggest that treatment to restore symmetric body weight distribution may prevent the progression of postural instability; however, this requires confirmation through further investigation.

Effect of Vestibular Rehabilitation on Postural Stability in Children with Visual Impairment

Background and Aim: Postural stability is monitored by a circuitous system, particularly visual perception, vestibular apparatus, and somatosensory organs. The ability to maintain balance is significantly compromised in children with visual impairment and has higher risks of falls than the normal sighted children. Children with visual disability reported delayed motor dexterity such as eye-hand coordination, gross and fine motor control involving struggle in gait procurement and postural control. Vestibular rehabilitation is the relevant therapy to restitute for maintaining postural control in the absence of visual information. This study aimed to find the effect of vestibular rehabilitation on postural stability in children with visual impairment. Methods: A quasi-experimental study was done in pre and post-test type design on 30 boys in the age group of 7-16 years’ children with visual impairment. Vestibular rehabilitation therapy was used as the exercise protocol to improve functional balance and reduction of falls in children with visual impairment for six weeks. Results: Statistical analysis was done between pre-test and post-test readings with SPSS 20 and there is a significant difference between the pre-test and post-test of total score and individual scores of Pediatric Balance Scale (PBS) after the intervention, since (p&lt;0.05). Conclusion: Vestibular rehabilitation therapy improved the capability of postural controlling and reduces the risk of falls to an extent in children with visual impairment. Keywords: Visual impairment; postural stability; vestibular rehabilitation; pediatric balance scale; high risk of falls

Vocabulary size predicts behavioral problems in emotionally reactive children

Internalizing and externalizing behavioral problems place children at an increased risk for low academic achievement and socioemotional maladjustment. Children's language skills and level of emotional reactivity have been shown to predict behavioral problems later in development. Yet, there is an absence of research investigating vocabulary by negative emotionality interactions with respect to the development of behavioral problems during early childhood. Our study sought to fill this gap by examining whether the relation between preschool (age 3) vocabulary size and internalizing/externalizing problems during the early school years (age 6) is moderated by preschool negative emotional reactivity, even after controlling for preschool behavioral problems as well as children's socioeconomic background. Longitudinal data was collected from 256 typically developing children (129 girls, 75% White) and their mothers (64% held a college degree). Linear regression analyses revealed moderate rank-order stability in children's internalizing and externalizing problems across this period of development. Evidence of an interaction effect emerged in both the internalizing and externalizing problems regression models. That is, age 3 vocabulary was negatively related to age 6 behavioral problems, but only among children exhibiting higher levels of negative emotional reactivity. Our results indicate that early vocabulary acquisition may serve as a buffer against adverse behavioral outcomes in children with a natural propensity toward expressing negative emotions. These findings point to a more nuanced picture of the relations between language, emotional reactivity, and behavioral problems in childhood, which are discussed in greater detail to inform future intervention and educational research.

Dynamic gait stability in children with and without Down syndrome during overground walking

BackgroundChallenging children with Down syndrome to walk fast and with external ankle load has demonstrated acute adjustments, such as increased step length and decreased step width, and improved joint stability. However, it is unknown to what extent these task constraints affect gait stability. Assessing dynamic gait stability through margin-of-stability not only quantifies adjustments related to balance control, but also informs safety considerations. MethodsTwenty-four children with and without Down syndrome participated in this study. Subjects walked overground at two speed conditions: self-selected (normal) and as fast as possible (fast); and two ankle load conditions: no load and ankle load of 2% body mass. We assessed margin-of-stability in the anteroposterior and mediolateral directions, separately, at three gait events of toe-off, mid-swing, and heel strike. FindingsChildren with Down syndrome walked with greater mediolateral margin-of-stability than typically developing children. Children with Down syndrome demonstrated less anteroposterior margin-of-stability than typically developing children only before heel-strike at normal speed but increased anteroposterior margin-of-stability at fast speed. The ankle load increased the mediolateral margin-of-stability in both groups but did not impact the anteroposterior margin-of-stability. In addition, children with Down syndrome took shorter and wider steps for more lateral placement of mediolateral margin-of-stability. InterpretationChildren with Down syndrome were capable of adjusting their margin-of-stability for fast walking and ankle-load conditions. However, children with Down syndrome walked with less mediolateral stability and anteroposterior mobility than typically developing children. Children with Down syndrome overcompensate the mediolateral foot placement to recapture their margin-of-stability and maintain gait stability.

Swimming as a means of harmonious development of high school children

This article is devoted to the study of the role of swimming as a harmonious development of children of high school age. In the context of the modern educational process, where the emphasis is on a comprehensive approach to the physical and mental development of children, swimming is an effective means of achieving this goal.&#x0D; The positive influence of swimming on the physical condition of children, in particular on the development of the musculoskeletal system and the cardiovascular system, improving their physical strength, endurance and coordination of movements is considered. Special attention is paid to the positive effect of swimming on the child's body. The impact of swimming on improving mental health has been analyzed, indicating the level of concentration, self-discipline and general emotional stability in children engaged in this sport. Immersion in water can promote relaxation and reduce stress. Swimming can improve mood, reduce anxiety levels and promote a general sense of well-being. It is also important to note the social aspect joint training and teamwork can help to form friendships and increase self-esteem.&#x0D; The conclusions of the article emphasize the importance of including swimming in the system of physical education, as an effective tool for achieving the harmonious development of their physical and mental health.

Gait and sEMG characteristics of lower limbs in children with unilateral spastic cerebral palsy during walking

BackgroundChildren with unilateral spastic cerebral palsy (USCP) have muscle hypertonia, balance, and coordination defects that affect gross motor skills, especially walking. Understanding the gait characteristics and lower limb muscle activation patterns of USCP children can provide an objective and quantitative basis for patient assessment and treatment plan formulation. ObjectiveThis study compared the gait and lower limb muscle activation characteristics of children with USCP and with typical development (TD) during walking. MethodsWe recorded gait and sEMG data of 20 children with USCP, and 20 with typical development. sEMG signals were acquired from the bilateral tibialis anterior (TA) and lateral gastrocnemius muscles (LG) during walking. The root mean square (RMS) value, integrated electromyographic (iEMG) value and co-contraction ratio (CR) were used to evaluate muscle activity. Student's t Test and non-parametric rank sum Test were used to compare the differences between the data groups (significance level of 0.05). ResultsThe stance time, step length, speed, single leg support time ratio, ground impact, pre-swing angle, and muscle strength of the affected side were significantly decreased compared to those of the unaffected side in children with USCP (P < 0.05), while the swing phase, muscle tonus of LG were significantly prolonged (P < 0.05). Compared with TD children, children with USCP exhibited reduced bilateral walking ability, particularly noticeable in their smaller pre-swing angle(P < 0.05), diminished muscle strength of the TA and LG, as well as LG spasms(P < 0.05). SignificanceChildren with USCP have decreased ambulatory gait stability. Step length, pull acceleration, pre-swing angle, and CR can be used as sensitive indicators for gait assessment. Strengthening the TA muscle and reducing ankle spasm may help improve gait and postural stability in children with USCP.

Stability in children’s residential arrangements and distance to nonresident parents in the 10 years after parental separation

Stability in children’s residential arrangements and distance to nonresident parents in the 10 years after parental separation

Postural Control &amp; Stability in Children Diagnosed With a Sport-Related Concussion When Performing Dual-Task Activities

Abstract Date Presented 04/22/2023 OT has a role in assessing sports-related concussion symptoms in children to prevent inappropriate return to play and further injuries that extend the length of recovery. Dual-task assessments have increased sensitivity to detect these deficits. Primary Author and Speaker: Ghazala T. Saleem Additional Authors and Speakers: Jillian Lawton, Gianna Yurchak, Adam T. Sing, Anna Kromer Contributing Authors: Anna Kromer, Jillian Lawton, Adam T. Sing, Pak Hin Tang, Gianna Yurchak, Ghazala T. Saleem