Objectives: This study investigated the effects of outpatient rehabilitation therapy (RT) on the functional performance of children from Eastern Taiwan with rare or genetic diseases. Materials and ...Methods: This retrospective observational cohort study included 73 children from Eastern Taiwan who were affected with rare or genetic diseases, with an average age of 8.57 ± 5.33 years (47 boys and 26 girls). Each child received the goal-directed therapy known as outpatient RT, which was delivered by a multidisciplinary team of specialists. To assess the effectiveness of RT, the WeeFIM-C questionnaire data were collected and analyzed. Results: After receiving outpatient RT, most of the children only required low-to-moderate assistance with self-care tasks (4.36 ± 2.38), and they could perform mobility-related activities under supervision or independently (5.70 ± 2.29). Moreover, most only required minimal assistance with tasks related to cognitive functioning and tended to complete such tasks under supervision (4.97 ± 2.05). The functional performance was significantly different among three studied groups, in terms of self-care (F2, 68 = 5.42, P < 0.007), mobility (F2, 68 = 8.17, P < 0.001), cognitive functioning (F2, 68 = 3.31, P < 0.042), and overall (F2, 68 = 6.44, P < 0.003) functional performance. Conclusion: The results of this study demonstrated that the functional status was different among three studied groups in terms of self-care, mobility, and cognitive functioning after receiving outpatient RT.
Acute flaccid myelitis (AFM) is a "polio-like" neurologic disorder of the spinal cord gray matter characterized by asymmetric, flaccid limb weakness of rapid onset following prodromal viral illness. ...It has affected the pediatric population of the United States since 2014, but there is a paucity of literature describing the post-acute comprehensive rehabilitation management that maximizes functional outcomes for patients. This case series attempts to mitigate this by describing the complete acute and post-acute care course of six children diagnosed with AFM in Western Pennsylvania. It is critical that pediatric rehabilitation medicine providers be knowledgeable about the complex medical and rehabilitation management for patients with AFM.
Prader–Willi syndrome (PWS) is a genetic disorder with obesity, developmental delay, short stature, and behavioral abnormalities. The study aimed to assess the functional independence in children ...with PWS. The Functional Independence Measure for Children (WeeFIM) was used to evaluate 81 children with PWS (44 boys and 37 girls) with a median age of 11 years 1 month (range 2 years 8 months to 20 years 2 months) were recruited between January 2013 and December 2016. The mean total WeeFIM score was 103.8 (maximum 126). Sixty‐five patients (80%) had deletion type PWS, 16 (20.0%) had nondeletion type. The scores were 103.6 ± 18.5 for deletion and 104.8 ± 18.3 for nondeletion type (p = .405), 104.8 ± 19.3 in boys and 102.6 ± 17.3 in girls (p = .293). The mean self‐care, mobility, and cognition scores were 47 (maximum 56), 33 (maximum 35), and 24 (maximum 35), respectively. All total scores and 18 subscores in the three functional domains were positively correlated with age (p < .05). Most children required assistance in problem‐solving, comprehension, and expression. The WeeFIM identified the strengths and limitations of children with PWS and confirmed that support and supervision were needed in cognitive and self‐care tasks.
Objectives: To investigate the performance of the Physical Abilities and Mobility Scale (PAMS) in children receiving inpatient rehabilitation for paralysis related to spinal cord disease and injury ...(SCD/SCI).
Methods: Participants were 146 children with paralysis related to SCD/SCI, aged 2-21, admitted between January 2010 and 2017 for inpatient rehabilitation at a single free-standing academically affiliated pediatric rehabilitation hospital. Retrospective chart review was performed to obtain admission and discharge scores on the PAMS and the functional independence measure for children (WeeFIM®), collected as part of clinical care. Internal consistency was evaluated using Cronbach's alpha. Inter-rater reliability was evaluated through overall agreement, Pearson correlations, and intraclass correlations. Construct validity was examined through exploratory factor analysis. Criterion validity was explored through correlations of PAMS overall and item scores with WeeFIM® total and subscale scores. Sensitivity to change was tested using paired t-tests examining differences between admission and discharge scores for each item and for the total score on the PAMS.
Results: Internal consistency and inter-rater reliability were high (0.94 at admission and 0.95 at discharge). Total PAMS scores are highly correlated with total WeeFIM®, mobility, self-care, and cognitive subscores at admission and discharge. Correlations with the WeeFIM® ranged from low (cognitive) to strong (mobility). Total PAMS score and all individual items increased significantly between admission and discharge.
Conclusions: The PAMS is a useful measure capturing incremental and granular functional motor skills changes occurring during inpatient rehabilitation for children with spinal cord-related paralysis.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Purpose
The Functional Independence Measure for children (WeeFIM) is a user-friendly functional outcomes tool that has been validated across other traditional functional scales. Historically, the ...significant neurologic and functional deficits of intramedullary spinal cord tumors (IMSCTs) have been monitored by coarse or overbearing functional outcomes tools that make it difficult to measure the slow improvement/decline seen in these patients. This study is the first to report WeeFIM outcomes on a series of IMSCTs with emphasis on an aggressive surgical strategy.
Methods
A retrospective review from 2005 to 2014 was performed for nine patients who underwent resective surgery for intramedullary spinal cord tumors with intraoperative ultrasound and neurophysiologic monitoring. WeeFIM scales were assessed at admission and discharge to evaluate changes in severity of disability and need for assistance.
Results
At the time of this submission, 7/9 patients are alive. The mean WeeFIM improvement was 27 points (8–50 points) with a mean WeeFIM efficiency of 2.0 points/day.
Conclusions
The WeeFIM scale is an appropriate and useful scale for measuring postoperative improvements in patients with IMSCTs undergoing aggressive resective surgery. Attention to intraoperative spinal cord monitoring and prevention of spinal column instability may prevent morbidity related to surgery, and functional outcomes do not appear to be compromised by an aggressive surgical approach.
(1) Background: Brain tumor (BT) survivors show difficulties in the acquisition of developmental milestones, related to academic achievement, vocational employment, social relationships, and ...autonomy. The skills underlying adaptive functioning (AF) are usually damaged in BT survivors due to the presence of the brain tumor, treatment-related factors, and other neurological sequelae. In this study, we aimed to explore the contribution of different cognitive factors in children with BT to AF, considering diagnosis-related variables. (2) Methods: Standardized cognitive assessment was undertaken and clinical information was collected from a retrospective cohort of 78 children with a BT, aged between 6 and 18 year old at the time of the assessment. Regression models were computed to investigate the influence of the selected variables on daily functional skills as measured by the Functional Independence Measure for Children (WeeFIM). (3) Results: The analyses showed that the main explanatory variables are processing speed and time since diagnosis. Other clinical variables, such as age at diagnosis and hydrocephalus, differentially influence functional skills according to distinct domains (i.e., self-care, mobility, and cognition). (4) Conclusions: The main explanatory variables of AF that emerged in our models point to a potential target of improving AF management in pediatric BT survivors.
Robot-assisted gait training (RAGT) can complement conventional therapies in children with cerebral palsy. We investigated changes in walking-related outcomes between children with different Gross ...Motor Function Classification System (GMFCS) levels and the dose-response relationship.
Data from 67 children (3.9-19.9 years) with GMFCS levels II-IV were evaluated retrospectively. Every child received RAGT with the Lokomat complementing a multidisciplinary rehabilitation program. Changes in various walking-related outcomes were assessed.
Walking-related outcomes did not improve differently between GMFCS level groups. Significant within-group improvements were mainly observed in children with GMFCS level IV. A dose-response relationship was present for children with GMFCS levels III and IV.
Our results indicated that, although children with a GMFCS level IV walked less during an average Lokomat session, they experienced significant improvements in walking-related outcomes. Further, training dose correlated with changes in walking-related outcomes. However, between-group differences in changes in walking-related outcomes were not significant.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
The purpose of the study was to explore whether a developmental test provides enough information to estimate a child's functional independence. The strength of the relationship between developmental ...level and functional independence of different skills was investigated.
The participants were 397 children (age 0-7 years) who were referred to NCCHD for suspected developmental delay. The participants' developmental level was measured with the Kyoto Scale of Psychological Development (KSPD) and their functional independence was assessed through a Japanese version of the WeeFIM II®. To calculate the strengths of the relationship between developmental age (DA) in different domains of the KSPD and WeeFIM II item scores, partial correlation analyses were conducted, controlling for chronological age.
Partial correlation coefficients between the score of each of the 18 WeeFIM II items and each of the three KSPD domain DAs (controlling chronological age) fell in the ranges of r = 0.169-0.581 (Posture-Motor; P-M), r = 0.377-0.627 (Cognitive-Adaptive; C-A), and r = 0.332-0.655 (Language-Social; L-S). When the participants were divided into three age groups, the correlations ranged from -0.095 to 0.552 for the youngest group (mean age = 14.21 months), from 0.283 to 0.653 for the middle group (mean age = 32.98 months), and from 0.345-0.692 for the oldest group (mean age = 57.48 months), depending on the combinations of the WeeFIM II items/developmental domains of the KSPD. The results indicated that for most of the daily living skills, its functional independence was only partially explained by the scores of a developmental test, once chronological age was controlled.
This study showed the limitation of a developmental test as a tool to measure the functional independence of children and the necessity of using an independent tool, such as WeeFIM II, to evaluate the level of required support for each daily living skill.
The aim of this study was to investigate the relationship among functional classification systems, the Manual Ability Classification System (MACS), the Gross Motor Function Classification System ...(GMFCS), and the functional status (WeeFIM) in children with spastic cerebral palsy (CP). One hundred and eighty-five children with spastic CP (101 males, 84 females), 65 (35.1%) diparetic, 60 (32.4%) quadriparetic, and 60 (32.4%) hemiparetic children, ranging from 4 to 15 years of age with a median age of 7 years, were included in the study. The children were classified according to the GMFCS for their motor function and according to the MACS for the functioning of their hands when handling objects in daily activities. The functional status and performance were assessed by using the Functional Independence Measure of Children (WeeFIM). A good correlation between the GMFCS and MACS was found in all children (
r
= 0.735,
p
< 0.01). There was also a correlation between the GMFCS and WeeFIM subscales according to subtypes and all parameters were correlated at the level of
p
< 0.01, the same as the MACS. There was no difference in the MACS scores among the age groups of 4–7, 8–11, and 12–15 years (
p
> 0.05). The use of both the GMFCS and MACS in practice and in research areas will provide an easy, practical, and simple classification of the functional status of children with CP. The adaptation of both of these scales and WeeFIM and using these scales together give the opportunity for a detailed analysis of the functional level of children with spastic CP and reflect the differences between clinical types of CP.
► A prospective cohort study describing functional independence in children with burns. ► 119 Dutch patients (0.5–16 years) were assessed using the WeeFIM® instrument. ► Burns impact children's ...functional independence. ► Six months after injury functional independence is adequate for age in the majority (>90%) of children with burns.
Although the attention for functional outcomes after burn injury has grown over the past decades, little is known about functional independence in performing activities of daily living in children after burn injury. Therefore, in this prospective cohort study functional independence was measured by burn care professionals with the WeeFIM® instrument in 119 pediatric patients with burns (age: 6 months–16 years; 58.8% boys) in the Netherlands. In order to identify whether functional independence was affected, participants’ total scores on the WeeFIM® instrument were compared to American norm values. Of the participants assessed at 2 weeks post burn (n=117), 3 months post burn (n=68) and/or 6 months post burn (n=38), 22, 9 and 9 participants showed affected performance, respectively. Improvements in WeeFIM® total scores for the total study population between 2 weeks and 6 months post burn were significant (Wilcoxon T=2.5; p<.001, effect size=−0.59). Individual improvements were found to be significant for 30.3% of the assessed participants between 2 weeks and 3 months post burn, and for 12.1% between 3 and 6 months post burn. This study is unique in providing data on functional independence for this large and special population. However, a proportion of participants were lost to follow-up and the use of the WeeFIM® instrument in this specific population and setting has its limitations. To conclude, burn injury impacts functional independence in children, yet the vast majority of Dutch pediatric patients with burns returns to functional independence typical for age within 6 months post burn.
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