Relatively little is known about the treatment effectiveness and functional outcomes of pediatric rehabilitation therapies. This study was conducted to gain knowledge of the type and quantity of ...inpatient rehabilitation services provided to children who received acute inpatient rehabilitation and compare functional gains by age and diagnosis.
A retrospective cohort design was used. Records of rehabilitation therapies and functional assessments of 814 pediatric patients who received inpatient rehabilitation during 1996, 1997, and 1998 were collected. The admission and discharge item ratings of the WeeFIM instrument were first transformed into interval-level measures of self-care, mobility, and cognition. Parametric analyses were used to compare functional gains across impairment groups and to examine the relationship between amount of treatment and functional gains.
Occupational therapy and physical therapy were the primary rehabilitation services received by patients across impairment groups (98% and 99%, respectively). A large proportion of children with traumatic brain injuries also received speech therapy (97%) and psychology services (60%). Across domains (self-care, mobility, cognition), the largest gains were made by children who were older than 7 years and had traumatic injuries. Functional gains were significantly related to the amount of discipline-specific treatment received, after controlling for age, impairment, and functional status at admission.
Rehabilitation therapy provision in pediatric inpatient rehabilitation varies greatly depending on children's age and the nature of the impairment. Systematic reporting of type and quantity of rehabilitation therapies along with functional assessments before and after hospitalization would allow researchers to track functional changes and study the determinants of functional improvement.
To determine the effect of botulinum toxin type A (BTX-A) on spasticity and functional development in children with cerebral palsy (CP) in conjunction with a physiotherapy program.
In this ...prospective study, 18 CP patients were evaluated. Multilevel BTX-A injection was applied to children at a dose of 15 U/kg. Children were assessed before and at the 5th and 12th week post-injection using Thomas test, Duncan-Ely test, passive range of motion (pROM) measurement, Distance Between Knee (DBK), Selective Motor Control (SMC) scale, modified Ashworth Scale (MAS) and modified Physician Rating Scale (mPRS). To assess functional improvement, Gross Motor Function Measure (GMFM) and Functional Independence Measure for Children (WeeFIM) were used before and at the 12th week post-injection.
At 5th week post-injection, a statistically significant decrease was determined in spasticity (p < 0.01). Improvement was observed in mPRS and pROM, but not in SMC. At the 12th week post-injection, GMFM (p< 0.001) and WeeFIM improved significantly (p< 0.001). The improvement in pROM and mPRS (p< 0.01) lasted until the 12th week post-injection, but the improvement in MAS (p > 0.05) and in the Tardieu test of hip adductors (p > 0.05) did not last after the 5th week.
BTX-A injection enhances functional and motor abilities in the development process.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Introduction Cerebral palsy (CP) is one of the most common causes of disability in childhood leading to functional limitations. Assessment of the functional limitations is important to determine the ...severity of the disability in CP and to evaluate the benefit of the rehabilitation programme. However, the results of the measurements show variations according to different sociocultural characteristics. The Functional Independence Measure of Children (WeeFIM) had not been studied in Turkish children previously. The aims of this study were to evaluate the functional disability of Turkish children with CP by using WeeFIM and to compare the results with those of healthy counterparts.
Methods A total of 86 children aged 24 months to 120 months were included in the study. Forty‐five children with CP and 41 healthy children representing the controls were evaluated with WeeFIM. Both children with CP and healthy controls were categorized into four groups according to their chronological age. The variations in the WeeFIM subsets scores (self‐care, sphincter control, transfers and locomotion, communication and social cognition) and total WeeFIM scores in children with CP and healthy controls were analysed.
Results The children with CP had lower WeeFIM scores than healthy controls. The sphincter control subset scores of children with CP increased as they grew up. There was no statistically significant difference in all WeeFIM subset scores and the total WeeFIM scores among the four age groups of children with CP.
Conclusion The WeeFIM appears to be a useful instrument for measuring the disability of Turkish children with CP. However, studies with wider series are needed to generalize our results.
Data on functional outcomes after pediatric pelvic fractures are limited to those obtained at hospital discharge. This study assesses functional status at both hospital discharge and at 6 months ...after injury.
A national multicenter prospective study began in February 2002 and is ongoing. Patients completed WeeFIM functional assessments at hospital discharge and at 6-month follow-up as part of this study. This report summarizes preliminary functional assessment results from 20 patients.
Patient data were accrued into 3 domains (self-care, mobility, and cognition), which constitute a total raw rating. Significant improvement at 6 months after injury was evident in self-care, mobility, and total raw ratings. This significance remained when total raw ratings were converted to age-adjusted functional quotients.
This preliminary assessment shows that after pelvic fractures, children improve their functional status at 6 months, returning to near-normal status.
Background: The purpose of this study was to explore the differences in and potential uses of information derived from developmental vs. functional assessment during the acute rehabilitation of very ...young children with acquired brain injury. Both methods of assessment are typically used during hospitalization in order to assist in developing individualized goals and outcome measures. With the trend of shortened hospital stays, effective assessment for determining optimal treatment goals and outcomes becomes increasingly important. The results from a developmental and a functional assessment obtained on 23 inpatient children below 6 years of age who had experienced either an acquired brain injury or encephalitis were compared. The data was collected through a retrospective chart review spanning 4 years.
Methods and outcome measures: Each child received a cognitive and a language test using either the Early Learning Accomplishment Profile (E-LAP) or the Learning Accomplishment Profile Diagnostic (LAP-D) for the developmental assessment measure. The Functional Independence Measure for Children (WeeFIM) was used as a functional assessment. Summary statistics and frequencies were calculated for variables including age and diagnosis. Partial Pearson correlations and 95% confidence intervals were calculated between the functional and developmental assessments, adjusting for the amount of time between administrations of the two exams. Pearson correlations were computed between length of hospital stay and performance on the developmental and functional quotients.
Results: Moderate, statistically significant Pearson partial correlations were found between the E-LAP/LAP-D cognitive quotient and the WeeFIM cognitive quotient (r = 0.42, 95% CI (0, 0.72)), the E-LAP/LAP-D language quotient and the WeeFIM cognitive quotient (r = 0.55, 95% CI (0.17, 0.79)) and the E-LAP/LAP-D cognitive quotient and the WeeFIM total quotient (r = 0.50, 95% CI (0.10, 0.76)). An inverse correlation was found between the length of stay and the E-LAP/LAP-D cognitive quotient (r = −0.68, 95% CI (−0.86, −0.34)) as well as the E-LAP/LAP-D language quotient (r = −0.61, 95% CI (−0.83, −0.23)).
Conclusions: The moderate but limited correlations between developmental and functional assessments may be attributed to differences in the two forms of assessment including the test items, their administration and scoring. While both forms of assessment were thought to be useful for developing individualized treatment goals and measuring outcomes, there were advantages and disadvantages to each.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
46.
Use of chopsticks in Chinese children Wong, Sheila; Chan, Kingsley; Wong, Virginia ...
Child : care, health & development,
March 2002, Letnik:
28, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Objective There has been no study on the developmental stage of acquiring the skill of using chopsticks, which is a common eating tool of the Orientals. We aimed to obtain a developmental profile for ...achieving the skills of chopsticks manipulation in Chinese children and to assess the correlation between chopsticks manipulation and the level of achieving independence in ‘eating’ item in the Functional Independence Measure of children (WeeFIM). We also studied the relationship between demographic and environmental factors and the age of achieving chopstick manipulation.
Methods Direct interview with the mothers of 445 non‐disabled children who were randomly selected from the community. A chopsticks score (CS) of 1 was defined as children who could use chopsticks to finish more than half the meal, and a CS of 0 as failure to do so.
Results The mean age of achieving a CS of 1 was 4.6 years. At 6.7 years, all these children achieved this skill. There was a significant relationship between age of achieving the skills of chopsticks and the level of attaining independence in ‘WeeFIM eating’ score. (P < 0.001) However, there was no correlation of age of achieving CS of 1 with sex, social class or the presence of a domestic helper.
Conclusion Most non‐disabled Chinese children can achieve the visual motor skill of using chopsticks at 4.6 years. There was also a correlation with the age of achieving independence in the WeeFIM eating score. The skill of using chopsticks should be added as part of the tools, apart from spoons or forks, for scoring WeeFIM in Chinese children.
Purpose: To study the use of Functional Independence Measure for children (WeeFIM) in monitoring neurorehabilitation programmes for children with neurodevelopmental disabilities. Methods: The ...neurorehabilitation team of the Children's Habilitation Institute of the Duchess of Kent Children's Hospital were trained to administer the WeeFIM. The WeeFIM was administered to children with various neurodevelopmental impairment groups undergoing neurorehabilitation programmes in the hospital inpatient and also outpatient setting. The WeeFIM was scored on hospital admission and prior to discharge for those admitted for the rehabilitation programme. The WeeFIM profile was then monitored half yearly. The pilot study used WeeFIM in assessing 104 children with different medical disease categories. The disease or impairment categories included very low birth weight babies (n=44), cerebral palsy (n=19), Down's syndrome (n=9), pervasive developmental disorder (n=11), Duchenne Muscular Dystrophy (n=18), and others (n=3). Results: WeeFim could be used to measure disability, monitor progress, enhance communication, measure the effective ness of treatment, and document the benefits of rehabilitation intervention. It also served as a networking of neurorehabilitation programmes for different impairment categories in a continuum of settings: hospital, community, school and at home. WeeFIM was found to be a quick and reliable functional assessment instrument in this rehabilitation facility. Conclusions: WeeFIM could be used to assist neurorehabilitation clinicians in the selection of short term realistic goals and long term rehabilitation strategies for children with various neurodevelopmental disabilities, and the subsequent progress of the children could be monitored objectively.
Purpose: 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. Methods: 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. Results: 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. Conclusions: 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 this study was to identify changes in the activities of daily living (ADL) of 93 children with cerebral palsy during inpatient rehabilitation by using the Functional Independence ...Measure for Children (WeeFIMTM). The mean age at admission was 6.3 yr. The mean length of inpatient stay was 149 days. The children included 35 girls and 58 boys. The WeeFIM was measured at admission and discharge. The mean total WeeFIM score and the mean motor and cognition subscores increased from 60.9 to 70.9, 40.4 to 48.0 and 20.6 to 29.2 respectively with significant differences. Similarly, the respective item scores increased with a significant difference. It was also elucidated that these improvements of the ADL during inpatient rehabilitation were superior to the natural improvements, using the Proportional Change Index (PCI) which compares the child's rate of development before intervention of therapy to that after intervention. We examined the associations the total, motor, cognition and respective item scores with five independent variables (length of inpatient stay, age at admission, GMFCS (Gross Motor Function Classification System) at admission, sex, and operation). The motor subscore increase was dependent on the length of inpatient stay. The cognition subscore increased according to GMFCS level.
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