Journal of Pediatric Rehabilitation Medicine - Volume 14, issue 1

Article Type: Editorial

DOI: 10.3233/PRM-219005

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 1-3, 2021

Authors: Afzal, Sarah Yasmeen

Article Type: Obituary

DOI: 10.3233/PRM-219003

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 5-6, 2021

Authors: Verkerk, Gijs J.Q. | van der Molen-Meulmeester, Lisanne | Alsem, Mattijs W.

Article Type: Research Article

Abstract: PURPOSE: Although the Canadian Occupational Performance Measure (COPM) is used with children, it is unclear how they and their parents experience this. This study aims to investigate the opinions of children and their parents about the COPM when it is used with children. METHODS: Semi-structured interviews were performed with 23 children varying in age between 8 and 18 years. The transcripts of the interviews were analysed using MAXQDA software to discover overarching themes. Parents’ responses to an eight-item multiple-choice questionnaire were analysed using SPSS software. RESULTS: Five themes extracted from the interviews with …the children show: My way of doing the COPM; The COPM shows my own problems and wishes for change; The COPM is important for identifying the support I need; The influence of my parents and my therapist; and The COPM is suitable for me. The children experienced the COPM as a valuable tool for determining and measuring the impact of an intervention. The parents experienced the COPM as suitable for their child and judged that the child’s scores were useful for showing the outcome of an intervention. CONCLUSION: Both the children and their parents valued the COPM as an outcome measure for intervention. Show more

Keywords: Validity, COPM, children, patient reported outcome measurement, PROM for children, feasibility

DOI: 10.3233/PRM-190604

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 7-17, 2021

Authors: Mohammadi, Mohammad Reza | Hojjat, Seyed Kaveh | Ahmadi, Nastaran | Alavi, Seyed Salman | Hooshyari, Zahra | Khaleghi, Ali | Ahmadi, Ameneh | Hesari, Mahsa Jafarzadeh | Shakiba, Alia | Amiri, Shahrokh | Molavi, Parviz | Arman, Soroor | Mohammadzadeh, Soleiman | Kousha, Maryam | Golbon, Atieh | Hosseini, Seyed Hamzeh | Delpisheh, Ali | Mojahed, Azizollah | ArmaniKian, Alireza | Sarraf, Nasrin | Safavi, Parvin | Moharari, Fatemeh | Dastjerdi, Reza | Talepasand, Siavash | Jaberghaderi, Nasrin | Ostovar, Rahim | Salmanian, Maryam | Zarafshan, Hadi | Nazari, Ali | Haghbin, Ali | Khalili, Mina Norozi

Article Type: Research Article

Abstract: PURPOSE: Currently, there is a paucity of studies on the prevalence of Elimination Disorders among Iranian children and adolescents. Due to the ongoing need to monitor the health status of these children and adolescents, the present study aims to investigate the prevalence of Elimination Disorders and comorbid disorders in Iranian children and adolescents. METHODS: In this cross-sectional study, 29,781 children and adolescents age 6 to 18 years old were selected and studied from all the provinces in Iran. The sampling was carried out by employing a multistage cluster sampling method, and several clinical psychologists using semi-structured …interviews collected the data. Furthermore, clinical psychologists collected demographic information (including information about gender, age, place of residence, education level, and parental education level). The collected data were analyzed using SPSS version 20. RESULTS: Generally, the prevalence of Elimination Disorders was found to be 5.4% covering both enuresis (p = 5.4, 95% CI = 5.1–5.7) and encopresis (p = 0.13, 95% CI = 0.09–0.2). The total prevalence of comorbid disorders was 38%, and among the comorbid disorders, Attention Deficit Hyperactivity Disorder (ADHD) (p = 11, 95% CI = 9.5–12.7) and Separation Anxiety (p = 10.6, 95% CI = 9.1–12.2) were the most prevalent. CONCLUSION: The prevalence of Elimination Disorders in Iranian children and adolescents is moderate compared to similar studies elsewhere. As for comorbid disorders, ADHD and Separation Anxiety were found to be the most prevalent disorders. Since Elimination Disorders coexist with psychiatric disorders in children, further studies of these comorbidities may give better insight into the treatment and prognosis of Elimination Disorders. Show more

Keywords: Prevalence, Elimination Disorders, enuresis, encopresis, comorbid psychiatric disorders

DOI: 10.3233/PRM-190628

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 19-29, 2021

Authors: Ghazwani, Yahya | Patay, Zoltan | Sadighi, Zsila S. | Sparrow, Jessica | Upadhyaya, Santhosh | Boop, Frederick | Gajjar, Amar | Qaddoumi, Ibrahim

Article Type: Case Report

Abstract: PURPOSE: To describe clinical data, rehabilitation services, and outcomes of children with handedness switching as their presenting symptom before low-grade glioma (LGG) diagnosis. METHODS: A retrospective chart review was performed for five patients (four female and four white) with LGG and confirmed handedness switching before LGG diagnosis. RESULTS: All children were less than 8 years at diagnosis, and two patients were less than 3 years. All children were initially right-handed and experienced loss of motor function, ranging from weakness to paresis, in their dominant hand. The median time from switching handedness to diagnosis …was 1 month (range: 0.75–60 months). Rehabilitation was offered for three patients, and motor function deficits in the initial dominant hand were resolved in two of the total cohort. At long-term follow-up, hand dominance returned to the initial hand in three patients. CONCLUSIONS: Handedness switching should be acknowledged as a potential sign of LGG in children, and early long-term rehabilitation services should be offered for these children. Show more

Keywords: Brain tumors, children, low-grade glioma, plasticity

DOI: 10.3233/PRM-190637

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 31-36, 2021

Authors: Levin, Jared | Siddiqi, Asad Raiz | Kim, Heakyung

Article Type: Case Report

Abstract: INTRODUCTION: Acute Flaccid Myelitis (AFM) is a recently recognized pediatric condition characterized by flaccid paralysis that can cause lifelong deficits. Adhesive Capsulitis (AC) is a chronic condition that causes loss of passive range of motion in the shoulder due to joint contracture. CASE REPORT: This is a case report of a 15-year-old male who suffered from shoulder pain with progressive loss of passive range of motion after AFM, diagnosed with AC based on exam and radiology. After failing conservative management, the patient was successfully treated with ultrasound guided corticosteroid injection. DISCUSSION/CONCLUSION: AC is …uncommonly reported in pediatric patients. However, secondary adhesive capsulitis is frequently associated with disorders of shoulder immobility in adults. This case contributes to the body of literature regarding pediatric frozen shoulder, highlights the successful use of ultrasound guided injections for management, and suggests a relationship between AFM and AC which may be beneficial for pediatric physiatrists in treating patients with shoulder pain or immobility related to this condition. Show more

Keywords: Adhesive capsulitis, frozen shoulder syndrome, acute flaccid myelitis, ultrasound, hydrolilation, hydrodilitation, capsular distention

DOI: 10.3233/PRM-190640

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 37-40, 2021

Authors: Potvin-Bélanger, Alex | Freeman, Andrew | Vincent, Claude

Article Type: Research Article

Abstract: PURPOSE: Hippotherapy is used by rehabilitation professionals to assist children with various diagnoses. Despite parents’ pivotal decision-making role regarding their children’s life and treatment, little is known about their perceptions of hippotherapy’s utility. This pilot study explored parents’ opinions regarding hippotherapy’s impact on their child’s life habits, as guided by the Disability Creation Process model. METHODS: A survey was conducted in September/October 2017 with the parents of children with varied diagnoses receiving hippotherapy in Quebec. The survey asked parents to priority rank life habit categories and then grade hippotherapy’s service characteristics and impact on children’s life …habits. Descriptive analysis and proportion tests were used to analyze the data. RESULTS: The parents of 26 children completed the survey. These children were on average seven years old with multiple diagnoses (e.g., autism spectra, developmental delay). A positive impact was perceived for 10 of 12 life habit categories, with a statistically significant association found with Mobility and Interpersonal relationships. It was not possible to calculate the association between the profession involved and hippotherapy effects due to the small sample size. CONCLUSION: This investigation provides some promising results regarding the benefits of hippotherapy for children’s life habits. Show more

Keywords: Life habits, social participation, hippotherapy, pediatric, survey

DOI: 10.3233/PRM-190641

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 41-49, 2021

Authors: de Godoy, Ana Carolina Pereira | de Godoy, Lívia Maria Pereira | de Godoy, Jose Maria Pereira | de Fatima Guerreiro Godoy, Maria

Article Type: Research Article

Abstract: PURPOSE: Lymphedema is a specific type of edema with a chronic, progressive nature. The aim of the present study is to report clinical findings related to edema and its location in children with primary lymphedema. METHODS: Sixty-eight children with congenital primary lymphedema were evaluated at the Godoy Clinic in São Jose do Rio Preto, Brazil, between 2014 and 2017. A retrospective, cross-sectional study was conducted involving the analysis of clinical data on the location of edema in 68 children with congenital primary lymphedema. We evaluated the charts of all children with this condition in the period …analyzed, recording the affected limbs and conditions associated with lymphedema. RESULTS: Sixty-eight children, 37 girls (54.41%) and 31 boys (45.58%), were evaluated. CONCLUSION: We found that congenital primary lymphedema predominantly affects the lower limbs and is more prevalent in girls than boys. Show more

Keywords: Clinical aspects, congenital primary lymphedema, limbs, arm

DOI: 10.3233/PRM-190642

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 51-53, 2021

Authors: Jain, Kritika | Solomon, John | Ramachandran, Selvam

Article Type: Research Article

Abstract: PURPOSE: The purpose of this study was to assess the knowledge, attitude and practices of health care professionals in pediatric settings on developmental surveillance and screening programs and also to identify the barriers and facilitators during its implementation. METHODS: The data were collected from health professionals involved in pediatric developmental care, practicing in various hospitals, clinics and nursing homes in a suburban city on west coast of Southern India. The study involved cross-sectional exploratory sequential mixed method design which included a quantitative questionnaire survey on health professionals (n = 52) followed …by qualitative face-to-face interviews with chosen respondents who participated in the survey (n = 8). The survey data are reported with descriptive statistics, and interview data are subjected to inductive content analysis for deriving codes, categories and themes. RESULTS: The study results indicate that health professionals involved in pediatric developmental care in Indian health care settings have fair knowledge and a favorable attitude towards the use of developmental surveillance and screening. Furthermore, the facilitators and barriers of implementation have been reported. The strategies outlined by interview respondents to improve adherence to implementation have been discussed. CONCLUSIONS: The practice of developmental surveillance and screening is limited despite favorable knowledge and attitude among health professionals in pediatric developmental care and is dependent on health care organizational setup. Show more

Keywords: Developmental surveillance, developmental screening, developmental delay, professional practice, interprofessional, primary child care

DOI: 10.3233/PRM-190649

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 55-63, 2021

Authors: Asante, Afua | Pastorius, Daniel | Sukhov, Renat

Article Type: Case Report

Abstract: An aneurysmal bone cyst (ABC) is a benign lesion often found in long bones. Almost one third of ABCs are secondary to primary tumors. When found in the spine, ABCs can cause insidious back pain and, in rare cases, neurological deficits. This case will discuss an adolescent female who acquired a non-traumatic spinal cord injury (NTSCI) as a result of complications from an aneurysmal bone cyst. Treatment consisted of surgical removal of the cyst, laminectomy, corpectomy, and fusion of the thoracic spine. Following surgical intervention, the child spent several weeks in an acute inpatient pediatric rehabilitation facility. Goal oriented outpatient services facilitated further recovery …and led to near complete resolution of symptoms associated with non-traumatic spinal cord injury. Contemporary and clinically oriented child and family interventions are essential in successful rehabilitation of children with NTSCI as a result of ABCs. Show more

Keywords: Aneurysmal bone cyst (ABC), non-traumatic spinal cord injury (NTSCI), acute inpatient rehabilitation, pediatrics

DOI: 10.3233/PRM-190672

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 65-68, 2021

Authors: Yang, David | Robertson, Helen Lee | Condliffe, Elizabeth G. | Carter, Melissa T. | Dewan, Tammie | Gnanakumar, Vithya

Article Type: Review Article

Abstract: PURPOSE: To perform a scoping review of the evidence for therapeutic interventions to manage functional impairments associated with Rett syndrome (RTT) throughout the lifespan. METHODS: MEDLINE, EMBASE, PsycINFO, CENTRAL, CINAHL, Scopus and Index to Chiropractic Literature were searched systematically up to December 2019. Two investigators independently reviewed all search results and extracted those that met the inclusion criteria. Human and animal model studies pertaining to therapies that increase functional ability or treat RTT-associated symptoms in all age groups were included. Relevant studies were grouped into intervention categories and rated using the Oxford Centre of Evidence Based …Medicine Levels of Evidence. Demographics of participants, interventions, and outcomes were summarized. RESULTS: Ninety-one articles representing 88 studies met the inclusion criteria, of which 80 were human clinical studies and eight were studies using animal models. Study designs were primarily case series and only six studies involved participants above the age of 40. CONCLUSION: A small number of rigorously studied rehabilitation interventions have been published. Published studies aim to address a wide variety of functional impairments. Research regarding implementation of therapies for older patients with RTT is lacking and requires further exploration. Show more

Keywords: Rett syndrome, rehabilitation, review

DOI: 10.3233/PRM-200683

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 69-96, 2021

Authors: Rodrigues, Margarida | Beça, Gustavo | Almeida, Ana | Natário, Inês | Vilabril, Filipa | Pereira, Margarida | Barreto, José | Dias, Leonor | Gandarez, Fátima

Article Type: Case Report

Abstract: INTRODUCTION: Spinal cord infarction (SCI) in children is rare and difficult to diagnose. Fibrocartilaginous embolism (FCE) is probably the underlying cause for some unexplained cases of spinal cord infarcts. Abrupt back pain followed by a progressive syndrome of myelopathy appears to be the typical presentation, with a close temporal relationship between the onset of symptoms and preceding minor trauma. Supportive care and rehabilitation are essential in the treatment of children with SCI. CASE REPORT: A previously healthy 12-year-old girl who practiced acrobatic gymnastics was admitted to a rehabilitation centre 14 days after being diagnosed with an …acute anterior SCI with no identified cause. Sensory modality of pin prick and light touch were impaired, with the former more significantly affected. She was not able to run and had difficulty on monopodal standing and performing motor sequencing. Additionally, she mentioned ineffective cough along with flatus incontinence and normal bladder function. After a 4-week multidisciplinary rehabilitation program her neurologic deficits improved. DISCUSSION: Given the patient’s age and clinical presentation, a literature review led to the consideration of FCE as the most likely definitive diagnosis. It should be recognized as a cause of SCI especially in those involved in sport activities, even if previous trauma is denied. Show more

Keywords: Pediatric, spinal cord infarction, fibrocartilaginous embolism, gymnastics, sport, rehabilitation

DOI: 10.3233/PRM-200684

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 97-101, 2021

Authors: Huurneman, Kim A.M. | Lankhorst, Ilse M.F. | Baars, Erwin C.T. | van Wijk, Iris | van der Sluis, Corry K.

Article Type: Research Article

Abstract: PURPOSE: Young adults with transversal upper limb reduction deficiency experience limitations regarding education, employment and obtaining a driver’s license. Contribution of rehabilitation care within these domains has been reported to be inadequate. This study evaluates the needs and suggestions of participants in rehabilitation care. METHODS: Two online focus groups with young adults and parents met during 4 consecutive days. Health care professionals joined a face-to-face focus group. Data analysis was based on framework analysis. RESULTS: The rehabilitation team was mainly consulted for problems with residual limb or for prostheses. Young adults and their …parents were mostly unaware of resources regarding education, job selection or obtaining a driver’s license. Professionals stated that these subjects were addressed during periodic appointments. Young adults didn’t always attend these appointments due to limited perceived benefit. To improve rehabilitation care, participants suggested methods for providing relevant information, facilitating peer contact and offering dedicated training programs to practice work-related tasks, prepare for job interviews or enhance self-confidence. CONCLUSION: Periodic appointments do not fulfil needs of young adults with transversal upper limb reduction deficiency. To improve care, rehabilitation teams should offer age-relevant information, share peer stories, and create dedicated training programs. Show more

Keywords: Upper extremity, reduction deficiency, transition, young adult, rehabilitation care

DOI: 10.3233/PRM-200690

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 103-112, 2021

Authors: Kempert, Heidi

Article Type: Case Report

Abstract: This case study documents a 13-year-old female who presented to our intensive inpatient chronic pain rehabilitation program with complex regional pain syndrome (CRPS) of her left leg, which was significantly interfering with her normal daily functioning. She participated in a full day of traditional interdisciplinary therapies, including physical and occupational therapy for 3 hours daily. As assistive equipment was altered or weaned her physical mobility, balance, and tremors worsened and/or increased. As she began advancing her legs more independently (versus requiring physical assist), she demonstrated more variable functional strength and stability, inconsistent balance reactions, and a more unsteady gait pattern. …The team was treating her according to her incoming CRPS diagnosis; however, as treatment progressed, her physical and psychological presentation seemed more aligned with diagnostic criteria of functional neurologic symptom disorder (FND). Staff then treated according to the FND diagnosis resulting in successful long-term outcomes. The clinical impact from this case study includes highlighting the commonalities between CPRS and FND clinically, discussing treatment suggestions depending on the diagnosis, and emphasizing key components of family/patient education. Show more

Keywords: Complex regional pain syndrome, functional neurologic symptom disorder, physical therapy, occupational therapy, case study

DOI: 10.3233/PRM-200700

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 113-120, 2021

Authors: Khaliq, Fareea | Santia, Christina | Erlandson, Erika

Article Type: Case Report

Abstract: In clinical practice, intrathecal baclofen (ITB) therapy is used to control spasticity. After initial placement of the ITB pump, clinicians incrementally increase the dose until effectiveness in alleviating spasms and spasticity is optimized. However, this case describes a 4-year-old male with Leigh syndrome who developed a paradoxical worsening of spasticity and pain with incremental increase of his ITB pump. In this rare genetic disease with a poor prognosis, an ITB pump was trialed and implanted and titrated upwards with initial improvement. However, his spasticity and pain then began to worsen with each dosage increase. Subsequently, his symptoms improved significantly when …the dose was weaned. This is the first case that describes this paradoxical reaction in a pediatric population and discusses recommendations about how clinicians should safely titrate the pump for patient care. Show more

Keywords: Intrathecal baclofen, spasticity, paradoxical reaction, Leigh syndrome

DOI: 10.3233/PRM-200709

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 121-125, 2021

Authors: Kurt, Merve | Şimşek, Tülay Tarsuslu

Article Type: Research Article

Abstract: PURPOSE: Assessing motivation and motivation-related factors will contribute to a better understanding of motivation and the development of optimal rehabilitation conditions. The purpose of this study was to determine the motivation level and investigate the relationship of motivation level with socio-demographic characteristics (i.e., age, gender, comorbidities), functional level, and family satisfaction with rehabilitation centers in children with disabilities. METHODS: Sixty-two children with disabilities were included in the study, and the socio-demographic characteristics were recorded. Children were assessed by the Pediatric Motivation Scale (PMOT) and the Pediatric Functional Independence Measure (WeeFIM). Also, parents were asked to complete …a questionnaire titled, “A patient satisfaction instrument for outpatient physical therapy clinics.” RESULTS: The mean age of the children was 12.16 ± 3.19 years. Total PMOT and WeeFIM scores were found to be 93.71 ± 9.66 and 108.23 ± 22.14, respectively. There was a positive correlation between children’s PMOT score and the satisfaction score of their families that was statistically significant (r = 0.602, p < 0.05). CONCLUSION: The level of family satisfaction with rehabilitation centers was found to be positively correlated with the motivation level of children. Improving family satisfaction with rehabilitation centers, potentially through modifying the physical conditions of rehabilitation centers and focusing on the interest of the family, may increase the motivation level of children, and thus may improve rehabilitation outcomes. Show more

Keywords: Motivation, disability, rehabilitation, satisfaction, functional level

DOI: 10.3233/PRM-200711

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 127-132, 2021

Authors: Gilbert, Courtney | Sauer, Michelle | Cheng, JenFu

Article Type: Case Report

Abstract: Lesch-Nyhan syndrome is a genetic metabolic disorder often involving dystonia and self-mutilating behavior. This case report describes a 13-year-old boy with Lesch-Nyhan syndrome and self-mutilating behavior who received botulinum toxin injections to his bilateral masseter muscles after failing multiple other treatments. Following injections, the patient had reduction in self-biting, along with improvements in speech, mastication and feeding observed in speech therapy. Botulinum toxin injections to the masseters may help to improve oromotor function and reduce self-mutilating behaviors in children with Lesch-Nyhan syndrome who have failed more conservative treatments, providing opportunity for improved functional status and patient safety. Further investigation is …indicated to establish optimal dosing. Additionally, the mechanism for the reduction of self-mutilating behavior is unclear and justifies additional investigation. Show more

Keywords: Lesch-Nyhan, botulinum, masseter, self-mutilation

DOI: 10.3233/PRM-200729

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 133-136, 2021

Article Type: Correction

DOI: 10.3233/PRM-219001

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 137-, 2021

Article Type: Other

DOI: 10.3233/PRM-219002

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 139-148, 2021

Article Type: Other

DOI: 10.3233/PRM-219004

Citation: Journal of Pediatric Rehabilitation Medicine, vol. 14, no. 1, pp. 149-150, 2021