Research in Rehabilitation for Children with Motor Disability

A special issue of Children (ISSN 2227-9067).

Deadline for manuscript submissions: closed (5 December 2023) | Viewed by 8224

Special Issue Editors


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Guest Editor
Faculty of Medicine, University of Modena and Reggio Emilia, Modena, Italy
Interests: rehabilitation; cerebral palsy; neuromuscular diseases; congenital diseases; neuromuscular manifestations; movement disorders

E-Mail Website
Guest Editor
IRCCS Local Health Unit of Reggio, Children Rehabilitation Unit, Reggio Emilia, Italy
Interests: rehabilitation; cerebral palsy; neuromuscular diseases; congenital diseases; neuromuscular manifestations; movement disorders

Special Issue Information

Dear Colleagues,

In the last several years, progress in the fields of neurophysiology, neuroimaging and human molecular genetics have provided insight into the pathogenetic mechanisms of several neuromotor diseases and their secondary disfunctions. Nonetheless, the evidence supporting rehabilitative interventions for children with motor disabilities is lacking. As Peter Rosenbaum (DMCN 2020, doi: 10.1111/dmcn.146732020) evidenced, the traditional framework applied to clinical research in child rehabilitation presents several limitations. Firstly, it often addresses biomedical impairments, which underly the disability, but may not fit the most relevant goal for the patients. Furthermore, evidence-based medicine values randomized controlled trials, which are based on one primary, independent outcome. Conversely, rehabilitation usually includes multifaceted programs, and several interdependent outcomes. Finally, restricted samples, based on the need to select a homogeneous population, and limited follow-up time, to reduce confounders related to growth and spontaneous development, are other limitations when considering rare diseases and developmental ages. In such instances, mixed-methods research designs might be more appropriate, as these enable the assessment of many dimensions of the outcomes of interest. From this perspective, non-randomized controlled studies are relevant to increase and share the knowledge on this topic.

The aim of this Special Issue is to collect the most recent evidence on assessments and rehabilitative interventions for neuromotor disabilities in children. The manuscripts may include submissions of any format (e.g., original article, case report, review or systematic review) that may contribute to this goal. This includes, but is not limited to, manuscripts on cerebral palsy, neuromuscular diseases, ataxic or dyskinetic disorders, and congenital abnormalities. Equally important will be the inclusion of reports or protocols about correlating clinical features and defining functional profiles, which may help in developing targeted approaches in the future.

We look forward to receiving your contributions.

Prof. Dr. Adriano Ferrari
Dr. Silvia Faccioli
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • rehabilitation
  • cerebral palsy
  • neuromuscular diseases
  • neurodevelopmental disorders
  • congenital, hereditary, and neonatal diseases and abnormalities
  • movement disorders
  • disabled persons
  • neuromuscular manifestations
  • assistive devices
  • orthotic devices

Published Papers (6 papers)

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Research

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13 pages, 609 KiB  
Article
Outcomes of a Parent-Delivered Baby-mCIMT Model for Infants at High Risk of Unilateral Cerebral Palsy Using Remote Coaching in Telerehabilitation
by Katarina Svensson, Heléne Sundelin and Ann-Christin Eliasson
Children 2024, 11(1), 101; https://doi.org/10.3390/children11010101 - 15 Jan 2024
Viewed by 867
Abstract
There is growing evidence of the positive effects of constraint-induced movement therapy (CIMT) for infants at high risk of unilateral cerebral palsy (UCP) when provided by parents with in-person coaching/supervision from occupational therapists during home visits. The aim of this study is to [...] Read more.
There is growing evidence of the positive effects of constraint-induced movement therapy (CIMT) for infants at high risk of unilateral cerebral palsy (UCP) when provided by parents with in-person coaching/supervision from occupational therapists during home visits. The aim of this study is to investigate whether Baby-mCIMT (modifiedCIMT) can be as effective if parents are coached/supervised remotely. In this case-control study, we recruited 20 infants and re-used 18 controls, 4–8-month-old infants in both groups at high risk of UCP. The same protocol regarding inclusion criteria, data collection, and training volume was used in both groups. The training was conducted for two 6-week periods, separated by a 6-week break, consisting of daily 30 min sessions conducted by parents, supported by therapist coaching once a week. The primary outcome was measured using the Hand Assessment for Infants (HAI). There was no difference in the change of HAI units (p = 0.803) or that of the affected-hand raw score (p = 0.942) between the two groups. The remote coaching method was well received by parents. In conclusion, this demonstrates that remote coaching/supervision is as effective as the in-person approach, requiring less time and effort for both families and healthcare providers. Full article
(This article belongs to the Special Issue Research in Rehabilitation for Children with Motor Disability)
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12 pages, 979 KiB  
Article
Knee Flexion While Walking Exceeds Knee Flexion Contracture in Children with Spastic Cerebral Palsy
by Åsa Bartonek and Cecilia Lidbeck
Children 2023, 10(12), 1867; https://doi.org/10.3390/children10121867 - 29 Nov 2023
Viewed by 849
Abstract
Flexed knee gait is commonly related to contractures in children with cerebral palsy (CP). Therefore, knee position while walking was compared with passive knee extension and explored with respect to functional mobility. Gait was assessed with 3D motion analysis in 30 children with [...] Read more.
Flexed knee gait is commonly related to contractures in children with cerebral palsy (CP). Therefore, knee position while walking was compared with passive knee extension and explored with respect to functional mobility. Gait was assessed with 3D motion analysis in 30 children with bilateral spastic CP, Gross Motor Function Classification System (GMFCS) levels I–III, and in 22 typically developing (TD) children. Knee angle at initial contact (KneeAngleIC) was greater than knee flexion in stance (MinKneeFlexSt) in all groups. MinKneeFlexSt exceeded knee contractures at GMFCS levels II and III. Both KneeAngleIC and MinKneeFlexSt were greater at GMFCS II and III than at GMFCS I and the TD group. The excessive knee flexion while walking at GMFCS II and III could not be explained by knee joint contractures. Functional mobility measured with the timed-up-and-go test took longer in children at GMFCS level III compared to the other groups, assumed to be explained by the energy-requiring flexed knee gait and spatial insecurity. Discriminating between passive knee extension at the physical assessment and maximum knee extension while weight bearing may contribute to further understanding of flexed knee gait and its causes in ambulating children with spastic bilateral CP. Full article
(This article belongs to the Special Issue Research in Rehabilitation for Children with Motor Disability)
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12 pages, 749 KiB  
Article
Motor Development in Children with Cerebral Palsy in Sweden—A Population-Based Longitudinal Register Study
by Cecilia Lidbeck, Henrike Häbel, Caroline Martinsson, Katina Pettersson and Kristina Löwing
Children 2023, 10(12), 1864; https://doi.org/10.3390/children10121864 - 28 Nov 2023
Viewed by 1394
Abstract
The aim was to explore longitudinal motor development in children with cerebral palsy (CP) in Sweden with respect to the Gross Motor Function Classification System (GMFCS). In this national CP registry-based study, 2138 children aged 0.5–19 years participated (42% girls). The distribution with [...] Read more.
The aim was to explore longitudinal motor development in children with cerebral palsy (CP) in Sweden with respect to the Gross Motor Function Classification System (GMFCS). In this national CP registry-based study, 2138 children aged 0.5–19 years participated (42% girls). The distribution with respect to GMFCS was I: 49%, II: 16%, III: 10%, IV: 14%, and V: 11%. In total, 5538 assessments (mean 2.7, min–max: 1–9) with the Gross Motor Function Measure-66 were included. Data were analysed using non-linear mixed-effects regression models, and the Stable Limit Model was selected to fit data. Five distinct curves of predicted gross motor development with respect to GMFCS levels were obtained. The achieved motor development was maintained over time. The estimated average GMFM-66 limit and the average age when 90% of the expected limits were reached were at GMFCS I: 88 at age 4.5; GMFCS II: 71 at age 4.2; GMFCS III: 54 at age 3.1; GMFCS IV: 38 at age 2.6, and at GMFCS V: 18 at age 0.9. In conclusion, this is the first national population-based study following motor development in CP. Five distinct curves reported in previous controlled research studies were confirmed. Our study adds knowledge about motor development captured in children’s everyday context. Full article
(This article belongs to the Special Issue Research in Rehabilitation for Children with Motor Disability)
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13 pages, 718 KiB  
Article
Responses to Sensory Events in Daily Life in Children with Cerebral Palsy from a Parent Reported Perspective and in a Swedish Context
by Annika Ericson, Åsa Bartonek, Kristina Tedroff and Cecilia Lidbeck
Children 2023, 10(7), 1139; https://doi.org/10.3390/children10071139 - 30 Jun 2023
Cited by 2 | Viewed by 1306
Abstract
The motor disorders of cerebral palsy (CP) are often accompanied by sensory disturbances, but knowledge of their relationship to motor functioning is sparse. This study explored responses to sensory events in relation to spastic subtype and motor functioning in children with CP. Parents [...] Read more.
The motor disorders of cerebral palsy (CP) are often accompanied by sensory disturbances, but knowledge of their relationship to motor functioning is sparse. This study explored responses to sensory events in relation to spastic subtype and motor functioning in children with CP. Parents of 60 children with CP (unilateral: 18, bilateral: 42) with GMFCS levels I:29, II:13, III:15 and IV:3 of mean age 12.3 years (3.7 SD) participated. The parents (n = 55) rated their children´s responses with the norm-referenced questionnaire Child Sensory Profile-2© (CSP-2©), Swedish version, incorporating nine sections and four sensory processing patterns/quadrants, and replied (n = 57) to two additional questions. On the CSP-2©, thirty (55%) of the children were reported to have responses “much more than others“ (>2 SD) in one or more of the sections and/or quadrants and 22 (40%) in the section of Body Position, overrepresented by the children with bilateral CP. The additional questions revealed that a greater proportion of children at GMFCS levels III-IV compared to level I frequently were requested to sit/stand up straight (14/17 versus 6/26, p < 0.001) and were sound sensitive at a younger age (14/17 versus 10/26, p = 0.005). The findings of this study highlight the sensory aspects of motor functioning in children with spastic CP. Full article
(This article belongs to the Special Issue Research in Rehabilitation for Children with Motor Disability)
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9 pages, 656 KiB  
Article
Reliability and Validity of the 10-Meter Walk Test (10MWT) in Adolescents and Young Adults with Down Syndrome
by Juan Luis Sánchez-González, Inés Llamas-Ramos, Rocío Llamas-Ramos, Francisco Molina-Rueda, María Carratalá-Tejada and Alicia Cuesta-Gómez
Children 2023, 10(4), 655; https://doi.org/10.3390/children10040655 - 30 Mar 2023
Viewed by 2034
Abstract
People with Down syndrome (DS) have gait deficits because motor milestones are usually reached later. Decreased gait speed or reduced stride length are some of the main deficits. The main objective of the present work was to assess the reliability of the 10-Meter [...] Read more.
People with Down syndrome (DS) have gait deficits because motor milestones are usually reached later. Decreased gait speed or reduced stride length are some of the main deficits. The main objective of the present work was to assess the reliability of the 10-Meter Walk Test (10MWT) in adolescents and young adults with DS. The objective has been to analyze the construct validity of the 10MWT with the Timed up and go (TUG) test. A total of 33 participants with DS were included. Reliability was verified by intraclass correlation coefficient (ICC). The agreement was analyzed by the Bland-Altman method. Finally, construct validity was evaluated through Pearson correlation coefficient. The 10MWT intra-rater and inter-rater reliability were good (ICC between 0.76 until 0.9) and excellent (ICC > 0.9), respectively. The minimal detectable change for intra-rater reliability was 0.188 m/s. Also, it has demonstrated moderate construct validity (r > 0.5) considering the TUG test. The 10MWT has shown high intra- and inter-rater reliability and validity in adolescent and adults with SD and a moderate construct validity between TUG test and 10MWT. Full article
(This article belongs to the Special Issue Research in Rehabilitation for Children with Motor Disability)
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13 pages, 1907 KiB  
Case Report
Effect of Ankle-Foot Orthoses in Pediatric Patients with Hereditary Motor-Sensory Neuropathy: A Case Series Study
by Corrado Borghi, Silvia Sassi, Daniela Pandarese, Samuele Messori and Silvia Faccioli
Children 2023, 10(9), 1529; https://doi.org/10.3390/children10091529 - 09 Sep 2023
Cited by 2 | Viewed by 973
Abstract
(1) Aims: to evaluate the effect on gait performance and standing stability of ankle-foot orthoses (AFO) in pediatric patients with hereditary motor-sensory neuropathy (HMSN). (2) Methods: a retrospective case-series study including three adolescents (S1, S2, S3, mean age 14 years) with HMSN. The [...] Read more.
(1) Aims: to evaluate the effect on gait performance and standing stability of ankle-foot orthoses (AFO) in pediatric patients with hereditary motor-sensory neuropathy (HMSN). (2) Methods: a retrospective case-series study including three adolescents (S1, S2, S3, mean age 14 years) with HMSN. The subjects were evaluated barefoot, with carbon AFO (Botter) and with solid AFO (SAFO) by means of: gait analysis, stabilometry and gait functional tests (10 Meter Walk Test, 2 Minute Walk Test). Finally, the CSD-OPUS questionnaire was administered to the assess satisfaction and impact of the orthoses on life quality. (3) Results: orthoses improved gait and stability performance. Botter allowed greater ankle movement than SAFO and provided greater push-off power. This, combined with the carbon elastic energy return, might explain better performances in the 2MWT, with a larger distance traveled compared to SAFO for both S1 (110 m vs. 72 m) and S2 (170 m vs. 155 m) and, compared to barefoot walking, also for S3 (211 m vs. 160 m), for which SAFO analysis was not available. Both orthoses improved performance at the stabilometric analysis. The CSD-OPUS questionnaire showed a significantly higher level of satisfaction with Botter for the subjects (S1, S2) who completed the comparison. (4) Conclusions: Both orthoses improved gait and standing, though Botter proved to be better tolerated and more effective in improving gait endurance. Full article
(This article belongs to the Special Issue Research in Rehabilitation for Children with Motor Disability)
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