scholarly journals Reference Values for Aerobic Fitness in Children, Adolescents, and Young Adults Who Have Cerebral Palsy and Are Ambulatory

2010 ◽  
Vol 90 (8) ◽  
pp. 1148-1156 ◽  
Author(s):  
Olaf Verschuren ◽  
Manon Bloemen ◽  
Cas Kruitwagen ◽  
Tim Takken
Keyword(s):  
Young Adults ◽  
Cerebral Palsy ◽  
Young People ◽  
Reference Values ◽  
Aerobic Fitness ◽  
Adolescents And Young Adults ◽  
Cross Sectional ◽  
Level I ◽  
Shuttle Run ◽  
Gmfcs Level

BackgroundVery few objective data exist regarding aerobic performance in young people with cerebral palsy (CP). The characterization of aerobic fitness could provide baseline and outcome measures for the rehabilitation of young people with CP.ObjectiveThe objective of this study was to provide reference values for aerobic fitness in a group of children, adolescents, and young adults who had CP and who were classified at Gross Motor Function Classification System (GMFCS) level I or II. Data were collected with 10-m shuttle run tests.DesignThis investigation was a cross-sectional observational study conducted between August 2008 and June 2009.MethodsReference values were established using data from a total of 306 children, adolescents, and young adults who had CP, who were 6 to 20 years old, and who were recruited from 26 rehabilitation centers in the Netherlands, Switzerland, Australia, Canada, and the United States. A total of 211 participants were classified at GMFCS level I (mean age=12.2 years, SD=3.0), and 95 were classified at GMFCS level II (mean age=12.4 years, SD=3.2); 181 were male, and 125 were female. Aerobic fitness was reflected by the level achieved on the 10-m shuttle run tests.ResultsOn the basis of a total of 306 assessments from the 10-m shuttle run tests, 4 reference curves were created.LimitationsThe limitation of this study is the cross-sectional nature of the design.ConclusionsThis study provided height-related reference values for aerobic fitness in children, adolescents, and young adults who had CP, who were 6 to 20 years old, and who were classified at GMFCS level I or II. Generalized additive models for location, scale, and shape were used to construct centile curves. These curves are clinically relevant and provide a user-friendly method for the prediction of aerobic fitness in young people with CP.

scholarly journals Reliability and Validity of Data for 2 Newly Developed Shuttle Run Tests in Children With Cerebral Palsy

2006 ◽  
Vol 86 (8) ◽  
pp. 1107-1117 ◽  
Author(s):  
Olaf Verschuren ◽  
Tim Takken ◽  
Marjolijn Ketelaar ◽  
Jan Willem Gorter ◽  
Paul JM Helders
Keyword(s):  
Cerebral Palsy ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Treadmill Test ◽  
Children With Cerebral Palsy ◽  
Level I ◽  
Test Retest Reliability ◽  
Shuttle Run ◽  
Gmfcs Level

Abstract Background and Purpose. The purpose of this study was to examine the reliability and validity of data obtained with 2 newly developed shuttle run tests (SRT-I and SRT-II) to measure aerobic power in children with cerebral palsy (CP) who were classified at level I or II on the Gross Motor Function Classification System (GMFCS). The SRT-I was developed for children at GMFCS level I, and the SRT-II was developed for children at GMFCS level II. Subjects. Twenty-five children and adolescents with CP (10 female, 15 male; mean age=11.9 years, SD=2.9), classified at GMFCS level I (n=14) or level II (n=11), participated in the study. Methods. To assess test-retest reliability of data for the 10-m shuttle run tests, the subjects performed the same test within 2 weeks. To examine validity, the shuttle run tests were compared with a GMFCS level–based treadmill test designed to measure peak oxygen uptake. Results. Statistical analyses revealed test-retest reliability for exercise time (number of levels completed) (intraclass correlation coefficients of .97 for the SRT-I and .99 for the SRT-II) and reliability for peak heart rate attained during the final level (intraclass correlation coefficients of .87 for the SRT-I and .94 for the SRT-II). High correlations were found for the relationship between data for both shuttle run tests and data for the treadmill test (r=.96 for both). Discussion and Conclusion. The results suggest that both 10-m shuttle run tests yield reliable and valid data. Moreover, the shuttle run tests have advantages over a treadmill test for children with CP who are able to walk and run (GMFCS level I or II). [Verschuren O, Takken T, Ketelaar M, et al. Reliability and validity of data for 2 newly developed shuttle run tests in children with cerebral palsy. Phys Ther. 2006;86:1107–1117.]

scholarly journals Self-versus Proxy-Reported Pain in Children with Cerebral Palsy: A Population-Based Registry Study of 3783 Children

2020 ◽  
Vol 11 ◽  
pp. 215013272091152 ◽  
Author(s):  
Gunnar Hägglund ◽  
Amanda Burman-Rimstedt ◽  
Tomasz Czuba ◽  
Ann I. Alriksson-Schmidt
Keyword(s):  
Logistic Regression ◽  
Cerebral Palsy ◽  
Classification System ◽  
Population Based ◽  
Registry Study ◽  
Cross Sectional ◽  
Marginal Effects ◽  
Level I ◽  
Average Marginal Effects ◽  
Gmfcs Level

Objective: To assess how the prevalence of pain in a population-based sample of children and adolescents with cerebral palsy (CP) differ based on self- or proxy reporting. Methods: This cross-sectional registry study included 3783 children (58% boys), 1 to 18 years old, enrolled in the Swedish follow-up program for CP. Logistic regression was used to regress source of reporting (self or proxy) on the presence of general pain adjusted for age, sex, Gross Motor Function Classification System (GMFCS), and Communication Function Classification System (CFCS) levels, including marginal effects between source of reporting and adjusted covariates. Results: The pain item was self-reported in 45%, proxy-reported in 51%, and information was missing in 3%. Pain was reported in 44% of those who self-reported and in 41% of those who proxy-reported ( P = .04). The logistic regression showed that the average marginal effects of proxy versus self-reported pain were lower among children at GMFCS level IV (−0.14, 95% CI −0.17 to −0.03) and CFCS level I (−0.09, CI −0.16 to −0.01) and higher at CFCS level III (0.11, CI 0.00-0.22). There were no statistically significant differences in average marginal effects related to age, sex, or the other GMFCS and CFCS levels between proxy and self-reporting. Conclusions: Pain was more often reported by those who self-reported. However, after adjusting for age, sex, CFCS level, and GMFCS level, the proportion of reported pain was almost equal between self and proxy-reporting. Assuming that the self- and proxy-reported groups were not significantly different on relevant factors not controlled for the results indicate that presence of pain is equally reported by children and parents.

Social and Community Participation of Children and Youth With Cerebral Palsy Is Associated With Age and Gross Motor Function Classification

2009 ◽  
Vol 89 (12) ◽  
pp. 1304-1314 ◽  
Author(s):  
Robert J. Palisano ◽  
Lin-Ju Kang ◽  
Lisa A. Chiarello ◽  
Margo Orlin ◽  
Donna Oeffinger ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Community Participation ◽  
Motor Function ◽  
Structured Interview ◽  
Children And Youth ◽  
Cross Sectional ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Level I ◽  
Gmfcs Level

Background Through social and community participation, children and youth with cerebral palsy (CP) form friendships, gain knowledge, learn skills, express creativity, and determine meaning and purpose in life. Objective The purposes of this study were: (1) to determine whether social and community participation of children and youth with CP differ based on age, sex, and gross motor function, and (2) to identify the types of activities in which social and community participation are highest. Design and Methods A prospective cross-sectional analytic design was used. The participants were a sample of convenience of 291 children (6–12 years of age) and 209 youth (13–21 years of age) with CP (55.4% males, 44.6% females) receiving services from 7 children's hospitals. Participants completed the Children's Assessment of Participation and Enjoyment (CAPE) by structured interview. Gross Motor Function Classification System (GMFCS) level was determined by the researchers. Results Youth did a higher percentage of activities with friends and others and outside the home than children. Children and youth in level I did a higher percentage of activities with friends and others compared with children and youth in levels II and III and in levels IV and V. Children and youth in level I and in levels IV and V did a higher percentage of activities outside the home than children and youth in levels II and III. Differences were not found between females and males. The percentage of activities done with friends and others and outside the home was highest for physical and skill-based activities. Limitations Findings cannot be attributed only to GMFCS level. Conclusions The ability to walk without restrictions is desirable for social and community participation. For children and youth with CP who have limitations in mobility, physical therapists have roles as consultants for accessibility, activity accommodations, and assistive technology and as advocates for inclusive environments.

scholarly journals Association between Gait Deviation Index and Physical Function in Children with Bilateral Spastic Cerebral Palsy: A Cross-Sectional Study

2019 ◽  
Vol 9 (1) ◽  
pp. 28 ◽  
Author(s):  
Tadashi Ito ◽  
Koji Noritake ◽  
Hiroshi Sugiura ◽  
Yasunari Kamiya ◽  
Hidehito Tomita ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Gait Speed ◽  
Spastic Cerebral Palsy ◽  
Cross Sectional ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Gait Deviation Index ◽  
Level I ◽  
Gmfcs Level

This study examined the association between Gait Deviation Index (GDI) and the five-times-sit-to-stand test (FTSST) or gait speed results, which represent mobility and muscle strength of the lower extremities in ambulatory children with Gross Motor Function Classification System (GMFCS) level I and II spastic cerebral palsy. In this cross-sectional, observational study, three-dimensional gait analysis data were obtained during gait trials to evaluate the GDI in 35 children (age 5–16 years) with spastic palsy. Motor function was evaluated using FTSST and gait speed. Gross motor function was evaluated using GMFCS. Children with GMFCS level II spastic cerebral palsy demonstrated lower GDI (p < 0.001) and poorer FTSST (p = 0.031) than those with GMFCS level I spastic cerebral palsy. Correlation analysis showed that FTSST results were significantly correlated with GDI (r = −0.624; p < 0.001). Motor function may be important for the maintenance of gait quality in patients with GMFCS level I and II spastic cerebral palsy and should not be ignored. In conclusion, reduction in gait impairment may affect the values of FTSST and GDI in patients with spastic cerebral palsy who can ambulate without an assistive device.

scholarly journals Comparison of the CHU-9D and the EQ-5D-Y instruments in children and young people with cerebral palsy: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037089
Author(s):  
Jennifer M Ryan ◽  
Ellen McKay ◽  
Nana Anokye ◽  
Marika Noorkoiv ◽  
Nicola Theis ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Missing Data ◽  
Young People ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Poor Agreement ◽  
Cross Sectional ◽  
Children And Young People ◽  
Utility Values ◽  
Gmfcs Level

ObjectiveTo compare the performance of the EuroQol 5D youth (EQ-5D-Y) and child health utility 9D (CHU-9D) for assessing health-related quality of life (HRQoL) in children and young people (CYP) with cerebral palsy (CP).DesignCross-sectional study.SettingEngland.ParticipantsSixty-four CYP with CP aged 10–19 years in Gross Motor Function Classification System (GMFCS) levels I–III.Main outcome measuresMissing data were examined to assess feasibility. Associations between utility values and individual dimensions on each instrument were examined to assess convergent validity. Associations between utility values and GMFCS level were examined to assess known-group differences.ResultsMissing data were <5% for both instruments. Twenty participants (32.3%) and 11 participants (18.0%) reported full health for the EQ-5D-Y and CHU-9D, respectively. There was poor agreement between utilities from the two instruments (intraclass correlation coefficient=0.62; 95% limits of agreement −0.58 to 0.29). Correlations between EQ-5D-Y and CHU-9D dimensions were weak to moderate (r=0.25 to 0.59). GMFCS level was associated with EQ-5D-Y utility values but not CHU-9D utility values.ConclusionThe EQ-5D-Y and CHU-9D are feasible measures of HRQoL in CYP with CP. However, the two instruments demonstrate poor agreement and should not be used to measure and value HRQoL in CYP with CP interchangeably. We propose that the CHU-9D may be preferable to use in this population as it assesses concepts that influence HRQoL among CYP with CP and provides less extreme utility values than the EQ-5D-Y.

Diagnostic timeliness in adolescents and young adults with cancer: Cross-sectional findings from the BRIGHTLIGHT cohort

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696689
Author(s):  
Annie Herbert ◽  
Georgios Lyratzopoulos ◽  
Jeremy Whelan ◽  
Rachel M Taylor ◽  
Julie Barber ◽  
...  
Keyword(s):  
Young Adults ◽  
Young People ◽  
Symptom Onset ◽  
Sociodemographic Factors ◽  
Adolescents And Young Adults ◽  
Bone Tumours ◽  
Cancer Site ◽  
Cross Sectional ◽  
Interval Time ◽  
Total Interval

BackgroundAdolescents and young adults (AYA) with cancer are thought to experience prolonged diagnostic intervals but robust evidence quantifying such associations is lacking.AimTo examine diagnostic timeliness in a cohort of young people, identifying sociodemographic factors and cancer sites associated with variation in timeliness.MethodWe analysed data from 830 patients with cancer aged 12–24 who completed BRIGHTLIGHT face-to-face interviews, for variation in the patient interval (time from symptom onset to first healthcare presentation); the number of pre-referral GP consultations; and the total interval (time from symptom onset to diagnosis). We present descriptive statistics of these outcomes by patient characteristics and cancer site and multivariable regression models for adjusted estimates of associations.ResultsAmong participants, 27% experienced a patient interval of >1 month and 35% of those consulting a GP had 3 or more (3+) pre-referral consultations. The median total interval was 62 days. We hereafter highlight significant associations (<0.05). Females were more likely to have 3+ consultations and longer total intervals compared with males. Patients with lymphoma or bone tumours were most likely to have 3+ pre-referral consultations and those with melanoma least likely. Females and patients with bone tumours had the longest median total intervals and those with leukaemia the shortest.ConclusionThese data benchmark diagnostic timeliness for young people with cancer and identify subgroups at higher risk of prolonged diagnostic journeys. Further work is now required to prioritise and stratify early diagnosis initiatives for these subgroups.FundingNational Institute for Health Research (RP-PG-1209-10013); Teenage Cancer Trust; Cancer Research UK (A18180).

Risk of Depression in Adolescents and Young Adults with Rheumatic Diseases

2020 ◽  
Vol 62 (1) ◽  
pp. 38-42
Author(s):  
Anna Kostiukow ◽  
Wojciech Strzelecki ◽  
Mateusz W. Romanowski ◽  
Marta Rosołek ◽  
Ewa Mojs ◽  
...  
Keyword(s):  
Young Adults ◽  
Young People ◽  
Rheumatic Diseases ◽  
Disease Risk ◽  
Statistical Significance ◽  
Energy Levels ◽  
Young Patients ◽  
Depression Scale ◽  
Adolescents And Young Adults ◽  
Control Group

Introduction: The study is aimed at drawing the attention of the medical environment to the mental health aspects of young patients as a factor that significantly influences the efficiency of their rheumatic disease treatment. Aim: This paper is to check the risk of depression among a group of adolescents and young adults with rheumatic diseases. Material and Methods: The study was conducted among a group of 68 late adolescents and young adults (18-22 years old) with rheumatic diseases. The control group consisted of 102 young people (18-22 years old) without a diagnosed chronic disease. Risk of depression was measured using a screening tool – the Kutcher Adolescent Depression Scale (KADS). Results: The analysis showed that the probability of depression in the study group was 35.3%. In the control group, this rate was 19.6%. The results were statistical significance (p=0.028). Conclusions: The results of this study prove that the risk of depression among adolescents and young adults with rheumatic diseases is significantly higher than in healthy young people. The highest risk of depression is related to feeling tired, fatigue, low energy levels and lack of motivation as well as feeling worried, nervous, panicky, tense, keyed-up and anxious.

scholarly journals Determinants of participation and quality of life of young adults with cerebral palsy: longitudinal approach and comparison with the general population – SPARCLE 3 study protocol

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Catherine Arnaud ◽  
Carine Duffaut ◽  
Jérôme Fauconnier ◽  
Silke Schmidt ◽  
Kate Himmelmann ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Young Adults ◽  
Cerebral Palsy ◽  
Young People ◽  
General Population ◽  
Transition Period ◽  
Well Being ◽  
Personal Factors ◽  
The Impact

Abstract Background Effective inclusion in society for young people with disabilities is increasingly seen as generating opportunities for self-development, and improving well-being. However, significant barriers remain in the vast majority of activities meaningful for young adults. Research argues that various personal (disabilities, health) and environmental (access to the resources needed, accessible environment, discrimination, lack of personal economic independence) factors contribute to limited participation. However, previous studies conducted in young people with cerebral palsy (CP) mainly investigated the transition period to adulthood, and did not fully consider the whole range of impairment severity profiles or environmental barriers. In this study, we will use the follow-up of the SPARCLE cohort and a comparison group from the general population (1) to investigate the impact of the environment on participation and quality of life of young adults with CP, (2) to determine predictors of a successful young adulthood in educational, professional, health and social fields, (3) to compare quality of life and frequency of participation in social, work and recreational activities with the general population, (4) to document on participation and quality of life in those with severe disabilities. Methods The SPARCLE3 study has a combined longitudinal and cross-sectional design. Young adults with CP aged 22 to 27 years in 6 European regions previously enrolled in the SPARCLE cohort or newly recruited will be invited to self-complete a comprehensive set of questionnaires exploring participation (daily life and discretionary activities), health-related quality of life, body function, personal factors (health, personal resources), and contextual factors (availability of needed environmental items, family environment, services provision) during home visits supervised by trained researchers. Proxy-reports or adapted questionnaires will be used for those with the most severe impairments. The recruitment of a large group from the general population (online survey) will enable to identify life areas where the discrepancies between young people with CP and their able-bodied peers are the most significant. Discussion This study will help identify to what extent disabilities and barriers in environment negatively affect participation and quality of life, and how previous valued experiences during childhood or adolescence might modulate these effects.

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