Journal of pediatric rehabilitation medicine最新文献

{"title":"Assessing the validity of caregiver-perceived severity in pediatric traumatic brain injury: A comparative analysis with the Glasgow Coma Scale.","authors":"Sophia Nichols, Angela H Ciccia, Jennifer P Lundine","doi":"10.1177/18758894251385506","DOIUrl":"https://doi.org/10.1177/18758894251385506","url":null,"abstract":"<p><p>PurposeThe Glasgow Coma Scale (GCS) is the gold standard in assessing severity for traumatic brain injury (TBI). This study aimed to compare GCS-rated severity to caregiver-perceived severity. Researchers assessed levels of agreement and explored which factors explained any differences and predicted whether a GCS score was provided.MethodsCaregiver-perceived severity, demographic, and medical information was collected via electronic survey from 107 youth with TBI. GCS-rated severity was collected via medical-chart review.ResultsThe strength of agreement fluctuated by severity (mild/concussion k = 0.60, moderate k = 0.1, severe k = 0.64). Caregiver perceptions were more severe in 62% of cases. No medical or demographic variables explained discrepancies. GCS was documented in 38% of medical records. Binomial regression modeling found that participants seen in the emergency department were most likely to receive a GCS rating.ConclusionResults suggest that caregivers may be reliable evaluators of their child's TBI severity, particularly for those classified as mild or severe injuries with GCS ratings. Allowing caregiver-perceived severity ratings could increase inclusivity in research, so participation is not limited to children who go to the emergency department. More research is needed to determine if caregiver-perceived severity tracks with long-term outcomes or if caregivers base severity ratings on factors outside of the initial injury event.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"18758894251385506"},"PeriodicalIF":1.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Musculoskeletal changes and treatments in paediatric spinal cord disorders: A scoping review.","authors":"Jamie Ellis, Peter Simm, Adam Scheinberg, Mary P Galea","doi":"10.1177/18758894251382368","DOIUrl":"https://doi.org/10.1177/18758894251382368","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to highlight the structural and functional musculoskeletal changes and associated treatment strategies in paediatric patients with spinal cord disorders (SCD).</p><p><strong>Methods: </strong>A systematic scoping review was conducted whereby PubMed, Excerpta Medica Database and MEDLINE Ovid databases, and grey literature were searched for articles published between January 2000 and June 2024. Study criteria included at least 50% of participant cohort being children aged under 18 years at time of SCD diagnosis, investigating the musculoskeletal effects of SCD in children, and related management or interventional strategies. Reports in which paediatric or SCD participants were less than 50% of the cohort were included if results were appropriately stratified. Included reports underwent descriptive analysis.</p><p><strong>Results: </strong>Forty-five reports were eligible for inclusion. Physiological Parameters, Musculoskeletal Complications, and Interventions were the main themes identified. It was observed that musculoskeletal changes following SCD can differ in children compared to their adult-injured counterparts, but the mechanisms underlying these differences are not known. Intervention studies that have been performed are important, but underpowered, and cannot yet be translated into routine care.</p><p><strong>Conclusion: </strong>Monitoring and treatment guidelines for musculoskeletal health in this population are scarce. Comprehensive research efforts are required to facilitate guideline development, which will be imperative in improving musculoskeletal outcomes following paediatric SCD.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"18758894251382368"},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of core knowledge and skills for Pediatric Rehabilitation Medicine certification: A systematic practice analysis.","authors":"Kevin P Murphy, David W Pruitt, Susan Apkon, Carolyn L Kinney, Mikaela M Raddatz, Siddiq M Kassam, Sherilyn W Driscoll","doi":"10.1177/18758894251353067","DOIUrl":"10.1177/18758894251353067","url":null,"abstract":"<p><strong>Purpose: </strong>In 2022, the American Board of Physical Medicine and Rehabilitation (ABPMR) contracted with Professional Services Industries LLC to complete a Pediatric Rehabilitation Medicine (PRM) practice analysis. The goal was to develop an updated examination content outline that accurately depicts the knowledge and skills expected for a competent PRM physician following completion of training. The purpose of this paper is to describe the process of practice analysis and to present candidate perceptions of scope of practice and relevancy of content from the first two examinations in which the new outline was applied.</p><p><strong>Methods: </strong>The practice analysis process was undertaken in four distinct stages: subject matter expert meetings to determine the tasks and knowledge areas; the development, issuance and analysis of a national survey; development of exam specifications; and results verification. Results were analyzed by a psychometrician and team to determine mean relative importance of task and knowledge items. A new outline was then created and used for the administration of the 2023 and 2024 ABPMR PRM Certification Examinations.</p><p><strong>Results: </strong>All active board certified PRM physicians identified were sent surveys via e-mail. One hundred ninety six (61.1%) respondents completed the survey. The top five task statements in order of perceived importance were performing history and physical examinations, managing muscle and tone abnormalities, prescribing orthoses and equipment, prescribing therapy services, and making appropriate specialty care referrals. The top five knowledge statements in order of perceived importance were cerebral palsy, spinal cord injury, abnormal growth and development, neuromuscular disorders, and musculoskeletal conditions. The new PRM Examination content outline created included six domains and 22 subdomains of knowledge content areas. A higher percentage of initial certification candidates sitting for the 2023 and 2024 ABPMR PRM Certification Examinations selected \"Strongly Agree\" or \"Agree\" when responding to the examination content reflecting both scope of training and relevancy.</p><p><strong>Conclusion: </strong>A practice analysis process was undertaken resulting in a new content outline for the ABPMR PRM Certification Examination. Following the implementation of the new content outline, initial certification candidate survey responses showed improved favorability regarding content reflecting scope of training and relevancy.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"230-243"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital experiences and medical traumatic stress in adults with spina bifida.","authors":"Ellen Fremion, Nora Deibler, Juliana Abel, Monique Ridosh","doi":"10.1177/18758894251333917","DOIUrl":"10.1177/18758894251333917","url":null,"abstract":"<p><p>PurposeThis study examined hospital and emergency department (ED) experiences of adults with spina bifida (SB), medical traumatic stress (MTS) and participant characteristics including anxiety, depression, post-traumatic stress disorder (PTSD) symptoms, and resiliency scores.MethodsAdults with SB who had a hospital or ED encounter within the last five years were recruited from a medical home clinic and completed a structured interview and validated questionnaires. Narrative inquiry was used and descriptive analyses were conducted. MTS scores were reported per participant characteristics and emotional health questionnaire score counts and percentages.ResultsTwenty-five adults with SB representing 37% of eligible patients were recruited. Most participants were positive for at least one MTS symptom cluster. There was an increased number of MTS symptom clusters for participants with higher depression, anxiety, and PTSD scores, and decreased MTS symptom clusters for those with increased resilience. The narrative analysis yielded three distinct themes: a negative hospital environment, SB-related condition concerns and complications, and positive support when in the hospital.ConclusionFurther research with a larger study population is necessary to examine the extent to which MTS is present in individuals with SB of all ages, to understand how MTS symptoms may change with age and experience, and to identify risk and protective factors for emotional health in the presence of MTS. However, this study identified opportunities for improving healthcare experiences for this patient population, including facilitating communication, promoting self-advocacy, self-efficacy, resilience, and familial support which can be implemented for all age groups.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"207-217"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital play and rehabilitation for children and adolescents in hospitals, outpatient departments and rehabilitation centres: A scoping review.","authors":"Lærke Winther, Camilla Milther, Sanne Miri Schroll, Emilie Tange Nielsen, Line Klingen Gjærde, Derek John Curtis, Jette Led Sørensen, Michelle Stahlhut","doi":"10.1177/18758894251341153","DOIUrl":"10.1177/18758894251341153","url":null,"abstract":"<p><p>PurposeThe growing interest among children in digital play provides new rehabilitation opportunities in hospital settings. There are, however, no published reviews on digital play interventions for the functional rehabilitation of children and adolescents across diagnoses and outcomes in hospital and rehabilitation settings. This scoping review aimed to identify and map the characteristics of digital play for functional rehabilitation in hospital and rehabilitation settings for children and adolescents to inform researchers and clinicians.MethodsStudies including participants aged ≤18 years investigating digital play and functional rehabilitation in hospital and rehabilitation settings were included. Reviews, text and opinion papers, conference papers, case studies, and studies with fewer than five participants were excluded. Five scientific databases were searched. The final search was conducted in October 2022. Four authors performed the study selection and data extraction.ResultsOf 13,663 references, 90 studies met the inclusion criteria. Digital play for rehabilitation was used in clinical settings, including hospitals, outpatient departments, and rehabilitation centres. Some interventions were conducted in human movement laboratories or at home. The relevant studies involved a wide range of disease categories, primarily neurological. A conceptual framework comprising five categories for gaming technologies utilizing digital play and rehabilitation was proposed: (1) traditional gaming platforms, (2) extended reality, (3) robotics and assistive technology, (4) sensors, and (5) rehabilitation systems. One hundred eighty different outcome measures used to evaluate the interventions were identified, almost one-third of which were unvalidated. The studies generally failed to report limitations and barriers to implementation.ConclusionThis scoping review gives a practical overview to assist and inspire healthcare professionals and researchers in digital play and rehabilitation, elucidating technology for rehabilitation within specific clinical contexts. In addition, this scoping review facilitates the exploration of implementation prospects associated with various technologies. Digital play and rehabilitation are primarily initiated in outpatient departments targeting children with neurological diseases. Future studies should investigate the potential of using digital play for the early rehabilitation of hospitalized children with various diseases.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"177-188"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A galvanizing event to promote improving health insurance.","authors":"Amy J Houtrow","doi":"10.1177/18758894251353071","DOIUrl":"10.1177/18758894251353071","url":null,"abstract":"<p><p>For almost all Americans, having affordable access to quality health care in the United States requires health insurance. Inadequate insurance is more common among children with disabilities and complex health conditions than other children. For children, insurance is considered adequate if the benefits must usually or always meet the child's needs and usually or always allow the child to see needed providers and the family reports no out-of-pocket expenses or out-of-pocket expenses deemed usually or always reasonable. After the CEO of UnitedHealthcare was killed in front of a Manhattan hotel on his way to his annual investor conference in December 2024, there was an outpouring of stories on social media about how people felt their loved ones were harmed by health insurance companies denying care that their doctors recommended. While murder as a form of vigilante justice should not be condoned, this event highlighted how angry Americans are at health insurance companies. Pediatric rehabilitation medicine physicians are no strangers to the frustrations of insurance denials for their patients and feel the strain of having to work through prior authorizations and peer-to-peers just to get their patients what they deem important for their health and functioning. The national data confirms what pediatric rehabilitation medicine physicians knew from collective experience - millions of children with more complex health care needs have inadequate insurance.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"173-176"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pediatric rehabilitation therapy audit study: A brief report.","authors":"Amy Houtrow, Natalie Silverman, Matthew Mesoros, Kristyn Felman, Molly Fuentes, Alyson Stover, Gina McKernan","doi":"10.1177/18758894251341160","DOIUrl":"10.1177/18758894251341160","url":null,"abstract":"<p><p>PurposeChildren with disabilities benefit from physical, occupational, and speech therapy, but families identify unmet needs for these services. The purpose of this study was to audit access to therapy services in a tri-state region. It was hypothesized that children who were publicly insured and children from minoritized identity groups would face greater access barriers and longer wait times than children covered by private insurance and non-minoritized White children.MethodsThis prospective audit study utilized callers who posed as mothers seeking outpatient therapy services for their child. Access difficulties were identified based on the number of phone calls required to obtain an appointment or determine if services would be obtained at all, as well as the number of days to the earliest available appointment.ResultsTherapy appointment access was a problem for 47.4% of simulated families. After 251 phone calls, 91 simulated families were able to schedule appointments in 76 clinics. Black and Hispanic simulated families had a harder time getting appointments, but days to appointment did not differ by telegraphed minoritized identity (F(3,88) = 1.474, p = .227).ConclusionSimulated families experienced substantial barriers to arranging therapy appointments with Black and Hispanic families experiencing more barriers than their White and Muslim peers.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"244-248"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of cardiorespiratory and muscle fitness assessment in two children with leukemia during early chemotherapy.","authors":"Virginie Aspirot-Buron, Charles Sèbiyo Batcho, Michèle Bisson, Bruno Michon, Marc-André Dugas, Isabelle Marc, Philippe Corbeil","doi":"10.1177/18758894251347128","DOIUrl":"10.1177/18758894251347128","url":null,"abstract":"<p><p>PurposeLimited data are available on the cardiorespiratory and muscle fitness of children with acute lymphoblastic leukemia (ALL) during chemotherapy. This pilot study evaluated the safety of testing the cardiorespiratory and muscle fitness of two children with ALL at different risk levels in early chem treatment.MethodsTwo girls with low- and high-risk B-cell ALL (DFCI-16-001) took part in two test sessions: T1 (induction, consolidation 1A/C) and T2 (consolidation 2). Each testing session included a maximal oxygen uptake (<math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math>O₂max) exercise test, muscular strength tests, physical activity and quality of life questionnaires, and a semi-structured interview. The parents agreed to these assessments at the start of chemotherapy treatment.ResultsThe participants experienced no significant adverse effects from undertaking the cardiorespiratory and muscular tests, and there was no impact on their chemotherapy treatment schedule. At their post-test interview, both participants reported that thigh pain and fatigue were the most difficult part of the <math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math>O₂max exercise test. Regarding physical performance outcomes, both participants exhibited low scores compared to their gender, weight- and age-predicted <math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math>O₂max and on most strength test values.ConclusionThe physical tests were safely and successfully conducted with these two participants during early chemotherapy.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"189-200"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144506027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Provider attitudes and perspectives on rehabilitation for pediatric cancer patients.","authors":"Maria C Swartz, Eduardo Gonzalez Villarreal, Keri Schadler, Donna Kelly, Alakh P Rajan, Clark Andersen, Shiming Zhang, Stephanie J Wells, Amy Heaton, Karen M Moody","doi":"10.1177/18758894251341150","DOIUrl":"10.1177/18758894251341150","url":null,"abstract":"<p><p>PurposeTwenty percent of childhood cancer survivors experience physical function impairments, and ∼75% develop a chronic health condition. Physical and occupational therapists (PT/OTs) can mitigate these late effects, yet few children receive cancer rehabilitation (CR). This research aimed to identify provider attitudes and perspectives towards CR services for children across inpatient and outpatient settings at a cancer center.MethodsThree cardiac rehabilitation instruments were adapted to evaluate knowledge, attitudes, and perceptions regarding CR delivery. Descriptive statistics were used to summarize participant survey results.ResultsTwenty administrators, 20 physicians/advanced practice providers (APPs), and 20 PT/OTs completed surveys. All disciplines strongly agreed on the value of CR for patient outcomes and care quality. Barriers to CR access included insurance models that disincentivize healthcare systems from providing CR, lack of a standardized screening and referral process, and inconsistent patient participation. Physicians/APPs (81%) endorsed clinical practice guidelines (CPGs) to promote CR referrals, and 90% of PT/OTs agreed hybrid CR delivery, which includes both supervised and unsupervised exercise, would increase patient participation.ConclusionThis study identified opportunities to increase CR access for childhood cancer survivors, including CPGs, streamlining referral processes, hybrid CR delivery, and closing insurance gaps. Future research should address these factors to improve CR access and ultimately improve outcomes for pediatric survivors.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"218-229"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of intensive, multidisciplinary neurorehabilitation on functional independence following pediatric acquired brain injury (ABI): A matched cohort study.","authors":"Raegan Furman, Steven Janselewitz, Patricia Coker-Bolt, Kristen Johnson","doi":"10.1177/18758894251355865","DOIUrl":"https://doi.org/10.1177/18758894251355865","url":null,"abstract":"<p><p>PurposeThe purpose of this matched cohort study was to determine the impact of intensive, multidisciplinary neurorehabilitation on functional independence following pediatric acquired brain injury.MethodsCohorts receiving lower-intensity (n = 19) and higher-intensity multidisciplinary neurorehabilitation (n = 19) were matched on age, injury characteristics, and admission functional status. Intensity was measured by time in physical, occupational (OT), and speech therapy over length of stay (LOS). Outcome measures included WeeFIM efficiency, WeeFIM developmental functional quotients (DFQs), and LOS.ResultsThere were no significant between-cohort findings in 1) WeeFIM efficiency, 2) WeeFIM DFQs or 3) LOS. There was a significant difference between admission and discharge WeeFIM DFQs for all participants (p < 0.001), demonstrating significant functional recovery regardless of intensity. Hierarchical linear regressions were significant for OT intensity and discharge WeeFIM DFQs (<i>p</i> = .003, Δ<i>R</i>² = .22). Total admission WeeFIM DFQs significantly predicted LOS in the lower-intensity (<i>p</i> = 0.016, <i>R</i>² = 0.29) and higher-intensity (<i>p</i> < 0.001, <i>R</i>² = 0.51) cohorts, indicating a greater variance explained with increased intensity.ConclusionWhile significant functional outcomes were not correlated with intensity, OT intensity did significantly predict variations in functional independence. Investigation into definitive parameters for intensive treatment, including the amount and context of therapeutic interventions, is needed.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"18758894251355865"},"PeriodicalIF":0.8,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}