Journal of pediatric rehabilitation medicine最新文献

{"title":"The salaried PM&R physician.","authors":"Joline E Brandenburg, Jeffrey S Brault","doi":"10.1177/18758894241296641","DOIUrl":"https://doi.org/10.1177/18758894241296641","url":null,"abstract":"<p><p>The breadth of medical practice for a physical medicine and rehabilitation (PM&R) physician is quite extensive. Not only are practice areas quite different among PM&R physicians, but practice settings, procedures, and salary models also vary significantly. For PM&R residents and fellows who are making career decisions regarding specialization versus general practice and/or in the process of negotiating contracts, salary is a significant influence in their decision of clinical practice. Physician payment models may create inadvertent bias against women, those seeking less than full time clinical employment, and those interested in an academic career. In this review and commentary, we will discuss the more common payment models encountered, with a focus on a fixed salary payment model. We will also discuss our experiences as pediatric and adult PM&R providers in a salaried payment model at a not-for-profit academic institution.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":"17 3","pages":"316-320"},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458389","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":"Physical activity and functional limitations in pediatric multiple sclerosis: Are fatigue and depression confounding variables?","authors":"E Morghen Sikes, Marcia Finlayson, Brenda Banwell, Ruth Ann Marrie, E Ann Yeh, Rob Motl","doi":"10.3233/PRM-220081","DOIUrl":"10.3233/PRM-220081","url":null,"abstract":"<p><strong>Purpose: </strong>Pediatric-onset multiple sclerosis (MS) is associated with risk for functional limitations defined as the perceived reduction in capacity for undertaking activities of daily living. Moderate-to-vigorous physical activity (MVPA) has been associated with less frequent and less impactful functional limitations, but the symptoms of fatigue and depression have not been considered as potential confounding variables. This study examined whether fatigue and depression confound the association between MVPA and functional limitations among youth with pediatric MS.</p><p><strong>Methods: </strong>Participant data were accumulated from three ongoing observational studies. The combined sample included 65 cases of pediatric-onset MS (24 male/41 female, 16±1.7 years of age). Data on self-report MVPA, functional limitations, depression, and fatigue were analyzed.</p><p><strong>Results: </strong>MVPA was significantly associated with functional limitations (<i>r</i> = 0.45), fatigue (<i>r</i> = -0.28), and depression (<i>r</i> = -0.32). Functional limitations were associated with fatigue (<i>r</i> = -0.45) and depressive symptoms (<i>r</i> = -0.53). MVPA was significantly correlated with functional limitations (β= 0.27, <i>p</i> = 0.04) even after accounting for general fatigue (β= 0.08, <i>p</i> = 0.64) and depressive symptoms (β= -0.40, <i>p</i> = 0.03) among those with pediatric MS.</p><p><strong>Conclusion: </strong>Self-reported MVPA was associated with perceived functional limitations among youth with pediatric MS independent of perceived fatigue and depressive symptoms.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"336-341"},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41127556","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":"Caregiver and student perspectives on school services for students with traumatic brain injury during the COVID-19 pandemic.","authors":"Cara Palusak, Libby Dart, Angela Ciccia, Drew Nagele, Jennifer P Lundine","doi":"10.3233/PRM-230021","DOIUrl":"https://doi.org/10.3233/PRM-230021","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to identify unique challenges created by COVID-19 school closures for students with traumatic brain injury (TBI) and their families with relation to special education accommodations, therapy services, social support systems, and mental health complications.</p><p><strong>Methods: </strong>Forty-one caregivers and students participated in semi-structured, virtual interviews. Families had students in kindergarten through 12th grade who experienced a TBI prior to spring 2020 and were receiving support services at schools in Pennsylvania (US). Researchers used reflexive thematic analysis to identify themes across interviews.</p><p><strong>Results: </strong>Central themes encompassing the student- and caregiver-reported challenges and advantages of COVID-19 school closures were changes in [1] education delivery, special education services, and accommodations for children with TBI, and [2] social relationships for students with TBI and their caregivers.</p><p><strong>Conclusion: </strong>COVID-19 and the transition to remote learning significantly impacted special education services and education received by students with TBI. Families in this study discussed both perceived obstacles to and advantages of remote learning in this population. As remote and asynchronous learning are now commonly integrated into the curriculum, research should clarify the facilitators and barriers for successful service provision for students with TBI.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108498","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":"Review of Appetite for Risk-What it is, Who has it and How I survived, by Robert R. Abbott.","authors":"Rajashree Srinivasan","doi":"10.3233/PRM-240045","DOIUrl":"https://doi.org/10.3233/PRM-240045","url":null,"abstract":"<p><p>Appetite for Risk is an autobiographical memoir of the author's life experiences. He vividly explains near-death experiences while maintaining humor, regaling about his escapades. It is thought-provoking to consider if human risky behavior is genetically predetermined.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108499","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":"Quantitative ultrasound of submental and masticatory muscles in children with cerebral palsy.","authors":"Marloes L J Lagarde, Karen van Hulst, Corrie E Erasmus, Lenie van den Engel-Hoek, Alexander C H Geurts, Nens van Alfen","doi":"10.3233/PRM-230029","DOIUrl":"https://doi.org/10.3233/PRM-230029","url":null,"abstract":"<p><strong>Purpose: </strong>Quantitative muscle ultrasound (QMUS) is potentially valuable as a diagnostic tool in central neurological disorders, as it provides information about changes in muscle architecture. This study aimed to investigate whether ultrasound images of the submental and masticatory muscles in children with spastic cerebral palsy (CP) differ from those obtained in a reference group, and whether observed ultrasound abnormalities differ between subgroups of children with different Eating and Drinking Ability Classification System (EDACS) levels to support its construct validity.</p><p><strong>Methods: </strong>A prospective cohort study was conducted in 25 children with spastic CP aged 3-18 years. QMUS of selected muscles was performed. Muscle thickness and echogenicity in the CP group were compared to previously collected reference values, and between different EDACS levels within the CP group.</p><p><strong>Results: </strong>Median echogenicity of all muscles was significantly higher in children with CP than in healthy controls. The temporalis muscle was significantly thinner in the CP group. There were no differences in muscle thickness or echogenicity between EDACS levels.</p><p><strong>Conclusion: </strong>QMUS is able to detect abnormal architecture of submental and masticatory muscles in children with spastic CP, but the interpretation of abnormalities in relation to the severity of mastication and swallowing problems needs further investigation.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141600258","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":"The functional secondary effect after an integrated rehabilitative intervention to learn reading and writing in a girl with Rubinstein-Taybi syndrome.","authors":"Donatella Saviola, Katia de Gaetano, Stefania Bruni, Margherita Chiari, Chiara Moschini, Erica Battagliola, Daniela Colla, Matteo Cantoni, Antonio De Tanti","doi":"10.3233/PRM-230051","DOIUrl":"https://doi.org/10.3233/PRM-230051","url":null,"abstract":"<p><strong>Purpose: </strong>A case report of a six-year and five-month-old female admitted with typical symptoms of Rubinstein-Taybi syndrome is presented. Clinical and rehabilitation settings where she acquired her reading, writing, and communication skills are described.</p><p><strong>Methods: </strong>Because of her cognitive disabilities, a multidisciplinary and long-term intervention (2014-2020) was necessary. Treatment included orthoptic, psychomotor, logopedic, occupational, and neuropsychological care. Her family and school were involved.</p><p><strong>Results: </strong>Increased attention led to decreased dysfunctional behaviors. Test results are still below average, but there has been significant improvement. Better communication skills resulted from increased phonetic range, improved articulation, lexical-semantic structure, comprehension, and production of sentences. Digital technologies played a significant role in enhancing her communication skills, not just in social interactions but also in school activities. The patient is oriented in time and space with the help of agendas and calendars. She can express her needs and compose concise narratives. As a result of acquiring functional skills, she is better equipped to handle real-life situations, which has led to increased social and family activities.</p><p><strong>Conclusion: </strong>This case report highlights the importance of personalized rehabilitation programs. Obtaining an early genetic diagnosis is crucial for timely tailored rehabilitation, and any delays in this process can hinder progress.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437024","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":"Approach to obtaining a swallow study in a five-year-old with a disability and significant procedural anxiety: A case report.","authors":"Tyler Estes, Aaron Gaul, Allison Thornton, Laura Hobart-Porter","doi":"10.3233/PRM-230063","DOIUrl":"https://doi.org/10.3233/PRM-230063","url":null,"abstract":"<p><strong>Case description: </strong>A five-year-old male with spastic quadriplegia cerebral palsy and an expressive communication disorder presented because the family desired liberalization of diet. The diet consisted of pureed solids and no liquids due to deficits identified on bedside swallow evaluation; further dysphagia assessment had not been obtained due to significant procedural anxiety. Comprehensive approaches were taken involving premedication with buspirone, desensitization, distraction, and positive reinforcement. The fluoroscopic swallow study was successfully completed, and the patient's diet was upgraded to include moderately thickened liquids.</p><p><strong>Discussion: </strong>Procedural anxiety management in special populations is not well-researched. The lack of definitive recommendations regarding these issues increases the difficulty of managing these patients. This case highlights one successful approach to addressing individual needs using widely-available pharmacologic and environmental techniques. Additionally, this case reinforces the need to identify underlying causes for procedural anxiety and involve an interdisciplinary team.</p><p><strong>Conclusions: </strong>Attempts should be made to identify factors driving procedural anxiety. After discussing with the patient and family, relevant information should be relayed to staff with an open-ended invitation to propose ideas. While not all hospitals have equivalent resources, concerns related to unfamiliarity, underlying anxiety, and locus of control can be addressed with limited resource utilization, as demonstrated in this case.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141093095","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":"Pure grit: Ordinary and extraordinary.","authors":"Matthew MacCarthy","doi":"10.3233/PRM-240012","DOIUrl":"10.3233/PRM-240012","url":null,"abstract":"","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":"17 1","pages":"139-141"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140326720","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":"Utilizing combination intrathecal baclofen and analgesic medication to manage spasticity and pain in patients with pediatric-onset disability: Case series.","authors":"Denesh Ratnasingam, Tess Woehrlen, Samantha Koerber, Emma Drenth, Neena Marupudi, Melisa Concepcion, Erika Erlandson","doi":"10.3233/PRM-220100","DOIUrl":"10.3233/PRM-220100","url":null,"abstract":"<p><strong>Purpose: </strong>The use of intrathecal medications for the management of spasticity and various pain syndromes in the adult population has been previously reported. However, no evidence-based guidelines currently exist in the pediatric population. This case series presents patients (n = 8) with pediatric-onset disability who underwent placement of intrathecal baclofen pumps initially for management of severe spasticity. Despite titration of dose and use of oral analgesia, their uncontrolled pain persisted. Each patient was transitioned to a combination of baclofen and analgesic intrathecal therapy. The outcome in pain improvement and quality of life, as reported by patients and/or caregivers, were retrospectively reviewed.</p><p><strong>Methods: </strong>Retrospective review of the background and decision-making process regarding transition to combination intrathecal therapy identified patient selection characteristics. Each patient and/or their caregivers completed a survey regarding improvements in pain, spasticity, function, and quality of life following initiation of combination intrathecal medications.</p><p><strong>Results: </strong>Survey results revealed improvements in functional and pain assessments after initiation of combination baclofen and analgesic intrathecal medication. Patients and caregivers reported decreases in pain and oral spasticity medications.</p><p><strong>Conclusion: </strong>Use of pumps with antispasmodic and analgesic medication for combination intrathecal medication delivery should be considered in the management of patients with childhood-onset disabilities who have both severe spasticity and pain.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":"17 1","pages":"57-66"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140326722","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":"Non-immersive virtual reality based treatment for children with unilateral cerebral palsy: Preliminary results.","authors":"Paolo Meriggi, Martina Mandalà, Mattia Randazzo, Elena Brazzoli, Anna Castagna, Valentina Di Giusto, Anna Cavallini, Alberto Marzegan, Tiziana Lencioni, Ivana Olivieri","doi":"10.3233/PRM-230028","DOIUrl":"10.3233/PRM-230028","url":null,"abstract":"<p><strong>Purpose: </strong>Unilateral cerebral palsy (UCP) represents about 30-40% of overall cerebral palsy diagnoses. Upper limb impairment has a significant negative impact on activities of daily living (ADL), and recent studies have shown that the use of virtual reality (VR) can increase motivation and promote an improvement in ADL. This preliminary study was aimed at exploring the acceptability and usability of a VR rehabilitation treatment, using the VITAMIN Platform, for children with UCP. A secondary goal of the study was to compare the results of usual standardized clinical scales and questionnaires with kinematic results as well as with the quantitative measures acquired by the VITAMIN platform in each exercise of the rehabilitation sessions.</p><p><strong>Methods: </strong>Six children with UCP (aged 7-15) were recruited for a preliminary investigation in using a non-immersive VR system. The treatment was composed of 10 weekly sessions of 45 minutes. Each child played five types of exergames, using the impaired upper limb to hit virtual objects projected on a wide screen. Standardized clinical scales, kinematic analysis, and questionnaires were used to extensively assess upper limb function before and at the end of treatment. Five typically-developing children provided a reference for the instrumented kinematic assessment.</p><p><strong>Results: </strong>At the end of the treatment, Melbourne Assessment 2 (MA2) scores increased for all the participants (mean increase in range of movement (ROM) + 19.1%, accuracy + 4.6%, dexterity + 13.1%, fluency + 10.3%). Shoulder flexion-extension ROM also improved (mean increase + 10.5°), and according to the kinematic analysis, shoulder movements became more similar to reference profiles. These results were confirmed by a general improvement in performing ADL, assessed by the ABILHAND-Kids questionnaire. Finally, a general agreement among the different measures and indexes emerged from the acquired data.</p><p><strong>Conclusion: </strong>The results show that VR treatment with the VITAMIN platform could be engaging and functional for rehabilitation of children with UCP. The good agreement among the qualitative and quantitative measures and indexes confirms the potential of such novel treatment. However, due to the limited sample size and small number of sessions, further and larger investigations are required to evaluate the effectiveness and to generalize the results.</p>","PeriodicalId":16692,"journal":{"name":"Journal of pediatric rehabilitation medicine","volume":" ","pages":"107-123"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140136886","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}