{"title":"Optimal Timing for Auditory Brainstem Response After Tympanostomy Tube Placement in Children with Cleft Lip and Palate: A Retrospective Study.","authors":"Koichiro Oyake, Sei Kobayashi, Tomotaka Shimura, Yasunobu Amari, Ayaka Kise, Naoto Miyoshi, Naomi Imaizumi, Yukiko Inoue, Toshikazu Shimane","doi":"10.3390/children12091243","DOIUrl":"10.3390/children12091243","url":null,"abstract":"<p><p><b>Objective</b>: Children with cleft lip and/or palate (CLP) commonly present with otitis media with effusion (OME), with increased referrals for newborn hearing screening (NHS). Auditory brainstem response (ABR) testing with OME may mimic sensorineural hearing loss. This study evaluated NHS and ABR findings on and optimal timing for ABR reassessment after tympanostomy in patients with CLP. <b>Methods</b>: We conducted a retrospective study reviewing 271 CLP cases at our institution. The data included the cleft type, NHS results, ABR findings, OME incidence, and tympanostomy rate. Subgroup analyses compared ABR results before and after tympanostomy and via postoperative timing. Statistical comparisons were performed using the Mann-Whitney U test and Fisher's exact test. <b>Results</b>: The NHS referral rate was 14.0%, and the OME incidence was 48.7%. These cases occurred in patients with cleft palate involvement, with an OME prevalence of 73.4%. Tympanostomy was performed in 72.6% of cases. Among 36 ears tested pre- and post-tympanostomy, wave V thresholds improved from 61.67 ± 16.08 to 34.72 ± 6.54 dBnHL (<i>p</i> < 0.0001), and wave I latency decreased from 2.27 ± 0.36 to 1.76 ± 0.12 ms (<i>p</i> < 0.0001). Postoperative wave V thresholds were significantly better in the ≥15-day group (<i>p</i> = 0.037), with 65% (17/26) of ears showing thresholds <40 dBnHL compared to 25% (3/12) in the <15-day group (<i>p</i> = 0.035). No timing-related differences were found regarding wave I latency. <b>Conclusions</b>: Tympanostomy significantly improved the ABR results in children with CLP and OME. Reassessment on or after postoperative day 15 may yield more accurate results and may help to reduce parental anxiety.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145178917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Children-BaselPub Date : 2025-09-16DOI: 10.3390/children12091241
Carina Omoeva, Rafael Contreras Gomez, Rachel Hatch, Frances Aboud, Ania Chaluda, Given Hapunda, Karma Choden, Francis Sichimba, Ksenija Krstić, Jill Popp
{"title":"Do Playful Parenting Programs Implemented at Scale Improve Caregiver Practices and Child Development?","authors":"Carina Omoeva, Rafael Contreras Gomez, Rachel Hatch, Frances Aboud, Ania Chaluda, Given Hapunda, Karma Choden, Francis Sichimba, Ksenija Krstić, Jill Popp","doi":"10.3390/children12091241","DOIUrl":"10.3390/children12091241","url":null,"abstract":"<p><p><b>Background/Objectives</b>: As an independent research group, we examined parent and child outcomes of three different parenting programs delivered at scale. The programs were implemented in Bhutan, Serbia and Zambia by different organizations. <b>Methods</b>: Mixed methods included a caregiver interview using the HOME Inventory, a direct child assessment using the Global Scales of Early Development (GSED) and focus group discussions with caregivers (FGD). Sampled mothers and children were randomly selected for the HOME/GSED: Bhutan <i>n</i> = 432, Serbia <i>n</i> = 636, Zambia <i>n</i> = 1024. Over 40 mothers and fathers of children under 3 years were purposively selected for FGD. Intention-to-treat and secondary regression analyses of attendees and non-attendees were conducted on the HOME and GSED; FGDs were subject to content analysis. <b>Results</b>: Parenting practices were found to be minimally (Bhutan) or modestly (Zambia) higher for caregivers who attended group sessions. Caregivers in Serbia who recalled receiving play messages had higher HOME scores. Child outcomes showed small (Bhutan) or no differences (Serbia, Zambia) associated with participation. <b>Conclusions</b>: Explanations focused on limits to program participation in scaled programs, the need for pilot evaluations to ensure that the program design is effective, and the need to monitor delivery quality and other implementation processes.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Children-BaselPub Date : 2025-09-16DOI: 10.3390/children12091236
Tatiana Costas, María de la O Rodríguez, María Martín Esquilas, Verónica Alarcón, Francisco Javier Goenaga, María Ángeles Cabrero, Ana María Cubo
{"title":"Long-Term Outcomes of Prenatally Diagnosed Fetal Hemivertebra: A 15-Year Single-Center Review.","authors":"Tatiana Costas, María de la O Rodríguez, María Martín Esquilas, Verónica Alarcón, Francisco Javier Goenaga, María Ángeles Cabrero, Ana María Cubo","doi":"10.3390/children12091236","DOIUrl":"10.3390/children12091236","url":null,"abstract":"<p><strong>Background/objectives: </strong>The primary aim of this study was to describe all cases of fetal hemivertebrae diagnosed prenatally at the Hospital Clínico Universitario de Salamanca over the last 15 years. Additionally, the presence of associated malformations was assessed, pregnancy outcomes were evaluated, and child development results were analyzed in affected cases.</p><p><strong>Methods: </strong>We undertook a prospective observational analysis of all cases (N = 10) of prenatally diagnosed hemivertebrae at our hospital between 2007 and 2022. Postnatal follow-up was performed through telephone interviews and reviewing medical records.</p><p><strong>Results: </strong>Most cases were diagnosed during the second-trimester ultrasound, with the lumbar region being the most frequently affected site (60%). Multiple hemivertebrae were detected in 4 of 10 cases. One case of Marfan syndrome and two cases of VACTERL association (vertebral defects, anal atresia, tracheoesophageal fistula, renal dysplasia, and limb abnormalities) were documented. Six cases presented with additional malformations. Cases involving multiple hemivertebrae (40%) were more likely to be associated with other anomalies and poorer prognoses, while isolated single hemivertebra showed favorable outcomes, with normal development during childhood. Vaginal delivery occurred in six cases, while cesarean sections were performed for standard obstetric indications unrelated to the hemivertebra diagnosis.</p><p><strong>Conclusions: </strong>Prenatal diagnosis of hemivertebra is achievable and holds critical neonatal and postnatal relevance. Hemivertebrae are often linked to additional disorders, including genetic syndromes, and carry significant prognostic implications depending on the associated anomalies and the extent of vertebral involvement.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gut Microbiota Composition and Sleep in Preschoolers: The ELFE Birth Cohort Study.","authors":"Zeinab Houshialsadat, Cécile Zaros, Marie-José Butel, Marie-Aline Charles, Gaël Toubon, Sabine Plancoulaine","doi":"10.3390/children12091240","DOIUrl":"10.3390/children12091240","url":null,"abstract":"<p><strong>Background/objectives: </strong>Sleep is essential for children's well-being, yet insufficient sleep duration and quality are common among preschoolers. The brain-gut microbiota axis, a bidirectional communication network connecting the brain, the gastrointestinal tract, and the microorganisms living there, known as the gut microbiota, influences sleep regulation, but its role in children remains largely unexplored. Here, we examined the association between gut microbiota and sleep in preschoolers from Étude Longitudinale Française depuis l'Enfance (ELFE) birth cohort study.</p><p><strong>Methods: </strong>This study included 597 children (51.2% boys) with available stool samples and sleep data at 3.5 years. The gut microbiota data was analyzed using bacterial 16S rRNA sequencing. Data on day and night sleep durations and frequencies of sleep onset difficulties and night waking were collected through telephone questionnaires and grouped into 'optimal' and 'suboptimal' clusters using Latent Class Analysis. Statistical analyses involved multivariate logistic regressions or multivariate permutation analysis of variance, controlling for confounders.</p><p><strong>Results: </strong>In total, 25% of the included children were in the suboptimal sleep cluster. No significant associations were found between gut microbiota diversity and composition and sleep clusters at age 3.5 years. Similarly, no differences were found in the abundance of specific microbiota genera between the two sleep clusters.</p><p><strong>Conclusions: </strong>While emerging evidence suggests correlations between gut microbiota and sleep in preschool children, our results do not confirm such correlations. The data used in this study were obtained from a homogeneous, high socioeconomic population, which must be considered when interpreting the findings. Further research is needed to validate the results of this study.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Children-BaselPub Date : 2025-09-15DOI: 10.3390/children12091231
Diogo C Frazao, Miguel A C Salgado, Ryan J Cody, Elizabeth M Kay, Henrique Pretti, G Dave Singh, Luiz A Pimenta
{"title":"Expanding Access to Presurgical Cleft Care: Digital Nasoalveolar Molding with Clear Aligners in a Rural Low-Income Population.","authors":"Diogo C Frazao, Miguel A C Salgado, Ryan J Cody, Elizabeth M Kay, Henrique Pretti, G Dave Singh, Luiz A Pimenta","doi":"10.3390/children12091231","DOIUrl":"10.3390/children12091231","url":null,"abstract":"<p><p><b>Background:</b> Presurgical nasoalveolar molding (NAM) improves outcomes in infants with cleft lip and palate by guiding alveolar segment alignment and enhancing nasal symmetry prior to primary lip repair. However, traditional NAM protocols require frequent clinical visits and specialized expertise, limiting access for families in rural and low-resource settings. <b>Objective</b>: This retrospective clinical study evaluated the feasibility and clinical outcomes of a digitally guided NAM approach using thermoformed clear aligners in infants with unilateral complete cleft lip and palate. <b>Material and Methods:</b> Twenty-five neonates residing in rural regions were treated over a 20-week pre-surgical period using a digital workflow that included intraoral scanning, 3D model design, and sequential aligner fabrication. The protocol minimized the number of in-office visits while engaging caregivers in home-based appliance management. Anatomical changes were assessed using 3D models at baseline and at treatment completion. <b>Results:</b> Significant reductions were observed in anterior cleft width (mean decrease: 5.38 mm, 95% CI: -7.58 to -3.18, <i>p</i> < 0.001) and posterior cleft width (mean decrease: 3.39 mm, 95% CI: -4.79 to -1.99, <i>p</i> < 0.001). Intermolar distance increased by 1.23 mm (<i>p</i> = 0.036), while intercanine width remained stable (<i>p</i> = 0.515), indicating preservation of maxillary arch form. Surgeons reported improved nasal symmetry and tissue alignment at the time of lip repair. <b>Conclusions:</b> This digitally planned NAM clear aligner protocol demonstrated clinical feasibility and effectiveness in reducing cleft width during the pre-surgical period. Findings should be interpreted with caution, given the retrospective design, lack of a control group, and absence of objective nasal outcome measures. Further studies are recommended to assess long-term outcomes and broader implementation potential.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145178946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Children-BaselPub Date : 2025-09-15DOI: 10.3390/children12091232
Hae Jeong Lee, Yechan Kyung, Dong Wan Kang, Mi Hyeon Jin, Seoheui Choi, Jun Hwa Lee
{"title":"Examining Pediatric Emergency Utilization Trends Before and After the COVID-19 Pandemic: An Eight-Year Cohort Study from a South Korean Tertiary Center.","authors":"Hae Jeong Lee, Yechan Kyung, Dong Wan Kang, Mi Hyeon Jin, Seoheui Choi, Jun Hwa Lee","doi":"10.3390/children12091232","DOIUrl":"10.3390/children12091232","url":null,"abstract":"<p><p><b>Purpose:</b> This study investigates trends in pediatric emergency department (ED) utilization before and after the COVID-19 pandemic, with a focus on age-specific patterns, triage severity, diagnostic categories, and clinical presentations. <b>Methods:</b> Data were collected for 71,560 individuals (40,428 males and 31,132 females aged 0-18 years) who visited the ED at Samsung Changwon Hospital between 1 January 2016 and 31 December 2023. Patients were categorized into pre-COVID-19 (2016-2019) and post-COVID-19 (2020-2023) periods. Age, Korean Triage and Acuity Scale (KTAS) scores, visit outcomes, diagnostic codes (ICD-10), and vital signs were analyzed. Age-specific analyses were performed in four groups: <12 months, 1-6 years, 7-12 years, and 13-18 years. <b>Results:</b> Since the COVID-19 pandemic, pediatric ED visits have decreased by 55.5%. The proportion of visits by infants (<12 months) and young children (1-6 years) decreased, and adolescent visits increased. Post-pandemic, there was a significant increase in lower-acuity visits (KTAS 4) and discharge rates, alongside a reduction in admissions. Visits for respiratory and infectious diseases (ICD-10 J and A & B codes) decreased markedly, and visits for non-specific symptoms (R codes) and trauma (S & T codes) increased. The mean body weight of young children increased significantly after the COVID-19 period. <b>Conclusions:</b> The COVID-19 pandemic has had a profound and lasting effect on pediatric emergency department utilization, with changes in the number of visits, illness patterns, and severity by age group. These findings highlight the need for age-specific strategies in emergency planning and pediatric public health policy, particularly in managing the indirect effects of pandemic-induced changes in behavior and access to healthcare.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Non-Invasive Wearables in Pediatric Healthcare: A Comprehensive Review of Uses and Implications.","authors":"Kyra-Angela Magsayo, Seyedeh Fatemeh Khatami Firoozabadi","doi":"10.3390/children12091233","DOIUrl":"10.3390/children12091233","url":null,"abstract":"<p><p>Wearable technology is rapidly evolving, with increasing efforts to integrate a wide range of sensors capable of capturing real-time physiological and behavioral health data from users. These devices have shown significant promise in supporting health monitoring and promoting well-being by providing continuous, objective feedback based on data analytics. Importantly, they enable early detection of potential health issues, allowing for timely intervention and more personalized healthcare. While a wide variety of commercially available wearable devices are designed for adults-tracking metrics such as physical activity, heart rate, body temperature, electrocardiograms (ECG), and oxygen saturation-there remains a notable gap in the availability and development of wearable technologies specifically tailored to the pediatric population. This narrative review paper focuses on non-invasive wearable technologies developed for individuals under the age of 18, with an emphasis on health-related applications. We examine the current landscape of pediatric wearable research, including devices aimed at monitoring developmental progress and chronic health conditions. Particular attention is given to the limited research on wearables for younger children, where physiological and developmental differences pose additional challenges. Furthermore, we explore emerging applications, identify key barriers to adoption, and discuss opportunities for future development, including improvements in design, data privacy, and age-appropriate functionality.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Children-BaselPub Date : 2025-09-15DOI: 10.3390/children12091230
Tania Gaspar, Cheila Serafim, Margarida Gaspar de Matos, Marina Carvalho
{"title":"Trend Analysis of Self-Harm Behaviors and Stress Management Skills in Adolescents Between 2018, 2022, and 2024: A Comprehensive Ecological Model.","authors":"Tania Gaspar, Cheila Serafim, Margarida Gaspar de Matos, Marina Carvalho","doi":"10.3390/children12091230","DOIUrl":"10.3390/children12091230","url":null,"abstract":"<p><strong>Background/objectives: </strong>Although non-suicidal self-harming behaviors (NSSHBs) are increasingly recognized as both a symptom and risk factor in adolescent development, few studies have explored their biopsychosocial correlates, such as stress management, quality of life, family and peer support, and school-related factors, within a longitudinal framework. The present study aims to explore self-harm behaviors among adolescents from an ecological and biopsychosocial perspective over three distinct time points: pre-pandemic (2018), during the pandemic (2022), and post-pandemic (2024).</p><p><strong>Methods: </strong>The total sample comprised 12,233 adolescents, with 5695 in 2018, 5931 in 2022, and 607 in 2024. The percentage of adolescents reporting self-harm behaviors increased from 18.0% in 2018 to 21.8% in 2022 and slightly decreased to 20.2% in 2024.</p><p><strong>Results: </strong>Results show that, in both groups, stress management skills were positively predicted by family support, teacher relationship, quality of friendship, and future expectations, and they were negatively predicted by psychosomatic symptoms. The explained variance (adjusted R<sup>2</sup>) was consistently higher in the self-harm behavior group. The findings confirm that NSSHB is not only a symptom of individual distress but also a marker of insufficient psychosocial support and coping resources.</p><p><strong>Conclusions: </strong>Stress management skills emerged as a key vulnerability domain and were consistently lower among adolescents with NSSHB. Family support, school relationships, and mental well-being were central predictors of coping skills, reinforcing the relevance of multilevel, ecological approaches to prevention and intervention.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Children-BaselPub Date : 2025-09-14DOI: 10.3390/children12091228
Xiangli Gu, Samantha Moss, Xiaoxia Zhang, Tao Zhang, Tracy L Greer
{"title":"Effect of the Virtual Reality-Infused Movement and Activity Program (V-MAP) on Physical Activity and Cognition in Head Start Preschoolers.","authors":"Xiangli Gu, Samantha Moss, Xiaoxia Zhang, Tao Zhang, Tracy L Greer","doi":"10.3390/children12091228","DOIUrl":"10.3390/children12091228","url":null,"abstract":"<p><p><b>Background/Objectives:</b> This study examined the efficacy of a physical activity (PA) intervention augmented by a non-immersive Virtual Reality (VR) gaming system (i.e., Virtual Reality-infused Movement and Activity Program; V-MAP) on physical activity (i.e., sedentary behavior, moderate-to-vigorous PA [MVPA], vigorous PA [VPA]) and cognitive skills (i.e., response error, movement latency and reaction time) in Head Start preschoolers. Methods: Using a repeated-measure with 1-month follow-up design, a sample of 13 Head Start preschoolers (Mage = 67.08 ± 4.32 months; 36.2% boys) engaged in a 6-week V-MAP intervention (30-min session; 8 sessions) that focused on non-immersive VR based movement integration. The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to measure cognition; school-based PA and sedentary behavior were assessed by ActiGraph accelerometer. Pedometers were used to monitor real time engagement and implementation over eight intervention sessions. <b>Results</b>: On average, children obtained 1105 steps during the 30-min intervention (36.85 steps/min). There was a significant increase in VPA after the V-MAP intervention, whereas no significant changes in MVPA or sedentary behavior were observed (ps > 0.05). Although we did not observe significant improvement in studied cognitive function variables (ps > 0.05) after the V-MAP intervention, some delayed effects were observed in the follow-up test (Cohen's d ranges from -0.41 to -0.73). <b>Conclusions</b>: This efficacy trial provides preliminary support that implementing V-MAP in recess may help Head Start preschoolers achieve or accumulate the recommended daily 60-min MVPA guideline during preschool years. The findings also provide insights that VR-based PA for as little as 30 min per day may benefit cognitive capability.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Children-BaselPub Date : 2025-09-14DOI: 10.3390/children12091229
Elena Beani, Elisa Matteucci, Elisa Sicola, Giada Martini, Maria Chiara Di Lieto, Clara Bombonato, Valentina Menici, Annalisa Cotardo, Marta Rizzo, Silvia Filogna, Federica Camuncoli, Laura Biagi, Giovanni Cioni, Francesca Fedeli, Chiara Gelmini, Rita Neviani, Olivia Vecchi, Silvia Perazza, Silvia Faccioli, Antonino Errante, Alessandro Piras, Eleonora Sicuri, Francesca Bozzetti, Roslyn N Boyd, Adriano Ferrari, Leonardo Fogassi, Giuseppina Sgandurra
{"title":"ACT-ON-DIP: Study Protocol of a Randomized Controlled Trial of a Home-Based ACTion Observation Tele-RehabilitatioN for Upper Limb in Children with DIPlegic Cerebral Palsy.","authors":"Elena Beani, Elisa Matteucci, Elisa Sicola, Giada Martini, Maria Chiara Di Lieto, Clara Bombonato, Valentina Menici, Annalisa Cotardo, Marta Rizzo, Silvia Filogna, Federica Camuncoli, Laura Biagi, Giovanni Cioni, Francesca Fedeli, Chiara Gelmini, Rita Neviani, Olivia Vecchi, Silvia Perazza, Silvia Faccioli, Antonino Errante, Alessandro Piras, Eleonora Sicuri, Francesca Bozzetti, Roslyn N Boyd, Adriano Ferrari, Leonardo Fogassi, Giuseppina Sgandurra","doi":"10.3390/children12091229","DOIUrl":"10.3390/children12091229","url":null,"abstract":"<p><p><b>Background</b>: Children with diplegic Cerebral Palsy often exhibit upper-limb (UL) motor impairments compounded by deficits in visuospatial, sensory, and executive functions. Despite this, research has primarily focused on lower-limb rehabilitation, leaving the treatment of UL function in diplegic Cerebral Palsy underexplored. Action Observation Therapy (AOT), based on Mirror Neuron System activation, has shown promise in promoting motor recovery, but evidence specific to this population is limited. This exploratory randomized controlled trial (RCT) aims to assess the feasibility and effectiveness of a home-based AOT program-ACT ON DIP-for improving upper-limb function in children and adolescents with diplegic Cerebral Palsy. <b>Methods</b>: Fifty-four participants with spastic diplegic Cerebral Palsy (MACS and GMFCS levels I-III, aged 5-16 years) will be randomly assigned to an experimental group (receiving an 8-week home-based AOT program) or a control group (receiving standard care). The ACT ON DIP system includes an ad hoc software, kits of objects for daily tasks, and wearable sensors. The system allows for delivering structured uni- and bimanual AOT activities tailored to the child's profile. Primary outcome is the Both Hands Assessment (BoHA); secondary outcomes include motor (MA-2, BBT, ABILHAND), neuropsychological (NEPSY-II, Corsi Test, BRIEF), and participation measures (COPM, PEM-CY, CP-QOL). A subgroup will undergo fMRI to explore neural correlates of training-related changes. <b>Results</b>: Feasibility, compliance, and user experience with the home-based system will be assessed. This study will evaluate short-, medium-, and long-term changes in UL performance and related neuropsychological functions. <b>Conclusions</b>: ACT ON DIP represents a novel, personalized, and accessible tele-rehabilitation intervention for children with diplegic Cerebral Palsy. If effective, it could expand treatment opportunities for UL rehabilitation in this population and support broader implementation of home-based AOT.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"12 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}