Developmental Medicine and Child Neurology最新文献

{"title":"Economic evaluation of the Akwenda Intervention Program for children and young people with cerebral palsy in rural Uganda: A trial-based analysis of costs and outcomes.","authors":"Elizabeth Asige, Eric Kintu, Gillian Saloojee, Godfrey Wanjala, Carin Andrews, Lukia H Namaganda, Angelina Kakooza-Mwesige, Diane L Damiano, Hans Forssberg","doi":"10.1111/dmcn.70581","DOIUrl":"https://doi.org/10.1111/dmcn.70581","url":null,"abstract":"<p><strong>Aim: </strong>To relate the trial-based costs of the Akwenda Intervention Program, a multi-component, community-based intervention for children and young people with cerebral palsy (CP) in rural Uganda, to multiple prespecified child and caregiver outcomes.</p><p><strong>Method: </strong>An economic evaluation was conducted within a cluster-randomized, assessor-blinded trial of 94 participants with CP (aged 2-23 years; 42 females) and their caregivers, allocated to intervention or usual care. Programme delivery costs were assessed from a restricted health care or provider perspective; selected out-of-pocket costs incurred by participating families were reported separately over 12 months. Outcome-specific incremental cost-effectiveness ratios (ICERs) were estimated for child outcomes (66-item Gross Motor Function Measure, Pediatric Evaluation of Disability Inventory [Ugandan version], and Picture My Participation) and caregiver outcomes (Zimbabwe Caregiver Challenges Scale and Pediatric Quality of Life Inventory Family Impact Module). Uncertainty was assessed using bootstrapping, cost-effectiveness planes, and exploratory acceptability curves. Costs were also determined per minimal clinically important difference (MCID) gained.</p><p><strong>Results: </strong>The mean incremental cost per child was US$1069 to US$1075. Outcome-specific ICERs ranged from US$26 to US$352 per unit of improvement for 10 of 11 outcomes; the Pediatric Evaluation of Disability Inventory (Ugandan version) mobility had a higher and highly uncertain ICER. Costs per MCID gained ranged from US$230 to US$600. Acceptability analyses were presented as exploratory uncertainty analyses because no established Uganda-specific willingness-to-pay thresholds exist for these outcome measures.</p><p><strong>Interpretation: </strong>The Akwenda Intervention Program improved child functioning, participation, and caregiver well-being at additional but predictable costs. This trial-based economic evaluation quantifies the costs associated with improvement across multiple prespecified outcomes and provides economic information relevant to the implementation of community-based rehabilitation in low-resource settings.</p>","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Envolvimento público no Registro Brasileiro de Paralisia Cerebral: um estudo exploratório, sequencial, de métodos mistos.","authors":"Luana Cristina da Silva, Claire Kerr, Israt Jahan, Raphael Fagundes Figueira Pinho, Aline Lincoln Silveira, Nádia Badawi, Gulam Khandaker, Gabriela Lorençoni Pauletti, Egmar Longo, Mercedes Ruiz Brunner, Paula Silva de Carvalho Chagas, Hércules Ribeiro Leite","doi":"10.1111/dmcn.70584","DOIUrl":"https://doi.org/10.1111/dmcn.70584","url":null,"abstract":"","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted gait training for respiratory function and quality of life in children with cerebral palsy: A randomized crossover trial.","authors":"Xiaoying Zhang, Xubo Yang, Wen Le, Jie Luo, Yunlan Xie, Mingtong Zhang, Hongmei Tang, Lu He, Jinling Li, Kaishou Xu","doi":"10.1111/dmcn.70572","DOIUrl":"https://doi.org/10.1111/dmcn.70572","url":null,"abstract":"<p><strong>Aim: </strong>To compare the effects of robot-assisted gait training (RAGT) to respiratory training on respiratory function and quality of life in non-ambulatory cerebral palsy.</p><p><strong>Method: </strong>In this randomized crossover trial, 22 children (13 males, nine females; mean age 5 years 10 months [SD 2 years 10 months], range 2 years 10 months-12 years 6 months) with cerebral palsy (classified in Gross Motor Function Classification System levels III-V) completed 6 weeks of RAGT and 6 weeks of respiratory training, separated by a 4-week washout. Assessments included tidal breathing parameters, accelerometer-based physical activity, the Caregiver Priorities & Child Health Index of Life with Disabilities, and the 88-item Gross Motor Function Measure.</p><p><strong>Results: </strong>Compared to respiratory training, RAGT yielded significantly greater improvements in tidal volume (RAGT 1.32 [1.12] vs respiratory training 0.51 [1.43], p < 0.001), time to peak tidal expiratory flow as a proportion of expiratory time (RAGT 4.82 [0.60] vs respiratory training 3.62 [0.60], p = 0.033), and minute ventilation (RAGT 0.44 [1.94] vs respiratory training 0.16 [1.66], p = 0.006), although these effects predominantly returned to baseline by the 4-week follow-up. Additionally, RAGT significantly reduced sedentary behaviour and increased light physical activity, as well as improved caregiver-reported mobility and gross motor function. No serious adverse events were reported.</p><p><strong>Interpretation: </strong>RAGT may be considered a potential short-term adjunct for improving respiratory function in non-ambulatory cerebral palsy.</p>","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Definition of childhood visual impairment: A systematic overview of reviews and authoritative sources across clinical, research, and policy contexts.","authors":"Martina Micai, Letizia Gila, Francesca Fulceri, Angela Caruso, Mara Sabbioni, Els Ortibus, Elisa Maria Fazzi, Corinna Bauer, John Ravencroft, Maria Luisa Scattoni","doi":"10.1111/dmcn.70519","DOIUrl":"https://doi.org/10.1111/dmcn.70519","url":null,"abstract":"<p><strong>Aims: </strong>To identify, synthesize, and compare current terminologies and definitions of cerebral visual impairment (CVI) in children across clinical, research, educational, and policy settings.</p><p><strong>Method: </strong>We conducted a systematic overview of systematic reviews and authoritative documents registered in PROSPERO (CRD420251025233) and reported in accordance with the PRISMA 2020 guidelines. We searched PubMed, Embase, CINAHL, Scopus, ProQuest Health and Medical, Web of Science, and the Cochrane Library for records published from 1st January 2015 to 10th April 2025, without language restrictions. Records were screened independently by pairs of reviewers. We performed manual searches of websites from governmental organizations, national health authorities, CVI societies, and international professional bodies.</p><p><strong>Results: </strong>Forty-eight systematic reviews and 26 authoritative documents were included. CVI was most commonly defined using World Health Organization-based or International Classification of Diseases-based distance visual acuity thresholds, typically defining visual impairment as a visual acuity worse than 6/12 in the better-seeing eye and blindness as visual acuity worse than 3/60. Visual field loss and near visual impairment were incorporated less consistently. Systematic reviews tended to prioritize measurable criteria, typically visual acuity in the better-seeing eye, whereas authoritative documents more frequently linked visual impairment to functional consequences for learning and daily activities. CVI was described in a subset of sources as brain-based visual dysfunction not fully explained by ocular pathology, but definitions and severity criteria varied widely. Few documents included structured functional vision assessment.</p><p><strong>Interpretation: </strong>CVI definitions remain heterogeneous and incompletely reflect real-world visual functioning, especially for CVI and functional vision. Consensus is needed on child-centred, multidimensional definitions integrating ocular and brain-based causes, multiple visual functions, and functional impact across sectors. A working definition of CVI is needed and has been proposed in this review.</p>","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International recommendations for child to adult care transition in rare neurological diseases: A scoping review and Delphi consensus study.","authors":"","doi":"10.1111/dmcn.70587","DOIUrl":"https://doi.org/10.1111/dmcn.70587","url":null,"abstract":"","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical cord deformation in cerebral palsy: Structural signatures of gross motor function and outcomes after selective dorsal rhizotomy.","authors":"Timur H Latypov, Karim Mithani, Sara Breitbart, Juliana Douglas, Amber Gill, Jackie Cotton, Leah Takeuchi, Aimee Chin-A-Young, Golda Milo-Manson, Darcy Fehlings, George M Ibrahim","doi":"10.1111/dmcn.70576","DOIUrl":"https://doi.org/10.1111/dmcn.70576","url":null,"abstract":"<p><strong>Aim: </strong>To identify structural signatures of cerebral palsy (CP) motor impairment and selective dorsal rhizotomy (SDR) outcomes using spinal cord deformation-based morphometry (scDBM).</p><p><strong>Method: </strong>This retrospective study quantifies spinal cord structural abnormalities in 39 children with CP, stratified by the baseline motor function (Gross Motor Function Classification System [GMFCS] levels I-II, n = 21 and GMFCS level > II, n = 18). T1-weighted clinical images were non-linearly registered to a healthy normative template. Localized spinal cord tissue volume change was modeled against baseline Gross Motor Function Measure (GMFM-66) and 12-month postSDR improvement.</p><p><strong>Results: </strong>In children with ambulatory impairment (GMFCS level > II, n = 18), lower motor capacity correlated with localized rostral cervical (C1-C4) deformation (p < 0.05); no correlates were identified in GMFCS levels I to II (n = 21). Clinical improvement after SDR was associated with baseline C1 dimensions closer to normative adult values, specifically involving reticulospinal and vestibulospinal tracts (p < 0.05).</p><p><strong>Interpretation: </strong>Spinal cord morphology reflects motor potential and surgical outcomes in CP (GMFCS level > II). Localizing C1 structural deficit, scDBM may provide an objective structural signature of severity to identify presurgical candidates with the necessary reserve to translate spasticity reduction into clinically meaningful motor gains.</p>","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric properties of the REACh developmental screening tool for preschool children in Sri Lanka.","authors":"","doi":"10.1111/dmcn.70588","DOIUrl":"https://doi.org/10.1111/dmcn.70588","url":null,"abstract":"","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical therapy interventions for children and adolescents with myelomeningocele: A systematic review.","authors":"","doi":"10.1111/dmcn.70589","DOIUrl":"https://doi.org/10.1111/dmcn.70589","url":null,"abstract":"","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pressure garment therapy and bimanual upper limb function in children with unilateral cerebral palsy: A randomized clinical trial.","authors":"","doi":"10.1111/dmcn.70590","DOIUrl":"https://doi.org/10.1111/dmcn.70590","url":null,"abstract":"","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meeting children where they are: The importance of culturally relevant developmental screening.","authors":"Benjamin Schindel","doi":"10.1111/dmcn.70541","DOIUrl":"https://doi.org/10.1111/dmcn.70541","url":null,"abstract":"","PeriodicalId":50587,"journal":{"name":"Developmental Medicine and Child Neurology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}