The SARA and BARS are reliable and valid measures and appear to be of equal value in determining the severity of ataxia in children with posterior fossa tumours.

Introduction Tumors of the cerebellum are the most common brain tumors in children. Modern treatment and aggressive surgery have improved the overall survival. Consequently, growing numbers of survivors are at high risk for developing adverse and long-term neurological deficits including deficits of cognition, behavior, speech, and language. Post-operative cerebellar mutism syndrome (pCMS) is a well-known and frequently occurring complication of cerebellar tumor surgery in children. In the acute stage, children with pCMS may show deterioration of cerebellar motor function as well as pyramidal and cranial neuropathies. Most debilitating is the mutism or the severe reduction of speech and a range of neurobehavioral symptoms that may occur. In the long term, children that recover from pCMS continue to have more motor, behavioral, and cognitive problems than children who did not develop pCMS after cerebellar tumor surgery. The severity of these long-term sequelae seems to be related to the length of the mute phase. Aim of this narrative review The impact of pCMS on patients and families cannot be overstated. This contribution aims to discuss the present knowledge on the natural course, recovery, and rehabilitation of children with pCMS. We suggest future priorities in developing rehabilitation programs in order to improve the long-term quality of life and participation of children after cerebellar tumor surgery and after pCMS in particular.

The effectiveness of exercise and physical therapy for children with ataxia is poorly understood. The aim of this systematic review was to critically evaluate the range, scope and methodological quality of studies investigating the effectiveness of exercise and physical therapy interventions for children with ataxia. The following databases were searched: AMED, CENTRAL, CDSR, CINAHL, ClinicalTrials.gov, EMBASE, Ovid MEDLINE, PEDro and Web of Science. No limits were placed on language, type of study or year of publication. Two reviewers independently determined whether the studies met the inclusion criteria, extracted all relevant outcomes, and conducted methodological quality assessments. A total of 1988 studies were identified, and 124 full texts were screened. Twenty studies were included in the review. A total of 40 children (aged 5–18 years) with ataxia as a primary impairment participated in the included studies. Data were able to be extracted from eleven studies with a total of 21 children (aged 5–18 years), with a range of cerebellar pathology. The studies reported promising results but were of low methodological quality (no RCTs), used small sample sizes and were heterogeneous in terms of interventions, participants and outcomes. No firm conclusions can be made about the effectiveness of exercise and physical therapy for children with ataxia. There is a need for further high-quality child-centred research.Electronic supplementary materialThe online version of this article (10.1007/s12311-019-01063-z) contains supplementary material, which is available to authorized users.

Background There is minimal literature specific to motor outcomes in children with posterior fossa tumors (PFTs) despite ataxia being a significant problem in this group. This study aims to report children’s physical outcomes following management of PFT and determine which factors affect severity of ataxia and functional limitations. Methods Forty-two children aged between 5 and 17 and between 1 and 4 years following surgery for PFT were assessed using the Scale for the Assessment and Rating of Ataxia (SARA), the Brief Ataxia Rating Scale (BARS), and the mobility Pediatric Evaluation of Disability Inventory (PEDI) subscale to determine prevalence and severity of ataxia and a measure of physical function. Analysis was undertaken comparing impact of tumor location, tumor histology, adjuvant treatment, age at diagnosis, presence of preoperative ataxia, and presence of cerebellar mutism syndrome (CMS) on ataxia and physical function scores. Results Seventy-one percent of children demonstrated a SARA and BARS score greater than 2. A total of 48% of children had a PEDI-m score greater than 90. There was no correlation between age at diagnosis or preoperative ataxia and assessment scores. There was a significant difference in SARA/BARS and PEDI-mobility scores depending on tumor histology, tumor location, and presence of CMS. Conclusions A high proportion of children (>1 year) following surgery for PFT continue to present with ataxia. Higher ataxia and lower physical function scores were demonstrated in children with medulloblastoma and midline tumors and those diagnosed with CMS. The high prevalence of ataxia demonstrates the need for further research regarding rehabilitation management in this population.

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IPNI (International Plant Names Index) has been providing nomenclatural data in one form or another for the past 138 years. Over the past decade, great progress has been made in improving the data and making it accessible via a new website. We will be showcasing the new features that have been added to the website, in particular the latest addition, name registration. While obligatory name registration has already been in place for fungi for a decade, we will be highlighting the opportunities it will bring to vascular plant sciences and our ever-increasing pace of data needs. Name registration will lighten the burden of finding newly published names and entering them into the IPNI database, allowing the IPNI curation team to focus on other aspects that have been left behind, like data standardisation. We will also be revisiting some of the longstanding features of IPNI like the LSID (Life Sciences Identifier), which has been used on the IPNI website since its launch in the year 2000, even though new projects still continue to invent their own identifiers. We will look into why this is and how these can improve the efficiency of curating databases that contain plant names, including WFO (World Flora Online). For the past 34 years, the IPNI data have been the basis for the taxonomic database, WCVP (World Checklist of Vascular Plants), which records both synonymy and biogeography of vascular plants. Since 2014, both these datasets are curated as part of the same team resulting in greater coordination and data improvements on both sides. WCSP contains some 200,000 names that are not in IPNI and the process has now started to add them to IPNI. IPNI LSIDs have also been added to WCVP, increasing the opportunities of linking to other programmes, like WFO. A widespread utilisation of IPNI LSIDS would offer the opportunity to combine different global plant checklists, allowing users to choose under which taxonomy they want to see data and forego the requirement for one globally agreed taxonomy. However, IPNI and WCVP are still stand-alone legacy database systems, which limit their functionality in a continually changing landscape of user needs. Although half of the WCVP data have been reviewed by experts, more integrated access is needed to speed up the review of the other half and continued direct access by these expert groups, including some of the TENs (Taxonomic Expert Networks) established for WFO. We will investigate the possible synergies that may be possible by combining the day-to-day grind of WCVP data management and expert input.

The aim of this study was to determine how physio therapists in different countries currently treat child ren with balance/coordination problems following sur gery for a brain tumour. An esurvey, with questions on type of physiotherapy treatment, intensity and ti ming of treatment, and aims and outcomes of phy siotherapy management, was sent to special interest groups, which included physiotherapists with expertise in this area. A total of 96 physiotherapists participated in the survey. The most common physiotherapy treat ments used were balance exercises and gait reedu cation. Mobility aids and orthotics (e.g. splints) were also commonly used. Physiotherapists reported chal lenges to treatment, including lack of availability of physiotherapy following discharge from hospital, lack of evidence to guide treatment, and impact of onco logy treatment (e.g. chemotherapy/radiotherapy) on the child's rehabilitation. In conclusion, there is little evidence in this area. The results of this survey pro vide an initial basis to understand the challenges of treatment and to plan future research. Objective: To determine current international practice regarding physiotherapy input for children with ataxia following surgery for posterior fossa tumour. Design: An e-survey covering the following domains: participant demographics, treatment/ intervention, virtual training, intensity/timing of treatment, and aims and outcomes of physiotherapy management. Participants: Physiotherapists involved in the management of children with ataxia following surgical resection of posterior fossa tumour.