Purpose The purpose of this pilot study was to investigate the feasibility of a 3-week constraint-induced movement therapy program in children with brain tumors and upper extremity hemiplegia and to describe change in extremity use. Methods Affected arm use, health-related quality of life, and parent-reported feasibility of program participation were measured before and after the intervention and at a 3-month follow-up visit. Results All 9 participants completed the entire study. The quality and amount of affected arm use improved significantly; gains were maintained at the 3-month follow-up evaluation. Some parents (44%) reported that program participation was difficult; however, all reported satisfaction with the program. Participants did not experience negative changes in health-related quality of life during the intervention, indicating that the program was well tolerated. Conclusions Findings suggest that a child with hemiplegia as a result of a brain tumor can adhere to and benefit from a CIMT program.
Purpose Because retinoblastoma typically arises at a very young age, children are particularly vulnerable to vision impairment, associated developmental delays, and functional limitations. Limited information is available describing developmental delay and functional limitations in this population, necessitating supportive services including rehabilitation. The aims of this study were to describe the participation of children with newly diagnosed retinoblastoma in an occupational therapy program that identifies children in need of rehabilitation services. We also identify indications for referral to rehabilitation services among children with newly diagnosed retinoblastoma and enumerate the likelihood of these children receiving the recommended services. Methods Twenty-two children participated in longitudinal occupational therapy assessments during the first year after diagnosis. Results We recommended 1 or more types of rehabilitation services for 16 of 22 (72.7%) participants. Twelve of 16 (75%) received services. Conclusions The results of this pilot study indicate that implementing a prospective occupational therapy–screening program is feasible and results in identification and initiation of therapy services in some children with retinoblastoma. Developmental screenings and follow-up of children with retinoblastoma is strongly recommended.
Regression analysis demonstrated a linear relationship between the number of benchmarks recovered by week 6 and degree of residual disability on the DRS (Adjusted R-square Z 0.6381; P < 0.0001). For each benchmark detected, the DRS score decreased (i.e., improved) by 1.7 points on average. while nearly half of the MCS+ subgroup (46.2%) recovered all 6 benchmarks, approximately 1 in 10 subjects in the MCS-(8.82%) and VS (11.4%) subgroups did so (see table 5). Degree of disability at week 6 indexed by the mean DRS differed significantly in favor of the MCS+ subgroup (MCS+ Z 12; MCS-Z 17; VS Z 23; Kruskal-Wallis Test Z P<0.001), as did the percentage of participants who emerged from MCS (MCS+ Z 73.1%; MCS-Z 38.2%; VS Z 14.3%; c2MH Z 21.20, 1 d.f., P < 0.0001). Conclusions: Significant functional recovery is common in patients with prolonged traumatic DoC following discharge from the intensive care setting. Patients in MCS with evidence of language function are most likely to recover other high-level behaviors linked to improvement in functional status. These findings should be considered in the context of early decision-making in the ICU concerning intensity of care and indications for rehabilitative treatment.
PURPOSE: To describe clinical data, rehabilitation services, and outcomes of children with handedness switching as their presenting symptom before low-grade glioma (LGG) diagnosis. METHODS: A retrospective chart review was performed for five patients (four female and four white) with LGG and confirmed handedness switching before LGG diagnosis. RESULTS: All children were less than 8 years at diagnosis, and two patients were less than 3 years. All children were initially right-handed and experienced loss of motor function, ranging from weakness to paresis, in their dominant hand. The median time from switching handedness to diagnosis was 1 month (range: 0.75–60 months). Rehabilitation was offered for three patients, and motor function deficits in the initial dominant hand were resolved in two of the total cohort. At long-term follow-up, hand dominance returned to the initial hand in three patients. CONCLUSIONS: Handedness switching should be acknowledged as a potential sign of LGG in children, and early long-term rehabilitation services should be offered for these children.
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