The Development and Pilot Testing of a Fidelity Checklist for a Family-Centered Telehealth Intervention for Parents of Children with Motor Delay.

This multi-methods study describes the development of a pediatric rehabilitation telehealth intervention fidelity checklist, estimates its inter-rater reliability, and documents raters' implementation experience. A literature scan and expert consultation identified eighteen key behaviors and categorized them into three subdomains, measured using a 5-point measurement system. To estimate the checklist's inter-rater reliability, three raters scored 33 video recordings. A Shrout and Fleiss Class 1,1 intraclass correlation (ICC)) and 95% confidence intervals (CI) calculated ICCs = 0.5 (CI: 0, 0.9) for both the Therapist and the Parent-Therapists subdomains, and the Parent subdomain an ICC = 0.3 (CI: 0, 0.8). In the implementation surveys, raters reported high levels of satisfaction (100%), ease of use (84% to 88%), and confidence in their video ratings (87% to 100%). Changes in procedures and scoring were recommended. Capturing raters' implementation experiences is crucial in the early evaluation of the fidelity checklists for telehealth.

Reliability of Selected Health-Related Fitness Tests for Children With Developmental Coordination Disorder.

Aim: To quantify test-retest reliability and minimal detectable change for 90 and 95% confidence levels (90MDC, 95MDC) for health-related fitness tests in children with developmental coordination disorder (DCD). Methods: Lower limb muscle strength [hand-held dynamometry (HHD), unilateral heel rise test (UHRT), standing broad jump (SBJ)], muscle endurance [Muscle Power Sprint Test (MPST)] and cardiorespiratory endurance [20-metre Shuttle Run Test (20mSRT)] were evaluated twice (2-7 day interval) in 31 children with DCD (20 males, 9.4 years old ± 2.0). Results: Test-retest reliability was reported as intraclass correlation coefficient (ICC) (2, 1) 95% confidence interval lower bounds. Values were excellent for MPST (peak and mean power: 0.93, 0.95), good for HHD (0.81-0.88), SBJ (0.82), and the 20mSRT (0.87) and moderate for UHRT (0.74). For HHD, the 90MDC and 95MDC were the largest for hip extensors (14.47, 12.14 Nm) and the smallest for ankle dorsiflexors (1.55, 1.30 Nm). For UHRT, SBJ, MPST and the 20mSRT, these MDC values were 11.90, 9.98 repetitions; 25.49, 21.38 cm; 4.70, 3.94 W (mean power), and 6.45, 5.42 W (peak power) and 0.87, 0.73 (number of stages), respectively. Conclusion: These tests yield reliable test-retest results that can be used to evaluate fitness changes in this group.

Reducing endocrine metabolic disease risk in adults with chronic spinal cord injury: strategic activities conducted by the Ontario-Quebec RIISC team.

PURPOSE: The Rehabilitation Interventions for Individuals with a Spinal Cord Injury in the Community (RIISC) team aimed to develop and evaluate innovative rehabilitation interventions to identify endocrine metabolic disease (EMD) risk, intending to reduce the frequency and severity of EMD related morbidity and mortality among adults living with chronic spinal cord injury or disease (SCI/D). MATERIALS AND METHODS: An interprovincial team from Ontario and Quebec reviewed available EMD literature and evidence syntheses and completed an inventory of health services, policies and practices in SCI/D care. The review outcomes were combined with expert opinion to create an EMD risk model to inform health service transformation. RESULTS: EMD risk and mortality are highly prevalent among adults with chronic SCI/D. In stark contrast, few rehabilitation interventions target EMD outcomes. The modelled solution proposes: 1) abandoning single-disease paradigms and examining a holistic perspective of the individual's EMD risk, and 2) developing and disseminating practice-based research approaches in outpatient community settings. CONCLUSIONS: RIISC model adoption could accelerate EMD care optimization, and ultimately inform the design of large-scale longitudinal pragmatic trials likely to improve health outcomes. Linking the RIISC team activities to economic evaluations and policy deliverables will strengthen the relevance and impact among policymakers, health care providers and patients.

Living with a spinal cord injury or disease (SCI/D) increases endocrine metabolic disease (EMD) risk.EMD-related outcomes include fracture; type II diabetes; and cardiovascular disease (myocardial infarction, sudden cardiac death and stroke), directly contributing to higher morbidity and mortality.Single-disease paradigms are not the ideal strategy to address multimorbidity contexts experienced in SCI/D.Practice-based research could be an alternative/adjunct to randomized control trials at generating evidence on current and emerging rehabilitation approaches.

A proposal for a universal physical therapy diagnostic concept.

BACKGROUND: In Canada, as in other countries, the physical therapist (PT) must make a diagnosis to comply with direct access responsibilities. This means making a diagnosis is an entry-to-practice essential competency. However, there is no consensus across physical therapy practice domains and contexts regarding the diagnostic concept, i.e., the classification system, labelling and diagnostic format that should be used. OBJECTIVE: To propose a universal diagnostic concept, one a PT could use regardless of their practice domain or context. METHODS: The relevant scientific and grey literature (1986-2022) were searched and key information was synthesized. RESULTS: Information from 194 retained documents (8506 identified) was synthesized to a list of seven essential criteria that were then used to develop a universal physical therapy diagnostic concept (PT-Dx-C). The PT-Dx-C format consists of three labels in the following order: (1) health problem, (2) primary impairment, and (3) primary activity limitation or participation restriction. Label definitions are those used by the World Health Organization. The specific health problem, impairment, and limitation or restriction making up the diagnosis are determined for each patient using valid tests and measures. CONCLUSIONS: The PT-Dx-C is consistent with best practices and could be applied to all patients, in all PT practice domains and contexts. It reflects the PT's expertise in the human movement system and their unique contribution to health care. Furthermore, its use may allow for communication of the PT's conclusions in a manner that can be understood by others thereby facilitating collaborative practice.

A Clinical Practice Guide to Enhance Physical Activity Participation for Children with Developmental Coordination Disorder in Canada.

Purpose: This clinical practice guide (CPG) aims to provide evidence-based recommendations for promoting and enhancing the participation and integration of children with developmental coordination disorder (DCD) into physical activities that take place in the home, school, community, or rehabilitation clinic contexts. Methods: A panel of key stakeholders relevant to these contexts (parents, instructors, rehabilitation professionals) developed evidence-based recommendations using a consensus methodology after reviewing results from a recent systematic review of relevant literature. The quality of the evidence on which the recommendations were based was evaluated (2011 Oxford Centre for Evidence-Based Medicine Levels of Evidence scale) as was the strength of the final CPG recommendations (American Society of Plastic Surgeons Grade Recommendation Scale). Results: Recommendations (n = 50; 36% supported by robust, empirically derived evidence) for the different stakeholder groups fell into three categories: 1) Choose an appropriate activity for your child, 2) Harmonize the activity with the child's interests and abilities, and 3) Help the child learn new movements prior to the activity. Conclusions: This comprehensive CPG provides concrete recommendations, based on the currently available evidence, that can be used by stakeholders to address the physical activity participation and integration needs of children with DCD in a variety of contexts.

Objectif: ces directives cliniques visent à fournir des recommandations basées sur les données probantes pour promouvoir et améliorer la participation et l'intégration des enfants ayant un trouble développemental de la coordination (TDC) à des activités physiques qui se déroulent à la maison, à l'école, dans la communauté ou dans des cliniques de réadaptation. Méthodologie: un groupe d'intervenants clés dans ces contextes (parents, entraineurs, professionnels de la réadaptation) a préparé des recommandations fondées sur des données probantes au moyen d'une méthodologie de consensus, après avoir révisé les résultats d'une récente analyse systématique de publications pertinentes. La qualité des données probantes sur laquelle reposent les recommandations a été évaluée (échelle de qualité des preuves de l'Oxford Centre for Evidence-Based Medicine de 2011) de même que les catégories des recommandations définitives tirées des directives (échelle des catégories de recommandations de l'American Society of Plastic Surgeons). Résultats: les recommandations (n = 50; 36 % soutenues par des données probantes empiriques vigoureuses) des divers groupes d'intervenants se déclinaient en trois catégories : 1) choisir une activité appropriée pour l'enfant, 2) harmoniser l'activité selon les intérêts et les capacités de l'enfant, 3) aider l'enfant à s'approprier de nouveaux mouvements pour aller vers l'activité. Conclusions: ces directives cliniques complètes fournissent des recommandations concrètes d'après les données probantes disponibles, que peuvent utiliser les intervenants pour aborder la participation à l'activité physique et les besoins d'intégration des enfants ayant un TDC dans divers contextes.

Rehabilitation interventions to modify endocrine-metabolic disease risk in individuals with chronic spinal cord injury living in the community (RIISC): A systematic search and review of prospective cohort and case-control studies.

CONTEXT: Endocrine-metabolic disease (EMD) is associated with functional disability, social isolation, hospitalization and even death in individuals living with a chronic spinal cord injury (SCI). There is currently very low-quality evidence that rehabilitation interventions can reduce EMD risk during chronic SCI. Non-randomized trials and alternative study designs are excluded from traditional knowledge synthesis. OBJECTIVE: To characterize evidence from level 3-4 studies evaluating rehabilitation interventions for their effectiveness to improve EMD risk in community-dwelling adults with chronic SCI. METHODS: Systematic searches of MEDLINE PubMed, EMBASE Ovid, CINAHL, Cochrane Database of Systematic Reviews, and PsychInfo were completed. All longitudinal trials, prospective cohort, case-control studies, and case series evaluating the effectiveness of rehabilitation/therapeutic interventions to modify/associate with EMD outcomes in adults with chronic SCI were eligible. Two authors independently selected studies and abstracted data. Mean changes from baseline were reported for EMD outcomes. The Downs and Black Checklist was used to rate evidence quality. RESULTS: Of 489 articles identified, 44 articles (N = 842) were eligible for inclusion. Individual studies reported statistically significant effects of electrical stimulation-assisted training on lower-extremity bone outcomes, and the combined effects of exercise and dietary interventions to improve body composition and cardiometabolic biomarkers (lipid profiles, glucose regulation). In contrast, there were also reports of no clinically important changes in EMD outcomes, suggesting lower quality evidence (study bias, inconsistent findings). CONCLUSION: Longitudinal multicentre pragmatic studies involving longer-term exercise and dietary intervention and follow-up periods are needed to fully understand the impact of these rehabilitation approaches to mitigate EMD risk. Our broad evaluation of prospective cohort and case-control studies provides new perspectives on alternative study designs, a multi-impairment paradigm approach of studying EMD outcomes, and knowledge gaps related to SCI rehabilitation.

Systematic review of the psychometric properties of cultural adaptations and translations of the Children's Assessment of Participation and Enjoyment (CAPE).

BACKGROUND: The Children's Assessment of Participation and Enjoyment (CAPE) is the most widely used questionnaire for the assessment of children participation. While several cultural adaptations and translations exist, the quality of the methods used to produce them, as well as their psychometric properties, remains unclear. The aim of this systematic review was to evaluate the different translated and/or culturally adapted versions of the CAPE for children and youth with and without disabilities. METHOD: A search was performed in five electronic databases CINAHL (EBSCO), MEDLINE (OVID), EMBASE (ELSEVIER), PSYCINFO (OVID), and WEB OF SCIENCE Core Collection (CLARIVATE), for articles available in French or English with the last update in July 2022. All studies related to a cultural adaptation and/or translation of the CAPE were retained and evaluated based on established guidelines for cross-cultural adaptations and measurement properties. The extraction was done independently by two authors. A critical appraisal of translation and psychometric properties methods was performed. Critical appraisal of the articles was done using the Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures tool and the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology. RESULTS: The search identified 642 studies (321 duplicates removed), 16 of which underwent full-text review. Nine studies met all inclusion criteria and underwent analysis. According to the recommended steps for cross-cultural adaptations, one study performed 100% of the steps and two others performed 80%. None of the studies met all the recommendations for the evaluation of psychometric properties. A full evaluation of reliability and internal consistency were reported by 74% of studies. None of the studies reported a full evaluation of responsiveness, agreement and/or construct validity. CONCLUSIONS: This review demonstrated limitations in the robustness of the methods used to develop and evaluate translated and culturally adapted versions of CAPE. To ensure valid and reliable results when conducting future research using the CAPE, it is recommended to fully evaluate the psychometric properties of the existing versions and to produce other translated and culturally adapted versions of the questionnaire.

Availability and Quality of Web Resources for Parents of Children With Disability: Content Analysis and Usability Study.

BACKGROUND: The internet is a valuable resource for parents of typical children, who are looking for information about their children's growth and development and how to boost them. However, for parents of children with special needs, especially for non-English-speaking parents, there are anecdotal reports stating that specific and accurate information is not available on the internet. OBJECTIVE: This study aims to describe the type of information available on the internet for French-speaking parents of children with disability as well as assess the quality of the information collected. METHODS: We carried out a search of the existing relevant websites targeted at parents of children with disability. We used a validated instrument to extract structural, textual, and visual characteristics of these websites and evaluate their usability. RESULTS: In all, 42 websites were analyzed; of these, the information had been validated by a trustworthy source in only 18 (43%) websites. Networking opportunities for parents were available in only 7 (17%) websites. Most websites provided information related to autism spectrum disorder (20/42, 42%) and learning disabilities (19/42, 45%), and only a few websites discussed other disability types such as behavorial disorders and developmental language disorders (4/42, 10% each). Community, social, and civic life (9/42, 22%); domestic life (12/42, 29%); and mobility (15/42, 36%) were the less frequently covered topics. With regard to the usability evaluation, 22 of the 42 (52%) websites received a global score <70%, whereas 20 (48%) scored ≥70. CONCLUSIONS: Although the internet is an infinite source of information, it is not necessarily actionable for parents of children with disability. Some information remains difficult to find online, and networking opportunities with other parents dealing with similar challenges are scarce.

Growth and muscle strength development in children with developmental coordination disorder.

AIM: To assess effects of growth on lower limb maximal isometric muscle strength (MIMS) development in children with developmental coordination disorder (DCD). METHOD: This observational study used hand-held dynamometry to evaluate MIMS (hip abductors, flexors, extensors; knee flexors and extensors; ankle dorsiflexors) in children with DCD (n=33, 12 females, 21 males, 6-12y, mean [SD] age 9y [2y]). Regression analysis compared changes in MIMS for similar changes in growth (height or body mass) for children with DCD and typically developing children (pre-existing database, n=183), controlling for age and sex. RESULTS: For the same height gain, the gain in muscle strength was 37.3% to 69.2% less in children with DCD compared with typically developing children, with significantly lower slopes (p-value between <0.001-0.042) in all muscle groups tested except knee extensors and ankle dorsiflexors in females. Strength gains related to body mass gains were not different for children with DCD compared to typically developing children. INTERPRETATION: Even when growing at a similar rate, children with DCD do not develop muscle strength gains at the same rate as their typically developing peers. WHAT THIS PAPER ADDS: Strength gains with growth (height) may be reduced in children with developmental coordination disorder.

Participation in leisure activities in adolescents with congenital heart defects.

AIM: To describe leisure participation in adolescents with congenital heart defects (CHD) and identify factors associated with intensity of participation. METHOD: Eighty adolescents with CHD were recruited (39 males, 41 females; mean age [SD] 15y 8mo [1y 8mo] range 11y 5mo-19y 11mo) of whom 78 completed the Children's Assessment of Participation and Enjoyment (CAPE) outcome measure of leisure participation. The measure has five subscales: recreational, active-physical, social, skill-based, and self-improvement. Associations between the CAPE and age, sex, and development were examined. Motor ability (Movement Assessment Battery for Children, Second Edition), cognition (Leiter International Performance Scale-Revised), behavior (Strengths and Difficulties Questionnaire), and motivation (Dimensions of Mastery Questionnaire) were assessed. RESULTS: Participants exhibited impaired motor (43.5%), behavioral (23.7%), and cognitive (29.9%) development. The most intense participation was in social (mean [SD] 3.3 [0.99]) and recreational (2.9 [0.80]) activity types on the CAPE. Male sex (p<0.05) and younger age were associated with greater physical activity (<15y: 1.87; ≥15y: 1.31, p<0.05). Greater engagement in social activities was related to better cognition (r=0.28, p<0.05), higher motor function (r=0.30-0.36, p<0.01), and fewer behavioral difficulties (r=-0.32 to -0.47, p<0.01). Cognitive ability (r=0.27, p<0.05), dexterity and aiming/catching (r=0.27-0.33, p<0.05), and behavior problems (r=0.38-0.49, p=0.001) were correlated with physical activity participation. Persistence in tasks, an aspect of motivation, correlated with physical (r=0.45, p<0.001) and social activity involvement (r=0.28, p<0.05). INTERPRETATION: Ongoing developmental impairments in adolescents with CHD are associated with decreased active-physical and social engagement, putting them at risk of poor physical and mental health. Health promotion strategies should be considered. WHAT THIS PAPER ADDS: Adolescents with congenital heart defects (CHD) have limited engagement in active-physical leisure activities. Cognitive, motor, and behavioral impairments are associated with decreased participation in leisure in children with CHD. Female sex and older age are associated with less engagement in leisure. Mastery motivation correlates with participation, suggesting an avenue for intervention.

Participación en actividades recreativas en adolescentes con cardiopatías congénitas OBJETIVO: Describir la participación en el tiempo libre en adolescentes con defectos cardíacos congénitos (CHD) e identificar los factores asociados con la intensidad de la participación. MÉTODO: Ochenta adolescentes con CHD fueron reclutados (39 varones, 41 mujeres; edad media [DE] 15 años 8 meses [1 año 8 meses] rango 11 año 5 meses- 19 año 11 meses) de los cuales 78 completaron la medida de resultado de la Evaluación de la Participación y el Disfrute de los Niños (Children's Assessment of Participation and Enjoyment [CAPE]) del ocio participación. La medida tiene cinco subescalas: recreación, actividad física, social, basada en habilidades y mejoría personal. Se examinaron las asociaciones entre el CAPE y la edad, el sexo y el desarrollo. Se evaluó la capacidad motora con la Batería de Evaluación de Movimiento para Niños (Movement Assessment Battery for Children, Segunda edición), la cognición (Leiter International Performance Scale-Revised), el comportamiento con el Cuestionario de Fortalezas y Dificultades (Strengths and Difficulties Questionnaire) y la motivación usando el cuestionario Dimensiones del Dominio (Dimensions of Mastery Questionnaire). RESULTADOS: Los participantes exhibieron problemas en el desarrollo motor (43.5%), conducta (23.7%) y en el desarrollo cognitivo (29.9%). La participación más intensa fue en los tipos de actividad social (media [DE] 3.3 [0.99]) y recreativa (2.9 [0.80]) en el CAPE. El sexo masculino (p <0.05) y la edad más joven se asociaron con una mayor actividad física (<15 años: 1.87; ≥15 años: 1.31, p <0.05). Una mayor participación en actividades sociales se relacionó con una mejor cognición (r = 0.28, p <0.05), una función motora más alta (r = 0.30-0.36, p <0.01) y menos dificultades en el comportamiento (r = -0.32 a -0.47, p < 0,01). La capacidad cognitiva (r = 0.27, p <0.05), la destreza manual y la habilidad para apuntar y atajar (r = 0.27-0.33, p <0.05) y los problemas de comportamiento (r = 0.38-0.49, p = 0.001) se correlacionaron con la participación en la actividad física. La capacidad de persistir en las tareas, un aspecto de la motivación se correlacionó con la participación física (r = 0.45, p <0.001) y la actividad social (r = 0.28, p <0.05). INTERPRETACIÓN: Los problemas de desarrollo en los adolescentes con CHD están asociados con una disminución de la participación física y social, lo que los pone a riesgo de una pobre salud física y mental. Deben buscarse estrategias para la promoción de la salud de esta población.

Participação em atividades de lazer em adolescentes com defeitos cardíacos congênitos OBJETIVO: Descrever a participação em lazer de adolescentes com defeitos cardíacos congênitos (DCC) e identificar fatores associados com a intensidade de participação. MÉTODO: Oitenta adolescentes com DCC foram recrutados (39 do sexo masculino, 41 do sexo feminino; média de idade [DP] 15a 8m [1a 8m] variação 11a 5m-19a 11m), dos quais 78 completaram a medida de participação em lazer Avaliação da participação e diversão das crianças (APDC). A medida tem cinco subescalas: recreacional, ativa-física, social, baseada em habilidades, e auto-aprimoramento. Associações entre a APDC e idade, sexo e desenvolvimento foram examinadas. A capacidade motora (Bateria de avaliação do movimento para crianças, segunda edição), cognição (Escala internacional de desempenho de Leiter- Revisada), comportamento (Questionário de capacidades e dificuldades), e motivação (Questionário de Dimensões do Domínio) foram avaliados. RESULTADOS: Os participantes exibiram comprometimento do desenvolvimento motor (43,5%), comportamental (23,7%), e cognitivo (29,9%). A participação mais intensa segundo a APDC foi nos tipos social (média [DP] 3,3 [0,99]) e recreacional (2.9 [0,80]). O sexo masculino (p<0,05) e menor idade foram associados com maior nível de atividade física (<15a: 1,87; ≥15a: 1,31, p<0,05). Um maior engajamento em atividades sociais foi relacionado com uma melhor cognição (r=0,28, p<0,05), maior função motora (r=0,30-0,36, p<0,01), e menos dificuldades comportamentais (r=-0,32 a -0,47, p<0,01). A capacidade cognitiva (r=0,27, p<0,05), destreza e mirar/apreender (r=0,27-0,33, p<0,05), e problemas comportamentais (r=0,38-0,49, p=0,001) foram correlacionadas com a participação em atividades físicas. A persistência nas tarefas, um aspecto da motivação, se correlacionou com o envolvimento em atividades físicas (r=0,45, p<0,001) e sociais (r=0,28, p<0,05). INTERPRETAÇÃO: Alterações persistentes do desenvolvimento de adolescentes com DCC são associadas com engajamento ativo-físico e social reduzidos, o que os coloca em risco para sua saúde física e mental. Estratégias de promoção de saúde deveriam ser consideradas.

Research and knowledge transfer priorities in developmental coordination disorder: Results from consultations with multiple stakeholders.

BACKGROUND: Priority-setting is a way to focus research and knowledge translation (KT) efforts for community-based research partnerships (CBRP). OBJECTIVE: To identify the developmental coordination disorder (DCD) research and KT priorities of stakeholders in Quebec, Canada, and their perceptions regarding the implementation of a CBRP. DESIGN: An advisory committee oversaw the research process including an online survey and four community forums. SETTING AND PARTICIPANTS: The survey was posted online and four community forums were organized. Participants included parents of children with DCD, adults with DCD, health professionals and school staff. MAIN VARIABLES: Stakeholder generated research and KT priorities, and optimal CBPR conditions. OUTCOME MEASURES: Participants selected their top five priorities based on a predefined list of 16 research and 12 KT priorities determined in collaboration with the advisory committee. They also rated the importance of various CBRP conditions. Preliminary survey results were discussed during the forums. RESULTS: Survey participants (n = 395) identified interwoven research and KT priorities where access to services was considered to be essential: supporting children at school; improving DCD identification and diagnosis; preventing secondary consequences; improving the organization of services and implementing effective services. Forum participants (n = 52) confirmed the relevance of these priorities and supported the establishment of a CBRP inclusive of all stakeholders to improve DCD services, research and KT. DISCUSSION AND CONCLUSIONS: A general consensus emerged among all groups, but adults with DCD were more concerned with employment than were the other stakeholder groups. These findings are presently being used to shape an ongoing, online CBRP.

Expérimentation d'une formation sur le trouble développemental de la coordination destinée aux enseignants en éducation physique.

Purpose: Best DCD practices include developing the ability of teachers to promote the participation of children in physical activities. The purpose of this study is to assess the impact of a one-day training session, including short lectures and workshops on developmental coordination disorder (DCD), on the perceptions that physical education teachers (PET) have of the knowledge, skills, and pedagogical practices. Methods: cohort study with a mixed pre-post-follow-up design that included a questionnaire before, immediately after, and three months after the training. Descriptive analyses, Wilcoxon tests, and a thematic analysis were performed. Results: 38, 35, and 22 PET respectively filled out the questionnaires at the three time-point. The perceptions of the knowledge, skills, and pedagogical practices of the PET were higher after the training compared to the initial perceptions (p < 0.006). At first, the PETs reported using certain general pedagogical strategies (e.g., modifying the task). After the training, the PETs gave more concrete examples and reported using new strategies (e.g., offering feedback after the task), which seems to have decreased behavioural problems. Conclusions: training can favourably modify the PETs' perceptions on their knowledge, skills, and practices. More research is necessary to assess the impact of the participation of children with a DCD.

Reliability of Inclinometer-Derived Passive Range of Motion Measures in Youth with Cerebral Palsy.

Aims: This study evaluated, for youth with cerebral palsy (CP), the reliability of passive range of motion (PROM) measures taken with an inclinometer, a device that may be simpler to use than a goniometer. Methods: The PROM for elbow and wrist extension, ankle dorsal flexion (knee flexed 90° and fully extended), and the knee popliteal angle of 30 youth with CP (18 boys, 12 girls, 7.0 ± 3.8 years old, classified in Gross Motor Function Classification levels I-V) was measured using an inclinometer. Two physical therapists took the measures during two different sessions, a maximum of 1 week apart. Results: Good mean intra-rater inter-session, inter-rater intra-session, and inter-rater inter-session reliability (ICC = 0.75-0.89), was found for the elbow, ankle, and knee sites. Absolute reliability for these sites and conditions was 7-14° (90% confident) and 10-16° (95% confident). Reliability values for wrist extension were comparable, albeit slight lower. Conclusions: Similar to published values for goniometry, inclinometery yields reliable upper and lower limb PROM measures from ambulatory and non-ambulatory youth with CP whether measures are carried out by different evaluators within or across sessions or whether measures are performed by the same evaluator across sessions.

Validity of Instrumented Insoles for Step Counting, Posture and Activity Recognition: A Systematic Review.

With the growing interest in daily activity monitoring, several insole designs have been developed to identify postures, detect activities, and count steps. However, the validity of these devices is not clearly established. The aim of this systematic review was to synthesize the available information on the criterion validity of instrumented insoles in detecting postures activities and steps. The literature search through six databases led to 33 articles that met inclusion criteria. These studies evaluated 17 different insole models and involved 290 participants from 16 to 75 years old. Criterion validity was assessed using six statistical indicators. For posture and activity recognition, accuracy varied from 75.0% to 100%, precision from 65.8% to 100%, specificity from 98.1% to 100%, sensitivity from 73.0% to 100%, and identification rate from 66.2% to 100%. For step counting, accuracies were very high (94.8% to 100%). Across studies, different postures and activities were assessed using different criterion validity indicators, leading to heterogeneous results. Instrumented insoles appeared to be highly accurate for steps counting. However, measurement properties were variable for posture and activity recognition. These findings call for a standardized methodology to investigate the measurement properties of such devices.

Children and Teens in Charge of their Health (CATCH): A protocol for a feasibility randomised controlled trial of solution-focused coaching to foster healthy lifestyles in childhood disability.

INTRODUCTION: Children with physical disabilities are rarely included in interventions to promote healthy lifestyles, despite being at higher risk for suboptimal dietary and physical activity behaviours. The Children and Teens in Charge of their Health study explores the feasibility and acceptability of conducting a randomised controlled trial (RCT) of a strengths-based, solution-focused coaching intervention for improving and sustaining physical activity and healthy dietary habits in children and young people with physical disabilities. METHODS AND ANALYSIS: Thirty children aged 10-18 years with a diagnosis of spina bifida or cerebral palsy who are able to set healthy lifestyle goals will be recruited from two children's rehabilitation hospitals in Ontario, Canada. Participants will be enrolled in the study for twelve months. All participants will receive standard care and printed information about healthy lifestyles. Of the 30 participants, 15 will be randomised to receive a coaching intervention for the first 6 months. Health indicators and psychosocial outcomes will be assessed by blinded assessors four times: at the start of the trial, immediately postintervention (6 months after randomisation), and at 3 and 6 months postintervention (9 and 12 months after randomisation, respectively). Predefined success criteria will be used to assess the feasibility of trial processes such as recruitment, attrition, stratification and intervention fidelity. Acceptability and perceived impact of the intervention will be explored qualitatively. ETHICS AND DISSEMINATION: The study has been approved by Holland Bloorview Kids Rehabilitation Hospital's Research Ethics Board (Ref: 17-752). A knowledge translation planning template will be used to ensure our findings have maximum reach. TRIAL REGISTRATION NUMBER: NCT03523806.

Design and Accuracy of an Instrumented Insole Using Pressure Sensors for Step Count.

Despite the accessibility of several step count measurement systems, count accuracy in real environments remains a major challenge. Microelectromechanical systems and pressure sensors seem to present a potential solution for step count accuracy. The purpose of this study was to equip an insole with pressure sensors and to test a novel and potentially more accurate method of detecting steps. Methods: Five force-sensitive resistors (FSR) were integrated under the heel, the first, third, and fifth metatarsal heads and the great toe. This system was tested with twelve healthy participants at self-selected and maximal walking speeds in indoor and outdoor settings. Step counts were computed based on previously reported calculation methods, individual and averaged FSR-signals, and a new method: cumulative sum of all FSR-signals. These data were compared to a direct visual step count for accuracy analysis. Results: This system accurately detected steps with success rates ranging from 95.5 ± 3.5% to 98.5 ± 2.1% (indoor) and from 96.5 ± 3.9% to 98.0 ± 2.3% (outdoor) for self-selected walking speeds and from 98.1 ± 2.7% to 99.0 ± 0.7% (indoor) and 97.0 ± 6.2% to 99.4 ± 0.7% (outdoor) for maximal walking speeds. Cumulative sum of pressure signals during the stance phase showed high step detection accuracy (99.5 ± 0.7%⁻99.6 ± 0.4%) and appeared to be a valid method of step counting. Conclusions: The accuracy of step counts varied according to the calculation methods, with cumulative sum-based method being highly accurate.

Recruitment, use, and satisfaction with a web platform supporting families of children with suspected or diagnosed developmental coordination disorder: a randomized feasibility trial.

Objectives. To determine the feasibility of recruiting families of children with suspected or diagnosed developmental coordination disorder (sdDCD) and explore their satisfaction with a web-based intervention Design. A feasibility randomized trial was conducted. Participants were the parents of 5-12-year-old children with sdDCD. The intervention group had access to online resources, group and private forums, and videoconferencing with a therapist. Main outcomes were recruitement and retention rates. Satisfaction was documented through a post-intervention survey and interview. Results. The recruitment rate was seven participants per month (n = 28 participants) and retention rate was 68%. Satisfaction was moderate. No differences in use and satisfaction were observed between groups. Participants formulated recommendations for improving the intervention, including targeting families earlier in the diagnosis process, and pre-scheduling meetings with therapists. Conclusions. This study demonstrated the feasibility of future trials, and highlighted avenues for improvement. Parent involvement during the development of the intervention is discussed at length. Abbreviations: DCD: Developmental Coordination Disorder; sdDCD: suspected or diagnosed Developmental Coordination Disorder; RCT: randomized-controled trial.

A Comparison of Developmental Outcomes of Adolescent Neonatal Intensive Care Unit Survivors Born with a Congenital Heart Defect or Born Preterm.

OBJECTIVE: To compare cognitive, motor, behavioral, and functional outcomes of adolescents born with a congenital heart defect (CHD) and adolescents born preterm. STUDY DESIGN: Adolescents (11-19 years old) born with a CHD requiring open-heart surgery during infancy (n = 80) or born preterm ≤29 weeks of gestational age (n = 128) between 1991 and 1999 underwent a cross-sectional evaluation of cognitive (Leiter International Performance Scale-Revised), motor (Movement Assessment Battery for Children-II), behavioral (Strengths and Difficulties Questionnaire), and functional (Vineland Adaptive Behavior Scale-II) outcomes. Independent samples t tests and Pearson χ2 or Fisher exact tests were used to compare mean scores and proportions of impairment, respectively, between groups. RESULTS: Adolescents born with a CHD and adolescents born preterm had similar cognitive, motor, behavioral, and functional outcomes. Cognitive deficits were detected in 14.3% of adolescents born with a CHD and 11.8% of adolescents born preterm. Motor difficulties were detected in 43.5% of adolescents born with a CHD and 50% of adolescents born preterm. Behavioral problems were found in 23.7% of adolescents in the CHD group and 22.9% in the preterm group. Functional limitations were detected in 12% of adolescents born with a CHD and 7.3% of adolescents born preterm. CONCLUSIONS: Adolescents born with a CHD or born preterm have similar profiles of developmental deficits. These findings highlight the importance of providing long-term surveillance to both populations and guide the provision of appropriate educational and rehabilitation services to better ameliorate long-term developmental difficulties.

The benefits of physical activities on cognitive and mental health in healthy and pathological aging.

Aging is associated with a decreased efficiency of different cognitive functions as well as in the perceptive, physical and physiological changes. The age-related cognitive decline concerns mainly attention, executive control and episodic memory. Some factors such as being physically active protect against the age-related decline. This review will discuss how physical activity can positively affect the cognitive efficiency and mental health of older healthy individuals, and possibly reduces the risk of progression into dementia, and depression. Underlying neurophysiological mechanisms play an important role for improving attention and episodic memory, which are the most sensitive to the effects of aging. We also present recommendations for the management of physical activity for the prevention of cognitive deficits, and the reduction of depressive symptoms in older persons. Given the benefits of physical activity for the prevention of neurodegenerative disease and the improvement of the well-being, it appears to be an important low cost therapeutic approach that should be integrated into clinical practice.