Evaluation of physical and cardiorespiratory fitness in 7-year-old prematurely born children - preliminary study.

INTRODUCTION: Premature birth is connected with the risk of incidence of numerous health complications, the consequences of which are observed in the long-term. Decreased physical and cardiorespiratory fitness can also be associated with preterm birth. OBJECTIVE: The aim of the study is evaluation of the development level of physical and cardiorespiratory fitness in 7-year-old prematurely born children. MATERIAL AND METHODS: The following 7-year-old children were qualified for participation in the research: 30 children born on time and 30 children born prematurely. Physical fitness was evaluated with the International Physical Fitness Test (IPFT), whereas cardiorespiratory fitness was assessed on the basis of the Kasch Pulse Recovery Test. RESULTS: The results obtained demonstrate a lower level of physical and cardiorespiratory fitness in the studied group. Statistically significant differences are noticeable with respect to all IPFT components, except for long jump. The studied group display statistically significant higher values of pulse rate after exercise than the control group. On the other hand, there is no statistically significant correlation between a child's gestational age week of birth and the parameters evaluated. CONCLUSIONS: 7-year-old prematurely born children present lower physical and cardiorespiratory fitness than children born on time. The research results show a need for long-term monitoring of prematurely born children's development, as well as overall body efficiency. Further studies and observation of a higher number of patients are planned in order to confirm the findings.

Peritraumatic distress in mothers of severely ill children: a cross-sectional study.

INTRODUCTION: Peritraumatic distress is a syndrome that involves negative emotions, such as anxiety, helplessness and horror, experienced during and shortly after a traumatic event. The intensity of peritraumatic distress is significantly linked to the intensity of post-traumatic stress syndrome (PTSD) symptoms. The aim of the study was to study the intensity of peritraumatic distress symptoms in the mothers of severely ill children and the relationship between peritraumatic distress and psychological, socio-demographic and medical coefficients in the mothers. MATERIAL AND METHODS: An anonymous survey was performed in a group of 135 mothers of children with a perinatal medical history and mothers of children hospitalized in an intensive care unit and an oncology unit. The demographic questionnaire was compiled by the authors along with several standardized research tools. RESULTS: Intensity of peritraumatic distress correlates strongly positively with anxiety, ρ = 0.50; P < 0.001, and moderately positively with intrusion ρ = 0.39; P < 0.00, arousal, ρ = 0.38; P < 0.001, PTSD intensification, ρ = 0.40; P < 0.001, depression, ρ = 0.49; P < 0.001. Significant predictors of peritraumatic distress include the use of such coping strategies as acceptance, ß = -0.44; P = 0.001, denial, ß = 0.20; P = 0.019, planning, ß = -0.26; P = 0.012 and humour, ß = -0.29; P = 0.048, as well as the possibility to obtain self-worth support, ß = -0.07; P = 0.029 (R2 corrected = 0,32; F(5.33) = 9.43; P < 0.001). CONCLUSIONS: Coping strategies are a potentially modifiable factor, thus, implementing prevention programmes concerning the strategies should be considered.

Neurodevelopmental outcome and early rehabilitation of premature babies - is it needed in the first 2 years of life?

INTRODUCTION AND OBJECTIVE: The aim of the study was to evaluate the neurodevelopmental outcomes of extremely premature babies at the age of 2 years, and to determine whether rehabilitation was carried out during this period. An additional aim was to determine the relationship between the use of rehabilitation and the degree of prematurity, asphyxia, birth weight, and the result of brain ultrasound. MATERIAL AND METHODS: The study included 87 premature babies born between 24-31 weeks of pregnancy. A rehabilitation specialist assessed the neurodevelopmental outcomes of the children aged 2 years. Based on the documentation, the frequency of rehabilitation and its dependence on prematurity, asphyxia, birth weight and ultrasound results were analyzed. RESULTS: Correct neurodevelopmental outcome in children aged 2 years was found in 57 (65%) children, of whom 40 (46%) did not undergo rehabilitation. Incorrect development was observed in a group of 30 children - 12 patients were diagnosed with CP (14%), and 18 (21%) had 'red flags' of development milestones, they underwent rehabilitation. There was no statistically significant relationship between the degree of prematurity, perinatal asphyxia, birth weight and rehabilitation in the first 2 years of life. Abnormal ultrasound results were more common in rehabilitated children (n = 25; 53%) than in children without rehabilitation (n = 10; 25%), p = 0.008. CONCLUSIONS: Correct neurodevelopmental outcome at the age of 2 reached two-thirds of extreme prematurities, most of which did not need rehabilitation during this period. According to the authors' knowledge, this is the first study to show the percentage of premature babies who in the first 2 years of life did not require rehabilitation and achieved normal development.

The predictive value of 'red flags' as milestones of psychomotor development of premature babies - preliminary study.

INTRODUCTION: Premature babies are a special group at risk of persistent brain damage caused by diseases, the most serious of which are cerebral palsy(CP), autism spectrum disorders (ASD) and mental retardation, among others. These conditions may occur concurrently, but appear more often as separate disease syndromes in the same group of at-risk children. Long-term observation of psychomotor development by an interdisciplinary medical team closely cooperating with parents is necessary. It is important to detect the risk of developing these diseases as soon as possible in all development spheres. MATERIAL AND METHODS: The research was conducted to demonstrate the prognostic value of 'red flags' of developmental milestones and the ability to detect early signs of risk of developing CP and ASD in extremely premature babies. In this preliminary study, 42 preterm babies, born after less than 32 weeks pregnancy participated. RESULTS: The occurrence of 'red flags'in the spheres: gross motor, fine motor and cognitive at 9 months was strongly associated with their presence at 24 months. The sensitivity and specificity were: gross motor - 0.91 (95% CI: 0.59, 1.00) and 0.94 (95% CI: 0.79, 0.99); fine motor - 0.83 (95% CI 0.36-1.00) and 1.00 (95% CI: 0.90-1.00); cognitive - 1.00 (0.40, 1.00) and 0.97 (0.86, 1.00). Other spheres had lower sensitivity but high specificity. CONCLUSIONS: The conclusion is that the 'red flags'at the 9 months milestones already predict the normal or developmental delay of premature babies, and predict the risk of CP and ASD. Due to the availability and lack of the need for specialized and costly training, it is worth considering their use in everyday life medical practice.

An Interdisciplinary Model of Treatment of Children with Cerebral Palsy in Poland. Recommendations of the Paediatric Rehabilitation Section of the Polish Rehabilitation Society.

Medical rehabilitation plays an important leading role in the treatment of children with cerebral palsy (CP). Collaboration between specialists in medical rehabilitation and the rehabilitation team is a prerequisite for good medical care. The quality of medical services for children with CP depends chiefly on the level of expertise of the treatment team. Through training of specialists and sharing of knowledge, we can help more patients. This idea was developed and implemented by Dr Ewa Kooyman-Piskorz, the founder and president of Wandafonds Foundation. Between 2003 and 2014, Dutch specialists working with children with CP conducted a number of training workshops in Poland under the supervision of the Polish Rehabilitation Society and Prof. Jules Becher, a world-famous expert in the rehabilitation of children. Based on these experiences, we present the recommendations of the Paediatric Rehabilitation Section of the Polish Rehabilitation Society regarding an interdisciplinary model of treatment of children with CP in Poland.

Self-rated health in mothers of children hospitalised for severe illnesses and mothers of healthy children: cross-sectional study.

INTRODUCTION: Self-rated health (SRH) is a recognised tool for predicting morbidity and mortality. AIM: The aim of the study was to investigate and compare SRH in a group of mothers of hospitalised children and mothers of healthy children and to indicate the variables associated with poor SRH in both groups. METHODS: We conducted questionnaire-based cross-sectional research in a group of 184 women. Half of the respondents (n = 92) were the mothers of children hospitalised for a severe illnesses (Group H). The control group (n = 92) comprised mothers of healthy children (Group C). Self-Rated Health (SRH), Numerical Rating Scale (NRS), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale-Revised (IES-R) and Interpersonal Support Evaluation List (ISEL-40 v. GP) were used. In order to facilitate critical appraisal and interpretation of results, STROBE recommendations were used. RESULTS: The prevalence of poor SRH was greater in mothers of children hospitalised for a severe illness than in those of healthy children (35 and 19%, respectively). In both groups, the risk of poor SRH was statistically significantly higher in those mothers who for the past 7 days reported at least moderate pain and in mothers who manifested anxiety symptoms. In both groups, the prevalence of poor SRH was statistically significantly lower if the respondents' children were in good health. The risk of poor SRH was associated with poor financial status in group H and with depression and at least moderate pain for the past 7 days in group C. RELEVANCE TO CLINICAL PRACTICE: In order to provide mothers of severely ill children with high-quality health care including preventive measures, it is recommended that their health is assessed by healthcare professionals.