Journal of pediatric rehabilitation medicine
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To evaluate the safety and feasibility of virtual reality (VR) exercise as a novel acute rehabilitation intervention in a Pediatric Critical Care Unit (PCCU) setting. ⋯ While the results of this pilot trial suggest that VR exercise may be safely applied in a subset of critically ill children, we observed several threats to its feasibility in this population.
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J Pediatr Rehabil Med · Jan 2013
Autonomic cardiovascular dysfunction and vitamin D deficiency in pediatric spinal cord injury.
The purpose of this manuscript is to present a general overview and preliminary results of pilot projects of two complications in pediatric spinal cord injury (SCI): autonomic cardiovascular dysfunction and vitamin D deficiency. ⋯ Because of the clinical significance of autonomic dysreflexia and orthostatic hypotension, baseline BP and HR need to be routinely assessed in youth with SCI. In view of the high prevalence of vitamin D insufficiency in youth with SCI and the risk of complications such as pathological fractures, serum 25-hydroxycholecalciferol levels should be routinely monitored.
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J Pediatr Rehabil Med · Jan 2012
ReviewGenetics and outcomes after traumatic brain injury (TBI): what do we know about pediatric TBI?
Human genetic association studies in individuals with traumatic brain injury (TBI) have increased rapidly over the past few years. Recently, several review articles evaluated the association of genetics with outcomes after TBI. However, almost all of the articles discussed in these reviews focused on adult TBI. ⋯ An additional search was then performed to evaluate genes beyond APOE that have been evaluated in adult TBI; findings from these studies are highlighted. Larger genetic studies will need to be performed in the future to better elucidate the association of APOE and other genes with outcomes after TBI in children. There is great potential to utilized genetic information to inform prognosis and management after TBI in children; however, we have much work ahead of us to reach the goal of individualized management.
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J Pediatr Rehabil Med · Jan 2012
Randomized Controlled Trial Multicenter StudyConstraint-induced movement therapy (CIMT) for young children with cerebral palsy: effects of therapeutic dosage.
To compare effects of 2 dosage levels of constraint-induced movement therapy (CIMT) for children with hemiplegic cerebral palsy (CP). We hypothesized that high-dosage CIMT would produce larger benefits than moderate-dosage. ⋯ Pediatric CIMT at both moderate and high dosages produced positive effects across multiple reliable, valid outcome measures. The findings refuted the hypothesis of differential dosage benefits. Future research should address long-term effects, enroll larger and more diverse samples, and assess lower dosages to ascertain a minimal-efficacy threshold.
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J Pediatr Rehabil Med · Jan 2012
Physical therapy and rehabilitation issues for patients supported with extracorporeal membrane oxygenation.
Extracorporeal Membrane Oxygenation (ECMO) is widely used to support patients who have failed conventional therapies for cardio-respiratory failure. Patient immobility during management of critical illness and ECMO support can result in physical impairment that can lead to prolonged hospitalization and poor functional outcomes for ECMO survivors. Although little information regarding the role of physical therapy in improving functional outcomes for ECMO patients is available, early intervention with physical therapy may decrease duration of hospitalization and improve functional outcomes for patients supported with ECMO.