Policy brief: adaptive cycling equipment for individuals with neurodevelopmental disabilities as durable medical equipment.

- Durable medical equipment (DME) policies require that the equipment be medically necessary; however, adaptive cycling equipment (bicycles and tricycles) are usually not deemed medically necessary. - Individuals with neurodevelopmental disabilities (NDD) are at high risk for secondary conditions, both physical and mental, that can be mitigated by increasing physical activity. - Significant financial costs are associated with the management of secondary conditions.

Clinical efficacy of instrumented gait analysis: Systematic review 2020 update.

Background: This paper updates our 2011 systematic review on the clinical efficacy of three-dimensional instrumented gait analysis (3DGA).

Research Question: What is the current evidence base pertaining to the clinical efficacy of 3DGA?

Methods: We identified English language articles published from September 2009 to October 2019 reporting primary research that used typical motion analysis laboratory methods to study human walking. Five gait laboratory experts classified articles according to the highest type of efficacy they addressed: type 1 (technical), 2 (diagnostic accuracy), 2b (outcome prediction), 3-4 (diagnostic thinking and treatment), 5 (patient outcome), 6 (societal).

An Analysis of Relative Gait Impairment in Commonly Diagnosed Pediatric Conditions.

Background: Gait indices were developed to represent the magnitude of impairment extracted from a gait analysis with a single value. The Gillette Gait Index (GGI), and the Gait Deviation Index (GDI) are 2 widely used indices that represent gait impairment differently based on their statistical properties. Our purpose was to (1) report on the results of gait analysis for a broad spectrum of pediatric conditions using the GGI and GDI, and (2) identify the parameters that dominate impairment.

Recurrent Idiopathic Catatonia: Implications beyond the Diagnostic and Statistical Manual of Mental Disorders 5th Edition.

We describe a case of recurrent, life-threatening, catatonic stupor, without evidence of any associated medical, toxic or mental disorder. This case provides support for the inclusion of a separate category of "unspecified catatonia" in the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) to be used to classify idiopathic cases, which appears to be consistent with Kahlbaum's concept of catatonia as a distinct disease state. But beyond the limited, cross-sectional, syndromal approach adopted in DSM-5, this case more importantly illustrates the prognostic and therapeutic significance of the longitudinal course of illness in differentiating cases of catatonia, which is better defined in the Wernicke-Kleist-Leonhard classification system.

Variation in kinematic and spatiotemporal gait parameters by Gross Motor Function Classification System level in children and adolescents with cerebral palsy.

Aim: The aim of this study was to examine differences in gait kinematics and spatiotemporal parameters in ambulatory children and adolescents with bilateral spastic cerebral palsy (BSCP) among Gross Motor Function Classification System (GMFCS) levels I-III.

Method: A retrospective review was conducted of individuals with BSCP who had three-dimensional motion analysis (3DGA) at one of seven pediatric hospitals. Means and standard deviations of each gait parameter were stratified by GMFCS levels (I-III) and for a typically developing comparison group.

Relationship of Strength, Weight, Age, and Function in Ambulatory Children With Cerebral Palsy.

Background: The natural history of ambulatory function in individuals with cerebral palsy (CP) consists of deterioration over time. This is thought to be due, in part, to the relationship between strength and weight, which is postulated to become less favorable for ambulation with age.

Methods: The study design was prospective, case series of 255 subjects, aged 8 to 19 years, with diplegic type of CP.

Analysis of the relationships that body composition and muscular strength have with oxygen cost of walking in children with cerebral palsy.

Objective: To investigate whether body composition and lower extremity strength relate to oxygen cost of walking in children with cerebral palsy (CP), and to evaluate the relative contributions of these measures to explain variation in oxygen cost seen in this population.

Methods: A total of 116 children with spastic diplegic CP, Gross Motor Function Classification System levels I-III, aged 8-18 participated. Strength, body composition (body mass index (BMI) and percent body fat) and oxygen cost were recorded.

Variability explained by strength, body composition and gait impairment in activity and participation measures for children with cerebral palsy: a multicentre study.

Objective: To determine the amount of variability in scores on activity and participation measures used to assess ambulatory individuals with cerebral palsy explained by strength, body composition, gait impairment and participant characteristics.

Design: Multicentre prospective cross-sectional study.

Setting: Seven paediatric-orthopaedic specialty hospitals.

Evaluation of the treatment of pectus carinatum with compressive orthotic bracing using three dimensional body scans.

Purpose: The purpose of this study is to measure the effectiveness of compressive orthotic brace therapy for the treatment of pectus carinatum using an adjusted Haller Index (HI) measurement calculated from 3D body scan (BS) images.

Methods: Pediatric patients with pectus carinatum were treated with either compressive orthotic bracing or observation. An adjusted BS Haller index (HI) was calculated from serial 3D BS images obtained on all patients.

One-Minute Walk and modified Timed Up and Go tests in children with cerebral palsy: performance and minimum clinically important differences.

AIM This prospective multicenter study assessed performance and changes over time, with and without surgical intervention, in the modified Timed Up and Go (mTUG) and One-Minute Walk tests (1MWT) in children with bilateral cerebral palsy (CP). Minimum clinically important differences (MCIDs) were established for these tools. METHOD Two hundred and nineteen participants with bilateral spastic CP (Gross Motor Function Classification System [GMFCS] levels I–III) were evaluated at baseline and 12 months follow-up.

Gait and participation outcomes in adults with cerebral palsy: a series of case studies using mixed methods.

Background: There is a paucity of information on long-term outcomes of adults with cerebral palsy (CP) who received orthopedic interventions in childhood. Clinical effectiveness research requires assessment of outcomes that account for personal and environmental factors that may mediate the effects of treatment, in addition to body structures & function, activity, and participation.

Objective/hypothesis: The purpose of this study is to provide a descriptive analysis of characteristics associated with gait and participation outcomes in a series of case studies of adults with CP.

Rasch analysis of items from two self-report measures of motor function: determination of item difficulty and relationships with children's ability levels.

Aim: The aim of this article was to determine item measurement properties of a set of items selected from the Gillette Functional Assessment Questionnaire (FAQ) and the Pediatric Outcome Data Collection Instrument (PODCI) using Rasch analysis, and to explore relationships between the FAQ/PODCI combined set of items, FAQ walking scale level, Gross Motor Function Classification System (GMFCS) levels, and the Gait Deviation Index on a common measurement scale.

Method: Rasch analysis was performed on data from a retrospective chart review of parent-reported FAQ and PODCI data from 485 individuals (273 males; 212 females; mean age 9 y 10 mo, SD 3 y 10 mo) who underwent first-time three-dimensional gait analysis. Of the 485 individuals, 289 had a diagnosis of cerebral palsy (104 GMFCS level I, 97 GMFCS level II, 69 GMFCS level III, and 19 GMFCS level IV).

Accuracy, reliability, and validity of a 3-dimensional scanner for assessing torso shape in idiopathic scoliosis.

Study Design: Prospective cohort with concurrent controls.

Objective: To establish accuracy, reliability, and validity of the Vitronic 3D Body Scanner for the evaluation of torso asymmetry in patients with idiopathic scoliosis.

Summary Of Background Data: Improved appearance is an important expectation of treatment for patients with scoliosis and their parents.

Determinants of intensity of participation in leisure and recreational activities by youth with cerebral palsy.

Objective: To test a model of determinants of intensity of participation in leisure and recreational activities by youth with cerebral palsy (CP).

Design: Prospective cohort study.

Setting: Children's hospitals (N=7).

Efficacy of clinical gait analysis: A systematic review.

The aim of this systematic review was to evaluate and summarize the current evidence base related to the clinical efficacy of gait analysis. A literature review was conducted to identify references related to human gait analysis published between January 2000 and September 2009 plus relevant older references. The references were assessed independently by four reviewers using a hierarchical model of efficacy adapted for gait analysis, and final scores were agreed upon by at least three of the four reviewers.

Gillette Functional Assessment Questionnaire 22-item skill set: factor and Rasch analyses.

Aim: To determine dimensionality and item-level properties of the Gillette Functional Assessment Questionnaire (FAQ) 22-item skill set using factor and Rasch analyses.

Method: A retrospective review of parent-reported FAQ 22-item skill set data was conducted of 485 individuals (273 males, 212 females; mean age 9 y 10 mo, SD 3 y 10 mo), including 289 with cerebral palsy and 196 with a variety of other neuromusculoskeletal conditions with orthopedic impairments. Factor analyses to validate unidimensionality of the skill set and Rasch analyses to determine relative item difficulty, item and test level information, and content coverage of the item set were performed.

Determinants of intensity of participation in leisure and recreational activities by children with cerebral palsy.

Aim: To test a model of child, family, and service determinants of intensity of participation in leisure and recreational activities by children with cerebral palsy (CP).

Method: Participants were 288 children with CP, age range 6 to 12 years (mean 9y 8mo, SD 2y), and their parents from seven children's hospitals. The sample comprised 166 (57.

Factor- and item-level analyses of the 38-item activities scale for kids-performance.

Aim: Children and adolescents highly value their ability to participate in relevant daily life and recreational activities. The Activities Scale for Kids-performance (ASKp) instrument measures the frequency of performance of 30 common childhood activities, and has been shown to be valid and reliable. A revised and expanded 38-item ASKp (ASKp38) version has been reported in recent literature and is currently used in clinical research.

Content range and precision of a computer adaptive test of upper extremity function for children with cerebral palsy.

This article reports on the content range and measurement precision of an upper extremity (UE) computer adaptive testing (CAT) platform of physical function in children with cerebral palsy. Upper extremity items representing skills of all abilities were administered to 305 parents. These responses were compared with two traditional standardized measures: Pediatric Outcomes Data Collection Instrument and Functional Independence Measure for Children.

Walking abilities of young adults with cerebral palsy: changes after multilevel surgery and adolescence.

Although there is some evidence to support the efficacy of single event multilevel surgery (SEMLS) in the short term for improving walking abilities in children with cerebral palsy (CP), long term effects are not known. It is hypothesized: (1) SEMLS improves walking abilities; (2) in young adulthood abilities deteriorate beyond pre-operative status; (3) walking abilities deteriorate from adolescence to young adulthood and are associated with weight status increase. Twenty-three young adults (mean age 25.