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Objective To examine the psychometric and clinimetric properties of the Melbourne Assessment 2 (MA2), an outcome measurement that is increasingly used in clinical studies. Design Psychometric and clinimetric study. Setting Community. Participants Seventeen children with cerebral palsy (CP) from 5 to 12 years were recruited for the estimation of the test-retest reliability and minimal detectable change (MDC). Thirty-five children with CP were recruited to receive an 8-week intensive neurorehabilitation intervention to estimate the validity, responsiveness, and minimal clinically important difference (MCID). Interventions Thirty-five children with CP received upper limb neurorehabilitation programs for 8 weeks. Main Outcome Measures The MA2 and the criterion measures, including the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2), the Box and Blocks Test (BBT), and the Pediatric Motor Activity Log–Revised (PMAL-R), were evaluated at pretreatment and posttreatment. Results The MA2 has 4 subscales: range of motion, fluency, accuracy, and dexterity. The test-retest reliability of the MA2 is high (intraclass correlation coefficient, .92–.98). The significant relationships between the MA2 and BBT, BOT-2, and PMAL-R support its validity. The significance of paired t test results ( P <.001) and large magnitudes of the standardized response mean (1.70–2.00) confirm the responsiveness of the MA2. The MDC values of the 4 subscales of the MA2 are 2.85, 1.63, 1.97, and 1.84, respectively, and the suggested MCID values of these 4 subscales are 2.35, 3.20, 2.09, and 2.22, respectively, indicating the minimum scores of improvement to be interpreted as both statistically significant and clinically important. Conclusions The study findings indicate that the MA2 has sound psychometric and clinimetric properties and is thus an adequate measurement for research and clinical applications. [ABSTRACT FROM AUTHOR]

Background Patients with infantile-onset Pompe disease (IOPD) can be treated by recombinant human acid alpha glucosidase (rhGAA) replacement beginning at birth with excellent survival rates, but they still commonly present with speech disorders. This study investigated the progress of speech disorders in these early-treated patients and ascertained the relationship with treatments. Methods Speech disorders, including hypernasal resonance, articulation disorders, and speech intelligibility, were scored by speech-language pathologists using auditory perception in seven early-treated patients over a period of 6 years. Statistical analysis of the first and last evaluations of the patients was performed with the Wilcoxon signed-rank test. Results A total of 29 speech samples were analyzed. All the patients suffered from hypernasality, articulation disorder, and impairment in speech intelligibility at the age of 3 years. The conditions were stable, and 2 patients developed normal or near normal speech during follow-up. Speech therapy and a high dose of rhGAA appeared to improve articulation in 6 of the 7 patients (86%, p = 0.028) by decreasing the omission of consonants, which consequently increased speech intelligibility ( p = 0.041). Severity of hypernasality greatly reduced only in 2 patients (29%, p = 0.131). Conclusion Speech disorders were common even in early and successfully treated patients with IOPD; however, aggressive speech therapy and high-dose rhGAA could improve their speech disorders. [ABSTRACT FROM AUTHOR]

Abstract: This study was aimed to investigate the rate of co-occurring sensory processing (SP) dysfunction in children with autism who had a difficult temperament characteristics, and the relationship between SP dysfunction and temperament characteristics in preschool children with autism. A total of 111 children aged 48–84 months, 67 children with autism and 44 age-matched typically developing children, participated in this study. Results of the study indicated that SP dysfunction was prevalent in children with autism who had difficult temperament characteristics, and that different SP patterns were associated with different temperament characteristics in preschool children with autism. In summary, the present findings highlight the importance of evaluating SP patterns in addition to assessing temperament in children with autism in order for clinicians to plan appropriate intervention programs and support children''s participation in their daily lives. Furthermore, the knowledge of the relationship between difficult temperament characteristics and SP dysfunction of the child can foster parental appreciation of individual differences in children, provide parents effective strategies to manage children''s behaviors, and promote adaptive parent–child interaction. [Copyright &y& Elsevier]

Abstract: This study aimed to investigate the sensory processing (SP) dysfunction and emotional and behavioral problems in preschool children with autism and then examine the relationship between the SP dysfunction and emotional and behavioral problems. The parents of 112 children aged 48–84 months (67 with autism; 45 age-matched typically developing) completed a demographic questionnaire, the Child Behavior Checklist-Chinese version (CBCL-C), and the Sensory Profile-Chinese version (SP-C). We found that 95.8% of children with autism who showed significant internalizing problems had at least one SP quadrant in the definite difference range, while 81.8% with significant externalizing problems had at least one SP quadrant in the definite difference range. Typically developing children showed lower percentages of 66.7% and 40.0%. Stepwise linear regression analysis revealed that in children with autism, avoiding and male gender were significant predictors of internalizing problems and sensitivity was a significant predictor of externalizing problems. In contrast, in typically developing children, avoiding was a significant predictor of internalizing problems and seeking was a significant predictor of externalizing problems. This study provided further understanding of the factors influencing emotional and behavioral problems in autism. [Copyright &y& Elsevier]

Abstract: Chang K-V, Wu S-H, Lin S-H, Shieh J-Y, Wang T-G, Chen W-S. Power Doppler presentation of shoulders with biceps disorder. Objectives: To investigate the patterns of power Doppler signals on the long head of the biceps tendon at asymptomatic controls and shoulders with clinically diagnosed biceps disorder. Design: Cross-sectional study. Setting: Hospital rehabilitation department. Participants: Asymptomatic adults (n=27) were included in the control group, and patients with unilateral biceps disorder (n=17) were recruited for the patient group. Basic gray color ultrasound screening was performed for rotator cuff tendons antecedently. Interventions: Not applicable. Main Outcome Measures: Three scan views were taken on the anterior shoulder by power Doppler sonography, including the transverse plane of the long head of the biceps tendon, and the longitudinal planes along the lateral and medial edge of the bicipital groove. We compared the patterns and the power Doppler signal area within and between both groups. Results: In shoulders of healthy controls and the asymptomatic side of patients, the power Doppler signal area of the longitudinal planes along the lateral edge of the bicipital groove was significantly larger than that along the medial edge of the bicipital groove. However, there was no significant difference in the painful side of patients. Moreover, the painful shoulders had a higher prevalence of power Doppler signal medial to the biceps tendon in the transverse plane, which paralleled bicipital peritendinous effusion and rotator cuff abnormalities. Conclusions: The power Doppler signal was more frequently observed medial to the biceps tendon in shoulders with clinically diagnosed biceps disorder. Whether shoulders with this specific power Doppler signal pattern benefit more from anti-inflammatory therapy needs further exploration. [Copyright &y& Elsevier]

Abstract: Wang C-Y, Wang H-K, Hsu C-Y, Shieh J-Y, Wang T-G, Jiang C-C. Role of sonographic examination in traumatic knee internal derangement. Objectives: To define the accuracy (compared with magnetic resonance imaging [MRI]) of sonographic examination in detecting knee effusion and to determine whether the presence of knee effusions in patients with traumatic knee injury can predict knee internal derangement as assessed by MRI. Design: Prospective study. Setting: Hospital rehabilitation department. Participants: Thirty patients (19 men, 11 women) with traumatic knee injury were recruited. Subjects received sonographic examination and MRI on the same day. Interventions: Not applicable. Main Outcome Measures: The presence or absence of knee effusion was assessed by sonographic examination. MRI was used as criterion standard to evaluate whether the presence of knee effusion and internal derangement, which included tear of anterior and posterior cruciate ligaments, as well as meniscus tear. Results: The sensitivity of sonographic examination for detecting knee effusion was 79.1%, and specificity was 50%. The positive-predictive value (PPV) was 86.3% and negative-predictive value (NPV) was 37.5%. The PPV of sonographic effusion to internal derangement was 90.9%, and the NPV was 37.5%. Conclusions: Sonographic examination can accurately detect effusion of the knee. The detection of knee effusion in patients with traumatic knee injury by sonographic examination is highly indicative of internal knee derangement. [Copyright &y& Elsevier]

Highlights: [•] The QOL determinants of children with CP are multidimensional in nature. [•] Behavioral and emotional problems impact pervasively on QOL of children with CP. [•] Many QOL determinants are caregiver's psychological and family-related factors. [Copyright &y& Elsevier]

Abstract: The aim of this study was to identify determinants of daily function in a population-based sample of children with cerebral palsy (CP). The study took into consideration factors from the entire scope of the International Classification of Functioning, Disability, and Health (ICF). Furthermore, the determinants of daily function were examined from the perspectives of capacity and performance respectively. A total of 216 children with CP (mean age 8.19 years, SD 3.39 years) and their caregivers participated in the study. The potential determinants of daily function from the dimensions of health condition, body functions and structures, environmental and personal factors of the ICF were collected. Stepwise multiple regression models showed that child''s age, grade, preferred hand, educational placement, severity of gross and fine motor impairment, and prosocial behavior were important determinants, accounting for 88.29% of the variance of daily capacity. The aforementioned variables together with birth order were determinants of performance of daily function, and accounted for 89.53% of the variance in that performance. Knowledge of determinants of daily function helps clinicians and educators to plan intervention and educational programs targeted at these determinants to improve capacity and performance in daily function for children with CP. [Copyright &y& Elsevier]

Duchenne muscular dystrophy (DMD) is a progressive muscular disease, but validated imaging tools to quantify muscle microstructure alteration as mobility declines are lacking. We aimed to determine the feasibility of using acoustic radiation force impulse shear-wave elastography (ARFI/SWE) in the quantitative assessment of lower limb muscle stiffness in DMD patients. Shear wave velocities (SWVs) of lower limbs were measured in 39 DMD patients and 36 healthy controls aged 3-20 y. Mean SWV values of the controls and of the DMD patients at different ambulatory stages were compared using analysis of variance with Bonferroni correction. The DMD group had increased lower limb muscle stiffness compared with controls. Stiffness of the tibialis anterior and medial gastrocnemius muscle decreased from ambulatory to early non-ambulatory stages, whereas stiffness of the rectus femoris muscle increased from ambulatory to late non-ambulatory stages. We describe how SWV changes in lower limb muscles have the potential to predict ambulatory decline in DMD. [ABSTRACT FROM AUTHOR]

Highlights: [•] Determinants of activity performance encompass all dimensions of the ICF-CY. [•] Prosocial behavior has a positive impact on cognitive activity performance. [•] “Recreation Movement” is the most difficult activity for children with CP. [•] “Memory and Understand” is the easiest activity for children with CP. [Copyright &y& Elsevier]

Abstract: Given the growing evidence for the effects of constraint-induced therapy (CIT) in children with cerebral palsy (CP), there is a need for investigating the characteristics of potential participants who may benefit most from this intervention. This study aimed to establish predictive models for the effects of pediatric CIT on motor and functional outcomes. Therapists administered CIT to 49 children (aged 3–11 years) with CP. Sessions were 1–3.5h a day, twice a week, for 3–4 weeks. Parents were asked to document the number of restraint hours outside of the therapy sessions. Domains of treatment outcomes included motor capacity (measured by the Peabody Developmental Motor Scales II), motor performance (measured by the Pediatric Motor Activity Log), and functional independence (measured by the Pediatric Functional Independence Measure). Potential predictors included age, affected side, compliance (measured by time of restraint), and the initial level of motor impairment severity. Tests were administered before, immediately after, and 3 months after the intervention. Logistic regression analyses showed that total amount of restraint time was the only significant predictor for improved motor capacity immediately after CIT. Younger children who restrained the less affected arm for a longer time had a greater chance to achieve clinically significant improvements in motor performance. For outcomes of functional independence in daily life, younger age was associated with clinically meaningful improvement in the self-care domain. Baseline motor abilities were significantly predictive of better improvement in mobility and cognition. Significant predictors varied according to the aspects of motor outcomes after 3 months of follow-up. The potential predictors identified in this study allow clinicians to target those children who may benefit most from CIT. [Copyright &y& Elsevier]

Abstract: The Cerebral Palsy Quality of Life for Children (CP QOL-Child) is the first health condition-specific questionnaire designed for measuring QOL in children with cerebral palsy (CP). However, its construct validity has not yet been confirmed by confirmatory factor analysis (CFA). Hence, this study assessed the construct validity of the caregiver proxy-report version of the Chinese version of the CP QOL-Child in children with CP using CFA. A total of 312 children with CP (mean age: 8.59 years, SD: 2.52 years) and their caregivers participated in this study. The Chinese version of the CP QOL-Child was completed by the caregivers of children with CP. Then, CFA was applied to evaluate the seven-factor measurement structure of the CP QOL-Child. The seven-factor CFA model had an adequate fit to our data as judged by χ 2 statistic and various goodness-of-fit (GOF) indices, including the root mean square error of approximation (RMSEA). This study provided empirical evidence of the construct validity of the CP QOL-Child to support its use with children with CP in the Chinese speaking society. [Copyright &y& Elsevier]