111 results on '"Christopher J. Newman"'
Search Results
2. Are Clinical Impairments Related to Kinematic Gait Variability in Children and Young Adults With Cerebral Palsy?
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Anne Tabard-Fougère, Dionys Rutz, Annie Pouliot-Laforte, Geraldo De Coulon, Christopher J. Newman, Stéphane Armand, and Jennifer Wegrzyk
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cerebral palsy ,gait ,variability ,kinematic ,clinical impairments ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Intrinsic gait variability (GV), i.e., fluctuations in the regularity of gait patterns between repetitive cycles, is inherent to the sensorimotor system and influenced by factors such as age and pathology. Increased GV is associated with gait impairments in individuals with cerebral palsy (CP) and has been mainly studied based on spatiotemporal parameters. The present study aimed to describe kinematic GV in young people with CP and its associations with clinical impairments [i.e., passive range of motion (pROM), muscle weakness, reduced selective motor control (selectivity), and spasticity]. This retrospective study included 177 participants with CP (age range 5–25 years; Gross Motor Function Classification System I-III) representing 289 clinical gait analyses [n = 172 for unilateral CP (uCP) vs. 117 for bilateral CP (bCP)]. As variability metrics, Root Mean Square Deviation (RMSD) for nine lower-limb kinematic parameters and Gait Standard Deviation (GaitSD) – as composite score of the kinematic parameters – were computed for the affected (unilateral = uCP) and most affected side (bilateral = bCP), respectively, as defined by clinical scores. GaitSD was then computed for the non/less-affected side for between leg comparisons. Uni- and multivariate linear regressions were subsequently performed on GaitSD of the affected/most affected side with all clinical impairments (composite scores) as independent variables. Highest RMSD were found in the transverse plane (hip, pelvis), for distal joints in the sagittal plane (knee, ankle) and for foot progression. GaitSD was not different between uCP and bCP (affected/most affected side) but higher in the non-affected vs. affected side in uCP. GaitSD was associated with age (p < 0.001), gait deviation index (GDI) (p < 0.05), muscle weakness (p < 0.001), selectivity (p < 0.05), and pROM (p < 0.001). After adjustment for age and GDI, GaitSD remained associated with muscle weakness (uCP: p = 0.003, bCP: p < 0.001) and selectivity (bCP: p = 0.024). Kinematic GV can be expressed as global indicator of variability (GaitSD) in young people with CP given the strong correlation of RMSD for lower-limb kinematic parameters. In terms of asymmetry, increased variability of the non-affected vs. affected side may indicate contralateral compensation mechanisms in uCP. Notably muscle weakness (uCP, bCP) and selectivity (bCP) – but not spasticity – were associated with GaitSD. Further studies need to explore the clinical relevance of kinematic GV in CP to support the interpretation of clinical gait analyses and therapeutic decision-making.
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- 2022
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3. Cohort profile: the Swiss Cerebral Palsy Registry (Swiss-CP-Reg) cohort study
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Fabiën N. Belle, Sandra Hunziker, Joël Fluss, Sebastian Grunt, Stephanie Juenemann, Christoph Kuenzle, Andreas Meyer-Heim, Christopher J. Newman, Gian Paolo Ramelli, Peter Weber, Claudia E. Kuehni, and Anne Tscherter
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Medicine - Abstract
BACKGROUND: Cerebral Palsy (CP) is a group of permanent disorders of movement and posture that follow injuries to the developing brain. It results in motor dysfunction and a wide variety of comorbidities like epilepsy; pain; speech, hearing and vision disorders; cognitive dysfunction; and eating and digestive difficulties. Central data collection is essential to the study of the epidemiology, clinical presentations, care, and quality of life of patients affected by CP. CP specialists founded the Swiss Cerebral Palsy Registry (Swiss-CP-Reg) in 2017. This paper describes the design, structure, aims and achievements of Swiss-CP-Reg and presents its first results. METHODS: Swiss-CP-Reg records patients of any age diagnosed with CP who are born, are treated, or live in Switzerland. It collects data from medical records and reports, from questionnaires answered by patients and their families, and from data linkage with routine statistics and other registries. The registry contains information on diagnosis, clinical presentation, comorbidities, therapies, personal information, family history, and quality of life. RESULTS: From August 2017 to August 2021, 546 participants (55% male, mean age at registration 8 years [interquartile range IQR: 5–12]), were enrolled in Swiss-CP-Reg. Most had been born at term (56%), were less than two years old at diagnosis (73%, median 18 months, IQR: 9–25), and were diagnosed with spastic CP (76%). Most (59%) live with a mild motor impairment (Gross Motor Function Classification System [GMFCS] level I or II), 12% with a moderate motor impairment (GMFCS level III), and 29% with a severe motor impairment (GMFCS level IV or V). In a subset of 170 participants, we measured intelligence quotient (IQ) and saw lower IQs with increasing GMFCS level. Swiss-CP-Reg has a strong interest in research, with four nested projects running currently, and many more planned. CONCLUSIONS: Swiss-CP-Reg collects and exchanges national data on people living with CP to answer clinically relevant questions. Its structure enables retrospective and prospective data collection and knowledge exchange between experts to optimise and standardise treatment and to improve the health and quality of life of those diagnosed with CP in Switzerland. ClinicalTrials.gov identifier: NCT04992871
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- 2022
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4. A complex interprofessional intervention to improve the management of painful procedures in neonates
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Colette Balice‐Bourgois, Christopher J. Newman, Giacomo D. Simonetti, and Maya Zumstein‐Shaha
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bundle of care ,complex interventions ,interprofessional relations ,knowledge translation ,neonate ,procedural pain ,Pediatrics ,RJ1-570 - Abstract
Abstract During hospitalization, neonates are exposed to a stressful environment and a high number of painful procedures. If pain is not treated adequately, short‐ and long‐term complications may develop. Despite evidence about neonatal pain and available guidelines, procedural pain remains undertreated. This gap between research and practice is mostly due to limited implementation of evidence‐based knowledge and time constraints. This study describes in detail the development process of a complex interprofessional intervention to improve the management of procedural pain in neonates called NEODOL© (NEOnato DOLore). The framework of the Medical Research Council (MRC) for the development and evaluation of complex interventions was used as a methodological guide for the design of the NEODOL© intervention. The development of the intervention is based on several steps and multiple methods. To report this process, we used the Criteria for Reporting the Development of Complex Interventions in Healthcare (CReDECI 2). Additionally, we evaluated the content of the intervention using a Delphi method to obtain consensus from experts, stakeholders, and parents. The complex interprofessional intervention, NEODOL©, is developed and designed for three groups: healthcare professionals, parents, and neonates for a level IIb neonatal unit at a regional hospital in southern Switzerland. A total of 16 panelists participated in the Delphi process. At the end of the Delphi process, the panelists endorsed the NEODOL© intervention as important and feasible. Following the MRC guidelines, a multimethod process was used to develop a complex interprofessional intervention to improve the management of painful procedures in newborns. Complex interprofessional interventions need theoretical bases, careful development, and integration of stakeholders to provide a comprehensive approach. The NEODOL intervention consists of promising components and has the potential to improve the management of painful procedures and should facilitate the knowledge translation into practice.
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- 2020
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5. Protocol of changes induced by early Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (e-HABIT-ILE) in pre-school children with bilateral cerebral palsy: a multisite randomized controlled trial
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Rodrigo Araneda, Stephane V. Sizonenko, Christopher J. Newman, Mickael Dinomais, Gregoire Le Gal, Daniela Ebner-Karestinos, Julie Paradis, Anne Klöcker, Geoffroy Saussez, Josselin Demas, Rodolphe Bailly, Sandra Bouvier, Emmanuel Nowak, Andrea Guzzetta, Inmaculada Riquelme, Sylvain Brochard, and Yannick Bleyenheuft
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Cerebral palsy ,Intensive training ,Bilateral ,Randomized controlled trials ,Neuroplasticity ,Biomechanical changes ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Abstract Background Cerebral palsy (CP), which is the leading cause of motor disability during childhood, can produce sensory and cognitive impairments at different degrees. Most recent therapeutic interventions for these patients have solely focused on upper extremities (UE), although more than 60% of these patients present lower extremities (LE) deficits. Recently, a new therapeutic concept, Hand-arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE), has been proposed, involving the constant stimulation of UE and LE. Based on motor skill learning principles, HABIT-ILE is delivered in a day-camp setting, promoting voluntary movements for several hours per day during 10 consecutive week days. Interestingly, the effects of this intervention in a large scale of youngsters are yet to be observed. This is of interest due to the lack of knowledge on functional, neuroplastic and biomechanical changes in infants with bilateral CP. The aim of this randomized controlled study is to assess the effects of HABIT-ILE adapted for pre-school children with bilateral CP regarding functional, neuroplastic and biomechanical factors. Methods This international, multicentric study will include 50 pre-school children with CP from 12 to 60 months of age, comparing the effect of 50 h (2 weeks) of HABIT-ILE versus regular motor activity and/or customary rehabilitation. HABIT-ILE presents structured activities and functional tasks with continuous increase in difficulty while the child evolves. Assessments will be performed at 3 period times: baseline, two weeks later and 3 months later. The primary outcome will be the Gross Motor Function Measure 66. Secondary outcomes will include Both Hands Assessment, Melbourne Assessment-2, Semmes-Weinstein Monofilament Test, algometry assessments, executive function tests, ACTIVLIM-CP questionnaire, Pediatric Evaluation of Disability Inventory (computer adaptative test), Young Children’s Participation and Environment Measure, Measure of the Process of Care, Canadian Occupational Performance Measure, neuroimaging and kinematics. Discussion The results of this study should highlight the impact of a motor, intensive, goal-directed therapy (HABIT-ILE) in pre-school children at a functional, neuroplastic and biomechanical level. In addition, this changes could demonstrated the impact of this intervention in the developmental curve of each child, improving functional ability, activity and participation in short-, mid- and long-term. Name of the registry Evaluation of Functional, Neuroplastic and Biomechanical Changes Induced by an Intensive, Playful Early-morning Treatment Including Lower Limbs (EARLY-HABIT-ILE) in Preschool Children With Uni and Bilateral Cerebral Palsy (HABIT-ILE). Trial registration NCT04017871 Registration date July 12, 2019.
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- 2020
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6. Gait stability in ambulant children with cerebral palsy during dual tasks
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Sophie Wist, Lena Carcreff, Sjoerd M. Bruijn, Gilles Allali, Christopher J. Newman, Joel Fluss, and Stéphane Armand
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Medicine ,Science - Abstract
Aim The aim of this cross-sectional study was to measure the effect of dual tasks on gait stability in ambulant children with cerebral palsy (CP) compared to typically developing (TD) children. Methods The children of the CP (n = 20) and TD groups (n = 20) walked first without a dual task, then while counting forward and finally while alternatively naming fruits and animals (DTf/a). They then completed the same cognitive exercises while sitting comfortably. We calculated the distance between the foot placement estimator (FPE) and the real foot placement in the anterior direction (DFPEAP) and in the mediolateral direction (DFPEML) as a measure of gait stability, in a gait laboratory using an optoelectronic system. Cognitive scores were computed. Comparisons within and between groups were analysed with linear mixed models. Results The dual task had a significant effect on the CP group in DFPEAP and DFPEML. The CP group was more affected than the TD group during dual task in the DFPEML. Children in both groups showed significant changes in gait stability during dual tasks. Interpretation The impact of dual task on gait stability is possibly due to the sharing of attention between gait and the cognitive task. All children favoured a ‘posture second’ strategy during the dual task of alternatively naming animals and fruits. Children with CP increased their mediolateral stability during dual task.
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- 2022
7. Telephone Referral to a Paediatric Emergency Department: Why Do Parents Not Show Up?
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Mélanie Freiermuth, Christopher J. Newman, and Judit Villoslada
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telephone triage ,non-adherence ,children ,emergency department ,Pediatrics ,RJ1-570 - Abstract
Medical call centres can evaluate and refer patients to an emergency department (ED), a physician or provide guidance for self-care. Our aim was (1) to determine parental adherence to an ED orientation after being referred by the nurses of a call centre, (2) to observe how adherence varies according to children’s characteristics and (3) to assess parents’ reasons for non-adherence. This was a prospective cohort study set in the Lausanne agglomeration, Switzerland. From 1 February to 5 March 2022, paediatric calls (
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- 2023
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8. Locomotion and cadence detection using a single trunk-fixed accelerometer: validity for children with cerebral palsy in daily life-like conditions
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Anisoara Paraschiv-Ionescu, Christopher J. Newman, Lena Carcreff, Corinna N. Gerber, Stephane Armand, and Kamiar Aminian
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Cerebral palsy ,Atypical gait ,Step detection ,Accelerometer ,Validation ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Abstract Background Physical therapy interventions for ambulatory youth with cerebral palsy (CP) often focus on activity-based strategies to promote functional mobility and participation in physical activity. The use of activity monitors validated for this population could help to design effective personalized interventions by providing reliable outcome measures. The objective of this study was to devise a single-sensor based algorithm for locomotion and cadence detection, robust to atypical gait patterns of children with CP in the real-life like monitoring conditions. Methods Study included 15 children with CP, classified according to Gross Motor Function Classification System (GMFCS) between levels I and III, and 11 age-matched typically developing (TD). Six IMU devices were fixed on participant’s trunk (chest and low back/L5), thighs, and shanks. IMUs on trunk were independently used for development of algorithm, whereas the ensemble of devices on lower limbs were used as reference system. Data was collected according to a semi-structured protocol, and included typical daily-life activities performed indoor and outdoor. The algorithm was based on detection of peaks associated to heel-strike events, identified from the norm of trunk acceleration signals, and included several processing stages such as peak enhancement and selection of the steps-related peaks using heuristic decision rules. Cadence was estimated using time- and frequency–domain approaches. Performance metrics were sensitivity, specificity, precision, error, intra-class correlation coefficient, and Bland-Altman analysis. Results According to GMFCS, CP children were classified as GMFCS I (n = 7), GMFCS II (n = 3) and GMFCS III (n = 5). Mean values of sensitivity, specificity and precision for locomotion detection ranged between 0.93–0.98, 0.92–0.97 and 0.86–0.98 for TD, CP-GMFCS I and CP-GMFCS II-III groups, respectively. Mean values of absolute error for cadence estimation (steps/min) were similar for both methods, and ranged between 0.51–0.88, 1.18–1.33 and 1.94–2.3 for TD, CP-GMFCS I and CP-GMFCS II-III groups, respectively. The standard deviation was higher in CP-GMFCS II-III group, the lower performances being explained by the high variability of atypical gait patterns. Conclusions The algorithm demonstrated good performance when applied to a wide range of gait patterns, from normal to the pathological gait of highly affected children with CP using walking aids.
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- 2019
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9. Walking Speed of Children and Adolescents With Cerebral Palsy: Laboratory Versus Daily Life
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Lena Carcreff, Corinna N. Gerber, Anisoara Paraschiv-Ionescu, Geraldo De Coulon, Kamiar Aminian, Christopher J. Newman, and Stéphane Armand
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cerebral palsy ,typical development ,capacity ,performance ,inertial sensors ,walking speed ,Biotechnology ,TP248.13-248.65 - Abstract
The purpose of this pilot study was to compare walking speed, an important component of gait, in the laboratory and daily life, in young individuals with cerebral palsy (CP) and with typical development (TD), and to quantify to what extent gait observed in clinical settings compares to gait in real life. Fifteen children, adolescents and young adults with CP (6 GMFCS I, 2 GMFCS II, and 7 GMFCS III) and 14 with TD were included. They wore 4 synchronized inertial sensors on their shanks and thighs while walking at their spontaneous self-selected speed in the laboratory, and then during 2 week-days and 1 weekend day in their daily environment. Walking speed was computed from shank angular velocity signals using a validated algorithm. The median of the speed distributions in the laboratory and daily life were compared at the group and individual levels using Wilcoxon tests and Spearman’s correlation coefficients. The corresponding percentile of daily life speed equivalent to the speed in the laboratory was computed and observed at the group level. Daily-life walking speed was significantly lower compared to the laboratory for the CP group (0.91 [0.58–1.23] m/s vs 1.07 [0.73–1.28] m/s, p = 0.015), but not for TD (1.29 [1.24–1.40] m/s vs 1.29 [1.20–1.40] m/s, p = 0.715). Median speeds correlated highly in CP (p < 0.001, rho = 0.89), but not in TD. In children with CP, 60% of the daily life walking activity was at a slower speed than in-laboratory (corresponding percentile = 60). On the contrary, almost 60% of the daily life activity of TD was at a faster speed than in-laboratory (corresponding percentile = 42.5). Nevertheless, highly heterogeneous behaviors were observed within both populations and within subgroups of GMFCS level. At the group level, children with CP tend to under-perform during natural walking as compared to walking in a clinical environment. The heterogeneous behaviors at the individual level indicate that real-life gait performance cannot be directly inferred from in-laboratory capacity. This emphasizes the importance of completing clinical gait analysis with data from daily life, to better understand the overall function of children with CP.
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- 2020
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10. Interprofessional Collaboration and Involvement of Parents in the Management of Painful Procedures in Newborns
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Colette Balice-Bourgois, Maya Zumstein-Shaha, Giacomo D. Simonetti, and Christopher J. Newman
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procedural pain management ,neonatal pain ,interprofessional collaboration ,parental involvement ,complex intervention ,Pediatrics ,RJ1-570 - Abstract
Introduction: Newborns are subject to many painful procedures. Pharmacological and non-pharmacological approaches alone are not enough, and it is necessary to consider other contributing elements such as the environment, interprofessional collaboration and parental involvement. The aim of this feasibility study was to explore interprofessionality and the role of parents in improving the management of painful procedures in newborns and pain management strategies.Materials and Methods: a pre-post feasibility study using a mixed method approach was conducted. Questionnaires, interviews and focus groups were used to describe the parents' views on their child's pain management and involvement in care as well as to explore the level of interprofessionality and feasibility.Results: Collaboration between physicians and nurses improved following the implementation of a complex interprofessional intervention involving professionals, parents and newborns. In spite of improving professional collaboration in procedural pain management, parents were attributed a passive role or only marginally involved in in the infant's pain management. However, parents stated—as elicited by the questionnaires and interviews—that they wished to receive more information and be included in painful procedures executed on their infant.Discussion: Management of painful procedures in neonates needs to be changed. Interprofessional collaboration contributes to improved procedural pain management in neonates. It is essential to include parents as active members in the interprofessional healthcare team.
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- 2020
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11. Parents’ Perspectives on Adaptive Sports in Children with Profound Intellectual and Multiple Disabilities
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Marion C. Neyroud and Christopher J. Newman
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PIMD ,physical activities ,adaptive sports ,children ,disability ,Pediatrics ,RJ1-570 - Abstract
Children with profound intellectual and multiple disabilities (PIMD) need adaptations to participate in sports and it is more difficult for them to access these activities. We investigated the effects of adaptive sports in children with PIMD as perceived by their parents. The parents answered a postal questionnaire exploring the effects of adaptive sports during the 3 days following an activity. The questionnaire explored twelve domains of children’s daily lives, such as sleep and appetite. We calculated a composite score, including all of these domains, to assess whether the children globally benefited from adaptive sports. Of the families, 27/63 responded (participation 42.9%). Four domains improved after the sports activity in an important proportion of children (improvement in 64.0% of children for wellbeing, 57.6% for mood, 56.0% for comfort and 48.1% for sleep). Among the majority of children, the other eight domains remained mostly stable. Three quarters of parents reported a globally positive effect of adapted physical activities on their child. These findings support the further development and provision of adaptive sports for children with severe neurological impairments.
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- 2021
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12. Paediatricians’ Views on Pain in Children with Profound Intellectual and Multiple Disabilities
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Lucie Petigas and Christopher J. Newman
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child ,disability ,pain ,paediatrician ,profound intellectual and multiple disabilities ,survey ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Pain is a frequent issue in children with profound intellectual and multiple disabilities (PIMD). Its identification and treatment can prove highly challenging for primary care physicians, mainly because of the children’s limited communication abilities. We used an online survey to explore paediatricians’ views regarding the experience and management of pain in children with PIMD and invited 480 professionals working in the canton of Vaud, Switzerland, to take part. We received 121 responses (participation rate 25.5%). A large majority of respondents provided care to children with PIMD. All paediatricians considered that these children feel pain at least as much as typically developing children. However, paediatricians had mixed views on their tolerance to pain. More than 90% held the view that their pain is under-assessed and undertreated. The principal barriers they reported to appropriate management were communication limitations with the child, difficulties in pain assessment, lack of knowledge about children with disabilities and lack of experience. Paediatricians have complex opinions regarding how children with PIMD experience pain and how to manage this problem. Professional education and training on the specificities of children with PIMD, including how to address their pain, seem necessary to foster paediatricians’ ability and confidence in approaching this complex issue.
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- 2021
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13. Multidimensional Measures of Physical Activity and Their Association with Gross Motor Capacity in Children and Adolescents with Cerebral Palsy
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Corinna N. Gerber, Lena Carcreff, Anisoara Paraschiv-Ionescu, Stéphane Armand, and Christopher J. Newman
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cerebral palsy ,inertial measurement units ,physical activity pattern ,capacity ,performance ,Chemical technology ,TP1-1185 - Abstract
The current lack of adapted performance metrics leads clinicians to focus on what children with cerebral palsy (CP) do in a clinical setting, despite the ongoing debate on whether capacity (what they do at best) adequately reflects performance (what they do in daily life). Our aim was to measure these children’s habitual physical activity (PA) and gross motor capacity and investigate their relationship. Using five synchronized inertial measurement units (IMU) and algorithms adapted to this population, we computed 22 PA states integrating the type (e.g., sitting, walking, etc.), duration, and intensity of PA. Their temporal sequence was visualized with a PA barcode from which information about pattern complexity and the time spent in each of the six simplified PA states (PAS; considering PA type and duration, but not intensity) was extracted and compared to capacity. Results of 25 children with CP showed no strong association between motor capacity and performance, but a certain level of motor capacity seems to be a prerequisite for the achievement of higher PAS. Our multidimensional performance measurement provides a new method of PA assessment in this population, with an easy-to-understand visual output (barcode) and objective data for clinical and scientific use.
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- 2020
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14. Correction to: Locomotion and cadence detection using a single trunk-fixed accelerometer: validity for children with cerebral palsy in daily life-like conditions
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Anisoara Paraschiv-Ionescu, Christopher J. Newman, Lena Carcreff, Corinna N. Gerber, Stephane Armand, and Kamiar Aminian
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Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
The original article [1] contained a minor error whereby the middle initial of Christopher J. Newman’s name was mistakenly omitted.
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- 2019
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15. What is the Best Configuration of Wearable Sensors to Measure Spatiotemporal Gait Parameters in Children with Cerebral Palsy?
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Lena Carcreff, Corinna N. Gerber, Anisoara Paraschiv-Ionescu, Geraldo De Coulon, Christopher J. Newman, Stéphane Armand, and Kamiar Aminian
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cerebral palsy ,gait ,inertial sensors ,gait events ,spatiotemporal parameters ,Chemical technology ,TP1-1185 - Abstract
Wearable inertial devices have recently been used to evaluate spatiotemporal parameters of gait in daily life situations. Given the heterogeneity of gait patterns in children with cerebral palsy (CP), the sensor placement and analysis algorithm may influence the validity of the results. This study aimed at comparing the spatiotemporal measurement performances of three wearable configurations defined by different sensor positioning on the lower limbs: (1) shanks and thighs, (2) shanks, and (3) feet. The three configurations were selected based on their potential to be used in daily life for children with CP and typically developing (TD) controls. For each configuration, dedicated gait analysis algorithms were used to detect gait events and compute spatiotemporal parameters. Fifteen children with CP and 11 TD controls were included. Accuracy, precision, and agreement of the three configurations were determined in comparison with an optoelectronic system as a reference. The three configurations were comparable for the evaluation of TD children and children with a low level of disability (CP-GMFCS I) whereas the shank-and-thigh-based configuration was more robust regarding children with a higher level of disability (CP-GMFCS II–III).
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- 2018
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16. Nouveaux outils d’évaluation du mouvement chez l’enfant avec handicap moteur
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Lena Carcreff, Stéphane Armand, Alice Bonnefoy-Mazure, Geraldo De Coulon, and Christopher J. Newman
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General Medicine - Published
- 2022
17. Only a paper moon
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Christopher J. Newman and William Ralston
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The Artemis Accords provide a framework of agreed principles which the United States and other partner countries have committed to following when conducting lunar exploration. Although negotiated as part of Project Artemis, the Accords could also shape the law as humans move out into the solar system. This chapter will examine both the compliance with existing space law and evaluate the suitability of the Accords as a blueprint for future human settlements beyond the Earth and Moon. It is contended that the most important contribution of the Accords is to reinforce existing principles of international space law. It is also argued that efforts must be made to ensure the maintenance of established international forums to avoid the fracturing of the existing Treaty frameworks and the increased risk of conflict that would bring.
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- 2022
18. Starting from the needs: what are the appropriate sources to co-create innovative solutions for persons with disabilities?
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Johanne Mensah-Gourmel, Maxime Bourgain, Christèle Kandalaft, Alain Chatelin, Odile Tissier, Guy Letellier, Jan Willem Gorter, Sylvain Brochard, Christelle Pons, Asma Benyahia, Inès Bréchoire, Pauline Julia, Tuong-Xuân Nguyen-Luong, Pierre Mirlesse, Tomas Studenik, Sebastien Loriot, Brian Tesar, Nolwenn Le Menn, Thomas Gayon, Amelie Genot, Juliette Ropars, Christopher J Newman, Julie Paradis, Laetitia Houx, Rodolphe Bailly, and Martine Venineaux
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Speech and Hearing ,Rehabilitation ,Biomedical Engineering ,Orthopedics and Sports Medicine ,Physical Therapy, Sports Therapy and Rehabilitation - Abstract
Technical solutions could facilitate activities and participation in individuals with disabilities. For the development of solutions, hackathons are a method of interdisciplinary collaboration. For hackathon, the definition of pain points that require solutions is crucial. We aimed to determine engineers' preferences and expectations regarding pain point qualities.We used a collaborative approach involving individuals with disability, families, and healthcare professionals to determine pain points for use by engineering students during a disability Hackathon. A pain point bank was built using 3 upstream sources: a survey (350 responses, 20 pain points selected), interviews (8 children, 13 pain points), and a multidisciplinary workshop based on design thinking methods (45 people, 32 pain points). A fourth source was 20 adults with disabilities present during the Hackathon. Engineering students rated pain point qualities from each source in a questionnaire that included closed questions relating to predefined criteria: achievability, specificity, relevance and attractiveness and open questions to collect non-predefined quality criteria.Pain points from the workshop were most frequently used (48%); followed by on-site discussions with mentors (43%), the survey (38%), and interviews (31%). On-site discussions received the highest quality ratings followed by the workshop, survey, and interviews. Three quality criteria emerged from the responses to open questions: "representative", "empathy", and "real-need".To be actionable by engineers, pain points must relate to real needs, be achievable, specific, relevant and attractive but also representative and arouse empathy. We devised a checklist of qualities along with a toolbox of methods to achieve each.Implications For RehabilitationThe first step of the development of technical solutions for children and individuals with disabilities is the identification of their needs and their adequate formulation to be submitted to technical solutions providers.Daily life needs of individuals with disability were gathered for an engineering hackathon and proposed as pain points to 400 engineering students.To facilitate the development of solutions by engineers, pain points must relate to real needs, be specific, relevant, achievable and attractive; be representative and arouse empathy; a toolbox of needs collection methods is proposed to achieve each of those qualities.Discussions with individuals with disability and health professionals should be provided.
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- 2022
19. A Personalized Approach to Improve Walking Detection in Real-Life Settings: Application to Children with Cerebral Palsy.
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Lena Carcreff, Anisoara Paraschiv-Ionescu, Corinna N. Gerber, Christopher J. Newman, Stéphane Armand, and Kamiar Aminian
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- 2019
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20. Digital technologies for motor rehabilitation in children: protocol for a cross-sectional European survey
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Christelle Pons, Sylvain Brochard, Anca Grigoriu, Christopher J Newman, Elegast Monbaliu, Johanne Mensah-Gourmel, Delphine Gaudin-Drouelle, Anis Toumi, Marco Konings, and Javier de la Cruz
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Europe ,Digital Technology ,Technology ,Cross-Sectional Studies ,PAEDIATRICS ,Humans ,Information technology ,REHABILITATION MEDICINE ,General Medicine ,Child - Abstract
IntroductionDigital technologies can be used as part of paediatric motor rehabilitation to remediate impairment, promote recovery and improve function. However, the uptake of digital technologies in this clinical field may be limited.The aim of this study is to describe and explain digital technology use for paediatric motor rehabilitation. The specific objectives will be: (1) to describe the access to, acceptance of and use of digital technologies as a function of individual factors related to professionals practicing motor rehabilitation with children, and of environmental factors related to paediatric rehabilitation practice and (2) to explain digital technology use with a causal model based on the ‘unified theory of acceptance and use of technology’.Methods and analysisRehaTech4child (Rehabilitation Technologies For children) is a cross-sectional study involving an online survey, that is sponsored by the European Academy of Childhood Disability (EACD). The survey protocol follows the Strengthening the Reporting of Observational Studies in Epidemiology and CHERRIES (Checklist for Reporting Results of Internet E-Surveys) guidelines. The survey includes 43 questions about (1) respondents’ individual and environmental characteristics; (2) the ease of access to digital technologies, and the frequency, type and purpose of use of those technologies and (3) acceptance of technologies and barriers to their use. The survey is intended for professionals involved in paediatric motor rehabilitation. It is disseminated across Europe by the EACD network in 20 languages. Participation is anonymous and voluntary. We aim to include 500 respondents to ensure sufficient precision for the description of study outcomes and to perform stratified analyses by the main determinants.Ethics and disseminationEthics approval was waived by the Brest CHRU Institutional Review Board. The study is conducted according to current French legislation (loi Jardé (n°2012-300)) and the survey is GDPR compliant. Study findings will be presented at national and international meetings and submitted for publication in a peer-reviewed journal.Trial registration numberNCT05176522.
- Published
- 2023
21. Space Law & Policy: The U.K. Approach to the Regulation of Space Activities
- Author
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Christopher J. Newman
- Abstract
Space activity within the United Kingdom (U.K.) has undergone a significant period of change with successive governments viewing space as a significant source of economic growth. This has seen increasing attention being paid to both space policy and regulation. As a signatory to the Outer Space Treaty 1967, the U.K. is internationally responsible for the space activity of both its governmental and commercial entities. These obligations were initially discharged through the Outer Space Act 1986 and the licensing framework that emerged from that. The decision of the government to develop the capability to launch small satellites from within the U.K., coupled with the promise of high-altitude activities and horizontal launch, meant that action was needed to update the law and regulation of space activity within the U.K. The need for investment to fuel the ambition of the U.K. is set out in the National Space Strategy.
- Published
- 2022
22. [New tools for movement assessment in children with motor disabilities]
- Author
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Lena, Carcreff, Stéphane, Armand, Alice, Bonnefoy-Mazure, Geraldo, De Coulon, and Christopher J, Newman
- Subjects
Artificial Intelligence ,Movement ,Humans ,Child - Abstract
Until recently, movement analysis of children with motor disabilities has mainly relied on in-lab measurements using optoelectronic systems. The development of new tools is mainly inspired from mainstream devices, such as video cameras associated with artificial intelligence or inertial sensors. These tools have extended the assessment of movement in these children beyond traditional movement analysis laboratories, to take an interest in their movements in everyday life. Through the complementarity of these measurements (and associated tools), which the use of is becoming mainstream, a more exhaustive understanding of children's motor disorders and their impacts will allow clinicians to optimize their therapeutic management.Jusqu’à récemment l’analyse du mouvement chez l’enfant avec handicap moteur s’est principalement appuyée sur des mesures détaillées effectuées en laboratoire à l’aide de systèmes optoélectroniques. Le développement de nouveaux outils de mesure s’appuie sur des dispositifs grand public, tels que les caméras vidéo associées à de l’intelligence artificielle ou les capteurs inertiels. Ces outils ont permis d’étendre le champ d’exploration du mouvement de ces enfants hors des laboratoires traditionnels d’analyse du mouvement pour s’intéresser à leurs mouvements dans la vie quotidienne. Par la complémentarité de ces mesures (et outils associés), dont l’utilisation est appelée à se démocratiser, une compréhension plus exhaustive des troubles moteurs de l’enfant et de ses impacts permettra d’optimiser leur prise en charge thérapeutique.
- Published
- 2022
23. Comparison of gait characteristics between clinical and daily life settings in children with cerebral palsy
- Author
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Corinna N. Gerber, Stéphane Armand, Geraldo De Coulon, Lena Carcreff, Christopher J. Newman, Kamiar Aminian, and Anisoara Paraschiv-Ionescu
- Subjects
Male ,030506 rehabilitation ,Wilcoxon signed-rank test ,deviation index ,lcsh:Medicine ,0302 clinical medicine ,Gait (human) ,Activities of Daily Living ,older-adults ,adolescents ,physical-activity ,Child ,lcsh:Science ,gross motor function ,Gait ,ddc:618 ,Multidisciplinary ,ddc:617 ,ambulatory system ,Female ,walking activity ,Gait Analysis ,0305 other medical science ,performance ,medicine.medical_specialty ,Adolescent ,Case-Control Studies ,Cerebral Palsy/physiopathology ,Cross-Sectional Studies ,Gait/physiology ,Humans ,Walking Speed ,Young Adult ,Qualitative evidence ,Clinical settings ,Paediatric research ,Article ,Cerebral palsy ,scale ,03 medical and health sciences ,Physical medicine and rehabilitation ,medicine ,patterns ,business.industry ,Cerebral Palsy ,lcsh:R ,Translational research ,medicine.disease ,lcsh:Q ,business ,human activities ,030217 neurology & neurosurgery - Abstract
Gait assessments in standardized settings, as part of the clinical follow-up of children with cerebral palsy (CP), may not represent gait in daily life. This study aimed at comparing gait characteristics in laboratory and real life settings on the basis of multiple parameters in children with CP and with typical development (TD). Fifteen children with CP and 14 with TD wore 5 inertial sensors (chest, thighs and shanks) during in-laboratory gait assessments and during 3 days of daily life. Sixteen parameters belonging to 8 distinct domains were computed from the angular velocities and/or accelerations. Each parameter measured in the laboratory was compared to the same parameter measured in daily life for walking bouts defined by a travelled distance similar to the laboratory, using Wilcoxon paired tests and Spearman’s correlations. Most gait characteristics differed between both environments in both groups. Numerous high correlations were found between laboratory and daily life gait parameters for the CP group, whereas fewer correlations were found in the TD group. These results demonstrated that children with CP perform better in clinical settings. Such quantitative evidence may enhance clinicians’ understanding of the gap between capacity and performance in children with CP and improve their decision-making.
- Published
- 2020
24. Comment faciliter la réinsertion socioprofessionnelle du patient neurolésé ? Outils pour le praticien
- Author
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Nicolas Perret, Dolores González-Morón, Hélène Queijo, Isabelle Honorez-Erard, Caroline Attwell, Philippe Ryvlin, Gilles Bovay, Dominique Dorthe, Christopher J. Newman, and Karin Diserens
- Subjects
General Medicine - Published
- 2020
25. Are Clinical Impairments Related to Kinematic Gait Variability in Children and Young Adults With Cerebral Palsy?
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Anne, Tabard-Fougère, Dionys, Rutz, Annie, Pouliot-Laforte, Geraldo, De Coulon, Christopher J, Newman, Stéphane, Armand, and Jennifer, Wegrzyk
- Subjects
Behavioral Neuroscience ,Psychiatry and Mental health ,Neuropsychology and Physiological Psychology ,Neurology ,cerebral palsy ,clinical impairments ,gait ,kinematic ,variability ,Biological Psychiatry - Abstract
Intrinsic gait variability (GV), i.e., fluctuations in the regularity of gait patterns between repetitive cycles, is inherent to the sensorimotor system and influenced by factors such as age and pathology. Increased GV is associated with gait impairments in individuals with cerebral palsy (CP) and has been mainly studied based on spatiotemporal parameters. The present study aimed to describe kinematic GV in young people with CP and its associations with clinical impairments [i.e., passive range of motion (pROM), muscle weakness, reduced selective motor control (selectivity), and spasticity]. This retrospective study included 177 participants with CP (age range 5-25 years; Gross Motor Function Classification System I-III) representing 289 clinical gait analyses [n = 172 for unilateral CP (uCP) vs. 117 for bilateral CP (bCP)]. As variability metrics, Root Mean Square Deviation (RMSD) for nine lower-limb kinematic parameters and Gait Standard Deviation (GaitSD) - as composite score of the kinematic parameters - were computed for the affected (unilateral = uCP) and most affected side (bilateral = bCP), respectively, as defined by clinical scores. GaitSD was then computed for the non/less-affected side for between leg comparisons. Uni- and multivariate linear regressions were subsequently performed on GaitSD of the affected/most affected side with all clinical impairments (composite scores) as independent variables. Highest RMSD were found in the transverse plane (hip, pelvis), for distal joints in the sagittal plane (knee, ankle) and for foot progression. GaitSD was not different between uCP and bCP (affected/most affected side) but higher in the non-affected vs. affected side in uCP. GaitSD was associated with age (p < 0.001), gait deviation index (GDI) (p < 0.05), muscle weakness (p < 0.001), selectivity (p < 0.05), and pROM (p < 0.001). After adjustment for age and GDI, GaitSD remained associated with muscle weakness (uCP: p = 0.003, bCP: p < 0.001) and selectivity (bCP: p = 0.024). Kinematic GV can be expressed as global indicator of variability (GaitSD) in young people with CP given the strong correlation of RMSD for lower-limb kinematic parameters. In terms of asymmetry, increased variability of the non-affected vs. affected side may indicate contralateral compensation mechanisms in uCP. Notably muscle weakness (uCP, bCP) and selectivity (bCP) - but not spasticity - were associated with GaitSD. Further studies need to explore the clinical relevance of kinematic GV in CP to support the interpretation of clinical gait analyses and therapeutic decision-making.
- Published
- 2022
26. PASTEC - a prospective, single-center, randomized, cross-over trial of pure physical versus physical plus attentional training in children with cancer
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Raffaele Renella, Sonia Matthey, Alice Destaillats, Christopher J. Newman, Pierluigi Ballabeni, Céline Dufour, Stéphane Maeder, Maja Beck Popovic, Andrea Orlando Fontana, Manuel Diezi, and Claire Mayor
- Subjects
medicine.medical_specialty ,Anxiety ,Single Center ,law.invention ,Randomized controlled trial ,law ,Neoplasms ,Clinical endpoint ,medicine ,Humans ,Prospective Studies ,Child ,Exercise ,Cross-Over Studies ,business.industry ,Neuropsychology ,Attendance ,Hematology ,Crossover study ,Oncology ,Pediatrics, Perinatology and Child Health ,Physical therapy ,medicine.symptom ,Motor Deficit ,business - Abstract
Despite recent improvements in survival rates in children with cancer, long-term toxicities remain a major concern. Physical activity could reduce the impact of long-term sequelae, notably in neuropsychological and physical areas. We report of a randomized trial of pure physical versus physical/attentional training in pediatric oncology patients. Twenty-two patients aged 6-18 y.o. were included, irrespective of their clinical diagnosis or treatment status, stratified by age and randomized 1:1 into pure physical vs. physical/attentional activity arms, with a cross-over at study midpoint. Neurological, motor and neuropsychological assessments were performed at inclusion, start, crossover and end of the program. Feasibility, defined as > 80% patients attending > 80% of sessions, was the primary endpoint. Secondary outcomes were improvements in neuropsychological and motor performance tests. While 68% of patients attended more than 80% of sessions during the pre-crossover phase of the study, this dropped to 36% post-crossover. Our study therefore failed to meet our primary endpoint. Nonetheless, significant improvements in anxiety (p
- Published
- 2021
27. Cohort profile: the Swiss Cerebral Palsy Registry (Swiss-CP-Reg) cohort study
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Joel Victor Fluss, Sebastian Grunt, Anne Tscherter, Christopher J. Newman, Christoph Kuenzle, Gian Paolo Ramelli, Peter Weber, Andreas Meyer-Heim, Sandra M. Hunziker, Claudia E. Kuehni, Stephanie Juenemann, and Fabiën N. Belle
- Subjects
Pediatrics ,medicine.medical_specialty ,business.industry ,Medical record ,Gross Motor Function Classification System ,medicine.disease ,Cerebral palsy ,Quality of life ,Interquartile range ,Cohort ,medicine ,Spastic ,business ,Cohort study - Abstract
SUMMARYBACKGROUNDCerebral Palsy (CP) is a group of permanent disorders of movement and posture that follows injuries to the developing brain. It results in motor dysfunction and a wide variety of comorbidities like epilepsy, pain, speech, hearing and vision disorders, cognitive dysfunction, and eating and digestive difficulties. Central data collection is essential to study the epidemiology, clinical presentations, care, and quality of life of patients affected by CP. CP specialists founded the Swiss Cerebral Palsy Registry (Swiss-CP-Reg) in 2017. This paper describes the design, structure, aims and achievements of the Swiss-CP-Reg and presents first results.METHODSSwiss-CP-Reg records patients of any age suffering from CP who are born, treated, or live in Switzerland. It collects data from medical records and reports, from questionnaires answered by patients and their families, and from data linkage with routine statistics and other registries. The registry contains information on diagnosis, clinical presentation, comorbidities, therapies, personal information, family history, and quality of life.ResultsFrom August 2017 to August 2021, 546 participants (55% males, mean age at registration 8 years (interquartile range [IQR]: 5-12) were enrolled in Swiss-CP-Reg. Most had been born at term (56%), were less than 2 years old at diagnosis (73%, median 9 months, IQR: 18-25), and were diagnosed with spastic CP (76%). Most (59%) live with a mild motor impairment (Gross Motor Function Classification System [GMFCS] level I or II), 12% with a moderate motor impairment (GMFCS level III), and 29% with a severe motor impairment (GMFCS level IV or V). In a subset of 170 participants, we measured intelligence quotient (IQ) and saw a reduced IQ by GMFCS scale increase. The Swiss-CP-Reg has a strong interest in research with currently 5 nested projects running, and many more planned.CONCLUSIONSSwiss-CP-Reg collects and exchanges national data on people living with CP to answer clinically relevant questions. Its structure enables retrospective and prospective data collection and knowledge exchange between experts to optimise and standardise treatment and improve the health and quality of life of those diagnosed with CP in Switzerland.ClinicalTrials.gov identifierNCT04992871
- Published
- 2021
28. The Space Industry Act 2018: Unlocking the UK Space Economy?
- Author
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Christopher J. Newman
- Subjects
Space industry ,Business ,Economic system ,Space (commercial competition) - Published
- 2019
29. By Way of Paris : A Novel
- Author
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Christopher J. Newman and Christopher J. Newman
- Abstract
Luke's life in North Carolina sucks until things start to look up when he sets off for a writing program in London, spending the month before his course exploring Europe. But his dream trip quickly derails in Paris after he discovers a body at a party and is blackmailed into hiding the evidence. Arriving in London, Luke decides that crafting the perfect novel will help him overcome the Paris catastrophe. He befriends Shane, a gang leader, and shadows a band of criminals as research for his manuscript. Luke finds a family with the young gang, but this new world is filled with violence and toxic masculinity, which strains his academic career, eventually entangling him in the London underworld as he embarks on a slew of crimes, making dangerous enemies along the way. When friends start dying and detectives begin calling, Luke is forced back to France, realizing that he's not the hero of his own story. Searching for an ending that could free his friends from Shane, Luke wants to bring justice to the murder that happened … by way of Paris.
- Published
- 2024
30. Intrinsic gait variability of kinematic parameters in children and young adults with spastic cerebral palsy: Relationship with clinical impairments
- Author
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Stéphane Armand, Jennifer Wegrzyk, G. De Coulon, Anne Tabard-Fougère, Christopher J. Newman, A. Pouliot-Laforte, and D. Rutz
- Subjects
medicine.medical_specialty ,Physical medicine and rehabilitation ,Gait (human) ,Spastic cerebral palsy ,business.industry ,Rehabilitation ,Biophysics ,medicine ,Orthopedics and Sports Medicine ,Kinematics ,Young adult ,medicine.disease ,business - Published
- 2021
31. Post-COVID-19 scientific conferences: virtual becomes the new reality
- Author
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Christopher J. Newman
- Subjects
2019-20 coronavirus outbreak ,Medical education ,Coronavirus disease 2019 (COVID-19) ,Invited Editorial ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,MEDLINE ,Developmental cognitive neuroscience ,Editorials ,COVID-19 ,Congresses as Topic ,Clinical neurology ,Developmental Neuroscience ,Political science ,Pediatrics, Perinatology and Child Health ,Videoconferencing ,Humans ,Neurology (clinical) ,Prevention control - Published
- 2021
32. Assessment of bimanual performance in 3-D movement analysis Validation of a new clinical protocol in children with unilateral cerebral palsy
- Author
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Isabelle Bonan, Christopher J. Newman, Florence Gaillard, Armel Crétual, Marine Cacioppo, Hélène Rauscent, Thibault Pasquet, Guillaume Bouzillé, Brice Bouvier, CHU Pontchaillou [Rennes], Laboratoire Mouvement Sport Santé (M2S), Université de Rennes (UR)-École normale supérieure - Rennes (ENS Rennes)-Université de Brest (UBO)-Université de Rennes 2 (UR2)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Médecine physique et de réadaptation [Rennes] (MPR), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Division de cardiologie [CHU Vaudois] (CHUV), Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), École normale supérieure - Cachan (ENS Cachan)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université de Brest (UBO)-Université de Rennes 2 (UR2), Université de Rennes (UNIV-RENNES)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), and CCSD, Accord Elsevier
- Subjects
Male ,030506 rehabilitation ,medicine.medical_specialty ,Adolescent ,Intraclass correlation ,Movement ,[SDV]Life Sciences [q-bio] ,Elbow ,Bimanual task ,Wrist ,Cerebral palsy ,Upper Extremity ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Clinical Protocols ,medicine ,Humans ,Orthopedics and Sports Medicine ,Child ,Upper limb ,ComputingMilieux_MISCELLANEOUS ,business.industry ,Cerebral Palsy ,Rehabilitation ,Reproducibility of Results ,Bimanual performance ,medicine.disease ,Hand ,Trunk ,[SDV] Life Sciences [q-bio] ,Unilateral cerebral palsy ,Standard error ,medicine.anatomical_structure ,Female ,0305 other medical science ,Range of motion ,business ,030217 neurology & neurosurgery ,3-D movement analysis - Abstract
The "Be an Airplane Pilot" (BE-API) protocol is a novel 3-D movement analysis (3DMA) protocol assessing the bimanual performance of children during a game.This study aimed to investigate the reliability and validity of this protocol in children with unilateral cerebral palsy (uCP).Angular waveforms (WAVE), maximum angles (MAX) and range of motion (ROM) of the trunk, shoulder, elbow and wrist joints were collected in children with uCP and in typically developing children (TDC) during 4 tasks of the BE-API protocol designed to explore specific degrees of freedom (DoF). The inter-trial reliability for children with uCP was assessed with the coefficient of multiple correlation (CMC) for WAVE and the intraclass correlation coefficient (ICC) and standard error of measurement (SEM) for MAX and ROM. Clinical performance-based measures, including the Assisting Hand Assessment (AHA) and ABILHAND-Kids scores, were used to explore correlations between clinical measures and kinematic parameters in children with uCP.20 children with uCP (13 boys; mean age 12.0 [SD 3.2] years) and 20 TDC (11 boys; mean age 11.9 [SD 3.4] years) were included. In children with uCP, most kinematic parameters showed high reliability (WAVE: CMC≥0.82; MAX and ROM: ICC≥0.85, SEM≤4.7°). Elbow extension, forearm supination, and wrist adduction were reduced and wrist flexion was increased for children with uCP versus TDC (P0.01). In children with uCP, MAX and ROM values were moderately correlated with clinical assessments (AHA score: r=0.48-0.65; ABILHAND-Kids score: r=0.48-0.49).The BE-API protocol is a 3DMA-bimanual performance-based assessment that is highly reliable in children with uCP. Children with uCP and TDC significantly differed in some clinically relevant kinematic parameters. The BE-API is a promising playful tool, helpful for better understanding upper-limb motor movement abnormalities in bimanual conditions and for tailoring treatments to individual deficits.
- Published
- 2020
33. Walking Speed of Children and Adolescents With Cerebral Palsy: Laboratory Versus Daily Life
- Author
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Christopher J. Newman, Stéphane Armand, Geraldo De Coulon, Corinna N. Gerber, Lena Carcreff, Kamiar Aminian, and Anisoara Paraschiv-Ionescu
- Subjects
0301 basic medicine ,Percentile ,Performance ,02 engineering and technology ,Walking speed ,Correlation ,gait deviation index ,physical-activity ,gross motor function ,Group level ,Original Research ,ddc:617 ,capability ,typical development ,Bioengineering and Biotechnology ,capacity ,cerebral palsy ,inertial sensors ,performance ,walking speed ,021001 nanoscience & nanotechnology ,ambulatory system ,Typical development ,0210 nano-technology ,Biotechnology ,medicine.medical_specialty ,Histology ,lcsh:Biotechnology ,Biomedical Engineering ,Bioengineering ,Inertial sensors ,Cerebral palsy ,clinical gait ,03 medical and health sciences ,Physical medicine and rehabilitation ,lcsh:TP248.13-248.65 ,medicine ,parameters ,Capacity ,business.industry ,medicine.disease ,Individual level ,Gait ,Preferred walking speed ,030104 developmental biology ,Gait analysis ,parkinsons-disease ,business - Abstract
The purpose of this pilot study was to compare walking speed, an important component of gait, in the laboratory and daily life, in young individuals with cerebral palsy (CP) and with typical development (TD), and to quantify to what extent gait observed in clinical settings compares to gait in real life. Fifteen children, adolescents and young adults with CP (6 GMFCS I, 2 GMFCS II, and 7 GMFCS III) and 14 with TD were included. They wore 4 synchronized inertial sensors on their shanks and thighs while walking at their spontaneous self-selected speed in the laboratory, and then during 2 week-days and 1 weekend day in their daily environment. Walking speed was computed from shank angular velocity signals using a validated algorithm. The median of the speed distributions in the laboratory and daily life were compared at the group and individual levels using Wilcoxon tests and Spearman's correlation coefficients. The corresponding percentile of daily life speed equivalent to the speed in the laboratory was computed and observed at the group level. Daily-life walking speed was significantly lower compared to the laboratory for the CP group (0.91 [0.58-1.23] m/s vs 1.07 [0.73-1.28] m/s, p = 0.015), but not for TD (1.29 [1.24-1.40] m/s vs 1.29 [1.20-1.40] m/s, p = 0.715). Median speeds correlated highly in CP (p < 0.001, rho = 0.89), but not in TD. In children with CP, 60% of the daily life walking activity was at a slower speed than in-laboratory (corresponding percentile = 60). On the contrary, almost 60% of the daily life activity of TD was at a faster speed than in-laboratory (corresponding percentile = 42.5). Nevertheless, highly heterogeneous behaviors were observed within both populations and within subgroups of GMFCS level. At the group level, children with CP tend to under-perform during natural walking as compared to walking in a clinical environment. The heterogeneous behaviors at the individual level indicate that real-life gait performance cannot be directly inferred from in-laboratory capacity. This emphasizes the importance of completing clinical gait analysis with data from daily life, to better understand the overall function of children with CP.
- Published
- 2020
34. [How to improve social and professional reinsertion of patients with neurodiabilities ? Practical indications for the general practitioner]
- Author
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Nicolas, Perret, Dolores, González-Morón, Hélène, Queijo, Isabelle, Honorez-Erard, Caroline, Attwell, Philippe, Ryvlin, Gilles, Bovay, Dominique, Dorthe, Christopher J, Newman, and Karin, Diserens
- Subjects
Employment ,General Practitioners ,General Practice ,Humans ,Disabled Persons ,Interpersonal Relations ,Referral and Consultation - Abstract
One part of the population of neurolesioned patients is the transition of young patients with neurodisabilities to adult life. To guarantee favourable social and professional reinsertion is a major challenge, requiring inter-professional care. For this reason, in 2006 the CHUV, Lausanne created a transition-consultation framework with neuro-paediatricians and adult neurologists specialised in neuro-rehabilitation linked to a Swiss pilot social and professional reinsertion project collaborating with the invalidity insurance. As a model of the follow up of neurolesioned patients, this article reports the results of the reinsertion project that aims to bring awareness to the general practitioner of an inter-disciplinary care method adaptable to individuals. The holistic service saves time and improves the rate of successful reinsertion of young adults into social and professional life.Les jeunes en transition de l’enfance à l’âge adulte présentant une maladie neurodéveloppementale sont une population spécialement vulnérable. Le suivi de leurs problèmes de santé et leur insertion socioprofessionnelle représentent un véritable défi. Au CHUV, à Lausanne, une consultation de transition entre les neurorééducateurs pédiatriques et adultes a été créée en 2006 ainsi qu’un projet pilote suisse de réinsertion socioprofessionnelle en collaboration avec l’Office de l’assurance invalidité pour le canton de Vaud. Le résultat de ce projet pilote, qui peut être utilisé comme modèle pour tous les patients neurolésés, est rapporté ici avec comme objectif d’informer le médecin traitant et de lui permettre d’utiliser les outils de cette prestation holistique afin d’optimiser la durée et la qualité de la réinsertion.
- Published
- 2020
35. A Systematic Review of Clinical Practice Guidelines for Acute Procedural Pain on Neonates
- Author
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Giacomo D. Simonetti, Cécile Jaques, Maya Zumstein-Shaha, Colette Balice-Bourgois, Christopher J. Newman, and Federica Vanoni
- Subjects
Parents ,medicine.medical_specialty ,media_common.quotation_subject ,MEDLINE ,Context (language use) ,CINAHL ,Pain, Procedural ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,Intensive care ,medicine ,Humans ,Pain Management ,Quality (business) ,Intensive care medicine ,media_common ,business.industry ,Infant, Newborn ,Pain management ,Acute Pain ,Clinical Practice ,Procedural Pain ,Hospitalization ,Anesthesiology and Pain Medicine ,Practice Guidelines as Topic ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Objectives During hospitalization in neonatal intensive care units, neonates are exposed to many painful procedures within a stressful environment. To date, many evidence-based guidelines are available. However, the quality of these guidelines and their clinical application remain unclear. This systematic review aimed to determinie the quality of existing guidelines on the management of procedural pain in neonates and to summarize the recommendations provided by these guidelines. Materials and methods A structured search was conducted in Embase, PubMed, CINAHL, JBI database, and gray literature resources in November 2018 to identify relevant guidelines published from 2007 onward. Published guidelines and guidelines from complementary searches were included in the treating assessment or management of procedural pain in neonates. The methodological quality was analyzed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument. Results A total of 1154 records were identified. After screening for eligibility, 17 guidelines were included in this review. Among these, 11 were identified to be high-quality guidelines. Besides the usual recommendations for pharmacological and nonpharmacological treatments, the inclusion of parents, improving interprofessional collaboration, and considering the setting were identified as important elements. Discussion The results of this review show that there is a need to improve the methodological quality of guidelines for procedural pain in newborns. The set of recommendations for procedural pain prevention needs to involve not only pharmacological and nonpharmacological pain treatment but also parents and interprofessional collaboration. It is also essential to take into account facilitators, barriers, and the context to improve pain management.
- Published
- 2020
36. Physicians’ attitudes when faced with life-threatening events in children with severe neurological disabilities
- Author
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Christopher J. Newman and Benjy Wosinski
- Subjects
Male ,medicine.medical_specialty ,Attitude of Health Personnel ,Clinical Decision-Making ,MEDLINE ,Brief, Resolved, Unexplained Event ,macromolecular substances ,03 medical and health sciences ,0302 clinical medicine ,Developmental Neuroscience ,Clinical decision making ,Surveys and Questionnaires ,Humans ,Medicine ,Pediatricians ,Child ,Intensive care medicine ,business.industry ,Rehabilitation ,Infant ,General Medicine ,Disabled Children ,Increased risk ,030228 respiratory system ,Pediatrics, Perinatology and Child Health ,Female ,business ,030217 neurology & neurosurgery - Abstract
Children with severe neurological disabilities are at an increased risk of acute, life-threatening events. We assessed physicians' attitudes when making decisions in these situations.We surveyed physicians in pediatric intensive care, neurology, and rehabilitation units in Swiss hospitals. The questionnaire explored participants' attitudes toward life-threatening situations in two scenarios: a child with profound intellectual and multiple disabilities (PIMD) and an infant with spinal muscular atrophy (SMA) type I.The participation rate was 55% (52/95). There was a consensus favoring non-invasive ventilation and comfort care as well as avoiding tracheostomy and invasive ventilation. For the child with PIMD, 61% of participants opposed cardiopulmonary resuscitation (CPR), 51% for the child with SMA. Physicians with over 20 years of experience were significantly more opposed to providing CPR than less experienced colleagues.Physicians held different views, influenced by personal factors. This highlights the importance of standardizing multidisciplinary processes toward approaching these complex situations.
- Published
- 2018
37. Myoglobinuria in two patients with Duchenne muscular dystrophy after treatment with zoledronate: a case-report and call for caution
- Author
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Andrea Klein, Nuria Garcia Segarra, Christopher J. Newman, Clemens Bloetzer, David Jacquier, Anton Ivanyuk, and Thierry Buclin
- Subjects
Male ,musculoskeletal diseases ,congenital, hereditary, and neonatal diseases and abnormalities ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Side effect ,Duchenne muscular dystrophy ,Zoledronic Acid ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Muscular dystrophy ,Genetics (clinical) ,030203 arthritis & rheumatology ,Bone Density Conservation Agents ,business.industry ,Myoglobinuria ,medicine.disease ,Muscular Dystrophy, Duchenne ,Neurology ,Pediatrics, Perinatology and Child Health ,Neurology (clinical) ,business ,Complication ,Rhabdomyolysis ,030217 neurology & neurosurgery ,After treatment ,Hypophosphatemia - Abstract
Rhabdomyolysis with myoglobinuria is a recognized complication of dystrophinopathies. It can be triggered by infections, exercise or volatile anesthetics. To our knowledge, it has never been reported in boys with Duchenne muscular dystrophy (DMD) after the administration of bisphosphonates. We report two patients with DMD who presented an apparent transient rhabdomyolysis with myoglobinuria after zoledronate administration. Possible mechanisms could involve hypophosphatemia, a known dose-dependent side effect of bisphosphonates, and/or direct myotoxicity of biphosphonates. Physicians and families should be aware of rhabdomyolysis with myoglobinuria as a potential uncommon side effect of bisphosphonates in DMD, in particular of zoledronate.
- Published
- 2018
38. Is height important for quality of life in children with skeletal dysplasias?
- Author
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Hortense Lorne, Sheila Unger, and Christopher J. Newman
- Subjects
0301 basic medicine ,Gerontology ,Male ,Parents ,Adolescent ,media_common.quotation_subject ,030105 genetics & heredity ,Affect (psychology) ,Short stature ,Efficacy ,03 medical and health sciences ,Quality of life ,Surveys and Questionnaires ,Genetics ,medicine ,Humans ,Quality (business) ,Achondroplasia ,Medical diagnosis ,Child ,Genetics (clinical) ,media_common ,Bone Diseases, Developmental ,Heterogeneous group ,business.industry ,General Medicine ,medicine.disease ,Body Height ,030104 developmental biology ,Quality of Life ,medicine.symptom ,business - Abstract
Skeletal dysplasias are a large and heterogeneous group of conditions that affect growth and development of the skeleton. As might be expected, short stature is a frequent manifestation of these disorders but other complications do occur with varying frequencies depending on specific diagnosis and age of the patient. With the ongoing development of targeted therapies for achondroplasia and possibly other skeletal dysplasias, it is important to ascertain what are the factors influencing quality of life if we are to make meaningful assessments of therapeutic efficacy. Is it the short stature, in and of itself, that affects the quality of life for children with skeletal dysplasias or are the other complications more important determinants? We sought to address the effect of height by the use of questionnaire designed specifically for short stature; QoLissy. This questionnaire has been validated for use in Europe across several languages. Our study included 8 families with children between 8 and 18 years with a variety of skeletal dysplasia diagnoses. The results indicate a relatively low health-related quality of life from the child and parents' perspective, good coping strategies and, interestingly, a difference in perception of quality of life between parents and children, with parents rating the quality of life lower than their children. These results highlight the need for a more careful dissection of quality of life-influencers before deciding on how to assess drug efficacy and before advocating for multi-year therapy in children.
- Published
- 2019
39. From congenial paralysis to post-early brain injury developmental condition: Where does cerebral palsy actually stand?
- Author
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Sylvain Brochard, Yannick Bleyenheuft, Carole Vuillerot, Margaux Pouyfaucon, Vincent Gautheron, Mickael Dinomais, Patrick Van Bogaert, Stéphane Chabrier, Alain Chatelin, Guillaume Sébire, Christopher J. Newman, Joel Victor Fluss, service de médecine physique et réadaptation pédiatrique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Bellevue-CHU de Saint-Etienne, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Université de Sherbrooke [Sherbrooke], Laboratoire Angevin de Recherche en Ingénierie des Systèmes (LARIS), Université d'Angers (UA), Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Hospices Civils de Lyon (HCL), Laboratoire de Traitement de l'Information Medicale (LaTIM), Université européenne de Bretagne - European University of Brittany (UEB)-Télécom Bretagne-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Mines-Télécom [Paris] (IMT), UCL - SSS/IONS/COSY - Systems & cognitive Neuroscience, Université de Sherbrooke (UdeS), and UCL - Louvain Bionics
- Subjects
Biopsychosocial model ,Motor disorder ,030506 rehabilitation ,[SDV]Life Sciences [q-bio] ,Umbrella term ,Disability and Health (ICF) ,International Classification of Functioning ,Developmental psychology ,Cerebral palsy ,Human development ,03 medical and health sciences ,0302 clinical medicine ,International Classification of Functioning, Disability and Health ,Paralysis ,medicine ,Humans ,Orthopedics and Sports Medicine ,Narrative ,education ,Narrative medicine ,education.field_of_study ,ddc:618 ,Rehabilitation ,Brain ,medicine.disease ,Brain Injuries ,medicine.symptom ,0305 other medical science ,Psychology ,030217 neurology & neurosurgery ,Early brain injury - Abstract
International audience; Cerebral palsy (CP), an umbrella term for a developmental motor disorder caused by early brain injury (EBI)/interference, remains debated. In this essay, we present a narrative, beginning with the original anatomical-clinical description of the so-called paralysie congéniale (congenial paralysis) by the French psychiatrist Jean-Baptiste Cazauvieilh. We then discuss how the concept has evolved over the last 2 centuries. We aim to illustrate these ideas with the biopsychosocial model of health, especially in light of the current neuroscientific and sociological knowledge of human development. We endeavour to integrate 3 connected but distinct entities: (1) the EBI as a seminal turning point of the individual's story; (2) the clinical findings we call CP, when motor impairment and activity limitation related to post-EBI (or other early non-progressive brain interference) appears, and; (3) a post-EBI developmental condition that encompasses the overall consequences of an EBI. This framework should guide individual, familial and collective care discussions and research strategies beyond the scope of CP.Copyright © 2019 Elsevier Masson SAS. All rights reserved.
- Published
- 2019
40. The need for innovation in participation in childhood disability
- Author
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Christopher J. Newman and Sylvain Brochard
- Subjects
Medical education ,Health Services Needs and Demand ,Educational method ,business.industry ,MEDLINE ,Disabled Children ,Disability Evaluation ,Text mining ,Developmental Neuroscience ,Pediatrics, Perinatology and Child Health ,Early Intervention, Educational ,Humans ,Neurology (clinical) ,business ,Psychology ,Child - Published
- 2019
41. Locomotion and cadence detection using a single trunk-fixed accelerometer: validity for children with cerebral palsy in daily life-like conditions
- Author
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Christopher J. Newman, Anisoara Paraschiv-Ionescu, Corinna N. Gerber, Kamiar Aminian, Lena Carcreff, and Stéphane Armand
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Accelerometry/methods ,Algorithms ,Biomechanical Phenomena ,Cerebral Palsy/physiopathology ,Child ,Child, Preschool ,Female ,Humans ,Locomotion ,Lower Extremity ,Reproducibility of Results ,Sensitivity and Specificity ,Thorax ,Torso ,Accelerometer ,Atypical gait ,Cerebral palsy ,Step detection ,Validation ,Population ,Health Informatics ,Standard deviation ,lcsh:RC321-571 ,Physical medicine and rehabilitation ,Accelerometry ,medicine ,education ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,education.field_of_study ,ddc:617 ,business.industry ,Research ,Rehabilitation ,Correction ,Gross Motor Function Classification System ,medicine.disease ,Trunk ,medicine.anatomical_structure ,business ,Cadence - Abstract
Background Physical therapy interventions for ambulatory youth with cerebral palsy (CP) often focus on activity-based strategies to promote functional mobility and participation in physical activity. The use of activity monitors validated for this population could help to design effective personalized interventions by providing reliable outcome measures. The objective of this study was to devise a single-sensor based algorithm for locomotion and cadence detection, robust to atypical gait patterns of children with CP in the real-life like monitoring conditions. Methods Study included 15 children with CP, classified according to Gross Motor Function Classification System (GMFCS) between levels I and III, and 11 age-matched typically developing (TD). Six IMU devices were fixed on participant’s trunk (chest and low back/L5), thighs, and shanks. IMUs on trunk were independently used for development of algorithm, whereas the ensemble of devices on lower limbs were used as reference system. Data was collected according to a semi-structured protocol, and included typical daily-life activities performed indoor and outdoor. The algorithm was based on detection of peaks associated to heel-strike events, identified from the norm of trunk acceleration signals, and included several processing stages such as peak enhancement and selection of the steps-related peaks using heuristic decision rules. Cadence was estimated using time- and frequency–domain approaches. Performance metrics were sensitivity, specificity, precision, error, intra-class correlation coefficient, and Bland-Altman analysis. Results According to GMFCS, CP children were classified as GMFCS I (n = 7), GMFCS II (n = 3) and GMFCS III (n = 5). Mean values of sensitivity, specificity and precision for locomotion detection ranged between 0.93–0.98, 0.92–0.97 and 0.86–0.98 for TD, CP-GMFCS I and CP-GMFCS II-III groups, respectively. Mean values of absolute error for cadence estimation (steps/min) were similar for both methods, and ranged between 0.51–0.88, 1.18–1.33 and 1.94–2.3 for TD, CP-GMFCS I and CP-GMFCS II-III groups, respectively. The standard deviation was higher in CP-GMFCS II-III group, the lower performances being explained by the high variability of atypical gait patterns. Conclusions The algorithm demonstrated good performance when applied to a wide range of gait patterns, from normal to the pathological gait of highly affected children with CP using walking aids.
- Published
- 2019
42. Reliability of single-day walking performance and physical activity measures using inertial sensors in children with cerebral palsy
- Author
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Stéphane Armand, Christopher J. Newman, Anisoara Paraschiv-Ionescu, Lena Carcreff, and Corinna N. Gerber
- Subjects
030506 rehabilitation ,genetic structures ,Intraclass correlation ,Performance ,physical activity ,Poison control ,Walking ,outcomes ,0302 clinical medicine ,sensor ,Orthopedics and Sports Medicine ,Child ,Gait ,Reliability (statistics) ,ddc:617 ,Rehabilitation ,health ,Reliability ,ambulatory system ,movement ,0305 other medical science ,Cadence ,Algorithms ,performance ,medicine.medical_specialty ,Adolescent ,education ,Physical activity ,gait ,Sitting ,Cerebral palsy ,03 medical and health sciences ,discrete gait parameters ,medicine ,Humans ,Exercise ,Sensor ,cerebral palsy ,reliability ,business.industry ,capacity ,test-retest reliability ,Reproducibility of Results ,medicine.disease ,Physical therapy ,business ,human activities ,030217 neurology & neurosurgery - Abstract
Background: There is a lack of objective and reliable tools to measure walking performance in children with cerebral palsy (CP)., Objective: To evaluate the reliability of inertial measurement units (IMUs) measuring daily life walking performance and physical activity (PA) in children with CP and healthy controls., Methods: Algorithms were developed to analyse data collected with IMUs during 2 standard school days of the same week and 1 weekend day in 15 children with CP and 14 controls. Additionally, within a clinical trial, 10 children with CP were measured twice, on the same weekday 2 to 4 weeks apart. Relative and absolute reliabilities of PA (% time walking, standing, sitting/lying) and gait parameters (e.g., velocity, cadence) were evaluated by using the intraclass correlation coefficient (ICC) and minimal detectable change (MDC95), comparing 2 school days of the same week, a school day with a weekend day, and the same weekday 2 to 4 weeks apart., Results: For the 15 children with CP (mean [SD] age 13.5 [3.4] years), ICCs were very high (0.70-0.98) when comparing gait parameters for 2 school days. ICCs were lower when comparing 2 school days for 14 control children (mean [SD] age 13.9 [3.0] years) and lowest when comparing a school day with a weekend day for both CP and control children. ICCs for PA were 0.90-0.91 when measuring the same weekday 2 to 4 weeks apart but were very low when comparing 2 school days of the same week or a school day with a weekend day. MDC95 values were high for both groups and all comparisons but comparable with findings of in-lab studies of similar parameters., Conclusions: Our IMU and algorithm setup appears to be a reliable tool to measure daily life gait parameters in children with CP when repeatedly measured on 2 school days. PA was also reliably assessed but when measuring the same school day some weeks apart. However, the high MDC95 values question whether the setup can be used as a responsive outcome measure of interventions. (C) C 2019 Elsevier Masson SAS. All rights reserved.
- Published
- 2019
43. Co-sleeping in school-aged children with a motor disability: a comparative population-based study
- Author
-
David Jacquier and Christopher J. Newman
- Subjects
Male ,Parents ,Gerontology ,medicine.medical_specialty ,Adolescent ,Population ,Poison control ,Community Health Planning ,Occupational safety and health ,Cerebral palsy ,Habits ,03 medical and health sciences ,Age Distribution ,0302 clinical medicine ,Developmental Neuroscience ,Surveys and Questionnaires ,030225 pediatrics ,Injury prevention ,medicine ,Humans ,Child ,education ,Neurorehabilitation ,education.field_of_study ,Sleep disorder ,Movement Disorders ,business.industry ,Co-sleeping ,medicine.disease ,Dyssomnias ,Cross-Sectional Studies ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Physical therapy ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Aim To determine the prevalence and determinants of co-sleeping in school-aged children with a motor disability compared with the school-aged general population. Method A questionnaire on demographic characteristics and co-sleeping habits, along with the Sleep Disturbance Scale for Children (SDSC), was sent to parents of children aged between 4 years and 18 years followed in our tertiary paediatric neurorehabilitation clinic, and to school-aged children in a representative sample of state schools. Result We analysed responses for 245 children with motor disability (142 males, 103 females; mean age 10y 6mo, standard deviation [SD] 3y 10mo, range 4–18y) and 2891 of the general population (1484 males, 1497 females; mean age [SD] 9y 6mo [3y 5mo], range 4–18y) (response rates 37% and 26% respectively). Cerebral palsy was the most common diagnosis among children with motor disability. Weekly co-sleeping was significantly more common in children with motor disability than in the general population (11.8% vs 7.9% respectively, p=0.032). Special care of the child with motor disability at night, mainly addressing epilepsy, was reported as a cause of co-sleeping by two-thirds of parents. Factors associated with co-sleeping in the motor disability group were age, housing crowding, severe visual impairment, and pathological sleep according to the SDSC. Interpretation Co-sleeping is common among children with motor disability. It is influenced by personal and medical factors, as well as the requirements for special care at night. Therefore, health professionals should explore sleeping arrangements in families of children with motor disability.
- Published
- 2016
44. Multidimensional Measures of Physical Activity and Their Association with Gross Motor Capacity in Children and Adolescents with Cerebral Palsy
- Author
-
Anisoara Paraschiv-Ionescu, Lena Carcreff, Corinna N. Gerber, Stéphane Armand, and Christopher J. Newman
- Subjects
030506 rehabilitation ,Performance ,Walking ,lcsh:Chemical technology ,Biochemistry ,Analytical Chemistry ,0302 clinical medicine ,Medicine ,lcsh:TP1-1185 ,Longitudinal Studies ,Child ,Instrumentation ,youth ,education.field_of_study ,physical activity pattern ,ddc:617 ,Inertial measurement units ,Atomic and Molecular Physics, and Optics ,fitness ,inertial measurement units ,Motor Skills ,Female ,movement ,0305 other medical science ,Algorithms ,performance ,medicine.medical_specialty ,ambulatory children ,Adolescent ,Population ,Gross motor skill ,Physical activity ,system ,gait ,Physical activity pattern ,Sitting ,Article ,Cerebral palsy ,03 medical and health sciences ,Physical medicine and rehabilitation ,Humans ,Performance measurement ,Electrical and Electronic Engineering ,education ,Association (psychology) ,Exercise ,Monitoring, Physiologic ,cerebral palsy ,reliability ,Capacity ,capacity ,business.industry ,medicine.disease ,Institutional repository ,business ,030217 neurology & neurosurgery - Abstract
The current lack of adapted performance metrics leads clinicians to focus on what children with cerebral palsy (CP) do in a clinical setting, despite the ongoing debate on whether capacity (what they do at best) adequately reflects performance (what they do in daily life). Our aim was to measure these children&rsquo, s habitual physical activity (PA) and gross motor capacity and investigate their relationship. Using five synchronized inertial measurement units (IMU) and algorithms adapted to this population, we computed 22 PA states integrating the type (e.g., sitting, walking, etc.), duration, and intensity of PA. Their temporal sequence was visualized with a PA barcode from which information about pattern complexity and the time spent in each of the six simplified PA states (PAS, considering PA type and duration, but not intensity) was extracted and compared to capacity. Results of 25 children with CP showed no strong association between motor capacity and performance, but a certain level of motor capacity seems to be a prerequisite for the achievement of higher PAS. Our multidimensional performance measurement provides a new method of PA assessment in this population, with an easy-to-understand visual output (barcode) and objective data for clinical and scientific use.
- Published
- 2020
45. Sensing sleep, the challenge of wearable technology for children with neuromuscular disorders
- Author
-
Christopher J. Newman
- Subjects
Male ,medicine.medical_specialty ,business.industry ,MEDLINE ,Neuromuscular Diseases ,General Medicine ,Sleep in non-human animals ,Muscular Dystrophy, Duchenne ,Wearable Electronic Devices ,Physical medicine and rehabilitation ,Pediatrics, Perinatology and Child Health ,Humans ,Medicine ,Neurology (clinical) ,Child ,Sleep ,business ,Wearable technology - Published
- 2020
46. Parent-reported sleep disorders in children with motor disabilities: a comparison with the Sleep Disturbance Scale for Children's new norms
- Author
-
Christopher J. Newman and David Jacquier
- Subjects
Male ,Parents ,Sleep Wake Disorders ,Pediatrics ,medicine.medical_specialty ,Drug Resistant Epilepsy ,Adolescent ,Cross-sectional study ,Population ,Motor Disorders ,Standard score ,Cerebral palsy ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Medicine ,Humans ,education ,Child ,Neurorehabilitation ,education.field_of_study ,Sleep disorder ,business.industry ,Cerebral Palsy ,General Medicine ,Odds ratio ,medicine.disease ,Confidence interval ,Cross-Sectional Studies ,030228 respiratory system ,Child, Preschool ,Female ,business ,030217 neurology & neurosurgery - Abstract
Children with motor disabilities such as cerebral palsy or neuromuscular diseases present more sleep disorders than their typically developing (TD) peers. However, research on these populations has always been performed using historical normative datasets or controls such as siblings. Therefore, we assessed the sleep quality of children with motor disabilities in comparison with a large, contemporary, general population sample.Demographic, medical, and the Sleep Disturbance Scale for Children (SDSC) questionnaires were sent to parents of children aged 4-18 years and followed by our tertiary pediatric neurorehabilitation clinic, and to those of school-aged children in regional primary and secondary schools. TD participant data allowed us to set pathological sleep score thresholds (T score ≥70).We collected 245 responses for children with motor disabilities and 2891 for those from the general population (37% and 26% response rates, respectively). Cerebral palsy was the most frequent diagnosis (N = 109, 44.5%). Children with motor disabilities had significantly more frequent pathological sleep reported in their total SDSC score (7% vs 1.9%, odds ratio (OR) 3.98, 95% confidence interval (CI) 2.17-7.27, p 0.001) and in five subscores. Single-parent households and drug-resistant epilepsy showed significant positive associations with pathological sleep among children with motor disabilities. For TD peers, parental unemployment and parental nationality were positively associated with pathological sleep.This population-based study robustly estimated the prevalence of sleep disorders in children with motor disabilities. Sleep disorders were significantly more frequent in children with motor disabilities, but at a lower frequency than previously reported.
- Published
- 2018
47. Interstitial cells of Cajal are normally distributed in both ganglionated and aganglionic bowel in Hirschsprung's disease
- Author
-
O Reinberg, Christopher J. Newman, Ricardo Laurini, Blaise J. Meyrat, and Y Lesbros
- Subjects
Male ,medicine.medical_specialty ,Pathology ,Gastroenterology ,Enteric Nervous System ,Interstitial cell ,symbols.namesake ,Internal medicine ,Pediatric surgery ,medicine ,Humans ,Hirschsprung Disease ,Intestine, Large ,Child ,Child Child, Preschool Enteric Nervous System/*cytology/pathology/physiopathology Female Hirschsprung Disease/pathology/*physiopathology Humans Infant Intestine, Large/*cytology/*innervation/pathology Male Retrospective Studies ,Hirschsprung's disease ,Retrospective Studies ,Gastrointestinal tract ,business.industry ,Infant ,Histology ,General Medicine ,medicine.disease ,digestive system diseases ,Interstitial cell of Cajal ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,symbols ,Immunohistochemistry ,Female ,Surgery ,Enteric nervous system ,business - Abstract
Surgery for Hirschsprung's disease is often complicated by post-operative bowel motility disorders. The impact of intestinal neural histology on the surgical outcome has been previously studied, but no information is available concerning the influence of the distribution of interstitial cells of Cajal (ICC) on these complications. These cells are considered to be pacemakers in the gastrointestinal tract. The aim of this study was to assess the distribution of ICC in the proximal segment of resected bowel in Hirschsprung's disease and confront these results with the clinical outcome. Using immunohistochemistry for light microscopy, we compared the pattern of distribution of ICC in the proximal segment of resected bowel in Hirschsprung's disease with that in normal colon. We correlated these results with the corresponding neural intestinal histology determined by CD56 and the protein gene product 9.5 immunohistochemistry. The distribution of ICC in the proximal segment of resected bowel is identical to that of normal colon, regardless of normal or abnormal colon innervation. ICC distribution does not seem to contribute to post-operative bowel motility disorders in patients operated for Hirschsprung's disease
- Published
- 2018
48. Introduction
- Author
-
Christopher J. Newman and Richard J. Wilman
- Published
- 2018
49. The effects of tandem skiing on posture and heart rate in children with profound intellectual and multiple disabilities
- Author
-
Diane Michaud, Christopher J. Newman, Francis Degache, L. Mondada, and Allan Bonjour
- Subjects
Male ,030506 rehabilitation ,medicine.medical_specialty ,Adolescent ,Multiple disabilities ,Posture ,Cardiac activity ,Postural control ,03 medical and health sciences ,Physical medicine and rehabilitation ,Developmental Neuroscience ,Heart Rate ,Skiing ,Intellectual Disability ,Heart rate ,Intellectual disability ,medicine ,Humans ,0501 psychology and cognitive sciences ,Child ,business.industry ,05 social sciences ,Rehabilitation ,Body segment ,Exercise therapy ,General Medicine ,medicine.disease ,Trunk ,Disabled Children ,Exercise Therapy ,Pediatrics, Perinatology and Child Health ,cardiovascular system ,Female ,0305 other medical science ,business ,human activities ,050104 developmental & child psychology - Abstract
Purpose: The objective of study was to determine the effect of tandem ski (TS) activity on postural control and cardiac activity in children with profound intellectual and multiple disabilities (PIMDs).Method: Twenty children with PIMD and 20 age-matched controls (typically developed (TD) children) participated. Body segment movements were measured with inertial sensors (Physilog®) placed on the head, C7, trunk (including ECG) and pelvis with a seat reference. Each participant was measured during a 12-turn slalom pattern.Results: In each group, significant differences were observed between the head vs. trunk and head vs. pelvis angular speeds (p
- Published
- 2018
50. What is the Best Configuration of Wearable Sensors to Measure Spatiotemporal Gait Parameters in Children with Cerebral Palsy?
- Author
-
Kamiar Aminian, Geraldo De Coulon, Anisoara Paraschiv-Ionescu, Christopher J. Newman, Stéphane Armand, Corinna N. Gerber, and Lena Carcreff
- Subjects
030506 rehabilitation ,medicine.medical_specialty ,Biomechanical Phenomena ,Cerebral Palsy ,Child ,Foot ,Gait ,Gait Disorders, Neurologic ,Humans ,Wearable Electronic Devices ,cerebral palsy ,gait ,gait events ,inertial sensors ,spatiotemporal parameters ,Computer science ,Wearable computer ,lcsh:Chemical technology ,Biochemistry ,Article ,Analytical Chemistry ,Cerebral palsy ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Inertial measurement unit ,medicine ,lcsh:TP1-1185 ,Electrical and Electronic Engineering ,Instrumentation ,Measure (data warehouse) ,ddc:618 ,ddc:617 ,medicine.disease ,Atomic and Molecular Physics, and Optics ,Gait analysis ,0305 other medical science ,030217 neurology & neurosurgery - Abstract
Wearable inertial devices have recently been used to evaluate spatiotemporal parameters of gait in daily life situations. Given the heterogeneity of gait patterns in children with cerebral palsy (CP), the sensor placement and analysis algorithm may influence the validity of the results. This study aimed at comparing the spatiotemporal measurement performances of three wearable configurations defined by different sensor positioning on the lower limbs: (1) shanks and thighs, (2) shanks, and (3) feet. The three configurations were selected based on their potential to be used in daily life for children with CP and typically developing (TD) controls. For each configuration, dedicated gait analysis algorithms were used to detect gait events and compute spatiotemporal parameters. Fifteen children with CP and 11 TD controls were included. Accuracy, precision, and agreement of the three configurations were determined in comparison with an optoelectronic system as a reference. The three configurations were comparable for the evaluation of TD children and children with a low level of disability (CP-GMFCS I) whereas the shank-and-thigh-based configuration was more robust regarding children with a higher level of disability (CP-GMFCS II-III).
- Published
- 2017
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