pediatric rehabilitation

小儿康复
  • 文章类型: Case Reports
    1型小脑畸形是一种染色体异常的遗传性疾病。这份个案报告一瞥父母带来的一名两岁男性的理疗康复,他抱怨上肢和下肢不能活动,与他的同龄人组相比,延迟的里程碑,吞咽困难。理疗康复包括Rood的神经发育技术方法,海马疗法,前庭球康复练习,口腔感觉运动刺激,和触觉刺激。该协议持续了12周。在康复结束时,肌肉张力显著改善,发育里程碑延迟.通过这个案例报告,我们总结了遗传咨询对遗传性疾病婴儿父母的重要性。我们应该提高对物理治疗在管理此类疾病中的关键作用的认识。我们得出的结论是,物理治疗可显着改善1型脑畸形患者的症状并提高生活质量。
    Type 1 lissencephaly is a genetic disorder of chromosomal abnormality. This case report glimpses at the physiotherapy rehabilitation for a two-year-old male brought by his parents with complaints of being unable to move his upper and lower limbs, delayed milestones as compared to his peer group, and difficulty in swallowing. Physiotherapy rehabilitation included Rood\'s approach to neurodevelopmental techniques, hippotherapy, vestibular ball rehabilitation exercises, oral sensorimotor stimulation, and tactile stimulation. The protocol lasted for 12 weeks. At the end of the rehabilitation, there was a significant improvement in the tone of the muscles and delayed developmental milestones. Through this case report, we conclude about the importance of genetic counseling to the parents of genetic disorders babies. We ought to improve awareness about the pivotal role of physiotherapy in managing such disorders. We conclude that physiotherapy significantly improved the symptoms and improved the quality of life of patients with type 1 lissencephaly.
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  • 文章类型: Case Reports
    脑性瘫痪(CP)表现为不典型的肌张力,姿势,和运动,分为四种主要类型:锥体外系(运动障碍),痉挛性四肢瘫痪,痉挛型偏瘫,痉挛型双瘫.CP患者可能会因此而笨拙地移动,因为这表明他们的肌肉很紧张。我们报告了一个13岁儿童的案例,该儿童在过去两年中抱怨右小腿肌肉酸痛和行走困难。他的病情被认为是痉挛性双瘫CP。本报告旨在了解神经物理治疗程序在CP背景下的影响。物理治疗采用各种治疗技术,以帮助患者在执行日常任务时变得更加独立,并提高他们的生活质量,包括拉伸,本体感觉神经肌肉促进,加强肢体锻炼,和步态训练。早期康复辅助治疗各种运动功能,比如平衡,姿势,口腔运动功能,精细的运动技能,粗略的运动技能,肌肉控制,肌肉张力,反射,和身体运动。它还可以帮助CP儿童充分发挥身体独立和健康的潜力,并提高儿童和家庭的生活质量。小儿康复在缓解痉挛性双瘫和马蹄内翻足畸形患者的行走困难和小腿肌肉疼痛方面具有显着的益处。
    Cerebral palsy (CP) manifests as atypical muscle tone, posture, and movement, and is classified into four main types: extrapyramidal (dyskinetic), spastic quadriplegia, spastic hemiplegia, and spastic diplegia. Patients with CP might move awkwardly because of this since it indicates that their muscles are tense. We report the case of a 13-year-old child who complained of soreness in his right calf muscle and trouble walking over the previous two years. His condition is recognized as spastic diplegic CP. This report aims to understand the impact of neurophysiotherapy procedures in the context of CP. Physical therapy employs various therapeutic techniques to help patients become more independent in carrying out their everyday tasks and enhance their quality of life, including stretching, proprioceptive neuromuscular facilitation, limb strengthening exercises, and gait training. Early rehabilitation aids in treating various motor functions, such as balance, posture, oral motor functioning, fine motor skills, gross motor skills, muscle control, muscle tone, reflexes, and body movement. It also helps children with CP reach their full potential for physical independence and fitness and enhances the quality of life for both the child and the family. Pediatric rehabilitation yields significant benefits in alleviating walking difficulty and calf muscle pain in individuals with spastic diplegic CP and clubfoot deformity.
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  • 文章类型: Case Reports
    Hirschsprung病(HD)的特征是后肠的肌间和粘膜下丛中不存在神经节细胞。这里,我们报告一例8岁男童腹胀,有反复气体通过史,并有大便通过主诉.2023年2月,该患者被诊断出患有Hirshsprung病,做了左侧结肠造口术。2023年11月,他接受了Hirshsprung第2阶段维修。他于2023年12月17日在全身麻醉结肠造口术动员下进行了手术。理疗开始和评估于2023年12月18日开始。结肠造口术后,切口削弱了腹部和下肢肌肉,而肠梗阻和不适进一步阻碍了患者进行日常活动的能力。体格检查显示呼吸工作增加,双侧髋关节的活动范围减小,下肢肌肉组织的肌肉力量降低,腹部肌肉力量降低,行走和蹒跚步态的困难。根据问题列表设置物理治疗目标。患者在两周的理疗开始中表现出改善,其次是功能能力的提高。康复阶段提供的全面护理旨在解决手术干预产生的具体需求,促进最佳肠道功能,提高范围和强度,确保整体健康。
    Hirschsprung disease (HD) is characterized by the absence of ganglion cells in the myenteric and submucosal plexuses of the hindgut. Here, we report a case of an eight-year-old male child who had abdominal distension with a history of repetitive gas passage and a complaint of stool passage. In February 2023, the patient was diagnosed with Hirshsprung disease, for which a left-side colostomy was done. In November 2023, he underwent Hirshsprung stage 2 repair. He was operated on the 17th of December 2023 under general anaesthesia colostomy mobilization. Physiotherapy commencement and evaluation were started on the 18th of December 2023. After the colostomy procedure, the incision weakened the abdominal and lower limb muscles, while bowel obstruction and discomfort further impeded the patient\'s ability to perform daily activities. Physical examination revealed increased work of breathing, reduced range of motion of the bilateral hip joint, reduced muscle strength of lower limb musculature, reduced abdominal muscle strength, difficulty in walking and waddling type of gait. Physiotherapy goals were set based on the problem list. The patient showed improvement in the two weeks of physiotherapy commencement, followed by improvement in functional ability. The comprehensive care provided during the rehabilitation phase aimed at addressing the specific needs arising from the surgical intervention, promoting optimal bowel function, improving ranges and strength and ensuring overall well-being.
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  • 文章类型: Journal Article
    以家庭为中心的服务(FCS)是提供儿童康复和医疗保健服务的既定方法。这篇文章描述了父母继续报告他们的孩子在医疗保健服务方面的混合经验,以及他们对这些服务需要和想要什么的想法。这些发现将为开发以家庭为中心的服务的最新措施提供信息,称为“护理过程措施”(MPOC2.0)。
    对父母进行了定性描述性研究,使用焦点小组和开放式访谈。使用归纳内容分析对数据进行分析。
    父母想要个性化的护理,协调,容易接近,并考虑到整个家庭的动态。他们希望服务提供商(SP)被告知并投资于他们的孩子的护理,并为家长提供实际帮助。他们也希望受到尊重,关心和同情,并与SP一起制定护理计划。原始FCS指导原则中未确定的新型护理组成部分包括:对需求和心理健康的响应;有效的沟通(与信息提供);实际支持(除了情感和信息支持);以及可用性和日程安排。
    本文确定了家庭认为有用和可取的医疗保健组成部分。
    以家庭为中心的服务(FCS)是提供儿童康复和医疗保健服务的既定方法。然而,父母继续经历不是以家庭为中心的护理方面。残疾儿童的父母确定了他们希望从医疗保健服务中获得的护理组成部分。超越FCS(MPOC)原始措施所确定的新护理组成部分包括:有效的沟通(与信息提供);实际支持(除了情感和信息支持之外);以及可用性和日程安排。
    UNASSIGNED: Family-centred service (FCS) is an established approach for delivering services in children\'s rehabilitation and healthcare. This article describes that parents continue to report mixed experiences with healthcare services for their children, as well as their ideas about what they need and want from these services. These findings will inform the development of an up-to-date measure of Family-Centred Service called Measure of Processes of Care (MPOC 2.0).
    UNASSIGNED: A qualitative descriptive study was conducted with parents, using focus groups and open-ended interviews. Data were analyzed using inductive content analysis.
    UNASSIGNED: Parents want care that is individualized, co-ordinated, easily accessible, and takes into account the entire family dynamic. They want service providers (SPs) to be informed and invested in their child\'s care, and to provide parents with practical assistance. They also want to be treated with respect, caring and empathy, and to work together with SPs on the care plan. Novel components of care not identified in the original FCS guiding principles include: responsiveness to needs and mental health; effective communication (vs information giving); practical support (in addition to emotional and informational support); and availability and scheduling.
    UNASSIGNED: This article identifies components of healthcare that families find helpful and desirable.
    Family-centred service (FCS) is an established approach for delivering services in children’s rehabilitation and healthcare.However, parents continue to experiences aspects of care that are not family-centred.Parents of children with disabilities identified components of care that they want from healthcare services.New components of care that go beyond what was identified in the original measure of FCS (MPOC) include: effective communication (vs information giving); practical support (in addition to emotional and informational support); and availability and scheduling.
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  • 文章类型: Case Reports
    动脉瘤性骨囊肿是罕见的病变,占原发性骨肿瘤的1%到6%。尽管是良性的,这些可能是当地的侵略性。我们报告了一个非典型表现的儿科病例。病人是一个七岁的男孩,由于右侧腹股沟疼痛而被送进急诊室,没有外伤史.症状急性发作,持续5天逐渐加重。X光片显示右股骨近端囊性病变和两个纵向骨折。经过进一步的诊断检查,并给出了动脉瘤性骨囊肿的可能诊断,进行了手术治疗。然后通过组织病理学分析确认诊断。手术后,病人持续剧烈疼痛,在受影响的肢体上具有重要的运动范围(ROM)和肌肉力量降低。因此,患者每天进行量身定制的物理医学和康复(PMR)计划,四个月.在完成治疗计划后,患者无症状:恢复了ROM和肌肉力量,以及恢复以前日常生活活动的能力。这是一种典型的情况,在排除了其他几种情况后,显示了一种罕见的情况,需要多学科的方法。
    Aneurysmal bone cysts are rare lesions, comprising one to six percent of primary bone tumors. Despite benign, those may be locally aggressive. We report a pediatric case with an atypical presentation. The patient was a seven-year-old boy, admitted to an emergency room due to right inguinal pain, without a history of trauma. The symptoms had acute onset and worsened gradually for five days. Radiographs revealed a cystic lesion on the proximal right femur and two longitudinal fractures. After further diagnostic work-up and given the probable diagnosis of an aneurysmal bone cyst, surgical treatment was performed. The diagnosis was then confirmed by histopathological analysis. After surgery, the patient maintained severe pain, having an important range of motion (ROM) and muscular strength reduction on the affected limb. As so, the patient engaged in a daily tailored Physical Medicine and Rehabilitation (PMR) program, for four months. After concluding the treatment plan, the patient was asymptomatic: recovery of both ROM and muscular strength was achieved, as well as the ability to return to previous daily-life activities. This is a paradigmatic case in which a rare condition with a rare presentation was displayed after several others were ruled out, requiring a multidisciplinary approach.
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  • 文章类型: Journal Article
    青年促进者(YF)是在儿科康复团队中工作的具有儿童发病残疾的同伴服务提供商(SP)。这项研究探讨了YF的作用,重点是YF做什么工作,与角色整合过程相关的感知促进者和挑战,以及研究期间角色的演变。
    纵向,定性案例研究方法用于通过访谈收集总共14个月的数据,焦点小组,工作负载日志,和观察。采用专题分析法对数据进行分析。
    两个YF,23名SP和两名经理参与了这项研究。YFs的工作包括独立咨询,资源供应,推荐制作,和项目共同促进。分析产生了两个截然不同的主题。当被视为客户的代表时,YF被认为将客户观点带到护理中,增加临床服务的可信度,并通过角色建模赋予客户和家庭权力。然而,当被视为专业SP时,由于角色不明确,他们的专业知识受到质疑,生活经验的可概括性有限,和组织限制。
    需要针对当地护理环境和组织支持的培训,以将YFs的经验知识转化为经验专业知识。我们提出了将同行提供者最佳整合到临床护理团队的策略。对康复的影响作为有残疾经历的同行服务提供者,青年促进者(YF)有可能通过促进客户和家庭的赋权来受益于儿科康复服务。YF的实践和培训范围应适应各个临床团队和当地护理环境,以帮助YF在跨学科团队中建立经验专业知识。建立YF的核心能力(例如,倡导,Coaching,和边界设置技能)可以帮助将他们的经验知识转化为经验专业知识。
    Youth Facilitators (YFs) are peer service providers (SPs) with childhood-onset disabilities working in pediatric rehabilitation teams. This study explored the YF role focusing on what work YFs do, the perceived facilitators and challenges pertinent to the role integration process, and the evolution of the role over the study period.
    A longitudinal, qualitative case study approach was used to gather data over a total period of 14 months through interviews, focus groups, workload logs, and observations. Data were analyzed using the method of thematic analysis.
    Two YFs, 23 SPs and two managers participated in the study. YFs\' work included independent consultation, resource provision, referral making, and program co-facilitation. Analysis produced two contrasting themes. When viewed as a representative of clients, YFs were considered bringing client perspectives to care, adding credibility to clinical services, and empowering clients and families through role modeling. However, when viewed as a professional SP, their expertise was questioned due to role unclarity, limited generalizability of lived experience, and organizational limitations.
    Training tailored to local care contexts and organizational supports are needed to transform YFs\' experiential knowledge into experiential expertise. We propose strategies for optimal integration of peer providers into clinical care teams.Implications for rehabilitationAs peer service providers with lived experience of disabilities, Youth Facilitators (YFs) have the potential to benefit pediatric rehabilitation services by facilitating empowerment in clients and families as they navigate through life transitions.The YF scope of practice and training should be adapted to fit with individual clinical teams and local care contexts to help YFs establish their experiential expertise in interdisciplinary teams.Establishing YF\'s core competencies (e.g., advocacy, coaching, and boundary setting skills) can help transform their experiential knowledge into experiential expertise.
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  • 文章类型: Journal Article
    BACKGROUND: IncobotulinumtoxinA (Xeomin®) is a botulinum neurotoxin type A with established efficacy in the treatment of upper-limb spasticity in adults. This retrospective case series in a university hospital setting aimed to elucidate the safety and tolerability of incobotulinumtoxinA for treatment of spasticity in children with cerebral palsy.
    METHODS: Participants received incobotulinumtoxinA injections up to a maximum total dose of 600 U, 24 U/kg body weight. Medical records were reviewed for key demographic information, incobotulinumtoxinA exposure, and adverse effects (AEs).
    RESULTS: Sixty-nine children were included (mean age [SD], 8.3 [3.9] years; 44/69 [63.8%] male). One-hundred-and-ninety-one injections were administered, with mean (SD) of 2.8 (1.5) treatment cycles/participant and dosing interval of 6.0 (1.7) months. The number of muscles injected increased from 2.4 (1.2) at cycle 1 to 4.2 (1.9) at cycle 6. The mean (SD) total incobotulinumtoxinA dose increased from 191.7 (126.2) U, (8.5 [5.4] U/kg body weight) at cycle 1 to 368.0 (170.1) U, (9.9 [5.5] U/kg body weight) at cycle 6. Seventy four adverse effects (37.5% of injections) were reported, the most frequent was injection pain (93.2% of AEs). Only three AEs were considered directly treatment-related by injectors: muscle weakness, generalized weakness, and fever.
    CONCLUSIONS: Our clinical experience indicates that incobotulinumtoxinA is a well-tolerated treatment option for focal spasticity in children with cerebral palsy.
    BACKGROUND: As the study was observational and retrospective, no EudraCT registration number was requested. The internal code assigned to the study in the administrative resolution was: 1143-N-15.
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    文章类型: Case Reports
    Bell\'s palsy (BP) in children is a rare case with no documented evidence regarding its rehabilitation management. Till date, individuals with BP are being treated with electrical stimulation are proportionately greater than other conventional means such as facial exercise and massage. These conventional modes of treatment have proved to have less incidence of synkinesis with more benefits. Here, we report a case of a 7-year-old boy diagnosed clinically to have right idiopathic facial nerve paralysis, who underwent 14 days of facial proprioceptive neuromuscular facilitation exercises along with facial therapeutic massage. Documented improvements in facial grading system reveal promising outcomes. Hence, we propose the above technique might improve the functional outcome in the children with BP.
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