BACKGROUND: Acute flaccid myelitis (AFM) is an illness defined by rapid onset of flaccid paralysis in one or more limbs or bulbar muscles, with MRI findings of predominantly spinal cord gray matter abnormalities spanning one or more spinal segments following a viral illness. Individuals with AFM may require rehabilitation to promote recovery. Activity-based restorative therapy (ABRT) has previously been shown to result in positive outcomes in children with neurologic deficits related to AFM. OBJECTIVES: This study examined functional changes in a group of children with AFM who participated in ABRT in an inpatient setting. METHODS: Retrospective chart review of children with AFM admitted to a single inpatient rehabilitation unit from 2014 to 2018. Children were assessed using the Functional Independence Measure for Children (WeeFIM), Manual Muscle Testing (MMT), Spinal Cord Independence Measure (SCIM), and the Physical Abilities and Mobility Scale (PAMS) as part of routine clinical care; the Modified Rankin Scale for Neurologic Disability was completed retrospectively. RESULTS: Children showed significant improvements across all outcome measures, with effect sizes ranging from moderate to large. Significant change was also seen across all muscle groups on MMT, with effect sizes ranging from small to large. Consistent with previous reports, children demonstrated better function in distal than proximal muscle groups at both admission and discharge. CONCLUSION: Children with AFM who participated in ABRT increased muscle strength and made functional gains across all outcome measures. These results support the utility of rehabilitation in the long-term care of children with AFM and residual neurologic deficit.
BACKGROUND: Acute flaccid myelitis (AFM) is an illness defined by rapid onset of flaccid paralysis in one or more limbs or bulbar muscles, with MRI findings of predominantly spinal cord gray matter abnormalities spanning one or more spinal segments following a viral illness. Individuals with AFM may require rehabilitation to promote recovery. Activity-based restorative therapy (ABRT) has previously been shown to result in positive outcomes in children with neurologic deficits related to AFM. OBJECTIVES: This study examined functional changes in a group of children with AFM who participated in ABRT in an inpatient setting. METHODS: Retrospective chart review of children with AFM admitted to a single inpatient rehabilitation unit from 2014 to 2018. Children were assessed using the Functional Independence Measure for Children (WeeFIM), Manual Muscle Testing (MMT), Spinal Cord Independence Measure (SCIM), and the Physical Abilities and Mobility Scale (PAMS) as part of routine clinical care; the Modified Rankin Scale for Neurologic Disability was completed retrospectively. RESULTS: Children showed significant improvements across all outcome measures, with effect sizes ranging from moderate to large. Significant change was also seen across all muscle groups on MMT, with effect sizes ranging from small to large. Consistent with previous reports, children demonstrated better function in distal than proximal muscle groups at both admission and discharge. CONCLUSION: Children with AFM who participated in ABRT increased muscle strength and made functional gains across all outcome measures. These results support the utility of rehabilitation in the long-term care of children with AFM and residual neurologic deficit.
Authors: David R Dolbow; Ashraf S Gorgey; Albert C Recio; Steven A Stiens; Amanda C Curry; Cristina L Sadowsky; David R Gater; Rebecca Martin; John W McDonald Journal: Aging Dis Date: 2015-08-01 Impact factor: 6.745
Authors: Carmen Yea; Ari Bitnun; Joan Robinson; Aleksandra Mineyko; Michelle Barton; Jean K Mah; Jiri Vajsar; Susan Richardson; Christoph Licht; Jason Brophy; Megan Crone; Shalini Desai; Juliette Hukin; Kevin Jones; Katherine Muir; Jeffrey M Pernica; Robert Pless; Daniela Pohl; Mubeen F Rafay; Kathryn Selby; Sunita Venkateswaran; Geneviève Bernard; E Ann Yeh Journal: J Child Neurol Date: 2016-12-20 Impact factor: 1.987
Authors: Susan J Harkema; Jessica Hillyer; Mary Schmidt-Read; Elizabeth Ardolino; Sue Ann Sisto; Andrea L Behrman Journal: Arch Phys Med Rehabil Date: 2012-09 Impact factor: 3.966
Authors: M J Mulcahey; Christina Calhoun Thielen; Cristina Sadowsky; Jennifer L Silvestri; Rebecca Martin; Lauren White; Julie A Cagney; Lawrence C Vogel; Jennifer Schottler; Loren Davidson; Ingrid Parry; Heather B Taylor; Kristine Higgins; Michelle L Feltz; Rebecca Sinko; Jackie Bultman; Jenny Mazurkiewicz; John Gaughan Journal: Spinal Cord Date: 2017-12-22 Impact factor: 2.772