TY - JOUR
T1 - Improvements in Function Following Inpatient Activity-Based Therapy for Children with Acute Flaccid Myelitis
AU - Hagen, Kaitlin
AU - Porter, Courtney
AU - Martin, Rebecca
AU - Dean, Janet
AU - Sadowsky, Cristina
AU - Sadowsky, Cristina
N1 - Publisher Copyright:
© 2020 American Spinal Injury Association.
PY - 2020/12/1
Y1 - 2020/12/1
N2 - 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.
AB - 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.
KW - activity-based therapy
KW - acute flaccid myelitis
KW - functional outcomes
UR - http://www.scopus.com/inward/record.url?scp=85101015547&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85101015547&partnerID=8YFLogxK
U2 - 10.46292/sci20-00010
DO - 10.46292/sci20-00010
M3 - Article
C2 - 33536733
AN - SCOPUS:85101015547
SN - 1082-0744
VL - 26
SP - 275
EP - 282
JO - Topics in Spinal Cord Injury Rehabilitation
JF - Topics in Spinal Cord Injury Rehabilitation
IS - 4
ER -