The Italian Consensus Conference on the role of rehabilitation for children and adolescents with leukemia, central nervous system tumors, and bone cancer, part 2: general principles for the rehabilitation treatment of motor function impairments.

In Italy, 1400 children and 800 adolescents are diagnosed with cancer every year. About 80% of them can be cured but are at high risk of experiencing severe side effects, many of which respond to rehabilitation treatment. Due to the paucity of literature on this topic, the Italian Association of Pediatric Hematology and Oncology organized a Consensus Conference on the role of rehabilitation of motor impairments in children/adolescents affected by leukemia, central nervous system tumors, and bone cancer to state recommendations to improve clinical practice. This paper includes the consensus on the rehabilitation of children and adolescents with these cancers.

The Italian consensus conference on the role of rehabilitation for children and adolescents with leukemia, central nervous system, and bone tumors, part 1: Review of the conference and presentation of consensus statements on rehabilitative evaluation of motor aspects.

Because of increasing survival rates in pediatric oncology, attention is focusing on cancer and its treatment-related side effects. Rehabilitation may reduce their impact. However, the literature does not provide strong evidence regarding rehabilitation pathways. Therefore, the Italian Association of Pediatric Hematology and Oncology organized a consensus conference on the role of rehabilitation of motor impairments in children/adolescents affected by leukemia, central nervous system, and bone tumors to define recommendations for daily practice. The grading of recommendation assessment, developing and evaluation (GRADE) method was used in order to formulate questions, select outcomes, evaluate evidence, and create recommendations. This paper includes the results on the rehabilitation assessment.

Internal Consistency and Floor/Ceiling Effects of the Gross Motor Function Measure for Use with Children Affected by Cancer: A Cross-Sectional Study.

Children/adolescents with cancer can develop adverse effects impacting gross motor function. There is a lack of gross motor function assessment tools that have been validated for this population. The aim of this multicenter cross-sectional study was to preliminary validate the 88-item Gross Motor Function Measure (GMFM-88) for use in children/adolescents with cancer, exploring internal consistency and floor/ceiling effect. Inclusion criteria regarded children/adolescents diagnosed with cancer on treatment or <1 year off therapy. The internal consistency was assessed using Cronbach's α, and the floor-ceiling effects were calculated through percentage. This study involved 217 participants with heterogeneous neoplasm conditions. Internal consistency was good, with a Cronbach's α of 0.989. Floor-ceiling effect analysis reveals that several items obtained a dichotomous scoring distribution in each of the five sub-scales of the GMFM-88. This can be explained by the heterogeneous clinical characteristics of the target population. The preliminary validation of GMFM-88 in a group of children/adolescents affected by cancer suggests that some items are not able to discriminate between different gross motor function levels, and therefore it does not represent an informative tool to measure gross motor function in children with cancer. Future research is needed to define which ones could be more useful for clinical practice.

Towards the Development of a Device for Assessing the Pliability of Burn Scars.

Burn injuries requires post-accident medical treatment. However, the treatment of burns does not end with first aid because scarred skin must be managed for many years, and in some circumstances, for life. The methods used to evaluate the state of a burn scar based, for instance, on Patient and Observer Scar Assessment Scale or similar ones, often lacks in univocally assessing the scarred skin's state of health. As a result, the primary aim of this research is to design and build a prototype that can support the doctor during scar assessment, and eventually therapy, by providing objective information on the state of the lesion, particularly the value of skin pliability. The developed tool is based on the depressomassage treatment probe named LPG, currently used to treat burn scars in a number of hospitals. It consists of a non-invasive massage technique using a mechanical device to suction and mobilize scar tissue and is used as a post-operative treatment to speed up the healing process to make the mark of the scar less visible. The prototype is specifically designed to be manufactured using Additive Manufacturing and was validated comparing its performances against the ones of a certified instrument (i.e., the Romer Absolute ARM with RS1 probe). Validation was carried out by designing and developing a tool to put the RS1 probe in the same measurement conditions of the new prototype probe. Tests performed to assess the performance of the devised prototype show that the probe developed in this work is able to provide measurements with a sufficient degree of accuracy (maximum error ±0.1 mm) to be adopted for a reliable estimation of the pliability value in a hospital environment.