Comparison of the two-step and midgait methods of plantar pressure measurement in children.

BACKGROUND: Plantar pressure measures can be a useful way to clinically track dynamic foot function in children. Different protocols to collect plantar pressures exist--mainly, a midgait method that measures plantar pressures in the midst of a longer walk and a two-step method for which plantar pressures are obtained on the second step. These two methods have been compared in adults with and without disabilities but not in children. We investigated the concurrent validity and reliability of the midgait and two-step methods. METHODS: Plantar pressure data variables of contact area, contact time, peak pressure, and pressure-time integral were compared between these two methods in children of typical development (ages 5 to 14.5 years) in the heel, midfoot, and forefoot. Paired t tests were used to evaluate the validity of the two-step method. Paired sample correlations and Bland-Altman plots were also used to compare both methods. Intraclass correlation coefficients were calculated to determine reliability. RESULTS: Both methods were reliable and differed only in contact time across all foot regions, with the midgait method having shorter contact times than the two-step method. CONCLUSION: Plantar pressure data collected with the two-step method are comparable to those collected with the midgait method and may be preferred for children because of ease and speed of data collection. Further investigation is necessary to have a more complete understanding of how these findings may apply to children with disabilities.

Outcomes of a home cycling program using functional electrical stimulation or passive motion for children with spinal cord injury: a case series.

BACKGROUND/OBJECTIVE: Children with spinal cord injury (SCI) are at risk for musculoskeletal and cardiovascular complications. Stationary cycling using functional electrical stimulation (FES) or passive motion has been suggested to address these complications. The purpose of this case series is to report the outcomes of a 6-month at-home cycling program for 4 children with SCI. METHODS: Two children cycled with FES and 2 cycled passively at home for 1 hour, 3 times per week. OUTCOME MEASURES: Data collected included bone mineral density of the left femoral neck, distal femur, and proximal tibia; quadriceps and hamstring muscle volume; stimulated quadriceps and hamstring muscle strength; a fasting lipid profile; and heart rate and oxygen consumption during incremental upper extremity ergometry testing. RESULTS: The 2 children cycling with FES and 1 child cycling passively exhibited improved bone mineral density, muscle volume, stimulated quadriceps strength, and lower resting heart rate. For the second child cycling passively, few changes were realized. Overall, the lipid results were inconsistent, with some positive and some negative changes seen. CONCLUSIONS: This case series suggests that cycling with or without FES may have positive health benefits and was a practical home exercise option for these children with SCI.

Quality of life in children with spinal cord injury.

PURPOSE: To compare reports of the child's quality of life (QOL) between children with spinal cord injury (SCI) and their parents using the Pediatric Quality of Life 4.0 Generic Scales (PedsQL), and assess agreement between parent and child responses. To examine the influence of level of injury on QOL and internal consistency reliability of the PedsQL in pediatric SCI. METHODS: Twenty-eight children (17 male children and 11 female children) between five and 13 years and their parents completed the PedsQL. RESULTS: Children rated their QOL better than their parents; however, there was good to excellent parent-child agreement. No differences were noted between children with tetraplegia and paraplegia. Low internal consistency reliability was obtained for various domains. CONCLUSIONS: In addition to using summary scores, specific ratings may raise important points for clinical decision-making. Results on internal consistency reliability suggest the need for condition-specific questionnaires for children with SCI.