Interventions for Gait Training in Children With Spinal Cord Impairments: A Scoping Review.

PURPOSE: This is a scoping review of the literature on interventions for gait in individuals with pediatric spinal cord impairments. SUMMARY OF KEY POINTS: Four categories of interventions were identified: orthoses/assistive devices, electrical stimulation, treadmill training, and infant treadmill stepping. CONCLUSIONS: Studies on orthotic intervention, electrical stimulation, and treadmill training reported benefits for various components of gait. The majority of articles (77%) were classified as levels of evidence III and IV. CLINICAL RECOMMENDATIONS: Each intervention targeted specific outcomes; therefore, it is important to identify individual patient characteristics and goals appropriate for each intervention to guide clinical practice. Determining the appropriate orthotic support for each child, and incorporating treadmill training or electrical stimulation, is recommended.

How to diagnose cervicogenic dizziness.

Cervicogenic dizziness (CGD) is a clinical syndrome characterized by the presence of dizziness and associated neck pain. There are no definitive clinical or laboratory tests for CGD and therefore CGD is a diagnosis of exclusion. It can be difficult for healthcare professionals to differentiate CGD from other vestibular, medical and vascular disorders that cause dizziness, requiring a high level of skill and a thorough understanding of the proper tests and measures to accurately rule in or rule out competing diagnoses. Consequently, the purpose of this paper is to provide a systematic diagnostic approach to enable healthcare providers to accurately diagnose CGD. This narrative will outline a stepwise process for evaluating patients who may have CGD and provide steps to exclude diagnoses that can present with symptoms similar to those seen in CGD, including central and peripheral vestibular disorders, vestibular migraine, labyrinthine concussion, cervical arterial dysfunction, and whiplash associated disorder.