Digital technologies for motor rehabilitation in children: protocol for a cross-sectional European survey.

INTRODUCTION: Digital technologies can be used as part of paediatric motor rehabilitation to remediate impairment, promote recovery and improve function. However, the uptake of digital technologies in this clinical field may be limited.The aim of this study is to describe and explain digital technology use for paediatric motor rehabilitation. The specific objectives will be: (1) to describe the access to, acceptance of and use of digital technologies as a function of individual factors related to professionals practicing motor rehabilitation with children, and of environmental factors related to paediatric rehabilitation practice and (2) to explain digital technology use with a causal model based on the 'unified theory of acceptance and use of technology'. METHODS AND ANALYSIS: RehaTech4child (Rehabilitation Technologies For children) is a cross-sectional study involving an online survey, that is sponsored by the European Academy of Childhood Disability (EACD). The survey protocol follows the Strengthening the Reporting of Observational Studies in Epidemiology and CHERRIES (Checklist for Reporting Results of Internet E-Surveys) guidelines. The survey includes 43 questions about (1) respondents' individual and environmental characteristics; (2) the ease of access to digital technologies, and the frequency, type and purpose of use of those technologies and (3) acceptance of technologies and barriers to their use. The survey is intended for professionals involved in paediatric motor rehabilitation. It is disseminated across Europe by the EACD network in 20 languages. Participation is anonymous and voluntary. We aim to include 500 respondents to ensure sufficient precision for the description of study outcomes and to perform stratified analyses by the main determinants. ETHICS AND DISSEMINATION: Ethics approval was waived by the Brest CHRU Institutional Review Board. The study is conducted according to current French legislation (loi Jardé (n°2012-300)) and the survey is GDPR compliant. Study findings will be presented at national and international meetings and submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT05176522.

Improvement in Gait and Participation in a Child with Angelman Syndrome after Translingual Neurostimulation Associated with Goal-Oriented Therapy: A Case Report.

Angelman syndrome is a genetic neurobehavioral syndrome characterized by motor and cognitive developmental delay, with a severe reduction in activity and participation. Treatments are limited and the effects of rehabilitation have not been studied. We report on the progress made by a 7-year-old boy with Angelman syndrome following an innovative synergic intervention involving translingual neurostimulation (TLNS) and goal-oriented rehabilitation to improve gait. The parents were interviewed regarding the child's abilities and participation level and three-dimensional gait analysis was performed before and after the 4-week intervention (five days per week, 4 h per day) and 6 months later. Spatiotemporal and kinematic gait variables improved considerably at 4 weeks, with a reduction in lower limb agonist-antagonist co-contractions, and a large increase in walking distance (from 500 m to 2 km). The child's engagement and ability to perform activities of daily living improved, as well as several functions not targeted by the intervention. Six months after cessation of the intervention, improvements were partially sustained. The rapid and considerable improvement in motor ability was likely due to potentiation of the rehabilitation by the TLNS. Further studies are required to understand the mechanisms underlying this effect and to determine if it is generalizable to other children with similar disorders.