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  4. Improvements in Function Following Inpatient Activity-Based Therapy for Children With Acute Flaccid Myelitis

Improvements in Function Following Inpatient Activity-Based Therapy for Children With Acute Flaccid Myelitis

Top Spinal Cord Inj Rehabil, 2020 · DOI: 10.46292/sci20-00010 · Published: January 1, 2020

NeurologyPediatricsRehabilitation

Simple Explanation

Acute flaccid myelitis (AFM) is a condition characterized by the rapid onset of limb paralysis, often following a viral illness. This study looks at how children with AFM improve after participating in activity-based restorative therapy (ABRT) while staying in the hospital. ABRT involves repeated movements to help regain lost function. The study found that children with AFM who underwent ABRT showed gains in muscle strength and overall function. This suggests that rehabilitation can be helpful for children with AFM, even long after the initial illness.

Study Duration
4 Years
Participants
29 children diagnosed with AFM
Evidence Level
Retrospective chart review

Key Findings

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    Children with AFM demonstrated statistically significant gains from admission to discharge across all clinical measures administered.
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    Significant change was seen from admission to discharge across all WeeFIM subdomains, including self-care, mobility, and cognition, with effect sizes ranging from small (cognition) to large (self-care, mobility, and total score).
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    Children also showed significant improvement on the SCIM and PAMS testing, with large effect sizes seen for both measures.

Research Summary

This study examined functional changes in children with AFM who participated in ABRT in an inpatient setting, finding significant improvements in muscle strength and functional abilities across various outcome measures. The results indicate the utility of ABRT inpatient rehabilitation, even beyond the acute phase of recovery, as children admitted months after the onset of their neurologic deficits still showed progress. The study also noted a distal to proximal pattern of muscle strength improvement, which has implications for addressing musculoskeletal consequences like shoulder and hip subluxation.

Practical Implications

Rehabilitation Utility

The study supports the utility of rehabilitation in the long-term care of children with AFM and residual neurologic deficit.

Home and Community Programs

Early intensive rehabilitation, the provision of a home and community rehabilitation program, and ongoing bouts of therapy may help to mitigate the long-term consequences of AFM.

Monitoring Neuromuscular Consequences

Children with AFM will need ongoing monitoring for potential longer term neuromuscular consequences of AFM.

Study Limitations

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