215 research outputs found

    Profiles of Fatigue Severity and Variability Among Adolescents and Young Adults with Cerebral Palsy

    Get PDF
    Background: Individuals with cerebral palsy (CP) experience progressive changes in functional status with the development of secondary impairments such as fatigue. Detailed accounts of the fatigue experience in CP are lacking. Purpose: This study describes the severity and variability of fatigue in CP using the Fatigue Impact and Severity Self-Assessment. Methods: This was a descriptive cross-sectional study surveying 130 (61 males) individuals (mean age 18 years, 11 months; SD four years, six months) with CP. Analyses comprised comparisons between two groups (Gross Motor Function Classification System (GMFCS) I and II-V), frequency counts and proportions. Results: Significant differences exist between GMFCS groups for all fatigue severity questions. In addition, 38% of individuals classified as GMFCS level I reported their average fatigue as moderate to severe and 53% experienced fatigue on three or more days in the previous week. Sixty-eight percent of individuals classified as GMFCS II-V reported their average fatigue to be moderate to severe and 78% were fatigued on three or more days in the previous week. Conclusions: Fatigue is a highly individualized phenomenon with significant burden for individuals with CP regardless of functional ability. Individuals in GMFCS Levels II-V reported increased fatigue severity and would benefit from specific management interventions

    Validity and reliability of two abbreviated versions of the Gross Motor Function Measure.

    Get PDF
    Aim: The “gold standard” to measure gross motor functioning for children with cerebral palsy (CP) is the Gross Motor Function Measure (GMFM-66). The purpose of this study was to estimate the validity and reliability of two abbreviated versions (item set (GMFM-66 IS) and basal and ceiling (GMFM-66 B&C) approaches) of the GMFM-66. Methods: Twenty-six children with CP aged 2 to 6 years across all GMFCS levels participated. At session one, both abbreviated versions were administered by two independent raters, followed by the full GMFM-66. In the subsequent session, only the abbreviated versions were administered, by the same raters. Concurrent validity, comparability between versions and test-retest reliability were determined using intraclass correlation coefficients (ICC 2,1). Results: Both versions demonstrated high levels of validity with ICCs reflecting associations with the GMFM-66 of 0.99 (95% CIs ranging from 0.972-0.997). Both versions were also shown to be highly reliable with ICCs greater than 0.98 (95% CIs ranging from 0.965-0.994). Interpretation: Both versions can be used in clinical practice or research. However, the GMFM-66-B&C is recommended as the preferred abbreviated version

    Construction and validation of the fatigue impact and severity self-assessment for youth and young adults with cerebral palsy.

    Get PDF
    Purpose: The Fatigue Impact and Severity Self-Assessment (FISSA) was created to assess the impact, severity and self-management of fatigue for individuals with cerebral palsy (CP) aged 14-31. Methods Used: Items were generated from a review of measures and interviews with individuals with CP. Focus groups with healthcare professionals were used for item reduction. A mailed survey was conducted (n=163/367) to assess the factor structure, known-groups validity and test-retest reliability. Results Obtained: The final measure contained 31-items in two factors and discriminated between individuals expected to have different levels of fatigue. Individuals with more functional abilities reported less fatigue (p\u3c 0.002) and those with higher pain reported higher fatigue (p\u3c 0.001). The FISSA was shown to have adequate test-retest reliability, ICC(3,1)=0.74 (95% CI 0.53-0.87). Conclusions Reached: The FISSA valid and reliable for individuals with CP. It allows for identification of the activities that may be compromised by fatigue to enhance collaborative goal setting and intervention planning

    Parents\u27 Experiences and Perceptions when Classifying their Children with Cerebral Palsy: Recommendations for Service Providers.

    Get PDF
    AIMS: This study investigated the experiences and perceptions of parents of children with cerebral palsy (CP) when classifying their children using the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), and the Communication Function Classification System (CFCS). The second aim was to collate parents\u27 recommendations for service providers on how to interact and communicate with families. METHODS: A purposive sample of seven parents participating in the On Track study was recruited. Semi-structured interviews were conducted orally and were audiotaped, transcribed, and coded openly. A descriptive interpretive approach within a pragmatic perspective was used during analysis. RESULTS: Seven themes encompassing parents\u27 experiences and perspectives reflect a process of increased understanding when classifying their children, with perceptions of utility evident throughout this process. Six recommendations for service providers emerged, including making the child a priority and being a dependable resource. CONCLUSIONS: Knowledge of parents\u27 experiences when using the GMFCS, MACS, and CFCS can provide useful insight for service providers collaborating with parents to classify function in children with CP. Using the recommendations from these parents can facilitate family-provider collaboration for goal setting and intervention planning

    Calibration Of The Johnson–Cook Model At High Temperatures For An Ultra-High Strength CrNiMoV Steel

    Get PDF
    This paper presents a study on the thermo-mechanical behavior of an ultra-high strength CrNiMoV steel at high temperatures and medium strain rates through hot tensile tests. The material was examined in two conditions: as-cast/heat-treated (AC/HT) and as-rolled (AR). Tensile tests were conducted at temperatures of 800,900,1000,1100, and 1200°C, and strain rates of 0.1,1, and 10s−1. Inclusion and porosity analysis was also performed on the tensile specimens. The results revealed that the flow stress decreased by approximately 70% on average from 800°C to 1200°C, while increasing by approximately 32% on average from 0.1s−1 to 10s−1 in strain rate. The elongation exhibited an increase from 16.5% at 800°C to 33% at 1200°C. However, the ductility transition was slower than expected, particularly for the AC/HT conditions. The AC/HT samples exhibited higher levels of inclusions and porosity compared to the AR samples, with porosity significantly affecting the elongation to failure and ultimate tensile strength (UTS) at a strain rate of 1s−1. Furthermore, calibrated Johnson–Cook parameters were reported and compared, demonstrating excellent agreement between predicted and experimental values with less than 20% variation. The calibrated Johnson–Cook model can be effectively employed for modeling purposes within the studied temperature range, and its application can even be extrapolated for higher strain rates

    The bodily experience of cerebral palsy: a journey to self-awareness.

    Get PDF
    PURPOSE: The aim of the study was to describe the lived bodily experience of cerebral palsy (CP). METHOD: This was a descriptive phenomenological inquiry. Ten participants were interviewed about their bodily experiences of living with CP. Interviews were semi-structured around pain and fatigue. Inductive thematic analysis was used to identify themes. RESULTS: The bodily experience of CP centered on issues of fatigue and pain as a feeling of muscle soreness. An overwhelming amount of the discussion on fatigue emphasized the fatigue that occurs with walking and prolonged activity. Self-awareness of the individuals\u27 own bodies and adapting activity to continue to participate in various aspects of their lives emerged as the most important theme. Some participants used strategies to manage their pain or fatigue; other participants were not yet fully aware of how to recognize signs of fatigue and/or how to adapt their activities. CONCLUSIONS: Self-awareness appears to be an important process to be fostered by service providers and parents. Specifically, encouraging youth with CP to be aware of their own bodies and the effects (positive and negative) of activity on pain and fatigue should be incorporated into transition programs as the individual becomes responsible for his or her own health care needs. Implications for Rehabilitation Fatigue is a major concern for some youth and young adults with cerebral palsy. Adolescents and young adults with cerebral palsy use a variety of techniques (including adapting or restricting activity and building in rest breaks) to manage fatigue. The process of self-awareness should be fostered by health care professionals leading up to and during transition from pediatric to adult care. Clinical conversations should explore the role of exercise, adaptive equipment, rest and other strategies for dealing with fatigue with a focus on understanding each client\u27s needs individually

    Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

    Get PDF
    Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

    Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

    Get PDF
    This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin
    • 

    corecore