Consequences of the COVID-19 pandemic on children's mental health: A meta-analysis

Abstract Background: The COVID-19 pandemic has exacerbated mental health problems in many individuals, including children. Children with pre-existing socio-demographic or developmental risk factors may be particularly vulnerable to the negative effects of the pandemic and associated public health preventive measures. Objective: This systematic review and meta-analysis explored the impacts of the COVID-19 pandemic on the mental health of children aged 5–13 years-old, while highlighting the specific difficulties experienced by children with neurodevelopmental issues or chronic health conditions. Methods: A systematic search of the published literature was conducted in Medline, ERIC, PsycINFO, and Google Scholar, followed by a quantitative meta-analysis of the eligible studies. Results: Out of the 985 articles identified, 28 empirical studies with prospective or retrospective longitudinal data were included in the quantitative synthesis. COVID-19 lockdown measures were associated with negative general mental health outcomes among children (g = 0.28, p < 0.001, and k = 21), but of small magnitude. Sleep habits were also changed during the pandemic, as sleep duration significantly increased in children (g = 0.32; p = 0.004, and k = 9). Moreover, results did not differ between children from the general population and those from clinical populations such as children with epilepsy, oncology, neurodevelopmental disorders, or obesity. Effect sizes were larger in European vs. Asian countries. Conclusions: Studies included in this review suggest that children's mental health was generally negatively impacted during the COVID-19 pandemic. More research is needed to understand the long-term effects of the COVID-19 pandemic on children's mental health and the influence of specific risks factors as they evolve over time

Validity and clinical utility of functional assessments in children with cerebral palsy

Objective To examine the validity and clinical utility of functional assessments (1-minute walk test, 10-meter walk test, Timed Up &amp;amp; Go [TUG] test, Timed Up and Down Stairs [TUDS] test, sit-to-stand [STS] test, and lateral step-up [LSU] test). Design Cross-sectional study. Setting Four special schools for adolescents with physical disabilities. Participants Adolescents with spastic tetraplegia and diplegia (at levels I-III) were selected through convenience sampling (N=35; mean age, 14.97±2.03y). Interventions Not applicable. Main Outcome Measures GMFM-88 (dimensions D and E), 1-minute walk, 10-meter walk, TUG, TUDS, STS, and LSU tests. Data were analyzed using Pearson intercorrelations, multiple regression analysis, and multivariate analysis of variance (MANOVA). Results Significant moderate to high intercorrelations were found. Three significant positive predictors emerged (1-minute walk, 10-meter walk, and LSU) with the following regression equation: YGMFM -88 (dimensions D and E) = 5.708 +.402 × X 1-minute walk +.920 × XLSU +.404 × X 10-meter walk The MANOVA was significant (Λ=.163, F=14.732, P&amp;lt;.001, η2=.596), and post hoc comparisons revealed significant differences across Gross Motor Function Classification System Expanded and Revised levels in all paired comparisons for the 1-minute walk and LSU tests. For the 10-meter walk test, significant differences were evident in the level I versus level III and level II versus level III comparisons. No significant differences were found in the 10-meter walk test between levels I and II. Conclusions These functional assessments (1-minute walk, LSU, and 10-meter walk tests) are simple to administer, quick, low cost, and user-friendly. Although these assessments are not a substitute for the criterion standard (GMFM-88), they may be used for a quick assessment in adolescents with cerebral palsy (levels I-III) either at school or during rehabilitation, especially when time is limited. © 2014 by the American Congress of Rehabilitation Medicine

Comparison of sport achievement orientation of male wheelchair basketball athletes with congenital and acquired disabilities

The study was designed to examine the sport achievement orientations of male wheelchair basketball athletes who differed by onset of experienced disability (congenital and acquired). The full Sport Orientation Questionnaire was administered to 166 U.S. national athletes. Athletes with congenital disabilities had higher mean scores than their peers with acquired disabilities on the three subscales of the full form and on the extraction items as a short form (Competitiveness, Win Orientation, and Goal Orientation). Multivariate analysis of variance yielded no significant differences between groups. Significant differences on Competitiveness and Goal Orientation, with a higher mean were found for the group with congenital disabilities than for the group with acquired disabilities, The results are discussed in relation to the literature, nature of wheelchair basketball, and application of the test to such athletes. © Perceptual and Motor Skills 2006

The effect of treadmill training on gross motor function and walking speed in ambulatory adolescents with cerebral palsy: A randomized controlled trial

OBJECTIVE: The aim of this study was to evaluate the effect of a treadmill program on gross motor function, walking speed, and spasticity of ambulatory adolescents with spastic cerebral palsy (diplegia and tetraplegia). DESIGN: In this randomized controlled trial, 22 adolescents (13-19 yrs old) from a special school for children with physical disabilities were randomly allocated to the experimental and control training groups. The experimental training group underwent a treadmill program without body weight support at a comfortable speed. The control group received treatment with conventional physiotherapy, which consisted of three sets of exercises with mat activities, balance, gait training, and functional gross motor activities. The program lasted 12 wks with a frequency of three times per week for both groups. Pretest and posttest measurements of self-selected walking speed, gross motor function, and spasticity were conducted. RESULTS: The analysis of covariance findings examining posttest differences between groups were significant with respect to self-selected walking speed (F = 8.545, P = 0.000) and gross motor function (F = 9.088, P = 0.007), whereas no significance was found for spasticity. CONCLUSIONS: Treadmill training may improve the walking speed and gross motor function of adolescents with spastic cerebral palsy, without adverse effects on spasticity. Copyright © 2012 Lippincott Williams &amp; Wilkins

Validity evidence of the Lateral Step Up (LSU) test for adolescents with spastic cerebral palsy

Purpose: The present study examined the concurrent and construct validity of the Lateral Step Up (LSU) test, for adolescents with CP. Method: A total of 35 adolescents, classified as GMFCS Levels I, II and III, were examined using LSU, GMFM-88 (D &amp;amp; E), other functional mobility measures (TUG, STS, TUDS), body structures and functions (strength, ROM and spasticity). Results: LSU inter-correlations with: (i) GMFM-88 (D &amp;amp; E) (r = 0.656), (ii) functional mobility measures (r = -0.567 to 0.721) and (iii) body structures and functions (r = 0.155 to 0.563) were at the appropriate range. The LSU differentiated adolescents with CP (F = 16.185, p = 0.000, η2 = 0.503), according to their GMFCS (I &amp;gt; II, II &amp;gt; III, I &amp;gt; III). Finally, 50.27% of the LSU variability was explained by GMFCS differences, with 65.7% of adolescents classified correctly across the three levels. Conclusions: The LSU may be perceived as a valid instrument for assessing the functional mobility of adolescents with CP. Implications for Rehabilitation LSU is valid for assessing functional mobility and strength in CP adolescents. LSU may be used in accordance with other functional mobility measures in the school environment. The LSU may be used from physical therapists to predict the functional mobility of CP adolescents at GMFCS Levels I-III. © 2013 Informa UK, Ltd

Hepatitis C virus survival curve analysis in naïve patients treated with PegInterferon α-2b plus ribavirin. A randomized controlled trial for induction with high doses of PegInterferon and predictability of sustained viral response from early virologic data

Aim. To evaluate the significance of induction with high doses of pegylated interferon α-2b (Peg-IFNα-2b) and the predictability of sustained virologic response (SVR) in naïve patients with chronic hepatitis C. Methods. 188 consecutive naïve patients with chronic hepatitis C were enrolled in a randomised controlled clinical trial. Patients were randomised to receive either Peg-IFNα-2b 3.0 mcg/kg QW x 12 weeks followed by 1.5 mcg/kg QW x 36 weeks plus 800-1200 mg ribavirin (Arm A) or Peg-IFNα-2b 1.5 mcg/kg QW x 48 weeks plus 800-1200 mg ribavirin (Arm B). HCV-RNA was obtained at 0, 4, 8, 12, 16, 24, 48 and 72 weeks. Differences between schemes were evaluated by Kaplan-Meier curves. Predictability of SVR was assessed by two-way contingency table analysis and ROC curve analysis. Results. From 176 patients, 75 had genotype 1, 15 genotype 2, 75 genotype 3 and 11 genotype 4. No statistical significance emerged in HCV-RNA positivity, side effects and withdrawals between schemes. Patients with genotype 1 achieved lower SVR (46.6%) in comparison to patients with genotypes 2/3 (94.1%, p<0.001) and 4 (90.9%, p=0.002). The most appropriate time for estimation of SVR for genotype 1 is week 8 (accuracy=0.84, AUC=0.90) while predictability increases with time in genotypes 2/3, reaching maximum accuracy=0.93 and AUC=0.76 at week 16. Conclusion. Induction with high doses of Peg-IFNα-2b does not preclude better outcome and rapid virologic response at 4 weeks of treatment sufficiently predicts SVR. These findings might be useful in an attempt to gain supportive evidence for decision making in difficult-to-treat patients