Rehabilitation Outcomes in Children With Acute Flaccid Myelitis From 2014 to 2019: A Multicenter Retrospective Review.

Autor: Marchese DL; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri; Children's Mercy-Kansas City, Kansas City, Missouri. Electronic address: dlmarchese@cmh.edu., Feldman K; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri; Children's Mercy-Kansas City, Kansas City, Missouri., Sinn C; Division of Pediatric Physical Medicine and Rehabilitation, Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Children's Health Dallas, Dallas, Texas., Javaid S; Division of Pediatric Physical Medicine and Rehabilitation, Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Children's Health Dallas, Dallas, Texas., Jaffe A; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Katz E; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Lider J; University of Utah/Primary Children's Hospital, Salt Lake City, Utah., Green MM; University of Utah/Primary Children's Hospital, Salt Lake City, Utah., Marcus L; Division of Pediatric Neurology, University of Alabama at Birmingham, Birmingham, Alabama., Swanson E; Division of Pediatric Rehabilitation Medicine, University of Alabama at Birmingham, Children's of Alabama, Birmingham, Alabama., Gober J; Department of Physical Medicine and Rehabilitation, Miller School of Medicine, University of Miami, Miami, Florida., Thomas SP; Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas., Deike D; Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois., Felman K; Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania., Sinha A; Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania., Dalal P; Division of Pediatric Rehabilitation Medicine, Rady Children's Hospital San Diego, San Diego, California., Ewing E; Division of Pediatric Rehabilitation Medicine, Rady Children's Hospital San Diego, San Diego, California., Hiller A; Department of Physical Medicine and Rehabilitation, Nationwide Children's Hospital, Columbus, Ohio., Rosenberg N; Department of Physical Medicine and Rehabilitation, Nationwide Children's Hospital, Columbus, Ohio., Mosher KA; Akron Children's Hospital, NeuroDevelopmental Science Center, Akron, Ohio., Houtrow AJ; Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania., McLaughlin MJ; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri; Children's Mercy-Kansas City, Kansas City, Missouri.
Jazyk: angličtina
Zdroj: Pediatric neurology [Pediatr Neurol] 2023 Aug; Vol. 145, pp. 41-47. Date of Electronic Publication: 2023 May 08.
DOI: 10.1016/j.pediatrneurol.2023.04.027
Abstrakt: Background: Acute flaccid myelitis (AFM) is a childhood illness characterized by sudden-onset weakness impairing function. The primary goal was to compare the motor recovery patterns of patients with AFM who were discharged home or to inpatient rehabilitation. Secondary analyses focused on recovery of respiratory status, nutritional status, and neurogenic bowel and bladder in both cohorts.
Methods: Eleven tertiary care centers in the United States performed a retrospective chart review of children with AFM between January 1, 2014, and October 1, 2019. Data included demographics, treatments, and outcomes on admission, discharge, and follow-up visits.
Results: Medical records of 109 children met inclusion criteria; 67 children required inpatient rehabilitation, whereas 42 children were discharged directly home. The median age was 5 years (range 4 months to 17 years), and the median time observed was 417 days (interquartile range = 645 days). Distal upper extremities recovered better than the proximal upper extremities. At acute presentation, children who needed inpatient rehabilitation had significantly higher rates of respiratory support (P < 0.001), nutritional support (P < 0.001), and neurogenic bowel (P = 0.004) and bladder (P = 0.002). At follow-up, those who attended inpatient rehabilitation continued to have higher rates of respiratory support (28% vs 12%, P = 0.043); however, the nutritional status and bowel/bladder function were no longer statistically different.
Conclusions: All children made improvements in strength. Proximal muscles remained weaker than distal muscles in the upper extremities. Children who qualified for inpatient rehabilitation had ongoing respiratory needs at follow-up; however, recovery of nutritional status and bowel/bladder were similar.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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