Objectives: The need for early postoperative rehabilitation in patients with congenital heart disease (CHD) is increasing. However, rehabilitation settings in the pediatric intensive care unit (PICU) are usually determined subjectively by therapists. To address the lack of objective measurements, we sought to determine the effectiveness of near-infrared spectroscopy (NIRS) in evaluating skeletal muscles during rehabilitation of patients in the PICU. This case series aimed to clarify the characteristics of skeletal muscle oxygenation during exercise in 2 postoperative patients with CHD. Methods: The participants were two 6-month-female infant: one had undergone the Yasui operation (Case 1), and the other had undergone a bidirectional Glenn anastomosis (Case 2). Vital signs and tissue oxygen saturation (StO₂) were measured during each exercise task, and the muscle oxygen extraction ratio (MOER), an index of the intramuscular oxygen extraction rate, was calculated. The results were compared between the two cases. Results: Case 1 showed no significant changes in vital signs, StO₂, or MOER, whereas Case 2 had low oxygen saturation at rest and low StO₂ during the exercise tasks. MOER increased during the exercise tasks. Conclusions: The results showed that sitting did not impose a strong cardiopulmonary load on postoperative patients. However, in children with cyanotic cardiac disease, such as in Case 2, skeletal muscle oxygenation should be considered, and NIRS monitoring may be useful for safely performing rehabilitation.

Objective: This study aimed to develop the Japanese version of the Posture and Postural Ability Scale (PPAS) and verify its inter- and intra-rater reliability, construct validity, and internal consistency in individuals with cerebral palsy (CP) in Japan. Methods: This cross-sectional study recruited 73 children and adults with CP at all Gross Motor Function Classification System (GMFCS) levels. The translation procedure was performed by three Japanese physiotherapists and the developer of the original version. Intra- and inter-rater reliability were evaluated using the weighted kappa coefficients, and construct validity was based on the correlation coefficients between PPAS and GMFCS. Cronbach’s alpha coefficients were calculated to assess internal consistency. Results: Weighted kappa coefficients for intra- and inter-rater reliability exceeded 0.81 for all items. The correlation coefficients between the PPAS and GMFCS were negative and showed “moderate” to “very strong” in almost all items (ρ = −0.66 to −0.91), except for one item (ρ = −0.37). Cronbach’s alpha coefficients exceeded 0.80 in all four positions. Conclusion: This study supports the Japanese version of the PPAS with excellent intra- and inter-rater reliability, good construct validity, and internal consistency in the Japanese CP population.

Family-centered care is recommended as the best practice in pediatric physiotherapy. It is a philosophy that pediatric physiotherapists should be familiar with, as it relates to the health of the child as well as the family. However, family-centered care has not been adequately taught in physiotherapy education in Japan. The term “Ryouiku” was coined in 1940 in Japan. The concept of the Ryouiku is essentially Evidence-Based Medicine and is the very essence of family-centered care with a focus on function. By re-thinking the Ryouiku and applying it to pediatric physiotherapy education in Japan, “glocal” family-centered care can be practiced in a Japanese setting.

Objective: The purpose of this study was to investigate if leg cycling could reduce lower extremity spasticity in patients with cerebral palsy (CP). In addition, we investigated whether the intervention could cause changes in the modulation of presynaptic inhibition. Methods: This study was a quasi-experimental study, with pretest–posttest for 1 group. Participants in this experiment were eight adult patients with CP with lower extremity spasticity. Spasticity parameters assessed were the amplitude of soleus maximum Hoffmann’s reflex (H_max) and maximum angular velocity (MAV) of knee flexion measured using the pendulum test. D1 inhibition, which seems to be related to the presynaptic inhibition, was recorded by measuring soleus Hoffmann’s reflex (H-reflex) with conditioned electric stimuli to the common peroneal nerve. Results: D1 inhibition was significantly enhanced immediately by the cycling intervention. The amplitude of the soleus H_max was significantly depressed, and there was significant difference in H_max/maximum M-wave. The MAV was increased due to inhibition of the stretch reflex. Conclusion: Leg cycling suppressed stretch reflex and H-reflex, and caused plasticity of inhibitory circuits in patients with CP with lower extremity spasticity. These findings strongly suggest that lower extremity spasticity can be improved by cycling movements.

Objective: Among solid tumours, medulloblastoma is the most common of the posterior fossa neoplasms, given that it represents 15%-20% of childhood brain tumours. The main aim of the present study was to assess the effects of action observation training on the activities of daily living (ADL) and the manipulation skills of children with acquired brain injury secondary to an oncological process. Methods: We recruited a consecutive convenience sample of 5 patients diagnosed with acquired brain injury secondary to an oncological process. ADL and manipulation skills were assessed using the ABILHAND-Kids and Jebsen-Taylor Hand Function Test, respectively. After conducting the initial evaluation, we planned the intervention, which lasted 10 weeks and consisted of 40 sessions for each participant, 10 in the occupational therapy department and 30 at home. After completing the intervention, we re-evaluated the main variables. Results: Overall, the results of the postintervention ABILHAND-Kids questionnaire showed a 5-point improvement, with a statistically significant difference and a large effect size. Eighty per cent of the sample showed better results in the total score, with differences between 4 and 8 points. In relation to manual dexterity, as measured by the Jebsen-Taylor Hand Function Test, there were no significant changes, except in one of the participants. Conclusion: It appears that action observation training can elicit positive changes with respect to the development of ADL, but the influence on manual dexterity was almost nonexistent.

Objective: To clarify the corrected age of walking attainment in very low birth weight infants by birth weight and gestational age, and determine perinatal factors affecting the delay in walking attainment. Method: This was a longitudinal study. We investigated walking attainment and perinatal factors in 145 very low birth weight infants without neurological abnormalities (mean birth weight 1019.3 ± 299.7 g, gestational age 29.0 ± 2.9 weeks). The study infants were stratified by birth weight (group A: <1,000 g, group B: 1,000 g≤, <1,500 g) and gestational age (group I: <28 weeks, group II: 28 weeks≤, <37 weeks) and were compared using unpaired t-tests. Furthermore, we examined the perinatal factors that affect the delay in walking attainment using multiple regression analysis. Results: Of the walking attainment, infants in Group A were older than those in Group B (50th percentile, 15.8 vs. 14.7 months). Infants in Group I were older than those in Group II (50th percentile, 16.0 vs. 14.8 months). Using multiple regression analysis with walking attainment age as the dependent variable, the duration of mechanical ventilation was found to be significantly related. Conclusion: Very low birth weight infants with light weight and short gestational age have delayed walking attainment, and longer duration of mechanical ventilation increases the risk of delay.

OBJECTIVE: We investigated the relationship between gross motor abilities and sensory processing in typically developing children. METHOD: Participants included children aged 18 to 36 months (N = 48). All participants were full-term infants. We assessed gross motor abilities based on the Gross Motor Function Measure (GMFM), and sensory processing characteristics based on the Infant/Toddler Sensory Profile (ITSP). The gross motor ability index was calculated using GMFM score which was estimated from the age. Pearson's product moment correlation coefficients were used to examine the relationships between the gross motor ability indexes and ITSP section scores. RESULTS: Our findings showed that gross motor ability may be related to oral sensory processing. The children who were more responsive to oral sensory processing tended to exhibit gross motor abilities below the standard for that age. CONCLUSION: Gross motor abilities were related with sensory processing, especially oral sensory processing, in children aged 18 to 36 months.

Despite the fact that children with cerebral palsy may not have any deformities at the time of birth, postural deformities, such as scoliosis, pelvic obliquity, and windswept hip deformity, can appear with increasing age. This may lead to respiratory function deterioration and, in more severe cases, affects survival. To date, postural care is believed to help improve the health and quality of life of children with cerebral palsy. This review provides an overview of the cause and clinical management of postural deformity that is seen in children with cerebral palsy.

Background: Sedentary behavior increases the risks of obesity and cardiovascular disease in adults, but these relationships are uncertain in elementary and junior high school students. We investigated whether sedentary behavior is related to overweight status and obesity in high-risk children with lifestyle diseases. Method: A cross-sectional study was performed in 115 children and primary caregivers who attended a lecture for preventing child lifestyle diseases in Ibaraki prefecture, Japan. The main outcome measure was excess weight (percent overweight). Factors associated with excess weight in children were evaluated using multiple regression analysis. Basic physical and demographic characteristics, biochemical data (total cholesterol [TC], low and high density lipoprotein cholesterol [LDL-C and HDL-C], alanine aminotransferase [ALT]), blood pressure, child and parental sedentary time, parental BMI, and family environment were evaluated. Results: In total, 107 children were eligible for participation in the study. Excess weight in these children was 28.6 ± 18.4. Sedentary time was 337.2 ± 122.5 min/day in children and 347.0 ± 196.2 min/day in parents. Multiple regression analysis revealed that children's sedentary behavior (β = 0.02, (95%CI: 0.00 to 0.04) ) and HDL-C (β = −0.59, (95%CI: −0.81 to −0.38) ) as independent predictors of children's excess weight. Conclusion: Study findings suggest that decreasing children's sedentary behavior in addition to greater physical activity is important for the prevention of overweight status and obesity in high-risk children with lifestyle diseases. Reduction of sedentary time, and engaging in regular exercise are all important for proper weight maintenance in children.

[Purpose] This study aimed to elucidate the actual state of powered wheelchair (PWC) prescription for preschool children with disabilities in Japan, and also to determine the approximate number of preschool children with disabilities who would potentially benefit from PWC use. [Subjects and Methods] A total of 318 facilities providing rehabilitation for disabled children in Japan were enrolled in the study. A questionnaire about PWC use for preschoolers was mailed to the facilities. Each study items were analyzed employing the Fisher's exact test. [Results] Of the 318 facilities, consent to participate in this study was obtained from 108 (return rate: 34.0%). After PWC provision, many facilities reported improvement in quality of life indices for preschool children with disabilities. It was revealed that there were 6 preschool children from 2 to 6 years of age with disabilities who might acquire a means of independent locomotion through PWC provision and thereby experience improved quality of life. [Conclusion] There was no negative comment from the facilities studied about the prescription and provision of PWC for preschool children with disabilities.