Care-related pain and discomfort in children with motor disabilities in rehabilitation centres / Jean-Sébastien Bourseul in Annals of physical and rehabilitation medicine, Vol. 59, n°5-6 (December 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 314-319 Titre : Care-related pain and discomfort in children with motor disabilities in rehabilitation centres Type de document : texte imprimé Auteurs : Jean-Sébastien Bourseul ; Sylvain Brochard ; Laetitia Houx ; [et al...] Année de publication : 2016 Article en page(s) : p. 314-319 Langues : Français (fre) Mots-clés : Induced-pain  Motor disability  Rehabilitation  Children Résumé : Background Pain is one of the symptoms reported most by children with motor disabilities particularly during daily living activities in institutions and during rehabilitation. Despite the care and consideration of professionals, a wide range of motor and cognitive disabilities, limited communication skills, the presence of chronic pain and frequent care interventions place such children at high risk of experiencing induced pain. Objectives We aimed to identify care-related pain and discomfort in children with motor disabilities in rehabilitation centres and the characteristics of children at risk of induced pain. A further aim was to evaluate the validity of a method for the continuous assessment of care-related pain. Methods Patients were recruited from 2 paediatric rehabilitation centres. The level of pain or discomfort experienced during each daily care activity was evaluated for 5 days and 1 night by using the FLACC-r scale and a visual analog scale (VAS) rated by the caregiver (VAS caregiver) and the patient (VAS patient). Results We included 32 children (mean age: 8.5±5 years, range: 1–15 years) with 1302 care activities evaluated. Overall, 3.6% of the activities were rated as painful and 11% uncomfortable. The most frequent painful activities were mouth care, transfers standing and dressing. The most frequent uncomfortable activities were passive limb mobilisation, dressing and transfers. Children with neurological disorders were at increased risk of induced pain. Conclusions Children with motor disabilities experienced pain during daily care activities. The methodology we propose is valid and can be used in any type of institution for children with motor disability to evaluate and reduce the frequency of care-related pain. Permalink : ./index.php?lvl=notice_display&id=47165 [article] Care-related pain and discomfort in children with motor disabilities in rehabilitation centres [texte imprimé] / Jean-Sébastien Bourseul ; Sylvain Brochard ; Laetitia Houx ; [et al...] . - 2016 . - p. 314-319. Langues : Français (fre) in Annals of physical and rehabilitation medicine > Vol. 59, n°5-6 (December 2016) . - p. 314-319 Mots-clés : Induced-pain  Motor disability  Rehabilitation  Children Résumé : Background Pain is one of the symptoms reported most by children with motor disabilities particularly during daily living activities in institutions and during rehabilitation. Despite the care and consideration of professionals, a wide range of motor and cognitive disabilities, limited communication skills, the presence of chronic pain and frequent care interventions place such children at high risk of experiencing induced pain. Objectives We aimed to identify care-related pain and discomfort in children with motor disabilities in rehabilitation centres and the characteristics of children at risk of induced pain. A further aim was to evaluate the validity of a method for the continuous assessment of care-related pain. Methods Patients were recruited from 2 paediatric rehabilitation centres. The level of pain or discomfort experienced during each daily care activity was evaluated for 5 days and 1 night by using the FLACC-r scale and a visual analog scale (VAS) rated by the caregiver (VAS caregiver) and the patient (VAS patient). Results We included 32 children (mean age: 8.5±5 years, range: 1–15 years) with 1302 care activities evaluated. Overall, 3.6% of the activities were rated as painful and 11% uncomfortable. The most frequent painful activities were mouth care, transfers standing and dressing. The most frequent uncomfortable activities were passive limb mobilisation, dressing and transfers. Children with neurological disorders were at increased risk of induced pain. Conclusions Children with motor disabilities experienced pain during daily care activities. The methodology we propose is valid and can be used in any type of institution for children with motor disability to evaluate and reduce the frequency of care-related pain. Permalink : ./index.php?lvl=notice_display&id=47165

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Do clowns attenuate pain and anxiety undergoing botulinum toxin injections in children? / Laetitia Houx in Annals of physical and rehabilitation medicine, Vol. 63, n°5 (Octobre 2020)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 63, n°5 (Octobre 2020) . - p. 393-399 Titre : Do clowns attenuate pain and anxiety undergoing botulinum toxin injections in children? Type de document : texte imprimé Auteurs : Laetitia Houx ; Amandine Dubois ; Sylvain Brochard ; Christelle Pons Année de publication : 2020 Article en page(s) : p. 393-399 Note générale : doi.org/10.1016/j.rehab.2018.12.004 Langues : Anglais (eng) Mots-clés : Clown  Pain  Anxiety  Botulinum toxin injections  Children  Motor disabilities Résumé : Objective Botulinum toxin injection (BTI) is the primary treatment for spasticity in children. Anxiety and pain are important concerns to address to attenuate the discomfort of BTI. The aim of this study was to compare the effectiveness of medical clowns and usual distractions, both added to nitrous oxide (N2O) and analgesic cream, on pain and anxiety during BTI sessions in children. Methods The primary outcome was pain evaluated by the Face, Legs, Activity, Cry, Consolability (FLACC) scale. Secondary criteria were pain rated on a Visual Analog Scale (VAS) by the child and parent, anxiety rated on a VAS before and during BTIs by the child and parent(s), rating of the success of the sessions on a 4-point Likert scale by the physician and parent(s), and rating of the benefits of the distraction by the parent(s). Non-parametric tests were used for between-group comparisons. Results Baseline group characteristics of the clown and control groups did not differ. During 88 BTI sessions (40 with clown distraction and 48 with control distraction) in 59 children (35 boys; 52 with cerebral palsy, 12 with moderate to severe cognitive disorders), median maximal FLACC score was 2.5 (interquartile range [IQR]: 1–4) in the clown group and 3 (IQR: 1–4.3) in the control group. VAS self-reported pain score was 2.5 (IQR: 0–5) and 3 (IQR: 1–6.3) in the clown and control groups (P = 0.56), and VAS proxy-reported pain score was 2.5 (IQR: 0.3–3.4) and 3 (IQR: 1–4.5) (P = 0.25). After BTI sessions, the 2 groups did not differ in VAS self- and proxy-reported anxiety (P = 0.83 and P = 0.81). Physician and parent ratings of the success of sessions were similar between the groups (P = 0.89 and P = 0.11). Parent ratings of the perceived benefits of distraction were higher in the clown than control group (P = 0.004). Conclusions Although clown distraction was particularly appreciated by parents, it did not significantly reduce pain or anxiety in children as compared with usual distraction. Permalink : ./index.php?lvl=notice_display&id=91308 [article] Do clowns attenuate pain and anxiety undergoing botulinum toxin injections in children? [texte imprimé] / Laetitia Houx ; Amandine Dubois ; Sylvain Brochard ; Christelle Pons . - 2020 . - p. 393-399. doi.org/10.1016/j.rehab.2018.12.004 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 63, n°5 (Octobre 2020) . - p. 393-399 Mots-clés : Clown  Pain  Anxiety  Botulinum toxin injections  Children  Motor disabilities Résumé : Objective Botulinum toxin injection (BTI) is the primary treatment for spasticity in children. Anxiety and pain are important concerns to address to attenuate the discomfort of BTI. The aim of this study was to compare the effectiveness of medical clowns and usual distractions, both added to nitrous oxide (N2O) and analgesic cream, on pain and anxiety during BTI sessions in children. Methods The primary outcome was pain evaluated by the Face, Legs, Activity, Cry, Consolability (FLACC) scale. Secondary criteria were pain rated on a Visual Analog Scale (VAS) by the child and parent, anxiety rated on a VAS before and during BTIs by the child and parent(s), rating of the success of the sessions on a 4-point Likert scale by the physician and parent(s), and rating of the benefits of the distraction by the parent(s). Non-parametric tests were used for between-group comparisons. Results Baseline group characteristics of the clown and control groups did not differ. During 88 BTI sessions (40 with clown distraction and 48 with control distraction) in 59 children (35 boys; 52 with cerebral palsy, 12 with moderate to severe cognitive disorders), median maximal FLACC score was 2.5 (interquartile range [IQR]: 1–4) in the clown group and 3 (IQR: 1–4.3) in the control group. VAS self-reported pain score was 2.5 (IQR: 0–5) and 3 (IQR: 1–6.3) in the clown and control groups (P = 0.56), and VAS proxy-reported pain score was 2.5 (IQR: 0.3–3.4) and 3 (IQR: 1–4.5) (P = 0.25). After BTI sessions, the 2 groups did not differ in VAS self- and proxy-reported anxiety (P = 0.83 and P = 0.81). Physician and parent ratings of the success of sessions were similar between the groups (P = 0.89 and P = 0.11). Parent ratings of the perceived benefits of distraction were higher in the clown than control group (P = 0.004). Conclusions Although clown distraction was particularly appreciated by parents, it did not significantly reduce pain or anxiety in children as compared with usual distraction. Permalink : ./index.php?lvl=notice_display&id=91308

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L’information : la clé de la relation parents–enfants–professionnels dans la paralysie cérébrale ? / A. Laouanan in Motricité cérébrale, Vol.42, n°2 (Juin 2021)

Public ISBD [article]  inMotricité cérébrale > Vol.42, n°2 (Juin 2021) . - p. 30-36 Titre : L’information : la clé de la relation parents–enfants–professionnels dans la paralysie cérébrale ? Type de document : texte imprimé Auteurs : A. Laouanan ; Laetitia Houx ; E. Fily ; S. Le Moal ; S. Brochard Année de publication : 2021 Article en page(s) : p. 30-36 Note générale : Doi : 10.1016/j.motcer.2021.04.002 Langues : Français (fre) Mots-clés : Enfants  Paralysie cérébrale  Information  Parcours de soins  Relation professionnels – patients Résumé : Introduction L’objectif de cette étude a été d’évaluer les besoins, les sources utilisées et la perception du contenu en information des enfants avec une paralysie cérébrale de 0 à 18 ans et de leurs parents. Méthodologie Un questionnaire de santé a été diffusé en ligne auprès des familles d’enfants avec paralysie cérébrale en France métropolitaine et DOM-TOM. Des statistiques descriptives et une analyse qualitative des questions ouvertes ont été utilisées . Résultats Cent onze questionnaires de familles ont été analysés (62,2 % garçons, 43,2 % âgés entre 6 et 12 ans, 52,3 % paralysie cérébrale unilatérale). Le besoin en information sur la paralysie cérébrale est rapporté comme un besoin fort pour 64 % des parents. Les trois sources d’information les plus utilisées par les parents étaient Internet, les professionnels de santé, les réseaux sociaux. La « rééducation et réadaptation » était le sujet d’information le plus demands par les parents et « apprendre à vivre avec la paralysie cérébrale » celui des enfants. Les professionnels de santé représentent la source d’information combinant la plus grande utilisation et la plus grande fiabilité pour les parents. Le support de médiation le plus demandé par les enfants est la vidéo. Discussion Cette enquête suggère une amélioration de la communication familles-professionnels. Le développement de l’éducation thérapeutique, des ressources numériques dédiées à la paralysie cérébrale, de la formation des professionnels mais aussi de la promotion de la pair-aidance et des patients partenaires sont des pistes à envisager, en distinguant deux cibles : les parents et les enfants. Permalink : ./index.php?lvl=notice_display&id=95189 [article] L’information : la clé de la relation parents–enfants–professionnels dans la paralysie cérébrale ? [texte imprimé] / A. Laouanan ; Laetitia Houx ; E. Fily ; S. Le Moal ; S. Brochard . - 2021 . - p. 30-36. Doi : 10.1016/j.motcer.2021.04.002 Langues : Français (fre) in Motricité cérébrale > Vol.42, n°2 (Juin 2021) . - p. 30-36 Mots-clés : Enfants  Paralysie cérébrale  Information  Parcours de soins  Relation professionnels – patients Résumé : Introduction L’objectif de cette étude a été d’évaluer les besoins, les sources utilisées et la perception du contenu en information des enfants avec une paralysie cérébrale de 0 à 18 ans et de leurs parents. Méthodologie Un questionnaire de santé a été diffusé en ligne auprès des familles d’enfants avec paralysie cérébrale en France métropolitaine et DOM-TOM. Des statistiques descriptives et une analyse qualitative des questions ouvertes ont été utilisées . Résultats Cent onze questionnaires de familles ont été analysés (62,2 % garçons, 43,2 % âgés entre 6 et 12 ans, 52,3 % paralysie cérébrale unilatérale). Le besoin en information sur la paralysie cérébrale est rapporté comme un besoin fort pour 64 % des parents. Les trois sources d’information les plus utilisées par les parents étaient Internet, les professionnels de santé, les réseaux sociaux. La « rééducation et réadaptation » était le sujet d’information le plus demands par les parents et « apprendre à vivre avec la paralysie cérébrale » celui des enfants. Les professionnels de santé représentent la source d’information combinant la plus grande utilisation et la plus grande fiabilité pour les parents. Le support de médiation le plus demandé par les enfants est la vidéo. Discussion Cette enquête suggère une amélioration de la communication familles-professionnels. Le développement de l’éducation thérapeutique, des ressources numériques dédiées à la paralysie cérébrale, de la formation des professionnels mais aussi de la promotion de la pair-aidance et des patients partenaires sont des pistes à envisager, en distinguant deux cibles : les parents et les enfants. Permalink : ./index.php?lvl=notice_display&id=95189

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Responsiveness of the ACTIVLIM-CP questionnaire measuring global activity performance in children with cerebral palsy / Julie Paradis  

Public ISBD Titre : Responsiveness of the ACTIVLIM-CP questionnaire measuring global activity performance in children with cerebral palsy Type de document : document électronique Auteurs : Julie Paradis ; Carlyne Arnould ; Jean-Louis Thonnard ; Laetitia Houx ; Christelle Pons-Becmeur ; Anne Renders ; Sylvain Brochard ; Yannick Bleyenheuft Année de publication : 2018 Note générale : Cet article est paru dans la revue Developmental Medecine & Child Neurology sous le DOI: 10.1111/dmcn.13927 Langues : Anglais (eng) Résumé : AIM To investigate the responsiveness of the ACTIVLIM-CP questionnaire after two evidence-based interventions for children with cerebral palsy (CP). METHOD Seventy-five children with CP either participated in an intensive motor-skill learning intervention (hand–arm bimanual intensive therapy including lower extremities [HABIT-ILE], n=47) or received botulinum neurotoxin-A (BoNT-A) injection(s) into lower extremities combined with conventional physical therapy (n=28). All children were assessed three times: at baseline (T0; before HABIT-ILE/the day of BoNT-A injection), at T1 (last day of HABIT-ILE/6wks after BoNT-A injection), and at follow-up (T2; 3 –4mo after the beginning of intervention). Parents completed ACTIVLIM-CP and three other activity questionnaires. Responsiveness was analysed using group (based on intervention), subgroup (based on gross motor function level), and individual approaches. RESULTS For the HABIT-ILE group, significant improvements in ACTIVLIM-CP were observed for the T0–T1 period (p<0.001) but not for the T1–T2 period. No significant changes were found in the BoNT-A group during assessments (p=0.84). In the subgroup analysis for the HABIT-ILE group (T0–T1), greater changes were demonstrated for children in Gross Motor Function Classification System levels III and IV (p<0.001, effect size=1.36). The individual approach was congruent with the group approach. INTERPRETATION ACTIVLIM-CP demonstrated high responsiveness after HABIT-ILE, showing that this scale may be used to investigate global activity performance in clinical trials focusing on improving daily life activities. En ligne : https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/dmcn.13927 Permalink : ./index.php?lvl=notice_display&id=98145 Responsiveness of the ACTIVLIM-CP questionnaire measuring global activity performance in children with cerebral palsy [document électronique] / Julie Paradis ; Carlyne Arnould ; Jean-Louis Thonnard ; Laetitia Houx ; Christelle Pons-Becmeur ; Anne Renders ; Sylvain Brochard ; Yannick Bleyenheuft . - 2018. Cet article est paru dans la revue Developmental Medecine & Child Neurology sous le DOI: 10.1111/dmcn.13927 Langues : Anglais (eng) Résumé : AIM To investigate the responsiveness of the ACTIVLIM-CP questionnaire after two evidence-based interventions for children with cerebral palsy (CP). METHOD Seventy-five children with CP either participated in an intensive motor-skill learning intervention (hand–arm bimanual intensive therapy including lower extremities [HABIT-ILE], n=47) or received botulinum neurotoxin-A (BoNT-A) injection(s) into lower extremities combined with conventional physical therapy (n=28). All children were assessed three times: at baseline (T0; before HABIT-ILE/the day of BoNT-A injection), at T1 (last day of HABIT-ILE/6wks after BoNT-A injection), and at follow-up (T2; 3 –4mo after the beginning of intervention). Parents completed ACTIVLIM-CP and three other activity questionnaires. Responsiveness was analysed using group (based on intervention), subgroup (based on gross motor function level), and individual approaches. RESULTS For the HABIT-ILE group, significant improvements in ACTIVLIM-CP were observed for the T0–T1 period (p<0.001) but not for the T1–T2 period. No significant changes were found in the BoNT-A group during assessments (p=0.84). In the subgroup analysis for the HABIT-ILE group (T0–T1), greater changes were demonstrated for children in Gross Motor Function Classification System levels III and IV (p<0.001, effect size=1.36). The individual approach was congruent with the group approach. INTERPRETATION ACTIVLIM-CP demonstrated high responsiveness after HABIT-ILE, showing that this scale may be used to investigate global activity performance in clinical trials focusing on improving daily life activities. En ligne : https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/dmcn.13927 Permalink : ./index.php?lvl=notice_display&id=98145

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