Journal of Hand Therapy 28 (2015) 89e90
Contents lists available at ScienceDirect
Journal of Hand Therapy journal homepage: www.jhandtherapy.org
Guest Editorial
Drawing inspiration from children
Hand and upper extremity function rapidly unfolds from its beginning in utero to an expansion in unimanual and bimanual skill within the first year. After the first birthday, development continues and with experience prehensile skills are refined until adulthood. Atypical development or injury alters this progression and refinement in prehension as exemplified in infants who cannot easily reach-to-grasp for toys or in children with pain associated with musculoskeletal disorders. Fortunately, neuroplasticity and the inherent motivation children have to engage can augment recovery and adaptation to potentially disabling upper extremity challenges. As clinicians, we can use this inherent motivation as inspiration for the design and implementation of creative and evidence based therapeutic interventions. Diversity in congenital and traumatic pediatric disorders requires clinicians to acquire knowledge of new theories and approaches to intervention. This 2015 Special Issue of the Journal of Hand Therapy on pediatric hand and upper extremity rehabilitation introduces the reader to a wide range of topics; from reaching in infancy to pediatric dystonia and medial elbow injuries. The intention is to increase general knowledge of rehabilitation for upper extremity disorders in pediatrics as well as to stimulate growth and innovation in the field. The special issue has four sections: Background, Assessment, Intervention and Clinical Pearls. Background, emphasizes foundational concepts that support development and progression of prehensile skill. This section begins with a review article by Moreau and Gannotti on muscle performance and resistive training. The authors share their expertise on the importance of improving the rate as well as the amount of muscle force production; a factor often missed in our therapeutic interventions. This thorough review and case study provide the reader with current information applicable to neurological and musculoskeletal conditions. Next, Krisa and Murray briefly review the neural influences on the developing upper extremity, highlighting the specific features of the peripheral and corticospinal components of the nervous system. This article provides a scientific foundation for understanding conditions secondary to prenatal and postnatal injury. Harbourne and Kamm then give us their perspective on the relationship between postural control and reaching. The authors review three cases at varying ages to reinforce an ecological approach to the treatment of different clinical conditions. The final paper in this section by Lobo, Galloway and Heathcock aims to characterize general exploration, reaching
Work on this special issue was supported by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development number T32 HD064578.
and object exploration behaviors in typical and atypical infants. To guide readers, the authors provide information on assessment including early warning signs of dysfunction and therapeutic strategies to promote these behaviors in atypical infants. The Assessment section highlights current and novel assessment methods in pediatric upper extremity rehabilitation. We begin this section with a review by Duff and DeMatteo of assessments for infants and young children who sustain perinatal brachial plexus injury. The authors use the International Classification of Functioning, Disability and Health (ICF) framework to guide the reader regarding when and which assessments to use highlighting tools that have been validated as well as those warranting validation with this population. Next, Ho provides a review of assessment after pediatric peripheral nerve injuries. This comprehensive evidence-based review presents a unique approach for children less than 10 years of age. Next Duff, Gogola, Valero-Cuevas and Aaron review common and novel features of pediatric dexterity measurement. The authors highlight two assessment tools, which vary in focus; one is validated for use in pediatrics with a new scoring strategy and the other measures control of instabilities, and is in the research phase of development. This section ends with a consensus statement by Hao, Bala, McRae, Carnahan, Borschel, and Ho on the utility of pediatric upper extremity outcome measures for clinical decision making across the ICF. This paper is an important step toward the development of a practice model for pediatric upper extremity assessment. The Intervention section features emerging trends across diverse conditions in pediatric rehabilitation. Lightdale-Miric, Mueske; Lawrence, Loiselle, Berggren, Dayanidhi, Stevanovic, Valero-Cuevas and Wren review results on long-term outcome after pollicization. In addition to other outcome measures, the paper examines the clinical utility of the StrengtheDexterity Test introduced in the dexterity paper in the Assessment section. Netscher and Goldie Steins then introduce an approach to the evaluation and treatment of severe camptodactyly. The authors’ expertise in treating this condition provides clinicians with an excellent reference and guide to intervention. Next, Gharbaoui, Gogola, Kozin and Aaron, examine the relationship between contractures and shoulder dysfunction in children with perinatal brachial plexus palsy. They describe a unique, yet targeted, strategy to measure shoulder angles and follow with therapeutic methods to address this dysfunction. Next, Bertucco and Sanger provide an excellent review of childhood dystonia. The authors emphasize current and emerging intervention strategies useful for clinicians and researchers. The options and confounders of pediatric flexor tendon injuries are examined by von der Heyde. She suggests that despite advances, more research in pediatric care and outcome is needed. This section ends with a
0894-1130/$ e see front matter Ó 2015 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jht.2015.01.006
90
Guest Editorial / Journal of Hand Therapy 28 (2015) 89e90
unique perspective on the etiology and intervention for medial elbow injuries in the adolescent athlete by Leahy, Schorpion, and Ganley. The assessment and treatment recommendations provided are timely given the popularity of year-round sports play. The section on Clinical Pearls affords an opportunity to showcase ideas and case studies offered by pediatric clinical specialists. Carsi, Clarke and Clarke provide the reader with an interesting case series on transient neonatal radial nerve palsy, differentiating this disorder from other perinatal brachial plexus injuries. Berggren and Baker then present a case study of a child with perinatal brachial plexus injury. In this case, clinicians combined neuromuscular electrical stimulation and constraint-induced movement therapy after infant microsurgery. Lake then shares her recommendation for post-operative elbow splinting in children with the Amyoplasia form of Arthrogryposis Multiplex Congentia. Finally, PeckeMurray describes creative treatments for pediatric hand rehabilitation using everyday items. The expert cover artwork entitled, “The Tree and the Rainbow,” by hand therapist and artist Sheila Yakobina, MA, OTR/L, CHT, is a creative expression of her many talents. In reference to the cover Sheila wrote, “One day, while drawing trees with my girls, they began using finger-paints to paint their hands. Of course, I thought, a hand therapist would have to use finger paints to do a journal cover. In that moment of inspiration, I asked my girls their favorite color: “rainbow” was my four-year old’s response; “raybo” echoed my two-year old.” It is an incredible gift to view the world through child-eyes. We are grateful to the authors who generously shared their expertise and time to create this special issue. Each author’s crea-
tivity, depth of knowledge, and appreciation of evidence is apparent. Our thanks to Paul LaStayo, PT, PhD, for the guidance, patience and humor he provided for this, his final publication as Editor in Chief of the Journal of Hand Therapy. Thank you again to Sheila and the many others responsible for this Special Pediatric Issue.
Susan V. Duff, EdD, PT, OTR/L, CHT, Associate Professor Thomas Jefferson University Department of Physical Therapy 901 Walnut St. Suite 510 Philadelphia PA 19107, USA Corresponding author. Tel.: þ1 215 503 1647 E-mail address: [email protected] (S.V. Duff) Dorit H. Aaron, MA, OTR, CHT, FAOTA Aaron & Winthrop Hand Therapy Services, Inc 2723 Amherst Houston, TX 77005, USA Linda Fetters, PT, PhD, FAPTA, Professor and Sykes Family Chair in Pediatric Physical Therapy, Health and Development Division of Biokinesiology & Physical Therapy Ostrow School of Dentistry and Department of Pediatrics Keck School of Medicine University of Southern California 1540 Alcazar St. CHP 155 Los Angeles CA 90089-9006, USA Co-Editors 2015 Special Pediatric Issue, Journal of Hand Therapy
Contents lists available at ScienceDirect
Journal of Hand Therapy journal homepage: www.jhandtherapy.org
Guest Editorial
Drawing inspiration from children
Hand and upper extremity function rapidly unfolds from its beginning in utero to an expansion in unimanual and bimanual skill within the first year. After the first birthday, development continues and with experience prehensile skills are refined until adulthood. Atypical development or injury alters this progression and refinement in prehension as exemplified in infants who cannot easily reach-to-grasp for toys or in children with pain associated with musculoskeletal disorders. Fortunately, neuroplasticity and the inherent motivation children have to engage can augment recovery and adaptation to potentially disabling upper extremity challenges. As clinicians, we can use this inherent motivation as inspiration for the design and implementation of creative and evidence based therapeutic interventions. Diversity in congenital and traumatic pediatric disorders requires clinicians to acquire knowledge of new theories and approaches to intervention. This 2015 Special Issue of the Journal of Hand Therapy on pediatric hand and upper extremity rehabilitation introduces the reader to a wide range of topics; from reaching in infancy to pediatric dystonia and medial elbow injuries. The intention is to increase general knowledge of rehabilitation for upper extremity disorders in pediatrics as well as to stimulate growth and innovation in the field. The special issue has four sections: Background, Assessment, Intervention and Clinical Pearls. Background, emphasizes foundational concepts that support development and progression of prehensile skill. This section begins with a review article by Moreau and Gannotti on muscle performance and resistive training. The authors share their expertise on the importance of improving the rate as well as the amount of muscle force production; a factor often missed in our therapeutic interventions. This thorough review and case study provide the reader with current information applicable to neurological and musculoskeletal conditions. Next, Krisa and Murray briefly review the neural influences on the developing upper extremity, highlighting the specific features of the peripheral and corticospinal components of the nervous system. This article provides a scientific foundation for understanding conditions secondary to prenatal and postnatal injury. Harbourne and Kamm then give us their perspective on the relationship between postural control and reaching. The authors review three cases at varying ages to reinforce an ecological approach to the treatment of different clinical conditions. The final paper in this section by Lobo, Galloway and Heathcock aims to characterize general exploration, reaching
Work on this special issue was supported by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development number T32 HD064578.
and object exploration behaviors in typical and atypical infants. To guide readers, the authors provide information on assessment including early warning signs of dysfunction and therapeutic strategies to promote these behaviors in atypical infants. The Assessment section highlights current and novel assessment methods in pediatric upper extremity rehabilitation. We begin this section with a review by Duff and DeMatteo of assessments for infants and young children who sustain perinatal brachial plexus injury. The authors use the International Classification of Functioning, Disability and Health (ICF) framework to guide the reader regarding when and which assessments to use highlighting tools that have been validated as well as those warranting validation with this population. Next, Ho provides a review of assessment after pediatric peripheral nerve injuries. This comprehensive evidence-based review presents a unique approach for children less than 10 years of age. Next Duff, Gogola, Valero-Cuevas and Aaron review common and novel features of pediatric dexterity measurement. The authors highlight two assessment tools, which vary in focus; one is validated for use in pediatrics with a new scoring strategy and the other measures control of instabilities, and is in the research phase of development. This section ends with a consensus statement by Hao, Bala, McRae, Carnahan, Borschel, and Ho on the utility of pediatric upper extremity outcome measures for clinical decision making across the ICF. This paper is an important step toward the development of a practice model for pediatric upper extremity assessment. The Intervention section features emerging trends across diverse conditions in pediatric rehabilitation. Lightdale-Miric, Mueske; Lawrence, Loiselle, Berggren, Dayanidhi, Stevanovic, Valero-Cuevas and Wren review results on long-term outcome after pollicization. In addition to other outcome measures, the paper examines the clinical utility of the StrengtheDexterity Test introduced in the dexterity paper in the Assessment section. Netscher and Goldie Steins then introduce an approach to the evaluation and treatment of severe camptodactyly. The authors’ expertise in treating this condition provides clinicians with an excellent reference and guide to intervention. Next, Gharbaoui, Gogola, Kozin and Aaron, examine the relationship between contractures and shoulder dysfunction in children with perinatal brachial plexus palsy. They describe a unique, yet targeted, strategy to measure shoulder angles and follow with therapeutic methods to address this dysfunction. Next, Bertucco and Sanger provide an excellent review of childhood dystonia. The authors emphasize current and emerging intervention strategies useful for clinicians and researchers. The options and confounders of pediatric flexor tendon injuries are examined by von der Heyde. She suggests that despite advances, more research in pediatric care and outcome is needed. This section ends with a
0894-1130/$ e see front matter Ó 2015 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jht.2015.01.006
90
Guest Editorial / Journal of Hand Therapy 28 (2015) 89e90
unique perspective on the etiology and intervention for medial elbow injuries in the adolescent athlete by Leahy, Schorpion, and Ganley. The assessment and treatment recommendations provided are timely given the popularity of year-round sports play. The section on Clinical Pearls affords an opportunity to showcase ideas and case studies offered by pediatric clinical specialists. Carsi, Clarke and Clarke provide the reader with an interesting case series on transient neonatal radial nerve palsy, differentiating this disorder from other perinatal brachial plexus injuries. Berggren and Baker then present a case study of a child with perinatal brachial plexus injury. In this case, clinicians combined neuromuscular electrical stimulation and constraint-induced movement therapy after infant microsurgery. Lake then shares her recommendation for post-operative elbow splinting in children with the Amyoplasia form of Arthrogryposis Multiplex Congentia. Finally, PeckeMurray describes creative treatments for pediatric hand rehabilitation using everyday items. The expert cover artwork entitled, “The Tree and the Rainbow,” by hand therapist and artist Sheila Yakobina, MA, OTR/L, CHT, is a creative expression of her many talents. In reference to the cover Sheila wrote, “One day, while drawing trees with my girls, they began using finger-paints to paint their hands. Of course, I thought, a hand therapist would have to use finger paints to do a journal cover. In that moment of inspiration, I asked my girls their favorite color: “rainbow” was my four-year old’s response; “raybo” echoed my two-year old.” It is an incredible gift to view the world through child-eyes. We are grateful to the authors who generously shared their expertise and time to create this special issue. Each author’s crea-
tivity, depth of knowledge, and appreciation of evidence is apparent. Our thanks to Paul LaStayo, PT, PhD, for the guidance, patience and humor he provided for this, his final publication as Editor in Chief of the Journal of Hand Therapy. Thank you again to Sheila and the many others responsible for this Special Pediatric Issue.
Susan V. Duff, EdD, PT, OTR/L, CHT, Associate Professor Thomas Jefferson University Department of Physical Therapy 901 Walnut St. Suite 510 Philadelphia PA 19107, USA Corresponding author. Tel.: þ1 215 503 1647 E-mail address: [email protected] (S.V. Duff) Dorit H. Aaron, MA, OTR, CHT, FAOTA Aaron & Winthrop Hand Therapy Services, Inc 2723 Amherst Houston, TX 77005, USA Linda Fetters, PT, PhD, FAPTA, Professor and Sykes Family Chair in Pediatric Physical Therapy, Health and Development Division of Biokinesiology & Physical Therapy Ostrow School of Dentistry and Department of Pediatrics Keck School of Medicine University of Southern California 1540 Alcazar St. CHP 155 Los Angeles CA 90089-9006, USA Co-Editors 2015 Special Pediatric Issue, Journal of Hand Therapy
