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    Measuring Pediatric Physical Function
    (Lippincott, Williams & Wilkins, 1995) Young, Nancy; Wright, J G
    Most pediatric orthopaedic interventions are intended to improve or preserve physical function, yet their outcomes have been assessed using primarily surrogate measures (e.g., radiographic indices) that may not accurately represent patients'function. Physical function may be more appropriately measured with activity-based scales, but these have been infrequently applied in surgical studies. The purpose of this study was to identify existing activity-based physical-function scales appropriate for pediatric orthopaedics, to present criteria useful for scale selection, and to discuss the special problems of measuring physical function in children. Twenty-one scales relevant to pediatric orthopaedics are described according to their target population, purpose, method of administration, content, and quality of standardization. These scales have been further classified according to a new taxonomy. The unique aspects of measuring physical function in children are discussed and include the effect of age and development, method of reporting, and question formats. Standardized measures of physical function based on physical-activity ability exist and should be used more frequently to assess pediatric orthopaedic interventions
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    Activities Scale for Kids: An Analysis of Normals
    (Lippincott Williams & Wilkins, 2003) Plint, Amy; Gaboury, Isabelle; Owen, Janice; Young, Nancy
    Several outcome tools have been developed to measure physical functioning in pediatric orthopedic patients. One such tool, the Activities Scale for Kids (ASK), allows assessment of physical functioning in the community in 5-to 15-year-olds. Previous validation of the ASK showed a significant difference in scores according to global ratings of disability. In this study, the ASK was administered to children without musculoskeletal disability to determine how normal respondents scored. ASK questionnaires were distributed to 137 children and 122 (89%) were returned. Normal children scored quite high, with a mean summary score of 93.12 (SD 6.45). This score differs significantly from the mean summary score for children with mild disabilities as determined in previous studies of disability (P = 0.005).
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    The Relationship Between Function, Self-Perception, and Spinal Deformity: Implications for Treatment of Scoliosis in Children With Spina Bifida
    (Lippincott, Williams & Wilkins, 2005) Wai, EK; Young, Nancy; Feldman, BM; Badley, EM; Wright, JG
    The purpose of this study was to determine the relationship of spinal deformity with physical function and self-perception in children with spina bifida. Ninety-eight eligible children with scoliosis and spina bifida were identified; 80 of them (82%) consented to participate. Spinal deformity was measured in many ways, including scoliosis, coronal balance, and pelvic obliquity. Measures of physical function included the Sitting Balance Scale, Jebsen Hand Scale, Hoffer Ambulation Scale, the Spine Bifida Spine Questionnaire, and the Activities Scale for Kids (ASK). Self-perception was determined with Harter's Self-Perception Profile. No relationship was found between spinal deformity and overall physical function (ASK). Of all aspects of spinal deformity, only coronal imbalance was significantly related to only one aspect of physical function (ie, sitting imbalance). No aspect of spinal deformity was related to self-perception. In conclusion, surgeons should be clear in their indications for surgery and recognize that in the short term the potential benefit of surgery may be, at best, to improve only sitting balance.
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    The transition to adulthood for children with cerebral palsy: what do we know about their health care needs?
    (Lippincott Williams & Wilkins, 2007) Young, Nancy
    There have been significant changes in the clinical management of cerebral palsy (CP) during the past 2 decades. Gastrostomy tubes and nutritional supplements have been paramount in enhancing the life expectancy of those with CP. The literature shows that as many as 90% of children with CP can now expect to live to adulthood.1-4 As a result, CP is no longer considered to be a condition limited to childhood. However, emerging populations pose new challenges to those who provide health care support. This article presents an overview of what we know about the health care needs of adults with CP.