Defining Goal-Directed Training for Children with Cerebral Palsy: A Scoping Review and Framework for Implementation.

: This scoping review aimed to define goal-directed training (GDT) and its impact on outcomes for children with cerebral palsy (CP), and to develop a structured framework outlining its core components for effective implementation. : Using the Arksey and O'Malley framework and PICO criteria, nine databases were searched and reference lists reviewed. Two reviewers independently screened and extracted data, which were analyzed using a qualitative descriptive approach.

Unsedated cerebrovascular reactivity imaging is well-tolerated in children.

Background: Unsedated MRI use in pediatric clinical and research settings is often feasible, but advanced imaging techniques like cerebrovascular reactivity (CVR) may affect tolerability of unsedated MRIs. Exogenous carbon dioxide (CO) provides a CVR vasodilatory challenge, but its impact on unsedated children's MRI tolerability is unknown.

Objective: We hypothesized that children would tolerate MRI with exogenous CO as well as children undergoing only MRI.

Impact of an Adaptive Dance Program on Physical Abilities and Psychosocial Well-Being of Youth With Cerebral Palsy: A Case Series.

Background: Dance provides therapeutic benefits to children and adolescents with cerebral palsy (CP), but the benefits of dance on both the physical abilities and psychosocial well-being of youth with CP have not been fully explored.

Methods: A prospective explanatory mixed-methods case series was conducted to explore the impact of "Dance!," a manualized adaptive dance program based on action-observation principles, on the physical abilities and psychosocial well-being of youth with CP.

Results: Three adolescent females (aged 13-16 years) diagnosed with CP (Gross Motor Functional Classification System I to II and Manual Ability Classification System I to III) participated in "Dance!" including preintervention and postintervention assessments and semistructured interviews following the program.

Constraint Therapy with and Without Virtual Reality for Children with Unilateral Cerebral Palsy: A Randomized Trial.

Background/objectives: Cerebral palsy (CP) is the most common childhood motor disorder, with unilateral cerebral palsy (UCP) presenting with asymmetrical motor function that can cause decreased upper limb function. Constraint-Induced Movement Therapy (CIMT) is an evidence-based intervention that addresses upper limb functional limitations, but further study on combining interventions with CIMT is warranted. Combining CIMT with virtual reality (VR) is hypothesized to enhance engagement and therapeutic outcomes.

National best practice guidelines for anaphylaxis prevention and management in Australian schools.

Background: Anaphylaxis prevention and management in the school setting is an important health and safety issue as the rates of food allergy in children continue to increase.

Objective: We describe the development and review of the Australian National Allergy Council best practice guidelines for anaphylaxis prevention and management in schools.

Methods: Developed in consultation with key stakeholders in health and education settings, the best practice guidelines incorporate 7 key recommendations for anaphylaxis prevention and management: an allergy aware approach; anaphylaxis management policy and plans; allergy documentation; emergency response; staff training; community and student education; and postincident management and incident reporting.

A Cost-Effectiveness Analysis of Intramedullary Nailing Versus External Fixation for Open Tibial Fractures in Tanzania.

Background: Open tibial fractures are a cause of substantial orthopaedic morbidity in low- and middle-income countries. These injuries represent a substantial cost burden to both individual patients and society because of their high propensity for complications, such as infection, nonunion, and malunion. External fixation and intramedullary (IM) nailing are both utilized for definitive treatment of open tibial fractures, but given the differences in cost and lack of clear superiority of intramedullary nailing, cost-effectiveness becomes important to consider in low- and middle-income countries.

Predictors of quality of life, economic impact, and loss to follow-up after open tibial shaft fractures in Ghana.

Objectives: Open tibia fractures are associated with substantial morbidity and impact on quality of life. Despite increasing incidence in low-resource settings, most open tibia fracture research comes from high-resource settings. This study aimed to assess the impact of socioeconomic status on treatment modality and evaluate predictors of health-related quality of life following open tibia fractures in Ghana.

A Randomized Clinical Trial of Direct Anterior Versus Mini-Posterior Total Hip Arthroplasty: Small, Early Functional Differences Did Not Lead to Meaningful Clinical Differences at 7.5 Years.

Background: Our previously reported randomized clinical trial of direct anterior approach (DAA) versus mini-posterior approach (MPA) total hip arthroplasty showed slightly faster initial recovery for patients who had a DAA and no differences in complications or clinical or radiographic outcomes beyond 8 weeks. The aims of the current study were to determine if early advantages of DAA led to meaningful clinical differences beyond 5 years and to identify differences in midterm complications.

Methods: Of the 101 original patients, 93 were eligible for follow-up at a mean of 7.

COVID-19 Stay-at-home mandates impacts daily ambulatory bout intensity and duration in elementary school-aged children: A wearable sensor based analysis.

Introduction: SARS COVID-19 pandemic resulted in major changes to how daily life was conducted. Health officials instituted policies to decelerate the spread of the virus, resulting in changes in physical activity patterns of school-aged children. The aim of this study was to utilize a wearable activity monitor to assess ambulatory activity in elementary-school aged children in their home environment during a COVID-19 Stay-at-Home mandate.

New Ceramic Heads With Titanium Sleeves on Retained Femoral Components: Results of Over 500 Revision Total Hip Arthroplasties.

Background: Ceramic heads are frequently combined with titanium sleeves in revision total hip arthroplasties (THAs), ostensibly to protect the ceramic head from existing damage to the retained trunnion. Although widely adopted, data on the performance and safety of this construct are minimal. The purpose of this study was to describe implant survivorships, radiographic results, and clinical outcomes of patients who underwent revision THA with a ceramic head and titanium sleeve on a retained femoral component.

Development of GO Move: A Website for Children With Unilateral Cerebral Palsy.

It is unknown if an online tool is wanted by therapists and parents of individuals with unilateral cerebral palsy (UCP) to support implementation of goal-directed home programs, and if wanted, the recommended features for the tool. The objective was to explore the experiences of therapists and parents who have implemented home programs, seek guidance on translating a paper-based home program toolbox into a mobile website, and develop the website. Qualitative descriptive methodology guided data collection using semi-structured interviews and thematic analysis, validated with field notes and member checking.

Combined Anteversion Technique for Total Hip Arthroplasty With Handheld Accelerometer-Based Navigation System.

Unlabelled: Aiming for a combined cup and stem anteversion within a target range is one way to assess appropriate prosthetic component orientation and restoration of functional range of motion. We describe a surgical technique that allows the surgeon to assess the combined anteversion using a handheld accelerometer-based navigation system for total hip arthroplasty through a posterior approach. The femur is prepared first, at which time the femoral version is estimated by the surgeon.

Healthcare Disparities in Orthopaedic Surgery: A Comparison of Anterior Cruciate Ligament Reconstruction Incidence Proportions With US Census-Derived Demographics.

Introduction: Disparities exist and affect outcomes after anterior cruciate ligament (ACL) injury. The purpose of this study was to investigate the association between race, ethnicity, and insurance type on the incidence of ACL reconstruction in the United States.

Methods: The Healthcare Cost and Utilization Project database was used to determine demographics and insurance types for those undergoing elective ACL reconstruction from 2016 to 2017.

Syringe Services Programs to Reduce Intravenous Disease Transmission in Substance Use Disorders.

Syringe services programs (SSPs) are evidence-based programs. SSPs are integral in preventing bloodborne diseases while increasing access to care and reducing drug overdose deaths. SSPs are often the only source of health care for people who use drugs.

Taking the Long Way to Care: Who is Traveling Farthest to Undergo Elective Total Hip Arthroplasty?

Background: Disparities in access to total hip arthroplasty (THA) exist. The purpose of this study is to examine how distance traveled to undergo elective THA correlates with sociodemographic variables and postoperative outcomes.

Material And Methods: The Healthcare Cost and Utilization Project New York and Florida state inpatient databases were used to identify patients who underwent elective THA between 2006 and 2014.

Outcomes of Intramedullary Nailing and External Fixation of Open Tibial Fractures: Three to Five-Year Follow-up of a Randomized Clinical Trial.

Background: While surgeons in low and middle-income countries have increasing experience with intramedullary nailing (IMN), external fixation (EF) continues to be commonly used for the management of open tibial fractures. We examined outcomes with extended follow-up of the participants enrolled in a clinical trial comparing these treatments.

Methods: Adults who were ≥18 years old with acute AO/OTA type-42 open tibial shaft fractures were randomly assigned to statically locked, hand-reamed IMN or uniplanar EF.

Demographics of Patients Traveling Notable Distances to Receive Total Knee Arthroplasty.

Introduction: Although disparities exist in patient access to and outcomes after total knee arthroplasty (TKA), there are limited data regarding the relationship between travel distance and patient demographics or postoperative complications.

Methods: We identified patients who underwent TKA in Florida and New York between 2006 and 2014 using the Healthcare Cost and Utilization Project State Inpatient Databases. The American Hospital Association and UnitedStatesZipCodes.

Host Perspectives of High-Income Country Orthopaedic Resident Rotations in Low and Middle-Income Countries.

Background: International orthopaedic resident rotations in low and middle-income countries (LMICs) are gaining popularity among high-income country (HIC) residency programs. While evidence demonstrates a benefit for the visiting residents, few studies have evaluated the impact of such rotations on the orthopaedic surgeons and trainees in LMICs. The purpose of this study was to further explore themes identified in a previous survey study regarding the local impact of visiting HIC resident rotations.

Disparity in Built Environment and Its Impacts on Youths' Physical Activity Behaviors During COVID-19 Pandemic Restrictions.

Objectives: Guided by the social ecological model, this study aimed to examine the relations of built environments (i.e., walking/cycling infrastructure, recreation facilities, neighborhood safety/crime), youth's transition abilities, and changes of youth's physical activity (PA) and play behaviors due to COVID-19-based restrictions.

Racial and Socioeconomic Differences in Distance Traveled for Elective Hip Arthroplasty.

Introduction: There are data that disparities exist in access to total hip arthroplasty (THA). However, to date, no study has examined the relationship between distance traveled to undergo THA and patient demographic characteristics, such as race, insurance provider, and income level as well as postoperative outcomes.

Methods: Data from the Healthcare Cost and Utilization Project, American Hospital Association, and the United States Postal Service were used to calculate the geographic distance between 211,806 patients' population-weighted zip code centroid points to the coordinates of the hospitals at which they underwent THA.

International Orthopaedic Volunteer Opportunities in Low and Middle-Income Countries.

Globally, the burden of musculoskeletal conditions continues to rise, disproportionately affecting low and middle-income countries (LMICs). The ability to meet these orthopaedic surgical care demands remains a challenge. To help address these issues, many orthopaedic surgeons seek opportunities to provide humanitarian assistance to the populations in need.

The Initial Economic Burden of Femur Fractures on Informal Caregivers in Dar es Salaam, Tanzania.

Background: Femur fracture patients require significant in-hospital care. The burden incurred by caregivers of such patients amplifies the direct costs of these injuries and remains unquantified.

Aim: Here we aim to establish the in-hospital economic burden faced by informal caregivers of femur fracture patients.