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Chicago Ridge, IL, United States

Albert C.,Marquette University | Albert C.,Orthopaedic and Rehabilitation Engineering Center | Jameson J.,Marquette University | Jameson J.,Orthopaedic and Rehabilitation Engineering Center | And 7 more authors.
Clinical Biomechanics | Year: 2013

Background: Osteogenesis imperfecta is a heterogeneous genetic disorder characterized by bone fragility. Previous research suggests that impaired collagen network and abnormal mineralization affect bone tissue properties, however, little data is yet available to describe bone material properties in individuals with this disorder. Bone material properties have not been characterized in individuals with the most common form of osteogenesis imperfecta, type I. Methods: Bone tissue elastic modulus and hardness were measured by nanoindentation in eleven osteotomy specimens that were harvested from children with osteogenesis imperfecta during routine surgeries. These properties were compared between osteogenesis imperfecta types I (mild, n = 6) and III (severe, n = 5), as well as between interstitial and osteonal microstructural regions using linear mixed model analysis. Findings: Disease severity type had a small but statistically significant effect on modulus (7%, P = 0.02) and hardness (8%, P < 0.01). Individuals with osteogenesis imperfecta type I had higher modulus and hardness than did those with type III. Overall, mean modulus and hardness values were 13% greater in interstitial lamellar bone regions than in osteonal regions (P < 0.001). Interpretation: The current study presents the first dataset describing bone material properties in individuals with the most common form of osteogenesis imperfecta, i.e., type I. Results indicate that intrinsic bone tissue properties are affected by phenotype. Knowledge of the material properties of bones in osteogenesis imperfecta will contribute to the ability to develop models to assist in predicting fracture risk. © 2012 Elsevier Ltd.


Klaas S.,Shriners Hospitals for Children Chicago | Kelly E.,Shriners Hospitals for Children Chicago | Kelly E.,University of Illinois at Chicago | Anderson C.,Shriners Hospitals for Children Chicago | And 2 more authors.
Topics in Spinal Cord Injury Rehabilitation | Year: 2014

Background: Little is known about depression and anxiety in adolescents with spinal cord injury (SCI). Objective: To examine how depression, anxiety, suicidal ideation, and usage of treatment differ by age and sex among adolescents with SCI. Method: Youth 12 to 18 years old who had acquired SCI at least 1 year prior were recruited from 3 specialty hospitals. They completed the Children's Depression Inventory (ages 12-17 years) or Beck Depression Inventory-II (18 years), and Revised Children's Manifest Anxiety Scale (12-18 years). Analyses assessed differences between younger and older adolescents and between males and females. Results: The 236 participants were an average age of 15.58 years (SD 1.98), 58% were male, and 60% Caucasian. Average age at injury was 10.57 years (SD 5.50), and 62% had paraplegia. For depression, 5.5% of adolescents ages 12 to 17 years exceeded the clinical cutoff and 12.7% of 18-year-old adolescents fell into a range of moderate or severe depression. For anxiety, 10.6% of adolescents ages 12 to 18 years exceeded the clinical cutoff. Univariate results revealed that older adolescents were more depressed than younger adolescents, and girls were more anxious than boys. An interaction between sex and age emerged, in that older adolescent girls were significantly more anxious than other youth. Older adolescents were also more likely to be taking medications for emotional, psychological, or behavioral reasons. Reports of suicidal ideation did not differ by adolescent age or sex. Conclusion: For these adolescents, depression differed with age, and anxiety differed based on age and sex. Implications for intervention include early identification and treatment for struggling adolescents. © 2014 Thomas Land Publishers, Inc.


Riordan A.,Shriners Hospitals for Children Chicago | Kelly E.H.,Shriners Hospitals for Children Chicago | Kelly E.H.,University of Illinois at Chicago | Klaas S.J.,Shriners Hospitals for Children Chicago | And 2 more authors.
Journal of Spinal Cord Medicine | Year: 2015

Objective: Examine psychosocial outcomes of youth with spinal cord injury (SCI) as a function of neurological level (paraplegia/tetraplegia) and severity (American Spinal Injury Association (ASIA) Impairment Scale (AIS)). Design: Survey research. Setting: Three pediatric SCI specialty centers in the USA. Participants: Youth with SCI ages 5-18 with neurological impairment classifications of: tetraplegia AIS ABC (tetraplegia ABC), paraplegia AIS ABC (paraplegia ABC), or AIS D. Outcome Measures: Children's Assessment of Participation and Enjoyment, Pediatric Quality of Life Inventory, Revised Children's Manifest Anxiety Scale, and Children's Depression Inventory. Results: Three hundred and forty youth participated; 57% were male; 60% were Caucasian, 21% Hispanic, 7% African-American, 2% Native American, and 3% reported "other". Their mean age was 8.15 years (standard deviation (SD) = 5.84) at injury and 13.18 years (SD = 3.87) at interview. Ninety-six youth (28%) had tetraplegia ABC injuries, 191 (56%) paraplegia ABC injuries, and 53 (16%) AIS D injuries. Neurological impairment was significantly related to participation and quality of life (QOL). Specifically, youth with paraplegia ABC and AIS D injuries participated in more activities than youth with tetraplegia ABC (P = 0.002; P = 0.018, respectively) and youth with paraplegia ABC participated more often than youth with tetraplegia ABC (P = 0.006). Youth with paraplegia ABC reported higher social QOL than youth with tetraplegia ABC (P = 0.001) and AIS D injuries (P = 0.002). Groups did not differ regarding mental health. Conclusion: Interventions should target youth with tetraplegia ABC, as they may need support in terms of participation, and both youth with tetraplegia ABC and AIS D injuries in terms of social integration. © The Academy of Spinal Cord Injury Professionals, Inc. 2015.


Flanagan A.,Shriners Hospitals for Children Chicago | Kelly E.H.,Shriners Hospitals for Children Chicago | Kelly E.H.,University of Illinois at Chicago | Vogel L.C.,Shriners Hospitals for Children Chicago | Vogel L.C.,Rush University Medical Center
Pediatric Physical Therapy | Year: 2013

PURPOSE: To describe psychosocial outcomes of children and adolescents with early-onset spinal cord injury (SCI) and spina bifida (SB) and identify differences between them. METHODS: Eighty-three participants had acquired SCI before age 3 years (mean age 10.6 ± 3.8 yrs), and 54 had SB (mean age 11.7 ± 4.1 yrs). The participants completed standardized assessments of participation, quality of life (QOL), anxiety, and depression. Independent-sample t tests and Mann-Whitney tests were used to assess group differences. RESULTS: Participants with SCI reported higher school QOL (P = .016) and lower anxiety with social concerns/concentration (P = .037) than did participants with SB. The subgroup of participants with SCI with paraplegia reported higher school (P = .014) and overall (P = .034) QOL, and they participated in more activities (P = .015) than participants with SB. CONCLUSIONS: Children and adolescents with SCI with paraplegia have greater school and overall QOL and participate in more activities than children and adolescents with SB. Children and adolescents with SB would benefit from increased support at school and in social participation. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins and Section on Pediatrics of the American Physical Therapy Association.


Bent L.,Shriners Hospitals for Children Chicago | Mulcahey M.J.,Thomas Jefferson University | Kelly E.,Shriners Hospitals for Children Chicago | Kelly E.,University of Illinois at Chicago | And 6 more authors.
Topics in Spinal Cord Injury Rehabilitation | Year: 2013

Objective: To evaluate the accuracy of computer adaptive tests (CATs) of daily routines for child- and parent-reported outcomes following pediatric spinal cord injury (SCI) and to evaluate the validity of the scales. Methods: One hundred ninety-six daily routine items were administered to 381 youths and 322 parents. Pearson correlations, intraclass correlation coefficients (ICC), and 95% confidence intervals (CI) were calculated to evaluate the accuracy of simulated 5-item, 10-item, and 15-item CATs against the full-item banks and to evaluate concurrent validity. Independent samplest tests and analysis of variance were used to evaluate the ability of the daily routine scales to discriminate between children with tetraplegia and paraplegia and among 5 motor groups. Results: ICC and 95% CI demonstrated that simulated 5-, 10-, and 15-item CATs accurately represented the full-item banks for both child- and parent-report scales. The daily routine scales demonstrated discriminative validity, except between 2 motor groups of children with paraplegia. Concurrent validity of the daily routine scales was demonstrated through significant relationships with the FIM scores. Conclusion: Child- and parent-reported outcomes of daily routines can be obtained using CATs with the same relative precision of a full-item bank. Five-item, 10-item, and 15-item CATs have discriminative and concurrent validity. © 2013 Thomas Land Publishers, Inc.

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