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Recent skin injuries in children with motor disabilities
Christopher John Newman1, Cécile Holenweg-Gross, Carole Vuillerot
1Paediatric Neurology and Neurorehabilitation Unit, University Hospital Lausanne, Lausanne, Switzerland. christopher.newman@chuv.ch
Insights
Children with neuromotor disabilities experience fewer skin injuries as mobility decreases. Unusual injuries in these children warrant suspicion of physical abuse, similar to those without disabilities.
Area of Science:
- Pediatrics
- Neurology
- Dermatology
Background:
- Children with neuromotor disabilities are a vulnerable population.
- Understanding injury patterns is crucial for their care and safety.
Purpose of the Study:
- To investigate the prevalence of recent skin injuries in children with neuromotor disabilities.
- To analyze the association between injury frequency and the severity of motor disability.
Main Methods:
- A cross-sectional study involving 168 children (aged 2-16 years) with neuromotor disabilities.
- Participants were categorized by mobility: unrestricted walkers, restricted walkers, or wheelchair-dependent.
- Systematic examination of the body surface (excluding the anal-genital area) for recent skin injuries.
Main Results:
- The average child had 5.3 recent skin injuries, including bruises, abrasions, and pressure lesions.
- A significant inverse relationship was observed between motor disability severity and the frequency of skin injuries, particularly on lower limbs.
- Gender, learning disabilities, and comorbidities did not significantly impact injury rates.
Conclusions:
- Skin injury frequency decreases progressively with reduced mobility in children with neuromotor disabilities.
- Unusual skin injuries in this population should prompt consideration of physical abuse, at a level comparable to children without disabilities.
Objective:
To determine the frequency of recent skin injuries in children with neuromotor disabilities and its association with disability.
Design:
Cross-sectional study of 168 children with neuromotor disabilities aged 2-16 years.
Setting:
Two outpatient child rehabilitation centres.
Main Outcome Measures:
Children were classified as unrestricted walkers, restricted walkers or wheelchair dependent. Each participant's body surface was systematically examined for recent skin injuries with the exception of the anal-genital area.
Results:
The mean age of our sample was 7.8 (SD 3.7) years with a 3:2 male/female ratio. Overall, 64% had cerebral palsy, 17% a neuromuscular disease and 19% other motor disabilities. Participants had on average 5.3 (SD 4.5) recent skin injuries (max 19), of which 2.5 were bruises (SD 3.3, max 16), 2.4 were abrasions, scratches or cuts (SD 3.0, max 16) and 0.4 were pressure lesions (SD 0.8, max 4). There was a significant decrease in the frequency of recent skin injuries and of bruises with increasing severity of motor disability. Most of this variation was accounted for by injuries to the lower limbs. There were no significant effects of gender, learning disabilities or other comorbidities.
Conclusions:
Children with neuromotor disabilities present a progressive reduction in the number of skin injuries with decreasing mobility. Therefore, recent skin injuries in this population which are unusual by their number, appearance or distribution, should raise at least the same level of suspicion for physical abuse as in children without disabilities.
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