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Many families changed equipment once the pump was in place; possibly 18?months was too short a time to determine if equipment would last longer once the children were more relaxed. Sampson et?al.28 looked at the financial cost of ITB in terms of the total health benefits over time, using Quality-Adjusted Life Years (QUALYS). They found it is very cost-effective in these terms, more so http://www.selleckchem.com/products/azd9291.html than many other procedures, including cardiac surgery. We have reported a controlled study of the effects of ITB over the long term of a homogeneous group of children with severe CP, using a range of outcome measures including the International Classification of Functioning, Disability and Health dimensions of activity and participation, and http://en.wikipedia.org/wiki/YES1 other aspects of quality of life. Significant improvements were found in comfort and ease of care. Few improvements were found in active functioning or social participation. In this group of children, ITB can be a major benefit to the quality of life of the children and their carers. Medtronic provided a grant to NG for this study, but did not participate in it in any other way. We thank all the local teams of orthopaedic surgeons and physiotherapists who worked with these children. We are also grateful for help with statistics from Professor Andrew Wood and Michael Tsagris, School of Mathematical Sciences, University of Nottingham, UK. ""This commentary is on the original article by Poretti et?al. on pages 1016�C1020 of this issue. ""To determine normative values for the Timed Up and Go (TUG) test in typically developing children and adolescents and to validate its use in individuals with Down syndrome. Participants in this cross-sectional study were South Brazilian schoolchildren aged 3 to 18?years. In phase 1, 459 typically developing individuals http://www.selleckchem.com/products/carfilzomib-pr-171.html (227 males, 232 females; mean age 10y 8mo (SD 4y 4mo) were included; and in phase 2, 40 individuals with Down syndrome (16 males, 24 females; mean age 10y 6mo (SD 4y 4mo). Anthropometric measurements, real leg length, TUG test scores, and Gross Motor Function Measure (GMFM) scores were evaluated. The association between the TUG test and possible predictive variables was analyzed. In phase 1, the mean time to perform the TUG test was 5.61?seconds (SD 1.06). Values were stratified in age groups that served as normative data for both sexes. A multiple linear regression analysis was conducted and the best variables to predict TUG scores were age and weight. The best model obtained presented an R2 of 0.25 and a standard error of the estimate of 0.92. Excellent intrasession reliability in the three tests performed (intraclass correlation coefficient [ICC] of 0.93, 0.94, and 0.95) and between the sessions (both with an ICC of 0.95) was demonstrated. In phase 2, the test also showed excellent reproducibility (ICC=0.82 between the two tests performed). The performance time was significantly longer (p