To explore if an intensive balance training protocol that incorporated the BrainPort sensory substitution device improves the standing postural balance of children with balance disorders.
Eight ...children with balance disorders received 8-weeks of balance training while using the BrainPort device. Pre- and post-intervention changes in the Bruininks-Oseretsky Test of Motor Proficiency balance subtest (BOT-2) scores, standing duration on an unstable surface, and center of pressure (COP) sway were assessed.
Post-intervention, the BOT-2 balance subtest scores increased by 29.6% and demonstrated clinically meaningful improvements. Overall, the standing duration with vision increased. The standing duration on the unstable surface without vision increased significantly from pre- to post-intervention. However, anterior-posterior (AP) and medial-lateral (ML) sway did not change post-intervention. The children also reported new functional activities (i.e. riding a bike, standing on unsteady or narrow surfaces).
Balance training with the BrainPort sensory substitution device has the potential to result in clinically relevant improvements in the standing postural balance of children with balance disorders.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Aims: Children with neuromotor delays are at risk for reaching and object exploration impairments, which may negatively affect their cognitive development and daily activity performance. This study ...evaluated the effectiveness of the Sitting Together And Reaching To Play (START-Play) intervention on reaching-related exploratory behaviors in children with neuromotor delays. Methods: In this randomized controlled clinical trial, 112 children (Mean=10.80, SD=2.59 months old at baseline) with motor delays were randomly assigned to receive START-Play intervention or usual care-early intervention. Performance for ten reaching-related exploratory behaviors was assessed at baseline and 1.5, 3, 6, 12 months post-baseline. Piecewise linear mixed-effects modeling was used to evaluate short- and long-term effects of the intervention. Results: Benefits of START-Play were observed for children with significant motor delays, but not for those with mild delays. START-Play was especially beneficial for children with significant motor delays who demonstrated early mastery in the reaching assessment (i.e., object contact 65% of the time within 3 months after baseline); these children showed greater improvements in manual, visual, and multimodal exploration, as well as intensity of exploration across time. Conclusions: START-Play advanced the performance of reaching-related exploratory behaviors in children with significant motor delays. This paper is the online first version of an article published in "Physical & Occupational Therapy in Pediatrics."
This study was designed to describe the development of posture control in sitting in response to a natural perturbation. Seven normal infants 2 to 5 months of age were tested at two stages of ...independent sitting development. Trunk support was removed from infants while sitting erect and the postural responses were videotaped and EMG recorded from the upper trunk extensors, lumbar paraspinals, gluteus maximus, rectus femoris, hamstrings, and abdominals. Kinematic variables (trunk displacement, trunk velocity, trunk curvature) and an EMG variable (pattern of muscle activation) were analyzed with computer programs. Between Stages 1 and 2 of sitting development, anterior trunk displacement and velocity decreased significantly, although the trunk extension curve did not change significantly. Infants had variable muscle responses during Stage 1; however, during Stage 2 EMG analysis revealed less variability and the emergence of postural synergies. Overall, lumbar paraspinals, hamstrings, and quadriceps were the muscles most frequently active during the postural response. Each subject had a preferred synergy, with the most common synergies being a lumbar paraspinal-hamstring synergy and a lumbar paraspinal-quadriceps synergy. These data provide evidence that trunk displacement and trunk velocity decrease in infants develop independent sitting posture, and these variables may be used to measure improvement in sitting control. We suggest that the control of sitting posture is related to the emergence and preferred use of the paraspinal-hamstring and paraspinal-quadriceps synergies.
Aims: This study evaluated whether caregiver-provided learning opportunities moderated the effect of START-Play physical therapy intervention on the cognitive skills of young children with neuromotor ...delays, and whether START-Play impacted caregiver-provided learning opportunities over time. Methods: One hundred and twelve children with neuromotor delays (7-16 months) participated in a multisite randomized clinical trial evaluating the efficacy of START-Play. Children were assessed at baseline and 3 (post intervention), 6, and 12 months post baseline. Cognition was scored from the Bayley Scales of Infant & Toddler Development, Third Edition, cognitive scale. The proportion of time caregivers spent providing learning opportunities was coded from a 5-minute caregiver-child free play interaction. Results: Baseline caregiver-provided learning opportunities moderated the 3- and 12-month effects of START-Play on cognition. Cognitive gains due to START-Play were more pronounced for children whose caregivers provided more learning opportunities. START-Play did not impact caregiver-provided learning opportunities over time. Conclusions: START-Play may have a lasting effect on children's cognition, but this effect is contingent on caregivers providing their child with ample opportunities to practice cognitive skills. Strategies for improving caregivers' uptake and transfer of START-Play principles to their daily routines should be evaluated. This is the online version of an article published in "Physical & Occupational Therapy In Pediatrics."
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