•Findings extend support for the effectiveness of activity-oriented, as well as body function-oriented approaches when combined with activities.•An important new finding was the evidence of training ...effectiveness when programs were conducted in a small group format and for programs aiming at improved physical fitness.•Data suggest that active computer-assisted training can be a useful adjunct treatment, but the active ingredients are unknown.•Relatively short duration interventions still demonstrated positive treatment effects.•Comparison studies between approaches and groups (age, gender, severity, whether referred or selected and with co-occurring conditions) are needed.
As part of the process of creating an update of the clinical practice guidelines for developmental coordination disorder (DCD) (Blank, Smits-Engelsman, Polatajko, & Wilson, 2012), a systematic review of intervention studies, published since the last guidelines statement was conducted.
The aim of this study was to 1) systematically review the evidence published from January 2012 to February 2017 regarding the effectiveness of motor based interventions in individuals with DCD, 2) quantify treatment effects using a meta-analysis, 3) examine the available information on different aspects of delivery including use of group intervention, duration and frequency of therapy, and 4) identify gaps in the literature and make recommendations for future intervention research.
An electronic search of 5 databases (PubMed, Embase, Pedro, Scopus and Cochrane) was conducted for studies that evaluated motor-based interventions to improve performance for individuals with DCD.
Thirty studies covering 25 datasets were included, 19 of which provided outcomes on standardized measures of motor performance. The overall effect size (Cohen’s d) across intervention studies was large (1.06), but the range was wide: for 11 interventions, the observed effect was large (>0.80), in eight studies moderate (>0.50), and in five it was small or negligible (<0.50). Positive benefits were evident for activity-oriented approaches, body function-oriented combined with activities, active video games, and small group programs.
Results showed that activity-oriented and body function oriented interventions can have a positive effect on motor function and skills. However, given the varied methodological quality and the large confidence intervals of some studies, the results should be interpreted with caution.
Abstract
Study Objectives
The relationship of iron with cognitive and motor impairment in idiopathic rapid eye movement sleep behavior disorder (iRBD) remains unknown.
Methods
Twenty-nine (29) ...patients and 28 healthy controls (HCs) underwent susceptibility weighted imaging and susceptibility mapping. These images were used to evaluate the nigrosome-1 (N1) sign in the substantia nigra (SN), global and regional high-iron (RII) content, and volume of subcortical nuclei.
Results
The number of iRBD patients with N1 loss (12) was significantly higher than HCs (2) (p = 0.005). Compared with HCs, the iRBD patients had reduced volume of the right caudate nucleus (RCN) (p < 0.05, false discovery rate FDR correction) but no significant changes in global and RII iron of the subcortical nuclei (all p > 0.05, FDR correction). Multiple regression analysis revealed that: for cognitive function, the RII iron of the RCN was significantly correlated with visuospatial function and the global iron of the right dentate nucleus (RDN) was correlated with memory function; for motor function, the RII iron of the left DN (LDN) and global iron of the left CN correlated with the Alternate-Tap test (left, average), the global iron of the LDN correlated with the Alternate-Tap test (right), and the global iron of the left GP correlated with the 3-m Timed Up and Go test (all p < 0.05, FDR correction).
Conclusions
Our exploratory analysis found that iRBD patients had a higher incidence of N1 loss and reduced RCN volume after FDR correction. Cognitive and motor impairment were associated with iron deposition in several cerebral nuclei after FDR correction.
Introduction: Shoulder joint pain in hemiplegic patients is a common complication which interferes with the therapeutic exercises, influences activities of daily living, social participation and ...delays the recovery process. Various treatment methods have been given to prevent and manage the Hemiplegic Shoulder Pain (HSP). The purpose of present systematic review was to find the study which is most effective in HSP. Aim: To determine the most effective method used in physical therapy for the management of HSP. Materials and Methods: In the present systematic review, a search of PubMed, Physiotherapy Evidence Database (PEDro), CINHAL, Scopus database, Google Scholar, Cochrane Library register of control trials and bibliography was conducted from January 2016 to March 2020. Randomised clinical trials were included in the review. The methodological quality of the identified Randomised Controlled Trials (RCTs) was assessed using the McMaster Critical Appraisal Tool. The RCTs which scored less than 9 out of 15 or below 64.2% on McMaster Critical Appraisal Tool were not included into the systematic review. Results: A total of 1337 citations were identified, however, only six RCTs matched the eligibility criteria and were included in the review. The identified studies were similar in design. Investigated diverse physical therapy modalities that were applied for dissimilar periods, and outcome measures assessed at different periods which shown inconsistent results. Conclusion: This systematic review found evidence for improvement in HSP in those treated with Kinesiotaping (KT) and Electromyograph (EMG) triggered Neuromuscular Electrical Stimulaton (NMES) with bilateral arm training. However, more number of RCTs needed to substantiate the results.
Vertical jump (VJ) capacity is a common assessment for monitoring athletes' neuromuscular function and has been proposed as a differentiating indicator between competitive levels of football players. ...This study aimed to compare the VJ capacity of Chilean footballers with cerebral palsy (CP) with international and national levels of proficiency, also according to their sport classes (i.e., FT1‒FT3). A total sample of 41 male footballers with CP were divided into international-level (n = 18) and national-level (n = 23) groups. All the participants performed two maximal squat jumps (SJs) and countermovement jumps (CMJs), where the best height obtained was registered. The VJ performance was significantly different between competitive levels, and players at international level had better scores (p < .001) than the national level in SJ (dg = 1.83, large) and CMJ (dg = 2.08, large). Considering the sport classes, significant differences were found in SJ (p = .024) and CMJ (p = .035), in which FT3 players performed higher jumping heights than FT1 players (dg = -.84 to -1.01, large). These results provide a deeper understanding of the differences in the motor impairment-specific performance of para-footballers with CP, where coaches and strength-conditioning professionals should consider VJ assessment for monitoring training and as a component for talent detection in this para-sport.
The role of albumin in Parkinson disease (PD) is not well understood, our study will investigate the association between the serum albumin level and risk of dementia, motor impairment, as well as ...survival outcome in PD. Data were obtained from the publicly available dataset in the DRYAD database (https://datadryad.org/). The original prospective study enrolled patients with PD from a single center in Japan between March 2004 and November 2007. Due to missing values, 242 and 274 participants were included in the study, in which we aimed to, respectively, analyze the relationship between serum albumin and cognitive function as well as motor impairment; additionally, 264 participants were included to assess the association between baseline serum albumin levels and risk of PD-related death with a median follow-up of 5.24 years. Compared to patients of the low tertile of albumin levels, Mini-Mental State Examination (MMSE) of patients of middle tertile increased 2.09 95% confidence interval (CI) (0.45, 3.73),
P
= .013, independent of age, sex, PD duration, modified Hoehn-Yahr (mHY) stage, C-reactive protein (CRP) level, and use of nonsteroidal anti-inflammatory drugs (NSAIDs). Further analysis revealed a positive curvilinear association between albumin and MMSE, with cutoff values of 3.9. As concentration serum albumin increased, the risk of severe motor impairment was grown odds ratio (OR) 0.34 (95% CI 0.14,0.8),
P
= .013 after adjustment by age, sex, PD duration, MMSE scores, CRP level, and use of NSAIDs. Albumin levels increased per unit of mg/dL, and the risk of PD-related death reduced 0.74-fold with 95% CI (0.15, 0.86) (
P
= .021), independent of age, sex, PD disease duration, mHY stage, CRP levels, use of NSAIDs, and MMSE. Higher serum albumin levels were significantly association with the better cognitive function when albumin was <3.9 mg/dL, and played a protective role in severe motor impairment and PD-related death.
There is a pressing need for strategies to slow or treat the progression of functional decline in people living with HIV. This paper explores a novel rehabilitation robotics approach to measuring ...cognitive and motor impairment in adults living with HIV, including a subset with stroke. We conducted a cross-sectional study with 21 subjects exhibiting varying levels of cognitive and motor impairment. We tested three robot-based tasks - trajectory tracking, N-back, and spatial span - to assess if metrics derived from these tasks were sensitive to differences in subjects with varying levels of executive function and upper limb motor impairments. We also examined how well these metrics could estimate clinical cognitive and motor scores. The results showed that the average sequence length on the robot-based spatial span task was the most sensitive to differences between various cognitive and motor impairment levels. We observed strong correlations between robot-based measures and clinical cognitive and motor assessments relevant to the HIV population, such as the Color Trails 1 (rho = 0.83), Color Trails 2 (rho = 0.71), Digit Symbol - Coding (rho = 0.81), Montreal Cognitive Assessment - Executive Function subscore (rho = 0.70), and Box and Block Test (rho = 0.74). Importantly, our results highlight that gross motor impairment may be overlooked in the assessment of HIV-related disability. This study shows that rehabilitation robotics can be expanded to new populations beyond stroke, namely to people living with HIV and those with cognitive impairments.
Genes encoding the ρ1/2 subunits of GABAA receptors have been associated with alcohol (ethanol) dependence in humans, and ρ1 was also shown to regulate some of the behavioral effects of ethanol in ...animal models. Ethanol inhibits GABA-mediated responses in wild-type (WT) ρ1, but not ρ1(T6'Y) mutant receptors expressed in Xenopus laevis oocytes, indicating the presence of an inhibitory site for ethanol in the second transmembrane helix. In this study, we found that ρ1(T6'Y) receptors expressed in oocytes display overall normal responses to GABA, the endogenous GABA modulator (zinc), and partial agonists (β-alanine and taurine). We generated ρ1 (T6'Y) knockin (KI) mice using CRISPR/Cas9 to test the behavioral importance of the inhibitory actions of ethanol on this receptor. Both ρ1 KI and knockout (KO) mice showed faster recovery from acute ethanol-induced motor incoordination compared to WT mice. Both KI and KO mutant strains also showed increased tolerance to motor impairment produced by ethanol. The KI mice did not differ from WT mice in other behavioral actions, including ethanol intake and preference, conditioned taste aversion to ethanol, and duration of ethanol-induced loss of righting reflex. WT and KI mice did not differ in levels of ρ1 or ρ2 mRNA in cerebellum or in ethanol clearance. Our findings indicate that the inhibitory site for ethanol in GABAA ρ1 receptors regulates acute functional tolerance to moderate ethanol intoxication. We note that low sensitivity to alcohol intoxication has been linked to risk for development of alcohol dependence in humans.
Display omitted
•ρ1 and ρ1(T6'Y) receptors differ in ethanol but not GABA responses.•ρ1(T6'Y) knockin mice were generated to test the in vivo role of the ethanol site.•ρ1 knockin and knockout mice recover faster from ethanol-induced ataxia.•ρ1 knockin and knockout mice show increased acute functional tolerance.•ρ1 regulates tolerance to ethanol intoxication, which may increase ethanol abuse.
Physical activity (PA) participation provides opportunities for preschool-age children to improve motor skills. This is especially important for children born extremely preterm (EP) or extremely low ...birthweight (ELBW) who are at greater risk of motor impairment, and are participating less frequently in PA, compared with children born at term. There is limited evidence on improving PA participation for this population.
This case series design study evaluated the feasibility of a Dance PaRticipation intervention for Extremely prEterm children with Motor Impairment at prEschool age (Dance PREEMIE), a community-based dance class intervention aiming to improve PA participation. Children born EP/ELBW with motor impairment were recruited at 3 years' corrected age. Dance teachers were recruited from community dance schools and provided with study-specific training. Intervention feasibility was assessed using; recruitment capability, class attendance, child involvement and enjoyment, teacher self-efficacy, and implementation fidelity.
Ten children and seven dance teachers were recruited. Most children (n = 7) attended >75% of classes. Children enjoyed the classes and were mostly ‘somewhat-very’ or ‘very’ involved. Teachers reported improved self-efficacy for teaching dance to children with motor impairment after attending the training day.
Further research is warranted to evaluate the efficacy of Dance PREEMIE in larger samples.
•Physical activity participation may benefit children born extremely preterm.•Dance PREEMIE is a community-based intervention for children with motor impairment.•Dance PREEMIE was fun, engaging, and well-attended by participating families.•Dance teachers attended Dance PREEMIE training before facilitating intervention.•Training improved self-efficacy for teaching children with motor impairment.
All people experience aging, and the related physical and health changes, including changes in memory and brain function. These changes may become debilitating leading to an increase in dependence as ...people get older. Many external aids and tools have been developed to allow older adults and elderly patients to continue to live normal and comfortable lives. This mini-review describes some of the recent studies on cognitive decline and motor control impairment with the goal of advancing non-invasive brain computer interface (BCI) technologies to improve health and wellness of older adults and elderly patients. First, we describe the state of the art in cognitive prosthetics for psychiatric diseases. Then, we describe the state of the art of possible assistive BCI applications for controlling an exoskeleton, a wheelchair and smart home for elderly people with motor control impairments. The basic age-related brain and body changes, the effects of age on cognitive and motor abilities, and several BCI paradigms with typical tasks and outcomes are thoroughly described. We also discuss likely future trends and technologies to assist healthy older adults and elderly patients using innovative BCI applications with minimal technical oversight.
People with mild to moderate intellectual or multiple disabilities may have serious difficulties in accessing leisure events, managing communication exchanges with distant partners, and performing ...functional daily activities. Recently, efforts were made to develop and assess technology-aided programs aimed at supporting people in all three areas (i.e., leisure, communication, and daily activities). This study assessed a new technology-aided program aimed at helping four participants with intellectual and multiple disabilities in the aforementioned areas. The program, which was implemented following a non-concurrent multiple baseline across participants design, relied on the use of a smartphone or tablet connected
via
Bluetooth to a two-switch device. This device served to select leisure and communication events and to control the smartphone or tablet’s delivery of step instructions for the activities scheduled. Data showed that during the baseline phase (with only the smartphone or tablet available), three participants failed in each of the areas (i.e., leisure, communication and functional activities) while one participant managed to access a few leisure events. During the intervention phase (with the support of the technology-aided program), all participants managed to independently access leisure events, make telephone calls, and carry out activities. These results suggest that the program might be a useful tool for helping people with intellectual and multiple disabilities improve their condition in basic areas of daily life.
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