Level Of Motor Function Research Articles

Neurosurgical procedures for children with myelomeningocele after fetal or postnatal surgery: a comparative effectiveness study.

To compare the frequencies of neurosurgical procedures to treat comorbid conditions of myelomeningocele in patients who underwent fetal surgery versus postnatal surgery for closure of the placode. By utilizing the National Spina Bifida Patient Registry in a comparative effectiveness study, 298 fetal surgery patients were matched by birthdate (±3mo) and spina bifida clinic site with one to three postnatal surgery patients (n=648). Histories were obtained by record review on enrollment and yearly subsequently. Multivariable Poisson regression was used to compare frequencies of procedures between cohorts, with adjustments for sex, ethnicity, insurance status, spinal segmental level of motor function, age at last visit recorded in the Registry, and, for shunt revision in shunted patients, age at cerebrospinal fluid (CSF) diversion. The median age at last visit was 4 years. In fully adjusted analyses in patients aged at least 12 months old, fetal surgery was associated with decreased frequency of CSF diversion for hydrocephalus by ventriculoperitoneal shunt insertion or endoscopic third ventriculostomy compared with postnatal surgery (46% vs 79%; incidence rate ratio=0.61; 95% confidence interval [CI] 0.53-0.71; p<0.01). Over all ages, fetal surgery was associated with decreased frequency of Chiari decompression for brainstem dysfunction (3% vs 7%; incidence rate ratio=0.41; 95% CI 0.19-0.88; p=0.02). Also over all ages, differences were not significant in frequencies of shunt revision in shunted patients (53% vs 55%; incidence rate ratio=0.87; 95% CI 0.69-1.11; p=0.27), nor tethered cord release for acquired spinal cord dysfunction (18% vs 16%; incidence rate ratio=1.11; 95% CI 0.84-1.47; p=0.46). Even with the variations inherent in clinical practice, fetal surgery was associated with lower frequencies of CSF diversion and of Chiari decompression, independent of covariates. What this paper adds Fetal surgery was associated with lower frequencies of cerebrospinal fluid diversion and decompression of Chiari II malformation than postnatal surgery. Frequencies of ventriculoperitoneal shunt revision and tethered cord release were not significantly different between cohorts.

Prevalence of depression and quality of life in primary caregiver of children with cerebral palsy.

Objective:Study the correlation of depression and quality of life (QoL) in primary caregivers (mothers) of children with cerebral palsy (CP).Methods:An observational cross-sectional study was conducted on a total of 203 primary caregivers (mothers) of children with CP. The depression and QoL in the caregivers were assessed using the Montgomery and Asberg Depression Rating Scale and World Health Organization Quality of Life Instrument (WHOQOL-BREF) (physical, psychological, social and environmental domains), respectively. The child’s gross motor function level was determined using the Gross Motor Functional Classification System-Expanded and Revised (GMFCS-ER). The association of depression and QoL in mothers to functional limitation in children were assessed. For statistical methods, P < 0.05 was considered significant.Results:The severity of the depression showed a statistically significant negative correlation with the physical domain (r = −0.498, P < 0.0001), psychological domains (r = −0.486, P < 0.0001), social relationships (r = −0.165, P = 0.019) and environmental domains (r = −0.195, P = 0.005). The mean QoL domains scores showed a decreasing trend with increasing motor dysfunction of the child, with a statistical association for physical (r = −0.327, P < 0.0001) and psychological domains (r = −0.440, P < 0.0001). Out of all the baseline demographic factors, the child’s age was a significant risk factor affecting the mother’s QoL (P = 0.041).Conclusion:CP, being a debilitating disease, requires around-the-clock caregiving for the child. However, caregiving causes a significant impact on the QoL with increasing severity of depression among the mothers.

Correlation of cardiovascular and respiratory comorbidities with motor functional independence in the elderly after hip fracture

Introduction. The aim of the study was to evaluate the correlation between different levels of examined comorbidities using the Cumulative Illness Rating Scale for Geriatrics and motor Functional Independence Measure test in the elderly after hip fracture. Material and Methods. The study included 203 geriatric patients, 65 years of age and older, who were referred to a rehabilitation program at the Institute for Rehabilitation after hip fracture. The following comorbidities were analyzed: cardiac, vascular, and respiratory. The motor component of Functional Independence Measure was used to assess functional recovery. The Cumulative Illness Rating Scale for Geriatrics was used to calculate the comorbidity index. The patients were assessed on 4 different occasions: on admission, on discharge, 3 months after discharge, and 6 months after discharge. The short-term and long-term efficiency of rehabilitation treatment was measured. Results. There is a significant difference in motor Functional Independence Measure scores between different levels of vascular (p = 0.010) and respiratory (p = 0.047) comorbidities only on admission, while at other times of observation no significant difference (p &gt; 0.05) was found. The highest level of correlation was found in level 3 comorbidity severity index for cardiac comorbidity (discharge/3 months) (Pearson?s correlation - R = 0.938) and vascular comorbidity (discharge/3 months) (R = 0.912), and level 2 comorbidity severity index for respiratory comorbidity (discharge/3 months) (R = 0.941). Conclusion. Rehabilitation treatment of the elderly after hip fracture plays a significant role both in short-term and long-term recovery, particularly in the functional domains even in persons with significant comorbidities. Early inclusion and an individually designed rehabilitation program with continuous monitoring of the elderly after hip fractures results in functional improvement and better quality of life.

The functional health status of children with cerebral palsy during the COVID-19 pandemic stay-at-home period: a parental perspective.

Coronavirus disease 2019 (COVID-19) pandemic was effective all over the world. The stay-athome period was proposed to protect against the pandemic. The aim of this study was to investigate the effects of the COVID-19 pandemic stay-at-home period on body structures and functions, activity and participation levels, and environmental factors of children with cerebral palsy (CP) from the parental perspective in Turkey. A twenty-question survey, using the International Classification of Functioning, Disability and Health for Children and Youth set to understand the functional changes of children with CP during the stay-athome period, was sent to parents in this prospective study. Motor function levels of children were determined by the Gross Motor Function Classification System parent report. The structural equation model was used for statistical analysis. One hundred and three parents of children with CP participated. At least one of four children with CP had increased levels of anxiety (41.8%), and increased level of a sensation of pain (34%) and sleep problems (25.2%). More than half of the children had increased tonus (67%), decreased range of motion (60.2%), decreased physical activity level (55.3%), and decreased support level of rehabilitation services (82.6%). During the stayat- home period activity and participation levels and environmental factors of children explained the changes of body functions as 70% and 33% (RMSEA=0.077, p < 0.05). This study is the first study to examine the functional health of children with CP biopsychosocially during the COVID-19 stay-at-home period. According to the parents, the functional health of children with CP was affected at different levels during the COVID-19 pandemic. Body functions may also be affected positively if physical activity level, home program and environmental supports increase.

Neurogenic bowel treatments and continence outcomes in children and adults with myelomeningocele

Neurogenic bowel dysfunction (NBD) is a common comorbidity of myelomeningocele (MMC), the most common and severe form of spina bifida. The National Spina Bifida Patient Registry (NSBPR) is a research collaboration between the CDC and Spina Bifida Clinics. Fecal continence (continence) outcomes for common treatment modalities for NBD have not been described in a large sample of individuals with MMC. NSBPR patients with MMC and NBD were studied to determine variation in continence status and their ability to perform their treatment independently according to treatment modality and individual characteristics. Continence was defined as < 1 episode of incontinence per month. Eleven common treatments were evaluated. Inclusion criteria were established diagnoses of both MMC and NBD, as well as age ⩾ 5 years (n= 3670). Chi-square or exact statistical tests were used for bivariate analyses. Logistic regression models were used to estimate the odds of continence outcomes by age, sex, race/ethnicity, level of motor function, and insurance status. At total of 3670 members of the NSBPR met inclusion criteria between November 2013 and December 2017. Overall prevalence of continence was 45%. Prevalence ranged from 40-69% across different treatments. Among continent individuals, 60% achieved continence without surgery. Antegrade enemas were the most commonly used treatment and had the highest associated continence rate. Ability to carry out a treatment independently increased with age. Multivariable logistic regression showed significantly higher odds of continence among individuals aged ⩾ 12 years, female, non-Hispanic white, and with private insurance.

YEME VE İÇME BECERİLERİ SINIFLANDIRMA SİSTEMİNİN TÜRKÇE VERSİYONU: SEREBRAL PALSİLİ ÇOCUKLARDA DEĞERLENDİRİCİ-İÇİ GÜVENİRLİĞİ VE DİĞER FONKSİYONEL SINIFLANDIRMA SİSTEMLERİ İLE İLİŞKİSİ

Amaç: Oral motor problemler ile beslenme ve yutma problemleri serebral palsili çocuklarda en sık rastlanan problemlerden bir tanesidir. Yeme İçme Becerisi Sınıflandırma Sistemi (EDACS) serebral palsili çocuklarda yeme ve içme performansını sınıflandırmak için kullanılır. Bu çalışmanın amaçları, EDACS’ı Türkçe’ye çevirmek, değerlendirici-içi güvenirliği ve diğer fonksiyonel sınıflandırma sistemleri ile ilişkisini araştırmaktı. Yöntem: EDACS İngilizce’den Türkçe’ye çevrildi. EDACS’ın Türkçe versiyonu 125 serebral palsili çocuğa uygulandı. Değerlendirici-içi güvenirliği için Türkçe EDACS iki hafta sonra tekrar puanlandı. Çocukların fonksiyonel durumlarını belirlemek için Kaba Motor Fonksiyon Sınıflandırma Sistemi, El Becerileri Sınıflandırma Sistemi ve İletişim Fonksiyonları Sınıflandırma Sistemi seviyeleri de kaydedildi. Sonuçlar: Yaş ortalaması 7,44±3,95 yıl olan 54 kız ve 71 erkek çalışmaya katıldı. Türkçe EDACS’ın değerlendirmeci içi güvenirliği neredeyse mükemmeldi (ICC=0,972 ve Güven Aralığı=0,959-0,980, p&amp;lt;0,001). Türkçe EDACS ile Kaba Motor Fonksiyon Sınıflandırma Sistemi (r=0,769), El Becerileri Sınıflandırma Sistemi (r=0,786) ve İletişim Fonksiyonları Sınıflandırma Sistemi (r=0,824) arasında anlamlı pozitif korelasyon bulundu (p&amp;lt;0,001). Tartışma: Türkçe EDACS son derece güvenilir bir araç olarak bulundu. Serebral palsili çocukların fonksiyonel yeme ve içme becerileri, motor fonksiyon seviyeleri ve iletişim durumları ile ilişkilidir.

School outcomes of adolescents with cerebral palsy in Sweden.

AimTo study school outcomes of adolescents with cerebral palsy (CP) compared with a matched comparison group from the general population, and to observe to what extent sociodemographic and disability‐specific factors are associated with school outcomes.MethodThis was a register study of persons with CP in Sweden, born between 1990 and 1999, with a matched comparison group. Logistic regressions were used to estimate the associations between CP and disability‐specific factors and school outcomes (receiving final grades, grade scores, fulfilling the requirements for progressing to secondary school/university, and attending secondary school).ResultsChildren with CP had substantially lower school achievement compared with a general population sample. Much of the difference can be attributed to intellectual disability; however, CP remained strongly negatively associated with school outcomes. Ability to communicate in an effective manner explained most of the variation in children with CP, whereas motor function played a smaller role.InterpretationThe results suggest that school achievements might be improved if the communication barrier could be reduced, for example by ascertaining access to appropriate communication devices and by educators being aware that communicative difficulties do not necessarily imply intellectual disability. This might enhance the school experience and create an environment where children with CP can reach their full potential.What this study adds There are reduced educational outcomes associated with cerebral palsy.Negative outcomes are mainly driven by reduced communicative and intellectual ability.Gross motor function is associated with outcomes, but plays a smaller part.

Baseline Motor Impairment Predicts Transcranial Direct Current Stimulation Combined with Physical Therapy-Induced Improvement in Individuals with Chronic Stroke.

Transcranial direct current stimulation (tDCS) can enhance the effect of conventional therapies in post-stroke neurorehabilitation. The ability to predict an individual's potential for tDCS-induced recovery may permit rehabilitation providers to make rational decisions about who will be a good candidate for tDCS therapy. We investigated the clinical and biological characteristics which might predict tDCS plus physical therapy effects on upper limb motor recovery in chronic stroke patients. A cohort of 80 chronic stroke individuals underwent ten to fifteen sessions of tDCS plus physical therapy. The sensorimotor function of the upper limb was assessed by means of the upper extremity section of the Fugl-Meyer scale (UE-FM), before and after treatment. A backward stepwise regression was used to assess the effect of age, sex, time since stroke, brain lesion side, and basal level of motor function on UE-FM improvement after treatment. Following the intervention, UE-FM significantly improved (p < 0.05), and the magnitude of the change was clinically important (mean 6.2 points, 95% CI: 5.2–7.4). The baseline level of UE-FM was the only significant predictor (R2 = 0.90, F(1, 76) = 682.80, p < 0.001) of tDCS response. These findings may help to guide clinical decisions according to the profile of each patient. Future studies should investigate whether stroke severity affects the effectiveness of tDCS combined with physical therapy.

Clinical Factors Associated With Chronic Pain in Communicative Adults With Cerebral Palsy: A Cross-Sectional Study.

Chronic pain is prevalent in adults with cerebral palsy. We aimed to explore associations between chronic pain and somatosensory, motor, cognitive, etiologic, and environmental factors in adults with cerebral palsy. This cross-sectional study enrolled 17 adult participants with cerebral palsy (mean age 31 years; 8 female; Gross Motor Functional Classification Status levels I-V) able to self-report and 10 neurotypical adult volunteers (mean age 34 years; 9 female). Participants reported pain characteristics, demographics, and affective factors. Physical examination included somatosensory and motor evaluation. Between-group comparisons used a ranksum test, and correlation analyses estimated effect size in terms of shared variance (ρ2). Individuals with cerebral palsy reported greater pain intensity, neuropathic qualities, and nociceptive qualities than control participants. Higher pain intensity was associated with female gender (ρ2 = 16%), anxiety/depression symptoms (ρ2 = 10%), and lower household income (ρ2 = 19%). It was also associated with better communicative ability (ρ2 = 21%), spinothalamic (sharp/temperature) sensory abnormalities (ρ2 = 33%), and a greater degree of prematurity (ρ2 = 17%). This study highlights similarity of chronic pain associations in people with cerebral palsy with patterns seen in other populations with chronic pain. Spinothalamic sensory abnormalities suggest central pain mechanisms.

LncRNA Neat1 Promotes Regeneration after Spinal Cord Injury by Targeting miR-29b.

Previous studies have shown that lncRNA NEAT1 and miR-29b are closely associated with repair of the injured spinal cord. However, the mechanism by which lncRNA NEAT1 promotes regeneration after spinal cord injury by regulating miR-29b has not been reported. Toexplore this mechanism, we established a rat model of spinalcord injury(SCI). The experimental rats were randomly assigned to one of six groups:the sham,model, si-NEAT1, miR-29b, si-NEAT1 + negative control and si-NEAT1 + si-miR-29b groups. Thehind limb motor functionof the rats was evaluatedondays 1,3, 7, 14,and 21 aftermodellingusingtheBBBratingscale. Seven days after theoperation, attenuation of pathological changes ininjured spinal cord tissues wasevaluated by HE staining. Anteriorhornneuronsandcavitiesinthe injuredareawerecounted by Nissl staining. In addition, the TUNEL assay was employed to study neuronal apoptosis in the anterior horn, and the expression of the apoptotic proteins Bcl-2 and Bax was analysed by western blotting. Finally,the protein expression of GFAP,NCAM,GAP43, and SCG10 wasmeasured byimmunohistochemistryand western blotting. BBBscoresrevealedthat decreasing the level of NEAT1 improvedthehind limb motor function ofthe rats by increasing miR-29b expression. H&Eand Nissl staining showedthatsilencingNEAT1attenuatedlesions in thespinal cord anddecreasedthenumber of cavities inthe injured spinal cord by upregulatingmiR-29b. Immunohistochemistryandwesternblottingsuggestedthatsilencing NEAT1significantly downregulatedGFAP expressionand upregulatedGAP43, SCG10 andNCAM expression byinducing overexpression ofmiR-29b. The TUNEL assay and western blotting also showed that silencing NEAT1 attenuated neuronal apoptosis.

Postural asymmetries, pain, and ability to change position of children with cerebral palsy in sitting and supine: a cross-sectional study

Purpose To examine any associations between postural asymmetries, postural ability, and pain for children with cerebral palsy in sitting and supine positions. Methods A cross-sectional study of 2,735 children with cerebral palsy, 0-18 years old, reported into the Swedish CPUP registry. Postural asymmetries, postural ability, the gross motor function classification system levels I–V, sex, age and report of pain were used to determine any relationship between these variables. Results Over half the children had postural asymmetries in sitting (n = 1,646; 60.2%) or supine (n = 1,467; 53.6%). These increased with age and as motor function decreased. Children were twice as likely to have pain if they had an asymmetric posture (OR 2.1–2.7), regardless of age, sex and motor function. Children unable to maintain or change position independently were at higher risk for postural asymmetries in both supine (OR 2.6–7.8) and sitting positions (OR 1.5–4.2). Conclusions An association was found between having an asymmetric posture and ability to change position in sitting and/or lying; and with pain. The results indicate the need to assess posture and provide interventions to address asymmetric posture and pain. Implications for rehabilitation Postural asymmetries are present in children with cerebral palsy at all levels of gross motor function. Postural asymmetries increase with age and are associated with pain. Assessment of posture should be included in surveillance programs to enable early detection and treatment.

Intra-cisterna magna delivery of an AAV vector with the GLUT1 promoter in a pig recapitulates the physiological expression of SLC2A1.

Glucose transporter 1 deficiency syndrome (GLUT1DS) is caused by haplo-insufficiency of SLC2A1, which encodes GLUT1, resulting in impaired hexose transport into the brain. Previously, we generated a tyrosine-mutant AAV9/3 vector in which SLC2A1 was expressed under the control of the endogenous GLUT1 promoter (AAV-GLUT1), and confirmed the improved motor function and cerebrospinal fluid glucose levels of Glut1-deficient mice after cerebroventricular injection of AAV-GLUT1. In preparation for clinical application, we examined the expression of transgenes after intra-cisterna magna injection of AAV-GFP (tyrosine-mutant AAV9/3-GFP with the CMV promoter) and AAV-GLUT1. We injected AAV-GFP or AAV-GLUT1 (1.63 × 1012 vector genomes/kg) into the cisterna magna of pigs to compare differential promoter activity. After AAV-GFP injection, exogenous GFP was expressed in broad areas of the brain and peripheral organs. After AAV-GLUT1 injection, exogenous GLUT1 was expressed predominantly in the brain. At the cellular level, exogenous GLUT1 was mainly expressed in the endothelium, followed by glia and neurons, which was contrasted with the neuronal-predominant expression of GFP by the CMV promotor. We consider intra-cisterna magna injection of AAV-GLUT1 to be a feasible approach for gene therapy of GLUT1DS.

SEREBRAL PALSİLİ ÇOCUKLARIN UYKU PROBLEMLERİ VE KABA MOTOR FONKSİYON İLİŞKİSİ VE EBEVEYNLERİNİN YAŞAM KALİTESİNİN İNCELENMESİ

Purpose: Sleep problems commonly seen in children with cerebral palsy (CP) adversely affect daily living activities and treatment participation. The study aimed to investigate the relationship between sleep problems and gross motor function levels in children with spastic CP and to determine parents' quality of life (QOL). Methods: Sixty children with spastic CP and 60 typically developing children between the ages of 4 and 12 years and their parents were enrolled in the study. After obtaining demographic data, Gross Motor Function Classification System (GMFCS) was used to determine motor function levels. International Classification of Diseases-10 was used for cognitive function. Children's Sleeping Habits Questionnaire measured children's sleeping habits. The Nottingham Health Profile was used to evaluate parents' QOL. Results: Fifty-two (86.7%) children with CP had sleep disorders. Sleep disturbance values were significantly higher in the CP group than the controls (52.7±7.6 vs 41.5±8.01, respectively), p=0.001. There was no significant difference between GMFCS levels and sleep disorders in children with CP (p&amp;gt;0.05) except morning fatigue (p=0.028). There was no difference between cognition, medication use, and sleep problems (p&amp;gt;0.05). Parents' QOL was found to be worse in the CP group (p=0.001). Conclusion: Rate of sleep disorders in children with CP was higher than controls. Their mothers' QOL values were found to be worse. Conditions that may be associated with sleep disorders in children with CP and their parents’ conditions need to be better identified and screened.

Patella Alta in Ambulatory Children With Cerebral Palsy: Prevalence and Functional Significance.

Gait dysfunction associated with patella alta (PA) in subjects with cerebral palsy (CP) has been presumed but not objectively established clinically or through biomechanical modeling. It is hypothesized that PA is associated with increasing level of motor impairment, increasing age, obesity, and worse stance phase knee kinematics and kinetics in children with CP. Retrospective case series of 297 subjects with CP studied in our Motion Analysis Center. Data analyzed included patient demographics (age, body mass index, CP classification), patella height (Koshino-Sugimoto Index), and knee kinematics and kinetics. PA was present in 180 of 297 subjects (61%), in 68 of the 146 (47%) with unilateral CP, and 112 of 151 subjects (74%) with bilateral CP. For unilateral CP, the prevalence of PA was not significantly different between Gross Motor Function Classification System (GMFCS) I and II (P=0.357). For bilateral CP, the prevalence of PA in GMFCS III was significantly greater than in GMFCS I and II (P=0.02). Regression analysis showed a significant trend between increasing age and PA in unilateral and bilateral groups (P<0.001 and 0.001, respectively). The prevalence of PA was not significantly different across body mass index categories for either unilateral or bilateral groups. There were only 2 of 10 significant correlations between PA and gait parameters for subjects with unilateral CP functioning at the GMFCS I and II levels. There were 8 of 12 significant correlations between PA and gait parameters for subjects with bilateral CP functioning at the GMFCS I, II, and III levels. PA is common in ambulatory children with CP across topographic types and motor functional levels. PA is well tolerated with respect to gait dysfunction in unilateral CP, but may contribute to crouch gait in bilateral CP. Gait dysfunction cannot be inferred from the radiographic assessment of patellar height, and radiographic evidence of PA by itself does not justify surgical correction with patellar tendon advancement or shortening. Level III-prognostic, retrospective series.

Physical workload during caregiving activities and related factors among the caregivers of children with cerebral palsy.

Caregiving demands contribute to both psychological and physical health of caregivers. Physical workload (PW) can be an important cause of musculoskeletal disorders in caregivers of children with cerebral palsy (CP). To investigate PW during caregiving activities and related factors among caregivers of children with CP. Children with CP (n = 291) and their caregivers (n = 291) were recruited for this cross-sectional study. Caregivers were categorized as their child has presence of intellectual disability (ID) and independent walking ability. Gross motor function was assessed using the Gross Motor Function Classification System (GMFCS) in children. PW; presence and distribution of musculoskeletal pain sites; levels of disability of neck, low back, arm, and leg; levels of depressive symptoms; and health-related quality of life (HRQOL) were assessed in caregivers. Significant differences were observed in PW, low back pain-related disability, depressive symptoms, and HRQOL between caregivers of children with and without an ID (p < 0.05). All study variables were significantly different between caregivers of children who can and cannot independently walk (p < 0.05). PW was correlated with caregiver's age, body mass index, lower extremity dysfunction, depressive symptoms, and child's GMFCS level (p < 0.05). Caregivers of a child having an ID and walking disability had higher PW. These caregivers had more problems related to musculoskeletal disorders, higher depressive symptoms, and lower HRQOL. Higher PW was associated with lower level of gross motor function of child and older age, higher body mass index, higher level of lower extremity disfunction and low back pain disability, and lower HRQOL of caregivers.

Caregiver perception of hand function in infants with cerebral palsy: psychometric properties of the Infant Motor Activity Log.

To evaluate the properties of the Infant Motor Activity Log (IMAL), a caregiver-report for frequency and quality of use of more affected upper extremity in infants with neurological and functional impairments. This was a prospective cohort study of 66 children (34 females, 32 males) aged 6 to 24months (mean age [SD] 13.7mo [5.3]) with neurological and functional impairments and a confirmed cerebral palsy diagnoses after 2years, and 51 age-matched typically developing children. The IMAL was administered at baseline and 4weeks later. Typically developing infants were tested with randomly assigned 'more affected' upper extremity. Psychometric properties were evaluated using Spearman's correlation coefficient, Cronbach's alpha, and Jonckheere-Terpstra tests. In the children with impairments, the IMAL showed internal consistency (alpha≥0.88) for the How Well Scale (HWS) and How Often Scale (HOS). Test-retest reliability was 0.64 (HOS) and 0.70 (HWS), demonstrating stability over time. Correlation with Bayley Scales of Infant and Toddler Development, Third Edition more affected arm raw scores were 0.70 (HOS) and 0.72 (HWS) (p<0.001) demonstrating construct validity. Both scale scores decreased with increasing Gross Motor Function Classification System and Mini-Manual Ability Classification System (p<0.001) levels, supporting discriminative validity. Discrimination between typically developing infants and infants with impairments was high (HWS: area under the receiver operating characteristic curve [AUC] 0.96, 95% confidence interval [CI] 0.94-0.99 and HOS AUC=0.95, CI 0.92-0.99). The IMAL is a valid and reliable discriminative caregiver measure of upper limb performance and may complement measures of capacity in infants with neurological and functional impairments. The Infant Motor Activity Log (IMAL) is a valid and reliable measure of caregiver perception of upper limb function. The IMAL fills a measurement gap for infant motor performance in children with impairments. The IMAL discriminates among motor function levels.

Analysis of type and frequency dynamics of rehabilitation assistive devices in children with cerebral palsy

Background. Currently, cerebral palsy is the most common neuromuscular disease in the pediatric population. Spastic forms of cerebral palsy are characterized by secondary musculoskeletal complications. They are corrected by the use of assistive devices and, especially, orthoses, along with surgical treatment, botulinum toxin, and others.&#x0D; Aim. The aim of this study was to assess the type and frequency dynamics of rehabilitation assistive devices in children with spastic forms of cerebral palsy, depending on the level of the gross motor function of the patient.&#x0D; Materials and methods. A prospective analysis was conducted by questioning 214 parents of children with spastic forms of cerebral palsy who were treated for the period from 2017 to 2019. The patients were divided into five groups according to the gross motor function classification (GMFCS). The statistical processing was performed using the application package Statistica 10 and Microsoft Excel.&#x0D; Results. Statistically significant differences in variances (p 0.05) were obtained between the number of rehabilitation assistive devices used in the anamnesis in the year before the questionnaire (period I) and assistive devices used in the last six months before the questionnaire (period II). Repeatedly, patients used orthopedic shoes the most often, and the trunk-hip-knee-ankle-foot orthoses the most rarely. We found five main causes groups of assistive device use failure for children with cerebral palsy.&#x0D; Conclusion. Statistically significant differences in variances were obtained between the frequency of rehabilitation assistive devices used in the anamnesis and during the last six months before the questionnaire was obtained. It has been confirmed that patients used orthopedic shoes most regularly; of all functional orthoses, hip adductor orthosis was used most often repeatedly, whereas the trunk-hip-knee-foot orthoses were the least common. Factors such as a negative attitude of the child towards the orthosis, uncomfortable in life, the presence of construction errors of the product, the absence of appropriate appointments in the individual rehabilitation and habilitation programs for the patient, have led to the most frequent rejection of the reuse of the technical device for rehabilitation. At the same time, positive or negative dynamics on the condition of the patient affected the regularity of the use of a technical device for rehabilitation in only one in six patients.

Kronik Engelli Bireylerde Ortez Ve Yardımcı Cihaz Memnuniyetinin Araştırılması

Amaç: Bu çalışmanın amacı ortez/yardımcı cihaz tavsiye edilen kronik engelli bireylerin ortez kullanım memnuniyetlerinin araştırılması. Bununla birlikte tanı grupları ve serebral palsili bireylerin motor fonksiyon seviyeleri ile ortez kullanım memnuniyeti arasında ilişki olup olmadığının araştırılmasıdır. Gereç ve Yöntem: Çalışmaya 105 kronik engelli birey (64 serebral palsili, 13 spina bifida, 14 musküler distrofi ve 14 farklı nörolojik tanılı birey) ve aileleri dahil edildi. Yardımcı cihaz/ortez kullanımı, günlük kullanma süreleri ve eğer ortezlerini kullanmıyorlarsa nedenleri sorgulandı. Bireylerin ortez kullanım memnuniyetleri araştırmacılar tarafından literatüre dayanarak oluşturulmuş Ortez Kullanım Memnuniyet Anketi ile değerlendirildi. Bulgular: Serebral palsili bireylerin motor fonksiyon düzeyleri ile ortez kullanım memnuniyeti arasında ilişki olmadığı bulundu (p=0.779). Ortez Kullanım Memnuniyet Anketi toplam skoru ve günlük ortez kullanma süreleri arasında pozitif yönlü zayıf bir ilişki saptandı (r=0.242, p=0.015). Ortez Kullanım Memnuniyet Anketi toplam skoru ve ne kadar zamandır ortez kullanıldığına ait veriler arasında bir ilişki bulunmadı (p=0.811). Engelli bireylerin tanılarının (p=0.23) ve cihaz/ortez tipinin ortez kullanma memnuniyeti skorları ile ilişkili olmadığı saptandı (p=0.97). Sonuç: Sonuç olarak, kronik engelli bireylerde ortez/yardımcı cihaz günlük kullanım süresi arttıkça kullanım memnuniyetinin arttığı ve cihaz/ortez tipinin ortez kullanma memnuniyeti ile ilşkili olmadığı gözlemlendi. Ayrıca serebral palsili, spina bifida, musküler distrofi ve diğer tanı gruplarının ortez memnuniyetlerinin benzer olduğu görüldü.

Effectiveness of Mirror Therapy on Motor Function among Patients with Cerebro Vascular Accident

The study was conducted to evaluate the effectiveness of mirror therapy on motor function among patients with cerebro vascular accident . Quasi experimental non- randomized control group design was adopted for the study. The sample were selected out of 60 samples, 30 were in study group and 30 in control group. Mirror therapy was given for 30 minutes to the study group for 10 days and with holded for control group. Post test was done for both study group and control group after 14 days. The findings revealed that, in study group, the mean score on level of motor function among patients with Cerebro Vascular Accident in study group was 1.46 in pre test and 2.46 in post test. The estimated paired ‘t’ value was 8.41 which was significant at p ? 0.05. Hence the research hypothesis (H1) was accepted. The mean score on level of motor function among patients with Cerebro Vascular Accident in study group was 2.46 and in control group was 0.71. The estimated unpaired ‘t’ value was 6.25 which is significant at p ? 0.05. Hence the research hypothesis (H2) was accepted. The study concluded that the Mirror therapy is effective to improve the level of motor function among patients with Cerebro Vascular Accident.

Effectiveness of Mirror Therapy on Motor Function among Patients with Cerebro Vascular Accident

The study was conducted to evaluate the effectiveness of mirror therapy on motor function among patientswith cerebro vascular accident . Quasi experimental non- randomized control group design was adoptedfor the study. The sample were selected out of 60 samples, 30 were in study group and 30 in control group.Mirror therapy was given for 30 minutes to the study group for 10 days and with holded for control group.Post test was done for both study group and control group after 14 days. The findings revealed that, in studygroup, the mean score on level of motor function among patients with Cerebro Vascular Accident in studygroup was 1.46 in pre test and 2.46 in post test. The estimated paired ‘t’ value was 8.41 which was significantat p ? 0.05. Hence the research hypothesis (H1) was accepted. The mean score on level of motor functionamong patients with Cerebro Vascular Accident in study group was 2.46 and in control group was 0.71.The estimated unpaired ‘t’ value was 6.25 which is significant at p ? 0.05. Hence the research hypothesis(H2) was accepted. The study concluded that the Mirror therapy is effective to improve the level of motorfunction among patients with Cerebro Vascular Accident.