Tests Of Motor Skills Research Articles

Postnatal erythropoietin treatment mitigates neural cell loss after systemic prenatal hypoxic-ischemic injury

Brain injury from preterm birth predisposes children to cerebral palsy, epilepsy, cognitive delay, and behavioral abnormalities. The CNS injury often begins before the early birth, which hinders diagnosis and concurrent treatment. Safe, effective postnatal interventions are urgently needed to minimize these chronic neurological deficits. Erythropoietin (EPO) is a pleiotropic neuroprotective cytokine, but the biological basis of its efficacy in the damaged developing brain remains unclear. Coordinated expression of EPO ligand and receptor expression occurs during CNS development to promote neural cell survival. The authors propose that prenatal third trimester global hypoxia-ischemia disrupts the developmentally regulated expression of neural cell EPO signaling, and predisposes neural cells to death. Furthermore, the authors suggest that neonatal exogenous recombinant human EPO (rhEPO) administration can restore the mismatch of EPO ligand and receptor levels, and enhance neural cell survival. Transient systemic hypoxia-ischemia (TSHI) on embryonic Day 18 in rats mimics human early-third trimester placental insufficiency. This model was used to test the authors' hypothesis using a novel clinically relevant paradigm of prenatal injury on embryonic Day 18, neonatal systemic rhEPO administration initiated 4 days after injury on postnatal Day 1, and histological, biochemical, and functional analyses in neonatal, juvenile, and adult rats. The results showed that prenatal TSHI upregulates brain EPO receptors, but not EPO ligand. Sustained EPO receptor upregulation was pronounced on oligodendroglial lineage cells and neurons, neural cell populations particularly prone to loss from CNS injury due to preterm birth. Postnatal rhEPO administration after prenatal TSHI minimized histological damage and rescued oligodendrocytes and gamma-aminobutyric acidergic interneurons. Myelin basic protein expression in adult rats after insult was reduced compared with sham controls, but could be restored to near normal levels by neonatal rhEPO treatment. Erythropoietin-treated TSHI rats performed significantly better than their saline-treated peers as adults in motor skills tests, and showed significant seizure threshold restoration using a pentylenetetrazole increasing-dose paradigm. These data demonstrate that neonatal rhEPO administration in a novel clinically relevant paradigm initiated 4 days after a global prenatal hypoxic-ischemic insult in rats rescues neural cells, and induces lasting histological and functional improvement in adult rats.

Validation of an Online Assessment of Orthopedic Surgery Residents' Cognitive Skills and Preparedness for Carpal Tunnel Release Surgery

Surgical competence requires both cognitive and technical skills. Relatively little is found in the literature regarding the value of Web-based assessments to measure surgery residents' mastery of the competencies. To determine the validity and reliability of 2 online instruments for predicting the cognitive preparedness of residents for performing carpal tunnel release surgery. Twenty-eight orthopedic residents and 2 medical school students responded to an online measure of their perception of preparedness and to an online cognitive skills assessment prior to an objective structured assessment of technical skills, in which they performed carpal tunnel release surgery on cadaveric specimens and received a pass/fail assessment. The 2 online assessments were analyzed for their internal reliability, external correlation with the pass/fail decision, and construct validity. The internal consistency of the perception of preparedness measure was high (α = .92) while the cognitive assessment was less strong (α = .65). Both instruments demonstrated moderately strong correlations with the pass/fail decision, with Spearman correlation of .606 (P = .000) and .617 (P = .000), respectively. Using logistic regression to analyze the predictive strength of each instrument, the perception of preparedness measure demonstrated a 76% probability (η(2) = .354) and the cognitive skills assessment a 73% probability (η(2) = .381) of correctly predicting the pass/fail decision. Analysis of variance modeling resulted in significant differences between levels at P < .005, supporting good construct validity. The online perception of preparedness measure and the cognitive skills assessment both are valid and reliable predictors of readiness to successfully pass a cadaveric motor skills test of carpal tunnel release surgery.

Effects of carbohydrate and caffeine ingestion on performance during a rugby union simulation protocol

In this study, we investigated the effect of ingesting carbohydrate alone or with caffeine on performance of a rugby union-specific shuttle running protocol. On three occasions, at least one week apart in a counterbalanced trial order, eight male rugby union forwards ingested either placebo or carbohydrate (1.2 g · kg−1 body mass · h−1) before and during a rugby union-specific protocol, with pre-exercise caffeine ingestion (4 mg · kg−1) before one of the carbohydrate trials (carbohydrate + caffeine). The intermittent exercise protocol included walking, jogging, and cruising at pre-determined intensities, simulated contact events, a sustained high-intensity test of speed and agility (Performance Test), and a 15-m sprint. Ratings of perceived exertion (RPE) were recorded every 5 min and a motor skills test was performed after each 21-min block. Performance Test times were not significantly different between trials but the likelihood of 2% improvements for carbohydrate + caffeine over placebo and carbohydrate were 98% and 44%, respectively. For carbohydrate + caffeine, 15-m sprints were faster than for placebo (P=0.05) and the motor skills test was performed faster in the carbohydrate + caffeine trial than the carbohydrate and placebo trials (P < 0.05), while RPE was lower in the carbohydrate + caffeine trial than the carbohydrate and placebo trials (P < 0.05). The results indicate a likely benefit to rugby performance following co-ingestion of carbohydrate and caffeine.

The Effects of a 4-Week After-School Program on Motor Skills and Fitness of Kindergarten and First-Grade Students

To examine the effects of an after-school NutriActive program on anthropometric measurements, motor skills, and fitness levels of young children. In this quasi-experimental study, anthropometric, motor skill, and fitness measurements were compared between intervention and control students at baseline, following a 4-week intervention, and after a summer break (4 months). Two intervention and two control microurban elementary schools. Forty-two intervention and 28 control kindergarten and first-grade students (50% boys, 82% Caucasian). A 4-week program consisted daily ofa morning walk and an after-school physical activity lesson with an emphasis on motor skill development, nutrition/health lesson, snack, and nonstructured active play. Body mass index, waist circumference, and fitness and motor skill levels. Repeated-measures analysis of variance, t-test, and stepwise regression. The intervention group scored significantly better on some fitness and all motor skill tests at 4 weeks. The improvements in fitness and skill levels ranged from 30% to 270%. At 4 months, differences between the groups diminished but remained significant, with better scores for the intervention group on some tests. Skill levels emerged as predictors of cardiovascular fitness at 4 months. Anthropometric measurements did not differ between the groups at any time point. A short, intense after-school program can produce significant, sustainable improvements in motor skill and fitness levels of young children.

Is prospective memory a dissociable cognitive function in HIV infection?

An emerging literature indicates that HIV infection is associated with deficits in prospective memory (ProM), or the ability to execute a future intention. This literature offers evidence of neurobiological dissociability of ProM from other cognitive abilities and its incremental ecological validity as a predictor of poorer everyday functioning outcomes (e.g., medication nonadherence). The present study evaluated the hypothesis that ProM represents a unique cognitive construct in HIV disease. A confirmatory 4-factor structural equation model was tested on data derived from 162 participants with HIV. The model posited that measures of ProM comprise a unique factor, apart from standard clinical tests of retrospective memory, executive functions, and motor skills. The fit of the model was evaluated using the Bollen–Stine bootstrap method and indicated that a 4-factor model with measures of ProM loading on a unique factor fit the data well, and better than a model with a single common factor hypothesized to drive cognitive performance. The results of this study lend further evidence to the dissociability of ProM in HIV infection, are consistent with prior studies in healthy adults, and contribute to a growing literature on the construct validity of ProM in HIV disease.

Childhood apraxia of speech and multiple phonological disorders in Cairo-Egyptian Arabic speaking children: Language, speech, and oro-motor differences

Childhood apraxia of speech is a neurological childhood speech-sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits. Children with childhood apraxia of speech and those with multiple phonological disorder share some common phonological errors that can be misleading in diagnosis. This study posed a question about a possible significant difference in language, speech and non-speech oral performances between children with childhood apraxia of speech, multiple phonological disorder and normal children that can be used for a differential diagnostic purpose. 30 pre-school children between the ages of 4 and 6 years served as participants. Each of these children represented one of 3 possible subject-groups: Group 1: multiple phonological disorder; Group 2: suspected cases of childhood apraxia of speech; Group 3: control group with no communication disorder. Assessment procedures included: parent interviews; testing of non-speech oral motor skills and testing of speech skills. Data showed that children with suspected childhood apraxia of speech showed significantly lower language score only in their expressive abilities. Non-speech tasks did not identify significant differences between childhood apraxia of speech and multiple phonological disorder groups except for those which required two sequential motor performances. In speech tasks, both consonant and vowel accuracy were significantly lower and inconsistent in childhood apraxia of speech group than in the multiple phonological disorder group. Syllable number, shape and sequence accuracy differed significantly in the childhood apraxia of speech group than the other two groups. In addition, children with childhood apraxia of speech showed greater difficulty in processing prosodic features indicating a clear need to address these variables for differential diagnosis and treatment of children with childhood apraxia of speech.

Dispositional reinvestment and skill failure in cognitive and motor tasks

Objective The objective of the study was to examine the moderating effect of dispositional reinvestment upon ‘choking’ in motor and cognitive tasks. Method Sixty-three university students (40 males, 23 females) completed low-complexity (peg-board) and high-complexity (golf putting) tests of motor skill, card sorting and working memory (modular arithmetic) under low-pressure and high-pressure conditions. Results Pressure had a deleterious effect on performance in the peg-board motor task, led to faster but more error-prone performance in the high-complexity card-sorting task, and led to more errors in the high-complexity modular arithmetic task. High reinvestment scale scores were significantly correlated with performance decrements from low to high-pressure conditions in both the peg-board and golf-putting tasks, and in both modular arithmetic tasks. Conversely, in the card-sorting tasks, higher reinvestment scores were associated with a speeding of performance from the low to high-pressure conditions. Discussion Our findings suggest that the association between reinvestment and choking extends beyond the motor skill domain to cognitive tasks, particularly those that place significant demands on working memory, and that this relationship is moderated by task complexity. The nature of the relationships between skill failure and sub-scales of the Reinvestment Scale, together with the extent to which these tap into explicit monitoring/conscious processing and distraction-based accounts of choking, is discussed.

The effect of month of birth on the attainments of primary and secondary school pupils

Previous research has produced conflicting results regarding the effects of season of birth and age-position on cognitive attainments. In Northern Ireland the school year divides the summer season into two providing an opportunity to evaluate the relative contribution of season of birth and age-position effects. To investigate the relationship between attainment in literacy skills and month of birth for primary and secondary school pupils and to determine the relationship between motor skills and month of birth in primary school pupils. One thousand one hundred and twenty four primary school pupils participated, and results for key stage 3 (KS3) English and GCSE English Language, for 3,493 Year 10 and 3,697 Year 12 secondary school pupils, respectively, were obtained. Primary school pupils were individually assessed using standardised reading and spelling tests, as well as tests of motor skill. They were also assessed using a standardised group reading test in their class groups. For the secondary school pupils, the results for two year cohorts, in KS3 English and GCSE English language, respectively, were analysed. For the primary school pupils there was evidence of both a season of birth and an age-position effect on all of the cognitive measures, particularly in the early years of schooling. There was, also, evidence of a significant age-position effect at both KS3 and GCSE in favour of the older pupils. For the younger primary school pupils there was evidence of significant age-position effects on both motor measures. The findings from the present study suggest that month of birth may be related to both season of birth and age-position effects. These effects may be compounded, particularly in the early years of primary school, when summer born children are youngest in their year, as in England. In Northern Ireland, age-position effects are also evident in secondary school public examination results, which may have implications for long-term life choices.

Effects of Food Form and Timing of Ingestion on Appetite and Energy Intake in Lean Young Adults and in Young Adults with Obesity

Objective Overweight and obesity have been attributed to increased eating frequency and the size of eating events. This study explored the influence of the timing of eating events and food form on appetite and daily energy intake. Design Crossover, clinical intervention where participants consumed 300-kcal loads of a solid (apple), semisolid (apple sauce), and beverage (apple juice) at a meal or 2 hours later (snack). Subjects Twenty normal-weight (body mass index 22.6±1.8) and 20 obese (body mass index 32.3±1.5) adults. There were 10 men and 10 women within each body mass index group. Measurements On six occasions, participants reported to the laboratory at their customary midday mealtime. Appetite questionnaires and motor skills tests were completed upon arrival and at 30-minute intervals for the 2 hours participants were in the laboratory and at 30-minute intervals for 4 hours after leaving the laboratory. Diet recalls were collected the next day. Data were collected between January 2006 and March 2007. Results Whether consumed with a meal or alone as a snack, the beverage elicited the weakest appetitive response, the solid food form elicited the strongest appetitive response and the semisolid response was intermediate. The appetite shift was greatest for the solid food when consumed as a snack. The interval between test food consumption and the first spontaneous eating event >100 kcal was shortest for the beverage. No significant treatment effects were observed for test day energy intake or between lean individuals and individuals with obesity. Conclusions Based on the appetitive findings, consumption of an energy-yielding beverage either with a meal or as a snack poses a greater risk for promoting positive energy than macronutrient-matched semisolid or solid foods consumed at these times.

Predictors of driving safety in early Alzheimer disease

To measure the association of cognition, visual perception, and motor function with driving safety in Alzheimer disease (AD). Forty drivers with probable early AD (mean Mini-Mental State Examination score 26.5) and 115 elderly drivers without neurologic disease underwent a battery of cognitive, visual, and motor tests, and drove a standardized 35-mile route in urban and rural settings in an instrumented vehicle. A composite cognitive score (COGSTAT) was calculated for each subject based on eight neuropsychological tests. Driving safety errors were noted and classified by a driving expert based on video review. Drivers with AD committed an average of 42.0 safety errors/drive (SD = 12.8), compared to an average of 33.2 (SD = 12.2) for drivers without AD (p < 0.0001); the most common errors were lane violations. Increased age was predictive of errors, with a mean of 2.3 more errors per drive observed for each 5-year age increment. After adjustment for age and gender, COGSTAT was a significant predictor of safety errors in subjects with AD, with a 4.1 increase in safety errors observed for a 1 SD decrease in cognitive function. Significant increases in safety errors were also found in subjects with AD with poorer scores on Benton Visual Retention Test, Complex Figure Test-Copy, Trail Making Subtest-A, and the Functional Reach Test. Drivers with Alzheimer disease (AD) exhibit a range of performance on tests of cognition, vision, and motor skills. Since these tests provide additional predictive value of driving performance beyond diagnosis alone, clinicians may use these tests to help predict whether a patient with AD can safely operate a motor vehicle.

ISSP position stand: To test or not to test? The use of physical skill tests in talent detection and in early phases of sport development

Searching for talent and the assessing ability in young prospects from individual and team sports often include measurement, analysis, and evaluation of physical and motor skills. The use of these tests in early stages of talent development has been widely observed in both female and male prospects. The purpose of this paper is to review a series of studies conducted on talented and less‐talented athletes/players that were aimed at distinguishing between the two groups and at predicting the athletes'/players’ future achievements/success. Thirteen studies examining the use of physical and motor skill tests in young prospects are reviewed. Based on this review, four main observations are highlighted and a number of benefits and limitations associated with the use of such tests are discussed. It is recommended that (1) coaches reduce the number of batteries of physical and motor skill tests used in early phases of talent development and (2) coaches and sport scientists specializing in measurement and evaluation cooperate in order to improve the effectiveness of the application and interpretation of physical skill tests given to prospects at early stages of talent development

Responsiveness of the Test of Basic Motor Skills of Children with Down Syndrome

The aim of this study was to examine the responsiveness of the Test of Basic Motor Skills for Children with Down Syndrome (BMS). Forty-one children with Down Syndrome, 3 to 36 months of age, participated in the study. Gross motor skills were assessed three times using the BMS and the Gross Motor Function Measure (GMFM) before and after a baseline period of 2 weeks (T1-T2) and after a period of 16 weeks (T2-T3). Internal and external responsiveness of the BMS was analyzed using Guyatt's Responsiveness Index (GRI) and 2 × 2 repeated measures. Change in BMS scores was compared to change in GMFM scores and parent and physiotherapist ratings of change. The responsiveness of the BMS was large (GRI = 2.55). A significant Time × Age interaction [F(1,37) = 8.87, p < .01] indicated that BMS scores increased more for children ≤ 2 years compared with children 2 to 3 years of age. The difference in GRI between the BMS and GMFM was 0.75 (95% CI −0.25–1.75), indicating that the BMS and GMFM did not significantly differ in responsiveness. The Time × Measure interaction was not significant, indicating that the increase in mean BMS and GMFM scores did not differ. Change in BMS scores were correlated with parent ratings of change (r = 0.65, p < .001) but not physiotherapist ratings (r = 0.36, p = .23). The results provide evidence that the BMS is responsive to change in gross motor development in children with Down Syndrome from 3 to 36 months of age.

スキルテストへの項目応答理論の適用（2）

This study investigated the applicability of item response theory to motor skill tests. In particular, we focused on the evaluation of children's motor skills using three Rasch models. Motor skill tests included the number of successes in a given trial, the number of successes in a given time, and a subjective rating regarding the form of the motor skill. We used Andrich's Binomial Trials Model, Rasch's Poisson Counts Model, and Masters' Partial Credit Model, respectively, to derive a synthesized motor skill ability using the item response theory from two or more motor skill test scores. A synthesized motor skill ability was computed by combining these three models and applying them to children's motor skill test items. The sample consisted of 205 kindergarten-aged children, and 8 motor skill items were tested, including (1) side jump, (2) jumping over a 30-cm high rope with hands on a board, (3) kicking and aiming a ball, (4) catching a ball, (5) rolling and aiming a ball, (6) forward roll, (7) side roll, and (8) jumping and turning 90 degrees until a complete 360-degree turn is completed. The following results were obtained:1) The correlational structure among motor skill test items for this sample had high homogeneity and was one-dimensional. High correlations were found between two sets of Difficulty Parameters, which were computed from two randomly divided subgroups. Obtained Difficulty Parameters were not affected by the sample used. 2) Significant correlations were found between synthesized ability parameters and age, standing height, and body weight, indicating that the motor skill ability parameters measured a latent motor skill, which developed with advancing age.3) A high correlation was found between synthesized motor skill ability and the Principal Component Scores computed by Principal Component Analysis. However, ability parameters showed lower correlations between motor skill test items and age and physique than Principal Component Scores. In contrast, high correlations between motor skill ability parameters and motor skill test items were found.Finally, the likelihoods for obtaining a synthesized motor skill parameter and an expected score for each test item were obtained, and an explanation for using these two values was provided.

MULTIDISCIPLINARY MEDICAL EVALUATION OF CHILDREN YOUNGER THAN 7.5 YEARS BORN AFTER PREIMPLANTATION GENETIC DIAGNOSIS FOR MONOGENIC DISEASES

INTRODUCTION: The growing cohort of children conceived after preimplantation genetic diagnosis (PGD) techniques underlines the importance of evaluating potential risks for their developmental outcome. There are some data concerning the incidence of congenital anomalies, medical status, and cognitive development of children conceived after PGD techniques, based mainly on reports and not on objective medical evaluation. OBJECTIVE: We sought to perform multidisciplinary evaluation (physical, genetic, and developmental) of 31 children conceived after PGD techniques (aged 30 days to 7.5 years) and the stress level of parents who used PGD regarding their parental role. METHODS: Among 24 couples at risk for transmitting monogenic diseases and with an unsuccessful reproductive history, 31 children conceived after PGD techniques were examined. Genetic examination was performed by 2 independent geneticists, and developmental assessment included formal testing of cognitive and motor skills (Bayley scales, Griffiths scales, Athina test). Parental stress was measured by using the Parent Stress Index-Short Form (PSI-SF), a self-report questionnaire that assesses parental stress. The PSI-SF was also completed by 35 parents of naturally conceived, healthy children matched for age, gender, and socioeconomic level. RESULTS: A high rate of cesarean deliveries were reported, but no higher risk was found for perinatal complications. The increased incidence of prematurity and low birth weight among children conceived after PGD techniques did not seem to affect their growth development later in life. Major malformations (cardiac, gastrointestinal, urogenital, skeletal) were present in 4 (12.9%) of 31 children, with a discrepancy between singletons and multiples. A significant number of children conceived after PGD techniques (6 of 31 [19%]), mostly multiple, premature, and small-for-gestational-age infants, experienced low levels of cognitive, verbal, and perceptual abilities (Global Development Quotient scores of &amp;lt;85). Parents who used PGD experienced lower levels of parenting stress compared with controls (P &amp;lt; .05). CONCLUSIONS: Children conceived after PGD techniques seem to be at greater risk for exhibiting congenital malformations and lower cognitive skills. Whether these observations are linked to the PGD procedure itself, rather than to subfertility, multiplicity, or prematurity, is a question that is difficult to answer. An unexpected finding was that once parents who used PGD finally had what they struggled for (a healthy infant), the stresses of parenthood may have been offset by a broader sense of fulfillment.

Hyperopia and Emergent Literacy of Young Children: Pilot Study

To compare emergent literacy skills in uncorrected hyperopic and emmetropic children. "Hyperopes" (>or=2.00 D sphere along the most hyperopic meridian; n=13; aged 67+/-13 mo) and "emmetropes" (<or=1.50 D sphere along the most hyperopic meridian; n=19; aged 58+/-12 mo) were tested for visual acuity (VA) and assessed for their emergent literacy skills [three standard tests (letter/word reading skills, receptive vocabulary and phonological awareness) and an experimental test of emergent orthography]. Parents completed a survey of family demographics, health/developmental concerns and home literacy experiences. Visual motor and visual perceptual skills tests were used to assess any visual cognitive differences. There were no differences in single letter VA for hyperopes and emmetropes and crowded letters for the right eye. Crowding effects were significantly greater in the left eye for hyperopes (t (30)=-2.74, p=0.01), with two of the hyperopes showing abnormal crowding. Hyperopes lagged behind emmetropes in letter and word recognition ability (Mann-Whitney U=72, p=0.049), receptive vocabulary (F(1,30)=9.64, p=0.004), and emergent orthography (F(1,29)=5.43, p=0.03). The groups did not differ in phonological awareness skills (F(1,29)=0.39, p=0.54). No statistically significant differences between the two groups were found for visual motor or visual perceptual skills, age, and some family variables known to contribute to emergent literacy skills. In this pilot study, uncorrected hyperopic children, ages 4 to 7 years, show reduced performance on tests of letter and word recognition, receptive vocabulary, and emergent orthography and crowded VA, despite no difference in phonological awareness skills, visual cognitive skills, and other family variables known to affect the acquisition of literacy skills. The relationship between hyperopia and the poorer progress in emergent literacy is complex, and it is not clear if the relationship is causal, and whether the hyperopes will catch up to the emmetropes with time.

Effects Of Caffeinated Sports Drinks On Physical/Mental Function During Team Sports Exercise

The ergogenic effects of caffeine ingestion (240–840 mg) on exercise performance is well established, albeit in some cases with negative side effects. However, recent evidence shows that much smaller doses can have beneficial effect on endurance performance as well as on mental function. Less is known about the possible synergistic effects of low dose of caffeine (CAF) and carbohydrate (CHO) feedings, especially as related to team sports performance. PURPOSE: To determine the effects of low dose (100 mg) CAF ingestion along with typically recommended CHO on physical and mental function during intermittent high intensity exercise that mimics the demands of competitive team sports. METHODS: Physically active male (N=6) and female (N=4) low to moderate caffeine users participated in this study. Experimental trials consisted of four ∼22-minute quarters (QTR) of shuttle running. Physical and mental function tests were administered throughout the experimental trial including (20-m sprint, vertical jump, gross motor skill test, force sensation, rating of perceived exertion, profile of mood states and psychomotor vigilance test).On four separate occasions, subjects received 20-oz of flavored water placebo (PLA), CHO, PLA+CAF and CHO+CAF prior to exercise. During exercise, subjects ingest PLA, CHO, PLA and CHO respectively (3.5 ml·kg-1). RESULTS: No difference was found in 20-m sprint time, vertical jump and gross motor skills performance between any treatments. However, both caffeine treatments (PLA+CAF and CHO+CAF) significantly improved psychomotor vigilance and reduced force sensation at HALFTIME (p<0.05). CHO+CAF also improved self-reported perception of fatigue, vigor and overall mood compared to PLA+CAF (p<0.05). Systolic blood pressure was increased with CHO+CAF compare to other three treatments. However, no difference was found in heart rate, core body temperature, plasma volume change, or hydration status between any treatments. CONCLUSION: The data suggest that ingestion of a low dose of caffeine prior to exercise did not add to the expected benefits of CHO feedings alone on physical tasks. However, all of the mental function tasks were significantly enhanced with the combination of CHO plus CAF, with little or no adverse side effects. Funded by Gatorade Sports Science Institute.

Neuropsychological deficits and functional impairment in bipolar depression, hypomania and euthymia

To examine whether patients with bipolar disorder (BD) have subtle neuropsychological deficits that manifest clinically as cognitive and functional compromise, and this study attempted to determine the pattern of such cognitive deficits and their functional impact across all three phases of BD. We hypothesised that euthymia does not equate with normal neuropsychological function and that each phase has a characteristic pattern of deficits, with disturbance in attention and memory being common across all phases of the illness: (i) bipolar depression - psychomotor slowing and impairment of memory; (ii) hypomania by frontal-executive deficits and (iii) euthymia - a mild disturbance of attention, memory and executive function. Twenty-five patients with a diagnosis of bipolar I disorder underwent neuropsychological testing over a period of 30 months in the natural course of their illness while hypomanic and/or depressed and/or euthymic. The results from these assessments were compared with findings from neuropsychological tests conducted on 25 healthy controls matched for age, sex, education and handedness. Initial analyses revealed modest impairment in executive functioning, memory and attention in both hypomanic and depressed bipolar patients, with additional fine motor skills impairment in the latter. Memory deficits, also noted in euthymic patients, were non-significant after controlling for confounding variables, although bipolar depressed patients remained significantly impaired on tests of verbal recall. Bipolar depressed and hypomanic patients differed with respect to the nature of their memory impairment. Depressed patients were more impaired as compared with euthymic patients on tests of verbal recall and fine motor skills. Psychosocial functioning was impaired across all three patient groups, but only in depressed and hypomanic patients did this correlate significantly with neuropsychological performance. The mood-state-related cognitive deficits in both bipolar depression and hypomania compromise psychosocial function when patients are unwell. In euthymic patients, subtle impairments in attention and memory suggest that an absence of symptoms does not necessarily equate to 'recovery'. The possibility of persistent cognitive deficits in BD is an issue of profound clinical and research interest that warrants further investigation; however, future research needs to adopt more sophisticated neuropsychological probes that are able to better define state and trait deficits and determine their functional impact.

Targeted reinnervation for enhanced prosthetic arm function in a woman with a proximal amputation: a case study

The function of current artificial arms is limited by inadequate control methods. We developed a technique that used nerve transfers to muscle to develop new electromyogram control signals and nerve transfers to skin, to provide a pathway for cutaneous sensory feedback to the missing hand. We did targeted reinnervation surgery on a woman with a left arm amputation at the humeral neck. The ulnar, median, musculocutaneous, and distal radial nerves were transferred to separate segments of her pectoral and serratus muscles. Two sensory nerves were cut and the distal ends were anastomosed to the ulnar and median nerves. After full recovery the patient was fit with a new prosthesis using the additional targeted muscle reinnervation sites. Functional testing was done and sensation in the reinnervated skin was quantified. The patient described the control as intuitive; she thought about using her hand or elbow and the prosthesis responded appropriately. Functional testing showed substantial improvement: mean scores in the blocks and box test increased from 4.0 (SD 1.0) with the conventional prosthesis to 15.6 (1.5) with the new prosthesis. Assessment of Motor and Process Skills test scores increased from 0.30 to 1.98 for motor skills and from 0.90 to 1.98 for process skills. The denervated anterior chest skin was reinnervated by both the ulnar and median nerves; the patient felt that her hand was being touched when this chest skin was touched, with near-normal thresholds in all sensory modalities. Targeted reinnervation improved prosthetic function and ease of use in this patient. Targeted sensory reinnervation provides a potential pathway for meaningful sensory feedback.

Effects of suggested motor program on developing basic motor skills of the students of second class in primary school

The research aimed at :- - Being aquatinted with the effects of using motor game program and the traditional physical education program in developing some basic motor skills of student second class in primary school . - Comparing between the results of pre and post tests of motor games program and traditional physical education program in developing some basic motor skills of student second class in primary school The research hypothesized the following :- - There are significant differences between the results of the students of both , post test and pre test , of basic motor skills for both groups . - There are significant difference between the posts tests of basic motor skills for both group . The experimental method was used because it suits the nurture of the research , the sample included ( 40 ) students of second in class primary schools and divided into two groups at random . The first was experimental which used the motor games programs on completion style basis ,while the second one applied the traditional physical program , the most basic motor skills was determined by a team of experts specialized in methodology of teaching and motor learning and processed by validity and stability . Sets of tools were used in the research , then equality between the two groups in some variables and tests of basic motor skills was achieved . The program conducted within ( 14 ) learning sessions lasted ( 7 ) weeks , with ( 2 ) sessions a week . The post test of both research groups was processed statistically by using ( mathematical mean , standard deviation and "t " test . The researchers concluded the following :- - The motor game program and the traditional physical education achieved a development in the basic motor skills . - The motor game program achieved development in comparison with the pre and post test . The researchers recommended the following :- - Using motor game program for primary school students for its active effects .

Neurocognitive profile in 22q11 deletion syndrome and schizophrenia

Objective Schizophrenia is associated with neurocognitive deficits, but its etiologic heterogeneity may complicate the delineation of a neurocognitive profile. Schizophrenia associated with 22q11 Deletion Syndrome (22qDS) represents a more genetically homogeneous subtype for study. We hypothesized that in adults with 22qDS the neurocognitive profiles would differ between those with and without schizophrenia. Method Using a comprehensive battery of tests, we compared the neurocognitive performance profiles in those with schizophrenia ( n = 27; 14 M, 13 F; mean age = 30.6 years, SD = 7.7 years) and those with no history of psychosis ( n = 29; 16 M, 13 F; mean age = 25.0 years, SD = 9.0 years). Results The 22qDS groups with and without schizophrenia had similar mean estimated IQ (71.6, SD = 8.2 and 74.8, SD = 6.1, respectively) and academic achievement, however the neurocognitive profiles of the two groups differed significantly on multivariate analysis ( F(24,31) = 2.25, p = 0.017). The group with schizophrenia performed significantly more poorly on tests of motor skills, verbal learning, and social cognition (effect sizes ≥ 0.8) after correction for multiple comparisons. Other tests, but not the attentional measures used, showed nominally significant differences. Conclusions In adults with 22qDS, the pattern of neurocognitive differences between those with and without schizophrenia appears similar to that between patients with schizophrenia and controls. Attentional dysfunction may be a more general feature of 22qDS. The findings support 22qDS-schizophrenia as a genetic model for neurodevelopmental investigations of schizophrenia.