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He Y, Zhang Q, Ma TT, Liang YH, Guo RR, Li XS, Liu QJ, Feng TY. Effect of repetitive transcranial magnetic stimulation-assisted training on lower limb motor function in children with hemiplegic cerebral palsy. BMC Pediatr 2024; 24:136. [PMID: 38383331 PMCID: PMC10882917 DOI: 10.1186/s12887-024-04605-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 01/30/2024] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVE To explore the effect of repetitive transcranial magnetic stimulation (rTMS)-assisted training on lower limb motor function in children with hemiplegic cerebral palsy (HCP). METHOD Thirty-one children with HCP who met the inclusion criteria were selected and randomly divided into a control group (n = 16) and an experimental group (n = 15). The control group received routine rehabilitation treatment for 30 min each time, twice a day, 5 days a week for 4 weeks. Based on the control group, the experimental group received rTMS for 20 min each time, once a day, 5 days a week for 4 weeks. The outcome measures included a 10-metre walk test (10MWT), a 6-minute walk distance (6MWD) test, D- and E-zone gross motor function measurements (GMFM), the symmetry ratio of the step length and stance time and the muscle tone of the triceps surae and the hamstrings (evaluated according to the modified Ashworth scale), which were obtained in both groups of children before and after treatment. RESULTS After training, the 10MWT (P < 0.05), 6MWD (P < 0.01), GMFM (P < 0.001) and the symmetry ratio of the step length and stance time of the two groups were significantly improved (P < 0.05), there was more of an improvement in the experimental group compared with the control group. There was no significant change in the muscle tone of the hamstrings between the two groups before and after treatment (P > 0.05). After treatment, the muscle tone of the triceps surae in the experimental group was significantly reduced (P < 0.05), but there was no significant change in the control group (P > 0.05). CONCLUSION Repetitive TMS-assisted training can improve lower limb motor function in children with HCP.
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Affiliation(s)
- Yan He
- Department of Paediatric Physiotherapy, China Rehabilitation Research Center, Beijing Bo'ai Hospital, No. 10 of Jiaomen North street, Fengtai District, Beijing, 100068, China
- Capital Medical University School of Rehabilitation Medicine, No. 10 of Jiaomen North Street, Fengtai District, Beijing, 100068, China
| | - Qi Zhang
- Department of Paediatric Physiotherapy, China Rehabilitation Research Center, Beijing Bo'ai Hospital, No. 10 of Jiaomen North street, Fengtai District, Beijing, 100068, China.
- Capital Medical University School of Rehabilitation Medicine, No. 10 of Jiaomen North Street, Fengtai District, Beijing, 100068, China.
| | - Ting-Ting Ma
- Department of Paediatric Physiotherapy, China Rehabilitation Research Center, Beijing Bo'ai Hospital, No. 10 of Jiaomen North street, Fengtai District, Beijing, 100068, China
- Capital Medical University School of Rehabilitation Medicine, No. 10 of Jiaomen North Street, Fengtai District, Beijing, 100068, China
| | - Yan-Hua Liang
- Department of Paediatric Physiotherapy, China Rehabilitation Research Center, Beijing Bo'ai Hospital, No. 10 of Jiaomen North street, Fengtai District, Beijing, 100068, China
- Capital Medical University School of Rehabilitation Medicine, No. 10 of Jiaomen North Street, Fengtai District, Beijing, 100068, China
| | - Rong-Rong Guo
- Department of Paediatric Physiotherapy, China Rehabilitation Research Center, Beijing Bo'ai Hospital, No. 10 of Jiaomen North street, Fengtai District, Beijing, 100068, China
| | - Xiao-Song Li
- Department of Paediatric Physiotherapy, China Rehabilitation Research Center, Beijing Bo'ai Hospital, No. 10 of Jiaomen North street, Fengtai District, Beijing, 100068, China
- Capital Medical University School of Rehabilitation Medicine, No. 10 of Jiaomen North Street, Fengtai District, Beijing, 100068, China
| | - Qian-Jin Liu
- Department of Paediatric Physiotherapy, China Rehabilitation Research Center, Beijing Bo'ai Hospital, No. 10 of Jiaomen North street, Fengtai District, Beijing, 100068, China
| | - Tian-Yang Feng
- Department of Paediatric Physiotherapy, China Rehabilitation Research Center, Beijing Bo'ai Hospital, No. 10 of Jiaomen North street, Fengtai District, Beijing, 100068, China
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Bieber E, Smits-Engelsman BCM, Sgandurra G, Martini G, Guzzetta A, Cioni G, Feys H, Klingels K. Insights on action observation and imitation abilities in children with Developmental Coordination Disorder and typically developing children. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 139:104556. [PMID: 37327576 DOI: 10.1016/j.ridd.2023.104556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Children with Developmental Coordination Disorder (DCD) face difficulties in motor learning. Action observation and imitation are strategies frequently used to teach motor skills. AIMS (1) To study action observation and imitation abilities in children with DCD compared with typically developing peers with a new protocol. (2) To gain insights in the relation between action observation, imitation, motor performance and activities of daily living (ADL). METHOD Twenty-one children with DCD (mean age 7 years 9 months, range 6-10 years) and 20 age-matched controls (mean age 7 years 8 months, range 6-10 years) were included. A newly developed protocol was used for testing action observation and imitation proficiency. Motor performance were evaluated with the Movement Assessment Battery for Children-2. ADL were investigated with DCD Questionnaire'07. RESULTS Children with DCD presented significantly lower action observation (p = .037) and imitation abilities (p < .001) than peers. Worse action observation and imitation abilities were related to lower motor performance and ADL skills and a younger age. Non-meaningful gestures imitation proficiency had predictive value for global motor performance (p = .009), manual dexterity (p = .02) and ADL (p = .004). CONCLUSIONS The new protocol for action observation and imitation abilities can be helpful for detecting motor learning difficulties and for delineating new opportunities for motor teaching approaches in children with DCD.
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Affiliation(s)
- Eleonora Bieber
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris,Pisa, Italy.
| | | | - Giuseppina Sgandurra
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris,Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Giada Martini
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris,Pisa, Italy
| | - Andrea Guzzetta
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris,Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris,Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Hilde Feys
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Tervuursevest 101, 3001 Heverlee, Belgium
| | - Katrijn Klingels
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Tervuursevest 101, 3001 Heverlee, Belgium; REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
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3
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Rodríguez-Costa I, Abuín-Porras V, Terán-García P, Férez-Sopeña A, Calvo-Fuente V, Soto-Vidal C, Pacheco-da-Costa S. Effectiveness of a Telecare Physical Therapy Program in Improving Functionality in Children and Adolescents with Cerebral Palsy: A Cases Study. CHILDREN 2023; 10:children10040663. [PMID: 37189912 DOI: 10.3390/children10040663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 03/26/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023]
Abstract
Cerebral palsy (CP) is the most common physical disability in childhood and results in motor impairment that is often associated with other disorders. The aim of this study was to assess whether a telecare intervention consisting of Action Observation Therapy with a family-center approach produces improvements in functionality in children and adolescents with CP. Seven girls with CP ages between 6 and 17 participated in this case series study that lasted 12 weeks: 6 weeks of telecare program with a total of six sessions; and a follow-up period of 6 weeks. The outcome variables were Gross Motor Function (Spanish version of the Gross Motor Function Measure), balance (Spanish version of the Pediatric Balance Scale), walking endurance (6-min walk test) and walking speed (10-m walk test). The variables were measured before starting the study, after 6 weeks of intervention and after the 6-week follow-up period. Results showed statistically significant improvements in gross motor function (p = 0.02) after the intervention. After the follow-up period, gross motor function remained statistically significant (p = 0.02), as well as balance (p = 0.04) and walking endurance (p = 0.02). These results show that a telecare program has been beneficial in improving functionality with enhancements in gross motor function, balance and endurance in children and adolescents with CP that will facilitate participation.
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Brauers L, Smeets R, Feys P, Gordon AM, Janssen-Potten Y, Ortibus E, Feys H, Rameckers E, Klingels K. Children With Cerebral Palsy Show Higher Static-But Not Higher Dynamic-Motor Fatigability in Grip and Pinch Tasks Than Children With Typical Development Do. Phys Ther 2023; 103:pzac155. [PMID: 37104625 PMCID: PMC10071583 DOI: 10.1093/ptj/pzac155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 06/16/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate differences in static and dynamic motor fatigability during grip and pinch tasks between children with unilateral spastic cerebral palsy (USCP) and children with typical development (TD) and between preferred and nonpreferred hands. METHODS Fifty-three children with USCP and 53 age-matched children with TD (mean = 11 years 1 month; SD = 3 years 8 months) participated in 30-second maximum exertion sustained and repeated grip and pinch tasks. For sustained tasks, the Static Fatigue Index and the ratio of mean force between the first and last thirds of the curve were calculated. For repeated tasks, the ratio of mean force and the ratio of numbers of peaks between the first and last thirds of the curve were calculated. RESULTS Higher Static Fatigue Index scores for grip and pinch were found with USCP in both hands and between hands in both groups. Dynamic motor fatigability showed inconsistent results, with higher levels of fatigability in children with TD than in children with USCP for grip in the ratio of mean force between the first and last thirds of the curve in nonpreferred hands and in the ratio of number of peaks between the first and last thirds of the curve in preferred hands. CONCLUSION Higher motor fatigability in children with USCP than in children with TD was found for static but not dynamic grip and pinch. Underlying mechanisms may play different roles in static and dynamic motor fatigability. IMPACT These results highlight that static motor fatigability in grip and pinch tasks should be part of a comprehensive upper limb assessment and that this could be the target of individualized interventions.
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Affiliation(s)
- Lieke Brauers
- REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands
| | - Rob Smeets
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands
| | - Peter Feys
- REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Andrew M Gordon
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Yvonne Janssen-Potten
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands
- Center of Expertise, Adelante Rehabilitation Center, Valkenburg, the Netherlands
| | - Els Ortibus
- Department of Development and Regeneration, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Hilde Feys
- Research Group for Neurorehabilitation, Department of Rehabilitation Sciences, KU Leuven, Belgium
| | - Eugene Rameckers
- REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands
- Center of Expertise, Adelante Rehabilitation Center, Valkenburg, the Netherlands
| | - Katrijn Klingels
- REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Research Group for Neurorehabilitation, Department of Rehabilitation Sciences, KU Leuven, Belgium
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Bono GLP, Achermann P, Rückriem B, Lieber J, van Hedel HJA. Goal-Directed Personalized Upper Limb Intensive Therapy (PULIT) for Children With Hemiparesis: A Retrospective Analysis. Am J Occup Ther 2022; 76:23966. [DOI: 10.5014/ajot.2022.049008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
Importance: Children with hemiparesis experience limitations in activities of daily living (ADLs) as a result of upper limb impairments. To address these limitations, we developed a group-based Personalized Upper Limb Intensive Therapy (PULIT) program combining modified constraint-induced movement therapy, bimanual intensive therapy, and exergame-based robotics.
Objective: To determine the effectiveness of PULIT in helping children with upper limb impairments achieve individually set goals and enable transfer of the attained motor skills into ADLs.
Design: Retrospective analysis.
Setting: Day camp at a pediatric rehabilitation clinic in Switzerland.
Participants: Twenty-three children with upper limb impairment (unilateral cerebral palsy, n = 16; acquired brain injury, n = 7); 13 boys and 10 girls (M age = 7 yr, 8 mo, SD = 2 yr, 1 mo; Manual Ability Classification System Level I–IV).
Intervention: Thirty hours of PULIT over the course of 8 days.
Outcomes and Measures: Goal attainment scaling (GAS) was assessed on the first and last day of intervention. The Canadian Occupational Performance Measure (COPM) and dexterity tests, such as the Box and Block Test (BBT), were administered 3 wk before and 3 wk after the intervention.
Results: Total goal achievement was 85.7%. GAS, parent- and child-rated COPM Performance and Satisfaction, and the BBT of the affected and dominant upper limb improved significantly.
Conclusions and Relevance: PULIT effectively increases children’s dexterity of the impaired and dominant upper limb, improves ADL performance, and achieves individual goals. This retrospective analysis could serve as a basis for a future randomized trial.
What This Article Adds: This article informs occupational therapy practitioners about a therapy program that includes conventional and rehabilitation technology interventions and enables children with hemiparesis of the upper limb to improve relevant ADL tasks in 8 days’ time.
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Affiliation(s)
- Géraldine L. P. Bono
- Géraldine L. P. Bono, MD, is Doctoral Candidate, Swiss Children’s Rehab, University Children’s Hospital Zurich, Affoltern am Albis, Switzerland, and Resident Physician, Department of Pediatrics, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Prisca Achermann
- Prisca Achermann, OT, is Occupational Therapist, Swiss Children’s Rehab, University Children’s Hospital Zurich, Affoltern am Albis, Switzerland
| | - Bärbel Rückriem
- Bärbel Rückriem, MScOT, is Head of Occupational Therapy, Swiss Children’s Rehab, University Children’s Hospital Zurich, Affoltern am Albis, Switzerland
| | - Jan Lieber
- Jan Lieber, MScOT, is Deputy Head of Occupational Therapy, Swiss Children’s Rehab, University Children’s Hospital Zurich, Affoltern am Albis, Switzerland
| | - Hubertus J. A. van Hedel
- Hubertus J. A. van Hedel, PhD, PT, is Head of Research, Swiss Children’s Rehab, University Children’s Hospital Zurich, Affoltern am Albis, Switzerland, and Professor of Neurorehabilitation, Children’s Research Center, University Children’s Hospital Zurich, University of Zurich, Zurich, Switzerland;
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Taghizadeh A, Webster KE, Bhopti A, Carey L, Hoare B. Are they really motor learning therapies? A scoping review of evidence-based, task-focused models of upper limb therapy for children with unilateral cerebral palsy. Disabil Rehabil 2022; 45:1536-1548. [PMID: 35468016 DOI: 10.1080/09638288.2022.2063414] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To identify the specific motor learning (ML) theories underpinning evidence-based, task-focused upper limb models of therapy for children with unilateral cerebral palsy; and to document the strategies used in the operationalisation of these theories. MATERIAL AND METHOD This scoping review searched for relevant studies using eight electronic databases. A list of 68 ML strategies and accompanying definitions was developed for data extraction. Three classifications; adequate, inadequate or not described were used to rate the description of ML strategies. A corresponding colour-coding system was used to provide a visual summary. RESULTS There is a limited description of the ML theories and strategies used to operationalise these theories in existing models of evidence-based upper limb therapy. Of 103 therapy protocols included, only 24 explicitly described the guiding ML theory. When described, there was significant variation in the underlying theories, leading to significantly different focus and content of therapy. Of the 68 ML strategies, only three were adequately described. CONCLUSIONS To support treatment fidelity and the implementation of evidence-based, task-focused models of upper limb therapy in clinical practice, future research needs to provide explicit details about the underlying theories and strategies used in the operationalisation of these theories.Implications for rehabilitationEvidence-based models of upper limb therapy purport to be based on motor learning theory, however, most provide a very limited description of the theories and strategies used.Dosage of practice is only one element that is specific to a therapy approach and other elements guided by the principles of type of task and type of feedback should be considered.To support the implementation of evidence-based approaches in clinical practice, and improve treatment fidelity, it is important for researchers to define the theories that guide therapy approaches and explicitly describe the strategies used to operationalise these theories.
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Affiliation(s)
- Atefeh Taghizadeh
- Department of Occupational Therapy, La Trobe University, Melbourne, Australia
| | - Kate E Webster
- Department of Occupational Therapy, La Trobe University, Melbourne, Australia
| | - Anoo Bhopti
- Department of Occupational Therapy, La Trobe University, Melbourne, Australia.,Department of Paediatrics, Monash University, Melbourne, Australia
| | - Leeanne Carey
- Department of Occupational Therapy, La Trobe University, Melbourne, Australia.,Neurorehabilitation and Recovery, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Brian Hoare
- Department of Occupational Therapy, La Trobe University, Melbourne, Australia.,Department of Paediatrics, Monash University, Melbourne, Australia
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McCall JV, Ludovice MC, Elliott C, Kamper DG. Hand function development of children with hemiplegic cerebral palsy: A scoping review. J Pediatr Rehabil Med 2022; 15:211-228. [PMID: 34864699 DOI: 10.3233/prm-200714] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Hemiplegic cerebral palsy (hCP) typically impacts sensorimotor control of the hand, but comprehensive assessments of the hands of children with hCP are relatively rare. This scoping review summarizes the development of hand function for children with hCP. METHODS This scoping review focused on the development of hand function in children with hCP. Electronic databases (PubMed, PEDro, Web of Science, CINAHL, and SpringerLink) were searched to identify studies assessing hand function in children with hCP. The search was performed using keywords (e.g., "hemiplegia"). An iterative approach verified by two authors was used to select the studies. Articles which reported quantitative data for children with hCP on any items of a specified set of hand evaluations were included. Measures were sorted into three categories: quantitative neuromechanics, clinical assessments, and clinical functional evaluations. RESULTS Initial searches returned 1536 articles, 131 of which were included in the final review. Trends between assessment scores and age were examined for both hands. CONCLUSION While several studies have evaluated hand function in children with hCP, the majority relied on clinical scales, assessments, or qualitative descriptions. Further assessments of kinematics, kinetics, and muscle activation patterns are needed to identify the underlying impairment mechanisms that should be targeted for treatment.
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Affiliation(s)
- James V McCall
- Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC, USA.,University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Miranda C Ludovice
- Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC, USA.,University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Catherine Elliott
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia.,Child and Adolescent Health Services, Perth Children's Hospital, Perth, Australia
| | - Derek G Kamper
- Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC, USA.,University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Wang Y, Yi H, Song Y. The safety of MSC therapy over the past 15 years: a meta-analysis. Stem Cell Res Ther 2021; 12:545. [PMID: 34663461 PMCID: PMC8522073 DOI: 10.1186/s13287-021-02609-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/25/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Despite increasing clinical investigations emphasizing the safety of mesenchymal stem cell (MSC) therapy in different populations with different diseases, no article has recently reviewed the adverse events in all populations. AIM To evaluate the safety of MSC therapy in all populations receiving MSC therapy and explore the potential heterogeneities influencing the clinical application of MSCs. METHODS The PubMed, Embase, Web of Science and Scopus databases were searched from onset until 1 March 2021. RESULTS All adverse events are displayed as odds ratios (ORs) and 95% CIs (confidential intervals). In total, 62 randomized clinical trials were included that enrolled 3546 participants diagnosed with various diseases (approximately 20 types of diseases) treated with intravenous or local implantation versus placebo or no treatment. All studies were of high quality, and neither serious publication bias nor serious adverse events (such as death and infection) were discovered across the included studies. The pooled analysis demonstrated that MSC administration was closely associated with transient fever (OR, 3.65, 95% CI 2.05-6.49, p < 0.01), administration site adverse events (OR, 1.98, 95% CI 1.01-3.87, p = 0.05), constipation (OR, 2.45, 95% CI 1.01-5.97, p = 0.05), fatigue (OR, 2.99, 95% CI 1.06-8.44, p = 0.04) and sleeplessness (OR, 5.90, 95% CI 1.04-33.47, p = 0.05). Interestingly, MSC administration trended towards lowering rather than boosting the incidence rate of arrhythmia (OR, 0.62, 95% CI 0.36-1.07, p = 0.09). CONCLUSIONS Conclusively, MSC administration was safe in different populations compared with other placebo modalities.
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Affiliation(s)
- Yang Wang
- Department of Orthopedics, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangdong Pharmaceutical University, No. 19 Nonglinxia Road, Yuexiu District, Guangzhou, Guangdong Province China
| | - Hanxiao Yi
- Department of Radiotherapy, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 600 Tianhe Road, Tianhe District, Guangzhou, Guangdong Province China
| | - Yancheng Song
- Department of Orthopedics, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangdong Pharmaceutical University, No. 19 Nonglinxia Road, Yuexiu District, Guangzhou, Guangdong Province China
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Test-retest reliability of static and dynamic motor fatigability protocols using grip and pinch strength in typically developing children. Eur J Pediatr 2021; 180:2505-2512. [PMID: 33876265 DOI: 10.1007/s00431-021-04033-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 03/10/2021] [Accepted: 03/12/2021] [Indexed: 10/21/2022]
Abstract
Upper limb motor fatigability is an important debilitating factor for activities of daily living in clinical pediatric populations. However, the reliability of fatigability protocols in these populations is currently unknown. Therefore, the current study investigates test-retest reliability of a static and dynamic motor fatigability protocol for grip and pinch strength in typically developing children (TDC). Eighty-nine TDC (35 boys, 54 girls; mean age 10 years 11 months) used a grip and pinch dynamometer for static (sustained) and dynamic (repeated) contractions during 30s. For static motor fatigability (SFI), mean (Fmean) and SD (Fvar) of force were calculated, and for dynamic motor fatigability, F mean and number of peaks (Npeaks) were calculated. Intraclass correlation coefficients (ICC) were calculated. ICCs of F mean in static and dynamic motor fatigability were high (ICC: 0.94-0.96 and 0.91-0.98). ICCs were moderate to high for F var (ICC: 0.67-0.85). The SFI showed moderate ICCs (ICC: 0.69-0.77). ICCs were moderate to high for N peaks (ICC: 0.78-0.91).Conclusion: The results suggest that static and dynamic motor fatigability in for grip and pinch can be used reliably in TD children aged 6-18 years. What is Known: •Psychometric properties of motor fatigability protocols using grip and pinch in children are lacking. •Motor fatigability in grip and pinch is an important debilitating symptom in multiple neurologic populations. What is New: •Static fatigability can be investigated using a 30-s maximum sustained grip strength protocol in children. •Dynamic fatigability can be investigated using a 30-s maximum repeated grip strength protocol in children.
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Wu F, Wang X, Li X, Jiang H, Huang T, Liu C, Wang M, Zhai Z, Zhang X, Zhang J, Liu H, Yang J. The Most Cited Original Articles in Brain Imaging of Children With Cerebral Palsy: A Bibliometric Analysis Between 1984 and 2019. Front Neurol 2020; 11:955. [PMID: 33013636 PMCID: PMC7508001 DOI: 10.3389/fneur.2020.00955] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 07/23/2020] [Indexed: 12/23/2022] Open
Abstract
Objective: Brain imaging is important in diagnosing children with cerebral palsy (CP) and in identifying its etiology. To provide study navigation in this field, a bibliometric analysis was conducted by analyzing the most highly cited articles. Methods: The Web of Science All Databases were used for literature search in this study. All original articles on imaging in children with CP were searched. Two reviewers screened the search results independently and eliminated articles based on exclusion criteria such as participants over 20 years old, topics referring to images outside of the brain, or trauma. According to descending order of yearly citation counts, the top 25% of all included articles were considered as highly cited articles. Information such as yearly citations, research purposes, imaging modalities, CP types, and study designs were recorded and analyzed. Results: A total of 50 highly cited articles ranked by yearly citations (from 23.85 to 3.33, 1991–2018) were included in this study. Considering different research purposes, these studies were classified into three categories: diagnosis studies (n = 25; 1991–2017, median: 2011), mechanism studies (n = 15; 1999–2018; median: 2014), and prognosis and therapeutic effect studies (n = 10; 2008–2017; median: 2014.5). First, for diagnosis studies, 22 studies used single modality and three used multi-modalities; the majority of these studies focused on diagnostic value evaluation (n = 10) and image performance (n = 12) of a single type of CP (n = 15) by using descriptive (n = 14) or cross-sectional approaches (n = 10). Second, for mechanism studies, the ratio between single and multi-modality was 8:7; most of these studies concentrated on a single subtype of spastic CP (hemiplegia = 10, quadriplegia = 2) with a cross-sectional study design (n = 10). Third, regarding the prognosis and therapeutic effect studies, the single vs. multi-modality ratio was 5:5, and these studies were dedicated to the efficiency of constraint-induced movement therapy in children with hemiplegia; paired design trials (n = 6) and randomized controlled trials (n = 2) were used more frequently. Conclusion: Studies using multi-modality and high-level evidence-based design to provide information regarding mechanism, prognosis, and therapeutic efficacy may be the potential future research direction in the field of CP research.
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Affiliation(s)
- Fan Wu
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Radiology, Guangzhou Women and Children's Medical Center, Affiliated Guangzhou Medical University, Guangzhou, China
| | - Xiaoyu Wang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xianjun Li
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Haoxiang Jiang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Tingting Huang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Radiology, The First Affiliated Hospital of Henan University of TCM, Zhengzhou, China
| | - Congcong Liu
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Miaomiao Wang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | | | | | - Jingjing Zhang
- Department of Radiology, Medical Imaging Center of Guizhou Province, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Heng Liu
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Radiology, Medical Imaging Center of Guizhou Province, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Jian Yang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
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11
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Simon-Martinez C, Mailleux L, Jaspers E, Ortibus E, Desloovere K, Klingels K, Feys H. Effects of combining constraint-induced movement therapy and action-observation training on upper limb kinematics in children with unilateral cerebral palsy: a randomized controlled trial. Sci Rep 2020; 10:10421. [PMID: 32591590 PMCID: PMC7320002 DOI: 10.1038/s41598-020-67427-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 05/26/2020] [Indexed: 11/15/2022] Open
Abstract
Modified constraint-induced movement therapy (mCIMT) improves upper limb (UL) motor execution in unilateral cerebral palsy (uCP). As these children also show motor planning deficits, action-observation training (AOT) might be of additional value. Here, we investigated the combined value of AOT to mCIMT on UL kinematics in children with uCP in a randomized controlled trial. Thirty-six children with uCP completed an UL kinematic and clinical evaluation after participating in a 9-day mCIMT camp wearing a splint for 6 h/day. The experimental group (mCIMT + AOT, n = 20) received 15 h of AOT, i.e. video-observation and execution of unimanual tasks. The control group (mCIMT + placebo, n = 16) watched biological-motion free videos and executed the same tasks. We examined changes in motor control (movement duration, peak velocity, time-to-peak velocity, and trajectory straightness) and kinematic movement patterns (using Statistical Parametric Mapping) during the execution of three unimanual, relevant tasks before the intervention, after and at 6 months follow-up. Adding AOT to mCIMT mainly affected movement duration during reaching, whereas little benefit is seen on UL movement patterns. mCIMT, with or without AOT, improved peak velocity and trajectory straightness, and proximal movement patterns. Clinical and kinematic improvements are poorly related. Although there seem to be limited benefits of AOT to CIMT on UL kinematics, our results support the inclusion of kinematics to capture changes in motor control and movement patterns of the proximal joints.
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Affiliation(s)
- Cristina Simon-Martinez
- Department of Rehabilitation Sciences, KU Leuven, 3000, Leuven, Belgium. .,Information Systems Institute, University of Applied Sciences Western Switzerland (HES-SO Valais), Sierre, Switzerland.
| | - Lisa Mailleux
- Department of Rehabilitation Sciences, KU Leuven, 3000, Leuven, Belgium
| | - Ellen Jaspers
- Neural Control of Movement Lab, ETH Zurich, Zurich, Switzerland
| | - Els Ortibus
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Kaat Desloovere
- Department of Rehabilitation Sciences, KU Leuven, 3000, Leuven, Belgium.,Clinical Motion Analysis Laboratory, University Hospitals Leuven, Leuven, Belgium
| | - Katrijn Klingels
- Department of Rehabilitation Sciences, KU Leuven, 3000, Leuven, Belgium.,Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Hilde Feys
- Department of Rehabilitation Sciences, KU Leuven, 3000, Leuven, Belgium
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12
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Jeong YA, Lee BH. Effect of Action Observation Training on Spasticity, Gross Motor Function, and Balance in Children with Diplegia Cerebral Palsy. CHILDREN-BASEL 2020; 7:children7060064. [PMID: 32570855 PMCID: PMC7346110 DOI: 10.3390/children7060064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/25/2020] [Accepted: 06/16/2020] [Indexed: 11/24/2022]
Abstract
This study evaluated the effect of action observation training on spasticity, gross motor function, and balance in children with spastic diplegia cerebral palsy. Eighteen children with cerebral palsy participated in this study. The participants were randomized into the action observation training group (n = 9) and a control group (n = 9). The action observation training group repeatedly practiced the action with their motor skills, while the control group practiced conventional physical therapy. Both groups received 30 min sessions, 3 days a week, for 6 weeks. To confirm the effects of intervention, the spasticity, gross motor function measurement (GMFM), and pediatric reaching test (PRT) were evaluated. The results showed that in the plantar flexor contracture test of both sides, the Modified Tardieu Scale (MTS) of the right side of knee joints, GMFM-B, C, and D were significantly increased between pre- and post-intervention within both groups (p < 0.05). PRT was significantly increased between pre- and post-intervention within the both groups (p < 0.05), and there was a significant difference between the two groups (p < 0.05). These results suggest that action observation training is both feasible and beneficial for improving spasticity, gross motor function, and balance in children with spastic diplegia cerebral palsy.
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Affiliation(s)
- Young-a Jeong
- Graduate School of Physical Therapy, Sahmyook University, 01795 Seoul, Korea;
| | - Byoung-Hee Lee
- Department of Physical Therapy, Sahmyook University, 01795 Seoul, Korea
- Correspondence: ; Tel.: +82-2-3399-1634
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13
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Simon-Martinez C, Mailleux L, Hoskens J, Ortibus E, Jaspers E, Wenderoth N, Sgandurra G, Cioni G, Molenaers G, Klingels K, Feys H. Randomized controlled trial combining constraint-induced movement therapy and action-observation training in unilateral cerebral palsy: clinical effects and influencing factors of treatment response. Ther Adv Neurol Disord 2020; 13:1756286419898065. [PMID: 32031542 PMCID: PMC6977217 DOI: 10.1177/1756286419898065] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 12/09/2019] [Indexed: 01/21/2023] Open
Abstract
Introduction: Constraint-induced movement therapy (CIMT) improves upper limb (UL) motor
execution in unilateral cerebral palsy (uCP). As these children also show
motor planning deficits, action-observation training (AOT) might be of
additional value. Here, we investigated the combined effect of AOT to CIMT
and identified factors influencing treatment response. Methods: A total of 44 children with uCP (mean 9 years 6 months, SD 1 year 10 months)
participated in a 9-day camp wearing a splint for 6 h/day and were allocated
to the CIMT + AOT (n = 22) and the CIMT + placebo group
(n = 22). The CIMT + AOT group received 15 h of AOT
(i.e. video-observation) and executed the observed tasks, whilst the
CIMT + AOT group watched videos free of biological motion and executed the
same tasks. The primary outcome measure was bimanual performance. Secondary
outcomes included measures of body function and activity level assessed
before (T1), after the intervention (T2), and at 6 months follow-up (T3).
Influencing factors included behavioural and neurological
characteristics. Results: Although no between-groups differences were found
(p > 0.05; η2 = 0–16), the addition of AOT
led to higher gains in children with initially poorer bimanual performance
(p = 0.02; η2 = 0.14). Both groups improved
in all outcome measures after the intervention and retained the gains at
follow up (p < 0.01; η2 = 0.02–0.71). Poor
sensory function resulted in larger improvements in the total group
(p = 0.03; η2 = 0.25) and high amounts of
mirror movements tended to result in a better response to the additional AOT
training (p = 0.06; η2 = 0.18). Improvements
were similar irrespective of the type of brain lesion or corticospinal tract
wiring pattern. Conclusions: Adding AOT to CIMT, resulted in a better outcome for children with poor motor
function and high amounts of mirror movements. CIMT with or without AOT
seems to be more beneficial for children with poor sensory function. Trial registration: Registered at ClinicalTrials.gov on 22nd August 2017 (ClinicalTrials.gov
identifier: NCT03256357).
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Affiliation(s)
- Cristina Simon-Martinez
- KU Leuven, Department of Rehabilitation Sciences, Herestraat 49, bus 1510, Leuven, 3000, Belgium
| | - Lisa Mailleux
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Jasmine Hoskens
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Els Ortibus
- KU Leuven, Department of Development and Regeneration, Leuven, Belgium
| | - Ellen Jaspers
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Switzerland
| | - Nicole Wenderoth
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Switzerland
| | - Giuseppina Sgandurra
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Calambrone, Italy
| | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Calambrone, Italy
| | - Guy Molenaers
- KU Leuven, Department of Development and Regeneration, Leuven, Belgium
| | - Katrijn Klingels
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Hilde Feys
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
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14
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Simon-Martinez C, Jaspers E, Alaerts K, Ortibus E, Balsters J, Mailleux L, Blommaert J, Sleurs C, Klingels K, Amant F, Uyttebroeck A, Wenderoth N, Feys H. Influence of the corticospinal tract wiring pattern on sensorimotor functional connectivity and clinical correlates of upper limb function in unilateral cerebral palsy. Sci Rep 2019; 9:8230. [PMID: 31160679 PMCID: PMC6547689 DOI: 10.1038/s41598-019-44728-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 05/21/2019] [Indexed: 12/02/2022] Open
Abstract
In children with unilateral cerebral palsy (uCP), the corticospinal tract (CST)-wiring patterns may differ (contralateral, ipsilateral or bilateral), partially determining motor deficits. However, the impact of such CST-wiring on functional connectivity remains unknown. Here, we explored resting-state sensorimotor functional connectivity in 26 uCP with periventricular white matter lesions (mean age (standard deviation): 12.87 m (±4.5), CST wiring: 9 contralateral, 9 ipsilateral, 6 bilateral) compared to 60 healthy controls (mean age (standard deviation): 14.54 (±4.8)), and between CST-wiring patterns. Functional connectivity from each M1 to three bilateral sensorimotor regions of interest (primary sensory cortex, dorsal and ventral premotor cortex) and the supplementary motor area was compared between groups (controls vs. uCP; and controls vs. each CST-wiring group). Seed-to-voxel analyses from bilateral M1 were compared between groups. Additionally, relations with upper limb motor deficits were explored. Aberrant sensorimotor functional connectivity seemed to be CST-dependent rather than specific from all the uCP population: in the dominant hemisphere, the contralateral CST group showed increased connectivity between M1 and premotor cortices, whereas the bilateral CST group showed higher connectivity between M1 and somatosensory association areas. These results suggest that functional connectivity of the sensorimotor network is CST-wiring-dependent, although the impact on upper limb function remains unclear.
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Affiliation(s)
| | - Ellen Jaspers
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH, Zurich, Switzerland
| | - Kaat Alaerts
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | - Els Ortibus
- KU Leuven Department of Development and Regeneration, Leuven, Belgium
| | - Joshua Balsters
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH, Zurich, Switzerland.,Department of Psychology, Royal Holloway University of London, Egham, United Kingdom
| | - Lisa Mailleux
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | | | | | - Katrijn Klingels
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.,Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Frédéric Amant
- KU Leuven Department of Oncology, Leuven, Belgium.,Centre for Gynaecologic Oncology, Antoni van Leeuwenhoek, Amsterdam, Netherlands.,Centre for Gynaecologic Oncology, Amsterdam University Medical Centres, Amsterdam, Netherlands
| | | | - Nicole Wenderoth
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH, Zurich, Switzerland
| | - Hilde Feys
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
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15
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Leite HR, Camargos ACR, Mendonça VA, Lacerda ACR, Soares BA, Oliveira VC. Current evidence does not support whole body vibration in clinical practice in children and adolescents with disabilities: a systematic review of randomized controlled trial. Braz J Phys Ther 2018; 23:196-211. [PMID: 30245042 DOI: 10.1016/j.bjpt.2018.09.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 09/04/2018] [Accepted: 09/06/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Whole body vibration has been used alone or combined with other interventions in rehabilitation of children and adolescents with disabilities; however, there is limited evidence to support this approach. OBJECTIVES To review the strength, quality, and conclusiveness of evidence supporting the use of whole body vibration in children and adolescents with disabilities. METHODS Electronic database search included Medline, AMED, Embase, Cochrane, SportDiscus, CINAHL and PEDro from the inception to June 2018. Studies investigating the effects of whole body vibration, alone or combined with other interventions, compared to minimal intervention or other interventions were included. The outcomes measured were: body structure and function (lean body mass, bone mineral density, knee muscle strength and overall stability) and activity and participation (gait speed, walking distance, gross motor function, self-care and mobility). RESULTS Fifteen randomized trials involving 403 participants were included. Methodological quality of eligible trials was moderate (mean of 5.5 points on the 10-point PEDro scale). Overall, whole body vibration was no better than minimal intervention. In all comparisons where additional effect of whole body vibration was better than other interventions, the effect size ranged from low to high in the trials, but ranged from very-low to low quality at short and medium-term follow-up. Sensitivity analysis for health condition and low-quality studies showed impact on trunk bone mineral density of additional effect of whole body vibration at medium-term compared to other interventions. CONCLUSION The low to very-low quality of evidence suggests caution in recommending the use of this approach. New studies could change the findings of this review. PROSPERO registration: CRD42017060704.
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Affiliation(s)
- Hércules Ribeiro Leite
- Discipline of Physical Therapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil.
| | | | - Vanessa Amaral Mendonça
- Discipline of Physical Therapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Discipline of Physical Therapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil
| | - Bruno Alvarenga Soares
- Discipline of Physical Therapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil
| | - Vinicius Cunha Oliveira
- Discipline of Physical Therapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil
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