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Bittencourt de Oliveira P, Pessóta Sudati I, Lima Gonçalves LG, de Campos AC. Physical Therapy Services During COVID-19 Pandemic: Perception of Families of Brazilian Children With Physical Disabilities. Pediatr Phys Ther 2024; 36:217-223. [PMID: 38568269 DOI: 10.1097/pep.0000000000001089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
PURPOSE To describe the perspective of caregivers about physical therapy (PT) during the COVID-19 pandemic and the effect of social distancing on the health of children with physical disabilities. METHODS This survey research used a remote questionnaire to identify the perceptions of caregivers about the effect of the COVID-19 pandemic on the health of children and adolescents with physical disabilities and on PT services. Data were analyzed using the frequency of responses; open-ended questions were analyzed through a hybrid approach to thematic analysis. RESULTS Caregivers of 47 children with cerebral palsy were included. Although most received regular PT services during the pandemic, worsened children's physical conditions and anxiety were prevalent. Caregivers believed that they lacked technical skills. CONCLUSIONS Social distancing impacted the health of children with physical disabilities, especially their physical conditions. Identifying facilitators and barriers for PT services can be helpful in future similar scenarios.Video abstract Supplemental Digital Content available at:http://links.lww.com/PPT/A503.
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Alves MLDF, Souto DO, Romeros ACSF, Magalhães EDD, Mendes LG, Ayupe KMA, Chagas PSDC, de Campos AC, Moreira RS, de Toledo AM, Camargos ACR, Longo E, Leite HR, Morais RLDS. Characterization of environmental factors in children and adolescents with cerebral palsy in Minas Gerais: Participa Minas. Rev Paul Pediatr 2024; 42:e2023043. [PMID: 38359317 PMCID: PMC10877669 DOI: 10.1590/1984-0462/2024/42/2023043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/03/2023] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To characterize the environmental factors of children and adolescents with Cerebral Palsy (CP) in the state of Minas Gerais (MG), Brazil. METHODS This is a cross-sectional study involving 164 caregivers of children/adolescents with CP, aged 1-14 years. The Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS) were used to classify the participants' functioning, and environmental factors were evaluated by an on-line questionnaire that examined products and technologies, physical environment, services, and systems. A descriptive analysis was performed using percentage and frequency. RESULTS Most participants had bilateral CP (66.9%) and 45% of them were spastic. Levels II and V of the GMFCS and MACS were the most frequent. About half (49.4%) used anticonvulsants, 27.4% underwent botulinum toxin application, and 29% went through orthopedic surgery in the lower limbs. Among the participants, 71.3% used orthoses in the lower limbs, and 51.8% used the public health care system. Most had access to physiotherapy (91.5%), but found difficulties to access interventions with other professionals, such as psychologists (28%) and nutritionists (37.8%). The school was the most frequently adapted environment (78%), and had the highest level of structural adaptation (42.7%). CONCLUSIONS The results of this study suggest that the barriers to access health services and barriers to the physical environment may impact participation and social inclusion.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Egmar Longo
- Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil
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Felix JB, de Campos AC, Logan SW, Machado J, Souza Monteiro K, Longo E. Go Zika Go: feasibility study with modified motorized ride-on cars for the mobility of children with Congenital Zika Syndrome (CZS). Disabil Rehabil Assist Technol 2024:1-14. [PMID: 38166551 DOI: 10.1080/17483107.2023.2300052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/21/2023] [Indexed: 01/04/2024]
Abstract
PURPOSE To explore the feasibility of an intervention using modified ride-on cars in terms of acceptability and potential changes in goal attainment, mobility, social function, and participation of children with Congenital Zika Syndrome (CZS). MATERIALS AND METHODS A pre- and post-intervention feasibility study was conducted with children with CZS, levels IV and V of the Gross Motor Function Classification System (GMFCS). The intervention consisted of 12 weeks of training (3 times a week for 40 min per session) and 4 weeks of follow-up. The primary outcomes included adherence, satisfaction, and learning in mobility. Secondary outcomes encompassed goal attainment, mobility, social/cognitive function, and participation. Descriptive statistics were performed. To explore potential individual changes with the intervention, Wilcoxon test was used to analyze Pediatric Evaluation of Disability Inventory - Computer Adaptive Test (PEDI-CAT) data and Young Children's Participation and Environment Measure (YC-PEM)/Participation and Environment Measure for Children and Youth (PEM-CY), along with standard error measurements of the PEDI-CAT domains. RESULTS Four children participated (median age 4.75 years; two females: three at level V on the GMFCS). Adherence was 75% of the total intervention time, and family members reported being satisfied or very satisfied. Children showed gains in learning the use of the modified ride-on cars and an increase in goal attainment after the intervention. Individual changes were observed in the PEDI-CAT domains (mobility and social/cognitive), but there were no significant changes in participation outcomes. CONCLUSIONS Children with CZS at GMFCS levels IV and V can learn to use motorized ride-on cars, attainment goals, and experience satisfaction.
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Affiliation(s)
- Jean Bendito Felix
- Postgraduate Program in Rehabilitation Sciences, University of Rio Grande do Norte/Faculty of Health Sciences of Trairi, Santa Cruz, Brazil
| | | | - Samuel W Logan
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Julianne Machado
- Postgraduate Program in Rehabilitation Sciences, University of Rio Grande do Norte/Faculty of Health Sciences of Trairi, Santa Cruz, Brazil
| | - Karoline Souza Monteiro
- Postgraduate Program in Rehabilitation Sciences, University of Rio Grande do Norte/Faculty of Health Sciences of Trairi, Santa Cruz, Brazil
| | - Egmar Longo
- Postgraduate Program in Rehabilitation Sciences, University of Rio Grande do Norte/Faculty of Health Sciences of Trairi, Santa Cruz, Brazil
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de Campos AC, Hidalgo-Robles Á, Longo E, Shrader C, Paleg G. F-words e ingredientes de las intervenciones tempranas dirigidas a niños no ambulantes con parálisis cerebral: Una revisión exploratoria. Dev Med Child Neurol 2024; 66:e1-e11. [PMID: 37491808 DOI: 10.1111/dmcn.15716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
La atención centrada en la familia (incluyendo coaching e intervenciones realizadas por los cuidadores) y el entrenamiento formal de los padres son estrategias efectivas para los niños con niveles IV y V de la GMFCS. Los ingredientes de la tecnología de apoyo pueden promover varias "F-words" (funcionamiento, estado físico, familia, diversión, amigos y futuro). Se encontró el nivel más bajo de evidencia para diversión, amigos y futuro. Otros factores (provisión de servicios, formación profesional, dosis de terapia, modificaciones del entorno) son relevantes para los niños pequeños con niveles IV y V de la GMFCS. Ingredientes de la intervención y F-words en intervenciones tempranas dirigidas a niños no ambulantes con parálisis cerebral.
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Affiliation(s)
- Ana Carolina de Campos
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, -SP, Brazil
| | | | - Egmar Longo
- Department of Physical therapy in Pediatrics, Federal University of Paraíba, João Pessoa, -PB, Brazil
| | - Claire Shrader
- HMS School for Children with Cerebral Palsy, Philadelphia, PA, USA
| | - Ginny Paleg
- Montgomery County Infants and Toddlers Program, Rockville, MD, USA
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Ayupe KMA, Dias IMBC, Cazeiro APM, de Campos AC, Longo E. Rehabilitation Practices Delivered by Physical and Occupational Therapists to Brazilian Children With Congenital Zika Syndrome: A Cross-Sectional Study. Glob Health Sci Pract 2023; 11:e2300219. [PMID: 38123996 PMCID: PMC10749651 DOI: 10.9745/ghsp-d-23-00219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Congenital Zika syndrome (CZS) is a health condition that has affected the development of thousands of children in Brazil. Because it is a new condition, its understanding is an ongoing process. Therefore, it is important to know the rehabilitation interventions being delivered to improve the functioning of these children. We aimed to describe the practices of physical therapists (PTs) and occupational therapists (OTs) who provide follow-up care for children with CZS in Brazil. METHODS This cross-sectional study included PTs and OTs who assist children with CZS in Brazil. An online questionnaire was used to verify the participants' personal characteristics and professional work environment, as well as the rehabilitation programs they implemented in Brazil for children with CZS. Data were analyzed using descriptive statistics. RESULTS A total of 116 professionals (79 PT and 37 OT) who work mainly in public health services (81.9%) participated in the study. Of these, 24.1% plan interventions based on reading scientific articles, 66.4% did not report using the biopsychosocial model, 52.6% do not perform any assessments before starting an intervention, 31.9% use neurodevelopmental treatment, and 22.4% use sensorimotor stimulation interventions. The majority of the interventions are delivered 1 to 2 times a week, lasting up to 1 hour. CONCLUSIONS Professional training and knowledge translation strategies are needed to implement evidence-based practices and improve the quality of rehabilitation programs for Brazilian children with CZS.
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Affiliation(s)
- Kennea Martins Almeida Ayupe
- Department of Integrated Health Education, Center for Health Sciences, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil.
| | - Ianka Maria Bezerra Cunha Dias
- Postgraduate Program in Rehabilitation Sciences, Universidade Federal do Rio Grande do Norte, Faculty of Health Sciences of Trairi, Santa Cruz, Rio Grande do Norte, Brazil
| | | | - Ana Carolina de Campos
- Postgraduate Program in Physical Therapy, Universidade Federal do São Carlos, São Carlos, São Paulo, Brazil
| | - Egmar Longo
- Postgraduate Program in Rehabilitation Sciences, Universidade Federal do Rio Grande do Norte, Faculty of Health Sciences of Trairi, Santa Cruz, Rio Grande do Norte, Brazil
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Sudati IP, Monteiro RFL, Nasser AB, Rocha NACF, de Campos AC. Telehealth in paediatric physical therapy education: Strategies and perceptions of interns and caregivers of children with disabilities in Brazil. Clin Teach 2023:e13653. [PMID: 37679054 DOI: 10.1111/tct.13653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/02/2023] [Indexed: 09/09/2023]
Abstract
AIMS To describe the implementation of paediatric rehabilitation telehealth at a physical therapy (PT) unit in Brazil during the COVID-19 pandemic and to describe the perception about this modality by two groups: (1) undergraduate PT students using telehealth during their clinical rotations in this unit and (2) the caregivers of children with disabilities receiving the services. METHODS Twenty-one PT interns (19 females; 25 ± 2 years of age) and seven caregivers (seven females; 40 ± 6 years of age) of seven children with disabilities (five females; 10 ± 4 years of age; five children diagnosed with cerebral palsy) responded to an online questionnaire about their experience with the telehealth programme. Participant attendance and frequency of objective responses were reported descriptively; open-ended responses were analysed qualitatively and grouped according to broad themes. RESULTS 71.4% of interns rated telehealth as an excellent or good experience, and 28.6% did not appreciate it. In addition, 28.6% of them thought that telehealth should be part of the mandatory internship. Regarding caregivers, 85.8% judged the telehealth programme as excellent or good. Both interns and caregivers cited pros and cons related to technology, professional resources, communication skills and caregiver-related aspects, among others. CONCLUSIONS Specific teaching strategies had to be utilised for implementation of telehealth. Despite being a novel modality for interns and caregivers, telehealth was well accepted.
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Affiliation(s)
| | | | - Ana Beatriz Nasser
- Department of Physical Therapy, Federal University of São Carlos, São Paulo, Brazil
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Lima CRG, Pavão SL, da Silva BR, de Campos AC, Saavedra S, Rocha NACF. Cognitive-Motor Dual-Task Costs on Postural Sway During Sit-to-Stand Movement in Children With Cerebral Palsy. Phys Ther 2023; 103:7044663. [PMID: 37086210 DOI: 10.1093/ptj/pzad016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 09/08/2022] [Accepted: 12/08/2022] [Indexed: 04/23/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate the cognitive-motor dual-task costs (DTCs) on postural sway of children with typical development (TD) and children with cerebral palsy (CP) during the sit-to-stand movement. METHODS Twenty children with TD (mean age = 9.35 years) and 17 children with CP (mean age = 8.29 years) randomly performed 3 test conditions: simple motor task, low-complexity cognitive-motor dual-task, and high-complexity cognitive-motor dual-task. The sit-to-stand movement was divided into 3 phases for data analysis: preparation (P1), rising (P2), and stabilization (P3). For each of these phases, the DTCs were calculated by the percentage change in the center of pressure area of sway, velocity of sway, and duration variables between the simple and dual-task conditions. Analysis of variance was applied to test the group, task conditions, and interaction effects. RESULTS Children with CP had lower DTC than children with TD in area of sway in P1 and P2 variables; anteroposterior velocity of sway in P1, P2, and P3; and duration in P3. Children with TD had higher DTC in the high-complexity cognitive-motor dual-task than in the low complexity one. Children with CP did not show adaptations between the dual-task conditions, showing no differences in DTCs. CONCLUSION The simultaneous performance of a motor task and a cognitive task seems to affect children with CP and children with TD differently, but the effects depend on the specific demands of each task. These results demonstrate the importance of rehabilitation actions to place demands involving a variety of postural sway strategies. IMPACT DTCs are different for children with TD and children with CP. Assessment and rehabilitation strategies must take into account the postural sway behavior of these children.
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Affiliation(s)
- Camila Resende Gâmbaro Lima
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Sílvia Leticia Pavão
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, São Carlos, São Paulo, Brazil
- Rehabilitation and Prevention in Physical Therapy Department, Universidade Federal do Paraná, Curitiba, Brazil
| | - Bruna Romão da Silva
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Ana Carolina de Campos
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Sandra Saavedra
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, Connecticut, USA
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Pauletti Oliveira MF, Resende Gâmbaro Lima C, Pavão SL, Moreira Pena G, da Silva BR, de Campos AC, Cicuto Ferreira Rocha NA. Biopsychosocial Factors Related to Postural Sway During Sit-to-Stand Movement in Children and Adolescents With Down Syndrome: A Cross-Sectional Study. Percept Mot Skills 2023; 130:386-402. [PMID: 36221987 DOI: 10.1177/00315125221133432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We investigated factors related to postural sway during sit-to-stand movement in children and adolescents with Down syndrome (DS). Our assessment of participants followed the biopsychosocial model. Body function and structure were represented by muscle strength and postural sway during sit-to-stand movement, which were assessed by manual muscle testing and kinetics analysis, respectively. The Gross Motor Function Measure and Pediatric Balance Scale depicted the activity component. In addition, we included these relevant contextual factors: age, Home Observation for Measurement of the Environment, family income, and maternal schooling. A correlation analysis verified a suspected association between biopsychosocial and postural sway variables. There were significant separated correlations between postural sway in the three phases of the sit-to-stand movement, and age, GMFM-88 dimension D, and muscle strength. Thus, postural control in sit-to-stand movement was related to biopsychosocial factors involving different life aspects of children and adolescents with DS, and these factors should be addressed in rehabilitation therapy intended to improve postural control among these individuals.
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Affiliation(s)
| | | | - Silvia Letícia Pavão
- 67828Federal University of São Carlos, Sao Carlos, Brazil.,230939Federal University of Paraná, Curitiba, Brazil
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Schiariti V, de Campos AC, Sudati IP, Seal AK, Springer PE, Thomson H, Wamithi S, Wei G, Spittle A, Gillick B. Global COVID-19 childhood disability data coordination: A collaborative initiative of the International Alliance of Academies of Childhood Disability. J Pediatr Rehabil Med 2023; 16:275-286. [PMID: 36847026 DOI: 10.3233/prm-220035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
PURPOSE The International Alliance of Academies of Childhood Disability created a COVID-19 Task Force with the goal of understanding the global impact of COVID-19 on children with disabilities and their families. The aim of this paper is to synthesize existing evidence describing the impact of COVID-19 on people with disabilities, derived from surveys conducted across the globe. METHODS A descriptive environmental scan of surveys was conducted. From June to November 2020, a global call for surveys addressing the impact of COVID-19 on disability was launched. To identify gaps and overlaps, the content of the surveys was compared to the Convention on the Rights of the Child and the International Classification of Functioning, Disability and Health. RESULTS Forty-nine surveys, involving information from more than 17,230 participants around the world were collected. Overall, surveys identified that COVID-19 has negatively impacted several areas of functioning - including mental health, and human rights of people with disabilities and their families worldwide. CONCLUSION Globally, the surveys highlight that impact of COVID-19 on mental health of people with disabilities, caregivers, and professionals continues to be a major issue. Rapid dissemination of collected information is essential for ameliorating the impact of COVID-19 across the globe.
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Affiliation(s)
- Verónica Schiariti
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Ana Carolina de Campos
- Laboratory of Analysis of Child Development, Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Isabella Pessóta Sudati
- Laboratory of Analysis of Child Development, Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Arnab K Seal
- Leeds Community Healthcare NHS Trust, Leeds, UK
- University of Leeds, Leeds, UK
| | - Priscilla E Springer
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Heather Thomson
- Divisional of Developmental Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
| | - Susan Wamithi
- Department of Paediatrics, Child & Adolescent Health at Aga Khan University Hospital, Nairobi, Kenya
| | - Guorong Wei
- Department of Pediatrics, Hebei Medical University, Shijiazhuang, China
| | - Alicia Spittle
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Physiotherapy, University of Melbourne, Parkville, Australia
| | - Bernadette Gillick
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Brugnaro BH, de Camargo OK, Corsi C, de Campos AC, Fernandes G, Pavão SL, Rocha NACF. Functioning of children and adolescents with Down syndrome and the association with environmental barriers and facilitators during the COVID-19 pandemic. J Intellect Disabil 2022; 26:824-838. [PMID: 34519228 DOI: 10.1177/17446295211032763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE To compare functioning and environmental aspects before and during physical distancing (DPD) and to determine which social, physical, behavioral and functioning aspects of DPD are correlated. METHODS Sixteen parents of children/adolescents with Down syndrome (11.38 ± 3.00 years) were surveyed before and DPD. Paired t-tests were used to compare functioning and environmental aspects before and DPD and chi-square tests were used to test associations. RESULTS There were increases in the frequency (p < 0.001) and involvement (p = 0.01) in home participation and on the impact, noticed by the parents, of the possibility of child to participate in daily activities (p = 0.036), as well as a reduction in social supports perceived by caregivers (p = 0.049). An association was found between the child's socio-emotional difficulties symptoms and practice of physical activity (p = 0.043) and with parents' satisfaction with the level of child's home participation (p = 0.042). CONCLUSION Functioning can be affected in either positive or negative ways.
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Brugnaro BH, Vieira FN, Fernandes G, de Camargo OK, Fumincelli L, de Campos AC, Pavão SL, Rocha NACF. Exploration of the Feasibility of Remote Assessment of Functioning in Children and Adolescents with Developmental Disabilities: Parents' Perspectives and Related Contextual Factors. Int J Environ Res Public Health 2022; 19:15101. [PMID: 36429822 PMCID: PMC9690884 DOI: 10.3390/ijerph192215101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic interrupted face-to-face health services, leveraging telehealth strategies. The aim of this cross-sectional study was to investigate, from a parent's perspective, the feasibility of a remote assessment of functioning in children with developmental disabilities during the pandemic and related contextual factors, based on how parents carry out the assessment. Parents of children with developmental disabilities (mean age = 7.56 ± 3.68) responded to a remote assessment via electronic forms and telephone interview. We analyzed parents' perspectives about the feasibility of the assessment. We also tested the association between feasibility score and sociodemographics/pandemic experience. Regression analysis tested if children's functioning characteristics predicted feasibility. A total of 57 mothers completed the remote assessment, and more than 95% did not report difficulties in accessing/responding to electronic forms. They scored remote assessment as easy and feasible, and reported no difficulties with telephone interview. Greater feasibility rates were related to lower maternal age (rho Spearman = -0.290; p = 0.029). The model shows that children's characteristics predicted 20.4% of feasibility (p < 0.005). Remote assessment showed to be feasible. Younger mothers might consider easier-to-use technologies, beyond considering remote assessment more viable. These results can guide the next steps in research and remote clinical practice.
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Affiliation(s)
- Beatriz Helena Brugnaro
- Child Development Analysis Laboratory (LADI), Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil
| | - Fabiana Nascimento Vieira
- Child Development Analysis Laboratory (LADI), Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil
| | - Gesica Fernandes
- Child Development Analysis Laboratory (LADI), Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil
| | - Olaf Kraus de Camargo
- CanChild, Department of Pediatrics, McMaster University, Hamilton, ON L8S 1C7, Canada
| | - Laís Fumincelli
- Department of Nursing, Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil
| | - Ana Carolina de Campos
- Child Development Analysis Laboratory (LADI), Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil
| | - Silvia Letícia Pavão
- Department of Prevention and Rehabilitation in Physical Therapy, Federal University of Paraná, Curitiba 80060-000, PR, Brazil
| | - Nelci Adriana Cicuto Ferreira Rocha
- Child Development Analysis Laboratory (LADI), Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil
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Arnoni JLB, Lima CRG, Verdério BN, Kleiner AFR, de Campos AC, Rocha NACF. Active Videogame Training Combined with Conventional Therapy Alters Body Oscillation in Children with Cerebral Palsy: A Randomized Controlled Trial. Games Health J 2022; 11:252-261. [PMID: 35687479 DOI: 10.1089/g4h.2021.0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective: Assess the effect of nonimmersive virtual reality (VR) training as complementary rehabilitation on body oscillation in children with cerebral palsy (CP) while standing on different bases of support and surfaces. Materials and Methods: Twenty-three children with unilateral CP randomly allocated to an intervention group (IG, n = 12) or control group (CG, n = 11). The IG underwent two weekly 50-minute sessions of VR training over 8 weeks, associated with conventional therapy, while the CG was submitted to two 45-minute sessions of conventional neurodevelopmental-based physiotherapy a week over the same time period. Participants were evaluated on a force platform under control conditions (CCs) (rigid surface, feet parallel); semitandem stance; flexible surface (FS) with feet parallel; and flexible surface in a semitandem (FSST) stance. The effect of the group and time factors on the center of pressure oscillation variables was analyzed by repeated-measures analysis of variance (ANOVA), with significance set at 0.05. Results: The main effect observed was for time on the FS, with a decline in the amplitude of mediolateral (ML Amp) (P = 0.01) and mediolateral root mean square (P = 0.01) after intervention. In the IG, ML Amp also declined after intervention under CCs (P = 0.02) and total velocity increased for FSST (P = 0.04). The percentage change was significant only in the IG. Conclusion: VR training as complementary rehabilitation can help improve body oscillation in children with CP and mild functional impairment. Nonimmersive VR can be considered a complementary tool for the physical rehabilitation of children with CP. This study was registered with the Brazilian Clinical Trials Registry (RBR-3zty4w).
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Affiliation(s)
- Joice Luiza Bruno Arnoni
- Neuropediatrics Section, Department of Physiotherapy, Federal University of Sao Carlos, Sao Carlos, Brazil
| | | | - Bruna Nayara Verdério
- Neuropediatrics Section, Department of Physiotherapy, Federal University of Sao Carlos, Sao Carlos, Brazil
| | | | - Ana Carolina de Campos
- Neuropediatrics Section, Department of Physiotherapy, Federal University of Sao Carlos, Sao Carlos, Brazil
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Santana CAS, Dos Santos MM, de Campos AC. Interrelationships of Touch and Proprioception with Motor Impairments in Individuals with Cerebral Palsy: A Systematic Review. Percept Mot Skills 2022; 129:570-590. [PMID: 35452588 DOI: 10.1177/00315125221093904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Considering that somatosensory impairments may impact motor performance in individuals with cerebral palsy (CP), a better understanding of these relations is relevant to planning interventions. To synthesize research evidence to date on the interrelationships between the somatosensory functions of touch and proprioception with motor functions in persons with CP, we systematically searched Embase, CINAHL, PsycINFO, and Medline databases for studies relating these variables that were published in English from the inception of these databases to November 2020. We targeted the following content categories in our literature search: (a) cerebral palsy; (b) sensory functions; (c) tactile functions; (d) proprioception functions; and (e) motor functions. The selection, data extraction, and methodological quality assessment of these studies were performed in duplicate. We retrieved and analyzed information regarding the studies' methodological approaches and synthesized results. The 11 studies that met our inclusion criteria showed that, in individuals with CP, impairments in tactile discrimination, proprioception, and stereognosis are related to motor functions in terms of overall manual ability, grip strength, postural control and locomotion. Thus, clinical practitioners should attend to somatosensory aspects of motor impairment in individuals with CP. More research is needed to clarify the direction of these associations.
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Affiliation(s)
- Camila A S Santana
- Department of Physical Therapy, 67828Federal University of São Carlos, Brazil
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Oliveira MR, Sudati IP, Konzen VDM, de Campos AC, Wibelinger LM, Correa C, Miguel FM, Silva RN, Borghi-Silva A. Covid-19 and the impact on the physical activity level of elderly people: A systematic review. Exp Gerontol 2022; 159:111675. [PMID: 34954282 PMCID: PMC8695515 DOI: 10.1016/j.exger.2021.111675] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Social isolation and lifestyle changes provoked by the COVID-19 pandemic have negatively affected the level of physical activity of the elderly people. OBJECTIVE To evaluate the available evidence related to the level of physical activity (PA) of elderly people during the COVID-19 pandemic. METHODS This is a systematic review, registered on PROSPERO (CRD42021241116), which included cross-sectional and cohort studies. Embase, Pubmed, Cochrane, Web of Science and Scopus databases were used to search for the studies. Finally, the New Castle-Ottawa Quality Assessment scale was used to measure the quality of the studies. RESULTS 25 studies were found, being 14 cross-sectional and 11 cohort studies. The studies showed that the elderly population was highly affected in relation to the level of physical activity and lifestyle during restrictions, quarantine and lockdowns caused by the COVID-19. There was a significant reduction in physical activity levels, leading to declines in physical fitness and increased sedentary lifestyle, factors directly related to the increase in frailty in this population. CONCLUSION The level of physical activity in the elderly population decreased during the quarantine period of COVID-19 worldwide. Strategies to maintain physical condition must be encouraged with physical exercises that meets the needs of the elderly in the current pandemic scenario, in order to maintain and improve the health of this population.
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Affiliation(s)
| | | | | | | | | | - Clisman Correa
- Lutheran University of Brazil, Cachoeira do Sul, Rio Grande do Sul, Brazil
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Lehmann KR, Banovski DC, Fernandes B, Oliveira DKD, Dal’Negro SH, Campos ACD. Where do older adults die in Brazil? An analysis of two decades. Geriatr Gerontol Aging 2022. [DOI: 10.53886/gga.e0220019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective: To describe the characteristics of older adult deaths reported in Brazil between 1998 and 2018. Methods: This is a retrospective, descriptive study performed using secondary data from the Brazilian Ministry of Health. Results: During the analyzed period, 14 145 686 older adults died in the country, of which 40.42% were over 80 years old. The main cause of death was circulatory system disease (21.50%), and the most frequent place of death was a hospital environment (68%). The Southeast region accounted for 52.83% of the country’s hospital deaths and 73.33% of those occurring in other health facilities, whereas 38.56% of the deaths that happened at home took place in the Northeast region. Conclusions: The hospital environment was the predominant place of death in all regions of the country, and the main causes of death were chronic noncommunicable diseases. Alternative care modalities emerge as a possibility of establishing accessible end-of-life care in scenarios other than the hospital.
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Abstract
Spanish and Portuguese translations of this editorial are available in the online issue.
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Affiliation(s)
| | - Egmar Longo
- Academia Latinoamericana de Desarrollo Infantil y Discapacidad (ALDID)
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Schiariti V, Longo E, de Campos AC. Impacto de la infección congénita por Zika virus y COVID-19 en la discapacidad infantil en América Latina. Dev Med Child Neurol 2021; 63:e1-e2. [PMID: 34651312 PMCID: PMC8652959 DOI: 10.1111/dmcn.15045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Verónica Schiariti
- Academia Latinoamericana de Desarrollo Infantil y Discapacidad (ALDID) San José Costa Rica
| | - Egmar Longo
- Academia Latinoamericana de Desarrollo Infantil y Discapacidad (ALDID) San José Costa Rica
| | - Ana Carolina de Campos
- Academia Latinoamericana de Desarrollo Infantil y Discapacidad (ALDID) San José Costa Rica
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Schiariti V, Longo E, de Campos AC. Impacto do vírus Zika congênito e COVID-19 na deficiência infantil na América Latina. Dev Med Child Neurol 2021; 63:e3. [PMID: 34651311 PMCID: PMC8653361 DOI: 10.1111/dmcn.15046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Verónica Schiariti
- Academia Latinoamericana de Desenvolvimento Infantil e Deficiência (ALDID) San José Costa Rica
| | - Egmar Longo
- Academia Latinoamericana de Desenvolvimento Infantil e Deficiência (ALDID) San José Costa Rica
| | - Ana Carolina de Campos
- Academia Latinoamericana de Desenvolvimento Infantil e Deficiência (ALDID) San José Costa Rica
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Santana CAS, Tudella E, Rocha NACF, de Campos AC. Lower Limb Sensorimotor Training (LoSenseT) for Children and Adolescents with Cerebral Palsy: A Brief Report of a Feasibility Randomized Protocol. Dev Neurorehabil 2021; 24:276-286. [PMID: 33393402 DOI: 10.1080/17518423.2020.1858458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Motor disorders in cerebral palsy (CP) are often accompanied by disturbances of sensation and impaired somatosensory functions have been reported in individuals with CP. To test the feasibility of a sensorimotor training protocol for lower limbs in children and adolescents with unilateral and bilateral CP, and to analyze the preliminary effects of this training on sensory and motor variables. This is a single-blind, prospective phase I feasibility randomized protocol. A total of twenty participants with uni or bilateral cerebral palsy, GMFCS level I-III, ages 5 to 20 years will be recruited. The LoSenseT protocol is composed of tactile and proprioceptive activities in a child-friendly format. An original qualitative feedback questionnaire was developed to assess the protocol feasibility. Additionally, proprioception, tactile discrimination, postural stability, and gait parameters will be assessed. The LoSenseT protocol can support the implementation of interventions targeting lower limbs somatosensory impairments in individuals with CP.
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Affiliation(s)
| | - Eloisa Tudella
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo State, Brazil
| | | | - Ana Carolina de Campos
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo State, Brazil
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Damiano DL, Longo E, Carolina de Campos A, Forssberg H, Rauch A. Systematic Review of Clinical Guidelines Related to Care of Individuals With Cerebral Palsy as Part of the World Health Organization Efforts to Develop a Global Package of Interventions for Rehabilitation. Arch Phys Med Rehabil 2021; 102:1764-1774. [PMID: 33453191 DOI: 10.1016/j.apmr.2020.11.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 10/29/2020] [Accepted: 11/01/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The World Health Organization's (WHO) Rehabilitation 2030 initiative is working to develop a set of evidence-based interventions selected from clinical practice guidelines for Universal Health Coverage. As an initial step, the WHO Rehabilitation Programme and Cochrane Rehabilitation convened global content experts to conduct systematic reviews of clinical practice guidelines for 20 chronic health conditions, including cerebral palsy. DATA SOURCES Six scientific databases (Pubmed, EMBASE, Scopus, Web of Science, PEDro, CINAHL), Google Scholar, guideline databases, and professional society websites were searched. STUDY SELECTION A search strategy was implemented to identify clinical practice guidelines for cerebral palsy across the lifespan published within 10 years in English. Standardized spreadsheets were provided for process documentation, data entry, and tabulation of the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool. Each step was completed by 2 or more group members, with disagreements resolved by discussion. Initially, 13 guidelines were identified. Five did not meet the AGREE II established threshold or criteria for inclusion. Further review by the WHO eliminated 3 more, resulting in 5 remaining guidelines. DATA EXTRACTION All 339 recommendations from the 5 final guidelines, with type (assessment, intervention, or service), strength, and quality of evidence, were extracted, and an International Classification of Functioning, Disability and Health Functioning (ICF) category was assigned to each. DATA SYNTHESIS Most guidelines addressed mobility functions, with comorbid conditions and lifespan considerations also included. However, most were at the level of body functions. No guideline focused specifically on physical or occupational therapies to improve activity and participation, despite their prevalence in rehabilitation. CONCLUSIONS Despite the great need for high quality guidelines, this review demonstrated the limited number and range of interventions and lack of explicit use of the ICF during development of guidelines identified here. A lack of guidelines, however, does not necessarily indicate a lack of evidence. Further evidence review and development based on identified gaps and stakeholder priorities are needed.
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Affiliation(s)
- Diane L Damiano
- Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD.
| | - Egmar Longo
- Federal University of Rio Grande do Norte-UFRN-FACISA, Santa Cruz, Brazil
| | - Ana Carolina de Campos
- Department of Physical Therapy, Federal University of São Carlos-UFSCar, São Carlos, Brazil
| | - Hans Forssberg
- Department of Women's and Children's Health, Karolinska Institutet, Astrid Lindgren Children's Hospital, Stockholm, Sweden
| | - Alexandra Rauch
- Sensory Functions, Disability and Rehabilitation Unit, Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
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Brugnaro BH, Lima CRG, Campos ACD, Rocha NACF. Translation of the “F-Words Tools” into Brazilian Portuguese. Fisioter mov 2021. [DOI: 10.1590/fm.2021.34110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: The International Classification of Functionality, Disability and Health (ICF) determines that for any health condition, functionality is the result of the multidirectional relationship between the positive aspects of the components of body structures and functions, activities, participation and contextual factors, encompassing personal and environmental factors. Objective: To translate and culturally adapt the “F-Words Tools” into Brazilian Portuguese. Methods: Permission to translate was granted by the authors. After reading and understanding the instruments, a researcher performed a non-certified translation into Brazilian Portuguese. Next, the back translation into English was done by a specialist in both languages without prior knowledge of the original versions. The result of the back translation was sent to the authors of the instrument for verification of semantics and content. Based on the authors' recommendations and the results of translation analyses, there was no need for cultural adaptation. Results: The back translation was approved by the authors, indicating that the Brazilian Portuguese version of all instruments was adequate. The translated titles are: Termo de Compromisso (Agreement), Colagem (Collage), Perfil (Profile) and Folha de Metas (Goal Sheet). The ICF framework was entitled: “The ICF model and My Favorite Words”. The material is available free of charge at the CanChild website. Conclusion: The translation into Brazilian Portuguese allows materials to be used in Brazil to disseminate the concepts of the ICF and the “F-words” in clinical and family settings.
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Lima CRG, Pavão SL, de Campos AC, Rocha NACF. Sit-to-stand movement in childrenwith cerebral palsy and relationships with the International classification of functioning, disability and health: A systematic review. Res Dev Disabil 2020; 107:103804. [PMID: 33160191 DOI: 10.1016/j.ridd.2020.103804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 06/09/2020] [Accepted: 10/16/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Studying sit-to-stand (STS) in children with Cerebral Palsy addressing the domains of ICF allows determining the factors influencing STS in this population. AIMS To systematically review the literature on STS in children with CP, identifying which ICF domains have been assessed and how they relate to sit-to-stand. METHODS AND PROCEDURES A literature search was conducted in electronic databases by combining the keywords (child OR children OR adolescent) AND ("Cerebral Palsy") AND (sit-to-stand). We included cross-sectional articles published in English, that assessed STS movements in children with CP up to 18 years old. OUTCOMES AND RESULTS 25 articles met the inclusion criteria. All of them assessed Body Functions and Structure. According to them, body alignment, muscle strength and postural sway affect STS movement. Six studies related Activity and Participation with STS, demonstrating that worse scores in scales that evaluate activities and participation are related to the poorer STS execution. Contextual factors were addressed in 15 studies: children's age, bench height, manipulation of sensory information and mechanical restriction impact the way children execute STS. CONCLUSION AND IMPLICATIONS Contextual factors and Body Functions and Structure impact the STS in children with CP. However, few studies have evaluated the participation of these children. Based on the theoretical framework of the ICF, it is important that future studies evaluate functional tasks in children with CP and the components that can affect them. The adoption of the biopsychosocial model strengthens the understanding of functioning, which can contribute to rehabilitation planning.
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Affiliation(s)
- Camila Resende Gâmbaro Lima
- Federal University of Sao Carlos. Department of Physical Therapy. Laboratory of Analysis of Childhood Development. Rod Washington Luis, Km 235, 13565-905, São Carlos, SP, Brazil.
| | - Silvia Leticia Pavão
- Federal University of Sao Carlos. Department of Physical Therapy. Laboratory of Analysis of Childhood Development. Rod Washington Luis, Km 235, 13565-905, São Carlos, SP, Brazil
| | - Ana Carolina de Campos
- Federal University of Sao Carlos. Department of Physical Therapy. Laboratory of Analysis of Childhood Development. Rod Washington Luis, Km 235, 13565-905, São Carlos, SP, Brazil
| | - Nelci Adriana Cicuto Ferreira Rocha
- Federal University of Sao Carlos. Department of Physical Therapy. Laboratory of Analysis of Childhood Development. Rod Washington Luis, Km 235, 13565-905, São Carlos, SP, Brazil
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Brugnaro BH, Oliveira MFP, de Campos AC, Pavão SL, Rocha NACF. Postural control in Down syndrome and relationships with the dimensions of the International Classification of Functioning, Disability and Health - a systematic review. Disabil Rehabil 2020; 44:2207-2222. [PMID: 33049152 DOI: 10.1080/09638288.2020.1830439] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE Postural control assessment in children with Down syndrome (DS) may contribute to understanding the impact of impairments in Body Structures and Functions on Activities and Participation, providing a biopsychosocial approach to support clinical practice. The present study aimed to systematically review the literature addressing postural control in children and adolescents with Down syndrome, with a focus in the interactions among the components of the International Classification of Functioning (ICF). METHODS We conducted a tailored search in PubMed; Web of Science, SCOPUS and Science Direct databases. RESULTS We identified 20 full-texts that fulfilled the inclusion and exclusion criteria. Children and adolescents with DS showed lower postural stability across studies. The ICF components most commonly addressed were Body Structure and Function and Activity. Although the studies measured these components, they did not analyze the interrelationships of components when describing the determinants of postural control in this population. CONCLUSIONS Overall, the studies indicate that children and adolescents with DS show decreased postural stability and greater vulnerability to sensory changes than their typical peers. There is a lack of studies using the biopsychosocial approach. Only few studies have related the activity level of the participants with the variables of postural control. None of them addressed components of Participation and Environmental Factors. The poor methodological quality of the included studies limits the translation of results to clinical practice. Further studies addressing children with disabilities, such as DS, should utilize the ICF framework, thus providing a biopsychosocial approach of health in these individuals.IMPLICATIONS FOR REHABILITATIONChildren with Down syndrome show decreased postural stability and greater vulnerability to sensory changes than their typical peers.In clinical practice, when assessing postural control of individuals with DS, rehabilitation professionals should not only address components of Body Structures and Functions, but also investigate their impact on Activity and Participation.Training of postural control should address strategies that include natural environments and participation situations.The biopsychosocial approach provided by the ICF framework should be implemented in clinical practice.
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Affiliation(s)
- Beatriz Helena Brugnaro
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Maria Fernanda Pauletti Oliveira
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Ana Carolina de Campos
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Silvia Letícia Pavão
- Departament of Prevention and Rehabilitation in Physical Therapy, Federal University of Paraná (UFPR), Curitiba, PR, Brazil
| | - Nelci Adriana Cicuto Ferreira Rocha
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
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Longo E, de Campos AC, Schiariti V. COVID-19 Pandemic: Is This a Good Time for Implementation of Home Programs for Children's Rehabilitation in Low- and Middle-Income Countries? Phys Occup Ther Pediatr 2020; 40:361-364. [PMID: 32408834 DOI: 10.1080/01942638.2020.1759947] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Egmar Longo
- Graduate Program in Rehabilitation Sciences and in Collective Health, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte (UFRN-FACISA), Santa Cruz, Rio Grande do Norte, Brazil
| | - Ana Carolina de Campos
- Graduate Program in Physical Therapy, Department of Physiotherapy, Federal University of São Carlos (UFSCAR), São Carlos, São Paulo, Brazil
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da Costa CSN, Pavão SL, Visicato LP, de Campos AC, Rocha NACF. Effects of sensory manipulations on the dynamical structure of center-of-pressure trajectories of children with cerebral palsy during sitting. Hum Mov Sci 2019; 63:1-9. [PMID: 30472351 DOI: 10.1016/j.humov.2018.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 11/08/2018] [Accepted: 11/18/2018] [Indexed: 11/16/2022]
Abstract
AIM To investigate the effects of manipulating visual information and the compliance of the support surface on the area of sway and dynamical trajectories of center-of-pressure (CoP) in children with CP and children with typical development during static sitting. METHODS 32 typical children, 14 children with mild CP and 12 with moderate-to-severe CP were tested for CoP sway during static sitting under four sensory conditions: (1) eyes open on a rigid surface; (2) eyes closed on a rigid surface; (3) eyes open on foam; (4) eyes closed on foam. RESULTS Children with moderate-to-severe CP showed greater regularity and local stability of dynamical CoP trajectories and lower complexity in their motor patterns than typical children and children with mild CP. Moreover, removing vision and sitting on a compliant surface reduced the regularity of CoP trajectories. CONCLUSION Children with CP were able to adjust the structure and complexity of their postural control responses to sensory challenges, although the structure of their postural responses was poorer than in typical children.
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Affiliation(s)
- Carolina Souza Neves da Costa
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, Rod. Washington Luis, km 235, 13565-905 São Carlos-SP, Brazil
| | - Silvia Leticia Pavão
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, Rod. Washington Luis, km 235, 13565-905 São Carlos-SP, Brazil.
| | - Livia Pessarelli Visicato
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, Rod. Washington Luis, km 235, 13565-905 São Carlos-SP, Brazil
| | - Ana Carolina de Campos
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, Rod. Washington Luis, km 235, 13565-905 São Carlos-SP, Brazil
| | - Nelci Adriana C F Rocha
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, Rod. Washington Luis, km 235, 13565-905 São Carlos-SP, Brazil
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Pavão SL, Pessarelli Visicato L, da Costa CSN, de Campos AC, Rocha NACF. Effect of the severity of manual impairment and hand dominance on anticipatory and compensatory postural adjustments during manual reaching in children with cerebral palsy. Res Dev Disabil 2018; 83:47-56. [PMID: 30138846 DOI: 10.1016/j.ridd.2018.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 06/19/2018] [Accepted: 08/03/2018] [Indexed: 06/08/2023]
Abstract
AIM To investigate the role of the severity of manual impairment and of hand dominance on postural sway during anticipatory [APA] and compensatory [CPA] postural adjustments in a seated manual reaching task performed by children with cerebral palsy (CP) and typical children (TC). METHODS We tested 26 TC (mean age 9.5 ± 2.1 years) and 29 children with CP (age 9.6 ± 3 years) classified based on manual impairment levels as mild (Manual Ability Classification System [MACS] I; n = 18) or moderate-to-severe (MACS II-III, n = 11). Participants were instructed to reach towards a target using their dominant vs. non-dominant arm while sitting on a force-plate. Center of pressure (CoP) sway was analyzed during APA and CPA. RESULTS For all groups, using the non-dominant arm determined greater amplitude and velocity of CoP sway in CPA. Children with moderate-to-severe manual impairment showed greater sway during APA and CPA compared to mild impairment and TC groups. CONCLUSION More severe manual impairment resulted in higher sway during the anticipatory and compensatory phases of the reaching task. Using the non-dominant arm resulted in greater compensatory adjustments during reaching.
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Affiliation(s)
- Silvia Leticia Pavão
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, Rod. Washington Luis, km 235, 13565-905, São Carlos, SP, Brazil.
| | - Livia Pessarelli Visicato
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, Rod. Washington Luis, km 235, 13565-905, São Carlos, SP, Brazil
| | - Carolina Souza Neves da Costa
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, Rod. Washington Luis, km 235, 13565-905, São Carlos, SP, Brazil
| | - Ana Carolina de Campos
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, Rod. Washington Luis, km 235, 13565-905, São Carlos, SP, Brazil
| | - Nelci Adriana C F Rocha
- Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, Rod. Washington Luis, km 235, 13565-905, São Carlos, SP, Brazil
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Longo E, de Campos AC, Palisano RJ. Let's make pediatric physical therapy a true evidence-based field! Can we count on you? Braz J Phys Ther 2018; 23:187-188. [PMID: 30420270 DOI: 10.1016/j.bjpt.2018.10.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 10/24/2018] [Indexed: 10/27/2022] Open
Affiliation(s)
- Egmar Longo
- Graduate Program in Rehabilitation Sciences, Trairi Health Sciences Faculty (FACISA), Universidade Federal do Rio Grande do Norte (UFRN), Santa Cruz, RN, Brazil.
| | - Ana Carolina de Campos
- Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Robert J Palisano
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA, United States
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Pavão SL, Maeda DA, Corsi C, Santos MMD, Costa CSND, de Campos AC, Rocha NACF. Discriminant ability and criterion validity of the Trunk Impairment Scale for cerebral palsy. Disabil Rehabil 2018; 41:2199-2205. [PMID: 29663838 DOI: 10.1080/09638288.2018.1462410] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Aims: To compare the performance of children with mild and moderate-to-severe cerebral palsy (CP) on the Trunk Impairment Scale (TIS), Gross Motor Function Measure (GMFM), and on center-of-pressure variables; to establish the discriminant ability of these tools to predict severity of motor impairment in CP; and to investigate the criterion validity of the TIS. Methods: Children with mild (n = 18, 11 males, 7 females, mean age = 9.5 ± 2.9 years, Gross Motor Function Classification System I-II) and moderate-to-severe (n = 18, 11 males, 7 females, mean age = 9.2 ± 229, Gross Motor Function Classification System III-IV) CP were tested using the TIS and the GMFM, and during static sitting on force-plate. Results: Children with mild CP showed better trunk (median; 95% confidence interval = 22.5; 21.29-22.59 vs. 13; 11.97-14.8; p < 0.001) and gross motor (60; 57.73-59.3 vs. 40; 38.96-46.25; p < 0.001) scores, and better postural control (lower center of pressure (CoP) displacement [anterior-posterior: (0.42; 0.32-1.11 vs. 0.89; 0.70-1.65; p = 0.022); medial-lateral: (0.42; 0.31-1.08 vs. 0.91; 0.65-1.17; p = 0.044)], and lower area of sway, (0.05; -0.15-0.97 vs. 0.44; 0.23-0.90; p = 0.008) than the moderate-to-severe group. Trunk control and gross motor function explained 81.5% of the variance in the severity of motor condition. Correlations between the TIS and the GMFM were excellent (ρ = 0.944, p < 0.001); correlations between the TIS and CoP variables were low (anterior-posterior displacement: ρ = -0.411, p < 0.05; medial-lateral displacement: ρ = -0.327, p < 0.05); area of sway: ρ = -0.430, p < 0.05; velocity of sway: ρ = -0.308, p < 0.05). Conclusions: The TIS is able to differentiate levels of trunk control across various levels of motor impairments in CP. It is a valid tool to assess trunk control, showing very high concurrent validity with the GMFM sitting dimension. Implications for Rehabilitation Trunk Impairment Scale (TIS) can be used by rehabilitation professionals to differentiate levels of trunk control across levels of motor impairment. TIS showed concurrent validity with Gross Motor Function Measure and should be used to assess trunk control in children with cerebral palsy (CP) in clinical settings. The use of TIS allows a reliable assessment of postural control in children with CP in clinical settings.
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Affiliation(s)
- Sílvia Leticia Pavão
- a Department of Physiotherapy, Neuropediatrics Section , Federal University of São Carlos , São Carlos , Brazil
| | - Davi Adiwardana Maeda
- a Department of Physiotherapy, Neuropediatrics Section , Federal University of São Carlos , São Carlos , Brazil
| | - Carolina Corsi
- a Department of Physiotherapy, Neuropediatrics Section , Federal University of São Carlos , São Carlos , Brazil
| | - Mariana Martins Dos Santos
- a Department of Physiotherapy, Neuropediatrics Section , Federal University of São Carlos , São Carlos , Brazil
| | - Carolina Souza N da Costa
- a Department of Physiotherapy, Neuropediatrics Section , Federal University of São Carlos , São Carlos , Brazil
| | - Ana Carolina de Campos
- a Department of Physiotherapy, Neuropediatrics Section , Federal University of São Carlos , São Carlos , Brazil
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Pavão SL, de Campos AC, Rocha NACF. Age-related Changes in Postural Sway During Sit-to-stand in Typical Children and Children with Cerebral Palsy. J Mot Behav 2018; 51:185-192. [DOI: 10.1080/00222895.2018.1454396] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Silvia Leticia Pavão
- Physical Therapy Department, Neuropediatrics Sector, Federal University of São Carlos, São Carlos-SP, Brazil
| | - Ana Carolina de Campos
- Physical Therapy Department, Neuropediatrics Sector, Federal University of São Carlos, São Carlos-SP, Brazil
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Cicuto Ferreira Rocha NA, de Campos AC, Cicuto Ferreira Rocha F, Pereira Dos Santos Silva F. Microcephaly and Zika virus: Neuroradiological aspects, clinical findings and a proposed framework for early evaluation of child development. Infant Behav Dev 2017; 49:70-82. [PMID: 28755567 DOI: 10.1016/j.infbeh.2017.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 05/30/2017] [Accepted: 07/14/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIMS As the recent outbreak of microcephaly cases caused by Zika virus has been declared a global health emergency, providing assessment guidelines for multidisciplinary teams providing early developmental screening and stimulation to infants with microcephaly is much needed. Thus, the aim of this manuscript is to provide an overview on what is known about neuroradiological aspects and clinical findings in infants with microcephaly caused by Zika virus and to propose a framework for early evaluation of child development. METHODS The keywords "Zika virus" and "microcephaly" were searched in PubMed database for articles published from incept to May 2017. These texts were reviewed, and the ones addressing neuroradiological and clinical findings in infants were selected. Recommendations for early assessment were made based on the International Classification of Functionality Disability and Health (ICF) model. OUTCOMES AND RESULTS The database search yielded 599 publications and 36 were selected. The studies detected microcephaly with diffuse brain malformations and calcifications, ventriculomegaly, optic nerve hypoplasia, macular atrophy, cataracts, impaired visual and hearing function, arthrogryposis, spasticity, hyperreflexia, irritability, tremors, and seizures, but very little is known about early development. Early assessments were described based on the ICF domains (Body Function and Structures, Activities and Participation and Contextual factors). CONCLUSION AND IMPLICATIONS Studies published showed abnormal brain, optic, neurologic and orthopedic findings, but very little is known about other aspects of functioning in infants with microcephaly caused by Zika virus. The biopsychosocial model based on the ICF paradigm provides an adequate framework to describe the condition of the infant with microcephaly receiving rehabilitative efforts to minimize disability. Efforts towards early identification of developmental delays should be taken within the first six months of life.
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Affiliation(s)
- Nelci Adriana Cicuto Ferreira Rocha
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), Rodovia Washington Luis, km 235, São Carlos, SP, 13565-905, Brazil.
| | - Ana Carolina de Campos
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), Rodovia Washington Luis, km 235, São Carlos, SP, 13565-905, Brazil
| | - Fellipe Cicuto Ferreira Rocha
- Medical School, Pontifical Catholic University of Campinas (PUC-Campinas), Av. John Boyd Dunlop, s/n - Jardim Ipaussurama, Campinas, SP, 13060-904, Brazil
| | - Fernanda Pereira Dos Santos Silva
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), Rodovia Washington Luis, km 235, São Carlos, SP, 13565-905, Brazil
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31
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Kukke SN, Curatalo LA, de Campos AC, Hallett M, Alter KE, Damiano DL. Coordination of Reach-to-Grasp Kinematics in Individuals With Childhood-Onset Dystonia Due to Hemiplegic Cerebral Palsy. IEEE Trans Neural Syst Rehabil Eng 2015. [PMID: 26208359 DOI: 10.1109/tnsre.2015.2458293] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Functional reaching is impaired in dystonia. Here, we analyze upper extremity kinematics to quantify timing and coordination abnormalities during unimanual reach-to-grasp movements in individuals with childhood-onset unilateral wrist dystonia. Kinematics were measured during movements of both upper limbs in a patient group ( n = 11, age = 17.5 ±5 years), and a typically developing control group ( n = 9, age = 16.6 ±5 years). Hand aperture was computed to study the coordination of reach and grasp. Time-varying joint synergies within one upper limb were calculated using a novel technique based on principal component analysis to study intra-limb coordination. In the non-dominant arm, results indicate reduced coordination between reach and grasp in patients who could not lift the grasped object compared to those who could lift it. Lifters exhibit incoordination in distal upper extremity joints later in the movement and non-lifters lacked coordination throughout the movement and in the whole upper limb. The amount of atypical coordination correlates with dystonia severity in patients. Reduced coordination during movement may reflect deficits in the execution of simultaneous movements, motor planning, or muscle activation. Rehabilitation efforts can focus on particular time points when kinematic patterns deviate abnormally to improve functional reaching in individuals with childhood-onset dystonia.
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Visicato LP, da Costa CSN, Damasceno VAM, de Campos AC, Rocha NACF. Evaluation and characterization of manual reaching in children with cerebral palsy: A systematic review. Res Dev Disabil 2015; 36C:162-174. [PMID: 25462477 DOI: 10.1016/j.ridd.2014.09.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 09/05/2014] [Accepted: 09/09/2014] [Indexed: 06/04/2023]
Abstract
Manual reaching is used daily to perform manipulative tasks and activities of daily routine. Children with cerebral palsy (CP) have limitations in this activity, with functional loss as a possible consequence. This review aimed to gather studies that evaluated and characterized manual reaching in children with CP, with the purpose of identifying the aspects analyzed, as well as review and discuss the results in the studies and its relationship to the children's level of functionality. 17 studies were selected for this systematic review from the search in electronic databases. The studies showed that children with CP show deficits in several spatio-temporal variables of reaching compared to typical children, such as longer time to perform the activity, higher peak velocity, lower index of curvature, and greater number of units of motion, which indicates lower smoothness and linearity of the movements of upper limbs. The performance is influenced by the level of motor impairment and various manipulations of the task. However, more studies are needed that help translating these results into treatment strategies that facilitate the performance of manual activities in children with CP.
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Affiliation(s)
- Lívia Pessarelli Visicato
- Department of Physiotherapy, Neuropediatric Research Unit, Federal University of São Carlos (UFSCar), Brazil.
| | | | | | - Ana Carolina de Campos
- Department of Physiotherapy, Neuropediatric Research Unit, Federal University of São Carlos (UFSCar), Brazil
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33
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Sukal-Moulton T, de Campos AC, Stanley CJ, Damiano DL. Functional near infrared spectroscopy of the sensory and motor brain regions with simultaneous kinematic and EMG monitoring during motor tasks. J Vis Exp 2014. [PMID: 25548919 DOI: 10.3791/52391] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
There are several advantages that functional near-infrared spectroscopy (fNIRS) presents in the study of the neural control of human movement. It is relatively flexible with respect to participant positioning and allows for some head movements during tasks. Additionally, it is inexpensive, light weight, and portable, with very few contraindications to its use. This presents a unique opportunity to study functional brain activity during motor tasks in individuals who are typically developing, as well as those with movement disorders, such as cerebral palsy. An additional consideration when studying movement disorders, however, is the quality of actual movements performed and the potential for additional, unintended movements. Therefore, concurrent monitoring of both blood flow changes in the brain and actual movements of the body during testing is required for appropriate interpretation of fNIRS results. Here, we show a protocol for the combination of fNIRS with muscle and kinematic monitoring during motor tasks. We explore gait, a unilateral multi-joint movement (cycling), and two unilateral single-joint movements (isolated ankle dorsiflexion, and isolated hand squeezing). The techniques presented can be useful in studying both typical and atypical motor control, and can be modified to investigate a broad range of tasks and scientific questions.
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Affiliation(s)
- Theresa Sukal-Moulton
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, Clinical Center, National Institutes of Health
| | - Ana Carolina de Campos
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, Clinical Center, National Institutes of Health
| | - Christopher J Stanley
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, Clinical Center, National Institutes of Health
| | - Diane L Damiano
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, Clinical Center, National Institutes of Health;
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Kukke SN, de Campos AC, Damiano D, Alter KE, Patronas N, Hallett M. Cortical activation and inter-hemispheric sensorimotor coherence in individuals with arm dystonia due to childhood stroke. Clin Neurophysiol 2014; 126:1589-98. [PMID: 25499610 DOI: 10.1016/j.clinph.2014.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 11/04/2014] [Accepted: 11/05/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Dystonia is a disabling motor disorder often without effective therapies. To better understand the genesis of dystonia after childhood stroke, we analyzed electroencephalographic (EEG) recordings in this population. METHODS Resting spectral power of EEG signals over bilateral sensorimotor cortices (Powrest), resting inter-hemispheric sensorimotor coherence (Cohrest), and task-related changes in power (TRPow) and coherence (TRCoh) during wrist extension were analyzed in individuals with dystonia (age 20±3years) and healthy volunteers (age 17±5years). RESULTS Ipsilesional TRPow decrease was significantly lower in patients than controls during the more affected wrist task. Force deficits of the affected wrist correlated with reduced alpha TRPow decrease on the ipsilesional and not the contralesional hemisphere. Cohrest was significantly lower in patients than controls, and correlated with more severe dystonia and poorer hand function. Powrest and TRCoh were similar between groups. CONCLUSIONS The association between weakness and cortical activation during wrist extension highlights the importance of ipsilesional sensorimotor activation on function. Reduction of Cohrest in patients reflects a loss of inter-hemispheric connectivity that may result from structural changes and neuroplasticity, potentially contributing to the development of dystonia. SIGNIFICANCE Cortical and motor dysfunction are correlated in patients with childhood stroke and may in part explain the genesis of dystonia.
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Affiliation(s)
- Sahana N Kukke
- Biomedical Engineering Department, The Catholic University of America, USA; Rehabilitation Medicine Department, National Institutes of Health Clinical Center, USA; National Institute of Neurological Disorders and Stroke, National Institutes of Health, USA
| | | | - Diane Damiano
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, USA
| | - Katharine E Alter
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, USA; Mount Washington Pediatric Hospital, USA
| | - Nicholas Patronas
- Radiology Department, National Institutes of Health Clinical Center, USA
| | - Mark Hallett
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, USA.
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de Campos AC, Cerra LCV, Silva FPDS, Rocha NACF. Bimanual coordination in typical and atypical infants: movement initiation, object touching and grasping. Res Dev Disabil 2014; 35:2416-2422. [PMID: 24973549 PMCID: PMC4111982 DOI: 10.1016/j.ridd.2014.05.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 05/29/2014] [Accepted: 05/29/2014] [Indexed: 05/29/2023]
Abstract
The development of bimanual actions reflects perceptual, motor and cognitive processes, as well as the functional connectivity between brain hemispheres. We investigated the development of uni- and bimanual actions in typically-developing (TD) infants and infants with Down syndrome (DS) while they reached for objects with varying sizes. Eight TD infants and seven infants with DS (ages 4-8 months) were tested at several stages of reaching experience. Movement strategies at movement initiation, object touching and grasping were recorded. With reaching experience, typical infants increased ability to anticipate reaching strategies, and independent use of the hands according to task demands. Strategies used by infants with DS were mostly compensatory rather than anticipatory, and showed a weaker tendency for interlimb coupling at early ages. These differences may underlie functional limitations, and should be subject to early intervention.
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Affiliation(s)
- Ana Carolina de Campos
- Department of Physical Therapy, Neuropediatrics Sector, Federal University of São Carlos (UFSCar), Rodovia Washington Luis, km 235, 13565-905 São Carlos, SP, Brazil.
| | - Larissa Carvalho Vanzo Cerra
- Department of Physical Therapy, Neuropediatrics Sector, Federal University of São Carlos (UFSCar), Rodovia Washington Luis, km 235, 13565-905 São Carlos, SP, Brazil.
| | - Fernanda Pereira Dos Santos Silva
- Department of Physical Therapy, Neuropediatrics Sector, Federal University of São Carlos (UFSCar), Rodovia Washington Luis, km 235, 13565-905 São Carlos, SP, Brazil.
| | - Nelci Adriana Cicuto Ferreira Rocha
- Department of Physical Therapy, Neuropediatrics Sector, Federal University of São Carlos (UFSCar), Rodovia Washington Luis, km 235, 13565-905 São Carlos, SP, Brazil.
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36
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Lobo MA, Kokkoni E, de Campos AC, Galloway JC. Not just playing around: infants' behaviors with objects reflect ability, constraints, and object properties. Infant Behav Dev 2014; 37:334-51. [PMID: 24879412 PMCID: PMC4083016 DOI: 10.1016/j.infbeh.2014.05.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Revised: 02/26/2014] [Accepted: 05/04/2014] [Indexed: 10/25/2022]
Abstract
This study describes infants' behaviors with objects in relation to age, body position, and object properties. Object behaviors were assessed longitudinally in 22 healthy infants supine, prone, and sitting from birth through 2 years. Results reveal: (1) infants learn to become intense and sophisticated explorers within the first 6 months of life; (2) young infants dynamically and rapidly shift among a variety of behavioral combinations to gather information; (3) behaviors on objects develop along different trajectories so that behavioral profiles vary across time; (4) object behaviors are generally similar in supine and sitting but diminished in prone; and (5) infants begin matching certain behaviors to object properties as newborns. These data demonstrate how infants learn to match their emerging behaviors with changing positional constraints and object affordances.
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Affiliation(s)
- Michele A Lobo
- Department of Physical Therapy, The University of Delaware, United States.
| | - Elena Kokkoni
- Department of Physical Therapy, The University of Delaware, United States
| | | | - James C Galloway
- Departments of Physical Therapy and Psychology, University of Delaware, United States
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Abstract
OBJECTIVE To review literature concerning Marden-Walker syndrome (MWS) and describe physical-functional characteristics of a child with a suspected diagnosis of MWS. METHODS Physical examination, laboratory and clinical tests were collected in a two-year-old boy. Bayley Scales of Infant and Toddler Development (BSITD-III) was applied to evaluate motor-cognitive development. RESULTS Several facial features (blepharophimosis/micrognathia/cleft palate/pectus deformation/kyphoscoliosis), besides delayed physical growth, anemia, hypoplastic muscles, muscle atrophy and arachnodactyly were found; which are typically described in MWS. BSITD-III scaled scores were 1, 2 and 1, respectively, for gross-motor, fine-motor and cognitive skills; representing delays that were slightly more severe for gross-motor and cognitive skills compared with fine motor. We did not find joint contractures, which are strongly associated with MWS. Instead, we observed moderate muscle shortening. CONCLUSIONS The results found could be attributed to the early intervention applied to the child since eight months old; findings that highlight the importance of early intervention.
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Affiliation(s)
- Adriana Neves dos Santos
- Department of Physical Therapy, Universidade Federal de Santa Catarina , Santa Catarina , Brazil and
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38
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de Campos AC, Kukke SN, Hallett M, Alter KE, Damiano DL. Characteristics of bilateral hand function in individuals with unilateral dystonia due to perinatal stroke: sensory and motor aspects. J Child Neurol 2014; 29:623-32. [PMID: 24396131 PMCID: PMC4096971 DOI: 10.1177/0883073813512523] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The authors assessed bilateral motor and sensory function in individuals with upper limb dystonia due to unilateral perinatal stroke and explored interrelationships of motor function and sensory ability. Reach kinematics and tactile sensation were measured in 7 participants with dystonia and 9 healthy volunteers. The dystonia group had poorer motor (hold time, reach time, shoulder/elbow correlation) and sensory (spatial discrimination, stereognosis) outcomes than the control group on the nondominant side. On the dominant side, only sensation (spatial discrimination, stereognosis) was poorer in the dystonia group compared with the control group. In the dystonia group, although sensory and motor outcomes were uncorrelated, dystonia severity was related to poorer stereognosis, longer hold and reach times, and decreased shoulder/elbow coordination. Findings of bilateral sensory deficits in dystonia can be explained by neural reorganization. Visual compensation for somatosensory changes in the nonstroke hemisphere may explain the lack of bilateral impairments in reaching.
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Affiliation(s)
| | - Sahana N. Kukke
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center,Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health
| | - Katharine E. Alter
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center,Mount Washington Pediatric Hospital
| | - Diane L. Damiano
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center
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Chao CC, Karabanov AN, Paine R, Carolina de Campos A, Kukke SN, Wu T, Wang H, Hallett M. Induction of motor associative plasticity in the posterior parietal cortex-primary motor network. Cereb Cortex 2013; 25:365-73. [PMID: 23968834 DOI: 10.1093/cercor/bht230] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
There is anatomical and functional connectivity between the primary motor cortex (M1) and posterior parietal cortex (PPC) that plays a role in sensorimotor integration. In this study, we applied corticocortical paired-associative stimuli to ipsilateral PPC and M1 (parietal ccPAS) in healthy right-handed subjects to test if this procedure could modulate M1 excitability and PPC-M1 connectivity. One hundred and eighty paired transcranial magnetic stimuli to the PPC and M1 at an interstimulus interval (ISI) of 8 ms were delivered at 0.2 Hz. We found that parietal ccPAS in the left hemisphere increased the excitability of conditioned left M1 assessed by motor evoked potentials (MEPs) and the input-output curve. Motor behavior assessed by the Purdue pegboard task was unchanged compared with controls. At baseline, conditioning stimuli over the left PPC potentiated MEPs from left M1 when ISI was 8 ms. This interaction significantly attenuated at 60 min after left parietal ccPAS. Additional experiments showed that parietal ccPAS induced plasticity was timing-dependent, was absent if ISI was 100 ms, and could also be seen in the right hemisphere. Our results suggest that parietal ccPAS can modulate M1 excitability and PPC-M1 connectivity and is a new approach to modify motor excitability and sensorimotor interaction.
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Affiliation(s)
- Chi-Chao Chao
- Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorder and Stroke, Department of Neurology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Anke Ninija Karabanov
- Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorder and Stroke, Danish Research Center for Magnetic Resonance, Hvidovre Hospital, Hvidovre DK-2650, Denmark, Department of Exercise and Sport Sciences, Copenhagen University, Copenhagen DK-2200, Denmark and
| | - Rainer Paine
- Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorder and Stroke
| | - Ana Carolina de Campos
- Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorder and Stroke
| | - Sahana N Kukke
- Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorder and Stroke
| | - Tianxia Wu
- Centre for Information Technology, National Institutes of Health, Bethesda, MD 20892, USA
| | - Han Wang
- Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorder and Stroke, Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - Mark Hallett
- Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorder and Stroke
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de Campos AC, da Costa CSN, Savelsbergh GJP, Rocha NACF. Infants with Down syndrome and their interactions with objects: development of exploratory actions after reaching onset. Res Dev Disabil 2013; 34:1906-1916. [PMID: 23584171 DOI: 10.1016/j.ridd.2013.03.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 03/03/2013] [Accepted: 03/04/2013] [Indexed: 06/02/2023]
Abstract
During infant development, objects and their functions are learned by means of active exploration. Factors that may influence exploration include reaching and grasping ability, object properties and the presence of developmental disorders. We assessed the development of exploratory actions in 16 typically-developing (TD) infants and 9 infants with Down syndrome (DS) after reaching onset. Infants with DS reached for and explored objects less frequently than TD infants, especially small objects. Over time, the amount of reaches increased in both groups, with no changes in the amount of exploration in the DS group. Pre-grasping actions were different across objects, but less efficient in generating action-relevant information in the DS group. These infants also performed fewer behaviors requiring complex motor skills. The results suggest that perceptual-motor abilities determine different exploratory behaviors in TD and DS infants. The reduced amount and complexity of exploratory actions may impact developmental outcome in DS.
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Affiliation(s)
- Ana Carolina de Campos
- Department of Physiotherapy, Neuropediatrics Sector, Federal University of São Carlos (UFSCar), Rodovia Washington Luis, km 235, 13565-905 São Carlos, SP, Brazil.
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Visicato LP, Costa CSND, Taube OLS, Campos ACD. Proposta de atuação fisioterapêutica em uma criança com síndrome de Angelman, enfatizando o equilíbrio postural: estudo de caso. Fisioter Pesqui 2013. [DOI: 10.1590/s1809-29502013000100012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A síndrome de Angelman (SA) é caracterizada por alterações neuromotoras como marcha atáxica e atraso na aquisição de habilidades motoras, porém são escassos os estudos investigando o efeito de intervenções aplicadas a essa população. O objetivo do estudo foi verificar o efeito de um treino de equilíbrio em uma criança com SA. Participou do estudo uma criança de nove anos de idade com diagnóstico de SA, sexo feminino. Foi aplicado um protocolo para treino de equilíbrio por oito semanas, com frequência de duas vezes por semana. O treino consistiu em atividades envolvendo equilíbrio estático sob diversas condições de dificuldade. Após o treino, a análise de biofotogrametria computadorizada do equilíbrio estático revelou redução do grau de oscilação, que passou de 38° para 13,78°. A pontuação na escala de Berg passou de 27 pontos, na avaliação, para 37 pontos na reavaliação. No teste Timed Up & Go, a criança realizou a tarefa em 15 segundos, na avaliação, e, na reavaliação, em 12 segundos. Em conjunto, os resultados sugerem que o treino favoreceu melhora no equilíbrio estático e dinâmico, bem como na mobilidade funcional.
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Abstract
O objetivo do estudo foi comparar crianças com síndrome de Down (SD) e crianças típicas quanto ao desempenho motor fino, avaliado pela Bayley Scales of Infant and Toddler Development - Third Edition (BSITD-III), e o desempenho em autocuidado segundo o Inventário Pediátrico de Avaliação de Incapacidade (PEDI); e investigar associação entre ambos os domínios. Participaram 12 crianças típicas e 12 crianças com SD, avaliadas na idade de 2 anos. As crianças com SD apresentaram desempenho motor fino e funcionalidade inferior às crianças típicas, possivelmente por dificuldades em desempenhar tarefas que exijam destreza e coordenação manual, como as que compõem a BSITD-III. Apesar disso, sua pontuação em autocuidado foi adequada para a faixa etária, possivelmente porque as habilidades funcionais exigidas nesse período, como retirar calçados/vestimenta, impõem menor demanda motora fina do que tarefas da BSITD-III. Esse fato pode ter contribuído para o bom desempenho funcional das crianças com SD, e para a ausência de associação entre os domínios. Fatores como os cuidados oferecidos à criança pelos cuidadores, bem como ambientes estimuladores provavelmente também contribuíram para os resultados.
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de Campos AC, Savelsbergh GJP, Rocha NACF. What do we know about the atypical development of exploratory actions during infancy? Res Dev Disabil 2012; 33:2228-2235. [PMID: 22820063 DOI: 10.1016/j.ridd.2012.06.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 06/27/2012] [Accepted: 06/27/2012] [Indexed: 06/01/2023]
Abstract
Recent theoretical approaches to infant development have highlighted the importance of exploratory actions to motor, perceptual and cognitive development in infancy. However, the performance of infants exposed to risk factors when exploring objects has been frequently overlooked as a variable of interest. The aim of this study was to review scientific publications investigating the role of developmental risk factors on the development of exploratory actions over objects. Electronic databases (Medline and Science Direct) were searched for papers by using for the following key-words in combination: "exploration", "exploratory", "infants". Eighteen papers were included in the review. The performance of infants exposed to various risk conditions such as prematurity, blindness, Down syndrome, autism and low socioeconomic level have been addressed in the literature. Each risk condition has influenced infants' behaviors in particular ways. Considerations for further research were made based on issues raised by the review that still need to be further understood.
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Affiliation(s)
- Ana Carolina de Campos
- Department of Physiotherapy, Neuropediatrics Sector, Federal University of São Carlos (UFSCar), Brazil.
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Santos MMD, Campos ACD, Rocha NACF. Ajustes nos movimentos de alcançar e apreender objetos: impacto da Síndrome de Down. Rev Bras Saude Mater Infant 2012. [DOI: 10.1590/s1519-38292012000200009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVOS: verificar a influência das propriedades dos objetos nos ajustes realizados por lactentes típicos e com Síndrome de Down (SD) dos quatro aos oito meses de idade ao alcançar e apreender objetos. MÉTODOS: 16 lactentes, avaliados uma vez ao mês dos 4 aos 8 meses, sendo oito típicos e oito com SD. Quatro objetos esféricos (maleável grande, maleável pequeno, rígido grande e rígido pequeno) foram apresentados, e os cinco primeiros movimentos válidos foram registrados para análise das variáveis: ajuste proximal (uni e bimanual), ajuste distal (orientação da palma, abertura da mão) e apreensão do objeto. RESULTADOS: os lactentes típicos apresentaram mais ajuste bimanual para objetos grandes aos seis e oito meses e os com SD aos sete meses. Quanto aos ajustes distais, os lactentes típicos variaram seu comportamento enquanto os com SD apresentaram uso predominante da posição oblíqua. Em geral, o grupo típico apresentou maior sucesso na apreensão dos objetos rígidos e maleável pequeno quando comparados aos lactentes com SD. CONCLUSÕES: Os lactentes com SD apresentaram menor variedade de ajustes o que levou a um menor sucesso na apreensão, possivelmente devido a restrições intrínsecas da SD.
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Rocha NACF, de Campos AC, Silva FPDS, Tudella E. Adaptive actions of young infants in the task of reaching for objects. Dev Psychobiol 2012; 55:275-82. [DOI: 10.1002/dev.21026] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Accepted: 02/22/2012] [Indexed: 11/11/2022]
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dos Santos AN, Pavão SL, de Campos AC, Rocha NACF. International Classification of Functioning, Disability and Health in children with cerebral palsy. Disabil Rehabil 2011; 34:1053-8. [PMID: 22107334 DOI: 10.3109/09638288.2011.631678] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE We intended to describe how concepts from recent models of disability have been studied for evaluation of children with cerebral palsy (CP) and their clinical implications. METHOD We revised studies that focused on the components of the International Classification of Functioning, Disability and Health (ICF) in children with CP. RESULTS Researchers have reported that children with CP exhibit impairments in various body functions/structures, limitations in functional activities performance and experience poorer participation outcomes than their typical peers. Moreover, it has been showed that participation of children with CP was affected by environmental factors. CONCLUSION Therefore, evaluation and rehabilitation processes should be focused on the quality of life improvement by emphasizing what a child can and wants to execute within the environment. Also, environmental factors should be recognized so that barriers could be minimized and adaptations to the environment achieved. However, few studies have verified the interrelationship between contextual factors and the functioning and disability domains in children with CP. This would allow us to know about approaches specifically designed for these children's needs.
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Affiliation(s)
- Adriana Neves dos Santos
- Department of Physiotherapy, Neuropediatrics Section, Universidade Federal de São Carlos, Rod. Washington Luis, São Carlos-SP, Brazil.
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Abstract
OBJECTIVE To support the use of TUG and TUDS to detect changes in functional mobility in children with mild cerebral palsy. METHODS Six children with spastic cerebral palsy and classified by GMFCS as level I or II were enrolled in the study. The gross motor function was measured by the GMFM and functional mobility by the TUG and TUDS. The participants were assessed before and after an 8-week follow-up. RESULTS After this period, increased GMFM scores were found at dimensions D (standing) and E (walking, running and jumping). The time to complete TUG and TUDS was shorter after the follow-up period. Negative correlations were found between GMFM dimension E and the TUG and TUDS tests. CONCLUSION Changes in the gross motor skills measured by the GMFM may be accompanied by changes in the movement speed measured by TUG and TUDS. These tests may complement information provided by GMFM.
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de Campos AC, Francisco KR, Savelsbergh GJP, Rocha NACF. How do object size and rigidity affect reaching and grasping in infants with Down syndrome? Res Dev Disabil 2011; 32:246-252. [PMID: 20970958 DOI: 10.1016/j.ridd.2010.09.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Accepted: 09/27/2010] [Indexed: 05/30/2023]
Abstract
Reaching and grasping skills have been described to emerge from a dynamic interaction between intrinsic and extrinsic factors. The purpose of the present study was to investigate the interaction between such an intrinsic factor, Down syndrome, and extrinsic factors, such as different object properties. Seven infants with Down syndrome and seven infants with typical development were assessed at the ages of 4, 5 and 6 months. The findings showed that object size influenced the kinematics of reaching for the infants with Down syndrome and the grasping frequency for the typical infants. The object rigidity was shown to have a major influence on grasping frequency.
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Affiliation(s)
- Ana Carolina de Campos
- Department of Physiotherapy, Neuropediatrics Sector, Federal University of São Carlos, Brazil.
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Abstract
O estudo visou avaliar o desempenho motor e sensorial de lactentes com e sem síndrome de Down (SD) aos seis meses de vida. Foram avaliados oito lactentes, sendo quatro com SD e quatro típicos, com 24 semanas de vida. Para verificar o desempenho motor foi utilizada a escala motora infantil de Alberta (AIMS), nas posturas supina, prona, sentada e em pé. O desempenho sensorial foi avaliado por meio de entrevista com o cuidador da criança utilizando o perfil sensorial infantil ITSP (infant/toddler sensory profile), que classifica comportamentos sensoriais como de"baixo registro" (dificuldade em registrar estímulos sensoriais), busca de estímulos, excessiva sensibilidade a estímulos e comportamentos de evitar estímulos. Os resultados no ITSP mostram que os lactentes com SD obtiveram piores escores em baixo registro, possivelmente por apresentarem altos limiares neurológicos, demorando mais para responder aos estímulos. Na AIMS os lactentes com SD tiveram um desempenho inferior quando comparados aos típicos na subescala prono, o que pode advir de dificuldades no controle postural e antigravitacional. Não foi encontrada correlação entre os escores do ITSP e da AIMS. Os resultados sugerem que os lactentes com SD podem se engajar com menos freqüência em atividades de interação com o ambiente, tanto por dificuldade em registrar estímulos cotidianos (como diferentes sons e pessoas), quanto por dificuldade em explorar o meio utilizando habilidades motoras.
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de Campos AC, Rocha NACF, Savelsbergh GJP. Development of reaching and grasping skills in infants with Down syndrome. Res Dev Disabil 2010; 31:70-80. [PMID: 19713074 DOI: 10.1016/j.ridd.2009.07.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2009] [Accepted: 07/25/2009] [Indexed: 05/28/2023]
Abstract
Reaching and grasping skills have been described to emerge from a dynamic interaction between intrinsic and extrinsic factors. The aims of the study were to investigate the effect of such intrinsic factors as age and Down syndrome on the development of reaching and grasping skills and on overall gross motor skill, and to test the influence of the overall level of gross motor skill on the development of reaching and grasping. Seven infants with Down syndrome (DS) and seven infants with typical development were assessed at the ages of 4, 5 and 6 months. The following variables were analyzed: straightness index, mean velocity, movement units and deceleration time (for reaching movements), grasping frequency and AIMS scores. Intrinsic factors such as age and DS were found to influence the development of reaching, grasping, and of the overall level of gross motor skill. The overall level of gross motor skill was observed to influence grasping.
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Affiliation(s)
- Ana Carolina de Campos
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil.
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