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Velghe S, Rameckers E, Meyns P, Johnson C, Hallemans A, Verbecque E, Klingels K. Effects of a highly intensive balance therapy camp in children with developmental coordination disorder - An intervention protocol. Res Dev Disabil 2024; 147:104694. [PMID: 38382234 DOI: 10.1016/j.ridd.2024.104694] [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: 05/12/2023] [Accepted: 02/02/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Children with Developmental Coordination Disorder (DCD) often (<87 %) experience postural control problems, impacting all levels of the International Classification of Functioning, Disability and Health (ICF) including their daily participation, self-esteem and mental health. Due to the multisystemic nature of postural control, comprehensive therapy should target all systems which is currently not the case. Highly intensive therapy is effective and commonly used in pediatric populations, but has not been explored yet to train postural control in children with DCD. AIMS To investigate the effects of a highly intensive functional balance therapy camp at all ICF levels in children with DCD. METHODS AND PROCEDURES The effects on postural control, muscle activity, brain alterations, self-perceived competence, self-identified goals, gross motor activities and participation are evaluated. Participants are assessed pre- and post-intervention, including a 3 months follow-up. Forty-eight children with DCD, aged 6-12 years old, receive 40 h of comprehensive balance training. This intervention is fun, individually tailored, targets all postural control systems, implements different motor learning strategies and includes both individual and group activities. CONCLUSION Novel insights into the effects of a highly intensive comprehensive balance therapy camp designed for children with DCD will be gained at all levels of the ICF.
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Affiliation(s)
- Silke Velghe
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.
| | - Eugene Rameckers
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; Department of Rehabilitation Medicine, Functioning, Participation & Rehabilitation research line, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands; Centre of Expertise, Adelante Rehabilitation Centre, Valkenburg, the Netherlands
| | - Pieter Meyns
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Charlotte Johnson
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; Research group MOVANT, University of Antwerp, Antwerp, Belgium
| | - Ann Hallemans
- Research group MOVANT, University of Antwerp, Antwerp, Belgium
| | - Evi Verbecque
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Katrijn Klingels
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
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Halapanavar B, Padmini MN, Deshmukh S, Tirupathi S, Waremani AS, Kasodekar A. Comparison of Skeletal Changes in the Temporomandibular Joint between the Twin Block Appliance and Fixed Functional Appliance: A Longitudinal Follow-up Study. Int J Clin Pediatr Dent 2024; 17:7-14. [PMID: 38559857 PMCID: PMC10978514 DOI: 10.5005/jp-journals-10005-2727] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Aim This current study evaluated and compared the skeletal changes in the head of the condyle, glenoid fossa, and articular space between the twin block appliance and PowerScope™ a fixed functional appliance. Materials and methods This study was a pilot, randomized, single-blinded, assessing the skeletal changes in the components of the temporomandibular joint (TMJ) using cone-beam computed tomography (CBCT). The study was conducted in 20 subjects in the age range of 11-14 years with class II division 1 malocclusion. These subjects were distributed randomly between two groups with an allocation ratio of 1:1 (group I-twin block and group I-PowerScope™). Follow-ups of both groups were done till desirable skeletal correction was attained (clinical edge-to-edge incisor relation). Results Condylar parameters such as position, height, and length were evaluated bilaterally in the CBCT scans. After using both devices, there was an increase in all condylar qualities; however, the twin block appliance showed a more noticeable difference, which has been determined to be statistically significant. In the twin block group, there was an average decrease of 0.56 mm in the anterior articular space and an increase of 1.2 and 2.64 mm in the middle and posterior articular spaces, respectively. In the PowerScope™ group, there was an average decrease of 0.23 mm in the anterior articular space and an increase of 2.55 and 1.85 mm in the middle and posterior articular spaces, respectively. In the case of the twin block device, the change in glenoid fossa angle was observed to be 6.1 mm on both sides and a mean difference of 1.25 mm on the right-side and 1.75 mm on the left-side was observed in the case of PowerScope™. The difference was established to be significant with a p < 0.05 in all cases. Conclusion Condylar attributes increased after the application of both devices but the difference was more pronounced in the case of twin block appliances. The difference in articular space (middle and posterior) between the twin block group and PowerScope™ group, was not significant statistically. In the present study, the remodeling in the glenoid fossa was greater in the twin block group compared to the PowerScope™ group. How to cite this article Halapanavar B, MN P, Deshmukh S, et al. Comparison of Skeletal Changes in the Temporomandibular Joint between the Twin Block Appliance and Fixed Functional Appliance: A Longitudinal Follow-up Study. Int J Clin Pediatr Dent 2024;17(1):7-14.
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Affiliation(s)
- Bhakti Halapanavar
- Department of Orthodontics & Dentofacial Orthopedics, Dr DY Patil Dental College and Hospital, Dr DY Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India
| | - MN Padmini
- Department of Orthodontics, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | - Sonali Deshmukh
- Department of Orthodontics & Dentofacial Orthopedics, Dr DY Patil Dental College and Hospital, Dr DY Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India
| | - Sunnypriyatham Tirupathi
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India
| | - Afshan S Waremani
- Department of Orthodontics, Dayananda Sagar College of Dental Sciences, Bengaluru, Karnataka, India
| | - Aniket Kasodekar
- Department of Orthodontics, Maratha Mandal's Nathajirao G. Halgekar Institute of Dental Sciences & Research Centre, Belagavi, Karnataka, India
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Iodice R, Aceto G, Ruggiero L, Cassano E, Manganelli F, Dubbioso R. A review of current rehabilitation practices and their benefits in patients with multiple sclerosis. Mult Scler Relat Disord 2023; 69:104460. [PMID: 36535234 DOI: 10.1016/j.msard.2022.104460] [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: 09/14/2022] [Revised: 11/18/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022]
Abstract
Multiple sclerosis (MS) is a chronic, debilitating disease characterised by demyelination of the nerves of the central nervous system that results in patients progressively losing the ability to perform daily tasks. As there is no cure for this disease, rehabilitation therapy is an important aspect of care; assisting patients to regain or retain function and improve their physical, mental and social wellbeing. At present there is no current consistent model of care for MS, likely due to the variable symptom presentation. Various forms of rehabilitation therapy are available, and these include physical rehabilitation methods, such as balance and gait therapy, speech and respiration rehabilitation, and occupational therapy. Contrary to previous understanding, exercise-based therapies have shown various benefits for patients with MS, and in addition to improving MS-related physical symptoms, have been shown to reduce the risk of developing cardiovascular disease and can improve cognitive function. Cognition rehabilitation therapy specifically focuses on behavioural tasks and is divided into two main forms: compensatory rehabilitation, which offers cognitive functioning benefits, and restorative rehabilitation, which offers memory benefits. Excitation therapies include cranial stimulation and other stimulation rehabilitation methods such as focal muscle vibration therapy and these non-invasive techniques may improve patient's physical ability. Additionally, more novel rehabilitation methods include robot-assisted gait therapy and telerehabilitation, both of which are expected to play progressively more prominent roles in the future of rehabilitation therapy. The structure of the care team has been found to impact patient outcomes, and both in- and out-patient care settings have been found to be beneficial, dependant on the patient's circumstances, with certain patients better suited to a particular setting. While a single point of care is recommended for patients, a multidisciplinary care team and regular reassessment is recommended to manage changing symptoms and ensure continuity of care. The importance of the critical components of rehabilitation have been identified, and these are of vital importance in achieving beneficial outcomes. These components include the patients' participation in the treatment, goal setting with a multidisciplinary care team, a guiding-light purpose for the patient, which focusses on recognizing their personal potential and obtaining improvements through a tailored plan. The final critical component of rehabilitation is the results measurement, which highlights the need for a quantifiable reduction in impairment and improvement in activity and participation. Overall, a lack of standardisation in outcome measurements makes comparison challenging. This is particularly important when comparing standard methods of care with more novel rehabilitation techniques. However, within the broad area of rehabilitation therapies, it is clear that patients with MS can benefit from rehabilitation practices; physically, mentally and socially.
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Affiliation(s)
- Rosa Iodice
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Napoli, Italy.
| | - Gabriella Aceto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Napoli, Italy
| | - Lucia Ruggiero
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Napoli, Italy
| | - Emanuele Cassano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Napoli, Italy
| | - Fiore Manganelli
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Napoli, Italy
| | - Raffaele Dubbioso
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Napoli, Italy
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Pavoni C, Cretella Lombardo E, Franchi L, Lione R, Cozza P. Treatment and post-treatment effects of functional therapy on the sagittal pharyngeal dimensions in Class II subjects. Int J Pediatr Otorhinolaryngol 2017; 101:47-50. [PMID: 28964309 DOI: 10.1016/j.ijporl.2017.07.032] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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] [Received: 06/09/2017] [Revised: 07/22/2017] [Accepted: 07/23/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To evaluate the craniofacial changes induced by functional appliances with special regard to the oro and nasopharyngeal sagittal airway dimensions in subjects with dentoskeletal Class II malocclusions when compared with an untreated Class II control group immediately after therapy and at long-term observation. METHODS A group of 40 patients (21 females and 19 males) with Class II malocclusion treated consecutively either with a Bionator or an Activator followed by fixed appliances was compared with a matched control group of 31 subjects (16 females and 15 males) with untreated Class II malocclusion. The treated sample was evaluated at T1, start of treatment (mean age: 9.9 ± 1.4 years); T2, end of functional treatment and prior to fixed appliances (mean age: 11.9 ± 1.3 years); and T3, long-term observation at the end of growth (mean age: 18.2 ± 2.1 years). Statistical comparisons were performed with independent sample t tests at T1 (baseline characteristics) and for the T1-T2, T2-T3, and T1-T3 changes. RESULTS During active treatment the treated group showed a significant increment in lower airway dimension (PNS-AD1), as well as a significant improvement in the upper airway dimension (PNS-AD2). A significant decrease in the upper adenoid size (AD2-H) was also found. In the longterm evaluation, a significant increase in both lower and upper airway thickness (PNS-AD1; PNS-AD2) and a significant decrease in the upper adenoid thickness were still present in the treated group. CONCLUSION The treatment with functional appliances produced significant favorable changes during active treatment in the oro- and nasopharyngeal sagittal airway dimensions in dentoskeletal Class II subjects when compared with untreated controls, and these changes were stable in the long-term.
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Affiliation(s)
- Chiara Pavoni
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy.
| | | | - Lorenzo Franchi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy; Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
| | - Roberta Lione
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy
| | - Paola Cozza
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy; Department of Orthodontics, University Zoja e Këshillit të Mirë, Tirane, Albania
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Speth L, Janssen-Potten Y, Leffers P, Rameckers E, Defesche A, Winkens B, Becher J, Smeets R, Vles JSH. Effects of botulinum toxin A and/or bimanual task-oriented therapy on upper extremity impairments in unilateral Cerebral Palsy: an explorative study. Eur J Paediatr Neurol 2015; 19:337-48. [PMID: 25661064 DOI: 10.1016/j.ejpn.2015.01.004] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 11/11/2014] [Accepted: 01/11/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study reports on the effects of botulinum toxin A (BoNT-A) injections in the upper extremity (UE) of children with unilateral Cerebral Palsy (uCP) combined with bimanual task oriented therapy (BITT) or either treatment modality performed separately on UE range of motion (ROM), spasticity and (functional) strength. METHODS Thirty-five children, mean age 7.14 years (SD 2.63) of whom 11 had a Manual Ability Classification Score (MACS) I, 15 MACS II and 9 MACS III, participated. The trial started with four study groups: BoNT-A-only (n = 5), BITT-only (n = 11), BoNT-A + BITT (n = 13), and control (n = 6). Twenty-two children were randomized and, due to recruitment problems 13 children received their parents' preferred treatment: BoNT-A + BITT or BITT-only. Three comparisons were analysed: BITT (BoNT-A + BITT and BITT-only; n = 24) versus no BITT (BoNT-A-only and control; n = 11), BoNT-A (BoNT-A-only and BoNT-A + BITT; n = 18) versus no BoNT-A (BITT-only and control; n = 17), and the additional effect of BoNT-A (BoNT-A + BITT versus BITT-only). RESULTS BoNT-A significantly decreased key grip strength and finger flexion tone, had a clinically relevant (additional) positive effect on active thumb abduction and supination and a significantly negative effect on unilateral functional strength. BITT + BoNT-A significantly increased active supination. BITT reduced elbow flexor tone and BITT-only resulted in more improvement than BoNT-A + BITT in functional unimanual and, to a lesser extent, in bimanual grip strength. CONCLUSIONS In comparison with BoNT-A + BITT, BITT-only gives more improvement on functional grip strength and, therefore, could possibly increase bimanual performance. In this case, the (additional) role of BoNT-A may be an increase in active supination and thumb abduction.
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Affiliation(s)
- Lucianne Speth
- Adelante, Paediatric Rehabilitation Centre, Onderstestraat 29, 6301 KA Valkenburg, The Netherlands; Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands.
| | - Yvonne Janssen-Potten
- Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands; Maastricht University, Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht, The Netherlands
| | - Pieter Leffers
- Maastricht University, Department of Epidemiology, Maastricht, The Netherlands
| | - Eugene Rameckers
- Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands; Maastricht University, Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht, The Netherlands
| | - Anke Defesche
- Adelante, Paediatric Rehabilitation Centre, Onderstestraat 29, 6301 KA Valkenburg, The Netherlands
| | - Bjorn Winkens
- Maastricht University, Department of Methodology and Statistics, Maastricht, The Netherlands
| | - Jules Becher
- Free University Medical Centre, Department of Rehabilitation Medicine, Amsterdam, The Netherlands
| | - Rob Smeets
- Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands; Maastricht University, Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht, The Netherlands; Maastricht University Medical Centre, Department of Rehabilitation Medicine, Maastricht, The Netherlands
| | - J S H Vles
- Maastricht University Medical Centre, Department of Neurology, Maastricht, The Netherlands; Maastricht University, Research School GROW, Department of Neurology, Maastricht, The Netherlands
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