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Brauers L, Smeets R, Feys P, Gordon AM, Janssen-Potten Y, Ortibus E, Feys H, Rameckers E, Klingels K. Children With Cerebral Palsy Show Higher Static-But Not Higher Dynamic-Motor Fatigability in Grip and Pinch Tasks Than Children With Typical Development Do. Phys Ther 2023; 103:pzac155. [PMID: 37104625 PMCID: PMC10071583 DOI: 10.1093/ptj/pzac155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 06/16/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate differences in static and dynamic motor fatigability during grip and pinch tasks between children with unilateral spastic cerebral palsy (USCP) and children with typical development (TD) and between preferred and nonpreferred hands. METHODS Fifty-three children with USCP and 53 age-matched children with TD (mean = 11 years 1 month; SD = 3 years 8 months) participated in 30-second maximum exertion sustained and repeated grip and pinch tasks. For sustained tasks, the Static Fatigue Index and the ratio of mean force between the first and last thirds of the curve were calculated. For repeated tasks, the ratio of mean force and the ratio of numbers of peaks between the first and last thirds of the curve were calculated. RESULTS Higher Static Fatigue Index scores for grip and pinch were found with USCP in both hands and between hands in both groups. Dynamic motor fatigability showed inconsistent results, with higher levels of fatigability in children with TD than in children with USCP for grip in the ratio of mean force between the first and last thirds of the curve in nonpreferred hands and in the ratio of number of peaks between the first and last thirds of the curve in preferred hands. CONCLUSION Higher motor fatigability in children with USCP than in children with TD was found for static but not dynamic grip and pinch. Underlying mechanisms may play different roles in static and dynamic motor fatigability. IMPACT These results highlight that static motor fatigability in grip and pinch tasks should be part of a comprehensive upper limb assessment and that this could be the target of individualized interventions.
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Affiliation(s)
- Lieke Brauers
- REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands
| | - Rob Smeets
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands
| | - Peter Feys
- REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Andrew M Gordon
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Yvonne Janssen-Potten
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands
- Center of Expertise, Adelante Rehabilitation Center, Valkenburg, the Netherlands
| | - Els Ortibus
- Department of Development and Regeneration, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Hilde Feys
- Research Group for Neurorehabilitation, Department of Rehabilitation Sciences, KU Leuven, Belgium
| | - Eugene Rameckers
- REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands
- Center of Expertise, Adelante Rehabilitation Center, Valkenburg, the Netherlands
| | - Katrijn Klingels
- REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Research Group for Neurorehabilitation, Department of Rehabilitation Sciences, KU Leuven, Belgium
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Fan Y, Bai D, Cheng C, Tian G. The effectiveness and safety of blood flow restriction training for the post-operation treatment of distal radius fracture. Ann Med 2023; 55:2240329. [PMID: 37505919 PMCID: PMC10392265 DOI: 10.1080/07853890.2023.2240329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/10/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
INTRODUCTION Distal radius fracture (DRF) is a common injury in the upper extremities. Blood flow restriction (BFR) has been proven to be effective in improving function in low-load training, which is suitable for post-op rehabilitation. We explored the effectiveness and safety of BFR therapy in DRF patients who underwent surgery. MATERIALS AND METHODS Thirty-five patients were randomly assigned to either the BFR or the regular training (RT; no BFR therapy) groups. All patients completed the same 4-week postoperative rehabilitation program, including anti-inflammatory treatments, strengthening and range of motion (ROM) training. In the BFR group, the pressure was 120 mmHg in strengthening training course. Pain, circumferences of wrists and forearms, ROM, muscle strength, and D-dimer levels were evaluated at weeks 0, 2, and 4. Radius union scoring system (RUSS) was measured at weeks 4 and 12. Finally, wrist functionality (Cooney modification) was evaluated at week 12. RESULTS The BFR group had significantly decreased pain levels compared with the RT group (p < 0.01, effect size= 2.33, -2.44 at weeks 2 and 4). Swelling was effectively relieved in both groups. The wrist swelling was less in the BFR group (p < 0.01, effect size = -2.17 at week 4). The isometric strength of wrist extension (p < 0.01, effect size = 1.5, 3.02 at weeks 2 and 4), flexion (p < 0.01, effect size = 1.33, 2.53 at weeks 2 and 4), and functionality significantly increased in the BFR group (p < 0.01, effect size = 2.80 at week 12). No risk of VT in the BFR group was found. BFR did not threaten bone healing. CONCLUSIONS In patients with DRF who underwent corrective surgery, BFR therapy effectively relieved pain and swelling, increased muscle strength and wrist function, and had no additional risks for bone healing and VT.
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Affiliation(s)
- Yi Fan
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dingqun Bai
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chongyuan Cheng
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Guihua Tian
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Uno Y, Ogasawara I, Konda S, Yoshida N, Otsuka N, Kikukawa Y, Tsujii A, Nakata K. Validity of Spatio-Temporal Gait Parameters in Healthy Young Adults Using a Motion-Sensor-Based Gait Analysis System (ORPHE ANALYTICS) during Walking and Running. SENSORS (BASEL, SWITZERLAND) 2022; 23:s23010331. [PMID: 36616928 PMCID: PMC9823871 DOI: 10.3390/s23010331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/13/2022] [Accepted: 12/23/2022] [Indexed: 05/25/2023]
Abstract
Motion sensors are widely used for gait analysis. The validity of commercial gait analysis systems is of great interest because calculating position/angle-level gait parameters potentially produces an error in the integration process of the motion sensor data; moreover, the validity of ORPHE ANALYTICS, a motion-sensor-based gait analysis system, has not yet been examined. We examined the validity of the gait parameters calculated using ORPHE ANALYTICS relative to those calculated using conventional optical motion capture. Nine young adults performed gait tasks on a treadmill at speeds of 2−12 km/h. The three-dimensional position data and acceleration and angular velocity data of the feet were collected. The gait parameters were calculated from motion sensor data using ORPHE ANALYTICS, and optical motion capture data. Intraclass correlation coefficients [ICC(2,1)] were calculated for relative validities. Eight items, namely, stride duration, stride length, stride frequency, stride speed, vertical height, stance phase duration, swing phase duration, and sagittal angleIC exhibited excellent relative validities [ICC(2,1) > 0.9]. In contrast, sagittal angleTO and frontal angleIC demonstrated good [ICC(2,1) = 0.892−0.833] and moderate relative validity [ICC(2,1) = 0.566−0.627], respectively. ORPHE ANALYTICS was found to exhibit excellent relative validities for most gait parameters. These results suggest its feasibility for gait analysis outside the laboratory setting.
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Affiliation(s)
- Yuki Uno
- Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, Suita 565-0871, Osaka, Japan
- ORPHE Inc., Shibuya 151-0053, Tokyo, Japan
| | - Issei Ogasawara
- Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, Suita 565-0871, Osaka, Japan
- Department of Sports Medical Biomechanics, Graduate School of Medicine, Osaka University, Suita 565-0871, Osaka, Japan
| | - Shoji Konda
- Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, Suita 565-0871, Osaka, Japan
- Department of Sports Medical Biomechanics, Graduate School of Medicine, Osaka University, Suita 565-0871, Osaka, Japan
| | - Natsuki Yoshida
- Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, Suita 565-0871, Osaka, Japan
| | | | | | - Akira Tsujii
- Department of Sports Medical Biomechanics, Graduate School of Medicine, Osaka University, Suita 565-0871, Osaka, Japan
| | - Ken Nakata
- Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, Suita 565-0871, Osaka, Japan
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Brauers L, Smeets R, Feys P, Gordon AM, van der Leij-Roelofsen B, Bastiaenen C, Rameckers E, Klingels K. Test-Retest Reliability of a Static and Dynamic Motor Fatigability Protocol Using Grip and Pinch Strength in Children With Cerebral Palsy. Phys Ther 2022; 102:6632290. [PMID: 35793460 DOI: 10.1093/ptj/pzac088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 10/03/2021] [Accepted: 01/02/2022] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the test-retest reliability, measurement error, and interpretability of new motor fatigability outcomes of grip and pinch strength for children with unilateral cerebral palsy (UCP). METHODS Motor fatigability during grip and pinch strength was measured twice (within 48 hours) in both hands of 50 children (mean age = 11 years 2 months; 14, 31, and 5 children with Manual Ability Classification System levels I, II, and III, respectively) using a 30-second static and dynamic maximum exertion protocol. For static motor fatigability, the Static Fatigue Index (SFI) and mean force (Fmean) in the first (Fmean1) and last (Fmean3) 10 seconds were calculated. For dynamic motor fatigability, Fmean1, Fmean3, and the number of peaks in the first and last 10 seconds were calculated. RESULTS For static motor fatigability, the intraclass correlation coefficients (ICCs) were moderate to high for Fmean1 and Fmean3 (0.56-0.88), and the SFI showed low to moderate reliability (ICC = 0.32-0.72). For dynamic motor fatigability, the ICCs were moderate to high for all outcomes (0.54-0.91). The standard error of measurement agreement and the smallest detectable difference agreement were large in all outcomes, except for the SFI in static motor fatigability. Details per age group are provided. In general, younger children (6-11 years old) showed lower reliability than older children (12-18 years old). CONCLUSION Most outcome measures for static and dynamic motor fatigability of grip and pinch strength show moderate to high reliability in children with UCP, indicating that these tests can be used reliably to investigate the presence of motor fatigability in UCP, especially in older children. Standard error of measurement agreement and smallest detectable difference agreement indicated that these outcome measures should be interpreted with caution when evaluating change. IMPACT Most of the proposed outcome measures for static and dynamic motor fatigability of grip and pinch are reliable in children with UCP and can be used for discriminative purposes.
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Affiliation(s)
- Lieke Brauers
- REVAL - Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.,Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Rob Smeets
- Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Peter Feys
- REVAL - Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Andrew M Gordon
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York
| | | | - Caroline Bastiaenen
- Department of Epidemiology, Research Line: Function, Participation and Rehabilitation, CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Eugene Rameckers
- REVAL - Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.,Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands.,Centre of Expertise, Adelante Rehabilitation Centre, Valkenburg, The Netherlands
| | - Katrijn Klingels
- REVAL - Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
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