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Toomer-Mensah N, O'Neil M, Blacutt M, Quinn L. Measuring Physical Activity in Children Who Do Not Walk and With Cerebral Palsy: An Exploratory Case Series. Pediatr Phys Ther 2024:00001577-990000000-00085. [PMID: 38758603 DOI: 10.1097/pep.0000000000001113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
AIM The purpose of this case series was to describe physical activity (PA) amount and intensity in the home and school environment. Accelerometers and heart rate (HR) monitors are reliable and valid measures of PA in children with cerebral palsy (CP) who can walk. There is limited research on PA measures in children with CP who cannot walk. METHODS Three 9-year-old boys with CP, Gross Motor Function Classification System levels IV and V, participated in a 1-week measurement period wearing waist- and wrist-worn triaxial accelerometers to measure PA counts and a wrist-worn HR monitor to measure PA intensity. PA intensity was calculated using an estimated HR max. Accelerometer counts were reported. Parents and school staff completed activity and eating journals. RESULTS Six days of PA and HR data were analyzed. Two participants spent more time in moderate/vigorous PA intensity during school compared to at home. Activities with greatest PA intensity included oral eating, communication, and social engagement. Higher activity counts were recorded from the wrist compared with the waist accelerometers. PA and eating journal adherence were high in both settings. CONCLUSION The findings provide preliminary data to evaluate PA amount and intensity in children with CP who have little walking ability. It is important to consider PA levels in daily activity for youth with CP when designing plans of care.
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Affiliation(s)
- Nia Toomer-Mensah
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York (Drs Toomer-Mensah and Quinn); Program in Physical Therapy, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, Massachusetts (Dr O'Neil); Department of Physical Therapy, Long Island University, Brooklyn, New York (Dr Toomer-Mensah).; Department of Psychology, Doctoral Program, Notre Dame, Notre Dame, Indiana (Mr Blacutt)
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Pereira KU, Silva MZ, Pfeifer LI. The use of virtual reality in the stimulation of manual function in children with cerebral palsy: a systematic review. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 41:e2021283. [PMID: 36921161 PMCID: PMC10014025 DOI: 10.1590/1984-0462/2023/41/2021283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 01/30/2022] [Indexed: 03/18/2023]
Abstract
OBJECTIVE To identify in national and international literature the use of virtual reality to develop manual skills of children with cerebral palsy. METHODS This is a systematic review carried out in the PubMed database, Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), and the Online System for Search and Analysis of Medical Literature (Ovid Medline) using the keywords "cerebral palsy", "virtual reality", "occupational therapy", "child", "daily activities/activities of daily living", in English and in Portuguese. The selected articles had their methodological quality evaluated through the Physiotherapy Evidence Database (PEDro scale). RESULTS 228 studies were selected, as they included children with cerebral palsy undergoing treatment with exposure to virtual reality to improve manual function in daily activities. Studies on other themes, incomplete, and duplicated reviews were excluded. Three evaluators conducted the study selection process and included 14 articles in the analysis. CONCLUSIONS The findings suggest that virtual reality therapy has contributed to an improvement in the manual function of children with cerebral palsy, constituting a useful resource for a supporting intervention to enhance traditional therapies.
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Affiliation(s)
| | | | - Luzia Iara Pfeifer
- Universidade de São Paulo, Ribeirão Preto, SP, Brazil.,Universidade Federal de São Carlos, São Carlos, SP, Brazil
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Perpetuini D, Russo EF, Cardone D, Palmieri R, Filippini C, Tritto M, Pellicano F, De Santis GP, Pellegrino R, Calabrò RS, Filoni S, Merla A. Psychophysiological Assessment of Children with Cerebral Palsy during Robotic-Assisted Gait Training through Infrared Imaging. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15224. [PMID: 36429941 PMCID: PMC9690262 DOI: 10.3390/ijerph192215224] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/09/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
Cerebral palsy (CP) is a non-progressive neurologic pathology representing a leading cause of spasticity and concerning gait impairments in children. Robotic-assisted gait training (RAGT) is widely employed to treat this pathology to improve children's gait pattern. Importantly, the effectiveness of the therapy is strictly related to the engagement of the patient in the rehabilitation process, which depends on his/her psychophysiological state. The aim of the study is to evaluate the psychophysiological condition of children with CP during RAGT through infrared thermography (IRT), which was acquired during three sessions in one month. A repeated measure ANOVA was performed (i.e., mean value, standard deviation, and sample entropy) extracted from the temperature time course collected over the nose and corrugator, which are known to be indicative of the psychophysiological state of the individual. Concerning the corrugator, significant differences were found for the sample entropy (F (1.477, 5.907) = 6.888; p = 0.033) and for the mean value (F (1.425, 5.7) = 5.88; p = 0.047). Regarding the nose tip, the sample entropy showed significant differences (F (1.134, 4.536) = 11.5; p = 0.041). The findings from this study suggests that this approach can be used to evaluate in a contactless manner the psychophysiological condition of the children with CP during RAGT, allowing to monitor their engagement to the therapy, increasing the benefits of the treatment.
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Affiliation(s)
- David Perpetuini
- Department of Neuroscience and Imaging, University G. D’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | | | - Daniela Cardone
- Department of Engineering and Geology, University G. D’Annunzio of Chieti-Pescara, 65127 Pescara, Italy
| | - Roberta Palmieri
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, Institute of Child Neuropsychiatry, University of Bari, 70121 Bari, Italy
| | - Chiara Filippini
- Department of Neuroscience and Imaging, University G. D’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | | | - Federica Pellicano
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy
| | - Grazia Pia De Santis
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy
| | - Raffaello Pellegrino
- Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, 6912 Lugano, Switzerland
| | | | - Serena Filoni
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy
| | - Arcangelo Merla
- Department of Engineering and Geology, University G. D’Annunzio of Chieti-Pescara, 65127 Pescara, Italy
- ITAB, Institute for Advanced Biomedical Technologies, 66100 Chieti, Italy
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Bekteshi S, Karlsson P, De Reyck L, Vermeerbergen K, Konings M, Hellin P, Aerts JM, Hallez H, Dan B, Monbaliu E. Eye movements and stress during eye-tracking gaming performance in children with dyskinetic cerebral palsy. Dev Med Child Neurol 2022; 64:1402-1415. [PMID: 35393636 DOI: 10.1111/dmcn.15237] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 03/15/2022] [Accepted: 03/15/2022] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to explore eye movements and stress during eye-tracking gaming performance in children with dyskinetic cerebral palsy (CP) compared with typically developing children, and associations between eye-tracking performance, eye movements, stress, and participants' characteristics. METHOD This cohort study included 12 children with dyskinetic CP aged 5 to 12 years (mean age 8 years 7 months, standard deviation [SD] 2 years 3 months) and 23 typically developing children aged 5 to 13 years (mean age 9 years 0 months, SD 2 years 7 months). Participants played 10 eye-tracking games. Tobii X3-120 and Tobii Pro Lab were used to record and analyse eye movements. Stress was assessed through heart rate variability (HRV), recorded during rest, and eye-tracking performance using the Bittium Faros360° ECG Holter device. Eye-tracking performance was measured using gaming completion time. Fixation and saccade variables were used to quantify eye movements, and time- and frequency-domain variables to quantify HRV. Non-parametric statistics were used. RESULTS Gaming completion time was significantly different (p < 0.001) between groups, and it was negatively correlated with experience (rs = -0.63, p = 0.029). No significant differences were found between groups in fixation and saccade variables. HRV significantly changed from rest to eye-tracking performance only in typically developing children and not in children with dyskinetic CP. INTERPRETATION Children with dyskinetic CP took longer to perform the 10 games, especially the inexperienced users, indicating the importance of the early provision of eye-tracking training opportunities. It seems that eye-tracking tasks are not a source of increased stress and effort in children with dyskinetic CP. WHAT THIS PAPER ADDS Participants with dyskinetic cerebral palsy (CP) took twice as long to perform 10 eye-tracking games than typically developing peers. Participants with dyskinetic CP with previous eye-tracking experience performed the games faster. Fixation and saccade variables were not significantly different between children with and without dyskinetic CP. Heart rate variability showed no differences between rest and performance in participants with dyskinetic CP. Gross Motor Function Classification System, Manual Ability Classification System, and Viking Speech Scale levels were not correlated to the eye movements or stress variables.
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Affiliation(s)
- Saranda Bekteshi
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
| | - Petra Karlsson
- University of Sydney, Cerebral Palsy Alliance, Sydney, Australia
| | - Lieselot De Reyck
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
| | - Karen Vermeerbergen
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
| | - Marco Konings
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
| | | | - Jean-Marie Aerts
- KU Leuven, Department of Biosystems, Division of Animal and Human Health Engineering, Measure, Model and Manage Bioresponse (M3-BIORES), Leuven, Belgium
| | - Hans Hallez
- KU Leuven, Bruges Campus, Department of Computer Science, Mechatronics Research Group, Bruges, Belgium
| | - Bernard Dan
- Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Elegast Monbaliu
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
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Bekteshi S, Nica IG, Gakopoulos S, Konings M, Maes R, Cuyvers B, Aerts JM, Hallez H, Monbaliu E. Exercise load and physical activity intensity in relation to dystonia and choreoathetosis during powered wheelchair mobility in children and youth with dyskinetic cerebral palsy. Disabil Rehabil 2021; 44:4794-4805. [PMID: 33970729 DOI: 10.1080/09638288.2021.1921064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To explore the relation between exercise load, physical activity intensity, and movement disorders during powered wheelchair (PW) mobility in people with severe dyskinetic cerebral palsy (DCP). METHODS Ten participants with DCP, 6-21 years old, users of a head/foot steering system were included. Dystonia and choreoathetosis were assessed using the Dyskinesia Impairment Mobility Scale (DIMS), heart rate (HR) was used to assess the exercise load of the tasks on the participants, and the accelerometry-based activity index (AI) to measure the physical activity intensity and energy expenditure during mobility task performance. RESULTS Neck- and distal arm dystonia showed significant correlations with HR (0.64 < rs < 0.77; 0.009 < p < 0.048), whereas neck- and proximal arm choreoathetosis with AI (0.64 < rs < 0.76, 0.011 < p < 0.044). Total-body AI was strongly correlated to the AI of the arms (0.66 < rs < 0.90, < 0.001 < p < 0.038), but not to the AI of the head. CONCLUSIONS During PW mobility tasks, dystonia is associated to exercise load and choreoathetosis to physical activity intensity and energy expenditure. Findings highlight the difficulties in measuring exercise load and activity intensity in PW users with DCP due to the involuntary hypertonic and/or hyperkinetic hallmark of the movement disorders. Nevertheless, a relaxed surrounding with minimal distractions during PW training may increase learning efficiency. Future studies with a bigger sample size are highly recommended to fully establish the relationship between the variables and to allow generalizability of results.Implications for rehabilitationDystonia is positively related to heart rate during powered mobility, which may be explained by the hypertonic hallmark of dystonia causing an increase in exercise load.Choreoathetosis is positively related to the physical activity index during powered mobility where the hyperkinetic hallmark of choreoathetosis may lead to an increase in physical activity intensity and energy expenditure.Arm overflow movements are the component which contribute the most to total-body activity index, thus, minimizing these movements may lower the overall energy expenditure during powered mobility.Mobility training in a relaxed surrounding with minimal distractions and minimized arm overflow movements may lead to a less-demanding powered wheelchair mobility experience and increased learning efficiency.
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Affiliation(s)
- Saranda Bekteshi
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
| | - Ioana Gabriela Nica
- KU Leuven, Department of Biosystems, Division of Animal and Human Health Engineering, Measure, Model and Manage Bioresponse (M3-BIORES), Leuven, Belgium
| | - Sotirios Gakopoulos
- KU Leuven, Bruges Campus, Department of Computer Science, Mechatronics Research Group, Bruges, Belgium
| | - Marco Konings
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
| | - Rozanne Maes
- KU Leuven, Department of Biosystems, Division of Animal and Human Health Engineering, Measure, Model and Manage Bioresponse (M3-BIORES), Leuven, Belgium
| | - Benoit Cuyvers
- KU Leuven, Department of Biosystems, Division of Animal and Human Health Engineering, Measure, Model and Manage Bioresponse (M3-BIORES), Leuven, Belgium
| | - Jean-Marie Aerts
- KU Leuven, Department of Biosystems, Division of Animal and Human Health Engineering, Measure, Model and Manage Bioresponse (M3-BIORES), Leuven, Belgium
| | - Hans Hallez
- KU Leuven, Bruges Campus, Department of Computer Science, Mechatronics Research Group, Bruges, Belgium
| | - Elegast Monbaliu
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
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Yoo IG. Benefits of emotion-based training for the rehabilitation of stroke patients: A scoping review. NeuroRehabilitation 2020; 47:99-108. [PMID: 32716327 DOI: 10.3233/nre-203163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The application of emotional stimuli is beneficial when practicing tasks that must be learned. OBJECTIVE This scoping review examined related literature to identify the applicability of emotion-based training for therapeutic activities. METHOD All relevant literature published as of April 1, 2020 in four prominent databases was searched (CINAHL, Embase, PubMed, and PsycINFO) using the five-stage review framework proposed by Arksey and O'Malley. RESULTS After sophisticated searches and exclusions, ten publications were included for further review. Our results revealed three types of emotion-based stimulation methods that can influence therapeutic effects on stroke patients. However, the research did not compare the difference between the pros, cons, and effectiveness of each type of sensory stimulation. CONCLUSION Rehabilitation specialists are encouraged to obtain a broad understanding of therapeutic situations and their possible impacts on a given environment.
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Affiliation(s)
- I G Yoo
- Department of Occupational Therapy, College of Medical Sciences, Jeonju University, Hyoja-dong 3-ga, Wansan-gu, Jeonju-si, Jeollabuk-do, 560-759, Republic of Korea Tel.: +82 63 220 2299; Fax: +82 63 220 2054; E-mail:
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Belmonte S, Montoya P, González-Roldán AM, Riquelme I. Reduced brain processing of affective pictures in children with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 94:103457. [PMID: 31520963 DOI: 10.1016/j.ridd.2019.103457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 07/31/2019] [Accepted: 08/04/2019] [Indexed: 06/10/2023]
Abstract
UNLABELLED Sensory and cognitive deficits are common comorbidities in children with cerebral palsy. This observational study examines if brain processing of affective information is also altered in children with cerebral palsy (CP) in comparison with typically developing peers (TDP). METHODS Evoked-related potentials were recorded in 15 children with CP (age = 11.27 ± 4.53 yr, 6 girls) and 14 TDP (age = 10.14 ± 4.29 yr, 5 girls) when viewing pleasant, unpleasant and neutral pictures. The subjective perception of valence and arousal of each one of the pictures was examined. RESULTS Children with CP showed a significant amplitude reduction of evoked potentials in the occipital region to the affective stimuli in early brain processing latencies (P100 and N200; all F > 2.9, all p < .05). Children with CP rated pictures with affective content (pleasant and unpleasant) as less arousing (F(2.25) = 46.71, p < .001), and neutral pictures as more pleasant, than their TDP (F(2.25) = 75.56, p < .001). CONCLUSION The pictures with emotional content produce less activation, both at the behavioral and brain processing levels in children with CP. These differences were found in early latencies of brain processing which could be related to alterations in the detection of emotionally relevant stimuli.
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Affiliation(s)
- Saliha Belmonte
- University Institute of Health Sciences Research (IUNICS-IdISPa), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Pedro Montoya
- University Institute of Health Sciences Research (IUNICS-IdISPa), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Ana M González-Roldán
- University Institute of Health Sciences Research (IUNICS-IdISPa), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Inmaculada Riquelme
- University Institute of Health Sciences Research (IUNICS-IdISPa), University of the Balearic Islands, Palma de Mallorca, Spain; Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain.
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