Rehabilitation of movement disorders11A commercial party with a direct financial interest in the results of the research supporting this article has conferred or will confer a financial benefit upon the author or one or more of the authors. Elovic is on the advisory board and speaker’s bureau of Allergan

Sensitive Training Through Body Awareness to Improve the Writing of Patients with Writer's Cramp

The aim of this article is to evaluate if body awareness is important to improve the writing ability before using the splints. Twelve patients with writer's cramp were evaluated by a specialist in movement disorders. The Burke-Fahn-Marsden Scale (BFM), the Jedynak Protocol and the Analog Pain Scale were used. The rehabilitation training was administered over an eight-week period, in two phases of four weeks each, twice a week. Each session would last 60 minutes. A significant improvement was shown, not only in the motor, but also in the pain perception, through the BFM scale, the Jedynak Protocol and the Analog Pain Scale. Therefore, we conclude that the motor training, thanks to the body awareness and immobilization by splints of the affected dystonic musculature, led to an important improvement in the writer's cramp writing.

Control entropy identifies differential changes in complexity of walking and running gait patterns with increasing speed in highly trained runners

Regularity statistics have been previously applied to walking gait measures in the hope of gaining insight into the complexity of gait under different conditions and in different populations. Traditional regularity statistics are subject to the requirement of stationarity, a limitation for examining changes in complexity under dynamic conditions such as exhaustive exercise. Using a novel measure, control entropy (CE), applied to triaxial continuous accelerometry, we report changes in complexity of walking and running during increasing speeds up to exhaustion in highly trained runners. We further apply Karhunen-Loeve analysis in a new and novel way to the patterns of CE responses in each of the three axes to identify dominant modes of CE responses in the vertical, mediolateral, and anterior/posterior planes. The differential CE responses observed between the different axes in this select population provide insight into the constraints of walking and running in those who may have optimized locomotion. Future comparisons between athletes, healthy untrained, and clinical populations using this approach may help elucidate differences between optimized and diseased locomotor control.

Movement disorder-childhood rating scale: reliability and validity

A new scale for children and adolescents aged 4-18 years, called the Movement Disorder Childhood Rating Scale, was designed to: (1) describe clinical features of different types of movement disorders; (2) evaluate the intensity of movement disorders in different body regions at rest and during specific tasks; and (3) assess the influence of movement disorders on motor function and daily living activities. The scale is divided into 2 parts: Part I for general assessment, and Part II for movement-disorder severity. It includes a 20-minute standardized video protocol of all items. The scale was applied to 61 patients with different types of movement disorder, and was independently scored by 3 observers. Reliability, construct validity, and consistency indexes are reported. High interrater agreement on each item, and a high degree of internal consistency on several proposed items, were evident.