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Rubin DA, Rose DJ, Escano DL, Holmes SC, Garcia SA, Pamukoff DN. Contributing factors to postural stability in Prader-Willi syndrome. Hum Mov Sci 2023; 91:103125. [PMID: 37515958 DOI: 10.1016/j.humov.2023.103125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 11/09/2022] [Accepted: 07/18/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Prader-Willi Syndrome (PWS) is a rare neurodevelopmental disorder affecting multiple functional parameters. This study examined postural stability and associated gait and neuromuscular factors in young adults with PWS. METHODS Participants included 10 adults with PWS [7 M/3F; Body Fat % 40.61 ± 7.79]; ten normal weight (NW) adults [7 M/3F; Body Fat % 23.42 ± 7.0]; ten obese (OB) adults [7 M/3F; Body Fat % 42.40 ± 5.62]. Participants completed the Sensory Organization Test (SOT)®. Condition (C) specific and a composite equilibrium score (CES) were calculated (maximum = 100). Quadriceps strength was assessed using an isokinetic dynamometer. Three-dimensional gait analyses were completed along a 10 m walkway using a motion capture system and two force plates. A gait stability ratio (GSR) was computed from gait speed and step length (steps/m). RESULTS The PWS group had lower scores for C1, C3, C4 and CES compared to the NW (p < .039 for all) and lower scores for C4 and CES than the OB (p < .019 for both) groups, respectively. In C5 (eyes closed, sway-referenced support) and C6 (sway-referenced vision and support), 33.3% of participants with PWS fell during the first trial in both conditions (X2 [2] 7.436, p = .024) and (X2 [2] 7.436, p = .024) but no participant in the other groups fell. Those with PWS showed higher GSR than participants with NW (p = .005) and those with obesity (p = .045). CONCLUSION Individuals with PWS had more difficulty maintaining standing balance when relying on information from the somatosensory (C3), visual-vestibular (C4) and vestibular systems (C5, C6). A more stable walk was related to shorter steps, slower velocity and reduced peak quadriceps torque. Participation in multisensory activities that require appropriate prioritization of sensory system(s) input for controlling balance in altered sensory environments should be routinely included. In addition, exercises targeting muscular force and power should be included as part of exercise programming in PWS.
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Affiliation(s)
- Daniela A Rubin
- Department of Kinesiology, California State University, Fullerton, Fullerton, CA, United States of America.
| | - Debra J Rose
- Department of Kinesiology, California State University, Fullerton, Fullerton, CA, United States of America
| | - Derrick L Escano
- Department of Kinesiology, California State University, Fullerton, Fullerton, CA, United States of America
| | - Skylar C Holmes
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, United States of America
| | - Steven A Garcia
- Department of Kinesiology, University of Michigan, Ann Arbor, MI, United States of America
| | - Derek N Pamukoff
- School of Kinesiology, University of Western Ontario, London, ON, Canada
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Calcaterra V, Magenes VC, Destro F, Baldassarre P, Silvestro GS, Tricella C, Visioli A, Verduci E, Pelizzo G, Zuccotti G. Prader–Willi Syndrome and Weight Gain Control: From Prevention to Surgery—A Narrative Review. CHILDREN 2023; 10:children10030564. [PMID: 36980122 PMCID: PMC10047227 DOI: 10.3390/children10030564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/01/2023] [Accepted: 03/12/2023] [Indexed: 03/19/2023]
Abstract
Severe obesity remains one of the most important symptoms of Prader–Willi Syndrome (PWS), and controlling weight represents a crucial point in the therapeutical approach to the syndrome. We present an overview of different progressive patterns of growth that involve controlling weight in PWS. Mechanisms involved in the development of obesity and in preventive and therapeutic strategies to control weight gain are discussed. Early diagnosis, a controlled diet regimen, regular physical activity, follow-up by multidisciplinary teams, and hormonal treatment improved the management of excessive weight gain. In selected cases, a surgical approach can be also considered. Controlling weight in PWS remains a challenge for pediatricians. The importance of consulting different healthcare specialists, starting from the neonatal and pediatric age, is also considered as a crucial approach to controlling weight, as well as to limiting and preventing the onset of obesity and its complications.
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Affiliation(s)
- Valeria Calcaterra
- Pediatrics and Adolescentology Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
- Correspondence:
| | | | - Francesca Destro
- Pediatric Surgery Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Paola Baldassarre
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | | | - Chiara Tricella
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Alessandro Visioli
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Elvira Verduci
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
- Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Gloria Pelizzo
- Pediatric Surgery Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
- Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy
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Comparison of Body Composition, Muscle Strength and Cardiometabolic Profile in Children with Prader-Willi Syndrome and Non-Alcoholic Fatty Liver Disease: A Pilot Study. Int J Mol Sci 2022; 23:ijms232315115. [PMID: 36499438 PMCID: PMC9739027 DOI: 10.3390/ijms232315115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022] Open
Abstract
Syndromic and non-syndromic obesity conditions in children, such as Prader-Willi syndrome (PWS) and non-alcoholic fatty liver disease (NAFLD), both lower quality of life and increase risk for chronic health complications, which further increase health service utilization and cost. In a pilot observational study, we compared body composition and muscle strength in children aged 7−18 years with either PWS (n = 9), NAFLD (n = 14), or healthy controls (n = 16). Anthropometric and body composition measures (e.g., body weight, circumferences, skinfolds, total/segmental composition, and somatotype), handgrip strength, six minute-walk-test (6MWT), physical activity, and markers of liver and cardiometabolic dysfunction (e.g., ALT, AST, blood pressure, glucose, insulin, and lipid profile) were measured using standard procedures and validated tools. Genotyping was determined for children with PWS. Children with PWS had reduced lean body mass (total/lower limb mass), lower handgrip strength, 6MWT and increased sedentary activity compared to healthy children or those with NAFLD (p < 0.05). Children with PWS, including those of normal body weight, had somatotypes consistent with relative increased adiposity (endomorphic) and reduced skeletal muscle robustness (mesomorphic) when compared to healthy children and those with NAFLD. Somatotype characterizations were independent of serum markers of cardiometabolic dysregulation but were associated with increased prevalence of abnormal systolic and diastolic blood pressure Z-scores (p < 0.05). Reduced lean body mass and endomorphic somatotypes were associated with lower muscle strength/functionality and sedentary lifestyles, particularly in children with PWS. These findings are relevant as early detection of deficits in muscle strength and functionality can ensure effective targeted treatments that optimize physical activity and prevent complications into adulthood.
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Pamukoff DN, Holmes SC, Garcia SA, Shumski EJ, Rubin DA. Lower extremity coordination and joint kinetic distribution during gait in adults with and without Prader-Willi Syndrome. J Biomech 2022; 141:111213. [DOI: 10.1016/j.jbiomech.2022.111213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/17/2022] [Accepted: 06/24/2022] [Indexed: 11/24/2022]
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Amaro AS, Rubin DA, Teixeira MCTV, Ferreira AJ, Rodrigues GM, Carreiro LRR. Health Problems in Individuals With PWS Are Associated With Lower Quality of Life for Their Parents: A Snapshot in the Brazilian Population. Front Pediatr 2022; 10:746311. [PMID: 35242723 PMCID: PMC8885721 DOI: 10.3389/fped.2022.746311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 01/03/2022] [Indexed: 11/13/2022] Open
Abstract
Prader-Willi syndrome (PWS) is a complex genetic disorder requiring interdisciplinary team monitoring and intensive care by parents. So far there is little information on people with PWS in Brazil. Our aim was to describe health problems and treatments used by people with PWS in Brazil and their relationship to their parents' quality of life. Parents answered questionnaires about their child's medical and exercise history, behavior problems, sociodemographic characteristics, and their own quality of life. Results: The responses of the participants showed similar health problems as in other countries. Anxiety and tantrums were the behavioral problems most commonly cited by parents. Parents of people with PWS had lower scores in respect of quality of life than the Brazilian population. Behavioral problems in individuals with PWS were negatively associated with their parents' quality of life. Behavioral and medical conditions in the children were associated with reduced quality of life in the parents. We conclude that heath care should not only be directed toward those with PWS, but also their parents.
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Affiliation(s)
- Alexandre Slowetzky Amaro
- Development Disorders Graduate Program, Center for Health and Biological Science, Universidade Presbiteriana Mackenzie, São Paulo, Brazil
| | - Daniela Andrea Rubin
- Department of Kinesiology, California State University, Fullerton, CA, United States
| | | | - Arcenio José Ferreira
- Development Disorders Graduate Program, Center for Health and Biological Science, Universidade Presbiteriana Mackenzie, São Paulo, Brazil
| | - Graciele Massoli Rodrigues
- Physical Education Program, Universidade São Judas Tadeu, São Paulo, Brazil.,Physical Education Program, Escola Superior de Educação Física de Jundiaí, Jundiaí, Brazil
| | - Luiz Renato Rodrigues Carreiro
- Development Disorders Graduate Program, Center for Health and Biological Science, Universidade Presbiteriana Mackenzie, São Paulo, Brazil
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Abstract
OBJECTIVE To explore motor praxis in adults with Prader-Willi syndrome (PWS) in comparison with a control group of people with intellectual disability (ID) and to examine the relationship with brain structural measurements. METHOD Thirty adult participants with PWS and 132 with ID of nongenetic etiology (matched by age, sex, and ID level) were assessed using a comprehensive evaluation of the praxis function, which included pantomime of tool use, imitation of meaningful and meaningless gestures, motor sequencing, and constructional praxis. RESULTS Results support specific praxis difficulties in PWS, with worse performance in the imitation of motor actions and better performance in constructional praxis than ID peers. Compared with both control groups, PWS showed increased gray matter volume in sensorimotor and subcortical regions. However, we found no obvious association between these alterations and praxis performance. Instead, praxis scores correlated with regional volume measures in distributed apparently normal brain areas. CONCLUSIONS Our findings are consistent in showing significant impairment in gesture imitation abilities in PWS and, otherwise, further indicate that the visuospatial praxis domain is relatively preserved. Praxis disability in PWS was not associated with a specific, focal alteration of brain anatomy. Altered imitation gestures could, therefore, be a consequence of widespread brain dysfunction. However, the specific contribution of key brain structures (e.g., areas containing mirror neurons) should be more finely tested in future research.
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Improved Motor Proficiency and Quality of Life in Youth With Prader-Willi Syndrome and Obesity 6 Months After Completing a Parent-Led, Game-Based Intervention. Pediatr Exerc Sci 2021; 33:177-185. [PMID: 34375948 DOI: 10.1123/pes.2020-0160] [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: 07/20/2020] [Revised: 03/05/2021] [Accepted: 04/14/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE To determine changes and potential differences in physical activity (PA), gross motor proficiency (MP), and health parameters after a 6-month follow-up (FU) period following participation in a parent-led PA intervention in youth with or without Prader-Willi syndrome (PWS). METHODS About 42 youth with PWS and 65 youth without PWS but with obesity (body fat percentage >95th percentile for age and sex), aged 8-16 years, participated. The intervention included preplanned PA sessions containing playground and console-based video games scheduled 4 days per week for 24 weeks. Families received training and curriculum materials. PA (accelerometry), MP (Bruininks-Oseretsky Test of MP), and health-related quality of life were obtained before (PRE), after completing the intervention (POST), and at FU. RESULTS There were no significant changes in PA at any time point. At FU and POST, participants showed higher bilateral coordination (PRE = 9.3 [0.4], POST = 11.7 [0.5], and FU = 11.1 [0.6]); speed and agility (PRE = 9.2 [0.4], POST = 10.8 [0.4], and FU = 11.5 [0.5]); and strength (PRE = 8.0 [0.3], POST = 9.2 [0.3], and FU = 9.2 [0.3]) than at PRE. At FU (80.3 [2.1]) and POST (79.8 [1.7]), youth without PWS showed higher health-related quality of life than PRE (75.0 [1.8]). CONCLUSION The improvements in MP and health-related quality of life at FU suggest long-term durability of intervention outcomes.
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Rubin DA, Wilson KS, Orsso CE, Gertz ER, Haqq AM, Castner DM, Dumont-Driscoll M. A 24-Week Physical Activity Intervention Increases Bone Mineral Content without Changes in Bone Markers in Youth with PWS. Genes (Basel) 2020; 11:genes11090984. [PMID: 32847020 PMCID: PMC7564578 DOI: 10.3390/genes11090984] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/17/2020] [Accepted: 08/19/2020] [Indexed: 11/16/2022] Open
Abstract
Bone mineral density (BMD) is of concern in Prader-Willi syndrome (PWS). This study compared responses to a physical activity intervention in bone parameters and remodeling markers in youth with PWS (n = 45) and youth with non-syndromic obesity (NSO; n = 66). Measurements occurred at baseline (PRE) and after 24 weeks (POST) of a home-based active games intervention with strengthening and jumping exercises (intervention group = I) or after a no-intervention period (control group = C). Dual x-ray absorptiometry scans of the hip and lumbar spine (L1-L4) determined BMD and bone mineral content (BMC). Bone markers included fasting bone-specific alkaline phosphatase (BAP) and C-terminal telopeptide of type I collagen (CTx). Both I and C groups increased their hip BMD and BMC (p < 0.001). Youth with PWS-I increased their spine BMC from PRE to POST (p < 0.001) but not youth with PWS-C (p = 1.000). Youth with NSO (I and C) increased their spine BMC between PRE and POST (all p < 0.001). Youth with PWS showed lower BAP (108.28 ± 9.19 vs. 139.07 ± 6.41 U/L; p = 0.006) and similar CTx (2.07 ± 0.11 vs.1.84 ± 0.14 ng/dL; p = 0.193) than those with NSO regardless of time. Likely, the novelty of the intervention exercises for those with PWS contributed to gains in spine BMC beyond growth. Bone remodeling markers were unaltered by the intervention.
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Affiliation(s)
- Daniela A. Rubin
- Department of Kinesiology, California State University Fullerton, 800 N. State College Blvd., Fullerton, CA 92831, USA; (K.S.W.); (D.M.C.)
- Correspondence: ; Tel.: +1-657-278-4704
| | - Kathleen S. Wilson
- Department of Kinesiology, California State University Fullerton, 800 N. State College Blvd., Fullerton, CA 92831, USA; (K.S.W.); (D.M.C.)
| | - Camila E. Orsso
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, 8602 112 Street, Edmonton, AB T6G 2E1, Canada; (C.E.O.); (A.M.H.)
| | - Erik R. Gertz
- Obesity and Metabolism Unit, Western Human Nutrition Research Center, U.S. Department of Agriculture, 430 W Health Sciences Drive, Davis, CA 95616, USA;
| | - Andrea M. Haqq
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, 8602 112 Street, Edmonton, AB T6G 2E1, Canada; (C.E.O.); (A.M.H.)
- Division of Pediatric Endocrinology, University of Alberta, 8440-112 Street, Edmonton, AB T6G 2B7, Canada
| | - Diobel M. Castner
- Department of Kinesiology, California State University Fullerton, 800 N. State College Blvd., Fullerton, CA 92831, USA; (K.S.W.); (D.M.C.)
| | - Marilyn Dumont-Driscoll
- Academic General Pediatrics, University of Florida, Gainesville, 1699 SW 16th Avenue, Gainesville, FL 32608, USA;
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Rubin DA, Wilson KS, Castner DM, Dumont-Driscoll MC. Changes in Health-Related Outcomes in Youth With Obesity in Response to a Home-Based Parent-Led Physical Activity Program. J Adolesc Health 2019; 65:323-330. [PMID: 30833118 DOI: 10.1016/j.jadohealth.2018.11.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 11/05/2018] [Accepted: 11/06/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE The purpose of this study was to elucidate whether implementation of a parent-led physical activity (PA) curriculum improved health parameters in youth with obesity. METHODS This prospective study included 45 youth with Prader-Willi syndrome (PWS) and 66 youth classified as obese without PWS. Participants were quasi-randomly assigned to an intervention (I) group which completed PA sessions (25-45+ minutes long) 4 days/week for 24 weeks or to a control (C) group. Generalized estimating equations analyzed differences in body composition, PA, and health-related quality of life (HRQL) by youth group, time, and treatment group. A secondary analysis in the I-group compared outcomes based on whether youth showed increases (n = 12) or decreases (n = 19) of ≥2 minutes of moderate-to-vigorous PA (MVPA). RESULTS Body mass index increased from baseline to 24 weeks in youth with obesity (p = .032) but not in youth with PWS. There were no changes in MVPA, total PA, or body fat indicators over time. The I-group demonstrated an increase of 7.2% and 7.6% in social and school HRQL, respectively, and a 3.3% improvement in total HRQL. Youth in the I-group who increased MVPA demonstrated decreased body mass (p = .010), body mass index z-score (p = .018), and body fat mass (p = .011); these changes were not observed in those who decreased MVPA over time. CONCLUSIONS Participation in a parent-led PA intervention at home can positively influence HRQL in youth with obesity and/or PWS. Increases in MVPA ≥2 minutes above baseline led to decreases in body mass and fat, while maintaining lean mass.
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Affiliation(s)
- Daniela A Rubin
- Department of Kinesiology, California State University, Fullerton, Fullerton, California.
| | - Kathleen S Wilson
- Department of Kinesiology, California State University, Fullerton, Fullerton, California
| | - Diobel M Castner
- Department of Kinesiology, California State University, Fullerton, Fullerton, California
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Morales JS, Valenzuela PL, Pareja-Galeano H, Rincón-Castanedo C, Rubin DA, Lucia A. Physical exercise and Prader-Willi syndrome: A systematic review. Clin Endocrinol (Oxf) 2019; 90:649-661. [PMID: 30788853 DOI: 10.1111/cen.13953] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 02/15/2019] [Accepted: 02/18/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The aim of this systematic review was to summarize evidence on the acute responses of individuals with Prader-Willi syndrome (PWS) to physical exercise, and on the effectiveness of long-term exercise interventions to improve the clinical manifestations of this syndrome. DESIGN/METHODS Relevant articles were identified in the electronic databases PubMed, Medline, CINAHL and SPORTDiscus (from inception to December 2018). Twenty-two studies including a total of 356 patients with PWS met all inclusion criteria and were included in the review. RESULTS Patients with PWS present with a decreased physical performance and impaired cardiorespiratory (maximal oxygen consumption, heart rate recovery after exercise) and hormonal (growth hormone release) responses to exercise. Most long-term exercise interventions have proven to decrease body mass while improving physical performance. Some benefits have also been reported in biochemical (glucose homeostasis, lipid profile) and biomechanical (gait pattern) variables, although there is controversy regarding the effects on body composition. No exercise-related adverse events have been reported in patients with PWS. CONCLUSION Physical exercise seems to be safe and effective for improving several phenotypes in PWS, notably physical fitness. However, further research is needed to confirm these results and especially to corroborate whether exercise per se or combined with dietary intervention is an effective coadjuvant treatment for reducing body mass in these patients.
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Affiliation(s)
- Javier S Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Pedro L Valenzuela
- Physiology Unit, Systems Biology Department, University of Alcalá, Madrid, Spain
- Department of Sport and Health, Spanish Agency for Health Protection in Sport (AEPSAD), Madrid, Spain
| | - Helios Pareja-Galeano
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- Research Institute of the Hospital 12 de Octubre (i+12), Madrid, Spain
| | | | - Daniela A Rubin
- Department of Kinesiology, California State University, Fullerton, California
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- Research Institute of the Hospital 12 de Octubre (i+12), Madrid, Spain
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Rubin DA, Wilson KS, Honea KE, Castner DM, McGarrah JG, Rose DJ, Dumont-Driscoll M. An evaluation of the implementation of a parent-led, games-based physical activity intervention: the Active Play at Home quasi-randomized trial. HEALTH EDUCATION RESEARCH 2019; 34:98-112. [PMID: 30346530 DOI: 10.1093/her/cyy035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 09/19/2018] [Indexed: 06/08/2023]
Abstract
NCT02058342. Registered 6 February 2014 retrospectively registered.
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Affiliation(s)
- D A Rubin
- Department of Kinesiology, California State University, Fullerton, CA, USA
| | - K S Wilson
- Department of Kinesiology, California State University, Fullerton, CA, USA
| | - K E Honea
- Department of Kinesiology, California State University, Fullerton, CA, USA
| | - D M Castner
- Department of Kinesiology, California State University, Fullerton, CA, USA
| | - J G McGarrah
- Department of Pediatrics, University of Florida, Gainesville, FL, USA
| | - D J Rose
- Department of Kinesiology, California State University, Fullerton, CA, USA
| | - M Dumont-Driscoll
- Department of Pediatrics, University of Florida, Gainesville, FL, USA
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Wilson RB, McCracken JT, Rinehart NJ, Jeste SS. What's missing in autism spectrum disorder motor assessments? J Neurodev Disord 2018; 10:33. [PMID: 30541423 PMCID: PMC6292106 DOI: 10.1186/s11689-018-9257-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 11/14/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Motor delays and impairments in autism spectrum disorders (ASD) are extremely common and often herald the emergence of pervasive atypical development. Clinical accounts of ASD and standardized measures of motor function have identified deficits in multiple motor domains. However, literature describing frequently used standardized motor assessments in children with ASD, their test properties, and their limitations are sparse. METHODS We systematically reviewed the literature to identify the most frequently used standardized motor assessments used to evaluate children with ASD from infancy to early childhood. All assessments included were required to possess reference norms, evaluate more than one motor domain, and have undergone some degree of validation. RESULTS We identified six frequently used standardized measures of motor function per our inclusion and exclusion criteria. We investigated and described in detail the psychometric properties of these assessments, their utility for use with children with ASD, and their individual and overall strengths and limitations. The global strengths of these assessments are the ability to identify early development delays and differences in fine and gross motor function in children with ASD. Global limitations of these studies are lack of validation in individuals with ASD and scoring systems that often miss specific and subtle abnormalities. CONCLUSIONS Standardized assessments of motor function have provided valuable information on motor impairments in ASD. However, significant limitations remain in the use of these measures in children with ASD. Moving forward, it is imperative that standardized measures of motor function receive greater validation testing in children with ASD to assess their potential application given the clinical heterogeneity of this condition. In addition, utilizing quantitative measures of motor function should allow for evaluation and comparison of individuals with ASD across the lifespan with varying cognitive and behavioral abilities.
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Affiliation(s)
- Rujuta B. Wilson
- UCLA Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine, 760 Westwood Plaza, Room A7-424, Los Angeles, CA 90095 USA
| | - James T. McCracken
- UCLA Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine, 760 Westwood Plaza, Room A7-424, Los Angeles, CA 90095 USA
| | - Nicole J. Rinehart
- Deakin University, Deakin Child Study Centre, School of Psychology, Faculty of Health, 221 Burwood Highway, Burwood, Geelong, VIC 3125 Australia
| | - Shafali S. Jeste
- UCLA Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine, 760 Westwood Plaza, Room A7-424, Los Angeles, CA 90095 USA
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