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Gentile AE, Rinella S, Desogus E, Verrelli CM, Iosa M, Perciavalle V, Ruggieri M, Polizzi A. Motor imagery for paediatric neurorehabilitation: how much do we know? Perspectives from a systematic review. Front Hum Neurosci 2024; 18:1245707. [PMID: 38571523 PMCID: PMC10987782 DOI: 10.3389/fnhum.2024.1245707] [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: 06/23/2023] [Accepted: 02/28/2024] [Indexed: 04/05/2024] Open
Abstract
Background Motor Imagery (MI) is a cognitive process consisting in mental simulation of body movements without executing physical actions: its clinical use has been investigated prevalently in adults with neurological disorders. Objectives Review of the best-available evidence on the use and efficacy of MI interventions for neurorehabilitation purposes in common and rare childhood neurological disorders. Methods systematic literature search conducted according to PRISMA by using the Scopus, PsycArticles, Cinahl, PUBMED, Web of Science (Clarivate), EMBASE, PsychINFO, and COCHRANE databases, with levels of evidence scored by OCEBM and PEDro Scales. Results Twenty-two original studies were retrieved and included for the analysis; MI was the unique or complementary rehabilitative treatment in 476 individuals (aged 5 to 18 years) with 10 different neurological conditions including, cerebral palsies, stroke, coordination disorders, intellectual disabilities, brain and/or spinal cord injuries, autism, pain syndromes, and hyperactivity. The sample size ranged from single case reports to cohorts and control groups. Treatment lasted 2 days to 6 months with 1 to 24 sessions. MI tasks were conventional, graded or ad-hoc. MI measurement tools included movement assessment batteries, mental chronometry tests, scales, and questionnaires, EEG, and EMG. Overall, the use of MI was stated as effective in 19/22, and uncertain in the remnant studies. Conclusion MI could be a reliable supportive/add-on (home-based) rehabilitative tool for pediatric neurorehabilitation; its clinical use, in children, is highly dependent on the complexity of MI mechanisms, which are related to the underlying neurodevelopmental disorder.
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Affiliation(s)
- Amalia Egle Gentile
- National Centre for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Sergio Rinella
- Department of Educational Science, Chair of Pediatrics, University of Catania, Catania, Italy
| | - Eleonora Desogus
- National Centre for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | | | - Marco Iosa
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
- Santa Lucia Foundation (IRCCS), Rome, Italy
| | | | - Martino Ruggieri
- Unit of Clinical Pediatrics, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Agata Polizzi
- Department of Educational Science, Chair of Pediatrics, University of Catania, Catania, Italy
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Fierro-Marrero J, Corujo-Merino A, La Touche R, Lerma-Lara S. Motor imagery ability in children and adolescents with cerebral palsy: a systematic review and evidence map. Front Neurol 2024; 15:1325548. [PMID: 38379703 PMCID: PMC10876901 DOI: 10.3389/fneur.2024.1325548] [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: 11/11/2023] [Accepted: 01/11/2024] [Indexed: 02/22/2024] Open
Abstract
Background Cerebral palsy (CP) refers to a group of permanent movement and posture disorders. Motor imagery (MI) therapy is known to provide potential benefits, but data on MI ability in children and adolescents with CP is lacking. Objective A systematic review was performed to explore MI abilities in children and adolescents with CP compared to typically developed (TD) subjects. Methods We searched on PubMed, Web of Science (WOS), EBSCO, Google Scholar, and PEDro including observational studies. Methodological quality was assessed with the modified Newcastle-Ottawa Scale and evidence map was created to synthesize the evidence qualitatively and quantitatively. Results Seven cross-sectional studies were selected, which included 174 patients with CP and 321 TD subjects. Three studies explored explicit MI, two MI-execution synchrony, and four implicit MI domains. Methodological quality ranged from 6 to 8 stars. Moderate evidence supported the absence of differences in vividness between the groups. As there was only limited evidence, establishing a clear direction for the results was not possible, especially for the capacity to generate MI, mental chronometry features, and MI-execution synchrony domains. Moderate evidence supported a lower efficiency in cases for hand recognition, derived from a lower accuracy rate, while reaction time remained similar between the two groups. Moderate evidence indicated that patients with CP and TD controls showed similar features on whole-body recognition. Conclusion Moderate evidence suggests that patients with CP present a reduced ability in hand recognition, which is not observed for whole-body recognition compared to healthy controls. Severe limitations concerning sample size calculations and validity of assessment tools clearly limits establishing a direction of results, especially for explicit MI and MI-Execution synchrony domains. Further research is needed to address these limitations to enhance our comprehension of MI abilities in children, which is crucial for prescribing suitable MI-based therapies in this child population.
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Affiliation(s)
- José Fierro-Marrero
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
| | - Alejandro Corujo-Merino
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), Madrid, Spain
| | - Sergio Lerma-Lara
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
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3
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Babik I, Cunha AB, Srinivasan S. Biological and environmental factors may affect children's executive function through motor and sensorimotor development: Preterm birth and cerebral palsy. Infant Behav Dev 2023; 73:101881. [PMID: 37643499 DOI: 10.1016/j.infbeh.2023.101881] [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: 11/08/2022] [Revised: 08/03/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023]
Abstract
Disruptive biological and environmental factors may undermine the development of children's motor and sensorimotor skills. Since the development of cognitive skills, including executive function, is grounded in early motor and sensorimotor experiences, early delays or impairments in motor and sensorimotor processing often trigger dynamic developmental cascades that lead to suboptimal executive function outcomes. The purpose of this perspective paper is to link early differences in motor/sensorimotor processing to the development of executive function in children born preterm or with cerebral palsy. Uncovering such links in clinical populations would improve our understanding of developmental pathways and key motor and sensorimotor skills that are antecedent and foundational for the development of executive function. This knowledge will allow the refinement of early interventions targeting motor and sensorimotor skills with the goal of proactively improving executive function outcomes in at-risk populations.
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Affiliation(s)
- Iryna Babik
- Department of Psychological Science, Boise State University, Boise, ID, USA.
| | - Andrea B Cunha
- Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sudha Srinivasan
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, USA
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4
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Metwaly MM, Salem EE, Abbass ME. Correlation between scapular alignment and upper extremity function in children with hemiparetic cerebral palsy. Physiother Theory Pract 2023; 39:2163-2170. [PMID: 35430957 DOI: 10.1080/09593985.2022.2066587] [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: 10/25/2021] [Revised: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To investigate the relationship between scapular alignment and upper extremity function. METHODS Eighty-five children (63 boys and 22 girls) with spastic hemiplegic cerebral palsy aged 3 to 6 years were included in the study. Scapular upward rotation was assessed using Postural Zone software, and upper extremity function was assessed using the Pediatric Arm Function Test. RESULTS There was a significant difference (p = .0001) in the degree of upward scapular rotation between less affected and affected sides (-41.78 ± 4.87 and -26.42 ± 6.34, respectively). There was a significant difference (p = .0001) between the function of the upper extremity of the affected side and the less affected sides (48.15 ± 14.37, 62.1 ± 6.62, respectively). Pearson Correlation Coefficient (r) was calculated, and there was a strong negative significant correlation between the degree of scapular upward rotation of the affected side, a unilateral score of the affected side, and the total score of the Pediatric Arm Function Test (r = -0.976, p = .0001 and r = -0.973, p = .0001, respectively). The correlation between symmetry index and total score of the Pediatric Arm Function Test was a strong positive significant correlation (r = 0.946, p = .0001). CONCLUSION The degree of upward scapular rotation was less on the affected side. Scapular alignment and symmetry may contribute to upper extremity function in children with hemiplegic cerebral palsy. Clinically, correction of scapular deviations may be considered in the rehabilitation program for children with hemiplegic cerebral palsy. This study suggests further experimental studies to find the cause and effect.
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Affiliation(s)
- Mahmoud Mohammed Metwaly
- Department of Pediatric Physical Therapy, Faculty of Physical Therapy, Cairo University, Giza, Eygpt
| | - Elham Elsayed Salem
- Department of Pediatric Physical Therapy, Faculty of Physical Therapy, Cairo University, Giza, Eygpt
| | - Mai Elsayed Abbass
- Department of Pediatric Physical Therapy, Faculty of Physical Therapy, Cairo University, Giza, Eygpt
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5
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Gutterman J, Gordon AM. Neural Correlates of Impaired Grasp Function in Children with Unilateral Spastic Cerebral Palsy. Brain Sci 2023; 13:1102. [PMID: 37509032 PMCID: PMC10377617 DOI: 10.3390/brainsci13071102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/13/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
Unilateral spastic cerebral palsy (USCP) is caused by damage to the developing brain and affects motor function, mainly lateralized to one side of the body. Children with USCP have difficulties grasping objects, which can affect their ability to perform daily activities. Although cerebral palsy is typically classified according to motor function, sensory abnormalities are often present as well and may contribute to motor impairments, including grasping. In this review, we show that the integrity and connectivity pattern of the corticospinal tract (CST) is related to execution and anticipatory control of grasping. However, as this may not explain all the variance of impairments in grasping function, we also describe the potential roles of sensory and sensorimotor integration deficits that contribute to grasp impairments. We highlight studies measuring fingertip forces during object manipulation tasks, as this approach allows for the dissection of the close association of sensory and motor function and can detect the discriminant use of sensory information during a complex, functional task (i.e., grasping). In addition, we discuss the importance of examining the interactions of the sensory and motor systems together, rather than in isolation. Finally, we suggest future directions for research to understand the underlying mechanisms of grasp impairments.
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Affiliation(s)
- Jennifer Gutterman
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY 10027, USA
| | - Andrew M Gordon
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY 10027, USA
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6
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Au KLK, Knitter JL, Morrow-McGinty S, Campos TC, Carmel JB, Friel KM. Combining Unimanual and Bimanual Therapies for Children with Hemiparesis: Is There an Optimal Delivery Schedule? Behav Sci (Basel) 2023; 13:490. [PMID: 37366742 DOI: 10.3390/bs13060490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/28/2023] Open
Abstract
Constraint-induced movement therapy (CIMT) and bimanual therapy (BT) are among the most effective hand therapies for children with unilateral cerebral palsy (uCP). Since they train different aspects of hand use, they likely have synergistic effects. The aim of this study was to examine the efficacy of different combinations of mCIMT and BT in an intensive occupational therapy program for children with uCP. Children (n = 35) participated in intensive modified CIMT (mCIMT) and BT, 6 weeks, 5 days/week, 6 h/day. During the first 2 weeks, children wore a mitt over the less-affected hand and engaged in functional and play activities with the affected hand. Starting in week 3, bimanual play and functional activities were added progressively, 1 hour/week. This intervention was compared to two different schedules of block interventions: (1) 3 weeks of mCIMT followed by 3 weeks of BT, and (2) 3 weeks of BT followed by 3 weeks of mCIMT. Hand function was tested before, after, and two months after therapy with the Assisting Hand Assessment (AHA), Pediatric Evaluation of Disability Inventory (PEDI), and Canadian Occupational Performance Measure (COPM). All three groups of children improved in functional independence (PEDI; p < 0.031), goal performance (COPM Performance; p < 0.0001) and satisfaction (COPM Satisfaction; p < 0.0001), which persisted two months post-intervention. All groups showed similar amounts of improvement, indicating that the delivery schedule for mCIMT and BT does not significantly impact the outcomes.
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Affiliation(s)
- Ka Lai K Au
- Blythedale Children's Hospital, Valhalla, NY 10595, USA
| | | | | | - Talita C Campos
- School of Nursing, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Jason B Carmel
- Weinberg Family Cerebral Palsy Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Kathleen M Friel
- Burke Neurological Institute, White Plains, NY 10605, USA
- Brain Mind Research Institute, Weill Cornell Medical College, New York, NY 10021, USA
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7
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Galli J, Garofalo G, Brunetti S, Loi E, Portesi M, Pelizzari G, Rossi A, Fazzi E, Buccino G. Children with Cerebral Palsy can imagine actions like their normally developed peers. Front Neurol 2022; 13:951152. [PMID: 36147045 PMCID: PMC9488128 DOI: 10.3389/fneur.2022.951152] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/01/2022] [Indexed: 11/16/2022] Open
Abstract
The present study aimed at assessing whether children with Cerebral Palsy (CP) can imagine object directed actions similarly to their normally developed peers. We asked children with CP (n = 12) and paired healthy controls (n = 12) to imagine in first person perspective eight daily actions, after observing them through videoclips presented on a computer screen. During motor imagery (MI) children were interrupted at a specific timepoint (e.g., at 2.5 s) from the start. Two frames extracted from the videoclips were then presented on the screen. One of the two depicted the correct timepoint at which the imagined action was interrupted, while the other represented an earlier or later timepoint. Children had to respond by pressing the key associated to the correct frame. Children also underwent VMIQ-2 questionnaire. Both groups performed similarly in the questionnaire and in the requested task, where they showed the same error rate. Errors mainly concerned the later frame, suggesting a similar strategy to solve the task in the two groups. The results support the view that children with CP can imagine actions similarly to their normally developed peers. This encourages the use of MI as a rehabilitative tool in children with motor impairment.
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Affiliation(s)
- Jessica Galli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Gioacchino Garofalo
- Division of Neuroscience, Università Vita-Salute San Raffaele, Milano, Italy
- IRCCS San Raffaele, Milano, Italy
| | - Sara Brunetti
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Erika Loi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Michela Portesi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Giovanni Pelizzari
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Andrea Rossi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Elisa Fazzi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Giovanni Buccino
- Division of Neuroscience, Università Vita-Salute San Raffaele, Milano, Italy
- IRCCS San Raffaele, Milano, Italy
- *Correspondence: Giovanni Buccino
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Sadeghi N, Joghataei MT, Shahbazi A, Tonekaboni SH, Akrami H, Nazari MA. Motor planning is not restricted to only one hemisphere: evidence from ERPs in individuals with hemiplegic cerebral palsy. Exp Brain Res 2022; 240:2311-2326. [PMID: 35876852 DOI: 10.1007/s00221-022-06425-4] [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: 05/20/2021] [Accepted: 07/17/2022] [Indexed: 11/27/2022]
Abstract
The evidence for the hemispheric specialization of motor planning reveals several inconsistencies between the left-lateralized hypothesis and a distributed system across the hemispheres. We compared participants with left hemiplegic cerebral palsy (HCP) to right-handed control subjects in this study's first experiment by inviting them to perform a motor planning task. Participants were required to release the start button, grasp a hexagon, and rotate it according to the instructions. In the second experiment, we compared left-HCP subjects with right-HCP subjects inviting them to perform the same task (we used the data for left-HCP subjects from the first experiment). P2 amplitude, as well as planning time, grasping time, releasing time, and initial grip selection planning patterns, were used as outcome measures in both experiments. The first experiment revealed that controls acted more quickly and chose more effective planning patterns. Also, the P2 amplitude was smaller in left-HCP subjects than in control subjects. No significant group effect was observed in the second experiment for any movement-related measure or P2. At the neural level, however, there was an interaction between 'region' and 'group,' indicating the distinction between the two groups in the right region. The results are discussed in terms of motor planning's hemispheric distribution and individual differences in the HCP group.
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Affiliation(s)
- Neda Sadeghi
- Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Shahid Hemmat Exp. way, Tehran, Iran
| | - Mohammad Taghi Joghataei
- Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Shahid Hemmat Exp. way, Tehran, Iran.
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Ali Shahbazi
- Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Shahid Hemmat Exp. way, Tehran, Iran
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Hassan Tonekaboni
- Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hale Akrami
- Department of Biomedical Engineering, University of Southern California, Los Angeles, USA
| | - Mohammad Ali Nazari
- Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Shahid Hemmat Exp. way, Tehran, Iran.
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9
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From Hemispheric Asymmetry through Sensorimotor Experiences to Cognitive Outcomes in Children with Cerebral Palsy. Symmetry (Basel) 2022. [DOI: 10.3390/sym14020345] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Recent neuroimaging studies allowed us to explore abnormal brain structures and interhemispheric connectivity in children with cerebral palsy (CP). Behavioral researchers have long reported that children with CP exhibit suboptimal performance in different cognitive domains (e.g., receptive and expressive language skills, reading, mental imagery, spatial processing, subitizing, math, and executive functions). However, there has been very limited cross-domain research involving these two areas of scientific inquiry. To stimulate such research, this perspective paper proposes some possible neurological mechanisms involved in the cognitive delays and impairments in children with CP. Additionally, the paper examines the ways motor and sensorimotor experience during the development of these neural substrates could enable more optimal development for children with CP. Understanding these developmental mechanisms could guide more effective interventions to promote the development of both sensorimotor and cognitive skills in children with CP.
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10
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Brun C, Traverse É, Granger É, Mercier C. Somatosensory deficits and neural correlates in cerebral palsy: a scoping review. Dev Med Child Neurol 2021; 63:1382-1393. [PMID: 34145582 PMCID: PMC9290873 DOI: 10.1111/dmcn.14963] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/19/2021] [Indexed: 12/15/2022]
Abstract
AIM To synthetize studies assessing somatosensory deficits and alterations in cerebral responses evoked by somatosensory stimulation in individuals with cerebral palsy (CP) compared to typically developing individuals. METHOD A scoping review of the literature was performed in the MEDLINE, Embase, PsycInfo, CINAHL, Evidence-Based Medicine Reviews, and Web of Science databases (last search carried out on 6th and 7th August 2020) with a combination of keywords related to CP and somatosensory functions. Somatosensory deficits were measured with clinical tests and alterations in cerebral responses were measured with functional magnetic resonance imaging, electroencephalography, and magnetoencephalography. RESULTS Forty-eight articles were included. Overall, 1463 participants with CP (mean [SD] age 13y 1mo [4y 11mo], range 1-55y; 416 males, 319 females, sex not identified for the remaining participants) and 1478 controls (mean [SD] age 13y 1mo [5y 8mo], range 1-42y; 362 males, 334 females, sex not identified for the remaining participants) were included in the scoping review. For tactile function, most studies reported registration (8 out of 13) or perception (21 out of 21) deficits in participants with CP. For proprioception, most studies also reported registration (6 out of 8) or perception (10 out of 15) deficits. Pain function has not been studied as much, but most studies reported registration (2 out of 3) or perception (3 out of 3) alterations. Neuroimaging findings (18 studies) showed alterations in the somatotopy, morphology, latency, or amplitude of cortical responses evoked by somatosensory stimuli. INTERPRETATION Despite the heterogeneity in the methods employed, most studies reported somatosensory deficits. The focus has been mainly on tactile and proprioceptive function, whereas pain has received little attention. Future research should rigorously define the methods employed and include a sample that is more representative of the population with CP. What this paper adds Most of the papers reviewed found tactile registration and perception deficits in the upper limbs. Proprioceptive deficits were generally observed in cerebral palsy but results were heterogeneous. Pain has received little attention compared to tactile and proprioceptive functions. Neuroimaging studies supported behavioral observations. Alterations were observed for both the most and least affected limb.
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Affiliation(s)
- Clémentine Brun
- Center for Interdisciplinary Research in Rehabilitation and Social IntegrationQuebec CityQuebecCanada
| | - Élodie Traverse
- Center for Interdisciplinary Research in Rehabilitation and Social IntegrationQuebec CityQuebecCanada,Department of RehabilitationLaval UniversityQuebec CityQuebecCanada
| | - Élyse Granger
- Centre IntégréUniversitaire de Santé et de Services Sociaux de la Capitale‐NationaleQuebec CityQuebecCanada
| | - Catherine Mercier
- Center for Interdisciplinary Research in Rehabilitation and Social IntegrationQuebec CityQuebecCanada,Department of RehabilitationLaval UniversityQuebec CityQuebecCanada
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Gözaçan Karabulut D, Tütün Yümin E, Öztürk Y. The effect of motor imagery training on individuals with unilateral cerebral palsy on motor imagery ability, functional mobility and muscle activity. Somatosens Mot Res 2021; 39:62-69. [PMID: 34732094 DOI: 10.1080/08990220.2021.1997983] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM This study aims to examine the effect of motor imagery (MI) training on MI abilities, functional mobility, and lower extremity muscle activity in children with unilateral cerebral palsy (UCP). METHOD 34 UCP and 17 typically developing participants were included. UCP was randomised into 2 groups as UCP MI and UCP control. Participants typically developing were included for baseline comparisons. UCP MI group received 8 weeks of physiotherapy and MI training, the UCP control group 8 weeks of physiotherapy training. The MI abilities, functional mobility, and lower extremity muscle activation were assessed in all groups. RESULTS It was found that MI training made a significant difference in favour of the UCP MI group in terms of Movement Imagery Questionnaire-For Children (MIQ-C), mental chronometry, functional mobility, and resting muscle activation (p < 0.05). There was no such significant change in the UCP control group. CONCLUSION This current approach in UCP is a feasible method, beneficial to include it in the rehabilitation process.
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Affiliation(s)
- Demet Gözaçan Karabulut
- Department of Physiotherapy and Rehabilitation, Gaziantep Islam Science and Technology University Faculty of Health Sciences, Gaziantep, Turkey
| | - Eylem Tütün Yümin
- Department of Physiotherapy and Rehabilitation, Bolu Abant Izzet Baysal University Faculty of Health Sciences, Bolu, Turkey
| | - Yusuf Öztürk
- Department of Child and Adolescent Mental Health and Diseases, Bolu Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
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12
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Abbass ME, Ibrahim NM. Effectiveness of action observation therapy on upper extremity function in children with cerebral palsy: systematic review and meta-analysis. PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2021.1978247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Mai Elsayed Abbass
- Pediatric Physical Therapy Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Nahla M. Ibrahim
- Pediatric Physical Therapy Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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13
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Anticipatory Motor Planning and Control of Grasp in Children with Unilateral Spastic Cerebral Palsy. Brain Sci 2021; 11:brainsci11091161. [PMID: 34573182 PMCID: PMC8465927 DOI: 10.3390/brainsci11091161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/24/2021] [Accepted: 08/28/2021] [Indexed: 11/16/2022] Open
Abstract
Children with unilateral spastic cerebral palsy (USCP) have impairments in motor planning, impacting their ability to grasp objects. We examined the planning of digit position and force and the flexibility of the motor system in covarying these during object manipulation. Eleven children with a left hemisphere lesion (LHL), nine children with a right hemisphere lesion (RHL) and nine typically developing children (controls) participated in the study. Participants were instructed to use a precision grip with their dominant/less affected hand to lift and keep an object level, with either a left, centered or right center of mass (COM) location. Digit positions, forces, compensatory torque and object roll where measured. Although children with USCP generated a compensatory torque and modulated digit placement by lift-off, their index finger was either collinear or higher than the thumb, regardless of COM location, leading to larger rolls after lift-off especially for the RHL group. The findings suggest that while the kinetics of grasp control is intact, the kinematics of grasp control is impaired. This study adds to the understanding of the underlying mechanisms of anticipatory planning and control of grasp in children with USCP and may provide insights on how to improve hand function in children with USCP.
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Upper Limb Motor Planning in Individuals with Cerebral Palsy Aged between 3 and 21 Years Old: A Systematic Review. Brain Sci 2021; 11:brainsci11070920. [PMID: 34356154 PMCID: PMC8306670 DOI: 10.3390/brainsci11070920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/07/2021] [Accepted: 07/07/2021] [Indexed: 11/17/2022] Open
Abstract
Individuals with cerebral palsy have difficulties performing activities of daily living. Beyond motor execution impairments, they exhibit motor planning deficits contributing to their difficulties. The objective of this review is to synthesize the behavioral evidence of motor planning deficits during an upper limb motor task in children, adolescents and young adults with cerebral palsy aged between 3 and 21 years. Methods: The inclusion criteria were: (1) including individuals with cerebral palsy from 3 to 21 years old; (2) assessing upper limb motor planning. Six databases were screened. The quality assessment of the studies was performed. Results: Forty-six studies and 686 participants were included. Five articles have been identified as very high quality, 12 as high, 20 as moderate, six as low, three as very low. Force planning studies reported a deficit for the more affected hand but adequate performances for the less affected hand. Object-manipulation studies reported hand posture planning deficits irrespectively of the hand assessed. Conclusions: Motor planning deficits has been shown in the more affected hand for force scaling, while the results for other variables showed overall deficits. Hence, variables affected by motor planning deficits in both hands should be considered in children with cerebral palsy to optimize intervention.
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15
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Williams J, Fuelscher I, Hyde C. Motor imagery in congenital hemiplegia: Impairments are not universal. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 114:103991. [PMID: 34029886 DOI: 10.1016/j.ridd.2021.103991] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 05/11/2021] [Accepted: 05/11/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Motor imagery (MI) training may benefit children with congenital hemiplegia, but reports on MI ability are mixed. This study considered individual patterns of performance to better understand MI ability in children with hemiplegia. METHOD Twenty children with hemiplegia (7-13 years; 10 with right hemiplegia), completed a MI task, IQ estimate and functional tests. Children with hemiplegia scoring above chance on the MI task were compared to a group of age-matched peers. The performance patterns of those scoring below chance were considered individually. RESULTS Three children with right hemiplegia were excluded due to low IQ. Seven of 10 children with left hemiplegia and three of seven with right hemiplegia performed MI at an equivalent level to peers without hemiplegia. The seven children with hemiplegia who scored significantly below chance scored lower on functional tests, but differences here failed to reach an adjusted significance level. Four of the seven appeared engaged in MI, but performed very poorly. The remaining three had unique performance patterns explored in more detail. CONCLUSION Motor imagery deficits are not universally observed in children with congenital hemiplegia and individual performance should be examined before completing group analyses. Recommendations for exclusions and reporting in future studies are made.
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Affiliation(s)
- Jacqueline Williams
- Institute for Health and Sport & College of Sport and Exercise Science, Victoria University, Melbourne, Australia.
| | - Ian Fuelscher
- Deakin University, Cognitive Neuroscience Unit, School of Psychology, Geelong, Australia
| | - Christian Hyde
- Deakin University, Cognitive Neuroscience Unit, School of Psychology, Geelong, Australia
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16
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Pierret J, Caudron S, Paysant J, Beyaert C. Impaired postural control of axial segments in children with cerebral palsy. Gait Posture 2021; 86:266-272. [PMID: 33819768 DOI: 10.1016/j.gaitpost.2021.03.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 03/03/2021] [Accepted: 03/05/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Sensorimotor control of axial segments, which develops during childhood and is not mature until adolescence, is essential for the development of balance control during motor activities. Children with cerebral palsy (CP) have deficits in postural control when standing or walking, including less stabilization of the head and trunk which could affect postural control. RESEARCH QUESTION Is dynamic stabilization of axial segments during an unstable sitting task deficient in children with CP compared to typically developing children? Is this deficit correlated with the deficit of postural control during standing? METHOD Seventeen children with CP (GMFCS I-II) and 17 typically-developing children from 6 to 12 years old were rated on the Trunk Control Measurement Scale (TCMS). In addition, posturography was evaluated in participants while they maintained their balance in stable sitting, unstable sitting, and quiet standing, under "eyes open" and "eyes closed" conditions. In sitting tasks, the participants had to remain stable while being prevented from using the lower and upper limbs (i.e. to ensure the involvement of axial segments alone). RESULTS Children with CP compared to TD children had significantly larger surface area, mean velocity and RMS values of CoP displacements measured during the unstable sitting task and the standing task, under both "eyes open" and "eyes closed" conditions. No significant group effects were observed during the stable sitting task. The TCMS total score was significantly lower, indicating trunk postural deficit, in the CP group than in the TD group and was significantly correlated with postural variables in the sitting and standing tasks. SIGNIFICANCE Children with CP indeed have a specific impairment in the postural control of axial segments. Since the postural control of axial segments is important for standing and walking, its impairment should be taken into account in rehabilitation programs for children with CP.
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Affiliation(s)
- Jonathan Pierret
- Université de Lorraine, DevAH (EA3450 Développement, Adaptation & Handicap), F-54000, Nancy, France; Institut Régional de Réadaptation, Centre Louis Pierquin, UGECAM du Nord-Est, Nancy, France.
| | - Sébastien Caudron
- Université de Lorraine, DevAH (EA3450 Développement, Adaptation & Handicap), F-54000, Nancy, France; Univ. Grenoble Alpes, CNRS, LPNC, 38000 Grenoble, France.
| | - Jean Paysant
- Université de Lorraine, DevAH (EA3450 Développement, Adaptation & Handicap), F-54000, Nancy, France; Institut Régional de Réadaptation, Centre Louis Pierquin, UGECAM du Nord-Est, Nancy, France.
| | - Christian Beyaert
- Université de Lorraine, DevAH (EA3450 Développement, Adaptation & Handicap), F-54000, Nancy, France; Institut Régional de Réadaptation, Centre Louis Pierquin, UGECAM du Nord-Est, Nancy, France.
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17
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da Silva TD, da Silva PL, Valenzuela EDJ, Dias ED, Simcsik AO, de Carvalho MG, Fontes AMGG, Alberissi CADO, de Araújo LV, Brandão MVDC, Dawes H, Monteiro CBDM. Serious Game Platform as a Possibility for Home-Based Telerehabilitation for Individuals With Cerebral Palsy During COVID-19 Quarantine - A Cross-Sectional Pilot Study. Front Psychol 2021; 12:622678. [PMID: 33633648 PMCID: PMC7901904 DOI: 10.3389/fpsyg.2021.622678] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/04/2021] [Indexed: 12/22/2022] Open
Abstract
Introduction There is a need to maintain rehabilitation activities and motivate movement and physical activity during quarantine in individuals with Cerebral Palsy (CP). Objective This paper sets out to evaluate the feasibility and potential benefits of using computer serious game in a non-immersive virtual reality (VR) implemented and evaluated completely remotely in participants with CP for Home-Based Telerehabilitation during the quarantine period for COVID-19. Methods Using a cross-sectional design, a total of 44 individuals participated in this study between March and June 2020, 22 of which had CP (14 males and 8 females, mean age = 19 years, ranging between 11 and 28 years) and 22 typically developing individuals, matched by age and sex to the individuals with CP. Participants practiced a coincident timing game1 and we measured movement performance and physical activity intensity using the rating of perceived exertion Borg scale. Results All participants were able to engage with the VR therapy remotely, reported enjoying sessions, and improved performance in some practice moments. The most important result in this cross-sectional study was the significant increasing in rating of perceived exertion (through Borg scale) in both groups during practice and with CP presenting a higher rating of perceived exertion. Conclusion Children with CP enjoyed participating, were able to perform at the same level as their peers on certain activities and increased both their performance and physical activity intensity when using the game, supporting the use of serious games for this group for home therapy and interactive games. Clinical Trials Registration https://Clinicaltrials.gov, NCT04402034. Registered on May 20, 2020.
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Affiliation(s)
- Talita Dias da Silva
- Departamento de Medicina (Cardiologia), Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil.,Faculdade de Medicina, Universidade Cidade de São Paulo (UNICID), São Paulo, Brazil
| | - Paula Lumy da Silva
- Fundação Hermínio Ometto (FHO-UNIARARAS), São Paulo, Brazil.,Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo (FOFITO - USP), São Paulo, Brazil
| | - Elisa de Jesus Valenzuela
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo (FOFITO - USP), São Paulo, Brazil
| | - Eduardo Dati Dias
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
| | - Amanda Orasmo Simcsik
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
| | - Mariana Giovanelli de Carvalho
- Departamento de Medicina (Cardiologia), Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
| | - Anne Michelli Gomes Gonçalves Fontes
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo (FOFITO - USP), São Paulo, Brazil
| | - Camila Aparecida de Oliveira Alberissi
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
| | - Luciano Vieira de Araújo
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
| | - Murilo Vinícius da Costa Brandão
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
| | - Helen Dawes
- Institute of Nursing and Allied Health Research, Oxford Brookes University, Oxford, United Kingdom.,Department of Clinical Neurology, University of Oxford, Oxford, United Kingdom
| | - Carlos Bandeira de Mello Monteiro
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil.,Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo (FOFITO - USP), São Paulo, Brazil
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18
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Steenbergen B, Krajenbrink H, Lust J, Wilson P. Motor imagery and action observation for predictive control in developmental coordination disorder. Dev Med Child Neurol 2020; 62:1352-1355. [PMID: 32735038 PMCID: PMC7689853 DOI: 10.1111/dmcn.14612] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/22/2020] [Indexed: 11/29/2022]
Abstract
In 2019, international clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder (DCD) were published. Informing our understanding of mechanisms, recent systematic reviews have shown that children with DCD have difficulties with the predictive control of movements, including aspects of motor planning, which is expressed as the internal modeling deficit hypothesis. This motor control deficit is most evident when the spatial and temporal demands of a task increase. An increasing number of empirical studies suggest that motor planning problems can be remediated through training based on one or a combination of motor imagery and action observation. In this review, we show evidence of motor planning problems in children with DCD and show that task demands or complexity affects its appearance. Implications of these findings are treatments based on motor imagery and action observation to remediate motor planning issues. The article concludes with recommendations for future research.
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Affiliation(s)
- Bert Steenbergen
- Behavioural Science Institute (BSI)Radboud UniversityNijmegenthe Netherlands
- Centre for Disability and Development Research (CeDDR)School of Behavioural and Health SciencesAustralian Catholic UniversityMelbourneVICAustralia
| | - Hilde Krajenbrink
- Behavioural Science Institute (BSI)Radboud UniversityNijmegenthe Netherlands
| | - Jessica Lust
- Behavioural Science Institute (BSI)Radboud UniversityNijmegenthe Netherlands
| | - Peter Wilson
- Centre for Disability and Development Research (CeDDR)School of Behavioural and Health SciencesAustralian Catholic UniversityMelbourneVICAustralia
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19
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Upadhyay J, Tiwari N, Ansari MN. Cerebral palsy: Aetiology, pathophysiology and therapeutic interventions. Clin Exp Pharmacol Physiol 2020; 47:1891-1901. [PMID: 32662125 DOI: 10.1111/1440-1681.13379] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/08/2020] [Accepted: 07/09/2020] [Indexed: 11/26/2022]
Abstract
Cerebral palsy (CP) is the most common non-progressive neurodevelopmental disorder in which the impairment of motor and posture functions occurs. This condition may be present in many different clinical spectra. Various aetiological and risk factors play a crucial role in the causation of CP. In various cases, the causes of CP may not be apparent. Interruption in the supply of oxygen to the fetus or brain asphyxia was considered to be the main causative factor explaining CP. Antenatal, perinatal, and postnatal factors could be involved in the origin of CP. Understanding its pathophysiology is also crucial for developing preventive and protective strategies. A major advancement in the brain stimulation techniques has emerged as a promising status in diagnostic and interventional approaches. This review provides a brief explanation about the various aetiological factors, pathophysiology, and recent therapeutic approaches in the treatment of cerebral palsy.
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Affiliation(s)
- Jyoti Upadhyay
- School of Health Sciences, University of Petroleum and Energy Studies, Dehradun, India
| | - Nidhi Tiwari
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, India
| | - Mohd Nazam Ansari
- Department of Pharmacology and Toxicology, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
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20
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Kara OK, Yardımcı BN, Livanelioglu A, Soylu AR. Examination of touch-coordinate errors of adolescents with unilateral spastic cerebral palsy at an aiming-tapping task. J Back Musculoskelet Rehabil 2020; 33:81-89. [PMID: 31033458 DOI: 10.3233/bmr-181385] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND/OBJECTIVE This study aimed to investigate performance (touch-coordinate errors, inter-touch interval) of touch screen technology in adolescents with unilateral spastic cerebral palsy (USCP) and healthy peers. MATERIALS AND METHODS This prospective case-control study included 31 adolescents. The participants consisted of 15 adolescents with CP in the USCP group and 16 age-matched healthy peers in the control group. All participants performed an aiming-tapping task with an Android tablet. Four sessions were randomly applied: visual feedback (VF) and no VF with the dominant hand's index finger (DHF), and VF and no VF with the non-dominant hand's index finger (NDHF). Inter-touch interval (ITI) and touch-coordinate errors (TCE) were calculated. RESULTS There were significant differences between the groups for VF and no VF-NDHF TCE and ITI (respectively p= 0.001, p= 0.01, p= 0.001, p= 0.004) and VF and no VF-DHF TCE values (respectively p= 0.01, p= 0.008). When comparing the dominant and non-dominant hand in the USCP group, there was a significant difference on TCE with no VF (p= 0.01). CONCLUSION This study provided insight into the touch screen performance of adolescents with USCP, who performed an aiming-tapping task with a tablet. Results showed that both affected and unaffected hand performance of touch screen tasks was impaired in adolescents with USCP.
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Affiliation(s)
- Ozgun Kaya Kara
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Bilge Nur Yardımcı
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Ayse Livanelioglu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Abdullah Ruhi Soylu
- Department of Biophysics, Faculty of Medical Sciences, Hacettepe University, Turkey
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21
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Di Vita A, Cinelli MC, Raimo S, Boccia M, Buratin S, Gentili P, Inzitari MT, Iona T, Iosa M, Morelli D, Ruggeri F, Russo G, Guariglia C, Palermo L. Body Representations in Children with Cerebral Palsy. Brain Sci 2020; 10:E490. [PMID: 32731526 PMCID: PMC7463564 DOI: 10.3390/brainsci10080490] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/17/2020] [Accepted: 07/27/2020] [Indexed: 11/28/2022] Open
Abstract
We constantly process top-down and bottom-up inputs concerning our own body that interact to form body representations (BR). Even if some evidence showed BR deficits in children with cerebral palsy, a systematic study that evaluates different kinds of BR in these children, taking into account the possible presence of a general deficit affecting non-body mental representations, is currently lacking. Here we aimed at investigating BR (i.e., Body Semantics, Body Structural Representation and Body Schema) in children with cerebral palsy (CP) taking into account performance in tasks involving body stimuli and performance in tasks involving non-body stimuli. Thirty-three CP (age range: 5-12 years) were compared with a group of 103 typically-developing children (TDC), matched for age and sex. 63.64% of children with CP showed a very poor performance in body representation processing. Present data also show alterations in different body representations in CP in specific developmental stages. In particular, CP and TDC performances did not differ between 5 to 7 years old, whereas CP between 8 and 12 years old showed deficits in the Body Structural Representation and Body Schema but not in Body Semantics. These findings revealed the importance of taking into account the overall development of cognitive domains when investigating specific stimuli processing in children who do not present a typical development and were discussed in terms of their clinical implications.
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Affiliation(s)
- Antonella Di Vita
- Department of Psychology, Sapienza University of Rome, via dei Marsi 78, 00185 Rome, Italy; (M.C.C.); (M.B.); (C.G.)
- IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (S.R.); (P.G.); (M.I.); (D.M.); (F.R.); (L.P.)
| | - Maria Cristina Cinelli
- Department of Psychology, Sapienza University of Rome, via dei Marsi 78, 00185 Rome, Italy; (M.C.C.); (M.B.); (C.G.)
- IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (S.R.); (P.G.); (M.I.); (D.M.); (F.R.); (L.P.)
| | - Simona Raimo
- IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (S.R.); (P.G.); (M.I.); (D.M.); (F.R.); (L.P.)
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (M.T.I.); (T.I.)
| | - Maddalena Boccia
- Department of Psychology, Sapienza University of Rome, via dei Marsi 78, 00185 Rome, Italy; (M.C.C.); (M.B.); (C.G.)
- IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (S.R.); (P.G.); (M.I.); (D.M.); (F.R.); (L.P.)
| | | | - Paola Gentili
- IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (S.R.); (P.G.); (M.I.); (D.M.); (F.R.); (L.P.)
| | - Maria Teresa Inzitari
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (M.T.I.); (T.I.)
| | - Teresa Iona
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (M.T.I.); (T.I.)
| | - Marco Iosa
- IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (S.R.); (P.G.); (M.I.); (D.M.); (F.R.); (L.P.)
| | - Daniela Morelli
- IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (S.R.); (P.G.); (M.I.); (D.M.); (F.R.); (L.P.)
| | - Francesco Ruggeri
- IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (S.R.); (P.G.); (M.I.); (D.M.); (F.R.); (L.P.)
| | - Giuseppina Russo
- ASP di Catanzaro, Unità Operativa Complessa di Neuropsichiatria Infantile, 88100 Catanzaro, Italy;
| | - Cecilia Guariglia
- Department of Psychology, Sapienza University of Rome, via dei Marsi 78, 00185 Rome, Italy; (M.C.C.); (M.B.); (C.G.)
- IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (S.R.); (P.G.); (M.I.); (D.M.); (F.R.); (L.P.)
| | - Liana Palermo
- IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (S.R.); (P.G.); (M.I.); (D.M.); (F.R.); (L.P.)
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (M.T.I.); (T.I.)
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Souto DO, Cruz TKF, Coutinho K, Julio-Costa A, Fontes PLB, Haase VG. Effect of motor imagery combined with physical practice on upper limb rehabilitation in children with hemiplegic cerebral palsy. NeuroRehabilitation 2020; 46:53-63. [DOI: 10.3233/nre-192931] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Deisiane Oliveira Souto
- Graduate Program in Neurosciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Department of Psychology, Developmental Neuropsychology Laboratory, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Thalita Karla Flores Cruz
- Graduate Program in Neurosciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Department of Psychology, Developmental Neuropsychology Laboratory, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Kênia Coutinho
- Department of Psychology, Developmental Neuropsychology Laboratory, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Annelise Julio-Costa
- Department of Psychology, Developmental Neuropsychology Laboratory, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Vitor Geraldi Haase
- Graduate Program in Neurosciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Department of Psychology, Developmental Neuropsychology Laboratory, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- National Institute of Science and Technology on Behavior, CNPq, Brazil
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23
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Simon-Martinez C, Mailleux L, Hoskens J, Ortibus E, Jaspers E, Wenderoth N, Sgandurra G, Cioni G, Molenaers G, Klingels K, Feys H. Randomized controlled trial combining constraint-induced movement therapy and action-observation training in unilateral cerebral palsy: clinical effects and influencing factors of treatment response. Ther Adv Neurol Disord 2020; 13:1756286419898065. [PMID: 32031542 PMCID: PMC6977217 DOI: 10.1177/1756286419898065] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 12/09/2019] [Indexed: 01/21/2023] Open
Abstract
Introduction: Constraint-induced movement therapy (CIMT) improves upper limb (UL) motor
execution in unilateral cerebral palsy (uCP). As these children also show
motor planning deficits, action-observation training (AOT) might be of
additional value. Here, we investigated the combined effect of AOT to CIMT
and identified factors influencing treatment response. Methods: A total of 44 children with uCP (mean 9 years 6 months, SD 1 year 10 months)
participated in a 9-day camp wearing a splint for 6 h/day and were allocated
to the CIMT + AOT (n = 22) and the CIMT + placebo group
(n = 22). The CIMT + AOT group received 15 h of AOT
(i.e. video-observation) and executed the observed tasks, whilst the
CIMT + AOT group watched videos free of biological motion and executed the
same tasks. The primary outcome measure was bimanual performance. Secondary
outcomes included measures of body function and activity level assessed
before (T1), after the intervention (T2), and at 6 months follow-up (T3).
Influencing factors included behavioural and neurological
characteristics. Results: Although no between-groups differences were found
(p > 0.05; η2 = 0–16), the addition of AOT
led to higher gains in children with initially poorer bimanual performance
(p = 0.02; η2 = 0.14). Both groups improved
in all outcome measures after the intervention and retained the gains at
follow up (p < 0.01; η2 = 0.02–0.71). Poor
sensory function resulted in larger improvements in the total group
(p = 0.03; η2 = 0.25) and high amounts of
mirror movements tended to result in a better response to the additional AOT
training (p = 0.06; η2 = 0.18). Improvements
were similar irrespective of the type of brain lesion or corticospinal tract
wiring pattern. Conclusions: Adding AOT to CIMT, resulted in a better outcome for children with poor motor
function and high amounts of mirror movements. CIMT with or without AOT
seems to be more beneficial for children with poor sensory function. Trial registration: Registered at ClinicalTrials.gov on 22nd August 2017 (ClinicalTrials.gov
identifier: NCT03256357).
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Affiliation(s)
- Cristina Simon-Martinez
- KU Leuven, Department of Rehabilitation Sciences, Herestraat 49, bus 1510, Leuven, 3000, Belgium
| | - Lisa Mailleux
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Jasmine Hoskens
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Els Ortibus
- KU Leuven, Department of Development and Regeneration, Leuven, Belgium
| | - Ellen Jaspers
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Switzerland
| | - Nicole Wenderoth
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Switzerland
| | - Giuseppina Sgandurra
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Calambrone, Italy
| | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Calambrone, Italy
| | - Guy Molenaers
- KU Leuven, Department of Development and Regeneration, Leuven, Belgium
| | - Katrijn Klingels
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Hilde Feys
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
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Hoffman RM, Wilson TW, Kurz MJ. Hand Motor Actions of Children With Cerebral Palsy Are Associated With Abnormal Sensorimotor Cortical Oscillations. Neurorehabil Neural Repair 2019; 33:1018-1028. [PMID: 31679451 DOI: 10.1177/1545968319883880] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background. The neuroimaging literature on cerebral palsy (CP) has predominantly focused on identifying the structural aberrations (eg, fiber track integrity), with very few studies examining neural activity within the key networks that serve the production of hand movements. Objective. We aimed to start to fill this knowledge gap by using magnetoencephalographic brain imaging to quantify the temporal dynamics of the sensorimotor oscillations during a hand motor action. Methods: Children with CP (n = 12; MACS [Manual Abilities Classification System] levels I-III) and typically developing (TD) children (n = 26) performed an arrow-based version of the Eriksen flanker task where a button press was performed with either the second or third digit of the right hand depending on the arrow's direction. Results: Overall, the children with CP were less accurate and had slower reaction times compared with the TD children. These behavioral differences were closely linked with aberrant sensorimotor cortical oscillations seen in the children with CP. Compared with the TD children, the children with CP had a weaker gamma (68-82 Hz) response during motor execution and a weaker post-movement beta rebound (PMBR; 14-26 Hz) response on movement termination. Moreover, we observed a significant correlation between the amplitude of the gamma and PMBR with reaction time, with weaker gamma and PMBR responses being linked with slower reaction times. Conclusions: Overall, these results suggest that aberrations in motor-related gamma and beta cortical oscillations are associated with the impaired hand motor actions seen in children with CP.
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Affiliation(s)
| | - Tony W Wilson
- University of Nebraska Medical Center, Omaha, NE, USA
| | - Max J Kurz
- University of Nebraska Medical Center, Omaha, NE, USA
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25
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Errante A, Bozzetti F, Sghedoni S, Bressi B, Costi S, Crisi G, Ferrari A, Fogassi L. Explicit Motor Imagery for Grasping Actions in Children With Spastic Unilateral Cerebral Palsy. Front Neurol 2019; 10:837. [PMID: 31447762 PMCID: PMC6692593 DOI: 10.3389/fneur.2019.00837] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 07/19/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Motor Imagery (MI) refers to mental simulation of a motor action without producing any overt movement. Previous studies showed that children with Unilateral Cerebral Palsy (UCP) are impaired in implicit MI, as demonstrated by the performance of Hand Laterality Judgment tasks. The aim of this study was to examine the specificity of explicit MI deficits in UCP children. Methods: A group of UCP children (n = 10; aged 9-14) performed a mental chronometry task consisting in grasping an object and placing it into a container, or in imagining to perform the same action. As control, a group of typically developing (TD) children, matched by age, performed the same task. Movement durations for executed and imagined trials were recorded. A subgroup of 7 UCP children and 10 TD children also underwent a session of functional MRI to examine the activation of parieto-frontal areas typically associated to MI processes, during the imagination of reaching-grasping actions performed with the paretic hand. Results: Behavioral results revealed the existence of a correlation between executed and imagined movement durations both in TD and UCP groups. Moreover, the regression analysis in TD children showed that higher scores in mental chronometry tasks were positively correlated to increased bilateral activation of the intraparietal sulcus (IPS), superior parietal lobule (SPL), and dorsal premotor (PMd) cortex. A similar analysis revealed in the UCP group a positive correlation between a higher score in the mental chronometry task and bilateral activations of IPS, and to activation of contralesional, right PMd, and putamen during imagination of grasping movements. Conclusions: These results provide new insights on the relationship between MI capacity and motor deficits in UCP children, suggesting the possibility of the use of explicit MI training to improve patient's upper limb motor functions.
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Affiliation(s)
- Antonino Errante
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Francesca Bozzetti
- Neuroradiology Unit, Department of Diagnostic, University Hospital of Parma, Parma, Italy
| | - Silvia Sghedoni
- Azienda Unità Sanitaria Locale - IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Barbara Bressi
- Azienda Unità Sanitaria Locale - IRCCS of Reggio Emilia, Reggio Emilia, Italy.,Department of Neuroscience, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Costi
- Azienda Unità Sanitaria Locale - IRCCS of Reggio Emilia, Reggio Emilia, Italy.,Department of Neuroscience, University of Modena and Reggio Emilia, Modena, Italy
| | - Girolamo Crisi
- Neuroradiology Unit, Department of Diagnostic, University Hospital of Parma, Parma, Italy
| | - Adriano Ferrari
- Azienda Unità Sanitaria Locale - IRCCS of Reggio Emilia, Reggio Emilia, Italy.,Department of Neuroscience, University of Modena and Reggio Emilia, Modena, Italy
| | - Leonardo Fogassi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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26
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Early Brain Damage Affects Body Schema and Person Perception Abilities in Children and Adolescents with Spastic Diplegia. Neural Plast 2019; 2019:1678984. [PMID: 31531012 PMCID: PMC6721097 DOI: 10.1155/2019/1678984] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 07/24/2019] [Indexed: 11/17/2022] Open
Abstract
Early brain damage leading to cerebral palsy is associated to core motor impairments and also affects cognitive and social abilities. In particular, previous studies have documented specific alterations of perceptual body processing and motor cognition that are associated to unilateral motor deficits in hemiplegic patients. However, little is known about spastic diplegia (SpD), which is characterized by motorial deficits involving both sides of the body and is often associated to visuospatial, attentional, and social perception impairments. Here, we compared the performance of a sample of 30 children and adolescents with SpD (aged 7-18 years) and of a group of age-matched controls with typical development (TD) at two different tasks tapping on body representations. In the first task, we tested visual and motor imagery abilities as assessed, respectively, by the object-based mental rotation of letters and by the first-person transformations for whole-body stimuli. In the second task, we administered an inversion effect/composite illusion task to evaluate the use of configural/holistic processing of others' body. Additionally, we assessed social perception abilities in the SpD sample using the NEPSY-II battery. In line with previously reported visuospatial deficits, a general mental imagery impairment was found in SpD patients when they were engaged in both object-centered and first-person mental transformations. Nevertheless, a specific deficit in operating an own-body transformation emerged. As concerns body perception, while more basic configural processing (i.e., inversion effect) was spared, no evidence for holistic (i.e., composite illusion) body processing was found in the SpD group. NEPSY-II assessment revealed that SpD children were impaired in both the theory of mind and affect recognition subtests. Overall, these findings suggested that early brain lesions and biased embodied experience could affect higher-level motor cognition and perceptual body processing, thus pointing to a strict link between motor deficits, body schema alterations, and person processing difficulties.
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27
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Krajenbrink H, Crichton A, Steenbergen B, Hoare B. The development of anticipatory action planning in children with unilateral cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 85:163-171. [PMID: 30557847 DOI: 10.1016/j.ridd.2018.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 09/28/2018] [Accepted: 12/09/2018] [Indexed: 06/09/2023]
Abstract
Background Previous studies suggest that compromised bimanual performance experienced by children with unilateral cerebral palsy (CP) is not only due to difficulties in action execution but may also be a result of impaired anticipatory action planning. Aims The effect of age and side of hemiplegia were examined and the relationship between anticipatory action planning, unimanual capacity and bimanual performance was explored. Methods and procedures Using a multi-centre, prospective, cross-sectional observational design, anticipatory action planning was analyzed in 104 children with unilateral cerebral palsy, aged 6-12 years, using the sword task. Outcomes and results Anticipatory action planning did not improve with age in children with unilateral CP, aged between 6-12 years. No differences were found between children with left or right hemiplegia. Finally, anticipatory action planning was not related to unimanual capacity or bimanual performance. Conclusion and implications This study demonstrates anticipatory action planning, measured using the sword task, does not improve with age in children with unilateral CP and is not related to bimanual performance or laterality. Future studies of anticipatory action planning in children with unilateral CP should consider using measures that require effective anticipatory action planning for successful task completion rather than end state comfort.
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Affiliation(s)
- Hilde Krajenbrink
- Department of Paediatrics, Monash University, Clayton, Victoria, 3168, Australia; Behavioural Science Institute, Nijmegen, the Netherlands
| | - Ali Crichton
- Department of Paediatrics, Monash University, Clayton, Victoria, 3168, Australia; Victorian Paediatric Rehabilitation Service, Monash Children's Hospital, 246 Clayton Rd, Clayton, Victoria, 3168, Australia
| | - Bert Steenbergen
- Behavioural Science Institute, Nijmegen, the Netherlands; Australian Catholic University, School of Psychology, Melbourne, Australia
| | - Brian Hoare
- Department of Paediatrics, Monash University, Clayton, Victoria, 3168, Australia; School of Occupational Therapy, La Trobe University, Bundoora, Victoria, 3168, Australia; Victorian Paediatric Rehabilitation Service, Monash Children's Hospital, 246 Clayton Rd, Clayton, Victoria, 3168, Australia.
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28
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Simon-Martinez C, Mailleux L, Ortibus E, Fehrenbach A, Sgandurra G, Cioni G, Desloovere K, Wenderoth N, Demaerel P, Sunaert S, Molenaers G, Feys H, Klingels K. Combining constraint-induced movement therapy and action-observation training in children with unilateral cerebral palsy: a randomized controlled trial. BMC Pediatr 2018; 18:250. [PMID: 30064396 PMCID: PMC6069849 DOI: 10.1186/s12887-018-1228-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 07/19/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Upper limb (UL) deficits in children with unilateral cerebral palsy (uCP) have traditionally been targeted with motor execution treatment models, such as modified Constraint-Induced Movement Therapy (mCIMT). However, new approaches based on a neurophysiological model such as Action-Observation Training (AOT) may provide new opportunities for enhanced motor learning. The aim of this study is to describe a randomised controlled trial (RCT) protocol investigating the effects of an intensive treatment model, combining mCIMT and AOT compared to mCIMT alone on UL function in children with uCP. Additionally, the role of neurological factors as potential biomarkers of treatment response will be analysed. METHODS An evaluator-blinded RCT will be conducted in 42 children aged between 6 and 12 years. Before randomization, children will be stratified according to their House Functional Classification Scale, age and type of corticospinal tract wiring. A 2-week day-camp will be set up in which children receive intensive mCIMT therapy for 6 hours a day on 9 out of 11 consecutive days (54 h) including AOT or control condition (15 h). During AOT, these children watch video sequences showing goal-directed actions and subsequently execute the observed actions with the more impaired UL. The control group performs the same actions after watching computer games without human motion. The primary outcome measure will be the Assisting Hand Assessment. Secondary outcomes comprise clinical assessments across body function, activity and participation level of the International Classification of Function, Disability and Health. Furthermore, to quantitatively evaluate UL movement patterns, a three-dimensional motion analysis will be conducted. UL function will be assessed at baseline, immediately before and after intervention and at 6 months follow up. Brain imaging comprising structural and functional connectivity measures as well as Transcranial Magnetic Stimulation (TMS) to evaluate corticospinal tract wiring will be acquired before the intervention. DISCUSSION This paper describes the methodology of an RCT with two main objectives: (1) to evaluate the added value of AOT to mCIMT on UL outcome in children with uCP and (2) to investigate the role of neurological factors as potential biomarkers of treatment response. TRIAL REGISTRATION NCT03256357 registered on 21st August 2017 (retrospectively registered).
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Affiliation(s)
| | - Lisa Mailleux
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Els Ortibus
- Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium
| | - Anna Fehrenbach
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Giuseppina Sgandurra
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Calambrone, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Calambrone, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Kaat Desloovere
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
- Clinical Motion Analysis Laboratory, University Hospitals Leuven, Pellenberg, Belgium
| | - Nicole Wenderoth
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH, Zurich, Switzerland
| | - Philippe Demaerel
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Stefan Sunaert
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Guy Molenaers
- Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium
| | - Hilde Feys
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Katrijn Klingels
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
- Rehabilitation Research Centre, BIOMED, Hasselt University, Diepenbeek, Belgium
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Bhoyroo R, Hands B, Wilmut K, Hyde C, Wigley A. Investigating motor planning in children with DCD: Evidence from simple and complex grip-selection tasks. Hum Mov Sci 2018; 61:42-51. [PMID: 30007548 DOI: 10.1016/j.humov.2018.07.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 07/05/2018] [Accepted: 07/06/2018] [Indexed: 10/28/2022]
Abstract
Several studies suggest that children with Developmental Coordination Disorder (DCD) may be able to plan simple movements as well as their peers, but experience increasing difficulties as the movements become complex. The present study aimed to clarify the nature of motor planning in DCD, including a putative deficit, by being the first to investigate motor planning using converging measures of simple and complex motor planning in a single sample of children with DCD. Boys aged between 8 and 12 years with (n = 10) and without DCD (n = 17) completed three commonly used 'simple' (bar grasping, sword, and bar transport tasks) measures and one 'complex' (octagon task) measure of end-state-comfort (ESC), a classic measurement of motor planning ability. To achieve ESC when manipulating an object, a person may choose to start with an uncomfortable grip in order to end the movement in a comfortable position. Results indicate that the participants with DCD planned for ESC as efficiently as their peers when performing the 'simple' measures of ESC but were significantly less likely to end their performances in ESC than those without DCD for the more 'complex' octagon task. Taken together, our data suggest that school-aged children with DCD may be able to plan simple movements as efficiently as their peers, but have more difficulty doing so for multi-movement or complex sequences. Based on the assumption that the efficiency of such motor planning is dependent on the integrity of internal modelling systems, we argue that our study provides indirect support for the internal modelling deficit hypothesis.
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Affiliation(s)
- Ranila Bhoyroo
- Institute for Health Research, University of Notre Dame, Perth, Australia.
| | - Beth Hands
- Institute for Health Research, University of Notre Dame, Perth, Australia
| | - Kate Wilmut
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Christian Hyde
- Deakin Child Study Centre, School of Psychology, Deakin University, Victoria, Australia
| | - Adam Wigley
- Institute for Health Research, University of Notre Dame, Perth, Australia
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30
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Qi YC, Niu XL, Gao YR, Wang HB, Hu M, Dong LP, Li YZ. Therapeutic Effect Evaluation of Neuromuscular Electrical Stimulation With or Without Strengthening Exercise on Spastic Cerebral Palsy. Clin Pediatr (Phila) 2018; 57:580-583. [PMID: 28990434 DOI: 10.1177/0009922817732619] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aims of this study were to investigate the effect of neuromuscular electrical stimulation (NMES) combined with strengthening exercise on movement in children with spastic cerebral palsy (CP). One hundred children with spastic CP were randomly divided into a treatment group (NMES and strengthening exercise, n = 50) and a control group (only NMES, n = 50). We compared the Comprehensive Spasticity Scale (CSS) score, Gross Motor Function Measure (GMFM) score, and walking speed before treatment and 6 weeks and 3 months after treatment between the 2 groups. There was no difference in CSS score between the treatment and control groups before the therapy (12.0 ± 3.4 vs 12.3 ± 3.6), which decreased much more in the treatment group after 6 weeks (7.6 ± 3.0 vs 9.5 ± 2.8) and 3 months (7.4 ± 2.4 vs 9.4 ± 2.6) with significant differences ( P < .05). No difference in GMFM score was observed between the treatment and control groups before the therapy (44.5 ± 13.2 vs 44.0 ± 12.6), which increased much more in the treatment group after 6 weeks (70.6 ± 15.2 vs 56.7 ± 14.3) and 3 months (71.0 ± 16.4 vs 58.0 ± 15.6) with significant differences ( P < .05). The walking speed improved over time, which was the same before the treatment (0.43 ± 0.13 m/s vs 0.45 ± 0.14 m/s), and was significantly greater in the treatment group than that in the control group (6 weeks: 0.69 ± 0.15 m/s vs 0.56 ± 0.12 m/s, P < .05; 3 months: 0.72 ± 0.17 m/s vs 0.57 ± 0.18 m/s, P < .05). NMES combined with strengthening exercise was more effective than NMES alone in the recovery of spastic CP.
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Affiliation(s)
- Ya-Chao Qi
- 1 Hebei General Hospital, Shijiazhuang, China
| | - Xiao-Li Niu
- 1 Hebei General Hospital, Shijiazhuang, China
| | - Ya-Ran Gao
- 1 Hebei General Hospital, Shijiazhuang, China
| | - He-Bo Wang
- 1 Hebei General Hospital, Shijiazhuang, China
| | - Ming Hu
- 1 Hebei General Hospital, Shijiazhuang, China
| | | | - Ya-Zhou Li
- 2 The Third Hospital of Hebei Medical University, Shijiazhuang, China
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31
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Ebner-Karestinos D, Flament B, Arnould C, Thonnard JL, Bleyenheuft Y. Precision grip control while walking down a step in children with unilateral cerebral palsy. PLoS One 2018; 13:e0191684. [PMID: 29390012 PMCID: PMC5794097 DOI: 10.1371/journal.pone.0191684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 01/09/2018] [Indexed: 01/01/2023] Open
Abstract
Aim To compare grip force (GF) and load force (LF) coordination while walking down a step between children with unilateral cerebral palsy (UCP) and typically developing (TD) children. Methods Twenty-five children with UCP (age 9.3±1.7 y) and 25 TD controls (age 9.4±2.1 y) walked down a step while holding a grip-lift manipulandum. Dynamic and temporal variables were analyzed. The maximum voluntary contraction (MVC) was also assessed. Results The temporal course was perturbed mainly in the more affected hand of children with UCP when compared to TD children because the increases in GF and LF onset occurred in a reversed order. Compared with the TD controls, the children with UCP presented higher LF values on both hands and a higher GF on the less affected hand. In children with UCP, the GF to LF adaptation was adequate on the less affected hand but overestimated on the more affected hand. Furthermore, children with UCP presented a lower MVC in the more affected hand, leading to a higher percentage of MVC used during the task. Interpretation Our findings highlight an anticipatory control of precision grip during a stepping down task in children with UCP that is adequate for the less affected hand but altered for the more affected hand.
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Affiliation(s)
| | - Benoît Flament
- Physical and Occupational Therapy Departments, Paramedical Category, Haute Ecole Louvain en Hainaut, Montignies-sur-Sambre, Belgium
| | - Carlyne Arnould
- Physical and Occupational Therapy Departments, Paramedical Category, Haute Ecole Louvain en Hainaut, Montignies-sur-Sambre, Belgium
| | - Jean-Louis Thonnard
- Institute of Neuroscience (IoNS), Université catholique de Louvain, Brussels, Belgium
- Physical and Rehabilitation Medicine Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Yannick Bleyenheuft
- Institute of Neuroscience (IoNS), Université catholique de Louvain, Brussels, Belgium
- * E-mail:
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Lust JM, Spruijt S, Wilson PH, Steenbergen B. Motor planning in children with cerebral palsy: A longitudinal perspective. J Clin Exp Neuropsychol 2017; 40:559-566. [PMID: 29061082 DOI: 10.1080/13803395.2017.1387645] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Motor planning is important for daily functioning. Deficits in motor planning can result in slow, inefficient, and clumsy motor behavior and are linked to disruptions in performance of activities of daily living in children with cerebral palsy (CP). However, the evidence in CP is primarily based on cross-sectional data. METHOD Data are presented on the development of motor planning in children with CP using a longitudinal design with three measurement occasions, each separated by 1 year. Twenty-two children with CP (9 boys, 13 girls; age in years;months, M = 7;1, SD = 1;2) and 22 age-matched controls (10 boys, 12 girls, M = 7;1, SD = 1;3) participated. Children performed a bar transport task in which some conditions ("critical angles") required participants to sacrifice initial posture comfort in order to achieve end-state comfort. Performance on critical trials was analyzed using linear growth curve modeling. RESULTS In general, children with CP showed poor end-state planning for critical angles. Importantly, unlike in controls, motor planning ability did not improve across the three measurement occasions in children with CP. CONCLUSION These longitudinal results show that motor planning issues in CP do not resolve with development over childhood. Strategies to enhance motor planning are suggested for intervention.
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Affiliation(s)
| | - Steffie Spruijt
- a Behavioural Science Institute , Radboud University , Nijmegen , The Netherlands
| | - Peter H Wilson
- b School of Psychology , Australian Catholic University , Melbourne , Australia.,c Centre for Disability and Development Research (CeDDR) , Australian Catholic University , Melbourne , Australia
| | - Bert Steenbergen
- a Behavioural Science Institute , Radboud University , Nijmegen , The Netherlands.,b School of Psychology , Australian Catholic University , Melbourne , Australia.,c Centre for Disability and Development Research (CeDDR) , Australian Catholic University , Melbourne , Australia
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Gordon AM. Impaired Voluntary Movement Control and Its Rehabilitation in Cerebral Palsy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 957:291-311. [PMID: 28035572 DOI: 10.1007/978-3-319-47313-0_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Cerebral palsy is caused by early damage to the developing brain, as the most common pediatric neurological disorder. Hemiplegia (unilateral spastic cerebral palsy) is the most common subtype, and the resulting impairments, lateralized to one body side, especially affect the upper extremity, limiting daily function. This chapter first describes the pathophysiology and mechanisms underlying impaired upper extremity control of cerebral palsy. It will be shown that the severity of impaired hand function closely relates to the integrity of the corticospinal tract innervating the affected hand. It will also shown that the developing corticospinal tract can reorganize its connectivity depending on the timing and location of CNS injury, which also has implications for the severity of hand impairments and rehabilitation. The mechanisms underlying impaired motor function will be highlighted, including deficits in movement execution and planning and sensorimotor integration. It will be shown that despite having unimanual hand impairments, bimanual movement control deficits and mirror movements also impact function. Evidence for motor learning-based therapies including Constraint-Induced Movement Therapy and Bimanual Training, and the possible pathophysiological predictors of treatment outcome and plasticity will be described. Finally, future directions for rehabilitations will be presented.
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Affiliation(s)
- Andrew M Gordon
- Department of Biobehavioral Sciences, Teachers College, Columbia University, 525 West 120th Street, New York, New York, Box 93, 10027, USA.
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34
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Wilson PH, Smits-Engelsman B, Caeyenberghs K, Steenbergen B. Toward a Hybrid Model of Developmental Coordination Disorder. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2017. [DOI: 10.1007/s40474-017-0115-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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35
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Di Lieto MC, Brovedani P, Pecini C, Chilosi AM, Belmonti V, Fabbro F, Urgesi C, Fiori S, Guzzetta A, Perazza S, Sicola E, Cioni G. Spastic diplegia in preterm-born children: Executive function impairment and neuroanatomical correlates. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 61:116-126. [PMID: 28073076 DOI: 10.1016/j.ridd.2016.12.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 12/12/2016] [Accepted: 12/18/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND The neuropsychological literature on preterm-born children with spastic diplegia due to periventricular leukomalacia is convergent in reporting deficits in non-verbal intelligence and in visuo-spatial abilities. Nevertheless, other cognitive functions have found to be impaired, but data are scant and not correlated with neuroimaging findings. AIMS This study analyzes the neuropsychological strengths and weaknesses in preterm-born children with spastic diplegia (pSD) and their relationships with neuroanatomical findings, investigated by a novel scale for MRI classification. METHODS AND PROCEDURES Nineteen children with pSD, mild to moderate upper limb impairment and Verbal IQ>80, and 38 normal controls were evaluated with a comprehensive neuropsychological battery (NEPSY-II), assessing Attention/Executive Functioning, Language, Memory, Sensorimotor, Social Perception and Visuospatial Processing domains. The MRIs were quantitatively scored for lesion severity. OUTCOMES AND RESULTS The results showed that, beyond core visuo-spatial and sensory-motor deficits, impairments in attention and executive functions were present in more than half of the sample, particularly in children with damage to the anterior corpus callosum. CONCLUSIONS AND IMPLICATIONS The findings are discussed in terms of clinical and rehabilitative implications tailored for pSD subgroups diversified for neuropsychological and neuroanatomical characteristics.
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Affiliation(s)
- Maria Chiara Di Lieto
- Department of Developmental Neuroscience, IRCCS Stella Maris, Viale del Tirreno 331, 56128, Calambrone, Pisa, Italy.
| | - Paola Brovedani
- Department of Developmental Neuroscience, IRCCS Stella Maris, Viale del Tirreno 331, 56128, Calambrone, Pisa, Italy.
| | - Chiara Pecini
- Department of Developmental Neuroscience, IRCCS Stella Maris, Viale del Tirreno 331, 56128, Calambrone, Pisa, Italy.
| | - Anna Maria Chilosi
- Department of Developmental Neuroscience, IRCCS Stella Maris, Viale del Tirreno 331, 56128, Calambrone, Pisa, Italy.
| | - Vittorio Belmonti
- Department of Developmental Neuroscience, IRCCS Stella Maris, Viale del Tirreno 331, 56128, Calambrone, Pisa, Italy.
| | - Franco Fabbro
- Department of Human Sciences, University of Udine, Via Margreth 3, 33100, Udine, Italy.
| | - Cosimo Urgesi
- Department of Human Sciences, University of Udine, Via Margreth 3, 33100, Udine, Italy.
| | - Simona Fiori
- Department of Developmental Neuroscience, IRCCS Stella Maris, Viale del Tirreno 331, 56128, Calambrone, Pisa, Italy.
| | - Andrea Guzzetta
- Department of Developmental Neuroscience, IRCCS Stella Maris, Viale del Tirreno 331, 56128, Calambrone, Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy.
| | - Silvia Perazza
- Department of Developmental Neuroscience, IRCCS Stella Maris, Viale del Tirreno 331, 56128, Calambrone, Pisa, Italy.
| | - Elisa Sicola
- Department of Developmental Neuroscience, IRCCS Stella Maris, Viale del Tirreno 331, 56128, Calambrone, Pisa, Italy.
| | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Stella Maris, Viale del Tirreno 331, 56128, Calambrone, Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy.
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Salavati M, Waninge A, Rameckers EAA, van der Steen J, Krijnen WP, van der Schans CP, Steenbergen B. Development and face validity of a cerebral visual impairment motor questionnaire for children with cerebral palsy. Child Care Health Dev 2017; 43:37-47. [PMID: 27481724 DOI: 10.1111/cch.12377] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 05/24/2016] [Accepted: 06/11/2016] [Indexed: 11/27/2022]
Abstract
AIM The objectives of this study were (i) to develop two cerebral visual impairment motor questionnaires (CVI-MQ's) for children with cerebral palsy (CP): one for children with Gross Motor Function Classification System (GMFCS) levels I, II and III and one for children with GMFCS levels IV and V; (ii) to describe their face validity and usability; and (iii) to determine their sensitivity and specificity. BACKGROUNDS The initial versions of the two CVI-MQ's were developed based on literature. Subsequently, the Delphi method was used in two groups of experts, one familiar with CVI and one not familiar with CVI, in order to gain consensus about face validity and usability. The sensitivity and specificity of the CVI-MQ's were subsequently assessed in 82 children with CP with (n = 39) and without CVI (n = 43). With the receiver operating curve the cut-off scores were determined to detect possible presence or absence of CVI in children with CP. RESULTS Both questionnaires showed very good face validity (percentage agreement above 96%) and good usability (percentage agreement 95%) for practical use. The CVI-MQ version for GMFCS levels I, II and III had a sensitivity of 1.00 and specificity of 0.96, with a cut-off score of 12 points or higher, and the version for GMFCS levels IV and V had a sensitivity of 0.97 and a specificity of 0.98, with a cut-off score of eight points or higher. CONCLUSION The CVI-MQ is able to identify at-risk children with CP for the probability of having CVI.
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Affiliation(s)
- M Salavati
- Centres of expertise for blind and visually impaired people, Royal Dutch Visio, The Netherlands.,Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - A Waninge
- Centres of expertise for blind and visually impaired people, Royal Dutch Visio, The Netherlands.,Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - E A A Rameckers
- Department of Rehabilitation Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Adelante Center of Expertise in Rehabilitation and Audiology, Valkenburg and Hoensbroek, The Netherlands.,Advanced Training for Professionals Working with Children with Movement Disabilities, AVANSplus, Breda, The Netherlands
| | - J van der Steen
- Centres of expertise for blind and visually impaired people, Royal Dutch Visio, The Netherlands.,Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands
| | - W P Krijnen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - C P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.,Department of Rehabilitation Medicine; Groningen, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - B Steenbergen
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.,School of Psychology, Australian Catholic University, Melbourne, Australia
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37
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The International Classification of Functioning (ICF) to evaluate deep brain stimulation neuromodulation in childhood dystonia-hyperkinesia informs future clinical & research priorities in a multidisciplinary model of care. Eur J Paediatr Neurol 2017; 21:147-167. [PMID: 27707656 DOI: 10.1016/j.ejpn.2016.08.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 08/11/2016] [Accepted: 08/29/2016] [Indexed: 12/12/2022]
Abstract
The multidisciplinary team (MDT) approach illustrates how motor classification systems, assessments and outcome measures currently available have been applied to a national cohort of children and young people with dystonia and other hyperkinetic movement disorders (HMD) particularly with a focus on dyskinetic cerebral palsy (CP). The paper is divided in 3 sections. Firstly, we describe the service model adopted by the Complex Motor Disorders Service (CMDS) at Evelina London Children's Hospital and King's College Hospital (ELCH-KCH) for deep brain stimulation. We describe lessons learnt from available dystonia studies and discuss/propose ways to measure DBS and other dystonia-related intervention outcomes. We aim to report on current available functional outcome measures as well as some impairment-based assessments that can encourage and generate discussion among movement disorders specialists of different backgrounds regarding choice of the most important areas to be measured after DBS and other interventions for dystonia management. Finally, some recommendations for multi-centre collaboration in regards to functional clinical outcomes and research methodologies for dystonia-related interventions are proposed.
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38
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Lust JM, Wilson PH, Steenbergen B. Motor imagery difficulties in children with Cerebral Palsy: A specific or general deficit? RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 57:102-111. [PMID: 27399206 DOI: 10.1016/j.ridd.2016.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 06/10/2016] [Accepted: 06/13/2016] [Indexed: 06/06/2023]
Abstract
AIM The aim of this study was to examine the specificity of motor imagery (MI) difficulties in children with CP. METHOD Performance of 22 children with CP was compared to a gender and age matched control group. MI ability was measured with the Hand Laterality Judgment (HLJ) task, examining specifically the direction of rotation (DOR) effect, and the Praxis Imagery Questionnaire (PIQ). RESULTS In the back view condition of the HLJ task both groups used MI, as evidenced by longer response times for lateral compared with medial rotational angles. In the palm view condition children with CP did not show an effect of DOR, unlike controls. Error scores did not differ between groups. Both groups performed well on the PIQ, with no significant difference between them in response pattern. CONCLUSION AND IMPLICATION The present study suggests that children with CP show deficits on tasks that trigger implicit use of MI, whereas explicit MI ability was relatively preserved, as assessed using the PIQ. These results suggest that employing more explicit methods of MI training may well be more suitable for children with CP in rehabilitation of motor function.
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Affiliation(s)
- Jessica M Lust
- Radboud University Nijmegen, Behavioural Science Institute, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands.
| | - Peter H Wilson
- Australian Catholic University, School of Psychology, Melbourne 3065, VIC, Australia
| | - Bert Steenbergen
- Radboud University Nijmegen, Behavioural Science Institute, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands; Australian Catholic University, School of Psychology, Melbourne 3065, VIC, Australia
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39
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Jongsma MLA, Baas CM, Sangen AFM, Aarts PBM, van der Lubbe RHJ, Meulenbroek RGJ, Steenbergen B. Children with unilateral cerebral palsy show diminished implicit motor imagery with the affected hand. Dev Med Child Neurol 2016; 58:277-84. [PMID: 26095695 DOI: 10.1111/dmcn.12819] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/15/2015] [Indexed: 11/30/2022]
Abstract
AIM Motor imagery refers to the mental simulation of a motor action without producing an overt movement. Implicit motor imagery can be regarded as a first-person kinesthetic perceptual judgement, and addresses the capacity to engage into the manipulation of one's body schema. In this study, we examined whether children with unilateral cerebral palsy (CP) are able to engage in implicit motor imagery. METHOD A modified version of the hand laterality judgment task was employed. Erroneous responses, reaction times, and event-related potentials from the electroencephalograph were analysed. RESULTS In 13 children with typical development (mean age 10y 7mo, SD 1y 2mo; seven male, six female), we observed the classic rotation direction effect. Specifically, when comparing outward rotated with inward rotated hand pictures, decreased accuracy and increased response times were observed. Event-related potentials analyses of the electroencephalogram revealed a more marked N1 and an enhanced rotation-related negativity. INTERPRETATION These findings suggest that an implicit motor imagery strategy was used to solve the task. However, in 10 children with unilateral CP (mean age 10y 7mo, SD 2y 5mo; five male, five female), these effects were observed only when the less-affected hand was involved. This observation suggests that children with CP could benefit from visual training strategies.
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Affiliation(s)
- Marijtje L A Jongsma
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, the Netherlands
| | - C Marjolein Baas
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, the Netherlands
| | - Anouk F M Sangen
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, the Netherlands
| | - Pauline B M Aarts
- Department of Pediatric Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Rob H J van der Lubbe
- Cognitive Psychology and Ergonomics, University of Twente, Enschede, the Netherlands.,Department of Cognitive Psychology, University of Finance and Management, Warsaw, Poland
| | - Ruud G J Meulenbroek
- Donders Institute for Brain, Cognition, and Behaviour, Donders Centre for Cognition, Radboud University Nijmegen, Nijmegen, the Netherlands
| | - Bert Steenbergen
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, the Netherlands.,School of Psychology, Australian Catholic University, Melbourne, Vic., Australia
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40
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Fuelscher I, Williams J, Wilmut K, Enticott PG, Hyde C. Modeling the Maturation of Grip Selection Planning and Action Representation: Insights from Typical and Atypical Motor Development. Front Psychol 2016; 7:108. [PMID: 26903915 PMCID: PMC4746323 DOI: 10.3389/fpsyg.2016.00108] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 01/20/2016] [Indexed: 12/04/2022] Open
Abstract
We investigated the purported association between developmental changes in grip selection planning and improvements in an individual’s capacity to represent action at an internal level [i.e., motor imagery (MI)]. Participants were groups of healthy children aged 6–7 years and 8–12 years respectively, while a group of adolescents (13–17 years) and adults (18–34 years) allowed for consideration of childhood development in the broader context of motor maturation. A group of children aged 8–12 years with probable DCD (pDCD) was included as a reference group for atypical motor development. Participants’ proficiency to generate and/or engage internal action representations was inferred from performance on the hand rotation task, a well-validated measure of MI. A grip selection task designed to elicit the end-state comfort (ESC) effect provided a window into the integrity of grip selection planning. Consistent with earlier accounts, the efficiency of grip selection planning followed a non-linear developmental progression in neurotypical individuals. As expected, analysis confirmed that these developmental improvements were predicted by an increased capacity to generate and/or engage internal action representations. The profile of this association remained stable throughout the (typical) developmental spectrum. These findings are consistent with computational accounts of action planning that argue that internal action representations are associated with the expression and development of grip selection planning across typical development. However, no such association was found for our sample of children with pDCD, suggesting that individuals with atypical motor skill may adopt an alternative, sub-optimal strategy to plan their grip selection compared to their same-age control peers.
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Affiliation(s)
- Ian Fuelscher
- Cognitive Neuroscience Unit, School of Psychology, Deakin University Melbourne, VIC, Australia
| | - Jacqueline Williams
- College of Sport and Exercise Science, Institute of Sport Exercise and Active Living, Victoria University Melbourne, VIC, Australia
| | - Kate Wilmut
- Faculty of Health and Life Sciences, Oxford Brookes University Oxford, UK
| | - Peter G Enticott
- Cognitive Neuroscience Unit, School of Psychology, Deakin University Melbourne, VIC, Australia
| | - Christian Hyde
- Cognitive Neuroscience Unit, School of Psychology, Deakin University Melbourne, VIC, Australia
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Adams ILJ, Lust JM, Wilson PH, Steenbergen B. Testing predictive control of movement in children with developmental coordination disorder using converging operations. Br J Psychol 2016; 108:73-90. [DOI: 10.1111/bjop.12183] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 10/28/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Imke L. J. Adams
- Behavioural Science Institute; Radboud University Nijmegen; The Netherlands
| | - Jessica M. Lust
- Behavioural Science Institute; Radboud University Nijmegen; The Netherlands
| | - Peter H. Wilson
- School of Psychology; Australian Catholic University; Melbourne Victoria Australia
| | - Bert Steenbergen
- Behavioural Science Institute; Radboud University Nijmegen; The Netherlands
- School of Psychology; Australian Catholic University; Melbourne Victoria Australia
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42
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Spruijt S, van der Kamp J, Steenbergen B. Current insights in the development of children's motor imagery ability. Front Psychol 2015; 6:787. [PMID: 26113832 PMCID: PMC4461854 DOI: 10.3389/fpsyg.2015.00787] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 05/26/2015] [Indexed: 11/30/2022] Open
Abstract
Over the last two decades, the number of studies on motor imagery in children has witnessed a large expansion. Most studies used the hand laterality judgment paradigm or the mental chronometry paradigm to examine motor imagery ability. The main objective of the current review is to collate these studies to provide a more comprehensive insight in children’s motor imagery development and its age of onset. Motor imagery is a form of motor cognition and aligns with forward (or predictive) models of motor control. Studying age-related differences in motor imagery ability in children therefore provides insight in underlying processes of motor development during childhood. Another motivation for studying age-related differences in motor imagery is that in order to effectively apply motor imagery training in children (with motor impairments), it is pertinent to first establish the age at which children are actually able to perform motor imagery. Overall, performance in the imagery tasks develops between 5 and 12 years of age. The age of motor imagery onset, however, remains equivocal, as some studies indicate that children of 5 to 7 years old can already enlist motor imagery in an implicit motor imagery task, whereas other studies using explicit instructions revealed that children do not use motor imagery before the age of 10. From the findings of the current study, we can conclude that motor imagery training is potentially a feasible method for pediatric rehabilitation in children from 5 years on. We suggest that younger children are most likely to benefit from motor imagery training that is presented in an implicit way. Action observation training might be a beneficial adjunct to implicit motor imagery training. From 10 years of age, more explicit forms of motor imagery training can be effectively used.
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Affiliation(s)
- Steffie Spruijt
- Behavioural Science Institute, Radboud University Nijmegen Nijmegen, Netherlands
| | - John van der Kamp
- Research Institute Move, VU University Amsterdam Amsterdam, Netherlands ; Institute of Human Performance, University of Hong Kong Hong Kong, China
| | - Bert Steenbergen
- Behavioural Science Institute, Radboud University Nijmegen Nijmegen, Netherlands ; School of Psychology, Australian Catholic University Melbourne, Australia
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Basu AP, Pearse J, Kelly S, Wisher V, Kisler J. Early intervention to improve hand function in hemiplegic cerebral palsy. Front Neurol 2015; 5:281. [PMID: 25610423 PMCID: PMC4285072 DOI: 10.3389/fneur.2014.00281] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 12/09/2014] [Indexed: 01/29/2023] Open
Abstract
Children with hemiplegic cerebral palsy often have marked hand involvement with excessive thumb adduction and flexion and limited active wrist extension from infancy. Post-lesional aberrant plasticity can lead to progressive abnormalities of the developing motor system. Disturbances of somatosensory and visual function and developmental disregard contribute to difficulties with hand use. Progressive soft tissue and bony changes may occur, leading to contractures, which further limit function in a vicious cycle. Early intervention might help to break this cycle, however, the precise nature and appropriateness of the intervention must be carefully considered. Traditional approaches to the hemiplegic upper limb include medications and botulinum toxin injections to manage abnormalities of tone, and surgical interventions. Therapist input, including provision of orthoses, remains a mainstay although many therapies have not been well evaluated. There has been a recent increase in interventions for the hemiplegic upper limb, mostly aimed outside the period of infancy. These include trials of constraint-induced movement therapy (CIMT) and bimanual therapy as well as the use of virtual reality and robot-assisted therapy. In future, non-invasive brain stimulation may be combined with therapy. Interventions under investigation in the infant age group include modified CIMT and action observation therapy. A further approach which may be suited to the infant with thumb-in-palm deformity, but which requires evaluation, is the use of elastic taping. Enhanced cutaneous feedback through mechanical stimulation to the skin provided by the tape during movement has been postulated to modulate ongoing muscle activity. If effective, this would represent a low-cost, safe, widely applicable early intervention.
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Affiliation(s)
- Anna Purna Basu
- Institute of Neuroscience, Newcastle University , Newcastle upon Tyne , UK ; Department of Paediatric Neurology, Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne , UK
| | - Janice Pearse
- Institute of Neuroscience, Newcastle University , Newcastle upon Tyne , UK ; Paediatric Physical Therapy, Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne , UK
| | - Susan Kelly
- Paediatric Physical Therapy, Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne , UK
| | - Vicki Wisher
- Paediatric Physical Therapy, Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne , UK
| | - Jill Kisler
- Institute of Neuroscience, Newcastle University , Newcastle upon Tyne , UK ; Department of Paediatric Neurology, Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne , UK
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44
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Valvano J. Neurophysiological evidence for motor planning limitations in children with cerebral palsy. Dev Med Child Neurol 2014; 56:1035-6. [PMID: 25039416 DOI: 10.1111/dmcn.12534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Joanne Valvano
- Department of Physical Medicine and Rehabilitation, University of Colorado Denver, Aurora, CO, USA
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45
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Noten M, Wilson P, Ruddock S, Steenbergen B. Mild impairments of motor imagery skills in children with DCD. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:1152-1159. [PMID: 24636024 DOI: 10.1016/j.ridd.2014.01.026] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 01/15/2014] [Accepted: 01/24/2014] [Indexed: 06/03/2023]
Abstract
It has been hypothesized that the underlying mechanism of clumsy motor behaviour in children with Developmental Coordination Disorder (DCD) is caused by a deficit in the internal modelling for motor control. An internal modelling deficit can be shown on a behavioural level by a task that requires motor imagery. Motor imagery skills are suggested to be related to anticipatory action planning, but motor imagery and action planning have not been tested within the same child. In the present study, action planning and motor imagery skills were assessed in 82 children between 7 and 12 years of age. Twenty-one of these children met the criteria for DCD, which was assessed by the McCarron Assessment of Neuromuscular Development and 56 of these children were used in the control group. Motor imagery was tested by a mental rotation task of hands that were shown from a back and palm point of view. The results show that motor imagery is affected in children with DCD but only in conditions with complex task constraints (i.e., rotation of hand stimuli presented in palm view). These results provide partial support for the internal modelling deficit hypothesis. We were not able to elicit motor planning deficits in this group, however, and argue that more complex planning tasks may be needed to identify such deficits.
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Affiliation(s)
- Malou Noten
- Radboud University Nijmegen, Behavioural Science Institute, PO Box 9104, 6500 HE Nijmegen, The Netherlands
| | - Peter Wilson
- Australian Catholic University, School of Psychology, 115 Victoria Pde, Melbourne, VIC 3450, Australia
| | - Scott Ruddock
- Australian Catholic University, School of Psychology, 115 Victoria Pde, Melbourne, VIC 3450, Australia
| | - Bert Steenbergen
- Radboud University Nijmegen, Behavioural Science Institute, PO Box 9104, 6500 HE Nijmegen, The Netherlands; Australian Catholic University, School of Psychology, 115 Victoria Pde, Melbourne, VIC 3450, Australia.
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46
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Gordon AM, Bleyenheuft Y, Steenbergen B. Pathophysiology of impaired hand function in children with unilateral cerebral palsy. Dev Med Child Neurol 2013; 55 Suppl 4:32-7. [PMID: 24237277 DOI: 10.1111/dmcn.12304] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2013] [Indexed: 11/28/2022]
Abstract
Unilateral spastic cerebral palsy, caused by damage to the developing central nervous system, is characterized by motor impairments mainly lateralized to one side of the body, with hand impairments greatly contributing to functional limitations. The integrity of the motor areas and the corticospinal tract (CST) is often compromised. The specific etiology may drastically influence subsequent development of CST pathways. Here we describe the pathophysiology underlying impaired upper extremity function, with particular emphasis on the relation between CST damage and hand function. We also describe the resulting sensory and motor deficits, with an emphasis on studies of precision grip, which highlight impairments in motor execution, sensorimotor integration, motor planning, and bimanual coordination beyond dexterity impairments. We show that the type and extent of early brain damage and/or CST reorganization is highly predictive of the severity of these impairments. We discuss the clinical implications of these findings, including the intriguing possibility that the specific pathophysiology is predictive of treatment outcomes. We suggest that a 'one-treatment fits all approach' may be insufficient, and that future rehabilitation efforts will be best guided by closely relating treatment efficacy with the specific pathophysiology.
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Affiliation(s)
- Andrew M Gordon
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
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