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Wu M, Kim J, Gaebler-Spira D. Improving trunk posture control in children with CP through a cable-driven robotic hippotherapy: A randomized controlled feasibility study. Gait Posture 2024; 113:209-214. [PMID: 38943825 DOI: 10.1016/j.gaitpost.2024.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 05/30/2024] [Accepted: 06/19/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND Many children with cerebral palsy (CP) show impairments in trunk posture control, one crucial factor contributing to impairments in gait and arm manipulation. RESEARCH QUESTION The goal of this study was to test the feasibility of the cable-driven hippotherapy system on improving trunk posture control and walking function in children with CP. METHOD Ten children were recruited in this study with average age 6.4 ± 3.0 years old, and were randomly assigned to the robotic group and the conventional balance training group. A custom designed cable-driven robotic hippotherapy system was used to deliver controlled pelvis perturbations while children were sitting astride. Participants from both groups underwent intensive robotic hippotherapy training or conventional balance training, depending on their group assignment, for 6 weeks (3 time/week). Outcome measures were assessed pre and post 6 weeks of robotic or conventional balance training, and 8 weeks after the end of training (follow-up test). The primary outcome measure was trunk control, which was measured using the Trunk Control Measurement Scale (TCMS). In addition, the Gross Motor Function Measure (GMFM-66), self-selected overground walking speed, and 6-minute walking distance were also assessed. RESULTS The change in TCMS score from baseline to the post intervention was significantly greater for the robotic group than that for the conventional group (i.e., 6 ± 3 vs. -1 ± 5, p = 0.048, Mann-Whitney test). GMFM scores, self-selected overground walking speed, and 6-minute walking distance showed no significant improvement after robotic hippotherapy and after conventional balance training (p > 0.05). SIGNIFICANCE Results from this study indicated that it was feasible to improve trunk posture control in children with CP using a cable-driven robotic hippotherapy system. Knowledge obtained from this study may provide an insight for the development of new perturbation-based intervention approaches for improving trunk posture control in children with CP.
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Affiliation(s)
- Ming Wu
- Legs and Walking Lab, Shirley Ryan AbilityLab, Chicago, IL, USA; Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL, USA; Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA.
| | - Janis Kim
- Legs and Walking Lab, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Deborah Gaebler-Spira
- Legs and Walking Lab, Shirley Ryan AbilityLab, Chicago, IL, USA; Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA
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Gözaçan Karabulut D, Numanoğlu Akbaş A. Validity and reliability of the Sitting Assessment Scale in cerebral palsy. J Eval Clin Pract 2024; 30:670-677. [PMID: 38588276 DOI: 10.1111/jep.13992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 03/13/2024] [Accepted: 03/22/2024] [Indexed: 04/10/2024]
Abstract
AIM The aim of this study was to examine the validity and reliability of the Sitting Assessment Scale (SAS) in individuals with cerebral palsy (CP). METHODS The study included 34 individuals with a diagnosis of spastic CP. Individuals were evaluated with the Gross Motor Function Classification System and the Manual Ability Classification System. SAS and Trunk Control Measurement Scale (TCMS) were applied to the participants. The intraclass correlation coefficient (ICC) was calculated to determine the intraobserver and interobserver reliability of the scale scored by three different physiotherapists at two different time intervals. Internal consistency was calculated with Cronbach's ⍺ coefficient. The fit between SAS and TCMS for criterion-dependent validity was evaluated using Pearson Correlation Analysis. RESULTS According to the GMFCS level, 79.41% of the children were mildly (Level I-II), 14.71% were moderately affected (level III), and 5.88% were severely affected (level IV). Intra > observer and interobserver reliability values of SAS were extremely high (ICCinterrater > 0.923, ICCintrarater > 0.930). It was observed that the internal consistency of SAS had high values (Cronbach ⍺test > 0.822, Cronbach ⍺retest > 0.804). For the criterion-dependent reliability; positive medium correlations found between SAS with Total TCMS Static Sitting Balance (r = 0.579, p < 0.001), with TCMS Selective Movement Control (r = 0.597, p < 0.001), with TCMS Dynamic Reaching (r = 0.609, p < 0.001), and with TCMS Total (r = 0.619, p < 0.001). CONCLUSION SAS was found to have high validity and reliability in children with CP. In addition, the test-retest reliability of the scale was also high. SAS is a practical tool that can be used to assess sitting balance in children with CP.
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Affiliation(s)
- Demet Gözaçan Karabulut
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gaziantep Islam Science and Technology University, Gaziantep, Turkey
| | - Ayşe Numanoğlu Akbaş
- Department of Physical Therapy and Rehabilitation, Health Sciences Faculty, Sivas Cumhuriyet University, Sivas, Turkey
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López-Ruiz J, Estrada-Barranco C, Giménez-Mestre MJ, Villarroya-Mateos I, Martín-Casas P, López-de-Uralde-Villanueva I. Differences between Novice and Expert Raters Assessing Trunk Control Using the Trunk Control Measurement Scale Spanish Version (TCMS-S) in Children with Cerebral Palsy. J Clin Med 2023; 12:jcm12103568. [PMID: 37240674 DOI: 10.3390/jcm12103568] [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: 04/19/2023] [Revised: 05/09/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
The Trunk Control Measurement Scale (TCMS) is a valid and reliable tool to assess static and dynamic trunk control in cerebral palsy. However, there is no evidence informing about differences between novice and expert raters. A cross-sectional study was conducted with participants between the ages of 6 and 18 years with a CP diagnosis. The TCMS Spanish version (TCMS-S) was administered in-person by an expert rater, and video recordings were taken for later scoring by the expert and three other raters with varying levels of clinical experience. The intraclass correlation coefficient (ICC) was used to evaluate reliability between raters for the total and subscales of the TCMS-S scores. Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) were also calculated. There was a high level of agreement between expert raters (ICC ≥ 0.93), while novice raters demonstrated good agreement (ICC > 0.72). Additionally, it was observed that novice raters had a slightly higher SEM and MDC than expert raters. The Selective Movement Control subscale exhibited slightly higher SEM and MDC values compared to the TCMS-S total and other subscales, irrespective of the rater's level of expertise. Overall, the study showed that the TCMS-S is a reliable tool for evaluating trunk control in the Spanish pediatric population with cerebral palsy, regardless of the rater's experience level.
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Affiliation(s)
- Javier López-Ruiz
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
- Doctoral Program in Healthcare, Faculty of Nursing, Physiotherapy and Podiatry, University Complutense of Madrid, 28040 Madrid, Spain
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Cecilia Estrada-Barranco
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Maria José Giménez-Mestre
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | | | - Patricia Martín-Casas
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
- InPhysio Research Group, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Ibai López-de-Uralde-Villanueva
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
- InPhysio Research Group, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
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López-Ruiz J, Estrada-Barranco C, Martín-Gómez C, Egea-Gámez RM, Valera-Calero JA, Martín-Casas P, López-de-Uralde-Villanueva I. Trunk Control Measurement Scale (TCMS): Psychometric Properties of Cross-Cultural Adaptation and Validation of the Spanish Version. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20065144. [PMID: 36982053 PMCID: PMC10049461 DOI: 10.3390/ijerph20065144] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/10/2023] [Accepted: 03/10/2023] [Indexed: 06/01/2023]
Abstract
The aim of this study was to develop a Spanish Version of the Trunk Measurement Scale (TCMS-S) to analyze its validity and reliability and determine the Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) in children with Cerebral Palsy (CP). Participants were assessed twice 7-15 days apart with the TCMS-S and once with the Gross Motor Function Measurement-88 (GMFM-88), Pediatric Disability Inventory-Computer Adaptive Test (PEDI-CAT), Cerebral Palsy Quality of Life (CPQoL), and Gross Motor Classification System (GMFCS). Internal consistency was evaluated using Cronbach's alpha, and the intraclass correlation (ICC) and kappa coefficients were used to investigate the agreement between the assessments. Finally, 96 participants with CP were included. The TCMS-S showed excellent internal consistency (Cronbach's alpha = 0.95 [0.93 to 0.96]); was highly correlated with the GMFM-88 (rho = 0.816) and the "mobility" subscale of the PEDI-CAT (rho = 0.760); showed a moderate correlation with the "feeling about functioning" CPQoL subscale (rho = 0.576); and differentiated between the GMFCS levels. Excellent test-retest agreement was found for the total and subscale scores (ICC ≥ 0.94 [0.89 to 0.97). For the total TCMS-S score, an SEM of 1.86 and an MDC of 5.15 were found. The TCMS-S is a valid and reliable tool for assessing trunk control in children with CP.
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Affiliation(s)
- Javier López-Ruiz
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea of Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (J.L.-R.); (C.E.-B.)
- Doctoral Program in Healthcare, Faculty of Nursing, Physiotherapy and Podiatry. University Complutense of Madrid, 28040 Madrid, Spain
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.V.-C.); (I.L.-d.-U.-V.)
| | - Cecilia Estrada-Barranco
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea of Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (J.L.-R.); (C.E.-B.)
| | | | - Rosa M. Egea-Gámez
- Spinal Unit, Department of Orthopedic Surgery and Traumatology, Hospital Infantil Universitario Niño Jesús, 28009 Madrid, Spain
| | - Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.V.-C.); (I.L.-d.-U.-V.)
- InPhysio Research Group, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Patricia Martín-Casas
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.V.-C.); (I.L.-d.-U.-V.)
- InPhysio Research Group, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Ibai López-de-Uralde-Villanueva
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.V.-C.); (I.L.-d.-U.-V.)
- InPhysio Research Group, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
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Samsonova TV, Krivonogov VA, Nazarov SB, Ryl’skaya YA. Assessment of postural control in children. ROSSIYSKIY VESTNIK PERINATOLOGII I PEDIATRII (RUSSIAN BULLETIN OF PERINATOLOGY AND PEDIATRICS) 2022. [DOI: 10.21508/1027-4065-2022-67-5-27-33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The relevance of the study is due to the high incidence of postural control impairment in patients with neurological diseases and lack of common approaches to their diagnosing in children. In this article we show the main stages in the formation of postural control and mechanisms of balance maintaining in childhood. We assessed the information content of existing clinical scales used to study components of postural balance in children in clinical practice. Also, we studied the diagnostic significance of functional methods for assessing postural control. Particular attention we paid to the study of the diagnostic significance of computer posturography (stabilometry) and accelerometry. We identified the main clinical and functional diagnostic markers of postural imbalance in children of different age and nosological groups. Further research in this area will make it possible to develop the most objective criteria for impaired postural control in childhood, which will increase the effectiveness of treatment and rehabilitation measures.
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Affiliation(s)
- T. V. Samsonova
- Gorodkov Ivanovo Research Institute of Maternity and Childhood
| | | | - S. B. Nazarov
- Gorodkov Ivanovo Research Institute of Maternity and Childhood
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Predictors of gross motor function and activities of daily living in children with cerebral palsy. Int J Rehabil Res 2021; 44:330-335. [PMID: 34545854 DOI: 10.1097/mrr.0000000000000497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To determine the influence of selected impairment variables, spasticity, trunk control, upper limb function and selective motor control of the lower limb on gross motor function and activities of daily living in children with cerebral palsy (CP). Seventy children with CP, 40 boys and 30 girls, with age range between 11 and 156 months were recruited in this cross-sectional study. Data on spasticity, selective motor control of the lower limb, upper limb function and trunk control were assessed using modified Ashworth scale (MAS), selective motor control of the lower limb (SCALE), paediatric arm function test, trunk motor control assessment and GMFM88, respectively. Among all the variables assessed, only trunk control significantly predicted gross motor function (beta = 0.880; P < 0.001) and activities of daily living (beta = 0.550; P < 0.05). However, gross motor function and activities of daily living have significant (P < 0.05) negative correlations with spasticity, and positive correlations with selective motor control of the lower limb and trunk control. Trunk control is the most influencing factor on gross motor function and activities of daily living in children with CP. Therefore, achieving trunk control especially in those at GMFCS levels V and VI should be a priority during the rehabilitation of children with CP.
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Santos ALYDS, Maciel FKDL, Fávero FM, Grossklauss LF, de Sá CDSC. Trunk Control and Upper Limb Function of Walking and Non-walking Duchenne Muscular Dystrophy Individuals. Dev Neurorehabil 2021; 24:435-441. [PMID: 33412969 DOI: 10.1080/17518423.2020.1869337] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Aim: To verify and compare trunk control and upper limb functionality (ULs) in walking and non-walking DMD individuals, with that of individuals without dystrophinopathies.Method: Cross-sectional study, with children without dystrophinopathy (healthy control group) and in walking and non-walking DMD children evaluated by the following scales: Segmental Control Evaluation Trunk (SATCo); Performance of Upper Limb (PUL) and Jebsen-Taylor Test (JTT).Results: There was a difference between the groups in trunk control and ULs function by the PUL scale, but there was no difference between walking and the reference group in all JTT subtests; The JTT writing subtest was not different between groups. There was a strong correlation between PUL and SATCo, both had a strong correlation with disease staging and a weak correlation with JTT.Conclusions: There is relevance to the evaluation of trunk control and ULs function of walking and non-walking DMD.
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Affiliation(s)
| | | | - Francis Meire Fávero
- Department Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil
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Meyns P, Blanckaert I, Bras C, Jacobs N, Harlaar J, van de Pol L, Plasschaert F, Van Waelvelde H, Buizer AI. Exergaming improves balance in children with spastic cerebral palsy with low balance performance: results from a multicenter controlled trial. Disabil Rehabil 2021; 44:5990-5999. [PMID: 34365883 DOI: 10.1080/09638288.2021.1954704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Previous studies investigating the effectiveness of exergame balance-training (using video-games) in children with cerebral palsy (CP) yielded inconsistent results that could be related to underpowered studies. Therefore, in this multicenter intervention study, we investigated whether exergaming improves balance clinically in spastic CP. MATERIALS AND METHODS In total, 35 children with unilateral or bilateral spastic CP (GMFCS-level I-II) were included (age-range: 7-16 years); 16 at VUMC (trial: NTR6034), 19 at UHG (trial: NCT03219112). All participants received care as usual. The intervention group (n = 24) additionally performed exergame-training; 6-8 weeks home-based X-box One Kinect training focused on balance. Balance performance was assessed with the pediatric balance scale (PBS) and two subscales of the Bruininks-Oseretsky Test of Motor Proficiency-2nd edition ("balance" [BOTbal] and "running speed and agility" [BOTrsa]). Mixed model ANOVAs with between and within factors were used to test differences between and within groups. RESULTS On group level, no post-intervention differences were found between the intervention and control group (PBS: p = 0.248, ηp2 = 0.040; BOTbal: p = 0.374, ηp2 = 0.024; BOTrsa: p = 0.841, ηp2 = 0.001). Distribution of CP-symptoms (unilateral versus bilateral) did not affect training (PBS: p = 0.373, ηp2 = 0.036; BOTbal: p = 0.127, ηp2 = 0.103; BOTrsa: p = 0.474, ηp2 = 0.024). Children with low baseline balance performance (based on PBS) in the intervention group showed improvements in balance performance after training (PBS: p = 0.003, ηp2 = 0.304; BOTbal: p = 0.008, ηp2 = 0.258), whereas children with high baseline balance performance did not. CONCLUSIONS This exergame-training resulted in balance improvements for the current population of CP that had a low baseline function.IMPLICATIONS FOR REHABILITATIONExergame-training (training using video-games) shows mixed results in children with cerebral palsy (CP).Children with spastic CP (GMFCS level I-II) with a high baseline balance-level did not show functional balance improvements after this home-based exergame-training, suggesting that these children should not be enrolled in this type of exergame-training protocol.Children with spastic CP (GMFCS level I-II) with a low baseline balance-level showed clinically relevant functional balance improvements after this home-based exergame-training, suggesting that these children can benefit from enrolment in this type of exergame-training protocol to improve their balance.The distribution of CP-symptoms did not affect the effectiveness of this balance exergame-training in children with spastic CP with GMFCS-level I and II.
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Affiliation(s)
- Pieter Meyns
- Rehabilitation Research (REVAL), Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Ian Blanckaert
- Pediatric Rehabilitation, Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Chloé Bras
- Amsterdam Movement Sciences, Rehabilitation Medicine, Amsterdam UMC locatie VUmc, Amsterdam, The Netherlands
| | - Nina Jacobs
- Rehabilitation Research (REVAL), Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Jaap Harlaar
- Amsterdam Movement Sciences, Rehabilitation Medicine, Amsterdam UMC locatie VUmc, Amsterdam, The Netherlands.,Biomechatronics and Human-Machine Control, Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Laura van de Pol
- Child Neurology, Amsterdam UMC locatie VUmc, Amsterdam, The Netherlands
| | - Frank Plasschaert
- Cerebral Palsy Reference Center, University Hospital Ghent, Ghent, Belgium.,Human Structure and Repair, Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Hilde Van Waelvelde
- Pediatric Rehabilitation, Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Annemieke I Buizer
- Amsterdam Movement Sciences, Rehabilitation Medicine, Amsterdam UMC locatie VUmc, Amsterdam, The Netherlands.,Emma Children's Hospital, Amsterdam UMC locatie VUmc, Amsterdam, The Netherlands
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Keller JW, Fahr A, Lieber J, Balzer J, van Hedel HJA. Impact of Upper Extremity Impairment and Trunk Control on Self-Care Independence in Children With Upper Motor Neuron Lesions. Phys Ther 2021; 101:pzab112. [PMID: 34464449 PMCID: PMC8407597 DOI: 10.1093/ptj/pzab112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 01/19/2021] [Accepted: 03/15/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the relative importance of different approaches to measure upper extremity selective voluntary motor control (SVMC), spasticity, strength, and trunk control for explaining self-care independence in children affected by upper motor neuron lesions. METHODS Thirty-one patients (mean [SD] age = 12.5 [3.2] years) with mild to moderate arm function impairments participated in this observational study. Self-care independence was evaluated with the Functional Independence Measure for children (WeeFIM). Upper extremity SVMC was quantified with the Selective Control of the Upper Extremity Scale (SCUES), a similarity index (SISCUES) calculated from simultaneously recorded surface electromyography muscle activity patterns, and an accuracy and involuntary movement score derived from an inertial-measurement-unit-based assessgame. The Trunk Control Measurement Scale was applied and upper extremity spasticity (Modified Ashworth Scale) and strength (dynamometry) were assessed. To determine the relative importance of these factors for self-care independence, 3 regression models were created: 1 included only upper extremity SVMC measures, 1 included upper extremity and trunk SVMC measures (overall SVMC model), and 1 included all measures (final self-care model). RESULTS In the upper extremity SVMC model (total variance explained 52.5%), the assessgame (30.7%) and SCUES (16.5%) were more important than the SISCUES (4.5%). In the overall SVMC model (75.0%), trunk SVMC (39.0%) was followed by the assessgame (21.1%), SCUES (11.0%), and SISCUES (4.5%). In the final self-care model (82.1%), trunk control explained 43.2%, upper extremity SVMC explained 23.1%, spasticity explained 12.3%, and strength explained 2.3%. CONCLUSION Although upper extremity SVMC explains a substantial portion of self-care independence, overall trunk control was even more important. Whether training trunk control and SVMC can translate to improved self-care independence should be the subject of future research. IMPACT This study highlights the importance of trunk control and selective voluntary motor control for self-care independence in children with upper motor neuron lesions.
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Affiliation(s)
- Jeffrey W Keller
- Swiss Children’s Rehab, University Children’s Hospital Zurich, Affoltern am Albis, Switzerland
- Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
- Doctoral Program Clinical Science, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Annina Fahr
- Swiss Children’s Rehab, University Children’s Hospital Zurich, Affoltern am Albis, Switzerland
- Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Jan Lieber
- Swiss Children’s Rehab, University Children’s Hospital Zurich, Affoltern am Albis, Switzerland
- Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Julia Balzer
- Swiss Children’s Rehab, University Children’s Hospital Zurich, Affoltern am Albis, Switzerland
- Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
- European University of Applied Sciences (EU | FH)/Erft GmbH, Applied Health Science, Rostock, Germany
| | - Hubertus J A van Hedel
- Swiss Children’s Rehab, University Children’s Hospital Zurich, Affoltern am Albis, Switzerland
- Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
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Kachmar O, Kushnir A, Fedchyshyn B, Cristiano J, O'Flaherty J, Helland K, Johnson G, Puig D. Personalized balance games for children with cerebral palsy: A pilot study. J Pediatr Rehabil Med 2021; 14:237-245. [PMID: 33720857 DOI: 10.3233/prm-190666] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To assess the changes in balance function in children with cerebral palsy (CP) after two weeks of daily training with personalized balance games. METHODS Twenty-five children with CP, aged 5 to 18 years were randomly selected for experimental or control groups. Over a period of two weeks, all participants received 8-9 game sessions for 15-20 minutes, totaling 150-160 minutes. The experimental group used personalized balance games available from the GAmification for Better LifE (GABLE) online serious gaming platform. Children from the control group played Nintendo Wii games using a handheld Wii Remote. Both groups received the same background treatment. Recorded outcome measures were from a Trunk Control Measurement Scale (TCMS), Timed Up & Go Test (TUG), Center of Pressure Path Length (COP-PL), and Dynamic Balance Test (DBT). RESULTS After two weeks of training in the experimental group TCMS scores increased by 4.5 points (SD = 3.5, p< 0.05) and DBT results increased by 0.88 points (IQR = 1.03, p< 0.05) while these scores did not change significantly in the control group. Overall, TUG and COP-PL scores were not affected in either group. CONCLUSION This study demonstrates improvement of balancing function in children with CP after a two-week course of training with personalized rehabilitation computer games.
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Affiliation(s)
- Oleh Kachmar
- International Clinic of Rehabilitation, Truskavets, Ukraine
| | - Anna Kushnir
- International Clinic of Rehabilitation, Truskavets, Ukraine
| | | | | | - John O'Flaherty
- The National Microelectronics Applications Centre Ltd., Limerick, Ireland
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Ravizzotti E, Vercelli S, Pellicciari L, Furmanek MP, Zagnoni G, Piscitelli D. Reliability and Validity of the Trunk Control Measurement Scale Among Children and Adolescents With Cerebral Palsy in Tanzania. Percept Mot Skills 2020; 128:731-745. [PMID: 33357090 DOI: 10.1177/0031512520983701] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to investigate the reliability and validity of the Trunk Control Measurement Scale (TCMS) among children with cerebral palsy (CP) who were living in Tanzania. Two physiotherapy trainees, each blinded to the other's test findings, independently administered the TCMS to 38 children with CP (16 female; M age = 7.2, SD = 4.8 years) twice over sessions separated by a 30-day interval. We assessed internal consistency and intra/inter-rater reliability using Cronbach's alpha and the Intraclass Correlation Coefficient (ICC), respectively. We examined measurement error through Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC). We assessed construct validity with Spearman's correlation coefficient between the TCMS and both the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS). We found a frank floor effect. Internal consistency (α = 0.945) and reliability indices were excellent for the total scale (ICC for intra-rater reliability = 0.985, inter- reliability = 0.997) and for each sub-scale score. We found low values of SEM (1.7 points) and MDC (4.8 points). Construct validity was supported by moderate and strong correlations between the TCMS and the GMFCS and MACS in this sample. We conclude that the psychometric properties of the TMCS support its clinical and research use for youth with CP in low-income settings.
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Affiliation(s)
| | - Stefano Vercelli
- Laboratory of Ergonomics and Musculoskeletal Disorders Assessment, Division of Physical Medicine and Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | | | - Mariusz P Furmanek
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland.,Department of Physical Therapy, Movement, and Rehabilitation Science, Bouvé College of Health Science, Northeastern University, Boston, Massachusetts. United States
| | - Giulia Zagnoni
- Nyumba Ali Organization, Bologna, Italy.,School of Medicine, Program in Physical Therapy, University of Bologna, Bologna, Italy
| | - Daniele Piscitelli
- Nyumba Ali Organization, Bologna, Italy.,School of Medicine and Surgery, University of Milano Bicocca, Milano, Italy
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Bulut N, Alemdaroğlu-Gürbüz I, Topaloğlu H, Yılmaz Ö, Karaduman A. The association between trunk control and upper limb functions of children with Duchenne muscular dystrophy. Physiother Theory Pract 2020; 38:46-54. [DOI: 10.1080/09593985.2020.1723151] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Numan Bulut
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Altındağ, Ankara, Turkey
| | - Ipek Alemdaroğlu-Gürbüz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Altındağ, Ankara, Turkey
| | - Haluk Topaloğlu
- Faculty of Medicine, İhsan Doğramacı Children Hospital, Pediatric Neurology Department, Hacettepe University, Altındağ, Ankara, Turkey
| | - Öznur Yılmaz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Altındağ, Ankara, Turkey
| | - Ayşe Karaduman
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Altındağ, Ankara, Turkey
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Severijns P, Overbergh T, Scheys L, Moke L, Desloovere K. Reliability of the balance evaluation systems test and trunk control measurement scale in adult spinal deformity. PLoS One 2019; 14:e0221489. [PMID: 31449540 PMCID: PMC6709918 DOI: 10.1371/journal.pone.0221489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 08/07/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To test the reliability of the Balance Evaluation Systems Test (BESTest) and Trunk Control Measurement Scale (TCMS) between sessions and raters in the adult spinal deformity (ASD) population. SUMMARY OF BACKGROUND DATA Up to now evaluation in ASD was mainly based on static radiographic parameters. Recently literature showed that dynamic balance was a better predictor of health-related quality of life than radiographic parameters, stressing the importance of balance assessment. However, to the best of our knowledge, reliability of balance assessment tools has not yet been investigated in the ASD population. METHODS Twenty ASD patients participated in this study. Ten patients were included in the test-retest study, including repeated measurements. Ten patients were measured once, simultaneously but independently by three raters. Each participant performed two balance scales, namely the BESTest and the TCMS. Statistical analysis consisted of intra class correlations (ICC) on scale- and subscale level, and kappa scores on item-level. Cronbach's alpha on total scores, standard errors of measurement (SEM), smallest detectable differences and percentages of agreement were also calculated. Bland-altman plots were created to investigate systematic bias. RESULTS ICC scores between sessions and raters for TCMS (0.76 and 0.88) and BESTest (0.90 and 0.94) total scores were good to excellent. SEM's between sessions and raters were also low for total scores on TCMS (1.66 and 2.35) and BESTest (2.99 and 2.32). However, on subscale- and item-level reliability decreased and ceiling effects were observed. No systematic bias was observed between sessions and raters. CONCLUSION BESTest and TCMS showed to be reliable tools to measure balance in ASD on scale-level. However, on subscale- and item-level reliability decreased and ceiling effects were observed. Therefore, the question arises if there is need for an ASD-specific balance scale.
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Affiliation(s)
- Pieter Severijns
- Institute for Orthopaedic Research and Training (IORT), Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Clinical Motion Analysis Laboratory (CMAL), University Hospitals Leuven, Leuven, Belgium
| | - Thomas Overbergh
- Institute for Orthopaedic Research and Training (IORT), Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Lennart Scheys
- Institute for Orthopaedic Research and Training (IORT), Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Division of Orthopaedics, University Hospitals Leuven, Leuven, Belgium
| | - Lieven Moke
- Institute for Orthopaedic Research and Training (IORT), Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Division of Orthopaedics, University Hospitals Leuven, Leuven, Belgium
| | - Kaat Desloovere
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Clinical Motion Analysis Laboratory (CMAL), University Hospitals Leuven, Leuven, Belgium
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Rodrigues CVC, Leffer A, Chesani FH, Mezadri T, Lacerda LLVD. Functional independence profile of people with physical disabilities. FISIOTERAPIA EM MOVIMENTO 2019. [DOI: 10.1590/1980-5918.032.ao26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: The Functional Independence Measure is an evaluation instrument that recognizes the functional evolution of the characteristics of physically disabilities and their abilities. Objective: To analyze the motor items of the functional independence level of people with physical disabilities in the municipality of Itajaí, state of Santa Catarina. Method: A cross-sectional quantitative study was carried out with 164 people with physical disabilities who lived in Itajaí/SC. Socioeconomic variables, and type and cause of disability were collected. To analyze the aspects that limit or contribute to functional independence, the Functional Independence Measure scale was applied. Statistical tests were used for comparisons according to the nature of the variables. Results: Most individuals (39%) were 41 to 60 years old; 44.5% had elementary education; only 10.4% are in the labor market, and 60.4% earns up to two minimum wages. Regarding the type of disability, 58% of participants presented plegia; 26.2%, paresis; and 15.8%, amputations. The etiology of disability was mainly related to neurological problems (43.3%). In the distribution of the average score of people with physical disabilities, half of the sample had average scores above six, and 67% above five, with significant differences in the mean independence scores according to occupation and type of disability. Conclusion: The results obtained support the decision-making process of physical therapists and health professionals.
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Heo JY, Shin HK. Reliability analysis of the Korean version of the trunk control measurement scale in cerebral palsy. J Phys Ther Sci 2018; 30:1-4. [PMID: 29410555 PMCID: PMC5788764 DOI: 10.1589/jpts.30.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 10/04/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to translate the Trunk Control Measurement Scale into a Korean version and to analyze the intra- and inter-rater reliability. [Subjects and Methods] Fifteen children with spastic cerebral palsy and four physical therapists with over 10 years of clinical experience participated in this study. A Korean-American physical therapist translated the trunk control measurement scale from English into a Korean version. Four physical therapists viewed the video data of 15 children and scored each child's trunk control measurement scale performance on seven separate days. Four testers analyzed the test-retest reliability and inter-rater reliability using the intra-class correlation coefficient. [Results] Intra-class correlation coefficients for test-retest and inter-rater reliability for the Korean trunk control measurement scale showed significantly high reliability in all testers and sublevels. [Conclusion] The Korean version of the measurement scale is a reliable and suitable instrument for assessing trunk control in individuals with cerebral palsy in Korea.
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Affiliation(s)
- Ju-Young Heo
- Department of Physical Therapy, The Graduate School, Daegu Catholic University, Republic of Korea
| | - Hwa-Kyung Shin
- Department of Physical Therapy, College of Bio and Medical Science, Daegu Catholic University: 13-13 Hayang-Ro, Hayang-Eup, Gyeongsan-si, Gyeongbuk 38430, Republic of Korea
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Balzer J, Marsico P, Mitteregger E, van der Linden ML, Mercer TH, van Hedel HJA. Influence of trunk control and lower extremity impairments on gait capacity in children with cerebral palsy. Disabil Rehabil 2017; 40:3164-3170. [PMID: 28944697 DOI: 10.1080/09638288.2017.1380719] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE We investigated the combined impact of trunk control and lower extremities impairments on predicting gait capacity in children with cerebral palsy (CP) and evaluated relationships between trunk control and lower extremities impairments. METHODS Data of 52 children with CP [29 boys, mean age 11 years 9 months (±4 years 6 months)] were included in this observational study. Gait capacity was measured by the "modified Time Up and Go test". Experienced therapists performed the "Modified Ashworth Scale", "Manual Muscle Test", the "Selective Control Assessment of the Lower Extremity", and the "Trunk Control Measurement Scale". We calculated Spearman correlations coefficients (ρ) and performed regression analyses. RESULTS Trunk control was the strongest predictor (β = -0.624, p < 0.001) when explaining the variance of gait capacity and remained in the model together with spasticity (R2 = 0.67). Muscle strength and selectivity correlated moderately to strongly with the trunk control and gait capacity (-0.68 ≤ ρ ≤ -0.78), but correlations for the spasticity were low (ρ<-0.3). CONCLUSIONS The interconnection between trunk control, leg muscle strength and selectivity for gait capacity in children with CP was shown. It indicates the significance of these impairments in gait assessment and, potentially, rehabilitation. Implications for Rehabilitation Trunk control was the strongest predictor for gait capacity in a regression model with lower extremity spasticity, muscle strength and selectivity and age as independent variables. Lower extremity muscle strength, selectivity, and trunk control explained a similar amount of gait capacity variance which is higher than that explained by lower extremity spasticity. Lower extremity muscle strength and selectivity correlated strongly with trunk control. Therefore, we cautiously suggest that a combined trunk control and lower extremity training might be promising for improving gait capacity in children with CP (Gross Motor Function Classification System level I-III), which needed to be tested in future intervention-studies.
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Affiliation(s)
- Julia Balzer
- a Pediatric Rehab Research Group , Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich , Affoltern am Albis , Switzerland
| | - Petra Marsico
- a Pediatric Rehab Research Group , Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich , Affoltern am Albis , Switzerland
| | - Elena Mitteregger
- a Pediatric Rehab Research Group , Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich , Affoltern am Albis , Switzerland.,b Regional Group Zurich Foundation Cerebral Palsy (RGZ) , Zurich , Switzerland.,c Institute for Physiotherapy, Zurich University of Applied Studies, ZHAW , Winterthur , Switzerland
| | - Marietta L van der Linden
- d Centre for Health, Activity and Rehabilitation Research, Queen Margaret University , Edinburgh , Scotland
| | - Thomas H Mercer
- d Centre for Health, Activity and Rehabilitation Research, Queen Margaret University , Edinburgh , Scotland
| | - Hubertus J A van Hedel
- a Pediatric Rehab Research Group , Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich , Affoltern am Albis , Switzerland
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