1
|
Gözaçan Karabulut D, Numanoğlu Akbaş A. The effect of horse riding simulator on upper extremity skills, trunk control and functionality in cerebral palsy: a randomized controlled trial. Disabil Rehabil 2024:1-8. [PMID: 39022889 DOI: 10.1080/09638288.2024.2380785] [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: 04/05/2024] [Accepted: 07/11/2024] [Indexed: 07/20/2024]
Abstract
PURPOSE The aim of this study was to investigate the effect of horse riding simulator on upper extremity skills, trunk control and functionality in cerebral palsy (CP). MATERIALS AND METHODS This randomized controlled trial included total 32 CP, 16 in horse riding simulator group (HRSG) and 16 in control group (CG). ABILHAND-Kids, Jebsen-Taylor Hand Function Test (JTHFT), Gross Motor Function Measurement-sitting dimension (GMFM-B), Trunk Control Measurement Scale (TCMS), Pediatric Evaluation of Disability Inventory (PEDI) were evaluated before and after procedure. RESULTS It was observed that there were improvements in both groups for ABILHAND-Kids scores after intervention, but the change in HRSG was significantly higher (p < 0.001). For all parameters of JTHFT (except writing dominant, non-dominant, turning cards-dominant), there was a significant difference between groups in favor of HRSG (p < 0.001-0.002). There was no change in GMFM-B values with intervention for both groups (p > 0.05). There were significant changes in favor of HRSG group in terms TCMS-Total (p = 0.003). There were significant changes in HRSG compared to CG for PEDI (pPEDI-Self-care<0.001, pPEDI-Mobility<0.001, pPEDI-Social function=0.016, respectively). CONCLUSIONS It has been found that HRS in addition to conventional physiotherapy have positive effects on upper extremity skills, trunk control and functional abilities in daily life in the rehabilitation process of CP.The study protocol is registered on ClinicalTrials.gov (Identifier: NCT05518370).
Collapse
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, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Balıkesir University, Balıkesir, Turkey
| |
Collapse
|
2
|
Adiguzel H, Kirmaci ZIK, Gogremis M, Kirmaci YS, Dilber C, Berktas DT. The effect of proprioceptive neuromuscular facilitation on functional skills, muscle strength, and trunk control in children with cerebral palsy: A randomized controlled trial. Early Hum Dev 2024; 192:106010. [PMID: 38653163 DOI: 10.1016/j.earlhumdev.2024.106010] [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: 03/22/2024] [Revised: 04/11/2024] [Accepted: 04/13/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Proprioceptive neuromuscular facilitation (PNF) is generally used for the lower limbs in children with Cerebral Palsy (CP). This study aimed to determine the effect of PNF and Neurodevelopmental Therapy (NDT) on functional abilities, muscle strength, and trunk control in children with CP. METHODS Thirty spastic CP children classified as either level I-II in the Gross Motor Function Classification System (GMFCS) or level I-II in the Manual Ability Classification System (MACS) were included. The PNF (n = 15) and the NDT group (n = 15) had physiotherapy for six weeks. The ABILHAND-Kids scale, the Purdue Pegboard Test (PBPT), the Nine-Hole Peg Test (9-HPT), and the Jebson-Taylor Hand Function Test (JTHFT) were employed. Pinch meters, Jamar handheld dynamometers, and digital muscular strength assessments were used. RESULTS The PNF group increased shoulder flexion (p < 0.05), adduction (p < 0.05), elevation (p < 0.05), scapular abduction (p < 0.05), elbow extension (right) (p < 0.05), grip (p < 0.05), and pinch strengths (left p < 0.05, right p < 0.05). The PNF group had significantly lower 9-HPT (p < 0.05), JTHFT (card turning), JTHFT (simulated feeding), JTHFT (lifting light cans), and JTHFT (lifting weight cans) durations (p < 0.05), and significantly higher PBPT (right-left) PBPT (bimanual), PBPT (assembly). (p < 0.05), ABILHAND (p < 0.05), and TCMS total scores (p < 0.001). While JTHFT (simulated feeding-left), JTHFT (stacking checkers-left), JTHFT (lifting light cans-left), and JTHFT (lifting weight cans-right/left) (p < 0.05) durations decreased in the NDT group, PBPT (right) (p < 0.05) had an increase in duration. CONCLUSION PNF improves trunk control, upper extremity functional skills, selective proximal muscle strength, and distal upper extremity muscle and grip strength.
Collapse
Affiliation(s)
- Hatice Adiguzel
- Kahramanmaras Sutcu Imam University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 46100 Dulkadiroglu, Kahramanmaras, Turkey.
| | - Zekiye Ipek Katirci Kirmaci
- Gaziantep Islamic Science and Technology University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 27010 Sahinbey, Gaziantep, Turkey
| | - Mehmet Gogremis
- Kahramanmaras Sutcu Imam University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 46100 Dulkadiroglu, Kahramanmaras, Turkey
| | - Yusuf Sinasi Kirmaci
- Kahramanmaras Sutcu Imam University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 46100 Dulkadiroglu, Kahramanmaras, Turkey
| | - Cengiz Dilber
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Child Health and Diseases, 46040 Onikisubat, Kahramanmaras, Turkey
| | - Deniz Tuncel Berktas
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Neurology, 46040 Onikisubat, Kahramanmaras, Turkey
| |
Collapse
|
3
|
Cesari A, Galeoto G, Panuccio F, Simeon R, Berardi A. Evaluation instruments for executive functions in children and adolescents: an update of a systematic review. Expert Rev Pharmacoecon Outcomes Res 2024; 24:487-508. [PMID: 38294492 DOI: 10.1080/14737167.2024.2311872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/25/2024] [Indexed: 02/01/2024]
Abstract
INTRODUCTION The aim of this study is to update a systematic review of instruments for evaluating the executive functions (EFs) in a pediatric population to assess their measurement properties. AREA COVERED Studies describing evaluation tools of EFs were systematically searched on four electronic databases: PubMed, EBSCO, Scopus, and Web of Science. To be included studies had to be on a population aged 0 to 18 were included. The individuals were either healthy or presented a neurodevelopment disorder. Risk of Bias was evaluated through the Consensus-based Standards to select the health Measurement Instruments (COSMIN). EXPERT OPINION The search was conducted on April 2023. Eighty-four papers met the inclusion criteria and were included in the study; the studies refer to 72 different evaluation tools of EFs. Most of the studies analyzed through a methodological quality analysis received an 'adequate' score. The instrument most mentioned was the Behavior Rating Inventory of Executive Function-2 (BRIEF2) in seven articles.
Collapse
Affiliation(s)
- Arianna Cesari
- School of Occupational Therapy, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Isernia, Italy
| | | | - Rachele Simeon
- School of Occupational Therapy, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Isernia, Italy
| |
Collapse
|
4
|
Poutanen J, Savolainen S, Shulga A, Arokoski J, Hiekkala S. ICF-linking and psychometric properties of upper extremity mobility outcome measures in spinal cord injury - a scoping review. J Spinal Cord Med 2024; 47:201-213. [PMID: 36622355 PMCID: PMC10885769 DOI: 10.1080/10790268.2022.2161867] [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] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE The purpose of this study was to explore the outcome measures used in upper extremity rehabilitation and research in spinal cord injury and to investigate their psychometry. DESIGN Scoping review. DATA SOURCES PubMed, the Cochrane library, PEDro, Medline (Ovid). ELIGIBILITY CRITERIA FOR SELECTING STUDIES The search process and study selection was carried out as follows: Firstly, a systematic search was carried out for articles on upper extremity rehabilitation after SCI. Performance or observational outcome measures which were designed for a clinical setting were collected from selected studies. Secondly, eligible outcome measures were linked to the ICF. The ICF-linked outcome measures were further screened for inclusion according to how comprehensively they covered ICF categories. Finally, a search of the selected outcome measures was performed to investigate their psychometry. RESULTS A total of four outcome measures and nine psychometric studies were selected for the scoping review; six studies addressed GRASSP, one addressed AuSpinal, one addressed SHFT and one addressed TRI-HFT. Of the 13 COSMIN measurement properties, studies of GRASSP covered seven, AuSpinal covered five and both SHFT and TRI-HFT covered three properties. CONCLUSIONS The psychometric properties of GRASSP were most extensively studied showing eligible reliability and validity. Although there are still some measurement properties to be explored, GRASSP can be recommended for use in the evaluation of upper extremity mobility in the SCI rehabilitation and research. More research is needed on the psychometrics of other outcome measures in people with spinal cord injuries before the outcome measures can be unconditionally recommended.
Collapse
Affiliation(s)
- Joonas Poutanen
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Sarianna Savolainen
- BioMag Laboratory, Helsinki University Hospital, Helsinki, Finland
- Validia Ltd., Helsinki, Finland
| | - Anastasia Shulga
- BioMag Laboratory, Helsinki University Hospital, Helsinki, Finland
- Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, Helsinki, Finland
- Department of Surgery, University of Helsinki, Helsinki, Finland
| | - Jari Arokoski
- Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, Helsinki, Finland
- Clinical Neurosciences, Neurology, Helsinki University Hospital, Helsinki, Finland
| | - Sinikka Hiekkala
- Validia Ltd., Helsinki, Finland
- The Finnish Association of People with Physical Disabilities, Helsinki, Finland
| |
Collapse
|
5
|
Gardas SS, Lysaght C, McMillan AG, Kantak S, Willson JD, Patterson CG, Surkar SM. Bimanual Movement Characteristics and Real-World Performance Following Hand-Arm Bimanual Intensive Therapy in Children with Unilateral Cerebral Palsy. Behav Sci (Basel) 2023; 13:681. [PMID: 37622821 PMCID: PMC10451828 DOI: 10.3390/bs13080681] [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: 06/16/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 08/26/2023] Open
Abstract
The purpose of this study was to quantify characteristics of bimanual movement intensity during 30 h of hand-arm bimanual intensive therapy (HABIT) and bimanual performance (activities and participation) in real-world settings using accelerometers in children with unilateral cerebral palsy (UCP). Twenty-five children with UCP participated in a 30 h HABIT program. Data were collected from bilateral wrist-worn accelerometers during 30 h of HABIT to quantify the movement intensity and three days pre- and post-HABIT to assess real-world performance gains. Movement intensity and performance gains were measured using six standard accelerometer-derived variables. Bimanual capacity (body function and activities) was assessed using standardized hand function tests. We found that accelerometer variables increased significantly during HABIT, indicating increased bimanual symmetry and intensity. Post-HABIT, children demonstrated significant improvements in all accelerometer metrics, reflecting real-world performance gains. Children also achieved significant and clinically relevant changes in hand capacity following HABIT. Therefore, our findings suggest that accelerometers can objectively quantify bimanual movement intensity during HABIT. Moreover, HABIT enhances hand function as well as activities and participation in real-world situations in children with UCP.
Collapse
Affiliation(s)
- Shailesh S. Gardas
- Department of Physical Therapy, East Carolina University, Greenville, NC 27834, USA; (S.S.G.); (C.L.); (A.G.M.); (J.D.W.)
| | - Christine Lysaght
- Department of Physical Therapy, East Carolina University, Greenville, NC 27834, USA; (S.S.G.); (C.L.); (A.G.M.); (J.D.W.)
| | - Amy Gross McMillan
- Department of Physical Therapy, East Carolina University, Greenville, NC 27834, USA; (S.S.G.); (C.L.); (A.G.M.); (J.D.W.)
| | - Shailesh Kantak
- Moss Rehabilitation Research Institute, Elkins Park, PA 19027, USA
- Department of Physical Therapy, Arcadia University, Glenside, PA 19038, USA
| | - John D. Willson
- Department of Physical Therapy, East Carolina University, Greenville, NC 27834, USA; (S.S.G.); (C.L.); (A.G.M.); (J.D.W.)
| | - Charity G. Patterson
- Department of Physical Therapy and School of Health and Rehabilitation Sciences Data Center, University of Pittsburgh, Pittsburgh, PA 15260, USA;
| | - Swati M. Surkar
- Department of Physical Therapy, East Carolina University, Greenville, NC 27834, USA; (S.S.G.); (C.L.); (A.G.M.); (J.D.W.)
| |
Collapse
|
6
|
Adams RJ, Lunsford CD, Stevenson RD, Ellington AL, Lichter MD, Patrie JT. Concurrent Validity of Measures of Upper Extremity Function Derived from Videogame-Based Motion Capture for Children with Hemiplegia. Games Health J 2023; 12:323-329. [PMID: 36944143 PMCID: PMC10357104 DOI: 10.1089/g4h.2022.0160] [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] [Indexed: 03/23/2023] Open
Abstract
Objective: Pediatric hemiplegia is associated with wide-ranging deficits in arm and hand motor function, neg-atively impacting participation in daily occupations and quality of life. This study investigated whether performance measures generated during therapy videogame play by children with hemiplegia can be valid indicators of upper extremity motor function. Materials and Methods: Ten children with hemiplegia used a custom therapy game system alternatively using their affected and non-affected hand to provide motion capture data that spans a wide range of motor function status. The children also completed a series of standardized outcome measure assessments with each hand, including the Quality of Upper Extremity Skills Test, the Jebsen Taylor Hand Function Test, and the Wolf Motor Function Test. Results: Statistical analysis using the nonparametric Spearman rank correlation revealed high and significant correlation between videogame-derived motion capture measures, characterizing the speed and smoothness of movements, and the standardized outcome measure assessments. Conclusion: The results suggest that a low-cost motion capture system can be used to monitor a child's motor function status and progress during a therapy program.
Collapse
Affiliation(s)
| | | | - Richard D. Stevenson
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA
| | - Allison L. Ellington
- Department of Occupational Therapy, Mary Baldwin University, Staunton, Virginia, USA
| | | | | |
Collapse
|
7
|
Lamboglia A, Romano R, Valente D, Berardi A, Cavalli G, Giovannone F, Sogos C, Tofani M, Galeoto G. Brief Autism Mealtime Behavior Inventory (BAMBI): Italian Translation and Validation. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1201. [PMID: 37508698 PMCID: PMC10378622 DOI: 10.3390/children10071201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/26/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
Food selectivity is among the most common problems for children with Autism Spectrum Disorder (ASD). The present study aims to validate the Brief Autism Mealtime Behavior Inventory (BAMBI) in an Italian population of children with ASD. BAMBI was translated and cross-culturally adapted following international guidelines, then we investigated internal consistency as measured by Cronbach's alpha and test-retest reliability, as measured by the Intraclass Correlation Coefficient (ICC) in a sample of both children with ASD and with typical development (TD). A total of 131 children were recruited in a clinical and community sample. Internal consistency revealed significant data for both TD and ASD children, with a Cronbach's Alpha of 0.86 and 0.71, respectively. Test-retest reliability showed excellent values for each item of the BAMBI (range 0.83-1.00). Furthermore, we investigated differences in gender and body max index; however, no significant differences were found among groups. In conclusion, the Italian version of the BAMBI showed good internal consistency and test-retest reliability and it can be used for clinical and research purposes.
Collapse
Affiliation(s)
- Antonella Lamboglia
- MSC in Rehabilitation Sciences for Health Professions, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy
| | - Roberta Romano
- MSC in Rehabilitation Sciences for Health Professions, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy
| | - Donatella Valente
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
- Neuromed IRCCS, 86077 Pozzili, Italy
| | - Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
| | - Gioia Cavalli
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
| | - Federica Giovannone
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
| | - Carla Sogos
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
| | - Marco Tofani
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
- Neuromed IRCCS, 86077 Pozzili, Italy
| |
Collapse
|
8
|
Mimouni-Bloch A, Shaklai S, Levin M, Ingber M, Karolitsky T, Grunbaum S, Friedman J. Developmental and acquired brain injury have opposite effects on finger coordination in children. Front Hum Neurosci 2023; 17:1083304. [PMID: 36755895 PMCID: PMC9899809 DOI: 10.3389/fnhum.2023.1083304] [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: 10/28/2022] [Accepted: 01/02/2023] [Indexed: 01/24/2023] Open
Abstract
The ability to coordinate finger forces to dexterously perform tasks develops in children as they grow older. Following brain injury, either developmental (as in cerebral palsy-CP) or acquired (as in traumatic brain injury-TBI), this developmental trajectory will likely be impaired. In this study, we compared finger coordination in a group of children aged 4-12 with CP and TBI to a group of typically developing children using an isometric pressing task. As expected, deficits were observed in functional tests (Jebsen Taylor test of hand function, Box and Block test) for both groups, and children in both groups performed the pressing task less well than the control group. However, differing results were observed between the CP and TBI groups when using the uncontrolled manifold hypothesis to look at the synergy index. This index measures the relative amount of "good" (does not affect the outcome measure) and "bad" (does affect the outcome measure) variability, where in this case the outcome measure is the total force produced by the fingers. While children with CP were more variable in their performance, their synergy index was not significantly different from typically developing children, suggesting the development of compensatory strategies. In contrast, the children following TBI showed performance that got worse as a function of age (i.e., the older children with TBI performed worse than the younger children with TBI). These differences between the groups may be a result of different areas of brain injury typically observed in CP and TBI, and the different amount of time that has passed since the injury.
Collapse
Affiliation(s)
- Aviva Mimouni-Bloch
- Pediatric Neurology and Development Unit, Loewenstein Rehabilitation Medical Center, Ra’anana, Israel,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Sharon Shaklai
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel,Department of Child and Youth Rehabilitation, Loewenstein Rehabilitation Medical Center, Ra’anana, Israel
| | - Moran Levin
- Department Physical Therapy, Sackler Faculty of Medicine, School of Health Professions, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Moria Ingber
- Department of Child and Youth Rehabilitation, Loewenstein Rehabilitation Medical Center, Ra’anana, Israel
| | - Tanya Karolitsky
- Department of Child and Youth Rehabilitation, Loewenstein Rehabilitation Medical Center, Ra’anana, Israel
| | - Sigal Grunbaum
- Department of Child and Youth Rehabilitation, Loewenstein Rehabilitation Medical Center, Ra’anana, Israel
| | - Jason Friedman
- Department Physical Therapy, Sackler Faculty of Medicine, School of Health Professions, Tel Aviv University, Tel Aviv-Yafo, Israel,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv-Yafo, Israel,*Correspondence: Jason Friedman,
| |
Collapse
|
9
|
McCall JV, Hu X, Kamper DG. Exploring Kinetic and Kinematic Finger Individuation Capability in Children With Hemiplegic Cerebral Palsy. Percept Mot Skills 2022; 130:732-749. [PMID: 36514237 DOI: 10.1177/00315125221145220] [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: 12/15/2022]
Abstract
While fine manual dexterity develops over time, the extent to which children show independent control of their digits in each hand and the impact of perinatal brain injury on this individuation have not been well quantified. Our goal in this study was to assess and compare finger force and movement individuation in 8-14 year old children with hemiplegic cerebral palsy (hCP; n = 4) and their typically developing peers (TD; n = 10). We evaluated finger force individuation with five independent load cells and captured joint movement individuation with video tracking. We observed no significant differences in individuation indices between the dominant and non-dominant hands of TD children, but individuated force and movement were substantially reduced in the paretic versus non paretic hands of children with hCP (p < 0.001). In TD participants, the thumb tended to have the greatest level of independent control. This small sample of children with hCP showed substantial loss of individuation in the paretic hand and some deficits in the non-paretic hand, suggesting possible benefit from targeted training of digit independence in both hands for children with CP.
Collapse
Affiliation(s)
- James V McCall
- Joint Department of Biomedical Engineering, 6798University of North Carolina at Chapel Hill/ North Carolina State University, Raleigh, NC, USA
| | - Xiaogang Hu
- Departments of Mechanical Engineering, Kinesiology, and Physical Medicine & Rehabilitation, 311285The Pennsylvania State University-University Park, University Park, PA, USA
| | - Derek G Kamper
- Joint Department of Biomedical Engineering, 6798University of North Carolina at Chapel Hill/ North Carolina State University, Raleigh, NC, USA
| |
Collapse
|
10
|
Mignolli E, Scialpi A, Valente D, Berardi A, Galeoto G, Tofani M. Sleep Disturbance Scale for Children: Italian Validation in Autism Spectrum Disorder Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10163. [PMID: 36011798 PMCID: PMC9407824 DOI: 10.3390/ijerph191610163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
Sleep disorders in children with autism spectrum disorders (ASDs) are well-described. However, there is a lack of specific assessment tools to investigate sleep disturbance in this target population. The present investigation reports the Italian validation of the Sleep Disturbance Scale for Children (SDSC) in the ASD population, also investigating the correlation between sleep disorders In both children and parents. Internal consistency and test−retest reliability were investigated using Cronbach’s alpha and intraclass correlation coefficient (ICC), respectively. Concurrent validity was analyzed by comparing the score of the SDSC with the Pittsburgh Sleep Quality Index (PSQI), while the correlation between the SDCS score and the General Sleep Disturbance Scale (GSDS) was used to analyze the correlation between sleep disorders in children and sleep disorders in their parents. In total, 99 children with a diagnosis of ASD participated in the study. Cronbach’s alpha revealed satisfactory value (0.853), as well as reliability (ICC 0.972) and concurrent validity (0.745). Our results also revealed a significant linear correlation between children’s and parents’ sleep disorders (p < 0.05). In conclusion, we found the SDSC to be a useful tool for measuring sleep disorders in ASD children. Our findings offer concrete inputs to achieve adequate pathways for taking care of children with ASDs and their parents.
Collapse
Affiliation(s)
- Ester Mignolli
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Alessia Scialpi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Donatella Valente
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- Neuromed—Istituto Neurologico Mediterraneo, Istituto di Ricovero e Cura a Carattere Scientifico—IRCCS, 86077 Pozzilli, Italy
| | - Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- Neuromed—Istituto Neurologico Mediterraneo, Istituto di Ricovero e Cura a Carattere Scientifico—IRCCS, 86077 Pozzilli, Italy
| | - Marco Tofani
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- Professional Development, Continuous Education and Research Service, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico—IRCCS, 00165 Rome, Italy
| |
Collapse
|
11
|
Tofani M, Santecchia L, Conte A, Berardi A, Galeoto G, Sogos C, Petrarca M, Panuccio F, Castelli E. Effects of Mirror Neurons-Based Rehabilitation Techniques in Hand Injuries: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5526. [PMID: 35564920 PMCID: PMC9104298 DOI: 10.3390/ijerph19095526] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 02/04/2023]
Abstract
Background: Hand trauma requires specific rehabilitation protocol depending on the different structures involved. According to type of surgical intervention, and for monitoring pain and edema, post-operative rehabilitation of a hand that has experienced trauma involves different timings for immobilization. Several protocols have been used to reduce immobilization time, and various techniques and methods are adopted, depending on the structures involved. Objective: To measure the effects of mirror neurons-based rehabilitation techniques in hand injuries throughout a systematic review and meta-analysis. Methods: The protocol was accepted in PROSPERO database. A literature search was conducted in Cinahl, Scopus, Medline, PEDro, OTseeker. Two authors independently identified eligible studies, based on predefined inclusion criteria, and extracted the data. RCT quality was assessed using the JADAD scale. Results: Seventy-nine suitable studies were screened, and only eleven were included for qualitative synthesis, while four studies were selected for quantitative analysis. Four studies were case reports/series, and seven were RCTs. Nine investigate the effect of Mirror Therapy and two the effect of Motor Imagery. Quantitative analyses revealed Mirror Therapy as effective for hand function recovery (mean difference = −14.80 95% Confidence Interval (CI) = −17.22, −12.38) (p < 0.00001) in the short term, as well as in long follow-up groups (mean difference = −13.11 95% Confidence Interval (CI) = −17.53, −8.69) (p < 0.00001). Clinical, but not statistical, efficacy was found for manual dexterity (p = 0.15), while no benefit was reported for range of motion. Conclusions: Mirror neurons-based rehabilitation techniques, combined with conventional occupational and physical therapy, can be a useful approach in hand trauma. Mirror therapy seems to be effective for hand function recovery, but, for motor imagery and action observation, there is not sufficient evidence to recommend its use. Further research on the efficacy of the mirror neurons-based technique in hand injury is recommended.
Collapse
Affiliation(s)
- Marco Tofani
- Professional Development, Continuous Education and Research Service, Bambino Gesù Children’s Hospital, 00165 Rome, Italy
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (A.B.); (G.G.); (C.S.)
| | - Luigino Santecchia
- Orthopedic Unit, Department of Surgery, Bambino Gesù Children’s Hospital, 00100 Rome, Italy;
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (A.B.); (G.G.); (C.S.)
- Neuromed IRCCS, 86077 Pozzili, Italy
| | - Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (A.B.); (G.G.); (C.S.)
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (A.B.); (G.G.); (C.S.)
- Neuromed IRCCS, 86077 Pozzili, Italy
| | - Carla Sogos
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (A.B.); (G.G.); (C.S.)
| | - Maurizio Petrarca
- Department of Intensive Neurorehabilitation and Robotics, Bambino Gesù Children’s Hospital, 00100 Rome, Italy; (M.P.); (E.C.)
| | | | - Enrico Castelli
- Department of Intensive Neurorehabilitation and Robotics, Bambino Gesù Children’s Hospital, 00100 Rome, Italy; (M.P.); (E.C.)
| |
Collapse
|
12
|
Berardi A, Galeoto G, Pasquali F, Baione V, Crisafulli SG, Tofani M, Tartaglia M, Fabbrini G, Conte A. Evaluation of the Psychometric Properties of Jebsen Taylor Hand Function Test (JTHFT) in Italian Individuals With Multiple Sclerosis. Front Neurol 2022; 13:847807. [PMID: 35370923 PMCID: PMC8971517 DOI: 10.3389/fneur.2022.847807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/16/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction The Jebsen Taylor Hand Function Test (JTHFT) is a non-diagnostic assessment scale for hand and upper limb dexterity that is commonly used in various countries around the world for diseases, such as muscular dystrophy, stroke, spinal cord injury, Parkinson, carpal tunnel syndrome, and rheumatoid arthritis. This study aimed to evaluate the psychometric properties of the JTHFT in Italian adults with Multiple Sclerosis (MS). Materials and Methods The test's internal consistency was evaluated with Cronbach's alpha, whereas its concurrent validity was evaluated by comparing the JTHFT with the Health Assessment Questionnaire (HAQ) and by calculating Pearson's correlation coefficient. Results The JTHFT was administered to 29 Italians with MS. The Cronbach's alpha showed that the nondominant hand has a value of 0.76 and 0.91 for the dominant hand. Pearson's correlation coefficient showed significant correlations between JTHFT and HAQ. Discussion The JTHFT is a reliable tool to evaluate the functionality of the upper limb and hand in patients with MS. This tool is useful for testing the effectiveness of a treatment in various diseases. The results obtained in this study are coherent with previous studies that are conducted in populations with different diseases. In particular, the correlation between JTHFT and HAQ showed that a disability related to the upper limbs can often have repercussions, not only on activities of daily living, but also on walking. Based on this correlation, the motor deficits that emerged may be linked to a brain marrow disease rather than a spinal disease, even if an essential deepening can confirm this hypothesis.
Collapse
Affiliation(s)
- Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- *Correspondence: Anna Berardi
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCSS Neuromed, Pozzilli, Italy
| | | | - Viola Baione
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | - Marco Tofani
- Department of Public Health and Infectious Disease, Sapienza University of Rome, Rome, Italy
| | - Matteo Tartaglia
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCSS Neuromed, Pozzilli, Italy
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCSS Neuromed, Pozzilli, Italy
| |
Collapse
|
13
|
The Effectiveness of Equine Therapy Intervention on Activities of Daily Living, Quality of Life, Mood, Balance and Gait in Individuals with Parkinson’s Disease. Healthcare (Basel) 2022; 10:healthcare10030561. [PMID: 35327039 PMCID: PMC8955834 DOI: 10.3390/healthcare10030561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives: The objective of this study was to evaluate the efficacy of equine therapy (ET) to detect changes in the activities of daily living, quality of life, mood, balance, and gait in individuals with Parkinson’s disease (PD). Material and Methods: In the study, 17 participants with PD were recruited to participate in 10 sessions of ET. The inclusion criteria of the study were: second and third stages of the Hoehn and Yahr scale, Mini-Mental State Examination (MMSE) greater than or equal to 24 points, and age up to 85 years. The outcome measures administered at the beginning and the end of treatment relied on measurements from the Rivermead ADL scale, Parkinson’s Disease Questionnaire-39 (PDQ-39), Zung Self-Rating Depression Scale (SDS), unified Parkinson’s disease rating scale (UPDRS), and Tinetti balance assessment. Data from the stabilometric platform were also collected to objectify the value obtained by the Tinetti balance assessment. The ET program included 10 biweekly 45 min sessions. Results: The results obtained included statistically significant increases in measurements from the Rivermead ADL, PDQ-39, UPDRS, SDS, and Tinetti balance assessment scales. The stabilometric platform did not report significant changes in data. Conclusion: ET that was used as a supportive therapy for traditional treatments resulted in statistically significant improvements in the occupational performance, mood, quality of life, gait, and balance of the participants. Data from the stabilometric platform did not show significant changes.
Collapse
|
14
|
Tofani M, Blasetti G, Lucibello L, Berardi A, Galeoto G, Sabbadini M, Santecchia L, Castelli E. An Italian Validation of ABILHAND-Kids for Children With Cerebral Palsy. Percept Mot Skills 2021; 128:2605-2620. [PMID: 34610765 DOI: 10.1177/00315125211049730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Limitations in hand function are common among children with cerebral palsy (CP), with almost 50% presenting an arm-hand dysfunction. However, there is no standardized assessment tool available in Italian for evaluating bimanual performance for this population. Our objective in this study was to evaluate the psychometric properties of an Italian translation of the ABILHAND-Kids (ABILHAND-Kids-IT) among children with CP. We examined internal consistency using Cronbach's Alpha and Omega coefficients, and we investigated test-retest reliability with intraclass correlation coefficients (ICC). We performed explorative factor analysis (EFA) to investigate structural validity. We calculated Pearson's correlation coefficients between the ABILAND-Kids IT and the Manual Ability Classification System (MACS) to assess criterion validity; and, to demonstrate the score variability of the ABILHAND-Kids-IT, we used analyses of variance (ANOVAs) to compare the 181 children with CP in this sample with their levels on the MACS. We enrolled 181 children with CP in the study. EFA confirmed a uni-dimensional scale. We obtained internal consistency on both Cronbach's Alpha and Omega coefficient of 0.98, and a one-week test-retest reliability analysis revealed an ICC with 95% of confidence interval of .992. The ANOVA revealed significant score variability (p < 0.01) and the Pearson correlation coefficient comparing the ABILHAND-Kids-It score with the MACS was -0.929 (p < 0.01). We conclude that the ABILHAND-Kids-IT is valid and reliable for use with Italian children with CP.
Collapse
Affiliation(s)
- Marco Tofani
- Department of Intensive Neurorehabilitation and Robotics, Bambino Gesù Children's Hospital, Rome, Italy
| | - Giulia Blasetti
- Department of Intensive Neurorehabilitation and Robotics, Bambino Gesù Children's Hospital, Rome, Italy
| | - Luca Lucibello
- Department of Research and Innovation, ITOP Officine Ortopediche, Palestrina, Italy
| | - Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,IRCCS Neuromed Pozzilli, Pozzilli, Italy
| | - Maurizio Sabbadini
- Department of Intensive Neurorehabilitation and Robotics, Bambino Gesù Children's Hospital, Rome, Italy
| | - Luigino Santecchia
- Orthopaedic Unit, Surgical Department, Bambino Gesù Children's Hospital, Rome, Italy
| | - Enrico Castelli
- Department of Intensive Neurorehabilitation and Robotics, Bambino Gesù Children's Hospital, Rome, Italy
| |
Collapse
|
15
|
Fabbri B, Berardi A, Tofani M, Panuccio F, Ruotolo I, Sellitto G, Galeoto G. A systematic review of the psychometric properties of the Jebsen-Taylor Hand Function Test (JTHFT). HAND SURGERY & REHABILITATION 2021; 40:560-567. [PMID: 34023565 DOI: 10.1016/j.hansur.2021.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/02/2021] [Accepted: 05/13/2021] [Indexed: 10/21/2022]
Abstract
This systematic review of the literature aimed to identify studies examining the psychometric properties of the Jebsen-Taylor Hand Function Test (JTHFT) in various international populations on. The search was conducted in MEDLINE, SCOPUS, CINAHL and Web Of Science, with no restrictions on publication period, the country in which the study was conducted, or the age of the patients. Eligible studies were selected on the basis of inclusion criteria and data were extracted. Study quality and the risk of bias were assessed using the COnsensus-based Standards to select the health Measurement Instruments (COSMIN) checklist. 805 articles were identified; after removing duplicates, there were 361 single studies. 338 articles did not concern the psychometric properties of JTHFT. The remaining 23 studies were selected for full text review, and all were included. They comprised 8 languages and 9 pathologies. These findings suggest the JTHFT is a useful test of manual dexterity in activities of daily living. This study provides specific information on the instrument's psychometric properties in different populations and supports clinicians in making informed decisions when choosing instruments for upper-limb evaluations.
Collapse
Affiliation(s)
- B Fabbri
- Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - A Berardi
- Department of Human Neurosciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - M Tofani
- Department of Intensive Neurorehabilitation and Robotics, Bambino Gesù Children's Hospital, Piazza di Sant'Onofrio 4, 00165, Rome, Italy
| | - F Panuccio
- Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - I Ruotolo
- Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - G Sellitto
- Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - G Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy; IRCCS Neuromed, Via Atinense 18, 86077, Pozzili, Italy.
| |
Collapse
|
16
|
Steel KA, Anderson DI, Smith CA, Ellem E, Liu KPY, Morrison-Gurza A, Dune T, Fairley LH. Potential Value of Customized Video Self-Modelling for Motor Skill Learning in Individuals with Cerebral Palsy: A Case-Study Approach. Percept Mot Skills 2021; 128:1464-1484. [PMID: 33892615 DOI: 10.1177/00315125211012810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cerebral Palsy (CP) is a common physical disability that is managed with a variety of strategies. One non-invasive intervention for people living with CP is a type of video self-modelling (VSM) referred to as positive self-review (PSR). PSR involves watching a video of oneself performing only the best examples of a desired task; this technique has been associated with improved performance and learning for people without disabilities and for those in various clinical populations, including children with spina bifida and stroke patients. PSR may have similar benefits for people living with CP. In this study we examined the effectiveness of PSR for improving a self-selected movement task among individuals living with CP. In this case study approach, eight participants completed a pre-, post-, and second post-test measuring and recording well-being, movement self-consciousness and tendency to consciously monitor movements. Results were mixed, with some participants improving their movement time, well-being ratings and tendency toward self-consciousness and conscious monitoring of movements and others showing no changes or regressions. The effectiveness of VSM appears to depend upon the match between type of task and disability and/or the length of practice. More study is needed.
Collapse
Affiliation(s)
- Kylie A Steel
- Western Sydney University, Sydney, Australia.,The MARCS Institute, Sydney, Australia
| | - David I Anderson
- San Francisco State University, San Francisco, California, United States
| | - Caroline A Smith
- Western Sydney University, Sydney, Australia.,National Institute of Complementary Medicine, Sydney, Australia
| | | | | | | | - Tinashe Dune
- Western Sydney University, Sydney, Australia.,Translational Health Research Institute, Sydney, Australia
| | | |
Collapse
|
17
|
Evaluation of the Psychometric Properties of the Scale A-ONE: An Italian Cross-Sectional Study. Occup Ther Int 2021; 2021:8874953. [PMID: 33824630 PMCID: PMC7994097 DOI: 10.1155/2021/8874953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 02/08/2021] [Accepted: 03/08/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose This study is aimed at validating the A-ONE scale in an Italian population with Central Nervous System (CNS) dysfunction. Material and Methods. Between May and November 2018, people aged between 60 and 90 with CNS dysfunction were recruited in a hospital in Rome, Italy. Patients were observed and evaluated during the activities of daily living. Internal consistency and reliability were evaluated with Cronbach's coefficient alpha and intraclass correlation coefficient, respectively. As measured with Pearson's correlation coefficient, the validity was examined comparing results of the A-ONE with the Barthel index. Responsiveness was evaluated 30 days after the first administration. Results A total of 70 people having a diagnosis of neurological disorders were evaluated. The internal consistency showed Cronbach's coefficient alpha ranging from 0.634 to 0.959. The measurement of reliability varied from 0.984 to 0.997 for intrarater and from 0.979 to 0.998 for interrater. Pearson's correlation coefficient between the A-ONE and the Barthel index and the responsiveness showed statistically significant values (p < 0.01). Conclusions The present study provides preliminary evidence of reliability, validity, and responsiveness of the A-ONE when using elderly people with CNS dysfunction.
Collapse
|
18
|
Internal consistency and validity of the Italian version of the Jebsen-Taylor hand function test (JTHFT-IT) in people with tetraplegia. Spinal Cord 2021; 59:266-273. [PMID: 33446935 DOI: 10.1038/s41393-020-00602-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/27/2020] [Accepted: 11/27/2020] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Psychometric study. OBJECTIVES This study aimed to evaluate the internal consistency and validity of the Italian version of the Jebsen-Taylor hand function test (JTHFT-IT) in people with tetraplegia. SETTING Italian spinal units. METHODS Psychometric properties of the JTHFT-IT were assessed following international guidelines. The internal consistency was examined using Cronbach's alpha coefficient. Pearson's correlation coefficient was calculated for the concurrent validity of JTHFT-IT with a dynamometer, while the construct validity was calculated in comparison to that of the Van Lieshout test short version in Italian (VLT-SV-IT). RESULTS The test was administered to 48 right-hand dominant people with tetraplegia. Cronbach's alpha calculation resulted in a value of 0.96 for the right hand and 0.94 for the left hand. In terms of the validity of the scale, the Pearson's correlation, as measured in relation to the VLT-SV-IT and dynamometer, showed statistically significant results (range for the correlation coefficient of between -0.96 and -0.12, p < 0.05). CONCLUSIONS The findings of this study support the internal consistency and validity of the JTHFT-IT and its use among a population with cervical SCI as a measure of hand functionality.
Collapse
|
19
|
SERRANO-GONZÁLEZ P, CUESTA-GARCÍA C, GIROL-LÓPEZ E, CUENCA-MARTÍNEZ F. Action Observation Training to Improve Activities of Daily Living and Manipulation Skills in Children with Acquired Brain Injury Secondary to an Oncologic Process: A Prospective Case Series Clinical Study. Phys Ther Res 2021; 25:41-48. [DOI: 10.1298/ptr.e10134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 10/22/2021] [Indexed: 11/23/2022]
Affiliation(s)
| | - César CUESTA-GARCÍA
- Occupational Thinks Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid
| | | | | |
Collapse
|