1
|
Hideshima Y, Asami T, Ichiba M, Matsuo K, Murata T. A study on the effectiveness of training in the operation of an electric mobility aid in severely mentally and physically handicapped children. JAPANESE JOURNAL OF COMPREHENSIVE REHABILITATION SCIENCE 2024; 15:8-16. [PMID: 38585159 PMCID: PMC10990755 DOI: 10.11336/jjcrs.15.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/25/2024] [Indexed: 04/09/2024]
Abstract
Hideshima Y, Asami T, Ichiba M, Matsuo K, Murata T. A study on the effectiveness of training in the operation of an electric mobility aid in severely mentally and physically handicapped children. Jpn J Compr Rehabil Sci 2024; 15: 8-16. Purpose We examined whether operation training for children with severe mental and physical disabilities using recently developed electric mobility aids improves their skills in operating such aids and their daily activities. By doing so, we aimed to clarify the effectiveness of electric mobility aid operation training for children with severe mental and physical disabilities. Method Operation training and normal training using an electric mobility aid were conducted for 42 school-aged children with severe mental and physical disabilities, aged 8-18 years old. The trainee children were randomly assigned to two groups: 21 to the intervention group to receive operation training and 21 to the control group to receive general training. The intervention lasted 20 minutes/training session, with three sessions/week over a period of eight weeks. The Powered Mobility Program (PMP) and Pediatric Evaluation of Disability Inventory (PEDI) were used for pre- and post-intervention assessments, and SPSS was used for two-way analysis of variance (ANOVA). Results PMP scaled scores significantly increased (p = 0.001) in both groups, but there was no interaction effect. The PEDI scaled scores did not significantly increase in either of the two groups. Discussion The effects of the intervention and use of the electric mobility aid on the operating skills of children with severe mental and physical disabilities were explicitly demonstrated. Future long-term studies are required to clarify the effects of training in the operation of electric mobility aids on the subsequent development of severely physically and mentally handicapped children.
Collapse
Affiliation(s)
- Yoshikazu Hideshima
- General School of Medical Science Course Medical School Faculty of Medicine, Saga University, Saga, Japan
| | - Toyoko Asami
- Department of Rehabilitation Medicine, Saga University Hospital, Saga, Japan
| | - Masayoshi Ichiba
- Department of Social Medicine, Saga University School of Medicine, Saga, Japan
| | | | | |
Collapse
|
2
|
Buccilli B. Exploring new horizons: Emerging therapeutic strategies for pediatric stroke. Exp Neurol 2024; 374:114701. [PMID: 38278205 DOI: 10.1016/j.expneurol.2024.114701] [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: 09/29/2023] [Revised: 12/31/2023] [Accepted: 01/23/2024] [Indexed: 01/28/2024]
Abstract
Pediatric stroke presents unique challenges, and optimizing treatment strategies is essential for improving outcomes in this vulnerable population. This review aims to provide an overview of new, innovative, and potential treatments for pediatric stroke, with a primary objective to stimulate further research in this field. Our review highlights several promising approaches in the realm of pediatric stroke management, including but not limited to stem cell therapy and robotic rehabilitation. These innovative interventions offer new avenues for enhancing functional recovery, reducing long-term disability, and tailoring treatments to individual patient needs. The findings of this review underscore the importance of ongoing research and development of innovative treatments in pediatric stroke. These advancements hold significant clinical relevance, offering the potential to improve the lives of children affected by stroke by enhancing the precision, efficacy, and accessibility of therapeutic interventions. Embracing these innovations is essential in our pursuit of better outcomes and a brighter future for pediatric stroke care.
Collapse
Affiliation(s)
- Barbara Buccilli
- Icahn School of Medicine at Mount Sinai, Department of Neurosurgery, 1 Gustave L. Levy Pl, New York, NY 10029, United States of America.
| |
Collapse
|
3
|
Ng G, Andrysek J. Classifying Changes in Amputee Gait following Physiotherapy Using Machine Learning and Continuous Inertial Sensor Signals. SENSORS (BASEL, SWITZERLAND) 2023; 23:1412. [PMID: 36772451 PMCID: PMC9921298 DOI: 10.3390/s23031412] [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: 12/19/2022] [Revised: 01/13/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Wearable sensors allow for the objective analysis of gait and motion both in and outside the clinical setting. However, it remains a challenge to apply such systems to highly diverse patient populations, including individuals with lower-limb amputations (LLA) that present with unique gait deviations and rehabilitation goals. This paper presents the development of a novel method using continuous gyroscope data from a single inertial sensor for person-specific classification of gait changes from a physiotherapist-led gait training session. Gyroscope data at the thigh were collected using a wearable gait analysis system for five LLA before, during, and after completing a gait training session. Data from able-bodied participants receiving no intervention were also collected. Models using dynamic time warping (DTW) and Euclidean distance in combination with the nearest neighbor classifier were applied to the gyroscope data to classify the pre- and post-training gait. The model achieved an accuracy of 98.65% ± 0.69 (Euclidean) and 98.98% ± 0.83 (DTW) on pre-training and 95.45% ± 6.20 (Euclidean) and 94.18% ± 5.77 (DTW) on post-training data across the participants whose gait changed significantly during their session. This study provides preliminary evidence that continuous angular velocity data from a single gyroscope could be used to assess changes in amputee gait. This supports future research and the development of wearable gait analysis and feedback systems that are adaptable to a broad range of mobility impairments.
Collapse
Affiliation(s)
- Gabriel Ng
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 1A1, Canada
- Bloorview Research Institute (BRI), Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G 1R8, Canada
| | - Jan Andrysek
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 1A1, Canada
- Bloorview Research Institute (BRI), Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G 1R8, Canada
| |
Collapse
|
4
|
Castelli E, Beretta E, De Tanti A, Arduini F, Biffi E, Colazza A, Di Pede C, Guzzetta A, Lucarini L, Maghini I, Mandalà M, Nespoli M, Pavarelli C, Policastro F, Polverelli M, Rossi A, Sgandurra G, Boldrini P, Bonaiuti D, Mazzoleni S, Posteraro F, Benanti P, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzon S, Molteni F, Morone G, Petrarca M, Picelli A, Senatore M, Turchetti G, Saviola D, Turchetti G. Robot-assisted rehabilitation for children with neurological disabilities: Results of the Italian consensus conference CICERONE. NeuroRehabilitation 2022; 51:665-679. [PMID: 36530098 DOI: 10.3233/nre-220036] [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
BACKGROUND The use of robotic technologies in pediatric rehabilitation has seen a large increase, but with a lack of a comprehensive framework about their effectiveness. OBJECTIVE An Italian Consensus Conference has been promoted to develop recommendations on these technologies: definitions and classification criteria of devices, indications and limits of their use in neurological diseases, theoretical models, ethical and legal implications. In this paper, we present the results for the pediatric age. METHODS A systematic search on Cochrane Library, PEDro and PubMed was performed. Papers published up to March 1st, 2020, in English, were included and analyzed using the methodology of the Centre for Evidence-Based Medicine in Oxford, AMSTAR2 and PEDro scales for systematic reviews and RCT, respectively. RESULTS Some positives aspects emerged in the area of gait: an increased number of children reaching the stance, an improvement in walking distance, speed and endurance. Critical aspects include the heterogeneity of the studied cases, measurements and training protocols. CONCLUSION Many studies demonstrate the benefits of robotic training in developmental age. However, it is necessary to increase the number of trials to achieve greater homogeneity between protocols and to confirm the effectiveness of pediatric robotic rehabilitation.
Collapse
Affiliation(s)
| | - Elena Beretta
- IRCCS Eugenio Medea, La Nostra Famiglia, Ponte Lambro, Italy
| | - Antonio De Tanti
- KOS-CARE, Santo Stefano Rehabilitation, Cardinal Ferrari Center, Parma, Italy
| | | | - Emilia Biffi
- IRCCS Eugenio Medea, La Nostra Famiglia, Ponte Lambro, Italy
| | | | - Chiara Di Pede
- IRCCS Eugenio Medea, La Nostra Famiglia, Ponte Lambro, Italy
| | - Andrea Guzzetta
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, Italy.,Dipartimento di Neuroscienze dello Sviluppo, IRCCS Stella Maris, Pisa, Italy
| | | | - Irene Maghini
- Department of Women's and Children's Health, Pediatric Pain and Palliative Care Service, University of Padua, Padua, Italy
| | - Martina Mandalà
- IRCCS Santa Maria Nascente - Fondazione Don C. Gnocchi, Milan, Italy
| | | | - Claudia Pavarelli
- Servizio di Neuropsichiatria Infanzia e dell'Adolescenza (NPIA), Vignola, Italy
| | - Francesca Policastro
- Dipartimento Scienze Mediche e Chirurgiche, Università degli Studi di Trieste, Trieste, Italy
| | - Marco Polverelli
- Dipartimento Riabilitazione, Azienda Ospedaliera Nazionale SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Andrea Rossi
- ASST Spedali Civili di Brescia, Ospedale dei Bambini, Brescia, Italy
| | - Giuseppina Sgandurra
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, Italy.,Dipartimento di Neuroscienze dello Sviluppo, IRCCS Stella Maris, Pisa, Italy
| | - Paolo Boldrini
- Italian Society of Physical Medicine and Rehabilitation, (SIMFER), Rome, Italy
| | - Donatella Bonaiuti
- Italian Society of Physical Medicine and Rehabilitation, (SIMFER), Rome, Italy
| | - Stefano Mazzoleni
- Department of Electrical and Information Engineering, Politecnico di Bari, Bari, Italy
| | - Federico Posteraro
- Department of Rehabilitation, Versilia Hospital - AUSL12, Viareggio, Italy
| | | | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Rome, Italy
| | - Vincenzo Falabella
- Italian Federation of Persons with Spinal Cord Injuries (FAIP Onlus), Rome, Italy
| | | | - Francesca Gimigliano
- Department of Mental, Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mauro Grigioni
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, Rome, Italy
| | - Stefano Mazzon
- Rehabilitation Unit, ULSS (Local Health Autority) Euganea, Camposampietro Hospital, Padua, Italy
| | - Franco Molteni
- Department of Rehabilitation Medicine, Villa Beretta Rehabilitation Center, Valduce Hospital, Lecco, Italy
| | | | - Maurizio Petrarca
- Movement Analysis and Robotics Laboratory (MARlab), IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Alessandro Picelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Michele Senatore
- Associazione Italiana dei Terapisti Occupazionali (AITO), Rome, Italy
| | | | - Donatella Saviola
- KOS-CARE, Santo Stefano Rehabilitation, Cardinal Ferrari Center, Parma, Italy
| | | |
Collapse
|
5
|
Zarkovic D, Sorfova M, Tufano JJ, Kutilek P, Viteckova S, Groleger-Srsen K, Ravnik D. Effect of Robot-Assisted Gait Training on Selective Voluntary Motor Control in Ambulatory Children with Cerebral Palsy. Indian Pediatr 2021. [PMID: 33089813 PMCID: PMC7605485 DOI: 10.1007/s13312-020-2005-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This pilot study investigated the efficacy of a four week robot-assisted gait training in twelve children with spastic diparesis. Short-term results and a 3-month follow-up showed statistically significantly increased selective motor control, walking farther distances, gross motor score, and decreased joint contractures.
Collapse
Affiliation(s)
- Dragana Zarkovic
- Department of Anatomy and Biomechanics, José Martího, Prague, the Czech Republic.
| | - Monika Sorfova
- Department of Anatomy and Biomechanics, José Martího, Prague, the Czech Republic
| | - James J Tufano
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, José Martího, Prague, the Czech Republic
| | - Patrik Kutilek
- Department of Natural Sciencces, Faculty of Biomedical Engineering, nam. Sitna, Kladno, the Czech Republic
| | - Slavka Viteckova
- Department of Natural Sciencces, Faculty of Biomedical Engineering, nam. Sitna, Kladno, the Czech Republic
| | - Katja Groleger-Srsen
- Children's Rehabilitation Department, Faculty of Medicine, University of Ljubljana, University Rehabilitation Institute, Linhartova cesta, Ljubljana, Republic of Slovenia
| | - David Ravnik
- Department of Nursing Care, Faculty of Health Sciences, University of Primorska, Polje, Izola, Republic of Slovenia
| |
Collapse
|
6
|
Apolo-Arenas MD, Jerônimo AFDA, Caña-Pino A, Fernandes O, Alegrete J, Parraca JA. Standardized Outcomes Measures in Physical Therapy Practice for Treatment and Rehabilitation of Cerebral PALSY: A Systematic Review. J Pers Med 2021; 11:604. [PMID: 34206816 PMCID: PMC8303849 DOI: 10.3390/jpm11070604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/20/2021] [Accepted: 06/18/2021] [Indexed: 01/23/2023] Open
Abstract
Cerebral palsy (CP) treatment includes physical therapy and various complementary therapies to the standard clinical treatment. However, there are not many reviews that focus on the methods used and evaluation procedures. This study aims to analyze which tools are most suitable for the evaluation and methodology of patients with CP treated with physical therapy. Following the PRISMA statement, through a PICOS strategy, PubMed/MEDLINE, Web of Science (WOS), Scopus, Science Direct, and Scielo were searched with the following terms: cerebral palsy AND (physical therapy modalities OR therapeutics) AND outcome assessment. The methodological quality of the RCTs was assessed with the Evidence Project risk of bias tool. Thirty-seven RCTs and six RCT protocols, comprising 1359 participants with different types of CP: spastic hemiplegia/paresis, spastic diplegia/paresis, and spastic CP, met the inclusion criteria, uncovering 21 variables measured through 77 different instruments and several interventions. The therapies most widely used in CP are gaming or technology-assisted therapies, aerobic training, hippotherapy, music therapy, gait training, and aquatic exercises. This study provides an overview of what the authors used in the neurorehabilitation field through procedure evaluation and checking the technological advance that began to be used.
Collapse
Affiliation(s)
- Maria Dolores Apolo-Arenas
- Departamento Terapéutica Médico Quirúrgica, Facultad de Medicina, Universidad de Extremadura, 06006 Badajoz, Spain; (M.D.A.-A.); (A.C.-P.)
| | - Aline Ferreira de Araújo Jerônimo
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal; (A.F.d.A.J.); (O.F.); (J.A.)
| | - Alejandro Caña-Pino
- Departamento Terapéutica Médico Quirúrgica, Facultad de Medicina, Universidad de Extremadura, 06006 Badajoz, Spain; (M.D.A.-A.); (A.C.-P.)
| | - Orlando Fernandes
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal; (A.F.d.A.J.); (O.F.); (J.A.)
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7004-516 Évora, Portugal
| | - Joana Alegrete
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal; (A.F.d.A.J.); (O.F.); (J.A.)
| | - Jose Alberto Parraca
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal; (A.F.d.A.J.); (O.F.); (J.A.)
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7004-516 Évora, Portugal
| |
Collapse
|
7
|
Petrarca M, Frascarelli F, Carniel S, Colazza A, Minosse S, Tavernese E, Castelli E. Robotic-assisted locomotor treadmill therapy does not change gait pattern in children with cerebral palsy. Int J Rehabil Res 2021; 44:69-76. [PMID: 33290305 DOI: 10.1097/mrr.0000000000000451] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although robotic-assisted locomotor treadmill therapy is utilized on children with cerebral palsy (CP), its impact on the gait pattern in childhood is not fully described. We investigated the outcome of robotized gait training focusing on the gait pattern modifications and mobility in individuals with CP. An additional intention is to compare our results with the previous literature advancing future solutions. Twenty-four children with diplegic CP (average age 6.4 years old with Gross Motor Functional Classification System range I-IV) received robotized gait training five times per week for 4 weeks. Gait analysis and Gross Motor Function Measurement (GMFM) assessments were performed before and at the end of the treatment. Gait analysis showed inconsistent modifications of the gait pattern. GMFM showed a mild improvement of the dimension D in all subjects, while dimension E changed only in the younger and more severely affected patients. In this study, a detailed investigation comprehensive of electromyography patterns, where previous literature reported only sparse data without giving information on the whole gait pattern, were conducted. We carried on the analysis considering the age of the participants and the severity of the gait function. The findings differentiate the concept of specific pattern recovery (no gait pattern changes) from the concept of physical training (mild GMFM changes).
Collapse
Affiliation(s)
- Maurizio Petrarca
- Paediatric Neurorehabilitation Division, 'Bambino Gesù' Children's Hospital - IRCCS, Rome, Italy
| | | | | | | | | | | | | |
Collapse
|
8
|
Gilardi F, De Falco F, Casasanta D, Andellini M, Gazzellini S, Petrarca M, Morocutti A, Lettori D, Ritrovato M, Castelli E, Raponi M, Magnavita N, Zaffina S. Robotic Technology in Pediatric Neurorehabilitation. A Pilot Study of Human Factors in an Italian Pediatric Hospital. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3503. [PMID: 32429562 PMCID: PMC7277142 DOI: 10.3390/ijerph17103503] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/08/2020] [Accepted: 05/13/2020] [Indexed: 11/17/2022]
Abstract
The introduction of robotic neurorehabilitation among the most recent technologies in pediatrics represents a new opportunity to treat pediatric patients. This study aims at evaluating the response of physiotherapists, patients and their parents to this new technology. The study considered the outcomes of technological innovation in physiotherapists (perception of the workload, satisfaction), as well as that in patients and their parents (quality of life, expectations, satisfaction) by comparing the answers to subjective questionnaires of those who made use of the new technology with those who used the traditional therapy. A total of 12 workers, 46 patients and 47 parents were enrolled in the study. Significant differences were recorded in the total workload score of physiotherapists who use the robotic technology compared with the traditional therapy (p < 0.001). Patients reported a higher quality of life and satisfaction after the use of the robotic neurorehabilitation therapy. The parents of patients undergoing the robotic therapy have moderately higher expectations and satisfaction than those undergoing the traditional therapy. In this pilot study, the robotic neurorehabilitation technique involved a significant increase in the patients' and parents' expectations. As it frequently happens in the introduction of new technologies, physiotherapists perceived a greater workload. Further studies are needed to verify the results achieved.
Collapse
Affiliation(s)
- Francesco Gilardi
- Health Directorate, Occupational Medicine Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.G.); (F.D.F.); (D.C.)
| | - Federica De Falco
- Health Directorate, Occupational Medicine Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.G.); (F.D.F.); (D.C.)
| | - Daniela Casasanta
- Health Directorate, Occupational Medicine Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.G.); (F.D.F.); (D.C.)
| | - Martina Andellini
- Health Technology Assessment Unit, Health Technology & Safety Research Unit, Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (M.A.); (M.R.)
| | - Simone Gazzellini
- Neurorehabilitation Units, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (S.G.); (M.P.); (A.M.); (D.L.); (E.C.)
| | - Maurizio Petrarca
- Neurorehabilitation Units, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (S.G.); (M.P.); (A.M.); (D.L.); (E.C.)
| | - Andreina Morocutti
- Neurorehabilitation Units, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (S.G.); (M.P.); (A.M.); (D.L.); (E.C.)
| | - Donatella Lettori
- Neurorehabilitation Units, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (S.G.); (M.P.); (A.M.); (D.L.); (E.C.)
| | - Matteo Ritrovato
- Health Technology Assessment Unit, Health Technology & Safety Research Unit, Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (M.A.); (M.R.)
| | - Enrico Castelli
- Neurorehabilitation Units, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (S.G.); (M.P.); (A.M.); (D.L.); (E.C.)
| | - Massimiliano Raponi
- Health Directorate, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Nicola Magnavita
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
- Department of Woman, Child & Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Salvatore Zaffina
- Health Directorate, Occupational Medicine Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (F.G.); (F.D.F.); (D.C.)
| |
Collapse
|
9
|
Lobato Garcia L, González González Y, Da Cuña Carrera I, Alonso Calvete A. [Benefits of robotics in gait rehabilitation in cerebral palsy: A systematic review]. Rehabilitacion (Madr) 2020; 54:128-136. [PMID: 32370827 DOI: 10.1016/j.rh.2020.01.004] [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] [Received: 03/01/2019] [Revised: 11/01/2019] [Accepted: 01/11/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM Cerebral palsy is the most common motor disability in childhood, with an estimated incidence of two out of every 1,000 live births. The impairment mostly affects gait. The aim of rehabilitation programmes is to enhance independence in affected individuals, especially mobility. To do this, robot-assisted gait rehabilitation programmes have been developed. Therefore, this study aimed to identify the benefits of robotics in gait rehabilitation in cerebral palsy. MATERIAL AND METHODS We performed a literature search using the MeSH terms «cerebral palsy», «robotics» and «gait». RESULTS After applying the selection criteria, we obtained 10 research studies and three protocols analysing the benefits of robotics in cerebral palsy and demonstrating that their use provides major advantages.
Collapse
Affiliation(s)
- L Lobato Garcia
- Facultad de Fisioterapia, Universidade de Vigo, Vigo, Pontevedra, España
| | | | - I Da Cuña Carrera
- Facultad de Fisioterapia, Universidade de Vigo, Vigo, Pontevedra, España
| | - A Alonso Calvete
- Facultad de Fisioterapia, Universidade de Vigo, Vigo, Pontevedra, España
| |
Collapse
|
10
|
RYAN JENNIFERL, LEVAC DANIELLEE, WRIGHT FVIRGINIA. Reliability of the Motor Learning Strategies Rating Instrument in physiotherapy intervention for children with cerebral palsy. Dev Med Child Neurol 2019; 61:1061-1066. [PMID: 30740648 PMCID: PMC6753581 DOI: 10.1111/dmcn.14177] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2018] [Indexed: 12/22/2022]
Abstract
AIM To evaluate the reliability of the Motor Learning Strategies Rating Instrument (MLSRI-20) in gait-based, video-recorded physiotherapy interventions for children with cerebral palsy (CP). METHOD Thirty videos of 18 children with CP, aged 6 to 17 years, participating in either traditional or Lokomat-based physiotherapy interventions were rated using the MLSRI-20. Physiotherapist raters provided general and item-specific feedback after rating each video, which was used when interpreting reliability results. RESULTS Both interrater and intrarater reliability of the MLSRI-20 total score was good. The interrater reliability intraclass correlation coefficient (ICC) was 0.78 with a 95% confidence interval (CI) of 0.53-0.89 and a coefficient of variation (CV) of 11.8%. The intrarater reliability ICC was 0.89 with a 95% CI of 0.76-0.95 and CV of 7.8%. Rater feedback identified task delineation and interpretation of therapist verbalizations as sources of interrater reliability-related scoring challenges. INTERPRETATION The MLSRI-20 is a reliable tool for measuring the extent to which a physiotherapist uses motor learning strategies during a video-recorded intervention. These results have clinical and research implications for documenting and analyzing the motor learning content of physiotherapy interventions for children with CP. WHAT THIS PAPER ADDS The Motor Learning Strategies Rating Instrument (MLSRI-20) is reliable for use by trained physiotherapist raters. Measuring motor learning strategies can identify active 'ingredients' in physiotherapy interventions for children with cerebral palsy. The MLSRI-20 promotes a common language in motor learning.
Collapse
Affiliation(s)
- JENNIFER L RYAN
- Bloorview Research Institute, Toronto, ON,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - DANIELLE E LEVAC
- Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, MA, USA
| | - F VIRGINIA WRIGHT
- Bloorview Research Institute, Toronto, ON,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
11
|
Alazem H, McCormick A, Nicholls SG, Vilé E, Adler R, Tibi G. Development of a robotic walker for individuals with cerebral palsy. Disabil Rehabil Assist Technol 2019; 15:643-651. [PMID: 31012754 DOI: 10.1080/17483107.2019.1604827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: This study describes the first use of a robotic walker in youth and young adults with cerebral palsy (CP) Gross Motor Function Classification (GMFCS) IV.Methods: Semi-structured interviews were conducted before and after each robotic walker trial. Interviews were recorded, then transcribed and subjected to thematic analysis.Results: Five participants (4 male, 13-22 years of age) with quadriplegia secondary to CP were recruited. Four individuals with mixed tone quadriplegia GMFCS IV were able to independently walk with the device. One individual with significant dyskinesia was unable to utilize the device. The assessment team included two physiotherapists, an occupational therapist, a physiatrist and three engineers. Major themes related to physical and social impacts were identified. Some physical advantages include the ability to walk hands-free and promotion of physical fitness. Examples of physical barriers include limited harness design and large device size. Social advantages include increased independence and peer engagement. Finally, a social disadvantage identified was limited use on uneven terrains.Discussion: Suggestions for modifications for identified challenges and disadvantages include decreasing the size of the robotic walker, more harness designs, decreasing the force required to take an initial step, adding a joy stick for user control and creating a more versatile base that can be used on different terrains such as ice or baseball fields.Conclusion: Robotics holds great hope for individuals with CP where mobility options are limited. Physical and social advantages are evident. Recommendations for future improvement and studies of use in exercise and participation are provided.IMPLICATIONS FOR REHABILITATIONAs youth and young adults with cerebral palsy age, options for mobilization can become limited with challenges in placing them in a walking device due to size and numerous other physical limitations.A robotic walker with a built-in mechanical lift is available for individuals with cerebral palsy.This study was able to gather important information and recommendations to tailor a new robotic walker prototype specifically for individuals with cerebral palsy.
Collapse
Affiliation(s)
- Hana Alazem
- Division of Development and Rehabilitation, Children's Hospital of Eastern Ontario, The Ottawa Hospital Rehabilitation Centre, University of Ottawa, Ottawa, Canada
| | - Anna McCormick
- Division of Development and Rehabilitation, Children's Hospital of Eastern Ontario, The Ottawa Hospital Rehabilitation Centre, University of Ottawa, Ottawa, Canada
| | | | - Elizabeth Vilé
- Division of Development and Rehabilitation at the Children's Hospitals of Eastern Ontario, Ottawa Children's Treatment Centre, Ottawa, Canada
| | - Roselle Adler
- Division of Development and Rehabilitation at the Children's Hospitals of Eastern Ontario, Ottawa Children's Treatment Centre, Ottawa, Canada
| | - Genevieve Tibi
- Division of Development and Rehabilitation at the Children's Hospitals of Eastern Ontario, Ottawa Children's Treatment Centre, Ottawa, Canada
| |
Collapse
|
12
|
Uematsu H, Sobue I. Effect of music (Brahms lullaby) and non-nutritive sucking on heel lance in preterm infants: A randomized controlled crossover trial. Paediatr Child Health 2019; 24:e33-e39. [PMID: 30792607 PMCID: PMC6376306 DOI: 10.1093/pch/pxy072] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES This study examined a more effective pain management method, without sucrose, on heel lance in preterm infants using the Premature Infant Pain Profile (PIPP). DESIGN In a nonblinded, randomized controlled, two-period, two-sequence crossover trial, 25 infants were randomly allocated to intervention (a Brahms lullaby with non-nutritive sucking, facilitated tucking and holding) or standard care (facilitated tucking and holding). SETTING Local Perinatal Medical Centre's NICU in Japan, July 2014 until June 2015. OUTCOME MEASURES The primary outcome variable was PIPP, and secondary outcomes were heart rate (HR), oxygen saturation, and abnormal HR (> baseline mean plus 2 SDs, or <120 minus 2 SDs). RESULTS The infants were 33.8 weeks gestational age at birth, 1,983.7 g birth weight, and 32 to 35 weeks postconceptual age. At all 10 measurement points, constructed of every 30 seconds postheel lance, mean PIPP of infants during the intervention (3.6 to 2.4) was significantly lower than during the standard care (8.0 to 4.6) (range, P=0.0039 to P<0.0001). All PIPP reduction rates from the 30 seconds point were similar between the two groups. The HR of preterm infants at the 120 seconds points were significantly lower (P=0.0151), and the HRs of 6 points were considerably lower during the intervention than during the standard care (range, P≤0.0879 to P≥0.049). The abnormal HR total number was significantly lower during the intervention (2) than the standard care (23) (frequency ratio=0.087, P<0.0001). CONCLUSION This method demonstrated stronger analgesia, early pain relief, and maintenance of homeostasis on heel lance in preterm infants.
Collapse
Affiliation(s)
- Hiroko Uematsu
- School of Nursing, Child Health Nursing, University of Human Environments, Obu, Aichi, Japan,Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan,Correspondence: Hiroko Uematsu, School of Nursing, University of Human Environments, Ebata-cho 3–220, Obu City, Aichi prefecture, 474-0035, Japan. Telephone +81-562-43-0701, fax +81-562-43-0702, e-mail ;
| | - Ikuko Sobue
- Department of Pediatric Nursing, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
13
|
Robotically-driven orthoses exert proximal-to-distal differential recovery on the lower limbs in children with hemiplegia, early after acquired brain injury. Eur J Paediatr Neurol 2018; 22:652-661. [PMID: 29650492 DOI: 10.1016/j.ejpn.2018.03.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 03/15/2018] [Accepted: 03/18/2018] [Indexed: 11/24/2022]
Abstract
Robotically-driven orthoses (RDO) are promising for treating gait impairment in children with hemiplegia after acquired brain injury (ABI). Despite this, existing literature on the employment of RDO in ABI is scanty, and cohorts' age spans throughout the adult age, with no specific focus on the developmental age. We aim to compare a treatment solely based on conventional physiotherapy (CP) with a program combining RDO training with CP, and to examine the effect of time following ABI on recovery. A prospective two-cohorts study was conducted in a rehabilitation hospital. Post-acute and chronic children with hemiplegia due to ABI underwent either: (i) 20 sessions of RDO plus 20 sessions of CP (n = 29), or (ii) 40 of CP (n = 12). Gross Motor Function Measures (GMFM), Functional Assessment Questionnaire (FAQ), 6 Minutes Walk Test and gait analysis (GA) parameters were recorded before and after training. Over all the patients in RDO + CP group, all GMFM domains and FAQ improved after RDO training (p < 0.05). The unaffected limb showed significantly decreased stance, increased step length and reduced anteroposterior center of pressure oscillation; the affected side increased the stride length. ROM hip and knee flex-extension increased bilaterally (p < 0.05 for all). RDO training during the acute/subacute post-injury phase increased motor functional abilities, cadence and velocity of gait (p < 0.05). We conclude that RDO imposes a proximal-to-distal differential effect on the lower limbs, with the hip joint being the most stimulated. RDO training fostered recovery, increasing the quality of gait on the unaffected side. Planning RDO early in the rehabilitation course of pediatric ABI is advantageous. RDO + CP may extend rehabilitation efficacy to the proximal segment of leg and to gait velocity.
Collapse
|
14
|
Valentín‐Gudiol M, Mattern‐Baxter K, Girabent‐Farrés M, Bagur‐Calafat C, Hadders‐Algra M, Angulo‐Barroso RM. Treadmill interventions in children under six years of age at risk of neuromotor delay. Cochrane Database Syst Rev 2017; 7:CD009242. [PMID: 28755534 PMCID: PMC6483121 DOI: 10.1002/14651858.cd009242.pub3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Delayed motor development may occur in children with Down syndrome, cerebral palsy, general developmental delay or children born preterm. It limits the child's exploration of the environment and can hinder cognitive and social-emotional development. Literature suggests that task-specific training, such as locomotor treadmill training, facilitates motor development. OBJECTIVES To assess the effectiveness of treadmill interventions on locomotor development in children with delayed ambulation or in pre-ambulatory children (or both), who are under six years of age and who are at risk for neuromotor delay. SEARCH METHODS In May 2017, we searched CENTRAL, MEDLINE, Embase, six other databases and a number of trials registers. We also searched the reference lists of relevant studies and systematic reviews. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs that evaluated the effect of treadmill intervention in the target population. DATA COLLECTION AND ANALYSIS Four authors independently extracted the data. Outcome parameters were structured according to the International Classification of Functioning, Disability and Health model. MAIN RESULTS This is an update of a Cochrane review from 2011, which included five trials. This update includes seven studies on treadmill intervention in 175 children: 104 were allocated to treadmill groups, and 71 were controls. The studies varied in population (children with Down syndrome, cerebral palsy, developmental delay or at moderate risk for neuromotor delay); comparison type (treadmill versus no treadmill; treadmill with versus without orthoses; high- versus low-intensity training); study duration, and assessed outcomes. Due to the diversity of the studies, only data from five studies were used in meta-analyses for five outcomes: age of independent walking onset, overall gross motor function, gross motor function related to standing and walking, and gait velocity. GRADE assessments of quality of the evidence ranged from high to very low.The effects of treadmill intervention on independent walking onset compared to no treadmill intervention was population dependent, but showed no overall effect (mean difference (MD) -2.08, 95% confidence intervals (CI) -5.38 to 1.22, 2 studies, 58 children; moderate-quality evidence): 30 children with Down syndrome benefited from treadmill training (MD -4.00, 95% CI -6.96 to -1.04), but 28 children at moderate risk of developmental delay did not (MD -0.60, 95% CI -2.34 to 1.14). We found no evidence regarding walking onset in two studies that compared treadmill intervention with and without orthotics in 17 children (MD 0.10, 95% CI -5.96 to 6.16), and high- versus low-intensity treadmill interventions in 30 children with Down syndrome (MD -2.13, 95% -4.96 to 0.70).Treadmill intervention did not improve overall gross motor function (MD 0.88, 95% CI -4.54 to 6.30, 2 studies, 36 children; moderate-quality evidence) or gross motor skills related to standing (MD 5.41, 95% CI -1.64 to 12.43, 2 studies, 32 children; low-quality evidence), and had a negligible improvement in gross motor skills related to walking (MD 4.51, 95% CI 0.29 to 8.73, 2 studies, 32 children; low-quality evidence). It led to improved walking skills in 20 ambulatory children with developmental delay (MD 7.60, 95% CI 0.88 to 14.32, 1 study) and favourable gross motor skills in 12 children with cerebral palsy (MD 8.00, 95% CI 3.18 to 12.82). A study which compared treadmill intervention with and without orthotics in 17 children with Down syndrome suggested that adding orthotics might hinder overall gross motor progress (MD -8.40, 95% CI -14.55 to -2.25).Overall, treadmill intervention showed a very small increase in walking speed compared to no treadmill intervention (MD 0.23, 95% CI 0.08 to 0.37, 2 studies, 32 children; high-quality evidence). Treadmill intervention increased walking speed in 20 ambulatory children with developmental delay (MD 0.25, 95% CI 0.08 to 0.42), but not in 12 children with cerebral palsy (MD 0.18, 95% CI -0.09 to 0.45). AUTHORS' CONCLUSIONS This update of the review from 2011 provides additional evidence of the efficacy of treadmill intervention for certain groups of children up to six years of age, but power to find significant results still remains limited. The current findings indicate that treadmill intervention may accelerate the development of independent walking in children with Down syndrome and may accelerate motor skill attainment in children with cerebral palsy and general developmental delay. Future research should first confirm these findings with larger and better designed studies, especially for infants with cerebral palsy and developmental delay. Once efficacy is established, research should examine the optimal dosage of treadmill intervention in these populations.
Collapse
Affiliation(s)
- Marta Valentín‐Gudiol
- Universitat Internacional de CatalunyaDepartment of Physical TherapyBarcelonaSpain
- Ramon Llull UniversityBlanquerna School of Health SciencesBarcelonaSpain
| | - Katrin Mattern‐Baxter
- California State UniversityDepartment of Physical Therapy6000 J StSacramentoCaliforniaUSA95819
| | - Montserrat Girabent‐Farrés
- Universitat Internacional de CatalunyaDepartment of Physical Therapy, Biostatistics UnitC/ Josep trueta, s/nSant Cugat del VallèsBarcelonaSpain08195
| | | | - Mijna Hadders‐Algra
- University of Groningen, University Medical Center Groningen, Department of PaediatricsHanzeplein 1GroningenNetherlands9713 GZ
| | - Rosa Maria Angulo‐Barroso
- University of BarcelonaDepartment of Health and Applied Sciences, National Institute of Physical EducationAve. de L'Estadi 12‐22BarcelonaBarcelonaSpain08036
- California State UniversityDepartment of KinesiologyNorthridgeCaliforniaUSA
| | | |
Collapse
|