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Rose DJ, Castner DM, Wilson KS, Rubin DA. Examination of sensory reception and integration abilities in children with and without Prader-Willi syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 149:104730. [PMID: 38615631 DOI: 10.1016/j.ridd.2024.104730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/08/2024] [Accepted: 04/05/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Good postural stability control is dependent upon the complex integration of incoming sensory information (visual, somatosensory, vestibular) with neuromotor responses that are constructed in advance of a voluntary action or in response to an unexpected perturbation. AIMS To examine whether differences exist in how sensory inputs are used to control standing balance in children with and without Prader-Willi syndrome (PWS). METHODS AND PROCEDURES In this cross-sectional study, 18 children with PWS and 51 children categorized as obese but without PWS (without PWS) ages 8-11 completed the Sensory Organization Test®. This test measures the relative contributions of vision, somatosensory, and vestibular inputs to the control of standing balance. The composite equilibrium score (CES) derived from performance in all sensory conditions, in addition to equilibrium scores (EQs) and falls per condition were compared between groups. OUTCOMES AND RESULTS The CES was lower for children with PWS compared to children without PWS (M=53.93, SD=14.56 vs. M=66.17, SD=9.89, p = .001) while EQs declined in both groups between conditions 1 and 4 (F (1.305, 66.577) = 71.381, p < .001). No group differences in the percent of falls were evident in condition 5 but more children with PWS fell in condition 6 (χ2 (1) = 7.468, p = .006). Group differences in frequency of repeated falls also approached significance in conditions 5 (χ2 (3) = 4.630, p = .099) and 6 (χ2 (3) = 5.167, p = .076). CONCLUSIONS AND IMPLICATIONS Children with PWS demonstrated a lower overall level of postural control and increased sway when compared to children with obesity. Both the higher incidence and repeated nature of falls in children with PWS in conditions 5 and 6 suggest an inability to adapt to sensory conditions in which vestibular input must be prioritized. Postural control training programs in this population should include activities that improve their ability to appropriately weight sensory information in changing sensory environments, with a particular focus on the vestibular system. WHAT DOES THIS STUDY ADD?: This study shows that children with PWS demonstrate a lower level of postural stability. The results suggest that children with PWS show inability to adapt to sensory conditions that require prioritizing vestibular information to maintain postural control. This information can be used to help guide training programs in this population.
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Affiliation(s)
- Debra J Rose
- Movement Enhancement Laboratory, Department of Kinesiology, California State University, Fullerton, CA, USA
| | - Diobel M Castner
- Movement Enhancement Laboratory, Department of Kinesiology, California State University, Fullerton, CA, USA; Nike Sport Research Laboratory, Beaverton, OR, USA
| | - Kathleen S Wilson
- Movement Enhancement Laboratory, Department of Kinesiology, California State University, Fullerton, CA, USA
| | - Daniela A Rubin
- Movement Enhancement Laboratory, Department of Kinesiology, California State University, Fullerton, CA, USA.
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Honea KE, Wilson KS, Fisher KL, Rubin DA. Parental and familial factors related to participation in a home-based physical activity intervention in children with obesity or Prader-Willi syndrome. OBESITY PILLARS (ONLINE) 2023; 8:100084. [PMID: 38125663 PMCID: PMC10728700 DOI: 10.1016/j.obpill.2023.100084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 12/23/2023]
Abstract
Background Increasing physical activity (PA) participation is vital to promote the development of health behaviors in childhood. This study examined which parental and familial factors predicted completion of and compliance with a home-based family PA program in a cohort of families with a child with Prader-Willi syndrome (PWS; a rare disorder with obesity and developmental disability) or with obesity but with neurotypical development. Methods Participants (n = 105) were parents of children with PWS (n = 41) and parents of children with obesity but without PWS (n = 64). Parents completed a series of questionnaires documenting their demographic characteristics, self-efficacy, social support, and family environment (active-recreational orientation and cohesion). Relationships between these factors and intervention completion and compliance were evaluated using bivariate correlations and logistic regression (compliance) and multiple regression (completion) analyses with groups together and then separately if the child group was a significant predictor. Results None of the variables of interest (marital status, employment, employed hours per week, self-efficacy, social support, and family environment) were significant predictors of intervention completion. Intervention compliance was negatively associated with parents working part-time and working full-time and positively associated with family cohesion (Model R2 = 0.107, F(3,100) = 4.011, p = .010). Child group was not a factor. Conclusions Compliance with a 24-week family home-based PA intervention was related to fewer employment hours of the primary caregiver and family environment factors. Future interventions should consider how to reduce the intervention's burden in working parents along with strategies to foster family cohesion.
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Affiliation(s)
- Kryston E. Honea
- Department of Kinesiology, California State University Fullerton, 800 N. State College Blvd., Fullerton, CA, 92834-3599, USA
| | - Kathleen S. Wilson
- Department of Kinesiology, California State University Fullerton, 800 N. State College Blvd., Fullerton, CA, 92834-3599, USA
| | - Koren L. Fisher
- Department of Kinesiology, California State University Fullerton, 800 N. State College Blvd., Fullerton, CA, 92834-3599, USA
| | - Daniela A. Rubin
- Department of Kinesiology, California State University Fullerton, 800 N. State College Blvd., Fullerton, CA, 92834-3599, USA
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Rubin DA, Rose DJ, Escano DL, Holmes SC, Garcia SA, Pamukoff DN. Contributing factors to postural stability in Prader-Willi syndrome. Hum Mov Sci 2023; 91:103125. [PMID: 37515958 DOI: 10.1016/j.humov.2023.103125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 11/09/2022] [Accepted: 07/18/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Prader-Willi Syndrome (PWS) is a rare neurodevelopmental disorder affecting multiple functional parameters. This study examined postural stability and associated gait and neuromuscular factors in young adults with PWS. METHODS Participants included 10 adults with PWS [7 M/3F; Body Fat % 40.61 ± 7.79]; ten normal weight (NW) adults [7 M/3F; Body Fat % 23.42 ± 7.0]; ten obese (OB) adults [7 M/3F; Body Fat % 42.40 ± 5.62]. Participants completed the Sensory Organization Test (SOT)®. Condition (C) specific and a composite equilibrium score (CES) were calculated (maximum = 100). Quadriceps strength was assessed using an isokinetic dynamometer. Three-dimensional gait analyses were completed along a 10 m walkway using a motion capture system and two force plates. A gait stability ratio (GSR) was computed from gait speed and step length (steps/m). RESULTS The PWS group had lower scores for C1, C3, C4 and CES compared to the NW (p < .039 for all) and lower scores for C4 and CES than the OB (p < .019 for both) groups, respectively. In C5 (eyes closed, sway-referenced support) and C6 (sway-referenced vision and support), 33.3% of participants with PWS fell during the first trial in both conditions (X2 [2] 7.436, p = .024) and (X2 [2] 7.436, p = .024) but no participant in the other groups fell. Those with PWS showed higher GSR than participants with NW (p = .005) and those with obesity (p = .045). CONCLUSION Individuals with PWS had more difficulty maintaining standing balance when relying on information from the somatosensory (C3), visual-vestibular (C4) and vestibular systems (C5, C6). A more stable walk was related to shorter steps, slower velocity and reduced peak quadriceps torque. Participation in multisensory activities that require appropriate prioritization of sensory system(s) input for controlling balance in altered sensory environments should be routinely included. In addition, exercises targeting muscular force and power should be included as part of exercise programming in PWS.
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Affiliation(s)
- Daniela A Rubin
- Department of Kinesiology, California State University, Fullerton, Fullerton, CA, United States of America.
| | - Debra J Rose
- Department of Kinesiology, California State University, Fullerton, Fullerton, CA, United States of America
| | - Derrick L Escano
- Department of Kinesiology, California State University, Fullerton, Fullerton, CA, United States of America
| | - Skylar C Holmes
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, United States of America
| | - Steven A Garcia
- Department of Kinesiology, University of Michigan, Ann Arbor, MI, United States of America
| | - Derek N Pamukoff
- School of Kinesiology, University of Western Ontario, London, ON, Canada
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Seims AL, Hall J, Bingham DD, Creaser A, Christoforou A, Barber S, Daly-Smith A. Interventions targeting children and young people's physical activity behavior at home: A systematic review. PLoS One 2023; 18:e0289831. [PMID: 37556477 PMCID: PMC10411747 DOI: 10.1371/journal.pone.0289831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/26/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND AND PURPOSE Increased time at home during the COVID-19 pandemic significantly decreased children's physical activity. This systematic review aimed to evaluate the effectiveness of children's home-based physical activity interventions, and identify 'active ingredients' underpinning these. METHODS Databases searched-AMED, PsychINFO, CINAHL, Cochrane, EMBASE, PubMed/Medline, Scopus, SPORTDiscus and Web of Science, from inception until June 2022. Eligibility criteria-children aged 2-16 years, targeting home-based physical activity, a control group, and physical activity measured pre- and post- intervention. Studies were excluded if it was not possible to identify change in physical activity at home. The review was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Study quality was evaluated using the quality assessment tool for quantitative studies. Study design, intervention characteristics, outcome data, behavior change theory, Behavior Change Techniques (BCTs) and process evaluation data were extracted and discussed using narrative syntheses. RESULTS 13 studies (including 1,182 participants) from 25,967 were included. Interventions primarily involved active video games, with the addition of coaching or telehealth support (n = 5). Three of the 13 studies significantly increased children's physical activity (1 = Moderate to vigorous physical activity, 2 = total volume, P<0.05). The largest effect size (d = 3.45) was for moderate to vigorous physical activity. 29% of BCTs were identified across included interventions; the most common being adding objects to the environment. The most effective intervention scored strong for design quality, incorporated telehealth coaching, and included the most commonly coded BCTs. Variation among studies and insufficient reporting of data made a meta-analysis unfeasible. CONCLUSION COVID-19 emphasized the importance of the home for physical activity. Whilst effectiveness of interventions was limited, building social support and self-efficacy are mechanisms that should be explored further. The review provides recommendations to improve the design and evaluation of future interventions. TRIAL REGISTRATION Prospero registration number: CRD42020193110.
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Affiliation(s)
- Amanda L. Seims
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Faculty of Health Studies, University of Bradford, Bradford, West Yorkshire, United Kingdom
| | - Jennifer Hall
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Faculty of Health Studies, University of Bradford, Bradford, West Yorkshire, United Kingdom
| | - Daniel D. Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Faculty of Health Studies, University of Bradford, Bradford, West Yorkshire, United Kingdom
- Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Amy Creaser
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | | | - Sally Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Andy Daly-Smith
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
- Faculty of Health Studies, University of Bradford, Bradford, West Yorkshire, United Kingdom
- Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
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Poleur M, Markati T, Servais L. The use of digital outcome measures in clinical trials in rare neurological diseases: a systematic literature review. Orphanet J Rare Dis 2023; 18:224. [PMID: 37533072 PMCID: PMC10398976 DOI: 10.1186/s13023-023-02813-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/07/2023] [Indexed: 08/04/2023] Open
Abstract
Developing drugs for rare diseases is challenging, and the precision and objectivity of outcome measures is critical to this process. In recent years, a number of technologies have increasingly been used for remote monitoring of patient health. We report a systematic literature review that aims to summarize the current state of progress with regard to the use of digital outcome measures for real-life motor function assessment of patients with rare neurological diseases. Our search of published literature identified 3826 records, of which 139 were included across 27 different diseases. This review shows that use of digital outcome measures for motor function outside a clinical setting is feasible and employed in a broad range of diseases, although we found few outcome measures that have been robustly validated and adopted as endpoints in clinical trials. Future research should focus on validation of devices, variables, and algorithms to allow for regulatory qualification and widespread adoption.
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Affiliation(s)
- Margaux Poleur
- Department of Neurology, Liege University Hospital Center, Liège, Belgium.
- Neuromuscular Reference Center, Division of Paediatrics University, Hospital University of Liège, Liège, Belgium.
- Centre de Référence des Maladies Neuromusculaires, Centre Hospitalier Régional de la Citadelle, Boulevard du 12eme de Ligne 1, 4000, Liège, Belgium.
| | - Theodora Markati
- MDUK Oxford Neuromuscular Centre and NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Laurent Servais
- MDUK Oxford Neuromuscular Centre and NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
- Neuromuscular Reference Center, Division of Paediatrics University, Hospital University of Liège, Liège, Belgium
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Freire K, Pope R, Size I, Andrews K, Fitz-Gerald E, Bowman T. Social exercise interventions for children who have complex developmental needs: A systematic review. J Child Health Care 2023:13674935231190984. [PMID: 37471588 DOI: 10.1177/13674935231190984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Exercise interventions are identified as effective treatments for children not meeting developmental milestones. This systematic review synthesizes research regarding exercise interventions that involved social participatory elements, for children with complex developmental needs. Academic Search Complete, CINAHL, Emcare, Proquest Theses and Dissertations, MEDLINE, and Google Scholar were searched systematically for relevant studies. Peer-reviewed studies meeting the review aim and published between 2000 and 2021 in English, were included. Methodological quality of 49 eligible studies (47 controlled trials, two mixed methods, total of 2355 participants) was appraised using the Mixed Methods Appraisal Tool. Narrative synthesis identified two groups of studies: Group 1 incorporated intentional social participatory elements; Group 2 likely involved incidental social participation. Most studies were of moderate to low methodological quality. Few measured impacts of interventions upon total physical activity levels. Short-term improvements in physical outcomes - particularly motor skills - were most frequently reported and were the main benefit of social exercise interventions for children with complex developmental needs, for which evidence exists. Further rigorous, longitudinal research is needed to assess social, psychological, and executive function outcomes of social exercise interventions in this population. Such interventions should incorporate booster sessions to provide children with greater opportunity to meet developmental milestones.
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Affiliation(s)
- Kate Freire
- Three Rivers Department of Rural Health, Charles Sturt University, Albury, NSW, Australia
| | - Rod Pope
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, NSW, Australia
| | - Isabella Size
- Child and Family Services, Royal Far West, Manly, NSW, Australia
| | - Kristen Andrews
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, NSW, Australia
| | - Emma Fitz-Gerald
- Child and Family Services, Royal Far West, Manly, NSW, Australia
| | - Tricia Bowman
- Division of Library Services, Charles Sturt University, Albury, NSW, Australia
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Burns RD, Podlog LW, Bai Y. Enjoyment Mediates Associations of the Physical and Family Environment With Adolescent Physical Activity: A Structural Equation Modeling Approach. J Adolesc Health 2022; 71:628-634. [PMID: 35927149 DOI: 10.1016/j.jadohealth.2022.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 05/11/2022] [Accepted: 06/03/2022] [Indexed: 10/31/2022]
Abstract
PURPOSE The purpose of this study was to examine the direct effects and mediating effect of physical activity (PA) enjoyment on the associations of the physical environment and family environment with adolescent PA behavior. METHODS Participants were US high school students who participated in the National Youth Physical Activity and Nutrition Study (N = 11,429; 49.4% female). The dependent variable was a latent variable from 3 survey items indicating adolescent PA behavior. One set of independent variables were items of the physical environment and a second set of independent variables were items of the family environment. A latent PA enjoyment mediating variable was constructed within a weighted structural equation model to examine the standardized direct and indirect effects (IEs) of the physical and family environment variables with adolescent PA controlling for demographic covariates. RESULTS Significant PA enjoyment mediating effects on adolescent PA were observed for the physical environment variables (IE range = 0.015-0.040) and adult transportation (IE = 0.013, 95% confidence interval [CI]: 0.006-0.020). The strongest direct effects were the associations between the family environment variables of adult PA encouragement (β = 0.11, 95% CI: 0.08-0.14), transportation (β = 0.14, 95% CI: 0.10-0.17), and watching (β = 0.12, 95% CI: 0.09-0.15) with adolescent PA. DISCUSSION Stronger PA enjoyment mediating effects on adolescent PA were observed for variables of the physical environment compared to the family environment but the strongest direct effects on adolescent PA were observed for family environment variables. Interventions that provide equipment, improve neighborhood safety, and educate parents on how to support PA may both indirectly and directly improve adolescent PA.
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Affiliation(s)
- Ryan D Burns
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah.
| | - Leslie W Podlog
- École de kinésiologie et des sciences de l'activité physique (EKSAP), Faculté de médecine, Université de Montréal, Montreal, Quebec, Canada
| | - Yang Bai
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah
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Amaro AS, Rubin DA, Teixeira MCTV, Ferreira AJ, Rodrigues GM, Carreiro LRR. Health Problems in Individuals With PWS Are Associated With Lower Quality of Life for Their Parents: A Snapshot in the Brazilian Population. Front Pediatr 2022; 10:746311. [PMID: 35242723 PMCID: PMC8885721 DOI: 10.3389/fped.2022.746311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 01/03/2022] [Indexed: 11/13/2022] Open
Abstract
Prader-Willi syndrome (PWS) is a complex genetic disorder requiring interdisciplinary team monitoring and intensive care by parents. So far there is little information on people with PWS in Brazil. Our aim was to describe health problems and treatments used by people with PWS in Brazil and their relationship to their parents' quality of life. Parents answered questionnaires about their child's medical and exercise history, behavior problems, sociodemographic characteristics, and their own quality of life. Results: The responses of the participants showed similar health problems as in other countries. Anxiety and tantrums were the behavioral problems most commonly cited by parents. Parents of people with PWS had lower scores in respect of quality of life than the Brazilian population. Behavioral problems in individuals with PWS were negatively associated with their parents' quality of life. Behavioral and medical conditions in the children were associated with reduced quality of life in the parents. We conclude that heath care should not only be directed toward those with PWS, but also their parents.
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Affiliation(s)
- Alexandre Slowetzky Amaro
- Development Disorders Graduate Program, Center for Health and Biological Science, Universidade Presbiteriana Mackenzie, São Paulo, Brazil
| | - Daniela Andrea Rubin
- Department of Kinesiology, California State University, Fullerton, CA, United States
| | | | - Arcenio José Ferreira
- Development Disorders Graduate Program, Center for Health and Biological Science, Universidade Presbiteriana Mackenzie, São Paulo, Brazil
| | - Graciele Massoli Rodrigues
- Physical Education Program, Universidade São Judas Tadeu, São Paulo, Brazil.,Physical Education Program, Escola Superior de Educação Física de Jundiaí, Jundiaí, Brazil
| | - Luiz Renato Rodrigues Carreiro
- Development Disorders Graduate Program, Center for Health and Biological Science, Universidade Presbiteriana Mackenzie, São Paulo, Brazil
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Improved Motor Proficiency and Quality of Life in Youth With Prader-Willi Syndrome and Obesity 6 Months After Completing a Parent-Led, Game-Based Intervention. Pediatr Exerc Sci 2021; 33:177-185. [PMID: 34375948 DOI: 10.1123/pes.2020-0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 03/05/2021] [Accepted: 04/14/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE To determine changes and potential differences in physical activity (PA), gross motor proficiency (MP), and health parameters after a 6-month follow-up (FU) period following participation in a parent-led PA intervention in youth with or without Prader-Willi syndrome (PWS). METHODS About 42 youth with PWS and 65 youth without PWS but with obesity (body fat percentage >95th percentile for age and sex), aged 8-16 years, participated. The intervention included preplanned PA sessions containing playground and console-based video games scheduled 4 days per week for 24 weeks. Families received training and curriculum materials. PA (accelerometry), MP (Bruininks-Oseretsky Test of MP), and health-related quality of life were obtained before (PRE), after completing the intervention (POST), and at FU. RESULTS There were no significant changes in PA at any time point. At FU and POST, participants showed higher bilateral coordination (PRE = 9.3 [0.4], POST = 11.7 [0.5], and FU = 11.1 [0.6]); speed and agility (PRE = 9.2 [0.4], POST = 10.8 [0.4], and FU = 11.5 [0.5]); and strength (PRE = 8.0 [0.3], POST = 9.2 [0.3], and FU = 9.2 [0.3]) than at PRE. At FU (80.3 [2.1]) and POST (79.8 [1.7]), youth without PWS showed higher health-related quality of life than PRE (75.0 [1.8]). CONCLUSION The improvements in MP and health-related quality of life at FU suggest long-term durability of intervention outcomes.
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Physical Activity in Patients with Prader-Willi Syndrome-A Systematic Review of Observational and Interventional Studies. J Clin Med 2021; 10:jcm10112528. [PMID: 34200339 PMCID: PMC8201387 DOI: 10.3390/jcm10112528] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/31/2021] [Accepted: 06/04/2021] [Indexed: 12/15/2022] Open
Abstract
Physical activity (PA) is an important aspect of the management of patients with Prader-Willi syndrome (PWS). However, the day-to-day implementation of PA programs is particularly challenging in these patients. This systematic review aimed (1) to describe habitual PA and sedentary behavior and (2) to assess the effects of PA interventions and to describe their implementation process, in children and adults with PWS. A systematic search of controlled trials, single-group interventions, observational, and qualitative studies published up to December 2020 was performed. Twenty-five studies were included. Habitual PA was found to be lower in patients with PWS compared to controls without obesity or with non-syndromic obesity. Habitual PA was positively associated with lean body mass and bone parameters in children with PWS, and these finding were strengthened by intervention studies reporting an increase in both outcomes after a PA program. PA programs also improved physical function (muscle strength, walking distance, and coordination), without significant effect on weight and fat mass. Attendance to exercise sessions was usually high and no serious adverse effect was reported. In conclusion, supervised PA programs are beneficial for children and adults with PWS. Support should be provided to families to facilitate their implementation in real-life settings.
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Medeiros RCDSCD, Santos IKD, Medeiros JAD, Cobucci RN, Silva TALD, Araujo JDS, Varela PWDA, Cabral BGDAT, Dantas PMS. Home Physical Activity Programs for Children and Adolescents as a Healthy Strategy During Social Isolation Caused by COVID-19: viewpoint. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20200183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Pamukoff DN, Holmes SC, Shumski EJ, Garcia SA, Rubin DA. Plantar Flexor Function in Adults with and without Prader-Willi Syndrome. Med Sci Sports Exerc 2021; 52:2189-2197. [PMID: 32936593 DOI: 10.1249/mss.0000000000002361] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE Prader-Willi Syndrome (PWS) is a form of congenital obesity characterized by excessive body fat, hypotonia, muscle weakness, and physical/cognitive disability. However, the sources of muscle dysfunction and their contribution to mobility are unclear. The purposes of this study were to 1) compare plantar flexor function between adults with and without PWS; and 2) to examine the relationship between plantar flexor function and gait speed in adults with PWS. METHODS Participants included 10 adults with PWS, 10 adults without PWS and with obesity, and 10 adults without PWS and without obesity (matched on age and sex). Plantar flexor function was assessed using isokinetic dynamometry (peak torque [PT], early/late rate of torque development [RTD]), Hoffman reflex (H/M ratio), ultrasound imaging (cross-sectional area [CSA], echo intensity, pennation angle, and fascicle length), and peak propulsive force and plantar flexor moment during gait. Outcomes were compared between groups using one-way MANOVA. Associations between plantar flexor outcomes and gait speed were assessed using Pearson correlation in the PWS group. RESULTS Adults with PWS had lower absolute and normalized early RTD, and lower H/M ratio than controls with and without obesity; lower absolute PT and late RTD than controls with obesity (all P < 0.05). Cross-sectional area, propulsive force, and plantarflexor moment were lower, and echo intensity was higher, in adults with PWS compared with controls without obesity (all P < 0.05). Greater absolute PT (r = 0.64), absolute early RTD (r = 0.62), absolute late RTD (r = 0.64), gastrocnemii CSA (r = 0.55), and propulsive force (r = 0.58) were associated with faster gait speed (all P < 0.05). CONCLUSIONS Adults with PWS have impaired plantar flexor function likely attributable to reduced neuromuscular function and altered muscle morphology, which are associated with slower gait speeds.
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Affiliation(s)
- Derek N Pamukoff
- Department of Kinesiology, California State University, Fullerton, CA
| | - Skylar C Holmes
- Department of Kinesiology, University of Massachusetts, Amherst, MA
| | - Eric J Shumski
- Department of Kinesiology, California State University, Fullerton, CA
| | - Steven A Garcia
- School of Kinesiology, University of Michigan, Ann Arbor, MI
| | - Daniela A Rubin
- Department of Kinesiology, California State University, Fullerton, CA
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Rubin DA, Wilson KS, Orsso CE, Gertz ER, Haqq AM, Castner DM, Dumont-Driscoll M. A 24-Week Physical Activity Intervention Increases Bone Mineral Content without Changes in Bone Markers in Youth with PWS. Genes (Basel) 2020; 11:genes11090984. [PMID: 32847020 PMCID: PMC7564578 DOI: 10.3390/genes11090984] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/17/2020] [Accepted: 08/19/2020] [Indexed: 11/16/2022] Open
Abstract
Bone mineral density (BMD) is of concern in Prader-Willi syndrome (PWS). This study compared responses to a physical activity intervention in bone parameters and remodeling markers in youth with PWS (n = 45) and youth with non-syndromic obesity (NSO; n = 66). Measurements occurred at baseline (PRE) and after 24 weeks (POST) of a home-based active games intervention with strengthening and jumping exercises (intervention group = I) or after a no-intervention period (control group = C). Dual x-ray absorptiometry scans of the hip and lumbar spine (L1-L4) determined BMD and bone mineral content (BMC). Bone markers included fasting bone-specific alkaline phosphatase (BAP) and C-terminal telopeptide of type I collagen (CTx). Both I and C groups increased their hip BMD and BMC (p < 0.001). Youth with PWS-I increased their spine BMC from PRE to POST (p < 0.001) but not youth with PWS-C (p = 1.000). Youth with NSO (I and C) increased their spine BMC between PRE and POST (all p < 0.001). Youth with PWS showed lower BAP (108.28 ± 9.19 vs. 139.07 ± 6.41 U/L; p = 0.006) and similar CTx (2.07 ± 0.11 vs.1.84 ± 0.14 ng/dL; p = 0.193) than those with NSO regardless of time. Likely, the novelty of the intervention exercises for those with PWS contributed to gains in spine BMC beyond growth. Bone remodeling markers were unaltered by the intervention.
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Affiliation(s)
- Daniela A. Rubin
- Department of Kinesiology, California State University Fullerton, 800 N. State College Blvd., Fullerton, CA 92831, USA; (K.S.W.); (D.M.C.)
- Correspondence: ; Tel.: +1-657-278-4704
| | - Kathleen S. Wilson
- Department of Kinesiology, California State University Fullerton, 800 N. State College Blvd., Fullerton, CA 92831, USA; (K.S.W.); (D.M.C.)
| | - Camila E. Orsso
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, 8602 112 Street, Edmonton, AB T6G 2E1, Canada; (C.E.O.); (A.M.H.)
| | - Erik R. Gertz
- Obesity and Metabolism Unit, Western Human Nutrition Research Center, U.S. Department of Agriculture, 430 W Health Sciences Drive, Davis, CA 95616, USA;
| | - Andrea M. Haqq
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, 8602 112 Street, Edmonton, AB T6G 2E1, Canada; (C.E.O.); (A.M.H.)
- Division of Pediatric Endocrinology, University of Alberta, 8440-112 Street, Edmonton, AB T6G 2B7, Canada
| | - Diobel M. Castner
- Department of Kinesiology, California State University Fullerton, 800 N. State College Blvd., Fullerton, CA 92831, USA; (K.S.W.); (D.M.C.)
| | - Marilyn Dumont-Driscoll
- Academic General Pediatrics, University of Florida, Gainesville, 1699 SW 16th Avenue, Gainesville, FL 32608, USA;
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Ragusa L, Crinò A, Grugni G, Reale L, Fiorencis A, Licenziati MR, Faienza MF, Wasniewska M, Delvecchio M, Franzese A, Rutigliano I, Fusilli P, Corica D, Campana G, Greco D, Chiarito M, Sacco M, Toscano S, Marini MG. Caring and living with Prader-Willi syndrome in Italy: integrating children, adults and parents' experiences through a multicentre narrative medicine research. BMJ Open 2020; 10:e036502. [PMID: 32764084 PMCID: PMC7412587 DOI: 10.1136/bmjopen-2019-036502] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Prader-Willi syndrome (PWS) significantly impacts health-related quality of life; however, its relational and existential aspects remain unknown in Italian clinical and social debate. The project aimed to investigate the impact of PWS on illness experience through narrative medicine (NM) to understand the daily life, needs and resources of patients with PWS and their caregivers, and to furnish insights for clinical practice. DESIGN AND SETTING The project involved 10 medical centres of the Italian Network for Rare Diseases and PWS family associations and targeted underage and adult patients with PWS and their caregivers. Written interviews, composed by a sociodemographic survey and a narrative, were collected through the project's website. Three dedicated illness plots employed evocative and open words to facilitate individual expression and to encourage reflection. Narratives were analysed through NVivo software. Researchers discussed the results with the project's steering committee. PARTICIPANTS Twenty-one children and adolescents and 34 adults with PWS joined the project, as well as 138 caregivers. A PWS diagnosis or the caregiving of a patient with PWS older than 5 years represented the eligibility criteria, as well as the willingness to share their illness experience by writing and the ability to communicate in Italian. RESULTS The analysis of narratives led to understanding the PWS social and relational issues concerning diagnosis and current management, PWS daily experiences and social contexts, PWS implications in the working sphere and participants' future perspectives. Narratives demonstrated that PWS management affects relationships and work-life balance and that social stigma remains present. CONCLUSION The project represented the first effort to investigate the impact of PWS on illness experience in Italy through NM while considering the perspectives of patients with PWS and their caregivers. The findings indicated that a multiprofessional approach is fundamental to ensure adequate treatment and provided elements for its improvement.
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Affiliation(s)
- Letizia Ragusa
- Unit of Paediatrics and Medical Genetics, OASI Maria SS Research Institute, Troina, Enna, Italy
| | - Antonio Crinò
- Autoimmune Endocrine Diseases Unit, Bambino Gesù Paediatric Hospital-Palidoro Research Institute, Rome, Italy
| | - Graziano Grugni
- Department of Auxology, Istituto Auxologico Italiano, Verbania, Italy
| | - Luigi Reale
- Healthcare Area, Fondazione ISTUD, Baveno, Verbano-Cusio-Ossola, Italy
| | | | - Maria Rosaria Licenziati
- Obesity and Endocrine Disease Unit, Department of Neuroscience, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Maria Felicia Faienza
- Pediatrics Unit, Department of Biomedical Sciences and Human Oncology, Universita degli Studi di Bari Aldo Moro, Bari, Italy
| | - Malgorzata Wasniewska
- Department of Human Pathology of Adulthood and Childhood 'G Barresi', University of Messina, Messina, Italy
| | - Maurizio Delvecchio
- Metabolic Diseases, Clinical Genetics and Diabetology Unit, Giovanni XXIII Children's Hospital, Bari, Italy
| | - Adriana Franzese
- Department of Translational Medical Sciences, University of Naples Federico II, Napoli, Campania, Italy
| | - Irene Rutigliano
- Department of Pediatrics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Paola Fusilli
- UOC Neonatologia, Ospedale 'Spirito Santo', Pescara, Italy
| | - Domenico Corica
- Department of Human Pathology of Adulthood and Childhood 'G Barresi', University of Messina, Messina, Italy
| | - Giuseppina Campana
- Obesity and Endocrine Disease Unit, Department of Neuroscience, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Donatella Greco
- Unit of Paediatrics and Medical Genetics, OASI Maria SS Research Institute, Troina, Enna, Italy
| | - Mariangela Chiarito
- Department of Biomedical Sciences and Human Oncology, University of Bari 'A Moro', Bari, Italy
| | - Michele Sacco
- Department of Pediatrics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Silvia Toscano
- Department of Translational Sciences, University Federico II, Naples, Italy
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15
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Bellicha A, Coupaye M, Hocquaux L, Speter F, Oppert JM, Poitou C. Increasing physical activity in adult women with Prader-Willi syndrome: A transferability study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 33:258-267. [PMID: 31578803 DOI: 10.1111/jar.12669] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 08/05/2019] [Accepted: 08/28/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND The present authors aimed (a) to objectively quantify spontaneous physical activity (PA) in adult patients with Prader-Willi syndrome (PWS) and (b) to evaluate the transferability of a home-based exercise training programme in these patients. METHOD Physical activity was compared between 10 adult women with PWS (PWS group) and 20 adult women with non-syndromic obesity (CON group, for cross-sectional comparison). In the PWS group, PA, body composition, walking capacity, quality of life and eating behaviour were then compared before and after a 16-week supervised exercise programme. RESULTS The PWS group displayed lower PA and higher sedentary time compared to the CON group. Median attendance to exercise sessions reached 100% (Q1-Q3: 97%-100%) sessions. Moderate-to-vigorous PA and walking capacity increased after the programme without significant effect on body composition. CONCLUSION Supervised home-based exercise sessions are an effective strategy to improve PA in women with PWS who are less active than women matched for adiposity.
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Affiliation(s)
- Alice Bellicha
- Faculty of Medicine, Institute of Cardiometabolism and Nutrition, Sorbonne Université, Paris, France.,Laboratory Bioengineering, Tissues and Neuroplasticity - EA7377, University Paris-Est Créteil, Créteil, France
| | - Muriel Coupaye
- Faculty of Medicine, Institute of Cardiometabolism and Nutrition, Sorbonne Université, Paris, France.,Department of Nutrition, Faculty of Medicine, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Reference Center for Prader-Willi Syndrome, Sorbonne Université, Paris, France
| | | | | | - Jean-Michel Oppert
- Faculty of Medicine, Institute of Cardiometabolism and Nutrition, Sorbonne Université, Paris, France.,Department of Nutrition, Faculty of Medicine, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Reference Center for Prader-Willi Syndrome, Sorbonne Université, Paris, France
| | - Christine Poitou
- Faculty of Medicine, Institute of Cardiometabolism and Nutrition, Sorbonne Université, Paris, France.,Department of Nutrition, Faculty of Medicine, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Reference Center for Prader-Willi Syndrome, Sorbonne Université, Paris, France.,INSERM, UMRS NutriOmics Team, Paris, France
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16
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Morales JS, Valenzuela PL, Pareja-Galeano H, Rincón-Castanedo C, Rubin DA, Lucia A. Physical exercise and Prader-Willi syndrome: A systematic review. Clin Endocrinol (Oxf) 2019; 90:649-661. [PMID: 30788853 DOI: 10.1111/cen.13953] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 02/15/2019] [Accepted: 02/18/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The aim of this systematic review was to summarize evidence on the acute responses of individuals with Prader-Willi syndrome (PWS) to physical exercise, and on the effectiveness of long-term exercise interventions to improve the clinical manifestations of this syndrome. DESIGN/METHODS Relevant articles were identified in the electronic databases PubMed, Medline, CINAHL and SPORTDiscus (from inception to December 2018). Twenty-two studies including a total of 356 patients with PWS met all inclusion criteria and were included in the review. RESULTS Patients with PWS present with a decreased physical performance and impaired cardiorespiratory (maximal oxygen consumption, heart rate recovery after exercise) and hormonal (growth hormone release) responses to exercise. Most long-term exercise interventions have proven to decrease body mass while improving physical performance. Some benefits have also been reported in biochemical (glucose homeostasis, lipid profile) and biomechanical (gait pattern) variables, although there is controversy regarding the effects on body composition. No exercise-related adverse events have been reported in patients with PWS. CONCLUSION Physical exercise seems to be safe and effective for improving several phenotypes in PWS, notably physical fitness. However, further research is needed to confirm these results and especially to corroborate whether exercise per se or combined with dietary intervention is an effective coadjuvant treatment for reducing body mass in these patients.
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Affiliation(s)
- Javier S Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Pedro L Valenzuela
- Physiology Unit, Systems Biology Department, University of Alcalá, Madrid, Spain
- Department of Sport and Health, Spanish Agency for Health Protection in Sport (AEPSAD), Madrid, Spain
| | - Helios Pareja-Galeano
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- Research Institute of the Hospital 12 de Octubre (i+12), Madrid, Spain
| | | | - Daniela A Rubin
- Department of Kinesiology, California State University, Fullerton, California
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- Research Institute of the Hospital 12 de Octubre (i+12), Madrid, Spain
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