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Jabouille F, Billot M, Hermand E, Lemonnier E, Perrochon A. Balance rehabilitation for postural control in children with Autism Spectrum Disorder: A two-case report study. Physiother Theory Pract 2023; 39:658-666. [PMID: 34939886 DOI: 10.1080/09593985.2021.2017090] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study aimed to investigate the effect of balance rehabilitation on postural control in both low and increased cognitive load conditions in two children with Autism Spectrum Disorders (ASD). METHODS Two children diagnosed with ASD participated in a 4-week personalized balance rehabilitation program with two sessions per week. We assessed postural control in two single task (ST) conditions with low cognitive load: Eyes Closed (EC), Eyes Open (EO); and in five increased cognitive load conditions. Those dual task (DT) conditions consisted of presenting images representing a neutral condition, sadness, anger, happiness, and fear. Postural control parameters (surface, velocity, medio-lateral and antero-posterior sway amplitudes of the center of pressure (CoP)) were collected by a posturographic platform before and after the balance rehabilitation. RESULTS The rehabilitation program resulted in a 30-96% improvement of postural control parameters in the ST condition for both participants. In DT, participant 1 progressed on all conditions while participant 2 progressed on 3 of the 5 conditions (sadness, anger and fear). CONCLUSION This suggests that these two children with ASD improved their balance control in both low and increased cognitive load conditions. These encouraging results need to be replicated before recommending balance rehabilitation as standard health rehabilitation in children with ASD.
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Affiliation(s)
- François Jabouille
- Ilfomer, Institut Limousin de Formation Aux Métiers de La Réadaptation, Université de Limoges, Limoges, France
| | - Maxime Billot
- Prismatics Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 2 Rue de La Milétrie, 86000 Poitiers, France
| | - Eric Hermand
- Laboratoire Ea 7369 URePSSS (Unité de Recherche Pluridisciplinaire Sport, Santé, Société), Université Du Littoral Côte d'Opale, Dunkerque, France.,Laboratoire Ea 6310 Havae (Handicap Autonomie Vieillissement Activité Environnement), Université de Limoges, Limoges, France
| | - Eric Lemonnier
- Centre Ressource Autisme, Hôpital Le Cluzeau, Centre Hospitalier Universitaire Limoges, Limoges, France
| | - Anaick Perrochon
- Ilfomer, Institut Limousin de Formation Aux Métiers de La Réadaptation, Université de Limoges, Limoges, France.,Laboratoire Ea 6310 Havae (Handicap Autonomie Vieillissement Activité Environnement), Université de Limoges, Limoges, France
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Roșca AM, Rusu L, Marin MI, Ene Voiculescu V, Ene Voiculescu C. Physical Activity Design for Balance Rehabilitation in Children with Autism Spectrum Disorder. CHILDREN 2022; 9:children9081152. [PMID: 36010043 PMCID: PMC9406473 DOI: 10.3390/children9081152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022]
Abstract
One of the characteristics of autism spectrum disorder (ASD) subjects is postural control deficit, which is significant when somatosensory perception is affected. This study analyzed postural stability evolution after physical therapy exercises based on balance training. The study included 28 children with ASD (average age 8 years, average weight 32.18 kg). The rehabilitation program involved performing balance exercises twice a week for three months. Subject assessment was carried out using the RSScan platform. The parameters were the surface of the confidence ellipse (A) and the length of the curve (L) described by the pressure center, which were evaluated before and after the rehabilitation program. Following data processing, we observed a significant decrease in the surface of the confidence ellipse by 92% from EV1 to EV2. Additionally, a decrease of 42% in the curve length was observed from EV1 to EV2. A t test applied to the ellipse surface showed a p = 0.021 and a Cohen’s coefficient of 0.8 (very large effect size). A t test applied to the length L showed p = 0.029 and Cohen’s coefficient of 1.27 mm. Thus, the results show a significant improvement in the two parameters. The application of the program based on physical exercise led to an improvement in the balance of children with autism under complex evaluation conditions.
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Affiliation(s)
- Andreea Maria Roșca
- Faculty of Physical Education and Sport, University of Craiova, 200585 Craiova, Romania; (A.M.R.); (V.E.V.)
| | - Ligia Rusu
- Faculty of Physical Education and Sport, University of Craiova, 200585 Craiova, Romania; (A.M.R.); (V.E.V.)
- Correspondence:
| | - Mihnea Ion Marin
- Faculty of Mechanics, University of Craiova, 200585 Craiova, Romania;
| | - Virgil Ene Voiculescu
- Faculty of Physical Education and Sport, University of Craiova, 200585 Craiova, Romania; (A.M.R.); (V.E.V.)
| | - Carmen Ene Voiculescu
- Faculty of Physical Education and Sport, Ovidius University of Constant, 900470 Constanța, Romania;
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Quantitative Assessment of Sensory Integration and Balance in Children with Autism Spectrum Disorders: Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9030353. [PMID: 35327725 PMCID: PMC8947293 DOI: 10.3390/children9030353] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/01/2022] [Accepted: 03/01/2022] [Indexed: 11/17/2022]
Abstract
Postural stability is dependent on the interpretation of external inputs acquired by sensory information processes, such as visual, vestibular, and proprioceptive systems, in order to accomplish neuromuscular control, balance maintenance, and appropriate motor response. A defect in any of these systems, or in the integration of information given by these systems, might threaten their capacity to maintain balance. Therefore, the purpose of this study was to investigate the sensory integration and balance using the Biodex balance system (BBS) in children with autism spectrum disorder (ASD) during the static posture. Seventy-four children from both sexes, 38 with ASD matched with 36 typically developed (TD) children as a control group, were included in the study. Using the Biodex balance system, the postural sway was evaluated through the modified Clinical Test of Sensory Integration and Balance (m-CTSIB) during quiet standing. In this test, four different situations were considered from standing position: eyes open/firm surface, eyes closed/firm surface, eyes open/foam surface, and eyes closed/foam surface. ASD children showed a significant increase in postural sway under all tested conditions when compared to the TD children group, especially for the conditions in which visual and somatosensory inputs were disrupted (p-value < 0.05). These results provide evidence that postural stability decreased in ASD children. Under static postural challenges, the current study’s findings imply that children diagnosed with ASD have postural control deficiencies, especially for the conditions in which visual and somatosensory input was disrupted. Further research must be conducted to find the best balance training program for ASD cases using the Biodex balance system and considering its impact on motor skills.
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Cordeiro ESG, Aprígio LCS, Azoni CAS, Gazzola JM. Postural balance in children with Autism Spectrum Disorders. REVISTA CEFAC 2021. [DOI: 10.1590/1982-0216/20212350921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to characterize the performance of children with autism spectrum disorders in two postural balance assessment scales. Methods: an observational cross-sectional study with a descriptive, analytical profile. Seven to 11-year-old children with mild autism spectrum disorder, diagnosed by an interdisciplinary team, according to the DSM-5, were assessed. The protocols used were the Sensory Organization Test and Pediatric Balance Scale. Results: all the children obtained maximum performance in the Sensory Organization Test. As for the Pediatric Balance Scale, the participants had similar responses in 8 out of its 14 items; in the other 6, there was a standard deviation. Conclusion: the participants did not have difficulties performing the Pediatric Balance Scale and Sensory Organization Test, scoring quite close to the maximum value.
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Cordeiro ESG, Azoni CAS, Silva EMTD, Fernandes FH, Lima-Alvarez CDD, Gazzola JM. Bibliometric analysis of the literature on postural balance in children with Autism Spectrum Disorder. REVISTA CEFAC 2020. [DOI: 10.1590/1982-0216/202022218319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to identify the state-of-the-art research on postural balance in children with autism spectrum disorder (ASD) in both Brazilian and international literature. Methods: a bibliometric review, developed through bibliographical search in databases using the following descriptors: "postural balance" OR "vestibular diseases" OR "postural equilibrium" AND "autism". The eligibility criteria for sample selection were articles published in Brazilian and international journals, in either English or Portuguese. There was no restriction regarding the year of publication. The selection was based on reading the title, abstract, and lastly the full text of the articles potentially relevant for this review. Results: 62 articles were found based on the eligibility criteria. The number of publications related to the study’s theme peaked in 2015 and 2016, the first publication being from 1974. There was a predominance of studies published in the USA (37%), in English, with a quantitative, cross-sectional approach. Most of the authors compared the performance in body balance tasks of children with ASD with that of children with typical development. Conclusion: it was observed that body balance and postural control in children with ASD are growing trends in scientific publications.
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Association between the promoter region of serotonin transporter polymorphisms and recurrent aphthous stomatitis: A meta-analysis. Arch Oral Biol 2020; 109:104555. [DOI: 10.1016/j.archoralbio.2019.104555] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/12/2019] [Accepted: 09/14/2019] [Indexed: 02/07/2023]
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Sapiro G, Hashemi J, Dawson G. Computer vision and behavioral phenotyping: an autism case study. CURRENT OPINION IN BIOMEDICAL ENGINEERING 2019; 9:14-20. [PMID: 37786644 PMCID: PMC10544819 DOI: 10.1016/j.cobme.2018.12.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Despite significant recent advances in molecular genetics and neuroscience, behavioral ratings based on clinical observations are still the gold standard for screening, diagnosing, and assessing outcomes in neurodevelopmental disorders, including autism spectrum disorder. Such behavioral ratings are subjective, require significant clinician expertise and training, typically do not capture data from the children in their natural environments such as homes or schools, and are not scalable for large population screening, low-income communities, or longitudinal monitoring, all of which are critical for outcome evaluation in multisite studies and for understanding and evaluating symptoms in the general population. The development of computational approaches to standardized objective behavioral assessment is, thus, a significant unmet need in autism spectrum disorder in particular and developmental and neurodegenerative disorders in general. Here, we discuss how computer vision, and machine learning, can develop scalable low-cost mobile health methods for automatically and consistently assessing existing biomarkers, from eye tracking to movement patterns and affect, while also providing tools and big data for novel discovery.
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Affiliation(s)
- Guillermo Sapiro
- Electrical and Computer Engineering, Computer Sciences, Biomedical Engineering, and Math, Duke University, Durham, NC, 27707, United States
| | - Jordan Hashemi
- Electrical and Computer Engineering, Duke University, Durham, NC, 27707, United States
| | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Science, Duke University, Durham, NC, 27707, United States
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Dawson G, Campbell K, Hashemi J, Lippmann SJ, Smith V, Carpenter K, Egger H, Espinosa S, Vermeer S, Baker J, Sapiro G. Atypical postural control can be detected via computer vision analysis in toddlers with autism spectrum disorder. Sci Rep 2018; 8:17008. [PMID: 30451886 PMCID: PMC6242931 DOI: 10.1038/s41598-018-35215-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 10/31/2018] [Indexed: 12/23/2022] Open
Abstract
Evidence suggests that differences in motor function are an early feature of autism spectrum disorder (ASD). One aspect of motor ability that develops during childhood is postural control, reflected in the ability to maintain a steady head and body position without excessive sway. Observational studies have documented differences in postural control in older children with ASD. The present study used computer vision analysis to assess midline head postural control, as reflected in the rate of spontaneous head movements during states of active attention, in 104 toddlers between 16-31 months of age (Mean = 22 months), 22 of whom were diagnosed with ASD. Time-series data revealed robust group differences in the rate of head movements while the toddlers watched movies depicting social and nonsocial stimuli. Toddlers with ASD exhibited a significantly higher rate of head movement as compared to non-ASD toddlers, suggesting difficulties in maintaining midline position of the head while engaging attentional systems. The use of digital phenotyping approaches, such as computer vision analysis, to quantify variation in early motor behaviors will allow for more precise, objective, and quantitative characterization of early motor signatures and potentially provide new automated methods for early autism risk identification.
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Affiliation(s)
- Geraldine Dawson
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA.
| | | | - Jordan Hashemi
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
- Department of Electrical and Computer Engineering, Duke University, Durham, North Carolina, USA
| | - Steven J Lippmann
- Department of Population Health Sciences, Duke University, Durham, North Carolina, USA
| | - Valerie Smith
- Department of Population Health Sciences, Duke University, Durham, North Carolina, USA
| | - Kimberly Carpenter
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Helen Egger
- NYU Langone Child Study Center, New York University, New York, New York, USA
| | - Steven Espinosa
- Department of Electrical and Computer Engineering, Duke University, Durham, North Carolina, USA
| | - Saritha Vermeer
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Jeffrey Baker
- Department of Pediatrics, Duke University, Durham, NC, USA
| | - Guillermo Sapiro
- Department of Electrical and Computer Engineering, Duke University, Durham, North Carolina, USA
- Departments of Biomedical Engineering, Computer Science, and Mathematics, Duke University, Durham, NC, USA
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Stins JF, Emck C. Balance Performance in Autism: A Brief Overview. Front Psychol 2018; 9:901. [PMID: 29922206 PMCID: PMC5996852 DOI: 10.3389/fpsyg.2018.00901] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 05/17/2018] [Indexed: 01/07/2023] Open
Abstract
Children with autism not only have limited social and communicative skills but also have motor abnormalities, such as poor timing and coordination of balance. Moreover, impaired gross motor skills hamper participation with peers. Balance control is interesting from a cognitive science perspective, since it involves a complex interplay between information processing, motor planning, and timing and sequencing of muscle movements. In this paper, we discuss the background of motor problems in children with autism, focusing on how posture is informed by sensory information processing. We also discuss the neurobiological basis of balance problems, and how this is related to anxiety in this group. We then discuss possible avenues for treatment of autism spectrum disorder (ASD) symptoms, especially as regards movement-related interventions. Finally, we present a theoretical outlook and discuss whether some of the symptoms in ASD can be understood from an embodied cognition perspective.
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Affiliation(s)
- John F Stins
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Claudia Emck
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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