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Faralli A, Fucà E, Lazzaro G, Menghini D, Vicari S, Costanzo F. Transcranial Direct Current Stimulation in neurogenetic syndromes: new treatment perspectives for Down syndrome? Front Cell Neurosci 2024; 18:1328963. [PMID: 38456063 PMCID: PMC10917937 DOI: 10.3389/fncel.2024.1328963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/25/2024] [Indexed: 03/09/2024] Open
Abstract
This perspective review aims to explore the potential neurobiological mechanisms involved in the application of transcranial Direct Current Stimulation (tDCS) for Down syndrome (DS), the leading cause of genetically-based intellectual disability. The neural mechanisms underlying tDCS interventions in genetic disorders, typically characterized by cognitive deficits, are grounded in the concept of brain plasticity. We initially present the neurobiological and functional effects elicited by tDCS applications in enhancing neuroplasticity and in regulating the excitatory/inhibitory balance, both associated with cognitive improvement in the general population. The review begins with evidence on tDCS applications in five neurogenetic disorders, including Rett, Prader-Willi, Phelan-McDermid, and Neurofibromatosis 1 syndromes, as well as DS. Available evidence supports tDCS as a potential intervention tool and underscores the importance of advancing neurobiological research into the mechanisms of tDCS action in these conditions. We then discuss the potential of tDCS as a promising non-invasive strategy to mitigate deficits in plasticity and promote fine-tuning of the excitatory/inhibitory balance in DS, exploring implications for cognitive treatment perspectives in this population.
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Affiliation(s)
- Alessio Faralli
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | - Elisa Fucà
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | - Giulia Lazzaro
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | - Deny Menghini
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
- Life Sciences and Public Health Department, Catholic University of Sacred Heart, Rome, Italy
| | - Floriana Costanzo
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
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CARRANZA-DEL RÍO J, DURSUN N, CEKMECE C, BONIKOWSKI M, PYRZANOWSKA W, DABROWSKI E, TILTON A, OLESZEK J, VOLTEAU M, PAGE S, SHIERK A, DELGADO MR. Goal Attainment after Treatment with Abobotulinumtoxina and a Tailored Home Therapy Programme in Children with Upper Limb Spasticity: Descriptive, Exploratory Analysis of a Large Randomized, Controlled Study. J Rehabil Med 2022; 54:jrm00349. [PMID: 36306168 PMCID: PMC9762673 DOI: 10.2340/jrm.v54.2540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE This exploratory analysis of a large, randomized, double-blind study (NCT02106351) describes the effect of treatment with abobotulinumtoxinA followed by a tailored home exercises therapy programme in enabling children with upper limb spasticity due to cerebral palsy to achieve their functional goals using goal attainment scaling (GAS). METHODS Children with cerebral palsy and spasticity in ≥ 1 upper limb received up to 4 injection cycles of abobotulinumtoxinA (2 U/kg (cycle 1 only), 8U/kg and 16U/kg) into the elbow and wrist flexors and other upper limb muscles selected to support individual treatment goals. Children followed a home exercises therapy programme, which included stretches and exercises specifically chosen to facilitate goal achievement and engagement in activities. RESULTS For cycle 1, most children had active function goals set as their primary goal (69.7% vs 19.2% passive function goals). GAS T- scores and goal responder rates at week 16 indicated that most types of primary goal were achieved at least as expected during cycle 1 (all groups). Primary goal GAS T-scores were generally maintained for the first 3 abobotulinumtoxinA treatment cycles. CONCLUSION Most children with upper limb spasticity treated with repeat cycles of abobotulinumtoxinA supported by an individualized home exercises therapy programme achieved their functional goals.
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Affiliation(s)
| | - Nigar DURSUN
- Kocaeli University Faculty of Medicine Department of Physical Medicine and Rehabilitation, Turkey
| | - Cigdem CEKMECE
- Kocaeli University Faculty of Medicine Department of Physical Medicine and Rehabilitation, Turkey
| | | | | | - Edward DABROWSKI
- Beaumont Health, Oakland University School of Medicine, Grosse Pointe, MI
| | - Ann TILTON
- LSU Health Sciences Center and Children’s Hospital New Orleans, New Orleans, LA
| | | | | | | | - Angela SHIERK
- University of Texas Southwestern Medical Center and Scottish Rite Hospital for Children, Dallas, TX, USA
| | - Mauricio R. DELGADO
- University of Texas Southwestern Medical Center and Scottish Rite Hospital for Children, Dallas, TX, USA
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Thomé Teixeira da Silva LV, Vegas M, Aquaroni Ricci N, Cardoso de Sá CS, Alouche SR. Selecting assessment tools to characterize upper limb function of children with cerebral palsy: A mega-review of systematic reviews. Dev Neurorehabil 2022; 25:378-391. [PMID: 35282778 DOI: 10.1080/17518423.2022.2046656] [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: 11/03/2022]
Abstract
AIM A mega-review of published systematic reviews without restriction on year of publication was implemented to summarize available assessment tools of upper limb (UL) function in children with Cerebral Palsy (CP). METHOD A multi-prong search strategy was used to identify 12 systematic literature reviews for inclusion in the mega-review. Included reviews were coded by descriptive analyses, which included methodological and reported measurement property description. Methodological quality of the selected systematic reviews was evaluated with the AMSTAR-2. We synthetized the measurement properties of the revised assessment tools and their coverage within the International Classification of Functioning, Disability and Health (ICF) domains. RESULTS The 12 systematic reviews addressed 84 assessment tools. Systematic reviews' methodological quality varied between critically low to moderate. Suggested assessment tools covered ICF domains of body structure and function, and activities and participation. Measurement property data analysis was based mostly on reliability and validity. INTERPRETATION Based on the findings of the mega-review, the ABILHAND-Kids, Assisting Hand Assessment (AHA) and Melbourne Assessment of Unilateral Upper Limb Function (MUUL) are the most suitable tools to evaluate children between 6 and 12 years of age with unilateral CP.
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Affiliation(s)
| | - Milena Vegas
- School of Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Natalia Aquaroni Ricci
- Master's and Doctoral Program in Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | | | - Sandra Regina Alouche
- Master's and Doctoral Program in Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
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Shim D, Choi JY, Yi SH, Park ES, Kim S, Yoo B, Park D, Park HR, Rha DW. Spatiotemporal parameters from instrumented motion analysis represent clinical measurement of upper limb function in children with cerebral palsy. Gait Posture 2022; 91:326-331. [PMID: 33246774 DOI: 10.1016/j.gaitpost.2020.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 10/26/2020] [Accepted: 11/09/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND There are various tools that measure upper limb function in children with cerebral palsy(CP) clinically, but these measurement methods are examiner-dependent and scale values are not proportional to the upper limb function which makes it difficult to quantify the function. RESEARCH QUESTION The purpose of this study was to investigate whether the new parameters derived from 3D motion analysis reflect the upper limb function which measured by Melbourne Assessment 2 (MA2) in children with cerebral palsy (CP) compared to the clinical measurements. METHODS Forty children with CP (24 boys, 16 girls; mean [SD] age, 6 years 11 months [3 years 5 months]) were recruited. Motion capture was conducted during phases T1-T4 of Reach and Grasp Cycles. New parameters (movement time, number of movement units, index of curvature) were derived from wrist marker data. Range of motion (ROM), accuracy, dexterity, and fluency of unilateral upper limb function were assessed using MA2. Spearman rank coefficients were determined to evaluate correlations between MA2 and the new parameters. RESULTS AND SIGNIFICANCE Index of curvature correlated negatively with MA2 accuracy scores during T1 (rs -0.347, p < 0.05), T2 (rs -0.471, p < 0.01), and T3 (rs -0.660, p < 0.01). Number of movement units correlated negatively with MA2 ROM, accuracy, and fluency scores during T1 (ROM rs -0.334; accuracy rs -0.331; fluency rs -0.375; p < 0.05) and T3 (ROM rs -0.499; accuracy rs -0.531; fluency rs -0.515; p < 0.01). Index of curvature and number of movement units are objective, simple parameters showing fair to good correlation with MA2 accuracy and fluency of upper limb function.
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Affiliation(s)
- Dain Shim
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ja Young Choi
- Department of Rehabilitation Medicine, Daejeon-Chungcheong Regional Rehabilitation Center, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Sook-Hee Yi
- Seoul Rehabilitation Hospital, Seoul, Republic of Korea
| | - Eun Sook Park
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seungki Kim
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Beomki Yoo
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dongho Park
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye-Rin Park
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong-Wook Rha
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Oleszek J, Tilton A, Carranza Del Rio J, Dursun N, Bonikowski M, Dabrowski E, Page S, Regnault B, Thompson C, Delgado MR. Muscle Selection and Dosing in a Phase 3, Pivotal Study of AbobotulinumtoxinA Injection in Upper Limb Muscles in Children With Cerebral Palsy. Front Neurol 2021; 12:728615. [PMID: 34803878 PMCID: PMC8603760 DOI: 10.3389/fneur.2021.728615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/27/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Guidelines recommend botulinum toxin-A in pediatric upper limb spasticity as part of routine practice. Appropriate dosing is a prerequisite for treatment success and it is important that injectors have an understanding on how to tailor dosing within a safe and effective range. We report upper limb dosing data from a phase 3 study of abobotulinumtoxinA injections in children with cerebral palsy. Methods: This was a double-blind, repeat-treatment study (NCT02106351). In Cycle 1, children were randomized to abobotulinumtoxinA at 2 U/kg control dose or clinically relevant 8 U/kg or 16 U/kg doses. Doses were divided between the primary target muscle group (PTMG, wrist or elbow flexors) and additional muscles tailored to clinical presentation. During Cycles 2–4, children received doses of 8 U/kg or 16 U/kg and investigators could change the PTMG and other muscles to be injected. Injection of muscles in the other upper limb and lower limbs was also permitted in cycles 2–4, with the total body dose not to exceed 30 U/kg or 1,000 U (whichever was lower) in the case of upper and lower limb treatment. Results: 212 children were randomized, of which 210 received ≥1 abobotulinumtoxinA injection. Per protocol, the elbow and wrist flexors were the most commonly injected upper limb muscles. Across all 4 cycles, the brachialis was injected in 89.5% of children (dose range 0.8–6 U/kg), the brachioradialis in 83.8% (0.4–3 U/kg), the flexor carpi ulnaris in 82.4% (0.5–3 U/kg) and the flexor carpi radialis in 79.5% (0.5–4 U/kg). Other frequently injected upper limb muscles were the pronator teres(70.0%, 0.3–3 U/kg). adductor pollicis (54.3%, 0.3-1 U/kg), pronator quadratus (44.8%, 0.1–2 U/kg), flexor digitorum superficialis (39.0%, 0.5-4 U/kg), flexor digitorum profundus (28.6%, 0.5–2 U), flexor pollicis brevis/opponens pollicis (27.6%, 0.3-1 U/kg) and biceps (27.1%, 0.5–6 U/kg). AbobotulinumtoxinA was well-tolerated at these doses; muscular weakness was reported in 4.3% of children in the 8 U/kg group and 5.7% in the 16 U/kg group. Conclusions: These data provide information on the pattern of injected muscles and dose ranges used in this study, which were well-tolerated. Per protocol, most children received injections into the elbow and wrist flexors. However, there was a wide variety of other upper limb muscles injected as physicians tailored injection patterns to clinical need.
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Affiliation(s)
- Joyce Oleszek
- Department of Physical Medicine and Rehabilitation, University of Colorado and Children's Hospital Colorado, Aurora, IL, United States
| | - Ann Tilton
- LSUHSC and Children's Hospital New Orleans, New Orleans, LA, United States
| | | | - Nigar Dursun
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Kocaeli University, Izmit, Turkey
| | | | - Edward Dabrowski
- Beaumont Health, Oakland University School of Medicine, Grosse Pointe, MI, United States
| | | | | | | | - Mauricio R Delgado
- Southwestern Medical Center, Scottish Rite Hospital for Children, University of Texas, Dallas, TX, United States
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Lopes JBP, Miziara IM, Galli M, Cimolin V, Oliveira CS. Effect of Transcranial Direct Current Stimulation Combined With Xbox-Kinect Game Experience on Upper Limb Movement in Down Syndrome: A Case Report. Front Bioeng Biotechnol 2020; 8:514. [PMID: 32548102 PMCID: PMC7273846 DOI: 10.3389/fbioe.2020.00514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 04/30/2020] [Indexed: 11/28/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique used to enhance local synaptic efficacy and modulate the electrical activity of the cortex in neurological disorders. Researchers have sought to combine this type of stimulation with well-established therapeutic modalities, such as motor training involving Xbox Kinect games, which has demonstrated promising results. Thus, this study aimed to determine whether tDCS can enhance upper limb motor training in an eight-year-old child with Down Syndrome (DS) (cognitive age: five years, based on the Wechsler Intelligence Scale for Children). The evaluations consisted of three-dimensional analysis of upper limb kinematics during a reaching task performed before, after10 session, and one month after the intervention. The intervention protocol involved 1 20-min sessions of tDCS over the primary motor cortex at an intensity of 1 mA during Xbox Kinect game training involving an upper limb motor task. The analysis of the kinematic data revealed that in the pre-intervention evaluation, the dominant limb executed the task slowly and over a long path. These aspects improved at the post-intervention and follow-up evaluations, as demonstrated by the shorter total movement duration (3.05 vs. 1.58 vs. 1.52 s, respectively). Similar changes occurred with the non-dominant upper limb; a significant increase in movement velocity at the post-intervention and follow-up evaluations was observed (0.53 vs. 0.54 vs. 0.85 m/s, respectively). The present case report offers preliminary data from a protocol study, and the results confirm the notion that anodal tDCS combined with upper limb motor training leads to improvements in different kinematic variables.
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Affiliation(s)
- Jamile Benite Palma Lopes
- Health Sciences Program, Faculty of Medical Sciences of Santa Casa de São Paulo, São Paulo, Brazil.,Undergraduate Department, Faculty of Taquaritinga - FTGA, Taquaritinga, Brazil
| | - Isabela Marques Miziara
- Undergraduate Department, Faculty of Electrical Engineering, Federal University of Uberlândia, Uberlândia, Brazil.,Undergraduate Department, Faculty of Electrical and Biomedical Engineering, Federal University of Pará, Belém, Brazil
| | - Manuela Galli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Veronica Cimolin
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Claudia Santos Oliveira
- Program in Human Movement and Rehabilitation Center of Anápolis, Anápolis, Brazil.,Master's and Doctoral Program in Health Sciences, São Paulo Santa Casa School of Medical Sciences, São Paulo, Brazil
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Shierk A, Jiménez-Moreno AC, Roberts H, Ackerman-Laufer S, Backer G, Bard-Pondarre R, Cekmece C, Pyrzanowska W, Vilain C, Delgado MR. Development of a Pediatric Goal-Centered Upper Limb Spasticity Home Exercise Therapy Program for Use in a Phase-III Trial of Abobotulinumtoxina (Dysport ®). Phys Occup Ther Pediatr 2019; 39:124-135. [PMID: 30204515 DOI: 10.1080/01942638.2018.1486346] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AIMS To create a standardized home exercise therapy program that could be implemented by international sites to provide a consistent level of therapeutic intervention for pediatric patients participating in an ongoing Phase-III, randomized, controlled trial of repeat abobotulinumtoxinA injections for pediatric upper limb spasticity (NCT02106351). METHODS Physical therapists, occupational therapists, and medical doctors worked collaboratively to design an exercise therapy program to be implemented in the home setting. In this article, we describe the development process and the finalized program that is currently being used in the Phase-III trial. RESULTS The final program is presented as a "toolbox" for therapists, and includes a standardized step-wise process for choosing the most appropriate exercises and functional activities to achieve the agreed treatment goals of each abobotulinumtoxinA injection. The core toolbox includes: a clear protocol for clinicians, information sheets, signature of commitment forms, exercise score charts, and the library of exercises and functional activities that therapists choose from to aid the patient in achieving their treatment goals. CONCLUSIONS Implementation of this home therapy program provides a standardized background of good practice against which to test the efficacy of abobotulinumtoxinA. Preliminary data show that the program is readily accepted by patients and their families.
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Affiliation(s)
- Angela Shierk
- a Texas Scottish Rite Hospital for Children , Dallas , TX , USA
| | | | - Heather Roberts
- a Texas Scottish Rite Hospital for Children , Dallas , TX , USA
| | | | | | - Rachel Bard-Pondarre
- f Centre Médico-Chirurgical de Réadaptation des Massues - Croix-Rouge Française , Lyon , France
| | - Cigdem Cekmece
- g Department of Rehabilitation , Kocaeli University , Izmit , Turkey
| | - Weronika Pyrzanowska
- h Non-public Healthcare Unit Mazovian Neurorehabilitation and Psychiatry Center in Zagorze , Wiazowna , Poland
| | | | - Mauricio R Delgado
- a Texas Scottish Rite Hospital for Children , Dallas , TX , USA.,i Department of Neurology, University of Texas Southwestern Medical Center , Dallas , TX , USA
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Daunoraviciene K, Ziziene J, Griskevicius J, Pauk J, Ovcinikova A, Kizlaitiene R, Kaubrys G. Quantitative assessment of upper extremities motor function in multiple sclerosis. Technol Health Care 2018; 26:647-653. [PMID: 29843287 DOI: 10.3233/thc-182511] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Upper extremity (UE) motor function deficits are commonly noted in multiple sclerosis (MS) patients and assessing it is challenging because of the lack of consensus regarding its definition. Instrumented biomechanical analysis of upper extremity movements can quantify coordination with different spatiotemporal measures and facilitate disability rating in MS patients. OBJECTIVE To identify objective quantitative parameters for more accurate evaluation of UE disability and relate it to existing clinical scores. METHODS Thirty-four MS patients and 24 healthy controls (CG) performed a finger-to-nose test as fast as possible and, in addition, clinical evaluation kinematic parameters of UE were measured by using inertial sensors. RESULTS Generally, a higher disability score was associated with an increase of several temporal parameters, like slower task performance. The time taken to touch their nose was longer when the task was fulfilled with eyes closed. Time to peak angular velocity significantly changed in MS patients (EDSS > 5.0). The inter-joint coordination significantly decreases in MS patients (EDSS 3.0-5.5). Spatial parameters indicated that maximal ROM changes were in elbow flexion. CONCLUSIONS Our findings have revealed that spatiotemporal parameters are related to the UE motor function and MS disability level. Moreover, they facilitate clinical rating by supporting clinical decisions with quantitative data.
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Affiliation(s)
- Kristina Daunoraviciene
- Department of Biomechanical Engineering, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Jurgita Ziziene
- Department of Biomechanical Engineering, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Julius Griskevicius
- Department of Biomechanical Engineering, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Jolanta Pauk
- Department of Mechanics and Applied Computer Science, Bialystok University of Technology, Bialystok, Poland
| | - Agne Ovcinikova
- Department of Neurology and Neurosurgery, Centre for Neurology, Vilnius University, Vilnius, Lithuania
| | - Rasa Kizlaitiene
- Department of Neurology and Neurosurgery, Centre for Neurology, Vilnius University, Vilnius, Lithuania
| | - Gintaras Kaubrys
- Department of Neurology and Neurosurgery, Centre for Neurology, Vilnius University, Vilnius, Lithuania
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Lopes JBP, de Moura RCF, Lazzari RD, de Almeida Carvalho Duarte N, Dumont AJL, Oliveira CS. Evaluation of upper limb movements in children with Down's syndrome: A systematic review. Infant Behav Dev 2018; 51:45-51. [PMID: 29649724 DOI: 10.1016/j.infbeh.2018.03.001] [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] [Received: 06/06/2017] [Revised: 02/16/2018] [Accepted: 03/13/2018] [Indexed: 10/17/2022]
Abstract
The aim of the present study was to perform a review of the literature on current quantitative clinical methods for the evaluation of upper limb movements in children and adolescents with Down syndrome, with a focus on describing the variables, protocols, motor function and motor control. METHODS A survey of PubMed, Scielo, BVS Bireme and PEDro databases using the following key words: upper limb and EMG and Down syndrome; upper limb and kinematics and Down syndrome; upper limb and motion analysis and Down syndrome; movement and upper limb and Down syndrome; upper limb and Down syndrome; reach and Down syndrome. RESULTS In all, 344 articles and five were selected to compose the present systematic review. No standardization was found among the studies analyzed with regard to data collection, data processing or procedures for the evaluation of the variables. CONCLUSION A kinematic evaluation is effective for the discussion of the results, but methodological differences among the studies and inconsistent results exert a negative influence on clinical interpretations and the possibility of reproducibility. The standardization of an upper limb movement evaluation protocol using kinematic analysis is important, as it would provide the basis for comparable, reproducible results and facilitate the planning of treatment interventions.
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Affiliation(s)
| | | | | | | | | | - Claudia Santos Oliveira
- Health Sciences Program, Faculty of Medical Sciences of Santa Casa de São Paulo, Brazil; University Center Of Anápolis, Goias, Brazil
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Kim HY. An investigation of the factors affecting handwriting articulation of school aged children with cerebral palsy based on the international classification of functioning, disability and health. J Phys Ther Sci 2016; 28:347-50. [PMID: 27065517 PMCID: PMC4792971 DOI: 10.1589/jpts.28.347] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 10/30/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study was designed to identify factors influencing handwriting articulation based on the international classification of functioning, disability and health (ICF) and to recommend effective evaluation and intervention strategies to improve the handwriting of children with cerebral palsy. [Subjects] The subjects were 96 elementary school children with cerebral palsy and the study was conducted from 04/07/2011 to 29/08/2011. [Methods] Factors related to handwriting articulation were investigated based on the ICF model. [Results] Wrist lateral deviation, upper-extremity speed of body function and education of personal factor were significantly associated with handwriting articulation. [Conclusion] Efforts to manage and improve the handwriting articulation of children with cerebral palsy should focus on wrist lateral deviation, upper-extremity speed, and education.
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Affiliation(s)
- Hee Young Kim
- Department of Occupational Therapy, Honam University, Republic of Korea
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Franco de Moura RC, Almeida CS, Dumont AJL, Lazzari RD, Lopes JBP, Duarte NADC, Braun LF, Oliveira CS. Kinematic upper limb evaluation of children and adolescents with cerebral palsy: a systematic review of the literature. J Phys Ther Sci 2016; 28:695-700. [PMID: 27065566 PMCID: PMC4793036 DOI: 10.1589/jpts.28.695] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 10/31/2015] [Indexed: 12/04/2022] Open
Abstract
[Purpose] The aim of the present study was to perform a review of the literature on
objective measures of upper limb movements in children and adolescents with cerebral palsy
and describe the methods used to investigate upper limb kinematics in this population.
[Materials and Methods] An extensive database search was performed using the keywords
kinematics, upper limb, and cerebral palsy. A total of 146 papers were identified, but
only five met the inclusion criteria. [Results] No consensus was found regarding the data
collection, processing, and analysis procedures or reporting of the results. [Conclusion]
Standardization of the protocol for 3D upper limb movement analysis will provide the
foundation for comparable, reproducible results and eventually facilitate the planning of
treatment interventions.
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Affiliation(s)
| | - Cibele Santos Almeida
- Department of Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, Brazil
| | | | | | | | | | - Luiz Ferreira Braun
- Department of Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, Brazil
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Rocha ACP, Tudella E, Pedro LM, Appel VCR, da Silva LGP, Caurin GADP. A Novel Device for Grasping Assessment during Functional Tasks: Preliminary Results. Front Bioeng Biotechnol 2016; 4:16. [PMID: 26942178 PMCID: PMC4761859 DOI: 10.3389/fbioe.2016.00016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 02/04/2016] [Indexed: 11/16/2022] Open
Abstract
This paper presents a methodology and first results obtained in a study with a novel device that allows the analysis of grasping quality. Such a device is able to acquire motion information of upper limbs allowing kinetic of manipulation analysis as well. A pilot experiment was carried out with six groups of typically developing children aged between 5 and 10 years, with seven to eight children in each one. The device, designed to emulate a glass, has an optical system composed by one digital camera and a special convex mirror that together allow image acquisition of grasping hand posture when it is grasped and manipulated. It also carries an Inertial Measurement Unit that captures motion data as acceleration, orientation, and angular velocities. The novel instrumented object is used in our approach to evaluate functional tasks performance in quantitative terms. During tests, each child was invited to grasp the cylindrical part of the device that was placed on the top of a table, simulating the task of drinking a glass of water. In the sequence, the child was oriented to transport the device back to the starting position and release it. The task was repeated three times for each child. A grasping hand posture evaluation is presented as an example to evaluate grasping quality. Additionally, motion patterns obtained with the trials performed with the different groups are presented and discussed. This device is attractive due to its portable characteristics, the small size, and its ability to evaluate grasping form. The results may be also useful to analyze the evolution of the rehabilitation process through reach-to-grasping movement and the grasping images analysis.
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Affiliation(s)
- Ana Carolinne Portela Rocha
- Research in Motion Analysis Laboratory, Department of Physical Therapy, Federal University of São Carlos , São Carlos , Brazil
| | - Eloisa Tudella
- Research in Motion Analysis Laboratory, Department of Physical Therapy, Federal University of São Carlos , São Carlos , Brazil
| | - Leonardo M Pedro
- Mechatronics Group, Department of Mechanical Engineering, Federal University of São Carlos , São Carlos , Brazil
| | - Viviane Cristina Roma Appel
- Mechatronics Group, Department of Mechanical Engineering, São Carlos School of Engineering, University of São Paulo , São Carlos , Brazil
| | | | - Glauco Augusto de Paula Caurin
- Mechatronics Group, Department of Mechanical Engineering, São Carlos School of Engineering, University of São Paulo , São Carlos , Brazil
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