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Czencz J, Shields N, Wallen M, Wilson PH, McGuckian TB, Imms C. Does exercise affect quality of life and participation of adolescents and adults with cerebral palsy: a systematic review. Disabil Rehabil 2023; 45:4190-4206. [PMID: 36458738 DOI: 10.1080/09638288.2022.2148297] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 11/11/2022] [Indexed: 12/04/2022]
Abstract
PURPOSE Investigate the effect of exercise for adults with cerebral palsy (CP) on quality of life, participation (attendance and involvement in life situations), functional mobility, pain, fatigue, mood, and self-efficacy. METHODS A systematic review was completed. Twelve databases were searched from inception to August 2022 for studies including participants (≥16 years) with cerebral palsy, and that evaluated an exercise intervention. Two reviewers independently assessed eligibility, risk of bias, and extracted data. RESULTS Seventeen studies (total n = 532) were included: 12 randomised control trials, four non-randomised trials, and one single case experimental design. Interventions studied were predominantly strength, aerobic or treadmill training, dance, and swimming. No study assessed participation, pain or mood. Of two studies that assessed quality of life, one reported a positive effect on an aspect of mental health immediately after the programme finished. All studies assessed functional mobility, but only one reported a positive effect. One study assessed self-efficacy and found no effect, and another assessed fatigue and reported conflicting results. CONCLUSIONS The effect of exercise for adults with CP, on outcomes that adults report as important to them - quality of life, participation, pain, mood, and fatigue - are unknown.IMPLICATIONS FOR REHABILITATIONTo address outcomes important to adults with cerebral palsy (CP), it is important to understand how exercise affects participation and quality of life.All modes of exercise reviewed appear safe for adults with CP and choice should be based on the client's preferences, access to services, and convenience.Addressing any needed accommodations in the environment and context is likely more important than exercise prescription parameters when tailoring exercise to meet the needs of adults with CP and sustain participation.
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Affiliation(s)
- James Czencz
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Nora Shields
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Melbourne, Australia
| | - Margaret Wallen
- School of Allied Health, Faculty of Health Sciences, Australian Catholic University, North Sydney, Australia
| | - Peter H Wilson
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Thomas B McGuckian
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Christine Imms
- Healthy Trajectories: Child and Youth Disability Research Hub, The University of Melbourne, Murdoch Children's Research Institute, Melbourne, Australia
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Januszyk D, Schafer E, Thompson H, Sargent B. Effect of Exercise and Motor Interventions on Physical Activity and Motor Outcomes of Adults with Cerebral Palsy: A Systematic Review. Dev Neurorehabil 2023; 26:389-412. [PMID: 38183292 PMCID: PMC10783540 DOI: 10.1080/17518423.2023.2259978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 09/13/2023] [Indexed: 01/08/2024]
Abstract
PURPOSE Systematically review the effect of exercise and motor interventions on physical activity and motor outcomes of adults with cerebral palsy (CP). METHODS Eight databases were searched. RESULTS Twenty-five studies were included, representing 439 adults with CP. Very low to low quality evidence supports that gait training is more effective than standard care or neurodevelopmental treatment for improving gait velocity, quality of gait, and ankle stiffness; balance training is more effective than seated therapeutic activities for improving walking self-confidence and perceived change in balance; whole-body vibration is no more effective than resistance training for improving strength or gait function; and resistance training is no more effective than a person's typical exercise program for improving strength or gait function of adults with CP. Adverse events were reported for balance training, functional training, resistance training, and whole-body vibration. DISCUSSION Further research is needed that is adequately powered and uses well-controlled study designs.
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Affiliation(s)
- Danielle Januszyk
- Children’s Hospital Los Angeles, Division of
Pediatric Rehabilitation Medicine, 4650 Sunset Blvd., Los Angeles, California
- University of Southern California, Division of
Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, Los Angeles,
California
| | - Ellen Schafer
- Children’s Hospital Los Angeles, Division of
Pediatric Rehabilitation Medicine, 4650 Sunset Blvd., Los Angeles, California
- University of Southern California, Division of
Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, Los Angeles,
California
| | - Holly Thompson
- University of Southern California, USC Libraries, Los
Angeles, California
| | - Barbara Sargent
- University of Southern California, Division of
Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, Los Angeles,
California
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Hickey L, Kuyucak O, Clausen L, Imms C. Mapping the focus of research conducted with adults with cerebral palsy: an overview of systematic reviews. Disabil Rehabil 2023; 45:185-208. [PMID: 35114857 DOI: 10.1080/09638288.2022.2032412] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE To map research conducted with adults with cerebral palsy (CP) to the International Classification of Functioning, Disability and Health (ICF) to understand the array of research available, identify key clinical messages and inform future research. MATERIALS AND METHODS An overview of systematic reviews was conducted. Comprehensive searches (to December 2021) were conducted in PsycINFO, Web of Science, MEDLINE, CINAHL, Cochrane, JBI, and EMBASE. Eligible studies were systematic reviews that included primary studies of adults with CP. Included reviews were assessed for study quality and mapped to the ICF components and chapters. A narrative synthesis of commonly reported outcomes within the component/s and chapter/s was conducted. RESULTS All 24 included reviews were published since 2010. Thirteen focused on body functions: movement related functions and cardiovascular and respiratory systems. Although nine reviews focused on gait and mobility, considerable overlap of included studies limited the volume of evidence and variability in review quality limited generalisability of findings. CONCLUSIONS Research involving adults with CP is growing; however, this overview of reviews found a predominant focus on mobility and gait. Future research, informed by consumer priorities, is needed to address a broader range of key health and participation outcomes.Implications for rehabilitationFitness, mobility, and gait were the most common research topics found in these systematic reviews suggesting a narrow research focus in adults with CP.There are significant gaps in our knowledge to inform clinical messages for practice about broad long-term outcomes of CP and how best to support their activity performance and participation.There is very limited evidence with which to guide and support rehabilitation professionals working in this field.
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Affiliation(s)
- Lyndal Hickey
- Department of Social Work, Faculty of Medicine, Dentistry and Health Sciences, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Osman Kuyucak
- Department of Social Work, Faculty of Medicine, Dentistry and Health Sciences, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Lukas Clausen
- Department of Social Work, Faculty of Medicine, Dentistry and Health Sciences, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Christine Imms
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
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4
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Bania TA, Taylor NF, Chiu HC, Charitaki G. What are the optimum training parameters of progressive resistance exercise for changes in muscle function, activity and participation in people with cerebral palsy? A systematic review and meta-regression. Physiotherapy 2022; 119:1-16. [PMID: 36696699 DOI: 10.1016/j.physio.2022.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/11/2022] [Accepted: 10/13/2022] [Indexed: 01/24/2023]
Abstract
OBJECTIVES To explore the effect of progressive resistance exercise (PRE) on impairment, activity and participation of people with cerebral palsy (CP). Also, to determine which programme parameters provide the most beneficial effects. DATA SOURCES Electronic databases searched from the earliest available time. ELIGIBILITY CRITERIA Randomised controlled trials (RCTs) implementing PRE as an intervention in people with cerebral palsy were included. STUDIES APPRAISAL & SYNTHESIS METHODS Methodological quality of trials was assessed with the PEDro scale. Meta-analysis and meta-regression were completed. RESULTS We included 20 reports of 16 RCTs (n = 504 participants). Results demonstrated low certainty evidence that PRE improved muscle strength (pooled standardised mean difference (SMD)= 0.59 (95%CI: 0.16-1.01; I²=70%). This increase in muscle strength was maintained an average of 11 weeks after training stopped. Τhere was also moderate certainty evidence that it is inconclusive whether PRE has a small effect on gross motor function (SMD= 0.14 (95%CI: -0.09 to 0.36; I²=0%) or participation (SMD= 0.26 (95%CIs: -0.02 to 0.54; I²=0%). When PRE was compared with other therapy there were no between-group differences. Meta-regression demonstrated no effect of PRE intensity or training volume (frequency x total duration) on muscle strength (p > 0.5). No serious adverse events were reported. There is lack of evidence of the effectiveness of PRE in adults and non-ambulatory people with CP. CONCLUSIONS PRE is safe and increases muscle strength in young people with CP, which is maintained after training stops. The increase in muscle strength is unrelated to the PRE intensity or dose. CONTRIBUTION OF THE PAPER.
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Affiliation(s)
- Theofani A Bania
- Department of Physiotherapy, University of Patras, Ktirio B', Rio, 26504 , Greece.
| | - Nicholas F Taylor
- School of Allied Health, Human Services and Sport, La Trobe University; and Allied Health Clinical Research Office, Eastern Health, Australia.
| | - Hsiu-Ching Chiu
- Department of Physical Therapy, I-Shou University, Xuecheng Road, Dashu District, Kaohsiung 82445 Taiwan.
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A Study on Physical Exercise and General Mobility in People with Cerebral Palsy: Health through Costless Routines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179179. [PMID: 34501769 PMCID: PMC8430775 DOI: 10.3390/ijerph18179179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/20/2021] [Accepted: 08/26/2021] [Indexed: 12/16/2022]
Abstract
Sedentary behavior (SB) is a common problem that may produce health issues in people with cerebral palsy (CP). When added to a progressive reduction in motor functions over time, SB can lead to higher percentages of body fat, muscle stiffness and associated health issues in this population. Regular physical activity (RPA) may prevent the loss of motor skills and reduce health risks. In this work, we analyzed data collected from 40 people (20 children and teenagers, and 20 adults) who attend two specialist centers in Seville to obtain an up-to-date picture regarding the practice of RPA in people with CP. Roughly 60% of the participants showed mostly mid/severe mobility difficulties, while 38% also had communicative issues. Most of the participants performed light-intensity physical activity (PA) at least once or twice a week and, in the majority of cases, had a neutral or positive attitude to exercising. In the Asociación Sevillana de Parálisis Cerebral (ASPACE) sample test, the higher the International Classification of Functioning, Disability and Health (ICF), the higher the percentage of negative responses to doing exercise. Conversely, in the Centro Específico de Educación Especial Mercedes Sanromá (CEEEMS), people likes PA but slightly higher ratios of positive responses were found at Gross Motor Function Classification System (GMFCS) levels V and II, agreeing with the higher personal engagement of people at those levels. We have also performed a literature review regarding RPA in CP and the use of low-cost equipment. As a conclusion, we found that RPA produces enormous benefits for health and motor functions, whatever its intensity and duration. Costless activities such as walking, running or playing sports; exercises requiring low-cost equipment such as elastic bands, certain smartwatches or video-games; or therapies with animals, among many others, have all demonstrated their suitability for such a purpose.
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6
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Joung HJ, Yang HK, Lee Y. Effect of Dance on Balance, Mobility, and Activities of Daily Living in Adults With Cerebral Palsy: A Pilot Study. Front Neurol 2021; 12:663060. [PMID: 34025566 PMCID: PMC8137835 DOI: 10.3389/fneur.2021.663060] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 04/12/2021] [Indexed: 11/25/2022] Open
Abstract
The age-related decline in motor function with respect to balance and mobility may hamper the activities of daily living, quality of life, and social participation. Despite the importance of managing secondary conditions leading to premature aging, the literature regarding appropriate physical activity for adults with cerebral palsy (CP) is still scarce. Dance forms have emerged as an effective physical activity that improves balance and mobility in individuals with neurological conditions and boosts social engagement. However, its effect on adults with CP has yet to be examined. This pilot study aimed to examine the long-term effect of dance on improving balance and mobility in adults with CP. This single-cohort study included 10 adults with CP. They attended two 90-min-long creative dance sessions per week for 12 weeks. The outcomes measured effects on balance, mobility, balance confidence, and level of functional independence. These measurements were obtained at pre-intervention, post-intervention, and the 3-month follow-up. Outcome data of pre- to post-intervention and pre-intervention to 3-month follow-up were analyzed and compared. Statistically significant differences were found in the pre- and post-intervention displacement of the center of pressure (CoP) in the eyes-opened (EO) condition, timed up and go test (TUG), and Berg Balance Scale (BBS), Dynamic Gait Index (DGI), and Korean-Activity of Balance Confidence (K-ABC) scores. Significant improvements were also observed for the CoP-EO, BBS, TUG, DGI, and K-ABC between the pre-intervention and 3-month follow-up assessments. However, there were no significant differences in the CoP in the eyes-closed condition and Korean modified Barthel Index score. Participants expressed enjoyment without any pain or fatigue. Our findings suggest that dance may have a positive impact in improving balance and mobility and may consequently contribute to healthy aging in adults with CP.
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Affiliation(s)
- Hee Joung Joung
- Department of Physical Education, Seoul National University, Seoul, South Korea
| | - Hye Kyung Yang
- Department of Physical Education, Seoul National University, Seoul, South Korea
| | - Yongho Lee
- Department of Physical Education, Seoul National University, Seoul, South Korea
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7
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Song JZ, Catizzone M, Arbour-Nicitopoulos KP, Luong D, Perrier L, Bayley M, Munce SEP. Physical performance outcome measures used in exercise interventions for adults with childhood-onset disabilities: A scoping review. NeuroRehabilitation 2020; 47:359-380. [PMID: 33164958 DOI: 10.3233/nre-203250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND People with childhood-onset disabilities face unique physical and social challenges in adulthood. Exercise interventions may improve physical performance in children, but there is a lack of research on adults. OBJECTIVE To describe studies that investigate exercise interventions and to evaluate the quality of physical performance outcome measures for adults with childhood-onset disabilities. METHODS Eligible studies reported on exercise interventions for adults (ages 16+) with cerebral palsy, spina bifida, or acquired brain injuries. Only randomized controlled trials published in English from 2008 to 2019 were included. MEDLINE, CINAHL, PEDro, EMBASE, and Cochrane Central Register of Controlled Trials were searched. Two reviewers independently screened studies and abstracted data. RESULTS This scoping review included 4 trials reporting on cerebral palsy only. Three strength training programs found significant improvements in gait, and one mixed training program found significant improvements in strength and fitness. Only two outcome measures used are valid/reliable for adults (6 Minute Walk Test and Borg-20 Grades). CONCLUSION Certain interventions may improve physical performance, but there is a lack of research on appropriate exercise interventions and physical performance outcome measures for adults with childhood-onset disabilities. Different exercise interventions should be investigated using larger sample sizes and outcome measures should be standardized.
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Affiliation(s)
- Jessica Z Song
- Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada
| | - Margot Catizzone
- Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada
| | | | - Dorothy Luong
- Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada
| | - Laure Perrier
- University of Toronto Libraries, Toronto, ON, Canada
| | - Mark Bayley
- Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada
| | - Sarah E P Munce
- Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada
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Klobucká S, Klobucký R, Kollár B. Effect of robot-assisted gait training on motor functions in adolescent and young adult patients with bilateral spastic cerebral palsy: A randomized controlled trial. NeuroRehabilitation 2020; 47:495-508. [PMID: 33136072 DOI: 10.3233/nre-203102] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Robot-assisted gait training (RAGT) allows an intensive gait training in patients with cerebral palsy (CP). There are few evidences on the effectiveness of RAGT in adults with CP. OBJECTIVE To assess the effect of RAGT on gross motor function in adolescent and adult patients with bilateral spastic CP and to compare the effect of RAGT with conventional kinesiotherapy. METHODS Forty-seven patients (mean age 21.2±5.33 years) with bilateral spastic CP were divided into two groups. Twenty-one patients underwent 20 therapeutic units of RAGT and 26 patients underwent 20 therapeutic units of conventional therapy/training (CON). The following parameters were evaluated before (V1) and after the therapy (V2): dimension A (lying and rolling), B (sitting), C (crawling and kneeling), D (standing), E (walking, running and jumping) of the Gross Motor Function Measure (GMFM-88). In patients in the experimental RAGT group, these parameters were also evaluated 3-4 months later (V3). RESULTS Comparing the mean improvements in endpoints in both groups (RAGT vs. CON) after 20 TUs, we observed the statistically significant difference (p < 0.001) and large effect size in all GMFM dimensions and total GMFM improvement in favour of the RAGT group. In RAGT patients, the improvement persisted even 3-4 months after RAGT (p < 0.001). CONCLUSION We demonstrated that the intensive RAGT regimen is more effective than conventional therapy in terms of improvements in gross motor functions in adolescent and adult patients with bilateral spastic CP.
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Affiliation(s)
| | - Robert Klobucký
- Slovak Academy of Sciences, Institute for Sociology, Bratislava, Slovakia
| | - Branislav Kollár
- 1st Department of Neurology, Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia
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9
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Cetin SY, Erel S. Investigation of the validity and reliability of the L test in children with cerebral palsy. Physiother Theory Pract 2020; 38:182-188. [DOI: 10.1080/09593985.2020.1731894] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Sebahat Yaprak Cetin
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Akdeniz University, Konyaalti/Antalya, Turkey
| | - Suat Erel
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
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10
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Bouça-Machado R, Duarte GS, Patriarca M, Castro Caldas A, Alarcão J, Fernandes RM, Mestre TA, Matias R, Ferreira JJ. Measurement Instruments to Assess Functional Mobility in Parkinson's Disease: A Systematic Review. Mov Disord Clin Pract 2019; 7:129-139. [PMID: 32071930 DOI: 10.1002/mdc3.12874] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/28/2019] [Accepted: 11/20/2019] [Indexed: 01/06/2023] Open
Abstract
Background Functional mobility (FM) is a person's ability to move to accomplish activities of daily living; it bridges the concepts of mobility and functional ability. There is frequently a loss of FM in Parkinson's disease (PD). Several instruments have been used to assess this concept in PD; however, there is no consensus on which are the most appropriate. Objective We aimed to identify and critically appraise which measurement instruments have been used to assess FM. Methods A systematic review was conducted using the databases CENTRAL, MEDLINE, Embase, and PEDro from their inception to January 2019 to identify all observational and experimental studies conducted in PD or atypical parkinsonism that included an FM assessment. Two reviewers independently screened citations, extracted data, and assessed clinimetric properties. Results We included 95 studies that assessed FM in PD. Fifty-five (57.9%) studies mentioned FM in the article, and 39 (41.1%) specified the measurement tools used to evaluate FM. FM was the primary outcome in 12 (12.6%) studies. The Timed Up and Go test was the most frequently used measurement tool. Only one study presented a definition of FM. Several overlapping terms were used, the most common being mobility. Conclusion Several studies reported the use of FM measurement tools in PD, though with frequent misconceptions, an inadequate context of use, or suboptimal assessment. We propose the establishment of the concept of FM applied to PD, followed by the adequate clinimetric validation of existing measurement tools to provide a comprehensive and reliable evaluation of FM in PD.
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Affiliation(s)
- Raquel Bouça-Machado
- Instituto de Medicina Molecular, Faculdade de Medicina Universidade de Lisboa Lisbon Portugal.,CNS-Campus Neurológico Sénior Torres Vedras Portugal
| | - Gonçalo S Duarte
- Instituto de Medicina Molecular, Faculdade de Medicina Universidade de Lisboa Lisbon Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina Universidade de Lisboa Lisbon Portugal
| | | | | | - Joana Alarcão
- Center for Evidence-Based Medicine, Faculdade de Medicina Universidade de Lisboa Lisbon Portugal
| | - Ricardo M Fernandes
- Instituto de Medicina Molecular, Faculdade de Medicina Universidade de Lisboa Lisbon Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina Universidade de Lisboa Lisbon Portugal.,Department of Pediatrics Santa Maria Hospital Lisbon Portugal
| | - Tiago A Mestre
- Parkinson's disease and Movement Disorders Center, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute University of Ottawa Brain and Research Institute Ottawa Ontario Canada
| | - Ricardo Matias
- Champalimaud Research and Clinical Centre Champalimaud Centre for the Unknown Lisbon Portugal.,Human Movement Analysis Lab Escola Superior Saúde-Instituto Politécnico de Setúbal Setúbal Portugal
| | - Joaquim J Ferreira
- Instituto de Medicina Molecular, Faculdade de Medicina Universidade de Lisboa Lisbon Portugal.,CNS-Campus Neurológico Sénior Torres Vedras Portugal
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Lilly H, Bitzel M, Pejnovic T, Schnell J, Doty A. Barriers and characteristics for successful transition to adult healthcare for individuals with cerebral palsy: a systematic review. PHYSICAL THERAPY REVIEWS 2019. [DOI: 10.1080/10833196.2019.1662995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Hannah Lilly
- Physical Therapy Department, Walsh University, North Canton, OH, USA
| | - Mackenzie Bitzel
- Physical Therapy Department, Walsh University, North Canton, OH, USA
| | - Tatiana Pejnovic
- Physical Therapy Department, Walsh University, North Canton, OH, USA
| | - Joanna Schnell
- Physical Therapy Department, Walsh University, North Canton, OH, USA
| | - Antonette Doty
- Physical Therapy Department, Walsh University, North Canton, OH, USA
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12
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Aguilar-Lazcano CA, Rechy-Ramirez EJ, Hu H, Rios-Figueroa HV, Marin-Hernandez A. Interaction Modalities Used on Serious Games for Upper Limb Rehabilitation: A Systematic Review. Games Health J 2019; 8:313-325. [PMID: 31287734 DOI: 10.1089/g4h.2018.0129] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
This systematic review aims to analyze the state-of-the-art regarding interaction modalities used on serious games for upper limb rehabilitation. A systematic search was performed in IEEE Xplore and Web of Science databases. PRISMA and QualSyst protocols were used to filter and assess the articles. Articles must meet the following inclusion criteria: they must be written in English; be at least four pages in length; use or develop serious games; focus on upper limb rehabilitation; and be published between 2007 and 2017. Of 121 articles initially retrieved, 33 articles met the inclusion criteria. Three interaction modalities were found: vision systems (42.4%), complementary vision systems (30.3%), and no-vision systems (27.2%). Vision systems and no-vision systems obtained a similar mean QualSyst (86%) followed by complementary vision systems (85.7%). Almost half of the studies used vision systems as the interaction modality (42.4%) and used the Kinect sensor to collect the body movements (48.48%). The shoulder was the most treated body part in the studies (19%). A key limitation of vision systems and complementary vision systems is that their device performances might be affected by lighting conditions. A main limitation of the no-vision systems is that the range-of-motion in angles of the body movement might not be measured accurately. Due to a limited number of studies, fruitful areas for further research could be the following: serious games focused on finger rehabilitation and trauma injuries, game difficulty adaptation based on user's muscle strength and posture, and multisensor data fusion on interaction modalities.
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Affiliation(s)
| | | | - Huosheng Hu
- School of Computer Science and Electronic Engineering, University of Essex, Colchester, United Kingdom
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13
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Barcala L, Politti F, Artilheiro MC, Speciali DS, Garbelotti SA, Correa JCF, Lucareli PRG. Adult dyskinetic cerebral palsy: Upper limb movement and muscle function. Acta Neurol Scand 2019; 139:505-511. [PMID: 30810219 DOI: 10.1111/ane.13083] [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: 10/20/2018] [Revised: 02/06/2019] [Accepted: 02/20/2019] [Indexed: 02/01/2023]
Abstract
AIM The aim of this study was to characterize upper limb motor function during a comparative analysis of electromyographic and upper limb movement analysis during drinking between healthy adults and individuals with DCP. METHOD Fifteen healthy individuals (CG) and fifteen individuals with DCP (DG) participated in the study. Upper limb function was analyzed during drinking and consisted of a task divided into three phases: the going, the adjustment, and the return. RESULTS Electromyographic analysis revealed a lower activity of the anterior deltoid, posterior deltoid, and biceps brachii muscles in the DG. When comparing the interactions between groups and phases, only biceps brachii shower lower muscle activity during going and adjustment phases. The DG presented a smaller range of motion (ROM) for the shoulder, elbow, forearm and wrist movements. An interaction between groups and phases showed smaller ROM for the flexion and internal rotation of the shoulder, elbow flexion, forearm pronation, and ulnar deviation in the return phase compared to CG. INTERPRETATION The results may contribute positively to the quantification of the level of motor impairment and may be used as a reference for the development of therapeutic interventions for patients with DCP.
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Affiliation(s)
- Luciana Barcala
- Human Motion Analysis Laboratory, Department of Rehabilitation Science Universidade Nove de Julho São Paulo Brazil
| | - Fabiano Politti
- Human Motion Analysis Laboratory, Department of Rehabilitation Science Universidade Nove de Julho São Paulo Brazil
| | - Mariana C. Artilheiro
- Human Motion Analysis Laboratory, Department of Rehabilitation Science Universidade Nove de Julho São Paulo Brazil
| | - Danielli S. Speciali
- Human Motion Analysis Laboratory, Department of Rehabilitation Science Universidade Nove de Julho São Paulo Brazil
- Human Movement Analysis Laboratory Albert Einstein Hospital São Paulo Brazil
| | - Silvio A. Garbelotti
- Department of Physical Therapy Universidade Cidade de São Paulo São Paulo Brazil
| | - João C. F. Correa
- Human Motion Analysis Laboratory, Department of Rehabilitation Science Universidade Nove de Julho São Paulo Brazil
| | - Paulo R. G. Lucareli
- Human Motion Analysis Laboratory, Department of Rehabilitation Science Universidade Nove de Julho São Paulo Brazil
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14
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Lopes S, Magalhães P, Pereira A, Martins J, Magalhães C, Chaleta E, Rosário P. Games Used With Serious Purposes: A Systematic Review of Interventions in Patients With Cerebral Palsy. Front Psychol 2018; 9:1712. [PMID: 30283377 PMCID: PMC6156132 DOI: 10.3389/fpsyg.2018.01712] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 08/24/2018] [Indexed: 11/17/2022] Open
Abstract
The purpose of the present systematic review was to examine extant research regarding the role of games used seriously in interventions with individuals with cerebral palsy. Therefore, PubMed, PsyINFO, Web of Science, Scopus, and IEEE databases were used. Search terms included: “serious games” OR “online games” OR “video games” OR “videogame” OR “game based” OR “game” AND “intervention” AND “cerebral palsy.” After the full reading and quality assessment of the papers, 16 studies met the inclusion criteria. The majority of the studies reported high levels of compliance, motivation, and engagement with game-based interventions both at home and at the clinical setting intervention. Regarding the effectiveness of the use of games, the results of the studies show both positive and negative results regarding their effectiveness. The efficacy was reported to motor function (i.e., improvements in the arm function, hand coordination, functional mobility, balance and gait function, postural control, upper-limbs function) and physical activity. Findings of this review suggest that games are used as a complement to conventional therapies and not as a substitute. Practitioners often struggle to get their patients to complete the assigned homework tasks, as patients display low motivation to engage in prescribed exercises. Data of this review indicates the use of games as tools suited to promote patients’ engagement in the therapy and potentiate therapeutic gains.
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Affiliation(s)
- Sílvia Lopes
- School of Psychology, University of Minho, Braga, Portugal
| | | | | | | | | | - Elisa Chaleta
- School of Psychology and Science Social, University of Évora, Évora, Portugal
| | - Pedro Rosário
- School of Psychology, University of Minho, Braga, Portugal
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15
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Long-term results of multilevel surgery in adults with cerebral palsy. INTERNATIONAL ORTHOPAEDICS 2018; 43:255-260. [PMID: 29922840 DOI: 10.1007/s00264-018-4023-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 06/04/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Deterioration of gait in adolescent and adult patients with cerebral palsy can be associated with multiple factors. Multilevel surgery (MLS) is one option in adults with cerebral palsy to improve gait function with encouraging short-term results. It is a question whether these improvements are maintained over time. METHODS In a retrospective consecutive cohort study, adults with bilateral spastic cerebral palsy (BSCP) treated with MLS between 1995 and 2011 were scanned for potential inclusion. Patients needed to fulfill the following inclusion criteria: age at MLS > 17, standardized three-dimensional gait analysis (3D-GA) including clinical examination at pre-operative (E0), a short-term follow-up (E1) and at least seven years (E2) after the index MLS. Twenty adults (10 women, 10 men) with a Gross Motor Function Classification Level (GMFCS) I-III and a mean age at MLS of 24.8 years were included in this study. The average long-term follow-up was 10.9 years. The Gait Profile Score (GPS) was used as primary outcome measure. RESULTS The GPS improved significantly from 13.8° before surgery to 11.2° at short-term (p = 0.007) and to 11.3° at long-term follow-up (p = 0.002). Mean GPS showed a slight deterioration between E1 and E2 due to a minority of six patients (30%) who showed a significant loss of correction. CONCLUSION Surgical treatment in adults with BSCP was feasible and effective in the long-term. Significant improvement of gait and function was maintained in the majority of patients, while some patients were prone to develop crouch gait, hip flexion contractures, or pain.
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Gannotti ME, Blanchard Y, Blumberg L, LaRocco D. Shared meanings of success, happiness, and health among adults with cerebral palsy and physiotherapists: implications for practice and research. Disabil Rehabil 2018; 41:1321-1330. [PMID: 29370730 DOI: 10.1080/09638288.2018.1425488] [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: 10/18/2022]
Abstract
PURPOSE To describe shared meanings of success, happiness, and health of adults with cerebral palsy and physiotherapists. MATERIALS AND METHODS Ethnography employed open ended/semi-structured interviews and structured questionnaires (Satisfaction with Life Scale, Beck Depression Inventory-II®, Oxford Happiness Questionnaire, Life Habits Questionnaire, Medical Outcomes Study-Social Support Survey, and PROMIS® Pain Interference Scale). Content analysis of qualitative data and principal components analysis of questionnaire responses identified shared meanings. RESULTS Fourteen adults with cerebral palsy and 15 physiotherapists (median age 46) had similar levels of education. For both groups, social achievements, personal goals, employment, and supporting a family defined success. Adults with cerebral palsy more frequently identified tenacity and persistence as important for success. Both groups described happiness as spending time with loved ones, recreational activities, and having purpose in life. Adults with cerebral palsy identified the importance of self-acceptance for happiness. For both, health included self-care of mind/spirit, cardiovascular and musculoskeletal wellness, and physical fitness (the ability to perform physical tasks). Analysis of questionnaire responses identified shared meanings (eigenvalue 41, 95% explained variance). CONCLUSIONS Adults with cerebral palsy and physiotherapists share similar experiences, behaviors, and feelings about success, happiness, and health. This knowledge may improve communication, enhance evidence-based practice, and foster services to support wellbeing. Implications for rehabilitation Cerebral palsy is a life-long condition, but we know little about social and physical outcomes for adults with cerebral palsy. Lack of understanding about meanings of success, happiness, and health may be a barrier for consumers accessing and for providers delivering evidence-based services. Physiotherapists and adults with cerebral palsy share similar meanings (feelings, experiences, beliefs, behaviors) of success, happiness, and health- or wellbeing. Knowledge of this common ground may result in improved communication between providers and consumers, and foster more relevant and meaningful services to support the wellbeing of adults with cerebral palsy.
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Affiliation(s)
- Mary E Gannotti
- a Department of Rehabilitation Sciences , University of Hartford , West Hartford , CT , USA
| | - Yvette Blanchard
- b Department of Physical Therapy , Sacred Heart University , Fairfield , CT , USA
| | - Lisa Blumberg
- a Department of Rehabilitation Sciences , University of Hartford , West Hartford , CT , USA
| | - Diana LaRocco
- c Social and Educational Sciences , Goodwin College , East Hartford , CT , USA
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Abstract
Cerebral palsy (CP) is a lifespan motor disorder arising from damage to the developing brain before or shortly after birth. People with CP may experience problems with muscle coordination and difficulties with the organization and processing of sensory information. Functional mobility is impaired and commonly influenced by spasticity and musculoskeletal system problems such as contractures or bony torsion. Around 60% of individuals with CP are able to walk independently or with aids when entering adulthood. However, many adults with CP experience increasing balance and mobility dysfunction associated with premature aging. Falls and reduced falls efficacy are commonly experienced, with associated physical and psychosocial consequences. There is evidence that ambulant adults with CP may be able to enhance their functional balance and mobility as a result of an individualized exercise program of sufficient duration and intensity. However, whether such programs result in a reduction in falls is unknown. Given the high number of falls with injury experienced by this population, attention to fall risk factors and provision of basic fall prevention strategies are warranted.
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Affiliation(s)
- Prue Morgan
- Physiotherapy Department, School of Primary and Allied Health Care, Monash University, Frankston, VIC, Australia.
| | - Jennifer L McGinley
- Physiotherapy Department, Melbourne School of Health Sciences, University of Melbourne, Parkville, VIC, Australia
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18
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Osoria HL, Blauwet CA. Prescribing Exercise to Individuals with Disabilities: What Are the Concerns? Curr Sports Med Rep 2017; 16:268-273. [PMID: 28696990 DOI: 10.1249/jsr.0000000000000379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
It is well known that individuals with disabilities, constituting 15% to 20% of the adult population, experience a disproportionate risk of cardiometabolic disease and are more likely to live sedentary lifestyles when compared with their able-bodied peers. Although many complex factors likely lead to these disparities, targeted exercise programs can be influential in improving the health outcomes of this population. Additionally, it is important to keep several factors in mind when tailoring the exercise prescription for individuals with varied types of disability, given unique factors related to medical history, mobility, and community barriers. By safely engaging individuals with disabilities in exercise programs, clinicians can promote inclusion while making a significant contribution to health outcomes, ensuring that the principles of "Exercise is Medicine" are accessible to individuals of all abilities.
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Affiliation(s)
- Hector Luis Osoria
- 1Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, MA, 2 Brigham and Women's Hospital, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, MA, and 3Kelley Adaptive Sports Research Institute, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, MA
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