Effect of Physical Guidance on Learning a Tracking Task in Children with Cerebral Palsy

From one to many: Hypertonia in schizophrenia spectrum psychosis an integrative review and adversarial collaboration report

Different types of resistance to passive movement, i.e. hypertonia, were described in schizophrenia spectrum disorders (SSD) long before the introduction of antipsychotics. While these have been rediscovered in antipsychotic-naïve patients and their non-affected relatives, the existence of intrinsic hypertonia vs drug-induced parkinsonism (DIP) in treated SSD remains controversial. This integrative review seeks to develop a commonly accepted framework to specify the putative clinical phenomena, highlight conflicting issues and discuss ways to challenge each hypothesis and model through adversarial collaboration. The authors agreed on a common framework inspired from systems neuroscience. Specification of DIP, locomotor paratonia (LMP) and psychomotor paratonia (PMP) identified points of disagreement. Some viewed parkinsonian rigidity to be sufficient for diagnosing DIP, while others viewed DIP as a syndrome that should include bradykinesia. Sensitivity of DIP to anticholinergic drugs and the nature of LPM and PMP were the most debated issues. It was agreed that treated SSD should be investigated first. Clinical features of the phenomena at issue could be confirmed by torque, EMG and joint angle measures that could help in challenging the selectivity of DIP to anticholinergics. LMP was modeled as the release of the reticular formation from the control of the supplementary motor area (SMA), which could be challenged by the tonic vibration reflex or acoustic startle. PMP was modeled as the release of primary motor cortex from the control of the SMA and may be informed by subclinical echopraxia. If these challenges are not met, this would put new constraints on the models and have clinical and therapeutic implications.

The challenge point framework to improve stepping reaction and balance in children with hemiplegic cerebral palsy: A case series study

PURPOSE

This study investigated the effects of the challenge point framework (CPF) to improve stepping reactions and enhance balance in children with hemiplegic cerebral palsy (HCP). The CPF relates practice variables to the skill level of the individual and task difficulty.

METHODS

Nine children with HCP (age: 7.7±2.4 years) completed six weeks (12 sessions) of a CPF intervention which consisted of progressively fewer sets and repetitions of a stepping reaction task wherein participants sought to improve both step length and reaction rate. Stepping reaction (step length and reaction rate) to a balance perturbation in the anterior, posterior, and lateral directions and static and dynamic balance (via the Pediatric Balance Scale) were measured at baseline, a second baseline 3 weeks later, and post-intervention. Repeated measures ANOVAs determined within-group changes. Cohen's d effect sizes were calculated.

RESULTS

Participants improved balance (d = 0.948, p = 0.010), step length (forward d = 0.938, p = 0.002; backward d = 0.839, p = 0.001; and lateral d = 0.876, p = 0.002), and reaction rate (forward d = 0.249, p = 0.042; backward d = 0.21, p = 0.047; and lateral d = 0.198, p = 0.049).

CONCLUSION

These findings indicate that children with HCP may benefit from completing a CPF program with a motor learning approach. This approach of retraining stepping reactions helped to improve static and dynamic balance. The CPF may aid progression of functional task training in children with HCP aged 4-12, though more studies with a long-term follow-up analysis are needed to confirm this result.

Reliability levels of motor competence in youth athletes

This study aimed to analyze the reliability of the tests included in the motor competence assessment (MCA) battery and compare the effects of the number of trials per test. Thirty female volleyball players (14.6 ± 1.3 years of age) were tested. The participants performed two or three trials of each test. Intra-class correlation (ICC) was calculated, and a paired sample t-test analyzed the variations between trials (1st vs. 2nd vs. 3rd). Results revealed a significant difference between the first and the second trials for jumping sideways [t(29) = -4.108, p < 0.01], standing long jump [t(29) = -3.643, p < 0.01], and shuttle run [t(29) = -3.139, p < 0.01]. No significant result was registered in the shifting platforms, ball throwing and kicking between the first and second trials. Hence, any difference was recorded between the second and third trial. High ICC values were registered in lateral jumps, among the three repetitions of ball kicking and ball throwing, and between the last two repetitions of shuttle run. Almost perfect values were recorded for the shifting platforms and standing long jump. Nevertheless, there seems to be a learning effect between the first and the second repetition-no differences were registered only considering the two manipulative tests. In conclusion, except for jumping sideways, the MCA tests are reliable and only need to be performed two times instead of three.

Effects of Multicomponent Exercise Training Program on Biochemical and Motor Functions in Patients with Alzheimer’s Dementia

The aim of this study was to examine the effects of a multicomponent exercise training program on motor function and biochemical markers in patients with Alzheimer’s-type dementia. Twenty patients with Alzheimer disease, divided into the intervention group (IG; aged 84 ± 3.1 years) and the control group (CG; aged 86 ± 2.6 years) were included in this study. The intervention group was enrolled into an exercise training program for three months (two sessions of 60 min per week). The CG was instructed to follow their daily rhythm of life (e.g., rest, reading) without a physical training program. After 3 months of participation in a multicomponent exercise program, gait speed, balance and walking parameters were all improved in the intervention group as measured with the Berg Balance Scale, the Tinetti test, the 6-min walking test and the timed up and go test (p < 0.05 for all; percentage range of improvements: 3.17% to 53.40%), except the walking while talking test, and biochemical parameters were not affected (p > 0.05). Our results demonstrate that exercise improves postural control, aerobic capacity and mobility functions in patients with Alzheimer disease. Physical exercise is a safe and effective method for treating physical disorders in patients with Alzheimer’s disease and can easily be integrated in various programs for the management of Alzheimer disease.