Assessment of visual perception in adolescents with a history of central coordination disorder in early life - 15-year follow-up study

Analysis of the prevalence of asymmetry and muscle tone disorders in the first year of life among youth with idiopathic scoliosis: A retrospective case-control study

BACKGROUND

Not much is known about developmental motor disorders in the first year of life of children diagnosed with idiopathic scoliosis (IS).

OBJECTIVE

This study aimed to compare the occurrence of asymmetry or muscle tone disorders in the first year of life in adolescents with IS and their healthy counterparts.

METHODS

The parents of adolescents with IS and without scoliosis completed a survey on the occurrence of asymmetry, abnormal muscle tone, and physiotherapy in their children in the first year of life. Pearson's chi square test and Cramer's coefficient were used.

RESULTS

The final analysis included 527 surveys completed by parents of adolescents with idiopathic scoliosis (150) and without scoliosis (377). A significantly higher frequency of asymmetry (p= 0.001) and muscle tone disorders (p= 0.001) was noted in adolescents with idiopathic scoliosis. The results also revealed a significant association between scoliosis and asymmetry (p= 0.001), as well as muscle tone (p= 0.001).

CONCLUSIONS

Developmental asymmetry or improper muscle tone in the first year of life could be considered a potential factor in the development of scoliosis; however, this hypothesis should be confirmed in future studies. Infants diagnosed with developmental disorders require systematic observation.

Identification, diagnosis, and early intervention of children with developmental language disorder in Ningxia

BACKGROUND

It is reported that the incidence of language development disorder in children at the age of 2 is as high as 17.0%. Timely discovery of the high-risk factors of language development disorder in children and early intervention can greatly reduce the incidence of language development disorder and shorten the course and condition of the patients with language development disorder. Therefore, in order to facilitate prompt diagnosis and early interventions for children with language development disorder (DLD) and improve their language ability, this study explored the influence of perinatal factors on the language development of children in Ningxia and identified the unfavorable and favorable factors that influenced language development.

METHODS

Children diagnosed in the General Hospital of Ningxia Medical University during 2018-2021 who met the screening criteria for DLD and practical pediatric diagnostic criteria for DLD were enrolled in this study. Perinatal factors (gestational age, weight, sex, delivery mode, maternal age, presence of intrauterine infection, asphyxia) were retrospectively analyzed. The perinatal factors affecting language development were assessed using a one-way analysis of variance (ANOVA).

RESULTS

Among 1,500 children aged 0-3, 240 cases (16.00%) had language delay. Of these, 122 were male and 118 were female. There were 115 cases of comprehension and expression disorder, 30 cases of articulation disorder, and 90 cases of mixed manifestation. And there were 194 cases with definite intrauterine and perinatal high-risk factors or neonatal diseases, accounting for 80.83% of the total number of children with language delay.

CONCLUSIONS

In Ningxia, factors in the neonatal period are the main cause of DLD, followed by fetal and maternal factors. Ischemic encephalopathy is the most common factor.

Cortisol Levels in Infants with Central Coordination Disorders during Vojta Therapy

Background: Due to the decrease in the percentage of perinatal mortality, which is one of the Millennium Development Goals, the number of children with a central coordination disorder (CCD) has increased, present in up to 40% of premature babies. Neurodevelopmental disorders detected in the diagnostic process require early interventions that will eliminate or overcome existing dysfunctions. These treatments often cause discomfort in the infant, which induces insecurity and activation of basic defense mechanisms. The aim of the work is to assess changes in cortisol concentration in infants treated with the Vojta method. Methods and findings: The study included 35 children with CCD aged between three and nine months. The participants had no comorbidities that could have affected the obtained results. The activities were planned to occur in three stages: 1. Collection of a saliva sample directly before the physiotherapy appointment. 2. Collection of saliva immediately after rehabilitation. 3. Collection of saliva 20 min after the end of rehabilitation. The physiotherapeutic intervention included the assessment of seven reactions of the body position in space according to Vojta and the conduct of a therapeutic session consisting of the first phase of rotation and creeping reflex according to Vojta. The concentration of free cortisol in saliva was assessed with LC-MS/MS. In the first measurement, none of the children presented an excess of the normative concentration of cortisol. The cortisol measurement performed directly after rehabilitation showed above-normative values in three children. In the third measurement, all of the children presented a decreased concentration of free cortisol. The analysis (paired two-tailed t-test, p < 0.05) showed statistically significant differences between particular stages of the measurements. The analysis of the scores obtained in the second measurement showed the concentration of scores in the area of “normal” at a level of 0.83 (normal concentration) and the area “above normal” at the level of 0.005 (very weak concentration). Based on the analysis of significance of the obtained scores, it was found that the result was not accidental, and the Vojta method used in the treatment of children with CCD was suitable. Conclusions: Here, for the first time, we presented how Vojta therapy was correlated with cortisol levels among children with a central coordination disorder.

Modulation of the human sensorimotor system by afferent somatosensory input: evidence from experimental pressure stimulation and physiotherapy

Peripheral afferent input is critical for human motor control and motor learning. Both skin and deep muscle mechanoreceptors can affect motor behaviour when stimulated. Whereas some modalities such as vibration have been employed for decades to alter cutaneous and proprioceptive input, both experimentally and therapeutically, the central effects of mechanical pressure stimulation have been studied less frequently. This discrepancy is especially striking when considering the limited knowledge of the neurobiological principles of frequently used physiotherapeutic techniques that utilise peripheral stimulation, such as reflex locomotion therapy. Our review of the available literature pertaining to pressure stimulation focused on transcranial magnetic stimulation (TMS) and neuroimaging studies, including both experimental studies in healthy subjects and clinical trials. Our search revealed a limited number of neuroimaging papers related to peripheral pressure stimulation and no evidence of effects on cortical excitability. In general, the majority of imaging studies agreed on the significant involvement of cortical motor areas during the processing of pressure stimulation. Recent data also point to the specific role of subcortical structures, such as putamen or brainstem reticular formation. A thorough comparison of the published results often demonstrated, however, major inconsistencies which are thought to be due to variable stimulation protocols and statistical power. In conclusion, localised peripheral sustained pressure is a potent stimulus inducing changes in cortical activation within sensory and motor areas. Despite historical evidence for modulation of motor behaviour, no direct link can be established based on available fMRI and electrophysiological data. We highlight the limited amount of research devoted to this stimulus modality, emphasise current knowledge gaps, present recent developments in the field and accentuate evidence awaiting replication or confirmation in future neuroimaging and electrophysiological studies.

Persistent Childhood Primitive Reflex Reduction Effects on Cognitive, Sensorimotor, and Academic Performance in ADHD

A study was performed on 2,175 individuals between the ages of 3.2 and 22.04 years diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and drawn from 89 separate locations across the United States in satellite clinics with common practices and common staff training and equipment. The objective was to determine the efficacy of a hemispheric-based training program to reduce extant retained primitive reflexes (RPRs) and examine the relationship to motor function by metronome-based motor, DL, and cognitive tasks measured by subtests of the Wechsler Wide Range Achievement Test. After a 12-week program, RPR's were significantly reduced, as well as performance on all motor and cognitive measures significantly increased. Listening comprehension demonstrated significant increases between pre- and post-testing of 7% (W = 1213000; df = 2094; p < 0.0001) and mathematical problem solving revealed a significant increase of 5% (W = 1331500; df = 2091; p < 0.0001) associated with a significant reduction in primitive reflexes. The study concluded that the incorporation of relatively simple hemispheric-based programming within the educational system worldwide could relatively inexpensively increase academic, cognitive, and motor performance.

Persistence of primitive reflexes and associated motor problems in healthy preschool children

INTRODUCTION

Retained primitive reflexes can disturb natural development and involve difficulties in social and educational children's life. They can also impact on psychomotor development. Mature responses in a child's psychomotor progress can only occur if the central nervous system itself has reached maturity. The process consist the transition made from brain stem reflex response to cortically controlled response. This study define the occurrence of primitive reflexes in healthy 4-6 years old children and analyze the impact of survived primitive reflexes on psychomotor development.

MATERIAL AND METHODS

The study involved 35 participants aged 4-6 years healthy preschool children. The study tools were: primitive reflexes tests by Sally Goddard for children and Motor Proficiency - Test (MOT 4-6 test) in 18 tasks.

RESULTS

Over a half (65%) preschool children had survived the primitive reflexes on the residual level. Eleven percent of them had no retained primitive reflexes. According to the psychomotor ability, 9% of the children were in the category of "altered development", 29% in "delayed development", 59% in "normal" and 3% in "very good development". The greater the severity of the reflex, the motor efficiency was lower (p < 0.05).

CONCLUSIONS

It seems reasonable to introduce reflexes integration therapy in children's with low psychomotor skills. Primitive reflexes routinely tested, can contribute to improved early psychomotor development in children with needs, thus preventing many difficulties which children can encounter within their social and school life.

Vojta method in the treatment of developmental hip dysplasia - a case report

Background

Developmental dysplasia of the hip joint is one of the most common congenital defects and often results in functional and structural disorders. Such cases particularly demand optimizing therapeutic effects and maximally reducing the duration of therapy.

Purpose

The aim of this case report is to present the therapeutic process in a child with developmental hip dysplasia.

Case report

This is a case report of a female child with a birth weight of 2,800 g and an Apgar score of 9 points born to a gravida 3 para 3 mother at 37 weeks. The child was delivered by cesarean section, and the pregnancy was complicated by oligohydramnios. Subluxation of the left hip joint was diagnosed by an orthopedist in the third month of life. The treatment followed was the Vojta method (the first phase of reflex turning and reflex crawling).

Results

During the 6 weeks of the Vojta treatment, the left half of the femoral head was centralized, and the process of formation of the hip joint acetabulum was influenced effectively enough to change the acetabulum’s Graff type from the baseline D to IIb after 41 days of treatment.

Conclusion

The diagnostic work-up of congenital hip joint dysplasia should involve a physiotherapist who will investigate the child’s neuromuscular coordination, in addition to a neonatologist and a pediatrician. The therapy for a disorder of hip joint development of neuromotor origin should involve the application of global patterns according to Vojta. Children with congenital dysplasia of the hip joint should commence rehabilitation as early as possible.

Krzych Ł, Kiebzak W. Early detection of idiopathic scoliosis - analysis of three screening models

INTRODUCTION

The prevalence of lateral curvatures of the spine ranges from 0.3% to 15.3% in the general population. The aim of the study was to develop and compare three different screening tests for idiopathic scoliosis (IS) with respect to their effectiveness and costs.

MATERIAL AND METHODS

The Delphi method was used to assess the efficacy of each screening algorithm in detecting IS in the population. An economic analysis was also performed.

RESULTS

Diagnostic Algorithm 1 for IS comprised a screening examination performed by nurses and a general practitioner (GP) with verification by specialists. The unit cost of carrying out diagnostic work-up for IS in Algorithm 1 was €94 per child. The second algorithm involved the use of the moiré computer method, followed by verification by a specialist. The lower unit cost of €86 per child of diagnostic work-up according to Algorithm 2 was due to fewer stages compared to Algorithm 1. The highest effectiveness with the highest costs were found for the third algorithm, with only one stage, a specialist's consultation (cost €153 per child).

CONCLUSIONS

The number of stages in an algorithm does not correlate positively with its efficacy or cost. The recommended scheme is Algorithm 3, where children are examined by rehabilitation specialists or a physiotherapist using a scoliometer and an inclinometer. The use of the apparently most expensive scheme (Algorithm 3) should result in lowering the costs of treatment of established idiopathic scoliosis and, in the long term, prove to be the most cost-effective solution for the health care system.