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Sabater-Gárriz Á, Molina-Mula J, Montoya P, Riquelme I. Pain assessment tools in adults with communication disorders: systematic review and meta-analysis. BMC Neurol 2024; 24:66. [PMID: 38368314 PMCID: PMC10873938 DOI: 10.1186/s12883-024-03539-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/15/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND Verbal communication is the "gold standard" for assessing pain. Consequently, individuals with communication disorders are particularly vulnerable to incomplete pain management. This review aims at identifying the current pain assessment instruments for adult patients with communication disorders. METHODS A systematic review with meta-analysis was conducted on PubMed, PEDRO, EBSCOhost, VHL and Cochrane databases from 2011 to 2023 using MeSH terms "pain assessment, "nonverbal communication" and "communication disorders" in conjunction with additional inclusion criteria: studies limited to humans, interventions involving adult patients, and empirical investigations. RESULTS Fifty articles were included in the review. Seven studies report sufficient data to perform the meta-analysis. Observational scales are the most common instruments to evaluate pain in individuals with communication disorders followed by physiological measures and facial recognition systems. While most pain assessments rely on observational scales, current evidence does not strongly endorse one scale over others for clinical practice. However, specific observational scales appear to be particularly suitable for identifying pain during certain potentially painful procedures, such as suctioning and mobilization, in these populations. Additionally, specific observational scales appear to be well-suited for certain conditions, such as mechanically ventilated patients. CONCLUSIONS While observational scales dominate pain assessment, no universal tool exists for adults with communication disorders. Specific scales exhibit promise for distinct populations, yet the diverse landscape of tools hampers a one-size-fits-all solution. Crucially, further high-quality research, offering quantitative data like reliability findings, is needed to identify optimal tools for various contexts. Clinicians should be informed to select tools judiciously, recognizing the nuanced appropriateness of each in diverse clinical situations. TRIAL REGISTRATION This systematic review is registered in PROSPERO (International prospective register of systematic reviews) with the ID: CRD42022323655 .
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Affiliation(s)
- Álvaro Sabater-Gárriz
- Balearic ASPACE Foundation, Marratxí, Spain
- Department of Nursing and Physiotherapy, University of Balearic Islands, Palma, 07122, Spain
- Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, Palma, 07122, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, 07010, Spain
| | - Jesús Molina-Mula
- Department of Nursing and Physiotherapy, University of Balearic Islands, Palma, 07122, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, 07010, Spain
| | - Pedro Montoya
- Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, Palma, 07122, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, 07010, Spain
| | - Inmaculada Riquelme
- Department of Nursing and Physiotherapy, University of Balearic Islands, Palma, 07122, Spain.
- Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, Palma, 07122, Spain.
- Health Research Institute of the Balearic Islands (IdISBa), Palma, 07010, Spain.
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Saussez G, Bailly R, Araneda R, Paradis J, Ebner-Karestinos D, Klöcker A, Sogbossi ES, Riquelme I, Brochard S, Bleyenheuft Y. Correction: Efficacy of integrating a semi-immersive virtual device in the HABIT-ILE intervention for children with unilateral cerebral palsy: a non-inferiority randomized controlled trial. J Neuroeng Rehabil 2024; 21:20. [PMID: 38326808 PMCID: PMC10848427 DOI: 10.1186/s12984-024-01317-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2024] [Indexed: 02/09/2024] Open
Affiliation(s)
- G Saussez
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium.
- Motor Sciences department, FfH Lab, CeREF Santé, HELHa, Rue Trieu Kaisin, 136, 6061, Montignies-Sur-Sambre, Belgium.
| | - R Bailly
- Fondation Ildys, Brest, France
- Laboratoire de Traitement de l'information Médicale (LaTIM), Inserm U1101, Université Bretagne Occidentale, Brest, France
| | - R Araneda
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium
- Exercise and Rehabilitation Science Institute, School of Physical Therapy, Faculty of Rehabilitation Science, Universidad Andres Bello, Santiago, Chile
| | - J Paradis
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - D Ebner-Karestinos
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium
- Exercise and Rehabilitation Science Institute, School of Physical Therapy, Faculty of Rehabilitation Science, Universidad Andres Bello, Santiago, Chile
| | - A Klöcker
- Haute Ecole Leonard de Vinci, Parnasse-ISEI, Brussels, Belgium
| | - E S Sogbossi
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium
- School of Physical Therapy, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - I Riquelme
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, Palma, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain
| | - S Brochard
- Fondation Ildys, Brest, France
- Laboratoire de Traitement de l'information Médicale (LaTIM), Inserm U1101, Université Bretagne Occidentale, Brest, France
| | - Y Bleyenheuft
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium
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Araneda R, Ebner-Karestinos D, Paradis J, Klöcker A, Saussez G, Demas J, Bailly R, Bouvier S, Carton de Tournai A, Herman E, Souki A, Le Gal G, Nowak E, Sizonenko SV, Newman CJ, Dinomais M, Riquelme I, Guzzetta A, Brochard S, Bleyenheuft Y. Changes Induced by Early Hand-Arm Bimanual Intensive Therapy Including Lower Extremities in Young Children With Unilateral Cerebral Palsy: A Randomized Clinical Trial. JAMA Pediatr 2024; 178:19-28. [PMID: 37930692 PMCID: PMC10628844 DOI: 10.1001/jamapediatrics.2023.4809] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/10/2023] [Indexed: 11/07/2023]
Abstract
Importance Intensive interventions are provided to young children with unilateral cerebral palsy (UCP), classically focused on the upper extremity despite the frequent impairment of gross motor function. Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) effectively improves manual dexterity and gross motor function in school-aged children. Objective To verify if HABIT-ILE would improve manual abilities in young children with UCP more than usual motor activity. Design, Setting, and Participants This prospective randomized clinical trial (November 2018 to December 2021), including 2 parallel groups and a 1:1 allocation, recruitment took place at European university hospitals, cerebral palsy specialized centers, and spontaneous applications at 3 sites: Brussels, Belgium; Brest, France; and Pisa, Italy. Matched (age at inclusion, lesion type, cause of cerebral palsy, and affected side) pairs randomization was performed. Young children were assessed at baseline (T0), 2 weeks after baseline (T1), and 3 months after baseline (T2). Health care professionals and assessors of main outcomes were blinded to group allocation. At least 23 young children (in each group) aged 12 to 59 months with spastic/dyskinetic UCP and able to follow instructions were needed. Exclusion criteria included uncontrolled seizures, scheduled botulinum toxin injections, orthopedic surgery scheduled during the 6 months before or during the study period, severe visual/cognitive impairments, or contraindications to magnetic resonance imaging. Interventions Two weeks of usual motor activity including usual rehabilitation (control group) vs 2 weeks (50 hours) of HABIT-ILE (HABIT-ILE group). Main Outcomes and Measures Primary outcome: Assisting Hand Assessment (AHA); secondary outcomes: Gross Motor Function Measure-66 (GMFM-66), Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT), and Canadian Occupational Performance Measure (COPM). Results Of 50 recruited young children (26 girls [52%], median age; 35.3 months for HABIT-ILE group; median age, 32.8 months for control group), 49 were included in the final analyses. Change in AHA score from T0 to T2 was significantly greater in the HABIT-ILE group (adjusted mean score difference [MD], 5.19; 95% CI, 2.84-7.55; P < .001). Changes in GMFM-66 (MD, 4.72; 95% CI, 2.66-6.78), PEDI-CAT daily activities (MD, 1.40; 95% CI, 0.29-2.51), COPM performance (MD, 3.62; 95% CI, 2.91-4.32), and satisfaction (MD, 3.53; 95% CI, 2.70-4.36) scores were greater in the HABIT ILE group. Conclusions and Relevance In this clinical trial, early HABIT-ILE was shown to be an effective treatment to improve motor performance in young children with UCP. Moreover, the improvements had an impact on daily life activities of these children. Trial registration ClinicalTrials.gov Identifier: NCT04020354.
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Affiliation(s)
- Rodrigo Araneda
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
- Exercise and Rehabilitation Science Institute, Faculty of Rehabilitation Science, Universidad Andres Bello, Santiago, Chile
| | - Daniela Ebner-Karestinos
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
- Exercise and Rehabilitation Science Institute, Faculty of Rehabilitation Science, Universidad Andres Bello, Santiago, Chile
| | - Julie Paradis
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Anne Klöcker
- Haute Ecole Léonard de Vinci, Parnasse-ISEI, Brussels, Belgium
| | - Geoffroy Saussez
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
- Forme et Fonctionnement Humain Unit, Department of Motor Sciences, CeREF - Haute Ecole Louvain en Hainaut, Belgium
| | - Josselin Demas
- Université d’Angers, Laboratoire Angevin de Recherche en Ingénierie des Systèmes (LARIS) – EA7315 F-49000 France
- Instituts de formation du Centre Hospitalier de Laval, Laval, France
| | - Rodolphe Bailly
- INSERM UMR 1101, LaTIM, Brest, France
- Pediatric Rehabilitation Department, Fondation Ildys, Brest, France
| | - Sandra Bouvier
- Pediatric Rehabilitation Department, Fondation Ildys, Brest, France
- Western Brittany University, Brest, France
| | | | - Enimie Herman
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | | | - Grégoire Le Gal
- University Hospital of Brest, Brest, France
- INSERM CIC 1412, Brest, France
| | - Emmanuel Nowak
- University Hospital of Brest, Brest, France
- INSERM CIC 1412, Brest, France
| | - Stephane V. Sizonenko
- Division of Child Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
| | - Christopher J. Newman
- Paediatric Neurology and Neurorehabilitation Unit, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Mickael Dinomais
- Université d’Angers, Laboratoire Angevin de Recherche en Ingénierie des Systèmes (LARIS) – EA7315 F-49000 France
- CHU Angers, Département de Médecine Physique et de Réadaptions, CHU Angers-Capucins, F- 49933, France
| | - Inmaculada Riquelme
- Department of Nursing and Physiotherapy and Research Institute on Health Sciences (UINICS-Idisba), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Andrea Guzzetta
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sylvain Brochard
- INSERM UMR 1101, LaTIM, Brest, France
- Pediatric Rehabilitation Department, Fondation Ildys, Brest, France
- Western Brittany University, Brest, France
- University Hospital of Brest, Brest, France
| | - Yannick Bleyenheuft
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
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Bautista JD, Perales FJ, Ramis S, Montoya P, Riquelme I. Adaptation and Validation of a Serious Game for Motor Learning Training in Children with Cerebral Palsy. Games Health J 2023; 12:480-488. [PMID: 37449840 DOI: 10.1089/g4h.2023.0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023] Open
Abstract
Objective: Children with cerebral palsy (CP) present motor learning disorders and somatosensory dysfunction. Although many protocols use videogames in children with CP, few apply or examine motor learning principles. This study aims at (1) implementing therapist-user-designer collaboration in adapting a videogame to the principles of motor learning and the characteristics of users with CP, and (2) piloting the effectiveness of these adaptations by analyzing the achievement of motor learning parameters (learning rate acquisition, retention, and transfer to motor and somatosensory function). Materials and Methods: Periodical interprofessional meetings conducted to the adaptation of a videogame, requiring the control of a joystick for traveling through a maze, to motor learning principles. In a pilot validation, effects in unilateral upper limb function, gross manual dexterity, and somatosensory thresholds were assessed before and after 10-week training in 13 children with CP. Results: After 10-week training with the adapted serious game, children showed learning rates above 90% and improvement in motor learning parameters along the sessions. Manual dexterity and pronation-supination of the dominant hand improved after training. No significant effects were found on somatosensory thresholds. Conclusion: Serious games are useful as motor learning tools for improving motor function in children with PC. Cooperative work among professionals and users is advisable for designing efficient videogames according to rehabilitation best practices.
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Affiliation(s)
- Juan D Bautista
- Institute of Health Sciences Research (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Francisco J Perales
- Institute of Health Sciences Research (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain
- Department of Mathematics and Computer Science, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Silvia Ramis
- Department of Mathematics and Computer Science, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Pedro Montoya
- Institute of Health Sciences Research (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Inmaculada Riquelme
- Institute of Health Sciences Research (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
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Riquelme I, Hatem SM, Sabater-Gárriz Á, Montoya P. A multidimensional investigation of the relationship between skin-mediated somatosensory signals, emotion regulation and behavior problems in autistic children. Front Neurosci 2023; 17:1227173. [PMID: 37662109 PMCID: PMC10470890 DOI: 10.3389/fnins.2023.1227173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/25/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Autistic children may have abnormal sensory perception, emotion dysregulation and behavior problems. The aim of this cross-sectional study was to explore the relationship between skin-mediated somatosensory signals and emotion/behavior difficulties in autistic children and adolescents, in comparison typically developing peers (TDP). Methods Thirty-eight autistic children and adolescents and 34 TDP completed a multidimensional assessment consisting of the measurement of somatosensory thresholds of touch, pain and temperature, a task on emotion knowledge and parent-reported questionnaires on sensory reactivity, emotion regulation and behavior. Results Autistic children had higher pain sensitivity, less sensory reactive behaviors and more behavior problems than their TDP. In contrast to TDP, several somatosensory thresholds of autistic children correlated with emotion regulation and behavior problems. Discussion Sensory dysfunction may affect the development of emotional processing and behavior in autistic children and adolescents. This knowledge can lay the foundation for future studies on co-occurring alterations in corresponding neural networks and for the implementation of early interventions, including sensory rehabilitation therapy, for promoting regulated behaviors in autistic children and adolescents.
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Affiliation(s)
- Inmaculada Riquelme
- Research Institute on Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Samar M. Hatem
- Faculty of Medicine, STIMULUS Research Group (reSearch and TeachIng neuroModULation Uz bruSsel), Vrije Universiteit Brussel, Brussels, Belgium
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Álvaro Sabater-Gárriz
- Research Institute on Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
- Balearic ASPACE Foundation, Marratxí, Spain
| | - Pedro Montoya
- Research Institute on Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain
- Center for Mathematics, Computation and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
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Saussez G, Bailly R, Araneda R, Paradis J, Ebner-Karestinos D, Klöcker A, Sogbossi ES, Riquelme I, Brochard S, Bleyenheuft Y. Efficacy of integrating a semi-immersive virtual device in the HABIT-ILE intervention for children with unilateral cerebral palsy: a non-inferiority randomized controlled trial. J Neuroeng Rehabil 2023; 20:98. [PMID: 37516873 PMCID: PMC10385889 DOI: 10.1186/s12984-023-01218-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 07/13/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND The implementation of virtual devices can facilitate the role of therapists (e.g., patient motivation, intensity of practice) to improve the effectiveness of treatment for children with cerebral palsy. Among existing therapeutic devices, none has been specifically designed to promote the application of principles underlying evidence-based motor skill learning interventions. Consequently, evidence is lacking regarding the effectiveness of virtual-based sessions in motor function rehabilitation with respect to promoting the transfer of motor improvements into daily life activities. We tested the effectiveness of implementing a recently developed virtual device (REAtouch®), specifically designed to enable the application of therapeutic motor skill learning principles, during a Hand Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) intervention. METHODS Forty children with unilateral cerebral palsy (5-18 years; MACS I-III; GMFCS I-II) were randomly assigned to a control group or a "REAtouch®" experimental group for a 90-h HABIT-ILE day-camp intervention (two weeks). Children in the REAtouch® group spent nearly half of their one-on-one therapeutic time using the REAtouch®. Participants underwent three testing sessions: the week before (T1), after intervention (T2), and at three months follow-up (T3). The primary outcome was the Assisting Hand Assessment (T3-T1; blinded). Secondary outcomes measured uni-bimanual hand function, stereognosis, gait endurance, daily life abilities, and functional goals. Accelerometers and a manual report of daily activities served to document therapeutic dosage and treatment characteristics. We used one-way RMANOVA to compare the efficacies of the two interventions, and non-inferiority analyses to contrast changes in the "REAtouch®" group versus the "HABIT-ILE" control group. RESULTS We found significant improvements in both groups for most of the outcome measures (p < 0.05). There was significant non-inferiority of changes in the REAtouch® group for upper extremities motor function, functional goals attainment, and abilities in daily life activities (p < 0.05). CONCLUSIONS Use of the REAtouch® device during HABIT-ILE showed non-inferior efficacy compared to the conventional evidence-based HABIT-ILE intervention in children with unilateral cerebral palsy. This study demonstrates the feasibility of using this virtual device in a high dosage camp model, and establishes the possibility of applying the therapeutic principles of motor skill learning during specifically designed virtual-based sessions. TRIAL REGISTRATION Trial registration number: NCT03930836-Registration date on the International Clinical Trials Registry Platform (ICTRP): June 21th, 2018; Registration date on NIH Clinical Trials Registry: April 29th, 2019. First patient enrollment: July 3rd, 2018.
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Affiliation(s)
- G Saussez
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium.
- Motor Sciences department, FfH Lab, CeREF Santé, HELHa, Rue Trieu Kaisin, 136, 6061, Montignies-Sur-Sambre, Belgium.
| | - R Bailly
- Fondation Ildys, Brest, France
- Laboratoire de Traitement de l'information Médicale (LaTIM), Inserm U1101, Université Bretagne Occidentale, Brest, France
| | - R Araneda
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium
- Exercise and Rehabilitation Science Institute, School of Physical Therapy, Faculty of Rehabilitation Science, Universidad Andres Bello, Santiago, Chile
| | - J Paradis
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - D Ebner-Karestinos
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium
- Exercise and Rehabilitation Science Institute, School of Physical Therapy, Faculty of Rehabilitation Science, Universidad Andres Bello, Santiago, Chile
| | - A Klöcker
- Haute Ecole Leonard de Vinci, Parnasse-ISEI, Brussels, Belgium
| | - E S Sogbossi
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium
- School of Physical Therapy, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - I Riquelme
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, Palma, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain
| | - S Brochard
- Fondation Ildys, Brest, France
- Laboratoire de Traitement de l'information Médicale (LaTIM), Inserm U1101, Université Bretagne Occidentale, Brest, France
| | - Y Bleyenheuft
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium
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Pades Jiménez A, García-Buades ME, Riquelme I. Development of emotional intelligence and assertiveness in physiotherapy students and effects of clinical placements. Physiother Theory Pract 2023; 39:72-79. [PMID: 34927528 DOI: 10.1080/09593985.2021.2005200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Emotional intelligence (EI) and assertiveness are key abilities for physiotherapists. Clinical placements seem to affect students' development of EI and assertiveness, and their construction of the professional role. PURPOSE This study aims to compare the EI of physiotherapy students with students from other health professions and explore the evolution of EI and assertiveness in physiotherapy students throughout their university education, focusing on the influence of clinical practice. METHOD Students (N = 753) completed a self-administered questionnaire to measure emotional intelligence (TMMS 24), assertiveness (CSES), and sociodemographic variables. RESULTS EI levels were adequate and very similar across the three disciplines. Regarding assertiveness, physiotherapy students in year 4 obtained significantly higher levels than students in years 1, 2, and 3. Significant correlations (rs (207) = 0.35, p < .001) were found between assertiveness and the number of modules of clinical practice. CONCLUSION This study contributes with further evidence on the improvement of assertiveness in physiotherapy students through their university education and, in particular, with clinical placements. Practical implications highlight the importance of training in EI and assertiveness during university, coupled with clinical placements, in order to prepare for an effective and satisfactory professional life.
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Affiliation(s)
- Antonia Pades Jiménez
- Department of Nursing and Physiotherapy, Universitat de Les Illes Balears, Palma de Mallorca, Spain
| | | | - Inmaculada Riquelme
- Department of Nursing and Physiotherapy, Universitat de Les Illes Balears, Palma de Mallorca, Spain.,University Institute of Health Sciences Research (IUNICS-IDISBA), Universitat de les Illes Balears, Palma de Mallorca, Spain
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González-Matilla R, Abuín-Porras V, Casuso-Holgado MJ, Riquelme I, Heredia-Rizo AM. Effects of neural mobilization in disorders associated with chronic secondary musculoskeletal pain: A systematic review and meta-analysis. Complement Ther Clin Pract 2022; 49:101618. [DOI: 10.1016/j.ctcp.2022.101618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/09/2022] [Accepted: 06/09/2022] [Indexed: 11/15/2022]
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Rey B, Oliver A, Monzo JM, Riquelme I. Development and Testing of a Portable Virtual Reality-Based Mirror Visual Feedback System with Behavioral Measures Monitoring. IJERPH 2022; 19:ijerph19042276. [PMID: 35206464 PMCID: PMC8872630 DOI: 10.3390/ijerph19042276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 02/04/2023]
Abstract
Virtual Reality (VR) is a technology that has been used to provide the Mirror Visual Feedback (MVF) illusion to patients with promising results. In the present work, the goal is to design, develop and test a portable VR-based MVF system that monitors behavioral information about the performance of a simple motor task. The developed application runs in a stand-alone VR system and allows the researcher to select the real and virtual hands used to perform the motor task. The system was evaluated with a group of twenty healthy volunteers (12 men and 8 women) with ages between 18 and 66 years. Participants had to repetitively perform a motor task in four different experimental conditions: two mirror conditions (performing real movements with the dominant and with the non-dominant hand) and two non-mirror conditions. A significant effect of the experimental condition on embodiment score (p < 0.001), response time (p < 0.001), performance time (p < 0.001), trajectory length (p < 0.004) and trajectory maximum horizontal deviation (p < 0.001) was observed. Furthermore, a significant effect of the experimental moment (initial, middle and final parts of the training) on the performance time was observed (p < 0.001). These results show that the monitored parameters provide relevant information to evaluate the participant’s task performance in different experimental conditions.
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Affiliation(s)
- Beatriz Rey
- Departamento de Ingeniería Gráfica, Universitat Politècnica de València, 46022 Valencia, Spain;
- Correspondence:
| | - Alejandro Oliver
- Departamento de Ingeniería Gráfica, Universitat Politècnica de València, 46022 Valencia, Spain;
| | - Jose M. Monzo
- Instituto de Instrumentación para Imagen Molecular (I3M), Centro Mixto CSIC-Universitat Politècnica de València, 46022 Valencia, Spain;
| | - Inmaculada Riquelme
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma, Spain;
- Institute of Health Sciences Research (IUNICS-IdISBa), University of the Balearic Islands, 07122 Palma, Spain
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Mingorance JA, Montoya P, Miranda JGV, Riquelme I. An Observational Study Comparing Fibromyalgia and Chronic Low Back Pain in Somatosensory Sensitivity, Motor Function and Balance. Healthcare (Basel) 2021; 9:1533. [PMID: 34828579 PMCID: PMC8619309 DOI: 10.3390/healthcare9111533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/08/2021] [Accepted: 11/08/2021] [Indexed: 01/07/2023] Open
Abstract
Fibromyalgia (FM) and chronic low back pain (CLBP) have shared pathophysiology and have a considerable impact on patients' daily activities and quality of life. The main objective of this study was to compare pain impact, somatosensory sensitivity, motor functionality, and balance among 60 patients with FM, 60 patients with CLBP, and 60 pain-free controls aged between 30 and 65 years. It is essential to know the possible differences existing in symptomatology of two of the major chronic pain processes that most affect the population, such as FM and CLBP. The fact of establishing possible differences in sensory thresholds, motor function, and proprioceptive measures among patients with FM and CLBP could bring us closer to a greater knowledge of the chronic pain process. Through an observational study, a comparison was made between the three groups (FM, CLBP, and pain-free controls) evaluating functional performance, postural balance, kinematic gait parameters, strength, depression, fatigue, and sensitivity to pain and vibration. Patients with chronic pain showed worse somatosensory sensitivity (p < 0.001) and motor function (p < 0.001) than pain-free controls. Moreover, patients with FM showed greater pain impact (p < 0.001) and bigger somatosensory (p < 0.001) and motor deficiencies (p < 0.001) than patients with CLBP. Further research should explore the possible reasons for the greater deterioration in patients with FM in comparison with other chronic pain conditions. Our results, showing the multiple areas susceptible of deterioration, make it necessary to adopt interdisciplinary interventions focused both on physical and emotional dysfunction.
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Affiliation(s)
- José Antonio Mingorance
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, 07122 Palma de Mallorca, Spain;
- Physiotherapy Department, Son Espases Hospital, 07120 Palma de Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma de Mallorca, Spain
| | - Pedro Montoya
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, 07122 Palma de Mallorca, Spain;
- Center for Mathematics, Computing and Cognition, Federal University of ABC, São Bernardo do Campo 09606-070, Brazil
| | - José García Vivas Miranda
- Laboratory of Biosystems, Institute of Physics, Federal University of Bahia, Salvador 40170-115, Brazil;
| | - Inmaculada Riquelme
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, 07122 Palma de Mallorca, Spain;
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma de Mallorca, Spain
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11
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Mingorance JA, Montoya P, Miranda JGV, Riquelme I. The Therapeutic Effects of Whole-Body Vibration in Patients With Fibromyalgia. A Randomized Controlled Trial. Front Neurol 2021; 12:658383. [PMID: 34149596 PMCID: PMC8208732 DOI: 10.3389/fneur.2021.658383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/03/2021] [Indexed: 12/04/2022] Open
Abstract
Fibromyalgia is a chronic pain disease with few effective therapeutic options. We evaluated the efficacy of a 12-weeks therapy program that involves the use of whole body vibration in patients with fibromyalgia. The experimental group (N = 20 patients) participated in a neuromuscular training with a rotational whole body vibration platform for 12 weeks. The control group (N = 20 patients) received no physiotherapy treatment. The following variables were assessed before, after and 3 months after the therapy program: Fibromyalgia impact questionnaire, pain intensity, quality of life, sensitivity measurements (pressure pain thresholds, vibration thresholds), motor function tasks (Berg scale, 6-min walk test, isometric back muscle strength), and static and dynamic balance. We found improvements in the indexes of functional disability, static equilibrium and vibration sensitivity and a reduction of pain sensitivity. Our results showed that the intervention group improved almost all parameters immediately after the therapy program, in contrast to the control group that showed no changes. These improvements were not maintained in the follow-up. The whole body vibration therapy can be an effective therapy in patients with fibromyalgia and it can improve symptomatology and quality of life in these patients.
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Affiliation(s)
- José A Mingorance
- Department of Nursing and Physiotherapy, University of Balearic Islands, Palma, Spain.,University Institute of Health Sciences Research (IUNICS), University of Balearic Islands, Palma, Spain
| | - Pedro Montoya
- University Institute of Health Sciences Research (IUNICS), University of Balearic Islands, Palma, Spain
| | - José G Vivas Miranda
- Laboratory of Biosystems, Institute of Physics, Federal University of Bahia, Salvador, Brazil
| | - Inmaculada Riquelme
- Department of Nursing and Physiotherapy, University of Balearic Islands, Palma, Spain.,University Institute of Health Sciences Research (IUNICS), University of Balearic Islands, Palma, Spain
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12
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Riquelme I, Escobio-Prieto I, Oliva-Pascual-Vaca Á, Heredia-Rizo AM, Montoya P. Effect of Social Support in Pain Sensitivity in Children with Cerebral Palsy and Typically Developing Children. Int J Environ Res Public Health 2021; 18:ijerph18094661. [PMID: 33925690 PMCID: PMC8125433 DOI: 10.3390/ijerph18094661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 04/25/2021] [Indexed: 12/03/2022]
Abstract
Pain and abnormal somatosensory processing are important associated conditions in children and adolescents with cerebral palsy (CP). Perceived social support is highly relevant for pain perception and coping. Aim: The aim of the present study was to assess the influence of social support on pain sensitivity in children and adolescents with cerebral palsy and healthy peers. Design: Cross-sectional study. Methods: Pressure pain thresholds were assessed in 42 children and adolescents with CP and 190 healthy peers during three different conditions: alone, with their mother and with a stranger. Results: Children with CP reported lower pain sensitivity when they were with their mother than being alone or with a stranger, whereas healthy peers did not experience different pain sensitivity related to the social condition. Sex or clinical characteristics did not affect the relationship between pain perception and social support. Conclusion: The present study shows how children with CP are highly affected by social and contextual influences for regulating pain sensitivity. Solicitous parental support may enhance pain perception in children with CP. Further research on the topic is warranted in order to attain well-founded conclusions for clinical practice.
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Affiliation(s)
- Inmaculada Riquelme
- Institute of Health Sciences Research (IUNICS-IdISBa), University of Balearic Islands, Carretera de Valldemossa km 7.5, 07122 Palma de Mallorca, Spain;
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma de Mallorca, Spain
- Correspondence: ; Tel.: +34-971-171-310; Fax: +34-971-172-309
| | - Isabel Escobio-Prieto
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain; (I.E.-P.); (Á.O.-P.-V.); (A.M.H.-R.)
| | - Ángel Oliva-Pascual-Vaca
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain; (I.E.-P.); (Á.O.-P.-V.); (A.M.H.-R.)
| | - Alberto Marcos Heredia-Rizo
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain; (I.E.-P.); (Á.O.-P.-V.); (A.M.H.-R.)
| | - Pedro Montoya
- Institute of Health Sciences Research (IUNICS-IdISBa), University of Balearic Islands, Carretera de Valldemossa km 7.5, 07122 Palma de Mallorca, Spain;
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Verger S, Riquelme I, Bagur S, Paz-Lourido B. Satisfaction and Quality of Life of Families Participating in Two Different Early Intervention Models in the Same Context: A Mixed Methods Study. Front Psychol 2021; 12:650736. [PMID: 33986712 PMCID: PMC8111014 DOI: 10.3389/fpsyg.2021.650736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/06/2021] [Indexed: 11/13/2022] Open
Abstract
Early intervention is developed following different types of service organization, which in turn require different professional and family roles. The aim of this study was to compare the perceived satisfaction and family quality of life amongst families receiving early intervention developed at centers in comparison to those receiving the routines-based early intervention in families' homes, that is a family centered intervention in ecological environments. Under a transformative paradigm, a mixed methods design was used, using the Consumer Report Effectiveness Scale (CRES-4) and the Beach Center Family Quality of Life Scale (FQOLS) and two focus groups as data collection instruments. The sample comprised 166 parents in the quantitative phase and 16 parents in the qualitative phase. Results showed that families receiving routines-based early intervention had greater satisfaction with the service although both groups showed similar scores for family quality of life in most of the analyzed domains. Three dimensions were identified throughout the qualitative phase: problem solving, professional team and service organization. Both the models analyzed have an impact on family quality of life and parents are in general satisfied. Strengths and weaknesses were found related to the problem-solving process, the role of the professional team, family empowerment and the service's organization. The areas requiring further development are the effective training of professionals focused on family practices, the exchange of information with the family and a more participatory organization that takes parent's perspectives into consideration. The value given to a combined model is another aspect highlighted in this study, as well as the need for a more agile assessment period to avoid unnecessary delays.
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Affiliation(s)
- Sebastià Verger
- Childhood, Technology, Education and Diversity Research Group, Institute of Research and Innovation in Education (IRIE), Palma, Spain.,Department of Applied Pedagogy and Psychology of Education, University of the Balearic Islands, Palma, Spain
| | - Inmaculada Riquelme
- Institute of Health Sciences Research (IUNICS-IdISBa), University of the Balearic Islands, Palma, Spain.,Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain
| | - Sara Bagur
- Department of Applied Pedagogy and Psychology of Education, University of the Balearic Islands, Palma, Spain
| | - Berta Paz-Lourido
- Childhood, Technology, Education and Diversity Research Group, Institute of Research and Innovation in Education (IRIE), Palma, Spain.,Institute of Health Sciences Research (IUNICS-IdISBa), University of the Balearic Islands, Palma, Spain.,Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain
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14
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Mingorance JA, Montoya P, Vivas Miranda JG, Riquelme I. A Comparison of the Effect of Two Types of Whole Body Vibration Platforms on Fibromyalgia. A Randomized Controlled Trial. Int J Environ Res Public Health 2021; 18:ijerph18063007. [PMID: 33804207 PMCID: PMC8001601 DOI: 10.3390/ijerph18063007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/04/2021] [Accepted: 03/10/2021] [Indexed: 11/23/2022]
Abstract
Whole body vibration has been proven to improve the health status of patients with fibromyalgia, providing an activation of the neuromuscular spindles, which are responsible for muscle contraction. The present study aimed to compare the effectiveness of two types of whole body vibrating platforms (vertical and rotational) during a 12-week training program. Sixty fibromyalgia patients (90% were women) were randomly assigned to one of the following groups: group A (n = 20), who performed the vibration training with a vertical platform; group B (n = 20), who did rotational platform training; or a control group C (n = 20), who did not do any training. Sensitivity measures (pressure pain and vibration thresholds), quality of life (Quality of Life Index), motor function tasks (Berg Scale, six-minute walking test, isometric back muscle strength), and static and dynamic balance (Romberg test and gait analysis) were assessed before, immediately after, and three months after the therapy program. Although both types of vibration appeared to have beneficial effects with respect to the control group, the training was more effective with the rotational than with vertical platform in some parameters, such as vibration thresholds (p < 0.001), motor function tasks (p < 0.001), mediolateral sway (p < 0.001), and gait speed (p < 0.05). Nevertheless, improvements disappeared in the follow-up in both types of vibration. Our study points out greater benefits with the use of rotational rather than vertical whole body vibration. The use of the rotational modality is recommended in the standard therapy program for patients with fibromyalgia. Due to the fact that the positive effects of both types of vibration disappeared during the follow-up, continuous or intermittent use is recommended.
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Affiliation(s)
- José Antonio Mingorance
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, 07122 Palma de Mallorca, Spain; (P.M.); (I.R.)
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma de Mallorca, Spain
- Correspondence:
| | - Pedro Montoya
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, 07122 Palma de Mallorca, Spain; (P.M.); (I.R.)
| | - José García Vivas Miranda
- Laboratory of Biosystems, Institute of Physics, Federal University of Bahia, Salvador 40170-115, Brazil;
| | - Inmaculada Riquelme
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, 07122 Palma de Mallorca, Spain; (P.M.); (I.R.)
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma de Mallorca, Spain
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15
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Abstract
Aim: Children with cerebral palsy (CP) have increased pain sensitivity and recurrent pain episodes; however, pain is underreported in children with intellectual impairment. Cardiac autonomic regulation is imbalanced in chronic pain conditions and neurological disorders. This study aims at exploring the autonomous nervous system regulation of pain in children with CP compared with typically developing peers (TDP).Method: Heart rate variability (HRV) was recorded during 24 hours in 26 children with CP and 26 TDP, and examined offline at baseline (sleeping, seated rest) and during spontaneous pain events. Pain and fatigue, HRV indices (linear indices on time - IBI, SDNN, RMSSD - and frequency domains - high, low, and very low frequency - and non-linear indices - Hurst coefficient and multiscale entropy) were computed.Results: Children with CP showed comparable HRV during daily conditions and similar reductions after pain events than their TDP, regardless of their level of intellectual impairment. Interpretation: Children with CP have an intact autonomic regulation in acute pain events. HRV could be an accurate pain biomarker in children with CP and intellectual disability.What this paper adds: Autonomic regulation in acute pain is efficient in children with cerebral palsy.Heart rate variability indices can be reliable pain biomarkers in intellectual impairment.
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Affiliation(s)
- Inmaculada Riquelme
- University Institute of Health Sciences Research (Iunics-idispa), University of the Balearic Islands, Palma De Mallorca, Spain.,Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma De Mallorca, Spain
| | | | - Kari Vehmaskoski
- School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland
| | - Pekka Natunen
- School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland
| | - Pedro Montoya
- University Institute of Health Sciences Research (Iunics-idispa), University of the Balearic Islands, Palma De Mallorca, Spain
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16
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Riquelme I, Sabater-Gárriz Á, Montoya P. Pain and Communication in Children with Cerebral Palsy: Influence on Parents' Perception of Family Impact and Healthcare Satisfaction. Children (Basel) 2021; 8:children8020087. [PMID: 33513751 PMCID: PMC7912482 DOI: 10.3390/children8020087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/29/2022]
Abstract
Cerebral palsy (CP) is an impacting chronic condition. Concomitant comorbidities such as pain and speech inability may further affect parents’ perception of the pathology impact in the family quality of life and the provided care. The objective of this cross-sectional descriptive correlational study was to compare parental reports on family impact and healthcare satisfaction in children with CP with and without chronic pain and with and without speech ability. Parents of 59 children with CP (age range = 4–18 years) completed several questions about pain and speech ability and two modules of the Pediatric Quality of Life Measurement Model: The PedsQLTM 2.0 Family Impact Module and the PedsQLTM Healthcare Satisfaction Generic Module. Our findings revealed that children’s pain slightly impacted family physical health, social health and worry. In children without pain, speech inability increased the perceived health impact. Parents’ healthcare satisfaction was barely affected by pain or speech inability, both increasing parents’ satisfaction in the professional technical skills and inclusion of family domains on the care plan. In conclusion, pain and speech inability in children with CP can impact family health but not healthcare satisfaction. Regular assessment and intervention in family health is essential for the design of family-centred programs for children with CP.
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Affiliation(s)
- Inmaculada Riquelme
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, 07122 Palma, Spain; (Á.S.-G.); (P.M.)
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma, Spain
- Correspondence: ; Tel.: +34-971-171-310; Fax: +34-971-172-309
| | - Álvaro Sabater-Gárriz
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, 07122 Palma, Spain; (Á.S.-G.); (P.M.)
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma, Spain
- Fundación Aspace Baleares, Ctra. Vieja de Bunyola, Km 8.2, 07141 Marratxí, Spain
| | - Pedro Montoya
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, 07122 Palma, Spain; (Á.S.-G.); (P.M.)
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17
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Araneda R, Sizonenko SV, Newman CJ, Dinomais M, Le Gal G, Ebner-Karestinos D, Paradis J, Klöcker A, Saussez G, Demas J, Bailly R, Bouvier S, Nowak E, Guzzetta A, Riquelme I, Brochard S, Bleyenheuft Y. Protocol of changes induced by early Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (e-HABIT-ILE) in pre-school children with bilateral cerebral palsy: a multisite randomized controlled trial. BMC Neurol 2020; 20:243. [PMID: 32532249 PMCID: PMC7291688 DOI: 10.1186/s12883-020-01820-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/03/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Cerebral palsy (CP), which is the leading cause of motor disability during childhood, can produce sensory and cognitive impairments at different degrees. Most recent therapeutic interventions for these patients have solely focused on upper extremities (UE), although more than 60% of these patients present lower extremities (LE) deficits. Recently, a new therapeutic concept, Hand-arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE), has been proposed, involving the constant stimulation of UE and LE. Based on motor skill learning principles, HABIT-ILE is delivered in a day-camp setting, promoting voluntary movements for several hours per day during 10 consecutive week days. Interestingly, the effects of this intervention in a large scale of youngsters are yet to be observed. This is of interest due to the lack of knowledge on functional, neuroplastic and biomechanical changes in infants with bilateral CP. The aim of this randomized controlled study is to assess the effects of HABIT-ILE adapted for pre-school children with bilateral CP regarding functional, neuroplastic and biomechanical factors. METHODS This international, multicentric study will include 50 pre-school children with CP from 12 to 60 months of age, comparing the effect of 50 h (2 weeks) of HABIT-ILE versus regular motor activity and/or customary rehabilitation. HABIT-ILE presents structured activities and functional tasks with continuous increase in difficulty while the child evolves. Assessments will be performed at 3 period times: baseline, two weeks later and 3 months later. The primary outcome will be the Gross Motor Function Measure 66. Secondary outcomes will include Both Hands Assessment, Melbourne Assessment-2, Semmes-Weinstein Monofilament Test, algometry assessments, executive function tests, ACTIVLIM-CP questionnaire, Pediatric Evaluation of Disability Inventory (computer adaptative test), Young Children's Participation and Environment Measure, Measure of the Process of Care, Canadian Occupational Performance Measure, neuroimaging and kinematics. DISCUSSION The results of this study should highlight the impact of a motor, intensive, goal-directed therapy (HABIT-ILE) in pre-school children at a functional, neuroplastic and biomechanical level. In addition, this changes could demonstrated the impact of this intervention in the developmental curve of each child, improving functional ability, activity and participation in short-, mid- and long-term. NAME OF THE REGISTRY Evaluation of Functional, Neuroplastic and Biomechanical Changes Induced by an Intensive, Playful Early-morning Treatment Including Lower Limbs (EARLY-HABIT-ILE) in Preschool Children With Uni and Bilateral Cerebral Palsy (HABIT-ILE). TRIAL REGISTRATION NCT04017871 REGISTRATION DATE: July 12, 2019.
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Affiliation(s)
- Rodrigo Araneda
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200 Brussels, Belgium
| | - Stephane V. Sizonenko
- Division of Child Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
| | - Christopher J. Newman
- Paediatric Neurology and Neurorehabilitation Unit, University Hospital of Lausanne, Lausanne, Switzerland
| | - Mickael Dinomais
- Département de Médecine Physique et de Réadaptions, CHU Angers-Capucins, Angers, France
- Laboratoire Angevin de Recherche en Ingénierie des Systèmes, Université d’Angers, Angers, France
| | - Gregoire Le Gal
- University Hospital of Brest, Brest, France
- INSERM CIC 1412, Brest, France
| | - Daniela Ebner-Karestinos
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200 Brussels, Belgium
| | - Julie Paradis
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Anne Klöcker
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200 Brussels, Belgium
- Haute Ecole Léonard de Vinci, Parnasse-ISEI, Brussels, Belgium
| | - Geoffroy Saussez
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200 Brussels, Belgium
| | - Josselin Demas
- Laboratoire Angevin de Recherche en Ingénierie des Systèmes, Université d’Angers, Angers, France
- Institut Régional de Formation aux Métiers de Rééducation et de Réadaptation (IFM3R), Nantes, France
| | - Rodolphe Bailly
- Pediatric rehabilitation department, Fondation Ildys, Brest, France
- INSERM UMR 1101, LaTIM, Brest, France
- Western Britany University, Brest, France
| | - Sandra Bouvier
- University Hospital of Brest, Brest, France
- INSERM UMR 1101, LaTIM, Brest, France
- Western Britany University, Brest, France
| | - Emmanuel Nowak
- University Hospital of Brest, Brest, France
- INSERM CIC 1412, Brest, France
| | - Andrea Guzzetta
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Inmaculada Riquelme
- Department of Nursing and Physiotherapy and Research Institute on Health Sciences (UINICS-Idisba), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Sylvain Brochard
- University Hospital of Brest, Brest, France
- Pediatric rehabilitation department, Fondation Ildys, Brest, France
- INSERM UMR 1101, LaTIM, Brest, France
- Western Britany University, Brest, France
| | - Yannick Bleyenheuft
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200 Brussels, Belgium
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18
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Araneda R, Sizonenko SV, Newman CJ, Dinomais M, Le Gal G, Nowak E, Guzzetta A, Riquelme I, Brochard S, Bleyenheuft Y. Functional, neuroplastic and biomechanical changes induced by early Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (e-HABIT-ILE) in pre-school children with unilateral cerebral palsy: study protocol of a randomized control trial. BMC Neurol 2020; 20:133. [PMID: 32290815 PMCID: PMC7155331 DOI: 10.1186/s12883-020-01705-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 03/27/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Cerebral palsy (CP) causes motor, cognitive and sensory impairment at different extents. Many recent rehabilitation developments (therapies) have focused solely on the upper extremities (UE), although the lower extremities (LE) are commonly affected. Hand-arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) applies the concepts of motor skill learning and intensive training to both the UE and LE. It involves constant stimulation of the UE and LE, for several hours each day over a 2-week period. The effects of HABIT-ILE have never been evaluated in a large sample of young children. Furthermore, understanding of functional, neuroplastic and biomechanical changes in infants with CP is lacking. The aim of this study is to carry out a multi-center randomized controlled trial (RCT) to evaluate the effects of HABIT-ILE in pre-school children with unilateral CP on functional, neuroplastic and biomechanical parameters. METHODS This multi-center, 3-country study will include 50 pre-school children with CP aged 1-4 years. The RCT will compare the effect of 50 h (two weeks) of HABIT-ILE versus usual motor activity, including regular rehabilitation. HABIT-ILE will be delivered in a day-camp setting, with structured activities and functional tasks that will be continuously progressed in terms of difficulty. Assessments will be performed at 3 intervals: baseline (T0), two weeks later and 3 months later. Primary outcomes will be the Assisting Hand Assessment; secondary outcomes include the Melbourne Assessment-2, executive function assessments, questionnaires ACTIVLIM-CP, Pediatric Evaluation of Disability Inventory, Young Children's Participation and Environment Measure, Measure of the Process of Care, Canadian Occupational Performance Measure, as well as neuroimaging and kinematics measures. DISCUSSION We expect that HABIT-ILE will induce functional, neuroplastic and biomechanical changes as a result of the intense, activity-based rehabilitation process and these changes will impact the whole developmental curve of each child, improving functional ability, activity and participation in the short-, mid- and long-term. Name of the registry: Changes Induced by Early HABIT-ILE in Pre-school Children With Uni- and Bilateral Cerebral Palsy (EarlyHABIT-ILE). TRIAL REGISTRATION Trial registration number: NCT04020354-Registration date on the International Clinical Trials Registry Platform (ICTRP): November 20th, 2018; Registration date on NIH Clinical Trials Registry: July 16th, 2019.
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Affiliation(s)
- R Araneda
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200, Brussels, Belgium
| | - S V Sizonenko
- Division of Child Development and Growth, Department of Pediatrics, University of Geneva, Geneva, Switzerland
| | - C J Newman
- Paediatric Neurology and Neurorehabilitation Unit, University Hospital of Lausanne, Lausanne, Switzerland
| | - M Dinomais
- CHU Angers, Département de Médecine Physique et de Réadaptions, CHU Angers-Capucins, Angers, France
- Université d'Angers, Laboratoire Angevin de Recherche en Ingénierie des Systèmes, (LARIS) - EA7315, Angers, France
| | - G Le Gal
- University Hospital of Brest, Brest, France
- INSERM CIC 1412, Brest, France
| | - E Nowak
- University Hospital of Brest, Brest, France
- INSERM CIC 1412, Brest, France
| | - A Guzzetta
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - I Riquelme
- Department of Nursing and Physiotherapy and Research Institute on Health Sciences (UINICS-Idisba), University of the Balearic Islands, Palma de Mallorca, Spain
| | - S Brochard
- University Hospital of Brest, Brest, France
- Western Britany University, Brest, France
- INSERM UMR 1101, LaTIM, Brest, France
- Pediatric rehabilitation department, Fondation Ildys, Brest, France
| | - Y Bleyenheuft
- Institute of Neuroscience, Université catholique de Louvain, Avenue Mounier 53 box B1.53.04, 1200, Brussels, Belgium.
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Avellanal M, Riquelme I, Díaz-Regañón G. Quantitative Sensory Testing in pain assesment and treatment. Brief review and algorithmic management proposal. ACTA ACUST UNITED AC 2020; 67:187-194. [PMID: 32113579 DOI: 10.1016/j.redar.2020.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/29/2019] [Accepted: 01/09/2020] [Indexed: 11/17/2022]
Abstract
Quantitative Sensory Testing (QST) is used to globally analyze the nociceptive system in order to obtain a more objective understanding of pain perception. In recent years, QST has become a common tool in many pain clinics and anesthesiology departments worldwide. In 2013, the Neuropathic Pain Special Interest Group of the IASP put forward the first recommendations for conducting QST in clinical practice and research. However, the wide variety of QST methodologies and standards in the literature make it difficult to generalize the used of this tool in clinical practice. In this study, we present the basic concepts of QST, the type of tests and devices used, how they are applied, and the role of QST in anesthesiology and pain management.
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Affiliation(s)
- M Avellanal
- Unidad del Dolor, Hospital Universitario Sanitas La Moraleja, Madrid, España; Consultores en Dolor, Madrid, España.
| | - I Riquelme
- Unidad del Dolor, Hospital Universitario Sanitas La Moraleja, Madrid, España; Consultores en Dolor, Madrid, España
| | - G Díaz-Regañón
- Unidad del Dolor, Hospital Universitario Sanitas La Moraleja, Madrid, España; Consultores en Dolor, Madrid, España
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van der Slot WMA, Benner JL, Brunton L, Engel JM, Gallien P, Hilberink SR, Månum G, Morgan P, Opheim A, Riquelme I, Rodby-Bousquet E, Şimşek TT, Thorpe DE, van den Berg-Emons RJG, Vogtle LK, Papageorgiou G, Roebroeck ME. Pain in adults with cerebral palsy: A systematic review and meta-analysis of individual participant data. Ann Phys Rehabil Med 2020; 64:101359. [PMID: 32061920 DOI: 10.1016/j.rehab.2019.12.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 12/29/2019] [Accepted: 12/31/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND There is little focus on adults with cerebral palsy (CP) in research and health care and insufficient knowledge on how to identify and manage pain in this population. OBJECTIVES This systematic review and meta-analysis aimed to determine whether pain prevalence in adults with CP is high and to explore variations in pain prevalence of subgroups, pain locations, pain severity and pain interference. METHODS Potential datasets were identified by experts in the field and literature searches in Embase, MEDLINE, and Cochrane, from January 2000 to October 2016. Included studies had a representative sample of ≥25 adults with CP and ≥1 pain outcomes. Methodological quality assessment, pain prevalence estimates and logistic regression models for subgroup effects on pain prevalence were conducted. RESULTS In total, 17 eligible studies were identified from 4584 publications. A meta-analysis was performed with individual participant data from 15 studies totalling 1243 participants (mean [SD] age 34.3 [12.6] years). Overall mean pain prevalence was 70% (95% CI 62-78). Women were more likely to have pain than men (P<0.001). The odds of pain was increased in adults with gross motor function level II (odds ratio [OR] 1.92, 95% CI 1.22-3.12) and IV (OR 1.77, 95% CI 1.03-4.29). Participants with pain reported pain predominantly in the legs (76%, 95% CI 66-84), and mean pain severity was 3.7/10 (95% CI 2.7-4.7) and pain interference 3.5/10 (95% CI 2.5-4.5). CONCLUSIONS This meta-analysis provides the first reliable pain prevalence estimate in a large international sample of adults with CP. The high prevalence of pain, 70%, suggests that adults with CP should be routinely screened for pain and treated accordingly. The range of measurement instruments used by the included studies emphasizes using common outcome measures specific to pain internationally.
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Affiliation(s)
- Wilma M A van der Slot
- Rijndam Rehabilitation and Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Joyce L Benner
- Department of Rehabilitation Medicine, Erasmus University Medical Center and Rijndam Rehabilitation, Rotterdam, The Netherlands
| | - Laura Brunton
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Joyce M Engel
- Department of Occupational Science and Technology, University of Wisconsin-Milwaukee, Milwaukee, Wi, USA
| | - Philippe Gallien
- Breizh Paralysie Cérébrale Health Network, Pôle MPR Saint-Hélier, Rennes, France
| | - Sander R Hilberink
- Department of Rehabilitation Medicine, Erasmus University Medical Center and Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Grethe Månum
- Department of Research, Sunnaas Rehabilitation Hospital and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Prue Morgan
- Department of Physiotherapy, Monash University, Frankston, Victoria, Australia
| | - Arve Opheim
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway; Department of Research and Development, Habilitation & Health, Region Västra Götaland and Department of Rehabilitation Medicine, Sahlgrenska Academy, University of Gothenburg, Region Västra Götaland, Gothenburg, Sweden
| | - Inmaculada Riquelme
- Department of Nursing and Physiotherapy, University Institute of Health Sciences, University of the Balearic Islands, Palma de Mallorca, Mallorca, Spain
| | - Elisabet Rodby-Bousquet
- Center for Clinical Research, Uppsala University, Region Västmanland, Västerås and Department of Clinical Sciences, Orthopaedics, Lund University, Lund, Sweden
| | - Tülay Tarsuslu Şimşek
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, İzmir, Turkey
| | - Deborah E Thorpe
- Division of Physical Therapy, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rita J G van den Berg-Emons
- Department of Rehabilitation Medicine, Erasmus University Medical Center and Rijndam Rehabilitation, Rotterdam, The Netherlands
| | - Laura K Vogtle
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Grigorios Papageorgiou
- Department of Biostatistics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Marij E Roebroeck
- Department of Rehabilitation Medicine, Erasmus University Medical Center and Rijndam Rehabilitation, Rotterdam, The Netherlands
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Belmonte S, Montoya P, González-Roldán AM, Riquelme I. Reduced brain processing of affective pictures in children with cerebral palsy. Res Dev Disabil 2019; 94:103457. [PMID: 31520963 DOI: 10.1016/j.ridd.2019.103457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 07/31/2019] [Accepted: 08/04/2019] [Indexed: 06/10/2023]
Abstract
UNLABELLED Sensory and cognitive deficits are common comorbidities in children with cerebral palsy. This observational study examines if brain processing of affective information is also altered in children with cerebral palsy (CP) in comparison with typically developing peers (TDP). METHODS Evoked-related potentials were recorded in 15 children with CP (age = 11.27 ± 4.53 yr, 6 girls) and 14 TDP (age = 10.14 ± 4.29 yr, 5 girls) when viewing pleasant, unpleasant and neutral pictures. The subjective perception of valence and arousal of each one of the pictures was examined. RESULTS Children with CP showed a significant amplitude reduction of evoked potentials in the occipital region to the affective stimuli in early brain processing latencies (P100 and N200; all F > 2.9, all p < .05). Children with CP rated pictures with affective content (pleasant and unpleasant) as less arousing (F(2.25) = 46.71, p < .001), and neutral pictures as more pleasant, than their TDP (F(2.25) = 75.56, p < .001). CONCLUSION The pictures with emotional content produce less activation, both at the behavioral and brain processing levels in children with CP. These differences were found in early latencies of brain processing which could be related to alterations in the detection of emotionally relevant stimuli.
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Affiliation(s)
- Saliha Belmonte
- University Institute of Health Sciences Research (IUNICS-IdISPa), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Pedro Montoya
- University Institute of Health Sciences Research (IUNICS-IdISPa), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Ana M González-Roldán
- University Institute of Health Sciences Research (IUNICS-IdISPa), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Inmaculada Riquelme
- University Institute of Health Sciences Research (IUNICS-IdISPa), University of the Balearic Islands, Palma de Mallorca, Spain; Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain.
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22
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Zamorano AM, Montoya P, Cifre I, Vuust P, Riquelme I, Kleber B. Experience-dependent neuroplasticity in trained musicians modulates the effects of chronic pain on insula-based networks - A resting-state fMRI study. Neuroimage 2019; 202:116103. [PMID: 31437550 DOI: 10.1016/j.neuroimage.2019.116103] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 07/02/2019] [Accepted: 08/14/2019] [Indexed: 10/26/2022] Open
Abstract
Recent resting-state fMRI studies associated extensive musical training with increased insula-based connectivity in large-scale networks involved in salience, emotion, and higher-order cognitive processes. Similar changes have also been found in chronic pain patients, suggesting that both types of experiences can have comparable effects on insula circuitries. Based on these observations, the current study asked the question whether, and if so in what way, different forms of experience-dependent neuroplasticity may interact. Here we assessed insula-based connectivity during fMRI resting-state between musicians and non-musicians both with and without chronic pain, and correlated the results with clinical pain duration and intensity. As expected, insula connectivity was increased in chronic pain non-musicians relative to healthy non-musicians (with cingulate cortex and supplementary motor area), yet no differences were found between chronic pain non-musicians and healthy musicians. In contrast, musicians with chronic pain showed decreased insula connectivity relative to both healthy musicians (with sensorimotor and memory regions) and chronic pain non-musicians (with the hippocampus, inferior temporal gyrus, and orbitofrontal cortex), as well as lower pain-related inferences with daily activities. Pain duration correlated positively with insula connectivity only in non-musicians, whereas pain intensity exhibited distinct relationships across groups. We conclude that although music-related sensorimotor training and chronic pain, taken in isolation, can lead to increased insula-based connectivity, their combination may lead to higher-order plasticity (metaplasticity) in chronic pain musicians, engaging brain mechanisms that can modulate the consequences of maladaptive experience-dependent neural reorganization (i.e., pain chronification).
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Affiliation(s)
- Anna M Zamorano
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain; Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, The Faculty of Medicine, Aalborg University, Denmark.
| | - Pedro Montoya
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Ignacio Cifre
- University Ramon Llull, Blanquerna, FPCEE, Barcelona, Spain
| | - Peter Vuust
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & The Royal Academy of Music, Aarhus/Aalborg, Denmark
| | - Inmaculada Riquelme
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain; Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Boris Kleber
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & The Royal Academy of Music, Aarhus/Aalborg, Denmark; Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
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23
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Riquelme I, Arnould C, Hatem SM, Bleyenheuft Y. The Two-Arm Coordination Test: Maturation of Bimanual Coordination in Typically Developing Children and Deficits in Children with Unilateral Cerebral Palsy. Dev Neurorehabil 2019; 22:312-320. [PMID: 30024779 DOI: 10.1080/17518423.2018.1498552] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: Tools to assess bimanual coordination are scant. We aimed to: 1) provide normative data of maturation of bimanual coordination in tipically developing (TD) children measured by the Two Arm Coordination Test (TACT), and 2) validate the TACT as an instrument to specifically discriminate impairment of bimanual coordination in children with unilateral cerebral palsy (UCP). Procedure: Cross-sectional observational study. 252 TD children and 26 children with UCP performed 8 trials of TACT (following a star pattern with a pointer steered by coordinated movements of both arms). Number of errors and time were combined in a performance index of motor learning.Results: In TD children, bimanual coordination improved with age (F(7,244)=36.888, p<.001). Children with UCP had a poorer bimanual coordination than TD children (all t>24.25, all p<.01). TACT scores were correlated moderately to manual dexterity and manual ability (all r>-.452, all p<.039), showing the capacity of the TACT to provide information on different aspects of hand function. Conclusion: TACT is a valid instrument to assess bimanual coordination.
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Affiliation(s)
- Inmaculada Riquelme
- a University Institute of Health Sciences Research (IUNICS-IDISBA), University of the Balearic Islands , Palma de Mallorca , Spain.,b Department of Nursing and Physiotherapy , University of the Balearic Islands, Palma de Mallorca , Spain
| | - Carlyne Arnould
- c Physical and Occupational Therapy Departments, Paramedical Category, Haute Ecole Louvain en Hainaut , Charleroi , Belgium
| | - Samar M Hatem
- d CHU Brugmann , Brussels , Belgium.,e Vrije Univeisiteit Brussel , Brussels , Belgium.,f Institute of Neuroscience, Université catholique de Louvain , Brussels , Belgium
| | - Yannick Bleyenheuft
- f Institute of Neuroscience, Université catholique de Louvain , Brussels , Belgium
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Riquelme I, Pades Jiménez A, Montoya P. Parents and Physiotherapists Recognition of Non-Verbal Communication of Pain in Individuals with Cerebral Palsy. Health Commun 2018; 33:1448-1453. [PMID: 28850264 DOI: 10.1080/10410236.2017.1358243] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pain assessment is difficult in individuals with cerebral palsy (CP). This is of particular relevance in children with communication difficulties, when non-verbal pain behaviors could be essential for appropriate pain recognition. Parents are considered good proxies in the recognition of pain in their children; however, health professionals also need a good understanding of their patients' pain experience. This study aims at analyzing the agreement between parents' and physiotherapists' assessments of verbal and non-verbal pain behaviors in individuals with CP. A written survey about pain characteristics and non-verbal pain expression of 96 persons with CP (45 classified as communicative, and 51 as non-communicative individuals) was performed. Parents and physiotherapists displayed a high agreement in their estimations of the presence of chronic pain, healthcare seeking, pain intensity and pain interference, as well as in non-verbal pain behaviors. Physiotherapists and parents can recognize pain behaviors in individuals with CP regardless of communication disabilities.
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Affiliation(s)
- Inmaculada Riquelme
- a Department of Nursing and Physiotherapy , University of the Balearic Islands
- b Research Institute on Health Sciences (IUNICS) , University of the Balearic Islands
| | | | - Pedro Montoya
- b Research Institute on Health Sciences (IUNICS) , University of the Balearic Islands
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25
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Riquelme I, do Rosário RS, Vehmaskoski K, Natunen P, Montoya P. Influence of chronic pain in physical activity of children with cerebral palsy. NeuroRehabilitation 2018; 43:113-123. [DOI: 10.3233/nre-172409] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Inmaculada Riquelme
- University Institute of Health Sciences Research (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
| | | | - Kari Vehmaskoski
- JAMK University of Applied Sciences, School of Health and Social Studies, Jyväskylä, Finland
| | - Pekka Natunen
- JAMK University of Applied Sciences, School of Health and Social Studies, Jyväskylä, Finland
| | - Pedro Montoya
- University Institute of Health Sciences Research (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain
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26
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Peñeñory VM, Manresa-Yee C, Riquelme I, Collazos CA, Fardoun HM. Scoping Review of Systems to Train Psychomotor Skills in Hearing Impaired Children. Sensors (Basel) 2018; 18:E2546. [PMID: 30081512 PMCID: PMC6111323 DOI: 10.3390/s18082546] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of this work is to provide a scoping review to compile and classify the systems helping train and enhance psychomotor skills in hearing impaired (HI) children. METHODS Based on an exhaustive review on psychomotor deficits in HI children, the procedure used to carry out a scoping review was: select keywords and identify synonyms, select databases and prepare the queries using keywords, analyze the quality of the works found using the PEDro Scale, classify the works based on psychomotor competences, analyze the interactive systems (e.g., sensors), and the achieved results. RESULTS Thirteen works were found. These works used a variety of sensors and input devices such as cameras, contact sensors, touch screens, mouse and keyboard, tangible objects, haptic and virtual reality (VR) devices. CONCLUSIONS From the research it was possible to contextualize the deficits and psychomotor problems of HI children that prevent their normal development. Additionally, from the analysis of different proposals of interactive systems addressed to this population, it was possible to establish the current state of the use of different technologies and how they contribute to psychomotor rehabilitation.
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Affiliation(s)
- Victor M Peñeñory
- Multimedia Engineering Program, University of San Buenaventura, Ave. 10 de Mayo, La Umbria, 760031 Cali, Colombia.
| | - Cristina Manresa-Yee
- Department of Mathematics and Computer Science, University of the Balearic Islands, Crta. Valldemossa km. 7.5, 07122 Palma, Spain.
| | - Inmaculada Riquelme
- Department of Nursing and Physiotherapy, Institute of Health Sciences Research, University of Balearic Islands, 07122 Palma, Spain.
| | - Cesar A Collazos
- Systems Program, University of Cauca, Cl. 5 No. 4⁻70, 190001 Popayan, Colombia, .
- King Abdulaziz University, Al Ehtifalat St, Al-Ruwais, 21589 Jeddah, Saudi Arabia.
| | - Habib M Fardoun
- Teaching Excellence Department, Ahlia University, Bld 41 Rd 18, Al Hoora 310, Bahrain.
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Brebi P, Cartas I, Mora B, Buchegger K, Viscarra T, Zanella L, Riquelme I, Ili C. PO-492 Establishment of new drug-resistant gastric cancer cell lines. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Ili C, Retamal J, Lopez J, Riquelme I, Bellolio E, Viscarra T, Zanella L, Abanto M, Buchegger K, Brebi P. PO-183 Identification of differentially hypomethylated genes associated to metastasis behaviour in colorectal cancer. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Campón-Checkroun AM, Luceño-Mardones A, Riquelme I, Oliva-Pascual-Vaca J, Ricard F, Oliva-Pascual-Vaca Á. Effects of the Right Carotid Sinus Compression Technique on Blood Pressure and Heart Rate in Medicated Patients with Hypertension. J Altern Complement Med 2018; 24:1108-1112. [PMID: 29733225 DOI: 10.1089/acm.2017.0350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVES To identify the immediate and middle-term effects of the right carotid sinus compression technique on blood pressure and heart rate in hypertensive patients. DESIGN Randomized blinded experimental study. SETTINGS Primary health centers of Cáceres (Spain). SUBJECTS Sixty-four medicated patients with hypertension were randomly assigned to an intervention group (n = 33) or to a control group (n = 31). INTERVENTION In the intervention group a compression of the right carotid sinus was applied for 20 sec. In the control group, a placebo technique of placing hands on the radial styloid processes was performed. OUTCOME MEASURES Blood pressure and heart rate were measured in both groups before the intervention (preintervention), immediately after the intervention, 5 min after the intervention, and 60 min after the intervention. RESULTS The intervention group significantly decreased systolic and diastolic blood pressure and heart rate immediately after the intervention, with a large clinical effect; systolic blood pressure remained reduced 5 min after the intervention, and heart rate remained reduced 60 min after the intervention. No significant changes were observed in the control group. CONCLUSIONS Right carotid sinus compression could be clinically useful for regulating acute hypertension.
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Affiliation(s)
- Angélica María Campón-Checkroun
- 1 Escuela de Osteopatía de Madrid , Madrid, Spain .,2 Department of Physical Therapy, Universidad Católica de Ávila , Ávila, Spain
| | | | - Inmaculada Riquelme
- 3 Department of Nursing and Physiotherapy, University of the Balearic Islands , Palma, Spain .,4 University Institute of Health Sciences Research (IUNICS-IdISPa), University of the Balearic Islands , Palma, Spain
| | - Jesús Oliva-Pascual-Vaca
- 1 Escuela de Osteopatía de Madrid , Madrid, Spain .,5 Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla , Sevilla, Spain .,6 EU Francisco Maldonado, Department of Physical Therapy, Universidad de Sevilla , Osuna, Spain
| | | | - Ángel Oliva-Pascual-Vaca
- 1 Escuela de Osteopatía de Madrid , Madrid, Spain .,5 Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla , Sevilla, Spain
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Riquelme I, Hatem SM, Montoya P. Reduction of Pain Sensitivity after Somatosensory Therapy in Children with Autism Spectrum Disorders. J Abnorm Child Psychol 2018; 46:1731-1740. [DOI: 10.1007/s10802-017-0390-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Zamorano AM, Cifre I, Montoya P, Riquelme I, Kleber B. Insula-based networks in professional musicians: Evidence for increased functional connectivity during resting state fMRI. Hum Brain Mapp 2017; 38:4834-4849. [PMID: 28737256 DOI: 10.1002/hbm.23682] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 05/24/2017] [Accepted: 05/26/2017] [Indexed: 12/22/2022] Open
Abstract
Despite considerable research on experience-dependent neuroplasticity in professional musicians, detailed understanding of an involvement of the insula is only now beginning to emerge. We investigated the effects of musical training on intrinsic insula-based connectivity in professional classical musicians relative to nonmusicians using resting-state functional MRI. Following a tripartite scheme of insula subdivisions, coactivation profiles were analyzed for the posterior, ventral anterior, and dorsal anterior insula in both hemispheres. While whole-brain connectivity across all participants confirmed previously reported patterns, between-group comparisons revealed increased insular connectivity in musicians relative to nonmusicians. Coactivated regions encompassed constituents of large-scale networks involved in salience detection (e.g., anterior and middle cingulate cortex), affective processing (e.g., orbitofrontal cortex and temporal pole), and higher order cognition (e.g., dorsolateral prefrontal cortex and the temporoparietal junction), whereas no differences were found for the reversed group contrast. Importantly, these connectivity patterns were stronger in musicians who experienced more years of musical practice, including also sensorimotor regions involved in music performance (M1 hand area, S1, A1, and SMA). We conclude that musical training triggers significant reorganization in insula-based networks, potentially facilitating high-level cognitive and affective functions associated with the fast integration of multisensory information in the context of music performance. Hum Brain Mapp 38:4834-4849, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Anna M Zamorano
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Ignacio Cifre
- University Ramon Llull, Blanquerna, FPCEE, Barcelona, Spain
| | - Pedro Montoya
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Inmaculada Riquelme
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain.,Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Boris Kleber
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University, Denmark.,Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
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Velasco-Roldán O, Riquelme I, Ferragut-Garcías A, Heredia-Rizo AM, Rodríguez-Blanco C, Oliva-Pascual-Vaca Á. Immediate and Short-Term Effects of Kinesio Taping Tightness in Mechanical Low Back Pain: A Randomized Controlled Trial. PM R 2017; 10:28-35. [PMID: 28602935 DOI: 10.1016/j.pmrj.2017.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 05/15/2017] [Accepted: 05/20/2017] [Indexed: 01/29/2023]
Abstract
BACKGROUND There is controversy regarding the best technique for applying Kinesio Taping (KT), and the theory supporting that skin convolutions may explain its efficacy has recently been challenged. OBJECTIVE To compare the immediate and short-term effectiveness of KT tightness on mechanosensitivity and spinal mobility in nonspecific low back pain (LBP), and to observe the influence of gender in the outcome measures. DESIGN Double-blind, randomized, controlled trial. SETTING University-based clinical research center. PARTICIPANTS A total of 75 individuals with a mean age of 33 years (±7.4 years), 60% female and 40% male, with nonspecific LBP were recruited and randomly assigned to 1 of the following study groups: standard KT tension (n = 26), increased KT tension (n = 25), and no KT tension (n = 24). INTERVENTIONS All participants received a two I-strip taping over the paravertebral muscles for 24 hours. Paper-off tension (15%-25% of the available stretch) was used in the standard KT group, which was increased to 40% in the increased KT tension group. The rest of participants received a taping procedure with no KT tension. Measurements were taken at baseline, immediately after the taping, 24 hours after the taping, and after KT removal. MAIN OUTCOME MEASURES The primary outcome included pressure pain thresholds over the erector spinae and gluteus medius muscles. The secondary outcome was lumbar mobility (assessed with a digital inclinometer, and back-saver sit-and-reach, finger-to-floor, and sit-and-reach tests). RESULTS In the between-groups analysis of the mean score changes after baseline assessment, no significant differences were found for any of the outcome measures (P > .05) except the left back-saver sit-and-reach test (P = .03). A statistically significant interaction group × gender × time was observed only for mechanosensitivity values (P = .02 for the gluteus and P = .01 for the erector spinae). CONCLUSION KT tightness does not seem to influence pain sensitivity and lumbar mobility in chronic LBP in either the immediate or short term. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Olga Velasco-Roldán
- Department of Nursing and Physiotherapy, University of the Balearic Islands, The Balearic Islands, Palma de Mallorca, Spain
| | - Inmaculada Riquelme
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain; Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Alejandro Ferragut-Garcías
- Department of Nursing and Physiotherapy, University of the Balearic Islands, The Balearic Islands, Palma de Mallorca, Spain
| | - Alberto Marcos Heredia-Rizo
- Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, Sevilla, Spain
| | - Cleofás Rodríguez-Blanco
- Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, Sevilla, Spain
| | - Ángel Oliva-Pascual-Vaca
- Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, Sevilla, Spain
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Riquelme I, Henne C, Flament B, Legrain V, Bleyenheuft Y, Hatem SM. Use of prism adaptation in children with unilateral brain lesion: Is it feasible? Res Dev Disabil 2015; 43-44:61-71. [PMID: 26163480 DOI: 10.1016/j.ridd.2015.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 06/12/2015] [Accepted: 06/23/2015] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Unilateral visuospatial deficits have been observed in children with brain damage. While the effectiveness of prism adaptation for treating unilateral neglect in adult stroke patients has been demonstrated previously, the usefulness of prism adaptation in a pediatric population is still unknown. The present study aims at evaluating the feasibility of prism adaptation in children with unilateral brain lesion and comparing the validity of a game procedure designed for child-friendly paediatric intervention, with the ecological task used for prism adaptation in adult patients. METHODS Twenty-one children with unilateral brain lesion randomly were assigned to a prism group wearing prismatic glasses, or a control group wearing neutral glasses during a bimanual task intervention. All children performed two different bimanual tasks on randomly assigned consecutive days: ecological tasks or game tasks. The efficacy of prism adaptation was measured by assessing its after-effects with visual open loop pointing (visuoproprioceptive test) and subjective straight-ahead pointing (proprioceptive test). RESULTS Game tasks and ecological tasks produced similar after-effects. Prismatic glasses elicited a significant shift of visuospatial coordinates which was not observed in the control group. CONCLUSION Prism adaptation performed with game tasks seems an effective procedure to obtain after-effects in children with unilateral brain lesion. The usefulness of repetitive prism adaptation sessions as a therapeutic intervention in children with visuospatial deficits and/or neglect, should be investigated in future studies.
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Affiliation(s)
- Inmaculada Riquelme
- University Institute of Health Sciences Research, University of Balearic Islands, Palma de Mallorca, Spain; Department of Nursing and Physiotherapy, University of Balearic Islands, Palma de Mallorca, Spain
| | | | - Benoit Flament
- Haute Ecole Louvain en Hainaut, Montignies-sur-Sambre, Belgium
| | - Valéry Legrain
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Yannick Bleyenheuft
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Samar M Hatem
- Brugmann University Hospital, Brussels, Belgium; Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium; Faculty of Medicine, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
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Badia M, Orgaz B, Riquelme I, Montoya P. The Relationship of Cerebral Palsy Comorbid Conditions with Participation and Quality of Life. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/978-3-319-15437-4_13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Zamorano AM, Riquelme I, Kleber B, Altenmüller E, Hatem SM, Montoya P. Pain sensitivity and tactile spatial acuity are altered in healthy musicians as in chronic pain patients. Front Hum Neurosci 2015; 8:1016. [PMID: 25610384 PMCID: PMC4285087 DOI: 10.3389/fnhum.2014.01016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 12/01/2014] [Indexed: 12/13/2022] Open
Abstract
Extensive training of repetitive and highly skilled movements, as it occurs in professional classical musicians, may lead to changes in tactile sensitivity and corresponding cortical reorganization of somatosensory cortices. It is also known that professional musicians frequently experience musculoskeletal pain and pain-related symptoms during their careers. The present study aimed at understanding the complex interaction between chronic pain and music training with respect to somatosensory processing. For this purpose, tactile thresholds (mechanical detection, grating orientation, two-point discrimination) and subjective ratings to thermal and pressure pain stimuli were assessed in 17 professional musicians with chronic pain, 30 pain-free musicians, 20 non-musicians with chronic pain, and 18 pain-free non-musicians. We found that pain-free musicians displayed greater touch sensitivity (i.e., lower mechanical detection thresholds), lower tactile spatial acuity (i.e., higher grating orientation thresholds) and increased pain sensitivity to pressure and heat compared to pain-free non-musicians. Moreover, we also found that musicians and non-musicians with chronic pain presented lower tactile spatial acuity and increased pain sensitivity to pressure and heat compared to pain-free non-musicians. The significant increment of pain sensitivity together with decreased spatial discrimination in pain-free musicians and the similarity of results found in chronic pain patients, suggests that the extensive training of repetitive and highly skilled movements in classical musicians could be considered as a risk factor for developing chronic pain, probably due to use-dependent plastic changes elicited in somatosensory pathways.
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Affiliation(s)
- Anna M Zamorano
- Research Institute on Health Sciences, University of Balearic Islands Palma de Mallorca, Spain
| | - Inmaculada Riquelme
- Research Institute on Health Sciences, University of Balearic Islands Palma de Mallorca, Spain ; Department of Nursing and Physiotherapy, University of Balearic Islands Palma de Mallorca, Spain
| | - Boris Kleber
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen Tübingen, Germany
| | - Eckart Altenmüller
- Department of Music Physiology and Musician's Medicine, University of Music, Drama and Media Hannover, Germany
| | - Samar M Hatem
- Physical Medicine and Rehabilitation, Brugmann University Hospital Brussels, Belgium ; Institute of Neuroscience, Université Catholique de Louvain Brussels, Belgium
| | - Pedro Montoya
- Research Institute on Health Sciences, University of Balearic Islands Palma de Mallorca, Spain
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Riquelme I, Cifre I, Montoya P. Are physiotherapists reliable proxies for the recognition of pain in individuals with cerebral palsy? A cross sectional study. Disabil Health J 2014; 8:264-70. [PMID: 25258089 DOI: 10.1016/j.dhjo.2014.08.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 08/06/2014] [Accepted: 08/12/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Pain is an important problem for individuals with cerebral palsy (CP). In addition to pain associated to the pathology, individuals with CP are often exposed to physiotherapy procedures which may cause or relieve pain. OBJECTIVE The major aim of this study was to compare pain ratings self-reported by individuals with cerebral palsy and ratings about pain in others provided by their physiotherapists. METHOD Cross-sectional study. Children and young adults with cerebral palsy (n = 50) and their physiotherapists (n = 18) completed semi-structured interviews about clinical pain, as well as about procedural pain and pain relief elicited by standardized health procedures. Moreover, pain ratings were obtained during the application of hamstring stretching and passive joint mobilization. RESULTS Moderate-to-high agreement was observed between individuals with cerebral palsy and their physiotherapists on presence and intensity of pain, pain interference with physical activities and current and retrospective pain ratings elicited by physiotherapy procedures. By contrast, agreement regarding pain relief elicited by physiotherapy techniques was low. CONCLUSIONS Our data suggest that although physiotherapists may be reliable proxies for the recognition of pain in individuals with cerebral palsy, further research should be done to improve the communication between health professionals and individuals with cerebral palsy around pain.
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Affiliation(s)
- Inmaculada Riquelme
- University Institute of Health Sciences Research (IUNICS), University of the Balearic Islands, Palma de Mallorca, Spain; Department of Nursing and Physical Therapy, University of the Balearic Islands, Palma de Mallorca, Spain.
| | - Ignacio Cifre
- University Institute of Health Sciences Research (IUNICS), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Pedro Montoya
- University Institute of Health Sciences Research (IUNICS), University of the Balearic Islands, Palma de Mallorca, Spain
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Badia M, Riquelme I, Orgaz B, Acevedo R, Longo E, Montoya P. Pain, motor function and health-related quality of life in children with cerebral palsy as reported by their physiotherapists. BMC Pediatr 2014; 14:192. [PMID: 25066900 PMCID: PMC4118265 DOI: 10.1186/1471-2431-14-192] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 07/16/2014] [Indexed: 12/18/2022] Open
Abstract
Background Children and adolescents with cerebral palsy suffer from higher levels of pain than their peers without disability. The aim of this study was to explore the impact of pain on health-related quality of life and motor function in individuals with cerebral palsy as reported by health professionals. Methods Cross-sectional study carried out in Associations for Care of Individuals with Cerebral Palsy and Related Disabilities (ASPACE) in Balearic Islands and Castile Leon (Spain). Thirty-five physiotherapists rated pain, health-related quality of life and motor function in 91 children and adolescents with cerebral palsy [8-19y]. A semi-structured interview was used to collect demographic and clinical data according with the Study of Participation of Children with Cerebral Palsy Living in Europe (SPARCLE). Results Physiotherapists reported that 51% of individuals with cerebral palsy suffered from pain. Physiotherapists also perceived that pain in individuals with cerebral palsy was responsible for reductions of psychological but not physical domains of health-related quality of life. According with physiotherapists’ estimations, motor impairment scores were not correlated with pain scores in individuals with cerebral palsy, but they were significantly associated with physical and autonomy domains of health-related quality of life. Conclusions These findings highlighted the importance of assessing and providing interventions for pain relief in persons with cerebral palsy even at an early age.
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Affiliation(s)
| | | | | | | | | | - Pedro Montoya
- Research Institute on Health Sciences (IUNICS), University of Balearic Islands, Carretera de Valldemossa km 7,5, 07122 Palma, Spain.
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Riquelme I, Padrón I, Cifre I, González-Roldán AM, Montoya P. Differences in somatosensory processing due to dominant hemispheric motor impairment in cerebral palsy. BMC Neurosci 2014; 15:10. [PMID: 24410983 PMCID: PMC3893529 DOI: 10.1186/1471-2202-15-10] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 12/31/2013] [Indexed: 11/24/2022] Open
Abstract
Background Although cerebral palsy (CP) is usually defined as a group of permanent motor disorders due to non-progressive disturbances in the developing fetal or infant brain, recent research has shown that CP individuals are also characterized by altered somatosensory perception, increased pain and abnormal activation of cortical somatosensory areas. The present study was aimed to examine hemispheric differences on somatosensory brain processing in individuals with bilateral CP and lateralized motor impairments compared with healthy controls. Nine CP individuals with left-dominant motor impairments (LMI) (age range 5–28 yrs), nine CP individuals with right-dominant motor impairments (RMI) (age range 7–29 yrs), and 12 healthy controls (age range 5–30 yrs) participated in the study. Proprioception, touch and pain thresholds, as well as somatosensory evoked potentials (SEP) elicited by tactile stimulation of right and left lips and thumbs were compared. Results Pain sensitivity was higher, and lip stimulation elicited greater beta power and more symmetrical SEP amplitudes in individuals with CP than in healthy controls. In addition, although there was no significant differences between individuals with RMI and LMI on pain or touch sensitivity, lip and thumb stimulation elicited smaller beta power and more symmetrical SEP amplitudes in individuals with LMI than with RMI. Conclusions Our data revealed that brain processing of somatosensory stimulation was abnormal in CP individuals. Moreover, this processing was different depending if they presented right- or left-dominant motor impairments, suggesting that different mechanisms of sensorimotor reorganization should be involved in CP depending on dominant side of motor impairment.
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Affiliation(s)
| | | | | | | | - Pedro Montoya
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, Carretera de Valldemossa km 7,5, Palma 07122, Spain.
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Riquelme I, Zamorano A, Montoya P. Reduction of pain sensitivity after somatosensory therapy in adults with cerebral palsy. Front Hum Neurosci 2013; 7:276. [PMID: 23805086 PMCID: PMC3690353 DOI: 10.3389/fnhum.2013.00276] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 05/27/2013] [Indexed: 11/13/2022] Open
Abstract
Objective: Pain and deficits in somatosensory processing seem to play a relevant role in cerebral palsy (CP). Rehabilitation techniques based on neuroplasticity mechanisms may induce powerful changes in the organization of the primary somatosensory cortex and have been proved to reduce levels of pain and discomfort in neurological pathologies. However, little is known about the efficacy of such interventions for pain sensitivity in CP individuals. Methods: Adults with CP participated in the study and were randomly assigned to the intervention (n = 17) or the control group (n = 20). The intervention group received a somatosensory therapy including four types of exercises (touch, proprioception, vibration, and stereognosis). All participants were asked to continue their standardized motor therapy during the study period. Several somatosensory (pain and touch thresholds, stereognosis, proprioception, texture recognition) and motor parameters (fine motor skills) were assessed before, immediately after and 3 months after the therapy (follow-up). Results: Participants of the intervention group showed a significant reduction on pain sensitivity after treatment and at follow-up after 3 months, whereas participants in the control group displayed increasing pain sensitivity over time. No improvements were found on touch sensitivity, proprioception, texture recognition, or fine motor skills. Conclusion: Data suggest the possibility that somatosensory therapy was effective in eliciting changes in central somatosensory processing. This hypothesis may have implications for future neuromodulatory treatment of pain complaints in children and adults with CP.
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Affiliation(s)
- Inmaculada Riquelme
- Research Institute on Health Sciences, University of the Balearic Islands, Palma de Mallorca , Spain ; Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca , Spain
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Riquelme I, Velasco O. Physiotherapy students' perceptions of competences obtained through PBL methodology. Med Teach 2011; 33:506-507. [PMID: 21755612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Riquelme I, Montoya P. Developmental changes in somatosensory processing in cerebral palsy and healthy individuals. Clin Neurophysiol 2010; 121:1314-20. [DOI: 10.1016/j.clinph.2010.03.010] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Revised: 03/09/2010] [Accepted: 03/11/2010] [Indexed: 11/28/2022]
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Saavedra N, Riquelme I, Rivas L, Jaramillo P, Caamaño J, Lanas C, Lanas F, Salazar LA. D 014 A148g Variant of Pon2 Gene in Chilean Individuals with Coronary Disease Confirmed by Angiography and Controls. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71708-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fernández-Alcantud J, Riquelme I, Pedroviejo V, Chaves R. [Infectious spondylodiscitis, epidural abscess, and spinal meningitis after epidural catheterization]. Rev Esp Anestesiol Reanim 2007; 54:512-513. [PMID: 17993105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Alcantud JF, Ruiz M, Planas A, Vázquez M, Hernández J, Riquelme I. [Unilateral compartment syndrome secondary to prolonged lithotomy positioning and peripheral vascular disease]. Rev Esp Anestesiol Reanim 2006; 53:61-2. [PMID: 16475646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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