Modulating Tone to Promote Motor Development Using a Neurofacilitation of Developmental Reaction (NFDR) Approach in Children with

Objective: To compare the efficacy of a Neurofacilitation of Developmental Reaction (NFDR) approach with that of a Conventional approach in the modulation of tone in children with neurodevelopmental delay. Methods: Experimental control design. A total of 30 spastic children ranging in age from 4 to 7 years with neurodevelopmental delay were included. Baseline evaluations of muscle tone and gross motor functional performance abilities were performed. The children were allocated into two intervention groups of 15 subjects each. In groups A and B, the NFDR and conventional approaches were applied, respectively, for 3 months and were followed by subsequent re-evaluations. Results: Between group analyses were performed using independent t test for tone and primitive reflex intensity and a Mann-Whitney U test for gross motor functional ability. For the within-group analyses, paired t tests were used for tone and primitive reflex intensity, and a Wilcoxon signed-rank test was used for gross motor functional ability. Conclusion: The NFDR approach/technique prepares the muscle to undergo tonal modulation and thereby enhances motor development and improves the motor functional performance abilities of the children with neurodevelopmental delay.

Influence of Sitting and Prone Lying Positions on Proprioceptive Knee Assessment Score in Early Knee Osteoarthritis

Background: Knee proprioception is compromised in knee osteoarthritis. There are several ways of measuring proprioceptive acuity, but there is lack of consensus over the ideal testing position. The study aimed to evaluate the influence of 2 testing positions (sitting versus prone lying) on proprioceptive knee assessment score in patients with early knee osteoarthritis. Methods: The study included 70 subjects who came to the Out-Patient Department with a diagnosis of early knee osteoarthritis. The subjects were assessed for their proprioceptive acuity scores in both the test positions at 30° and 60° of knee flexion using proprioceptive knee assessment device. They were asked to perform 5 trials in both testing positions with appropriate rest intervals. After initial assessment, the subjects were randomly allocated among group 1 and group 2. Treatment implementation was done for 8 weeks followed by re-evaluation: group 1 received context-specific proprioceptive retraining along with multijoint coupling strategies and group 2, conventional treatment. Results: The subjects were compared using difference of pre- and post-treatment proprioceptive acuity scores. The difference of proprioceptive acuity impairment scores of the left knee at 30° and 60°, and the right knee at 60° in prone lying position were statistically significant, with P value ranging from less than 0.001 to 0.028. Conclusion: It was found that the prone lying testing position was more sensitive than sitting position for assessing proprioceptive acuity for knee osteoarthritis.