Structure, contents and psychometric properties of measurement of motor function and motor ability applicable to children and adolescents with disabilities: a systematic review / 中国康复理论与实践

ObjectiveTo evaluate the main structural and content features of four instruments for motor function and motor ability assessment and their psychometric properties for children and adolescents with disabilities, based on International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY). MethodsPubMed, Medline and Web of Science databases were searched for literature on motor function and motor ability assessment for children and adolescents with disabilities published from establishment to May, 2023. The main structural and content characteristics of the tools were analyzed using ICF-CY, and the quality of measurement tools was assessed using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). ResultsNine papers were eventually included, and four assessment tools were identified, including Gross Motor Function Measure-88 (GMFM-88), Peabody Developmental Motor Scales second edition (PDMS-2), Bruininks-Oseretsky Test of Motor Proficiency second edition (BOT-2), and Movement Assessment Battery for Children second edition (MABC-2). The GMFM-88 consisted of 88 items in five dimensions: zone A (lying and rolling), zone B (sitting), zone C (crawling and kneeling), zone D (standing), and zone E (walking and running and jumping); it involved joint movement function (b710), random movement control function (b760), etc., in body function; and the change of basic body posture to maintain a body posture (d410) and maintain a body posture (d415) in activity and participation, with good to excellent levels of internal consistency reliability, test-retest reliability, content validity, and structural validity. The PDMS-2 consisted of six subtests, including reflexes, posture, movement, physical manipulation, grasping and visuomotor integration, with a total of 249 items; it involved memory function (b144) and joint mobility function (b710) in body function; as well as looking (d110) and imitation (d130) in activity and participation; with good psychometric properties in terms of internal consistency reliability, test-retest reliability, content validity, structural validity, and hypothesis testing and cross-cultural feasibility. There are two versions of BOT-2: long form and short form. The long form consisted of eight subtests with 53 items, involving joint mobility function (b710) and joint stability function (b715) in body function; as well as imitation (d130) and learned calculation (d150) in activity and participation; it achieved excellent levels of psychometric properties in terms of internal consistency reliability, content validity, and structural validity, and good level in reliability and test-retest reliability. MABC-2 consisted of two parts: an activity ability test and a checklist with 30 items; it involved joint mobility function (b710), joint stability function (b715), etc., in body function; as well as fine-hand use (d440), hand and arm use (d445) in activity and participation; with good psychometric properties such as reliability, content validity, and structural validity. ConclusionThis systematic review analyzed the main structural and content characteristics of four types of measurement tools for assessing motor function and motor ability in children and adolescents with disabilities based on the ICF-CY, and evaluated the quality of psychometric properties (internal consistency reliability, test-retest reliability, content validity, structural validity, and cross-cultural consistency, etc.) of the four types of measurement tools using the COSMIN criteria. For the structure and content, PDMS-2 appears the broadest content, and measures fine hand movements, dynamic and static balance, along with the BOT-2 and MABC-2. GMFM-88 focuses more on gross motor functions such as postural control. Four instruments show high internal consistency reliability, test-retest reliability, content validity and structural validity, while the BOT-2 and PDMS-2 show better reliability. To ensure the reliability and validity of the measures, rehabilitation workers and educators need to receive standardized training and qualification before using the standardized instruments for motor function and motor ability for children with disabilities. With norm-referenced measures, the results need to be converted to standard scores.

Training in a wearable exoskeleton improves the lower limb motor recovery of stroke survivors / 中华物理医学与康复杂志

Objective:To explore any differential effect of training wearing a unilateral exoskeleton on the lower-limb motor function of stroke survivors.Methods:Forty stroke survivors were randomly divided into an exoskeleton group ( n=20) and a control group ( n=20). The control group performed conventional lower extremity exercise training while the exoskeleton group received exoskeleton-assisted lower-limb physical therapy. Each participant received eighteen 40-minute training sessions over three weeks. Before and after the intervention, the walking ability, lower-limb function, balance and ability in the activities of daily living of both groups were evaluated. Integrated electromyography (iEMG) of the rectus femoris and tibialis anterior of both legs was also recorded during sit-to-stand transitions to assess the activation of the affected muscles and the symmetry of bilateral muscle activation. Results:After the three weeks, significant improvement was observed in all of the measurements in both groups, but with the exoskeleton group scoring significantly better on average in functional ambulation category grading (1.63±0.72). Both groups′ iEMGs had also improved significantly compared with before treatment, but the exoskeleton group′s average result was by that time significantly better than the control group′s average.Conclusions:A wearable exoskeleton can effectively improve the rehabilitation of walking, lower limb movement, balance and skill in the activities of daily living of persons with subacute stroke. It better activates the affected lower limb muscles and improves the symmetry of bilateral lower limb muscle activation.

Effects of Interactive Dynamic Scalp Acupuncture on Motor Function and Gait of Lower Limbs after Stroke: A Multicenter, Randomized, Controlled Clinical Trial / 中国结合医学杂志

OBJECTIVE@#To evaluate the effects of interactive dynamic scalp acupuncture (IDSA), simple combination therapy (SCT), and traditional scalp acupuncture (TSA) on motor function and gait of the lower limbs in post-stroke hemiplegia patients.@*METHODS@#A total of 231 patients with post-stroke hemiplegia was randomly divided into IDSA (78 cases), SCT (78 cases), and TSA (75 cases) groups by a random number table. Scalp acupuncture (SA) and lower-limb robot training (LLRT) were both performed in the IDSA and SCT groups. The patients in the TSA group underwent SA and did not receive LLRT. The treatment was administered once daily and 6 times weekly for 8 continuous weeks, each session lasted for 30 min. The primary outcome measures included Fugl-Meyer assessment of the lower extremity (FMA-LE), berg balance scale (BBS), modified barthel index (MBI), and 6-min walking test (6MWT). The secondary outcome measures included stride frequency (SF), stride length (SL), stride width (SW), affected side foot angle (ASFA), passive range of motion (PROM) of the affected hip (PROM-H), knee (PROM-K) and ankle (PROM-A) joints. The patients were evaluated before treatment, at 1- and 2-month treatment, and 1-, and 2-month follow-up visits, respectively. Adverse events during 2-month treatment were observed.@*RESULTS@#Nineteen patients withdrew from the trial, with 8 in the IDSA and 5 in the SCT groups, 6 in the TSA group. The FMA-LE, BBS, 6MWT and MBI scores in the IDSA group were significantly increased after 8-week treatment and 2 follow-up visits compared with the SCT and TSA groups (P<0.05 or P<0.01). Compared with pre-treatment, the grade distribution of BBS and MBI scores in the 3 groups were significantly improved at 1, 2-month treatment and 2 follow-up visits (P<0.05 or P<0.01). The SF, PROM-H, PROM-K and PROM-A in the IDSA group was significantly increased compared with the SCT and TSA groups after 8-week of treatment (P<0.05 or P<0.01). Compared with the SCT group, ASFA of the IDSA group was significantly reduced after 8-week of treatment (P<0.05). SF, SL, PROM-K and PROM-A were significantly increased at the 2nd follow-up visit whereas the ASFA was significantly reduced in the IDSA group compared with the SCT groups at 1st follow-up visit (P<0.05 or P<0.01). The SF was significantly increased in the SCT group compared with the TSA group after 8-week treatment (P<0.05). Compared with the TSA group, PROM-K, PROM-A were significantly increased at the 2nd follow-up visit (P<0.05).@*CONCLUSIONS@#The effects of IDSA on lower-limb motor function and walking ability of post-stroke patients were superior to SCT and TSA. The SCT was comparable to TSA treatment, and appeared to be superior in improving the motion range of the lower extremities. (Registration No. ChiCTR1900027206).

Perceptual-motor ability assessment in people with atypical development / Avaliação da maturidade perceptomotora em pessoas com desenvolvimento atípico / Evaluación de la madurez percepto-motriz en personas con desarrollo atípico

The assessment of perceptual-motor maturity has been investigated, and evidence indicates its relevance in the prediction of academic performance, which justifies the relevance of its investigation. This study investigated the psychometric qualities of a screening version of the Bender-Gradual Scoring System (B-SPG in Portuguese) in 273 individuals aged between six and 24 (M = 13.27, SD = 3.63), 166 (60, 8%) males, who were diagnosed with intellectual disabilities. The results of the exploratory factor analysis and regression analysis were satisfactory and demonstrated that it is possible to use only three figures to carry out the evaluation, which facilitates the psychologist's work. The accuracy of the instrument was also estimated, and the results showed adequate indexes. It is concluded that the screening version of the B-SPG proves to be an adequate measure for children with atypical development. However, other studies should be performed.

A avaliação da maturidade perceptomotora tem sido investigada, e evidências indicam sua relevância na predição do desempenho acadêmico, o que justifica a pertinência de sua investigação. O presente estudo investigou as qualidades psicométricas de uma versão de rastreio do Bender-Sistema de Pontuação Gradual (B-SPG) em 273 indivíduos com idades variando de 6 a 24 anos (M = 13,27, DP = 3,63), sendo 166 (60,8%) do sexo masculino, que tinham o diagnóstico de deficiência intelectual. Os resultados da análise fatorial exploratória e da análise de regressão foram satisfatórios e revelaram que é possível utilizar apenas três figuras para realizar a avaliação, o que facilita o trabalho do psicólogo. A precisão também foi estimada, e os resultados mostraram índices adequados. Conclui-se que a versão de rastreio do B-SPG se mostra uma medida adequada para crianças com desenvolvimento atípico, no entanto outros estudos devem ser realizados.

La evaluación del desarrollo percepto-motriz ha sido investigada y existen evidencias de su relevancia para predecir el desempeño académico, lo cual justifica la realización del trabajo. Este estudio investigó las cualidades psicométricas de una versión de sondeo del Bender-Sistema de Pontuação Gradual (B-SPG) en 273 individuos con edades entre 6 y 24 años (M = 13,27, DT = 3,63), siendo 166 (60,8%) del sexo masculino, que poseían diagnóstico de deficiencia intelectual. Los resultados del análisis factorial exploratorio y del análisis de regresión fueron satisfactorios, revelando que es posible utilizar apenas tres figuras para realizar la evaluación, lo cual facilitaría el trabajo del psicólogo. La confiabilidad también fue verificada y los resultados mostraron índices adecuados. Se concluye que la versión de sondeo del B-SPG parece ser una medida adecuada para niños con deficiencia intelectual, pero pese a eso, otros estudios deben ser realizados.

An Evaluation of Lower Limb Motor Ability Based on Xception-LSTM / 中国康复理论与实践

Objective:To establish an algorithm to quantitatively evaluate the lower limb motor ability. Methods:From August, 2016 to March, 2017, 40 subjects were divided into young healthy group (n = 20), middle-aged group (n = 10) and elderly group (n = 10). The gait video, knee angle and ground reaction force of the subjects were collected, and the gait contour was extracted from the gait video by using the ViBe algorithm. The gait image feature was extracted by Xception-LSTM, and fused it with the knee joint angle and the ground reaction force in the feature layer. The fusion features were reduced in dimension by kernel principal component analysis, and the gait ability score (GAS) was established. All the subjects were assessed with Wisconsin Gait Scale (WGS). Results:GAS was less in middle-aged group and elderly group than in the young healthy group (t > 4.164, P < 0.01), and was less in the elderly group than in the middle-aged group (t = 7.338, P < 0.01). GAS was negative correlated with the score of WGS (r = -0.91, P < 0.01). Conclusion:The lower limb exercise ability could be quantified with GAS, which may be applied in developing rehabilitation and fitting walking aids.

Teste de Bender: versão de rastreio para a avaliação da maturidade perceptomotora / Bender Test: screening version for evaluation of perceptive-motor maturity / Test de Bender: versión de rastreo para la evaluación de la madurez perceptomotora

Este estudo buscou evidências de validade de conteúdo e critério para a versão de rastreio do Bender - Sistema de Pontuação Gradual. Para isso, 693 crianças, ambos os sexos, com idades entre seis e 10 anos (M = 8,42; DP = 1,38) reproduziram a cópia de três figuras. Os resultados indicaram que a Figura 3 apresentou alto nível de dificuldade, sendo necessário maior nível de maturidade perceptomotora para sua execução. As Figuras 7a e 7b, embora apresentem sobreposição, foram mais fáceis de serem copiadas. Verificou-se que os erros de distorções na reprodução das figuras tendem a diminuir gradualmente conforme aumenta a idade das crianças. Observou-se que as três figuras não apresentam funcionamento diferencial dos itens entre meninas e meninos, além disso também não foram encontradas diferenças de média de desempenho. Esses achados sugerem que a versão de rastreio é uma proposta promissora para ser utilizada na avaliação da maturidade perceptomotora. (AU)

This study sought evidence of content and criteria validity for the screening version of the Bender - Gradual Scoring System. For this, 693 children of both sexes, between 6 and 10 years of age (M = 8.42; SD = 1.38), reproduced three figures. The results indicated that Figure 3 had a greater level of difficulty, with a greater level of perceptive-motor maturity required for its execution. Figures 7a and 7b, although overlapping, were easier to reproduce. It was found that the errors of distortions in the reproduction of figures tended to gradually decrease as the child's age increased. Another point observed was that the three figures did not present differential functioning for the items between girls and boys, nor were any mean performance differences found. These findings suggest that the screening version is a promising proposition for use in the evaluation of perceptive-motor maturity. (AU)

El estudio buscó evidencias de validez de contenido y criterio para la versión de rastreo del Bender - Sistema de Puntuación Gradual. Por esto, participaron 693 niños de ambos sexos con edades entre 6 y 10 años (M= 8,42; DP = 1,38), que reprodujeron la copia de tres figuras. Los resultados indicaron que la Figura 3 presentó alto nivel de dificultad, siendo necesario un mayor nivel de madurez perceptiva para su ejecución. Las Figuras 7a y 7b, aunque presentaban superposición, fueron más fáciles de dibujar. Se verificó que los errores de distorsión en la reproducción de las figuras tienden a disminuir gradualmente según aumenta la edad de los niños. Otro punto observado fue que las tres figuras no presentan funcionamiento diferencial entre las niñas y niños, además tampoco se encontraron diferencias de promedio de rendimiento. Estos hallazgos sugieren que la versión de rastreo es una propuesta oportuna para ser usada en la evaluación de la madurez perceptiva. (AU)

Motor development analysis of three-year-old children born preterm through the Motor Development Scale - Case Report

INTRODUCTION: Prematurity and low birth weight are conditions that may compromise the normal development of a child at different stages of development. Considering that these conditions may cause delay in the acquisition of motor skills, it is important to evaluate, detect and prevent possible changes in motor development. OBJECTIVE: To investigate the influence of prematurity and low birth weight on the motor development of children of three years old relating chronological age to general motor age. METHODS: This is an analysis of five cases of preterm children 32.1 (± 1.82) weeks and underweight 1704 (± 384.41) grams, mean chronological age of 43.2 (± 2.59) months, evaluated through the Motor Development Scale (MDS) in the Laboratory of Electromyography and Kinematics (LAELCIN) of the Federal University of Triângulo Mineiro (UFTM), considering general motor age (GMA) and chronological age (CA) as variables CASE: The five preterm and low birth weight children presented a difference between the mean general motor age (37.6 ± 7.40) months and the mean chronological age (43.2 ± 2.59) months, indicating delayed motor development. CONCLUSION: It was observed the absence of linearity of the variables, indicating delay in the motor development, thus justifying the necessity and importance of the longitudinal monitoring of this population for early detection and intervention.

INTRODUÇÃO: A prematuridade e o baixo peso ao nascimento são condições que podem comprometer o desenvolvimento normal da criança nas diferentes etapas evolutivas. Considerando que estas condições podem acarretar atraso na aquisição de habilidades motoras, é importante avaliar, detectar e prevenir as possíveis alterações no desenvolvimento motor. OBJETIVO: Analisar a influência da prematuridade e do baixo peso ao nascimento no desenvolvimento motor de crianças na faixa etária de três anos de idade, relacionando a idade cronológica com a idade motora geral. MÉTODO: Trata-se de uma análise com cinco casos de crianças nascidas pré-termo 32,1 (±1,82) semanas e com baixo peso 1704 (± 384,41) gramas, idade cronológica média de 43,2 (±2,59) meses, avaliadas por meio da Escala de Desenvolvimento Motor (EDM) no Laboratório de Eletromiografia e Cinemática (LAELCIN) da Universidade Federal do Triângulo Mineiro (UFTM), considerando as variáveis idade motora geral (IMG) e idade cronológica (IC). RELATO: As cinco crianças nascidas pré-termo e com baixo peso apresentaram diferença entre a idade motora geral média (37,6, ±7,40) meses e a idade cronológica média (43,2, ±2,59) meses, indicando atraso no desenvolvimento motor. CONCLUSÃO: Observou-se ausência de linearidade das variáveis, indicando atraso no desenvolvimento motor, justificando assim, a necessidade e importância do acompanhamento longitudinal dessa população para detecção e intervenção precoce.

Analysis of the relevance of age and toe out angle of normal adults' gait / 生物医学工程学杂志

Due to the decline of motor ability and the impact of the diseases, abnormalities in gait is common in the elderly population, which will raise the risk of fall and cause serious injury. This study focuses on the analysis of the gait kinematics parameters of normal adults' gait, aiming to investigate the characteristics of gait parameters in different age groups and to explore the role of gait parameters in motor function assessment and clinical diagnosis. Based on the gait data gained by electronic walkway, the relationship among the toe out angles and their correlation with age and gender etc. were quantitatively analyzed. The results show that most normal subjects walk with positive toe out angles, and the angles increase with age. Such changes are slow in the young and middle age groups. However, the elevations of the left out toe angle and the angles between the feet are statistically significant after entering elder age ( >60 years). The results also suggest that the angle between the feet is a kind of practical gait parameter for varying applications. This study concludes that feet angle analysis is potential to provide a convenient and quantitative tool for the assessment of lower limb motor ability and the diagnosis of knee joint diseases.

Evolução funcional da distrofia muscular do tipo Cinturas em indivíduos de uma mesma família / Functional evolution of Girdle Muscular Dystrophy in individuals of the same family

A Distrofia Muscular de Cinturas (DMC) possui herança autossômica dominante ou recessiva e caracteriza-se por paresia progressiva que induz à deterioração funcional e dificuldades no desempenho de atividades cotidianas. O objetivo do presente estudo foi analisar a evolução funcional de indivíduos com diagnóstico de DMC de uma mesma família. Nove indivíduos foram avaliados por um questionário para identificação do parentesco, idade de inicio dos primeiros sintomas e queixas principais, e pelas Escalas de Vignos (EV) e Hammersmith (EMFH). O projeto foi aprovado pelo CEP/UFVJM, protocolo nº061/12. A idade média foi de 33 ± 8.1 anos, com seis indivíduos sendo do sexo masculino, a idade de aparecimento dos primeiros sintomas foi aos 9± 2,83 anos e os sintomas iniciais mais frequentes foram dificuldade de correr, quedas e marcha equina. Os sujeitos pontuaram 4, 6 e 7 na EV e no exame físico verificou-se acometimento principalmente dos membros inferiores. Foi encontrado correlação negativa entre idade dos sujeitos e escore na EMFH (r2=-0,839) e entre pontuação na EV e EMFH (r2 =-0,819), e correlação positiva entre EV e uso de dispositivos (r2=0,866). Nossos achados sugerem que a mesma patologia diagnosticada em indivíduos de uma mesma família apresenta repercussões funcionais diferentes. O aspecto ambiente deve ser levado em consideração ao avaliar a funcionalidade desses indivíduos uma vez que, independente do diagnóstico em comum, da idade, e limitações físicas, os indivíduos apresentaram adaptações particulares com objetivo de manutenção do seu deslocamento de acordo com as características do ambiente em que vive.(AU)

Limb Girdle Muscular Dystrophy (LGMD) is an autosomal-dominant or recessive hereditary disease. Progressive muscular weakness leads to functional damage and difficulty to perform activities of daily life. The present study aimed to analyze the functional evolution of LGMD individuals of the same family. Nine individuals were assessed using a questionnaire (to identify their relationship, age of onset of the first signs of the disease and main complaints) and by Vignos and Hammersmith Scales. Projetct was aproved by Ethics Committee of UFVJM, protocol nº061/12. Mean age was 33±8.1 years old, six male, mean age of onset of the first signs was 9± 2,83 years old and the most frequent signs were difficulty to run, falls and gait with ankle on plantar flexion. Subjects scored 4, 6 and 7 on Vignos Scale and on physical exam, lower limbs were the most affected. Negative correlation between age and Hammermith scale (r 2=-0,839), Vignos and Hammersmith Scale (r2=-0,819) were found. Positive correlation between Vignos Scale and use of assistive devices (r2=0,866). Our finds suggest that the same disease in individuals of the same family leads to different functional impairment. The environmental aspect should be considered when assessing functionality of individuals with LGMD once although they present the same diagnosis, they present particular adaptations with the aim of maintain displacement according to characteristics of the environment where they live.(AU)

Habilidad viso-motriz y deficiencia intelectual: estudio de validez para el Bender-SPG / Visual motor ability and intellectual disabilities: validity study of the Bender-SPG / Habilidade viso-motriz e deficiência intelectual: estudo de validade para o Bender-SPG

Este trabajo tuvo por objetivo establecer la evidencia de validez convergente por medio del análisis de la asociación entre el la Prueba Gestáltica Viso-Motriz de Bender-Sistema de Puntuación Gradual (B-SPG), el Dibujo de la Figura Humana-Escala Sisto (DFH) y las Matrices Progresivas Coloridas de Raven (CPM). Participaron en el estudio 397 personas, entre los seis y 24 años de edad, con deficiencia intelectual. Los datos fueron obtenidos en la escuela de los niños y de forma individual. Los resultados indicaron una correlación de magnitud moderada entre los tests, confirmando la evidencia de validez para el B-SPG. Además, al comparar los resultados con los baremos de los tres tests se verificó que el desempeño de los sujetos de esta investigación estuvo muy debajo de lo esperado, una vez que el resultado fue semejante o inferior al de niños de seis años de los baremos que aparecen en los manuales de los tests.

This study aimed to establish evidence of convergent validity through the analysis of the association between the Bender Visual-Motor Gestalt Test -Gradual Scoring System (B-SPG, for its Spanish acronym), the Human Figure Drawing Test - Sisto's Scale (DFH for its Spanish acronym) and the Colorful Raven's Progressive Matrices (CPM).The participants in the study were 397 individuals, aged between 6 and 24 years old, who showed intellectual impairment. Data were gathered on an individual basis at the school these people attended. Results indicated a moderate magnitude correlation between the tests, thus confirming validity evidence for B-SPG. Moreover, when comparing the results with the scales of the three tests it was verified that the performance of the participants in this research was well below expectations, since the scores obtained were similar to or lower than those of children six years old of the scales contained in the testing manuals.

Este trabalho teve como objetivo estabelecer a evidência de validade convergente por meio da análise da associação entre o Teste Gestáltico Visomotor de Bender-Sistema de Pontuação Gradual (B-SPG), o Desenho da Figura Humana-Escala Sisto (DFH) e as Matrizes Progressivas Coloridas de Raven (CPM). Participaram no estudo 397 pessoas, entre seis e vinte e quatro anos de idade, com deficiência intelectual. Os dados foram obtidos na escola das crianças e de forma individual. Os resultados indicaram uma correlação de magnitude moderada entre os testes, confirmando a evidência de validade para o B-SPG. Além disso, ao comparar os resultados com parâmetros dos três testes verificou-se que o desempenho dos sujeitos desta pesquisa esteve muito abaixo do esperado, já que o resultado foi similar ou inferior ao de crianças de seis anos dos parâmetros que aparecem nos manuais dos testes.

Relationship between Activity of Thorax and Spinal Motor Ability in Patients with Ankylosing Spondylitis / 中国康复理论与实践

@#Objective To study the relationship between activity of thorax and each spinal intervertebral angle in patients with ankylosing spondylitis. Methods Each spinal intervertebral angle of 41 patients with ankylosing spondylitis were measured by Spinalmouse in different postures. And the activity of thorax was measured. Correlation between activity of thorax and shape of spinal were analyzed. Results The activity of thorax positively correlated with the entire lumbar spinal column in flexion (P<0.01), as well as the intervertebral angle of L1/2, L2/3 and L4/5 in flexion (P<0.05), but negatively correlated with the intervertebral angle of L1/2 and L2/3, curvature of the entire lumbar spinal column in upright and the intervertebral angle of L1/2, L3/4, curvature of the entire lumbar spinal column in extension. Conclusion There was a significant relation between activity of thorax and lumbar vertebra motor ability.

Comparison of motor strength and function in patients with Duchenne muscular dystrophy with or without steroid therapy / Comparação da força e função motora em pacientes com distrofia muscular de Duchenne com ou sem corticoterapia

OBJECTIVE: To compare muscle strength (MS) and motor function in patients with Duchenne muscular dystrophy (DMD) receiving steroids for different times against the natural evolution of DMD described by Scott et al. METHOD: 90 patients with DMD (aged 5- 12 years), receiving steroids for one to seven years, were evaluated by Medical Research Council Scale (MRC) and Hammersmith motor ability score. The relation between MS and motor abilities measurement from our data and Scott's ones were ascertained statistically. RESULTS: The relation between patient's age and Hammersmith scores revealed decrease of 0.76 point per year for age against decrease of 2.23 points on Scott's study. The relation between MRC scale and patient's age showed decrease of 0.80 point per year of age against decrease of 3.65 points on Scott's study. CONCLUSION: In patients with DMD aged five to 12 years the progression of the disease is delayed by steroids and the motor function is less reduced than muscular strength.

OBJETIVO: Comparar força muscular e função motora de pacientes com distrofia muscular de Duchenne (DMD) em corticoterapia com a evolução natural da doença descrita por Scott et al. MÉTODO: Noventa pacientes, entre 5 e 12 anos de idade, em corticoterapia por um até sete anos, foram avaliados quanto à força muscular (FM) (escala MRC) e função motora (Hammersmith motor ability score). A relação entre idade, FM e função motora e a comparação com o estudo de Scott et al foram determinadas estatisticamente. RESULTADOS: a relação idade/escore Hammersmith diminuiu 0,76 pontos a cada ano de aumento da idade (2,23 pontos na história natural). A relação idade/MRC decresceu 0,80 pontos a cada ano de aumento da idade (3,65 pontos na história natural). CONCLUSÃO: Nos pacientes em corticoterapia, a progressão da doença é mais lenta que na evolução natural em todas as faixas etárias avaliadas, sendo a FM mais comprometida que a função motora.

Quantificação da força muscular e habilidades motoras de pacientes com Distrofia Muscular de Duchenne, em corticoterapia por período de 1 a 7 anos / Quantification of muscle strength and motor abilities in patients with Duchenne Muscular Dystrophy on steroid therapy for periods of 1 to 7 years

Os objetivos deste trabalho foram: comparar a força muscular (FM) e as habilidades motoras de pacientes com Distrofia Muscular de Duchenne (DMD) em corticoterapia com a evolução natural da doença (Scott, 1982) e identificar a idade ideal de início da corticoterapia. Noventa pacientes com DMD em seguimento ambulatorial no Hospital das Clínicas da Faculdade de Medicina da USP, submetidos à corticoterapia (deflazacort ou prednisolona) por um período variável de um a sete anos, foram avaliados quanto à FM através da escala MRC e quanto às habilidades motoras através da escala Hammersmith motor ability score. Foram incluídos no estudo todos os pacientes com idade entre cinco e 12 anos, que compreendiam comandos verbais e que não haviam sido submetidos a cirurgias ortopédicas corretivas ou interrompido em algum momento a corticoterapia. A relação entre FM e habilidades motoras, a comparação dos dados com aqueles do estudo de Scott et al. e a análise da influência do tempo de tratamento, da idade de início e da idade na avaliação, sobre os valores obtidos nos testes foram submetidas a tratamento estatístico. Concluiu-se que: a progressão da perda da FM e das habilidades motoras em relação à idade foi mais lenta do que a da evolução natural em todas as faixas etárias avaliadas; quanto maior a idade maior a diferença entre os dois estudos; a perda da FM foi mais intensa do que a perda da funcionalidade; a metodologia utilizada não permitiu estabelecer com clareza a influência da idade de início do tratamento sobre os parâmetros avaliados, porém demonstrou a influência positiva do tempo de tratamento sobre a FM e habilidades motoras.

The aims of this study were: to compare muscle strength (MS) and motor abilities of Duchenne Muscular Dystrophy (DMD) patients in use of steroids, with the natural evolution of the disease (Scott, 1982) and to identify the ideal age for starting on steroid therapy. Ninety patients with DMD followed as outpatients at the Clinics Hospital of the University of São Paulo School of Medicine and submitted to steroid therapy (deflazacort or prednisolone) for a period of one to seven years were assessed for MS using the MRC scale, and for motor abilities with the motor ability score from the Hammersmith scale. All patients aged between five and 12 years who understood verbal commands and who had not been submitted to corrective orthopedic surgery and had no interruption in steroid therapy, were included in the study. Statistical analysis was carried out to assess the relationship between MS and motor abilities and to compare our data against results of Scott's study. The influence of length of treatment, age at disease onset and first assessment, on values obtained in the tests was investigated. We concluded that: the progression in loss of MS and of motor abilities with age was slower than the natural evolution across all age groups studied; the higher the age the greater the difference between the two studies; loss of MS was more intense than loss of functionality; the methodology used was unable to clearly ascertain the influence of age at treatment on the parameters assessed, but a positive influence of length of treatment on both MS and motor abilities was identified.

Effect of Motor Relearning Program on Recovery of Event-related Potential of Cerebral Infarction / 中国康复理论与实践

@#Objective To explore event-related potential(ERP) P300 of cerebral infarction patients during motor relearning program. Methods 99 cerebral infarction patients were divided into observation group(52 cases, receiving motor relearning program) and control group(47 cases, no treatment), and 50 healthy subjects as normal control. After 12 weeks, they were measured by: 1)Berg balance scale; 2)Sheikh body control scale; 3)Fugl-Meyer movement assessment; 4) walk ability and 5) ERP P300.Results The scores of Berg balance scale, Fugl-Meyer movement assessment, Sheikh body control scale and walk ability scale increased significantly, and the latency of ERP P300 decreased significantly(P<0.01), and the amplitude of ERP P300 increased significantly in the observation group. ERP P300 of the observation group has significantly difference(P<0.01) from the normal control group.Conclusion Motor relearning program can effectively retrieve the ERP P300 and motor ability of cerebral infarction patients.

Correlation between Cognitive Ability and Motor Ability in Stroke Patients / 中国康复理论与实践

@# Objective To explore the correlation between cognitive ability and motor ability in stroke patients.Methods 30 stroke patients were assessed with the 3 m Timed Up and Go Test (TUG). The anticipated time by patients and the actual time were recorded, and their difference was caculated, named as the cognitive error. They were also assessed with Trail Making Test-Part A (TMT-A). The actual time of TUG, cognitive error and the time of TMT-A was compared among different groups of Brunnstrom stage of lower limb, and their correlation was analyzed. Results There was a significant difference between the actual time of TUG between Brunnstrom stage Ⅲ and Ⅴ (F=4.600, P<0.05). There was positive correlation between actual time of TUG and cognitive error（r=0.844, P<0.01）, time of TMT-A and cognitive error（r=0.508, P<0.01）, time of TMT-A and actual time of TUG （r=0.414, P<0.05）. Conclusion Motor ability of stroke patients can be influenced by deficient attention and motor cognition.

A capacidade funcional de idosos fisicamente independentes praticantes de atividade física / Fitness of physically independent and active elderly subjects

O objetivo do presente estudo foi traçar o perfi l funcional de idosos acima de 60 anos de níveis funcionais IV e V em relação às capacidades físico-motoras e capacidade funcional. As variáveis analisadas foram: agilidade, fl exibilidade, equilíbrio, força de membros superiores e inferiores, habilidade em realizar tarefas de coordenação motora fi na, habilidade em calçar meias, levantar-se do solo, subir degraus, sentar, levantar e locomover-se com agilidade e equilíbrio. Os testes foram aplicados em 193 idosos de níveis funcionais IV e V com idade, entre 60 e 90 anos. Para comparação dos resultados foi usada a análise de variância de um fator. Os dados mostraram ausência de diferenças, com exceção para a capacidade motora agilidade e para a capacidade funcional levantar-se do solo. Os resultados obtidos permitem concluir que o perfi l funcional de idosos fi sicamente ativos mantém-se em condições ótimas até idades avançadas, acima da média dos idosos sedentários, quando realizam um programa de atividade física.

The object of this paper is to describe functional and motor abilities of physically independent subjects older than 60 years old. We applied tests for agility; fl exibility; upper and lower limbs strength; fi ne motor coordination; ability to wear socks, to rise from the fl oor; to step up stairs, and balance. The subjects were 193 physically independent elderly subjects, classifi ed at motor-physical and functional abilities levels IV and V. We run one-way ANOVA to compare the results. There were no effects of aging on most of variables, but agility and to rise from the fl oor. We conclude the fi tness of physically active elderly people remains stable across aging, higher than sedentary subjects.

Problems of Driver's License Test for the Handicapped People with Weak Upper Extremities in Korea: A case report

The mobility provided by a car can obviously give much greater independence and opportunities for work and social activities to people with physical handicaps, even though they may still find it difficult to drive an ordinary production car. But, in our country, the driver's license test is to the disadvantage for driving of the handicapped people who can drive a car with suitable modifications. The authors examined the relationship between the motor ability test of driver's license test for the handicapped people and actual car-driving abilities in three handicapped people who have driven suitably modified cars for several years. All three subjects failed in steering wheel operation of motor ability test and one subject failed in parking brake operation. These results showed that the motor ability test of driver's license test for the handicapped people was inappropriate and had to be changed.

Study of the Influence on Hemipl egic Patients Treated with Rehabil itation Medicine Sooner or Later / 中国康复理论与实践

@#hemiplegic patients following stroke were devided into two groups一一group A andgroup B for this study. Rehabilitation treatment started for the patients in group A in one month,yet forthose in group B in two or three months after onset of the stroke. Compared the conditions of the twogroups of patients before their rehabilitation treatment,there was no obvious difference(P<0.05)in thefour aspects of their motor ability(Ⅰ-activity in bed;Ⅱ-aclivity in wheel-chair;Ⅲ-in-ward;Ⅳ-outdoor activity).While the result of analysis on their post-treating shift of motor ability showed that thetrend,which the proportion of patients with ability Ⅰ andⅡ decreased but the proportion of patients withability Ⅲ and Ⅳ increased,was more significant in group A than in group B(P<0.05).Thereby it indicatesthat the early starting of rehabilitation treatment is favourable for improving motor ability of hemiplegic pa-tients following stroke.

Motor abilities of older adults in Japanese urban and rural communities / 体力科学

A motor performance test was administered to elderly adults in Koganei City and Nangai Village of Japan as the baseline study of Tokyo Metropolitan Institute of Gerontology, Longitudinal Interdisciplinary Study on Aging (TMIG-LISA) . The participants in this study totaled 405 (183 males and 222 females) aged 65 to 84 from Koganei City, and 734 (295 males and 439 females) aged 65 and over from Nangai Village. The test consisted of measurement of grip strength, one-leg stand-ing, walking at preferred and maximum speeds, and finger-tapping. All motor performances examined were higher among males than females, and they all deteriorated with aging. A regional difference was found in terms of motion speed abilities: finger-tapping rate and walking speed were higher among urban residents than rural residents. Individual differences (coefficient of variation) in the motor ability increased with aging, and reached 106% (maximum tapping rate in female) to 290% (maximum walking speed in female) of those in the twenties. Significant correlations between motor abilities were detected indicating that the specificity of the motor ability found in the young may not account for older adults.

Effect of aging on motor ability in men aged 18 to 83 years / 体力科学

A study was conducted to determine the effect of aging on motor ability and to establish a test battery for physical fitness in the elderly. The subjects were 150 men aged 18 to 83 years. The test items examined were selected, according to Fleishman's list of motor abilities; (1) trunk flexion, (2) grip and isometric knee extension strength, (3) postural sway with eyes open and closed, (4) step test, (5) walking test at preferred and maximum speeds, (6) simple visual reaction time, (7) peg-board test, (8) finger tapping test at maximum rate and in time to metronome sounds. Performances for the test items, except for preferred walking speed and coefficient of variation in finger tapping at 5 Hz, showed significant decreases with aging. The decrease in motor performance at age 80 years relative to the level at age 20 years was less than 30% for finger dexterity and reaction time, 40-60% for muscle strength, maximum walking speed and the step test, and over 70% for trunk flexion and postural sway with eyes closed. A test battery composed of trunk flexion, grip strength, knee extension, step test, walking as fast as possible, postural sway with eyes closed, and finger tapping, is therefore recommended for assessing the effect of aging on physical fitness.