Therapeutic Effects of Metaverse Rehabilitation for Cerebral Palsy: A Randomized Controlled Trial.

Metaverse physical therapy (MPT), an adjuvant technology for the rehabilitation of children with cerebral palsy (CP), has gained notoriety in the clinical field owing to its accessibility and because it provides motivation for rehabilitation. The aim is to compare the gross motor function and cardiopulmonary function, the activities of daily living, quality of life (QOL), and the perceived risk of coronavirus disease (COVID)-19 transmission between MPT and conventional physical therapy (CPT). A convenience sample of 26 children with CP (mean age, 11.23 ± 3.24 years, 14 females) were randomized into either the MPT or CPT group and received therapy three days/week for four weeks. Clinical outcomes included gross-motor-function measure 66 (GMFM-66), heart rate (HR), Borg-rating perceived exertion (BRPE), functional independence measure (FIM), pediatric QOL, and the risk of COVID-19 transmission. An analysis of variance showed that compared with CPT, MPT exerted positive effects on GMFM, HR, and BRPE. An independent t-test showed that compared with CPT, MPT exerted positive effects on the perceived transmission risk of COVID-19 but not on FIM and QOL. Our results provide promising therapeutic evidence that MPT improves gross motor function, cardiopulmonary function, and the risk of COVID-19 in children with CP.

Effects of COVID-19 related physical inactivity on motor skills in children with intellectual disability.

BACKGROUND: Children with intellectual disabilities (ID) may show declines in motor skills during the Covid-19 restrictions. This study compared the effects of physical inactivity due to COVID-19 on the motor skills of active and inactive children with ID. METHOD: In this prospective cohort study, 30 boys with ID were divided into two groups based on study inclusion criteria (mean age 10.86 ± 1.81 active, 10.20 ± 1.42 inactive). The BESS test, the Y test, the Timed Up and Go (TUG) test, and the Bruininks-Oseretsky test-short form were used. RESULTS: Results showed a significant difference between active and inactive groups in the total score of gross motor skills (P = 0.001), fine motor skills (P = 0.002), motor skills (P = 0.001), postural control (P = 0.01), and dynamic balance (P = 0.01). CONCLUSIONS: The results showed a significant difference between active and inactive children with ID in terms of gross and fine motor skills after a one-year movement restriction. Therefore, considering the tendency to be sedentary among these people and the subsequent complications caused by this inactivity, including obesity and chronic diseases, it is suggested that parents and educators design practical and numerous exercises and encourage them to be more active and participate in physical activity programs.

Effects of Eight Weeks of Selected Virtual-Assisted Montessori-Based Games on Motor Proficiency and Perceived Self-Control in Children with Spastic Hemiplegia during the Coronavirus Outbreak.

This study is aimed at examining the effect of eight weeks of selected virtual-assisted games based on Montessori pedagogical principal on the motor proficiency and perceived self-control in the children with spastic hemiplegia during the coronavirus outbreak. In this quasi-experimental study, the children (6.42y ± 1.12y) with hemiplegia were randomly selected and assigned to either the experimental group or the control group. In the pretest, motor skills and self-controlling were evaluated using 36-item Lincoln-Oseretsky Motor Development Scale and Children's Perceived Self-Control Scale (CPSC) (ss, 1982), respectively. The experimental group then engaged in three 45-minute sessions of virtual game play over the course of eight weeks. 24 hours following the last practice session, the posttest was given on the same day as the pretest. After ensuring the normal distribution of collected data with Shapiro-Wilk test, the data were analyzed using Analysis of Covariance test (ANCOVA). Results showed that the experimental group compared to the control group was better in the motor proficiency and perceived self-control after performing selected virtual-assisted Montessori games can significantly improve motor proficiency and perceived self-control (P < 0.05). This pattern of data revealed that the virtual-assisted intervention based on Montessori pedagogical principles may increase motor proficiency and self-control in children with hemiplegia, particularly when confronted with the limitations imposed on by the coronavirus epidemic.

Measurement Properties of Canadian Agility and Movement Skill Assessment for Children Aged 9-12 Years Using Rasch Analysis.

The Canadian Agility and Movement Skill Assessment (CAMSA) was recently widely used to assess fundamental motor skills in children. Although the CAMSA is reported to be reliable and valid, its measurement properties are not clear. This study aimed to examine the measurement properties of the CAMSA in a sample of Chinese children using Rasch analysis. The study sample was from 1,094 children aged 9-12 years in Zunyi City, Guizhou Province. Descriptive data were analyzed using SPSS 24.0 software, and the dichotomous data were analyzed by Winsteps version 4.5.4 and Facets 3.67.1 software performing Rasch analysis. The present study investigated CAMSA measurement characteristics by Rasch analysis, including the reliability of the rating instrument, unidimensionality, item-fit statistics, and differential item functioning (DIF). Inter-rater reliability and retest reliability showed that the CAMSA had a good internal consistency. Rasch analysis indicated that the CAMSA was unidimensional, locally independent, and had a good item-fit-statistic. Additionally, the CAMSA displayed a good fit for the item separation index (12.50 > 2.0), as well as for item reliability (0.99 > 0.90). However, the item difficulty of the CAMSA did not fit well with personal ability, and a significant DIF was found across genders. In the Chinese children sample test, the CAMSA demonstrated appropriate goodness-of-fit validity and rater reliability. Thus, future research will explore item difficulty and person ability fit, as well as DIF across genders.

Telehealth Program for Infants at Risk of Cerebral Palsy during the Covid-19 Pandemic: A Pre-post Feasibility Experimental Study.

Aim: To verify the effects of a telerehabilitation program for infants at high risk for Cerebral Palsy (CP) during the COVID-19 pandemic.Method: Longitudinal study. Infants were aged 3-18 months corrected age, at risk of developmental delay. The General Movement Assessment or a neurologic examination were performed to identify the risk of CP. Motor function was assessed using the Gross Motor Function Measure-88 (GMFM-88) and the Alberta Infant Motor Scale (AIMS). Caregivers of infants at high risk of CP applied a home-based program supervised by a Physical therapist, five times a week over 12 weeks. The program included guidance for optimal positioning, optimization of goal-directed activities, environmental enrichment, and educational strategies.Results: 100 infants at risk for delayed motor development were recruited. Eighteen infants were classified at high risk of CP, and 10 families completed telerehabilitation (83% final retention rate). No adverse events were reported. Adherence to the telecare program was high (90%). The costs were low. We found increased scores for all dimensions and the total score of the GMFM-88, and the AIMS percentile at the end of the intervention. Most infants presented a clinically significant change for the GMFM-88.Conclusions: The telecare program was feasible.

Physical Education on the Beach: An Alternative Way to Improve Primary School Children's Skill- and Health-Related Outcomes during the COVID-19 Pandemic.

The COVID-19 restrictions could preclude children from participating in physical education (PE) interventions. This study aimed to evaluate the efficacy of a PE intervention conducted on the beach on children's skill- and health-related outcomes, as a possible alternative PE intervention that could be also applied during the COVID-19 pandemic. The study involved 106 primary school children, randomly assigned to the traditional indoor (TI) intervention or to the experimental outdoor (EO) intervention. The intervention period lasted 4 months and consisted of two 1-h sessions per week. Intervention was conducted just before the beginning of the COVID-19 pandemic. Children's anthropometric parameters (height, weight, BMI, body fat percentage, and abdominal circumference), fitness parameter (VO2peak), health parameters (resting heart rate, and systolic and diastolic blood pressure), gross motor coordination, and physical activity level were assessed before and after intervention. Both groups significantly improved fitness and motor coordination but worsened some anthropometric parameters (weight, abdominal circumference) after the intervention period. The EO group showed a higher increase of gross motor coordination than the TI group. Results of this study demonstrated that children benefited from a well-structured PE intervention conducted in the natural environment of the beach improving physical fitness and gross motor coordination. Therefore, planning outdoor PE interventions could be an alternative and safe way to encourage and implement physical activity at school during the particular period of COVID-19 pandemic.

The Value of a Motor Intervention for 3 to 6-Year-Old Children Infected with and Affected by HIV.

Human immunodeficiency virus (HIV)/Aquired Immune Deficiency Syndrome (AIDS) is a large threat to human health and is challenging to address. This study aims to determine if motor intervention is a possibility for promoting the life expectancy and quality of life of children with HIV. The group consisted of 22 participants: 11 HIV-infected (51.73 months, SD 10.15) and 11 HIV-affected children (44.45 months, SD 10.76). A two-group (intervention and control group) pre-test-post-test research design was followed. The HIV-infected and affected children were randomly matched and grouped into an intervention and control group. The intervention group participated in a 12-week motor intervention of 60 min per session, twice per week. The effect of the program was analyzed with regard to motor skills, as established by the PDMS-2 and two strength capabilities. An ANCOVA adjusted for pre-test differences (p < 0.05) indicated statistically significant improvement (p < 0.05) with large practical significance (d > 0.8) in locomotor, fine motor and overall motor skills. The infected children also showed better improvement compared to the affected children. Motor intervention is recommended in the health care path of children affected and infected with HIV, although modifications for improvement of the program are suggested, based on the results attained.

A Feasibility Trial for Virtual Administration of the Test of Gross Motor Development-3 for Children With Autism Spectrum Disorders During the COVID-19 Pandemic.

The Test of Gross Motor Development-3 is one of the most popular assessment tools in physical education and physical activity settings. It is a valid assessment originally designed to administer in-person, but the virtual administration of the assessment has yet to be deemed feasible. Thus, the purpose of this study was to explore the trial feasibility of virtual data collection using the Test of Gross Motor Development-3 to assess the fundamental motor skills of children with autism spectrum disorder. Most specifically, we report on the design and feasibility of the online assessment process. A total of 22 families of children with autism spectrum disorder participated in the online data collection.

Active Video Games Improve Muscular Fitness and Motor Skills in Children with Overweight or Obesity.

(1) Background: Childhood obesity is an important public health problem. Children with overweight or obesity often tend to show the pediatric inactivity triad components; these involve exercise deficit disorder, pediatric dynapenia, and physical illiteracy. The aim of the study was to examine the influence of an active video games (AVG) intervention combined with multicomponent exercise on muscular fitness, physical activity (PA), and motor skills in children with overweight or obesity. (2) Methods: A total of 29 (13 girls) children (10.07 ± 0.84 years) with overweight or obesity were randomly allocated in the intervention group (AVG group; n = 21) or in the control group (CG; n = 8). The intervention group performed a 5-month AVG training using the Xbox 360® with the Kinect, the Nintendo Wii®, dance mats, and the BKOOL® interactive cycling simulator, combined with multicomponent exercise, performing three sessions per week. The control group continued their daily activities without modification. Weight, PA using accelerometers, and motor competence using the Test of Gross Motor Development 3rd edition were measured. Muscular fitness was evaluated through the Counter Movement Jump height, maximal isometric strength of knee extension and handgrip strength, and lean mass using Dual-energy X-ray Absorptiometry. Mann-Whitney U and Wilcoxon signed rank tests were performed. The biserial correlation coefficients (r) were calculated. Spearman's correlation coefficients among PA, muscular fitness, and motor competence variables were also calculated. (3) Results: The AVG group significantly increased their knee extension maximal isometric strength (4.22 kg; p < 0.01), handgrip strength (1.93 kg; p < 0.01), and jump height (1.60 cm; p < 0.01), while the control group only increased the knee extension maximal isometric strength (3.15 kg; p < 0.01). The AVG group improved motor competence and light physical activity (p < 0.05) and decreased sedentary time (p < 0.05). Lean mass improved in both AVG group and CG (p < 0.05). Lastly, the percentage of improvement of motor skills positively correlated with the percentage of improvement in vigorous PA (r = 0.673; p = 0.003) and the percentage of improvement in CMJ (r = 0.466; p = 0.039). (4) Conclusions: A 5-month intervention combining AVG with multicomponent training seems to have positive effects on muscle fitness, motor competence, and PA in children with overweight or obesity.

The Impact of Protective Gloves on Manual Dexterity in Cold Environments-A Pilot Study.

Our research aimed to determine the impact of two types of protective gloves. The research tested the glove performance on men exposed to a range of temperatures reflecting the working conditions in fruit and vegetable processing. The gloves were assessed for performance within the time required to complete a specific manual task and for performance relative to the subjective thermal sensations in the male subjects. Six males participated in a total of 3 study variants: at +5 °C (with double gloves and single glove), at -1 °C (with double gloves and single glove) and in reference conditions +20 °C (without gloves), in which they performed manual tasks. The measurement of manual task performance time was used to assess manual dexterity. Subjective thermal sensations were determined. Differences in the time required to complete specific tasks were observed between the variants with gloves (both at a temperature of +5 °C and -1 °C), and without gloves (p < 0.05). The type of protective gloves had an impact on the time needed to complete manual tasks and therefore may affect manual dexterity.

Recognizing Full-Body Exercise Execution Errors Using the Teslasuit.

Regular physical exercise is essential for overall health; however, it is also crucial to mitigate the probability of injuries due to incorrect exercise executions. Existing health or fitness applications often neglect accurate full-body motion recognition and focus on a single body part. Furthermore, they often detect only specific errors or provide feedback first after the execution. This lack raises the necessity for the automated detection of full-body execution errors in real-time to assist users in correcting motor skills. To address this challenge, we propose a method for movement assessment using a full-body haptic motion capture suit. We train probabilistic movement models using the data of 10 inertial sensors to detect exercise execution errors. Additionally, we provide haptic feedback, employing transcutaneous electrical nerve stimulation immediately, as soon as an error occurs, to correct the movements. The results based on a dataset collected from 15 subjects show that our approach can detect severe movement execution errors directly during the workout and provide haptic feedback at respective body locations. These results suggest that a haptic full-body motion capture suit, such as the Teslasuit, is promising for movement assessment and can give appropriate haptic feedback to the users so that they can improve their movements.

Telerehabilitation during COVID-19 lockdown and gross motor function in cerebral palsy: an observational study.

BACKGROUND: COVID-19 (Coronavirus disease 2019) refers to a mainly respiratory disease, caused by a new SARS-CoV-2 virus predominantly transmitted through direct or indirect contact with mucous membranes of eyes, mouth, or nose. The main control measures are physical distancing, use of specific protective devices, hand hygiene and disinfection of environments and tools. During this health emergency, telemedicine and telerehabilitation guaranteed patients to receive continuity of care through a virtual support while maintaining physical distance. AIM: The aim of this study was to evaluate the effects of telerehabilitation on gross motor skills in children with cerebral palsy (CP) during COVID-19 lockdown. DESIGN: This is an observational study. SETTING: Pediatric Outpatient Neurorehabilitation Service. POPULATION: Fifty-three children with cerebral palsy aged between 6 months and 12 years classified according to the Gross Motor Function Classification System (GMFCS). METHODS: Variation on the Gross Motor Function Measure-66 (GMFM-66) Score calculated before and after the telerehabilitation period was analyzed. RESULTS: After telerehabilitation there was a statistically significant increase in the median value of GMFM scores both on the total sample (from 54.82% to 63.18%, P=0.000005) and in the subgroups. Specifically, in children classified as level I and II at the GMFCS, this value increased more after the telerehabilitation period. Only the GMFCS level V group did not show statistically significant changes and only in two cases a decrease in the GMFM Score after the telerehabilitation phase occurred. CONCLUSIONS: Telerehabilitation can be considered an efficient tool that can temporarily replace the in-person therapy. It can allow the patient or caregiver to acquire skills in performing home exercises and to integrate and implement activity carried out at the Rehabilitation Center. CLINICAL REHABILITATION IMPACT: This study shows a positive effect of telerehabilitation on gross motor function in children with cerebral palsy.

[Is the implementation of Vojta therapy associated with faster gross motor development in children with cerebral palsy?] / Segíti-e a cerebralis paresisben szenvedo gyermekek bruttó motoros funkcióinak fejlodését a Vojta-módszer?

BACKGROUND AND PURPOSE: Vojta therapy has been reported as clinically beneficial for strength, movement and gross motor activities in individual cases and is being included within the second of three levels of evidence in interventions for cerebral palsy. The goal of this study is to understand the effect of Vojta therapy on the gross motor function. METHODS: Our clinical trial followed a one group, pre-post design to quantify rates of changes in GMFM-88 after a two-months period undergoing Vojta therapy. RESULTS: A total of 16 patients were recruited. Post-intervention acceleration rates of GMFM-88-items acquisition (0.005; p<0.001) and Locomotor Stages (1.063; p<0.0001) increased significatively following Vojta the-rapy intervention. CONCLUSION: In this study, Vojta therapy has shown to accelerate the acquisition of GMFM-88-items and Loco-motor Stages in children with cerebral palsy younger than 18 months. Because functional training was not utilised, and other non-Vojta therapy intervention did not influence the outcome, Vojta therapy seems to activate the postural control required to achieve uncompleted GMFM-88-items.

COVID-19 triggered encephalopathic crisis in a patient with glutaric aciduria type 1.

OBJECTIVES: The impact of coronavirus disease-19 (COVID-19) on metabolic outcome in patients with inborn errors of metabolism has rarely been discussed. Herein, we report a case with an acute encephalopathic crisis at the course of COVID-19 disease as the first sign of glutaric aciduria type 1 (GA-1). CASE PRESENTATION: A 9-month-old patient was admitted with encephalopathy and acute loss of acquired motor skills during the course of COVID-19 disease. She had lethargy, hypotonia, and choreoathetoid movements. In terms of COVID-19 encephalopathy, the reverse transcription-polymerase chain reaction assay test for COVID-19 was negative in cerebral spinal fluid. Brain imaging showed frontotemporal atrophy, bilateral subcortical and periventricular white matter, basal ganglia, and thalamic involvement. Elevated glutarylcarnitine in plasma and urinary excretion of glutaric and 3-OH-glutaric acids was noted. A homozygote mutation in the glutaryl-CoA dehydrogenase gene led to the diagnosis of GA-1. CONCLUSIONS: With this report, neurological damage associated with COVID-19 has been reported in GA-1 patients for the first time in literature.

Feasibility of motor imagery and effects of activating and relaxing practice on autonomic functions in healthy young adults: A randomised, controlled, assessor-blinded, pilot trial.

INTRODUCTION: Motor imagery (MI) is the mental rehearsal of a motor task. Between real and imagined movements, a functional equivalence has been described regarding timing and brain activation. The primary study aim was to investigate the feasibility of MI training focusing on the autonomic function in healthy young people. Further aims were to evaluate participants' MI abilities and compare preliminary effects of activating and relaxing MI on autonomic function and against controls. METHODS: A single-blinded randomised controlled pilot trial was performed. Participants were randomised to the activating MI (1), relaxing MI (2), or control (3) group. Following a MI familiarisation, they practiced home-based kinaesthetic MI for 17 minutes, 5 times/week for 2 weeks. Participants were called once for support. The primary outcome was the feasibility of a full-scale randomised controlled trial using predefined criteria. Secondary outcomes were participants' MI ability using the Movement Imagery Questionnaire-Revised, mental chronometry tests, hand laterality judgement and semi-structured interviews, autonomic function. RESULTS: A total of 35 participants completed the study. The feasibility of a larger study was confirmed, despite 35% attrition related to the COVID-19 pandemic. Excellent MI capabilities were seen in participants, and significant correlations between MI ability measures. Interview results showed that participants accepted or liked both interventions. Seven major themes and insider recommendations for MI interventions emerged. No significant differences and negligible to medium effects were observed in MI ability or autonomic function between baseline and post-intervention measures or between groups. CONCLUSIONS: Results showed that neither activating nor relaxing MI seems to change autonomic function in healthy individuals. Further adequately powered studies are required to answer open questions remaining from this study. Future studies should investigate effects of different MI types over a longer period, to rule out habituation and assess autonomic function at several time points and simultaneously with MI.

Changes in motor function in Duchenne muscular dystrophy patients after travel restrictions due to COVID-19.

INTRODUCTION/AIM: This retrospective study aimed to quantify the changes in motor function in patients with Duchenne muscular dystrophy (DMD) due to the government-imposed travel restrictions associated with the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Twelve DMD patients were enrolled in this investigation (mean ± SD age: 9.8 ± 3.6 y). Their physical characteristics and motor function were evaluated approximately 3 mo before, immediately before, and approximately 3 mo after the travel restrictions were decreed. Statistical comparisons were performed of the changes in motor function before and after the travel restrictions. RESULTS: The change in range of motion (ROM) of ankle dorsiflexion was significantly decreased after the travel restrictions. Changes in body mass index and other motor function parameters were not significant. DISCUSSION: An apparent decrease in the amount of physical activity due to travel restrictions in response to COVID-19 negatively affected ankle dorsiflexion ROM but not other motor functions. A more sedentary lifestyle and lack of regular physical therapy services most likely contributed to this reduction. The use of remote rehabilitation tools with the involvement of physiotherapists may help mitigate such changes and prevent more severe physical decline.

A Deep Learning Approach for Table Tennis Forehand Stroke Evaluation System Using an IMU Sensor.

Psychological and behavioral evidence suggests that home sports activity reduces negative moods and anxiety during lockdown days of COVID-19. Low-cost, nonintrusive, and privacy-preserving smart virtual-coach Table Tennis training assistance could help to stay active and healthy at home. In this paper, a study was performed to develop a Forehand stroke' performance evaluation system as the second principal component of the virtual-coach Table Tennis shadow-play training system. This study was conducted to show the effectiveness of the proposed LSTM model, compared with 2DCNN and RBF-SVR time-series analysis and machine learning methods, in evaluating the Table Tennis Forehand shadow-play sensory data provided by the authors. The data was generated, comprising 16 players' Forehand strokes racket's movement and orientation measurements; besides, the strokes' evaluation scores were assigned by the three coaches. The authors investigated the ML models' behaviors changed by the hyperparameters values. The experimental results of the weighted average of RMSE revealed that the modified LSTM models achieved 33.79% and 4.24% estimation error lower than 2DCNN and RBF-SVR, respectively. However, the R ¯ 2 results show that all nonlinear regression models are fit enough on the observed data. The modified LSTM is the most powerful regression method among all the three Forehand types in the current study.