Fractal fluctuations in exploratory movements predict differences in dynamic touch capabilities between children with Attention-Deficit Hyperactivity Disorder and typical development.

Children with Attention-Deficit Hyperactivity Disorder (ADHD) struggle to perform a host of daily activities. Many of these involve forceful interaction with objects and thus implicate dynamic touch. Therefore, deficits in dynamic touch could underlie functional difficulties presented by ADHD children. We investigated whether performance on a dynamic touch task (length perception by wielding) differ between children with ADHD and age-matched controls. We further examined whether this difference could be explained by fractal temporal correlations (wielding dynamics). Forty-two children (ADHD: 21; typically developing: 21) wielded unseen wooden rods and reported their perceived length in the form of magnitude productions. The rods varied in the magnitude of the first principal moment of inertia (I1). Three-dimensional displacements of hand and rod positions were submitted to Detrended Fluctuation Analysis to estimate trial-by-trial temporal correlations. Children with ADHD reported shorter length for rods with higher I1 than their typically developing peers, indicative of reduced sensitivity to mechanical information supporting dynamic touch. Importantly, temporal correlations in wielding dynamics moderated children's usage of I1. This finding points to a role of exploratory movements in perceptual deficits presented by children with ADHD and, thus, should be considered a new potential target for interventions.

Effects of attentional focus on movement coordination complexity.

Attentional focus affects performance and learning of motor tasks. An external attentional focus (on the effects of movement) can lead to more efficient and effective movements compared to an internal focus (on body movement itself). According to the "constrained action hypothesis", an external focus facilitates fast and reflexive movement control while an internal focus leads to disruption of automatic coordination processes. Such disruption should be apparent in the complexity of movement. In this study, multiscale entropy measures were used to investigate if the external focus is related to superior coordination complexity compared to internal focus. Twenty participants were divided in two groups that balanced over an unstable platform in fourteen trials over two days, either with internal or external focus of attention instructions, followed by seven retention trials on the third day. Multiscale entropy measures were used to quantify complexity of motions of the platform, the participant, and the composite of participant and platform motions. Results were contrary to expectations. For the external focus group, despite better overall performance, multiscale entropy values of participant and composite motions were lower in some scales compared to the internal focus group, especially in the first and last days. This may be consistent with previous findings that predictability increases during learning of a balance task. Results also indicate the need to identify the correct physiological interpretation of single or multiscale entropy measures. Further investigation is needed to establish if entropy differences are causally related to performance and learning advantages of the external focus.

Reliability of Foot Posture Index individual and total scores for adults and older adults.

BACKGROUND: Previous studies have suggested that the Foot Posture Index (FPI-6) is valid and reliable to evaluate foot posture of adults and children. However, studies with adults had some important limitations. In addition, it is not clear if FPI-6 is reliable for older adults. Variations in foot structure, such as edema, bone callosity and bunions, are more frequent in older adults, which may compromise FPI-6 reliability for this population. OBJECTIVES: To investigate test-retest and inter-rater reliability of FPI-6 total and individual scores for the assessment of foot posture of adults and older adults. METHODS: Twenty-one adults and 19 older adults participated in this study. The examiners performed FPI-6 on two days of data collection. We used Cohen Weighted Kappa and Intraclass Correlation Coefficient for categorical and continuous variables, respectively. RESULTS: For adults, FPI-6 scores demonstrated test-retest reliability varying from fair to substantial and inter-rater reliability varying from fair to almost perfect. For older adults, FPI-6 scores demonstrated test-retest reliability varying from not reliable to moderate and inter-rater reliability varying from fair to almost perfect. The examiners demonstrated more than 80% of agreement in all FPI-6 scores for adults and older adults. CONCLUSIONS: The relatively low reliability in light of this high level of agreement suggest that the current version of FPI-6 can be a useful tool to assess foot posture for adults and should be further examined. On the other hand, FPI-6 should be cautiously used for older adults.

New version of the Pediatric Evaluation of Disability Inventory (PEDI-CAT): translation, cultural adaptation to Brazil and analyses of psychometric properties

ABSTRACT Background The Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT), developed with innovative measurement methodologies, evaluates functioning of children and youth, from 0 to 21 years, with different health conditions. It is a revision of an earlier instrument (PEDI) that has been used in national and international clinical practice and research. It was felt to be necessary to make this new version (PEDI-CAT) available in Brazil. Objectives Translate and culturally adapt the PEDI-CAT to the Brazilian-Portuguese language and test its psychometric properties. Method This methodological study was developed through the following stages: (1) translation, (2) synthesis, (3) back-translation, (4) revision by an expert committee, (5) testing of the pre-final version, and (6) evaluation of the psychometric properties. The 276 translated PEDI-CAT items were divided into three age groups (0-7, 8-14, and 15-21 years). Results The PEDI-CAT translation followed all six stages. The adaptations incorporated cultural and socioeconomic class specificities. The PEDI-CAT/Brazil showed good indices of inter-examiner (intraclass correlation coefficient-ICC=0.83-0.89) and test-retest (ICC=0.96-0.97) reliability, good internal consistency (0.99) and small standard error of measurement in all three age groups (0.12-0.17). Factor analyses grouped the items from the three functional skills domains into one factor, and items from the responsibility scale into three factors, supporting the adequacy of these factor solutions to the conceptual structure of the instrument and the developmental model. Conclusion The PEDI-CAT/Brazil is a theoretically consistent, culturally appropriate, and reliable instrument. Its availability in Brazil will contribute to the evaluation and measurement of functional outcomes from clinical interventions, longitudinal follow-up, and rehabilitation research.

New version of the Pediatric Evaluation of Disability Inventory (PEDI-CAT): translation, cultural adaptation to Brazil and analyses of psychometric properties.

BACKGROUND: The Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT), developed with innovative measurement methodologies, evaluates functioning of children and youth, from 0 to 21 years, with different health conditions. It is a revision of an earlier instrument (PEDI) that has been used in national and international clinical practice and research. It was felt to be necessary to make this new version (PEDI-CAT) available in Brazil. OBJECTIVES: Translate and culturally adapt the PEDI-CAT to the Brazilian-Portuguese language and test its psychometric properties. METHOD: This methodological study was developed through the following stages: (1) translation, (2) synthesis, (3) back-translation, (4) revision by an expert committee, (5) testing of the pre-final version, and (6) evaluation of the psychometric properties. The 276 translated PEDI-CAT items were divided into three age groups (0-7, 8-14, and 15-21 years). RESULTS: The PEDI-CAT translation followed all six stages. The adaptations incorporated cultural and socioeconomic class specificities. The PEDI-CAT/Brazil showed good indices of inter-examiner (intraclass correlation coefficient-ICC=0.83-0.89) and test-retest (ICC=0.96-0.97) reliability, good internal consistency (0.99) and small standard error of measurement in all three age groups (0.12-0.17). Factor analyses grouped the items from the three functional skills domains into one factor, and items from the responsibility scale into three factors, supporting the adequacy of these factor solutions to the conceptual structure of the instrument and the developmental model. CONCLUSION: The PEDI-CAT/Brazil is a theoretically consistent, culturally appropriate, and reliable instrument. Its availability in Brazil will contribute to the evaluation and measurement of functional outcomes from clinical interventions, longitudinal follow-up, and rehabilitation research.

Assessment of gait in toddlers with normal motor development and in hemiplegic children with mild motor impairment: a validity study.

BACKGROUND: The optimization of gait performance is an important goal in the rehabilitation of children with cerebral palsy (CP) who present a prognosis associated with locomotion. Gait analysis using videos captured by digital cameras requires validation. OBJECTIVE: To evaluate the validity of a method that involves the analysis of videos captured using a digital camera for quantifying the temporal parameters of gait in toddlers with normal motor development and children with CP. METHOD: Eleven toddlers with normal motor development and eight children with spastic hemiplegia who were able to walk without assistive devices were asked to walk through a space contained in the visual field of two instruments: a digital camera and a three-dimensional motion analysis system, Qualisys Pro-Reflex. The duration of the stance and swing phases of gait and of the entire gait cycle were calculated by analyzing videos captured by a digital camera and compared to those obtained by Qualisys Pro-Reflex, which is considered a highly accurate system. RESULTS: The Intraclass Correlation Coefficient (ICC) demonstrated excellent agreement (ICC>0.90) between the two procedures for all measurements, except for the swing phase of the normal toddlers (ICC=0.35). The standard error of measurement was less than 0.02 seconds for all measures. CONCLUSIONS: The results reveal similarities between the two instruments, suggesting that digital cameras can be valid instruments for quantifying two temporal parameters of gait. This congruence is of clinical and scientific relevance and validates the use of digital cameras as a resource for helping the assessment and documentation of the therapeutic effects of interventions targeted at the gait of children with CP.

Assessment of gait in toddlers with normal motor development and in hemiplegic children with mild motor impairment: a validity study / Avaliacao da marcha de lactentes com desenvolvimento motor normal e criancas hemiplegicas com comprometimento motor leve: estudo de validade

BACKGROUND: The optimization of gait performance is an important goal in the rehabilitation of children with cerebral palsy (CP) who present a prognosis associated with locomotion. Gait analysis using videos captured by digital cameras requires validation. OBJECTIVE: To evaluate the validity of a method that involves the analysis of videos captured using a digital camera for quantifying the temporal parameters of gait in toddlers with normal motor development and children with CP. METHOD: Eleven toddlers with normal motor development and eight children with spastic hemiplegia who were able to walk without assistive devices were asked to walk through a space contained in the visual field of two instruments: a digital camera and a three-dimensional motion analysis system, Qualisys Pro-Reflex. The duration of the stance and swing phases of gait and of the entire gait cycle were calculated by analyzing videos captured by a digital camera and compared to those obtained by Qualisys Pro-Reflex, which is considered a highly accurate system. RESULTS: The Intraclass Correlation Coefficient (ICC) demonstrated excellent agreement (ICC>0.90) between the two procedures for all measurements, except for the swing phase of the normal toddlers (ICC=0.35). The standard error of measurement was less than 0.02 seconds for all measures. CONCLUSIONS: The results reveal similarities between the two instruments, suggesting that digital cameras can be valid instruments for quantifying two temporal parameters of gait. This congruence is of clinical and scientific relevance and validates the use of digital cameras as a resource for helping the assessment and documentation of the therapeutic effects of interventions targeted at the gait of children with CP. .

CONTEXTUALIZAÇÃO : A otimização da marcha é objetivo relevante na reabilitação de crianças com prognóstico de locomoção na paralisia cerebral (PC). A análise da marcha com vídeos capturados por câmeras digitais necessita ser validada. OBJETIVO : Avaliar a validade de um método que envolve a inspeção de vídeos capturados por câmera digital para quantificação de variáveis temporais da marcha de lactentes com desenvolvimento motor normal e crianças com PC. MÉTODO : Onze lactentes com desenvolvimento motor normal e oito crianças com PC do tipo hemiplegia espástica capazes de deambular sem dispositivos de auxílio de marcha foram solicitadas a caminhar em um espaço contido no campo visual de dois instrumentos: câmera digital e sistema tridimensional de análise de movimento Qualisys Pro-Reflex. As medidas de duração das fases de apoio e balanço e o tempo total do ciclo da marcha foram calculados a partir da análise de vídeos de câmera digital e comparados às medidas obtidas pelo Qualisys Pro-Reflex, considerado sistema de alta acurácia. RESULTADOS: O Coeficiente de Correlação Intraclasse (CCI) demonstrou concordância excelente (CCI>0,90) nas medidas dos dois grupos, exceto para a fase de balanço dos lactentes (CCI=0,35). O erro padrão das medidas foi menor que 0,02 segundos para todas as mensurações. CONCLUSÕES : Resultados revelam semelhança entre os dois instrumentos, sugerindo que a câmera digital pode ser instrumento válido para quantificação de dois parâmetros temporais da marcha. Tal congruência tem relevância clínica e científica, preconizando uso da câmera ...