Is more always better? Effectiveness of constraint-induced movement therapy in children with high-risk or unilateral cerebral palsy (0-6 years): Systematic review and meta-analysis.

BACKGROUND: While constraint-induced movement therapy is strongly recommended as an intervention for infants with unilateral cerebral palsy, the optimal dosage remains undefined. This systematic review aims to identify the most effective level of intensity of constraint-induced movement therapy to enhance manual function in infants at high risk of asymmetric brain lesions or unilateral cerebral palsy diagnosis. METHODS: This systematic review with meta-analysis encompassed a comprehensive search across four electronic databases to identify articles that met the following criteria: randomised controlled trials, children aged 0-6 with at high risk or with unilateral cerebral palsy, and treatment involving constraint-induced movement therapy for upper limb function. Studies with similar outcomes were pooled by calculating the standardised mean difference score for each subgroup, and subgroups were stratified every 30 h of total intervention dosage (30-60, 61-90, >90 h). Risk of bias was assessed with Cochrane Collaboration's tool. RESULTS: Seventeen studies were included. Meta-analyses revealed significant differences among subgroups. The 30-60 h subgroup showed a weak effect for spontaneous use of the affected upper limb during bimanual performance, grasp function, and parents' perception of how often children use their affected upper limb. Additionally, this subgroup demonstrated a moderate effect for the parents' perception of how effectively children use their affected upper limb. CONCLUSIONS: Using a dosage ranging from 30 to 60 h when applying a constraint-induced movement therapy protocol holds promise as the most age-appropriate and cost-effectiveness approach for improving upper limb functional outcomes and parent's perception.

Postural Control and Sensory Processing in Preschool Children with Autistic Spectrum Disorder: A Cross-Sectional Study.

The role of sensory processing in maintaining postural control (PC) among preschool-aged children with autism spectrum disorder (ASD) remains underexplored despite its potential implications for their developmental trajectory. This study aimed to assess the utilization of sensory information for PC maintenance while standing in preschool-aged children with ASD and to examine its correlation with PC during functional tasks using a standardized tool. The cross-sectional study recruited 27 children, aged between 3 and 6 years, diagnosed with ASD. Participation indexes for somatosensory, vestibular, visual, and visual preference were computed during a modified Clinical Test of Sensory Integration and Balance (m-CTSIB), based on sagittal plane body sway analyzed via video with Kinovea® software (version 0.9.4). Additionally, scores from the Pediatric Balance Scale (PBS) were analyzed. Statistical analysis of data derived from lateral malleolus and mastoid process sway using the Friedman test revealed significant differences in the utilization of various sensory systems involved in PC during the m-CTSIB (p < 0.001). There was a pronounced reliance on somatosensory information, coupled with increased instability in the absence or with the variability of visual information. The mean PBS score was 50.44 ± 2.74, exhibiting a significant negative correlation with the vestibular index (p < 0.05). Preschool-aged children with ASD demonstrated challenges in maintaining PC while standing under different sensory conditions, indicating a heightened dependence on somatosensory cues, particularly in the absence or with the variability of visual stimuli. While these challenges were not reflected in PBS scores, they were negatively correlated with the vestibular index.

Relationship between Female Sexual Dysfunction and Trunk Stability Post-Stroke: A Cross-Sectional Study.

Background and Objectives: Stroke can lead to a variety of consequences, the severity and nature of which are contingent upon the affected brain region or lesion type. These consequences manifest with distinct clinical presentations and recovery trajectories. This study aims to investigate the potential correlation between feminine sexual dysfunction and trunk stability among stroke survivors. Materials and Methods: Thirty-eight women (stroke group n = 19 and control group n = 19) were recruited. A cross-sectional observational study was designed. Outcome measures were recorded using the Feminine Sexual Function Index, the National Institute of Health Stroke Score, the Newcastle Stroke-specific Quality of Life Measure Beck Depression Index, the Barthel Index, the Urge-urinary Distress Inventory, and the Trunk Impairment Scale. Spearman's correlation was tested between different factors influencing feminine sexual dysfunction and trunk stability. Results: Statistically significant differences were found in sexual function between the stroke group versus the control group (Z = 88; p = 0.007; rb = 0.51). The correlation showed a relationship between feminine sexual dysfunction and trunk stability (p < 0.05). A relationship between quality of life and sexual dysfunction was also found (p < 0.05). There were no statistically significant results for the association between dependency, severity of stroke, time after stroke type of stroke, and sexual dysfunction (p = 0.378). Conclusions: The results of this study support the existence of a correlation between feminine sexual dysfunction and trunk stability, probably due to trunk and pelvic floor muscle synergy. Multidisciplinary teams assessing sexual dysfunction after stroke should include a physical therapist to assess the physical components that may interfere with feminine sexual health post-stroke.

Effectiveness of motor imagery in complex regional pain syndrome: A systematic review with meta-analysis.

OBJECTIVE: The purpose of this study was to determine the effects of motor imagery (MI) on pain intensity and disability in individuals with complex regional pain syndrome (CRPS). METHODS: A systematic search was conducted in various electronic databases to identify all relevant studies: PubMed, CINAHL, WOS, PEDro, CENTRAL, and Scopus. Randomized controlled trials assessing the effects of MI in individuals with CRPS were included. The risk of bias was assessed with the Cochrane Risk of Bias tool, the methodological quality was evaluated using PEDro scale, and the level of evidence was reported according to the GRADE. Between-groups standardized mean differences (SMD) were calculated. RESULTS: Six studies were included. The meta-analysis found moderate-quality evidence that MI improves pain intensity and related disability as immediate (pain: SMD -1.07, 95% CI: -1.53 to -0.60; disability: SMD 1.05, 95% CI: 0.59 to 1.51), short-term (pain: SMD -1.28, 95% CI: -2.14 to -0.42; disability: SMD 1.37; 95% CI: 0.16 to 2.58), and long-term effects (pain: SMD -1.18; 95% CI: -1.89 to -0.46; disability: SMD 1.18; 95% CI: 0.46 to 1.89), as compared with a comparison group. The risk of bias of the trials was relatively low, but the imprecision of the results downgraded the level of evidence. CONCLUSIONS: Moderate-quality evidence suggests a positive effect of MI for improving pain intensity and disability immediately after and at short-term in individuals with CRPS.

Natural Semantic Networks of the Neurorehabilitation Concept by Spanish Physiotherapists-A Qualitative Phenomenological Representational Study.

The Natural Semantic Networks (NSN) model is highly useful in analyzing the words that define a concept in terms of the value, strength, weight, or density that a specific population assigns to the construction of a learned concept. The main objective of this study was to describe the conceptualization of the concept of neurorehabilitation by Spanish physiotherapists specializing in this field using NSN. A phenomenological study is presented. The participants were physiotherapy professionals who graduated from three Spanish universities and were working in the field of neurorehabilitation. A questionnaire was administered via Google Forms, which was constructed using the NSN technique. A total of 191 physiotherapists participated in this study. The Spanish physiotherapists interviewed used a total of 1247 defining words for the concept of neurorehabilitation. The semantic core of the concept was mainly formed by the words 'treatment', 'recovery', 'functionality', 'neuroplasticity', and 'learning', which carried significant weight. Results were also presented taking into account the academic level and years of professional experience of the sample. The semantic network observed in this study allows us to elucidate the polysemy of the concept of neurorehabilitation, which is composed not only of certain associated words but also the meanings they imply.

Psychometric Properties and Clinical Usefulness of the Spanish Version of the Toe Walking Tool.

BACKGROUND: The Toe Walking Tool (TWT) was developed in Australia as a valid and reliable screening tool for children who toe-walk. However, psychometric properties of the Spanish version of the TWT have not been studied. The aim of this study was to assess psychometric properties and clinical usefulness of the Spanish version of the TWT. METHODS: A cross-sectional study was conducted. Twelve children were assessed with the TWT. Intrarater and interrater reliability and agreement were calculated using the intraclass correlation coefficient (ICC) and the Fleiss kappa method for multiple raters. Internal consistency and construct validity were assessed with the Kuder-Richardson formula 20 coefficient and known-group methods, respectively. Sensitivity and specificity were analyzed using the receiver operating characteristic curve. The Content Validity Index was calculated to determine clinical usefulness. RESULTS: An excellent intrarater (ICC = 1) and interrater reliability (ICC = 0.8), moderate interrater agreement (Fleiss kappa, 0.6), strong internal consistency (Kuder-Richardson formula 20 coefficient, 0.86), and very good construct validity were found. Sensitivity and specificity results were appropriate (area under the curve, 0.845). The Content Validity Index was 0.906, suggesting high usefulness. CONCLUSIONS: The Spanish version of the TWT was found to be a valid, reliable and useful screening tool for children who toe-walk, providing evidence for its recommendation.

Validación de la Pain Catastrophizing Scale for Children (PCS-C) al español / Validation of the Spanish version of the Pain Catastrophizing Scale for Children (PCS-C)

Introducción: El catastrofismo relacionado con el dolor es un factor influyente en el pronóstico del tratamiento, así como en el bienestar emocional y físico. La escala pediátrica Pain Catastrophizing Scale for Children (PCS-C) es ampliamente utilizada, pero no está validada en español. Este estudio tuvo como objetivo traducir la PCS-C al español y evaluar su validez y su fiabilidad. Pacientes y métodos: Este estudio se llevó a cabo en dos fases: a)traducción del instrumento (mediante un proceso de traducción directa e inversa) y b)análisis psicométrico (validez de constructo: análisis factorial exploratorio y confirmatorio, consistencia interna, efectos suelo y techo, y validez convergente) a través de un estudio transversal con una muestra, seleccionada por conveniencia de un hospital pediátrico y compuesta por niños de 8 a 18años. Este estudio siguió la lista de verificación STARD. Resultados: En el estudio se incluyeron 150 niños y adolescentes (edad media: 12,45años; 63,8% varones) y sus padres. El análisis exploratorio y posteriormente el análisis confirmatorio mostraron un buen ajuste del modelo a la estructura original de tres modelos con 13 ítems. La consistencia interna de la escala resultó excelente (α de Cronbach =0,904) y no se detectaron efectos techo ni suelo. En cuanto al análisis de validez convergente, la PCS-C en español mostró una correlación moderada con la interferencia del dolor (r=0,400) y con la calidad de vida relacionada con la salud (r=0,217-0,303). Conclusiones: Estos resultados demuestran que la versión en español de la PCS-C es una escala válida y fiable para evaluar el catastrofismo relacionado con el dolor en niños y en adolescentes.(AU)

Introduction: Pain catastrophizing is a powerful factor that can affect health care outcomes as well as emotional and physical well-being. The Pain Catastrophizing Scale for Children (PCS-C) is widely used, but it is not validated in Spanish. The aim of the study was to translate the PCS-C to Spanish and assess the validity and reliability of the translated version. Patients and methods: This study was carried out in two phases: (a)instrument translation (via a translation-back-translation process) and (b)psychometric analysis (construct validity: exploratory and confirmatory factor analysis, internal consistency, floor and ceiling effects and convergent validity). It had a cross-sectional design and was conducted on a sample of children aged 8 to 18years was selected by convenience in a paediatric hospital. The study followed the STARD checklist. Results: The sample included 150 children and adolescents (mean age, 12.45years; 63.8% male) and their parents. The exploratory and the confirmatory analysis showed a good adjustment of the model to the original 3-model structure with 13items. The internal consistency of the scale was excellent (Cronbach α, 0.904), and no floor or ceiling effects were detected. In the convergent validity analysis, the Spanish version of the PCS-C showed a moderate correlation with pain interference (r=0.400) and with health-related quality of life (r=0.217-0.303). Conclusions: These results show that the Spanish version of the PCS-C is a valid and reliable scale to assess pain catastrophizing in children and adolescents.(AU)

Validation of the Spanish version of the Pain Catastrophizing Scale for Children (PCS-C).

INTRODUCTION: Pain catastrophizing is a powerful factor that can affect health care outcomes as well as emotional and physical well-being. The Pain Catastrophizing Scale for Children (PCS-C) is widely used, but it is not validated in Spanish. The aim of the study was to translate the PCS-C to Spanish and assess the validity and reliability of the translated version. PATIENTS AND METHODS: This study was carried out in two phases: (a) instrument translation (via a translation-back-translation process) and (b) psychometric analysis (construct validity: exploratory and confirmatory factor analysis, internal consistency, floor and ceiling effects and convergent validity). It had a cross-sectional design and was conducted on a sample of children aged 8-18 years was selected by convenience in a paediatric hospital. The study followed the STARD checklist. RESULTS: The sample included 150 children and adolescents (mean age, 12.45 years; 63.8% male) and their parents. The exploratory and the confirmatory analysis showed a good adjustment of the model to the original 3-model structure with 13 items. The internal consistency of the scale was excellent (Cronbach α, 0.904), and no floor or ceiling effects were detected. In the convergent validity analysis, the Spanish version of the PCS-C showed a moderate correlation with pain interference (r=0.400) and with health-related quality of life (r=0.217-0.303). CONCLUSIONS: These results show that the Spanish version of the PCS-C is a valid and reliable scale to assess pain catastrophizing in children and adolescents.

Spanish adaptation and validation of the child- and parent-report cystic fibrosis questionnaire-revised (CFQ-R).

OBJECTIVE: To evaluate the psychometric properties of the Spanish versions of the child- and parent-report cystic fibrosis questionnaire-revised (CFQ-R). METHODS: A Spanish adaptation of the CFQ-R was performed; 68 children with CF (6-13 years) and their parents completed the child- and parent-report CFQ-R, respectively, and the Revidierter KINDer Lebensqualitätsfragebogen (KINDL) questionnaire. The CFQ-R was completed twice, 7-10 days apart, and its psychometric properties were analyzed. RESULTS: The internal consistency of both CFQ-R versions was adequate (child-report version, Cronbach's α >.60 for all domains except "Treatment Burden" [α = .42] and "Social Functioning" [α = .57]; parent-report version, α > .60 for all domains except "Social Functioning" [α = .58]). For the child-report version, the lowest measurement error was for "Emotional Functioning" (standard error of measurement [SEM]: 8.3%; minimal detectable change [MDC90 ]: 19.3%), and the highest was for "Body Image" (SEM: 15%; MDC90 : 35%). For the parent-report version, the lowest measurement error was for "Physical Functioning" (SEM: 7.1%; MDC90 : 16.5%), and the highest was for "Weight" (SEM: 17.2%; MDC90 ; 40.1%). The correlation between the versions showed higher agreement for the domains related to observable signs ("Physical Functioning") and lower agreement for "Emotional Functioning." There was a significant correlation between the CFQ-R and KINDL. CONCLUSION: Both the child- and parent-report versions of the Spanish CFQ-R have adequate reliability and validity for clinical and research purposes. These versions can be administered before and after starting modulator therapy to assess its effect on daily functioning. The MDC90 can help identify, with a high probability, whether real changes have occurred in the quality-of-life subscales in children with CF.

Adaptación y validación española del Empowerment of Parents in the Intensive Care-Neonatology (EMPATHIC-N) / Spanish adaptation and validation of the empowerment of parents in the intensive care-neonatology (EMPATHIC-N) questionnaire

Introducción: La satisfacción de los padres de niños en Unidades de Cuidados Intensivos Neonatales (UCIN) apenas se evalúa por la carencia de herramientas específicas. El EMpowerment of PArents in THe Intensive Care Neonatology (EMPATHIC-N) es un cuestionario de satisfacción que evalúa los cuidados centrados en el desarrollo y la familia, validado en varios países pero no en España. Objetivos: Realizar la adaptación y validación del EMPATHIC-N para la evaluación de la satisfacción de los padres de niños ingresados en UCIN. Material y métodos: Primero, se realizó una traducción-retrotraducción y adaptación transcultural siguiendo un procedimiento estandarizado con un comité de expertos, mediante el método Delphi. Posteriormente, se realizó un estudio piloto con ocho padres y un estudio transversal en la unidad neonatal de un hospital terciario para analizar la fiabilidad y la validez convergente del cuestionario. Resultados: La versión española del EMPATHIC-N demostró su comprensibilidad, viabilidad, aplicabilidad y utilidad en el ámbito sanitario infantil, evaluado por 19 profesionales y 60 padres. Su validez de contenido global resultó excelente (0,93). La fiabilidad y validez convergente del EMPHATIC-N se analizaron en 65 encuestas. El α de Cronbach por dominios se situó por encima de 0,7, indicando una alta consistencia interna. La validez fue medida correlacionando los cinco dominios con los cuatro ítems de satisfacción general, demostrando una correlación adecuada (rs: 0,4-0,76; p < 0,01). Conclusiones: La versión española del cuestionario EMPATHIC-N es un instrumento comprensible, viable, aplicable, útil, válido y fiable para medir la satisfacción de los padres en las unidades neonatales. (AU)

Introduction: Parental satisfaction is rarely measured in the neonatal intensive care unit due to a lack of specific assessment tools. The EMpowerment of PArents in THe Intensive Care-Neonatology (EMPATHIC-N) questionnaire is an instrument to assess satisfaction in relation to family-centred care that has been validated in several countries, but not Spain. Objectives: To perform the translation and cultural adaptation of the EMPATHIC-N to Spanish followed by its validation for the purpose of assessing satisfaction in parents with children admitted to the neonatal intensive care unit. Material and methods: The questionnaire first underwent forward and backward translation and transcultural adaptation by a panel of experts through a standardized process based on the Delphi method, followed by a pilot study in 8 parents and then a cross-sectional study in the neonatal intensive care unit of a tertiary care hospital to assess the reliability and converging validity of the Spanish version. Results: The study proved the comprehensibility, validity, feasibility, applicability and usefulness of the Spanish version of the EMPATHIC-N in the field of paediatric health after being evaluated by 19 professionals and 60 parents. The content validity was found to be excellent (0.93). The reliability and convergent validity of the Spanish version of the EMPHATIC-N was analysed in a sample of 65 completed questionnaires. The Cronbach α for each domain was greater than 0.7, indicating a high internal consistency. We assessed validity by analysing the correlation of the 5 domains with the with the 4 general satisfaction items. The validity was found to be adequate (rs, 0.4-0.76; P < .01). Conclusions: The Spanish version of the EMPATHIC-N questionnaire is a comprehensible, useful, valid and reliable instrument to measure satisfaction in the parents of children admitted to neonatal care units. (AU)

Spanish adaptation and validation of the empowerment of parents in the intensive care-neonatology (EMPATHIC-N) questionnaire.

INTRODUCTION: Parental satisfaction is rarely measured in the neonatal intensive care unit due to a lack of specific assessment tools. The Empowerment of Parents in The Intensive Care-Neonatology (EMPATHIC-N) questionnaire is an instrument to assess satisfaction in relation to family-centred care that has been validated in several countries, but not Spain. OBJECTIVES: To perform the translation and cultural adaptation of the EMPATHIC-N to Spanish followed by its validation for the purpose of assessing satisfaction in parents with children admitted to the neonatal intensive care unit. MATERIAL AND METHODS: The questionnaire first underwent forward and backward translation and transcultural adaptation by a panel of experts through a standardized process based on the Delphi method, followed by a pilot study in 8 parents and then a cross-sectional study in the neonatal intensive care unit of a tertiary care hospital to assess the reliability and converging validity of the Spanish version. RESULTS: The study proved the comprehensibility, validity, feasibility, applicability and usefulness of the Spanish version of the EMPATHIC-N in the field of paediatric health after being evaluated by 19 professionals and 60 parents. The content validity was found to be excellent (0.93). The reliability and convergent validity of the Spanish version of the EMPHATIC-N was analysed in a sample of 65 completed questionnaires. The Cronbach α for each domain was greater than 0.7, indicating a high internal consistency. We assessed validity by analysing the correlation of the 5 domains with the with the 4 general satisfaction items. The validity was found to be adequate (rs, 0.4-0.76; P < .01). CONCLUSIONS: The Spanish version of the EMPATHIC-N questionnaire is a comprehensible, useful, valid and reliable instrument to measure satisfaction in the parents of children admitted to neonatal care units.

Adaptación transcultural y propiedades psicométricas de la versión española de la Child Pain Anxiety Symptoms Scale / Cross-cultural adaptation and psychometric properties of Spanish Child Pain Anxiety Symptoms Scale

Introducción: La ansiedad relacionada con el dolor es un componente psicológico que es capaz de regular y modificar la experiencia de dolor en niños y adolescentes. Además, puede modificar el éxito del tratamiento en procedimientos quirúrgicos, dolor crónico e intervenciones psicológicas. El objetivo de este estudio fue traducir al español la Child Pain Anxiety Symptoms Scale (CPASS) y analizar sus propiedades psicométricas. Pacientes y métodos: En primer lugar, la CPASS se tradujo al español de acuerdo con las recomendaciones internacionales. En segundo lugar, para evaluar las propiedades psicométricas de la CPASS, se analizó una muestra pediátrica. Un total de 160 niños (mujeres=49,37%; edad media=14,5±2,3 [8-18 años]) completaron cuestionarios de catastrofismo relacionado con el dolor, calidad de vida relacionada con la salud, interferencia del dolor e intensidad del dolor. Se evaluaron las siguientes propiedades psicométricas: validez de constructo (análisis factorial exploratorio y confirmatorio), consistencia interna, efecto suelo/techo y validez convergente (relación del CPASS con el resto de los cuestionarios cumplimentados y con aspectos objetivos de la historia clínica). Resultados: En el análisis factorial exploratorio, la versión final de 18 ítems (sin los ítems 18 y 19) de la CPASS fue la que mejor se ajustó, con todos los ítems incluidos en el factor teórico supuesto y mostrando una carga factorial óptima. El análisis factorial confirmatorio mostró que la versión final de 18 ítems incluidos en 4 factores es un modelo adecuado para la estructura de la escala. No se detectaron efectos suelo o techo en la versión final. Finalmente, los resultados confirman que la versión española presenta una buena consistencia interna (coeficiente alfa de Cronbach=0,88) y una validez convergente adecuada. (AU)

Introduction: Pain anxiety is a psychological component that can regulate and modulate the experience of pain in children and adolescents. It can also have an impact on the outcomes of surgical procedures, chronic pain management and psychological interventions. The aim of our study was to translate the Child Pain Anxiety Symptoms Scale (CPASS) into Spanish and assess the psychometric properties of the Spanish version. Patients and methods: First, the CPASS was translated according to international guidelines. Secondly, to assess the psychometric properties of the translated version, we conducted an analysis in a paediatric sample. A total of 160 children, 49.37% female, with a mean age of 14.5 years (SD, 2.3; range, 8–18 years) completed pain catastrophising, health-related quality of life, pain interference and pain intensity scales. We assessed the following psychometric properties: construct validity (exploratory and confirmatory factor analysis), internal consistency, floor and ceiling effects and convergent validity (correlation of CPASS to the other completed questionnaires completed and with objective aspects of the health history). Results: In the exploratory factor analysis, the final 18-item version (having excluded items 18 and 19) of the CPASS was the best fit, with all items included in the hypothetical construct and exhibiting optimal factor loadings. The confirmatory factor analysis showed that the final 18-item, 4-factor model was adequate for the scale structure. We did not detect any floor or ceiling effects in the final version. Lastly, the results confirmed that the Spanish version has good internal consistency (Cronbach α, 0.88) and an adequate convergent validity. (AU)

Cross-cultural adaptation and psychometric properties of Spanish Child Pain Anxiety Symptoms Scale.

INTRODUCTION: Pain anxiety is a psychological component that can regulate and modulate the experience of pain in children and adolescents. It can also have an impact on the outcomes of surgical procedures, chronic pain management and psychological interventions. The aim of our study was to translate the Child Pain Anxiety Symptoms Scale (CPASS) into Spanish and assess the psychometric properties of the Spanish version. PATIENTS AND METHODS: First, the CPASS was translated according to international guidelines. Secondly, to assess the psychometric properties of the translated version, we conducted an analysis in a paediatric sample. A total of 160 children, 49.37% female, with a mean age of 14.5 years (SD, 2.3; range, 8-18 years) completed pain catastrophising, health-related quality of life, pain interference and pain intensity scales. We assessed the following psychometric properties: construct validity (exploratory and confirmatory factor analysis), internal consistency, floor and ceiling effects and convergent validity (correlation of CPASS to the other completed questionnaires completed and with objective aspects of the health history). RESULTS: In the exploratory factor analysis, the final 18-item version (having excluded items 18 and 19) of the CPASS was the best fit, with all items included in the hypothetical construct and exhibiting optimal factor loadings. The confirmatory factor analysis showed that the final 18-item, 4-factor model was adequate for the scale structure. We did not detect any floor or ceiling effects in the final version. Lastly, the results confirmed that the Spanish version has good internal consistency (Cronbach  α, 0.88) and an adequate convergent validity. CONCLUSION: The Spanish CPASS exhibits good psychometric proprieties and it can be used to assess pain anxiety in the paediatric population.

Differences between Novice and Expert Raters Assessing Trunk Control Using the Trunk Control Measurement Scale Spanish Version (TCMS-S) in Children with Cerebral Palsy.

The Trunk Control Measurement Scale (TCMS) is a valid and reliable tool to assess static and dynamic trunk control in cerebral palsy. However, there is no evidence informing about differences between novice and expert raters. A cross-sectional study was conducted with participants between the ages of 6 and 18 years with a CP diagnosis. The TCMS Spanish version (TCMS-S) was administered in-person by an expert rater, and video recordings were taken for later scoring by the expert and three other raters with varying levels of clinical experience. The intraclass correlation coefficient (ICC) was used to evaluate reliability between raters for the total and subscales of the TCMS-S scores. Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) were also calculated. There was a high level of agreement between expert raters (ICC ≥ 0.93), while novice raters demonstrated good agreement (ICC > 0.72). Additionally, it was observed that novice raters had a slightly higher SEM and MDC than expert raters. The Selective Movement Control subscale exhibited slightly higher SEM and MDC values compared to the TCMS-S total and other subscales, irrespective of the rater's level of expertise. Overall, the study showed that the TCMS-S is a reliable tool for evaluating trunk control in the Spanish pediatric population with cerebral palsy, regardless of the rater's experience level.

Trunk Control Measurement Scale (TCMS): Psychometric Properties of Cross-Cultural Adaptation and Validation of the Spanish Version.

The aim of this study was to develop a Spanish Version of the Trunk Measurement Scale (TCMS-S) to analyze its validity and reliability and determine the Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) in children with Cerebral Palsy (CP). Participants were assessed twice 7-15 days apart with the TCMS-S and once with the Gross Motor Function Measurement-88 (GMFM-88), Pediatric Disability Inventory-Computer Adaptive Test (PEDI-CAT), Cerebral Palsy Quality of Life (CPQoL), and Gross Motor Classification System (GMFCS). Internal consistency was evaluated using Cronbach's alpha, and the intraclass correlation (ICC) and kappa coefficients were used to investigate the agreement between the assessments. Finally, 96 participants with CP were included. The TCMS-S showed excellent internal consistency (Cronbach's alpha = 0.95 [0.93 to 0.96]); was highly correlated with the GMFM-88 (rho = 0.816) and the "mobility" subscale of the PEDI-CAT (rho = 0.760); showed a moderate correlation with the "feeling about functioning" CPQoL subscale (rho = 0.576); and differentiated between the GMFCS levels. Excellent test-retest agreement was found for the total and subscale scores (ICC ≥ 0.94 [0.89 to 0.97). For the total TCMS-S score, an SEM of 1.86 and an MDC of 5.15 were found. The TCMS-S is a valid and reliable tool for assessing trunk control in children with CP.

Mobile Applications for Resting Tremor Assessment in Parkinson's Disease: A Systematic Review.

(1) Background: Resting tremor is a motor manifestation present in most Parkinson's disease (PD) patients. For its assessment, several scales have been created, but mobile applications could help in objectively assessing resting tremor in PD patients in person and/or remotely in a more ecological scenario. (2) Methods: a systematic review following the PRISMA recommendations was conducted in scientific databases (PubMed, Medline, Science Direct, Academic Search Premier, and Web of Science) and in the main mobile application markets (Google Play, iOS App Store, and Windows Store) to determine the applications available for the assessment of resting tremor in patients with PD using only the measurement components of the phone itself (accelerometers and gyroscopes). (3) Results: 14 articles that used mobile apps to assess resting tremor in PD were included, and 13 apps were identified in the mobile application markets for the same purpose. The risk of bias and of applicability concerns of the articles analyzed was low. Mobile applications found in the app markets met an average of 85.09% of the recommendations for the development of medical mobile applications. (4) Conclusions: the use of mobile applications for the evaluation of resting tremor in PD patients has great potential, but validation studies for this purpose are scarce.

Imagined Timed Up and Go test (iTUG) in people with Parkinson's Disease: test-retest reliability and validity.

PURPOSE: To determine the test-retest reliability and validity of the Imagined Timed Up and Go Test (iTUG) as a Motor Imagery measure of temporal accuracy in people with Parkinson's Disease (PD). MATERIALS AND METHODS: A descriptive study was conducted following the GRRAS recommendations. Thirty-two people with idiopathic, mild to moderate PD (Hoehn and Yahr I-III), without cognitive impairment (MMSE ≥ 24), were assessed twice (7-15 days apart) with the iTUG. The absolute unadjusted difference in seconds, and the absolute adjusted difference as percentage of estimation error, between real and imagined TUG times, were calculated as outcome measures. Test-retest reliability was assessed using a two-way mixed-effects model of the ICC. Construct validity was tested with the Imagined Box and Blocks Test (iBBT) and convergent validity with clinical characteristics of PD, using the Spearman's rank correlation coefficient. RESULTS: The ICC for the unadjusted and adjusted measures of the iTUG was ICC = 0.61 and ICC = 0.55, respectively. Correlations between iTUG and iBBT were not statistically significant. The iTUG was partially correlated to clinical characteristics of PD. CONCLUSIONS: Test-retest reliability of the iTUG was moderate. Construct validity between iTUG and iBBT was poor, so caution should be taken when using them concurrently to assess imagery's temporal accuracy.

In people with Parkinson's Disease (PD), the absolute unadjusted difference (in seconds) and the absolute adjusted difference (as a percentage of estimation error) of the Imagined Timed Up and Go test (iTUG) were moderately reliable.iTUG and Imagined Box and Blocks Test (iBBT) measures were not statistically correlated. Therefore, temporal accuracy measures of Motor Imagery are highly task-dependant and thus their construct validity is poor.Correlations between the adjusted and unadjusted measures of the iTUG and the majority of clinical variables of PD were not statistically significant. Statistically significant correlations were only found between the unadjusted difference and MDS-UPDRS Part III, Schwab and England, and Berg Balance scales, as well as the adjusted difference and disease duration.

Test-Retest Reliability and Criterion Validity of the Spanish Version of Two Motor Imagery Questionnaires in People With Parkinson Disease.

BACKGROUND AND PURPOSE: The Kinesthetic and Visual Imagery Questionnaire (KVIQ) and the Movement Imagery Questionnaire-Revised Second Version (MIQ-RS) are measurement instruments that assess motor imagery vividness. The aim of this study was to examine the validity and reliability of the Spanish KVIQ and MIQ-RS in people with Parkinson disease (PD). METHODS: A longitudinal descriptive study was conducted following the COSMIN standards. Thirty-five people with idiopathic PD were evaluated twice (7-15 days apart) with the Spanish KVIQ and MIQ-RS. Structural validity, internal consistency, test-retest reliability (ICC), standard error of measurement (SEM), smallest detectable change (SDC), and criterion validity of the MIQ-RS and KVIQ long (KVIQ-20), short (KVIQ-10), and extended (KVIQ-34) versions and their subscales (if pertinent) were tested. RESULTS: Factor analysis was satisfactory for the MIQ-RS, KVIQ-20, and KVIQ-10, providing evidence of their 2-dimensional structure. Evidence of the structural validity of the KVIQ-34 was not confirmed and thus was analyzed as an overall score. Revelle's ω > 0.9 showed excellent internal consistency. Test-retest reliability was moderate (ICC = 0.58-0.75) and higher for all visual subscales. SEM and SDC were up to 14.39% and 39.89% of the scores, respectively. Criterion validity between questionnaires and subscales was strong (Spearman's r > 0.7). DISCUSSION AND CONCLUSIONS: The results provide evidence for the validity and reliability of the Spanish MIQ-RS, KVIQ-20, and KVIQ-10 to assess motor imagery vividness in people with PD, whereas the KVIQ-34 should only be interpreted as an overall score. Psychometric, procedural, and practical features of the questionnaires should be considered when applying into clinical practice.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A401).

Development of the Web-Based Spanish Version of the Barthel Index in Patients with Multiple Sclerosis.

BACKGROUND: The aims of this study were to develop a web-based Spanish form of the Barthel index (BI), to evaluate its psychometric properties and stability over time (test-retest), and to determine minimal detectable change (MDC) in patients with multiple sclerosis (MS). METHODS: Participants answered the BI on two forms (web-based and face-to-face interview), 7-10 days apart. The internal consistency was evaluated using Cronbach's alpha, and intraclass correlation (ICC) and kappa (κ) coefficients were used to investigate the agreement between both forms. RESULTS: 143 participants were included. The Spanish web-based form of the BI showed excellent agreement between both forms for each item (κ = 0.86 (0.79 to 0.92), and for total score (κ = 0.87 (0.81 to 0.93); ICC = 0.99 (0.98 to 0.99). The internal consistency was good-excellent (Cronbach's alpha = 0.89 (0.86-0.91)). The stability over time was adequate, the agreement of each item was κ = 0.63 (0.52-0.74)), and for total score (ICC = 0.97), determining a MDC95 of 12.09 points. CONCLUSIONS: The Spanish web-based form of the BI is a valid and reliable tool to assess functionality and can be applied in both formats in patients with MS. A total score difference of more than 12 points was found to indicate a deterioration or improvement in the patient's functionality.

[Systematic review on the effectiveness of cognitive multisensory rehabilitation].

Cognitive multisensory rehabilitation (CMR) -a therapeutic approach to help recover movement using neurocognitive exercises- activates patient's perceptive and cognitive processes, key for motor learning. The aim of this systematic review was to assess the effectiveness of CMR on motor function and quality of life and compare the findings with other rehabilitation approaches or no-intervention in neurological and trauma adult and pediatric patients. We carried out a systematic review of randomized controlled clinical trials, pilot studies, and case series in PubMed, PEDro, Cochrane Library, and the CINHAL Complete database published between 2012 and 2021. Ten studies met the eligibility criteria. CMR provides similar or superior benefits compared to other types of approaches for the restoration of upper limb function, gait, balance, and quality of life in neurological and trauma patients. Further research with larger samples and higher methodological quality need to be developed to de-termine its long-term effectiveness.