ABSTRACT
PURPOSE: To determine the effect of an intense physical therapy intervention on gross motor function, community walking and participation in children with cerebral palsy (CP). METHODS: A single group design was used with two pre-test and two post-test measures. Subjects were 17 ambulatory children with CP who participated in an intense intervention (i.e., four hours per day, five days per week, three weeks), a modified version of the TheraSuit protocol. Gross motor function measure (GMFM-66), Step watch activity monitor (SAM), Canadian occupational performance measure (COPM) and pediatric outcomes data collection instrument (PODCI) were tested twice at baseline, immediately following the intervention, and three months later. RESULTS: Immediately following the intervention, GMFM-66, COPM and PODCI scores improved significantly (p < 0.001). At three months, improvements remained for GMFM-66 and COPM (p < 0.01). Walking amount or intensity (SAM) did not improve. CONCLUSIONS: Participants improved gross motor skills and participation but not community ambulation following this intense physical therapy intervention.
Subject(s)
Cerebral Palsy/rehabilitation , Physical Therapy Modalities , Cerebral Palsy/classification , Cerebral Palsy/diagnosis , Child , Child, Preschool , Clinical Protocols , Disability Evaluation , Female , Follow-Up Studies , Humans , Male , Motor Skills , Patient Satisfaction , Treatment Outcome , WalkingABSTRACT
There remains uncertainty regarding any progressive nature of psychopathology and cognitive dysfunction in late-stage schizophrenia, and whether duration of initially untreated psychosis (DUP) might be associated with such 'progression'. This study examines longitudinally, over 3 years, the psychopathology and neuropsychology in 82 inpatients with DSM-IV schizophrenia, many of whom were admitted in the pre-neuroleptic era. Increase in executive dysfunction exceeded that in general cognitive impairment. Positive but not negative symptom severity decreased modestly; the primary predictor of negative symptom severity was DUP. On index assessment, psychopathology evidenced a three-factor structure; at follow-up, psychomotor poverty evidenced greater prominence and cohesion, and was on both occasions predicted primarily by DUP, while reality distortion was altered and disorganisation disassembled into alternative elements. It would appear that as years of chronic, refractory illness accrue, psychomotor poverty becomes more sharply delineated and dominant within the overall structure of psychopathology, and its prominence is predicted enduringly by DUP.
Subject(s)
Psychotic Disorders/diagnosis , Psychotic Disorders/therapy , Schizophrenia/diagnosis , Schizophrenia/rehabilitation , Schizophrenic Psychology , Adult , Cognition Disorders/epidemiology , Diagnostic and Statistical Manual of Mental Disorders , Female , Follow-Up Studies , Hospitalization , Humans , Long-Term Care , Male , Prospective Studies , Psychotic Disorders/epidemiology , Schizophrenia/epidemiology , Severity of Illness Index , Time FactorsABSTRACT
OBJECTIVE: To localize genes conferring susceptibility to bipolar affective disorder. METHODS: Seven families were selected on the basis of containing multiple cases of bipolar affective disorder present in three or more generations, an absence of schizophrenia and unilineal transmission. DNA samples from these families were genotyped with 365 microsatellite markers spaced at approximately 10 cM intervals across the whole genome. All markers were subjected to initial two-point and three-point analyses using LOD score and model-free analysis. All regions producing a result significant at P<0.01 were then subjected to four-point LOD score analysis under the assumption of heterogeneity. RESULTSA four-point LOD score of 2.8 was obtained using a dominant model and including unipolar cases as affected in the region of D12S342. Four-point LOD scores of 2 were obtained around D1S243, D1S251 and D3S1265. The positive results around D1S243 were accounted for by a LOD score of 3.1 occurring in a single pedigree. CONCLUSIONS: Since there has been previous strong support for linkage to the region of 12q23-q24 around D12S342, it now seems very probable that it does indeed contain a gene influencing susceptibility to bipolar affective disorder. Some evidence for linkage in the region of 1q near to D1S251 has been reported in one previous study. It therefore seems that this region of 1q and the region of 1p close to D1S243 may also harbour susceptibility genes.
