Training Response Abilities of Children With Intellectual Disabilities: A Randomized Controlled Trial.

Response abilities, i.e., response time (RT) and response force (RF), which are essential for efficient motor control, are impaired in children with intellectual disabilities (ID). The study aimed to evaluate the effects of object control skills training, computer-based games training, or standard care on the RT and RF of children with ID when measured across task conditions. A randomized controlled trial was conducted in a special education school where 75 children with ID, between 9 and 17 years of age, were randomly assigned to object control skills training, computer-based games training, or standard care, where intervention groups were provided thrice a week for four weeks. The RT and RF were measured using a response analyzer for simple response task, (passive and active) dual-task, and choice response task at baseline, post-intervention, and four-week follow-up. The RT significantly reduced with object control skills training (ηp2= .325) and computer-based games training (ηp2= .159). Participants who received the object control skills training had greater stability in force production than the other groups. With training, children with ID take less time and show better stability in their ability to modulate force in various task settings, with more pronounced effects with the object control skills training.

Shedding Light on Perioperative Nerve Injury: An Investigation Using the SHED (Symptoms Categorization-History Taking-Examination-Diagnostic Evaluations) Approach.

Peripheral nerve blocks (PNBs) provide analgesia and anesthesia in diverse surgical procedures. Despite their recognized benefits, the occurrence of complications, particularly peripheral nerve injuries (PNIs), is a noteworthy concern. Prompt identification and intervention for perioperative nerve injuries are crucial to prevent permanent neurological impairment. A meticulous, systematic evaluation centered on the onset and progression of symptoms becomes imperative. The SHED (symptoms categorization-history taking-examination-diagnostic evaluations) approach serves as a valuable tool for diagnosing causative factors, determining the type of nerve injury, and formulating an effective treatment plan to mitigate further harm. This case report employs the SHED approach to elucidate a perplexing instance of PNIs. The patient, experiencing neurological symptoms post-forearm surgery under a PNB, serves as a focal point. The report underscores the significance of a systematic, stepwise approach in managing patients with suspected PNIs. Vigilant patient monitoring, collaborative teamwork, shared responsibilities, and consideration of potential contributing factors beyond the nerve block are highlighted for an accurate diagnosis and effective treatment of PNIs. The aim is to guide healthcare professionals in navigating similar clinical scenarios, ultimately ensuring patient safety and optimizing outcomes.

Correlations between Trunk Control and Balance in Children with Bilateral Spastic Cerebral Palsy.

Impairments of postural responses are a salient feature of children with cerebral palsy (CP). While the systems approach describes balance in seven components, the relationship between trunk control and balance in children with CP has not been previously examined with all seven of these components. In this study, we aimed to identify correlations between trunk control and all seven systems approach balance components in children with bilateral spastic CP. Our participants were 30 children (M age = 11.83, SD = 2.32 years) with CP having a Gross Motor Function Classification System level ranging from I to III. We assessed trunk control with the Trunk Control Measurement Scale, including static and dynamic balance (selective voluntary control and reaching). Balance in standing was assessed using Kids-Mini-BESTest involving four domains: anticipatory, reactive, sensory orientation and stability in gait. We used Spearman's rank correlations to correlate trunk control and balance, and we obtained a moderate correlation between the trunk control measurement scale and the Kids-Mini-BESTest in children with both bilateral spastic CP (rs = .618, p < .001) and spastic diplegic CP (rs = .52, p = .02). Analysis of the correlations between separate domains of the Kids-Mini-BESTest and the trunk control measurement scale subscales revealed moderate correlations between the static sitting balance subscale and all four domains of the Kids-Mini-BESTest. The dynamic selective motor control subscale of the trunk control measurement scale moderately correlated with the anticipatory domain of the Kids-Mini-BESTest. The dynamic reaching subscale also correlated moderately with anticipatory and stability in gait domains. This correlation was statistically significant in the 13 to 17-year-old age group and was strong among females, whereas the correlation was moderate in males. Trunk control was moderately associated with balance considering all the systems theory components of balance in children with bilateral spastic cerebral palsy.

Upper limb electromyographic analysis of manual wheelchair transfer techniques in individuals with spinal cord injury: A systematic review.

BACKGROUND AND PURPOSE: The objective of this study is to determine the upper limb muscle electromyographic (EMG) activity required during various manual wheelchair transfers in the population of spinal cord injury (SCI). METHODS: This review included observational studies reporting the (EMG) activity of upper limb muscles during wheelchair transfers in people with SCI. We searched electronic databases and reference lists of relevant literature between 1995 and March 2022 with English language limits, yielding 3870 total articles. Two independent researchers performed data extraction and conducted quality assessment using two checklists, the Modified Downs and Blacks and National Heart, Lung, and Blood Institute for observational cohort and cross-sectional studies. RESULTS: After eligibility screening, seven studies were included in this review. The sample size ranged from 10 to 32 participants aged 31-47 years. They assessed four types of transfers and mostly evaluated six upper limb muscles were biceps, triceps, anterior deltoid, pectoralis major, latissimus dorsi and ascending fibres of the trapezius. The peak EMG value indicated that muscle recruitment varied in both upper limbs according to the task demand, and the highest activity was seen during the lift-pivot transfer phase. Because of the data heterogeneity, a meta-analysis of study results was not feasible. CONCLUSION: There were various ways of reporting the upper limb EMG muscle activity profile across all the included studies with a limited sample size. The crucial role of upper limb muscles during different types of manual wheelchair transfers was interpreted in this review. This is essential for predicting functional independence of individuals with SCI and warranting optimal rehabilitation strategies for wheelchair transfer skills.

The Impact of Functional Strength Training on Muscle Strength and Mobility in Children with Spastic Cerebral Palsy - A Systematic Review and Meta-Analysis.

OBJECTIVE: To review the effects of functional strength training (FST) on muscle strength and mobility in children with spastic cerebral palsy (CP). METHODS: Eight databases were screened through March 2022 for studies assessing the impact of FST on strength, mobility, balance, and endurance in children with spastic CP. Study quality was assessed using the Downs and Black checklist and Cochrane Risk of Bias tools, followed by a meta-analysis. RESULTS: Twelve intervention studies of moderate-to-high-level evidence were selected. The interventions included open and closed chain exercises using free weights or body weight, administered approximately thrice a week for 12 weeks. The FST was found to have a moderate-to-large, statistically significant, positive effect on muscle strength (quadriceps, hamstrings, and plantar flexors) and mobility (GMFM D and E), with only four studies showing maintenance of gains during follow-up assessment. CONCLUSION: FST has a positive effect on muscle strength and mobility in children with spastic CP, but evidence of sustained effects following FST is limited.

Motor performance of children with attention deficit hyperactivity disorder: focus on the Bruininks-Oseretsky Test of Motor Proficiency.

The literature review aimed to analyze studies assessing the motor abilities of children with attention deficit hyperactivity disorder (ADHD) using the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP). The PubMed, OVID, Cochrane, and PEDro databases were searched for relevant articles published between February 2003 and September 2021. Despite the retrieval of limited studies, most included in this review were of fair to good quality. The diagnostic criteria for ADHD adhered to Diagnostic and Statistical Manual of Mental Disorders standards. The BOTMP has been used diversely in various countries, has been translated into various languages, is administered by various qualified medical professionals on children with variants of ADHD, with the long form of the tool used more widely than its short form. The motor performance of children with ADHD was better than that of children with other developmental disorders, but children with ADHD underperformed compared to their age-matched typically developing peers. Although the BOTMP tool has been widely used to evaluate the motor performance of children with various disabilities, our understanding of the motor repertoire of children with ADHD is inadequate. Future research can aim to use the BOTMP to better understand the motor repertoire of children with ADHD to aid their overall rehabilitation.

Response abilities of children with Down Syndrome and other intellectual developmental disorders.

Efficiency with which a task is performed results from the precise timing and force with which the task is executed. We aimed at assessing the influence of change in task constructs on the response abilities of children who are known to have impaired perceptual motor control. To answer this question, we assessed the response abilities in terms of response time(RT) and response force(RF) among children with Down Syndrome(DS), intellectual developmental disorders(IDD) and those who are typically developing. A response analyzer was used to assess their response abilities across a variety of task constructs namely while performing a simple response task, dual task (i.e. passive and active dual tasks), force modulation task and choice response task. Across all tasks, it was seen that their RT increased while RF decreased as the tasks became more complex in nature. The number of participants in the DS and IDD group diminished as the task complexity increased, reflecting their inherent difficulty in learning new tasks and executing a common expected response under different task conditions. The response abilities of the DS and IDD group was comparable across tasks and varied significantly from the TDC group. The study enables us to understand the influence of task difficulties on the response abilities and participation across groups of children with and without disabilities. The results of the study necessitate the need to evaluate and find methods to train the response abilities of children with DS and IDD, which has considerable implications towards the performance of their daily life skills.

Can response time be trained with bilateral limb training in children with Down syndrome?

AIMS: Response time (RT), that is, the time taken to respond is known to be delayed in children with Down syndrome (DS). We performed a pilot study to evaluate whether bilateral limb training can be used to train RT, in children with DS. SETTINGS AND DESIGN: 10 children with DS (5 males) were recruited from a special school in a suburban region using convenience sampling. SUBJECTS AND METHODS: Response time was measured using an indigenously developed RT Analyzer, before and after intervention, from right and left hand. Structured bilateral limb training was given for a period of 4 weeks, using low-cost, locally available materials, in community settings. STATISTICAL ANALYSIS USED: The Wilcoxon signed ranks test was used for statistical analysis. RESULTS: Significant improvements in RT following 4 weeks of intervention were seen in the left hand (P = 0.006) but not in the right hand (P = 0.104). CONCLUSIONS: Response time can be trained in children with DS using 4 weeks of bilateral limb training activities using low-cost, locally available materials.

Clinical trial registration in physical therapy journals: a cross-sectional study.

BACKGROUND: Clinical trial registration has become an important part of editorial policies of various biomedical journals, including a few physical therapy journals. However, the extent to which editorial boards enforce the need for trial registration varies across journals. OBJECTIVE: The purpose of this study was to identify editorial policies and reporting of trial registration details in MEDLINE-indexed English-language physical therapy journals. DESIGN: This study was carried out using a cross-sectional design. METHODS: Editorial policies on trial registration of MEDLINE-indexed member journals of the International Society of Physiotherapy Journal Editors (ISPJE) (Journal of Geriatric Physical Therapy, Journal of Hand Therapy, Journal of Neurologic Physical Therapy, Journal of Orthopaedic and Sports Physical Therapy, Journal of Physiotherapy [formerly Australian Journal of Physiotherapy], Journal of Science and Medicine in Sport, Manual Therapy, Physical Therapy, Physical Therapy in Sport, Physiotherapy, Physiotherapy Research International, Physiotherapy Theory and Practice, and Revista Brasileira de Fisioterapia) were reviewed in April 2013. Full texts of reports of clinical trials published in these journals between January 1, 2008, and December 31, 2012, were independently assessed for information on trial registration. RESULTS: Among the 13 journals, 8 recommended trial registration, and 6 emphasized prospective trial registration. As of April 2013, 4,618 articles were published between January 2008 and December 2012, of which 9% (417) were clinical trials and 29% (121/417) of these reported trial registration details. A positive trend in reporting of trial registration was observed from 2008 to 2012. LIMITATIONS: The study was limited to MEDLINE-indexed ISPJE member journals. CONCLUSIONS: Editorial policies on trial registration of physical therapy journals and a rising trend toward reporting of trial registration details indicate a positive momentum toward trial registration. Physical therapy journal editors need to show greater commitment to prospective trial registration to make it a rule rather than an option.