Motor proficiency of persons with attention deficit hyperactivity disorder or autism spectrum disorder diagnosed in adulthood.

PURPOSE: To compare (1) motor proficiency of persons diagnosed in adulthood with attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) with normative values of motor proficiency, and (2) motor proficiency between persons with ADHD and those with ASD diagnosed in adulthood. METHODS: A total of 153 adults (median age 32 years, 36% women) participated in this cross-sectional study. Fifty-three persons with predominately inattentive presentation (ADHD-I), 67 persons with combined presentation (ADHD-C), and 33 persons with ASD performed the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2). One-sample binominal tests were used to compare motor proficiency against standardized norms of BOT-2 for young adults. One-way ANOVAs and Kruskal-Wallis tests were used to compare test outcomes between the groups. RESULTS: The total sample showed significantly impaired motor proficiency in comparison to norms in all test domains (p < 0.001-0.006), except for fine motor skills. The ASD group showed significantly poorer body coordination compared with the ADHD-I and ADHD-C groups, with a moderate effect size (p = 0.003-0.02, η2 = 0.061). CONCLUSIONS: Motor proficiency is impaired in most persons with ADHD or ASD diagnosed in adulthood, suggesting that motor assessment should be included in clinical examinations of adults with suspected neurodevelopment disorders.

Motor proficiency is impaired in most adults with adult-diagnosed attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD).Body coordination is more impaired in adults with ASD than adults with ADHD.Motor assessment of adults with suspected neurodevelopment disorders is recommended.

Midwives' and Diabetes Nurses' Experience of Screening and Care of Women with Gestational Diabetes Mellitus: A Qualitative Interview Study.

Background: Gestational diabetes mellitus (GDM) is increasing and is associated with adverse outcomes for both mother and child. The metabolic demands of pregnancy can reveal a predisposition for type 2 diabetes mellitus (T2DM), and women with a history of GDM are more likely to develop T2DM than women with normoglycemic pregnancies. Aim: The aim of this study was to explore midwives' and diabetes nurses' experience of their role in screening, care, and follow-up of women with gestational diabetes mellitus and, further, to explore their opinions and thoughts about existing routines and guidelines. Method: Individual interviews were performed with ten diabetes nurses and eight midwives working in primary and special care. Qualitative content analysis was done according to Graneheim and Lundman. Results: The analysis of the interviews resulted in the overall theme "An act of balance between normalcy and illness, working for motivation with dilemmas throughout the chain of health care." Difficulties in carrying out the important task of handling GDM while at the same time keeping the pregnancy in focus were central. Women were described as highly motivated to maintain a healthy lifestyle during pregnancy with the baby in mind, but it seemed difficult to maintain this after delivery, and compliance with long-term follow-up with the aim of reducing the risk of T2DM was low. The women came to the first follow-up but did not continue with later contact. This was at a time when the women felt healthy and were focusing on the baby and not themselves. A lack of cooperation and easy access to a dietician and physiotherapist were pointed out as well as a wish for resources such as group activities and multiprofessional teams.

Evaluation of Concurrent Validity between a Smartphone Self-Test Prototype and Clinical Instruments for Balance and Leg Strength.

The evolving use of sensors to objectively assess movements is a potentially valuable addition to clinical assessments. We have developed a new self-test application prototype, MyBalance, in the context of fall prevention aimed for use by older adults in order to independently assess balance and functional leg strength. The objective of this study was to investigate the new self-test application for concurrent validity between clinical instruments and variables collected with a smartphone. The prototype has two test procedures: static standing balance test in two positions, and leg strength test performed as a sit-to-stand test. Thirty-one older adults were assessed for balance and functional leg strength, in an outpatient physiotherapy setting, using seven different clinical assessments and three sensor-tests. The results show that clinical instruments and sensor measurements correlate to a higher degree for the smartphone leg strength test. For balance tests, only a few moderate correlations were seen in the Feet Together position and no significant correlations for the Semi Tandem Stance. This study served as a first step to develop a smartphone self-test application for older adults to assess functional balance at home. Further research is needed to test validity, reliability, and user-experience of this new self-test application.

Physical activity and sedentary time during pregnancy and associations with maternal and fetal health outcomes: an epidemiological study.

BACKGROUND: Physical activity is generally considered safe for the pregnant woman as well as for her fetus. In Sweden, pregnant women without contraindications are recommended to engage in physical activity for at least 30 min per day most days of the week. Physical activity during pregnancy has been associated with decreased risks of adverse health outcomes for the pregnant woman and her offspring. However, there are at present no recommendations regarding sedentary behavior during pregnancy. The aim was to examine the level of physical activity and sedentary time in a representative sample of the pregnant population in Sweden, and to explore potential effects on gestational age, gestational weight gain, birth weight of the child, mode of delivery, blood loss during delivery/postpartum, self-rated health during pregnancy and risk of pregnancy-induced hypertension and preeclampsia. METHODS: This was an epidemiological study using data from the prospective, population-based NorthPop study in Northern Sweden and information on pregnancy outcomes from the national Swedish Pregnancy Register (SPR). A questionnaire regarding physical activity and sedentary time during pregnancy was answered by 2203 pregnant women. Possible differences between categories were analyzed using one-way Analysis of variance and Pearson's Chi-square test. Associations between the level of physical activity/sedentary time and outcome variables were analyzed with univariable and multivariable logistic regression and linear regression. RESULTS: Only 27.3% of the included participants reported that they reached the recommended level of physical activity. A higher level of physical activity was associated with a reduced risk of emergency caesarean section, lower gestational weight gain, more favorable self-rated health during pregnancy, and a decreased risk of exceeding the Institute of Medicine's recommendations regarding gestational weight gain. Higher sedentary time was associated with a non-favorable self-rated health during pregnancy. CONCLUSIONS: Our study showed that only a minority of pregnant women achieved the recommended level of physical activity, and that higher physical activity and lower sedentary time were associated with improved health outcomes. Encouraging pregnant women to increase their physical activity and decrease their sedentary time, may be important factors to improve maternal and fetal/child health outcomes.

Differences in motor variability among individuals performing a standardized short-cycle manual task.

Motor variability (MV) has been suggested to be a determinant of the risk for developing musculoskeletal disorders in repetitive work. In this study we examined whether individuals consistently differed in the extent of motor variability when performing a standardized short-cycle manual task. On three separate days, arm kinematics was recorded in 14 healthy subjects performing a pipetting task, transferring liquid from a pick-up tube to eight target tubes with a cycle time of 2.8s. Cycle-to-cycle standard deviations (SD) of a large selection of shoulder and elbow kinematic variables, were processed using principal component analysis (PCA). Thereafter, between-subjects and between-days (within-subject) variance components were calculated using a random effects model for each of four extracted principal components. The results showed that MV differed consistently between subjects (95% confidence intervals of the between-subjects variances did not include zero) and that subjects differed consistently in MV between days. Thus, our results support the notion that MV may be a consistent personal trait, even though further research is needed to verify whether individuals rank consistently in MV even across tasks. If so, MV may be a candidate determinant of the risk of developing fatigue and musculoskeletal disorders in repetitive occupational work.

Acuity of goal-directed arm movements to visible targets in chronic neck pain.

OBJECTIVE: To evaluate end-point acuity in goal-directed arm movements in subjects with chronic neck pain, while taking the trade-off between speed and accuracy into account, and to evaluate associations between reduced acuity and self-rated characteristics. DESIGN: Single-blinded, controlled, comparative group study. SUBJECTS: Forty-five subjects with chronic non-traumatic, non-specific neck pain (n = 24) and whiplash-associated disorders (n = 21). Healthy subjects served as controls (n = 22). The groups were age- and sex-matched. METHODS: Subjects performed fast and accurate pointing movements to a visual target. Group differences in end-point variability, controlled for peak velocity, were evaluated. Associations between end-point variability and self-rated symptoms, functioning, self-efficacy and kinesiophobia were analysed. RESULTS: End-point acuity, controlled for peak velocity, was reduced for both neck-pain groups. Similar spatial error patterns across all groups indicated no direction-specific reduction. For both neck-pain groups, associations were found between end-point acuity and neck movement deficits, physical functioning and, in whiplash, also balance and pain. CONCLUSION: Acuity of goal-directed arm movements can be reduced in chronic neck pain. Associations between acuity and self-rated characteristics support the clinical validity of the results and indicate that impaired neck function contributes to reduced end-point acuity. The results can be of importance for characterization and rehabilitation of neck disorders.

Predictive and discriminative value of shoulder proprioception tests for patients with whiplash-associated disorders.

OBJECTIVE: To evaluate whether patients suffering from whiplash-associated disorders have impaired shoulder proprioception and whether the acuity of shoulder proprioception is reflected in the patients' symptoms and self-rated function. DESIGN: A comparative group design, including a correlation design for the patient group. SUBJECTS: Patients with chronic whiplash-associated disorders (n=37) and healthy subjects (n=41). The groups were matched for age and gender. METHODS: All subjects underwent a shoulder proprioception test involving active ipsilateral arm position-matching. Group difference was evaluated by multiple analysis of variance and analysis of variance. The patient group completed questionnaires addressing functioning and health and performed pain ratings. Associations between proprioceptive acuity and self-rated functioning and symptoms were studied by correlation and regression analyses. RESULTS: The patient group showed significantly lower acuity of shoulder proprioception. Moderate correlations were found between proprioceptive acuity and questionnaire scores representing physical functioning, so that low proprioceptive acuity was associated with low self-rated physical functioning. Scores representing pain-intensity did not correlate with proprioceptive acuity. CONCLUSION: The results show that, at the group level, patients with whiplash-associated disorders have impaired shoulder proprioception. The clinical relevance of this finding is strongly supported by the association between shoulder proprioceptive acuity and self-rated functioning in the patient group.