Gender Differences in Psychosocial and Physical Outcomes in Haitian Amputees.

OBJECTIVE: The purpose of this study was to investigate the gender differences in psychosocial and physical outcomes in users of lower-extremity prostheses who became amputees after the 2010 earthquake in Haiti. METHOD: We enrolled 140 unilateral amputees in this cross-sectional study in Port-au-Prince, Haiti. Trained staff administered the assessments by reading the questions aloud to participants. Participants completed the Trinity Amputation and Prosthesis Experience Scales and Locomotor Capabilities Index about 2 yr after the earthquake. RESULTS: We found no gender differences in psychosocial adjustment and physical outcomes, except for strenuous physical activities and phantom pain, and both genders reported difficulty in social adjustment. After controlling for strenuous physical activities and phantom pain, we found that men showed worse psychosocial adjustment than women. CONCLUSION: Services for psychosocial adjustment are critical for traumatic amputees and should be incorporated into rehabilitation programs after a disaster. Interventions should consider gender roles in the indigenous culture.

Evaluation of eye, head and trunk coordination during target tracking tasks.

This study tested the feasibility of a method to synchronise and to evaluate eye, head and trunk movement patterns during target tracking tasks performed by 10 subjects. A projected central target was randomly repositioned at 40° and 70° of rotation to the left and right. Subjects were instructed to change gaze as quickly as possible. Head and trunk motion was measured using a motion analysis system, and eye movement was measured using an eye-tracker; all data were synchronised. For healthy subjects, the eye moved faster than the head, there was no trunk movement and the head moved more than the eye to reach further displaced targets. The method tested was feasible, and it could be used to evaluate eye, head and trunk movement patterns of subjects with injuries such as whiplash and concussions. Practitioner Summary: Studies of eye, head and trunk movements using synchronised methods are needed. We tested the feasibility of a method to synchronise and evaluate eye, head and trunk movement patterns. The method tested was feasible, and it could be used to evaluate movement patterns of subjects with injuries such as whiplash.

Motor response investigation in individuals with cerebral palsy using near infrared spectroscopy: pilot study.

Cerebral palsy (CP) describes a group of motor impairment syndromes secondary to genetic that may be due to acquired disorders of the developing brain. In this study, near infrared spectroscopy (NIRS) is used to investigate the prefrontal cortical activation and lateralization in response to the planning and execution of motor skills in controls and individuals with CP. The prefrontal cortex, which plays a dominant role in the planning and execution of motor skill stimulus, is noninvasively imaged using a continuous wave-based NIRS system. During the study, 7 controls (4 right-handed and 3 left-handed) and 2 individuals with CP (1 right-handed and 1 left-handed) over 18 years of age performed 30 s of a ball throwing task followed by 30 s rest in a 5-block paradigm. The optical signal acquired from the NIRS system was processed to elucidate the activation and lateralization in the prefrontal region of controls and individuals with CP. The preliminary result indicated a difference in activation between the task and rest conditions in all the participant types. Bilateral dominance was observed in the prefrontal cortex of controls in response to planning and execution of motor skill tasks, while an ipsilateral dominance was observed in individuals with CP. In conjunction, similar contralateral dominance was observed during rest periods, both in controls and individuals with CP.

Functional and psychosocial status of Haitians who became users of lower extremity prostheses as a result of the 2010 earthquake.

The January 12, 2010 earthquake devastated Port-Au-Prince, the capital of the Republic of Haiti, and its surroundings. Among the 300,000 injured, 1,200 to 1,500 people underwent traumatic /surgical amputations. The purpose of this study was to describe the functional and psychosocial impact of prostheses users who suffered a traumatic lower-limb amputation after the earthquake of 2010 in Haiti. We recruited 140 participants in collaboration with a large health care organization in Port-au-Prince from October 2011 to May 2012. Participants underwent an evaluation of physical impairments and completed questionnaires translated into Haitian Creole. The Trinity Amputation and Prosthesis Experience Scale (TAPES), and the Locomotor Capabilities Index (LCI) were used in this study. The questionnaires were administered verbally in Haitian Creole by a trained staff. We conducted descriptive statistics and t-tests using SPSS for data analysis. Participants had a mean age of 34.9 ± 12.0; 51.4% were women; 48.6% were transfemoral amputees. The mean of TAPES general adjustment (3.65 ± 0.59) and adjust to limitation (3.67 ± 0.86) were higher than the score for the social adjustment (2.58 ± 0.49). The LCI showed over 90% of subjects were physically independent in self-care; fewer were independent walking on uneven ground or inclement weather (69%). The relatively poor social adjustment is consistent with the literature that describes limited acceptance of people with physical disabilities in Haitian society. Prostheses users in Haiti would benefit from a health delivery infrastructure that also addresses the psychosocial reintegration of individuals with physical disabilities.

Validation of a Clinical Prediction Model for the Development of Neuromuscular Scoliosis: A Multinational Study.

BACKGROUND: The objective of this study was to evaluate the performance of a clinical prediction model of neuromuscular scoliosis via external validation. METHODS: We analyzed a series of 120 patients (mean age ± standard deviation, 15.7 ± 1.8 years; range: 12 to 18 years) with cerebral palsy, severe motor disorders, and cognitive impairment with and without neuromuscular scoliosis treated in two specialized units (70 patients from Nice, France, and 50 patients from Lublin, Poland) in a cross-sectional, double-blind study. Data on etiology, diagnosis, functional assessments, type of spasticity, epilepsy, scoliosis, and clinical history were collected prospectively between 2005 and 2015. Fisher's exact test and multiple logistic regressions were used to identify influential factors for developing spinal deformity. Thus, we applied a predictive model based on a logistic regression algorithm to predict the probability of scoliosis onset for new patients. RESULTS: Children with truncal tone disorders (P = Multivariate logistic regression highlighted previous hip surgery (P = 0.002 ≈ 0.005), intractable epilepsy (P = 0.01 ≈ 0.04) and female gender (0.07) as influent factors in the two cohorts. Average accuracy, sensitivity, and specificity of the predictive model were 74%. CONCLUSIONS: We validated a prediction model of neuromuscular scoliosis. In cerebral palsy subjects with the previouslymentioned predictors of scoliosis, the frequency of clinical examinations of spine and spinal x-ray should be increased to easily identify candidates for treatment.

Concurrent validity of the Early Intervention Developmental Profile and the Peabody Developmental Motor Scale-2.

PURPOSE: The purpose of this study was to determine the concurrent validity of the Early Intervention Developmental Profile (EIDP) and the Peabody Developmental Motor Scale-2 (PDMS-2) in examining gross motor delay. METHODS: Thirty children with a variety of developmental delays attending an early intervention program were administered both the PDMS-2 and the EIDP as part of their developmental evaluations. RESULTS: The PDMS-2 and EIDP were strongly correlated (r = 0.91, p < 0.01) but the mean age equivalent scores were significantly different. Age equivalent scores were on average 26% higher on the EIDP. CONCLUSIONS: Differences in age equivalent scores between tests may affect a child's eligibility for services in some states. This study supports the use of norm-based tests when determining a percentage of delay relative to the norm. Developmental tests should not be the sole determinant of the clinical decision making processes.