Impact of transcranial magnetic stimulation on motor function in children with acquired brain injury: a scoping review protocol.

BACKGROUND: Children with severe acquired brain injury (ABI) require early and effective neurorehabilitation provision to promote a good long-term functional outcome. Transcranial magnetic stimulation (TMS) has been used to improve motor skills for children with cerebral palsy but there is limited material supporting its use in children with ABI who have a motor disorder. OBJECTIVE: To systematically answer what the TMS intervention effects are on motor function in children with ABI as reported in the literature. METHODS AND ANALYSIS: This scoping review will follow Arksey and O'MaIIey's scoping review methodological framework. A comprehensive computerised bibliographic databases search will be performed in MEDLINE, EMBASE, CINAHL, Allied and Complementary Medicine, BNI, Ovid Emcare, PsyclNFO, Physiotherapy Evidence Database, Cochrane Central Register using keywords related to TMS and children with ABI.Studies that examine the effect of TMS intervention on motor function as either a primary or secondary objective will be included for this review. Study design and publication detail, participant demographic details, type and severity of ABI and other clinical information, TMS procedure, associated therapy intervention, comparator/control parameters and the outcome measure used data will be gathered.The International Classification of Functioning, Disability and Health for Children and Youth framework will be used to report the TMS effect in children with ABI. A narrative synthesis of the findings describing the therapeutic effects of TMS intervention, limitations and adverse effects will be synthesised and reported. This review will help to summarise the existing knowledge base and to guide further research areas. This review outcome may help to evolve therapists' role to next-generation technology-based neurorehabilitation programmes. ETHICS AND DISSEMINATION: No ethical approval is required for this review as we will be collecting data from previously published studies. We will present the findings at scientific conferences and publish in a peer-review journal.

The effect of core stability training with ball and balloon exercise on respiratory variables in chronic non-specific low back pain: An experimental study.

BACKGROUND: Studies have shown the involvement of respiratory characteristics and their relationship with impairments in non-specific low back pain (NS-LBP). The effects of core stability with a combined ball and balloon exercise (CBB) on respiratory variables had not been investigated. OBJECTIVE: To evaluate the effectiveness of CBB on respiratory variables among NS-LBP patients. STUDY DESIGN: pre- and post-experimental study. PARTICIPANTS: Forty participants were assigned to an experimental group (EG) [n = 20] and control group (CG) [n = 20] based on the study criteria. INTERVENTIONS: The EG received CBB together with routine physiotherapy and the CG received routine physiotherapy over a period of 8 weeks. Participants were instructed to carry out the exercises for 3 days per week. The training was evaluated once a week and the exercises progressed based on the level of pain. OUTCOME MEASURES: Primary outcomes were maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and maximum voluntary ventilation (MVV). The secondary outcomes were measured in the numeric rating scale (NRS), total faulty breathing scale (TFBS), cloth tape measure (CTM) and lumbo-pelvic stability. RESULTS: The MIP increased significantly among the EG when compared with that in the CG (p > 0.05).The EG showed a significant increase in MVV (p = 0.04) when compared to the CG (p = 0.0001). There was a significant reduction in pain for both groups. The MEP, TFBS, chest expansion and core stability showed no changes in either group. CONCLUSION: CBB was effective in improving respiratory variables among NS-LBP patients.

Intra-rater and inter-rater reliability of total faulty breathing scale using visual observation and videogrammetry methods.

Faulty breathing is an aspect of alteration in the normal fundamental pattern of breathing. The available existence of scales in assessing faulty breathing has not frequently been used. Measurement errors in assessing and quantifying breathing patterns may originate from unclear directions and variation between observers. This study determined the measure reliability of the Total Faulty Breathing Scale (TFBS) for quantifying breathing patterns. Twenty seven participants were recruited comprising healthy and unhealthy subjects. Two examiners assessed their breathing patterns using the TFBS on two different occasions with visual observation and a videogrammetry method. Evaluation of the observational breathing pattern method for intra-rater and inter-rater showed agreement of 96.30% and a kappa score of greater than 0.78, which indicated substantial agreements. The videogrammetry method showed a percent agreement of (100%) with a kappa score of (1.00). This study indicates that the TFBS is a considerably reliable tool for evaluating breathing patterns with both visual observation and a videogrammetry method.