Contribution of static and dynamic balance skills to activities of daily living in children with intellectual disabilities.

BACKGROUND: Static and dynamic balance skills can be related to the activities of daily living (ADL) in children with non-syndromic intellectual disabilities, and the type of balance skills affecting ADL can differ depending on the domain of ADL (self-care, mobility, and social function). METHODS: The ADL capabilities of 66 children with intellectual disabilities were assessed using the Pediatric Evaluation of Disability Inventory (PEDI) and were examined in relation to static and dynamic balance skills. RESULTS: Significant positive correlations were found between the one-leg standing and PEDI (r = .841 for self-care, r = .700 for mobility, and r = .760 for social function). Our analysis showed that static balance skills affected self-care, dynamic balance skills affected mobility, and intelligence quotient affected social function. CONCLUSIONS: Improving balance skills is important for enhancing ADL capabilities, and the type of balance skills that need enhancement vary based on the domain of ADL.

Effect of a controlled starting position on the relationship between the forward reach distance and movement distance of the center of pressure in the functional reach test using the ankle joint strategy.

[Purpose] This study aimed to clarify whether the distribution range of the forward reach distance and the relationship between the forward reach distance and the movement distance of the center of pressure differed depending on whether the controlled starting standing position during the functional reach test with an ankle joint strategy. [Participants and Methods] Sixteen healthy male volunteers participated in the study. The distribution range of the forward reach distance and the relationship between the forward reach distance and movement distance of the center of pressure in the controlled starting standing position and non-controlled starting standing position conditions were analyzed. [Results] The distribution range of the forward reach distance was significantly smaller in the controlled starting standing position than in the non-controlled starting standing position. In both groups, the forward reach distance was associated with the movement distance of the center of pressure. [Conclusion] The findings suggested that the use of an ankle joint strategy with a controlled starting standing position in the functional reach test may be a more accurate method to evaluate standing balance ability.

Effect of performing daily activities while standing on the quantity and quality of the thigh muscles in adults with severe cerebral palsy: a cross-sectional study.

[Purpose] To observe the effect of daily standing, as indicated by gross motor function, on the quantity and quality of the thigh muscles in adults with severe cerebral palsy and to obtain data to determine an appropriate intervention that will improve their quality of life. [Participants and Methods] Thirty-three adults with severe cerebral palsy participated in the study. We assessed the gross motor function using the GMFM-66-IS. We then evaluated the quadriceps muscle thickness and the rectus femoris muscle echo intensity using ultrasonography. We divided the participants into the standing and non-standing groups and then examined the correlations of the GMFM-66-IS score to muscle thickness and echo intensity. We calculated the difference in mean muscle thickness and echo intensity between the two groups using an independent t-test. [Results] Significant positive correlations were found between the GMFM-66-IS score and muscle thickness and echo intensity. In the group-specific analysis, no significant correlation was found between echo intensity and the GMFM-66-IS score in either group. Muscle thickness and echo intensity were greater in the participants of the standing group. [Conclusion] Daily standing, as indicated by gross motor function, affected muscle thickness and echo intensity. Quantitative and qualitative data might need to be evaluated when assessing the muscles of adults with severe cerebral palsy using ultrasonography.

Perception of trunk inclination during sitting with feet in contact with the floor.

[Purpose] To clarify the sitting postural control, the influences of several reference sitting positions on the perception of the trunk position while sitting with the feet in contact with the floor and keeping the eyes closed were investigated. [Participants and Methods] Fifteen young healthy volunteers participated in the present study. The perception of the trunk position was evaluated by calculating the absolute error (error magnitude) and constant error (error direction) between the reference trunk position (which the subjects memorized; the reference position) and the position that they adopted when reproducing the reference position (the reproduced position). Eight reference positions were set at 5° increments (from 15° backward inclination [-] to 20° forward inclination [+]). [Results] The reference positions had a significant effect on the absolute error, and the absolute error values at -15° and -10° were significantly smaller than at 20°. However, the reference positions had no effect on the constant error. [Conclusion] The present study revealed that the perception of the trunk position while sitting with the feet in contact with the floor is better when inclining backward than when inclining forward. The perception of the trunk position may be higher in a low-stability position and lower in a high-stability position.

Anteroposterior perception of the trunk position while seated without the feet touching the floor.

[Purpose] The purpose of this study was to investigate the trunk position perception in the anteroposterior direction in young participants sitting without their feet touching the floor to avoid the influence of the hamstrings tension and the feet pressure on the perception. [Subjects and Methods] Fourteen healthy volunteers were seated on a chair fitted with an original manual goniometer. There were 7 reference positions set at 5° increments, from -15° to 15°, and reproductions of each position were conducted 5 times. Trunk position perception was evaluated by the absolute error between the reproduced trunk angle and the reference position angle. [Results] The results revealed a significant effect of reference position on the absolute error. The absolute error at the -5° reference position was significantly larger than at the -15° and 15° positions, and the absolute error at the 0° position was significantly larger than at the -15°, 10°, and 15° positions. [Conclusion] These results suggest that the perception of extreme forward- and backward-leaning trunk positions while sitting without the feet touching the floor would be higher than in a neutral sitting position. The relationship between the stability of the posture and the perception may be involved in the sitting position.

Urinary Excretion Contributes to Long-Lasting Blockade of Bladder Muscarinic Receptors by Imidafenacin: Effect of Bilateral Ureteral Ligation.

Imidafenacin is a potent and selective antagonist of M1 and M3 muscarinic receptors that is safe, efficacious, and well tolerated for controlling the symptoms of overactive bladder (OAB). However, the precise mechanisms responsible for the bladder-selective pharmacological effects of this agent remain unclear. The in vivo pharmacologic effects of imidafenacin result from receptor occupancy. Therefore, the present study was performed to characterize in vivo muscarinic receptor binding by tritium-labeled imidafenacin with high specific activity ([3H]imidafenacin) in the bladder and other tissues of mice, and to clarify the mechanisms underlying selective binding of imidafenacin to bladder muscarinic receptors. After intravenous injection of [3H]imidafenacin, its binding to muscarinic receptors in the bladder and other tissues of mice was assessed by a radioligand binding assay. [3H]Imidafenacin showed a significantly longer duration of binding to muscarinic receptors in the bladder than in other tissues, and muscarinic receptor binding of [3H]imidafenacin was markedly suppressed in the bladder alone after bilateral ligation of the ureters. After intravenous injection, the [3H]imidafenacin concentration was markedly higher in the urine than in the plasma, suggesting that urinary excretion may contribute significantly to the selective and long-lasting binding of imidafenacin to bladder muscarinic receptors. These findings suggest that the intravesicular concentration of an antimuscarinic agent and its active metabolites may have a substantial influence on its pharmacological effect and duration of action in patients with OAB. In addition, factors that modulate urine production may influence the efficacy and safety of antimuscarinic agents.