Functioning of children and adolescents with Down syndrome and the association with environmental barriers and facilitators during the COVID-19 pandemic.

PURPOSE: To compare functioning and environmental aspects before and during physical distancing (DPD) and to determine which social, physical, behavioral and functioning aspects of DPD are correlated. METHODS: Sixteen parents of children/adolescents with Down syndrome (11.38 ± 3.00 years) were surveyed before and DPD. Paired t-tests were used to compare functioning and environmental aspects before and DPD and chi-square tests were used to test associations. RESULTS: There were increases in the frequency (p < 0.001) and involvement (p = 0.01) in home participation and on the impact, noticed by the parents, of the possibility of child to participate in daily activities (p = 0.036), as well as a reduction in social supports perceived by caregivers (p = 0.049). An association was found between the child's socio-emotional difficulties symptoms and practice of physical activity (p = 0.043) and with parents' satisfaction with the level of child's home participation (p = 0.042). CONCLUSION: Functioning can be affected in either positive or negative ways.

Effect of physical therapy interventions on spatiotemporal gait parameters in children with cerebral palsy: a systematic review.

AIM: To investigate the effect of physical therapy interventions on spatiotemporal gait parameters in children with cerebral palsy. METHODS: Six databases were searched: PubMed, Embase, Web of Science, Science Direct, Lilacs, and Scopus. Two independent reviewers worked on primary study selection based on titles, abstracts, and full text reading. We included randomized controlled trials investigating the role of therapeutic interventions on gait kinematics in children with cerebral palsy. The independent reviewers extracted information about study population, intervention type, main outcomes, and methodological quality according to PEDro Scale. The body of evidence was synthesized through GRADE. RESULTS: Twenty-six studies were found addressing the following treatment categories: functional electrical stimulation, transcranial stimulation, gait training, muscular strengthening, vibratory platform training, and serial casting. A moderate level of evidence was identified for vibratory platform training, gait training, transcranial stimulation (positive effect), and isolated muscle strengthening (negative effect) in relation to gait velocity. Electrical stimulation showed a moderate level of evidence regarding stride length. The evidence for other outcomes was of low or very low quality. CONCLUSION: Vibratory platform, gait training, electrical stimulation, and transcranial stimulation were effective to improve spatiotemporal gait parameters, especially velocity in children with cerebral palsy.Implication for rehabilitationImprovement and maintenance of gait of children with cerebral palsy is a great challenge to rehabilitation professionalsVibratory platform, gait training, electrical stimulation, and transcranial stimulation improve gait parameters.Isolated strength training was not effective to improve gait parameters in Cerebral Palsy.Long-term effect of most techniques on gait parameters until unclear.

Go Zika Go: A Feasibility Protocol of a Modified Ride-on Car Intervention for Children with Congenital Zika Syndrome in Brazil.

Children with congenital Zika syndrome (CZS) present severe motor disability and can benefit from early powered mobility. The Go Zika Go project uses modified ride-on toy cars, which may advance the body functions, activities, and participation of children. This paper describes the study protocol aiming to assess the feasibility of a modified ride-on car intervention for children with CZS in Brazil. A mixed-methods design with a multiple 1-week baseline, 3-month intervention, and 1-month follow-up will be implemented. Modified ride-on car training sessions will be conducted three times a week at the participants' home or in the clinic. The primary outcome will be a narrative description of study feasibility (photovoice method, focus groups, parent feasibility questionnaire and assessment of learning powered mobility). Secondary outcomes will be switch activation, driving sessions journal, social-cognitive interactions, mobility (pediatric evaluation of disability inventory computer adaptive test), goal attainment scaling (GAS), and participation (young children's participation and environment measure). Go Zika Go is expected to be viable and to improve function, activity, and participation of children with CZS, providing a low-cost, evidence-based rehabilitation option that will be relevant to early child development in a global perspective.

Kinetic-based indexes for the functional evaluation of gait in diplegic children: a preliminary report.

We evaluated the feasibility of a set of indexes based on ground reaction forces to discriminate between the degree of severity of spastic diplegia, identified via Gross Motor Function Classification System (GMFCS). A stepwise discriminant ordinal regression analysis performed on a sample of 58 children returned a subset of variables related to the ratio between braking and propulsive vertical forces and anteroposterior timings. Rather, parameters concerning bilateral symmetry were poorly discriminating. The relative simplicity of the selected indexes allows for their easy implementation on existing gait analysis applications for screening purposes.

A biomechanical study of gait initiation in Down syndrome.

BACKGROUND: Gait Initiation (GI) is a functional task that challenges the balance control requiring weight shift and a transition from standing to walking. Individuals with Down Syndrome (DS) walk with low velocity, prolonged stance and shorter steps beside an increased support base. However, no studies performed GI analysis on this population. The aim of this study is to quantitatively characterize the GI task in subjects with DS compared with a typically developed control group. METHODS: Seventeen individuals with DS (17 to 40 years) and 19 healthy subjects (17 to 40 years) were enrolled in the study. Data were acquired using an optoelectronic motion capture system and force plates in order to measure the displacement and velocity of Center of Mass (CoM) and the trajectory of Center Of Pressure (CoP). All participants were asked to stand barefoot on the first force platform and received a verbal cue to begin walking for 6 gait initiation trials (three starting with each foot). The CoP duration, velocity, length and excursion were calculated during the anticipatory postural adjustments phases (APAs) and the locomotor (LOC) phase. For the analysis of the CoM, its displacements in antero-posterior (AP) and medio-lateral (ML) during the APAs and LOC phases. Statistical analysis was conducted to compare the two groups. RESULTS: Regarding CoP measures, when compared to control group, individuals with DS presented higher durations, lower velocities, longer lengths during the second APA and total phases, and shorter lengths during the first APA and LOC phases. The group with DS also presented longer CoP excursion during the second APA, whereas a shorter excursion was present during the first APA and LOC phases. The AP excursion in CoM is reduced in the participants with DS. CONCLUSIONS: Our results could be useful in the rehabilitation of individuals with DS as they suggest to reinforce exercise programs to improve balance in AP and ML directions, which is demonstrated to be impaired in these subjects.

Discriminant ability and criterion validity of the Trunk Impairment Scale for cerebral palsy.

Aims: To compare the performance of children with mild and moderate-to-severe cerebral palsy (CP) on the Trunk Impairment Scale (TIS), Gross Motor Function Measure (GMFM), and on center-of-pressure variables; to establish the discriminant ability of these tools to predict severity of motor impairment in CP; and to investigate the criterion validity of the TIS. Methods: Children with mild (n = 18, 11 males, 7 females, mean age = 9.5 ± 2.9 years, Gross Motor Function Classification System I-II) and moderate-to-severe (n = 18, 11 males, 7 females, mean age = 9.2 ± 229, Gross Motor Function Classification System III-IV) CP were tested using the TIS and the GMFM, and during static sitting on force-plate. Results: Children with mild CP showed better trunk (median; 95% confidence interval = 22.5; 21.29-22.59 vs. 13; 11.97-14.8; p < 0.001) and gross motor (60; 57.73-59.3 vs. 40; 38.96-46.25; p < 0.001) scores, and better postural control (lower center of pressure (CoP) displacement [anterior-posterior: (0.42; 0.32-1.11 vs. 0.89; 0.70-1.65; p = 0.022); medial-lateral: (0.42; 0.31-1.08 vs. 0.91; 0.65-1.17; p = 0.044)], and lower area of sway, (0.05; -0.15-0.97 vs. 0.44; 0.23-0.90; p = 0.008) than the moderate-to-severe group. Trunk control and gross motor function explained 81.5% of the variance in the severity of motor condition. Correlations between the TIS and the GMFM were excellent (ρ = 0.944, p < 0.001); correlations between the TIS and CoP variables were low (anterior-posterior displacement: ρ = -0.411, p < 0.05; medial-lateral displacement: ρ = -0.327, p < 0.05); area of sway: ρ = -0.430, p < 0.05; velocity of sway: ρ = -0.308, p < 0.05). Conclusions: The TIS is able to differentiate levels of trunk control across various levels of motor impairments in CP. It is a valid tool to assess trunk control, showing very high concurrent validity with the GMFM sitting dimension. Implications for Rehabilitation Trunk Impairment Scale (TIS) can be used by rehabilitation professionals to differentiate levels of trunk control across levels of motor impairment. TIS showed concurrent validity with Gross Motor Function Measure and should be used to assess trunk control in children with cerebral palsy (CP) in clinical settings. The use of TIS allows a reliable assessment of postural control in children with CP in clinical settings.

Impact of extrinsic factors on fine motor performance of children attending day care / Repercussões de fatores extrínsecos no desempenho motor fino de crianças frequentadoras de creches

Abstract Objective: To assess the impact of extrinsic factors on fine motor performance of children aged 2-years old. Methods: 73 children attending public and 21 private day care centers were assessed. Day care environment was evaluated using the Infant/Toddler Environment Rating Scale-Revised Edition (ITERS-R), fine motor performance was assessed through the Bayley Scales of Infant and Toddler Development-III (BSITD-III), socioeconomic data, maternal education and time of start at the day care were collected through interviews. Spearman's correlation coefficient was calculated to assess the association between the studied variables. Results: The time at the day care was positively correlated with the children's performance in some fine motor tasks of the BSITD-III, showing that the activities developed in day care centers were important for the refinement of specific motor skills, while the overall fine motor performance by the scale was associated with maternal education and the ITERS-R scale sub-item “language and understanding”. Conclusions: Extrinsic factors such as higher maternal education and quality of day care centers are associated with fine motor performance in children attending day care.

Resumo Objetivo: Verificar as repercussões de fatores extrínsecos no desempenho motor fino de crianças de dois anos. Métodos: Foram avaliadas 73 crianças de creches públicas e 21 de creches particulares. O ambiente da creche foi avaliado com a escala Infant/Toddler Environment Rating Scale - Revised Edition (ITERS-R), o desempenho motor fino pela escala Bayley Scales of Infant and Toddler Development - III (BSITD-III), dados socioeconômicos, escolaridade materna e tempo de ingresso na creche foram colhidos por meio de entrevista. Foi calculado o coeficiente de correlação pelo teste de Spearmann para verificar a relação entre as variáveis avaliadas. Resultados: O tempo de creche apresentou correlação positiva com o desempenho das crianças em algumas tarefas de motricidade fina da BSITD-III, demonstrou que as atividades desenvolvidas nas creches foram importantes para o refinamento de habilidades motoras específicas, enquanto o desempenho motor fino geral pela escala estava relacionado com a escolaridade materna e com o subitem da escala ITERS-R “Linguagem e compreensão”. Conclusões: Fatores extrínsecos como maior escolaridade materna e qualidade de creches estão relacionados com o desempenho motor fino de crianças frequentadoras de creches.

Impact of extrinsic factors on fine motor performance of children attending day care. / Repercussões de fatores extrínsecos no desempenho motor fino de crianças frequentadoras de creches.

OBJECTIVE: To assess the impact of extrinsic factors on fine motor performance of children aged two years old. METHODS: 73 children attending public and 21 private day care centers were assessed. Day care environment was evaluated using the Infant/Toddler Environment Rating Scale - Revised Edition (ITERS-R), fine motor performance was assessed through the Bayley Scales of Infant and Toddler Development - III (BSITD-III), socioeconomic data, maternal education and time of start at the day care were collected through interviews. Spearman's correlation coefficient was calculated to assess the association between the studied variables. RESULTS: The time at the day care was positively correlated with the children's performance in some fine motor tasks of the BSITD-III, showing that the activities developed in day care centers were important for the refinement of specific motor skills, while the overall fine motor performance by the scale was associated with maternal education and the ITERS-R scale sub-item "language and understanding". CONCLUSIONS: Extrinsic factors such as higher maternal education and quality of day care centers are associated with fine motor performance in children attending day care.

Comparison of motor and cognitive performance of children attending public and private day care centers.

BACKGROUND: Given that environmental factors, such as the school environment, can influence child development, more attention should be paid to the development of children attending day care centers. OBJECTIVE: To determine whether there are differences in the gross motor, fine motor, or cognitive performances of children between 1 and 3 years-old of similar socioeconomic status attending public and private day care centers full time. METHOD: Participants were divided into 2 groups, 1 of children attending public day care centers (69 children) and another of children attending private day care centers (47 children). All children were healthy and regularly attended day care full time for over 4 months. To assess cognitive, gross and fine motor performance, the Bayley Scales of Infant and Toddler Development III was used. The Mann-Whitney test was used for comparative analyses between groups of children between 13 and 24 months, 25 and 41 months, and 13 and 41 months. RESULTS: Children in public day care centers exhibited lower scores on the cognitive development scale beginning at 13 months old. The fine and gross motor performance scores were lower in children over the age of 25 months attending public centers. Maternal education was not related to the performance of children in either group. CONCLUSION: The scores of cognitive performance as well as fine and gross motor performance of children of similar socioeconomic status who attend public day care centers are lower than children attending private daycare centers.

Comparison of motor and cognitive performance of children attending public and private day care centers / Comparacao do desempenho motor e cognitivo de criancas frequentadoras de creches publicas e particulares

BACKGROUND: Given that environmental factors, such as the school environment, can influence child development, more attention should be paid to the development of children attending day care centers. OBJECTIVE: Todetermine whether there are differences in the gross motor, fine motor, or cognitive performances of children between 1 and3 years-old of similar socioeconomic status attending public and private day care centers full time. METHOD: Participants were divided into 2 groups, 1 of children attending public day care centers (69 children) and another of children attending private day care centers (47 children). All children were healthy and regularly attended day care full time for over 4 months. To assess cognitive, gross and fine motor performance, the Bayley Scales of Infant and Toddler Development III was used. The Mann-Whitney test was used for comparative analyses between groups of children between 13 and 24 months, 25 and 41 months, and 13 and 41 months. RESULTS: Children in public day care centers exhibited lower scores on the cognitive development scale beginning at 13 months old. The fine and gross motor performance scores were lower in children over the age of 25 months attending public centers. Maternal education was not related to the performance of children in either group. CONCLUSION: The scores of cognitive performance as well as fine and gross motor performance of children of similar socioeconomic status who attend public day care centers are lower than children attending private daycare centers. .

CONTEXTUALIZAÇÃO: Considerando que fatores ambientais, tal como o ambiente escolar, podem influenciar o desenvolvimento infantil, maior atenção deve ser empregada ao desenvolvimento de crianças que frequentam creches. OBJETIVO: Verificar se há diferença no desempenho motor grosso, fino e desempenho cognitivo de crianças entre 1 e 3 anos, de mesma classificação socioeconômica, frequentadoras de creches públicas e particulares em período integral. MÉTODO: Os participantes foram divididos em dois grupos, um de creches públicas (69 crianças) e outro de creches particulares (47 crianças). Todas as crianças eram saudáveis e deveriam frequentar a creche em período integral há mais de quatro meses. Para avaliação do desempenho motor fino, grosso e desempenho cognitivo, foi utilizada a escala Bayley Scales of Infant and Toddler Development - III. Para análise de comparação entre os grupos, foi realizado o teste de Mann-Whitney com crianças entre 13 e 24 meses, entre 25 e 41 meses e entre 13 e 41 meses. RESULTADOS: Crianças de creches públicas apresentaram menores escores quanto ao desenvolvimento cognitivo desde os 13 meses de vida. Os desempenhos motor fino e grosso, por sua vez, apresentaram menores escores nas crianças de escolas públicas com idade acima de 25 meses. A escolaridade materna não foi relacionada ao desempenho das crianças nos dois grupos CONCLUSÃO: O desempenho cognitivo, motor fino e grosso de crianças de mesma classe econômica, frequentadoras de creches públicas, apresentam piores performances quando comparadas às de creches particulares. .