Physical Fitness in Children With Developmental Coordination Disorder: A Systematic Review.

OBJECTIVE: To synthesize evidence about physical fitness levels in children with developmental coordination disorder (DCD) compared with typically developing (TD) children. METHODS: We searched four databases (PubMed, Scopus, Web of Science, and PsycINFO) for cross-sectional, case-control, and cohort studies comparing physical fitness between children with and without DCD. We assessed the methodological quality of the studies with the Newcastle-Ottawa Scale (NOS). We calculated Cohen's d effect sizes to provide clinical evidence of group differences in aerobic capacity, anaerobic capacity, muscle strength, body composition and flexibility. RESULTS: We included 32 studies for qualitative synthesis after applying eligibility criteria. All selected studies ranged from moderate to high research quality. Effect sizes in favor of typically developing children over children with DCD were large for aerobic capacity (d = 1.15), anaerobic capacity (d = 0.90), and muscle strength (d = 0.79), and small for body composition (d = 0.43) and flexibility (d = 0.21) outcomes. CONCLUSION: Children with DCD presented significantly lower physical fitness than their typically developing peers, particularly in aerobic and anaerobic capacity and in muscle strength.

Developmental coordination disorder in preterm children: A systematic review and meta-analysis.

This study aimed to review the prevalence of developmental coordination disorder (DCD) in individuals born preterm and systematically explore this prevalence according to gestational age and different assessment cut-offs and compare it to full-term peers. The eligibility criteria were observational and experimental studies reporting the prevalence of DCD in preterm individuals. A systematic search was performed in databases from inception until March 2022. Two independent reviewers performed the selection. Study quality assessment was performed using the checklists from Joanna Briggs Institute (JBI). Data analysis was performed on Excel and Review Manager Software 5.4. Among the 1774 studies identified, 32 matched the eligibility criteria. The pooled estimate rate of the DCD rate in preterm was 21% (95% confidence interval [CI] 17.8-24.3). The estimate rates were higher as gestational age decreased, and preterm children are two times more likely to have DCD than their full-term peers risk ratio (RR) 2.2 (95% CI 1.77-2.79). The limitation was high heterogeneity between studies; the assessment tools, cut-off points and age at assessment were diverse. This study provided evidence that preterm children are at higher risk for DCD than full-term children, and the risks increased as gestational age decreased.

Assessing Stroke-Related Sarcopenia in Chronic Stroke: Identification of Clinical Assessment Tools-A Pilot Study.

Stroke-related sarcopenia has recently been defined as the muscle atrophy consequent to stroke and assessing it following the guidelines with simple clinical tools is crucial in chronic stroke survivors. The aim of this study was to determine the characteristics of patient-friendly instruments sarcopenia in a chronic stroke sample (SG) compared to non-stroke counterparts (CG). Each participant underwent a single assessment which consisted of: SARC-F questionnaire, assessment of muscle strength (hand grip and five-times sit-to-stand test, 5STS), the calf circumference (CC) of both legs, the short physical performance battery (SPPB), and the 10 m walk test. A total of 68 participants were included (SG, n = 34 and CG, n = 34). All variables showed statistical differences (p < 0.05) between the SG and the CG, except handgrip although it showed lower values for SG. The values of the 5STS (16.26 s) and the SPPB (7 points) were below to the cutoff values for the SG. The five-times sit-to-stand test, SPPB, and gait speed can lead clinicians to detect stroke-related sarcopenia. Maximum handgrip shows a trend of low values for men and women in the SG, however, CC did not detect sarcopenia in our sample.

Beyond TORCH: A narrative review of the impact of antenatal and perinatal infections on the risk of disability.

Infections and inflammation during pregnancy or early life can alter child neurodevelopment and increase the risk for structural brain abnormalities and mental health disorders. There is strong evidence that TORCH infections (i.e., Treponema pallidum, Toxoplasma gondii, rubella virus, cytomegalovirus, herpes virus) alter fetal neurodevelopment across multiple developmental domains and contribute to motor and cognitive disabilities. However, the impact of a broader range of viral and bacterial infections on fetal development and disability is less well understood. We performed a literature review of human studies to identify gaps in the link between maternal infections, inflammation, and several neurodevelopmental domains. We found strong and moderate evidence respectively for a higher risk of motor and cognitive delays and disabilities in offspring exposed to a range of non-TORCH pathogens during fetal life. In contrast, there is little evidence for an increased risk of language and sensory disabilities. While guidelines for TORCH infection prevention during pregnancy are common, further consideration for prevention of non-TORCH infections during pregnancy for fetal neuroprotection may be warranted.

A Clinical Practice Guide to Enhance Physical Activity Participation for Children with Developmental Coordination Disorder in Canada.

Purpose: This clinical practice guide (CPG) aims to provide evidence-based recommendations for promoting and enhancing the participation and integration of children with developmental coordination disorder (DCD) into physical activities that take place in the home, school, community, or rehabilitation clinic contexts. Methods: A panel of key stakeholders relevant to these contexts (parents, instructors, rehabilitation professionals) developed evidence-based recommendations using a consensus methodology after reviewing results from a recent systematic review of relevant literature. The quality of the evidence on which the recommendations were based was evaluated (2011 Oxford Centre for Evidence-Based Medicine Levels of Evidence scale) as was the strength of the final CPG recommendations (American Society of Plastic Surgeons Grade Recommendation Scale). Results: Recommendations (n = 50; 36% supported by robust, empirically derived evidence) for the different stakeholder groups fell into three categories: 1) Choose an appropriate activity for your child, 2) Harmonize the activity with the child's interests and abilities, and 3) Help the child learn new movements prior to the activity. Conclusions: This comprehensive CPG provides concrete recommendations, based on the currently available evidence, that can be used by stakeholders to address the physical activity participation and integration needs of children with DCD in a variety of contexts.

Objectif: ces directives cliniques visent à fournir des recommandations basées sur les données probantes pour promouvoir et améliorer la participation et l'intégration des enfants ayant un trouble développemental de la coordination (TDC) à des activités physiques qui se déroulent à la maison, à l'école, dans la communauté ou dans des cliniques de réadaptation. Méthodologie: un groupe d'intervenants clés dans ces contextes (parents, entraineurs, professionnels de la réadaptation) a préparé des recommandations fondées sur des données probantes au moyen d'une méthodologie de consensus, après avoir révisé les résultats d'une récente analyse systématique de publications pertinentes. La qualité des données probantes sur laquelle reposent les recommandations a été évaluée (échelle de qualité des preuves de l'Oxford Centre for Evidence-Based Medicine de 2011) de même que les catégories des recommandations définitives tirées des directives (échelle des catégories de recommandations de l'American Society of Plastic Surgeons). Résultats: les recommandations (n = 50; 36 % soutenues par des données probantes empiriques vigoureuses) des divers groupes d'intervenants se déclinaient en trois catégories : 1) choisir une activité appropriée pour l'enfant, 2) harmoniser l'activité selon les intérêts et les capacités de l'enfant, 3) aider l'enfant à s'approprier de nouveaux mouvements pour aller vers l'activité. Conclusions: ces directives cliniques complètes fournissent des recommandations concrètes d'après les données probantes disponibles, que peuvent utiliser les intervenants pour aborder la participation à l'activité physique et les besoins d'intégration des enfants ayant un TDC dans divers contextes.

Use of Virtual Reality-Based Games to Improve Balance and Gait of Children and Adolescents with Sensorineural Hearing Loss: A Systematic Review and Meta-Analysis.

BACKGROUND: Children and adolescents with sensorineural hearing loss (SNHL) often experience motor skill disturbances, particularly in balance and gait, due to potential vestibular dysfunctions resulting from inner ear damage. Consequently, several studies have proposed the use of virtual reality-based games as a technological resource for therapeutic purposes, aiming to improve the balance and gait of this population. OBJECTIVE: The objective of this systematic review is to evaluate the quality of evidence derived from randomized or quasi-randomized controlled trials that employed virtual reality-based games to enhance the balance and/or gait of children and adolescents with SNHL. METHODS: A comprehensive search was conducted across nine databases, encompassing articles published in any language until 1 July 2023. The following inclusion criteria were applied: randomized or quasi-randomized controlled trials involving volunteers from both groups with a clinical diagnosis of bilateral SNHL, aged 6-19 years, devoid of physical, cognitive, or neurological deficits other than vestibular dysfunction, and utilizing virtual reality-based games as an intervention to improve balance and/or gait outcomes. RESULTS: Initially, a total of 5984 articles were identified through the searches. Following the removal of duplicates and screening of titles and abstracts, eight studies remained for full reading, out of which three trials met the eligibility criteria for this systematic review. The included trials exhibited a very low quality of evidence concerning the balance outcome, and none of the trials evaluated gait. The meta-analysis did not reveal significant differences in balance improvement between the use of traditional balance exercises and virtual reality-based games for adolescents with SNHL (effect size: -0.48; [CI: -1.54 to 0.57]; p = 0.37; I2 = 0%). CONCLUSION: Virtual reality-based games show promise as a potential technology to be included among the therapeutic options for rehabilitating the balance of children and adolescents with SNHL. However, given the methodological limitations of the trials and the overall low quality of evidence currently available on this topic, caution should be exercised when interpreting the results of the trials analyzed in this systematic review.

Motor repertoire in 3- to 5- month-old infants with prenatal exposure to syphilis and toxoplasmosis.

AIM: To characterize the motor repertoire of 3- to 5-month-old infants who were prenatally exposed to the infectious agents of syphilis and toxoplasmosis. METHODS: Exploratory observational study that evaluated 15 exposed infants (34.4 ± 3.5 weeks gestation) recruited from a referral center. Age assessment ranged 12-20 (median 12) weeks post-term. General Movement Assessment, including the Motor Optimality Score-Revised (MOS-R), was used to assess the global quality of fidgety movements (FMs) and to quantify and detail coexisting motor patterns. Clinical variables were also collected. Later motor outcomes were obtained from medical reports when possible. RESULTS: MOS-R ranged 10-26 (median 24). There was a higher proportion of infants with normal (80.0 %) than aberrant FMs, but the proportion of infants with reduced MOS-R (80.0 %) was higher compared to optimal MOS-R. One infant with aberrant FMs was later diagnosed with cerebral palsy. Only 13.3 % of the infants showed smooth and fluent movement character. All observed tongue movements were abnormal. CONCLUSION: Infants had predominantly normal FMs, but with reduced MOS-R and abnormalities in the coexisting motor repertoire.

Effectiveness of CO-OP Approach for Children With Neurodevelopmental Disorders: A Systematic Review.

Objective: To examine the scientific evidence regarding the effectiveness of the Cognitive Orientation to Daily Occupational Performance (CO-OP) approach for children with neurodevelopmental disorders (NDDs). Data Sources: Selected articles published between January 2001 and September 2020 and listed in CINAHL, MEDLINE, and PsycINFO on the EBSCO platform, or found searching with Scopus, Google Scholar, OTseekern Central Register of Controlled Trials in the Cochrane Library, WHO International Clinical Trials Registry Platform, Turning Research into Practice, and ProQuest Dissertations and Theses. An update was performed in March 2022. Study Selection: Eligibility criteria included studies that assessed the effectiveness of the CO-OP approach on children (0-18 years) with NDDs. Unpublished results were excluded, as well as research published in a language other than English or French. Data Selection: The first 2 authors independently reviewed the titles, abstracts, and full texts. Discrepancies were discussed and resolved by consensus. Included studies were quality appraised using the PEDro-P scale or using the risk of bias scale in N-of-1 trials (RoBiNT) according to experimental design. Data Synthesis: Results were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Eighteen studies were initially included, with 2 additional studies added in the update. Three reached evidence level III (15%), 10 reached level IV (70%), and 5 reached level V (15%). All data collected on the activity-participation domain showed a significant improvement. Group therapy sessions show promising results for the improvement of activities or participation, as well as psychosocial dimensions such as self-esteem. Conclusions: The scientific evidence analyzed shows that the CO-OP approach has a positive effect on children with NDDs, particularly in regard to their activities and participation. Future experimental studies should be designed in ways that allow determining effect sizes. Group therapy sessions appear relevant but require further research.

Telerreabilitação na fisioterapia neurofuncional pediátrica durante a pandemia de COVID-19: percepção dos pais, desafios e contribuições / Telerehabilitation in pediatric neurofunctional physical therapy during the COVID-19 pandemics: parent's perception, challenges and contributions

INTRODUÇÃO: A telerreabilitação é uma modalidade de atendimento realizado à distância que foi considerada um recurso fundamental durante a pandemia da COVID-19. Entretanto, era uma modalidade ainda não vivenciada por muitos profissionais e familiares. OBJETIVO: Descrever a percepção dos pais ou responsáveis por crianças em tratamento fisioterapêutico, sobre os desafios e as contribuições da experiência com a telerreabilitação realizada em serviço ambulatorial durante a pandemia de COVID-19. MATERIAIS E MÉTODOS: Estudo observacional transversal exploratório, realizado com pais ou responsáveis por crianças, com idade entre 0 a 12 anos, com qualquer condição de saúde neurológica ou musculoesquelética em acompanhamento fisioterapêutico por telerreabilitação, no período de junho a agosto de 2021. Um questionário elaborado pelas autoras com perguntas sobre a percepção dos responsáveis, desafios e contribuições da telerreabilitação foi encaminhado para os responsáveis por meio de um link do Google Forms, via e-mail ou aplicativo de mensagem no celular, e foi auto aplicado. Realizaramse análises descritivas dos dados coletados por meio da frequência de respostas dos pais ou responsáveis nas questões específicas. As variáveis numéricas foram apresentadas como média ± desvio-padrão e as variáveis categóricas, como frequências absolutas e relativas. RESULTADOS: Dezoito responsáveis receberam e responderam o questionário completamente. A mãe foi a responsável mais citada, a maioria das crianças recebeu atendimento duas vezes na semana e o diagnóstico mais prevalente foi paralisia cerebral. Setenta e três por cento dos responsáveis avaliaram a telerreabilitação como acima do nível esperado e com contribuição além de suas expectativas. CONCLUSÃO: De acordo com a percepção dos pais, sobre os desafios e as contribuições da experiência com a telerreabilitação realizada em serviço ambulatorial, os benefícios parecem superar os desafios.

INTRODUCTION: Telerehabilitation is a modality of care provided remotely that was considered a fundamental resource during the COVID-19 pandemic. However, it was a modality not yet experienced by many professionals and family members. OBJECTIVE: To describe the perception of parents or guardians of children undergoing physical therapy, about the challenges and contributions of the experience with telerehabilitation performed in an outpatient service during the COVID-19 pandemics. MATERIAL AND METHODS: An exploratory crosssectional observational study carried out with parents or guardians of children, aged between 0 and 12 years old, with any neurological or musculoskeletal health condition in physiotherapeutic treatment by telerehabilitation, from June to August 2021. A questionnaire prepared by the authors with questions about the perception of those responsible, challenges and contributions of telerehabilitation was sent to those responsible through a Google Forms link, by email or mobile messaging app and was self-applied. Descriptive analysis of the data collected was carried out through the frequency of responses from parents or guardians on specific questions. Numerical variables were presented as mean ± standard deviation and categorical variables as absolute and relative frequencies. RESULTS: Eighteen guardians received and answered the questionnaire completely. The mother was the most cited guardian, most children received care twice a week and the most prevalent diagnosis was cerebral palsy. Seventythree percent of those responsible rated telerehabilitation as above the expected level and with a contribution beyond their expectations. According to them, the greatest contribution of telerehabilitation was the satisfactory motor development presented by the children during the period of social isolation. CONCLUSION: According to the parents' perception of the challenges and contributions of the experience with telerehabilitation performed in outpatient service, the benefits seem to outweigh the challenges.

Developmental Skills of Individuals with Angelman Syndrome Assessed Using the Bayley-III.

We describe the development of 236 children with Angelman syndrome (AS) using the Bayley Scales of Infant and Toddler Development, Third Edition. Multilevel linear mixed modeling approaches were used to explore differences between molecular subtypes and over time. Individuals with AS continue to make slow gains in development through at least age 12 years of age at about 1-2 months/year based on age equivalent score and 1-16 growth score points/year depending on molecular subtype and domain. Children with a deletion have lower scores at baseline and slower rate of gaining skills while children with UBE3A variant subtype demonstrated higher scores as well as greater rates of skill attainment in all domains. The developmental profiles of UPD and ImpD were similar.

The Impact of COVID-19 Pandemic and Social Distancing on Motor Function and Growth of Children with Congenital Zika Syndrome: A Prospective Cohort Study.

This article describes the impact of social distancing during the COVID-19 pandemic on the motor function and growth of children with congenital Zika syndrome (CZS). Children's motor function, weight, height and joint range of movement (ROM) were evaluated before the onset of the pandemic and soon after their return to face-to-face activities at a rehabilitation center. Fifty-two children (Mean 46.07 months, SD 3.76 months) were assessed. Results showed a reduction in proportion of children with adequate body mass index (p = .04), an increase in proportion with adequate height (p < 0.001), deterioration in gross motor function in children with severe motor impairment (p < .01), and a reduction in the maximum ROM for shoulder (p < .01) and wrist flexion (p = .046), elbow (p = .01), knee (p = .03) and ankle extension (p < .01), and an increase in hip flexion (p = .04). The social distancing period appears to have contributed to important losses in motor function and joint mobility of children with CZS; however, this period of time appeared to have less impact on their growth.

Motor and cognitive outcomes of neonates with low birth weight in Brazil: a systematic review and meta-analysis / Desfechos motores e cognitivos de recém-nascidos com baixo peso ao nascer no Brasil: uma revisão sistemática e metanálise

Abstract Background Data on the outcomes of preterm newborns in South American countries are scarce. Given the great effect of low birth weight (LBW) and/or prematurity on children's neurodevelopment, it is extremely necessary to conduct studies on these phenomena in greater depth in more heterogeneous populations such as those ones from countries with limited resources. Methods We conducted a comprehensive literature search on databases including PubMed, the Cochrane Library, and Web of Science for articles published in Portuguese and English up to March 2021 involving children born and evaluated in Brazil. The analysis of the risk of bias was adapted from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and used to evaluate the methodology of the included studies. Results From the eligible trials, 25 articles were selected for qualitative synthesis, and 5 of those, for quantitative synthesis (meta-analysis). The meta-analyses showed that children born with LBW presented lower scores on motor development when compared with controls (standardized mean difference: -1.15; 95% confidence interval [95%CI]: -1.56--0.73]; I2: 80%) and also scored lower in terms of cognitive development (standardized mean difference: -0.71; 95% CI: -0.99--0.44; I2: 67%). Conclusion The results of the present study reinforce that impaired motor and cognitive functions can be a significant long-term outcome of LBW. The lower the gestational age at delivery, the higher the risk of impairment in those domains. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database under number CRD42019112403.

Resumo Antecedentes Dados sobre desfechos de recém-nascidos prematuros em países da América do Sul são escassos. Dado o grande efeito do baixo peso ao nascer (BPN) e/ou da prematuridade no neurodesenvolvimento das crianças, é extremamente necessária a realização de estudos que investiguem esses fenômenos com maior profundidade em populações mais heterogêneas. Métodos Realizou-se uma busca da literatura em bases de dados, incluindo PubMed, Cochrane Library e Web of Science, por artigos publicados em português e inglês até março de 2021 envolvendo crianças nascidas e avaliadas no Brasil. A análise de risco de viés foi adaptada da declaração de Fortalecimento do Relato de Estudos Observacionais em Epidemiologia (Strengthening the Reporting of Observational Studies in Epidemiology, STROBE), que foi utilizada para avaliar a metodologia dos estudos. Resultados Dos estudos elegíveis, 25 artigos foram selecionados para síntese qualitativa, e 5 desses 25, para síntese quantitativa (metanálise). As metanálises mostraram que crianças nascidas com BPN apresentaram pontuação menor em desenvolvimento motor quando comparadas aos controles (diferença média padronizada, -1,15; intervalo de confiança de 95% [IC95%]: -1,56--0,73]; I2: 80%) e pontuação também menor em termos de desenvolvimento cognitivo (diferença média padronizada, -0,71; IC95%: -0,992-0,44; I2: 67%). Conclusão Os resultados deste estudo reforçam que o comprometimento das funções motoras e cognitivas pode ser um desfecho significativo de longo prazo do BPN. Quanto menor a idade gestacional no momento do parto, maior o risco de prejuízo nesses domínios. O protocolo do estudo foi registrado no banco de dados International Prospective Register of Systematic Reviews (PROSPERO) sob o número CRD42019112403.

Bilateral coordination of gait at self-selected and fast speed in patients with multiple sclerosis: a case-control study.

BACKGROUND: Multiple sclerosis (MS) is characterized by progressive demyelinating deterioration of nervous tissues in the brain and cord, leading to a disruption in the ability of parts of the nervous system to transmit signals. Although dorsal column pathways are compromised in neuropathological studies, gait control assessments, especially on speed effects, have been understudied in MS. OBJECTIVE: This study aimed to compare bilateral coordination of gait in subjects with MS at self-selected and fast speed and to relate these findings to disease severity (Expanded Disability Status Scale (EDSS)) and age. METHODS: An age-matched and sex-matched case-control study was performed to assess the bilateral coordination of gait of 26 MS subjects by evaluating the gait spatiotemporal parameters captured by an inertial measurement unit sensor. The bilateral variability, accuracy, and overall coordination (the sum of variability and accuracy) were assessed at a self-selected and fast speed, and correlated with disease severity and age. RESULTS: All gait control parameters improved at the fast speed compared to the self-selected walking speed (p<0.05 for all comparisons). The bilateral coordination of gait was moderately related to disease severity and age (p<0.05), and the gait spatiotemporal parameters were related to disease severity (p<0.001, from R=0.66 to R=0.70). CONCLUSION: Patients with MS showed significant impairment in the bilateral coordination of gait at self-selected compared to fast speed. Functional mobility tests and locomotor interventions should be cautious when analyzed at different paces. Interventions aiming to increase speed can be a proper and safe strategy in locomotor studies.

Parental Occupational Exposure and Neurodevelopmental Disorders in Offspring: a Systematic Review and Meta-analysis.

PURPOSE OF REVIEW: Parental occupational exposures might be associated with neurodevelopmental disorders (NDDs) in offspring. We aimed to conduct a systematic review and meta-analysis to summarize and synthesize the current literature and to estimate the pooled magnitude of the underlying association(s) between parental occupational exposures and subsequent risk of NDDs. RECENT FINDINGS: In the meta-analysis of 20 included studies, significant associations were found between parental occupational exposure to pesticides or solvents and the risk of attention deficit hyperactivity disorder in offspring. Prenatal occupational exposure to pesticides was significantly associated with motor development or cognition disorders in children. Furthermore, some evidence showed that metals might have a role in the development of autism spectrum disorders. Further studies need to identify the level of parental occupational exposures that can be significantly associated with NDDs. Moreover, utilizing standardized outcome and exposure scales is recommended to incorporate paternal, maternal, and parental as well as both prenatal and postnatal exposure in future studies.

Clinical Motor Coordination Tests in Adult Neurology: A Scoping Review.

Purpose: This scoping review aimed to identify which clinical tests are used to assess upper limb, lower limb, and trunk motor coordination, and their metric and measurement properties for adult neurological populations. Method: MEDLINE (1946-) and EMBASE (1996-) databases were searched using keywords such as movement quality, motor performance, motor coordination, assessment, and psychometrics. Data regarding the body part assessed, neurological condition, psychometric properties, and scored metrics of spatial and/or temporal coordination were independently extracted by two reviewers. Alternate versions of some tests such as the Finger-to-Nose Test were included. Results: Fifty-one included articles yielded 2 tests measuring spatial coordination, 7 tests measuring temporal coordination, and 10 tests measuring both. Scoring metrics and measurement properties differed between tests, with a majority of tests having good-to-excellent measurement properties. Conclusions: The metrics of motor coordination scored by current tests vary. Since tests do not assess functional task performance, the onus falls on clinicians to infer the connection between coordination impairments and functional deficits. Clinical practice would benefit from the development of a battery of tests that assesses the metrics of coordination related to functional performance.

Objectif : la présente revue exploratoire visait à déterminer quels tests cliniques sont utilisés pour évaluer la coordination motrice des membres supérieurs, des membres inférieurs et du tronc, ainsi que pour déterminer leurs propriétés métriques et de mesures dans les populations d'adultes ayant des troubles neurologiques. Méthodologie : les chercheurs ont fouillé les bases de données de MEDLINE (1946­) et d'EMBASE (1996­) au moyen de mots-clés comme movement quality, motor performance, motor coordination, assessment et psychometrics. Deux analystes indépendants ont extrait les données relatives aux parties du corps évaluées, à l'affection neurologique, aux propriétés psychométriques et aux mesures de coordination spatiale ou temporelle calculées. D'autres versions de certains tests, comme l'épreuve doigt-nez, ont été incluses. Résultats : au total, les 51 articles retenus incluaient deux tests qui mesuraient la coordination spatiale, sept tests qui mesuraient la coordination temporelle et dix qui mesuraient ces deux types de coordination. Les mesures calculées et les propriétés de mesure différaient entre les tests, mais les propriétés de la majorité d'entre elles étaient bonnes à excellentes. Conclusions : les mesures de coordination motrice calculées par les tests actuels varient. Puisque les tests n'évaluent pas la performance des tâches fonctionnelles, il revient aux cliniciens d'extrapoler les liens entre les déficits de coordination et les déficits fonctionnels. La création d'une batterie de tests pour évaluer les mesures de coordination liées à la performance fonctionnelle serait bénéfique en pratique clinique.

Which gait training intervention can most effectively improve gait ability in patients with cerebral palsy? A systematic review and network meta-analysis.

Background: A vital objective to treat people with cerebral palsy (CP) is to increase gait velocity and improve gross motor function. This study aimed to evaluate the relative effectiveness of gait training interventions for persons with CP. Methods: Studies published up to October 26, 2022 were searched from four electronic databases [including Medline (via PubMed), Web of Science, Embase and Cochrane]. Studies with randomized controlled trials (RCTs), people with CP, comparisons of different gait training interventions and outcomes of gait velocity and gross motor function measures (GMFM) were included in this study. The quality of the literature was evaluated using the risk of bias tool in the Cochrane Handbook, the extracted data were analyzed through network meta-analysis (NMA) using Stata16.0 and RevMan5.4 software. Results: Twenty RCTs with a total of 516 individuals with CP were included in accordance with the criteria of this study. The results of the NMA analysis indicated that both external cues treadmill training (ECTT) [mean difference (MD) = 0.10, 95% confidence interval CI (0.04, 0.17), P < 0.05] and partial body weight supported treadmill training (BWSTT) [MD = 0.12, 95% CI (0.01, 0.23), P < 0.05] had better gait velocity than over ground gait training (OGT), BWSTT [MD = 0.09, 95%CI(0.01,0.18), P < 0.05] had a better gait velocity than robot-assisted gait training (RAGT), BWSTT [MD = 0.09, 95% CI (0.06, 0.13) P < 0.05] had a better gait velocity than treadmill training (TT), and BWSTT [MD = 0.14, 95% CI (0.07, 0.21), P < 0.05] had a better gait velocity than conventional physical therapy (CON). The SUCRA ranking indicated that BWSTT optimally improved the gait velocity, and the other followed an order of BWSTT (91.7%) > ECTT (80.9%) > RAGT (46.2%) > TT (44%) > OGT (21.6%) > CON (11.1%). In terms of GMFM, for dimension D (GMFM-D), there was no statistical difference between each comparison; for dimension E (GMFM-E), RAGT [MD = 10.45, 95% CI (2.51, 18.40), P < 0.05] was significantly more effective than CON. Both SUCRA ranking results showed that RAGT improved GMFM-D/E optimally, with rankings of RAGT (69.7%) > TT (69.3%) > BWSTT (67.7%) > OGT (24%) > CON (20.3%), and RAGT (86.1%) > BWSTT (68.2%) > TT (58%) > CON (20.1%) > OGT (17.6%) respectively. Conclusion: This study suggested that BWSTT was optimal in increasing the gait velocity and RAGT was optimal in optimizing GMFM in persons with CP. Impacted by the limitations of the number and quality of studies, randomized controlled trials with larger sample sizes, multiple centers, and high quality should be conducted to validate the above conclusion. Further studies will be required to focus on the total duration of the intervention, duration and frequency of sessions, and intensity that are optimal for the promotion of gait ability in this population. Systematic review registration: https://doi.org/10.37766/inplasy2022.10.0108, identifier: INPLASY2022100108.

Plasma acyl-carnitines, bilirubin, tyramine and tetrahydro-21-deoxycortisol in Parkinson's disease and essential tremor. A case control biomarker study.

BACKGROUND AND PURPOSE: Given the overlapping clinical manifestations and pathology, the differentiation between essential tremor (ET) and Parkinson's disease (PD) is difficult. Our aims were to examine the plasma metabolomics profiling and their association with motor and non-motor symptoms (NMS) in patients with PD, and to determine differences between de novo PD compared to moderate-advanced PD vs. controls and patients with ET. METHODS: Plasma samples were collected from 137 subjects including 35 age matched controls, 29 NOVO-PD, 35 PD and 38 ET patients. PD severity, motor and NMS including cognitive function were assessed using the UPDRS, NMS and PD cognitive rating scales, respectively. Metabolomics analysis was performed by UPLC-ESI-QToF-MS followed by unsupervised multivariate statistics. The area under the curve of the biomarkers according to distribution of their concentrations and the diagnosis of PD (NOVO-PD, advanced PD) vs ET and healthy controls was used as a measurement of diagnostic ability. RESULTS: Several acyl-carnitines, bilirubin, tyramine and tetrahydro-21-deoxycortisol (THS) presented good predictive accuracy (AUC higher than 0.8) for differentiating de novo PD and advanced PD from controls and ET, suggesting an alteration in the lipid oxidation pathway. In multivariate regression analysis, metabolite levels were not significantly associated with motor and NMS severity in PD. CONCLUSIONS: Diverse acyl-carnitines, bilirubin, tyramine and some adrenal gland derived metabolites are suggested as potential biomarkers able to distinguish between PD from controls and ET.

Health-related quality of life in developmental coordination disorder and typical developing children.

PURPOSE: To analyse: 1) the differences in health-related quality of life (HRQoL) between typically developing (TD) children and children with developmental coordination disorder (DCD) according to parents' and children's perception, and 2) the differences and level of agreement between parents and children's perceptions in HRQoL in both children's samples. METHODS: Cross-sectional analysis in 115 Spanish schoolchildren 4-to-7 years. Motor competence and HRQoL were assessed using the MACB-2 and the KINDL-R questionnaire, respectively. RESULTS: ANCOVA model showed that children with DCD children obtained lower scores in physical well-being, friends, school and total HRQoL dimensions than TD peers after controlling for covariates (p < 0.05). Moreover, parents' perception scores in HRQoL were lower in children with DCD than in TD peers (79.7 vs 84.8; p = 0.022). Student T-tests for repeated-measures showed non-significant differences between children and parents' perceptions in mean HRQoL scores, by motor competence categories. The intraclass correlations coefficients between parents and children's perception of HRQoL was moderate in DCD category (0.62; p = 0.024) and small in TD category (0.29; p = 0.049). CONCLUSIONS: Children under 6 years old with DCD have lower HRQoL scores than their TD peers. No differences were found between children's and parents' perceptions in total HRQoL, although the perceptions of children and parents in DCD category showed a significantly higher level of agreement than TD children. Interventions aimed at promoting motor skills in school settings during the preschool age seem necessary to improve children's quality of life.

Neuroimaging and motor development of twins with congenital microcephaly associated with Zika virus: a case report / Neuroimagem e desenvolvimento motor de gêmeas com microcefalia congênita por Zika virus: estudo de caso

Objective: We aimed to describe a case of congenital microcephaly caused by Zika virus infection in a monozygotic twin pregnancy. Methods: Transfontanelle ultrasonography and cranial computed tomography revealed different lesion patterns for both twins with congenital microcephaly caused by Zika virus infection. Motor development assessments were performed using the Alberta Infant Motor Scale and the Gross and Motor Function Measure before, during, and after physiotherapy. Results: The evaluations showed differences in motor acquisition between the twins. The values in the first case were much lower than those in the second case, which showed more motor delay. Conclussion: The present study showed that despite the twins being monozygotic, the effects of neurological lesions as revealed by neuroimaging were worse in the first case, and even with two weekly rehabilitation sessions, motor development over time was considerably worse in the twin in case 1 than in the other twin.

Objetivo: Descrever um caso de microcefalia congênita causada pela infecção do Zika vírus em uma gestação gemelar monozigótica. Métodos: A ultrassonografia transfontanelar e a tomografia computadorizada de crânio revelaram diferentes padrões de lesão para ambos gêmeos com microcefalia congênita causada pela infecção do Zika vírus. As avaliações do desenvolvimento motor foram realizadas por meio da Escala Motora Infantil de Alberta (EMIA) e da Medida de Função Motora Grossa antes, durante e após o tratamento fisioterapêutico. Resultados: As avaliações mostraram diferenças na aquisição motora entre os gêmeos. Os valores nas avaliações do primeiro caso foram bem menores do que os do segundo caso, que apresentou maior atraso motor. Conclusão: O presente estudo mostrou que apesar dos gêmeos serem monozigóticos, os efeitos das lesões neurológicas reveladas por exames de neuroimagem foram piores no primeiro caso, e mesmo com duas sessões semanais de reabilitação, o desenvolvimento motor ao longo do tempo foi consideravelmente pior no gêmeo do caso 1 quando comparado ao caso 2.

Repercussions of the Degrees of Hearing Loss and Vestibular Dysfunction on the Static Balance of Children With Sensorineural Hearing Loss.

OBJECTIVE: The purpose of this study was to assess the static balance of children with sensorineural hearing loss (SNHL) according to the degrees of SNHL and the function of the vestibular system. METHODS: This cross-sectional study was conducted in public schools located in Caruaru, Pernambuco state, Brazil, with 130 children (65 with normal hearing and 65 with SNHL as documented by air and bone conduction audiometry) of both sexes between 7 and 11 years old. Static balance was assessed by a stabilometric analysis using a force platform consisting of the circular area of center-of-pressure displacement of the children evaluated in 3 positions: bipedal support with feet together and parallel (PF), tandem feet (TF), and 1 foot (OF), carried out under 2 sensory conditions each, with eyes open and eyes closed. After balance assessments, the children with SNHL received examinations of auditory and vestibular functions-through audiometry and computerized vectoelectronystagmography, respectively-to compose the groups according to degrees of SNHL and vestibular function. RESULTS: The children with severe and profound SNHL demonstrated more static balance instabilities than the children with normal hearing in 5 positions assessed with eyes open (PF, TF, and OF) and eyes closed (PF and TF). The same phenomenon occurred in children with SNHL and associated vestibular dysfunction in all of the positions assessed with eyes open and eyes closed (PF, TF, and OF). CONCLUSION: The larger the degree of SNHL, the greater the balance instability of the children. The children with SNHL and associated vestibular dysfunction showed the highest balance instabilities in this study. IMPACT: Children with larger degrees of SNHL and associated vestibular dysfunction might require prolonged periods to rehabilitate their balance.