Pinch Strength Measurements in Adolescents With Pediatric Multiple Sclerosis.

BACKGROUND: Multiple sclerosis (MS) is a degenerative disease with typical onset between 20 and 50 years of age. An increase in MS cases has been found in the adolescent US population. Adolescents require fine motor manipulation skills for their functional and academic performance. Deficits in the major components of manipulation skills may result in insufficient function. This study examined the 2-point, 3-point, and lateral pinch strength of adolescents diagnosed as having MS. METHODS: Seventy-four adolescents, 37 with a diagnosis of relapsing-remitting MS and a control group of 37 age-matched peers, participated in this study. Data on 2-point, 3-point, and lateral pinch strength in both hands were collected using a pinch meter. Analyses of covariance were used to describe differences across the 2 groups, and effect sizes (Cohen d) were calculated by finding the mean difference between the study groups divided by the pooled SD. RESULTS: A significant difference was found in the 2-point pinch strength of the right hand of participants with pediatric MS compared with age- and sex-matched control participants. There were no significant differences in 2-point pinch strength of the left hand or in 3-point or lateral pinch strength of the right and left hands. CONCLUSIONS: Pinch grasp strength was differentially affected in adolescents with MS. Pinch strength should be assessed and considered in adolescents with MS for a better understanding of their functional performance of fine motor tasks in activities of daily living and academics.

The effects of home-based exercise therapy for breast cancer-related fatigue induced by radical radiotherapy.

BACKGROUND: Radiotherapy (RT) can lead to cancer-related fatigue (CRF) and decreased health-related quality of life (HRQoL) in breast cancer patients. The purpose of this trial was to examine the feasibility and efficacy of a home-based resistance and aerobic exercise intervention for reducing CRF and improving HRQoL in breast cancer patients during RT. METHODS: Women with breast cancer (N = 106) commencing RT were randomized to 12 weeks of home-based resistance and aerobic exercise (EX) or usual care/control (CON). The primary endpoint was CRF, with secondary endpoints of HRQoL, sleep duration and quality, and physical activity. Measurements were undertaken prior to RT, at completion of RT (~ 6 weeks), at completion of the intervention (12 weeks), and 6 and 12 months after RT completion, while CRF was also measured weekly during RT. RESULTS: Eighty-nine women completed the study (EX = 43, CON = 46). Over the 12-week intervention, EX completed 1-2 resistance training sessions and accumulated 30-40 min of aerobic exercise weekly. For CRF, EX had a quicker recovery both during and post-RT compared to CON (p < 0.05). Moreover, there was a significant difference in HRQoL between groups at RT completion, with HRQoL unchanged in CON and higher in EX (p < 0.05). There was no change in sleep duration or quality for either group and there were no exercise-related adverse effects. CONCLUSIONS: Home-based resistance and aerobic exercise during RT is safe, feasible, and effective in accelerating CRF recovery and improving HRQoL. Improvements in CRF and HRQoL for these patients can be achieved with smaller exercise dosages than stated in the generic recommendations for breast cancer.

Environmental Risk Factors and Their Different Effects in Depressive Symptoms of Left-Behind Children in Rural China Compared with Non-Left-Behind Children.

In China, 61 million children were left behind in rural areas as a result of massive urbanization and migration of parents from the countryside to the cities in search of economic opportunities. This study explores the effects of environmental risk factors (i.e., peer victimization, perceived discrimination, and stressful life events) on depressive symptoms of left-behind children (LBC) and examines whether these risk factors have a higher impact on LBC compared with that of non-left-behind children (NLBC). Data collected involve 1548 first and second-year middle school students. Logistic regressions were conducted to examine the associations between environmental risk factors and LBC's depressive symptoms, the moderating effect of the parental separation duration on these associations, and to compare if the risk factors had a higher impact on LBC's depressive symptoms than on those of NLBC. Peer victimization is associated with an increased likelihood of depressive symptoms for LBC who were left behind for more than five years. Finally, stressful life events have a higher impact on LBC's depressive symptoms, while peer victimization has a higher impact on NLBC's depressive symptoms. The results suggest that stressful life events are an important risk factor that puts LBC at a disadvantage in terms of their mental health.

Changes in gross grasp strength and fine motor skills in adolescents with pediatric multiple sclerosis.

This study examined the gross grasp strength and fine motor dexterity of adolescents, who are diagnosed with multiple sclerosis (MS). A total sample size of 72 participants between the ages of 13 to 17 was studied. Thirty six with a diagnosis of pediatric relapse remitting MS and 36 matched control participants were selected from various local youth groups. Data on hand strength and dexterity was collected using a dynamometer, nine hole peg board and Purdue pegboard on both groups. Utilizing ANCOVA to describe the differences across the two groups by diagnosis, controlling for age and gender, it was found that the MS group demonstrated significantly decreased dexterity when compared to age and gender matched controls. There was no significant difference in gross grasp strength by diagnostic group. This preliminary study showed that children with a diagnosis of pediatric MS may have differences in fine motor dexterity, but not gross grasp strength from their peers who do not have the diagnosis. Further study is indicated to examine this phenomenon.

The status of occupational therapy: addressing the needs of people experiencing homelessness.

SUMMARY This paper discusses the move of occupational therapy practitioners towards providing services for people who are homeless, presents the results of an internet-based survey of assessment tools used with this population, and provides an overview of this volume's papers while discussing the current status of occupational therapy interventions.

Mother-toddler interactions during child-focused activity in transitional housing.

SUMMARY This report describes the videotaped interactions of five mother-toddler dyads living in transitional housing. This study was designed to specifically examine the interactions as a function of routine in different types of child-focused activity. The interactions were described using the Parent-Toddler Coding System and Rating Scales of Dyadic Interaction (Ray & Tickle-Degnen, 2004). The focus was to examine the socio-emotional and task-supporting interactions that relate to the child's engagement in child-focused activity. Interactions were examined during free play, block play, slide play, and while having a snack. Positive moderate associations were noted between maternal and child socio-emotional dimensions of interactions in all activity conditions. The associations between maternal socio-emotional and task-related dimensions of interactions with child task-related dimensions of interaction were small in a positive direction, with higher associations noted in more familiar tasks such as during slide play or while having a snack. These preliminary findings suggest that familiarity with routines should be considered when examining the interactions that support child activity in families living in transitional housing for the homeless.