Conventional video-based system for measuring the subtask speed of the Timed Up and Go Test in older adults: Validity and reliability study.

The Timed Up and Go Test (TUG) is a simple fall risk screening test that covers basic functional movement; thus, quantifying the subtask movement ability may provide a clinical utility. The video-based system allows individual's movement characteristics assessment. This study aimed to investigate the concurrent validity and test-retest reliability of the video-based system for assessing the movement speed of TUG subtasks among older adults. Twenty older adults participated in the validity study, whilst ten older adults participated in the reliability study. Participant's movement speed in each subtask of the TUG under comfortable and fast speed conditions over two sessions was measured. Pearson correlation coefficient was used to identify the validity of the video-based system compared to the motion analysis system. Intraclass correlation coefficient (ICC3,2) was used to determine the reliability of the video-based system. The Bland-Altman plots were used to quantify the agreement between the two measurement systems and two repeatable sessions. The validity analysis demonstrated a moderate to very high relationship in all TUG subtask movement speeds between the two systems under the comfortable speed (r = 0.672-0.906, p < 0.05) and a moderate to high relationship under the fast speed (r = 0.681-0.876, p < 0.05). The reliability of the video-based system was good to excellent for all subtask movement speeds in both the comfortable speed (ICCs = 0.851-0.967, p < 0.05) and fast speed (ICCs = 0.720-0.979, p < 0.05). The Bland-Altman analyses showed that almost all mean differences of the subtask speed of the TUG were close to zero, within 95% limits of agreement, and symmetrical distribution of scatter plots. The video-based system was a valid and reliable tool that may be useful in measuring the subtask movement speed of TUG among healthy older adults.

Reliability and validity of the Swaymeter for measuring the trunk control in children with spastic cerebral palsy.

AIMS: To examine the reliability and validity of a simple device, the Swaymeter, for measuring trunk control in children with CP. METHODS: Twenty children with spastic CP participated in this study. Trunk sway was measured while quietly sitting for 30s. Children lean forward or backward as far as possible for measuring dynamic balance range. Test-retest reliability was conducted. The concurrent and construct validity of the Swaymeter was assessed by comparison to the motion capture system and gross motor function measure (GMFM). RESULTS: The reliability of the Swaymeter was moderate to excellent in measuring trunk sway and dynamic balance range (ICCs = 0.696-0.948). Concurrent validity showed good results (r = 0.818-0.997) and construct validity of dynamic balance in anterior direction showed moderate to high correlation with the GMFM (r = 0.599-0.849). CONCLUSION: Assessment of trunk control in a sitting position using the Swaymeter in this study was valid and reliable in children with CP.

Trunk and pelvis biomechanical responses in children with cerebral palsy and with typical development during horseback riding.

BACKGROUND: Children with cerebral palsy (CP) have poor postural control. Horseback riding (HR) is an alternative treatment shown to improve postural control among children with CP. However, there is a paucity of research investigating the underlying mechanisms responsible for improving postural control during HR. RESEARCH QUESTION: What are the three-dimensional biomechanical responses of the trunk and pelvis during HR among children with CP and with typical development (TD)? METHODS: The participants, aged 4-12 years old, were inexperienced horseback riders, consisting of 10 children with TD and 10 children with spastic diplegia CP (SDCP) with GMFCS level III. Participants donned inertial measurement units (IMU) on their trunk and pelvis in order to measure angular displacement and velocity. An additional IMU was placed on the horse's lumbosacral joint. The mean absolute relative phase (MARP) and deviation phase (DP) were calculated from each plane of movement for the angular displacement and velocity across the gait cycle of the horse. Differences between groups were analyzed using independent t-tests. RESULTS: The MARP in the frontal plane was lower in the SDCP group, when compared to the TD group (p = 0.01). Additionally, no differences were found between groups for the DP along all three axes. However, the TD group demonstrated greater pelvic movement variability in relation to the horse's pelvis movement, when compared to the SDCP group. SIGNIFICANCE: Children with SDCP demonstrated an in-phase coupling pattern with decreased variability of pelvic movement in relation to the horse's pelvis.

Smartphone addiction and its association with upper body musculoskeletal symptoms among university students classified by age and gender.

[Purpose] The purposes of this study were to: 1) survey smartphone addiction among university students, 2) survey the prevalence of upper body musculoskeletal symptoms in relation to the respondents' sitting posture, and 3) determine the association between smartphone addiction and upper body musculoskeletal symptoms, classified by age and gender. [Participants and Methods] Two self-report questionnaires were employed to collect data from 2,645 university students in Chiang Mai, Thailand. [Results] Of 2,027 respondents (860 males and 1,167 females), the participants' ages ranged from 18 to 26 years with a mean age of 20.5 ± 1.38 years. The prevalence of smartphone addiction and upper body musculoskeletal symptoms among participants were 15.9% and 30%, respectively. Overall, the mean value of pain severity was 3.66 ± 1.67 out of 10 on the visual analog scale. Multivariate logistic regression analysis revealed that smartphone addiction (OR=6.05, 95% CI: 4.68-7.84), was significantly associated with upper-body musculoskeletal symptoms when adjusted by age and gender. [Conclusion] The prevalence of upper body musculoskeletal symptoms was relatively high, especially for female smartphone users and students aged over 20 years. These results suggest that smartphone addiction may be a potential risk factor for upper body musculoskeletal symptoms in university students.

Prognostic predictors for ambulation in children with cerebral palsy: a systematic review and meta-analysis of observational studies.

PURPOSE: The purpose of this study is to investigate the prognostic predictors for ambulation in children with cerebral palsy using meta-analysis of observational studies. METHOD: Electronic searches were conducted in PubMed, SCOPUS, CINAHL, ProQuest, Ovid, Wiley InterScience, and ScienceDirect databases from their start dates to December 2015. RESULTS: Of the 1123 identified articles, 12 met the inclusion criteria for qualitative synthesis, eight of which were deemed appropriate for meta-analysis. Qualitative synthesis found that the type of cerebral palsy, early motor milestones, primitive reflexes and postural reactions, absence of visual impairment, absence of intellectual disability, absence of epilepsy or seizure, and ability to feed self were indicated as potential predictors for ambulation. Meta-analysis detected four significant prognostic predictors for ambulation: sitting independently at 2 years, absence of visual impairment, absence of intellectual disability, and absence of epilepsy or seizure. CONCLUSION: These prognostic predictors should be taken into consideration in therapeutic plans and rehabilitation goals, especially sitting independently before the age of 2 years. Implications for rehabilitation The meta-analysis supports strong evidence that sitting independently at 2 years of age, absence of visual impairment, absence of intellectual disability, and absence of epilepsy or seizure are positive predictors for ambulation in children with cerebral palsy. The therapeutic plans and rehabilitation goals should be considered cautiously for these predictors, especially sitting independently before the age of two years.

Derivation of an Ambulatory Prognostic Score Chart for Thai Children with Cerebral Palsy Aged 2 to 18.

Background: Most parents want to know that their children with cerebral palsy will be able to walk. A simple tool to predict ambulatory status and one uses The Gross Motor Function Classification System is still lacking. Objective: To develop a simple prognostic score chart for predicting ambulatory status in Thai children with cerebral palsy. Material and Method: Four hundred seventy one children with cerebral palsy aged 2 to 18 registered and treated at six special schools or hospitals for children with physical disability between 2008 and 2013 were recruited. Baseline characteristics and clinical histories of children with cerebral palsy were collected from medical and physical therapy records. Ambulatory status was classified as three ordinal scales by The Gross Motor Function Classification System - Expanded and Revised version. Results: Multivariable ordinal continuation ratio logistic regression analysis identified age, type of cerebral palsy, sitting independently at the age of two, and eating independently as significant predictors of ambulation. These items were combined into a clinical prediction score: non-ambulation (scores <7), assisted ambulation (scores 7 to 8), and independent ambulation (scores >8). Conclusion: The prognostic tool has high discriminative values of ambulatory status among children with cerebral palsy. However, the validation of this tool needs to be tested in other subjects before clinical practice application.

Prognostic Predictors for Ambulation in Thai Children With Cerebral Palsy Aged 2 to 18 Years.

The objectives of this study were to determine prognostic predictors for ambulation among Thai children with cerebral palsy and identify their ambulatory status. A retrospective cohort study was performed at 6 special schools or hospitals for children with physical disabilities. The prognostic predictors for ambulation were analyzed by multivariable ordinal continuation ratio logistic regression. The 533 participants aged 2 to 18 years were divided into 3 groups: 186 with independent ambulation (Gross Motor Function Classification System [GMFCS I-II]), 71 with assisted ambulation (Gross Motor Function Classification System III), and 276 with nonambulation (Gross Motor Function Classification System IV-V). The significant positive predictors for ambulation were type of cerebral palsy (spastic diplegia, spastic hemiplegia, dyskinesia, ataxia, hypotonia, and mixed type), sitting independently at age 2 years, and eating independently. These predictors were used to develop clinical scoring for predicting the future ability to walk among Thai children with cerebral palsy.