Psychometric Properties of the Turkish Version of the Abiloco: Factor Analysis.

The ABILOCO is a questionnaire measuring mobility in stroke patients. The aim of the study was to evaluate the psychometric properties of the ABILOCO-Turkish. One hundred forty stroke patients were included. Thirteen items were rated according to 3 levels: difficult, easy, and impossible. The construct validity of the ABILOCO-Turkish was investigated using exploratory and confirmatory factor analysis. The reliability of the ABILOCO-Turkish was investigated through internal consistency approaches and test-retest reliability. The ABILOCO-Turkish was compared with the Timed Up & Go (TUG) test and the Berg Balance Scale for validity. The scale was repeated 1 week later for test-retest reliability. The Cronbach's alpha value calculated was 0.96 and item-total score correlations were between 0.464 and 0.899. The intraclass correlation coefficient (ICC) calculated for test-retest reliability was 0.989. According to the results, the ABILOCO-Turkish is highly correlated with the TUG (r: -0.830, p < 0.001) and the Berg Balance Scale (r: 0.919, p < 0.001). The exploratory factor analysis of the ABILOCO-Turkish showed that it is unidimensional, with this factor explaining 66.56% of the variance, and the construct validity was proven by confirmatory factor analysis. The Turkish version of the ABILOCO is a reliable and valid scale for evaluating mobility in stroke patients.

Correlations between plantar pressure and postural balance in healthy subjects and their comparison according to gender and limb dominance: A cross-sectional descriptive study.

BACKGROUND: Lower extremity injuries rank among the most common injuries affecting young population, and numerous factors affect the outcomes of plantar pressure and balance assessment. RESEARCH QUESTION: Does a correlation exist between plantar pressure and postural balance in healthy subjects and are there any difference in the results based on gender and limb dominance? METHODS: This study involved thirty healthy recreationally active young adults (15 females, 15 males). Plantar pressures were analyzed using the MatScan Pressure Mat System, and postural balance was evaluated using Biodex Balance System. All assessments conducted under both static and dynamic conditions. Correlations were tested by Spearman Correlation Coefficient, and comparative tests were performed for gender and limb dominance. RESULTS: Correlations were observed between plantar pressure parameters and balance scores, particularly in the dynamic conditions (p < 0.05). Gender-based differences were noted in plantar pressure parameters (p < 0.05), with females demonstrating improved balance stability scores. No significant differences were found based on limb dominance in plantar pressure and postural balance data (p > 0.05). SIGNIFICANCE: This study provides valuable detailed insights into the existing literature concerning plantar pressure and postural balance assessments within the healthy population. A strong correlation was observed between plantar pressure and postural balance, and the comparisons of these assessments were affected by gender but not by limb dominance. These results could lead the way for better rehabilitation approaches by considering the correlations and differences across diverse populations.

Early Spontaneous Movements and Sensory Processing in Preterm Infants.

IMPORTANCE: Preterm infants are at higher risk of motor development abnormalities and sensory processing difficulties. Few studies have examined both movement development and sensory processing in the early months of life, and the results are controversial. OBJECTIVE: In this cross-sectional study, we investigated (1) differences in early spontaneous movements and sensory processing between preterm infants born at <32 wk gestation and those born at 32 to 36 wk gestation when they reached corrected (postterm) age 3 to 5 mo and (2) the relationship between early spontaneous movements and sensory processing. PARTICIPANTS: We included 50 preterm infants born at <32 wk gestation and 61 preterm infants born at 32 to 36 wk gestation. OUTCOMES AND MEASURES: We assessed early spontaneous movements, including fidgety movements, using the General Movements Assessment (GMA), which provides the Motor Optimality Score (MOS), and sensory processing using the Infant Sensory Profile-2. RESULTS: The preterm infants born at <32 wk gestation had lower MOS results (p = .035) and more sensory processing difficulties (p = .006) than those born at 32 to 36 wk gestation. We found no significant relationship between early spontaneous movements and sensory processing (p > .05). CONCLUSIONS AND RELEVANCE: Preterm infants born at <32 wk gestation are at increased risk for motor development abnormalities and sensory processing difficulties. What This Article Adds: Assessment of both motor development and sensory processing can play a crucial role in identifying infants who need early intervention.

Early motor repertoire and developmental function outcomes in infants with West syndrome: a case series.

BACKGROUND: West syndrome (WS), also known as infantile spasm, is a rare form of severe epilepsy that begins during early infancy. This case series aimed to describe the early motor repertoire and examine the developmental function outcomes of infants with WS. CASE DESCRIPTIONS: Three infants (one female) with WS were assessed for early motor repertoire using the General Movement Assessment (GMA) which determined General Movement Optimality Scores (GMOS) at 4 post-term weeks of age, and Motor Optimality Scores (MOS) at 12 post-term weeks of age. Cognitive, language, and motor development were evaluated with the Bayley Scales of Infant and Toddler Development - Third Edition (Bayley-III) at 3, 6, 12, and 24 months of age. OUTCOMES: At 4-weeks post-term, one infant showed poor repertoire movements, while the other two showed cramped-synchronized movements with their GMOS ranging from 6 to 16 (out of 42). All infants showed sporadic/absent fidgety movements at 12 weeks post-term with their MOS ranging from 5 to 9 (out of 28). All sub-domain scores of Bayley-III were <2 SD at all follow-up assessments, that is <70, indicating severe developmental delay. CONCLUSION: These infants with WS had less than optimal scores of early motor repertoire, and developmental delay at a later age. Early motor repertoire might be an early sign for developmental function outcome at a later age in this population suggesting the need for additional research.

Sensory processing and sleep characteristics in preterm infants in the early period of life.

OBJECTIVE: The present study aimed to investigate the following: (i) differences in sensory processing and sleep characteristics between preterm infants born at < 32 weeks', vs. those born at ≥ 32 weeks' gestation; (ii) differences in sleep characteristics between preterm infants with typical vs. atypical sensory processing; and (iii) relationship between sensory processing and sleep characteristics in preterm infants at 3 months of age. METHODS: A total of 189 preterm infants, 54 born at < 32 weeks' gestation (26 females; mean gestational age [standard deviation (SD)], 30.1 [1.7] weeks), and 135 born at ≥ 32 weeks' gestation (78 females; mean gestational age [SD], 34.9 [0.9] weeks) were included in the present study. Sleep characteristics were evaluated using the Brief Infant Sleep Questionnaire, and sensory processing was assessed using the Infant Sensory Profile-2. RESULTS: There were no significant differences in sensory processing (P > 0.05) or sleep characteristics (P > 0.05) between the preterm groups; however, more infants snored in the <32 weeks' gestation group (P = 0.035). Preterm infants with atypical sensory processing showed lower nighttime (P = 0.027) and total sleep durations (P = 0.032), and higher rates of nocturnal wakefulness (P = 0.038) and snoring (P = 0.001) than preterm infants with typical sensory processing. A significant relationship, therefore, was observed between sensory processing and sleep characteristics (P < 0.05). CONCLUSIONS: Sensory processing patterns may play an important role in understanding sleep problems in preterm infants. The early detection of sleep problems and sensory processing difficulties are necessary for early intervention.

General movements in spinal muscular atrophy type 1.

PURPOSE: To investigate the motor repertoire of infants diagnosed with spinal muscular atrophy Type I (SMA Type I) without administration of any disease-modifying agent. METHODS: Motor Optimality Score-Revised (MOS-R) was calculated from videos recorded between post-term weeks 9-17 for 22 infants with SMA Type I. The MOS-R of infants with SMA Type I was compared with those of 22 infants with cerebral palsy (CP) and 22 infants with typical development. RESULTS: Of the infants with SMA Type I, 17 had absent fidgety movements (FMs) and 5 had sporadic FMs. Age adequate movement repertoire was absent, and the variety of movements in infants was very low. Movements were symmetrical but movements of four limbs remained on the surface level. Antigravity movements were very rare. Movement characterization was monotonous, slow speed, and small amplitude. The MOS-R of infants with SMA Type I was lower than those of infants with typical development but similar to those of infants with CP. CONCLUSIONS: Infants with SMA Type I had a motor repertoire similar to infants with CP, while they had a poorer motor repertoire than infants with typical development in the fidgety period as evidenced by MOS-R. Central nervous system involvement in these infants with SMA Type I with absent FMs and reduced MOS-R is unknown. Further studies are needed to determine the role of problems in the afferent and efferent pathways of spinal cord and muscle atrophy in the observation of normal FMs.

Assessment of spinal alignment in children with unilateral cerebral palsy.

BACKGROUND: Children/youths with unilateral cerebral palsy are at high risk for the development of scoliosis and other postural deformities. The purpose of this study was to perform spinal assessment in the frontal and sagittal plane using Spinal Mouse® in children/youths with unilateral cerebral palsy and to compare their spinal shape and angles with typically developing children/youths. METHODS: 25 children/youths with unilateral cerebral palsy and 25 typical children/youths, aged 6-18 years, were included. The subject's frontal (scoliosis) and sagittal plane (kyphosis and lordosis) spinal curvatures were compared by assessing them with Spinal Mouse®. FINDINGS: Scoliosis was detected in 40% of subjects in the unilateral cerebral palsy group and this rate was considerably higher than that in typical subjects (12%). The median angle of scoliosis was 8° in subjects with unilateral cerebral palsy and 5.3° in typical subjects. While the median angle of scoliosis was higher in subjects with unilateral cerebral palsy than typical subjects (p < 0.001), there was no significant difference in the angles of lordosis and kyphosis between both groups (p > 0.05). Curvature patterns of subjects with unilateral cerebral palsy differed from typical subjects. INTERPRETATION: Our findings will allow children/youths with unilateral cerebral palsy, who are at risk of developing spinal deformity, to be identified earliest possible and included in the intervention. Children/youths with unilateral cerebral palsy have to be assessed in detail from the earliest period, especially when the possibility of an age-related increase in scoliosis is considered.

The cross-cultural adaptation and factor analysis of the Turkish version of Iconographical Falls Efficacy Scale Long Version.

BACKGROUND: Iconographical Falls Efficacy Scale (Icon-FES) is the first visual scale for fear of falling. Unlike the others, Icon-FES, including 30 items offers a unique perspective to assess the fear of falling by providing more precise contexts. OBJECTIVES: The study aimed to introduce the 30-item Icon-FES, the first visual content fear of falling scale, into Turkish and to explore its psychometric properties. METHODS: First, the Turkish language validity of Icon-FES was ensured by following the forward-backward translation protocol. A total of 150 older adults independent in their daily living activities were included in the study. Falls Efficacy Scale International (FES-I) and Activities Specific Balance and Confidence Scale (ABC), which are frequently preferred in the literature for the same purpose, were used to provide the criterion validity of the scale. The exploratory factor analysis method was utilised for the construct validity of the scale. RESULTS: Factor analysis revealed a two-factor structure. 52.22% of the total variance was explained with single-factor analysis. In the criterion validity analysis, while there was a strong positive correlation between Icon-FES and FES-I (r = 0.910, p < 0.01), a strong negative correlation was found between Icon-FES and ABC (r = -0.887, p < 0.01). The Cronbach Alpha value for the internal consistency of the scale was calculated as 0.965. The intraclass correlation coefficient between two measurements performed one-week interval was found to be 0.985 (p < 0.001). CONCLUSION: The study showed that Icon-FES is a valid, reliable and rapid result assessment tool for community-dwelling older adults without cognitive dysfunction.

The early spontaneous movements, and developmental functioning and sensory processing outcomes in toddlers born preterm: A prospective study.

BACKGROUND: Preterm infants may present sensory processing difficulties as well as developmental disorders. However, studies investigating both early spontaneous movements, and later sensory processing and development functioning are limited. AIMS: To examine; (1) early spontaneous movements between the ages of 3 and 5 months, (2) the differences of sensory processing between the ages of 24 and 35 months in infants who had normal and aberrant fidgety movements between 3 and 5 months corrected age, and (3) the relationship between sensory processing and both early spontaneous movements and developmental functioning. STUDY DESIGN: A prospective observational study design. SUBJECTS: Eighty-eight preterm infants (median gestational age 32 weeks, range 23-36) were included. OUTCOME MEASURES: Early spontaneous movements, including fidgety movements, were assessed according to the General Movements Assessment (GMA), which determines the Motor Optimality Score (MOS). Developmental functioning was assessed using the Bayley Scales of Infant and Toddler Development, Third-Edition (Bayley-III) and sensory processing was assessed with Toddler Sensory Profile-2 between the ages of 24 and 35 months. RESULTS: Sixteen preterm infants (18.1%) displayed aberrant fidgety movements. Median MOS was 25. Infants who displayed aberrant fidgety movements had a lower Bayley-III score in cognitive, language, and motor domains (p = 0.001, p = 0.006, p < 0.001, respectively) and showed more atypical movement sensory processing (p = 0.016) and touch sensory processing (p = 0.018). Fidgety movements were related to typical/atypical movement processing (p = 0.004, r = 0.300). CONCLUSION: In addition to motor assessment, sensory processing assessment in preterm infants might play a crucial role due to sensory processing difficulties from the early-period of life.

Comparison of physical fitness, activity, and quality of life of the children with epilepsy and their healthy peers.

OBJECTIVE: To identify physical fitness and activity levels, and health-related quality of life of children with epilepsy in Turkey and compare the results with their healthy peers. METHODS: The study included 21 children with epilepsy (with no seizures and not taking anti-epileptic drugs for at least a year) and 20 healthy peers. The FitnessGram Physical Fitness Test Battery was used to assess physical fitness, the 6-Minute Walk Test to assess physical performance, the Pediatric Quality of Life Inventory 4.0 (PedsQL) to assess the quality of life, and a pedometer was used to assess the physical activity of the children. RESULTS: The physical fitness assessments including the trunk-lift test and flamingo balance test results were significantly lower in the children with epilepsy (p < 0.05). There was no significant difference between the groups in terms of BMI, the cadence-based curl-up test, the push-up test and the back saver sit/reach test (p > 0.05). Physical activity, physical performance, and quality of life results were significantly lower in children with epilepsy (p < 0.05). CONCLUSION: The presence of epilepsy may negatively affect many aspects of physical fitness, physical activity, and quality of life in childhood. The children with epilepsy adopted a more sedentary lifestyle than their healthy peers. Quality of life outcomes reveal that epilepsy has negative physical and psychosocial effects on children. These results support the necessity of raising awareness in both health professionals and families to encourage their children to be more active.

The Effects of Different Exteroceptive Experiences on the Early Motor Repertoire in Infants With Down Syndrome.

OBJECTIVE: Down syndrome is a chromosomal abnormality in which muscle tone, motor development, and sensory systems are affected. The objectives of this study were to examine the changes in movements and postures of 3- to 5-month-old infants with Down syndrome and infants who were neurotypical controls during exposure to a rough-textured surface and to compare the differences occurring before and during an exteroceptive condition that was different between the 2 groups. METHODS: In this quasi-experimental study, participants were 20 infants with Down syndrome (8 female infants; age range = 10-18 weeks, mean [SD] = 12 weeks 2 days [2 weeks 2 days]) and 20 age-matched infants with typical development (8 female infants; age range = 9-17 weeks, mean (SD) = 12 weeks 6 days [1 week 5 days]). The movements and postures of the infants, including fidgety movements, were assessed according to the General Movements Assessment, which determines the Motor Optimality Score (MOS), on 2 surfaces. RESULTS: The MOS outcomes of the infants with Down syndrome (median = 21.5, range = 6-28) were significantly lower than those of the infants who were neurotypical (median = 28, range = 23-28) on a standard mattress. The postures were found to be significantly better in infants with Down syndrome during exposure to a rough-textured surface. The MOS did not change due to the different exteroceptive experiences in infants with Down syndrome and infants who were neurotypical. CONCLUSION: The different exteroceptive experiences caused only postural alterations, which might play a crucial role in early intervention programs for infants with Down syndrome. IMPACT: This is the first study, to our knowledge, on the effects of different exteroceptive conditions, such as a coco coir mattress covered with muslin fabric, on the early motor repertoire in infants with Down syndrome. The findings showed that infants with Down syndrome had heterogeneity in their fidgety movements and large variability of the MOS, and the MOS results from infants with Down syndrome were lower than those of infants who were neurotypical. Fidgety movements and the MOS did not change due to the different exteroceptive experiences in either group. Significant improvements in posture were observed during exposure to a rough-textured surface. The improvement of posture is essential; clinicians might consider the positive effect of putting an infant with Down syndrome on a rough-textured surface and include this strategy in early intervention programs.

The general movements assessment and effects of an early intervention in an infant with Cri du chat syndrome: a case report.

BACKGROUND: Cri du chat syndrome (CdCS) is a rare orphan genetic disorder. Infants with CdCS have a neurodevelopmental dysfunction, but there are limited studies on their spontaneous movements or effect of the early interventions in children with CdCS. This study aimed to describe early spontaneous movements and investigate the effects of an early intervention in an infant with the CdCS. CASE: We analyzed the detailed general movements assessment (GMA) of an infant with CdCS at 14 weeks, and the Bayley Scales of Infant and Toddler Development-third edition (Bayley-III) were used for the determining and the follow-up of developmental functioning at 14 weeks, 6 months and 12 months. The infant was included in an early intervention beginning from 14 weeks. Fidgety movements were absent. The motor repertoire appeared significantly reduced, and the movement character was monotonous at 14 weeks. Although the infant achieved some developmental milestones with the early intervention program, the improvements were not reflected in the Bayley-III composite score. CONCLUSIONS: As a consequence, abnormal GMA results, including fidgety movements and concurrent movement patterns, seen in CdCS can be associated with early signs of neurodevelopmental dysfunction. Early intervention programs in infants with genetic disorders could help enable the early achievement of motor milestones.

Motor repertoire is age-inadequate in infants with cystic fibrosis.

BACKGROUND: General movements (GMs) in infants occur as fidgety movements (FMs) between postterm 9 and 20 weeks. We aimed to evaluate FMs and motor repertoire in infants with cystic fibrosis (CF) and their relation with clinical findings. METHODS: Demographic and clinical characteristics were recorded. FMs and motor repertoire were analyzed from a 5-min video recording of each infant. Videos were rated based on the Prechtl General Movement Assessment and motor optimality score (MOS) was calculated. RESULTS: The analysis included 18 infants with CF and 20 healthy infants at postterm age of 3-5 months. MOS was significantly lower in the infants with CF compared to controls (p < 0.05). Fifty percent of the infants with CF had abnormal or absent/sporadic FMs. MOS was negatively associated with hospitalization duration (r = -0.378, p = 0.036); and positively associated with vitamin A level in CF infants (r = 0.665, p = 0.026). CONCLUSIONS: Infants with genetically anticipated severe CF phenotype tended to have lower MOS. MOS may be used in addition to genetic testing to predict disease severity in infants with CF. Infants with CF, absent/sporadic FMs, and lower MOS could be considered for planning specific age-adequate early intervention programs. IMPACT: Motor repertoire was age-inadequate in infants with cystic fibrosis (CF). 50% of infants with CF had abnormal or absent/sporadic fidgety movements (FMs). Motor optimality score (MOS) was positively associated with vitamin A level and negatively correlated with hospitalization duration in infants with CF. MOS tended to decrease as genetically anticipated disease severity increased; thus, MOS might enable us to predict disease severity in CF. The relationship between motor repertoire and phenotype and genotype is unclear and warrants further study. CF infants with absent/sporadic FMs, and lower MOS could be considered for planning early intervention.

General Movements and Developmental Functioning in an Individual with Rhizomelic Chondrodysplasia Punctata within the First Months of the Life: A Case Report.

AIMS: Rhizomelic chondrodysplasia punctata (RCDP) is an autosomal recessive inherited disorder. Individuals with RCDP have a wide range of neurodevelopmental outcomes, but there are limited descriptions of their early motor development before 5 months of age. This study aimed to describe in detail the age-specific spontaneous movements and examine the developmental functioning in an individual with RCDP. METHODS: A female infant (born at 39 weeks' gestation), diagnosed with RCDP at 3 weeks of age, was assessed at 4 and 16 weeks for general movements (GMs) and concurrent motor repertoire; the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) was also applied at the same ages. RESULTS: At 4 weeks, the infant showed poor repertoire GMs, with a detailed General Movement Optimality Score of 16/42. At 16 weeks, age-specific fidgety movements were absent, and the movement character was monotonous and stiff; the detailed Motor Optimality Score was severely reduced (7/28). All Bayley-III scores were <2 SD, that is <70 indicating severe developmental delay. CONCLUSION: Functional assessments such as the GM assessment and age-specific detailed assessment could be complementary to neuroimaging assessments to predict the neurodevelopmental outcomes in infants with RCDP.

Are general movements at 3-5 months correlated and compatible with the Bayley-III at 1,5-2 years age?

Since early intervention is important in risky infants, it is also important to identify developmental problem as early as possible. There are various assessment methods for this. One of them is the General movements assessment (GMs), and the other one is the Bayley Scales of Infants and Toddler Developmental, third edition (Bayley-III). The present study aimed to compare the neurodevelopmental outcomes and Bayley-III scores at the age of 1.5-2 years with fidgety GMs. One hundred and twenty-six infants (57 females, 69 males) were assessed by the GMs at the corrected 3-5 months and also by the Bayley-III at the age of 1.5-2 years. According to the GMs, 21 infants exhibited the absence of fidgety movements, six infants exhibited abnormal fidgety movements, and 99 infants exhibited normal fidgety movements. According to the Bayley-III, 19 infants` motor scores, 13 infants` language scores, and 18 infants` cognitive scores were low (-2SD). Various neurodevelopmental problems were identified in 25.4% of the infants. As a result, although in the present study the Bayley-III underestimates the rates of motor impairment, it was found to be moderately compatible with the GMs at 3-5 months (r= 0.4, p < 0.001). However, the GMs were better than the Bayley-III in predicting neurodevelopmental outcomes at the age of 1.5-2. Although the Bayley-III and GMs may be valuable tools for estimating the later outcomes of infants, care should be taken while interpreting their results.

Assessment of Motor Repertoire in 3- to 5-Month-Old Infants With Obstetric Brachial Plexus Lesion.

PURPOSE: The aim of this study was to define the movement characteristics and postures of infants with obstetric brachial plexus lesion. METHODS: The study group included 20 infants with obstetric brachial plexus lesion and a control group of 20 infants with normal neurological outcome, aged 9 to 17 weeks postterm. Infants were evaluated by global and detailed general movements assessment. RESULTS: There were no significant differences between the motor optimality scores of the 2 groups. However, there were some differences in terms of concurrent movements and the posture. Infants with obstetric brachial plexus lesion demonstrated more excitement bursts, head rotation, hand-knee contact, rolling, and few finger posture and postural asymmetry, and performed jerky movements when compared with the control group. CONCLUSIONS: Obstetric brachial plexus lesion did not affect the quality of fidgety movements of the infants but leads to compensatory movements in concurrent movements on the unaffected sides.

Deviations of body functions and structure, activity limitations, and participation restrictions of the International Classification of Functioning, Disability, and Health model in children with cystic fibrosis and non-cystic fibrosis bronchiectasis.

BACKGROUND: To the best of our knowledge, there is no study in the literature investigating the extrapulmonary outcomes of children with non-cystic fibrosis (CF) bronchiectasis and CF under the framework of the International Classification of Functioning, Disability, and Health (ICF) model. The purpose of the present study is to evaluate the children with CF and non-CF bronchiectasis using the ICF model. MATERIALS AND METHODS: Children with CF, non-CF bronchiectasis, and healthy counterparts were evaluated (20 participants in each group) according to the ICF items in domain b (body functions), domain s (body structures), and domain d (activities and participation). The pulmonary functions, respiratory and peripheral muscle strength tests, and posture analysis were carried out for domain b. For domain d, however, the Glittre-activities of daily living test and Pediatric Outcome Data Collection were used. RESULTS: Muscle strength of shoulder abductors and hip extensors in children with CF was significantly lower than healthy children and adolescents (P < .05). The severity of lateral and posterior postural abnormalities in children with CF and non-CF bronchiectasis was higher than those of healthy children (P < .05). Among the patient groups, global function, sports/physical function, expectations, transfers/basic mobility, and pain/comfort were the most affected participation dimensions (P < .05). CONCLUSIONS: This study highlights the need for comprehensive up-to-date evaluation methods according to the ICF model for understanding rehabilitation requirements in CF and non-CF bronchiectasis in different age groups.

Examination of touch-coordinate errors of adolescents with unilateral spastic cerebral palsy at an aiming-tapping task.

BACKGROUND/OBJECTIVE: This study aimed to investigate performance (touch-coordinate errors, inter-touch interval) of touch screen technology in adolescents with unilateral spastic cerebral palsy (USCP) and healthy peers. MATERIALS AND METHODS: This prospective case-control study included 31 adolescents. The participants consisted of 15 adolescents with CP in the USCP group and 16 age-matched healthy peers in the control group. All participants performed an aiming-tapping task with an Android tablet. Four sessions were randomly applied: visual feedback (VF) and no VF with the dominant hand's index finger (DHF), and VF and no VF with the non-dominant hand's index finger (NDHF). Inter-touch interval (ITI) and touch-coordinate errors (TCE) were calculated. RESULTS: There were significant differences between the groups for VF and no VF-NDHF TCE and ITI (respectively p= 0.001, p= 0.01, p= 0.001, p= 0.004) and VF and no VF-DHF TCE values (respectively p= 0.01, p= 0.008). When comparing the dominant and non-dominant hand in the USCP group, there was a significant difference on TCE with no VF (p= 0.01). CONCLUSION: This study provided insight into the touch screen performance of adolescents with USCP, who performed an aiming-tapping task with a tablet. Results showed that both affected and unaffected hand performance of touch screen tasks was impaired in adolescents with USCP.

Combined Effects of Mirror Therapy and Exercises on the Upper Extremities in Children with Unilateral Cerebral Palsy: A Randomized Controlled Trial.

Purpose: This study investigated the combined effects of mirror therapy involving power and strength exercises of the upper extremities in children with Unilateral Spastic Cerebral Palsy (USCP).Methods: Thirty children were included in either an experimental group or a control group. All participants were evaluated with the Quality of Upper Extremity Skill Test (QUEST), Canadian Occupational Performance Measure (COPM), and a handheld dynamometer to measure isometric muscle strength.Results: Compared to the control group, greater improvement was found in dissociated movements (p < .001, d = 1.82), grasp (p < .001, d = 1.38), weight bearing (p = .006, d = 0.91), and total scores (p = .001, d = 1.16) of QUEST; performance (p < .001, d = 2.9), satisfaction (p < .001, d = 1.91), and total scores (p < .001, d = 2.87) of COPM; and isometric muscle strength of the biceps brachii (p < .001, d = 1.27) and triceps brachii (p = .002, d = 2.22) of the affected upper limbs in the experimental group.Conclusions: Mirror therapy combined with power and strength exercises is a promising intervention approach to improve activity performance and upper-limb function in children with USCP.

The Effects of Functional Progressive Strength and Power Training in Children With Unilateral Cerebral Palsy.

PURPOSE: The purpose of this study was to investigate the effects of a novel functional strength and power-training program on gait and gross motor function in participants with unilateral cerebral palsy. METHODS: This 12-week trial of functional strength and power training included 30 participants with cerebral palsy, randomly assigned to the experimental or comparison group. The primary outcomes, 1-minute walk test, muscle power, and the Gross Motor Function Measure, were assessed at baseline and 12 weeks after the intervention. Secondary outcomes included dynamic balance as measured by Timed Up and Go, muscle strength, and 1-repetition maximum measures. RESULTS: Significantly greater improvements were seen in the experimental group for muscle power, Gross Motor Function Measure E score, and 1-minute walk test (P < .05), as well as for dynamic balance, 1-repetition maximum, and muscle strength. CONCLUSION: Functional strength training combined with plyometric exercises improved gait and gross motor function, dynamic balance, muscle strength, and power. VIDEO ABSTRACT: For more insights from the authors, access Supplemental Digital Content 1, available at: http://links.lww.com/PPT/A254.