Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 129
Filtrar
1.
J Neuroeng Rehabil ; 18(1): 165, 2021 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-34823545

RESUMO

BACKGROUND: Home-based rehabilitation of arm function is a significant gap in service provision for adult stroke. The EDNA-22 tablet is a portable virtual rehabilitation-based system that provides a viable option for home-based rehabilitation using a suite of tailored movement tasks, and performance monitoring via cloud computing data storage. The study reported here aimed to compare use of the EDNA system with an active control (Graded Repetitive Arm Supplementary Program-GRASP training) group using a parallel RCT design. METHODS: Of 19 originally randomized, 17 acute-care patients with upper-extremity dysfunction following unilateral stroke completed training in either the treatment (n = 10) or active control groups (n = 7), each receiving 8-weeks of in-home training involving 30-min sessions scheduled 3-4 times weekly. Performance was assessed across motor, cognitive and functional behaviour in the home. Primary motor measures, collected by a blinded assessor, were the Box and Blocks Task (BBT) and 9-Hole Pegboard Test (9HPT), and for cognition the Montreal Cognitive Assessment (MoCA). Functional behaviour was assessed using the Stroke Impact Scale (SIS) and Neurobehavioural Functioning Inventory (NFI). RESULTS: One participant from each group withdrew for personal reasons. No adverse events were reported. Results showed a significant and large improvement in performance on the BBT for the more-affected hand in the EDNA training group, only (g = 0.90). There was a mild-to-moderate effect of training on the 9HPT for EDNA (g = 0.55) and control (g = 0.42) groups, again for the more affected hand. In relation to cognition, performance on the MoCA improved for the EDNA group (g = 0.70). Finally, the EDNA group showed moderate (but non-significant) improvement in functional behaviour on the SIS (g = 0.57) and NFI (g = 0.49). CONCLUSION: A short course of home-based training using the EDNA-22 system can yield significant gains in motor and cognitive performance, over and above an active control training that also targets upper-limb function. Intriguingly, these changes in performance were corroborated only tentatively in the reports of caregivers. We suggest that future research consider how the implementation of home-based rehabilitation technology can be optimized. We contend that self-administered digitally-enhanced training needs to become part of the health literacy of all stakeholders who are impacted by stroke and other acquired brain injuries. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR) Number: ACTRN12619001557123. Registered 12 November 2019, http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378298&isReview=true.

2.
Artigo em Inglês | MEDLINE | ID: mdl-34528720

RESUMO

BACKGROUND: Receiving a diagnosis can have a major impact on the child and its family. Parental satisfaction concerning the diagnostic trajectory is important with regard to acceptance and coping with their child's problems. Our aim was to describe the diagnostic trajectory of developmental coordination disorder (DCD) in the Netherlands and identify factors that are related to parents' satisfaction. METHOD: Mothers of 60 children with a DCD diagnosis completed an online survey concerning their experiences during and after the diagnostic trajectory of obtaining this diagnosis. RESULTS: Forty percent of the mothers rated the diagnostic trajectory towards a DCD diagnosis as stressful and 47% rated the knowledgeability of the first professional they consulted (mostly a general practitioner, paediatric physical therapist, or youth health care physician) as having no or just superficial knowledge about DCD. Around 60% of the mothers described a lack of knowledge and support at their child's school after receiving the diagnosis. Notwithstanding this, the majority of the participating mothers was (very) satisfied with the diagnostic trajectory. Higher appreciation of both the manner of the diagnosing professional and the post-diagnostic support provided were predictive of higher satisfaction. CONCLUSIONS: Our results underline the importance of improving the knowledgeability in primary schools and primary health care professionals with regard to DCD.

3.
J Sports Sci ; : 1-19, 2021 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-34219609

RESUMO

The aim of this study was to assess the current state of evidence and methodological quality of studies on implicit and explicit motor learning in both typically developing children and children with developmental disorders. A systematic literature review was conducted on the experimental literature published up to April 2020. A total of 25 studies were included. Studies were evaluated on methodological quality, paradigm used, and level of evidence. The results showed that implicit paradigms are as effective as explicit paradigms in both groups of children. Studies are predominantly experimental in nature involving mostly upper limb aiming tasks. The few studies that were performed outside the lab (n = 5) suggest superior efficacy of the implicit paradigm. Methodological quality varied between studies and was not always of sufficient standard to allow conclusions. In particular, manipulation checks were only performed in 13 studies (52% of all studies), limiting conclusions. Further progress can be made by focussing on improving methodological quality through retention testing by the inclusion of a control group, by the inclusion of a manipulation check, and via assessment of relevant co-variables, such as working memory, age, and motor competence.

4.
Hum Mov Sci ; 79: 102836, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34252757

RESUMO

The second-order motor planning ability of children with developmental coordination disorder (DCD) has often been studied using tasks that require judgements of end-state comfort (ESC). In these studies, children may have chosen to prioritize other aspects of performance (e.g., a comfortable start-posture) over ESC while still being able to complete the goal of the task. This is a limitation that is inherent to previously used ESC paradigms. To avoid this in the present study, 52 children with and without DCD (aged 5-12 years) completed a task that requires second-order motor planning for its successful completion. In the hexagonal knob task, children were instructed to grasp and rotate a hexagonal knob. The rotation angle varied in size: 60°, 120°, 180°, and 240° rotations. Both the 180° and 240° rotation conditions required an uncomfortable starting posture for successful task completion. Results showed that children with DCD were less likely to adjust their initial grip in anticipation of the required rotation angle, resulting in more task failures compared with typically developing (TD) children. Based on this finding we conclude that children with DCD experience genuine second-order motor planning difficulties. Analysis of temporal outcomes, showed that initial reaction time increased with rotation angle, but this was less pronounced for children with DCD than for TD children. There were no between group differences in timing of subsequent events. These results suggest that the difficulties of children with DCD are related to the initial planning process, that is, before the start of the movement.


Assuntos
Transtornos das Habilidades Motoras , Criança , Força da Mão , Humanos , Destreza Motora , Movimento , Tempo de Reação
5.
Front Psychol ; 12: 625577, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33584483

RESUMO

The end-state comfort (ESC) effect refers to the consistent tendency of healthy adults to end their movements in a comfortable end posture. In children with and without developmental coordination disorder (DCD), the results of studies focusing on ESC planning have been inconclusive, which is likely to be due to differences in task constraints. The present pilot study focused on the question whether children with and without DCD were able to change their planning strategy and were more likely to plan for ESC when demanded by complex object manipulations at the end of a task. To this end, we examined ESC planning in 18 children with and without DCD (aged 5-11years) using the previously used sword-task and the newly developed hammer-task. In the sword-task, children had to insert a sword in a wooden block, which could be relatively easily completed with an uncomfortable end-posture. In the hammer-task, children had to strike down a nail in a wooden pounding bench, which required additional force and speed demands, making it relatively difficult to complete the movement with an uncomfortable end-posture. In line with our hypothesis, the results demonstrated that children with and without DCD were more likely to plan for ESC on the hammer-task compared with the sword-task. Thus, while children with and without DCD show inconsistent ESC planning on many previously used tasks, the present pilot study shows that many of them are able to take into account the end-state of their movements if demanded by task constraints.

6.
Ann Phys Rehabil Med ; 64(2): 101390, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32445975

RESUMO

BACKGROUND: Wii-based interventions have shown significant benefits in motor learning for children with developmental coordination disorder (DCD); however, studies comparing the effects of Wii interventions versus matched non-Wii interventions, such as task-specific training (TST), are scarce. OBJECTIVE: We compared motor learning in children with DCD who participated in 12 sessions of Wii-based training and those participating in 12 closely matched non-Wii TST sessions as well as when the highest improvements in performance occurred. METHODS: In total, 32 children with DCD (16 per group) were randomly allocated to receive the Wii intervention or TST during 12 sessions. Motor learning was assessed in 3 consecutive phases during the intervention and was determined by the mean of the games scores obtained in the: (1) first 4 sessions, (2) intermediate 4 sessions, and (3) last 4 sessions. Six different tasks (table tennis, frisbee, archery, bowling, tightrope walking/balance beam, and marble balance/balance disc) were performed in every session. Each session lasted 42min (time on task). RESULTS: Wii training and TST elicited improvements in motor learning, as assessed by increased scores with the frisbee and marble balance/balance disc tasks. However, Wii training elicited better performance in the archery and bowling tasks, whereas only TST elicited improvements in the balance beam and table tennis tasks. CONCLUSION: Wii training is not always superior to non-Wii training, and improvements are based on the type of task trained. Thus, each type of intervention benefits a certain skill.

7.
Clin Neurophysiol ; 131(12): 2829-2840, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33152523

RESUMO

OBJECTIVE: During motor execution (ME), mu power is diminished over the contralateral hemisphere and increased over the ipsilateral hemisphere, which has been associated with cortical activation of the contralateral motor areas and inhibition of the ipsilateral motor areas respectively. The influence of action observation (AO) and motor imagery (MI) on mu power is less clear, especially in children, and remains to be studied in children with unilateral cerebral palsy (uCP). METHODS: We determined mu power during ME, AO, and MI of 45 typically developing (TD) children and 15 children with uCP over both hemispheres, for each hand. RESULTS: In TD children, over the left hemisphere mu power was lowered during ME when the right hand was used. In line, over the right hemisphere mu power was lowered when the left hand was addressed. In addition, during AO and MI increased mu power was observed when the right hand was addressed. In children with uCP, over the spared hemisphere mu power was diminished during ME when the less-affected hand was used. However, over the lesioned hemisphere, no mu changes were observed. CONCLUSIONS: The results of TD children fit the activation/inhibition model of mu power. SIGNIFICANCE: The results of children with uCP suggest that the lesioned hemisphere is unresponsive to the motor tasks.


Assuntos
Paralisia Cerebral/fisiopatologia , Desenvolvimento Infantil/fisiologia , Eletroencefalografia/métodos , Imaginação/fisiologia , Movimento/fisiologia , Desempenho Psicomotor/fisiologia , Adolescente , Ondas Encefálicas/fisiologia , Paralisia Cerebral/psicologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Estimulação Luminosa/métodos
8.
Dev Med Child Neurol ; 62(11): 1317-1323, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32770756

RESUMO

AIM: To analyse the development of motor skill and executive function in school-aged children with and without developmental coordination disorder (DCD). METHOD: Using a longitudinal design, 186 children (86 males, 100 females) aged 6 to 11 years at Time 1 were tested over a 2-year period, 52 of whom were diagnosed with DCD at Time 1 (27 males, 25 females; mean age 8y 5mo, SD 1y 6mo) using DSM-5 criteria. The McCarron Assessment of Neuromuscular Development assessed motor status at Time 1 and at 2-year follow-up (Time 2). Executive function was assessed using a well-validated measure, the Groton Maze Learning Test. RESULTS: The DCD cohort at Time 1 had moderate incidence of executive function deficit (41%). Most importantly, at a group level, children with persisting DCD (across Times 1 and 2) also showed significantly lower levels of executive function than children with typical motor development at both time points. At an individual level, around 26% of children in this group had persisting executive function deficits relative to normal ranges of performance. INTERPRETATION: Children with persisting DCD are at significant risk of executive function issues. The combination of motor and cognitive issues as a potential risk factor in the longer-term development of children is discussed. WHAT THIS PAPER ADDS: Around half of children initially diagnosed with developmental coordination disorder (DCD) had the same diagnosis at 2-year follow-up. 41% of children with DCD have impaired executive function. Children with persisting DCD show poorer executive function than those with typical motor development or remitting DCD.


Assuntos
Desenvolvimento Infantil/fisiologia , Disfunção Cognitiva/fisiopatologia , Progressão da Doença , Função Executiva/fisiologia , Transtornos das Habilidades Motoras/fisiopatologia , Destreza Motora/fisiologia , Criança , Disfunção Cognitiva/etiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Aprendizagem em Labirinto/fisiologia , Transtornos das Habilidades Motoras/complicações
9.
J Exp Child Psychol ; 199: 104945, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32750601

RESUMO

Second-order motor planning of grasping movements is usually measured using tasks that focus on the relative (dis)comfort of end posture of the arm and hand regardless of the objective outcome of performance. This may underestimate the ability for forward planning in young children. In the current study, we aimed to examine the developmental mechanisms of motor planning in children using a task that necessitates second-order motor planning for its successful completion. We tested 311 children (aged 5-12 years) who were instructed to grasp and rotate a hexagonal knob over 60°, 120°, 180°, or 240°. The 180° and 240° rotation conditions necessitated adjustment of the preferred start grip for successful task completion. We examined successful or unsuccessful task completion, reaction time (RT), and movement time (MT) as a function of task demands (i.e., rotation angle) and age. Results showed that most children of all ages were able to successfully complete the task in the 180° rotation condition. In the most demanding 240° rotation condition, many children had difficulty in completing the task, but successful task completion increased with age. Time course analysis showed increased RT and MT with increasing task demands. Furthermore, whereas RT decreased with age for each rotation angle, MT remained stable with the exception of an increase in MT for the most demanding rotation condition. Together, these results exemplify that children aged 5-12 years are indeed able to engage in forward planning. With development, second-order motor planning proficiency increases, especially for more demanding movements, and the process becomes more efficient.


Assuntos
Desenvolvimento Infantil/fisiologia , Força da Mão/fisiologia , Desempenho Psicomotor/fisiologia , Tempo de Reação/fisiologia , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Postura , Rotação , Tempo
10.
Dev Med Child Neurol ; 62(12): 1352-1355, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32735038

RESUMO

In 2019, international clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder (DCD) were published. Informing our understanding of mechanisms, recent systematic reviews have shown that children with DCD have difficulties with the predictive control of movements, including aspects of motor planning, which is expressed as the internal modeling deficit hypothesis. This motor control deficit is most evident when the spatial and temporal demands of a task increase. An increasing number of empirical studies suggest that motor planning problems can be remediated through training based on one or a combination of motor imagery and action observation. In this review, we show evidence of motor planning problems in children with DCD and show that task demands or complexity affects its appearance. Implications of these findings are treatments based on motor imagery and action observation to remediate motor planning issues. The article concludes with recommendations for future research.


Assuntos
Imaginação/fisiologia , Atividade Motora/fisiologia , Transtornos das Habilidades Motoras/fisiopatologia , Transtornos das Habilidades Motoras/reabilitação , Reabilitação Neurológica/métodos , Desempenho Psicomotor/fisiologia , Percepção Visual/fisiologia , Humanos
11.
Res Dev Disabil ; 105: 103714, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32623248

RESUMO

BACKGROUND: Although many studies report children with vision impairments (VIs) experience play difficulties compared to sighted peers, large variation is present within the population of children with VIs. AIMS: The present study investigated peer play variation in 70 elementary school-aged children with VIs (M age = 8;11 years, SD = 2.25) and associations with specific child characteristics in sub-groups of participants. Also, it was examined how play materials with supportive auditory cues affected social play in children with varying cooperative play skills. METHODS AND PROCEDURES: Play behavior was coded while participants used play materials with and without auditory cues and parents filled in questionnaires about child characteristics. Data were analyzed using binomial logistic regression analyses. OUTCOMES AND RESULTS: Although the profoundness of the VI was not associated to cooperative or symbolic play, age, language ability and gender did predict the demonstration of these play behaviors. Furthermore, auditory cues were particularly facilitative of social play in children with VIs with low cooperative play capabilities. CONCLUSIONS AND IMPLICATIONS: In sum, this emphasizes that child characteristics other than the VI can play a significant role during peer play and interaction, and that individual variation should be considered when providing peer play support.


Assuntos
Grupo Associado , Comportamento Social , Criança , Humanos , Pais , Instituições Acadêmicas , Transtornos da Visão
12.
Hum Mov Sci ; 69: 102556, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31989949

RESUMO

This study investigated the role of working memory capacity on implicit and explicit motor sequence learning in young children. To this end, a task was utilized that required a gross motor response (flexing the elbow) and that could differentiate between movement speed (i.e., reaction time and movement time) and movement accuracy. Children aged 7-9 years practiced a serial reaction time task that involved the production of a fixed sequence of elbow flexions of prescribed magnitude across two consecutive days. Children in the explicit group were informed about the presence of the sequence and were shown this sequence, while children in the implicit group were not made aware of the sequence. Additionally, children's verbal and visuospatial working memory capacity was assessed. Results of day 1 regarding movement speed revealed no evidence of sequence learning for either group, but movement accuracy results suggested that sequence learning occurred for the implicit group. For both groups, only improvements in movement accuracy were consolidated on day 2, indicating both general and sequence specific learning. Working memory capacity did not correlate with learning in either of the groups. Children in the explicit group accumulated more sequence knowledge compared to children in the implicit group, but this knowledge did not translate to more or better sequence learning. The minimal differences found between the implicit and explicit condition and the absence of a role for working memory capacity add to the increasing evidence that the observed differences between implicit and explicit sequence learning in adults may be less distinct in children.


Assuntos
Aprendizagem/fisiologia , Memória de Curto Prazo/fisiologia , Movimento , Análise de Variância , Criança , Humanos , Conhecimento , Destreza Motora , Tempo de Reação , Interface Usuário-Computador
13.
Disabil Rehabil ; 42(18): 2611-2620, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-30794762

RESUMO

Purpose: To evaluate in children with developmental coordination disorder (DCD) the effects of Wii-training compared with task-specific matched training (TST).Material and methods: A randomized controlled trial (RCT) was conducted with 32 children having DCD, aged 7-10 years. Children were randomly assigned to the Wii or task-specific training. Both interventions consisted of 16, 60-min sessions over an 8-week period. The primary outcome measure of movement skill was the Movement Assessment Battery for Children-2 (MABC-2), administered by blinded assessors. Measures included total standard scores (TSS), manual dexterity, aiming/catching, and balance component scores.Results: From pre- to post-test, both groups improved significantly on TSS and balance after intervention. The Wii intervention group also improved on manual dexterity. Neither group improved significantly on aiming/catching.Conclusions: Both the Wii and task-specific training improved overall motor performance and balance. On other MABC-2 component scores, treatment effects differed between groups: Task-specific training had more pronounced effects on balance skills, while Wii training had slightly stronger treatment effects than task-specific training on manual dexterity. It was concluded that task-specific training affords stronger benefits for general motor skill than Wii-based training. Whether Wii training can promote clinically significant benefits for upper-limb function remains to be seen.Trial Registration: This study is registered in a clinical trials registry platform (Protocol: RBR-89YDGJ). Available on the Brazilian Clinical Trials Registry Implications for rehabilitationWii-training and task-specific matched training programs afforded gains in motor performance in children with developmental coordination disorder, similarly;The selected Wii tasks were able to improve the motor performance in children with developmental coordination disorder, but should not be used as an exclusive strategy for these children;Our findings suggest caution in recommending Wii-based training as a viable alternative to more task-specific matched training for children with developmental coordination disorder.


Assuntos
Transtornos das Habilidades Motoras , Jogos de Vídeo , Brasil , Criança , Humanos , Destreza Motora , Equilíbrio Postural
14.
Child Neuropsychol ; 26(4): 534-559, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31766934

RESUMO

This is the first review to provide both a systematic and meta-analytic approach to characterizing motor planning deficits in children with Developmental Coordination Disorder (DCD). Task complexity appears to be a key factor affecting motor planning in children with DCD. However, the different task-related factors and how they affect motor planning ability has not been examined. By systematically reviewing ten studies examining motor planning in children aged 4- to 14 years with and without DCD using grip selection tasks, task complexity was determined according to grip choices, level of precision, number of action steps and degree of rotation. A meta-analysis (N = 607; DCD = 255) revealed that, overall, those with DCD were 6.8% less likely to plan motor actions comfortably than typically developing children. This ability was moderated by task complexity (I2 = 66.7%), with performance differences ranging from 2.33% for low (g = 0.21) to 13.77% (g = 0.79) for high complexity. The results confirmed that children with DCD are able to plan for comfortable end states for tasks with simple and medium complexity level. When task complexity increased, compared to typically developing children, the motor planning ability of those with DCD was affected to a significantly greater extent. These findings provide important implications for both behavioral and neurological interventions.


Assuntos
Força da Mão/fisiologia , Transtornos das Habilidades Motoras/fisiopatologia , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos Transversais , Coleta de Dados , Feminino , Humanos , Estudos Longitudinais , Masculino
15.
Disabil Rehabil ; : 1-10, 2019 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-31814455

RESUMO

Background: In children with Brachial Plexus Birth Injury, a non-use of the affected upper limb despite sufficient capacity, is sometimes observed, called developmental disregard. The combination of modified constraint-induced-movement-therapy with bimanual training is frequently applied to overcome developmental disregard in unilateral Cerebral Palsy. In the current study the effects of the combination of modified constraint-induced-movement-therapy with bimanual training are investigated in children with Brachial Plexus Birth Injury in comparison to children with unilateral Cerebral Palsy. We hypothesize that the combination of modified constraint-induced-movement-therapy with bimanual training is effective in Brachial Plexus Birth Injury.Methods: Data of 19 children with Brachial Plexus Birth Injury (Mage: 4.1 years) and 18 with unilateral Cerebral Palsy (Mage: 4.5 years) were compared. The effects of modified constraint-induced-movement-therapy with bimanual training (54 h modified constraint-induced-movement-therapy, 18 h bimanual training, 8-10 weeks) was investigated by assessing spontaneous affected-upper-limb-use ("Assisting Hand Assessment"), manual abilities ("ABILHAND-kids") and subjective performance and satisfaction of problematic bimanual activities ("Canadian Occupational Performance Measure") at three time points (pre-treatment, post-treatment, follow-up). This data was analyzed using repeated-measures analysis.Results: Children with Brachial Plexus Birth Injury showed significant improvements on all outcome measures following modified constraint-induced-movement-therapy with bimanual training. These results were comparable to those observed in the group of children with unilateral Cerebral Palsy.Discussion: These results suggest that modified constraint-induced-movement-therapy with bimanual training is effective in Brachial Plexus Birth Injury. They indicate a comparable improved bimanual performance in children with Brachial Plexus Birth Injury than in unilateral Cerebral Palsy and suggests that both groups of children have affectively overcome their developmental disregard.IMPLICATIONS FOR REHABILITATIONChildren with Brachial Plexus Birth Injury frequently experience difficulties in activities of daily living.It has recently been suggested that children with Brachial Plexus Birth Injury may also show a non-use of the affected upper limb despite sufficient capacity, called developmental disregard.Children with Brachial Plexus Birth Injury and developmental disregard might therefore benefit from intensive therapies aimed at overcoming developmental disregard, originally developed for children with unilateral Cerebral Palsy.A combination of modified Constrained-Induced Movement Therapy with intensive Bimanual Training has shown to be affective in children with unilateral Cerebral Palsy.In a small sample, this study shows that a combination of modified Constrained-Induced Movement Therapy with intensive bimanual training is effective in children with Brachial Plexus Birth Injury, comparable and even more than in unilateral Cerebral Palsy.

16.
Front Hum Neurosci ; 13: 232, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31354451

RESUMO

Children with Developmental Coordination Disorder (DCD) have difficulty performing and learning motor skills. Automatic activation of the mirror neuron system (MNS) during action observation and its coupling to the motor output system are important neurophysiological processes that underpin observational motor learning. In the present study, we tested the hypothesis that MNS function is disrupted in children with DCD by using sensitive electroencephalography (EEG)-based measures of MNS activation during action observation. Specifically, we predicted reduced mu-suppression and coherence in DCD compared with typically developing children. Neural activation of the motor network was measured by EEG, specifically event-related desynchronization (ERD) of mu rhythms and fronto-parietal coherence. Children (15 DCD/15 controls) were tested under two task conditions: observational learning (imitation of an observed action) and detection (report a deviant movement after observation). EEG-metrics were compared between groups using linear mixed-effects models. As predicted, children with DCD showed lower levels of mu suppression and reduced modulation of coherence during the observational learning task compared with their non-DCD peers. Notably, mu suppression was reduced in DCD over the entire imitation task (repetitions, and both observation and pause intervals). Action observation can be used for the acquisition of new motor skills. This form of learning entails the transposition of the observed action to the existing internal representations of the observer's own motor system. The present neurophysiological results suggest that this process of learning is impaired in children with DCD. The results are discussed in relation to current hypotheses on mechanisms of DCD.

17.
J Neuroeng Rehabil ; 16(1): 56, 2019 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-31092252

RESUMO

BACKGROUND: Virtual reality technologies show potential as effective rehabilitation tools following neuro-trauma. In particular, the Elements system, involving customized surface computing and tangible interfaces, produces strong treatment effects for upper-limb and cognitive function following traumatic brain injury. The present study evaluated the efficacy of Elements as a virtual rehabilitation approach for stroke survivors. METHODS: Twenty-one adults (42-94 years old) with sub-acute stroke were randomized to four weeks of Elements virtual rehabilitation (three weekly 30-40 min sessions) combined with treatment as usual (conventional occupational and physiotherapy) or to treatment as usual alone. Upper-limb skill (Box and Blocks Test), cognition (Montreal Cognitive Assessment and selected CogState subtests), and everyday participation (Neurobehavioral Functioning Inventory) were examined before and after inpatient training, and one-month later. RESULTS: Effect sizes for the experimental group (d = 1.05-2.51) were larger compared with controls (d = 0.11-0.86), with Elements training showing statistically greater improvements in motor function of the most affected hand (p = 0.008), and general intellectual status and executive function (p ≤ 0.001). Proportional recovery was two- to three-fold greater than control participants, with superior transfer to everyday motor, cognitive, and communication behaviors. All gains were maintained at follow-up. CONCLUSION: A course of Elements virtual rehabilitation using goal-directed and exploratory upper-limb movement tasks facilitates both motor and cognitive recovery after stroke. The magnitude of training effects, maintenance of gains at follow-up, and generalization to daily activities provide compelling preliminary evidence of the power of virtual rehabilitation when applied in a targeted and principled manner. TRIAL REGISTRATION: this pilot study was not registered.


Assuntos
Recuperação de Função Fisiológica , Reabilitação do Acidente Vascular Cerebral/métodos , Realidade Virtual , Adulto , Idoso , Idoso de 80 Anos ou mais , Cognição/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atividade Motora/fisiologia , Modalidades de Fisioterapia/instrumentação , Projetos Piloto , Acidente Vascular Cerebral/fisiopatologia
18.
Surv Ophthalmol ; 64(4): 512-557, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30703405

RESUMO

Visual impairment in childhood often has life-long implications. To aim for the highest levels of functioning, participation, and quality of life and to ensure children's well-being, children should be entitled to the most effective rehabilitation programs. We review evidence for the effectiveness of rehabilitation interventions for children with visual impairment to improve skills and behavior, thereby improving participation and quality of life as an ultimate goal. Of the 441 potentially relevant articles identified, 66 studies met our inclusion criteria (i.e., 28 randomized controlled trials, 18 nonrandomized controlled trials, and 20 before-after comparisons). The results suggest that sports camps, prescription and training in the use of low vision devices, and oral hygiene programs might be effective in improving functioning and elements of participation and quality of life in children with visual impairment. Other interventions showed mixed or negative results. The results should be interpreted with caution because of moderate to high risk of bias and suboptimal reporting. Heterogeneity of results and the use of over 50 different outcome measures prevented a meta-analysis. Future studies should focus on promising interventions for which effectiveness is still unclear (e.g., mobility, social skills), with adequately designed methodology.


Assuntos
Atividades Cotidianas , Qualidade de Vida , Baixa Visão/reabilitação , Humanos , Destreza Motora/fisiologia , Leitura , Habilidades Sociais
19.
Trials ; 20(1): 794, 2019 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-31888736

RESUMO

BACKGROUND: Despite the benefits highlighted by motor interventions based on virtual reality for children with Developmental Coordination Disorder (DCD), there are still doubts as to whether these are greater than those obtained with conventional interventions due to the absence of systematized protocols, and lack of evidence. Here, we present a protocol to systematically compare the effects of two motor-training programs (one Nintendo® Wii-based and the other no-Wii motor activities) on the motor learning in children with DCD. METHODS/DESIGN: Two intervention protocols (one based on Nintendo® Wii and the other no-Wii motor activities) will be carried out, with interventions occurring twice a week in 60-min sessions, with a minimum of 12 and a maximum of 16 sessions per child. The protocols were developed based on the domains of the Movement Assessment Battery for Children - Second Edition (MABC-2) (Manual Dexterity, Aiming and Catching, Balance), with two activities for each of the MABC - two domains. The study will include children aged 7 to 10 years with a total MABC-2 score ≤ 16, and a Developmental Coordination Disorder Questionnaire (DCDQ) score < 46 (age of 7 years), score < 55 (age group of 8 to 9 years and 11 months), or score < 57 (age of 10 years) as scored by the parents. Children will be randomly allocated by draw in one of the two intervention protocols. MABC-2 and DCDQ will be applied before and after intervention to evaluate the effects of the interventions on motor performance and parents' perception, respectively. Motor learning will be assessed by means of the scores obtained in the games. Evaluators and therapists will be trained and evaluators will be blind regarding the data of the children in the study. DISCUSSION: Owing to its motivating aspects, training with Nintendo® Wii may be particularly beneficial for children with DCD. The results of this study protocol should help researchers and therapists to better understand the benefits of Nintendo® Wii-based motor intervention over those obtained with no-Wii interventions in children with DCD. It should also create references about more systematized protocols for replication in clinical practice, seeking the improvement of the motor components of these children. TRIAL REGISTRATION: RBR-89ydgj.


Assuntos
Terapia por Exercício/métodos , Transtornos das Habilidades Motoras/terapia , Destreza Motora , Jogos de Vídeo , Criança , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Motivação , Equilíbrio Postural , Realidade Virtual , Caminhada
20.
Motor Control ; 23(1): 34-51, 2019 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-30012053

RESUMO

Effective learning methods are essential for motor skill development and participation in children with low motor abilities. Current learning methods predominantly aim to increase declarative knowledge through explicit instructions that necessitate sufficient working memory capacity. This study investigated the roles of declarative knowledge and working memory capacity in explicit motor learning of children with low motor abilities. We studied both acquisition performance (i.e., performance during practice) and learning (i.e., the improvement in performance from pretest to posttest). After practice with explicit instructions, children with low motor abilities showed significant learning, albeit that improvement was relatively small. However, working memory capacity and declarative knowledge did not predict learning. By contrast, working memory capacity and declarative knowledge did predict performance during practice. These findings suggest that explicit instructions enhance motor performance during practice, but that motor learning per se is largely implicit in children with low motor abilities.


Assuntos
Conhecimento , Aprendizagem/fisiologia , Memória de Curto Prazo/fisiologia , Destreza Motora/fisiologia , Criança , Feminino , Humanos , Masculino
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...