Do Children with Co-Occurring ADHD and DCD Differ in Motor Performance?

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by inappropriate levels of activity, impulsivity, and inattention. Developmental Coordination Disorder (DCD) is a condition involving challenges in acquiring and executing motor skills. This cross-sectional study aimed to distinguish motor symptoms between ADHD and ADHD/DCD. A total of 283 children from two elementary schools underwent screening, leading to the identification of 27 children with ADHD. The assessment encompassed the Swanson, Nolan, and Pelham-IV Questionnaire (SNAP-IV), the Movement Assessment Battery for Children (MABC-2), and the Motor Development Scale (MDS). The groups consisted of ADHD (14) and ADHD/DCD (13). Statistical analysis revealed significant differences in general motor age means between groups (p = 0.016), indicating inferior performance in the ADHD/DCD group. The coexistence of DCD significantly influenced the motor performance of children with ADHD, particularly in fine motor skills (p = 0.018) and balance (p = 0.033). Both groups exhibited mild to moderate risk of motor development delay. It is suggested that ADHD is associated with motor problems, even when DCD is not co-occurring. Specific domain-based analysis could demonstrate how the co-occurrence with DCD affects the motor performance of children with ADHD, with statistically significant differences observed in fine motor skills and balance.

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.

The impact of severity of motor delay, timing of task mastery, and START-play intervention on the development of means-end problem solving in young children.

BACKGROUND: Children with motor delays are at increased risk for delayed means-end problem-solving (MEPS) performance. OBJECTIVES: To evaluate children with motor delays: 1) the impact of motor delay severity and MEPS mastery timing on developmental trajectories of MEPS; and 2) the effectiveness of Sitting Together And Reaching To Play (START-Play) intervention for improving MEPS. METHODS: This represents a secondary analysis from a multi-site randomized controlled trial, with blinded assessors and prospective registration. Children with mild or significant motor delays (n = 112, mean age=10.80, SD=2.59 months at baseline) were randomly assigned to START-Play or usual care early intervention (UC-EI) and assessed at five visits across one year using the Means-End Problem-Solving Assessment Tool that included three 30-second MEPS trials per visit. Task mastery occurred at the first visit the child achieved the highest level of performance in at least two of the three trials. Multilevel analyses evaluated trajectories of MEPS outcomes dependent upon the timing of MEPS mastery, motor delay severity, and intervention group. RESULTS: At baseline, children with mild motor delays demonstrated better MEPS than children with significant delays, but this difference was only observed for children who achieved mastery late. Children with significant delays demonstrated greater improvements in MEPS in the post-intervention phase compared to children with mild delays. No MEPS differences were found between START-Play and UC-EI. CONCLUSION: Motor delay severity and timing of task mastery impacted MEPS trajectories, whereas START-Play intervention did not impact MEPS for children with motor delays. CLINICAL TRIALS REGISTRY IDENTIFIER: NCT02593825 (https://clinicaltrials.gov/ct2/show/NCT02593825).

Social responsiveness in children with developmental coordination disorder.

BACKGROUND: Developmental coordination disorder (DCD) is a neurodevelopmental disorder characterized by deficits in performing motor tasks. Research suggests social skills are also altered. OBJECTIVE: To investigate (1) whether the presence of DCD affects social responsiveness, (2) whether the co-occurrence of autism spectrum disorder (ASD) affects social responsiveness in children with DCD, and (3) whether there is an association between motor performance and social responsiveness in children with DCD. METHODS: Based on parental reports, children aged 5 to 15.5 years were assigned to one of three groups: DCD only (noASD, n = 67), DCD and suspected ASD (sASD, n = 13), and DCD and confirmed ASD (cASD, n = 22). Parental answers to the Social Responsiveness Scale (SRS-2) and the DCD-Questionnaire (DCD-Q) were compared to norm values using one sample t-tests, and between groups using ANOVA and MANOVA. Pearson correlation coefficients explored the relationship between the SRS-2 and DCD-Q in the total group and per group. RESULTS: Compared to norm values, difficulties in all areas of social responsiveness were reported in children with DCD, regardless of group (p<0.001). Compared to the noASD group, more unfavorable SRS-2 total T-scores and poorer DCD-Q scores were observed in sASD and cASD groups. Only in the total group, motor performance showed significant weak to moderate associations with the SRS-2 total T-score and all subscales except for 'social motivation' (r=-0.306 to -0.405; p ≤ 0.02). CONCLUSION: Social responsiveness difficulties are more common in children with DCD and are more severe in the ASD groups. Motor performance and social responsiveness are weak to moderately associated. CLINICAL TRIAL REGISTRATION NUMBER: NCT05092893 (https://clinicaltrials.gov/study/NCT05092893).

Short- and Long-Term Changes in Balance After Active Video Game Training in Children With and Without Developmental Coordination Disorder: A Randomized Controlled Trial.

Active video games (AVG) have been used as training tools and are known to ameliorate balance performance in children with Developmental Coordination Disorder (DCD). Our aim was to evaluate balance using clinical tests and by measuring body sway using a force plate with a mixed design of vision (eyes open/eyes closed), surface (rigid/soft), and support (stance/semitandem) before, and after, training and 4 months later (follow-up). Thirty-six DCD children and 40 typically developing children participated in the study, of which 50 children (26 DCD; 24 typically developing) were retested after 4 months. Balance improved on the clinical measures after the training, which was independent of type of AVG (Wii-Fit and Xbox Kinect) used, and this effect was still present after 4 months. The AVG training did not influence general sway behavior, but only sway in the eyes-open condition, corresponding with task demands of the training and indicating a training-specific effect. Overall, DCD children and typically developing children responded comparably to the AVG training, thereby maintaining the gap in performance between the two groups. The changes in postural sway are interpreted as a sign of more confidence and less freezing of the joints, enabling greater flexibility of movements and balance strategies as supported by the improved performance on balance tests in the DCD children. This is the first study that showed long-term effects of AVG training on balance performance. However, these follow-up results should be interpreted with caution given that 35% of the children were lost in follow-up.

Predictive validity of the Denver developmental screening test (Denver-II) to detect risk of developmental coordination disorder in preterm children.

INTRODUCTION: The Denver-II is widely used as a screening tool, however, no studies were found about its validity to predict the risk of Developmental Coordination Disorder (DCD) in preterm children. OBJECTIVE: To verify the predictive validity and accuracy of the Denver-II to identify the risk of DCD in preterm children. METHODS: Methodological study with 121 preterm children, evaluated with the Denver-II at ages 1, 2, 3, 4 and/or 5 years and with the Movement Assessment Battery for Children (MABC-2) at 7 years. Univariate binary logistic regression analyses were performed and ROC curves were derived. RESULTS: Children classified as suspect by Denver-II at 2, 3, and 4 years were, respectively, 3.45, 7.40 and 6.06 times more likely to have a risk of DCD on the MABC-2 (p < 0.05). The area under the ROC curve was considered fair for ages 2 (0.60, 95 % CI 0.50-0.70), 3 (0.61, 95 % CI 0.51-0.71) and 4 (0.64, 95 % CI 0.54-0.74) years. The greater the number of suspects in Denver-II over time, the greater the probability of risk of DCD in the MABC-2 (p < 0.001). CONCLUSIONS: Global developmental assessment with the Denver-II at ages 2 to 4 years is considered to have fair accuracy to discriminate risk of DCD at school age in children born preterm.

Health-related quality of life in children with developmental coordination disorder: a systematic review.

The aims of this study were (1) to synthesize evidence of the general health-related quality of life in children with DCD compared to their typically developing peers, and (2) to verify which domains of HRQOL are more compromised in children with DCD. A systematic search was carried out to identify cross-sectional studies that evaluated self-perception and/or the parent's perception of the HRQOL in children with and without DCD as an outcome. The methodological quality of the studies was assessed, and the effect size calculated. Initial searches in the databases identified 1092 articles. Of these, six were included. Most of the articles (5/6) included noted that children with DCD show a significantly lower HRQOL than their typically developing peers. Regarding the most compromised HRQOL domains, the results are heterogeneous. Most studies (3/6) had moderate methodological quality, and two studies were classified as high methodological quality. Effect sizes ranged from low to high.

Motor, Physical, and Psychosocial Parameters of Children with and without Developmental Coordination Disorder: A Comparative and Associative Study.

(1) Background: Developmental coordination disorder (DCD) is a chronic impairment that affects several domains that mark the developmental trajectory from childhood to adulthood. Aim: This study examined the differences in physical and psychosocial factors for children with DCD and typical development (TD) and the associations between these factors with gross motor coordination. (2) Methods: Children with DCD (n = 166; age: M = 8.74, SD = 2.0) and TD (n = 243; Age: M = 8.94; SD = 2.0) attending private and public schools were screened using the MABC-2. Children were then assessed using the Körperkoordination test für Kinder (gross coordination), the Perceived Efficacy and Goal Setting System (self-efficacy), horizontal jump (lower limb strength), and dynamometer (handgrip strength). A semi-structured interview was carried out to examine the oriented physical activity practice in the daily routine, the time spent in the activities, and the use of public spaces to practice non-oriented physical activities. (3) Results: Children with TD showed scores significantly higher than children with DCD in almost all factors with small to very large effect sizes; the exceptions were self-care and daily physical activity. The structural equation model showed that for children with DCD, the BMI explained negatively and significantly the motor coordination (b = -0.19, p = 0.019), whereas physical activity (b = 0.25, p < 0.001), lower limb strength (b = 0.38, p < 0.001), and perceived self-efficacy (b = 0.19, p = 0.004) explained it positively. For children with TD, the BMI explained negatively and significantly the motor coordination (b = -0.23, p = 0.002), whereas physical activity (b = 0.25, p < 0.001) and lower limb strength (b = 0.32, p < 0.001) explained it positively. (4) Conclusions: The authors extended previous research by providing evidence that factors affecting motor coordination vary across childhood for children with DCD and TD. Self-efficacy was relevant only in explaining motor coordination for children with DCD.

Distinct mental health profiles in children with Developmental Coordination Disorder: A latent class analysis and associations.

BACKGROUND: Children with Developmental Coordination Disorder (DCD) show indications for mental health problems. However, these problems are poorly understood. AIMS: To identify patterns (profiles) of mental health in this population and to analyze the associations between profiles and child characteristics. METHODS AND PROCEDURES: Parents of 119 children with DCD completed the Strengths and Difficulties Questionnaire. OUTCOMES AND RESULTS: Results indicated that a four latent class was the best model. Profile 1 was defined as "no" mental health problems (n = 28; 24 %), Profile 2 was defined as "hyperactivity" problems (n = 53; 43.3 %), for clinical indications for hyperactivity, Profile 3 was defined as "internalizing" problems (n = 8; 7.3 %), for clinical indications for emotional symptoms and peer problems, and Profile 4 was defined as "internalizing and externalizing problems" (n = 30; 25.4 %), for clinical indications for problems in both areas. In addition, having a co-occurring disorder, accommodation plans, and using medications were associated with the profiles. CONCLUSIONS AND IMPLICATIONS: There are distinct and unique profiles that children with DCD exhibit. Clinicians can use these profiles to better understand the presentation of mental health symptoms in this population and provide adequate services or support if mental health difficulties are present.

Motor development of children exposed to the zika virus: systematic reviews / Desenvolvimento motor de crianças expostas ao zika vírus: revisão sistemática

Abstract Objectives: to describe the motor development, in the first two years of life, of children with evidence of congenital Zika virus syndrome (CZS) at birth and of children exposed to the Zika virus (ZIKV) during pregnancy, but without evidence of CZS. Methods: systematic review, according to the recommendations of the Preferred Reporting Items for Systematic Reviews (PRISMA). The search took place in the VHL/LILACS interface and BIREME/ PubMed interface databases until March 2020. Two researchers analyzed the quality of the studies using the Johanna Briggs Institute methodology. Results: 21 articles were selected. Children with CZS have severe impairment of motor functions and a high prevalence of spastic cerebral palsy. At two years of life, most reached only early levels of motor development; with impaired vision, hearing, language, cognition, behavior, and social interaction. On the other hand, children exposed to ZIKV, but without evidence of CZS, are at lower risk, about 20% have late manifestations of delay and/or neurodevelopmental disorder. Variables associated with greater motor impairment are early maternal infection, preterm birth, lower head circumference, abnormal imaging, use of anticonvulsant, increasing age, arthrogryposis, epilepsy, deficits in vision, language, cognition, and lower income. Conclusion: Most children with CZS show severe motor impairment; a small part of those exposed to ZIKV, without evidence of the syndrome at birth, have alteration in neurodevelopment. Those children should be followed in the long-term, since some manifestations may occur belatedly.

Resumo Objetivos: analisar o desenvolvimento motor, nos dois primeiros anos de vida, de crianças com evidências da síndrome congênita pelo Zika vírus (SCZ) ao nascimento e de crianças expostas ao Zika vírus (ZIKV) durante a gestação, mas sem evidências da SCZ. Métodos: revisão sistemática, segundo as recomendações da Preferred Reporting Items for Systematic Reviews (PRISMA). A busca ocorreu nas bases BVS/interface LILACS e BIREME/interface PubMed até março de 2020. Duas pesquisadoras analisaram a qualidade dos estudos pela metodologia do Johanna Briggs Institute. Resultados: entre 184 publicações, selecionou-se 21 artigos. Crianças com a SCZ apresentam grave comprometimento das funções motoras e alta prevalência de paralisia cerebral espástica. Aos dois anos de vida, a maior parte atingiu apenas níveis iniciais do desenvolvimento motor; com comprometimento da visão, audição, linguagem, cognição, comportamento e interação social. Já as crianças expostas ao ZIKV, mas sem evidências da SCZ, estão em menor risco, cerca de 20% apresentam manifestações tardias de atraso e/ou anormalidade do neurodesenvolvimento. Variáveis associadas a maior comprometimento motor são: infecção materna precoce, nascimento pré-termo, menor perímetro cefálico, exame de imagem anormal, uso de anticonvulsivante, aumento da idade, artrogripose, epilepsia, déficits da visão, linguagem, cognição, e menor renda. Conclusão: a maioria das crianças com SCZ apresenta grave comprometimento motor; pequena parte das expostas ao ZIKV, sem evidências da síndrome ao nascimento, tem alteração no neurodesenvolvimento. Estas crianças devem ser acompanhadas por longo prazo, pois algumas manifestações podem ser tardias.

Cross-cultural validation of the Brazilian Little Developmental Coordination Disorder Questionnaire (LDCDQ-BR) for preschool children.

INTRODUCTION: Motor difficulties associated with Developmental Coordination Disorder (DCD) are frequently apparent before the accepted diagnostic age of 5. Tools to support identification of DCD markers would allow provision of early intervention to reduce negative sequelae. OBJECTIVE: Establish psychometric properties and define preliminary cut-off scores for the Brazilian Little Developmental Coordination Disorder Questionnaire - Brazil (LDCDQ-BR). METHODS AND PROCEDURES: Parents of 3- and 4-year-old children (n = 312; 154 girls) from Belo Horizonte/MG, Brazil, completed the LDCDQ-BR, the Brazil Economic Classification Criterion and a demographic questionnaire. One sub-set of children (n = 119) was assessed with the Movement Assessment Battery for Children-2nd Edition; another sub-set (n = 77) completed the LDCDQ-BR a second time. RESULTS: Rasch analysis indicated good item functioning with only one erratic item, suggesting unidimensionality. Item calibration reliability was excellent (0.97), children's measures reliability was low (0.72), but implying separation of 2.46 motor ability levels. Significant, low correlations were found between the LDCDQ-BR and MABC-2 (r = 0.30, p < 0.01). Test-retest reliability was 0.77 (total score) and 0.44-0.78 (individual items). ROC curve analysis revealed sensitivity of 68% at a cut-off score of 64. CONCLUSION: The LDCDQ-BR shows promising psychometric properties to support early identification of DCD.

Do executive functions and gross motor skills predict writing and mathematical performance in children with developmental coordination disorder?

Aim: To examine whether executive functions, and gross motor skills were predictors for school performance in children with DCD, with risk for DCD (r-DCD), and with typical development (TD).Methods: Participants were 63 children with DCD (Mage = 8.70, SDage = .64), 31 children with r-DCD (Mage = 8.90, SDage = 0.74), and 63 typical development children (Mage = 8.74, SDage = .63). Wechsler Abbreviated Scale of Intelligence, Movement Assessment Battery for Children-2, Test of Gross Motor Development-3, Oral Word Span in Sentences, Odd-One-Out, Go/No-Go, Hayling Test, Trail Making Test, Five Digits Test, and the Test of School Performance-II were utilized.Results: In DCD, processing speed (ß = -.42, p = .005), and auditory-motor inhibition (ß = -.36, p = .009), and auditory-verbal inhibition (ß = -.38, p = .023) predicted math performance; and auditory-motor (ß = -.40, p = .38) and visuospatial working memory (ß = -.33 p = .011) predicted writing performance. In r-DCD, auditory-motor (ß = - .67; p = .002) and visual-motor (ß = -.40; p = .040) inhibition predicted math performance; visual-motor inhibition predicted writing performance (ß = -.47; p = .015).Conclusion: Lower inhibitory control and visuospatial working memory scores affect children with DCD and r-DCD' school performance.

Intrahemispheric EEG: A New Perspective for Quantitative EEG Assessment in Poststroke Individuals.

The ratio between slower and faster frequencies of brain activity may change after stroke. However, few studies have used quantitative electroencephalography (qEEG) index of ratios between slower and faster frequencies such as the delta/alpha ratio (DAR) and the power ratio index (PRI; delta + theta/alpha + beta) for investigating the difference between the affected and unaffected hemisphere poststroke. Here, we proposed a new perspective for analyzing DAR and PRI within each hemisphere and investigated the motor impairment-related interhemispheric frequency oscillations. Forty-seven poststroke subjects and twelve healthy controls were included in the study. Severity of upper limb motor impairment was classified according to the Fugl-Meyer assessment in mild/moderate (n = 25) and severe (n = 22). The qEEG indexes (PRI and DAR) were computed for each hemisphere (intrahemispheric index) and for both hemispheres (cerebral index). Considering the cerebral index (DAR and PRI), our results showed a slowing in brain activity in poststroke patients when compared to healthy controls. Only the intrahemispheric PRI index was able to find significant interhemispheric differences of frequency oscillations. Despite being unable to detect interhemispheric differences, the DAR index seems to be more sensitive to detect motor impairment-related frequency oscillations. The intrahemispheric PRI index may provide insights into therapeutic approaches for interhemispheric asymmetry after stroke.

Neuropsychomotor development in children born preterm at 6 and 12 months of corrected gestational age.

OBJECTIVE: To assess the incidence of neuropsychomotor developmental delay at 6 and 12 months of corrected gestational age in children born at 32 gestational weeks or less. METHODS: A descriptive and prospective study was carried out at two public maternity hospitals. Between April 2017 and January 2019, we assessed 133 children without any known risk factors for neuropsychomotor developmental delay. The Bayley III scale was used to evaluate cognitive and motor development. The p value of the numerical variables was calculated using the Mann-Whitney test, whereas proportions of categorical variables were compared using the Z-test. RESULTS: The mean maternal age was 26±6.9 years,78.8% were from middle and lower economic classes, and 57.1% of the analyzed children were female. Children presented with a higher incidence of delay at 12 months than at 6 months (10.3 and 2.3% at 12 and 6 months, respectively, for the cognitive score; 22.7 and 12% at 12 and 6 months, respectively, for the composite motor score; and 24.7 and 8.4% at 12 and 6 months, respectively, for the fine motor score). CONCLUSIONS: Cognitive and motor developmental delays were significant, with the highest incidence at 12 months. The results of this study encourage further research on this topic, since the exclusion criteria were comprehensive and the delays in neuropsychomotor development were significant.

The effect of physical exercise on the rehabilitation quality of human waist dysfunction / O efeito do exercício físico na qualidade da reabilitação da disfunção da cintura humana / El efecto del ejercicio físico en la calidad de rehabilitación de la disfunción de la cintura humana

ABSTRACT Introduction Human motor dysfunction can affect the quality of life, especially waist dysfunction. And an effective means to improve muscle strength during exercise. Object This article compares and analyzes the effectiveness of human muscle exercise on the decline in quality of life caused by motor dysfunction. Method The article divides patients with motor dysfunction into trunk isokinetic training group (experimental group) and waist and abdominal muscle functional training group (control group), and comparative analysis of related indicators before and after treatment. Results Before treatment, the specific indicators of the two were different (P>0.05). After treatment, the patients' quality of life indicators and motor function indicators were significantly different (P<0.05). Conclusion Exercise has an obvious curative effect for patients with human motor dysfunction, and it is worthy of clinical promotion. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução A disfunção motora humana pode afetar a qualidade de vida, principalmente a disfunção da cintura. E um meio eficaz de melhorar a força muscular é o exercício. Objetivo este artigo compara e analisa a eficácia do exercício muscular humano no declínio da qualidade de vida causado por disfunção motora. Método O artigo divide os pacientes com disfunção motora em grupo treinamento isocinético de tronco (grupo experimental) e grupo treinamento funcional de cintura e músculos abdominais (grupo controle), e análise comparativa dos indicadores relacionados antes e após o tratamento. Resultados Antes do tratamento, os indicadores específicos dos dois eram diferentes (P> 0,05). Após o tratamento, os indicadores de qualidade de vida e indicadores de função motora dos pacientes foram significativamente diferentes (P <0,05). Conclusão O exercício tem um efeito curativo óbvio para pacientes com disfunção motora humana e é digno de promoção clínica. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción La disfunción motora humana puede afectar la calidad de vida, especialmente la disfunción de la cintura. Y un medio eficaz para mejorar la fuerza muscular es el ejercicio. Objeto Este artículo compara y analiza la efectividad del ejercicio muscular humano sobre el deterioro de la calidad de vida causado por la disfunción motora. Método El artículo divide a los pacientes con disfunción motora en grupo de entrenamiento isocinético del tronco (grupo experimental) y grupo de entrenamiento funcional de cintura y músculos abdominales (grupo control), y análisis comparativo de indicadores relacionados antes y después del tratamiento. Resultados Antes del tratamiento, los indicadores específicos de los dos eran diferentes (P> 0.05). Después del tratamiento, los indicadores de calidad de vida de los pacientes y los indicadores de función motora fueron significativamente diferentes (P <0,05). Conclusión El ejercicio tiene un efecto curativo obvio para los pacientes con disfunción motora humana y es digno de promoción clínica. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

Estado clínico de pacientes con enfermedad de Parkinson sometidos a magnetoterapia / Clinical status of patients with Parkinson disease under magneto-therapy

Introducción:La enfermedad de Parkinson es crónica, lleva al paciente a la discapacidad, el tratamiento rehabilitador, juega un papel importante para mantener mayor tiempo, la independencia funcional, da como resultado una mejor calidad de vida.Objetivo:Describir el estado clínico de los pacientes con la enfermedad de Parkinson, antes y después del tratamiento con magnetoterapia.Métodos:Se realizó un estudio observacional, descriptivo longitudinal y prospectivo, en los pacientes con enfermedad de Parkinson, atendidos en la sala de rehabilitación integral José Jacinto Milanés de la provincia Matanzas, en el periodo de enero a diciembre del 2018. El universo estuvo constituido por 20 pacientes con diagnóstico de la enfermedad que acudieron a la sala y cumplieron con los criterios establecidos. Se estudiaron las variables:edad, sexo; examen motor antes y después del tratamiento y complicaciones. La información se obtuvo mediante el interrogatorio y la revisión de las historias clínicas, se realizó el análisis estadístico y el software para Windows, SPSS-15.0.Resultados:Predominaron los pacientes entre 70 a 79 años de edad, 14 de ellos, para un 70 por ciento, del sexo masculino, el 60 por ciento, todas las variables motoras mejoraron en mayor o menor grado, excepto la rigidez que no se modificó y no se presentaron complicaciones durante el tratamiento.Conclusiones:La magnetoterapia logra modificar los síntomas motores presentes, en los pacientes con enfermedad de Parkinson.(AU)

IntroductionParkinson disease is chronic, it takes the patient to incapacity, rehabilitating treatment, plays an important role to keep the functional Independence most of the time, it gives as a result a better life quality.Objective:To describe the clinical status of patients with Parkinson disease before and after being under magneto-therapy.Methods:An observational, descriptive longitudinal and prospective study was carried out in patients with Parkinson disease, assisted at ¨José Jacinto Milanés¨ integral rehabilitation ward in Matanzas, from January to December, 2018. The universe was formed by 20 patients with the diagnosis of the disease who went to the ward and fulfilled with the established criteria. The studied variables were: age, sex, sex, sex , sex; motor exam before and after the treatment and complications. The information was obtained by interviews and the revision of patients ‘charts, the statistical analysis and the software for Windows, SPSS-15.0.Results:Patients between 70 79 years old prevailed, 14 of them, for a 70 per cent, of the male sex, the 60 per cent, all the motor variables improved in in higher or lower degree, except stiffness that was not modified, complications were not presented during treatment.Conclusions:Magneto-therapy can modify the present motor symptoms in patients with Parkinson disease.(AU)

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.

Reconstrucción de la fosa poplítea con colgajo fasciocutáneo de la arteria safena / Reconstruction of the popliteal fossa with fasciocutaneous flap of the saphenous artery

INTRODUCCIÓN. Los defectos de la fosa poplítea suponen un desafío reconstructivo para el cirujano plástico, dada la relación íntima de esta área con la articulación de la rodilla y la neurovasculatura vital subyacente. El propósito de éste informe fie compartir la experiencia en la utilización de un colgajo fasciocutaneode la arteria safena. CASO CLÍNICO. Paciente de 5 años de edad que sufrió quemadura térmica en miembros inferiores con dos años y medio de evolución, ameritó injertos, presentó contractura por tejido cicatricial en fosa poplítea, dificultó la deambulación y desarrollo neuro osteomuscular. Se realizó reconstrucción de la fosa poplítea con colgajo fasciocutáneo de la arteria safena. RESULTADOS. El colgajo fasciocutáneo de la arteria safena dio cobertura al defecto en fosa poplítea izquierda tras retiro del tejido cicatricial que producía contractura, limitaba la marcha y el desarrollo neuro osteo-muscular. Seis meses postquirúrgicos brindó cobertura cutánea definitiva y estable en el área crítica, que permitió la deambulación con movimientos de extensión y flexión de rodilla conservados. DISCUSIÓN. Este colgajo al igual que en otros estudios que respaldan su ejecución brindó excelentes resultados en defectos de partes blandas a nivel de la articulación de la rodilla. CONCLUSIÓN. El colgajo fasciocutáneo de la arteria safena demostró utilidad para la reconstrucción del defecto de la fosa poplítea, posibilitó una cobertura definitiva, funcional y estética, restableció los ángulos de movilidad y favoreció el desarrollo pondoestatural del paciente.

INTRODUCTION. Defects of the popliteal fossa pose a reconstructive challenge for the plastic surgeon, because of the intimate relation of this area with the knee joint and the near vital neurovasculature; the purpose of this report was to share the experience of using a fasciocutaneous flap of the saphenous artery. CLINICAL CASE. A 5 year old patient who suffered thermal burn in lower limbs with two and a half years of evolution, he nedeed grafts and presented tissue contracture because the scar in the popliteal fossa hindered ambulation and neuro-osteomuscular growth. Reconstruction of the popliteal fossa was made it with a fasciocutaneous flap of the saphenous artery. RESULTS. The fasciocutaneous flap of the saphenous artery covered the defect in the left popliteal fossa after removal of the scar tissue that caused contracture, limited to walk and growth. Six months after surgery the flap provided definitive and secure skin coverage in the critical area, which allowed to walk with preserved knee extension and flexion movements. DISCUSSION. This flap was useful for the recons-truction of the defect of the popliteal fossa and provided excellent results in soft tissue defects in this area of the knee joint. CONCLUSION. The fasciocutaneous flap of the saphenous artery proved useful for the reconstruction of the popliteal fossa defect, it permited a definitive, functional and esthetic coverage, reestablished the angles of mobility and helped with the patient growth

MOVEMENT ASSESSMENT BATTERY FOR CHILDREN-SECOND EDITION: THEORETICAL ADEQUACY OF A MOTOR ASSESSMENT INSTRUMENT.

OBJECTIVE: To investigate the adequacy of the theoretical model of the Movement Assessment Battery for Children-Second Edition (MABC-2) instrument. METHODS: 582 children, of both sexes, aged between 3 and 5 years and residents in the city of Maringá (state of Paraná, Southern Brazil) participated in the study. Data were collected from May/2014 to June/2015 and analyzed using descriptive and inferential statistics. RESULTS: The evidence obtained from exploratory factor analysis indicated the presence of two factors, which was the option that best fitted the explanatory model. Hence, it was necessary to regroup the motor tasks of the dimensions "Aiming & catching" and "Balance" into only one dimension. It is noteworthy that the "Bicycle trail" motor task did not fit the model, as it presented a low and negative factor load in the analyzed dimensions. In the confirmatory factor analysis, adequate adjustment indices were observed for the tested model, which confirmed the non-classification of the "Bicycle trail" motor task in the original dimension. CONCLUSIONS: After removing the "Bicycle trail" motor task, the adjusted two-factor model seems to be the most appropriate to assess the motor performance of children participating in the study.