Monitoring the Motor Phenotype in Huntington's Disease by Analysis of Keyboard Typing During Real Life Computer Use.

BACKGROUND: Besides cognitive and psychiatric abnormalities, motor symptoms are the most prominent in Huntington's disease. The manifest disease is preceded by a prodromal phase with subtle changes such as fine motor disturbances or concentration problems. OBJECTIVE: Movement disorders show a high variation in their clinical manifestation depending on condition and external influences. Therefore, devices for continuous measurements, which patients use in their daily life and which can monitor motor abnormalities, in addition to the medical examination, might be useful. The aim of current scientific efforts is to find markers that reflect the prodromal phase in gene carriers. This is important for future interventional studies, as future therapies should be applied at the stage of neuronal dysfunction, i.e., before the clinical manifestation. METHODS: We performed a software-supported, continuous monitoring of keyboard typing on the participants' own computer to evaluate this method as a tool to assess the motor phenotype in HD. We included 40 participants and obtained sufficient data from 25 participants, 12 of whom were manifest HD patients, 7 HD gene expansion carriers (HDGEC) and 6 healthy controls. RESULTS: In a cross-sectional analysis we found statistically significant higher typing inconsistency in HD patients compared to controls. Typing inconsistency compared between HDGEC and healthy controls showed a trend to higher inconsistency levels in HDGEC. We found correlations between typing cadence and clinical scores: the UHDRS finger tapping item, the composite UHDRS and the CAP score. CONCLUSION: The typing cadence inconsistency is an appropriate marker to evaluate fine motor skills of HD patients and HDGEC and is correlated to established clinical measurements.

Classification of Australian football kick types in-situation via ankle-mounted inertial measurement units.

The utility of inertial measurement units (IMUs) for sporting skill and performance analysis during training and competition is advantageous for enhancing the objectivity of athlete monitoring. This study aimed to classify Australian Rules football (AF) kick types in an applied environment using ankle-mounted IMUs. IMUs and video capture of a controlled protocol, including four kick types at varying distances, were recorded during a single testing session with female AF athletes (n = 20). Processed IMU data were modelled using support vector machine classifier, random forest, and k-nearest neighbour algorithms under a 2-Kick, 4-Kick, and kick distance (10, 20, 30 m) conditions. The random forest model showed the highest results for overall classification accuracy (83% 2-Kick and 80% 4-Kick), test F1-score (0.76 2-Kick and 0.81 4-Kick), and AUC score (0.58 2-Kick and 0.60 4-Kick). Kick distance classification showed a model test and class weighted F1-score of 0.63 and overall accuracy of 64%, respectively. This study highlights the potential for an applied semi-automated AF training kick detection and type classification system using IMUs.

The Stability of the Gross Motor Function Classification System in Children with Cerebral Palsy Living in Stockholm and Factors Associated with Change.

AIM: To determine the degree of stability in the Gross Motor Function Classification System (GMFCS) for children with cerebral pares (CP) and to analyze factors associated with changes of the over time, in Stockholm between the year 2000 and 2019. METHOD: A register study on 768 children with at least two GMFCS ratings, linear regression analysis was used to study factors associated to a change in GMFCS level. RESULTS: 72% of the children kept the same GMFCS level. A change in GMFCS level was most common for children in GMFCS level II (68%). The first change in GMFCS level happened most commonly between the ages 2 and 4. Initial GMFCS level (Beta 0.127; p < 0.001) and one or more intensive training periods with a physiotherapist (Beta 0.097; p = 0.018) were associated with a change in GMFCS level. INTERPRETATION: Most children with CP remain stable in their GMFCS level, but for those classified in level II, a change occurs for almost seven out of ten. Classifications made before the child turns four are less certain than those made later. Further studies are needed to clarify if occurrence of intensive training is the cause or result of the change in GMFCS level.

Longitudinal Trajectories and Reference Percentiles for Participation in Family and Recreational Activities of Children with Cerebral Palsy.

AIM: To create longitudinal trajectories and reference percentiles for frequency of participation in family and recreational activities for children with cerebral palsy (CP) by Gross Motor Function Classification System (GMFCS) level. METHODS: 708 children with CP 18-months to 12-years of age and their families participated in two to five assessments using the GMFCS and Child Engagement in Daily Life Measure. Data were analyzed using mixed-effects models and quantile regression. RESULTS: Longitudinal trajectories depict the relatively stable level of frequency of participation with considerable individual variability. Average change in the frequency of participation scores of children from 2-12 years of age by GMFCS level varied from 3.7 (GMFCS level I) to - 9.0 points (GMFCS level V). A system to interpret the magnitude of change in percentiles over time is presented. CONCLUSIONS: Longitudinal trajectories and reference percentiles can inform therapists and families for collaboratively designing services and monitoring performance to support children's participation in family and recreational activities.

Inter-Rater and Test-Retest Reliability of the Sensory Integration Clinical Observations.

AIMS: The purpose of this study was to examine the inter-rater and test-retest reliability of the Sensory Integration Clinical Observations. METHODS: Clinical observations were administered by trained occupational therapists (recent graduates to 40 years of experience, median = 3 years) to 20 children aged 4 - 12 years. Testing was completed again on 16 children after an average of 2.5 weeks. Inter-rater therapists scored the measure from video recordings. Total score and section scores (i.e. Postural-Ocular, Motor Planning - Fine Motor, Vestibular Processing, and Praxis and Coordination) were obtained. RESULTS: Intraclass correlations found test-retest reliability of total score to be excellent (ICC=.95) and section scores to be acceptable (ICC = .79-.94). Inter-rater reliability was also excellent for total score (ICC-.94) and section scores (ICC=.84-.96). CONCLUSIONS: The Sensory Integration Clinical Observations can be administered reliably by multiple raters of varying levels of experience and results are stable over an average two-week interval. Good inter-rater reliability serves as a first step toward demonstration of consistency of administration and scoring of the Sensory Integration Clinical Observations. These findings may begin to establish a foundation for use of clinical observations to measure change in sensory-motor performance over time, although further research is needed.

A Video-Based Classification System for Assessing Locomotor Skills in Children.

The Test of Gross Motor Development 2 (TGMD-2) is currently the standard approach for assessing fundamental movement skills (FMS), including locomotor and object control skills. However, its extensive application is restricted by its low efficiency and requirement of expert training for large-scale evaluations. This study evaluated the accuracy of a newly-developed video-based classification system (VCS) with a marker-less sensor to assess children's locomotor skills. A total of 203 typically-developing children aged three to eight years executed six locomotor skills, following the TGMD-2 guidelines. A Kinect v2 sensor was used to capture their activities, and videos were recorded for further evaluation by a trained rater. A series of computational-kinematic-based algorithms was developed for instant performance rating. The VCS exhibited moderate-to-very good levels of agreement with the rater, ranging from 66.1% to 87.5%, for each skill, and 72.4% for descriptive ratings. Paired t-test revealed that there were no significant differences, but significant positive correlation, between the standard scores determined by the two approaches. Tukey mean difference plot suggested there was no bias, with a mean difference (SD) of -0.16 (1.8) and respective 95% confidence interval of 3.5. The kappa agreement for the descriptive ratings between the two approaches was found to be moderate (k = 0.54, p < 0.01). Overall, the results suggest the VCS could potentially be an alternative to the conventional TGMD-2 assessment approach for assessing children's locomotor skills without the necessity of the presence of an experienced rater for the administration.

Rasgos característicos del comportamiento motor del niño con prematurez durante los primeros meses de vida posnatal: una revisión de la literatura / Characteristics of motor behaviour in premature infants during the first months of postnatal life. A literature review

OBJETIVO: Describir los rasgos característicos del comportamiento motor del niño con prematurez durante los primeros meses de vida posnatal, de acuerdo con la evidencia disponible. MATERIALES Y MÉTODOS: Se realizó una revisión sistematizada de la literatura; este método forma parte de los estudios secundarios en investigación y describe un fenómeno en detalle, tomando como base fuentes primarias de información. RESULTADOS: El proceso de búsqueda en las bases de datos consultadas arrojó 7.228 artículos; a partir de estos se identificaron 15 más a través de las estrategias de búsqueda «en bola de nieve». Iniciando el proceso de tamizaje o cribado se eligieron 63 registros por título y resumen, y se excluyeron 14 por encontrarse duplicados; se seleccionaron 49 artículos para ser revisados a texto completo y, de estos, se excluyeron 37 por no cumplir con los criterios de inclusión en su totalidad, resultando al final 12 artículos que fueron elegidos para elaborar la síntesis cualitativa del presente trabajo de investigación. CONCLUSIONES: En comparación con los niños nacidos a término los prematuros demuestran un repertorio motor particular, derivado de la inmadurez de sus sistemas; su comportamiento motor traza una línea de desarrollo a través de la cual se expresan deficiencias del tono muscular, del control postural, del balance muscular y de la activación muscular antigravitatoria como las principales

OBJECTIVE: To describe the characteristics of motor behaviour in premature infants during the first months of postnatal life, according to the available evidence. MATERIALS AND METHODS: A systematic literature review was carried out; this method forms part of secondary studies under investigation and describes a phenomenon in detail based on primary sources of information. RESULTS: The literature search in the databases consulted yielded 7,228 articles; of these, 15 more were identified through "snowball" search strategies. At the start of the screening process, 63 eligible records were chosen based on their title and summary, and 14 were excluded because they were duplicates. A total of 49 articles were selected for a full text revision and, of these, 37 were excluded because they did not meet all the inclusion criteria. Finally, 12 articles were selected to prepare the qualitative synthesis of the present research work. CONCLUSIONS: In comparison with neonates born at term, premature infants demonstrate a particular motor repertoire, due to the immaturity of their systems; their motor behaviour follows a line of development mainly characterised by deficits in muscle tone, postural control, muscle balance, and antigravity muscle activation

Self-Care Trajectories and Reference Percentiles for Children with Cerebral Palsy.

Aims: To create longitudinal trajectories and reference percentiles for performance in self-care of children with cerebral palsy (CP).Methods: Participants were 708 children with CP, 18 months through 11 years of age and their parents residing in 10 regions across Canada and the United States. Gross Motor Function Classification System (GMFCS) levels were determined by consensus between parents and therapists. Parents' completed the Performance in Self-Care domain of the Child Engagement in Daily Life Measure two to five times at 6-month intervals. Nonlinear mixed-effects models were used to create longitudinal trajectories. Quantile regression was used to construct cross-sectional reference percentiles.Results: The trajectories for children in levels I, II, and III are characterized by an average maximum score between 79.6 (level I) and 62.8 (level III) and an average attainment of 90% of the maximum score between 7 and 9 years of age. The trajectories for children in level IV and V show minimal change over time. Extreme variation in performance among children of the same age and GMFCS level complicate interpretation of percentile change of individual children.Conclusion: The findings are useful for monitoring self-care of children with CP and evaluating change for children in GMFCS levels I-III.

A machine learning approach for automatic detection and classification of changes of direction from player tracking data in professional tennis.

The purpose of this study was to develop an automated method for identifying and classifying change of direction (COD) movements in professional tennis using tracking data. Three sport science and strength and conditioning experts coded match-play footage of nineteen professional tennis players (9 male and 10 female) from the Australian Open Grand Slam for COD of medium and high intensity. A total of 1,494 changes were identified and aligned with 2D player position sampled at 25 Hz based on camera tracking data. Several machine learning classifiers were trained and tested on a set of 1,128 time-motion features. A random forest algorithm was found to have the best out-of-sample performance, classifying medium and high intensity changes with an F1-score of 0.729. This research offers a novel and applicable way for utilising player tracking data and machine learning techniques to automatically identify and classify COD movements in professional tennis.

Influence of Functional Classification on Skill Tests in Elite Female Wheelchair Basketball Athletes.

Background and objectives: Wheelchair basketball players are classified into four functional classes according to the player's "volume of action", characterized by trunk movement and stability. As this classification is based on a kinematic point of view, test items might be differentially affected by the functional classification level. We aimed to clarify field-based skill test items closely related to the functional classification level. Materials and Methods: Twenty-six female wheelchair basketball athletes (Japan National Team candidates) completed seven field-based skill tests (20 m sprint, agility T-test, figure-eight with a ball test, the Yo-Yo 10 m recovery test, and three types of maximal passes), and anthropometric measurements were applied. Results: Significant differences among the classification levels were found for one-hand maximal passes (baseball and hook passes) and the figure-eight with a ball test. Furthermore, performance in the 20 m sprint and 10 m Yo-Yo recovery tests significantly differed between classes 1 and 4. Conclusions: The test items most influenced by the classification levels were one-hand passes, which require trunk stability and balance not only in the horizontal plane, but also in the sagittal and frontal planes. Coaches should consider which test items are strongly affected by the functional classification level when assessing a player's performance.

Cross-Cultural Validity: Canadian Norm Values of the Alberta Infant Motor Scale Evaluated for Dutch Infants.

PURPOSE: To examine whether the Canadian normative values of the Alberta Infant Motor Scale (AIMS) are appropriate for Dutch infants. METHOD: In a cross-sectional study, 499 infants developing typically (0.5-19 months) were assessed using the AIMS home video method. The scaling method was used for calculating item locations of the Dutch sample, and Welch test to compare Canadian and Dutch raw scores. RESULTS: THE: AIMS items (45 of 58) met the criterion for stable regression to calculate item locations of the Dutch data set and compare these with the Canadian data set. Dutch infants passed 42 of 45 items at an older age. Most monthly age groups of Dutch infants had lower mean AIMS scores. CONCLUSION: The Canadian norms are not appropriate for the Dutch study sample. Dutch infants appear to develop in a similar sequence but at a slower rate. This has implications regarding the clinical use of the AIMS in the Netherlands.

Destrezas académicas y velocidad de procesamiento. Modelos predictivos del rendimiento escolar en básica primaria / Academic skills and processing speed. Predictive models of school achievement in primary school

Resumen El modelo de inteligencia de Cattell-Horn-Carroll (CHC) propone que los procesos cognitivos que componen la inteligencia pueden conceptualizarse como habilidades específicas, implicadas en tareas particulares, y habilidades generales, relacionadas con una amplia cantidad de contextos. Entre las habilidades más estudiadas bajo este modelo se encuentra la velocidad de procesamiento, identificada como uno de los mejores predictores del rendimiento académico y de la capacidad cognitiva general. En este artículo se presentan los resultados del análisis de la relación entre la velocidad de procesamiento y rendimiento académico general. Se evaluó una muestra de 223 estudiantes (53% mujeres) de Preescolar y básica primaria. Los resultados muestran una diferencia en la capacidad predictiva del componente perceptual (β =.76, p < .001) y conceptual (β =.09; p = .121) de la velocidad de procesamiento en procesos académicos básicos de lectura y matemática, así como ajustes similares en modelos de regresión a partir de su conceptualización como habilidad general (R2 = .68) o específica (R2 = .69). El análisis de la relación grado a grado mostró cambios en la capacidad predictiva de la velocidad de procesamiento sobre las habilidades académicas conforme avanza el proceso educativo, apoyando modelos previamente establecidos en el área (Cai, Li & Deng, 2013; Demetriou, Spanodius & Shayer, 2014). Finalmente, es generó un modelo de ecuaciones estructurales (X 2=1.431; p=.232; CFI=1.000; TLI=.999; NFI=.999; RFI=.996; RMSEA=.044) que permitió probar el ajuste de los modelos propuestos a los datos.

Abstract The Cattell-Horn-Carroll (CHC) intelligence model proposes that the cognitive processes that make up intelligence can be conceptualized as specific skills, involved in particular tasks, and general skills, related to a wide variety of contexts. Among the most studied skills under this model is the speed of processing, identified as one of the best predictors of academic performance and general cognitive ability. This article presents the results of the analysis of the relationship between processing speed and general academic performance. A sample of 223 students (53% women) of preschool and primary school was evaluated. The results show a difference in the predictive capacity of the perceptual component (β = .76, p < .001) and conceptual (β = .09; p = .121) of the processing speed in basic academic processes of reading and mathematics, as well as similar adjustments in regression models from their conceptualization as general (R 2 = .68) or specific (R 2 = .69) ability. The analysis of the grade-to-grade relationship showed changes in the predictive capacity of processing speed over academic skills as the educational process progresses, supporting previously established models in the area (Cai, Li & Deng, 2013; Demetriou, Spanodius & Shayer, 2014). Finally, a model of structural equations (X 2 = 1.431, p = .232, CFI = 1.000, TLI = .999, NFI = .999, RFI = .996, RMSEA = .044) was used to prove the adjustment of the proposed models to data.

A Coding System to Quantify Powerful Actions in Soccer Match Play: A Pilot Study.

PURPOSE: The powerful activity profile of elite soccer match play has not been documented appropriately to inform specific maximal power assessment and development criteria. The aims of the current study were to develop a reliable  soccer-specific powerful action (SSPA) notational analysis coding system that could be used to compare frequency and durations of powerful actions during elite youth soccer match play. METHODS: Sixteen elite male English Premier League (EPL) Academy players (19 ± 1 yrs) were recorded by an individual camera during 16 competitive EPL U18 and U21 games. Video footage was analyzed using performance analysis software and SSPAs were coded according to the following categories: initial acceleration, leading acceleration, sprint, unilateral jump and bilateral jump. RESULTS: The SSPA coding system demonstrated very good inter- and intra-rater reliability (kappa coefficients ≥ 0.827). Elite youth EPL soccer players undertook significantly more initial (31 ± 9) and leading (37 ± 12) accelerations than sprints (8 ± 3; p = .014, d = 1.7, and p < .001, d = 1.7, respectively) and jumps (6 ± 5; p = .002, d = 1.7 and p < .001, d = 1.7, respectively). Players performed a significantly greater number of initial and leading accelerations with action durations below 1.5 s compared to above 1.5 s (p = .001, d = 1.6, and p = .002, d = 1.4), respectively. CONCLUSIONS: Our SSPA coding system provides a reliable observational instrument for quantifying the frequency and duration of powerful actions performed during elite soccer match play. In our sample of elite youth soccer players, horizontal accelerations of short duration (< 1.5 s) from different starting speeds appear the most dominant powerful action in elite youth soccer match play.

Is the motor skills checklist appropriate for assessing children in Japan?

PURPOSE: Motor skill screening tools are essential for the early detection of developmental coordination disorder (DCD). The present study aimed to examine any cultural and rater effects on these tools. This then enabled us to judge the validity of the original cut-off values for identifying diagnosable children. METHODS: A community sample survey was performed in Japan; 3852 children aged 6-9 years were recruited. Both parents and teachers evaluated the motor skills of their children using the Movement Assessment Battery for Children - Second Edition Checklist. The psychometric properties were evaluated and the scoring characteristics examined based on the type of rater and country of origin, as compared to data originally sampled in the UK. RESULTS: High reliability and validity of the Japanese samples were confirmed. The Japanese adults evaluated their children's motor skills more rigorously than the Europeans. Additionally, there was a large disagreement between parent and teacher rating scores; the degree of agreement varied depending on the severity of motor deficits in the child. CONCLUSION: The first findings from a Japanese sample suggest that the assessment of motor skills in children is significantly affected by culture and rater. These cultural characteristics and rater biases strongly suggest that new cut-off values, reflecting country and rater type, be introduced for identifying children at risk of DCD.

Developmental Trajectories for the Early Clinical Assessment of Balance by Gross Motor Function Classification System Level for Children With Cerebral Palsy.

Background: Children with cerebral palsy (CP) characteristically present with impairments in balance. Currently, the pattern and timing of the development of balance ability have not been described for children with CP of varying Gross Motor Function Classification System (GMFCS) levels. Objective: The purpose of this study was to document longitudinal developmental trajectories in a measure of balance, the Early Clinical Assessment of Balance (ECAB) scores, along with age-specific reference percentiles and the amount of change typical over a 1-year period for children within different GMFCS levels. Design: The design was a longitudinal cohort study. Methods: Participants included 708 children with CP, aged 18 months through their 12th birthday, and their families. Children participated in 2 to 5 assessments using the GMFCS and ECAB. Results: Longitudinal trajectories describing the average change in the ECAB score with respect to age were created by fitting separate nonlinear mixed-effect models for children in each GMFCS level. Reference percentiles were constructed using quantile regression of ECAB data from the first visit (baseline) and 12-month and 24-month visits. Using these reference points, the amount of change in percentiles was calculated for all children by subtracting the baseline percentile score from the 12-month percentile score. Children whose percentile changes are within the 80% limits can usually be described as "developing as expected" for their age and GMFCS levels. Limitations: Limitations of this study included use of a convenience sample, a ceiling effect of the ECAB for some children in GMFCS levels I and II, and the use of both a 12-month and 24-month study protocol that impacted the number of children available for each assessment session. Conclusions: When used appropriately to monitor development and change over time for children with CP, the ECAB longitudinal trajectories, reference percentiles, and the associated change scores presented here should assist therapists and families in collaborative interaction to proactively plan services and interventions relative to balance ability.

Stability of the Manual Ability Classification System in young children with cerebral palsy.

AIM: To examine the stability over time of the Manual Ability Classification System (MACS) levels in children with cerebral palsy (CP) aged 18 to 60 months. METHOD: This was a prospective longitudinal population-based study of 252 Australian children (160 males [63%] 92 females [37%]; mean age [SD] 41.7mo [14], range 17.2mo-69.2mo) with CP. Children were classified at 18 months (n=70), 24 months (n=131), 30 months (n=173), 36 months (n=209), 48 months (n=226), and 60 months (n=221) of age. Stability of the MACS was examined using the proportion of specific positive agreement and transition proportions, which are measures of agreement. RESULTS: There were 1030 unique observations, with each of the 252 participants seen between two and six occasions (median=4). Average specific positive agreement over the study period was 76% for MACS level I, 67% for level II, 50% for level III, 51% for level IV, and 83% for level V. MACS levels I and V have the highest degree of stability, while levels III and IV have the lowest. We show how this may be explained by the proportion of children in each MACS level. INTERPRETATION: Using measures of agreement rather than measures of reliability provides accurate information when measuring stability over time of an ordinal classification system. The relative stability of MACS levels can be explained by the proportion of children in each level. WHAT THIS PAPER ADDS: Children classified in Manual Ability Classification System (MACS) levels III and IV change levels at next assessment about 50% of the time. Children should be assessed with the MACS regularly, particularly those in levels III and IV. Stability within ordinal classification level categories can be predicted using a measurement error model. Transition proportions or specific agreement is recommended for reporting stability of ordinal classification systems.

Estabilidade do Sistema de Classificação da Habilidade Manual (MACS) em crianças jovens com paralisia cerebral OBJETIVO: Examinar a estabilidade ao longo do tempo dos níveis do Sistema de Classificação da Habilidade Manual (MACS) em crianças com paralisia cerebral (PC) com idade entre 18 e 60 meses. MÉTODO: Este foi um estudo prospectivo de caráter longitudinal, com amostra baseada no estudo da população de 252 crianças Australianas (160 meninos [63%], 92 meninas [37%]; idade média [desvio padrão] de 41,7 meses [14], variação de 17, 2 a 69, 2 meses de idade]) com PC. As crianças foram classificadas aos 18 meses (n = 70), 24 meses (n = 131), 30 meses (n = 173), 36 meses (n = 209), 48 meses (n = 226), e aos 60 meses (n = 221) de idade. A estabilidade do MACS foi examinada utilizando a proporção de concordância positiva específica e proporções de transição, sendo estas as medidas de concordância. RESULTADOS: Foram realizadas um total de 1.030 observações com os 252 participantes, os quais foram avaliados individualmente entre dois e seis momentos (média = 4). A média de concordância específica positiva durante o estudo foi de 76% para MACS nível I, 67% para nível II, 50% para nível III, 51% para nível IV, e 83% para nível V. Os classificados com MACS nível I e V tiveram os maiores graus de estabilidade, enquanto os classificados com os níveis III e IV tiveram os menores graus de estabilidade. Estes resultados podem ser explicados pela proporção de crianças classificadas em cada nível do MACS. INTERPRETAÇÃO: A utilização de medidas de concordância ao invés de medidas de confiabilidade proporciona informações mais precisas quando se mensura estabilidade ao longo do tempo com um sistema de classificação ordinal. A estabilidade relativa dos níveis do MACS pode ser explicada pela proporção de crianças classificadas em cada nível.

Estabilidad del Sistema de Clasificación de Habilidad Manual (MACS) en niños pequeños con parálisis cerebral OBJETIVO: Examinar la estabilidad en el tiempo de los niveles del Sistema de Clasificación de Habilidad Manual (MACS) en niños con parálisis cerebral (PC) de 18 a 60 meses. MÉTODO: Este fue un estudio prospectivo longitudinal basado en la población de 252 niños australianos (160 [63%] hombres, 92 mujeres [37%]; edad media [DE] 41.7mo [14], rango 17.2mo-69.2mo]) con PC. Los niños se clasificaron a los 18 meses (n = 70), 24 meses (n = 131), 30 meses (n = 173), 36 meses (n = 209), 48 meses (n = 226) y 60 meses (n = 221) de edad. La estabilidad del MACS se examinó utilizando la proporción de acuerdo positivo específico y las proporciones de transición, que son medidas de acuerdo. RESULTADOS: Con cada uno de los 252 participantes vistos entre dos y seis ocasiones (mediana = 4) hubo 1030 observaciones únicas. La concordancia positiva específica promedio durante el período de estudio fue de 76% para MACS nivel I, 67% para nivel II, 50% para nivel III, 51% para nivel IV y 83% para nivel V. Los niveles I y V de MACS son los más altos de estabilidad, mientras que los niveles III y IV tienen los más bajos. Mostramos cómo esto puede explicarse por la proporción de niños en cada nivel de MACS. INTERPRETACIÓN: El uso de medidas de acuerdo - en lugar de medidas de confiabilidad - proporciona información precisa cuando se mide la estabilidad en el tiempo de un sistema de clasificación ordinal. La estabilidad relativa de los niveles de MACS puede explicarse por la proporción de niños en cada nivel.

Spinal muscular atrophy 5Q - Treatment with nusinersen.

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.

[Therapeutic cooling is associated with better function in children with cerebral palsy due to birth asphyxia according to the national health care quality registry CPUP]. / Kylbehandling efter förlossnings­asfyxi minskar skadeutveckling - Barn med cerebral pares får bättre funktion, visar retrospektiv genomgång i kvalitetsregistret CPUP.

Hypothermic treatment after birth asphyxia was introduced as a recommended practice in Sweden in 2007. CPUP is a national quality register and surveillance program that encompasses the total population of children with cerebral palsy (CP) in Sweden. In an analysis of CPUP data children with CP and asphyxia treated with cooling were compared to children with CP and asphyxia who were not cooled. A lower proportion of severe motor and cognitive impairments were observed in the group that did receive the cooling/hypothermic treatment.

Functional profiles of children with cerebral palsy in Jordan based on the association between gross motor function and manual ability.

BACKGROUND: Cerebral palsy (CP) is the most common cause of physical disability in childhood. A major challenge for delivering effective services for children with CP is the heterogeneity of the medical condition. Categorizing children into homogeneous groups based on functional profiles is expected to improve service planning. The aims of this study were to (1) to describe functional profiles of children with CP based on the Gross Motor Function Classification System-Expanded & Revised (GMFCS-E & R) and the Manual Ability Classification System (MACS); and (2) to examine associations and agreements between the GMFCS-E & R and the MACS for all participants then for subgroups based on subtypes of CP and chronological age of children. METHODS: A convenience sample of 124 children with CP (mean age 4.5, SD 2.9 years, 56% male) participated in the study. Children were classified into the GMFCS-E & R and the MACS levels by research assistants based on parents input. Research assistants determined the subtypes of CP. RESULTS: Thirty six percent of the participants were able to ambulate independently (GMFCS-E & R levels I-II) and 64% were able to handle objects independently (MACS levels I-II). The most common functional profile of children with CP in our study is the "manual abilities better than gross motor function". An overall strong correlation was found between the GMFCS-E & R and the MACS (rs = .73, p < .001), the correlations vary significantly based on subtypes of CP and chronological age of children. A very strong correlation was found in children with spastic quadriplegia (rs = .81, p < .001), moderate with spastic diplegia (rs = .64, p < .001), and weak with spastic hemiplegia (rs = .37, p < .001). CONCLUSIONS: The GMFCS- E & R and the MACS provide complementary but distinctive information related to mobility and manual abilities of children with CP. Subtypes of CP and chronological age differentiated functional profiles. Functional abilities of children with CP in Jordan have similar patterns to children with CP in other countries. Functional profiles can inform clinicians, researchers, and policy makers.

Spinal muscular atrophy 5Q - Treatment with nusinersen

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.