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1.
Phys Ther ; 100(4): 633-644, 2020 04 17.
Artigo em Inglês | MEDLINE | ID: mdl-32154876

RESUMO

BACKGROUND: Motor impairments are pervasive in Autism Spectrum Disorder (ASD); however, children with ASD rarely receive a dual diagnosis of Developmental Coordination Disorder (DCD). The Simons Foundation SPARK study engaged families affected by ASD through an online study. OBJECTIVES: The DCD parent questionnaire (DCDQ) was used to assess the prevalence of a risk for motor impairment or DCD in children with ASD between 5 and 15 years of age. DESIGN: This study utilizes parent reports from a large database of children with ASD. METHODS: A total of 16,705 parents of children with ASD completed the DCDQ. We obtained our final SPARK dataset (n = 11,814) after filtering out invalid data, using stronger cut-offs to confirm ASD traits, and excluding children with general neuromotor impairments/intellectual delays. We compared DCDQ total and subscale scores from the SPARK dataset with published norms for each age between 5 and 15 years. RESULTS: The proportion of children with ASD at risk for a motor impairment was very high at 86.9%. Children with ASD did not outgrow their motor impairments and continued to present with a risk for DCD even into adolescence. Yet, only 31.6% of children were receiving physical therapy services. LIMITATIONS: Our analysis of a large database of parent-reported outcomes using the DCDQ did not involve follow-up clinical assessments. CONCLUSIONS: Using a large sample of children with ASD, this study shows that a risk for motor impairment or DCD was present in most children with ASD and persists into adolescence; however, only a small proportion of children with ASD were receiving physical therapist interventions. A diagnosis of ASD must trigger motor screening, evaluations, and appropriate interventions by physical and occupational therapists to address the functional impairments of children with ASD while also positively impacting their social communication, cognition, and behavior. Using valid motor measures, future research must determine if motor impairment is a fundamental feature of ASD.


Assuntos
Transtorno do Espectro Autista/complicações , Transtornos Motores/etiologia , Transtornos das Habilidades Motoras/etiologia , Adolescente , Fatores Etários , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Criança , Pré-Escolar , Transtornos da Comunicação/epidemiologia , Bases de Dados Factuais , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Transtornos Motores/diagnóstico , Transtornos Motores/epidemiologia , Transtornos das Habilidades Motoras/diagnóstico , Transtornos das Habilidades Motoras/epidemiologia , Pais , Medição de Risco
2.
Int J Rehabil Res ; 43(2): 167-174, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32097140

RESUMO

Problems have been reported in the execution and development of motor skills and its treatment as a cause of cancer in children. The purpose of this study was to examine the effect of the task-orientated rehabilitation program (ToRP) on motor skills of children with childhood cancer. Following the consort guideline, 93 children (49 males and 44 females) with pediatric cancer were randomized to either study (n = 52; 12.35 ± 3.43 years) or control (n = 41; 11.89 ± 3.56 years) groups. The study group received ToRP, and the control group received a home-based therapeutic strategies program for 20 sessions. Motor skill outcomes were assessed with Bruininks-Oseretsky Test of Motor Proficiency, Short Form (BOTMP-SF) by assessor who was blind to group allocation and interventions. The groups were homogenous in terms of demographic characteristics and motor skills. The study group showed a significant increase in both gross and fine motor skills (P values for all subtests: P < 0.001), whereas running speed, bilateral coordination, strength, response speed and visual motor control did not show significant improvement with the control group (P > 0.05). The ToRP appears to provide beneficial effects in improving motor skills at the early stages of rehabilitation for children with childhood cancer.


Assuntos
Desenvolvimento Infantil , Transtornos das Habilidades Motoras/reabilitação , Neoplasias/complicações , Modalidades de Fisioterapia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Transtornos das Habilidades Motoras/etiologia
3.
Fisioter. Pesqui. (Online) ; 27(1): 41-47, jan.-mar. 2020. tab
Artigo em Português | LILACS | ID: biblio-1090407

RESUMO

RESUMO As cardiopatias congênitas (CC) estão entre as principais causas de morbimortalidade na primeira infância e os lactentes com essa condição podem apresentar atrasos no desenvolvimento neuropsicomotor (DNPM). O objetivo deste estudo foi avaliar a influência da CC no DNPM de lactentes. Trata-se de um estudo observacional com avaliação do desenvolvimento neuropsicomotor realizada pela Bayley Scales of Infant and Toddler Development (BSID-III). As condições maternas e clínicas dos lactentes foram verificadas no relatório de alta médica e na caderneta de saúde da criança, e a condição socioeconômica das famílias pelo Critério da Classificação Econômica Brasil. Para associar as variáveis clínicas e o DNPM foram utilizados o coeficiente de correlação de Spearman e o teste de razão de verossimilhança. Foram avaliados 18 lactentes, com predomínio do sexo feminino (72,2%). A maioria das mães (47,1%) possuía ensino médio completo ou superior incompleto, com média da idade de 27,2±5,5 anos. Houve correlação das escalas do BSID-III com as variáveis quantitativas analisadas: escala motora com o peso (p=0,02 e r=0,54) e com uso de oxigenoterapia (p=0,009 e r=−0,591); já para as variáveis qualitativas as associações foram entre: escala motora e condição socioeconômica (p=0,015), escala motora e comunicação interatrial - (CIA) (p=0,023) e escala da linguagem e CIA (p=0,038). A CC influenciou o DNPM, principalmente no aspecto motor. Além disso peso, diagnóstico de CIA, uso de oxigenoterapia e condição socioeconômica foram considerados como principais fatores de risco para o atraso no DNPM.


RESUMEN Las cardiopatías congénitas (CC) se encuentran entre las principales causas de morbimortalidad en la primera infancia, y los lactantes con esta afección pueden tener retrasos en el desarrollo neuropsicomotor (DNPM). El presente estudio tuvo el objetivo de evaluar la influencia de las CC en el DNPM de los lactantes. Este es un estudio observacional en el cual se evaluó el desarrollo neuropsicomotor utilizando la Bayley scales of infant and toddler development (BSID-III). Las condiciones maternas y clínicas de los lactantes se obtuvieron en el informe de alta médica y en la libreta de salud del niño, y el estado socioeconómico de las familias en el Criterio de Clasificación Económica de Brasil. Para asociar las variables clínicas y el DNPM, se utilizaron el coeficiente de correlación de Spearman y la prueba de razón de probabilidad. Se evaluaron a 18 lactantes, con un predominio del sexo femenino (72,2%). La mayoría de las madres (47,1%) tenían la secundaria completa o la educación superior incompleta, con una edad promedio de 27,2±5,5 años. Hubo una correlación entre las escalas BSID-III y las variables cuantitativas analizadas: escala motora con el peso (p=0,02 y r=0,54) y con el uso de oxigenoterapia (p=0,009 y r=−0,591); para las variables cualitativas, las asociaciones fueron entre: escala motora y estado socioeconómico (p=0,015), escala motora y comunicación interauricular (CIA) (p=0,023) y escala de lenguaje y CIA (p=0,038). Las CC influyeron en el DNPM, principalmente en el aspecto motor. Además, el peso, el diagnóstico de CIA, el uso de oxigenoterapia y el estado socioeconómico fueron considerados los principales factores de riesgo para el retraso en el DNPM.


ABSTRACT Congenital heart defects (CHD) are among the main causes of morbidity and mortality in infants who has this impairment may present delays in neuropsychomotor development (NPMD). This study assesses the influence of CHD on NPMD of infants. This is an observational study assessing neuropsychomotor development performed by Bayley Scales of Infant and Toddler Development - BSID-III. The Brazilian Economic Classification Criteria was used to verify the socioeconomic status of the families and also the maternal and infants' clinical conditions were verified in the medical discharge report and in the child's health handbook. For the association between the quantitative and qualitative variables with the NPMD, the Spearman's correlation coefficient and the likelihood ratio test were used. A total of 18 infants were assessed, with a predominance of females (72.2%). Most mothers (47.1%) had complete high school or incomplete higher education, with a mean age of 27.2±5.5 years. There was a correlation between the BSID-III scales and the quantitative variables analyzed: motor scale with weight (p=0.02 and r=0.54) and oxygen therapy (p=0.009 and r=−0.591); besides that, the qualitative variables correlation were: motor scale and socioeconomic condition (p=0.015), motor scale and Interatrial Communication - IAC (p=0.023) and language with IAC scales (p=0.038). CHD influences the delay of NPMD, mainly for motor aspect. Furthermore, weight, diagnosis of IAC, use of oxygen therapy and socioeconomic status were considered the main risk factors for the delay in NPMD.


Assuntos
Humanos , Lactente , Transtornos Psicomotores/etiologia , Transtornos das Habilidades Motoras/etiologia , Transtornos do Neurodesenvolvimento/etiologia , Cardiopatias Congênitas/complicações , Oxigenoterapia/efeitos adversos , Transtornos Psicomotores/diagnóstico , Fatores Socioeconômicos , Desenvolvimento Infantil/fisiologia , Estudos Transversais , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Transtornos das Habilidades Motoras/diagnóstico , Transtornos do Neurodesenvolvimento/diagnóstico , Hospitalização , Transtornos da Linguagem/diagnóstico , Transtornos da Linguagem/etiologia , Tempo de Internação , Testes Neuropsicológicos
4.
Brain Nerve ; 71(10): 1097-1103, 2019 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-31588054

RESUMO

We reported a male who showed typing disorders after resection of a tumor in the left posterior superior and middle frontal gyri. He was a right-handed Japanese in his 50s and was good at touch typing as a system engineer. After the tumor resection, he presented typing errors and slightly impaired dexterity of his right fingers. The results of neuropsychological examinations indicated that his typing impairment was not due to aphasia or agraphia of kana letters (Japanese syllabogram). Typing errors were classified into adjacent key, non-adjacent key, omission, and insertion errors. Adjacent key, omission, and insertion errors were commonly found in both words and non-words. Adjacent key errors appeared more frequently in the right hand than the left-hand assigned keys, which may be explained by impaired dexterity of the right fingers associated with the left frontal lesion. Non-adjacent key errors were found exclusively for words and more frequently with the left hand than with the right hand. We consider that the patient's left frontal lesion may have impaired the motor engrams of word typing or its output process necessary to type individual words as a programmed series of pushing keys. (Received November 2, 2018; Accepted July 16, 2019; Published October 1, 2019).


Assuntos
Neoplasias Encefálicas/complicações , Lobo Frontal/patologia , Transtornos das Habilidades Motoras/etiologia , Agrafia , Afasia , Neoplasias Encefálicas/cirurgia , Humanos , Masculino
6.
Physiother Res Int ; 24(4): e1786, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31172663

RESUMO

OBJECTIVES: To investigate the use of outcome measures for children with cerebral palsy (CP) by paediatric physiotherapists (PTs) who are based in the United Kingdom, as limited research exists regarding their use in this population, and to explore therapists' use of measures within different Gross Motor Function Classification System (GMFCS) levels and for different types of CP. METHODS: A six-item online survey was advertised through two paediatric therapy special interest groups inviting physiotherapists to participate. Descriptive statistics (range, frequencies, and percentages) were used to analyse survey data. RESULTS: Two hundred and seven physiotherapists returned completed survey questionnaires. One hundred and seventy-six (85%) therapists reported using a wide variety of outcome measures (57). Eighty-one per cent of therapists' responses for having "most difficulty" in identifying responsive outcome measures were for children with impaired mobility at GMFCS Levels IV-V and children with more significant body involvement (76%), for example, spastic quadriplegia or dyskinesia. Eighty-six per cent of therapists' responses for having "greatest ease" of identifying responsive outcome measures were for children within GMFCS Levels I-III and for children with less significant body involvement (72%), for example, hemiplegia. The variety of outcome measures used by therapists with children within GMFCS IV-V was less (16). CONCLUSIONS: The majority (85%) of the PTs surveyed used outcome measures with children with CP, but 81% perceived a difficulty in identifying responsive measures for children with more severe impairments who are classified as GMFCS IV-V. The reasons for this perceived difficulty warrant investigation and may suggest a need for training regarding relevant measures and/or a need to develop new measures for this group of children.


Assuntos
Paralisia Cerebral/reabilitação , Transtornos das Habilidades Motoras/terapia , Índice de Gravidade de Doença , Adolescente , Paralisia Cerebral/complicações , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Destreza Motora , Transtornos das Habilidades Motoras/etiologia , Avaliação de Resultados em Cuidados de Saúde , Fisioterapeutas , Inquéritos e Questionários , Reino Unido
7.
BMC Pediatr ; 19(1): 149, 2019 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-31088407

RESUMO

BACKGROUND: Maternal alcohol consumption in pregnancy may have adverse effects on child gross motor (GM) development. There have been few human studies on this topic, particularly ones examining low exposure. This study examined the association between prenatal alcohol exposure (PAE) and infant GM development at 12-months of age. METHODS: Participants were 1324 women recruited from antenatal clinics in Sydney and Perth, Australia. Maternal and paternal alcohol use was assessed in pregnancy via interview; offspring GM development was measured at 12-months with the Bayley Scales of Infant Development (BSID-III). RESULTS: Any alcohol use in pregnancy was common: 56.1%, of pregnant women drank early in Trimester one (0-6 weeks), however this reduced to 27.9% on average thereafter and at predominantly low levels. However, infant BSID GM scale scores were not found to differ significantly as a function of PAE in the first 6-weeks (low, moderate, binge or heavy PAE), nor with low PAE across pregnancy. CONCLUSIONS: We found no evidence to suggest that low PAE is associated with measurable impairment in infant GM development at 12-months. Further research is needed to examine potential PAE impacts on GM development in heavier exposure groups and through the childhood years when subtle GM deficits may be more detectable.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Transtornos do Espectro Alcoólico Fetal/diagnóstico , Exposição Materna/efeitos adversos , Transtornos das Habilidades Motoras/etiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Adulto , Austrália , Bases de Dados Factuais , Feminino , Transtornos do Espectro Alcoólico Fetal/epidemiologia , Humanos , Recém-Nascido , Masculino , Transtornos das Habilidades Motoras/epidemiologia , Gravidez , Cuidado Pré-Natal/métodos , Prevalência , Prognóstico , Estudos Prospectivos , Medição de Risco
8.
Am J Case Rep ; 20: 430-436, 2019 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-30936415

RESUMO

BACKGROUND Kabuki syndrome (KS) is a rare disease with an estimated prevalence of approximately 1: 32 000. While the clinical presentation of KS is heterogeneous, manifestations may include: characteristic facial features, postnatal growth retardation, and skeletal abnormalities. With regards to the cognitive profile, most individuals with KS have an Intellectual Disability, but the magnitude of the impairment ranges from mild to severe, and verbal abilities are generally stronger than nonverbal abilities (i.e., visual spatial and visual perception abilities). Given the low incidence of KS, there is limited literature illustrating the longitudinal development of individuals with the condition. This report presents the cognitive and behavioral trajectory of an individual with KS. CASE REPORT The patient in this case report was a 27-year-old female with KS. Her cognitive profile had remained in the average range over time, but consistent with the limited KS literature, her verbal abilities were significantly higher than her nonverbal abilities. Specifically, our patient demonstrated significant deficits in visual motor and visual perceptual skills. With regards to her core language skills, her expressive skills were average, yet her receptive skills were below average. Throughout the majority of her schooling, her academic achievement skills were mildly delayed. Notably, her performance on cognitive and academic assessments remained stable over time. During young adulthood, she developed significant internalizing symptoms, particularly depressive symptoms. CONCLUSIONS This is the first case report to illustrate the presentation of an individual with KS from toddlerhood through young adulthood. The patient's clinical presentation across time was relatively consistent with the KS literature to date; notable patterns of language, motor, cognitive and behavioral deficits illustrate the considerable heterogeneity that exists within the syndrome. This case report, particularly, illustrates the persistence of the cognitive profile over time and also the co-occurring psychiatric symptoms that might emerge.


Assuntos
Transtornos Cognitivos/etiologia , Face/anormalidades , Doenças Hematológicas/complicações , Doenças Vestibulares/complicações , Anormalidades Múltiplas , Adulto , Ansiedade/etiologia , Depressão/etiologia , Feminino , Humanos , Transtornos da Linguagem/etiologia , Transtornos das Habilidades Motoras/etiologia
9.
Arq Neuropsiquiatr ; 77(3): 155-160, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30970127

RESUMO

Deficits in motor skills and depressive symptoms are common effects observed after stroke, so it is necessary to understand how these variables interact with each other. Therefore, the aim of this study was to investigate the relationship between these two variables in post-ischemic stroke patients. We evaluated 135 patients with a mean age of 60 years (± 15). The Fugl-Meyer assessment of motor function was used to assess motor skills in the upper limbs, lower limbs, balance, and sensitivity and the Beck Depression Inventory was applied to evaluate depressive symptoms. To assess the relationship between both components, Spearman's correlation was performed. Depressive symptoms were negatively correlated with all variables of motor skills. This study suggests that higher motor skills in post-stroke patients may be associated with fewer depressive symptoms. Thus, a better understanding of how post-stroke symptoms are interrelated may improve patient treatment and care, contributing to a better quality of life.


Assuntos
Depressão/etiologia , Transtornos das Habilidades Motoras/etiologia , Transtornos das Habilidades Motoras/psicologia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/psicologia , Fatores Etários , Idoso , Extremidades/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Qualidade de Vida/psicologia , Valores de Referência , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Reabilitação do Acidente Vascular Cerebral/psicologia , Inquéritos e Questionários , Fatores de Tempo
10.
Eur J Pediatr ; 178(4): 433-454, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30810821

RESUMO

The aim of this review was to evaluate the evidence for nonpharmacological rehabilitation interventions for motor and cognitive impairment following pediatric stroke. A literature search was conducted using multiple scientific databases. Studies were included if (1) the study population was > 50% pediatric (< 18 years) stroke, (2) a diagnosis of stroke was explicitly stated, (3) there were ≥ 3 pediatric stroke participants included in the study sample, and (4) motor or cognitive outcome measures were used to assess effect of treatment. Levels of evidence were assigned to each study to determine the strength of the evidence for each intervention. A total of 18 articles met inclusion criteria. Most studies (N = 14) examined rehabilitation of the upper limb, with constraint-induced movement therapy (CIMT) as the most common intervention. Overall, the evidence supports the use of CIMT, forced use therapy, repetitive transcranial magnetic stimulation, functional electrical stimulation, and robotics, but suggests no beneficial effect of transcranial direct current stimulation. Very few studies assessed interventions for the lower limb (N = 1) or cognitive impairment (N = 3).Conclusion: Effective rehabilitation approaches are important for optimizing outcomes in children who have had a stroke. Although the number of published clinical trials has increased in recent years, little evidence-based guidance exists for this clinical population. What is Known: • Pediatric stroke is a significant cause of disability in children that is often associated with long-term motor and cognitive sequelae. • There is a need to establish a knowledge base regarding available evidence-based rehabilitation therapies for this clinical population. What is New: • Most studies examining interventions for motor function focus on upper limb rehabilitation, whereas few studies have investigated interventions for improving lower limb or cognitive impairment. • An important gap exists regarding evidence-based rehabilitative treatment approaches for pediatric stroke.


Assuntos
Disfunção Cognitiva/terapia , Transtornos das Habilidades Motoras/terapia , Reabilitação do Acidente Vascular Cerebral/métodos , Atividades Cotidianas , Adolescente , Criança , Pré-Escolar , Disfunção Cognitiva/etiologia , Terapia por Estimulação Elétrica , Técnicas de Exercício e de Movimento , Feminino , Humanos , Lactente , Recém-Nascido , Extremidade Inferior/fisiopatologia , Masculino , Transtornos das Habilidades Motoras/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Robótica , Acidente Vascular Cerebral/complicações , Estimulação Transcraniana por Corrente Contínua , Extremidade Superior/fisiopatologia
12.
Eur J Paediatr Neurol ; 23(2): 296-303, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30711366

RESUMO

BACKGROUND: Developmental Coordination Disorder (DCD) is a neurodevelopmental disorder that involves difficulties in goal-directed motor coordination, with ineffective control of fine and gross motor movements in the absence of sensory impairment or neurological condition. DCD is frequently reported in children born very preterm (VP) who survive without CP. AIMS: To measure the risk of DCD at school age in a large area-based cohort of VP children and general population controls, adjusting for gender, birth weight by gestational age and age at assessment. METHODS: VP children (N = 608) were part of a prospective cohort study in Italy. Controls (N = 370) were participants in the DCDQ-Italian validation study in the same age range. The Italian version of Developmental Coordination Disorder Questionnaire (DCDQ-Italian) was used to measure the performances in motor coordination during ordinary activities from the parental point of view. Multivariable regression analysis was used to obtain adjusted risk ratios of screening positive for DCD. RESULTS: VP children had scores significantly lower than peers, and about 30% of them appeared at risk of DCD using the 15th percentile cut-off of the Italian validation study. Birth-weight <10th percentile for gestational age and male gender were significant predictors. A slight trend effect was present, with extremely preterm children (<28 weeks gestation) showing the highest risk. CONCLUSIONS: Our study confirmed the higher DCD risk in VP children, particularly when males and SGA.


Assuntos
Lactente Extremamente Prematuro , Transtornos das Habilidades Motoras/epidemiologia , Transtornos das Habilidades Motoras/etiologia , Peso ao Nascer , Criança , Feminino , Humanos , Recém-Nascido , Itália , Masculino , Controle da População , Estudos Prospectivos , Inquéritos e Questionários
13.
Cardiol Young ; 29(2): 100-109, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30352635

RESUMO

BACKGROUND: Early identification of infants with CHD at heightened risk of developmental delays can inform surveillance priorities. This study investigated pre-operative and post-operative neuromotor performance in infants undergoing open-heart surgery, and their developmental status at 6 months of age, to identify risk factors and inform care pathways. METHODS: Infants undergoing open-heart surgery before 4 months of age were recruited into a prospective cohort study. Neuromotor performance was assessed pre-operatively and post-operatively using the Test of Infant Motor Performance and Prechtl's Assessment of General Movements. Development was assessed at 6 months of age using the Ages and Stages Questionnaire third edition. Pre-operative and post-operative General Movements performance was compared using McNemar's test and test of infant motor performance z-scores using Wilcoxon's signed rank test. Risk factors for delayed development at 6 months were explored using logistic regression. RESULTS: Sixty infants were included in this study. In the 23 (38%) infants. A total of 60 infants were recruited. In the 23 (38%) infants assessed pre-operatively, there was no significant difference between pre- and post-operative performance on the GMs (p=0.63) or TIMP (p=0.28). At discharge, 15 (26%) infants presented with abnormal GMs, and the median TIMP z-score was -0.93 (IQR: -1.4 to -0.69). At 6 months, 28 (52.8%) infants presented with gross motor delay on the ASQ-3, significantly negatively associated with gestational age (p=0.03), length of hospital stay (p=0.04) and discharge TIMP score (p=0.01). CONCLUSIONS: Post-operative assessment using the GMs and TIMP may be useful to identify infants requiring individualised care and targeted developmental follow-up. Long-term developmental surveillance beyond 6 months of age is recommended.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Desenvolvimento Infantil , Cardiopatias Congênitas/complicações , Transtornos das Habilidades Motoras/etiologia , Transtornos do Neurodesenvolvimento/etiologia , Medição de Risco/métodos , Austrália/epidemiologia , Feminino , Seguimentos , Idade Gestacional , Cardiopatias Congênitas/cirurgia , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Transtornos das Habilidades Motoras/epidemiologia , Transtornos das Habilidades Motoras/fisiopatologia , Transtornos do Neurodesenvolvimento/epidemiologia , Transtornos do Neurodesenvolvimento/fisiopatologia , Exame Neurológico , Período Pós-Operatório , Estudos Prospectivos , Fatores de Risco , Fatores de Tempo
14.
Phys Occup Ther Pediatr ; 39(2): 193-203, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29608120

RESUMO

AIMS: This study provides information on how two standardized measures based on different theoretical frameworks can be used in collecting information on motor development and performance in 4- and 5-year-olds with autism spectrum disorder (ASD). The purpose of the study was to determine the concurrent validity of the Miller Function and Participation Scales (M-FUN) with the Peabody Developmental Motor Scales, Second Edition (PDMS-2) in young children with ASD. METHODS: The gross motor sections of the PDMS-2 and the M-FUN were administered to 22 children with ASD between the ages of 48 and 71 months. Concurrent validity between overall motor scores and agreement in identification of motor delay were assessed. RESULTS: A very strong correlation (Pearson's r =.851) was found between the M-FUN scale scores and the PDMS-2 gross motor quotients (GMQs). Strong agreement in identification of children with average motor skills and delayed motor skills at 1.5 standard deviations below the mean was also found. CONCLUSIONS: This study supports the concurrent validity of the M-FUN with the PDMS-2 for young children with ASD. While both tests provide information regarding motor delay, the M-FUN may provide additional information regarding the neurological profile of the child.


Assuntos
Transtorno do Espectro Autista/fisiopatologia , Transtornos das Habilidades Motoras/diagnóstico , Destreza Motora/fisiologia , Testes Neuropsicológicos/estatística & dados numéricos , Transtorno do Espectro Autista/complicações , Pré-Escolar , Feminino , Humanos , Masculino , Transtornos das Habilidades Motoras/etiologia , Reprodutibilidade dos Testes
15.
Dev Med Child Neurol ; 61(2): 161-167, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-29845603

RESUMO

AIM: To describe 5-year motor and functional outcomes after paediatric arterial ischaemic stroke (AIS) and to explore factors associated with poorer long-term outcome. METHOD: Thirty-three children (21 males, 12 females) with AIS were recruited to a single-site, cross-sectional study, from a previously reported prospective longitudinal stroke outcome study. Children were stratified according to age at diagnosis: neonates (≤30d), preschool (>30d-5y), and school age (≥5y). Motor and functional outcomes were measured at 5 years after stroke. Neurological outcomes were evaluated using the Pediatric Stroke Outcome Measure (PSOM) at 1 month and more than 4 years after stroke. RESULTS: At 5 years after stroke, motor function, quality of life, fatigue, adaptive behaviour, activities of daily living, and handwriting speed were significantly poorer than age expectations. The preschool group had the highest percentage of fine and gross motor impairment. Poorer fine motor skills were associated with subcortical-only lesions and large lesion size. Poorer gross motor outcomes correlated with preschool age, bilateral lesions, and PSOM impairment at 1 month. INTERPRETATION: Children are at elevated risk for motor and functional impairments after AIS, with the preschool age group most vulnerable. Identifying early predictors of poorer outcomes facilitates targeted early intervention and long-term rehabilitation. WHAT THIS PAPER ADDS: Following paediatric stroke, children are at elevated risk of motor and functional difficulties. Stroke occurring between 30 days and 5 years of age may result in poorer motor and functional outcomes.


Assuntos
Atividades Cotidianas , Isquemia Encefálica/complicações , Deficiências do Desenvolvimento/etiologia , Transtornos das Habilidades Motoras/etiologia , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/psicologia , Adaptação Fisiológica , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Exame Neurológico , Qualidade de Vida/psicologia
16.
Arch Phys Med Rehabil ; 100(6): 1032-1041, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30476488

RESUMO

OBJECTIVE: To compare, by collection time and patient characteristics, inpatient rehabilitation quality measure scores calculated using patient-reported data. DESIGN: Cohort study of rehabilitation inpatients with neurologic conditions who reported their experience of care and pain status at discharge and 1month after discharge. SETTING: Two inpatient rehabilitation facilities (IRFs). PARTICIPANTS: Patients with neurologic conditions (N=391). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: We calculated 18 quality measure scores using participants' responses to 55 experience of care and health status questions addressing communication, support and encouragement, care coordination, discharge information, goals, new medications, responsiveness of staff, cleanliness, quietness, pain management, care transitions, overall hospital rating, willingness to recommend, and pain. RESULTS: Of the 391 participants reporting at discharge, 277 (71%) also reported postdischarge after multiple attempts by e-mail, mail, and telephone. Discharge experience of care quality scores ranged from 25% (responsiveness of hospital staff) to 75% (willingness to recommend hospital); corresponding postdischarge scores were 32% to 87%, respectively. Five of the 16 experience of care quality scores increased significantly between discharge and postdischarge. The percentage of participants reporting high pain levels at discharge did not change across time periods. Patients with less education, older age, higher motor and cognitive function, and those who were not Hispanic or black had more favorable quality measure scores. CONCLUSION: Patients' experience of care responses tended to be more favorable after discharge compared to discharge, suggesting that survey timing is important. Responses were more favorable for patients with selected characteristics, suggesting the possible need for risk adjustment if patient-reported quality measure scores are compared across IRFs.


Assuntos
Hospitais de Reabilitação/normas , Pacientes Internados/psicologia , Doenças do Sistema Nervoso/reabilitação , Satisfação do Paciente/estatística & dados numéricos , Qualidade da Assistência à Saúde , Adulto , Fatores Etários , Idoso , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/psicologia , Escolaridade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos das Habilidades Motoras/etiologia , Transtornos das Habilidades Motoras/psicologia , Alta do Paciente , Satisfação do Paciente/etnologia , Recursos Humanos em Hospital/normas , Indicadores de Qualidade em Assistência à Saúde , Inquéritos e Questionários , Fatores de Tempo
17.
Pediatr Blood Cancer ; 66(1): e27419, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30152099

RESUMO

BACKGROUND: Adaptive behavior, i.e., the performance on daily activities required for personal and social independence, is essential to estimate in children with low-grade glioma (LGG) since most of them are long-term survivors. Our aim was to investigate adaptive behavior in children with LGG. METHODS: In a cross-sectional study, adaptive behavior was assessed using the paper pencil version of the Parent Form of the Vineland Adaptive Behavior Scales 2nd edition (VABS-II) testing communication, daily living skills, social skills, and motor skills. Scores of children with LGG, younger than 20 years, and diagnosed between 2004 and 2014 were compared with family controls. Correlations between clinical variables and adaptive behavior were explored. RESULTS: Fifty-six children with LGG (median age, 12.1 years; 52% male) and 46 controls (median age, 11.0 years; 43% male) were included in the analyses. Compared with controls, the LGG group was more impaired on total adaptive behavior, communication, and motor skills and in the subdomain gross motor skills (effect sizes d, 0.64-0.86, P < 0.003). Younger age at diagnosis (r = -0.357, P < 0.01) and chemotherapy (r = -0.342, P < 0.05) were associated with poorer motor skills. Residual disease was associated with poorer total adaptive behavior (r = -0.282, P < 0.05). No other significant correlations were found. CONCLUSION: At the group level, adaptive functioning of children with LGG is impaired compared with family controls. Regular structured monitoring of adaptive behavior is recommended to be able to define the needs for tailored rehabilitation in daily life at home as well as at school.


Assuntos
Atividades Cotidianas , Adaptação Psicológica , Comunicação , Glioma/fisiopatologia , Transtornos das Habilidades Motoras/etiologia , Destreza Motora/fisiologia , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos Transversais , Feminino , Seguimentos , Glioma/complicações , Glioma/psicologia , Humanos , Lactente , Masculino , Transtornos das Habilidades Motoras/patologia , Gradação de Tumores , Adulto Jovem
18.
Sci Signal ; 11(560)2018 12 11.
Artigo em Inglês | MEDLINE | ID: mdl-30538177

RESUMO

Ischemic stroke, which is caused by a clot that blocks blood flow to the brain, can be severely disabling and sometimes fatal. We previously showed that transient focal ischemia in a rat model induces extensive temporal changes in the expression of cerebral microRNAs, with a sustained decrease in the abundance of miR-7a-5p (miR-7). Here, we evaluated the therapeutic efficacy of a miR-7 mimic oligonucleotide after cerebral ischemia in rodents according to the Stroke Treatment Academic Industry Roundtable (STAIR) criteria. Rodents were injected locally or systemically with miR-7 mimic before or after transient middle cerebral artery occlusion. Decreased miR-7 expression was observed in both young and aged rats of both sexes after cerebral ischemia. Pre- or postischemic treatment with miR-7 mimic decreased the lesion volume in both sexes and ages studied. Furthermore, systemic injection of miR-7 mimic into mice at 30 min (but not 2 hours) after cerebral ischemia substantially decreased the lesion volume and improved motor and cognitive functional recovery with minimal peripheral toxicity. The miR-7 mimic treatment substantially reduced the postischemic induction of α-synuclein (α-Syn), a protein that induces mitochondrial fragmentation, oxidative stress, and autophagy that promote neuronal cell death. Deletion of the gene encoding α-Syn abolished miR-7 mimic-dependent neuroprotection and functional recovery in young male mice. Further analysis confirmed that the transcript encoding α-Syn was bound and repressed by miR-7. Our findings suggest that miR-7 mimics may therapeutically minimize stroke-induced brain damage and disability.


Assuntos
Isquemia Encefálica/prevenção & controle , MicroRNAs/genética , Transtornos das Habilidades Motoras/prevenção & controle , Traumatismo por Reperfusão/fisiopatologia , Acidente Vascular Cerebral/complicações , alfa-Sinucleína/antagonistas & inibidores , Administração Intravenosa , Animais , Apoptose , Autofagia , Isquemia Encefálica/etiologia , Isquemia Encefálica/metabolismo , Feminino , Masculino , Camundongos Endogâmicos C57BL , Camundongos Knockout , MicroRNAs/administração & dosagem , Dinâmica Mitocondrial , Transtornos das Habilidades Motoras/etiologia , Transtornos das Habilidades Motoras/metabolismo , Estresse Oxidativo , Ratos , Ratos Endogâmicos SHR , alfa-Sinucleína/fisiologia
19.
J Psychiatr Pract ; 24(4): 230-238, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30427806

RESUMO

Motor dysfunction is commonly present in children with neurodevelopmental disorders. Developmental changes in voluntary control of motor skills include improvements in speed and motor coordination as well as reduced frequency of neurological soft signs (NSS) that are commonly observed in typically developing younger children. NSS are motor and sensory conditions that cannot be linked to specific cerebral lesions. The persistence of NSS into later childhood and adolescence is linked with an increased risk of psychiatric disorders. This finding gives support to the neurodevelopmental model of NSS in which minor neurological impairments may be viewed as potential signs of deviant brain development and might represent trait markers of vulnerability for neurodevelopmental disorders. Given that NSS are easily detectable, it is important that clinicians increase their knowledge of the clinical presentation and research implications of the relationship between NSS and childhood neurodevelopmental disorders. To the best of our knowledge, this is the first review article to give an updated overview of the current knowledge of NSS in the most common neuropsychiatric disorders of childhood/adolescence, such as attention-deficit/hyperactivity disorder, autism spectrum disorder, obsessive-compulsive disorder, bipolar disorder, and first episode of psychosis. The article also presents key points for future research studies on this topic.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Espectro Autista/diagnóstico , Transtorno Bipolar/diagnóstico , Transtornos das Habilidades Motoras/diagnóstico , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtornos Psicóticos/diagnóstico , Transtornos das Sensações/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtorno do Espectro Autista/complicações , Transtorno do Espectro Autista/fisiopatologia , Transtorno Bipolar/complicações , Transtorno Bipolar/fisiopatologia , Criança , Pré-Escolar , Humanos , Transtornos das Habilidades Motoras/etiologia , Transtornos das Habilidades Motoras/fisiopatologia , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/fisiopatologia , Transtornos Psicóticos/complicações , Transtornos Psicóticos/fisiopatologia , Transtornos das Sensações/etiologia , Transtornos das Sensações/fisiopatologia
20.
Mov Disord ; 33(9): 1472-1480, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30277603

RESUMO

BACKGROUND: Musician's dystonia critically impacts professional musicians' careers as they may lose musical skills, which have been acquired through long and intensive training. Yet the pathophysiology of musician's dystonia and its link to the neural mechanisms supporting musical skills is poorly understood. We tested if resting-state functional connectivity might reflect an aspect of musical skill linked to the pathophysiology of musician's dystonia. We also tested a second hypothesis that the region with altered resting-state functional connectivity might be correlated with a quantitative measure of musical skills. METHODS: We studied 21 patients with musician's dystonia affecting their hands and 34 healthy musicians, using resting-state functional magnetic resonance imaging and behavioral assessment. We tested between-group differences of resting-state functional connectivity throughout the whole brain using independent component analysis. RESULTS: We found abnormal basal ganglia resting-state functional connectivity in the putamina of patients with musician's dystonia compared with those of healthy musicians (P = 0.035 corrected for multiple comparisons). We also found that the temporal precision of keystrokes was correlated with basal ganglia functional connectivity in the putamina of healthy pianists (r = 0.72, P = 0.0005), but not in pianists with musician's dystonia (r = -0.11, P = 0.64). CONCLUSIONS: We show that abnormalities of the putamen exist even at rest in musician's dystonia, whereas putaminal abnormality has previously been reported during a task. Moreover, basal ganglia resting-state functional connectivity in the putamen represented training levels in healthy musicians, and its disruption was associated with musician's dystonia. This novel finding hints at the pathophysiological mechanisms by which musician's dystonia follows extensive musical training. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.


Assuntos
Gânglios da Base/diagnóstico por imagem , Distúrbios Distônicos/complicações , Distúrbios Distônicos/patologia , Transtornos das Habilidades Motoras/etiologia , Descanso , Adulto , Mapeamento Encefálico , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Vias Neurais/diagnóstico por imagem , Oxigênio/sangue , Análise de Componente Principal , Estatísticas não Paramétricas , Adulto Jovem
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