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1.
Dev Neurorehabil ; 23(1): 64-67, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31411516

RESUMO

Objective: To explore the effects of a web platform, aiming to support parents of children 5-12 years old with suspected or diagnosed developmental coordination disorder (DCD), on parental knowledge and skills.Method: A randomized pilot trial was undertaken (Clinical trial NCT03141333). Parents of the intervention group (n = 15) had access to a web platform (including resources, forum and virtual interactions) for three months. The control group (n = 13) only had access to resources. The primary outcome was measured pre- and post-intervention with the Parent Knowledge and Skills Questionnaire. Pre- post-questionnaires evaluated secondary outcomes (parents' sense of competence, children's strenghts and difficulties, and occupational performance).Results and discussion: All outcome measures improved over time for the intervention group. However, those improvements were not clinically or statistically significant (p 0.08-0.41).Conclusion: Web platforms supporting parents of children with DCD need further evaluation. Especially, usability of web platforms and new outcome measures should be explored.


Assuntos
Transtornos das Habilidades Motoras/reabilitação , Reabilitação Neurológica/métodos , Pais/psicologia , Apoio Social , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Inquéritos e Questionários
2.
Medicine (Baltimore) ; 98(45): e17946, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702684

RESUMO

BACKGROUND: Adaptive balance control is often compromised in children with developmental coordination disorder (DCD). Neuromuscular training (NMT) is commonly used in clinical settings to improve neuromuscular control and hence balance performance in these children. However, its effectiveness has not been proven scientifically. This randomized controlled study aimed to explore the effectiveness of NMT for improving adaptive balance performance and the associated leg muscle activation times in children with DCD. METHODS: Eighty-eight children with DCD were randomly assigned to the NMT or control group (44 per group). The NMT group received two 40-minute NMT sessions/week for 3 months, whereas the control group received no intervention. The outcomes were measured at baseline and 3 and 6 months. The primary outcome was the sway energy score (SES) in both the toes-up and toes-down conditions as derived using the Adaptation Test (ADT). Secondary outcomes included the medial gastrocnemius, medial hamstring, tibialis anterior and rectus femoris muscle activation onset latencies during ADT, measured using surface electromyography and accelerometry. Data were analyzed using a repeated measures analysis of covariance based on the intention-to-treat principle. RESULTS: At 3 months, no significant within-group or between-group differences were noted in the SESs for either group. At 6 months, the toes-down SES decreased by 6.8% compared to the baseline value in exclusively the NMT group (P = .004). No significant time, group or group-by-time interaction effects were observed in any leg muscle activation outcomes. CONCLUSIONS: Short-term NMT failed to improve adaptive balance performance and leg muscle activation times in children with DCD. Further studies should explore the clinical applications of longer-term task-specific interventions intended to improve the adaptive balance performance of these children.


Assuntos
Terapia por Exercício/métodos , Transtornos das Habilidades Motoras/reabilitação , Equilíbrio Postural , Adaptação Fisiológica , Criança , Eletromiografia , Feminino , Humanos , Masculino , Método Simples-Cego , Resultado do Tratamento
3.
Percept Mot Skills ; 126(6): 1117-1144, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31390305

RESUMO

Motor disorders often accompany autism spectrum disorder (ASD), although they are not included in its diagnostic criteria. Slower motor development is evident in early childhood in this population, making early motor skills intervention advisable. As educational games and modern technology can represent new forms of treatment, this study evaluated four Kinect-based visuo-motor games called Fruits that were specially designed for this research. We sought to test whether children with ASD would show behavior changes during their game play and whether any effects would generalize to another game called Rackets. The study included 10 elementary school children with ASD, aged 9-13 years, who were divided into (a) an experimental group (n = 5) who, in addition to standard treatment, played Fruits once a week for a 5-week period and Rackets both before and after the 5-week period and (b) a control group (n = 5) who received only standard treatment during this period and also played Rackets before and after it. We found significant improvements in gross motor skills and successful generalization of acquired skills among children in the experimental group relative to the control group. The experimental group also showed an increase in positive emotions and a decrease in loss of attention while playing the games. These preliminary findings indicate a motor skill benefit for children with ASD who play Kinect-based educational games, but further research is needed to replicate and expand these findings with larger participant samples.


Assuntos
Transtorno do Espectro Autista/reabilitação , Transtornos das Habilidades Motoras/reabilitação , Destreza Motora , Jogos de Vídeo , Adolescente , Atenção , Criança , Feminino , Humanos , Masculino , Estudo de Prova de Conceito
4.
Pediatr Phys Ther ; 31(2): 217-224, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30865149

RESUMO

PURPOSE: The proposed project tests the principle that frequency of rehabilitation is an important regulator of therapeutic response in infants. METHODS: We will randomize 75 infants with cerebral palsy, 6 to 24 months of age and/or Gross Motor Function Classification System levels III to V (higher severity), to determine the short-term and long-term effects of 3 dosing protocols consisting of an identical number of 2-hour sessions of the same motor learning-based therapy applied over a different total number of calendar weeks. RESULTS AND CONCLUSIONS: The results will inform clinicians, families, and scientists about dosing and will provide needed recommendations for frequency of rehabilitation to optimize motor function and development of young children with cerebral palsy.


Assuntos
Paralisia Cerebral/reabilitação , Transtornos das Habilidades Motoras/reabilitação , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Destreza Motora/fisiologia , Índice de Gravidade de Doença , Fatores de Tempo
5.
J Rehabil Med ; 51(3): 217-224, 2019 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-30815705

RESUMO

OBJECTIVES: To compare sensitivity to light touch in children with developmental coordination disorder and those with typical development. Also, to investigate how changes/increases in sensitivity to light touch influence the effects of light fingertip touch on reducing body sway in both groups, while controlling for the confounding effects of arm configuration. METHODS: Twenty-six children with developmental coordination disorder and 26 typically developing children were enrolled in the study. To change/increase sensitivity to light touch, participants immersed their dominant index finger in a surfactant-water solution. Sensitivity to light touch was measured before and after soaking. Participants performed all conditions (no fingertip touch, light fingertip touch, and light fingertip touch after soaking) with the same arm configuration, while body sway was measured. RESULTS: Analysis of variance (ANOVA) revealed that the children with developmental coordination disorder were less sensitive to light touch than typically developing children (p <0.05). For both groups, immersing a fingertip in surfactant-water solution increased sensitivity to light touch (p < 0.05). Finger soaking enhanced the effects of light fingertip touch on reducing body sway only in those children with developmental coordination disorder (p < 0.05). CONCLUSION: Finger soaking can be used as a rehabilitation strategy for promoting sensitivity to light touch, as well as for enhancing the effects of light fingertip touch in reducing body sway in children with developmental coordination disorder.


Assuntos
Dedos/fisiologia , Transtornos das Habilidades Motoras/reabilitação , Equilíbrio Postural/fisiologia , Tato/fisiologia , Criança , Feminino , Humanos , Masculino
6.
Top Spinal Cord Inj Rehabil ; 25(1): 97-103, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30774293

RESUMO

Intrauterine spinal cord infarcts (IUSCI) with resulting tetraplegia are extremely rare, and there is minimal evidence describing outcomes in this population. This case describes the functional progress of a 3-year-old girl born with IUSCI who participated in activity-based therapies (ABT). Children have developing nervous systems and are particularly suited to benefit from ABT. Over the course of treatment, the child in this case has demonstrated improvements in developmental milestone achievement including fine and gross motor skills and social/cognitive development. Intense, interdisciplinary ABT should be considered for the treatment of children with IUSCI.


Assuntos
Infarto/terapia , Transtornos das Habilidades Motoras/reabilitação , Medula Espinal/irrigação sanguínea , Desenvolvimento Infantil/fisiologia , Pré-Escolar , Terapia Combinada , Avaliação da Deficiência , Terapia por Exercício/métodos , Feminino , Serviços de Assistência Domiciliar , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Destreza Motora/fisiologia , Terapia Ocupacional/métodos , Equipe de Assistência ao Paciente , Modalidades de Fisioterapia , Diagnóstico Pré-Natal , Resultado do Tratamento
8.
Clin Rehabil ; 33(4): 704-710, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30599772

RESUMO

OBJECTIVES:: To investigate the feasibility and potential efficacy of a six-week interactive computer play training on balance and gross motor function in children with moderate cerebral palsy. DESIGN:: A pilot single-blinded matched randomized controlled study. SETTING:: Community. PARTICIPANTS:: In total, 18 children with moderate cerebral palsy were recruited, paired according to age and severity of cerebral palsy and randomized into intervention group or control group. INTERVENTION:: The intervention group received additional trunk control training using the interactive computer play in sitting four times per week, 20 minutes per session for six weeks. All study children continued their usual physiotherapy programme. MEASUREMENTS:: All study children were assessed at baseline, week 3, week 6 (completion of intervention) and week 12 using the Pediatric Reach Test, Gross Motor Function Measure-66-Item Set and 2-Minute Walk Test. RESULTS:: All intervention children completed and enjoyed the training with no reported adverse event. All children were assessed at all time points. No significant difference was found between the two groups in all assessments. In both groups of children, significant improvements were found in the Gross Motor Function Measure-66-Item Set between week 3 (intervention group: mean 53.41, SD 5.34; control group: mean 52.86, SD 8.33) and week 6 (intervention group: mean 55.00, SD 6.32; control group: mean 54.20, SD 8.35). CONCLUSION:: The intervention protocol of a six-week interactive computer play training was feasible and safe for children with moderate cerebral palsy in special school settings. Future studies with larger sample sizes or using single-subject designs are recommended.


Assuntos
Paralisia Cerebral/reabilitação , Transtornos das Habilidades Motoras/reabilitação , Equilíbrio Postural/fisiologia , Jogos de Vídeo , Paralisia Cerebral/fisiopatologia , Criança , Avaliação da Deficiência , Feminino , Humanos , Masculino , Transtornos das Habilidades Motoras/fisiopatologia , Testes Neuropsicológicos , Projetos Piloto , Método Simples-Cego
9.
Disabil Rehabil ; 41(9): 995-1011, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-29316816

RESUMO

PURPOSE: A systematic review was performed to (1) evaluate the effectiveness of augmented visual feedback-based treatments for motor rehabilitation in Parkinson's disease, and (2) examine treatment design factors associated with enhanced outcomes following these treatments. METHODS: Eight databases were searched from their start-date up to January 2017 using the key terms Parkinson's Disease and augmented visual feedback. Two independent raters screened the abstracts and full articles for inclusion. Relevant data were extracted and summarized, and methodological quality of accepted articles was assessed. RESULTS: Eight single-group studies and 10 randomized control trials were included in the review. Augmented visual feedback-based treatments resulted in improved outcomes with small to large effect sizes post-treatment for the majority of impairment, activity, participation, and global motor function measures, and these improvements were often superior to traditional rehabilitation/education programs. Enhanced treatment outcomes were observed in studies that provided large amounts and high intensities of treatment; gamified feedback; and provided knowledge of performance feedback in real-time on 100% of practice trials. CONCLUSION: Augmented visual feedback appears to be a useful motor rehabilitation tool in Parkinson's disease; however, high-quality, rigorous studies remain limited. Future studies should consider factors that enhance rehabilitation outcomes when designing augmented visual feedback-based interventions. Implications for rehabilitation Augmented visual feedback is a useful tool for motor rehabilitation in Parkinson's disease; augmented visual feedback-based treatments are often superior to traditional programs. These treatments are associated with improved outcomes in impairment, activity, participation, and global motor function domains. Rehabilitation professionals can optimize their use of augmented visual feedback-based treatments by providing large amounts and a high intensity of treatment, gamifying feedback, and providing knowledge of performance feedback in real-time and at a high frequency.


Assuntos
Retroalimentação Sensorial , Doença de Parkinson/reabilitação , Eletromiografia , Transtornos Neurológicos da Marcha/fisiopatologia , Transtornos Neurológicos da Marcha/reabilitação , Humanos , Transtornos das Habilidades Motoras/fisiopatologia , Transtornos das Habilidades Motoras/reabilitação , Doença de Parkinson/fisiopatologia , Equilíbrio Postural/fisiologia , Software , Jogos de Vídeo
10.
Eur J Phys Rehabil Med ; 55(2): 291-300, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30311491

RESUMO

INTRODUCTION: Although virtual reality (VR) is an increasingly popular approach within studies that propose interventions for children with developmental coordination disorder (DCD), evidence on the effectiveness of VR remains debatable. The aim of this study was to synthesize evidence on the effectiveness of VR interventions for motor performance improvement in children with DCD. EVIDENCE ACQUISITION: Searches were conducted in the MEDLINE/PubMed, Scopus, Web of Science and ERIC databases to select studies published from 1 January 2006 to 30 November 2017. Two independent reviewers performed the primary study selection based on titles, abstracts and full-text reading; this selection included randomized controlled trials (RCTs) that applied VR interventions to children with DCD and assessed outcomes related to motor performance. The methodological quality of the studies included in the search was assessed through the PEDro scale. PRISMA guidelines and Cochrane recommendations for systematic reviews were followed. The effect size of each intervention was calculated to allow for the interpretation of clinical effects, and the body of evidence was synthesised through the GRADE approach. EVIDENCE SYNTHESIS: A total of 2160 publications were retrieved; by the end of the selection process, twelve RCTs had been included. Of these twelve, seven were classified as having high methodological quality. Only three studies satisfied the homogeneity conditions to be assessed through the GRADE system, which showed a low level of evidence in favor of VR for improving the motor performance of children with DCD. CONCLUSIONS: Not enough evidence currently exists to support or refute the use of VR over non-VR interventions for improving motor performance in children with DCD. Despite the potential for improving the motor performance of DCD children, the absence of specific protocols prevents formal recommendations of VR for these children. Future studies should consider VR protocols that are more specific regarding the tasks, features and target motor skills to be developed by DCD children. In addition, comparisons of similar groups at baseline, the concealment of allocation and the blinding of assessors are internal validity aspects which deserve researchers' attention.


Assuntos
Transtornos das Habilidades Motoras/fisiopatologia , Transtornos das Habilidades Motoras/reabilitação , Terapia de Exposição à Realidade Virtual , Criança , Humanos
11.
Pediatr Phys Ther ; 31(1): E14-E21, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30557295

RESUMO

PURPOSE: This report assesses functional mobility in children with neurological impairments and documented gross motor delays, before and after receiving either hippotherapy or standard outpatient physical therapy (PT). SUMMARY OF KEY POINTS: This is a case-series report using data previously collected for a discontinued randomized controlled trial, in which participants received hippotherapy or standard outpatient clinic PT for a 12-week treatment period. Results demonstrated both subjective and objective functional mobility improvements after treatment in participants receiving hippotherapy and standard outpatient PT, as determined by the Peabody Developmental Motor Scales-2, the Pediatric Evaluation of Disability Inventory, and the Goal Attainment Scaling. STATEMENT OF CONCLUSION AND RECOMMENDATIONS FOR CLINICAL PRACTICE:: When compared with standard outpatient PT, hippotherapy appears to be a viable treatment strategy for children aged 2 to 5 years with neurological impairments and gross motor delays, but additional research in this area is needed to validate findings.


Assuntos
Deficiências do Desenvolvimento/reabilitação , Terapia Assistida por Cavalos , Transtornos das Habilidades Motoras/reabilitação , Doenças do Sistema Nervoso/reabilitação , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Masculino , Amplitude de Movimento Articular , Resultado do Tratamento
12.
Int J Rehabil Res ; 42(1): 46-55, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30371552

RESUMO

Discrete and rhythmic movements are two fundamental motor primitives being, at least partially, controlled by separate neural circuitries. After a stroke, both primitives may be impaired in the upper limb. Currently, intensive functional movement therapy is recommended after stroke, but it is mainly composed of discrete movements. No recommendation is made for the specific training of rhythmic movements. However, if they form two different primitives, both should receive a specific training to recover the complete motor repertoire, as many daily live movements integrate both of them. This paper reports the effects of a pure unilateral rhythmic movement therapy on motor performance, after stroke. Thirteen patients with chronic stroke participated in this longitudinal pilot study. They were assessed twice before the therapy to validate their chronic state, and twice after the last session to establish the short-term and long-term effects of the therapy. The therapy itself was composed of 12 sessions spread over 1 month. The exercises consisted in performing straight or circular rhythmic movements, while receiving assistance as need through a robotic device. Short-term and long-term improvements were observed in rhythmic movements regarding smoothness, velocity, and harmonicity. More surprisingly, some transfer occurred to the untrained discrete movements. This finding disputes previous studies that reported no transfer from rhythmic to discrete movements with healthy participants.


Assuntos
Transtornos das Habilidades Motoras/reabilitação , Robótica , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/fisiopatologia , Extremidade Superior/fisiopatologia , Idoso , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Transtornos das Habilidades Motoras/fisiopatologia , Projetos Piloto
13.
Res Dev Disabil ; 84: 131-138, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30097306

RESUMO

BACKGROUND: There are few exercise interventions focused on adolescents with low motor competence and most interventions are short with little follow up and engagement over time. METHODS AND PROCEDURES: Fifty-eight adolescents with low motor competence (39 males, Mean Age = 13.6, SD = 1.4 years) attended an exercise clinic twice a week for each 13 week program. Two programs ran each year, and participants attended for as long as they felt progress was made or they turned 18 years of age. Performance on the Multistage Fitness Test (MSFT), Curl-ups, Grip Strength, 1RM Leg press and Chest Press, Vertical Jump and Standing Broad Jump (SBJ) were recorded pre and post each program for up to six years. Linear Mixed Modelling (LMM) determined changes in fitness measures over time whilst adjusting for gender, age and Neuromuscular Developmental Index (McCarron, 1997). RESULTS: All fitness measures increased, and specifically four of the seven fitness outcomes showed significant improvement over time (MSFT,p = 0.011; curl-ups, p < 0.001, grip strength p = 0.003, and SBJ p = 0.006). CONCLUSION: An individually tailored regular exercise program in a supportive environment can achieve exercise adherence and sustainable improvements in fitness outcomes for adolescents with low motor competence. Future research should consider the addition of a comparison LMC control group to increase understanding of the intervention effect.


Assuntos
Transtornos das Habilidades Motoras/reabilitação , Força Muscular , Aptidão Física , Treinamento de Resistência/métodos , Adolescente , Exercício , Feminino , Força da Mão , Humanos , Modelos Lineares , Masculino
14.
Clin Rehabil ; 33(3): 465-472, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30501396

RESUMO

OBJECTIVE:: To evaluate the effects of an intervention based on a specific set of goals on goal attainment, manual dexterity, hand grip strength and finger prehension force compared to a standardized approach in patients with Parkinson's disease. DESIGN:: Randomized controlled trial. SETTING:: Home-based. PARTICIPANTS:: Fifty patients with a clinical diagnosis of Parkinson's disease acknowledging impaired manual ability were randomized into two groups. INTERVENTIONS:: Patients in the experimental group ( n = 25) were included in an intervention focused on task components that involved goals proposed by participants. Patients in the control group ( n = 25) received a standard intervention focused on impairments in range of motion, grasp and manipulation. Home condition and duration (four weeks, twice a week) were similar in both groups. MAIN OUTCOME MEASURES:: The primary outcome measure was goal achievement assessed with the Goal Attainment Scaling. Secondary outcomes were manual dexterity evaluated with the Purdue Pegboard Test and hand grip strength and finger prehension force assessed using a dynamometer. RESULTS:: After four weeks, significant between-group improvement in goal attainment was observed in the experimental group (change 17.36 ± 7.48 vs. 4.03 ± 6.43, P < 0.001). Compared to the control group, the experimental group also showed a significant improvement ( P < 0.05) in manual dexterity (postintervention values in the most affected arm 10.55 ± 1.95 vs. 7.33 ± 3.63 pins, P < 0.001) and finger prehension force (postintervention values in the most affected arm 8.03 ± 1.93 vs. 6.31 ± 1.85 kg, P = 0.010). CONCLUSIONS:: Targeting therapy toward specific goals leads to greater changes in arm function than a standardized approach in people with Parkinson's disease.


Assuntos
Metas , Doença de Parkinson/reabilitação , Idoso , Feminino , Força da Mão/fisiologia , Humanos , Masculino , Transtornos das Habilidades Motoras/fisiopatologia , Transtornos das Habilidades Motoras/reabilitação , Doença de Parkinson/fisiopatologia , Modalidades de Fisioterapia , Método Simples-Cego
15.
Rehabilitación (Madr., Ed. impr.) ; 52(3): 148-157, jul.-sept. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-175759

RESUMO

Introducción: En la hemiplejía, la afectación de la función manual está asociada con dificultad en la ejecución de patrones selectivos de movimiento de tipo individual y bilateral, y aunque no está claro el potencial de recuperación, existen métodos de intervención que pueden disminuir los niveles de discapacidad, como el modelo de reaprendizaje motor. Objetivo: Determinar la efectividad del modelo de reaprendizaje motor en la función de la mano espástica del adulto con hemiplejía. Materiales y métodos: Se realizó una búsqueda sistemática de literatura científica en PubMed, registro Central Cochrane de Ensayos Clínicos Controlados, LILACS, Scielo, así como en diferentes bibliotecas virtuales desde julio de 2015 hasta febrero de 2016. Para determinar la calidad de los estudios se usó la lista de chequeo de la estrategia CONSORT (Consolidated Standars of Reporting Trials) y se evaluó la calidad metodológica mediante la escala de PEDro. Resultados: Se incluyeron 8 estudios, 4 de los cuales fueron seleccionados para metaanálisis e incluían entrenamiento orientado a tareas y de la fuerza muscular. Se encontró que los efectos del modelo no fueron estadísticamente significativos con relación a otro tipo de intervenciones, aunque hubo una tendencia a la mejoría. Conclusión: Los estudios muestran efectividad del modelo de reaprendizaje motor para el tratamiento de la mano espástica del adulto con hemiplejía, aunque no se evidencian estudios que muestren gran poder estadístico con suficiente calidad metodológica para determinar su efectividad frente a la terapia convencional


Introduction: In hemiplegia, the involvement of manual function is associated with difficulty in executing selective patterns of individual and bilateral movement. Although the potential for recovery is not clear, there are interventions that can reduce disability, such as the motor relearning model. Objective: To determine the effectiveness of the motor relearning model in improving the function of the spastic hand in adults with hemiplegia. Materials and methods: A systematic search of scientific literature was performed in PubMed, Cochrane Central Register of Controlled Trials, LILACS, and Scielo, as well as in different virtual libraries from July 2015 to February 2016. To determine the quality of the studies, the CONSORT strategy (Consolidated Standards of Reporting Trials) was used and the methodological quality was evaluated using the PEDro scale. Results: Eight studies were included, and 4 were selected for a meta-analysis. The selected studies included task-oriented and muscular strength training and found that the effects of the model were not statistically significant in relation to other types of interventions, although there was a tendency to improvement. Conclusion: The studies show the effectiveness of the motor relearning model for the treatment of spastic hand in adults with hemiplegia, although there are no studies showing strong statistical power and with sufficient methodological quality to determine their effectiveness compared with that of conventional therapy


Assuntos
Humanos , Hemiplegia/reabilitação , Espasticidade Muscular/reabilitação , Modalidades de Fisioterapia , Transtornos das Habilidades Motoras/reabilitação , Resultado do Tratamento
16.
BMJ Open ; 8(6): e020367, 2018 06 27.
Artigo em Inglês | MEDLINE | ID: mdl-29950462

RESUMO

INTRODUCTION: Children with developmental coordination disorder (DCD) are less physically active than their typically developing peers. No substantiated interventions are available to address this issue. Therefore, this study aims to describe the design and rationale of (1) a family-focused intervention to increase motivation for physical activity (PA) and, indirectly, lifestyle PA in children aged 7-12 years with DCD and (2) the methods to examine its preliminary effectiveness and feasibility. METHODS AND ANALYSIS: This intervention is the second part of a more comprehensive, multidisciplinary treatment called We12BFit! The intervention was developed using the steps of treatment theory which includes the concept of targets, mechanism of action and essential ingredients. The content of the intervention is based on the transtheoretical model of change (TTM). In the intervention, the motivation for PA will be targeted through application of behaviour change strategies that fit the stages of the TTM. The modes of delivery include: pedometer, poster, parent meeting, booklet and coaching. At least 19 children with DCD, aged 7-12 years, will be included from two schools for special education and two rehabilitation centres. The intervention will be evaluated using a single-arm mixed-method design. Effectiveness will be assessed at three instances by using ActiGraph accelerometers accompanied by an activity log. Feasibility will be assessed using interviews with the participants and coaches. This evaluation may add to our understanding of motivation for PA in children with DCD and may eventually improve the rehabilitation programme of children with DCD. ETHICS AND DISSEMINATION: The study has been approved by the Medical Ethics Committee of the University Medical Center of Groningen (METc 2015.216). We will disseminate the final results to the public through journal publications and presentations for practice providers and scientists. A final study report will also be provided to funding organisations. PROTOCOL VERSION: 4, 12 April 2018. TRIAL REGISTRATION NUMBER: NTR6334; Pre-results.


Assuntos
Exercício/fisiologia , Estilo de Vida , Transtornos das Habilidades Motoras/reabilitação , Actigrafia , Criança , Exercício/psicologia , Estudos de Viabilidade , Feminino , Humanos , Entrevistas como Assunto , Masculino , Motivação , Países Baixos , Pais/psicologia , Projetos de Pesquisa , Inquéritos e Questionários
17.
Aust Occup Ther J ; 65(4): 295-305, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29806699

RESUMO

BACKGROUND/AIM: Children with developmental coordination disorder demonstrate limited participation in daily occupations which negatively impacts on their physical and psycho-social wellbeing. Literature is emerging supporting the use of the Cognitive Orientation to daily Occupational Performance (CO-OP) within a group format. The purpose of this study was to explore the feasibility of the CO-OP approach in a group format for children with motor coordination difficulties. METHODS: A single group mixed-method approach was employed. Four children with motor coordination difficulties between seven-to-nine years of age and their mothers, participated in a CO-OP group intervention once a week over 10 weeks. The study examined performance (perceived and actual) and satisfaction of family-chosen goals, gross and fine motor functioning and parental experience of participating in the intervention. RESULTS: Improvements in performance (perceived) and satisfaction ratings of family-chosen goals bordered on achieving statistical significance. Fine and gross motor functioning and performance (actual) improved, however, the change in performance was variable between participants and among the overarching goals. Semi-structured interviews were thematically analysed. Themes included: formation of the group, moving from disenabling to enabling, belonging and the importance of small successes. CONCLUSIONS: CO-OP offers a feasible intervention approach when delivered in a group format. Parental perceptions are valuable in shaping the delivery of the CO-OP in future studies. More research is needed to support these findings and contribute to evidence-based practice.


Assuntos
Transtornos das Habilidades Motoras/reabilitação , Terapia Ocupacional/métodos , Criança , Feminino , Processos Grupais , Humanos , Masculino , Satisfação do Paciente
18.
Phys Ther ; 98(6): 494-502, 2018 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-29767802

RESUMO

Background: There is limited research examining the efficacy of early physical therapy on infants with neuromotor dysfunction. In addition, most early motor interventions have not been directly linked to learning, despite the clear association between motor activity and cognition during infancy. Objective: The aim of this project is to evaluate the efficacy of Sitting Together And Reaching To Play (START-Play), an intervention designed to target sitting, reaching, and motor-based problem solving to advance global development in infants with motor delays or neuromotor dysfunction. Design: This study is a longitudinal multisite randomized controlled trial. Infants in the START-Play group are compared to infants receiving usual care in early intervention (EI). Setting: The research takes place in homes in Pennsylvania, Delaware, Washington, and Virginia. Participants: There will be 140 infants with neuromotor dysfunction participating, beginning between 7 to 16 months of age. Infants will have motor delays and emerging sitting skill. Intervention: START-Play provides individualized twice-weekly home intervention for 12 weeks with families to enhance cognition through sitting, reaching, and problem-solving activities for infants. Ten interventionists provide the intervention, with each child assigned 1 therapist. Measurements: The primary outcome measure is the Bayley III Scales of Infant Development. Secondary measures include change in the Early Problem Solving Indicator, change in the Gross Motor Function Measure, and change in the type and duration of toy contacts during reaching. Additional measures include sitting posture control and parent-child interaction. Limitations: Limitations include variability in usual EI care and the lack of blinding for interventionists and families. Conclusions: This study describes usual care in EI across 4 US regions and compares outcomes of the START-Play intervention to usual care.


Assuntos
Desenvolvimento Infantil , Transtornos das Habilidades Motoras/reabilitação , Modalidades de Fisioterapia , Jogos e Brinquedos , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Projetos de Pesquisa
19.
Int J Med Inform ; 114: 81-87, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29673608

RESUMO

Self-care problems diagnosis and classification is an important challenge in exceptional children health care systems. Since, self-care problems classification is a time-consuming process and requires expert occupational therapists, using an expert system in classifying these problems can decrease cost and time, efficiently. Expert systems refer to the systems that are based on artificial intelligence methods, which have the ability to learn, infer, and predict. In order to configure and train an expert system, a standard dataset is critical for the learning phase. Hence, in this research, a new standard dataset called SCADI (Self-Care Activities Dataset based on ICF-CY) is introduced innovatively. SCADI is based on ICF-CY, which is a conceptual framework, released by the World Health Organization. According to the best of our knowledge, SCADI is the first standard dataset in the self-care activates based on ICF-CY in which 29 self-care activities are considered. In this research, to show the applicability of SCADI in the expert systems, two different types of expert systems are proposed for the self-care problems classification of children with physical and motor disability. In the first expert system, an Artificial Neural Network (ANN) is employed as a classifier. This classifier is trained by using SCADI during the learning process. Since ANNs do not provide any explanation for the inference rules and manners, in the second expert system, to evaluate the applicability of SCADI in the rule-based systems, C4.5, a popular decision tree algorithm is used to extract self-care problems classification rules precisely. The experiment results show that the ANN-based system has high accuracy in self-care problems classification, which is 83.1% and SCADI has the high applicability to be employed in the different classification systems such as neural networks and rule-based systems.


Assuntos
Crianças com Deficiência/reabilitação , Classificação Internacional de Funcionalidade, Incapacidade e Saúde , Transtornos das Habilidades Motoras/reabilitação , Autocuidado/classificação , Autocuidado/normas , Atividades Cotidianas , Adolescente , Inteligência Artificial , Criança , Árvores de Decisões , Sistemas Especialistas , Feminino , Humanos , Masculino , Inquéritos e Questionários , Organização Mundial da Saúde
20.
Pediatr Phys Ther ; 30(2): 106-111, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29578996

RESUMO

PURPOSE: To explore the role of pediatric physical therapists (PPT) in promoting sports participation in children with developmental coordination disorder (DCD) and identify associated barriers and facilitators. METHODS: Questionnaires were provided to 243 PPTs. Qualitative, semistructured, in-depth interviews were administered with the PPTs, children with DCD, and parents. RESULTS: Approximately 67% of questionnaires were returned. Approximately 46% of PPTs were active in guiding children with DCD to sports clubs. This guidance was facilitated by knowledge of local sports, clubs that include children with DCD, and contact persons. Barriers to sports participation were the motor impairment or coincident disorder, insufficient participants to compose a team, and lack of guidance on how to include children with DCD. CONCLUSIONS: PPTs currently guide children with DCD to sports clubs, but this guidance may be improved by connecting them to special exercise programs and mainstream sports clubs and examining children's experiences during sports.


Assuntos
Crianças com Deficiência/reabilitação , Transtornos das Habilidades Motoras/reabilitação , Fisioterapeutas/psicologia , Papel Profissional , Esportes , Criança , Humanos
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