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Author: Erin Elizabeth Butler Publisher: ISBN: Category : Languages : en Pages :
Book Description
The ability to reach, grasp, transport, and release objects is central to activities of daily living, such as feeding and grooming. However, children with cerebral palsy (CP) often have difficulty with these tasks, limiting their independence. While it is challenging to characterize and quantify specific upper limb movement disorders in CP, it is essential for identifying the underlying neural correlates and etiology, assessing movement disorder subtypes, i.e. spasticity, dystonia, and ataxia, which affect treatment selection, and measuring treatment outcomes. Current methods for measuring upper limb motion deficits are based predominantly on subjective, observational assessments. Thus, we have proposed three-dimensional motion analysis of the upper limbs during a Reach & Grasp Cycle to address the need for a standardized protocol for analysis of upper limb motion. The Reach & Grasp Cycle is a sequence of tasks that incorporates all major joints of the upper limb and simulates a functional task that is feasible yet challenging for individuals with CP. Using a biomechanical model of the trunk and upper limbs, we calculated three-dimensional joint kinematics and temporal-spatial parameters for 30 typically developing (TD) children and 25 children with CP and upper limb involvement, ages 5-18 years, using an optoelectric motion analysis system. Consistent normative data and clinically significant differences in joint motions and temporal-spatial parameters between the CP and TD children suggest the Reach & Grasp Cycle is a repeatable protocol for objective and quantitative clinical evaluation of functional upper limb motor performance. Next, we derived a single score of upper limb pathology from upper limb kinematics called the Pediatric Upper Limb Motion Index (PULMI). The root-mean-square difference was calculated between the data of each child with CP and the average from the TD population for eight kinematic variables over the Reach & Grasp Cycle. The raw value was then scaled such that a PULMI score [greater than or equal to] 100 indicated the absence of upper limb pathology, and every 10 points below 100 corresponded to one standard deviation away from the TD PULMI mean. The PULMI was significantly different between the TD children and children with CP (Wilcoxon Z=-5.06, p
Author: Erin Elizabeth Butler Publisher: ISBN: Category : Languages : en Pages :
Book Description
The ability to reach, grasp, transport, and release objects is central to activities of daily living, such as feeding and grooming. However, children with cerebral palsy (CP) often have difficulty with these tasks, limiting their independence. While it is challenging to characterize and quantify specific upper limb movement disorders in CP, it is essential for identifying the underlying neural correlates and etiology, assessing movement disorder subtypes, i.e. spasticity, dystonia, and ataxia, which affect treatment selection, and measuring treatment outcomes. Current methods for measuring upper limb motion deficits are based predominantly on subjective, observational assessments. Thus, we have proposed three-dimensional motion analysis of the upper limbs during a Reach & Grasp Cycle to address the need for a standardized protocol for analysis of upper limb motion. The Reach & Grasp Cycle is a sequence of tasks that incorporates all major joints of the upper limb and simulates a functional task that is feasible yet challenging for individuals with CP. Using a biomechanical model of the trunk and upper limbs, we calculated three-dimensional joint kinematics and temporal-spatial parameters for 30 typically developing (TD) children and 25 children with CP and upper limb involvement, ages 5-18 years, using an optoelectric motion analysis system. Consistent normative data and clinically significant differences in joint motions and temporal-spatial parameters between the CP and TD children suggest the Reach & Grasp Cycle is a repeatable protocol for objective and quantitative clinical evaluation of functional upper limb motor performance. Next, we derived a single score of upper limb pathology from upper limb kinematics called the Pediatric Upper Limb Motion Index (PULMI). The root-mean-square difference was calculated between the data of each child with CP and the average from the TD population for eight kinematic variables over the Reach & Grasp Cycle. The raw value was then scaled such that a PULMI score [greater than or equal to] 100 indicated the absence of upper limb pathology, and every 10 points below 100 corresponded to one standard deviation away from the TD PULMI mean. The PULMI was significantly different between the TD children and children with CP (Wilcoxon Z=-5.06, p
Author: Julia Mazzarella Publisher: ISBN: Category : Autism spectrum disorders Languages : en Pages : 0
Book Description
Cerebral palsy (CP) is a non-progressive motor disorder resulting from injury to the brain. Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects social interaction and adaptive behavior. Together, CP and ASD are the second- and third-most-common developmental disabilities. While ASD is not primarily a motor disorder, up to 80% of children with ASD have motor delays. Impairments in upper extremity coordination are present in many children with CP and ASD. Physical therapy is often utilized for children with CP and ASD to improve motor function. Participation outcomes are often the most important element of PT to children with CP and ASD and their families. Participation is a component of the International Classification of Functioning, Disability, and Health framework, which refers to participation in life situations. Upper extremity function can play a major role in participation, as the upper extremities are commonly involved in leisure, play, and school activities. Physical therapy (PT) using hippotherapy and the equine environment shows promise for improving function and participation in children with CP and ASD. There is also preliminary evidence that hippotherapy might be effective in improving upper extremity function in children with CP. Hippotherapy is the use of equine movement in therapy, and PT in the equine environment refers to any other therapeutic activities involving equines or aspects of the equine environment. While reach and grasp are inherent to many upper extremity activities, there are few outcome measures to evaluate reach and grasp abilities. The measures that are available involve clinical observation and subjective scoring of performance which could be affected by rater bias. Three-dimensional (3D) motion capture offers an objective and quantitative measurement of human movement and is the gold standard for evaluating gait in motor-impaired populations. A few studies have used 3D motion capture to evaluate reach kinematics with performance of functional tasks important for daily living, such as reaching to eat or drink, in school-aged children with typical development and those with motor disabilities. Aim 1 built upon previous research to identify normal ranges of timing and coordination in upper extremity movement during functional reach-and-grasp tasks in children with typical development. To do so, differences in end-point kinematics of upper extremity movement between functional reach-to-drink, reach-to-eat, and bimanual (two-handed) tasks were evaluated in n=71 school-aged children. Specifically, speed, straightness, and smoothness of hand movement was compared between tasks, phases of the tasks, unilateral and bilateral tasks, and dominant and non-dominant hands.
Author: Maxime Robert Publisher: ISBN: Category : Languages : en Pages :
Book Description
"Cerebral Palsy (CP) is the most common pediatric neurological disorder with sensorimotor impairments. Collectively, these impairments could alter reaching movements, leading to limited functional activities and participation levels. The use of motor learning principles (e.g., practice intensity and extrinsic feedback) to change movement behaviour may increase functional activity and participation levels. Extrinsic feedback is defined as additional information provided to the individual whether during and/or after performance of a task via different frequencies and modalities (e.g., visual and auditory). Though the provision of extrinsic feedback can improve motor learning in children with CP, there is a lack of standardized research paradigms that examined which types of feedback frequencies and modalities to prioritize. Thus, a more robust research design is needed in which extrinsic feedback can be manipulated and standardized, possibly with the use of virtual reality systems. The global aim of this thesis is to optimize motor learning through the manipulation of extrinsic feedback in children with mild hemiplegic CP.This thesis includes four manuscripts: three experimental studies and one literature review. The first manuscript, consisting of a secondary analysis of an intervention trial, examines the role of sensation on upper limb motor learning in children with hemiplegic CP. Results from 16 children with hemiplegic CP who participated in a 15-hour intervention demonstrated that better tactile thresholds and proprioception were associated with retention of improvements in velocity during a reach-to-grasp task. The second manuscript describes the role of extrinsic feedback on upper limb motor learning in healthy children and in children with CP as the latter group may need additional sensory information to compensate for their reduced sensation. This review indicated that there is a lack of consistency in modalities and in frequencies of feedback delivery for the improvement of motor learning in healthy children and in children with CP. Moreover, the delivery of continuous extrinsic feedback, which requires less cognitive processing, appears to be beneficial when learning a complex task. The results highlighted the need for a research paradigm that directly compares combinations of modalities of and frequencies of extrinsic feedback.The third manuscript presents a comparison between reaching kinematics of three gestures in a virtual reality system to those made in a matched physical environment of healthy children and of children with mild hemiplegic CP. Reaching in the virtual environment was slower and required less trunk flexion and rotation in healthy children. Hand trajectories of children with CP were more curved and less trunk flexion and rotation was used. Between the two populations, the movement time was clinically insignificantly longer in healthy children. When setting goals or designing protocols to improve reaching with a virtual reality system, movement variables should be considered. The fourth manuscript examines the feasibility of delivering different frequencies of extrinsic feedback and of implementing a short intensive intervention through a virtual reality system for children with mild hemiplegic CP. Seven children with CP participated in a 7-day intervention. Results showed that all participants completed all sessions. Changes were observed in clinical scores and kinematics. This pilot study demonstrated the possibility of manipulating and standardizing extrinsic feedback in children with mild hemiplegic CP to improve their upper limb motor learning. The findings of this thesis highlighted the use of principles to optimize motor learning in children with mild hemiplegic CP and more specifically, the possibility of using a virtual reality system to deliver extrinsic feedback. " --
Author: Hsiang-Han Huang Publisher: ISBN: Category : Languages : en Pages : 180
Book Description
Abstract: The purpose of this dissertation is to examine the impacts of body-scaled information on emergent reaching and grasping patterns for children with hemiplegic cerebral palsy (CP). While previous studies indicate that one-handed and two-handed reaching patterns are influenced by an object size in relation to the maximal index finger and thumb aperture (i.e., body-scaled information) for adults and typically developing children (TDC), it requires further investigation whether similar body-scaled information is perceived for the reaching actions for children with hemiplegic CP who have altered personal constraints. Investigating the relationship between perceived body-scaled information and the emergent reaching patterns for children with hemiplegic CP may provide us with a more explicit understanding of the critical factors influencing this emergent action. In the first experiment, we asked 20 adults and 17 TDC to reach and grasp ten different sizes of cubes to examine the body-scaled information that specifies the relation of hand size, object size, and reach and grasp patterns. More specifically, we aimed at analyzing the data statistically to investigate the differences and the variability between adults and children, which were not reported in the previous evidence. Our findings indicated that body-scaled information, expressed by dimensionless ratios, guides similar emergent reaching and grasping patterns for adults and children regardless of the differences in body dimensions. However, children have more variability of reaching and grasping patterns than adults. In the second experiment, we asked children with hemiplegic CP to complete the same task with the aim of gaining a more thorough understanding of the impacts of body-scaled information on reaching for children with altered personal constraints. Our findings indicated that the specific dimensionless ratio was not significantly different for either preferred or non-preferred arms both within and between children with hemiplegic CP and TDC groups. Moreover, we demonstrate that the variability for the paretic and non-preferred arms is similar for both groups. The results of this dissertation indicate that body-scaled information of object size in relation to hand size influences the emergent reaching and grasping patterns for individuals with different constraints. These findings suggest the importance of the upper limb intervention of this preschool age for children with CP because they are able to perceive similar body-scaled information for the emergent action patterns as TDC. Future research is encouraged to further systematically examine the relationship of different constraints and the body-scaled information, and how this information affects the emergent actions.
Author: Publisher: ISBN: Category : Languages : en Pages :
Book Description
Upper Extremity Selective Voluntary Motor Control in Children with Unilateral Cerebral Palsy and its association with Upper Extremity FunctionBackground and AimsChildren with Cerebral Palsy (CP) reduced selective motor control (SMC) can prevent many common bimanual activities that require independent control of both hands. For this reason, it is aimed to define the relationship between upper extremity SMC and upper extremity function in children with unilateral CP.MethodTwenty-six volunteer unilateral CP participated in the study between the ages of 6 and 18 years. Children's manual skills classified with MACS. To assess the quality of the upper extremity, the Quality of Upper Extremity Skill Test (QUEST) which assessed four areas including dissociated movement, grasp, weight bearing and protective extension, was used. Upper extremity functions were assessed using the Jebsen Taylor Hand Function Test (JTT). The Selektif Control of Upper Extremity Scale (SCUES) was used to evaluate the selective movements of the upper extremity. The SCUES evaluates the movement of the trunk during the upper limb movements and mirror movements via video recording.ResultsStatistically significant decreases in SCUES scores from shoulder to fingers were found using the Page statistical test for trend (p
Author: Freeman Miller Publisher: JHU Press ISBN: 0801883547 Category : Health & Fitness Languages : en Pages : 537
Book Description
When a child has a health problem, parents want answers. But when a child has cerebral palsy, the answers don't come quickly. A diagnosis of this complex group of chronic conditions affecting movement and coordination is difficult to make and is typically delayed until the child is eighteen months old. Although the condition may be mild or severe, even general predictions about long-term prognosis seldom come before the child's second birthday. Written by a team of experts associated with the Cerebral Palsy Program at the Alfred I. duPont Hospital for Children, this authoritative resource provides parents and families with vital information that can help them cope with uncertainty. Thoroughly updated and revised to incorporate the latest medical advances, the second edition is a comprehensive guide to cerebral palsy. The book is organized into three parts. In the first, the authors describe specific patterns of involvement (hemiplegia, diplegia, quadriplegia), explain the medical and psychosocial implications of these conditions, and tell parents how to be effective advocates for their child. In the second part, the authors provide a wealth of practical advice about caregiving from nutrition to mobility. Part three features an extensive alphabetically arranged encyclopedia that defines and describes medical terms and diagnoses, medical and surgical procedures, and orthopedic and other assistive devices. Also included are lists of resources and recommended reading.
Author: Erin Elizabeth Butler
Author: Erin Elizabeth Butler
Author: Julia Mazzarella
Author: Laura Van Roie
Author: Pieter Meyns
Author: Maxime Robert
Author: Hsiang-Han Huang
Author: 
Author: Sheila Schneiberg
Author: Jenny Hedberg Graff
Author: Freeman Miller