First name
Samuel
Middle name
R
Last name
Pierce

Title

The Relationship between Family Empowerment and Fine Motor, Gross Motor, and Cognitive Skills in Young Children with Cerebral Palsy.

Year of Publication

2022

Date Published

12/2022

ISSN Number

1365-2214

Abstract

BACKGROUND: Family empowerment in families of young children with cerebral palsy (CP) is an important consideration because the first few years of life can be overwhelming for parents. The purpose of this research was to investigate the relationship between family empowerment, fine motor (FM), gross motor (GM), and cognitive development in children with CP who were under three years of age.

METHODS: Forty-one children with a mean age of 23.8 months participated in this study. The FES was completed by the participants' parents while the FM, GM, and cognitive subscales of the Bayley Scales of Infant and Toddler Development Third edition (B-III) were administered by physical therapists.

RESULTS: Statistically significant positive correlations were found between the FES total and B-III raw scores for FM, GM, and cognitive subscales with coefficients ranging from 0.35-0.41. Significant relationships were also found between the FES Community subscale and the B-III FM, GM, and cognitive subscales.

CONCLUSIONS: This study provides evidence of a relationship between family empowerment and FM, GM, and cognitive abilities in young children with CP, with a greater severity of impairments related to lower levels of caregiver empowerment.

DOI

10.1111/cch.13091

Alternate Title

Child Care Health Dev

PMID

36519729

Title

Reliability of the Telemedicine Application of the Gross Motor Function Measure-88 in Patients With Leukodystrophy.

Year of Publication

2021

Number of Pages

34-39

Date Published

2021 Sep 24

ISSN Number

1873-5150

Abstract

<p><strong>BACKGROUND: </strong>Leukodystrophies are a rare class of disorders characterized by severe neuromotor disability. There is a strong need for research regarding the functional status of people with leukodystrophy which is limited by the need for in-person assessments of mobility. The purpose of this study is to assess the reliability of the Gross Motor Function Measure-88 (GMFM-88) using telemedicine compared with standard in-person assessments in patients with leukodystrophy.</p>

<p><strong>METHODS: </strong>A total of 21 subjects with a diagnosis of leukodystrophy (age range&nbsp;= 1.79-52.82&nbsp;years) were evaluated by in-person and by telemedicine evaluations with the GMFM-88 by physical therapists. Inter-rater reliability was assessed through evaluation of the same subject by two independent raters within a three-week period (n&nbsp;=&nbsp;10 encounters), and intrarater reliability was assessed through blinded rescoring of video-recorded assessments after a one-week time interval (n&nbsp;=&nbsp;6 encounters).</p>

<p><strong>RESULTS: </strong>Remote assessments were performed by caregivers in all 21 subjects using resources found in the home with remote guidance. There was agreement between all paired in-person and remote measurements (Lin's concordance correlation ≥0.995). The Bland-Altman analysis indicated that the paired differences were within ±5%. Intrarater and inter-rater reliability demonstrated an intraclass correlation coefficient of &gt;0.90.</p>

<p><strong>CONCLUSIONS: </strong>These results support that remote application of the GMFM-88 is a feasible and reliable approach to assess individuals with leukodystrophy. Telemedicine application of outcome measures may be of particular value in rare diseases and those with severe neurologic disability that impacts the ability to travel.</p>

DOI

10.1016/j.pediatrneurol.2021.09.012

Alternate Title

Pediatr Neurol

PMID

34624609

Title

The Use of Dynamic Weight Support with Principles of Infant Learning in a Child with Cerebral Palsy: A Case Report.

Year of Publication

2021

Number of Pages

166-175

Date Published

2021

ISSN Number

1541-3144

Abstract

<p><strong>AIMS: </strong>Typical infant movement is characterized by a high degree of motor exploration, error, and variability. However, children with cerebral palsy (CP) often cannot create these experiences due to their neuromotor impairments. The purpose of this case study is to describe a 6-month course of physical therapy (PT) incorporating principles of infant motor learning using dynamic weight support (DWS) in a child with CP.</p>

<p><strong>METHODS: </strong>The child was a 27-month-old girl with diplegic CP who functioned at Gross Motor Function Classification System Level IV. The child received 68 PT sessions over a six-month period. DWS was used during therapy to encourage motor practice. The therapy area was arranged to encourage active exploration, motor variability, and error experience. Gross motor function, postural control, parent perception of performance, and parent satisfaction were measured before, during, and after the course of therapy.</p>

<p><strong>RESULTS: </strong>Gross motor function increased during the treatment beyond the level predicted from natural progression. Postural control fluctuated and demonstrated no appreciable improvement. Parent-perceived performance and satisfaction improved on three of four goals.</p>

<p><strong>CONCLUSIONS: </strong>Using DWS to incorporate principles of infant learning may have facilitated the development of gross motor skills in a child with diplegic CP.</p>

DOI

10.1080/01942638.2020.1766638

Alternate Title

Phys Occup Ther Pediatr

PMID

32423264

Title

Infants at risk for physical disability may be identified by measures of postural control in supine.

Year of Publication

2021

Date Published

2021 Jun 26

ISSN Number

1530-0447

Abstract

<p><strong>BACKGROUND: </strong>Early detection of delay or impairment in motor function is important to guide clinical management and inform prognosis during a critical window for the development of motor control in children. The purpose of this study was to investigate the ability of biomechanical measures of early postural control to distinguish infants with future impairment in motor control from their typically developing peers.</p>

<p><strong>METHODS: </strong>We recorded postural control from infants lying in supine in several conditions. We compared various center of pressure metrics between infants grouped by birth status (preterm and full term) and by future motor outcome (impaired motor control and typical motor control).</p>

<p><strong>RESULTS: </strong>One of the seven postural control metrics-path length-was consistently different between groups for both group classifications and for the majority of conditions.</p>

<p><strong>CONCLUSIONS: </strong>Quantitative measures of early spontaneous infant movement may have promise to distinguish early in life between infants who are at risk for motor impairment or physical disability and those who will demonstrate typical motor control. Our observation that center of pressure path length may be a potential early marker of postural instability and motor control impairment needs further confirmation and further investigation to elucidate the responsible neuromotor mechanisms.</p>

<p><strong>IMPACT: </strong>The key message of this article is that quantitative measures of infant postural control in supine may have promise to distinguish between infants who will demonstrate future motor impairment and those who will demonstrate typical motor control. One of seven postural control metrics-path length-was consistently different between groups. This metric may be an early marker of postural instability in infants at risk for physical disability.</p>

DOI

10.1038/s41390-021-01617-0

Alternate Title

Pediatr Res

PMID

34175891

Title

Computer Vision to Automatically Assess Infant Neuromotor Risk.

Year of Publication

2020

Number of Pages

2431-2442

Date Published

2020 11

ISSN Number

1558-0210

Abstract

<p>An infant's risk of developing neuromotor impairment is primarily assessed through visual examination by specialized clinicians. Therefore, many infants at risk for impairment go undetected, particularly in under-resourced environments. There is thus a need to develop automated, clinical assessments based on quantitative measures from widely-available sources, such as videos recorded on a mobile device. Here, we automatically extract body poses and movement kinematics from the videos of at-risk infants (N = 19). For each infant, we calculate how much they deviate from a group of healthy infants (N = 85 online videos) using a Naïve Gaussian Bayesian Surprise metric. After pre-registering our Bayesian Surprise calculations, we find that infants who are at high risk for impairments deviate considerably from the healthy group. Our simple method, provided as an open-source toolkit, thus shows promise as the basis for an automated and low-cost assessment of risk based on video recordings.</p>

DOI

10.1109/TNSRE.2020.3029121

Alternate Title

IEEE Trans Neural Syst Rehabil Eng

PMID

33021933

Title

The relationship between spasticity and muscle volume of the knee extensors in children with cerebral palsy.

Year of Publication

2012

Number of Pages

177-81; discussion 182

Date Published

2012 Summer

ISSN Number

1538-005X

Abstract

<p><strong>PURPOSE: </strong>The purpose of this study was to examine the relationship between spasticity and muscle volume in children with cerebral palsy (CP), using isokinetic dynamometry and magnetic resonance imaging.</p>

<p><strong>METHODS: </strong>A retrospective sample of 8 children with diplegic CP was analyzed. One set of 10 passive knee flexion movements was completed at a velocity of 180° per second with concurrent surface electromyography of the medial hamstrings (MH) and vastus lateralis (VL) to assess knee extensor spasticity. Magnetic resonance imaging was used to measure maximum cross-sectional area and muscle volume of the quadriceps femoris.</p>

<p><strong>RESULTS: </strong>The quadriceps femoris muscle volume was positively correlated with MH reflex activity, VL reflex activity, MH/VL co-contraction, and peak knee extensor passive torque (P &lt; .05).</p>

<p><strong>CONCLUSION: </strong>The present findings suggest that higher levels of knee extensor muscle spasticity are associated with greater quadriceps muscle volume in children with spastic diplegic CP.</p>

DOI

10.1097/PEP.0b013e31824cc0a9

Alternate Title

Pediatr Phys Ther

PMID

22466388

Title

The responsiveness and validity of the Early Clinical Assessment of Balance in toddlers with cerebral palsy: Brief report.

Year of Publication

2019

Number of Pages

496-498

Date Published

2019 Oct

ISSN Number

1751-8431

Abstract

<p><strong>Purpose:</strong> The Early Clinical Assessment of Balance (ECAB) is a measure of postural stability for children with cerebral palsy (CP). The purpose of this research was to investigate the relationship between the ECAB and Gross Motor Function Measure-66 (GMFM-66) and to determine the responsiveness of the ECAB in children with CP under three years of age. <strong>Methods:</strong> Twenty seven children (mean age of 25&nbsp;months) participated. Data were collected before and after 3 and 6 months of physical therapy. Responsiveness was calculated using standardized response means (SRM). <strong>Results:</strong> Significant relationships were observed between the ECAB, GMFM-66 score (r&nbsp;=&nbsp;0.87), and GMFM subscales (r&nbsp;=&nbsp;0.63-0.86). A moderate effect size (SRM&nbsp;=&nbsp;0.62) and a large effect size (SRM&nbsp;=&nbsp;0.92) for the ECAB were found over the 3- and 6-month intervention periods, respectively. <strong>Conclusions:</strong> These results support the validity and responsiveness of the ECAB in young children with CP.</p>

DOI

10.1080/17518423.2018.1523244

Alternate Title

Dev Neurorehabil

PMID

30252589

Title

iMOVE: Intensive Mobility training with Variability and Error compared to conventional rehabilitation for young children with cerebral palsy: the protocol for a single blind randomized controlled trial.

Year of Publication

2018

Number of Pages

329

Date Published

2018 10 16

ISSN Number

1471-2431

Abstract

<p><strong>BACKGROUND: </strong>Cerebral palsy (CP) is the most common cause of physical disability in children. The best opportunity to maximize lifelong independence is early in motor development when there is the most potential for neuroplastic change, but how best to optimize motor ability during this narrow window remains unknown. We have systematically developed and pilot-tested a novel intervention that incorporates overlapping principles of neurorehabilitation and infant motor learning in a context that promotes upright mobility skill and postural control development. The treatment, called iMOVE therapy, was designed to allow young children with CP to self-initiate motor learning experiences similar to their typically developing peers. This manuscript describes the protocol for a subsequent clinical trial to test the efficacy of iMOVE therapy compared to conventional therapy on gross motor development and other secondary outcomes in young children with CP.</p>

<p><strong>METHODS: </strong>The study is a single-blind randomized controlled trial. Forty-two participants with CP or suspected CP between the ages of 1-3&nbsp;years will be randomized to receive either the iMOVE or conventional therapy group. Distinguishing characteristics of each group are detailed. Repeated measures of gross motor function will be collected throughout the 12-24&nbsp;week intervention phase and at three follow-up points over one year post therapy. Secondary outcomes include measures of postural control, physical activity, participation and caregiver satisfaction.</p>

<p><strong>DISCUSSION: </strong>This clinical trial will add to a small, but growing, body of literature on early interventions to optimize the development of motor control in young children with CP. The information learned will inform clinical practice of early treatment strategies and may contribute to improving the trajectory of motor development and reducing lifelong physical disability in individuals with CP.</p>

<p><strong>TRIAL REGISTRATION: </strong>ClinicalTrials.gov identifier NCT02340026 . Registered January 16, 2015.</p>

DOI

10.1186/s12887-018-1303-8

Alternate Title

BMC Pediatr

PMID

30326883

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