Developmental neurorehabilitation最新文献

Background: Positional plagiocephaly or brachycephaly (PPB), linked to developmental delays and asymmetrical features, often prompts parental concern and medical consultation.

Objective: This qualitative study explores factors influencing parental adherence to PPB prevention strategies.

Methods: Fifteen parents of newborns participated in semi-structured interviews.

Results: Employing deductive and inductive thematic analysis, three key factors were identified: characteristics of prevention messaging, environmental optimization, and parental priorities, shaped by evolving parenting competencies and the baby's developmental progress.

Conclusion: Our findings highlight solutions endorsed by parents themselves, offering valuable insights to enhance adherence to prevention strategies.

The aim of this study was to investigate factors related to performance in daily activities, mobility, social/cognitive skills, and responsibility of Brazilian children/adolescents with cerebral palsy (CP). Multivariate binary logistic regression analyses were performed. A total of 190 children/adolescents participated. Most participants performed below expected in mobility, which could be explained by age, locomotion ability, and anatomical distribution of motor impairment (R² = 0.50). Performance in daily activities (R² = 0.44) and responsibility (R² = 0.23) were explained by age and locomotion ability. This study contributes to understanding the factors that explain the functioning of children/adolescents with CP in Brazil, a low/middle-income country.

Background: Cerebral palsy (CP) is one of the most important causes of disability across the globe. Transcutaneous electrical nerve stimulation (TENS) has been proposed as a potential adjunct therapy.

Objective: This systematic review aims to explore the application of TENS in the rehabilitation of individuals with CP.Methods: A comprehensive literature search was conducted across multiple databases for studies published up to December 2023. Inclusion criteria encompassed clinical studies that evaluated the effects of TENS on rehabilitation outcomes in individuals with CP. Data were extracted and synthesized in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the included studies was assessed using the appropriate Joanna Briggs Institute (JBI) checklist based on the study design.

Results: A total of 11 studies were eligible for entering this systematic review. Studies reported the application of TENS for different CP-induced conditions, including motor function, spasticity, and gait. Following the administration of TENS in CP patients, an overall favorable trend with few to no side effects was reported. Nevertheless, most of the included studies were of low to moderate quality.

Conclusion: Although this review offers a comprehensive examination of the use of TENS in CP rehabilitation, the scarcity of high-quality studies indicates that further research is necessary to confirm its efficacy in this population.

Purpose: We examined the association of walking and activities of daily living(ADL) with trunk and lower extremity muscle thickness in children with Down syndrome (DS).

Methods: 27 children with DS participated in this study. Walking was assessed using measurements of the maximal walking speed and step length, while ADL was assessed using the Pediatric Evaluation of DisabilityInventory (PEDI). The thickness of the trunk and lower extremity muscles was measured using an ultrasound imaging device.

Results: The peroneus brevis muscle thickness was a significant and independent factor associated with step length. The tibialis posterior muscle thickness was significant and independent factor of self-care. The thickness of the soleus and tibialis posterior muscles were significant and independent factors of mobility. Finally, the soleus muscle thickness was a significant and independent factor of social function in PEDI.

Conclusions: The findings of this study indicate that future clinical work should focus on the function of the plantar flexor muscles in walking and ADL in children with DS.

The aim of this study was to investigate the effects of the virtual reality device on the evolution of motivation, and motor, functional and kinematic parameters of the upper limb in children with cerebral palsy. Twenty children were randomly assigned in VR and control groups. VR group scored higher than the control group in the Movement Assessment Battery for Children - Second Edition (MABC-2; standardized motor skills test), exhibited an increased range of motion, and showed improved results in various movement parameters in the interaction with the 3D virtual space. All participants presented high motivation scores in the iVR sessions. This new Immertrack tool may improve the motor, kinematic parameters, and motivation in children with CP.

Purpose: Participant recruitment for studies investigating neurodevelopmental conditions can be difficult, limited, and resource intensive. In this study, caregivers were surveyed to learn about the factors influencing their decision to enroll their neurodivergent child in research.Method: Data were collected through an online survey from caregivers of neurodivergent children who were signing up for a research recruitment database (n = 46).Results: Participants indicated the most important motives were to help achieve better outcomes for other children and to contribute to scientific understanding. Personal curiosities, such as the caregiver or child learning more about their condition, were identified as important for some parents. The most influential barrier to enrollment noted by participants was a heightened possibility of a significant negative side effect.Conclusion: These findings provide essential insight that can inform study design and associated research support that could overcome barriers and ensure families are aware of the benefits of participating in research.

This pilot clinical trial aimed to evaluate the effects of vestibular stimulation, through Hammock-positioning therapy (HPT) or by multidirectional balancing, administered during physical therapy, on movement repertoire, sleep-wakefulness state, and pain in late preterm infants. The newborns were randomly allocated into two groups: 1) vestibular sensory stimulation by HPT (HG) and 2) conventional vestibular stimulation (CG). Movement repertoire was evaluated using the General Movement Assessment (GMA), sleep-wakefulness state was evaluated using the Adapted Brazelton Scale, finally pain was evaluated by the Neonatal Facial Activity Coding System (NFCS). An increase in normal GMAs and a reduction in abnormal GMAs was observed in the HG group after intervention. An Improvement in the sleep-wakefulness state scores was observed in the HG group. In the CG group, same improvements were seen. In conclusion, HPT has a positive effect on the sleep-wakefulness state and movement repertoire in late preterm infants similar to the conventional group.

Aim: Investigating the effect of Neurodevelopmental Treatment (NDT) on the risk of falling and balance in children diagnosed with Cerebral Palsy (CP).

Methods: Participants were randomly assigned to experimental and control groups. At baseline, the balancing skills of all participants was assessed using the Pediatric Balance Scale, and the gait parameters and fall risk was measured using the LEGSys. The experimental group underwent an 8-week, case-specific, NDT program with intensive gait and balance training for 45-minute sessions, twice a week. The control group received only conventional physiotherapy for the duration of the study. Balancing, gait, and fall risk evaluations repeated after treatment was completed.

Results: A total of 44 cases (Experimental: 22, Control: 22) were analyzed. Pre- and post-treatment comparisons were made within groups and change rates for both groups were compared. The differences in the change rates of specific fall risk parameters between groups was significant.

Conclusion: The eight-week NDT and conventional physiotherapy combined program effectively reduced the risk of falling in children with spastic CP.

This longitudinal prospective cohort study examined participation between 6 months and 1.5 years after pediatric mild Traumatic Brain Injury (mTBI) in 68 children aged 6-18 years. Levels of participation in different settings remain mostly stable between 6 months and 1.5 years after mTBI, with a substantial proportion of children continuing to indicate less than full functioning. Future studies should examine risk factors and opportunities for early identification to prevent long-term negative consequences of pediatric mTBI regarding participation.

Purpose: Identify relations of gross motor function and primary motor cortex (M1) functional activity pre and post gross motor interventions for children with unilateral cerebral palsy (UCP).

Methods: Thirteen children with UCP completed a gross motor intervention. Pre/post-intervention functional MRI outcomes included the laterality index (LI), activation volume, and spatial overlap of M1 activation during active ankle dorsiflexion. Advanced gross motor function (Challenge) was assessed pre/post-intervention, and 2-6 months later. Bivariate correlations and linear regression assessed relations between neuroimaging and motor function.

Results: Mean pre-intervention M1 activity was contralateral during dominant (LI =  +0.85, SD 0.21) but variable during the affected (LI =  +0.43, SD 0.57) ankle dorsiflexion. Changes in motor function and neuroimaging outcomes were not significantly associated. However, smaller affected ankle activation and less spatial overlap between ankle activations pre-intervention predicted Challenge improvements post-intervention (adjusted R² = 0.74, p = .001.).

Conclusions: This exploratory study identified pre-intervention neuroimaging predictors of post-intervention improvements in advanced gross motor function.