1,720,961 research outputs found
Neuroanatomical correlates of gross manual dexterity in children with unilateral spastic cerebral palsy
No full textUnilateral spastic Cerebral Palsy (UCP) results from congenital brain injury, and Magnetic Resonance Imaging (MRI) has a role in understanding the etiology and severity of brain insult. In UCP, functional impairment predominantly occurs in the upper limb (UL) of the more affected side, where manual ability and dexterity are typically reduced. Also, mirror movements (MMs), are often present in UCP, with a further possible negative functional impact. This study aims to investigate the relationships among neuroanatomical characteristics of brain injury at MRI, manual functional impairment and MMs, in children with UCP. Thirty-five children with UCP participated in the study (20, M = 15, F, mean age 9.2 ± 3.5 years). Brain lesions at MRI were categorized according to the Magnetic Resonance Classification System (MRICS) and by using a semi-quantitative MRI (sqMRI) scale. Gross manual performance was assessed through Manual Ability Classification System (MACS) and the Box and Block Test (BBT), and MMs by Woods and Teuber scale, for both hands. Non-parametric correlation analyses were run to determine the relationship between neuroanatomical and functional features. Regression models were run to explore the contribution of neuroanatomical features and MMs to UL function. Correlation analyses revealed moderate to strong associations between sqMRI scores contralateral to the more affected side and UL functional impairment on MACS and BBT, with more severe brain injuries significantly correlating with poorer function in the more affected hand. No association emerged between brain lesion severity scores and MMs. MRICS showed no association with MACS or BBT, while a significant correlation emerged between MRICS category and MMs in the more affected hand, with brain lesion category that are suggestive of presumed earlier injury being associated with more severe MMs. Finally, exploratory regression analyses showed that neuroanatomical characteristics of brain injury and MMs contributed to the variability of UL functional impairment. This study contributes to the understanding of the neuroanatomical and neurological correlates of some aspects of manual functional impairment in UCP by using a simple clinical brain MRI assessment
Concurrent and predictive validity of the infant motor profile in infants at risk of neurodevelopmental disorders
Full text linkBACKGROUND: Preterm infants and infants with perinatal brain injury show a higher incidence of neurodevelopmental disorders (NDD). The Infant Motor Profile (IMP) is a clinical assessment which evaluates the complexity of early motor behaviour. More data are needed to confirm its predictive ability and concurrent validity with other common and valid assessments such as the Alberta Infant Motor Scale (AIMS) and Prechtl's General Movement Assessment (GMA). The present study aims to evaluate the concurrent validity of the IMP with the AIMS, to assess its association with the GMA, to evaluate how the IMP reflects the severity of the brain injury and to compare the ability of the IMP and the AIMS to predict an abnormal outcome in 5-month-old infants at risk of NDD.METHODS: 86 infants at risk of NDD were retrospectively recruited among the participants of two clinical trials. Preterm infants with or without perinatal brain injury and term infants with brain injury were assessed at 3months corrected age (CA) using the GMA and at 5months CA using the IMP and the AIMS. The neurodevelopmental outcome was established at 18months.RESULTS: Results confirm a solid concurrent validity between the IMP Total Score and the AIMS (Spearman's rho 0.76; p<.001) and a significant association between IMP Total Score and the GMA. Unlike the AIMS, the IMP Total score accurately reflects the severity of neonatal brain injury (p<.001) and proves to be the strongest predictor of NDD (p<.001). The comparison of areas under receiver operating characteristic curves (AUC) confirms that the IMP Total score has the highest diagnostic accuracy at 5months (AUC 0.92). For an optimal IMP Total Score cut-off value of 70, the assessment shows high sensitivity (93%) and specificity (81%) (PPV 84%; NPV 90%).CONCLUSIONS: Early motor behaviour assessed with the IMP is strongly associated with middle-term neurodevelopmental outcome. The present study confirms the concurrent validity of the IMP with the AIMS, its association with the GMA and its ability to reflect brain lesion load, hence contributing to the construct validity of the assessment.TRIAL REGISTRATION: NCT01990183 and NCT03234959 (clinicaltrials.gov)
Implementazione della tele-riabilitazione nei servizi territoriali: nuovo modello organizzativo per la riabilitazione dei disturbi dell'equilibrio tramite il Virtual Reality Rehabilitation System (VRRS)
No full textL’equilibrio è definito, da un punto di vista fisico, come lo stato di un oggetto quando le azioni di carico risultanti, forze e momenti che agiscono su di esso, sono uguali a zero. In un individuo quando si parla di controllo dell’equilibrio o controllo posturale, si intendono quei meccanismi e quelle strategie che il sistema nervoso centrale (SNC) mette in atto per garantire una risposta nei confronti della forza di gravità, stabilizzando i vari distretti anatomici in uno stato di equilibrio, a seconda delle diverse situazioni in cui l’individuo si trova.
Lo sviluppo dell’equilibrio inizia dalla nascita, perfezionandosi durante lo sviluppo, in età adolescenziale, con un miglioramento progressivo fino all’età adulta. Il controllo posturale richiede l'organizzazione e l'integrazione degli input propriocettivi, visivi e vestibolari da parte del SNC, così da generare adeguate risposte motorie.
Per questo, qualsiasi deficit cognitivo, sensoriale o motorio può provocare un disturbo del controllo posturale, che è un problema comune nei bambini con disturbi neurologici (sia centrali che periferici), ortopedici e/o vestibolari. Infatti, il controllo posturale è influenzato da tutte quelle patologie che alterano gli organi coinvolti in tale funzione, quindi patologie che disturbano l'output sensoriale, il controllo della forza e del movimento e l'orientamento spaziale. È di fondamentale importanza identificare precocemente i deficit dell’equilibrio, in quanto possono avere un grande impatto su tutto lo sviluppo motorio.
Tra i disturbi che possono manifestare un’alterazione dell’equilibrio durante l’età evolutiva ricordiamo la Paralisi Cerebrale Infantile (PCI) e il Disturbo della Coordinazione Motoria (DCD) per cui è necessario utilizzare strumenti di valutazione, test clinici standardizzati e test strumentali che forniscano variabili qualitative e quantitative sia per lo screening e la diagnosi, sia per definire un percorso riabilitativo.
Infatti, la presa in carico del soggetto in età evolutiva con un disturbo dell’equilibrio prevede la stesura di un progetto riabilitativo individuale, utilizzando un approccio valutativo e riabilitativo che non può prescindere dall’applicare i principi fondamentali della Classificazione Internazionale del Funzionamento, della Disabilità e della Salute, ICF (OMS, 2001).
All’interno di questa cornice, i dispositivi tecnologici possono essere di notevole aiuto in quanto supportano il lavoro del clinico, offrendo la possibilità di misurare e registrare parametri e variabili della performance motoria. Negli ultimi anni, si sono verificati rapidi sviluppi tecnologici, tra cui l’utilizzo della telemedicina e tele-riabilitazione, anche in età evolutiva.
La tele-riabilitazione offre una buona opportunità di accesso ai servizi di riabilitazione, in modo da garantire una continuità delle cure, un sostanziale risparmio di costi, un miglioramento del comfort e dello stile di vita del paziente e una maggiore frequenza e aderenza al trattamento. Studi dimostrano che tale metodo di riabilitazione può essere promettente per diversi gruppi di pazienti, tra cui i bambini con disturbi neurologici e per il trattamento di disturbi motori e del controllo posturale. Oggigiorno, diversi strumenti tecnologici possono essere sfruttati per la tele-riabilitazione, tra cui i sistemi di realtà virtuale che, grazie al loro approccio immersivo, permettono all’utente di interagire con l’ambiente virtuale e di ricevere feedback sensoriali (visivi, uditivi, tattili, etc.)
Questo progetto di tesi si è posto l’obiettivo di descrivere l’uso di un nuovo sistema di realtà virtuale, il Virtual Reality Rehabilitation System (VRRS) (Khymeia, Italia), come strumento di riabilitazione e tele-riabilitazione, per promuovere le capacità di equilibrio nei bambini con un disturbo del neurosviluppo. In particolare, lo studio si propone di implementare la tele-riabilitazione anche nei servizi territoriali, portando in esame tre casi esemplificativi di un diverso utilizzo del sistema, così da rappresentare tre possibili modelli operativi differenti su cui poter discutere le prospettive future. I risultati ottenuti sono promettenti e anche se sono presenti dei limiti, sarà interessante continuare e migliorare l’esperienza della tele-riabilitazione e riabilitazione con il VRRS.
Lo studio è stato svolto presso il laboratorio INNOVATE (Laboratorio di Tecnologie INNOVATivE in Neuroriabilitazione) dell’IRCCS Fondazione Stella Maris di Calambrone (Pisa)
Innovative technological approaches for evaluation and rehabilitation of children with motor disorders
No full textGoing Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Wearable sensors for measuring spontaneous upper limb use in children with unilateral cerebral palsy and typical development
Full text linkBackground: Unilateral Cerebral Palsy (UCP) is a clinical condition which mainly involves the movement and muscle tone of one side of the body, often impacting the general manual function. While there are some clinical assessment tools aimed to quantify the Upper Limbs (UpLs) use and the manual abilities, acquiring information regarding the motor abilities outside the clinical environment, such as the UpLs use and their asymmetry during daily life, could provide a more complete evaluation of the child and open a new clinical reasoning. For this purpose, wearable sensors are one of the newest approaches for continuously monitoring UpLs functions without being invasive. The aim of this study was to use wearable sensors to compare spontaneous/daily UpLs usage and asymmetry with the Assisting Hand Assessment (AHA) test, as well as comparing the daily UpLs usage behavior of children with UCP with respect to Typical Developing (TD) peers. Methods: Eighty children (54 with UCP and 26 TD) wore an Actigraph sensor on each wrist during the AHA test and then at least for the following week of daily life. The amount of use of each hand and the asymmetry were analyzed during both the AHA and the following week of daily life using linear regression analysis and ANOVA models. Results: Significant relationships were found between the asymmetry detected during the week and both the AHA scores and the asymmetry detected during the test. UCP and TD children week asymmetry distributions were significantly different; moreover, some differences were found when grouping them by MACS levels. Conclusion: This paper proposes a new and easy technological methodology for monitoring UpLs behavior in daily life. Through wearable sensor data analysis, we demonstrate a linear correlation between asymmetry measured during smi-structured assessments and daily life. Additionally, we provide evidence of distinct patterns of UpLs usage between typically developing children and children with UCP in daily life. Trial registration: Clinical Trials.gov (NCT03054441)
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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