1,721,110 research outputs found
Is a portable pressure plate an alternative to force plates for measuring postural stability and interlimb coordination of quiet standing balance control?
No full textIntroduction: Center-of-pressure (COP) synchronization and symmetry can inform adaptations in balance control following one-sided sensorimotor impairments (e.g., stroke). As established force plates are impossible to transport, we aimed to criterion validate a portable pressure plate for obtaining reliable COP synchronization and symmetry measures, next to conventional postural stability measures. Methods: Twenty healthy adults participated. In a single session, three 40-s eyes-open and eyes-closed quiet stance trials were performed per plate-type, randomly ordered. Individual-limb COPs were measured to calculate between-limb synchronization (BLS) and dynamic control asymmetry (DCA). Net COP (i.e., limbs combined) area, amplitude, and velocity were used to describe anteroposterior (AP) and mediolateral (ML) postural stability. Criterion validity was evaluated using Spearman correlations (r) and Bland-Altman plots. Test-retest reliability was tested using intraclass correlation coefficients (ICC). Results: Strong correlations (r > 0.75) and acceptable reliability (ICC > 0.80) were found regarding individual-limb COP velocity and DCA, net COP ML amplitude and AP and ML velocities. Bland-Altman plots yielded possible proportional bias; the pressure plate systematically underestimated COP scores by force plates and a larger error associated with a larger measurement. Conclusions: Despite correlations between instruments and sufficient reliability for measuring postural stability and DCA, this technical note strongly suggests, due to a systematic deviation, using the same plate-type to accurately assess performance change within subjects longitudinally over time.Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The authors would like to acknowledge funding by the Research Foundation Flanders (FWO), Belgium who provided JS a doctoral (PhD) grant for strategic basic research (application number 1S64819N) to conduct this research.
Acknowledgments
The authors would like to thank Charlotte Johnson for writing assistance, and the following M.Sc. students for aiding data collection and subject recruitment: Heleen Leurs, Carolien Van de Perck, Silke Van Goubergen, Gabriela Wimberska, Denice Kliebisch, and Sofia Lopez-Cotarelo Flemons
Validity of Deep Learning-Based Motion Capture Using DeepLabCut to Assess Proprioception in Children
No full textProprioceptive deficits can lead to impaired motor performance. Therefore, accurately measuring proprioceptive function in order to identify deficits as soon as possible is important. Techniques based on deep learning to track body landmarks in simple video recordings are promising to assess proprioception (joint position sense) during joint position reproduction (JPR) tests in clinical settings, outside the laboratory and without the need to attach markers. Fifteen typically developing children participated in 90 knee JPR trials and 21 typically developing children participated in 126 hip JPR trials. Concurrent validity of two-dimensional deep-learning-based motion capture (DeepLabCut) to measure the Joint Reproduction Error (JRE) with respect to laboratory-based optoelectronic three-dimensional motion capture (Vicon motion capture system, gold standard) was assessed. There was no significant difference in the hip and knee JRE measured with DeepLabCut and Vicon. Two-dimensional deep-learning-based motion capture (DeepLabCut) is valid to assess proprioception with respect to the gold standard in typically developing children. Tools based on deep learning, such as DeepLabCut, make it possible to accurately measure joint angles in order to assess proprioception without the need of a laboratory and to attach markers, with a high level of automatization.Funding: NJ and this work were supported by the Research Foundation—Flanders (FWO)
(grant.number: 92836, 2021) and the Special Research Fund (BOF) for Small Research Project—Hasselt
University (BOF19KP08), respectively.
Acknowledgments: The authors would like to thank all children and parents who volunteered and
participated in this study and the school and master’s students who collaborated and assisted with
the recruitment of the children
A continuum of balance performance between children with developmental coordination disorder, spastic cerebral palsy, and typical development
No full textBACKGROUND: Balance deficits are one of the most common impairments in developmental coordination disorder (DCD) and cerebral palsy (CP), with shared characteristics between both groups. However, balance deficits in DCD are very heterogeneous, but unlike in CP, they are poorly understood. AIM: To unravel the heterogeneity of balance performance in children with DCD by comparing them with CP and typical development (TD). DESIGN: Cross-sectional case-control study. SETTING: Different outpatient settings and the community. POPULATION: Children aged 5-10.9 years with TD (N.=64, boys: 34, mean [SD] age: 8.1 [1.6]), DCD (N.=39, boys: 32, mean [SD] age: 8.1 [1.5], formal diagnosis [N.=27]), and CP (N.=24, boys: 14, mean [SD] age: 7.5 [1.4], GMFCS level I [N.=14]/II [N.=10], unilateral [N.=13]/bilateral [N.=11]). METHODS: We evaluated balance performance with the extended version of the Kids-Balance Evaluation Systems Test (Kids-BESTest). Between-group differences in domain and total scores (%) were assessed via ANCOVA (covariate: age), with Tukey post-hoc analyses (P RESULTS: Children with DCD and CP performed poorer than TD children on total and domain scores with large effects (domains: eta(2)=0.25-0.66 [P CONCLUSIONS: There is a continuum of balance performance between children with TD, DCD and CP, but with great inter- and intra-individual heterogeneity in DCD and CP. DCD and CP children have difficulties with tasks requiring anticipatory postural adjustments, fast reactive responses, and with tasks that require complex sensory integration, suggesting an internal modeling deficit in both groups. This implies that these children must rely on slow conscious feedback-based control rather than fast feedforward control and fast automatic feedback. The performance of both DCD and CP children on their stability limits/verticality is similarly poor which further emphasizes a potential deficit in their sensory input and/or integration. Future research must focus on unraveling the control mechanisms, to further understand the heterogeneity of these balance deficits. CLINICAL REHABILITATION IMPACT: The heterogeneous balance performances in both children with DCD and CP underscore the importance of comprehensively evaluating balance deficits in both groups. This comprehensive assessment contributes to a better understanding of individual balance deficits, thereby facilitating more tailored treatment programs.We would like to thank all the children and parents who volunteered and the schools and therapists who collaborated and helped with the recruitment of the children and patients. a special thank you to the cerebral palsy referral center antwerp (cepra) for the recruitment of children with cerebral palsy and colleagues silke Velghe and Mieke Goetschalckx for the recruitment of children with developmental coordination disorder. thank you to all master students at both hasselt university and university of antwerp for the help during the test sessions. thank you, Erik fransen, for the statistical support
Reliability and concurrent validity of a modified timed up and go test for healthy preschoolers
No full textThe purpose of this study was to assess the interrater and test-retest reliability and the concurrent validity of the modified timed up and go test for preschoolers. As such, we aim to determine the most suited outcome of the modified timed up and go test: the best or the average performance. Thirty-two children (age 3-5) performed three timed up and go test trials as fast as possible on two separate occasions. During the first session, two researchers recorded the time to perform the task simultaneously. For reliability analyses, intra-class correlation coefficients (ICCs) and the minimal detectable change were determined. A Pearson correlation coefficient was calculated to determine concurrent validity between the timed up and go test and the balance subscale of the Movement Assessment Battery for Children, 2nd edition. Interrater (ICC > 0.97) and test-retest (ICC > 0.75) reliability were good both for the average and the best timed up and go test performance. A minimal detectable change of 1.86 s was found for the best performance, and 2.30 s for the average performance. Only the best timed up and go test performance correlated significantly with the balance subscale of the Movement Assessment Battery for Children, 2nd edition, though fair (r = -0.347, p = 0.007).Conclusion: The modified timed up and go test for preschoolers using the best performance is reliable and recommended to reduce standard and measurement error. What is Known: • A large variety of timed up and go test protocols is available for children • The protocols differ in the instructions on walking speed (self-selected/fastest), the use of an extra motivation (e.g., touch a star on the wall) and the applied outcome (average/best performance) What is New: • The best timed up and go test performance induces more consistent test results between raters and sessions and also less standard and measurement error in 3- to 5-year-old children • The best timed up and go test performance should be preferred over the average performance to achieve both reliable and valid test results in 3- to 5-year-old children.status: Publishe
Aging and the Relationship between Balance Performance, Vestibular Function and Somatosensory Thresholds
No full textOBJECTIVES: The objective of this study was two-fold: (1) To evaluate the impact of the physiological aging process on somatosensory, vestibular, and balance functions, and (2) To examine the extent to which age and somatosensory and vestibular functions can predict balance performance. MATERIALS and METHODS: In this cross-sectional study, 141 asymptomatic subjects were assessed for touch pressure thresholds ( TPT) with Semmes-Weinstein monofilaments (SWF), vibration thresholds (VT) with a neurothesiometer (NT) and a Rydel-Seiffer tuning fork 128Hz (RSTF). Horizontal vestibulo-ocular reflexes (HVOR gain and asymmetry) were assessed using the video Head Impulse Test (vHIT). A modified version of the Romberg test was used to assess standing balance and the Timed Up and Go test (TUG) and tandem gait (TG) to evaluate dynamic balance. RESULTS: Significant age effects were found for TPT, VT, and balance but not for HVOR gain or asymmetry. Standing balance was explained for 47.2% by age, metatarsal 1 (MT1) (NT), and heel (SWF). The variance in TUG performance was explained for 47.0% by age, metatarsal 5 (MT5) (SWF), and medial malleolus (MM) (NT). Finally, the variance in TG performance was predicted for 43.1% by age, MT1 (NT), HVOR gain, and heel (SWF). CONCLUSION: Among asymptomatic adult population, both somatosensation and balance performance deteriorate with aging. In contrast, HVOR remains rather constant with age, which is possibly explained by the process of vestibular adaptation. Furthermore, this study provides evidence that the VT, TPT, HVOR gain, and age partly predict balance performance. Still, further research is needed, especially with bigger samples in decades 8 and 9.This project is granted by STIMPRO internal funding of the University of Antwerp.Johnson, C (corresponding author), Univ Antwerp, Dept Rehabil Sci & Physiotherapy, Antwerp, Belgium.
[email protected]
A Critical View on Motor-based Interventions to Improve Motor Skill Performance in Children With ADHD: A Systematic Review and Meta-analysis
No full textOBJECTIVE: To map the effect of motor-based interventions on motor skills in children with ADHD. METHOD: A systematic literature search was performed in Pubmed, Web of Science, and the SCOPUS database (last search: October 30th 2022). Methodological quality was assessed using the PEDro-scale and the quality of evidence was determined with the GRADE-method. Meta-analysis was performed when at least five studies were available. RESULTS: Thirteen studies (7 RCTs) satisfied the inclusion criteria, five of which were eligible for meta-analysis. Only one of the included studies reached the low risk of bias threshold. Comparing different motor-based interventions to any non-motor control intervention showed large motor skill improvements (SMD = 1.46; 95% CI = [1.00;1.93]; I² = 47.07%). The most effective type of motor-based intervention and the optimal treatment parameters could not be determined yet. CONCLUSION: Motor-based interventions in general seem to improve motor skills in children with ADHD. Additional RCTs are needed to increase current low GRADE confidence.status: Published onlin
Effects of a highly intensive balance therapy camp in children with developmental coordination disorder - An intervention protocol
No full textBACKGROUND: Children with Developmental Coordination Disorder (DCD) often (<87 %) experience postural control problems, impacting all levels of the International Classification of Functioning, Disability and Health (ICF) including their daily participation, self-esteem and mental health. Due to the multisystemic nature of postural control, comprehensive therapy should target all systems which is currently not the case. Highly intensive therapy is effective and commonly used in pediatric populations, but has not been explored yet to train postural control in children with DCD. AIMS: To investigate the effects of a highly intensive functional balance therapy camp at all ICF levels in children with DCD. METHODS AND PROCEDURES: The effects on postural control, muscle activity, brain alterations, self-perceived competence, self-identified goals, gross motor activities and participation are evaluated. Participants are assessed pre- and post-intervention, including a 3 months follow-up. Forty-eight children with DCD, aged 6-12 years old, receive 40 h of comprehensive balance training. This intervention is fun, individually tailored, targets all postural control systems, implements different motor learning strategies and includes both individual and group activities. CONCLUSION: Novel insights into the effects of a highly intensive comprehensive balance therapy camp designed for children with DCD will be gained at all levels of the ICF
Time-Normalization Approach for fNIRS Data During Tasks with High Variability in Duration
No full textFunctional near-infrared spectroscopy (fNIRS) is particularly suitable for measuring brain activity during motor tasks, due to its portability and good motion tolerance. In such cases, the trials' duration may vary depending on the experimental conditions or the participant's response, therefore a comparison of hemodynamic responses across repetitions cannot be properly performed. In this work, we present a MATLAB (R2023a) function (TaskNorm.m) developed for time-normalizing fNIRS data recorded during trials with different durations. It is based on a spline interpolation method that rescales the time-axis to the percentage of the trial with a fixed number of samples. This allows us to successively average across repetitions to obtain the mean hemodynamic responses and complete the standard data processing. The algorithm was tested on eight subjects (four with developmental coordination disorder, age: 9.78 ± 0.30 and four typically developing children, age: 9.02 ± 0.30) performing three different tasks. The results show that the TaskNorm function works as expected, allowing both a comparison and averaging of the data across multiple repetitions. The performance of the function is independent of the task or the pre-processing pipeline applied. The proposed function is publicly available and importable into the HomER3 package (v1.72.0), representing a further step in the ongoing standardization process of fNIRS data analysis.Funding
This research was partially funded by the Italian Ministry of Health (Ricerca Corrente 2023–2024 and 2024–2025 to E. Biffi) and by the Research Foundation-Flanders (FWO) (grant number: 43498, year: 2020)
Acknowledgments
Special thanks go to all the children and their parents who took part in the stud
Foot-floor contact pattern in children and adults with Dravet Syndrome
Full text linkBackground
Dravet Syndrome (DS) is a developmental and epileptic encephalopathy characterized by severe drug-resistant seizures and associated with cognitive and motor impairments. Walking problems are frequently observed. As the foot plays a key role during walking, compromised foot function can be a feature of deviant gait.
Aim
To investigate foot function in DS by characterizing foot-floor contact patterns using pedobarography.
Methods
A total of 31 children and adults were included in the DS group (aged 5.2-32.8 years, 17 female, 174 steps) and 30 in the control group (aged 6.0-32.9, 16 female, 180 steps). The foot-floor contact pattern was evaluated based on progression, length and smoothness (spectral arc length) of the center of pressure (CoP). Linear mixed models were used to identify differences between non-heel strikes and heel strikes and between the DS and control group.
Results
Fifteen participants with DS showed inconsistency in the type of foot-floor contact (heel strikes and non-heel strikes). Heel strikes of participants with DS had significantly reduced time of CoP under the hindfoot and increased time under the midfoot region compared to the control group. Significant time and age effects were detected.
Conclusions and implications
Deviant foot-floor contact patterns were observed in DS. Possible gait immaturity and instability as well as implications for interventions are discussed
Time-dependency of test-retest reliability and measurement error of center-of-pressure synchronization and symmetry during quiet standing within specific frequencies in early sub-acute stroke
No full textBackground: People with unilateral sensorimotor impairments after a stroke exhibit poor between-limb synchronization and asymmetries in balance control by relying on their less-affected side to maintain stability during standing. Therefore, there is a growing consensus to include center-of-pressure metrics as between-limb synchronization and dynamic control asymmetry when investigating balance improvements poststroke. However, the test-retest reliability of these metrics remains under-investigated, hindering uptake of these assessments in future stroke rehabilitation and recovery studies. Research question: First, are three immediate test-repetitions necessary for obtaining reliable synchronization and asymmetry scores in individuals with sub-acute stroke, or can fewer repetitions suffice? Second, does timing of assessments at 3-, 5-, 8-, and 12-weeks poststroke affect these estimates' test-retest reliability and measurement error? Methods: Thirty stroke survivors with moderate-to-severe motor impairments were tested at 3-, 5-, 8-, and 12weeks poststroke. At each timepoint, they completed three 40-second quiet standing trials on a dual force plate which measured center-of-pressure signals separately on each side. We calculated between-limb synchronization (i.e., cross-correlation) and dynamic control asymmetry (i.e., symmetry index) using the original centerof-pressure signal, and after decomposition into high and low (cut-off 0.4 Hz) frequency bands. Intraclass correlation coefficients (ICC) and Bland-Altman plots were used to assess test-retest reliability and measurement error. A cut-off was used to determine acceptable reliability (ICC>0.75). Results: Between-limb synchronization and dynamic control asymmetry showed good-to-excellent reliability (ICCs=0.80-0.97) across three repetitions at all timepoints. Reducing to two repetitions yielded acceptable reliability (ICC=0.77-0.95) for dynamic control asymmetry and high-frequency measures, yet insufficient reliability for between-limb synchronization. At the 3-weeks timepoint, ICCs were generally lower, with more error, compared to later timepoints. Conclusion: Novel performance metrics quantifying synchronization and asymmetry of balance control can be reliably obtained during the early sub-acute phase if three test-repetitions are administered per assessment.JS received a strategic basic research doctoral (PhD) fellowship by the Research Foundation Flanders (FWO), Belgium (application no.1S64819N) for conducting the TARGEt studies; AvH received a doctoral (PhD) fellowship from the special reserach fund DOCPRO, University of Antwerp, Belgium (application no.44607) for the analyses set forth here
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