Lower extremity kinetics for balance control in children with cerebral palsy

The authors examined and compared the effect of support-surface perturbations of various magnitudes on lower extremity kinetics of 7 children with cerebral palsy (CP) and 8 typically developing (TD) children. Results showed that the highest velocity tolerated without stepping was slower in children with CP than in either age-matched TD or younger TD children. Multimodal torque profiles were more frequent in children with CP than in TD controls. TD groups temporally and spatially organized torque activation, whereas children with CP activated all joints simultaneously and showed altered torque contribution patterns among joints. Those results suggest that impairments in reactive postural control in children with CP result not only from developmental delay but also from pathology. Evidence for pathology included increased numbers of torque bursts required to regain stability and less efficient temporal and spatial organization of torque activation patterns.     

Effects of whole body vibration on spasticity and lower extremity function in children with cerebral palsy

AimThe aim of this study was to evaluate the effect of whole body vibration (WBV) on lower extremity spasticity and ambulatory function in children with cerebral palsy (CP) with a complete crossover design.MethodSixteen participants aged 9.8(2.3) years received a 20-min WBV and a control condition in a counterbalanced order on two separate days. Change scores of each outcome variable were used to show the improvement.ResultsRepeated-measures analyses revealed significant differences in condition scores among variables including active range-of-motion (active ROM, increased), relaxation index (RI, increased), Modified Ashworth Scale (MAS, decreased), timed up-and-go (TUG, decreased), and Six Minute Walk Test (6MWT, increased). Significant differences were also found in time change scores for MAS and 6MWT. Correlation results revealed that TUG was significantly correlated with RI (r = −.512, p = .042), and 6MWT (r = −.700, p = .003).InterpretationThis study suggested that WBV intervention can control the spasticity, enhance ambulatory performance and increase active ROM. Along with previous results, data from this study revealed the potential use of WBV in clinical rehabilitation in children with CP. Future investigations should focus on finding the combination of treatment frequency and duration to achieve an ideal result.     

The training & support programme for parents of children with ataxia: a pilot study

The aim of the study was to evaluate the impact of the Training and Support Programme among parents of children with ataxia. A total of 39 parents expressed an interest in the TSP, 27 (mean age 41; range 25-58) returned baseline questionnaires and completed the study. Twenty-four children (mean age 12.5 years, SD=12.4) received the TSP. Data were collected by self-administered questionnaires mailed to parents immediately before attending the TSP and at 4-month follow-up. Interviews were conducted with 10 parents immediately following TSP completion. Comparisons over time revealed significant decreases in parental anxious mood (p=.011), depressed mood (p=.046) and perceived stress (p=.020) and significant improvements in generalized self-efficacy (p=.010), satisfaction with life (p=.045) and parental health status (p=.020). Parents reported improvements in children's mobility, "jumping legs", sleep patterns, energy and activity levels, relaxation, and happiness (e.g., more smiles). Parents felt closer to their children and one parent had become "more accepting" of their child's ataxia. Results indicate that the TSP may enhance the psychosocial well-being of parents of children with ataxia although a randomized controlled trial would be necessary to determine whether the changes reported here are in fact due to attending the TSP.     

Gait training facilitates push-off and improves gait symmetry in children with cerebral palsy

BackgroundHuman walking involves a rapid and powerful contraction of ankle plantar flexors during push-off in late stance.ObjectiveHere we investigated whether impaired push-off force contributes to gait problems in children with cerebral palsy (CP) and whether it may be improved by intensive gait training.MethodsSixteen children with CP (6–15 years) and fourteen typically developing (TD) children (4–15 years) were recruited. Foot pressure was measured by insoles and gait kinematics were recorded by 3-dimensional video analysis during treadmill and overground walking. The peak derivative of ground reaction force at push off (dPF) was calculated from the foot pressure measurements. Maximal voluntary plantar flexion (MVC) was measured while seated. Measurements were performed before and after a control period and after 4 weeks of 30 minutes daily inclined treadmill training.ResultsdPF and MVC were significantly lower in children with CP on the most affected (MA) as compared to TD children (p < .001). dPF was lower on the MA leg as compared to the less affected (LA) leg in children with CP (p < .05). Following gait training, increases in dPF (p < .001) and MVC (p < .01) were observed for the MA leg. Following gait training children with CP showed similar timing of dPF and similar stance phase duration on both legs indicating improved symmetry of gait. These effects were also shown during overground walking.ConclusionImpaired ability to voluntarily activate ankle plantar flexors and produce a rapid and powerful push-off during late stance are of importance for impaired gait function in children with CP. Intensive treadmill training may facilitate the drive to ankle plantar flexors and reduce gait asymmetry during both treadmill and overground walking.     

Computerized tabletop games as a form of a video game training for old-old

This research aimed at investigating the utility of a computerized version of a cognitively stimulating activity as a video game intervention for elderly. The study focused on the effect of a 6-week extensive practice intervention on aspects of cognitive functioning (vigilance, working memory (WM), inhibition, reasoning) of old-old participants (N = 29), randomly assigned to trained or active control group. The difference between groups was in the content of the extended video game practice – cognitively complex card game for trained and computerized version of a simple dice-game of chance for control participants. A pretest, posttest and a 4-month follow-up measurement was conducted. Results revealed improvements in both groups, except for improved reasoning found only in trained participants. These results suggest that: (1) improvements are dependent on the complexity of the program, (2) cognitively stimulating activity are a valid training procedure for old-old, (3) novelty of computer use is an important factor in determining training efficacy.     

Space Fortress game training and executive control in older adults: A pilot intervention

ABSTRACT

We investigated the feasibility of using the Space Fortress (SF) game, a complex video game originally developed to study complex skill acquisition in young adults, to improve executive control processes in cognitively healthy older adults. The study protocol consisted of 36 one-hour game play sessions over 3 months with cognitive evaluations before and after, and a follow-up evaluation at 6 months. Sixty participants were randomized to one of three conditions: Emphasis Change (EC) – elders were instructed to concentrate on playing the entire game but place particular emphasis on a specific aspect of game play in each particular game; Active Control (AC) – game play with standard instructions; Passive Control (PC) – evaluation sessions without game play. Primary outcome measures were obtained from five tasks, presumably tapping executive control processes. A total of 54 older adults completed the study protocol. One measure of executive control, WAIS-III letter–number sequencing, showed improvement in performance from pre- to post-evaluations in the EC condition, but not in the other two conditions. These initial findings are modest but encouraging. Future SF interventions need to carefully consider increasing the duration and or the intensity of the intervention by providing at-home game training, reducing the motor demands of the game, and selecting appropriate outcome measures.     

Dopamine transporter gene moderates response to behavioral parent training in children with ADHD: a pilot study

There is great variability in the degree to which children with attention deficit/hyperactivity disorder (ADHD) improve through behavioral treatments. This study investigates the influence of the dopamine transporter gene (SCL6A3/DAT1) on outcome of behavioral parent training (BPT). Study subjects were a subsample (n = 50, for whom DAT1 genotypes were available) of a randomized controlled BPT effectiveness study (N = 94) comparing BPT plus ongoing routine clinical care (RCC) versus RCC alone in referred children (4-12 years old) with ADHD. Treatment outcome was based on parent-reported ADHD symptoms and behavioral problems. Presence of 2 versus no or 1 DAT1 10-repeat allele served as moderator variable. Time × Treatment × Genotype effect was analyzed with repeated-measures analysis of variance, controlling for baseline medication status. Results indicate that DAT1 moderated treatment response (p = .009). In children with no or 1 DAT1 10-repeat allele, superior treatment effects of BPT + RCC compared with RCC alone were present (p = .005), which was not the case in children with 2 DAT1 10-repeat alleles (p = .57). Our findings suggest that genetic differences in DAT1 in children with ADHD influence their susceptibility to a behavioral intervention directed at shaping their environment through their parents. The role of the dopamine system in motivation and learning and in the aberrant sensitivity to reinforcement in children with ADHD may explain this moderating effect, given that the management of contingencies is typically addressed in BPT.     

Space Fortress game training and executive control in older adults: a pilot intervention

We investigated the feasibility of using the Space Fortress (SF) game, a complex video game originally developed to study complex skill acquisition in young adults, to improve executive control processes in cognitively healthy older adults. The study protocol consisted of 36 one-hour game play sessions over 3 months with cognitive evaluations before and after, and a follow-up evaluation at 6 months. Sixty participants were randomized to one of three conditions: Emphasis Change (EC)--elders were instructed to concentrate on playing the entire game but place particular emphasis on a specific aspect of game play in each particular game; Active Control (AC)--game play with standard instructions; Passive Control (PC)--evaluation sessions without game play. Primary outcome measures were obtained from five tasks, presumably tapping executive control processes. A total of 54 older adults completed the study protocol. One measure of executive control, WAIS-III letter-number sequencing, showed improvement in performance from pre- to post-evaluations in the EC condition, but not in the other two conditions. These initial findings are modest but encouraging. Future SF interventions need to carefully consider increasing the duration and or the intensity of the intervention by providing at-home game training, reducing the motor demands of the game, and selecting appropriate outcome measures.     

Memory for words and drawings in children with hemiplegic cerebral palsy

A list-learning paradigm was used to study learning and memory of verbal and figurative material in children with right versus left-sided hemiplegic cerebral palsy. Thirty-one children with right (n=18), or left (n=13) congenital hemiplegia were compared with normal controls (n=19). All children had normal intelligence (IQ>80), and were attending standard schools. The inclusion criteria for the two hemiplegic groups were; no epilepsy, no hearing or visual impairments, and a mild to moderate hemiparesis. The aim of this study was to explore material-specific (words and drawings) differences in the acquisition, recall and serial position effects in children with an early unilateral brain lesion. The left-hemisphere impaired (i.e. right hemiplegia) group showed impaired acquisition for drawings, as compared with the normal controls. There was also a material-specific difference in the serial position effect for all three groups. Learning of words followed the primacy principle, whereas the learning of drawings followed the recency principle. There were no group-differences in delayed-recall (i.e. long-term memory) for either words or drawings. The results are discussed in terms of acquisition and retention of verbal and figurative materials in relation to lesion side and size.     

Encounter group counsellor training with pre-service industrial psychologists: A pilot study

This study explored the efficacy of an encounter group counsellor training protocol to prepare pre-service industrial-organisational (I-O) psychologists as workplace counsellors. The participants included 48 master’s degree students enrolled for I-O professional education at a South African university over the span of two years (female = 59%, aged 23 to 30 years, white = 79% and Afrikaans speaking = 70%). They were engaged in an encounter group training process as part of their professional preparation. Qualitative impressions on the students’ experiences impacting on their intra-and interpersonal awareness were gathered after the training using a structured observation design. The data were thematically analysed and the findings indicated the participants portrayed a higher sense of inter-and intrapersonal awareness following the encounter group training. Encounter group experiences might be of added value in the training of future I-O psychologists for interpersonal awareness.     

Self-awareness training associated with personality traits and sex: a pilot study

107 volunteers learning Reiki-Do self-awareness techniques participated in this study. Results indicate that personality traits in healthy participants might be affected by specific self-awareness training, such as Reiki-Do, with participants' sex playing an independent role.     

Mirror writing in pre-school children: a pilot study

Mirror writing refers to the production of individual letters, whole words or sentences in reverse direction. Unintentional mirror writing has been observed in young children learning to write and interpreted as the manifestation of different cognitive impairments. We report on mirror writing instances in a sample of 108 pre-school children. Results showed MW to be age-related but independent from handedness and left-right discrimination abilities. We propose an account of mirror writing as reflecting dissociation between acquired motor programmes for letter shape composition and unspecified spatial direction of hand movements. Before learning to write, the child’s directional cognitive system is assumed to be dichotomous, thus inducing the production of randomly oriented asymmetrical letters.     

Autobiographical recall training in elderly adults with subjective memory complaint: a pilot study

Subjective memory complaint is a self-reported memory impairment which affects elderly people. This problem does not interfere with daily living activities but could decrease quality of life. This study's purpose was to verify whether a specific, newly developed, autobiographical recall training could modify self-perception of memory of subjects with subjective memory complaint. Seven elderly subjects (4 women and 3 men; mean age 65.5 yr., SD=11) with such complaint, evidenced through a specific questionnaire, attended the training course and were prospectively assessed on standard neuropsychological tests, depressive symptomatology, and self-perception of memory. Self-perception of memory, as assessed by scores on a formalized questionnaire, improved significantly after the training, while depressive symptoms did not change. Neuropsychological performances were normal before and after the training, but a statistically significant improvement was observed only on the phonological fluency test. Thus the present pilot study suggested that the training may be effective in improving self-perception of memory and metamnestic capacity in elderly people with subjective memory complaints but not in changing subjects' depressive symptoms. This requires replication of this work with a much larger sample so statistical power is adequate.     

fMRI of parents of children with Asperger Syndrome: a pilot study

BACKGROUND: People with autism or Asperger Syndrome (AS) show altered patterns of brain activity during visual search and emotion recognition tasks. Autism and AS are genetic conditions and parents may show the 'broader autism phenotype.' AIMS: (1) To test if parents of children with AS show atypical brain activity during a visual search and an empathy task; (2) to test for sex differences during these tasks at the neural level; (3) to test if parents of children with autism are hyper-masculinized, as might be predicted by the 'extreme male brain' theory. METHOD: We used fMRI during a visual search task (the Embedded Figures Test (EFT)) and an emotion recognition test (the 'Reading the Mind in the Eyes' (or Eyes) test). SAMPLE: Twelve parents of children with AS, vs. 12 sex-matched controls. DESIGN: Factorial analysis was used to map main effects of sex, group (parents vs. controls), and sexxgroup interaction on brain function. An ordinal ANOVA also tested for regions of brain activity where females>males>fathers=mothers, to test for parental hyper-masculinization. RESULTS ON EFT TASK: Female controls showed more activity in extrastriate cortex than male controls, and both mothers and fathers showed even less activity in this area than sex-matched controls. There were no differences in group activation between mothers and fathers of children with AS. The ordinal ANOVA identified two specific regions in visual cortex (right and left, respectively) that showed the pattern Females>Males>Fathers=Mothers, both in BA 19. RESULTS ON EYES TASK: Male controls showed more activity in the left inferior frontal gyrus than female controls, and both mothers and fathers showed even more activity in this area compared to sex-matched controls. Female controls showed greater bilateral inferior frontal activation than males. This was not seen when comparing mothers to males, or mothers to fathers. The ordinal ANOVA identified two specific regions that showed the pattern Females>Males>Mothers=Fathers: left medial temporal gyrus (BA 21) and left dorsolateral prefrontal cortex (BA 44). CONCLUSIONS: Parents of children with AS show atypical brain function during both visual search and emotion recognition, in the direction of hyper-masculinization of the brain. Because of the small sample size, and lack of age-matching between parents and controls, such results constitute a pilot study that needs replicating with larger samples.     

Effectiveness of social skills training with children: A meta-analytic study

This meta-analytic study examined the relative effectiveness of three methods of social skills training with socially isolated children: coaching, interpersonal cognitive problem solving, and modelling. An exhaustive search of the published literature in the area produced a total of 43 studies that met stringent criteria for inclusion in the subsequent analysis. Social skills training produced significant improvements in children's levels of social interaction, sociometric status and cognitive problem solving abilities. No training technique produced a significantly greater improvement than either of the others. Isolated children showed larger increases in their levels of social interaction and sociometric status than non-isolate children. Multi-modal training programmes were recommended to capitalize on the independent therapeutic effects which derive from a number of different social skills training techniques.