Fine motor impairment in children with epilepsy: Relations with seizure severity and lateralizing value

Background Over the past decade, a large number of mobile health (mHealth) apps have been created to help individuals to better manage their own health. However, very few of these mHealth apps were specifically designed for people with disabilities, and only a few of them have been assessed for accessibility for people with disabilities. As a result, people with disabilities have difficulties using many of these mHealth apps. Objective The objective of this study was to identify an approach that can be generally applied to improve the accessibility of mHealth apps. Methods We recruited 5 study participants with a primary diagnosis of cerebral palsy or spinal cord injury. All the participants had fine motor impairment or lack of dexterity, and hence, they had difficulties using some mHealth apps. These 5 study participants were first asked to use multiple modules in the client app of a novel mHealth system (iMHere 2.0), during which their performance was observed. Interviews were conducted post use to collect study participants’ desired accessibility features. These accessibility features were then implemented into the iMHere 2.0 client app as customizable options. The 5 participants were asked to use the same modules in the app again, and their performance was compared with that in the first round. A brief interview and a questionnaire were then performed at the end of the study to collect the 5 participants’ comments and impression of the iMHere 2.0 app in general and of the customizable accessibility features. Results Study results indicate that the study participants on their first use of the iMHere 2.0 client app experienced various levels of difficulty consistent with the severity of their lack of dexterity. Their performance was improved after their desired accessibility features were added into the app, and they liked the customizable accessibility features. These participants also expressed an interest in using this mHealth system for their health self-management tasks. Conclusions The accessibility features identified in this study improved the accessibility of the mHealth app for people with dexterity issues. Our approach for improving mHealth app accessibility may also be applied to other mHealth apps to make those apps accessible to people with disabilities.

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092 Effect of the dual orexin receptor antagonist (DORA) daridorexant on behaviour upon awakening in rats and dogs

SLEEP ◽

10.1093/sleep/zsab072.091 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A38-A39

Author(s):

Giorgio Bergamini ◽

Catherine Roch ◽

Sean Durkin ◽

Michel Steiner

Keyword(s):

Grip Strength ◽

Motor Skills ◽

Muscle Weakness ◽

Motor Behavior ◽

Motor Impairment ◽

Phase Behaviour ◽

Fine Motor ◽

Dependent Manner ◽

The Impact ◽

Time Point

Abstract Introduction The ability to be fast alert and to interact with the environment without motor impairment upon waking up, is a critical feature of natural sleep. DORAs represent a new class of insomnia medications that specifically inhibit the wake-promoting effects of orexin neuropeptides. Daridorexant is a potent and selective DORA under late stage development for the treatment of insomnia. Here, we assessed the impact of sleep-promoting doses of daridorexant on rats’ and dogs’ behaviour upon forced awakening. Zolpidem (a positive GABAA receptor modulator) was used as active comparator in rats because of its known negative impact on motor functions. Methods Rats were woken up at different time points after oral administration of daridorexant (10, 30, 100 mg/kg) or zolpidem (30, 100 mg/kg) during their inactive phase, and repeatedly subjected to two motor tasks: 1) the rotating rod test (lasting 120 sec, at each time point) assessing gross motor skills and coordination, and 2) the forepaw grip strength test assessing fine motor skills and muscle strength. Dogs were presented with food as an external, salient stimulus, three hours after administration of daridorexant in gelatin capsules (10, 30 or 90 mg/dog) during their active phase. Behaviour and signs of muscle weakness, after having woken up, were assessed by manual inspection of video recordings and concomitant electroencephalogram/electromyogram recordings. Results In both the rotarod and grip tests, daridorexant treatment had no effect on motor behavior at any dose or time point tested, while zolpidem significantly reduced the time spent on the rotarod and the grip strength in a dose and time-dependent manner (N=12/group; p<0.001;) (e.g. at 30 min post-dose, time spent on the rotarod was 84, 79–89 and 10–19 sec for vehicle, daridorexant and zolpidem, respectively). Dogs treated with daridorexant were able to wake up easily upon food presentation. They behaved and ate normally and did not show any signs of muscle weakness. Conclusion The type of sleep promoted by daridorexant is surmountable in rats and dogs and similar to physiological sleep. It allows animals to easily wake up, to behave normally without motor impairment and to respond efficiently to the environmental conditions. Support (if any) Funded by Idorsia Pharmaceuticals Ltd

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Oral 5-Hydroxytryptophan (5-HTP) Does not Affect Grooved Pegboard Test Performance

Journal of North Carolina Academy of Science ◽

10.7572/jncas-d-16-00003.1 ◽

2017 ◽

Vol 133 (1-2) ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Mathew H. Gendle ◽

Stanley W. Dowell ◽

Rachel E. Paxton ◽

Rebecca H. O'Krent

Keyword(s):

Test Performance ◽

Iowa Gambling Task ◽

Safety Information ◽

Motor Impairment ◽

Nutritional Supplement ◽

Controlled Study ◽

Fine Motor ◽

Tower Of London ◽

Double Blind ◽

Grooved Pegboard Test

Abstract: There is limited knowledge of the neurocognitive effects of the serotonin precursor 5-hydroxytryptophan (5-HTP), which is sold over-the-counter as a nutritional supplement. Animal studies have demonstrated that exogenous 5-HTP promotes the production of ectopic serotonin in dopaminergic neurons—an effect that may reduce dopamine output in these cells. Behavioral studies in humans have demonstrated specific 5-HTP induced cognitive deficits on the Iowa Gambling Task and the Tower of London task that are likely the result of reduced forebrain dopamine. However, it remains unclear if 5-HTP induced performance decrements observed on the Tower of London task were the result of a motor or cognitive impairment. The objective of this double-blind, placebo-controlled study was to clarify this point by determining if oral administration of 150 mg of 5-HTP disrupts fine motor control, as measured by the Grooved Pegboard Test. Seventy five university undergraduates received either a placebo or 5-HTP and completed the Grooved Pegboard Test. The groups did not differ in the amount of time needed to complete the place (p = 0.67) and remove (p = 0.48) components of the Grooved Pegboard Test. Therefore, 5-HTP induced reductions in performance on the Tower of London task appear to be cognitive in nature, and are unlikely to be the result of fine motor impairment (as measured by the Grooved Pegboard Test). These results also provide important safety information for 5-HTP by demonstrating that a 150 mg oral dose does not generally alter fine motor function.

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Motor Problems among Children of Very Low Birthweight

British Journal of Occupational Therapy ◽

10.1177/030802268905200307 ◽

1989 ◽

Vol 52 (3) ◽

pp. 97-99 ◽

Cited By ~ 9

Author(s):

B L Roberts ◽

N Marlow ◽

R W I Cooke

Keyword(s):

Motor Skills ◽

Low Birthweight ◽

Motor Impairment ◽

Occupational Therapists ◽

Demographic Variables ◽

Fine Motor ◽

Early Assessment ◽

Very Low Birthweight ◽

Motor Outcome ◽

Motor Problems

The motor outcome for 53 six-year-old children with birthweights of 1251g or less who were receiving mainstream education is reported. Compared with age and sex matched classmates, these children had significantly poorer motor skills, as assessed by the Test of Motor Impairment. Despite lower scores in tests of fine motor, ball and balancing skills, these children were perceived by their teachers to be performing satisfactorily at school. The impairment observed was independent of IQ and social and demographic variables. Because of the risk of later schooling difficulties, very low birthweight children should be considered for early assessment by occupational therapists and physiotherapists in view of the frequent motor problems encountered.

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ASSESSING MOTOR SKILLS TO INFORM A FETAL ALCOHOL SPECTRUM DISORDER DIAGNOSIS FOCUSING ON PERSONS OLDER THAN 12 YEARS: A SYSTEMATIC REVIEW OF THE LITERATURE

Journal of Population Therapeutics and Clinical Pharmacology ◽

10.22374/1710-6222.25.1.3 ◽

2018 ◽

Vol 25 (1) ◽

pp. e25-e38 ◽

Cited By ~ 2

Author(s):

Bernadette Safe ◽

Annette Joosten ◽

Roslyn Giglia

Keyword(s):

Systematic Review ◽

Motor Skills ◽

Fetal Alcohol Spectrum Disorder ◽

Motor Impairment ◽

Spectrum Disorder ◽

Current Evidence ◽

Fine Motor ◽

Prenatally Exposed ◽

Fetal Alcohol ◽

Fetal Alcohol Spectrum

Background Motor impairments are one of the difficulties present in people prenatally exposed to alcohol, and are included in the diagnostic criteria for Fetal Alcohol Spectrum Disorder. Objectives The aim of this review was to examine the extent and common types of motor impairment present in persons aged over 12 years prenatally exposed to alcohol as evidence for determining the skills that should be assessed and addressed in intervention. Methods A systematic review of current evidence using various electronic databases was conducted. Studies were appraised using a recognised clinical appraisal tool. Results Seven studies published between 1998 and 2014 met the inclusion criteria. There is some evidence that difficulties with fine motor skills, visual motor integration, and balance skills persist in people who have been prenatally exposed to alcohol. Most studies did not focus on adolescent or adult participants in isolation, making it difficult to generalise results. Varied methodological designs made it difficult to compare studies as few used common standardised assessments Conclusion A review of functional difficulties in each individual would be required to determine if a motor assessment is warranted. Further research is required using assessments recommended in diagnostic guidelines to determine the common motor difficulties seen in adolescents and adults.

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Assessing the Share of Impaired Visual Function, Fine Motor Coordination and Visual-motor Integration in Dyslexic Children with the Eta/Mu Model

Archives of Current Research International ◽

10.9734/acri/2019/v18i230134 ◽

2019 ◽

pp. 1-13

Author(s):

Carlo Aleci ◽

Francesca Vai

Keyword(s):

Motor Coordination ◽

Motor Impairment ◽

Rehabilitation Program ◽

Second Order ◽

Motor Domain ◽

Fine Motor ◽

Motor Deficits ◽

First Order ◽

Visual Motor Integration ◽

Visual Motor

Aims: A computational model aimed to estimate the proportion of visual/motor deficits (first-order defects) and visual-motor abnormal integration (second-order defect) in dyslexic children is described. Study Design: Single-masked case-control study. Place and Duration of Study: Sample: Service of Neuro-Ophthalmology, University of Turin, between December 2017 and November 2018. Methodology: Twenty subjects (age 8-10) were administered a set of tests that recruit the visual and motor domain in different proportions. The score obtained in each trial is weighed by the correspondent share of visuoperceptive and motor recruitment. This way two indexes are obtained: Eta (h) and Mu (m), that quantify the expected and estimated damage of the two functions across the range of average performance. The difference between the expected and estimated level of damage in the two domains represents the quota of selective visuoperceptive / motor impairment of the subject. In turn, no or negligible difference in the presence of abnormal z-score would reveal impaired visual-motor integration with no evident visual or motor damage. Results: The model detected a prevalent first-order defect in the visuo perceptive or motor domain in 58% of the cases (visuo perceptive alteration: 27%, motor alteration: 73%), and a prevalent second-order defect in the remaining 42% of the subjects. Internal consistency was adequate for research and screening purpose (Cronbach’s coefficient alpha: from 0.77 to 0.84). Conclusion: The Eta/Mu model seems a promising tool to detect cases of visual and motor alteration as well as the level of visual-motor integration in dyslexic children. Further effort is needed to improve test-retest reliability by examining larger samples, so as to make it suitable to customize the rehabilitation program of children suffering from learning disabilities.

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Disorders of fine motor skills after a stroke: the processes of neuroplasticity and sensorimotor integration

Clinical Practice ◽

10.17816/clinpract10116-22 ◽

2019 ◽

Vol 10 (1) ◽

pp. 16-22

Author(s):

Eugeniia V. Ekusheva ◽

A. A. Komazov

Keyword(s):

Ischemic Stroke ◽

Motor Skills ◽

Motor Impairment ◽

Fine Motor ◽

Voluntary Movements ◽

Moderate Degree ◽

Fine Motor Skills ◽

Social Maladjustment ◽

The Right

Background. Impairment of fine motor skills in the hand is one of the most frequent causes of the persistent loss of professional skills, social maladjustment, and the impossibility of self-care in patients after a stroke, which ultimately leads to a significant reduction in the quality of their life. The article discusses the features of the fine motor skills’ impairment in the hand in patients after a stroke, in the context of a lateralized hemispheric lesion. Methods. We have studied 26 patients after a primary ischemic stroke in the pool of middle cerebral artery of the right (n=12) or left (n=14) brain hemisphere. The average age of patients was 55.7±7.3 years. Patients with a right-sided ischemic stroke were comparable to those with a left-sided stroke in their age, disease duration, size of the lesion and the gender ratio. Results. All the patients after an ischemic stroke had motor impairment in the form of a hemiparesis of a mild or moderate degree. Discussion. We suggest the existence of differentiated mechanisms for the development of fine and highly coordinated voluntary movements in the hand of patients after an ischemic stroke, depending on the lateralization of the supratentorial lesion: diffuse deficit of the afferent support in a right-sided ischemic stroke vs. bilateral efferent deficit for a left hemisphere lesion. Conclusion. The obtained data on the differentiated mechanisms for the development of fine and highly coordinated voluntary movements in the hand of patients after an ischemic stroke warrant the necessity of a further, more targeted research on those disorders in the post-stroke period, on order to optimize the existing rehabilitation approaches and improve the functional potential and quality of life of such patients.

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Communication Profile of a Minimally Verbal School-Age Autistic Child: A Case Study

Language Speech and Hearing Services in Schools ◽

10.1044/2020_lshss-19-00021 ◽

2020 ◽

Vol 51 (3) ◽

pp. 671-686

Author(s):

Verónica Vidal ◽

Anita McAllister ◽

Laura DeThorne

Keyword(s):

Augmentative And Alternative Communication ◽

Motor Impairment ◽

Low Frequency ◽

Fine Motor ◽

Speech Impairment ◽

Minimally Verbal ◽

Thick Description ◽

Sensory Motor ◽

Behavioral Assessments

Purpose The present clinical focus draws on an intrinsic case study to provide a thick description of the communication profile of John, a 9-year-old minimally verbal autistic student. Method Specifically, traditional behavioral assessments, classroom video observations, and semistructured interviews were used to gather information regarding John's communication profile and potential sensory–motor differences. Results Convergent evidence indicated that John's expressive profile was characterized by single words, emergent word combinations, some conventional gestures, and a low frequency of communicative initiations. Concomitant language comprehension challenges and poor intelligibility associated with motor speech impairment were also indicated. His sensory–motor profile was marked by fine motor impairment, relative strengths in gross motor abilities, and sensory differences across visual, hearing, and tactile modalities. Conclusion Direct implications for supporting minimally verbal autistic students like John include the need to (a) consider sensory–motor influences on social interaction and (b) support flexible use of multimodal communication resources, including augmentative and alternative communication. Supplemental Material https://doi.org/10.23641/asha.12202448

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Dendritic Spine Density and Dynamics of Layer 5 Pyramidal Neurons of the Primary Motor Cortex Are Elevated With Aging

Cerebral Cortex ◽

10.1093/cercor/bhz124 ◽

2019 ◽

Vol 30 (2) ◽

pp. 767-777 ◽

Cited By ~ 3

Author(s):

A M Davidson ◽

H Mejía-Gómez ◽

M Jacobowitz ◽

R Mostany

Keyword(s):

Motor Cortex ◽

Dendritic Spine ◽

Healthy Aging ◽

Primary Motor Cortex ◽

Cortical Cell ◽

Motor Impairment ◽

Fine Motor ◽

Aged Mouse ◽

Spine Density ◽

Dendritic Spine Density

AbstractIt is well established that motor impairment often occurs alongside healthy aging, leading to problems with fine motor skills and coordination. Although previously thought to be caused by neuronal death accumulating across the lifespan, it is now believed that the source of this impairment instead stems from more subtle changes in neural connectivity. The dendritic spine is a prime target for exploration of this problem because it is the postsynaptic partner of most excitatory synapses received by the pyramidal neuron, a cortical cell that carries much of the information processing load in the cerebral cortex. We repeatedly imaged the same dendrites in young adult and aged mouse motor cortex over the course of 1 month to look for differences in the baseline state of the dendritic spine population. These experiments reveal increased dendritic spine density, without obvious changes in spine clustering, occurring at the aged dendrite. Additionally, aged dendrites exhibit elevated spine turnover and stabilization alongside decreased long-term spine survival. These results suggest that at baseline the aged motor cortex may exist in a perpetual state of relative instability and attempts at compensation. This phenotype of aging may provide clues for future targets of aging-related motor impairment remediation.

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Comparing Standardized and Parent-Reported Motor Outcomes of Extremely Preterm Infants

Children ◽

10.3390/children6080090 ◽

2019 ◽

Vol 6 (8) ◽

pp. 90

Author(s):

Maeve Morgan-Feir ◽

Andrea Abbott ◽

Anne Synnes ◽

Dianne Creighton ◽

Thevanisha Pillay ◽

...

Keyword(s):

Preterm Infants ◽

Motor Impairment ◽

Fine Motor ◽

Chi Square ◽

Increased Risk ◽

Extremely Preterm ◽

Extremely Preterm Infants ◽

Ages And Stages Questionnaire ◽

Motor Outcomes

Extremely preterm infants are at increased risk of motor impairment. The Canadian Neonatal Follow-Up Network (CNFUN) afforded an opportunity to study the outcomes of extremely preterm children. The purpose of this study was to compare 18-month corrected age (CA) motor outcomes of extremely preterm infants with parent-reported functional outcomes at 3 years CA. CNFUN data of 1376 infants were used to conduct chi-square analyses to compare Bayley-III motor scores (composite, gross, and fine motor) at 18 months CA with parent-reported Ages and Stages Questionnaire motor scores (gross and fine motor) at 3 years CA. The correlation of motor scores at 18-months CA with parent-reported gross and fine motor scores at 3 years CA was also examined. We found that 1 in 5 infants scoring within or above the average range on the Bayley-III had parent-reported functional fine and gross motor difficulties at 3 years CA. Bayley-III scores were only moderately correlated with functional motor outcomes. Results of the study suggest that the Bayley-III at 18 months CA was able to detect the majority of infants with motor problems, but not all; therefore, ongoing follow-up of extremely preterm infants is required. The Bayley-III motor composite score has greater clinical utility compared to sub-scale scores.

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