Independent walking and balance in children with CHARGE syndrome

2020 ◽  
pp. 026461962094606
Author(s):  
Pamela Haibach-Beach ◽  
Melanie Perreault ◽  
Lauren Lieberman ◽  
Elizabeth Foster
Keyword(s):  
Postural Control ◽  
Motor Development ◽  
Balance Training ◽  
Building Blocks ◽  
Charge Syndrome ◽  
Anticipatory Control ◽  
Evaluation Systems ◽  
Functional Balance ◽  
And Gender ◽  
Dynamic Gait

Children with CHARGE syndrome (CWCS) are born with multiple physical disabilities, several of which impair balance and the onset of motor milestones. Early motor development problems can include delayed independent walking, which has been found in CWCS. In addition, few studies have examined balance in CWCS and these studies have been limited in scope, necessitating a more comprehensive examination of balance in this population. Motor development occurs as a progression of stages as represented by Seefeldt’s conceptual model. As such, it is essential to examine the association of early development of foundational skills, such as balance, with the onset of motor milestones as they are building blocks to motor competence. The aims of this study are to (1) examine the differential effects of children with and without CHARGE syndrome on balance and (2) examine the association of age of walking to these balance measures. In this study, 27 CWCS and 22 children without CHARGE syndrome, aged 7 to 16 years, were assessed on four components of balance including anticipatory control, reactive postural control, sensory orientation, and dynamic gait using the shortened version of the Balance Evaluation Systems Test (mini-BESTest) and parental reported age of independent walking. Their balance and age of walking were compared to 22 typically developing peers of similar age and gender distribution. Results revealed that CWCS walked three times later than their peers without CHARGE syndrome and had significant deficits on all balance systems assessed with the largest difference occurring in anticipatory control. Anticipatory control is critically important in maintaining static and dynamic postural control. These results indicate a critical need for early functional balance training and compensatory strategies in CWCS.

Relationship Between Motor Skills, Balance, and Physical Activity in Children with CHARGE Syndrome

2020 ◽  
Vol 114 (4) ◽  
pp. 315-324
Author(s):  
Melanie Perreault ◽  
Pamela Haibach-Beach ◽  
Lauren Lieberman ◽  
Elizabeth Foster
Keyword(s):  
Physical Activity ◽  
Physical Education ◽  
Motor Skills ◽  
Motor Development ◽  
School Setting ◽  
Charge Syndrome ◽  
Anticipatory Control ◽  
Balance Test ◽  
Positive Correlations ◽  
The Relationship

Introduction: Children with CHARGE syndrome often show delays in balance and motor skills due to multisensory impairments. Research also suggests that children with CHARGE syndrome have fewer opportunities to engage in physical activity. However, little research has examined the relationship among all of these variables. Thus, the purpose of this study was to examine the relationship between balance, motor skills, and physical activity. Methods: Participants consisted of 37 children with CHARGE syndrome aged 3–16 years who could walk independently. Parents of each child with CHARGE syndrome completed a demographics questionnaire and the Physical Activity Questionnaire for Children or Adolescents. Their child completed the Mini-BEST balance test and five motor skills (run, jump, slide, kick, and throw) from the Test of Gross Motor Development II. Results: Results indicate that anticipatory control had significant positive correlations with all five motor skills, sensory orientation with three motor skills, and reactive postural control and dynamic gait with two motor skills. Running was the only variable that had a significant positive correlation with physical activity. Discussion: The findings indicate that balance, especially anticipatory control, plays an important role in fundamental motor skills of children with CHARGE syndrome. There is also a strong connection between physical activity and running competence for this population; however, since this is based on a correlational analysis, the direction of the relationship is unclear. Implications for practitioners: Physical education teachers should work with students with CHARGE syndrome on increasing balance and motor skill performance to give them the competence and confidence to engage in physical activity. Moreover, parents can help by engaging in physical activity with their child at an early age and seeking out additional physical activity opportunities for their child outside of the physical education and school setting.

scholarly journals Case of cerebellar ataxia successfully treated by virtual reality-guided rehabilitation

2021 ◽  
Vol 14 (5) ◽  
pp. e242287
Author(s):  
Kazuhiro Takimoto ◽  
Kyohei Omon ◽  
Yuichiro Murakawa ◽  
Hideo Ishikawa
Keyword(s):  
Virtual Reality ◽  
Physical Therapy ◽  
Test Score ◽  
Daily Life ◽  
Balance Training ◽  
Balance Function ◽  
Brainstem Infarction ◽  
Evaluation Systems ◽  
Functional Balance ◽  
Trunk Sway

A male patient in his 40s was transferred to our hospital for rehabilitation of ataxia after right cerebellar and brainstem infarction. After 3 weeks of conventional physical therapy, his activities of daily life successfully improved with an increase in the functional impedance measure from 101 to 124. However, he still fell short of gaining a higher level of balance function, which was necessary for his job as a standup forklift driver. We introduced virtual reality-guided balance training. The training was performed for approximately 40 min on weekdays for 2 weeks. As a result, the Scale for the Assessment and Rating of Ataxia score decreased from 5 to 1, Functional Balance Scale score improved from 48 to 56, and Mini-Balance Evaluation Systems Test score increased from 20 to 28. The trunk sway disappeared clinically. He regained confidence and returned to work after an additional 2 weeks of physical therapy.

Postural control using a vibratory feedback system for balance training in the elderly

2008 ◽  
pp. 263-270
Author(s):  
T Ifukube ◽  
Y Oyama ◽  
S Shirogane ◽  
T Izumi ◽  
Y Maeda ◽  
...  
Keyword(s):  
Postural Control ◽  
Balance Training ◽  
Feedback System ◽  
The Elderly

scholarly journals Gender responsiveness diagnostic of national monitoring and evaluation systems – methodological reflections

2017 ◽  
Vol 5 (1) ◽  
Author(s):  
Madri S. Jansen van Rensburg ◽  
Caitlin Blaser Mapitsa
Keyword(s):  
South Africa ◽  
Capacity Building ◽  
Diagnostic Tool ◽  
Monitoring And Evaluation ◽  
Capacity Development ◽  
Diagnostic Study ◽  
Evaluation Systems ◽  
National Monitoring ◽  
The Government ◽  
And Gender

Background: This article reflects on the implementation of a diagnostic study carried out to understand the gender responsiveness of the national monitoring and evaluation (M&E) systems of Benin, South Africa and Uganda. Carrying out the study found that the potential for integrating the cross-cutting systems of gender and monitoring and evaluation (M&E) are strong. At the same time, it highlighted a range of challenges intersecting these two areas of work. This article explores these issues, which range from logistical to conceptual.Objectives: This article aims to share reflections from the gender diagnostic study to enable more appropriate capacity building in the field of gender responsiveness in national M&E systems. Developing more sophisticated tools to measure gender responsiveness in complex contexts is critical. A better understanding of how gender and national M&E systems intersect is important to understanding firstly how we can more accurately measure the gender responsiveness of existing systems and secondly how better to engender capacity development initiatives.Method: As part of the Twende Mbele programme, Centre for Learning on Evaluation and Results (CLEAR) commissioned Africa Gender and Development Evaluator’s Network (AGDEN) to coordinate teams of researchers in Benin, Uganda, and South Africa to collaboratively develop the diagnostic tool, and then implement it by conducting a review of key documentation and to interview officials within the government wide monitoring and evaluation systems as well as the national gender machinery in each country.Results: The study found that the gender responsiveness of M&E systems across all three systems was unequal, but more importantly, it is important to do more work on how M&E and gender are conceptualised, to ensure this can be studied in a more meaningful way. To strengthen national monitoring and evaluation systems, gender responsiveness and equity must serve as a foundation for growth. However, intersection M&E with gender is complex, and riddled with gaps in capacity, conceptual differences, and challenges bringing together disparate and complex systems.Conclusion: A stronger understanding of the linkages between M&E and gender is an important starting place for bringing them together holistically.

scholarly journals Postural control learning dynamics in Parkinson’s disease: early ‎improvement with plateau in stability, and continuous progression in ‎flexibility and mobility

2020 ◽  
Author(s):  
Zahra Rahmati ◽  
Saeed Behzadipour ◽  
Alfred C. Schouten ◽  
Ghorban Taghizadeh ◽  
Keikhosrow Firoozbakhsh
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Control ◽  
Training Program ◽  
Center Of Pressure ◽  
Balance Training ◽  
Patient Specific ◽  
Learning Dynamics ◽  
Early Improvement ◽  
Model Based

Abstract Background: Balance training improves postural control in Parkinson’s disease (PD). However, a systematic approach for the development of individualized, optimal training programs is still lacking, as the learning dynamics of the postural control in PD, over a training program are poorly understood. Objectives: We investigated the learning dynamics of the postural control in PD, during a balance-training program, in terms of the clinical, posturographic, and novel model-based measures. Methods: Twenty patients with PD participated in a balance-training program, 3 days a week, for 6 weeks. Clinical tests assessed functional balance and mobility pre-training, mid-training, and post-training. Center-of-pressure (COP) was recorded at four time-points during the training (pre-, week 2, week 4, and post-training). COP was used to calculate the sway measures and to identify the parameters of a patient-specific postural control model, at each time-point. The posturographic and model-based measures constituted the two sets of stability- and flexibility-related measures. Results: Mobility- and flexibility-related measures showed a continuous improvement during the balance-training program. In particular, mobility improved at mid-training and continued to improve to the end of the training, whereas flexibility-related measures reached significance only at the end. The progression in the balance- and stability-related measures was characterized by early improvements over the first three to four weeks of training, and reached a plateau for the rest of the training. Conclusions: The progression in balance and postural stability is achieved earlier and susceptible to plateau out, while mobility and flexibility continues to improve during the balance training.

Worlds

2020 ◽  
pp. 253-302
Author(s):  
David Damrosch
Keyword(s):  
Gender Relations ◽  
Building Blocks ◽  
Literary Works ◽  
Relative Wealth ◽  
The World ◽  
Fictional Worlds ◽  
And Gender

This chapter focuses on the worldly presence of literary works and considers how they relate to the world around them through the worlds they create. It explores the dimensions of the imaginative world that are built up by a novel, staged by a playwright, or envisioned by a poet. It also investigates the boundaries, environment, history, sociology or ethnography, economic and class determinants, and gender relations of the imaginative world. The chapter looks into “Fictional Worlds” by Thomas Pavel, which discusses the variable “referential density” that a work can have, and the relative wealth or paucity of information given per page, scene, or stanza about the world envisioned by the work. It emphasizes on “amplitude” and “completeness” in order to describe the coordinates and building blocks with which a writer creates a virtual literary world.

Rehabilitation after acute vestibular disorders

2008 ◽  
Vol 123 (4) ◽  
pp. 397-402 ◽  
Author(s):  
R Teggi ◽  
D Caldirola ◽  
B Fabiano ◽  
P Recanati ◽  
M Bussi
Keyword(s):  
Visual Analogue Scale ◽  
Postural Control ◽  
Analogue Scale ◽  
Visual Cues ◽  
Control Group ◽  
Index Test ◽  
Supervised Exercise ◽  
Dynamic Gait Index ◽  
Dynamic Gait ◽  
Gait Index

AbstractObjectives:To assess the efficacy of rehabilitation for dizzy patients after recent acute vestibular disturbance.Methods:Forty patients recently hospitalised for an acute episode of rotational vertigo which lasted days were randomly divided into two groups. The first group (20 patients; group R) underwent active rehabilitation, while the second group (20 patients; group C) were told only to ‘perform their daily activities’. Group R subjects underwent a total of 10 sessions of rehabilitation, including exercises on a stabilometric platform, point de mire and a series of five exercises repeated five times daily. All patients performed static stabilometry (posturography), undertook the dynamic gait index test, and completed a dizziness handicap questionnaire and a visual analogue scale for anxiety, at baseline and on completion.Results:At 25 days, the rehabilitated patients obtained better results for all recorded outcomes, compared with the control group. The greatest difference in the rehabilitated subjects, compared with the control group, was for the dynamic gait index test; however, this difference was not statistically significant. The visual analogue scale anxiety score was statistically significantly more reduced in rehabilitated patients compared with control patients. Control patients maintained a higher visual dependence for postural control.Conclusions:These results would appear to support the effectiveness of a supervised exercise programme for patients following acute onset of vestibular disturbance. A correlation was found in both groups between dynamic gait index results and anxiety. In our experience, a rehabilitation programme seems to reduce dependence on visual cues for postural control.

scholarly journals Is Young Age a Limiting Factor When Training Balance? Effects of Child-Oriented Balance Training in Children and Adolescents

2018 ◽  
Vol 30 (1) ◽  
pp. 176-184 ◽  
Author(s):  
Michael Wälchli ◽  
Jan Ruffieux, ◽  
Audrey Mouthon ◽  
Martin Keller ◽  
Wolfgang Taube
Keyword(s):  
Postural Control ◽  
Postural Sway ◽  
Age Groups ◽  
Balance Training ◽  
Young Age ◽  
Limiting Factor ◽  
Training Outcomes ◽  
Balance Exercises ◽  
Explosive Force ◽  
First Time

Purpose: Balance training (BT) studies in children reported conflicting results without evidence for improvements in children under the age of 8. The aim of this study therefore was to compare BT adaptations in children of different age groups to clarify whether young age prevents positive training outcomes. Methods: The effects of 5 weeks of child-oriented BT were tested in 77 (38 girls and 39 boys) participants of different age groups (6–7 y, 11–12 y, and 14–15 y) and compared with age-matched controls. Static and dynamic postural control, explosive strength, and jump height were assessed. Results: Across age groups, dynamic postural sway decreased (−18.7%; P = .012; ) and explosive force increased (8.6%; P = .040; ) in the intervention groups. Age-specific improvements were observed in dynamic postural sway, with greatest effects in the youngest group (−28.8%; P = .026; r = .61). Conclusion: In contrast to previous research using adult-oriented balance exercises, this study demonstrated for the first time that postural control can be trained from as early as the age of 6 years in children when using child-oriented BT. Therefore, the conception of the training seems to be essential in improving balance skills in young children.

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