scholarly journals Can adults with cerebral palsy perform and benefit from ballistic strength training to improve walking outcomes? A mixed methods feasibility study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Beate Eltarvåg Gjesdal ◽  
Silje Mæland ◽  
Gavin Williams ◽  
Mona Kristin Aaslund ◽  
Cecilie Brekke Rygh ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Mixed Methods ◽  
Strength Training ◽  
Physical Performance ◽  
Feasibility Study ◽  
Performance Measures ◽  
Rating Scale ◽  
Assessment Tool ◽  
Plantar Flexors ◽  
Physical Measures

Abstract Background Power bursts of hips and ankle plantar flexors are prerequisites to walking propulsion. However, these power bursts are reduced during gait for persons with cerebral palsy (CP) and mainly in the ankle plantar flexors. Hence, task specific training, such as ballistic strength training, is suggested to increase muscle power in walking but not investigated in adults with CP. Therefore, the aim was to investigate if adults with CP could perform and benefit from ballistic strength training to improve walking, evaluated through physical measures and self-reported measures and interviews. Methods In this mixed methods feasibility study, eight ambulatory adults (aged 24–56) with spastic CP conducted ballistic strength training on a glideboard targeting the ankle plantarflexors two times a week for eight weeks. The feasibility of the training was assessed through objectives described by Orsmond and Cohn. Before and after the intervention, physical measures (6-Minute Walk Test and the eight-item High-level Mobility Assessment Tool) and self-reported measures (Patient Global Impression of Change, Numeric Pain Rating Scale, Fatigue Impact and Severity Self-Assessment, and Walk-12) were collected. After the intervention, semi-structured interviews explored experiences of this training. Results The participants experienced training the ankle plantar flexor as relevant but reported it took about four weeks to coordinate the exercises successfully. Although we observed no changes in the physical performance measures, most participants reported improvements; some felt steadier when standing, walking, and hopping. Conclusion This study demonstrated that ballistic strength training was feasible and suitable in adults with CP. However, guidance and a long (4 weeks) familiarization time were reported necessary to master the exercises. Most participants reported self-experienced improvements, although no physical performance measures improved. Thus, prolonged intervention may be required for perceived physical improvements to emerge. Also, other outcome measures sensitive to power output remains to be investigated.

scholarly journals Reliability and validity of a computer game-based tool of upper extremity assessment for object manipulation tasks in children with cerebral palsy

2021 ◽  
Vol 8 ◽  
pp. 205566832110140
Author(s):  
Anuprita Kanitkar ◽  
Sanjay T Parmar ◽  
Tony J Szturm ◽  
Gayle Restall ◽  
Gina Rempel ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Upper Extremity ◽  
Performance Measures ◽  
Assessment Tool ◽  
Computer Game ◽  
Object Manipulation ◽  
Manual Dexterity ◽  
Assessment Tools ◽  
Significant Difference ◽  
Children With Cerebral Palsy

Introduction A computer game-based upper extremity (CUE) assessment tool is developed to quantify manual dexterity of children with Cerebral Palsy (CP). The purpose of this study was to determine test-retest reliability of the CUE performance measures (success rate, movement onset time, movement error, and movement variation) and convergent validity with the Peabody Developmental Motor Scale version 2 (PDMS-2) and the Quality of Upper Extremity Skills Test (QUEST). Methods Thirty-five children with CP aged four to ten years were tested on two occasions two weeks apart. Results CUE performance measures of five chosen object manipulation tasks exhibited high to moderate intra-class correlation coefficient (ICC) values. There was no significant difference in the CUE performance measures between test periods. With few exceptions, there was no significant correlation between the CUE performance measures and the PDMS-2 or the QUEST test scores. Conclusions The high to moderate ICC values and lack of systematic errors indicate that the CUE assessment tool has the ability to repeatedly record reliable performance measures of different object manipulation tasks. The lack of a correlation between the CUE and the PDMS-2 or QUEST scores indicates that performance measures of these assessment tools represent distinct attributes of manual dexterity.

scholarly journals Relationship between SHARE-FI Frailty Scores and Physical Performance Measures in Older Adult Medicaid Recipients

Geriatrics ◽  
2018 ◽  
Vol 3 (3) ◽  
pp. 51 ◽  
Author(s):  
Margaret Danilovich ◽  
Laura Diaz ◽  
Daniel Corcos ◽  
Jody Ciolino
Keyword(s):  
Older Adult ◽  
Physical Performance ◽  
Performance Measures ◽  
Gait Speed ◽  
Fall Risk ◽  
Assessment Tool ◽  
Performance Measure ◽  
Self Report ◽  
Timed Up And Go ◽  
Cross Sectional

The Survey of Health, Ageing and Retirement in Europe-Frailty Instrument (SHARE-FI) is a frailty assessment tool designed for primary care settings comprised of four self-report questions and grip strength measurement, yet it is not known how SHARE-FI scores relate to objective physical performance measures that assess physical functioning, fall risk, and disability. This cross-sectional, observational study examined the association between SHARE-FI scores and a battery of physical performance measures in a sample of older adult, Medicaid waiver recipients (n = 139, mean age = 74.19 ± 8.36 years). We administered the SHARE-FI, Timed Up and Go (TUG), gait speed, and Short Physical Performance Battery (SPPB) in participants’ homes. Among clients, 45% were frail, 35% pre-frail, and 20% non-frail. There were significant differences in all physical performance measure scores with respect to SHARE-FI category. SHARE-FI continuous scores significantly predicted TUG time, all domains of the SPPB, gait speed, and inability to complete the chair rise test. Self-reported walking difficulty and objectively measured gait speed were significantly correlated. The SHARE-FI continuous frailty score predicts scores on a variety of validated physical performance measures. Given the fast administration time, the SHARE-FI could potentially be used to serve as a surrogate for physical performance measures with known association with physical function, fall risk, and disability.

scholarly journals M183. SINGLE-SESSION DANCE/MOVEMENT THERAPY FOR THOUGHT AND BEHAVIORAL DYSFUNCTION ASSOCIATED WITH ACUTE SCHIZOPHRENIA: A MIXED METHODS FEASIBILITY STUDY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S206-S206
Author(s):  
Jacelyn Biondo
Keyword(s):  
Mixed Methods ◽  
Feasibility Study ◽  
Quantitative Data ◽  
Rating Scale ◽  
Movement Therapy ◽  
Dance Movement Therapy ◽  
Single Session ◽  
Dance Movement ◽  
Acute Schizophrenia ◽  
And Control

Abstract Background Dance/movement therapy (DMT) interventions have been used to support people with schizophrenia; however, these typically include lengthier interventions. Current inpatient hospitalization lengths of stay do not offer the time needed to implement such interventions. The current treatment protocol for people in acute phases of schizophrenia is psychopharmacological; however, high rates of medication nonadherence and limited effects on negative symptomatology suggest the need for complementary psychosocial treatment options. The purpose of this study was to determine: feasibility of protocol completion, feasibility of measurement sensitivity, and the effects of a single-session DMT intervention compared to a single-session verbal treatment as usual (TAU) intervention. Methods This mixed methods feasibility study utilized a convergent mixed methods feasibility design. Qualitative and quantitative data were collected simultaneously in a single phase from the experimental and control groups. In this study, the quantitative strand was prioritized and constituted most of the data collection. A qualitative strand was added to enhance the understanding of participants’ experiences of the intervention and control conditions. Thirty-two participants were randomized to a 45-minute DMT session or a 45-minute verbal TAU session. Quantitative data were collected using the Brief Psychiatric Rating Scale, and qualitative data through semi-structured interviews. Results indicated that participants in the DMT intervention group had statistically significant symptom reduction versus those in the TAU group in overall BPRS scores (p < 0.001), Psychological Discomfort (p < 0.001), Negative Symptoms (p = 0.007), and Positive Symptoms (p = 0.003). No statistical significance was shown for Resistance. Qualitative findings substantiate the quantitative findings, however, show divergence regarding Resistance. Participants in the DMT group expressed feeling more in control, less angry, and motivated for continued treatment. Discussion These findings suggest that a single-session DMT intervention can alleviate symptoms associated with acute schizophrenia including affective regulation, and positive and negative symptomatology such as isolation, spontaneity, interpersonal skills, paranoia, and auditory hallucinations. Psychosocial interventions may be used in tandem with psychopharmacological interventions to support increased stabilization for patients experiencing acute phases of schizophrenia.

scholarly journals Reamed intramedullary nailing versus circular frame external fixation for segmental tibial fractures (STIFF-F): a mixed methods feasibility study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Caroline B. Hing ◽  
Elizabeth Tutton ◽  
Toby O. Smith ◽  
Molly Glaze ◽  
Jamie R. Stokes ◽  
...  
Keyword(s):  
Mixed Methods ◽  
External Fixation ◽  
Intramedullary Nailing ◽  
Feasibility Study ◽  
Online Survey ◽  
Tibial Fracture ◽  
Tibial Fractures ◽  
Circular Frame ◽  
Pilot Rct ◽  
Randomised Controlled

Abstract Background Segmental tibial fractures are fractures in two or more areas of the tibial diaphysis resulting in a separate intercalary segment of the bone. Surgical fixation is recommended for patients with segmental tibial fractures as non-operative treatment outcomes are poor. The most common surgical interventions are intramedullary nailing (IMN) and circular frame external fixation (CFEF), but evidence about which is better is of poor quality. An adequately powered randomised controlled trial (RCT) to determine optimum treatment is required. STIFF-F aimed to assess the feasibility of a multicentre RCT comparing IMN with CFEF for segmental tibial fracture. Methods STIFF-F was a mixed-methods feasibility study comprising a pilot RCT conducted at six UK Major Trauma Centres, qualitative interviews drawing on Phenomenology and an online survey of rehabilitation. The primary outcome was recruitment rate. Patients, 16 years and over, with a segmental tibial fracture (open or closed) deemed suitable for IMN or CFEF were eligible to participate. Randomisation was stratified by site using random permuted blocks of varying sizes. Participant or assessor blinding was not possible. Interviews were undertaken with patients about their experience of injury, treatment, recovery and participation. Staff were interviewed to identify contextual factors affecting trial processes, their experience of recruitment and the treatment pathway. An online survey was developed to understand the rehabilitation context of the treatments. Results Eleven patients were screened and three recruited to the pilot RCT. Nineteen staff and four patients participated in interviews, and 11 physiotherapists responded to the survey. This study found the following: (i) segmental tibial fractures were rarer than anticipated, (ii) the complexity of the injury, study setup times and surgeon treatment preferences impeded recruitment, (iii) recovery from a segmental tibial fracture is challenging, and rehabilitation protocols are inconsistent and (iv) despite the difficulty recruiting, staff valued this research question and strived to find a way forward. Conclusion The proposed multicentre RCT comparing IMN with CFEF is not feasible. This study highlighted the difficulty of recruiting patients to an RCT of a complex rare injury over a short time period. Trial registration The study was registered with the International Standard Randomised Controlled Trials Number Registry: ISRCTN11229660

“Help Me to Improve my Own Priorities!”: A Feasibility Study of an Individualized Intensive Goal Training for Adolescents with Cerebral Palsy

2021 ◽  
pp. 1-18
Author(s):  
Aline M. Feitosa ◽  
Marisa C. Mancini ◽  
Ana Paula M. Silvério ◽  
Andrew M. Gordon ◽  
Marina B. Brandão
Keyword(s):  
Cerebral Palsy ◽  
Feasibility Study

Objective structured assessment of technical skill in temporal bone dissection: validation of a novel tool

2021 ◽  
pp. 1-11
Author(s):  
M Stavrakas ◽  
G Menexes ◽  
S Triaridis ◽  
P Bamidis ◽  
J Constantinidis ◽  
...  
Keyword(s):  
Temporal Bone ◽  
Rating Scale ◽  
Assessment Tool ◽  
Three Dimensional ◽  
Technical Skills ◽  
Technical Skill ◽  
Global Rating Scale ◽  
Global Rating ◽  
Validity And Reliability ◽  
Cortical Mastoidectomy

Abstract Objective This study developed an assessment tool that was based on the objective structured assessment for technical skills principles, to be used for evaluation of surgical skills in cortical mastoidectomy. The objective structured assessment of technical skill is a well-established tool for evaluation of surgical ability. This study also aimed to identify the best material and printing method to make a three-dimensional printed temporal bone model. Methods Twenty-four otolaryngologists in training were asked to perform a cortical mastoidectomy on a three-dimensional printed temporal bone (selective laser sintering resin). They were scored according to the objective structured assessment of technical skill in temporal bone dissection tool developed in this study and an already validated global rating scale. Results Two external assessors scored the candidates, and it was concluded that the objective structured assessment of technical skill in temporal bone dissection tool demonstrated some main aspects of validity and reliability that can be used in training and performance evaluation of technical skills in mastoid surgery. Conclusion Apart from validating the new tool for temporal bone dissection training, the study showed that evolving three-dimensional printing technologies is of high value in simulation training with several advantages over traditional teaching methods.

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