scholarly journals A Systematic Review of Training Methods That May Improve Selective Voluntary Motor Control in Children With Spastic Cerebral Palsy

2020 ◽  
Vol 11 ◽  
Author(s):  
Annina Fahr ◽  
Jeffrey W. Keller ◽  
Hubertus J. A. van Hedel
Keyword(s):  
Cerebral Palsy ◽  
Motor Control ◽  
Methodological Quality ◽  
Evidence Synthesis ◽  
Spastic Cerebral Palsy ◽  
Mirror Therapy ◽  
Robot Assisted ◽  
Level Of Evidence ◽  
Voluntary Motor ◽  
Best Evidence Synthesis

Background: Impaired selective voluntary motor control is defined as “the reduced ability to isolate the activation of muscles in response to demands of a voluntary posture or movement.” It is a negative motor sign of an upper motor neuron lesion.Objective: This paper reviews interventions that may improve selective motor control in children and youths with spastic cerebral palsy. The aim was to systematically evaluate the methodological quality and formulate the level of evidence from controlled studies.Methods: Six databases (Scopus, Web of Science, PubMed, Embase, MEDLINE, and CINAHL) were searched with predefined search terms for population, interventions, and outcomes. Two reviewers independently completed study selection and ratings of methodological quality and risk of bias. Evidence was summarized in a best evidence synthesis.Results: Twenty-three studies from initially 2,634 papers were included. The interventions showed a wide variety of approaches, such as constraint-induced movement therapy (CIMT), electrical stimulation, robot-assisted therapy, and functional training. The evidence synthesis revealed conflicting evidence for CIMT, robot-assisted rehabilitation and mirror therapy for the upper extremities in children with cerebral palsy.Conclusions: Final recommendations are difficult due to heterogeneity of the reviewed studies. Studies that include both an intervention and an outcome that specifically focus on selective voluntary motor control are needed to determine the most effective therapy.

scholarly journals Effect of Robot-Assisted Gait Training on Selective Voluntary Motor Control in Ambulatory Children with Cerebral Palsy

2020 ◽  
Vol 57 (10) ◽  
pp. 964-966
Author(s):  
Dragana Zarkovic ◽  
Monika Sorfova ◽  
James J Tufano ◽  
Patrik Kutilek ◽  
Slavka Viteckova ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Motor Control ◽  
Gait Training ◽  
Robot Assisted ◽  
Voluntary Motor ◽  
Children With Cerebral Palsy

Efficacy of Taping for the Treatment of Plantar Fasciosis

2010 ◽  
Vol 100 (1) ◽  
pp. 41-51 ◽  
Author(s):  
Alexander T. M. van de Water ◽  
Caroline M. Speksnijder
Keyword(s):  
Health Care Providers ◽  
Clinical Relevance ◽  
Methodological Quality ◽  
Evidence Synthesis ◽  
Plantar Fascia ◽  
Controlled Trials ◽  
Care Providers ◽  
Short Term ◽  
Best Evidence Synthesis ◽  
Evidence Database

Background: The proximal insertional disorder of the plantar fascia is plantar fasciosis. Although plantar fasciosis is frequently seen by different health-care providers, indistinctness of etiology and pathogenesis is still present. A variety of interventions are seen in clinical practice. Taping constructions are frequently used for the treatment of plantar fasciosis. However, a systematic review assessing the efficacy of this therapy modality is not available. Methods: To assess the efficacy of a taping construction as an intervention or as part of an intervention in patients with plantar fasciosis on pain and disability, controlled trials were searched for in CINAHL, EMBASE, MEDLINE, Cochrane CENTRAL, and PEDro using a specific search strategy. The Physiotherapy Evidence Database scale was used to judge methodological quality. Clinical relevance was assessed with five specific questions. A best-evidence synthesis consisting of five levels of evidence was applied for qualitative analysis. Results: Five controlled trials met the inclusion criteria. Three trials with high methodological quality and of clinical relevance contributed to the best-evidence synthesis. The findings were strong evidence of pain improvement at 1-week follow-up, inconclusive results for change in level of disability in the short term, and indicative findings that the addition of taping on stretching exercises has a surplus value. Conclusions: There is limited evidence that taping can reduce pain in the short term in patients with plantar fasciosis. The effect on disability is inconclusive. (J Am Podiatr Med Assoc 100(1): 41–51, 2010)

scholarly journals Topical glyceryl trinitrate for the treatment of tendinopathies: a systematic review

2018 ◽  
Vol 53 (4) ◽  
pp. 251-262 ◽  
Author(s):  
Dimitris Challoumas ◽  
Paul D Kirwan ◽  
Dmytro Borysov ◽  
Christopher Clifford ◽  
Michael McLean ◽  
...  
Keyword(s):  
Systematic Review ◽  
Glyceryl Trinitrate ◽  
Strong Evidence ◽  
Evidence Synthesis ◽  
Clinical Effects ◽  
Range Of Movement ◽  
Level Of Evidence ◽  
Moderate Evidence ◽  
Best Evidence Synthesis ◽  
Topical Glyceryl Trinitrate

ObjectiveTo produce a best evidence synthesis of the clinical effects of topical glyceryl trinitrate (GTN) in the treatment of tendinopathies.DesignA systematic review of published randomised controlled trials (RCTs) of the use of GTN in patients with tendinopathy.Data sourcesMEDLINE, Embase, Scopus and CINAHL from database inception to January 2018.MethodsWe examined RCTs comparing the effects of topical GTN with either placebo or other treatments on tendinopathy. Overall quality of each eligible study was determined based on a combined assessment of internal validity, external validity and precision. The level of evidence for each assessed parameter was rated based on the system by van Tulderet al.ResultsA total of 10 eligible RCTs were identified including patients with tendinopathy of the rotator cuff (n=4), wrist extensors (n=3), Achilles (n=2) and patellar (n=1) tendons. For all tendinopathies, improvements in pain were significant when comparing GTN versus placebo in the short term (<8 weeks; poor evidence). Significant improvements in midterm outcomes for treatment with GTN versus placebo included the following: patient satisfaction (strong evidence); chances of being asymptomatic with activities of daily living (strong evidence); range of movement (moderate evidence); strength (moderate evidence); pain (at night and with activity; poor evidence) and local tenderness (poor evidence). Patients treated with topical GTN reported a higher incidence of headaches than those who received placebo (moderate evidence).Conclusions and relevanceTreatment of tendinopathies with topical GTN for up to 6 months appears to be superior to placebo and may therefore be a useful adjunct to the treating healthcare professions.

scholarly journals In-Home Kicking-Activated Mobile Task to Motivate Selective Motor Control of Infants at High Risk of Cerebral Palsy: A Feasibility Study

2020 ◽  
Vol 100 (12) ◽  
pp. 2217-2226
Author(s):  
Barbara Sargent ◽  
Kathryn L Havens ◽  
Jessica L Wisnowski ◽  
Tai-Wei Wu ◽  
Masayoshi Kubo ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Motor Control ◽  
High Risk ◽  
White Matter Injury ◽  
Abnormal Development ◽  
Spastic Cerebral Palsy ◽  
Learning Abilities ◽  
Age Appropriate ◽  
Mobile Task ◽  
Leg Movements

Abstract Objective Children with spastic cerebral palsy (CP) have gait impairments resulting from decreased selective motor control, an inability to move the leg joints independently of one another, relying on excessive flexion or extension coupling across the 3 joints. Infants with white matter injury are at high risk of CP and have decreased selective motor control as early as 1 month corrected age. An in-home kicking-activated mobile task was developed to motivate more selective hip-knee control of infants at high risk of CP. The purposes of this study were to determine the feasibility of the in-home mobile task and to determine whether infants at high risk of CP and infants with typical development (TD) learn the association between their leg movements and mobile activation. Methods Ten infants at high risk of CP based on neuroimaging and 11 infants with TD participated in this cohort study at 3.5 to 4.5 months corrected age. Each infant participated in the in-home kicking-activated mobile task for 8 to 10 min/d, 5 d/wk, for 6 weeks. Learning was assessed weekly based on an increase in the time that the infant demonstrated the reinforced leg actions when interacting with the kicking-activated mobile compared with spontaneous kicking. Results With regard to feasibility, participation averaged 92% for infants at high risk of CP and 99% for infants with TD. With regard to learning, the group at high risk of CP demonstrated learning of the task for 2 of 6 weeks, whereas the group with TD demonstrated learning for all 6 weeks. Conclusions Infants at high risk of CP demonstrated learning of the kicking-activated mobile task but at a reduced amount compared with infants with TD. Further research is necessary to determine whether the kicking-activated mobile task has potential as an intervention to motivate more selective hip-knee control and improve walking outcomes of infants at high risk of CP. Impact This study investigated the feasibility of an in-home kicking-activated mobile task, a discovery learning task designed to motivate infants at high risk of CP to engage in the intensive task practice necessary to promote their learning abilities and selective motor control. Lay Summary CP is a lifelong disorder of movement caused by abnormal development or early damage to the brain. If an in-home infant kicking-activated mobile task could be used to motivate certain types of age-appropriate leg movements of infants who are at high risk of CP, the task could help improve walking outcomes, which eventually could contribute to improving children’s ability to participate in daily life. This study showed that infants at high risk of CP did learn the infant kicking-activated mobile task but at a much reduced amount compared with infants who are developing typically; so, this is a first step in determining whether the task has potential to motivate more age-appropriate leg movements in infants at high risk of cerebral palsy.

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