Sufficiency of the BOT-2 short form to screen motor competency in preschool children with strabismus

Background Strabismus is one of the most common visual disorders in children, with a reported prevalence of 2.48% in preschoolers. Additionally, up to 89.9% of preschool children with strabismus do not have normal stereopsis. Whether this lack of normal stereopsis affects the motor competency of preschool children with strabismus is unknown. The Bruininks-Oseretsky Test of Motor Proficiency Second Edition short form (BOT-2 SF) can be a useful tool for screening; however, its sufficiency as a diagnostic tool for children with various disorders is controversial. Objective The aims of this study were thus to examine motor competency in preschool children with strabismus by using the BOT-2 and to evaluate the usefulness of the BOT-2 SF to identify those at risk for motor competency issues. Methods Forty preschool children (aged 5–7 years) with strabismus were recruited, all of whom had abnormal stereopsis. The BOT-2 complete form (CF) was administered to all children. The BOT-2 CF was administered to all children. The scores of the BOT-2 SF were extracted from the relevant items of the BOT-2 CF for further analysis. Results The prevalence of children with strabismus who had below average performance in the composites of “Fine Manual Control”, “Manual Coordination”,”Body Coordination”, and “Strength and Agility” were 15%, 70%, 32.5%, and 5%, respectively, on the BOT-2 CF. Compared with these results, the sensitivity of the BOT-2 SF was 33.33% (95% CI = 7.49%–70.07%) and the specificity was 100% (95% CI = 88.78%–100%). Conclusion Preschool children with strabismus had a high prevalence of impaired motor competency, especially in fine motor competency. The BOT-2 SF was not as sensitive in identifying motor difficulties in preschool children with strabismus. Therefore, the BOT-2 CF is recommended for evaluating motor proficiency in preschool children with strabismus.

Discrepancies between Parent and Teacher Reports of Motor Competence in 5–10-Year-Old Children with and without Suspected Developmental Coordination Disorder

Parents and teachers have knowledge of children’s daily motor performance yet may make different judgments about the levels of competence observed at home and school. The current study aimed to examine the discrepancies between parent and teacher reports using the Movement ABC-2 Checklist and the Developmental Coordination Disorder Questionnaire (DCDQ) on children with and without suspected Developmental Coordination Disorder (DCD). The Movement ABC-2 Test was administered to 1276 children aged 5–10 years in China. The Movement ABC-2 Checklist and DCDQ were completed by both parents and teachers of all children. A total of 172 children achieving a score below the 15th percentile on the Movement ABC-2 Test were identified as children with suspected DCD. Both parents and teachers showed suitable agreement in judging children’s motor competence but low sensitivity in identifying children with DCD. Parent scores of children’s motor competence were more closely associated with test performance scores compared to teacher scores. Teachers tended to over-rate children’s motor competence. The motor difficulties identified by parents were associated with low Movement ABC-2 Test scores on Manual Dexterity and Balance components, while motor difficulties identified by teachers were associated with the Balance component only. The results demonstrated discrepancies between parent and teacher reports, suggesting the importance of using a range of measures to identify and describe motor difficulties in children.

Clonally expanded CD8 T cells characterize Amyotrophic Lateral Sclerosis 4

Amyotrophic Lateral Sclerosis (ALS) is a heterogeneous neurodegenerative disorder that affects motor neurons in the brain and spinal cord, causing progressive loss of voluntary muscle control1,2. ALS heterogeneity includes the age of manifestation, the rate of progression, and the anatomical sites of symptom onset. In addition, disease-causing mutations in specific genes have been identified and are used to catalog different subtypes of ALS3. Interestingly, several ALS-associated genes have been shown to affect immune functions, and a variety of aberrant inflammatory events have been reported in patients and mouse models4-11, suggesting that specific immune features can also account for ALS heterogeneity. ALS4 is characterized by juvenile-onset and slow progression12. After experiencing mild symptoms during their childhood, ALS4 patients show motor difficulties by their 30s, and most of them require walkers or wheelchairs by their 50s. ALS4 is caused by dominant mutations in the gene SETX. Using Setx knock-in (KI) mice carrying the ALS4 causative L389S mutation, we discovered an immunological signature consisting of clonally activated CD8 T cells specifically in the central nervous system and blood of KI animals. Expansion of antigen-specific CD8 T cells mirrors disease progression. Bone marrow transplantation experiments indicate an essential role of the immune system in ALS4 neurodegeneration. Furthermore, we found that clonally expanded CD8 T cells circulate in the peripheral blood of ALS4 patients. Our results provide evidence of an antigen-specific CD8 T cell response linked to ALS4, and can serve not only to unravel specific disease mechanisms, but as a potential biomarker of disease activity.

Motor intervention and autism: one way, several domains of effectiveness

In the literature, a delay in the development and acquisition of motor skills is generally described in children with autism spectrum disorder, affecting between 50% and 80% of this population. In spite of this high frequency of occurrence, motor difficulties are not yet considered in the same way as the core deficits of this disorder (difficulties in social interaction, communication and behavior); addictionaly, there is not yet enough research about the efficacy of a specific intervention that can support the development of motor functions compromised in autism. Recent findings, which support the correlation between motor domain and other areas of development (social and cognitive), together with other evidence that underline the benefits of practicing motor activities on the individual's well-being, lead us to re-evaluate the effects of motor intervention for autism. To define the salient points of this kind of intervention, with particular attention to rehabilitation practice, a literature search was carried out on four different databases, which sifted through 602 bibliographic citations and found 10 studies that were able to meet the set research purposes. This review showed that physical activity in autistic children not only improves motor performance, but also plays an important role in the social, cognitive and behavioural development, as well as helping to reduce some secondary or associated symptoms, such as stereotypies or sleep disorders.

Physical and emotional development of adolescents with low motor competence: Mothers’ perspectives

Background Parent support influences adolescent’s social-emotional well-being. One factor that may influence parent’s perception of support is their child’s level of motor competence. Aim The purpose of this study was to explore mothers’ experience of providing support for the health of adolescents with low motor competence physical and emotional development. Methods A phenomenological approach was used to guide this study. After initial screening, five one-on-one interviews with mothers of adolescents aged 12–16 years were conducted. Results Analysis of the interviews identified five themes of ‘supportive building blocks’, ‘building achievement and commitment,’ ‘building mechanisms for future support’ ‘building stability in relationships’ and ‘building confidence and a sense of autonomy’. Mother’s awareness of their child’s motor difficulties resulted in their active provision of alternative strategies for their child by building self-confidence and seeking support from health professionals. Conclusion Mothers were aware of their child’s inadequacies and actively sought support to help with their development. Support services that recognise low motor competence could better help mothers support their adolescent’s development. One implication arising from this study is the importance of using multi-disciplinarian teams such as occupational therapist, exercise physiologist and parents to help children with low motor competence.

Perception and Motion in Real and Virtual Environments: A Narrative Review of Autism Spectrum Disorders

Atypical sensorimotor developmental trajectories greatly contribute to the profound heterogeneity that characterizes Autism Spectrum Disorders (ASD). Individuals with ASD manifest deviations in sensorimotor processing with early markers in the use of sensory information coming from both the external world and the body, as well as motor difficulties. The cascading effect of these impairments on the later development of higher-order abilities (e.g., executive functions and social communication) underlines the need for interventions that focus on the remediation of sensorimotor integration skills. One of the promising technologies for such stimulation is Immersive Virtual Reality (IVR). In particular, head-mounted displays (HMDs) have unique features that fully immerse the user in virtual realities which disintegrate and otherwise manipulate multimodal information. The contribution of each individual sensory input and of multisensory integration to perception and motion can be evaluated and addressed according to a user’s clinical needs. HMDs can therefore be used to create virtual environments aimed at improving people’s sensorimotor functioning, with strong potential for individualization for users. Here we provide a narrative review of the sensorimotor atypicalities evidenced by children and adults with ASD, alongside some specific relevant features of IVR technology. We discuss how individuals with ASD may interact differently with IVR versus real environments on the basis of their specific atypical sensorimotor profiles and describe the unique potential of HMD-delivered immersive virtual environments to this end.

Spondyloarthritis and Strength Training: A 4-Year Report

Peripheral spondyloarthritis (SpA) has predominant peripheral (arthritis, enthesitis, or dactylitis) involvement. The severity of the symptoms can have a significant impact on the quality of life. There is no therapeutic gold standard, and physical exercise, with the opposition of resistance, remains controversial. Herein, we report the case of a woman who, at the age of 50, comes to our center with evident motor difficulties. She was previously diagnosed with SpA and was in therapy with a biological drug (adalimumab) for over one year. The training program and the nutritional intervention plan improved her condition, as pointed out by WOMAC, SQS, RAD-36 questionnaire, and BIA analysis, suspending biological therapy for almost two years. During this period, she achieved in sequence: (i) the Italian master deadlift championship, and (ii) the Italian master powerlifting championship, both for two consecutive years.

Eventration in Green Iguana (Iguana iguana)

Background: The reptile class could be considered one of the biggest vertebrate groups and are divided in orders and suborders according to their characteristics. These animals’ maintenance in captivity, either at home, captive bred or at zoos, can generate risk to their health, if the required cares are not given for each respective species. The lack of individual cares could lead to bone and muscular diseases and to traumatic lesions in soft tissues, mainly in the coelomic cavity. The report that is being presented aims to describe the case of a green iguana (Iguana iguana) that presented an increase of volume in the coelomic cavity. The animal belongs to the squad of the Zoo “Dr. Fábio de Sá Barreto”.Case: A green iguana arrived at the Zoo in February 2019 coming from another Zoo, with already an increase of volume in the coelomic cavity. The animal was put in quarantine and later on, it was put in display at a terrarium in the Zoo considered adequate to reptiles, with another seven green iguanas along with an argentine tegu (Salvator rufescens). Their feed was offered in the morning and was composed of fruits, vegetables and flowers like hibiscus. In the end of July 2019, it was reported by the attendant that the animal was presented with anorexia and prostration, and these symptoms progressed to neurologic signs, as it walked in circles. So, the animal was evaluated by the Zoo veterinarians and on exam they noticed lethargy, dehydration, absence of reflexes (pupillary, eyelid and painful), locomotion difficulty and when the iguana moves, it walks in circles. The increase in volume had the same size as reported in February and a soft consistency. After that, the animal was interned and treated according to the symptoms and the clinical evolution. Ten days after the hospitalization, the animal was still not eating, and locomotion stopped completely. It was performed in an ultrasonographic exam evaluating all the coelomic cavity, in which a great anechoic area was visualized, and a true hernia was diagnosed. However, the content of the hernia was not identified. In the next day, the animal died, and, in the necropsy, it was possible to verify that the increase in volume was actually a bladder eventration. The eventration occurred due to a laceration in the coelomic cavity musculature that allows the passage of the bladder to the subcutaneous space and its incarceration. So, the elimination of the urine and of nitrogen compounds was difficult and a large accumulation of uric acid from the bladder to the urodeo.Discussion: Iguana iguana is a uricotelic animal, which means that the main nitrogenous waste product is uric acid. Nevertheless, ammonia is also eliminated in less quantity, because of the excess of protein in the diet. These animals eliminate around 98 to 99% of the nitrogen compounds as uric acid and less than 1% as ammonia, which prove that it is possible for the accumulation of ammonia in reptiles, if any obstacle in its elimination exists. The excess of ammonia is extremely toxic to the organism, leading to emesis, irritability, lethargy, anorexia, ataxia, motor difficulties, behavioral and neurological changes, and could progress to coma or even death. The bladder incarceration reported in this case, made it impossible for the excretion of urine, uric acid and ammonia, and these compounds remained accumulated. So, the clinical signs, along with the necropsy findings, were suggestive of intoxication by ammonia accumulation which could be responsible for the signs presented by the animal and the evolution to neurologic symptoms, coma and death.