Factors affecting rehabilitation of infants with Central Coordination Disorders during a three-month-long observation

Background Central coordination disorders (CCD) encompass various abnormalities observed in infants but early therapy may have an impact on their condition. The aim was to seek factors that may affect the early results of therapy of infants with CCD. Methods We analyzed the outcomes of a three-month period of rehabilitation of infants living with CCD. Children were treated at Non-public Specialist Healthcare Institution Medi-Reh in Kalisz in the period from 1 Jan 2014 to 31 Nov 2019. In our retrospective study results of three-month therapy of infants, aged 1 to 6 months, with CCD were analysed regards to the effectiveness and the potential impact of different factors. Therapy and assessment of children were conducted with the use of the Vojta method, which was performed during the first visit (WW) and the follow-up visit (after 3 months- 1WK). The analysis of the influence of various factors on the effect of therapy included: mother's age at the time of delivery, duration of breastfeeding, child APGAR, gestational age in which the child was born, sex of the child, birth weight, age of the child at WW, type of delivery, craniosacral therapy as an additive treatment. Results Based on the examination results from 66 medical records it was demonstrated that after active period of the therapy, improvement was observed in 54 (81.81%) (p=0.48) children (condition during WW versus 1WK among the group). The sole factor impacting improvement after 3 months was the age of the child at WW, when the child started therapy. This factor significantly (p=0.002) increased the chance of achieving improvement - by 3.2 times (OR= 3,2; CI= 95). No statistically significant differences were shown for the other studied factors. Conclusions Prompt implementation of rehabilitation in children with CCD provides a better chance of improving their motor function. The rehabilitation should be started as soon as possible after the diagnosis is constituted.

The Effect of Selected Cognitive Games on the Promotion and Stability of Executive Functions in Children With Developmental Coordination Disorders

Background and Aims: Children with developmental coordination disorders experience some form of impairment in some executive functions. The present study was designed and conducted to study the effect and retention of cognitive games on the development of three components of executive functions (response inhibition, working memory, and cognitive flexibility) among children with developmental coordination disorders. Methods: The present study was a quasi-experimental study with a control group. Thirty girls aged 7-10 years with developmental coordination disorder Based on the score obtained in the Movement Assessment Battery for Children-second edition (MABC-2) test set and based on the IQ score, were divided into two experimental and control groups. MABC-2 and Cattle and intelligence tests were used for initial screening, and N-Back, Stroop, and Go-NOGO tests measured working memory, cognitive flexibility, and response inhibition. The training protocol consisted of a series of purposeful cognitive and motor games that explicitly considered the development of a specific component of executive functions. Data were analyzed using a combined two-way analysis (2×3) of variance. Results: The findings showed, performance Working memory (P=0.0001) performance, cognitive flexibility (P=0.045), and response inhibition (P=0.010) increased in the experimental group from pretest to posttest, While no such change was observed in the control group. Also, the effect of improving games on working memory (P=0.0001) and response inhibition (P=0.033) was maintained until the retention test. At the same time, there was no significant difference between cognitive flexibility in the retention test of children with developmental coordination disorder in the experimental group and control. Conclusion: Based on the findings, cognitive-motor games effectively improve and maintain working memory, inhibit response, and develop cognitive flexibility. As a result, according to the results of this study and other studies, it can be acknowledged that intervention as a process as a process-oriented therapy with the involvement of the individual in a mental process improves the executive functions of children with developmental coordination disorder and games introduced in this Research is a good framework for designing and implementing high quality and reproducible programs.

Factors Affecting Rehabilitation of Infants With Central Coordination Disorders During a Three-month-long Observation

Background:Central coordination disorders (CCD) encompass various abnormalities observed in infants but early therapy may have an impact on their condition.The aim was to seek factors that may affect the early results of therapy of infants with CCD.Methods: In our retrospective study results of three-month therapy of infants, aged 1 to 6 months, with CCD were analysed regards to the effectiveness and the potential impact of different factors. Therapy and assessment of children were conducted with the use of the Vojta method, which was performed during the first (WW) and the follow-up visit (after 3 months- 1WK). The analysis of the influence of various factors on the effect of therapy included: mother's age at the time of delivery, duration of breastfeeding, child APGAR, gestational age in which the child was born, sex of the child, birth weight, age of the child at WW, type of delivery, craniosacral therapy as an additive treatment.Results:Based on the examination results from 66 medical records it was demonstrated that after 3 months of therapy, improvement was observed in 54 (81.81%) children. The sole factor impacting improvement after 3 months was the age of the child at WW, when the child started therapy. This factor significantly (p=0.002) increased the chance of achieving improvement - by 3.2 times. No statistical differences were shown for the other studied factors.ConclusionsThe age of the child at the beginning of the treatment had a significant impact on early (3 mo) improvement.

The Virtual Challenge: Virtual Reality Tools for Intervention in Children with Developmental Coordination Disorder

This narrative review highlights the latest achievements in the field of tele-rehabilitation: Virtual Reality (VR) and Augmented Reality (AR) serious games aimed at restoring and improving cognitive functions could be effectively used in Developmental Coordination Disorder Training. Studies investigating the effects of the abovementioned tech applications on cognitive improvement have been considered, following a comprehensive literature search in the scientific electronic databases: Pubmed, Scopus, Plos One, ScienceDirect. This review investigates the effects of VR and AR in improving space/motor skills through mental images manipulation training in children with developmental coordination disorders. The results revealed that in spite of the spreading of technology, actually only four studies investigated the effects of VR/AR tools on mental images manipulation. This study highlights new, promising VR and AR based therapeutic opportunities for digital natives now available, emphasizing the advantages of using motivational reward-oriented tools, in a playful therapeutic environment. However, more research in this filed is needed to identify the most effective virtual tool set for clinical use.

Is body mass index (BMI) or body adiposity index (BAI) a better indicator to estimate body fat and selected cardiometabolic risk factors in adults with intellectual disabilities?

Background The BMI index cannot always be used in people with intellectual disabilities due to neuromuscular coordination disorders and psychological barriers that may hinder conventional body weight measurement. The study aimed to assess the usefulness of BMI and BAI in estimating obesity and body fat in people with intellectual disabilities. Methods The first stage of the research involved 161 people with profound intellectual disabilities. Somatic parameters (BM, BH, WC, HC) were measured and BMI, BAI, WHR were calculated. Fifty seven persons with above-normal BMI and BAI were included in the second stage of the study and biochemical parameters were determined (TC, LDL-cholesterol, HDL-cholesterol, TG, GL). Results According to both BMI and BAI classifications, most people were overweight or obese. A high correlation of %BF with BMI and BAI indices was observed (r = 0.78). The sensitivity of both indices was 95.65%. In groups with above-normal BMI and BAI, an upward trend was found for mean values of TC, LDL, TG, and GL, with a simultaneous downward trend for HDL. Statistically significant intergroup differences were recorded for TG and GL (p < 0.05) for both indices (BMI and BAI). Conclusions Our research demonstrated that BAI is complementary to BMI and can be recommended for the estimation of body fat and cardiometabolic risks in people with intellectual disabilities. Due to the ease of measurement, BAI has high utility value.

Peculiarities of the clinical course of stroke in the vertebro-basillar system

The relevance of CVD (Cerebrovascular Diseases), in particular strokes, is due to the high prevalence, disability and mortality. The degree of medical, social, psychological rehabilitation of patients after Ischemic Stroke depends on the regression of the clinical picture and cerebral disintegration. Objectives of the study: detection of the entire spectrum of clinical manifestations from examined patients, corresponding to damage to the structures of the brain supplied by the vessels of the Vertebrobasilar basin, the relationship with regression of the primary focus and the subtype of Ischemic Stroke, and determination of the presence of a statistically significant dependence of clinical manifestations on COPD. To achieve the goal and solve the set tasks, 126 patients, 60 men and 66 women were examined in the recovery period of stroke in the in the vertebro-basillar system, at the age of 50-80. The Blindemark scale was used to assess the neurological status. To assess neuropsychological status, the Montreal Cognitive Assessment Scale, the Hospital Anxiety and Depression Scale, the Rankin scale were used, as well as for objectification of MRI data and Dopplerography. Results of the study: In patients with Ischemic Stroke in the vertebro-basillar system, paresis and paralysis prevailed in the structure of clinical manifestations, 68 patients had them, which is 54%, 43.7% of patients had dysarthria, coordination disorders were observed in 48.4% of patients, 26.2% had vertigo, 24.6% had sensory impairments and 5.6% had neglect. In patients with Ischemic Stroke in the vertebro-basillar system, a correlation was found between the scores of Renkin scale. Various pathogenetic subtypes of ischemic stroke in vertebro-basillar system were analyzed. They have a significant correlation between NIHSS scores at the time of hospitalization and at the end of rehabilitation. In patients with AT Ischemic Stroke in the vertebro-basillar system the incidence of oculomotor disorders is significantly lower. Based on the above mentioned, the following conclusions can be drawn: 1. A certain localization of the focus of ischemic stroke in the vertebra-basilar system is more likely to be characteristic of the corresponding stroke subtype. 2. The rate of reduction and reorganization of the focus does not depend on the stroke subtype, localization of the hearth, comorbidphone, rehabilitation methods and is proportional to the initial size of the heart attack site. 3. The degree of severity of COPD has a correlation with the blood flow indices of posterior cerebral arteries and vertebral arteries, as well as the asymmetry coefficient.

Application of flow coils to occlude distal vertebrobasilar aneurysms

Objective ‒ to improve the quality of treatment and endovascular occlusion techniques in case of distal vertebrobasilar (VB) aneurysms with implementation of flow coils usage.Materials and methods. Retrospective analysis of 4 patients (3 women and 1 man, mean age 53.5 years) with VB aneurysms in a 2-year period treated in Scientific-Practical Center of Endovascular Neuroradiology NAMS of Ukraine. Pretreatment clinical status was recorded from the patient files, any new neurologic symptoms after the treatment were recorded. Clinical outcome of the patients was established from the patient files. We describe the case of distal superior cerebellar artery aneurysm, 3 cases of posterior inferior cerebellar artery neurysms treated successfully with flow coils with 3-month follow-up at least. All patients underwent cerebral angiography with transfemoral access. Subsequently, coiling of the most distal to the aneurysm segment of the artery was performed.Results. All patients presented with subarachnoid hemorrhage with vestibulo-atactic disorder, diplopia in the case of an aneurysm of the superior cerebellar artery. Endovascular deconstructive occlusion of the aneurysm was performed, according to the data of cerebral angiography, anatomy of the involved artery. In postprocedure Reversible neurological decline in one patient after performing deconstructive occlusion was observed, the symptom completely recovered within 2 weeks of the post-procedural period. Three patients noted the regression of static-coordination disorders in the first 5 days after surgery. No cases of extravasation during coiling and recanalization of the artery during the control examination were observed.Conclusions. Aneurysms of posterior inferior cerebellar artery and superior cerebellar artery are rare. Technical availability to reach the distal to the aneurysm segment of the artery is the key of successful procedure. In comparison with general microcatheters used to insert detachable coils, A microcatheter that is congruent to flow coils is a better navigated in a flow and has lower risk of damaging the artery wall because its physical properties. When the favorable positioning of the tip of the microcatheter is achieved, the flow coils effectively and in a controlled manner occlude the eligible segment of the artery.

Motor Coordination Disorders Evaluated through the Grid Test and Changes in the Nigral Nrf2 mRNA Expression in Rats with Pedunculopontine Lesion

Neurotoxic lesion of the pedunculopontine nucleus (PPN) is known to cause subtle motor dysfunctions. However, motor coordination during advance on a discontinuous and elevated surface has not been studied. It is also not known whether there are changes in the mRNA expression of nuclear factor (erythroid-derived 2)-like 2 (Nrf2) in nigral tissue. Methods: The effects of the unilateral neurotoxic lesion of the PPN in motor coordination evaluated through grid test and Nrf2 mRNA expression in nigral tissue were evaluated. Two experimental designs (ED) were organized: ED#1 behavioral study (7 and 30 days after PPN lesion) and ED#2 molecular biology study (24 h, 48 h and 7 days) after PPN lesion. Results: ED#1—The number of faults made with left limbs, were significant higher in the lesioned groups (p < 0.01) both 7 and 30 days post-lesion. The number of failures made by the right limbs, was also significantly higher (p < 0.05) vs. control groups. ED#2—Nrf2 mRNA expression showed an increase 24 h after PPN injury (p < 0.01), followed by a peak of expression 48 h post injury (p < 0.001). Conclusions: Disorders of motor coordination associated with PPN injury are bilateral. The increased Nrf2 mRNA expression could represent an adaptive response to oxidative stress in the nigral tissue following pontine injury.