HeadUp: A Low-Cost Solution for Tracking Head Movement of Children with Cerebral Palsy Using IMU

Cerebral palsy (CP) is a common reason for human motor ability limitations caused before birth, through infancy or early childhood. Poor head control is one of the most important problems in children with level IV CP and level V CP, which can affect many aspects of children’s lives. The current visual assessment method for measuring head control ability and cervical range of motion (CROM) lacks accuracy and reliability. In this paper, a HeadUp system that is based on a low-cost, 9-axis, inertial measurement unit (IMU) is proposed to capture and evaluate the head control ability for children with CP. The proposed system wirelessly measures CROM in frontal, sagittal, and transverse planes during ordinary life activities. The system is designed to provide real-time, bidirectional communication with an Euler-based, sensor fusion algorithm (SFA) to estimate the head orientation and its control ability tracking. The experimental results for the proposed SFA show high accuracy in noise reduction with faster system response. The system is clinically tested on five typically developing children and five children with CP (age range: 2–5 years). The proposed HeadUp system can be implemented as a head control trainer in an entertaining way to motivate the child with CP to keep their head up.

Eliciting health state utilities for Aromatic L-amino Acid Decarboxylase (AADC) deficiency: a UK vignette study

Purpose The aim of this study was to generate health state utilities for aromatic L-amino acid decarboxylase (AADC) deficiency, a rare genetic, lifelong neurogenerative condition predominantly manifesting in young infants. Methods Participants were presented with health state vignettes. These had been previously developed based on published literature, clinician input, interviews with parents of AADC deficiency patients and expert opinion. A total of 5 health state vignettes were presented: bedridden, head control, sitting unsupported, standing with assistance and walking with assistance. Health state utilities (HSU) were elicited using time-trade off (TTO; 10-year time horizon) and the standard gamble (SG). The vignettes were completed online by panel participants drawn from a representative sample of the United Kingdom residential population. Results A total of 1598 participants completed the vignettes. Around 21% had incongruent responses (higher utilities for the bedridden compared to walking health states). Incongruent responses were associated with shorter task completion times, gender and parental status. These responses were removed from the analysis. Health state utilities (HSU) increased correspondingly as health states improved for both the TTO and SG. The mean HSU (standard deviation) for the TTO task were: bedridden state 0.49 (0.34); head control 0.54 (0.33), sitting unsupported 0.63 (0.31); standing with assistance 0.68 (0.31); and walking with assistance 0.73 (0.31). For the SG, mean health state utilities were: 0.56 (0.28), 0.57 (0.27), 0.67 (0.24), 0.70 (0.24), and 0.75 (0.25), respectively. Conclusion Health state utilities were derived for AADC deficiency through a vignette study. These will be used for a cost-effectiveness model of an AADC deficiency treatment.

The Head Control Scale: Interrater Reliability Among Therapy Students

Date Presented 04/13/21 This study assesses reliability and accuracy of the Head Control Scale (HCS) when used by inexperienced raters. Physical therapy and OT students used the HCS to rate five videotaped pediatric subjects. The kappa coefficient for interrater reliability among students was "almost perfect" (>.80). In one subscale, when comparing student raters with clinicians, there was strong agreement in grading between each group. The HCS may be consistently used by both new and experienced raters. Primary Author and Speaker: Amy Armstrong-Heimsoth Additional Authors and Speakers: Emily Mei Chun, Elizabeth Diane Hesse, Kelsey E. Ranneklev, and Camila E. Sanchez

A clinical observational analysis of aerosol emissions from dental procedures.

There remains uncertainty as to which dental procedures constitute aerosol generating procedures. We aimed to quantify aerosol concentration produced during different dental procedures. Where aerosol was detected, we assessed whether the aerosol size distribution from patient procedures was explained by the non-salivary contaminated instrument source, using phantom head controls. This study obtained ethical approval within the AERATOR grant. Patients were recruited consecutively, and written consent was obtained. Both an optical and an aerodynamic particle sizer were used to measure aerosol, attached to a 3D-printed polylactide funnel 22cm from the patients face. A range of periodontal, oral surgery and orthodontic procedures were captured using time-stamped protocols. High-fidelity phantom head control experiments for each procedure were performed, under the same conditions. Aerosol was measured for each procedure. Where aerosol was detected, phantom head control and patient procedure aerosol size distributions were compared, with the assumption that if the distributions were the same, aerosol detected from the patient could be explained by the instrument source. 41 patients underwent fifteen different dental procedures. For nine procedures, no aerosol was detected. Where aerosol was detected, the percentage of procedure time that aerosol was observed above background ranged from 12.7% for ultrasonic scaling to 42.9% for 3-in-1 air + water syringe. For ultrasonic scaling, 3-in-1 syringe use and surgical drilling, the aerosol size distribution matched the non-salivary contaminated instrument source. High and slow speed drilling produced aerosol from patient procedures which appear to have different size distributions from a phantom head control and so may pose a greater risk of (potentially infected) salivary contamination. Ultrasonic scaling does not appear to generate additional aerosol above that of the instrument itself and therefore does not increase the risk to dental teams, relative to the risk from being in close proximity to the patient.

Pengaruh Massage Effleurag Terhadap Kemampuan Head Control Extensi Bayi Usia 3-4 Bulan

Abstrak. Head control merupakan salah satu penggerak yang terpenting dari sebagian besar dalam penilaian perkembangan bayi. Gangguan head control sering dikutip sebagai faktor resiko awal penundaan perkembangan head control. Penelitian ini merupakan jenis penelitian quasi eksperiment yang bertujuan untuk mengetahui pengaruh massage bayi dengan teknik effleurage terhadap kemampuan head control extensi pada posisi tengkurap bayi usia 3-4 bulan, dimana responden penelitian dibagi menjadi dua yaitu kelompok perlakuan berjumlah 8 responden dan kelompok control berjumlah 8 responden. Penelitian ini dilaksanakan di puskesmas paccerakkang Makassar. Instrument penelitian dengan menggunakan Test Of Infant Motor Performance (TIMP) yang digunakan untuk menilai control kepala pada bayi usia 34 minggu sampai dengan 4 bulan. Penelaian ini menilai seberapa lama dan seberapa tinggi bayi dapat mengangkat dan mempertahankan kepala saat posisi tengkurap. Berdasarkan uji mann whitney diperoleh nilai p 0.001 < 0,005 yang berarti bahwa ada pengaruh yang bermakna antra kelompok perlakuan (massage bayi) dengan kelompok kontrol. Untuk melihat hasil yang lebih baik berdasarkan nilai selisih reratanya ternyata kelompok perlakuan lebih tinggi nilai selisih rerata yaitu 18,75 dibanding kelompok kontrol. Kata kunci : Massage Effleurage, head control, bayi usia 3-4 bulan. Effect of Massage Effleurage on Head Control Ability of Infant 3-4 Month Old Extensions Abstract. Head control is one of the most important drivers of most of the assessment of infant development. Head control disorders are often cited as a risk factor for early delays in head control development. This research is a quasi-experimental research which aims to determine the effect of massage effleurage on the ability of head control extension in the prone position of infants aged 3-4 months, where the research respondents are divided into two, namely the treatment group of 8 respondents and the control group of 8 respondents. This research was conducted at the Puskesmas Paccerakkang Makassar. The research instrument used the Test Of Infant Motor Performance (TIMP) which was used to assess head control in infants aged 34 weeks to 4 months. This study assesses how long and how high the baby can lift and hold the head in a prone position. Based on the Mann Whitney test, the p value was 0.001 <0.005, which means that there was a significant effect between the treatment group (baby massage) and the control group. To see a better result based on the mean difference value, it turns out that the treatment group has a higher mean difference value, namely 18.75 than the control group. Keywords : massage effleurage, head control,baby aged 3-4 months

MCT8 deficiency in a patient with a novel frameshift variant in the SLC16A2 gene

MCT8 deficiency is an X-linked recessive disorder. We report the case of a 2-year-old Japanese boy with MCT8 deficiency caused by a novel frameshift variant, NM_006517.5(SLC16A2_v001):c.966dup [p.(Ile323Hisfs*57)]. He presented no head control and spoke no meaningful words, indicating severe developmental delay. Although missense or in-frame mutations of SLC16A2 are usually related to milder phenotypes and later-onset pyramidal signs, loss-of-function mutations are expected to cause severe clinical symptoms.

Reliability of Clinical Rating Scale in Evaluation of Head Control in children with Cerebral Palsy

Introduction The clinical rating scale for head control assesses control of head/neck in children with neurological conditions. Head control is important for activities of daily living and quality of life in children. Objectives The aim of the study was to determine the intra-rater and inter-rater reliability of the scale in children with Cerebral Palsy. Method The study was a cross-sectional study approved by Research ethics committees of Kano State Ministry of Health and Aminu Kano Teaching Hospital involving children with CP. Three independent raters assessed the children using Clinical Rating Scale for Head Control at two different times, and the intra-rater and inter-rater reliabilities were analyzed using kappa statistics and Bland-Altman analysis. Results Fifty children with CP with mean age, 24.17±12.17 months participated in the study. The result of the study showed that there were very good agreement in all the test positions for the three raters and between the first and the second ratings and in all the test positions between the three raters respectively (k>0.8). Similarly, there was no proportional bias between ratings in 24 of the measurements (p>0.05). Conclusion Clinical rating scale for head control seems to be a reliable instrument. Thus, it can be used to monitor the progress of rehabilitation in CP patients to help improve their quality of life.