Randomised clinical trial of group-based physiotherapy in extremely low birthweight children with minimal/mild motor impairment: A preliminary study.

Aim: Extremely low birthweight infants often present with mild neurodevelopmental impairments in gross motor function and postural stability in early childhood. The aim of the study was to undertake a randomised controlled trial to determine the short- and longer-term effects of group-based physiotherapy compared to standard care on performance in extremely low birthweight children with minimal/mild impairment.

Methods: Fifty children aged 4 years, born <28 weeks gestation and/or birthweight <1000 g with minimal/mild motor impairment were enrolled in a randomised controlled trial and randomly allocated to 6 weeks of group-based intervention (n = 24) or standard care (n = 26).

Behaviour of 4- to 5-year-old nondisabled ELBW children: Outcomes following group-based physiotherapy intervention.

Background: Extreme prematurity or extremely low birth weight (ELBW) can adversely affect behaviour. Nondisabled ELBW children are at risk of behavioural problems, which may become a particular concern after commencement of formal education. This study explored the frequency of behavioural and emotional problems amongst nondisabled ELBW children at 4 to 5 years of age and whether intervention had a positive influence on behaviour.

Goal Attainment Scaling to Evaluate Intervention on Individual Gains for Children Born Extremely Preterm.

Purpose: To investigate the effect of group-based physical therapy on individual gains among preterm and/or extremely low-birth-weight children with minimal or mild impairment at 4 years using Goal Attainment Scaling (GAS). To explore the relationship between GAS with motor and postural outcomes and effect of gender on GAS scores.

Methods: Twenty-four 4-year-old children (born <28 weeks' gestation and/or birth weight <1000 g) with minimal or mild motor impairment completed 6 group-based weekly intervention sessions and a goal-based home program.

Are behaviour problems in extremely low-birthweight children related to their motor ability?

Aim: To investigate whether behaviour problems are independently related to mild motor impairment in 11-13-year-old children born preterm with extremely low birthweight (ELBW).

Methods: The cross-sectional study included 48 (27 males) non-disabled, otherwise healthy ELBW children (<1000 g) and 55 (28 males) term-born peers. Parents reported behaviour using the Child Behaviour Checklist (CBCL).

Motor performance, postural stability and behaviour of non-disabled extremely preterm or extremely low birth weight children at four to five years of age.

Background: Extremely preterm or extremely low birth weight (ELBW) children who are non-disabled and otherwise healthy are at risk of neurodevelopmental impairments. Further understanding of these impairments is needed before commencement of formal education to optimise participation levels at a critical time point for these children.

Aims: To explore motor co-ordination, postural stability, limb strength and behaviour of non-disabled four to five year old children with a history of extreme prematurity or ELBW.

Fitness limitations in non-disabled extremely low birthweight adolescents.

Aim: This study aims to compare non-disabled otherwise healthy extremely low birthweight (ELBW) (<1000 g) children and term-born peers in an investigation of relationship between cardiorespiratory endurance and parent report of competence.

Methods: Forty-eight of 105 eligible ELBW 11- to 13-year-old children (27 male) and 55 term-born school peers (28 male) completed a 20-m shuttle run, anthropometric measures, respiratory function tests and the Motor Assessment Battery for Children. Parents completed the Child Behavior Checklist (CBCL).

Perinatal events and motor performance of children born with ELBW and nondisabled.

Purpose: To explore the relationship between perinatal variables and motor performance in children who were born with extremely low birth weight (ELBW) and were nondisabled at 1 and 4 years.

Methods: Children without neurological or cognitive impairment (n = 48) born weighing less than 1000 g between 1992 and 1994 were assessed at 1 and 4 years corrected age using the Neurosensory Motor Developmental Assessment (NSMDA). Scores were used to categorize motor performance as normal or abnormal.

Perinatal factors in non-disabled ELBW school children and later performance.

Aim: To determine the association between perinatal events and subsequent motor performance, cardiorespiratory endurance and respiratory function in non-disabled extremely low birthweight (ELBW) school children at 12 years of age.

Methods: Forty-eight ELBW infants were included in this study. The Movement Assessment Battery for Children (MABC), VO(2) max score as a measure of cardiorespiratory endurance and respiratory function testing were performed and perinatal variables were extracted from the children's hospital files.

The long-term predictive validity of early motor development in "apparently normal" ELBW survivors.

Background: Within the able majority of ELBW survivors, there is a lack of identified predictors of which children will require extra support despite having escaped significant disability.

Aims: Investigate the predictive validity of early motor scores, compared to that of perinatal descriptors or early growth, on long-term motor impairment in non-disabled ELBW (<1000g) children.

Study Design: Prospective longitudinal study.

Prevalence of incontinence and incontinence-specific quality of life impairment in women with cystic fibrosis.

Aims: Cystic fibrosis (CF) is the commonest autosomal recessive disorder in Caucasians. With advancing medical technology, the life expectancy has more than double in the last twenty years. This has led to new unforeseen health problems like urinary incontinence.

Motor coordination difficulties and physical fitness of extremely-low-birthweight children.

Motor coordination difficulties and poor fitness exist in the extremely low birthweight (ELBW) population. This study investigated the relative impact of motor coordination on the fitness of ELBW children aged 11 to 13 years. One hundred and nine children were recruited to the study: 54 ELBW participants (mean age at assessment 12y 6mo; 31 male, 23 female; mean birthweight 769g, SD 148g; mean gestational age 26.

The association between early minor motor difficulties in extreme low birth weight infants and school age attentional difficulties.

Introduction: Extremely premature infants of normal intellectual ability have an increased prevalence of motor and attentional difficulties. Knowledge of the relationship between early motor difficulties and measures of attention at school age would enhance understanding of these developmental pathways, their interrelationship and opportunities for intervention.

Objective: This study examines whether an association exists between early findings of minor motor difficulties and school age clinical and psychometric measures of attention.

Anesthetic efficacy of the palatal-anterior superior alveolar injection.

Background: A single palatal-anterior superior alveolar, or P-ASA, injection has been reported to provide pulpal anesthesia of the four maxillary incisors and usually the canines. The authors conducted a prospective, randomized, double-blind study to compare the anesthetic efficacy of 2 percent lidocaine with 1:100,000 epinephrine and 3 percent mepivacaine using a computer-assisted injection system to administer the P-ASA injection.

Materials And Methods: In a double-blind manner, the authors used a crossover design to administer randomly P-ASA injections of 1.

Movement and motor development in ELBW infants at 1 year is related to cognitive and motor abilities at 4 years.

A relationship between motor ability and cognitive performance has been previously reported. This study aimed to investigate the association between movement and cognitive performance at 1 and 4 years corrected age of children born less than 1000 g, and whether developmental testing of movement at 1 year is predictive of cognitive performance at 4 years. Motor development was assessed at both ages using the neurosensory motor developmental assessment (NSMDA) and motor development was classified as normal, or minimal, mild, moderate-severe dysfunction.

Goal-directed upper limb movements by children with and without DCD: a window into perceptuo-motor dysfunction?

Background And Purpose: Developmental co-ordination disorder (DCD) occurs in at least 6% of school-aged children. Researchers agree that motor co-ordination problems evident in DCD are, in part, the result of perceptual and cognitive processes, but the limited research available remains inconclusive. The present study investigated perceptual-motor abilities, with regard to vision, kinaesthesia and cross-modal judgement, in children with and without DCD.

Injection pain and postinjection pain of the palatal-anterior superior alveolar injection, administered with the Wand Plus system, comparing 2% lidocaine with 1:100,000 epinephrine to 3% mepivacaine.

Purpose: The purpose of this prospective, randomized, double-blind study was to compare injection pain and postinjection pain of 2% lidocaine with 1:100,000 epinephrine and 3% mepivacaine using the computer-assisted Wand Plus injection system to administer the palatal-anterior superior alveolar (P-ASA) injection. Additionally study was done to determine if the use of topical anesthetic decreased the pain of needle insertion with the P-ASA injection.

Study Design: Using a crossover design, 40 subjects randomly received, in a double-blind manner, P-ASA injections of 1.

The effect of task uncertainty on muscle activation patterns in 8-10-year-old children.

Background And Purpose: Postural muscle activity accompanying voluntary arm movements has been researched extensively in adults; however, few studies of this kind have been conducted with children. It is not clear whether children respond like adults to internal perturbations, and if so, whether this response is similar across a variety of task conditions. The aims of the present study were to determine the postural muscle activity demonstrated by 8-10-year-old children when performing a rapid shoulder flexion movement and to compare the pattern produced under simple reaction-time versus complex reaction-time conditions.

Hemodynamic and ventilatory effects of manual respiratory physiotherapy techniques of chest clapping, vibration, and shaking in an animal model.

Chest clapping, vibration, and shaking were studied in 10 physiotherapists who applied these techniques on an anesthetized animal model. Hemodynamic variables (such as heart rate, blood pressure, pulmonary artery pressure, and right atrial pressure) were measured during the application of these techniques to verify claims of adverse events. In addition, expired tidal volume and peak expiratory flow rate were measured to ascertain effects of these techniques.

Differences in postural control and movement performance during goal directed reaching in children with developmental coordination disorder.

Poor upper-limb coordination is a common difficulty for children with developmental coordination disorder (DCD). One hypothesis is that deviant muscle timing in proximal muscle groups results in poor postural and movement control. The relationship between muscle timing, arm motion and children's upper-limb coordination deficits has not previously been studied.

Non-anaemic iron deficiency identified by ZPP test in extremely premature infants: prevalence, dietary risk factors, and association with neurodevelopmental problems.

Introduction: The aims of this study were to determine, in a cohort of extremely premature infants, the prevalence of iron deficiency identified by zinc protoporphyrin/heme ratio (ZPP) testing, and its association with neurodevelopmental problems and dietary risk factors for iron deficiency.

Methods: Infants of less than 29 weeks' gestation or less than 1000 g birth weight were studied prospectively at a multidisciplinary follow-up clinic. Assessments were made at a corrected age of either 12 months (n=72) or 2 years (n=69).

The influence of preparedness on rapid stepping in young and older adults.

Objective: To investigate the influence of age and preparation level on postural muscle activation and step completion time during a rapid step task.

Design: Postural muscle onset times (EMG) and ground reaction forces were recorded from healthy young (n = 20, age 21 +/- 3 years) and older (n = 25, age 71 +/- 5 years) female adults during a choice reaction-time stepping paradigm.

Main Outcome Measures: Onset times of six trunk and hip muscles, reaction time and components of the step (weight shift time, step time and task time) were recorded.

Hand positioning sense in children with spina bifida myelomeningocele.

This study was undertaken to establish whether children with myelomeningocele have abnormal kinaesthesia of the hands. Twenty-one children with myelomeningocele and 21 control children aged between six and 12 years were involved in the study. The level of kinaesthetic awareness in the hands was measured by examining the child's ability to copy hand positions, using visual cueing and kinaesthetic cueing.

The validity of button fastening as a test of hand disability in myotonic dystrophy.

This study evaluated the validity of testing button fastening ability as a measurement of hand disability in patients with myotonic dystrophy. Forty subjects with myotonic dystrophy were tested on their ability to fasten four shirt buttons. The association between button fastening ability, strength of selected proximal upper limb muscles and lateral pinch grip was determined.

The measurement of the medial longitudinal arch in children.

Both feet of two hundred and seventy two children aged between five years six months and ten years and eleven months were studied using a footprint technique called the arch index (Al), and the vertical height of the navicular (NH) as non invasive techniques of objective measures of the medial longitudinal arch (MLA). In addition to age the study investigated the influence of gender, limb dominance, and body weight. The study found the existence of a relationship between the two measures of the MLA.

The influence of "sputum-like gel" viscosity on crackle characteristics in a mechanically ventilated porcine lung model.

This study investigated the influence of airway secretion viscosity on the characteristics of crackle sounds produced using a mechanically ventilated porcine lung model. Aqueous ultrasonic methylene blue stained gel solutions of viscosity 100, 150 and 200 P were prepared and instilled into 15 isolated, mechanically ventilated, porcine lungs immersed in water. Sound signals recorded by a hydrophone before and after instillation of gel were subjected to both fast Fourier transform and wave-form analysis.