Robust unsupervised texture segmentation for motion analysis in ultrasound images.

Purpose: Ultrasound imaging has emerged as a promising cost-effective and portable non-irradiant modality for the diagnosis and follow-up of diseases. Motion analysis can be performed by segmenting anatomical structures of interest before tracking them over time. However, doing so in a robust way is challenging as ultrasound images often display a low contrast and blurry boundaries.

Effectiveness of wheelchair skills training for improving manual wheelchair mobility in children and adolescents: protocol for a multicenter randomized waitlist-controlled trial.

Background: Self-directed mobility during childhood can influence development, social participation, and independent living later in life. For children who experience challenges with walking, manual wheelchairs (MWCs) provide a means for self-directed mobility. An effective MWC skills training program exists for adults, but controlled trials have not yet been documented in children and adolescents.

Evaluation of pediatric-specific resources to support utilization of the Wheelchair Skills Training Program by the users of the resources: a descriptive qualitative study.

Background: Children's ability to engage in meaningful activities is positively influenced by their ability to move independently. Preliminary evidence in children suggests that wheelchair skills training improves wheelchair skills, which are important for independent mobility. The Wheelchair Skills Training Program is a standardized program to teach wheelchair skills.

Early auditory responses to speech sounds in Parkinson's disease: preliminary data.

Parkinson's disease (PD), as a manifestation of basal ganglia dysfunction, is associated with a number of speech deficits, including reduced voice modulation and vocal output. Interestingly, previous work has shown that participants with PD show an increased feedback-driven motor response to unexpected fundamental frequency perturbations during speech production, and a heightened ability to detect differences in vocal pitch relative to control participants. Here, we explored one possible contributor to these enhanced responses.

Current Trends and Challenges in Pediatric Access to Sensorless and Sensor-Based Upper Limb Exoskeletons.

Sensorless and sensor-based upper limb exoskeletons that enhance or support daily motor function are limited for children. This review presents the different needs in pediatrics and the latest trends when developing an upper limb exoskeleton and discusses future prospects to improve accessibility. First, the principal diagnoses in pediatrics and their respective challenge are presented.

Adapting the Wheelchair Skills Program for pediatric rehabilitation: recommendations from key stakeholders.

Background: Backed by over 20 years of research development, the Wheelchair Skills Program (WSP) has proven to be a safe and effective program to improving wheelchair skills for adult wheelchair users. However, evidence is lacking for the pediatric population, which may help to explain the limited use of the WSP in pediatric settings. While additional evidence specific to the pediatric population is needed, concurrent implementation of the WSP into pediatric clinical practice is equally prudent to allow those users to benefit from the years of accumulated WSP evidence.

Effect of low dose robotic-gait training on walking capacity in children and adolescents with cerebral palsy.

Objective: Robotic gait training presents a promising training modality. Nevertheless, evidence supporting the efficacy of such therapy in children with cerebral palsy remains insufficient. This study aimed to assess the effect of robotic gait training in children/adolescents with cerebral palsy.

Development of a toolkit for educators of the wheelchair service provision process: the Seating and Mobility Academic Resource Toolkit (SMART).

Background: Insufficient wheelchair training among rehabilitation professionals has been identified as an important factor that hinders access to appropriate wheelchair services. The aim of this study was to develop a toolkit to promote the integration of wheelchair education into academic curricula of rehabilitation programs.

Methods: A participatory action research design was carried out in three phases: (1) development of the Initial and Alpha Versions involving secondary analyses of surveys (n = 72), interviews (n = 14), and academic training partners meeting presentations (n = 16); (2) development of the Beta Version based on feedback from collaborators (n = 21); and (3) development of the Launch Version based on feedback from participants attending presentations of the Beta Version at conferences, symposiums, and webinars (n = 94).

Muscle fatigue during a short walking exercise in children with cerebral palsy who walk in a crouch gait.

Background: A deterioration of crouch gait was found in a group of children with cerebral palsy (CP) after a short walking exercise. The increased knee flexion reported after a continuous walk could be related with muscle fatigue and muscle strength.

Aim: Does muscle fatigue appears at the end of a walking exercise in children with CP who walk in a crouch gait?

Methods: Eleven children with cerebral palsy (GMFCS I to III) who walk in a crouch gait were included.

Evaluation of ligament laxity during pregnancy.

Objective: Pregnancy-related changes in ligament laxity have been shown to be associated with various disorders such as back pain or pelvic floor disorders. The purpose of this study was to assess laxity changes during pregnancy by confronting different methods in order to suggest a simple clinical tool helping to prevent the aforementioned problems.

Design: Seventeen pregnant women were evaluated at the first, second and third trimesters as cases and 16 non-pregnant women participated as controls.

Reliability of maximum isometric hip and knee torque measurements in children with cerebral palsy using a paediatric exoskeleton - Lokomat.

Background: The Lokomat (by L-Force tool) allows the measurement of the maximum voluntary isometric torque (MVIT) at the knee and hip joints in a standing position, as close as possible to the posture adopted during walking. However, the reliability of this measurement in children with cerebral palsy (CP) remains unknown. The main goal of this study was to evaluate inter and intra-tester reliability of a novel tool (L-Force) in CP population.

Test-retest reliability of posture measurements in adolescents with idiopathic scoliosis.

Background Context: Posture changes are a major consequence of idiopathic scoliosis (IS). Posture changes can lead to psychosocial and physical impairments in adolescents with IS. Therefore, it is important to assess posture, but the test-retest reliability of posture measurements still remains unknown in this population.

Classification of upper limb disability levels of children with spastic unilateral cerebral palsy using K-means algorithm.

Treatment for cerebral palsy depends upon the severity of the child's condition and requires knowledge about upper limb disability. The aim of this study was to develop a systematic quantitative classification method of the upper limb disability levels for children with spastic unilateral cerebral palsy based on upper limb movements and muscle activation. Thirteen children with spastic unilateral cerebral palsy and six typically developing children participated in this study.

Most children with cancer are not enrolled on a clinical trial in Canada: a population-based study.

Background: Primary objective was to describe the proportion of children newly diagnosed with cancer enrolled on a therapeutic clinical trial. Secondary objectives were to describe reasons for non-enrollment and factors associated with enrollment on trials.

Methods: In this retrospective cohort study, we included children newly diagnosed with cancer between 0 and 14 years of age and diagnosed from 2001 to 2012.

Sensorimotor adaptation of whole-body postural control.

The aim of the present study was to examine the modification of postural symmetry during quiet standing using a sensorimotor adaptation paradigm. A group of neurologically typical adult participants performed a visually guided mediolateral (left-right) weight shifting task requiring precise adjustments in body orientation. During one phase of the task, the visual feedback of center of pressure (COP) was systematically biased toward the left or the right, requiring an adjustment in posture to compensate.

Internationally educated nurses in Canada: predictors of workforce integration.

Background: Global trends in migration accompanied with recent changes to the immigrant selection process may have influenced the demographic and human capital characteristics of internationally educated nurses (IENs) in Canada and in turn the assistance required to facilitate their workforce integration. This study aimed to describe the demographic and human capital profile of IENs in Canada, to explore recent changes to the profile, and to identify predictors of IENs' workforce integration.

Methods: A cross-sectional, descriptive, correlational survey design was used.

Use of electromyography to optimize Lokomat settings for subject-specific gait rehabilitation in post-stroke hemiparetic patients: A proof-of-concept study.

Objectives: While generic protocols exist for gait rehabilitation using robotic orthotics such as the Lokomat, several settings - guidance, body-weight support (BWS) and velocity - may be adjusted to individualize patient training. However, no systematic approach has yet emerged. Our objective was to assess the feasibility and effects of a systematic approach based on electromyography to determine subject-specific settings with application to the strengthening of the gluteus maximus muscle in post-stroke hemiparetic patients.

Atypical teratoid rhabdoid tumor in the first year of life: the Canadian ATRT registry experience and review of the literature.

While 2/3 of patients with ATRT are less than 3 years at diagnosis, the literature suggests younger children present with more aggressive disease and poorer outcome. However, little data exist on characteristics and outcome of patients diagnosed with ATRT in the first year of life. In particular, it is unclear whether they access similar treatments as do older children.

Joint torque variability and repeatability during cyclic flexion-extension of the elbow.

Background: Joint torques are generally of primary importance for clinicians to analyze the effect of a surgery and to obtain an indicator of functional capability to perform a motion. Given the current need to standardize the functional evaluation of the upper limb, the aim of this paper is to assess (1) the variability of the calculated maximal elbow joint torque during cyclic elbow flexion-extension movements and (2) participant test-retest repeatability in healthy young adults. Calculations were based on an existing non-invasive method including kinematic identification and inverse dynamics processes.

Impact of a short walking exercise on gait kinematics in children with cerebral palsy who walk in a crouch gait.

Background: Crouch gait results in an increase of the joint stress due to an excessive knee flexion. Daily walking exercises, even when performed at a self-selected speed, may result in a decrease of the extensor muscle strength which could lead to a more severe crouch gait pattern. The aim of this study was to assess the impact of a short walking exercise on gait kinematics in children with cerebral palsy who walk with a crouch gait.

Mechanical risk of rotator cuff repair failure during passive movements: A simulation-based study.

Background: Despite improvements in rotator cuff surgery techniques, re-tear rate remains above 20% and increases with tear severity. Mechanical stresses to failure of repaired tendons have been reported. While optimal immobilization postures were proposed to minimize this stress, post-operative rehabilitation protocols have never been assessed with respect to these values.

Physical activity in youth with osteogenesis imperfecta type I.

Introduction: Individuals with Osteogenesis Imperfecta (OI) type I often show muscular weakness. However, it is unclear whether muscular weakness is a consequence of physical inactivity or a result of the disease itself. The aim was to assess muscle function in youth with OI type I and evaluate physical activity (PA).

The functional muscle-bone unit in patients with osteogenesis imperfecta type I.

Context: Osteogenesis imperfecta (OI) type I is a heritable bone fragility disorder that is caused by mutations affecting collagen type I. We recently showed that patients with OI type I frequently have muscle weakness. As muscle force and bone mass are usually closely related, we hypothesized that muscle weakness in OI type I could contribute to increase bone mass deficit in the lower extremities.

Impaired visually guided weight-shifting ability in children with cerebral palsy.

The ability to control voluntary weight shifting is crucial in many functional tasks. To our knowledge, weight shifting ability in response to a visual stimulus has never been evaluated in children with cerebral palsy (CP). The aim of the study was (1) to propose a new method to assess visually guided medio-lateral (M/L) weight shifting ability and (2) to compare weight-shifting ability in children with CP and typically developing (TD) children.

Effect of long-term orthotic treatment on gait biomechanics in adolescent idiopathic scoliosis.

Background Context: A previous study showed subtle biomechanical changes in the gait of unbraced adolescent idiopathic scoliosis (AIS) patients such as a reduction of pelvic, hip, knee, and ankle displacements. However, lumbopelvic muscles' timing activity was bilaterally increased during gait and correlated to excessive oxygen consumption as compared with healthy subjects. Usually, a brace, when indicated, is worn strictly for 22 hours every day in skeletally immature idiopathic scoliotic girls.