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Purpose: Our purpose was to start examining clinical swallowing and motor speech skills of school-age children with unilateral cerebral palsy (UCP) compared to typically developing children (TDC), how these skills relate to each other, and whether they are predicted by clinical/demographic data (age, birth history, lesion type, etc.). Method: Seventeen children with UCP and 17 TDC (7-12 years old) participated in this cross-sectional study. Feeding/swallowing skills were evaluated using the Dysphagia Disorder Survey (DDS) and a normalized measure of mealtime efficiency (normalized mealtime duration, i.e., nMD). Motor speech was assessed via speech intelligibility and speech rate measures using the Test of Children's Speech Plus. Analyses included nonparametric bootstrapping, correlation analysis, and multiple regression. Results: Children with UCP exhibited more severe (higher) DDS scores (p = .0096, Part 1; p = .0132, Part 2) and reduced speech rate than TDC (p = .0120). Furthermore, in children with UCP, total DDS scores were moderately negatively correlated with speech intelligibility (words: r = -.6162, p = .0086; sentences: r = -.60792, p = .0096). Expressive language scores were the only significant predictor of feeding and swallowing performance, and receptive language scores were the only significant predictor of motor speech skills. Conclusions: Swallowing and motor speech skills can be affected in school-age children with UCP, with wide variability of performance also noted. Preliminary cross-system interactions between swallowing, speech, and language are observed and might support the complex relationships between these domains. Further understanding these relationships in this population could have prognostic and/or therapeutic value and warrants further study., Cerebral palsy (CP) represents a group of disorders of the development of movement and posture caused by diverse nonprogressive abnormalities in the developing brain, which are frequently accompanied by disorders [...]

Studies have reported that physical exercise reduces maladaptive stereotyped motor behaviours (SMB) in children with ASD, but these intervention studies vary in design and outcome. The present systematic review and meta-analysis included 22 studies, involving 274 children with ASD, to quantify the effect of exercise on SMB and its potential moderators. Multi-level modelling revealed a large overall effect, Hedges' g = 1.16, with significant heterogeneity across participant, treatment, and study levels. Further, a more appropriate model using between-case estimation for within-subject effects to improve comparability between single-case and group-design studies, yielded a smaller but still significant effect, g = 0.51. Lastly, higher exercise intensity, but not age, exercise duration or settings, reliably predicted treatment effectiveness. Implications for clinical practice and research are discussed., Author(s): Elizabeth J. Teh [sup.1] , Ranjith Vijayakumar [sup.2] , Timothy Xing Jun Tan [sup.2] , Melvin J. Yap [sup.2] Author Affiliations: (1) grid.4280.e, 0000 0001 2180 6431, Department of [...]

Objectives Hyperglycaemia first detected in pregnancy (HFDP), on the rise in urban sub-Saharan Africa (SSA), may negatively impact foetal neurodevelopment, with potential long-term cognitive consequences for the child. Data on this association from SSA is lacking, and we aimed to investigate the association in 3- to 6-year-old children in Soweto, South Africa. Methods In this comparative study, we compared cognitive skills measured with the Herbst Early Childhood Development Criteria test in 95 children born to mothers with HFDP and 99 participants unexposed to maternal HFDP. Fine and gross motor skills were secondary outcomes. Ordinal regression analysis with known confounders was performed for children born at-term. Results Of children exposed to HFDP born at-term, 24.3% scored 'high' and 25.7% scored 'low' in the cognitive subsection of the test, as opposed to 37.7% and 12.9% in the HFDP-unexposed group, respectively. In ordinal regression, exposed participants had a significantly lower odds of scoring in a higher cognitive category when adjusting for maternal confounders and socio-economic status (OR 0.33, 95% CI 0.15-0.74, p = 0.007). No difference was found in gross motor development between the two groups; differences in fine motor development were attenuated after adjustment for maternal pregnancy factors and household socioeconomic status (OR 0.62, 95% CI 0.28-1.37, p = 0.239). Conclusions for Practice Exposure to HFDP was negatively associated with cognitive development at preschool age. Optimising maternal (preconception) health and early childhood cognitive stimulation could help more children reach their developmental potential., Author(s): L. M. Soepnel [sup.1] [sup.2] , V. Nicolaou [sup.2] , C. E. Draper [sup.2] , N. S. Levitt [sup.3] , K. Klipstein-Grobusch [sup.1] [sup.4] , S. A. Norris [sup.2] [...]

The purpose of this study was to examine the moderating role of adaptive behavior on the pathways connecting motor competence, physical activity, and health-related fitness in 7-12 year old children with ASD (N = 27). Results demonstrate that motor competence and health-related fitness were positively related (r = .42, p < .05), and this relationship was moderated by adaptive behavior. Specifically, we found that motor competence and health-related fitness were significantly related for those participants scoring approximately one or more standard deviations below the mean on adaptive behavior. No other significant pathways were present. Implications of these associations and directions for future research are discussed., Author(s): Emily Bremer [sup.1] [sup.2] , John Cairney [sup.1] [sup.2] Author Affiliations: (1) grid.17063.33, 0000 0001 2157 2938, Faculty of Kinesiology and Physical Education, University of Toronto, , 55 Harbord [...]

Purpose: The autosegmental-metrical (AM) framework represents an established methodology for intonational analysis in unimpaired speaker populations but has found little application in describing intonation in motor speech disorders (MSDs). This study compared the intonation patterns of unimpaired participants (CON) and those with Parkinson's disease (PD), ataxic dysarthria (AT), and foreign accent syndrome (FAS) to evaluate the approach's potential for distinguishing types of MSDs from each other and from unimpaired speech. Method: Spontaneous speech from 8 PD, 8 AT, 4 FAS, and 10 CON speakers were analyzed in relation to inventory and prevalence of pitch patterns, accentuation, and phrasing. Acoustic-phonetic baseline measures (maximum-phonation-duration, speech rate, and F0-variability) were also performed. Results: The analyses yielded differences between MSD and CON groups and between the clinical groups in regard to prevalence, accentuation, and phrasing. AT and FAS speakers used more rising and high pitch accents than PD and CON speakers. The AT group used the highest number of pitch accents per phrase, and all 3 MSD groups produced significantly shorter phrases than the CON group. Conclusions: The study succeeded in differentiating MSDs on the basis of intonational performances by using the AM approach, thus, demonstrating its potential for charting intonational profiles in clinical populations. Key Words: intonation, autosegmental-metrical (AM) approach, hypokinetic dysarthria, ataxic dysarthria, foreign accent syndrome, Prosodic disturbances such as changes in speech rate, pausing, stress, rhythm or intonation play a major role in motor speech disorders (MSDs), as demonstrated early on in the classification system [...]

The direct and indirect pathways of the basal ganglia have been proposed to oppositely regulate locomotion and differentially contribute to pathological behaviors. Analysis of the distinct contributions of each pathway to behavior has been a challenge, however, due to the difficulty of selectively investigating the neurons comprising the two pathways using conventional techniques. Here we present two mouse models in which the function of striatonigral or striatopallidal neurons is selectively disrupted due to cell type--specific deletion of the striatal signaling protein dopamine- and cAMP-regulated phosphoprotein Mr 32kDa (DARPP-32). Using these mice, we found that the loss of DARPP-32 in striatonigral neurons decreased basal and cocaine-induced locomotion and abolished dyskinetic behaviors in response to the Parkinson's disease drug L-DOPA. Conversely, the loss of DARPP-32 in striatopallidal neurons produced a robust increase in locomotor activity and a strongly reduced cataleptic response to the antipsychotic drug haloperidol. These findings provide insight into the selective contributions of the direct and indirect pathways to striatal motor behaviors. basal ganglia | DARPP-32 | locomotor behavior | striatonigral | striatopallidal doi/ 10.1073/pnas.1009874107

Background. Existing self-report measures of mobility ignore important contextual features of movement and require respondents to make complex judgments about specific tasks. Thus, we describe the development and validation of a short form (sf) video-animated tool for assessing mobility, the Mobility Assessment Tool--MAT-sf. Methods. This study involves cross-sectional and longitudinal analyses examining the measurement properties of the MAT-sf. The MAT-sf consists of 10 animated video clips that assess respondents' level of proficiency in performing each task. The main outcome measures used for validation included the Pepper Assessment Tool for Disability (PAT-D), the Short Physical Performance Battery (SPPB), and 400-m walk test. Results. Participants (n = 234), 166 women and 68 men, had an average age of 81.9 years and a variety of comorbidities with 65.4% having high blood pressure. An average SPPB score of 8.6 (range 2-12) suggests that the study sample had evidence of compromised physical function but was quite heterogeneous. The MAT-sf had good content validity, excellent tes--retest reliability (r = .93), and criterion-related validity with the PAT-D. Moreover, the MAT-sf added considerable variance to the prediction of both SPPB scores and 400-m gait speed over and above the PAT-D mobility subscale. The MAT-sf also discriminated between older adults who completed or failed the 400-m walk test. Conclusion. The MAT-sf is an innovative psychometrically sound measure of mobility. It has utility in epidemiological studies, translational science, and clinical practice. Key Words: Mobility--Aging--Measurement--Disability. doi: 10.1093/gerona/glq055

Background. The purpose of the present study was to examine, first, whether heating acuity predicts falls and whether the potential association is explained by postural balance and, second, to examine whether shared genetic or environmental effects underlie these associations. Methods. Heating was measured using a clinical audiometer as a part of the Finnish Twin Study on Aging in 103 monozygotic and 114 dizygotic female twin pairs aged 63-76 years. Postural balance was indicated as a center of pressure (COP) movement in semitandem stance, and participants filled in a fall-calendar daily for an average of 345 days after the baseline. Results. Mean hearing acuity (better ear heating threshold level at 0.5-4 kHz) was 21 dB (standard deviation [SD] 12). Means of the COP velocity moment for the best to the poorest hearing quartiles increased linearly from 40.7 [mm.sup.2]/s (SD 24.4) to 52.8 [mm.sup.2]/s (SD 32.0) (p value for the trend = .003). Altogether 199 participants reported 437 falls. Age-adjusted incidence rate ratios (IRRs) for falls, with the best hearing quartile as a reference, were 1.2 (95% confidence interval [CI] = 0.4-3.8) in the second, 4.1 (95% CI = 1.1-15.6) in the third, and 3.4 (95% CI = 1.0-11.4) in the poorest hearing quartiles. Adjustment for COP velocity moment decreased IRRs markedly. Twin analyses showed that the association between hearing acuity and postural balance was not explained by genetic factors in common for these traits. Conclusion. People with poor hearing acuity have a higher risk for falls, which is partially explained by their poorer postural control. Auditory information about environment may be important for safe mobility. Key Words: Heating--Postural balance--Fall--Twin study--Heritability--Aging.

Iron deficiency during early growth and development adversely affects multiple facets of cognition and behavior in adult rats. The purpose of this study was to assess the nature of the learning and locomotor behavioral deficits observed in male and female rats in the absence of depressed brain iron levels at the time of testing. Adult female Wistar rats were fed either an iron-enriched diet (>225 mg/kg Fe) or an iron-restricted diet (3 mg/kg Fe) for 2 wk prior to and throughout gestation, and a nonpurified diet (270 mg/kg Fe) thereafter. Open-field (OF) and Morris water maze (MWM) testing began when the offspring reached early adulthood (12 wk). At birth, perinatal iron-deficient (PID) offspring had reduced (P < 0.001) hematocrits (-33%), liver iron stores (-83%), and brain iron concentrations (-38%) compared with controls. Although there were no differences in iron status in adults, the PID males and females exhibited reduced OF exploratory behavior, albeit only PID males had an aversion to the center of the apparatus (2.5 vs. 6.9% in controls, P < 0.001). Additionally, PID males required greater path lengths to reach the hidden platform in the MWM, had reduced spatial bias for the target quadrant, and had a tendency for greater thigmotactic behavior in the probe trials (16.5 vs. 13.0% in controls; P= 0.06). PID females had slower swim speeds in all testing phases (-6.2%; P< 0.001). These results suggest that PID has detrimental programming effects in both male and female rats, although the behaviors suggest different mechanisms may be involved in each sex.

The authors used functional magnetic resonance imaging to explore whether the primary motor area (M1) serves a processing role in a finger-movement tracking task, emphasizing attention to accuracy, beyond its [...]

Movement of an affected hand after stroke is associated with increased activation of ipsilateral motor cortical areas, suggesting that these motor areas in the undamaged hemisphere may adaptively compensate for damaged or disconnected regions. However, this adaptive compensation has not yet been demonstrated directly. Here we used transcranial magnetic stimulation (TMS) to interfere transiently with processing in the ipsilateral primary motor or dorsal premotor cortex (PMd) during finger movements. TMS had a greater effect on patients than controls in a manner that depended on the site, hemisphere, and time of stimulation. In patients with right hemiparesis (but not in healthy controls), TMS applied to PMd early (100 ms) after the cue to move slowed simple reaction-time finger movements by 12% compared with controls. The relative slowing of movements with ipsilateral PMd stimulation in patients correlated with the degree of motor impairment, suggesting that functional recruitment of ipsilateral motor areas was greatest in the more impaired patients. We also used functional magnetic resonance imaging to monitor brain activity in these subjects as they performed the same movements. Slowing of reaction time after premotor cortex TMS in the patients correlated inversely with the relative hemispheric lateralization of functional magnetic resonance imaging activation in PMd. This inverse correlation suggests that the increased activation in ipsilateral cortical motor areas during movements of a paretic hand, shown in this and previous functional imaging studies, represents a functionally relevant, adaptive response to the associated brain injury.

Background. The relationships between motor performance and age, anthropometric characteristics, and serum lipids were studied in a population-based sample of women (N = 865). Methods. Motor performance was measured by a precise laboratory test, the Postural-Locomotion-Manual test, using an optoelectronic technique. Anthropometric measurements included body mass index (BMI) and waist-to-hip ratio. Blood samples were drawn for the measurement of total cholesterol, high-density lipoprotein (HDL) cholesterol, and triglyceride concentrations. Results. Motor performance deteriorated with age in a curvilinear way. High BMI, high waist-to-hip ratio, high triglycerides and low HDL cholesterol were all correlated to poor motor performance after adjustment for age, vascular disease, hypertension, diabetes, smoking, physical exercise, and some chronic diseases. Stepwise regression analyses showed that age, waist-to-hip ratio, triglycerides, HDL cholesterol, physical exercise, and vascular diseases were independent predictors of motor performance. Conclusions. High age, high waist-to-hip ratio, high triglycerides, and low HDL cholesterol were associated with poor motor performance in women. Monitoring abdominal adiposity and serum lipids in clinical work might help us to identify people with early motor impairment and to prevent more severe mobility disability.

Placing infants to sleep on their backs does not appear to significantly delay motor development. The American Academy of Pediatrics recommends that infants sleep on their sides or backs, rather than their stomachs, to reduce the risk of sudden infant death syndrome. Parents of 351 infants recorded their sleeping positions and developmental milestones from 2 to 6 months of age. Babies who slept on their stomachs rolled, sat, crawled, and stood earlier than supine sleepers, but all tested babies developed normally, and there was no difference in ages when walking began., Background. As a result of the American Academy of Pediatrics&apos; recommendation that healthy infants be placed on their side or back for sleep, the percentage of infants sleeping prone has decreased dramatically. With the increase in supine sleeping, pediatricians have questioned if there are differences in the rate of acquisition of early motor milestones between prone and supine sleeping infants. Methods. To examine this question, we performed a prospective, practice-based study of healthy term infants. Infants were recruited before the age of 2 months. Parents were asked to record infant sleep position and awake time spent prone until 6 months of age. A developmental log was used to track milestones from birth until the infant was walking. Age of acquisition of eight motor milestones was determined, and the mean ages of milestone attainment of prone and supine sleepers were compared. Results. Three hundred fifty-one infants completed the study. Prone sleepers acquired motor milestones at an earlier age than supine sleepers. There was a significant difference in the age of attainment of rolling prone to supine, tripod sitting, creeping, crawling, and pulling to stand. There was no significant difference in age when infants walked. Conclusions. The pattern of early motor development is affected by sleep position. Prone sleepers attain several motor milestones earlier than supine sleepers. However, all infants achieved all milestones within the accepted normal age range. Pediatricians can use this information to reassure parents. This difference in milestone attainment is not a reason to abandon the American Academy of Pediatrics&apos; sleep position recommendations. sleep position, sudden infant death syndrome, infant development, motor development., ABBREVIATIONS. AAP, American Academy of Pediatrics; SIDS, sudden infant death syndrome. In 1992, the American Academy of Pediatrics[1] (AAP) published a recommendation that "healthy infants, when being put down for [...]

Zinc deficiency has been associated with growth deficits, reduced dietary intake and appetite, and has been hypothesized to result in reduced activity. This randomized, double-blind, placebo-controlled study examined whether 10 mg of oral zinc as zinc sulfate, given daily for up to 7 mo, affected activity patterns of 85 Guatemalan infants recruited at 6-9 mo of age. Infant activity was assessed by time sampling-observation method at 10-min intervals during a 12-h data collection period, at base line, 3 and 7 mo follow-up. Motor development and the percentage of time infants were observed in various positions (being carried, lying down, sitting, crawling, standing or walking) and engaged in various activities (eating, sleeping, resting, crying/whining or playing) were compared by treatment group. No differences in motor development were observed by treatment group. However, at follow-up 2 (after 7 mo of supplementation), zinc-supplemented infants were significantly more frequently observed sitting up compared with lying down, and were playing during 4.18 [+ or -] 1.95% (P < 0.05) more observations than unsupplemented infants. They were also somewhat less likely to be observed crying or whining (P < 0.10) compared with those receiving the placebo. These effects are independent of other factors including infant age, motor development, sex, maternal education, family socioeconomic status and nutritional status at base line. Further research must be conducted to determine the long-term developmental importance of these differences in activity patterns associated with zinc supplementation in this setting. KEY WORDS: zinc; activity; motor activity; infant development; growth; humans

Background. The study addressed whether changes in gait speed in community-dwelling older adults were associated with changes in fitness (strength and aerobic capacity), physical health status, and/or depressive symptoms. Methods. The study sample comprised 152 community-dwelling adults aged 68-85 who had participated in an exercise study. Study measures at baseline and 6-month follow-up included gait speed, a leg strength score, maximal aerobic capacity [Mathematical Expression Omitted], CES-Depression scale, and physical health status (SIP Physical Dimension). Results. In cross-sectional regression analyses, leg strength, [Mathematical Expression Omitted], weight, and the strength by [Mathematical Expression Omitted] interaction term were significant independent predictors of gait speed ([R.sup.2] = 26%). Based upon the observed 7% increase in [Mathematical Expression Omitted] and 8% increase in strength in the exercise groups, the regression model predicted only a 2% (1.5 m/min) increase in gait speed, which did not differ significantly from the observed increase of 0% (.32 m/min). The strongest correlate of change in gait speed was change in CES-D scores (partial R = -.37). Change in physical health status also correlated with change in gait speed (partial R = -.28), while change in fitness did not. Conclusions. The results suggest, in the range of fitness of the study sample, that changes in gait speed are related to changes in depressive symptoms and physical health status, but not to modest changes in fitness. A model assuming nonlinear relationships may be appropriate for understanding how strength and aerobic capacity affect gait speed.

A variety of influences, including perinatal, health, family, and parental factors, affect the early development of children. Usually, studies of these factors examine the effects of single factors. However, attention has recently focused on the cumulative effects of several factors, leading to the consideration of an index approach, in which the presence of multiple factors are evaluated. The relative cumulative effects of health status, which has been poorly studied, as well as perinatal complications, family background, and child rearing on development of cognitive and motor skills were evaluated in 476 girls and 510 boys. Adverse child rearing attitudes and practices were significantly associated with perinatal complications and family adversity for both boys and girls. Adverse family background was also associated with poor level of health in boys. Perinatal complications were associated with IQ and language scores in boys. Family adversity and child-rearing index were predictive of all developmental scores in girls. Health status was significantly related to IQ and motor ability scores in girls, and to motor ability scores in boys. Increasing levels of adverse factors most strongly affected IQ and language skills. The report indicates that developmental screening of children should consider the additive effects of the multiple risk factors described. (Consumer Summary produced by Reliance Medical Information, Inc.)