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To understand the impact of an intensive rehabilitation program based on exergames in balance and lower limb function in a teenager with cerebral palsy. The rehabilitation program comprised different customised exergames and was delivered in 5 weekly sessions of 30 min for 4 weeks. Pre-, post-, and 1-month Follow-up assessments included the following metrics: Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Gross Motor Function Measure (GMFM), Posturography, and Gait analysis. We observed increased scores after the intervention of 9/72 points in GMF – Module E (Walk, Run and Jump) and of 9/56 points in BBS, sustained at Follow-up. Changes in function, specifically in the quality and independence of the performance of specific movements such as turning 360°, increased distance reaching forward, walk behind, step over obstacles, and step stairs up and down were also observed. Gait kinematics and Spatio-temporal parameters tended to get closer to the 50th percentile. We observed positive changes in motor function of a teenager with cerebral palsy, with sustained increased scores at a 1-month Follow-up. Findings are suggestive that intensive rehabilitation programs using exergames with high customisation features are a potentially valuable rehabilitation tool for training balance in teenagers with Cerebral Palsy. Exergames may be a useful for providing balance training for teenagers who have a mixed form of cerebral palsy. Exergames that require body displacement may be suitable for modulating gait kinematics and spatio-temporal parameters. The customisation of virtual rehabilitation tools seems to impact the motivation and effort of the user positively. [ABSTRACT FROM AUTHOR]

The purpose of this case series was to explore using a child's power mobility learner group (exploratory, operational, or functional) to tailor power mobility interventions. Materials and methods: Five cases representing 2 exploratory power mobility learners, 2 operational power mobility learners, and 1 functional power mobility learner are presented. In each case, the participant's power mobility learner group was used to tailor his/her power mobility intervention program including establishing desired outcomes/goals of power mobility use, selecting outcome measures, determining the power mobility device to be used, and identifying the specific intervention strategies to be used. All participants demonstrated improvements in power mobility device use following provision of the tailored intervention. Cases involving use of the Canadian Occupational Performance Measure demonstrated clinically significant improvements in post-intervention scores. These cases illustrate a means to tailor power mobility interventions that may potentially optimise learning by providing an environment and conditions that meet each child's specific needs. The short-term and long-term gains made by the children in these cases warrants a controlled study exploring the use of a child's power mobility learner group to tailor power mobility interventions. Using a child's power mobility learner group to tailor power mobility intervention may potentially optimise learning by providing an environment and conditions that meet each child's specific needs. Children across the learning continuum represented by the 3 power mobility learner groups (exploratory, operational, and functional) may benefit from power mobility interventions. Using a child's power mobility learner group to tailor power mobility interventions may support translation research knowledge into clinical practice. [ABSTRACT FROM AUTHOR]

Purpose:To validate outcome variables from the limits of stability protocol that are derived from the center of pressure with those same variables derived from the center of mass during rapid, volitional responses in transtibial prosthesis users. Method:Prosthesis users (n = 21) and matched controls (n = 21) executed movements while force and motion data were collected. Correlation coefficients were used to investigate relationships between center of pressure and center of mass for: x/y coordinates positions, limits of stability outcome variables and muscular reaction times. Results:Significant differences were seen in correlation between x/y coordinate positions toward the intact limb (mean effect size of differences:r = .38). Limits of stability variables were positively correlated (reaction time and maximum excursion rangers: .585–.846; directional control and mean velocity rangers: .307–.472). Muscular reaction times correlated weakly with those from center of pressure (meanrsprosthesis users: .186 and controls: .101). Conclusions:Forceplate measures are valid in describing rapid, volitional movements in unilateral transtibial prosthesis users. Limits of stability outcomes extracted from center of pressure and center of mass are highly correlated, but can be sensitive to direction. Muscular reaction time correlates very little with reaction times extracted from the other variables. Implications for rehabilitationRehabilitation programs utilizing limits of stability are valid measures of postural control in transtibial prosthesis users.Clinicians interpreting the outcomes from limits of stability need to be aware of their varying validity.Muscular reaction times correlate weakly with other measures of reaction time, highlighting the complexity of rapidly coordinating volitional movements in prosthesis users. [ABSTRACT FROM PUBLISHER]

Purpose: An investigative study to examine whether sitting ability could be improved through the use of a suite of computer games operated by leaning in one of four directions in a seated position. Method: Young people with cerebral palsy played with a suite of computer games controlled using a sitting platform that can detect changes in the distribution of pressure. A randomized cross-over trial with two periods of three months involving intervention or no intervention was used. Sitting ability was measured at the beginning and end of each period with participants acting as their own controls. Results: Statistically significant improvements were seen in two elements of box sitting using the Chailey levels (shoulder girdle position and spinal profile) and in five elements of the Sitting Assessment for Children with Neuromotor Dysfunction across both reach and rest phases of the assessment. Conclusions: The study provides evidence to suggest that a meaningful and engaging therapeutic activity, such as using computer games controlled by leaning the upper body, can help to improve sitting ability in children with neuromotor dysfunction. Further work is required to understand fully what effects such activities have on the various components of sitting ability. [ABSTRACT FROM AUTHOR]

Purpose. An evaluation of the current research evaluating the impact of seat inclinations upon postural control, muscle activity and upper extremity function in children with cerebral palsy. Method. A literature review searching 13 electronic databases was undertaken. Inclusion criteria were applied to abstracts found; full text research articles were retrieved and a critical review of the eligible articles completed. Results. Ten studies were reviewed which investigated the effect of seat inclinations. Improved postural control and a reduction in pathological movements were achieved in anterior tilt; reduced postural sway was evident for children with spastic cerebral palsy sitting on anterior incline, and increased sway for those with hypotonia; extensor thrust was evoked when in posterior incline; and there was evidence of improved arm and hand function whilst seated in the functional sitting position as opposed a posterior seat incline. Conclusions. (i) The current literature is inconclusive, however there are indications that neutral and anterior seat inclines do positively affect function for children with cerebral palsy; (ii) Individual assessment of seating ability and need is advocated for these children rather than the adoption of a universal seat incline. [ABSTRACT FROM AUTHOR]