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When people experience or expect pain, they move differently. Pain-altered movement strategies, collectively described here as pain-related movement dysfunction (PRMD), may persist well after pain resolves and, ultimately, may result in altered kinematics and kinetics, future reinjury, and disability. Although PRMD may manifest as abnormal movements that are often evident in clinical assessment, the underlying mechanisms are complex, engaging sensory-perceptual, cognitive, psychological, and motor processes. Motor control theories provide a conceptual framework to determine, assess, and target processes that contribute to normal and abnormal movement and thus are important for physical therapy and rehabilitation practice. Contemporary understanding of motor control has evolved from reflex-based understanding to a more complex task-dependent interaction between cognitive and motor systems, each with distinct neuroanatomic substrates. Though experts have recognized the importance of motor control in the management of painful conditions, there is no comprehensive framework that explicates the processes engaged in the control of goal-directed actions, particularly in the presence of pain. This Perspective outlines sensory-perceptual, cognitive, psychological, and motor processes in the contemporary model of motor control, describing the neural substrates underlying each process and highlighting how pain and anticipation of pain influence motor control processes and consequently contribute to PRMD. Finally, potential lines of future inquiry-grounded in the contemporary model of motor control--are outlined to advance understanding and improve the assessment and treatment of PRMD. Impact. This Perspective proposes that approaching PRMD from a contemporary motor control perspective will uncover key mechanisms, identify treatment targets, inform assessments, and innovate treatments across sensory-perceptual, cognitive, and motor domains, all of which have the potential to improve movement and functional outcomes in patients with painful conditions. Keywords: Motor Control and Motor Learning, Movement, Pain, Introduction Pain, a complex experience in itself, is further complicated by its reciprocal interactions with movement. (1-5) In the presence or anticipation of pain, people move differently to minimize or [...]

Objective. Children born Methods. In this cohort study, 123 children born Results. Children born Conclusion. Preschool-aged children born Impact. In our study, children born Lay Summary. Preschool-aged children born Keywords: Grip Strength, Motor Function, Preterm Birth, Preschool Child, Physical Activity, Sedentary behavior, Introduction Preterm birth is a substantial cause of global morbidity in childhood. (1) Preschool-aged children born Physical activity (PA) is important in early childhood, as higher PA levels are associated [...]

Objective. Positional plagiocephaly/brachycephaly (PPB) is associated with lower cognitive scores in school-aged children. This study tested the hypothesis that infant motor skills mediate this association. Methods. Children with a history of PPB (cases, n = 187) and without PPB (controls, n = 149) were followed from infancy through approximately 9 years of age. Infant motor skills were assessed using the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-3), and cognition was assessed using the Differential Ability Scales, 2nd edition (DAS-2). The Bayley-3 motor composite was examined as a mediator of the association between PPB and DAS-2 general cognitive ability (GCA) scores. In secondary analyses, mediation models were examined for the DAS-2 verbal ability, nonverbal ability, and working memory scores; models using the Bayley-3 fine versus gross motor scores also were examined. Results. Cases scored lower than controls on the DAS-GCA ([beta] = -4.6; 95% CI = -7 . 2 t o -2.0), with an indirect (mediated) effect of [beta] = -1.5 (95% CI = -2.6 to -0.4) and direct effect of [beta] = -3.1 (95% CI = -5.7 to -0.5). Infant motor skills accounted for approximately 33% of the case-control difference in DAS-2 GCA scores. Results were similar for other DAS-2 outcomes. Evidence of mediation was greater for Bayley-3 gross motor versus fine motor scores. Conclusion. Infant motor skills partially mediate the association between PPB and cognition in school-aged children. Monitoring motor development and providing intervention as needed may help offset associated developmental concerns for children with PPB. Impact. To our knowledge, this study is the first longitudinal investigation of the development of children with and without PPB from infancy through the early school years and the first to examine motor skills as a mediator of cognitive outcomes in this population. The findings highlight the importance of early motor skills for other developmental outcomes. Lay Summary. Infants' motor skills are related to the development of PPB and its association with later cognition. If your child has PPB, physical therapists may have an important role in assessing and providing treatment to promote motor development. Keywords: Infant, Motor Development, Plagiocephaly, Cognitive Function, Introduction Positional plagiocephaly/brachycephaly (PPB) became prevalent after the Back to Sleep campaign to prevent sudden infant death syndrome. (1,2) Assessments and treatments for PPB have focused on the cosmetic effects [...]