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This letter reports lifetime measurements of excited states in the odd-N nucleus 163W using the recoil-distance Doppler shift method to probe the core polarising effect of the i13/2 neutron orbital on the underlying soft triaxial even-even core. The ratio B(E2:21/2⁺ → 17/2⁺)/B(E2:17/2⁺ → 13/2⁺) is consistent with the predictions of the collective rotational model. The deduced B(E2) values provide insights into the validity of collective model predictions for heavy transitional nuclei and a geometric origin for the anomalous B(E2) ratios observed in nearby even-even nuclei is proposed.

This letter reports lifetime measurements of excited states in the odd-N nucleus 163W using the recoil-distance Doppler shift method to probe the core polarising effect of the i13/2 neutron orbital on the underlying soft triaxial even-even core. The ratio B(E2:21/2⁺ → 17/2⁺)/B(E2:17/2⁺ → 13/2⁺) is consistent with the predictions of the collective rotational model. The deduced B(E2) values provide insights into the validity of collective model predictions for heavy transitional nuclei and a geometric origin for the anomalous B(E2) ratios observed in nearby even-even nuclei is proposed.

This letter reports lifetime measurements of excited states in the odd-N nucleus 163W using the recoil-distance Doppler shift method to probe the core polarising effect of the i13/2 neutron orbital on the underlying soft triaxial even-even core. The ratio B(E2:21/2⁺ → 17/2⁺)/B(E2:17/2⁺ → 13/2⁺) is consistent with the predictions of the collective rotational model. The deduced B(E2) values provide insights into the validity of collective model predictions for heavy transitional nuclei and a geometric origin for the anomalous B(E2) ratios observed in nearby even-even nuclei is proposed.

This letter reports lifetime measurements of excited states in the odd-N nucleus 163W using the recoil-distance Doppler shift method to probe the core polarising effect of the i13/2 neutron orbital on the underlying soft triaxial even-even core. The ratio B(E2:21/2⁺ → 17/2⁺)/B(E2:17/2⁺ → 13/2⁺) is consistent with the predictions of the collective rotational model. The deduced B(E2) values provide insights into the validity of collective model predictions for heavy transitional nuclei and a geometric origin for the anomalous B(E2) ratios observed in nearby even-even nuclei is proposed.

This letter reports lifetime measurements of excited states in the odd-N nucleus 163W using the recoil-distance Doppler shift method to probe the core polarising effect of the i13/2 neutron orbital on the underlying soft triaxial even-even core. The ratio B(E2:21/2⁺ → 17/2⁺)/B(E2:17/2⁺ → 13/2⁺) is consistent with the predictions of the collective rotational model. The deduced B(E2) values provide insights into the validity of collective model predictions for heavy transitional nuclei and a geometric origin for the anomalous B(E2) ratios observed in nearby even-even nuclei is proposed.

Lifetime measurements in \(^{178}\)Pt with excited states de-exciting through \(\gamma\)-ray transitions and internal electron conversions have been performed. Ionic charges were selected by the in-flight mass separator MARA and measured at the focal plane in coincidence with the \(4^{+}_{1}→2^{+}_{1}\) 257 keV γ-ray transition detected using the JUROGAM 3 spectrometer. The resulting charge-state distributions were analysed using the differential decay curve method (DDCM) framework to obtain a lifetime value of 430(20) ps for the \(2^{+}_{1}\) state. This work builds on a method that combines the charge plunger technique with the DDCM analysis. As an alternative analysis, ions were selected in coincidence with the \(^{178}\)Pt alpha decay (\(E_{\mathrm {alpha}} = 5.458(5)\) MeV) at the focal plane. Lifetime information was obtained by fitting a two-state Bateman equation to the decay curve with the lifetime of individual states defined by a single quadrupole moment. This yielded a lifetime value of 430(50) ps for the \(2^{+}_{1}\) state, and 54(6) ps for the \(4^{+}_{1}\) state. An analysis method based around the Bateman equation will become especially important when using the charge plunger method for the cases where utilising coincidences between prompt \(\gamma\) rays and recoils is not feasible.

Lifetime measurements in Pt-178 with excited states de-exciting through gamma-ray transitions and internal electron conversions have been performed. Ionic charges were selected by the in-flight mass separatorMARAand measured at the focal plane in coincidence with the 4(1)(+) -> 2(1)(+) 257 keV gamma-ray transition detected using the JUROGAM 3 spectrometer. The resulting charge-state distributions were analysed using the differential decay curve method (DDCM) framework to obtain a lifetime value of 430(20) ps for the 2(1)(+) state. This work builds on a method that combines the charge plunger technique with the DDCM analysis. As an alternative analysis, ions were selected in coincidence with the Pt-178 alpha decay (E-alpha = 5.458(5) MeV) at the focal plane. Lifetime informationwas obtained by fitting a two-state Bateman equation to the decay curve with the lifetime of individual states defined by a single quadrupolemoment. This yielded a lifetime value of 430(50) ps for the 2(1)(+) state, and 54(6) ps for the 4(1)(+) state. An analysis method based around the Bateman equation will become especially important when using the charge plunger method for the cases where utilising coincidences between prompt gamma rays and recoils is not feasible.

Lifetime measurements in Pt-178 with excited states de-exciting through gamma-ray transitions and internal electron conversions have been performed. Ionic charges were selected by the in-flight mass separatorMARAand measured at the focal plane in coincidence with the 4(1)(+) -> 2(1)(+) 257 keV gamma-ray transition detected using the JUROGAM 3 spectrometer. The resulting charge-state distributions were analysed using the differential decay curve method (DDCM) framework to obtain a lifetime value of 430(20) ps for the 2(1)(+) state. This work builds on a method that combines the charge plunger technique with the DDCM analysis. As an alternative analysis, ions were selected in coincidence with the Pt-178 alpha decay (E-alpha = 5.458(5) MeV) at the focal plane. Lifetime informationwas obtained by fitting a two-state Bateman equation to the decay curve with the lifetime of individual states defined by a single quadrupolemoment. This yielded a lifetime value of 430(50) ps for the 2(1)(+) state, and 54(6) ps for the 4(1)(+) state. An analysis method based around the Bateman equation will become especially important when using the charge plunger method for the cases where utilising coincidences between prompt gamma rays and recoils is not feasible.

A charge plunger device has been commissioned based on the DPUNS plunger (Taylor et al., 2013) using the in-flight mass separator MARA at the University of Jyväskylä. The ¹⁵²Sm(³²S,4n)¹⁸⁰ reaction was used to populate excited states in ¹⁸⁰. A lifetime measurement of the state \(2_1^+\) was performed by applying the charge plunger technique, which relies on the detection of the charge state-distribution of recoils rather than the detection of the emitted γ rays. This state was a good candidate to test the charge plunger technique as it has a known lifetime and depopulates through a converted transition that competes strongly with γ-ray emission. The lifetime of the \(2_1^+\) state was measured to be 480(10)ps, which is consistent with previously reported lifetimes that relied on the standard γ-ray techniques. The charge plunger technique is a complementary approach to lifetime measurements of excited states that depopulate through both γ-ray emission and internal conversion. In cases where it is not possible to detect Doppler-shifted γ rays, for example, in heavy nuclei where internal conversion dominates, it may well be the only feasible lifetime analysis approach.

© 2020 We are proposing optimal training conditions that can lead to an increase in the number of serial sarcomeres (SSN) and muscle fascicle length (FL) in spastic muscles. Therapeutic interventions for increasing FL in clinical populations with neurological origin, in whom relative shortness of muscle fascicles contributed to the presentation of symptoms such as spasticity, contracture, and limited functional abilities, do not generally meet these conditions, and therefore, result in less than satisfactory outcomes. Based on a review of literature, we argue that protocols of exercise interventions that led to sarcomerogenesis, and increases in SSN and FL in healthy animal and human models satisfied three criteria: 1) all involved eccentric exercise at appropriately high velocity; 2) resulted in positive strain of muscle fascicles; and 3) momentary deactivation in the stretched muscle. Accordingly, to increase FL in spastic muscles, new exercise protocols in which the three presumed criteria are satisfied, must be developed, and long-term muscle architectural and functional adaptations to such trainings must be examined.

A new method of extracting the gamma-ray intensities necessary to perform lifetime measurements using the differential decay curve method (DDCM) is presented in this work, the unresolved Doppler-shifted components method (UDCM). The UDCM allows for a DDCM analysis to be performed using a gamma-ray transition for which the fully Doppler-shifted and degraded components are unresolvable in energy and so are detected as a single peak. This technique was used to measure the known lifetime of the yrast 2(1)(+) state in Mn-50 with a depopulating transition that does not have resolvable fully Doppler-shifted and degraded components. The lifetime measured through applying the UDCM was consistent with the standard DDCM measurement of the 2(1)(+) state. Use of the UDCM allows for DDCM lifetime measurements to be made using transitions of smaller gamma-ray energies, smaller recoil velocities and, in some cases, with a smaller uncertainty. In contrast to a standard DDCM analysis, a UDCM analysis is also independent of the widths of the fully Doppler-shifted and degraded components and as a result they do not need to be determined.

A charge plunger device has been commissioned based on the DPUNS plunger (Taylor a al., 2013) using the in-flight mass separator MARA at the University of Jyvaskyla. The Sm-152(S-32,4n)Pt-180 reaction was used to populate excited states in Pt-180. A lifetime measurement of the 2(1)(+ )state was performed by applying the charge plunger technique, which relies on the detection of the charge state-distribution of recoils rather than the detection of the emitted gamma rays. This state was a good candidate to test the charge plunger technique as it has a known lifetime and depopulates through a converted transition that competes strongly with gamma-ray emission. The lifetime of the 2(1)(+) state was measured to be 480(10) ps, which is consistent with previously reported lifetimes that relied on the standard gamma-ray techniques. The charge plunger technique is a complementary approach to lifetime measurements of excited states that depopulate through both gamma-ray emission and internal conversion. In cases where it is not possible to detect Doppler-shifted gamma rays, for example, in heavy nuclei where internal conversion dominates, it may well be the only feasible lifetime analysis approach.

© 2020 We are proposing optimal training conditions that can lead to an increase in the number of serial sarcomeres (SSN) and muscle fascicle length (FL) in spastic muscles. Therapeutic interventions for increasing FL in clinical populations with neurological origin, in whom relative shortness of muscle fascicles contributed to the presentation of symptoms such as spasticity, contracture, and limited functional abilities, do not generally meet these conditions, and therefore, result in less than satisfactory outcomes. Based on a review of literature, we argue that protocols of exercise interventions that led to sarcomerogenesis, and increases in SSN and FL in healthy animal and human models satisfied three criteria: 1) all involved eccentric exercise at appropriately high velocity; 2) resulted in positive strain of muscle fascicles; and 3) momentary deactivation in the stretched muscle. Accordingly, to increase FL in spastic muscles, new exercise protocols in which the three presumed criteria are satisfied, must be developed, and long-term muscle architectural and functional adaptations to such trainings must be examined.

A new method of extracting the gamma-ray intensities necessary to perform lifetime measurements using the differential decay curve method (DDCM) is presented in this work, the unresolved Doppler-shifted components method (UDCM). The UDCM allows for a DDCM analysis to be performed using a gamma-ray transition for which the fully Doppler-shifted and degraded components are unresolvable in energy and so are detected as a single peak. This technique was used to measure the known lifetime of the yrast 2(1)(+) state in Mn-50 with a depopulating transition that does not have resolvable fully Doppler-shifted and degraded components. The lifetime measured through applying the UDCM was consistent with the standard DDCM measurement of the 2(1)(+) state. Use of the UDCM allows for DDCM lifetime measurements to be made using transitions of smaller gamma-ray energies, smaller recoil velocities and, in some cases, with a smaller uncertainty. In contrast to a standard DDCM analysis, a UDCM analysis is also independent of the widths of the fully Doppler-shifted and degraded components and as a result they do not need to be determined.

A charge plunger device has been commissioned based on the DPUNS plunger (Taylor a al., 2013) using the in-flight mass separator MARA at the University of Jyvaskyla. The Sm-152(S-32,4n)Pt-180 reaction was used to populate excited states in Pt-180. A lifetime measurement of the 2(1)(+ )state was performed by applying the charge plunger technique, which relies on the detection of the charge state-distribution of recoils rather than the detection of the emitted gamma rays. This state was a good candidate to test the charge plunger technique as it has a known lifetime and depopulates through a converted transition that competes strongly with gamma-ray emission. The lifetime of the 2(1)(+) state was measured to be 480(10) ps, which is consistent with previously reported lifetimes that relied on the standard gamma-ray techniques. The charge plunger technique is a complementary approach to lifetime measurements of excited states that depopulate through both gamma-ray emission and internal conversion. In cases where it is not possible to detect Doppler-shifted gamma rays, for example, in heavy nuclei where internal conversion dominates, it may well be the only feasible lifetime analysis approach.

Lifetimes of the T = 1 isobaric analog I-pi = 2(+) states in Mn-50 and Cr-50 were measured simultaneously by employing the recoil distance Doppler-shift (RDDS) technique. The states were populated in a fusion- evaporation reaction with a C-12 beam on a Ca-40 target. An analysis of the data and the calculations from the present work, together with the available B(E2 : 2(+) -> 0(+)) data of the isobaric analog states in Fe-50 and Cr-50, were used to study isospin symmetry in the three A = 50 isobaric nuclei. Shell-model calculations reproduce the magnitudes as well as the increasing trend of the B(E2) data with increasing Z. To draw a firm conclusion on the level of isospin mixing in the triplet, a new precision measurement of the 2(+) -> 0(+) transition rate in Fe-50 will be required.

This letter reports lifetime measurements of excited states in the odd-N nucleus W-163 using the recoil-distance Doppler shift method to probe the core polarising effect of the i(13/2) neutron orbital on the underlying soft triaxial even-even core. The ratio B(E2:21/2(+) -> 17/2(+))/B(E2:17/2(+) -> 13/2(+)) is consistent with the predictions of the collective rotational model. The deduced B(E2) values provide insights into the validity of collective model predictions for heavy transitional nuclei and a geometric origin for the anomalous B(E2) ratios observed in nearby even-even nuclei is proposed. (C) 2019 The Authors. Published by Elsevier B.V.

This study assessed the validity, intra-rater and inter-rater reliability of segmentation of in vivo medial gastrocnemius (MG), lateral gastrocnemius (LG) and soleus (SOL) muscle volume measurement using a single sweep freehand 3D ultrasound (3DUS) in children with cerebral palsy (CP). The MG, LG and SOL of both limbs of 18 children with CP (age 8 years 4 months ± 1 year 10 months, 11 males, unilateral CP = 9, bilateral CP = 9, Gross Motor Functional Classification System I = 11, II = 7) were scanned using freehand 3DUS and magnetic resonance imaging (MRI). All freehand 3DUS and MRI images were segmented and volumes rendered by two raters. Validity was assessed using limits of agreement method. Intra-rater and inter-rater reliability was assessed using intra-class correlation (ICC), coefficient of variance (CV) and minimal detectable change (MDC). Freehand 3DUS overestimated muscle volume of the MG and LG by < 0.3 mL (1%) and underestimated SOL by < 1.3 mL (1.5%) compared with MRI. ICCs for intra-rater reliability of the segmentation process for the freehand 3DUS system and MRI for muscle volume were > 0.98 and 0.99, respectively, for all muscles. ICCs for inter-rater reliability of the segmentation process for freehand 3DUS and MRI volumes were > 0.96 and 0.98, respectively, for all muscles. MDCs for single rater freehand 3DUS and MRI were < 4.0 mL (14%) and 3.2 mL (11%), respectively, in all muscles. Freehand 3DUS is a valid and reliable method for the measurement of lower leg muscle volume that can be measured with a single sweep in children with CP in vivo. It can be used as an alternative to MRI for the detection of clinically relevant changes in calf muscle volume as the result of growth and interventions.

Lifetimes of the T = 1 isobaric analog I-pi = 2(+) states in Mn-50 and Cr-50 were measured simultaneously by employing the recoil distance Doppler-shift (RDDS) technique. The states were populated in a fusion- evaporation reaction with a C-12 beam on a Ca-40 target. An analysis of the data and the calculations from the present work, together with the available B(E2 : 2(+) -> 0(+)) data of the isobaric analog states in Fe-50 and Cr-50, were used to study isospin symmetry in the three A = 50 isobaric nuclei. Shell-model calculations reproduce the magnitudes as well as the increasing trend of the B(E2) data with increasing Z. To draw a firm conclusion on the level of isospin mixing in the triplet, a new precision measurement of the 2(+) -> 0(+) transition rate in Fe-50 will be required.

This letter reports lifetime measurements of excited states in the odd-N nucleus W-163 using the recoil-distance Doppler shift method to probe the core polarising effect of the i(13/2) neutron orbital on the underlying soft triaxial even-even core. The ratio B(E2:21/2(+) -> 17/2(+))/B(E2:17/2(+) -> 13/2(+)) is consistent with the predictions of the collective rotational model. The deduced B(E2) values provide insights into the validity of collective model predictions for heavy transitional nuclei and a geometric origin for the anomalous B(E2) ratios observed in nearby even-even nuclei is proposed. (C) 2019 The Authors. Published by Elsevier B.V.

A differential- plunger device was used to measure the lifetimes of the lowest states in the pi g(7/2) circle times nu h(11/2) rotational band in doubly odd I-112 with the Ni-58(Ni-58, 3pn) reaction. A differential decay curve method was performed using the fully shifted and degraded gamma-ray intensity measurements as a function of target- to- degrader distance. The lifetimes of the lowest three states in the pi g(7/2) circle times nu h(11/2) band in I-112 were measured to be 124(30), 130(25), and <= 6.5(5) ps, respectively. As the lifetimes of successive excited states in a rotational band are expected to decrease with increasing excitation energy, these measurements suggest that the order of the transitions in the established band in I-112 may need revising and that the state tentatively assigned to be (7(-)) may not belong to the rotational band.

A differential- plunger device was used to measure the lifetimes of the lowest states in the pi g(7/2) circle times nu h(11/2) rotational band in doubly odd I-112 with the Ni-58(Ni-58, 3pn) reaction. A differential decay curve method was performed using the fully shifted and degraded gamma-ray intensity measurements as a function of target- to- degrader distance. The lifetimes of the lowest three states in the pi g(7/2) circle times nu h(11/2) band in I-112 were measured to be 124(30), 130(25), and <= 6.5(5) ps, respectively. As the lifetimes of successive excited states in a rotational band are expected to decrease with increasing excitation energy, these measurements suggest that the order of the transitions in the established band in I-112 may need revising and that the state tentatively assigned to be (7(-)) may not belong to the rotational band.

This study assessed the validity, intra-rater and inter-rater reliability of segmentation of in vivo medial gastrocnemius (MG), lateral gastrocnemius (LG) and soleus (SOL) muscle volume measurement using a single sweep freehand 3D ultrasound (3DUS) in children with cerebral palsy (CP). The MG, LG and SOL of both limbs of 18 children with CP (age 8 years 4 months ± 1 year 10 months, 11 males, unilateral CP = 9, bilateral CP = 9, Gross Motor Functional Classification System I = 11, II = 7) were scanned using freehand 3DUS and magnetic resonance imaging (MRI). All freehand 3DUS and MRI images were segmented and volumes rendered by two raters. Validity was assessed using limits of agreement method. Intra-rater and inter-rater reliability was assessed using intra-class correlation (ICC), coefficient of variance (CV) and minimal detectable change (MDC). Freehand 3DUS overestimated muscle volume of the MG and LG by < 0.3 mL (1%) and underestimated SOL by < 1.3 mL (1.5%) compared with MRI. ICCs for intra-rater reliability of the segmentation process for the freehand 3DUS system and MRI for muscle volume were > 0.98 and 0.99, respectively, for all muscles. ICCs for inter-rater reliability of the segmentation process for freehand 3DUS and MRI volumes were > 0.96 and 0.98, respectively, for all muscles. MDCs for single rater freehand 3DUS and MRI were < 4.0 mL (14%) and 3.2 mL (11%), respectively, in all muscles. Freehand 3DUS is a valid and reliable method for the measurement of lower leg muscle volume that can be measured with a single sweep in children with CP in vivo. It can be used as an alternative to MRI for the detection of clinically relevant changes in calf muscle volume as the result of growth and interventions.

Purpose: This study aimed to investigate the efficacy of a 12-wk combined functional anaerobic and strength training program on neuromuscular properties and functional capacity in young adults with spastic-type cerebral palsy. Methods: A total of 17 young adults (21 ± 4 yr, 9 males, Gross Motor Function Classification System I = 11 and II = 6) were randomized to 12 wk, 3 sessions per week, of high-intensity functional anaerobic and progressive resistance training of the lower limbs (n = 8), or a waitlist control group (n = 9). Pre- and posttraining plantarflexor and tibialis anterior muscle volumes and composition, passive and active plantarflexor muscle properties, and functional capacity outcomes were assessed. Results: The training group had higher values compared with the control group (adjusted mean difference) at 12 wk for the following: More- and less-impaired total plantarflexor and tibialis anterior muscle volumes, maximum isometric plantarflexion strength, muscle power sprint test peak power, agility shuttle time, composite functional strength score, and 6-min walk test distance. The change in total plantarflexor muscle volume was associated with the change in plantarflexor muscle strength. There were relationships between the change in plantarflexor muscle strength and the change in functional capacity outcomes (functional strength; 6-min walk test). Conclusions: Combined functional anaerobic and strength training increased muscle size, strength, and functional capacity in young adults with cerebral palsy. The addition of anaerobic training to progressive resistance training programs assists in the transfer to improved functional capacity.

Objective: To investigate the relation between lower limb muscle strength, passive muscle properties, and functional capacity outcomes in adults with cerebral palsy (CP). Design: Cross-sectional study. Setting: Tertiary institution biomechanics laboratory. Participants: Adults with spastic-type CP (N=33; mean age, 25y; range, 15–51y; mean body mass, 70.15±21.35kg) who were either Gross Motor Function Classification System (GMFCS) level I (n=20) or level II (n=13). Interventions: Not applicable. Main Outcome Measures: Six-minute walk test (6MWT) distance (m), lateral step-up (LSU) test performance (total repetitions), timed up-stairs (TUS) performance (s), maximum voluntary isometric strength of plantar flexors (PF) and dorsiflexors (DF) (Nm.kg -1 ), and passive ankle joint and muscle stiffness. Results: Maximum isometric PF strength independently explained 61% of variance in 6MWT performance, 57% of variance in LSU test performance, and 50% of variance in TUS test performance. GMFCS level was significantly and independently related to all 3 functional capacity outcomes, and age was retained as a significant independent predictor of LSU and TUS test performance. Passive medial gastrocnemius muscle fascicle stiffness and ankle joint stiffness were not significantly related to functional capacity measures in any of the multiple regression models. Conclusions: Low isometric PF strength was the most important independent variable related to distance walked on the 6MWT, fewer repetitions on the LSU test, and slower TUS test performance. These findings suggest lower isometric muscle strength contributes to the decline in functional capacity in adults with CP.

© 2017 World Federation for Ultrasound in Medicine and Biology Three-dimensional ultrasound (3-DUS) was used to examine the size and appearance of the medial gastrocnemius (MG) muscle in children with unilateral cerebral palsy (CP). Twenty-six children with CP and 10 typically developing (TD) children participated. Three-dimensional US images of both limbs in children with CP and the right limb in TD children were analysed using quantitative methods to determine muscle volume, global echo intensity, global echo pattern and regional echo intensity. Significant differences in MG volume and all echo parameters were found between TD and CP children. The more involved limb was smaller and had higher echo intensity and a more heterogenous echo pattern compared with the TD group. Compared with that of the more involved limb, the MG of the less involved limb was larger but had a similar echo appearance. The MG of both limbs in children with unilateral spastic CP is smaller and, based on quantitative ultrasound, structurally different from that of TD children.

Background: Serial lower limb intramuscular Botulinum toxin-A (BoNT-A) injections are administered to children with bilateral spastic cerebral palsy (BCP) to reduce spasticity, improve walking and functional mobility, and delay the need for orthopaedic surgery. Gait quality is clinically assessed following BoNT-A with 2D video gait assessments (2DVGA) using the Edinburgh Visual Gait Score (EVGS). Aim: To determine the effect of three consecutive treatment cycles of lower limb intramuscular BoNT-A injections on gait quality using the EVGS in children with BCP by retrospectively reviewing repeated 2DVGA measures. Methods and procedures: Seventeen children with BCP and dynamic equinus (8 females and 9 males, age mean (SD), 4.0 (2.2) years, GMFCS I = 2 and II = 15) were included in the study after a retrospective audit of the records of the Queensland Children’s Gait Laboratory (QCGL), Children’s Health Queensland, Brisbane. The medical records of children who attended the QCGL between January 2001 and January 2016 were searched for eligibility. Children who had undertaken pre- and post-treatment 2DVGA for the first three lower limb BoNT-A treatment cycles (6 assessments) were reviewed using the EVGS. BoNT-A treatments were administered 7.7 (2.3) months apart and post-BoNT-A reviews occurred 12.6 (6.7) weeks after injection. Mixed-effects linear regression assessed the change from baseline to each subsequent assessment (p < 0.05). Outcomes and results: EVGS reduced significantly by a mean of 2.4 points from pre- to post-BoNT-A in the first treatment cycle (p = 0.001). Compared to baseline, mean total EVGS reduced significantly during the second (pre-BoNT-A −1.7 (p = 0.020), post BoNT-A −2.8 (p < 0.001)) and third (pre-BoNT-A −2.6 (p = 0.001), post BoNT-A −2.4 (p = 0.002)) treatment cycles. There was no difference in EVGS between post-BoNT-A in the first treatment cycle and scores for the second and third treatment cycles. Conclusions and implications: Improvements in ga

© 2017 Wolters Kluwer Health, Inc. and Academy of Pediatric Physical Therapy of the American Physical Therapy Association. Purpose: To evaluate the validity of the ActiGraph accelerometer (AG) to differentiate between standardized, physical activity tasks using oxygen consumption (o 2) as the criterion measure in children and adolescents with an acquired brain injury; to determine vector magnitude activity intensity cut-points; to compare performance of cut-points to previously published cut-points. Methods: Twenty-seven children performed standardized walking and stepping activities wearing a portable indirect calorimeter, AG, and heart rate monitor. Differences in o 2 and AG vector magnitude activity counts were measured during activities. Receiver operating characteristic curves were determined for intensity cut-points. Results: o 2 and AG activity counts significantly increased as walking speed increased. Discrimination of the newly derived cut-points was excellent and demonstrated greater agreement compared with the previously published cut-points. Conclusion: Output from accelerometers can differentiate physical activity intensity in children with an acquired brain injury. Future studies can apply these cut-points to evaluate physical activity performance.

Objectives: Cerebral palsy (CP) remains the world's most common childhood physical disability with total annual costs of care and lost well-being of $A3.87b. The PREDICT-CP (NHMRC 1077257 Partnership Project: Comprehensive surveillance to PREDICT outcomes for school age children with CP) study will investigate the influence of brain structure, body composition, dietary intake, oropharyngeal function, habitual physical activity, musculoskeletal development (hip status, bone health) and muscle performance on motor attainment, cognition, executive function, communication, participation, quality of life and related health resource use costs. The PREDICT-CP cohort provides further follow-up at 8-12 years of two overlapping preschool-age cohorts examined from 1.5 to 5 years (NHMRC 465128 motor and brain development; NHMRC 569605 growth, nutrition and physical activity). Methods and analyses: This population-based cohort study undertakes state-wide surveillance of 245 children with CP born in Queensland (birth years 2006-2009). Children will be classified for Gross Motor Function Classification System; Manual Ability Classification System, Communication Function Classification System and Eating and Drinking Ability Classification System. Outcomes include gross motor function, musculoskeletal development (hip displacement, spasticity, muscle contracture), upper limb function, communication difficulties, oropharyngeal dysphagia, dietary intake and body composition, participation, parent-reported and child-reported quality of life and medical and allied health resource use. These detailed phenotypical data will be compared with brain macrostructure and microstructure using 3 Tesla MRI (3T MRI). Relationships between brain lesion severity and outcomes will be analysed using multilevel mixed-effects models. Ethics and dissemination: The PREDICT-CP protocol is a prospectively registered and ethically accepted study protocol. The study combines data at 1.5-5 then 8-12 years of di

Objective: To compare efficacy of a web-based multimodal training programme, 'Move it to improve it' (MitiiTM), to usual care on gross motor capacity and performance for children with an acquired brain injury. Design: Randomized waitlist controlled trial. Setting: Home environment. Participants: A total of 60 independently ambulant children (30 in each group), minimum 12 months post-acquired brain injury were recruited and randomly allocated to receive either 20 weeks of MitiiTM training (30 minutes/day, six days/week, total 60 hours) immediately, or waitlisted (usual care control group) for 20 weeks. A total of 58 children completed baseline assessments (32 males; age 11 years 11 months ± 2 years 6 months; Gross Motor Function Classification System equivalent I = 29, II = 29). Intervention: The MitiiTM program comprised of gross motor, upper limb and visual perception/cognitive activities. Main measures: The primary outcome was 30-second, repetition maximum functional strength tests for the lower limb (sit-to-stand, step-ups, half-kneel to stand). Secondary outcomes were the 6-minute walk test, High-level Mobility Assessment Tool, Timed Up and Go Test and habitual physical activity as captured by four-day accelerometry. Results: Groups were equivalent at baseline on demographic and clinical measures. The MitiiTM group demonstrated significantly greater improvements on combined score of functional strength tests (mean difference 10.19 repetitions; 95% confidence interval, 3.26-17.11; p = 0.006) compared with the control group. There were no other between-group differences on secondary outcomes. Conclusion: Although the MitiiTM programme demonstrated statistically significant improvements in the functional strength tests of the lower limb, results did not exceed the minimum detectable change and cannot be considered clinically relevant for children with an acquired brain injury. Clinical Trial Registration: Australian New Zealand Clinical Trials Registration Number

Aim: To examine characteristics associated with physical activity capacity and performance in children with acquired brain injury (ABI). Methods: 58 children (32 men; age 11 years 11 months ± 2 years 6 months; Gross motor function classification system [GMFCS] equivalent I = 29, II = 29) >12 months post ABI were recruited. Physical activity capacity measures included: (i) combined score of three 30-second repetition maximum functional strength exercises; (ii) timed up and go; (iii) 6-minute walk test and (iv) high-level mobility assessment tool (HiMAT). Physical activity performance determined time spent in sedentary, light and moderate to vigorous physical activity (MVPA). Full scale intelligence quotient (FSIQ) was assessed using the Wechsler intelligence scale for Children-IV. Regression models were constructed with functional strength score (n = 56), activity counts/minutes and time spent in MVPA and sedentary (n = 37). Results: The HiMAT and FSIQ explained 69% of the variance in functional strength. Age explained 12% of the variance in counts/min and 14% of the variance in time spent sedentary. GMFCS explained 10% of the variance in time spent in MVPA. Conclusions: The ability to perform functional strength exercises is associated with mobility beyond independence and adequate intellectual ability for children with ABI. Age was the most significant factor associated with physical activity performance, and interventions should target adolescents with ABI.

© 2017 Mac Keith Press.Aim: This study investigates the in vivo function of the medial gastrocnemius and soleus muscle-tendon units (MTU), fascicles, and tendons during walking in children with cerebral palsy (CP) and an equinus gait pattern. Method: Fourteen children with CP (9 males, 5 females; mean age 10y 6mo, standard deviation [SD] 2y 11mo; GMFCS level I=8, II=6), and 10 typically developing (6 males, 4 females; mean age 10y, SD 2y 1mo) undertook full body 3D gait analysis and simultaneous B-mode ultrasound images of the medial gastrocnemius and soleus fascicles during level walking. Fascicle lengths were analysed using a semi-automated tracking algorithm and MTUs using OpenSim. Statistical parametric mapping (two-sample t-test) was used to compare differences between groups (p<0.05). Results: In the CP group medial gastrocnemius fascicles lengthened during mid-stance gait and remained longer into late-stance compared to the typically developing group (p<0.001). CP medial gastrocnemius fascicles shortened less during stance (1.16mm [SD 1.47mm]) compared to the typically developing group (4.48mm [SD 1.94mm], p<0.001). In the CP group the medial gastrocnemius and soleus MTU and tendon were longer during early- and mid-stance (p<0.001). Ankle power during push-off (p=0.015) and positive work (p<0.002) and net work (p<0.001) were significantly lower in the CP group. Interpretation: Eccentric action of the CP medial gastrocnemius muscle fascicles during mid-stance walking is consistent with reduced volume and neuromuscular control of impaired muscle. Reduced ankle push-off power and positive work in the children with CP may be attributed to reduced active medial gastrocnemius fascicle shortening. These findings suggest a reliance on passive force generation for forward propulsion during equinus gait.

Aim: To systematically review the efficacy of physiotherapy interventions to improve gross motor capacity, performance and societal participation in children aged 5–17 years with an acquired brain injury (ABI). Methods: Randomized and non-randomized controlled trials, cohort, case series, case-control and case studies were included and classified according to grades of evidence. Methodological quality of studies was assessed using the Downs and Black (D&B) scale and quantitative data was analysed using effect sizes. Results: Two home-based studies investigated functional strength training (one ’randomized controlled trial, n = 20, level 2b, D&B = 16/32 and one non-randomized self-control study, n = 19, level 4, D&B = 15/32). Four studies evaluated virtual reality including: one pilot study, n = 50, level 4, D&B = 22/32; one single-subject, non-concurrent, randomized multiple baseline study, n = 3, level 4, D&B = 15/32; one case series study, n = 2, level 4, D&B = 15/32; one case study, n = 1, level 4, D&B = 15/32. Effect sizes for the ’randomized controlled trial ranged between 0.30–1.29 for the Functional Reach and Timed Up and Go outcome measures. Conclusion: There is preliminary evidence to support the efficacy of physiotherapy interventions to improve gross motor outcomes in children with an ABI. Both functional strength training and virtual-reality based therapy are potential treatment options for clinicians to prescribe in either home or clinical settings.

Aim: Calf muscle growth in children with unilateral cerebral palsy (UCP) and bilateral cerebral palsy (BCP) is unknown. This cross-sectional study examines the medial gastrocnemius growth rates of ambulatory children with UCP and BCP compared with children with typical development (CTD), aged 2 to 9 years. Method: Fifty children with UCP (mean age 66mo [SD 18], 29 males, Gross Motor Function Classification System [GMFCS] I=32, II=18), 50 children with BCP (age 64mo [SD 19], 31 males, GMFCS I=21, II=29), and 78 CTD (age 64mo [SD 16], 40 males) participated in the study. The medial gastrocnemius muscle volume was measured at rest using a validated freehand three-dimensional (3D) ultrasound method. Results: Normalized medial gastrocnemius muscle growth rate was significantly less in the children with UCP (0.001 mL/kg/mo) compared with the BCP (0.015 mL/kg/mo, p=0.001) and CTD (0.014 mL/kg/mo, p<0.001) groups. Normalized medial gastrocnemius muscle growth rate was the same in the BCP and CTD groups (p=0.77). Interpretation: The normalized growth rate of the medial gastrocnemius muscle in children aged 2 to 9 years with UCP is significantly lower compared with children with BCP and CTD. The growth rate differences in the children with UCP compared with BCP raises questions about the underlying mechanisms that lead to reduced growth in each cerebral palsy (CP) group and potential differences in muscle recovery response in UCP and BCP following treatment.

Objective: To determine test–re-test reproducibility of the Timed Up & Go (TUG) test, 30-second repetition maximum (repmax) of functional exercises, 6-Minute Walk Test (6MWT) and High-level Mobility Assessment Tool (HiMAT) in children with Acquired Brain Injury (ABI). Secondarily, to assess the accuracy between hand-timed and video-timed scores for the TUG test and HiMAT. Methods: Thirty children at least 1 year post-ABI (mean age at assessment = 11 years 11 months, SD = 2 years 4 months; 14 males; Gross Motor Function Classification Scale I = 17, II = 13) were assessed twice. Intra-class correlation coefficients (ICC), standard error of measurement and minimum detectable change (MDC) were determined. The Bland-Altman method and 95% limits of agreement (LOA) were used to assess the agreement between hand and video-timed TUG test and HiMAT scores. Results: Test–re-test reproducibility was acceptable for the TUG test (ICC = 0.92; MDC = 1.2s); repmax of functional exercises (ICC = 0.84–0.98; MDC = 4–8 reps); 6MWT (ICC = 0.90; MDC = 69.38 m) and HiMAT (ICC = 0.98; MDC = 6). Comparison of hand and video scores for the TUG test and HiMAT demonstrated a mean difference of 0.23 (LOA = –0.3–0.7) and –0.07 (LOA = –1.99–1.85), respectively. Conclusions Test–re-test reproducibility of lower limb activity capacity measures in children with ABI are acceptable. The MDC scores provide a useful reference to interpret treatment effectiveness. Video timing was more accurate than hand-timing for the TUG test.

Aim: The aim of this study was to systematically review the current literature to determine the impact of strength training on skeletal muscle morphology and architecture in individuals aged 4-20 years with spastic type cerebral palsy. Methods: A comprehensive search for randomised and non-randomised controlled trials, cohort studies and cross-comparison trials was performed on five electronic databases. Included studies were graded according to level of evidence and assessed for methodological quality using the Downs and Black scale. Quantitative data was analysed using effect sizes. Results: Six of 304 articles met the inclusion criteria. Methodological quality of the included papers ranged from 14 to 19 (out of 32). A large effect was found on muscle cross-sectional area following strength training, with small to moderate effects on muscle volume and thickness. Conclusion and implications: There is preliminary evidence that strength training leads to hypertrophy in children and adolescents with CP. A paucity of studies exist measuring morphological and architectural parameters following strength training in these individuals. Overall low study methodological quality along with heterogeneous study design, dissimilar outcome measures, and lack of adequate control groups, indicated that care is needed when interpreting the results of these studies in isolation.

© 2016 Taylor & Francis Group, LLC. Aim: To examine the reproducibility in measurement of physical activity performance using the ActiGraph® GT3X+ accelerometer in children aged 8–16 years with Acquired Brain Injury (ABI). Methods: Reproducibility of standardized tasks: Thirty-two children with ABI (12 years 1 month, SD = 2 years 4 months; 20 males; Gross Motor Function Classification System I = 17, II = 15) performed the following activities on 2 consecutive days while wearing an accelerometer and a heart rate monitor: quiet sitting, slow walking (SW), moderate walking (MW), fast walking (FW) and rapid stepping on/off a block (STEP). Intra-class correlation coefficients (ICC) were calculated. Performance variability: Fifty-one participants (12 years 1 month, SD = 2 years 5 months; 27 males; GMFCS I = 26, II = 25) wore an accelerometer for 4 days in the community and reliability coefficients were calculated using standardized 12-hour time spent in moderate-to-vigorous physical activity (MVPA). Results: Test–re-test reproducibility was excellent for all activities (SW, ICC = 0.90; MW, ICC = 0.83; FW, ICC = 0.91; STEP, ICC = 0.89). Three days of monitoring produced excellent variability estimates of MVPA (R = 0.78). Conclusion: Therapists can confidently use accelerometry as a reproducible measure of physical activity under standardized walking and stepping conditions, as well as in the community for children with ABI.

This commentary is on the original article by Herskind et al

This commentary is on the original article by Herskind et al

© 2015 Boyd et al. Background: Acquired brain injury (ABI) refers to multiple disabilities arising from damage to the brain acquired after birth. Children with an ABI may experience physical, cognitive, social and emotional-behavioural impairments which can impact their ability to participate in activities of daily living (ADL). Recent developments in technology have led to the emergence of internet-delivered therapy programs. "Move it to improve it" (Mitii™) is a web-based multi-modal therapy that comprises upper limb (UL) and cognitive training within the context of meaningful physical activity. The proposed study aims to compare the efficacy of Mitii™ to usual care to improve ADL motor and processing skills, gross motor capacity, UL and executive functioning in a randomised waitlist controlled trial. Methods/Design: Sixty independently ambulant children (30 in each group) at least 12 months post ABI will be recruited to participate in this trial. Children will be matched in pairs at baseline and randomly allocated to receive either 20 weeks of Mitii™ training (30 min per day, six days a week, with a potential total dose of 60 h) immediately, or be waitlisted for 20 weeks. Outcomes will be assessed at baseline, immediately post-intervention and at 20 weeks post-intervention. The primary outcomes will be the Assessment of Motor and Process Skills and 30 s repetition maximum of functional strength exercises (sit-to-stand, step-ups and half kneel to stand). Measures of body structure and functions, activity, participation and quality of life will assess the efficacy of Mitii™ across all domains of the International Classification of Functioning, Disability and Health framework. A subset of children will undertake three tesla (3T) magnetic resonance imaging scans to evaluate functional neurovascular changes, structural imaging, diffusion imaging and resting state functional connectivity before and after intervention. Discussion: Mitii™ provides an alternative approach

Introduction: Individuals with cerebral palsy (CP) have muscles that are smaller, weaker and more resistant to stretch compared to typically developing people. Progressive resistance training leads to increases in muscle size and strength. In CP, the benefits of resistance training alone may not transfer to improve other activities such as walking; however, the transfer of strength improvements to improved mobility may be enhanced by performing training that involves specific functional tasks or motor skills. This study aims to determine the efficacy of combined functional anaerobic and strength training in (1) influencing muscle strength, structure and function and (2) to determine if any changes in muscle strength and structure following training impact on walking ability and gross motor functional capacity and performance in the short (following 3 months of training) and medium terms (a further 3 months post-training). Methods and analysis: 40 adolescents and young adults with CP will be recruited to undertake a 12-week training programme. The training programme will consist of 3×75 min sessions per week, made up of 5 lower limb resistance exercises and 2-3 functional anaerobic exercises per session. The calf muscles will be specifically targeted, as they are the most commonly impacted muscles in CP and are a key muscle group involved in walking. If, as we believe, muscle properties change following combined strength and functional training, there may be long-term benefits of this type of training in slowing the deterioration of muscle function in people with spastic-type CP. Ethics and dissemination: Ethical approval has been obtained from the ethics committees at The University of Queensland (2014000066) and Children's Health Queensland (HREC/15/QRCH/30). The findings will be disseminated by publications in peer-reviewed journals, conferences and local research organisations' media.

Salmonella enterica serovar Typhimurium (S. Typhimurium) and several mutant derivatives were able to enter efficiently murine bone marrow-derived dendritic cells using mechanisms predominantly independent of the Salmonella pathogenicity island 1 type III secretion system. The levels of intracellular bacteria did not increase significantly over many hours after invasion. Using fluid endocytic tracers and other markers, S. Typhimurium-containing vacuoles (SCVs) were physically distinguishable from early endocytic compartments. Fifty to eighty per cent of SCVs harbouring wild-type S. Typhimurium or aroA, invH and ssaV mutant derivatives were associated with late endosome markers. In contrast, S. Typhimurium sifA was shown to escape the SCVs into the cytosol of infected dendritic cells. S. Typhimurium aroC sifA was more efficient than S. Typhimurium aroC in delivering a eukaryotic promoter-driven green fluorescent protein reporter gene for expression in dendritic cells. In contrast, S. Typhimurium aroC sifA did not detectably increase the efficiency of MHC class I presentation of the model antigen ovalbumin to T cells compared to a similar aroC derivative. Mice infected with the S. Typhimurium aroC sifA expressing ovalbumin did not develop detectably enhanced levels of cytotoxic T cell or interferon-gamma production compared to S. Typhimurium aroC derivatives.

The digitization of this collection was funded by a gift from EBSCO Industries.