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Introduction/aim: Flip-flops are a popular choice of footwear for children. However, their inherent design provides minimal support to the foot and ankle and has been suggested to increase the work performed by muscle and tendon structures, potentially predisposing them to injury. Therefore, the aim of this study was to compare the length change behaviour of the medial gastrocnemius (MG) muscle fascicles and muscle tendon unit (MTU) and their mechanical function at the ankle and subtalar joints in children during walking with and without flip-flop.Methods: Eight healthy children walked barefoot and with flip-flops whilst 3D gait analysis and simultaneous B-mode ultrasound images of the MG fascicles during level walking were collected. Joint kinematics, kinetics and MTU lengths were analysed using musculoskeletal modelling and fascicle lengths using a semi-automated tracking algorithm.Results: The muscles and tendons across the ankle absorbed greater amounts of power during barefoot walking compared to flip-flop walking. The muscle activations of the lateral gastrocnemius, soleus and tibialis anterior remained invariant across the conditions as did the activation, and fascicle length change behaviour of the medial gastrocnemius. In the barefoot condition, there was a trend of greater MTU lengthening, to potentially absorb greater amounts of power, although no differences in shortening was observed during late stance.Conclusion: Walking with flip-flops does not increase the mechanical work performed by the MG muscle at the ankle and subtalar joints, suggesting that flip-flops do not increase the stresses and strains of the Achilles tendon and hence its predisposition to strain induced injury. Instead, our results suggest that flip-flops, act as a compliant surface and absorb energy during contact and hence the strain experienced by the Achilles tendon. [ABSTRACT FROM AUTHOR]

Individuals with cerebral palsy (CP) develop skeletal muscle contractures that impair muscle function. In turn, contractures affect the ability to ambulate and often promote a sedentary lifestyle. The aim of the present study was to investigate the systemic inflammatory markers transforming growth factor beta-1 (TGFβ1), C-reactive protein (CRP), and interleukin-6 (IL-6) in children and adults with CP. Blood samples of n = 34 participants (24 individuals with CP (n = 14 children with CP age 10.36 ± 1.1 and n = 10 adults with CP age 38.80 ± 3.6) and 10 healthy adults age 36.63 ± 3.8) were analyzed for circulating levels of TGFβ1, CRP, and IL-6 using Sandwich Enzyme linked immunosorbent assay (ELISA) analyses (R&D systems). TGFβ1 and CRP levels were significantly higher in children with CP compared to both adults with CP (TGFβ1: P < 0.0005 and P < 0.0002, respectively) and healthy adults (CRP: P < 0.0001 and P < 0.0001, respectively), while no differences were observed between the adults with CP and healthy adults in TGFβ1 (P = 0.29) and CRP (P = 0.59), respectively. Furthermore, IL-6 levels showed no significant differences between the groups. The present findings indicate that the level of systemic inflammation is increased in children with CP. We speculate that persisting inflammation in children with CP might influence the development of muscle contractures, resulting in reduced muscle mass and marked muscle weakness in adults with CP. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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, ANZCTR12613000403730. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM PUBLISHER]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this study was to compare voluntary and involuntary force generating capacity of the triceps surae muscles in healthy young and older adult participants during isometric and isokinetic contractions. Ultrasound was used to measure medial gastrocnemius (MG) fascicle length during maximal voluntary isometric contractions and supra-maximal isometric twitch contractions at five ankle angles throughout the available range of motion, as well as isokinetic concentric and eccentric contractions at four ankle velocities. Maximum voluntary activation of the plantar flexors was assessed using the twitch interpolation technique. Peak plantar flexor torque was significantly lower in older adults compared to young participants by 42%, 28% and 43% during maximal voluntary isometric contractions, supra-maximal isometric twitch and concentric contractions respectively. No age-related differences in eccentric torque production were detected. When age-related differences in triceps surae muscle volume determined from MRI were taken into account, the age-related peak plantar flexor torque deficits for maximum voluntary isometric, supra-maximal twitch, and concentric contractions were 24%, 19% and 24% respectively. These age-related differences in torque were not explained by torque–length–velocity behaviour of the MG muscle fascicles, passive plantar flexor torque–angle properties, decreased neural drive of the plantar flexor muscles or antagonistic co-activation of the tibialis anterior muscle. The residual deficit in isometric and concentric plantar flexor torques in healthy older adults may involve reduced muscle quality. A significant reduction in supra-maximal twitch torque at longer MG fascicle lengths as well as a lower MG fascicle velocity during eccentric contractions in older adults was detected, which could possibly be a function of the reported increased Achilles tendon compliance in older adults. [Copyright &y& Elsevier]

Abstract: Individuals with spastic cerebral palsy (CP) typically experience muscle weakness. The mechanisms responsible for muscle weakness in spastic CP are complex and may be influenced by the intrinsic mechanical properties of the muscle and tendon. The purpose of this study was to investigate the medial gastrocnemius (MG) muscle fascicle active torque-length and Achilles tendon properties in young adults with spastic CP. Nine relatively high functioning young adults with spastic CP (GMFCS I, 17±2 years) and 10 typically developing individuals (18±2 years) participated in the study. Active MG torque-length and Achilles tendon properties were assessed under controlled conditions on a dynamometer. EMG was recorded from leg muscles and ultrasound was used to measure MG fascicle length and Achilles tendon length during maximal isometric contractions at five ankle angles throughout the available range of motion and during passive rotations imposed by the dynamometer. Compared to the typically developing group, the spastic CP group had 33% lower active ankle plantarflexion torque across the available range of ankle joint motion, partially explained by 37% smaller MG muscle and 4% greater antagonistic co-contraction. The Achilles tendon slack length was also 10% longer in the spastic CP group. This study confirms young adults with mild spastic CP have altered muscle–tendon mechanical properties. The adaptation of a longer Achilles tendon may facilitate a greater storage and recovery of elastic energy and partially compensate for decreased force and work production by the small muscles of the triceps surae during activities such as locomotion. [Copyright &y& Elsevier]

Abstract: Individuals with spastic cerebral palsy (SCP) exhibit restricted joint range of motion and increased joint stiffness due to structural alterations of their muscles. Little is known about which muscle–tendon structures are responsible for these alterations. The aim of this study was to compare the passive mechanics of the ankle joint and medial gastrocnemius (MG) muscle in young adults with SCP and typically developed (TD) individuals. Nine ambulant SCP (17±2 years) and ten TD individuals (18±2 years) participated in the study. Physiological cross sectional area was estimated using freehand 3D ultrasound and found to be 37% lower in the SCP group. An isokinetic dynamometer rotated the ankle through its range while joint torque and ultrasound images of the MG muscle fascicles were simultaneously measured. Mean ankle stiffness was found to be 51% higher and mean MG fascicle strain 47% lower in the SCP group. Increased resistance to passive ankle dorsiflexion in SCP appears to be related to the inability of MG muscle fascicles to elongate with increased force. [Copyright &y& Elsevier]

Fixed shortening of a muscle, or contracture, often develops in individuals with an upper motor neuron disorder. A clinical measure of muscle length would therefore be useful for identifying the presence of muscle contracture, tracking changes over time and evaluating the effect of interventions. This study compared a novel ultrasound-tape length method with a previously validated freehand 3D ultrasound method for measuring muscle length. The ultrasound-tape method intra-session reliability was also assessed. Resting medial gastrocnemius muscle length was measured at three ankle joint angles in 15 typically developed (TD) adults and nine adults with cerebral palsy (CP) using the two methods. The ultrasound-tape method on average overestimated the muscle length in the TD group by < 0.1% (95% CI, 6%) and underestimated in the muscle length in the CP group by 0.1% (95% CI, 6%) compared with the 3D ultrasound method. Intra-session reliability of the ultrasound-tape method was high, with intra-class correlation coefficients > 0.99. The ultrasound-tape method has sufficient accuracy to detect clinically relevant differences and changes in medial gastrocnemius muscle length and may therefore be a useful clinical tool for assessing muscle length changes associated with contracture. [ABSTRACT FROM AUTHOR]

The aim of this article was to compare medial gastrocnemius muscle volume, physiological cross-sectional area (PCSA), muscle length, fascicle length, and pennation angle in children aged 2 to 5 years with spastic cerebral palsy (CP) and in typically developing children. Fifteen children with spastic CP (11 males, four females; mean age 45mo [SD 15mo]; five with hemiplega; 10 with diplega; 10 classified at Gross Motor Function Classification System (GMFCS) level I, five at GMFCS level II) and 20 typically developing children (11 males, nine females; mean age 48mo [SD 14mo]) participated in the study. Individuals with spastic CP were included if they had a minimum range of motion of 0° ankle dorsiflexion with the knee extended and were excluded if they had had previous botulinum toxin treatment to the calf muscles or previous calf surgery. Typically developing children were included if they were able to walk independently and were excluded if there was a history of previous lower leg injury or other developmental disorder affecting the lower limb. Freehand two-dimensional and three-dimensional ultrasound was used to assess muscle properties of the relaxed medial gastrocnemius muscle at three ankle joint angles: maximum dorsiflexion, neutral and maximum plantarflexion. PCSA was calculated as a function of muscle volume and muscle fascicle length and pennation angle was recorded at the neutral ankle joint angle. Medial gastrocnemius muscle volume was 22% lower in the group with spastic CP than in the typically developing group, which in the absence of significant group differences in neutral fascicle length gave rise to an equivalent reduction in PCSA for the group with spastic CP. Significant positive correlations were found between muscle volume and age ( r=0.63-0.65) and between muscle length and age ( r=0.72-0.81) in both groups. Maximum ankle dorsiflexion angle was also reduced in the group with spastic CP (8°) compared with the typically developing group (26°). The observed reduction in muscle PCSA in the group with spastic CP would be expected to contribute to the clinically observed muscle weakness in spastic CP and suggests the need for early intervention in order to minimize loss of muscle PCSA in spastic CP. [ABSTRACT FROM AUTHOR]

Abstract: Muscle volume and length are important parameters for examining the force-generating capabilities of muscle and their evaluation is necessary in studies that investigate muscle morphology and mechanical changes due to age, function, pathology, surgery and training. In this study, we assessed the validity and reliability of in vivo muscle volume and muscle belly length measurement using a multiple sweeps freehand 3D ultrasound (3DUS). The medial gastrocnemius of 10 subjects was scanned at three ankle joint angles (15°, 0° and −15° dorsiflexion) three times using the freehand 3DUS and once on the following day using magnetic resonance imaging (MRI). All freehand 3DUS and MRI images were segmented, volumes rendered and volumes and muscle belly lengths measured. The freehand 3DUS overestimated muscle volume by 1.9±9.1mL, 1.1±3.8% difference and underestimated muscle belly length by 3.0±5.4mm, 1.3±2.2% difference. The intra-class correlation coefficients (ICC) for repeated freehand 3DUS system measures of muscle volume and muscle belly length were greater than 0.99 and 0.98, respectively. The ICCs for the segmentation process reliability for the freehand 3DUS system and MRI for muscle volume were both greater than 0.99 and muscle belly length were 0.97 and 0.99, respectively. Freehand 3DUS is a valid and reliable method for the measurement of human muscle volume and muscle belly length in vivo. It could be used as an alternative to MRI for measuring in vivo muscle morphology and thus allowing the determination of PCSA and estimation of the force-generating capacity of individual muscles within the setting of a biomechanics laboratory. [Copyright &y& Elsevier]

Quantitative ultrasound of muscle echogenicity may be influenced by the size of the muscle and, so, corrections may be required when comparing echogenicity between populations with different muscle size. This study examined the relationship between regional muscle echogenicity and geometry in young, typically developing children (n = 49, mean ± standard deviation [SD] age = 70.8 ± 30.0 mo). Three-dimensional ultrasound was used to measure mean echo intensity (EI) and echo variation (EV), together with muscle thickness, cross-sectional area (CSA) and width, over the entire muscle length for the medial gastrocnemius (MG), rectus femoris (RF) and tibialis anterior muscles. Pearson's correlation coefficient (r) was used to assess the strength of the relationship between echogenicity and geometry using all images taken over the entire muscle length. There were moderate-strong correlations (r = 0.67-0.90) between EI and EV and thickness for each muscle, with the strongest correlations evident for the MG and RF. EI and EV were moderately correlated with muscle CSA and weakly correlated with muscle width. Normalisation of echogenicity to muscle thickness may help delineate between regions of contractile and non-contractile tissue and provide a useful measure of muscle echogenicity when comparing muscles of different cross-sectional dimensions. We recommend that researchers consider controlling for muscle size-dependent effects on echogenicity, by normalising EI and EV to muscle thickness, or including the latter as a covariate when comparing between groups. [ABSTRACT FROM AUTHOR]

Purpose: Distal lower limb motor impairment impacts gait mechanics in individuals with cerebral palsy (CP), however, the contribution of impairments of muscle activation to reduced gross motor function (GMF) is not clear. This study aimed to investigate deficits in plantar flexion voluntary activation capacity in CP compared to typically developed (TD) peers, and evaluate relationships between voluntary activation capacity, strength and GMF.Methods: Fifteen ambulant individuals with spastic CP (23 ± 6 years, GMFCS I-III) and 14 TD (22 ± 2 years) people participated. Plantar- and dorsiflexion strength were assessed with a dynamometer. Voluntary activation capacity was assessed using the interpolated twitch technique via single twitch supramaximal tibial nerve stimulation. GMF was assessed using the timed upstairs test, 10 m walk test, muscle power sprint test and six-minute walk test.Results: Plantar- and dorsiflexion strength were 55.6% and 60.7% lower in CP than TD (p < 0.001). Although voluntary activation capacity was 17.9% lower on average for CP than TD (p = 0.039), 46.7% of individuals with CP achieved a sufficiently high activation to fall within one standard deviation of the TD mean. Plantar flexion voluntary activation capacity did not correlate with strength (R2 = 0.092, p = 0.314) or GMF measures in the high functioning CP group (GMFCS I-II).Conclusion: In contrast to previous research, plantar flexion activation capacity did not strongly predict weakness or reduced GMF. We propose that muscle size contributes more to weakness than voluntary activation capacity in high functioning individuals with CP and that relationships between muscle activation and functional capacity are complicated by effects at multiple joints. [ABSTRACT FROM AUTHOR]

Individuals with cerebral palsy (CP) develop skeletal muscle contractures that impair muscle function. In turn, contractures affect the ability to ambulate and often promote a sedentary lifestyle. The aim of the present study was to investigate the systemic inflammatory markers transforming growth factor beta-1 (TGFβ1), C-reactive protein (CRP), and interleukin-6 (IL-6) in children and adults with CP. Blood samples of n = 34 participants (24 individuals with CP (n = 14 children with CP age 10.36 ± 1.1 and n = 10 adults with CP age 38.80 ± 3.6) and 10 healthy adults age 36.63 ± 3.8) were analyzed for circulating levels of TGFβ1, CRP, and IL-6 using Sandwich Enzyme linked immunosorbent assay (ELISA) analyses (R&D systems). TGFβ1 and CRP levels were significantly higher in children with CP compared to both adults with CP (TGFβ1: P < 0.0005 and P < 0.0002, respectively) and healthy adults (CRP: P < 0.0001 and P < 0.0001, respectively), while no differences were observed between the adults with CP and healthy adults in TGFβ1 (P = 0.29) and CRP (P = 0.59), respectively. Furthermore, IL-6 levels showed no significant differences between the groups. The present findings indicate that the level of systemic inflammation is increased in children with CP. We speculate that persisting inflammation in children with CP might influence the development of muscle contractures, resulting in reduced muscle mass and marked muscle weakness in adults with CP. [ABSTRACT FROM AUTHOR]

This commentary is on the original article by Herskind et al. on pages 485–491 of this issue. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Purpose: Weakness of plantar flexor muscles is related to reduced push-off and forward propulsion during gait in persons with cerebral palsy (CP). It has not been clarified to what an extent altered muscle contractile properties contribute to this muscle weakness. Here, we investigated the torque generating capacity and muscle fascicle length in the triceps surae muscle throughout ankle range of motion (ROM) in adults with CP using maximal single muscle twitches elicited by electrical nerve stimulation and ultrasonography.Methods: Fourteen adults with CP (age 36, SD 10.6, GMFCS I-III) and 17 neurological intact (NI) adults (age 36, SD 4.5) participated. Plantar flexor torque during supramaximal stimulation of the tibial nerve was recorded in a dynamometer at 8 ankle angles throughout ROM. Medial gastrocnemius (MG) fascicle length was tracked using ultrasonography.Results: Adults with CP showed reduced plantar flexor torque and fascicle shortening during supramaximal stimulation throughout ROM. The largest torque generation was observed at the ankle joint position where the largest shortening of MG fascicles was observed in both groups. This was at a more plantarflexed position in the CP group.Conclusion: Reduced torque and fascicle shortening during supramaximal stimulation of the tibial nerve indicate impaired contractile properties of plantar flexor muscles in adults with CP. Maximal torque was observed at a more plantarflexed position in adults with CP indicating an altered torque-fascicle length/ankle angle relation. The findings suggest that gait rehabilitation in adults with CP may require special focus on improvement of muscle contractility. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This is the 85th annual report of the British Trust for Ornithology's Ringing Scheme, incorporating the report of the Nest Record Scheme and covering work carried out and data processed in 2021. In 2021, 105 Constant Effort Sites submitted data for the year. Long-term (1984–2020) declines in abundance were observed for five migrant, one partial migrant and five resident species, while long-term increases in abundance were recorded for two short-distance migrants and seven resident species. Ten species are exhibiting significant long-term declines in productivity, while only Chaffinch Fringilla coelebs shows a significant long-term increase. Long-term trends in survival indicate increases for 12 species and declines for seven. Short-term trends, which compare the current year to the five-year mean for 2016–20, show that the abundance of seven species increased significantly in 2021, with one species, Treecreeper Certhia familiaris, being recorded in higher numbers than in any previous year of CES monitoring. Significant decreases in abundance were recorded for four species. Productivity decreased significantly for seven migrant and 11 resident species in 2021, with six species recording their lowest breeding success since CES monitoring began; no species recorded a significant short-term increase. Significant changes in survival rate were observed for two species in 2021 compared to the five-year mean, with Song Thrush Turdus philomelos increasing and Chaffinch both declining and recording its lowest survival rate ever. The Garden CES trial continued in 2021, with 60 sites submitting data. The new winter ringing project also continued in 2021, with submissions received from 126 sites. The number of Retrapping Adults for Survival projects that were able to run and submit data in 2021 was 192, with data from one more project submitted too late to be included in this report and another four active projects unable to operate. In total, 60 species were monitored, with Starling Sturnus vulgaris (21 projects), House Sparrow Passer domesticus (20 projects), Pied Flycatcher Ficedula hypoleuca (19 projects), Reed Warbler Acrocephalus scirpaceus (nine projects) and Sand Martin Riparia riparia (nine projects) the species most studied. A total of 900 131 birds were ringed during the year, comprising 146 458 nestlings, 438 342 first-year birds, 291 127 adults (birds in their second calendar year or older) and 24 204 birds whose age could not be determined. In addition, there were 210 147 recaptures of ringed birds at or near the ringing site. In total, 42 328 recoveries (birds found dead, recaptured or resighted at least 5 km from the place of ringing) of BTO-ringed birds were reported in 2021. The Appendix highlights a selection of recoveries that have extended our knowledge of movements, as well as longevity records established during the year. A total of 41 096 NRS submissions were received in 2021. Mean laying dates for 2021 were significantly later than the average for 13 species and only one species significantly advanced its laying date. Five species displayed a significant change in fledglings per breeding attempt, with two recording increased productivity and three reduced productivity. Permits or licences to disturb breeding birds on Schedule 1 of the Wildlife and Countryside Act 1981 (as amended) were prepared and issued to 602 ringers and nest recorders in 2021. During 2021, 2588 marking endorsements, 868 sampling endorsements and 214 trapping endorsements were issued in the UK and overseas. [ABSTRACT FROM AUTHOR]

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 gait quality were statistically significant, but did not reach the EVGS smallest real difference value of 4 points. Repeated lower limb intramuscular BoNT-A injections to improve gait quality in children with BCP should be reconsidered. [ABSTRACT FROM AUTHOR]

This commentary is on the original article by Smith et al on pages 264–270 of this issue. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The primary of this study was to compare the volume, length, echo intensity, and growth rate of the medial gastrocnemius (MG) and tibialis anterior (TA) muscle of both limbs (more-involved and less-involved) in children with unilateral spastic cerebral palsy (USCP), with those of an age-matched typically developing (TD) group. A secondary aim in the USCP group was to explore the associations between these muscle parameters and discrete ankle positions during phase of gait. Muscle parameters were assessed using 3D ultrasound. Maximal ankle dorsiflexion in stance and swing during walking were determined from 2D video analysis. Group differences in muscle size and echo intensity were assessed using a two-way analysis of covariance (age-by-group), with the interaction term used to compare muscle growth rates. Associations between muscle parameters and maximal ankle dorsiflexion in stance and swing were assessed using backwards multiple linear regression analyses. The MG of both limbs in children with USCP had signs of impaired muscle development (smaller volume and length, higher echo intensity and lower growth rate). There was no evidence of impaired muscle development of TA between limbs or compared the TD children. Tibialis anterior volume, length, echo intensity and MG volume explained 66% and 83% of the variance in maximal ankle dorsiflexion position in the stance and swing phases of walking, respectively. Unlike the MG, the TA volume and growth rate in children with USCP are equivalent between limbs and compared to TD children. For the more-involved limb only, TA volume, length, and echo intensity appear associated with maximal ankle dorsiflexion during walking and represent important muscle parameters that could be targeted in with early exercise therapy. Tibialis anterior (TA) size and echogenicity appear normal in both limbs in young children with unilateral spastic cerebral palsy (USCP); findings that could indicate sufficient mechanical stimulus and muscle anabolism to maintain normal muscle growth. Tibialis anterior size and echogenicity are associated with maximal ankle dorsiflexion in both stance and swing phase of walking in young children with USCP; though such relations appear isolated to the more-involved limb. Early therapeutic interventions that target TA are likely to be successful in maintaining muscle size and may offset the negative effects of medial gastrocnemius atrophy in the development of fixed ankle equinus of the more-involved limb and improve ankle positioning during gait. [ABSTRACT FROM AUTHOR]

Muscle size is an important determinant of muscular fitness and health, and so it is important to have accurate estimates of actual muscle growth in children. This study compared actual versus age‐predicted growth rates of the medial gastrocnemius (MG) muscle in young children over a 12‐month period. Three‐dimensional ultrasound was used to measure MG length and volume in 50 children (mean ± standard deviation [SD] age = 70.3 ± 29.9 months) to establish age‐predicted muscle growth rates using a least‐squares linear regression. Twenty children (mean ± SD age = 78.5 ± 27.2 months) were followed up at 6 and 12 months to establish actual muscle growth of MG volume and length. These data were then compared to their age‐predicted muscle growth from the linear regression equation using paired t‐tests and Bland–Altman limits of agreement method. Age‐predicted MG growth significantly underestimated actual muscle growth for both volume and length at each timepoint. On average, actual muscle volume and length were 11.5% and 21.5% greater than the age‐predicted volume and length respectively. Caution is warranted when predicting future muscle size in young children based solely on age. [ABSTRACT FROM AUTHOR]

Tendon xanthoma and altered mechanical properties have been demonstrated in people with familial hypercholesterolaemia. However, it is unclear whether mild, untreated hypercholesterolaemia alters musculotendinous mechanical properties and muscle architecture. We conducted a case-control study of adults aged 50 years and over, without lower limb injury or history of statin medication. Based on fasting low-density lipoprotein (LDL) cholesterol levels, 6 participants had borderline high LDL (>3.33 mmol/L) and 6 had optimal LDL cholesterol (<2.56 mmol/L). Using shear wave elastography, shear wave velocity (SWV) of the Achilles tendon and gastrocnemius medialis muscle (a proxy for stiffness), along with muscle fascicle length and pennation angle were measured under four passive tensile loads (0, 0.5, 1.0, 1.5 kg) applied via a pulley system. Differences between groups were found for tendon SWV but not muscle SWV, fascicle length or pennation angle. Participants with hypercholesterolaemia showed greater SWV (mean difference, 95 % CI: 2.4 m/s, 0.9 to 4.0, P = 0.024) compared to the control group across all loads. These findings suggest that adults with mild hypercholesterolaemia have increased tendon stiffness under low passive loads, while muscle was not affected. Future research is needed to confirm findings in a larger cohort and explore the impact of hypercholesterolaemia on tendon fatigue injury and tendinopathy. [ABSTRACT FROM AUTHOR]

This is the 84th annual report of the British Trust for Ornithology's Ringing Scheme, incorporating the report of the Nest Record Scheme and covering work carried out and data processed in 2020. An analysis of Curlew Numenius arquata ringing records was carried out to investigate recent declines. Results showed that survival rates are high, so current population declines are more likely to have been driven by low productivity. To reverse the recent population declines, breeding success would need to increase and effective conservation strategies will be needed to maintain the high levels of survival. We examined the potential opportunities and challenges of using winter ringing records to produce survival estimates, as well as other outputs such as age ratios and recruitment, by analysing 2 641 352 encounter records from the winters of 2007/08 to 2017/18: winter-to-winter survival analyses on adult birds were undertaken, initially on 44 species. Results indicated that fortnightly ringing sessions should yield sufficient data to produce useful survival estimates. This research identified a number of potential analytical and methodological options for future development. Covid-19 restrictions limited the amount of fieldwork carried out in 2020; consequently, only 72 CE sites submitted data for the year. Long-term (1984–2019) declines in abundance were observed for five migrant, one partial migrant and four resident species while long-term increases in abundance were recorded for two short-distance migrants and six resident species. Six species are exhibiting significant long-term declines in productivity while only Chaffinch Fringilla coelebs shows a significant long-term increase. Long-term trends in survival indicate increases for 10 species and declines for nine. Short-term trends, which compare the current year to the five-year mean (2015–19), show that the abundance of 10 species increased significantly in 2020, with three species being recorded in higher numbers than in any previous year since CES monitoring began. Significant decreases in abundance were recorded for only two species. Productivity decreased significantly for one migrant and five resident species in 2020; no species recorded a significant increase. Productivity was lower in 2020 than in any previous CES year for Blue Tit Cyanistes caeruleus and Great Tit Parus major. Significant changes in survival rate were observed in two species in 2020 compared to the five-year mean, with Bullfinch Pyrrhula pyrrhula increasing and Blackbird Turdus merula decreasing. A new habitat was added to the suite of standard CES habitats in 2020 in the first year of a Garden CES trial. Submissions were received from 92 sites. A new winter ringing project was also launched in 2020, following a similar methodology to CES. Submissions were received from 111 sites. The number of Retrapping Adults for Survival projects that were able to run and submit data in 2020 was 146, from 200 that were registered. In total, 60 species were monitored, with Pied Flycatcher Ficedula hypoleuca (20 projects), Starling Sturnus vulgaris (19), House Sparrow Passer domesticus (18), Sand Martin Riparia riparia (10) and Reed Warbler Acrocephalus scirpaceus (eight) the species most studied. A total of 930 091 birds were ringed during the year, comprising 98 500 nestlings, 523 777 first-year birds, 278 157 adults (birds in their second calendar year or older) and 29 657 birds whose age could not be determined. In addition, there were 212 414 recaptures of ringed birds at or near the ringing site. In total, 42 987 recoveries (birds found dead, recaptured or resighted at least 5 km from the place of ringing) of BTO-ringed birds were reported in 2020. The Appendix highlights a selection of recoveries that have extended our knowledge of movements, as well as longevity records established during the year. A total of 23 928 NRS submissions were received in 2020, far fewer than usual due to Covid-19 restrictions being in place during the height of the nesting season. As the seasonality of nest records was biased towards the end of the breeding season, after Covid-19 restrictions had lifted, it was not possible to generate meaningful NRS trends for 2020. Permits or licences to disturb breeding birds on Schedule 1 of the Wildlife and Countryside Act 1981 (as amended) were prepared and issued to 611 ringers and nest recorders in 2020. During 2020, the use of special methods was authorised for 1182 marking projects and 146 trapping projects. [ABSTRACT FROM AUTHOR]

This is the 83rd annual report of the British Trust for Ornithology's Ringing Scheme, incorporating the report of the Nest Record Scheme and covering work carried out and data processed in 2019. In 2019, 130 CE sites submitted data. Long-term (1984–2018) declines in abundance were observed for five migrant, one partial migrant and four resident species while long-term increases in abundance continue to be recorded for two short-distance migrants and four resident species. Seven species are exhibiting significant long-term declines in productivity while only Chaffinch Fringilla coelebs is exhibiting a significant long-term increase. Long-term trends in survival indicate increases for 14 species and declines for six. Compared to the five-year mean (2014–18), the abundance of eight species decreased significantly in 2019, with five species being recorded in lower numbers than in any previous year since CES monitoring began. Significant increases in abundance were recorded for six species. Productivity increased significantly for two migrant and six resident species in 2019 and decreased for only one species; Productivity rates were higher in 2019 than in any previous year for Chaffinch. Significant declines in survival rate were observed in one species in 2019 compared to the five-year mean; no species exhibited a significant increase. The number of Retrapping Adults for Survival submissions increased slightly in 2019 to 195. In total, 59 species were monitored, with Pied Flycatcher Ficedula hypoleuca (22 projects), Starling Sturnus vulgaris (17), House Sparrow Passer domesticus (16), Sand Martin Riparia riparia (11) and Reed Warbler Acrocephalus scirpaceus (10) the species most studied. A total of 1 050 520 birds were ringed during the year, comprising 181 766 nestlings, 518 575 first-year birds, 318 390 adults (birds in their second calendar year or older) and 31 789 birds whose age could not be determined. In addition, there were 243 775 recaptures of ringed birds at or near the ringing site. In total, 45 610 recoveries (birds found dead, recaptured or resighted at least 5 km from the place of ringing) of BTO-ringed birds were reported in 2019. The Appendix highlights a selection of recoveries that have extended our knowledge of movements, as well as longevity records established during the year. A total of 41 367 NRS submissions were received in 2019, higher than the previous season but otherwise the lowest annual total since 2013. Mean laying dates for 2019 were significantly earlier than the five-year mean (2014–18) for 12 of 52 species analysed and five species displayed a significant increase in breeding success (fledglings per breeding attempt). Permits or licences to disturb breeding birds on Schedule 1 of the Wildlife and Countryside Act 1981 (as amended), were prepared and issued to 547 ringers and nest recorders in 2019. During 2019, the use of special methods was authorised for 613 marking projects and 158 trapping projects. [ABSTRACT FROM AUTHOR]

Purpose: Rehabilitation goals often focus on increasing community integration for adults with disabilities and are measured by objective assessments. Research methods have lagged behind in capturing current conceptualizations of community integration as a multidimensional construct that incorporates participation, social supports, and feelings of belonging in the community. This paper addresses this challenge by describing a multi-method approach to assessing community integration for adults with cerebral palsy. Methods: Measures include standardized questionnaires, qualitative methods, measures of function and physical activity, and geospatial measures using Geographic Information System mapping and Global Positioning System tracking. These objective and subjective data are used to determine where adults spend time and are most active, and which activities and social connections are associated with feeling integrated into the community. Results: Two case examples highlight the importance of using a multi-method approach to assess community integration for adults with cerebral palsy. Results of objective clinical measures were comparable among case examples; however, actual experiences of feeling connected to the community were vastly different. Conclusions: Multiple measures are required to capture the complexity of community integration. Relying solely on objective measures may not provide a complete picture of community integration. Community integration is a complex construct that incorporates participation, socialization, and feelings of belonging in the community. New methods and measures are needed to assess the many aspects of community integration in adults with disabilities. A multi-method approach is recommended to provide a richer characterization of community integration in individuals with disabilities. A combination of quantitative and qualitative measures addressing the physical, social and psychological aspects of community integration should be used. [ABSTRACT FROM AUTHOR]

This is the 82nd annual report of the British Trust for Ornithology's Ringing Scheme, incorporating the report of the Nest Record Scheme and covering work carried out and data processed in 2018. We reviewed the literature on tracking devices to assess the impact of their use on individual birds. More than 3400 studies were identified, the first dating back to the early 1960s. The ecological questions being studied varied, with migration being the most common study subject. The frequency of effects was significantly related to attachment type and the likelihood of adverse effects was related to device weight. The proportion of studies reporting adverse effects has declined over time and the research highlighted the need for systematic documentation of potential effects. NRS and CES data were used in a collaborative study which investigated mismatches between the timing of breeding for 21 British songbirds and the availability of food for their chicks. Results indicate that birds did breed later in warmer springs relative to the timing of spring; however, this did not have a significant impact on long-term breeding success. In 2018, 135 CE sites submitted data. Long-term (1984–2017) declines in abundance were observed in six migrant, one partial migrant and three resident species while long-term increases in abundance continue to be recorded in two short-distance migrants and four resident species. Seven species are exhibiting significant long-term declines in productivity; only two species, Reed Warbler Acrocephalus scirpaceus and Chaffinch Fringilla coelebs, are exhibiting a significant long-term increase in productivity. Long-term trends in survival indicate increases for 12 species and declines for eight. Compared to the five-year mean (2013–17), the abundance of 14 species decreased significantly in 2018 with five species being recorded in lower numbers than in any previous year since CES monitoring began. No significant increases in abundance were recorded. Productivity increased significantly for six migrant and four resident species in 2018 and decreased for only two species (both residents). Significant declines in survival rates were observed in 10 species in 2018 compared to the five-year mean. The number of Retrapping Adults for Survival submissions fell slightly in 2018 to 190; eight projects ran for the first time. In total, 58 species were monitored, with Pied Flycatcher Ficedula hypoleuca (23 projects), House Sparrow Passer domesticus (18), Starling Sturnus vulgaris (17), Sand Martin Riparia riparia (13) and Reed Warbler (10) the most-studied species. A total of 982 858 birds were ringed during the year, comprising 170 619 nestlings, 465 610 first-year birds, 319 955 adults (birds in their second calendar year or older) and 26 674 birds whose age could not be determined. In addition, there were 236 314 recaptures of ringed birds at or near the ringing site. In total, 54 324 recoveries (birds found dead, recaptured or resighted at least 5 km from the place of ringing) of BTO-ringed birds were reported in 2018. The Appendix highlights a selection of recoveries that have extended our knowledge of movements, as well as longevity records established during the year. A total of 38 269 NRS submissions were received in 2018, the lowest total since 2009. Mean laying dates for four species were significantly earlier than the five-year mean (2013–17) with eight of the 52 species analysed laying significantly later. Eight species displayed a significant increase in breeding success (fledglings per breeding attempt) in 2018 compared to the five-year mean, with one decreasing significantly. Permits or licences to disturb breeding birds on Schedule 1 of the Wildlife and Countryside Act 1981 (as amended), were prepared and issued to 502 ringers and nest recorders in 2018. During 2018, the use of special methods was authorised for 557 marking projects, 66 trapping projects and 52 sampling projects. [ABSTRACT FROM AUTHOR]

Each year, billions of songbirds cross large ecological barriers during their migration. Understanding how they perform this incredible task is crucial to predict how global change may threaten the safety of such journeys. Earlier studies based on radar suggested that most songbirds cross deserts in intermittent flights at high altitude, stopping in the desert during the day, while recent tracking with light loggers suggested diurnal prolongation of nocturnal flights and common non-stop flights for some species. We analyzed light intensity and temperature data obtained from geolocation loggers deployed on 130 individuals of ten migratory songbird species, and show that a large variety of strategies for crossing deserts exists between, but also sometimes within species. Diurnal stopover in the desert is a common strategy in autumn, while most species prolonged some nocturnal flights into the day. Non-stop flights over the desert occurred more frequently in spring than in autumn, and more frequently in foliage gleaners. Temperature recordings suggest that songbirds crossed deserts with flight bouts performed at various altitudes according to species and season, along a gradient ranging from low above ground in autumn to probably >2000 m above ground level, and possibly at higher altitude in spring. High-altitude flights are therefore not the general rule for crossing deserts in migrant songbirds. We conclude that a diversity of migration strategies exists for desert crossing among songbirds, with variations between but also within species. [ABSTRACT FROM AUTHOR]

Wind energy generation has become an important means to reduce reliance on fossil fuels and mitigate against human‐induced climate change, but could also represent a significant human–wildlife conflict. Airborne taxa such as birds may be particularly sensitive to collision mortality with wind turbines, yet the relative vulnerability of species' populations across their annual life cycles has not been evaluated.Using GPS telemetry, we studied the movements of lesser black‐backed gulls Larus fuscus from three UK breeding colonies through their annual cycle. We modelled the distance travelled by birds at altitudes between the minimum and maximum rotor sweep zone of turbines, combined with the probability of collision, to estimate sensitivity to collision. Sensitivity was then combined with turbine density (exposure) to evaluate spatio‐temporal vulnerability.Sensitivity was highest near to colonies during the breeding season, where a greater distance travelled by birds was in concentrated areas where they were exposed to turbines.Consequently, vulnerability was high near to colonies but was also high at some migration bottlenecks and wintering sites where, despite a reduced sensitivity, exposure to turbines was greatest.Synthesis and applications. Our framework combines bird‐borne telemetry and spatial data on the location of wind turbines to identify potential areas of conflict for migratory populations throughout their annual cycle. This approach can aid the wind farm planning process by: (a) providing sensitivity maps to inform wind farm placement, helping minimize impacts; (b) identifying areas of high vulnerability where mitigation warrants exploration; (c) highlighting potential cumulative impacts of developments over international boundaries and (d) informing the conservation status of species at protected sites. Our methods can identify pressures and linkages for populations using effect‐specific metrics that are transferable and could help resolve other human–wildlife conflicts. [ABSTRACT FROM AUTHOR]

This study examined the effect of diamond deloading tape on medial gastrocnemius (MG) muscle behaviour during exercise in healthy adults (n = 27). A randomised cross-over trial assessed the effect of tape (no-tape, sham-tape and deload-tape) on ankle and MG fascicle kinematics during three heel raise-lower exercises [double leg (DL), single leg (SL) and loaded single leg (LSL)]. There was no effect of tape on standing fascicle length (FL) or pennation angle (PA), or ankle or knee joint angle. There was a significant effect of tape on ankle kinematics for all exercises. Both the deload-tape and sham-tape resulted in less ankle plantar flexion but had no effect on dorsiflexion. There was a significant effect of tape on FL change for the SL and LSL exercise. Compared to no-tape, the deload-tape resulted in less fascicle shortening during ankle plantar flexion, and more fascicle lengthening during ankle dorsiflexion. For the LSL exercise, deload-tape caused MG fascicles to operate at longer lengths, for a given joint angle. Diamond taping, with or without added tension, has only a small effect on ankle and MG fascicle kinematics during the heel raise-lower exercise. With the exception of the LSL exercise, both tape conditions resulted in similar changes in the FL-angle relations. [ABSTRACT FROM AUTHOR]

Background: Leg muscle weakness is a major impairment for individuals with cerebral palsy (CP) and is related to reduced functional capacity. Evidence is limited regarding the translation of strength improvements following conventional resistance training to improved gait outcomes.Research Question: Does a combined functional anaerobic and lower limb strength training intervention improve gait kinematics and kinetics in individuals with CP aged 15-30 years? 17 young adults (21 ± 4 years, 9 males, GMFCS I = 11, II = 6) were randomized to 12 weeks, 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 post-training outcomes included maximum ankle dorsiflexion angle at foot contact and during stance, gait profile score, ankle and hip power generation during late stance, and the ratio of ankle to hip power generation.Results: There were no between-group differences after the intervention for any kinematic or kinetic gait outcome variable. Within-group analysis revealed an increase in peak ankle power during late stance (0.31 ± 0.28 W·kg-1, p = 0.043) and ankle to hip power ratio (0.43 ± 0.37, p = 0.034) following training in the intervention group.Significance: We have previously reported increased overground walking capacity, agility and sprint power, in the training group compared to the control group at 12-weeks. These changes in overground measures of functional capacity occurred in the absence of changes in treadmill gait kinematics and kinetics reported here.Anzctr: 12614001217695. [ABSTRACT FROM AUTHOR]

This is the 81st annual report of the British Trust for Ornithology's Ringing Scheme, incorporating the report of the Nest Record Scheme and covering work carried out and data collected and processed in 2017. Demographic data contributed to several research studies during the year, including a review of the conservation status of Raven Corvus corax and the impacts of licensed control. This quantified the extent to which non-breeding birds could be removed without impacting overall population sustainability, as well as the data permitted, but noted that a better understanding of age-specific survival rates was required. Nest Record Scheme data contributed to a large-scale collaborative study investigating the impact that temperature and rainfall have on the timing of events throughout the annual cycles of 10 000 animal and plant species across different trophic levels. The results indicated that the speed of response was greatest at low trophic levels. Future changes under a range of emission scenarios were estimated; these results indicated that advances in timing would be greatest for primary consumers. A statistical method was developed, using nest record data, to quantify nest failure, taking into account uncertainties generated during data collection. The method was applied to Blackbird Turdus merula records to compare survival rates of nests in gardens with those in the wider countryside. Survival in suburban areas was found to be higher than in urban or rural areas, and nests survived better in wetter conditions across all habitats. In order to quantify any welfare impacts of capturing wild birds, we examined the frequency with which passerines were reported to have died either whilst in the net or during handling. Analyses of capture data submitted from 2005 to 2013 indicated that the average mortality rate is around 0.1%, and that this is consistent between years. Most fatalities occurred before individuals had been extracted from the nets and juveniles appeared to be at greater risk than adults. In 2017, 135 CE sites submitted data. Long-term (1984–2016) declines in abundance were observed in four migrant, one partial migrant and one resident species and concurrent increases in abundance continued to be recorded in two short-distance migrants and four resident species. There was no change to the 10 species which exhibited significant long-term declines in productivity; only one species, Chaffinch Fringilla coelebs, exhibited a significant long-term increase in productivity. Compared to the five-year mean (2012–16), the abundance of six species increased significantly in 2017; Treecreepers Certhia familiaris were seen in greater numbers in 2017 than in any other year since CES monitoring began. Conversely, the abundance of six species fell significantly in 2017, with Chaffinch and Greenfinch Chloris chloris numbers at their lowest since CES monitoring began. Productivity increased significantly for three species in 2017 and decreased for eight species. The only significant change in survival rates between 2017 and the five-year mean was for Wren Troglodytes troglodytes, although the survival rate for Song Thrush Turdus philomelos was at its highest. The number of Retrapping Adults for Survival submissions fell slightly in 2017 to 195; 11 projects ran for the first time. In total, 58 species were monitored, with Pied Flycatcher Ficedula hypoleuca (20 projects), House Sparrow Passer domesticus (16), Starling Sturnus vulgaris (15) and Sand Martin Riparia riparia (11) continuing to be the most-studied species. Once again, over a million birds (1 020 356) were ringed during the year, comprising 165 565 nestlings, 500 580 first-year birds, 321 945 adults (birds in their second calendar year or older) and 32 266 birds where the age could not be determined. In addition, there were 242 719 recaptures of ringed birds at or near the ringing site. In total, 41 049 recoveries (birds found dead, recaptured or resighted at least 5 km from the place of ringing) of BTO-ringed birds were reported in 2017. The Appendix highlights a selection of recoveries that have extended our knowledge of movements, as well as longevity records established during the year. NRS submissions in 2017 exceeded 4 0 000 for the eighth consecutive year, with a total of 43 570 records received. Mean laying dates for 22 species were significantly earlier than the five-year mean (2012–16) with none of the 52 species analysed laying significantly later. There was a significant increase in breeding success (fledglings per breeding attempt) for two species in 2017, compared to the five-year mean, with one decreasing significantly. Permits or licences to disturb breeding birds on Schedule 1 of the Wildlife and Countryside Act 1981 (as amended), were prepared and issued to 580 ringers and nest recorders in 2017. During 2017, the use of special methods was authorised for 584 marking projects and 67 trapping projects, a 4% decrease from 2016. [ABSTRACT FROM AUTHOR]

Aim: If increased muscle stiffness and contractures in children with cerebral palsy (CP) are related to impaired muscle growth, reduced muscle growth should precede or coincide with increased muscle stiffness during development. Here, we compared the volume of the medial gastrocnemius muscle and the passive (non-neural) stiffness of the triceps surae musculotendinous unit in typically developing children and children with CP from birth until 4 years of age.Method: Forty-one children with CP and 45 typically developing children were included. Freehand three-dimensional ultrasound was used to evaluate the volume of the medial gastrocnemius muscle. Biomechanical and electrophysiological measures were used to determine passive and reflex mediated stiffness of the triceps surae musculotendinous unit.Results: Medial gastrocnemius muscle volume increased with the same rate in typically developing and children with CP until 12 months of age, when a significant smaller rate of growth was observed in children with CP. Passive stiffness of the triceps surae musculotendinous unit showed a linear increase with age in typically developing children. Children with CP older than 27 months showed a significant increase in passive stiffness. Reflex mediated stiffness was only pathologically increased in four children with CP.Interpretation: The deviation of medial gastrocnemius muscle volume, earlier than musculotendinous unit stiffness, is consistent with the hypothesis. The data also point out that muscle atrophy and muscle stiffness already develops within the first 1 to 2 years. This emphasizes the necessity of early interventions to promote lower limb muscle growth in this population.What This Paper Adds: Medial gastrocnemius muscle growth is reduced in children with cerebral palsy (CP) around 12 months after birth. Triceps surae musculotendinous unit stiffness is increased in children with CP around 27 months after birth. Reflex excitability is rarely increased in children with CP. Reduced muscle growth may be involved in the pathophysiology of contractures. [ABSTRACT FROM AUTHOR]

Altered neural control of movement and musculoskeletal deficiencies are common in children with spastic cerebral palsy (SCP), with muscle weakness and contracture commonly experienced. Both neural and musculoskeletal deficiencies are likely to contribute to abnormal gait, such as equinus gait (toe-walking), in children with SCP. However, it is not known whether the musculoskeletal deficiencies prevent normal gait or if neural control could be altered to achieve normal gait. This study examined the effect of simulated muscle weakness and contracture of the major plantarflexor/dorsiflexor muscles on the neuromuscular requirements for achieving normal walking gait in children. Initial muscle-driven simulations of walking with normal musculoskeletal properties by typically developing children were undertaken. Additional simulations with altered musculoskeletal properties were then undertaken; with muscle weakness and contracture simulated by reducing the maximum isometric force and tendon slack length, respectively, of selected muscles. Muscle activations and forces required across all simulations were then compared via waveform analysis. Maintenance of normal gait appeared robust to muscle weakness in isolation, with increased activation of weakened muscles the major compensatory strategy. With muscle contracture, reduced activation of the plantarflexors was required across the mid-portion of stance suggesting a greater contribution from passive forces. Increased activation and force during swing was also required from the tibialis anterior to counteract the increased passive forces from the simulated dorsiflexor muscle contracture. Improvements in plantarflexor and dorsiflexor motor function and muscle strength, concomitant with reductions in plantarflexor muscle stiffness may target the deficits associated with SCP that limit normal gait. [ABSTRACT FROM AUTHOR]

This is the 80th annual report of the British Trust for Ornithology's Ringing Scheme, incorporating the report of the Nest Record Scheme and covering work carried out and data processed in 2016. BTO and JNCC have used seabird population data to investigate how demographic processes drive population changes, enabling improved population models to be produced. These population models were used to help quantify the risks associated with large-scale infrastructure projects (e.g. windfarms) and recommendations were made concerning approaches to be used in particular circumstances. Density dependence in seabirds, and its potential impact on population models, was also reviewed but little evidence of significant effects was found. Research on the demographic causes of declines in migratory species, undertaken in collaboration with the University of East Anglia, focused on population changes in Willow Warblers Phylloscopus trochilus. Data from the Nest Record Scheme (NRS), Constant Effort Sites scheme (CES) and the Breeding Bird Survey were combined; the results showed that reduced productivity levels in Willow Warblers in the south of Britain were driving the decline. In 2016, 134 CE sites submitted data. Five migrant and two resident species exhibited long-term (1984-2015) declines in abundance while four migrant and six resident species showed declines in productivity. Compared to the five-year mean (2011-15), the abundance of 10 species increased significantly in 2016 with Cetti's Warbler Cettia cetti, Chiffchaff Phylloscopus collybita, Wren Troglodytes troglodytes and Robin Erithacus rubecula abundance at its highest since CES monitoring began. The abundance of three species fell significantly in 2016. Productivity increased for one species in 2016 and decreased significantly for 16 species. Survival rates increased significantly for three species and fell significantly for one. For the first time, the number of Retrapping Adults for Survival submissions passed 200. A total of 59 species were monitored and 24 projects ran for the first time. The most-studied species were Pied Flycatcher Ficedula hypoleuca (23 projects), House Sparrow Passer domesticus (17), Sand Martin Riparia riparia (15) and Starling Sturnus vulgaris (13). Over a million birds (1 051 629) were ringed during the year, comprising 157 653 nestlings, 490 796 first-year birds, 370 019 adults (birds in their second calendar year or older) and 33 161 birds where the age could not be determined. In addition, there were 255 898 recaptures of ringed birds at or near the ringing site. In total, 40 257 recoveries (birds found dead, or recaptured or resighted at least 5 km from the place of ringing) of BTO-ringed birds were reported in 2016. The Appendix highlights a selection of recoveries that have extended our knowledge of movements, as well as longevity records established during the year. NRS submissions in 2016 exceeded 45 000 for the third consecutive year, with a total of 46 514 records received. Mean laying dates for five species were significantly earlier than the five-year mean (2011-15) with 10 species laying significantly later. Three species displayed a significant increase in breeding success (fledglings per breeding attempt) in 2016 compared to the five-year mean, with four decreasing significantly. Permits/licences to disturb breeding birds on Schedule 1 of the Wildlife and Countryside Act 1981 (as amended), were prepared/issued to 587 ringers and nest recorders in 2016. During 2016, the use of special methods was authorised for 559 marking projects and 73 trapping projects, a 13% increase on 2015 [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This is the 79thannual report of the British Trust for Ornithology’s Ringing Scheme, incorporating the report of the Nest Record Scheme and covering work carried out and data processed in 2015. Constant Effort Sites (CES) data from across Europe, relating to eight common warblers, were analysed to investigate large-scale variation in survival rates and showed that changes in survival outside the breeding season are not a key driver of long-term population trends. Retrapping Adults for Survival (RAS) seabird data sets were reviewed to understand their ability to supplement geographically limited, long-term studies carried out by professionals. Most RAS studies re-encountered sufficient numbers of seabirds to estimate average survival rates; however, only those with re-encounter rates of around 40% were able to detect changes in survival rates efficiently. Over 100,000 nest records, relating to four insectivorous woodland passerines, were used to investigate changes in laying dates in response to temperature. Laying dates advanced by 2.3–4.8 days per °C rise in temperature, suggesting that these species may be able to change their laying dates in response to climate changes, even if the rate of climate change is rapid. Over 10,000 phenological data sets, including laying dates for 37 bird species, were used to look at the mechanisms behind species’ responses to changes in climate. Primary producers and primary consumers advanced timing of breeding more quickly than secondary consumers, potentially leading to a greater mismatch between the timing of breeding in birds (secondary consumers) and their prey availability under future climate-change projections. Data were received for 134 CE sites in 2015. Long-term (1984–2014) population trends derived from the CES data identified five migrant species and four resident species that have decreased significantly in abundance over this period. Abundance of three species decreased significantly in 2015 compared to the five-year mean (2010–14) with WhitethroatSylvia communisabundance at its lowest since CES monitoring began. There were significant increases in abundance for 12 species, with GoldfinchCarduelis carduelisat its highest since CES monitoring began. Productivity decreased significantly in ten species and increased significantly in three species compared to the five-year mean (2010–14); productivity for Willow WarblerPhylloscopus trochiluswas at its lowest since CES began. There were no significant changes in survival in 2015. The total number of active RAS projects increased again in 2015; 190 submissions were received, including data from 23 new projects. Projects were carried out on 57 species, with Pied FlycatcherFicedula hypoleuca(23 projects), Sand MartinRiparia riparia(15) and House SparrowPasser domesticus(20) still the most-studied species. The total number of birds ringed in 2015 was just under one million (987,253) and comprised 472,462 first-year birds, 319,230 adults (birds in their second calendar year or older), 27,993 unaged birds and 167,568 nestlings. In addition, there were 236,540 recaptures of ringed birds at or near the ringing site. In total, 32,253 recoveries (birds found dead, or recaptured or resighted at least 5 km from the place of ringing) of BTO-ringed birds were reported in 2015. A selection of recoveries that have extended our knowledge of movements is presented, as well as longevity records established during the year. In total, 48,957 nest records were received for 2015, the highest annual submission since the Scheme began in 1939. Mean laying dates for five species were significantly earlier than the five-year mean (2010–14) with nine species laying significantly later. Only one species showed a significant increase in breeding success (fledglings per breeding attempt) in 2015, with four decreasing significantly. A total of 612 permits/licences to disturb breeding birds on Schedule 1 of the Wildlife and Countryside Act 1981 (as amended), were prepared/issued in 2015, a small increase from 2014. During 2015, the use of special methods was authorised for 489 marking projects and 68 trapping projects, 25% more than in 2014. [ABSTRACT FROM PUBLISHER]

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. [ABSTRACT FROM AUTHOR]

This is the 78thannual report of the British Trust for Ornithology's Ringing Scheme, incorporating the report of the Nest Record Scheme and covering work carried out and data processed in 2014.Many species have shifted their range towards the Earth's poles in response to global temperature increases. Data from four European Constant Effort Sites (CES) ringing schemes were examined to determine the impact of large-scale temperature variations on productivity in a group of seven migratory bird species to determine the potential for future range changes. Increased productivity at northern sites was apparent only in Reed WarblerAcrocephalus scirpaceus, although there was evidence of local adaptation in six species, suggesting that the rate of northward range shift may be constrained by adaptation to local climatic conditions.A study on the role of carry-over effects in RedstartPhoenicurus phoenicurus, Spotted FlycatcherMuscicapa striataand Wood WarblerPhylloscopus sibilatrixfound that carry-over effects from passage regions impacted on the timing of breeding more strongly than climate on the breeding grounds and that warmer conditions in the breeding area were not associated with reduced productivity.Work on the impact of environmental variables on annual population changes found that, over 40 years, the strongest impact on migrants was rainfall in the Sahel. Over 25 years, positive population changes in response to wetter winters were found for 12 of 16 species studied.Data were submitted for 132 CE sites in 2014. Long-term (1984–2013) population trends derived from the CES data have changed little in the past year. The abundance of five migrant species and five resident species decreased significantly in 2014 compared to the five-year mean (2009–13). The abundance of five of these species (Willow WarblerPhylloscopus trochilus, Sedge WarblerAcrocephalus schoenobaenus, BlackbirdTurdus merula, ChaffinchFringilla coelebsand GreenfinchChloris chloris) was at its lowest since CES monitoring began. There were significant increases in abundance for three species. Productivity decreased significantly in Willow TitPoecile montanacompared to the five-year mean (2009–13), but there were significant increases for eleven species (seven residents and four migrants),with productivity for Reed Warbler, Blackbird and BullfinchPyrrhula pyrrhulaat its highest since CES began. There were only two significant changes in survival in 2014.A total of 176 Retrapping Adults for Survival (RAS) projects were active in 2014, the highest total ever, with 22 new projects starting, 17 of which involved RAS target species. Projects were carried out on Tawny OwlStrix alucoand SwiftApus apusfor the first time.The total number of birds ringed in 2014 exceeded one million for the third time (1,047,026) and comprised 520,477 first-year birds, 303,086 adults (birds in their second calendar year or older), 29,799 unaged birds and 193,664 nestlings. In addition, there were 226,303 recaptures of ringed birds at or near the ringing site.In total, 28,187 recoveries of BTO-ringed birds were reported for 2014. A selection of recoveries that have extended our knowledge of movements is presented, as well as longevity records established during the year. The numbers of birds recovered between 2010 and 2013 have been revised as data submitted as retraps have been examined and some have been reclassified as recoveries.For the fifth year running, annual totals of nest records surpassed 40,000, reaching 46,382. Mean laying dates for 55 species were significantly earlier than the five-year mean (2009–13) with 19 species laying significantly later than the five-year mean. Breeding success (fledglings per breeding attempt) increased significantly for 14 species, with none showing a decrease.Nearly 600 permits/licences to disturb breeding birds on Schedule 1 of the Wildlife and Countryside Act (1981), were prepared/issued in 2014, a small increase from 2013.The use of special methods was authorised for 398 marking projects and 47 trapping projects in 2014, 12% fewer than in 2013. [ABSTRACT FROM PUBLISHER]

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 to deliver intensive therapy for children with an ABI in the convenience of the home environment. If Mitii™ is found to be effective, it may offer an accessible and inexpensive intervention option to increase therapy dose. Trial Registration: ANZCTR12613000403730 [ABSTRACT FROM AUTHOR]

Study Design. Descriptive. Objective. The purpose of this study was to determine the in vivo kinematics of functional spinal units, during gait, in individuals with a single-level lumbar total disc replacement (TDR). Summary of Background Data. TDR is a motion preservation technology that offers an alternative to spinal fusion for treatment of degenerative disc disease. The aim of TDRs is to replicate motion of the functional spinal units, which may protect adjacent intervertebral discs against accelerated degeneration. At present, there is limited understanding of the in vivo motion of TDRs, particularly during dynamic activities such as gait. Such information is important for understanding the wear characteristics of TDRs and furthering design rationale of future implants. Methods. TDR motions were obtained from 24 participants who underwent implantation with single-level L4-L5 or L5-S1 CHARITÉ or In Motion TDRs. Video fluoroscopy was used to obtain measurements in the frontal and sagittal planes during fixed speed treadmill walking. Results. The mean range of motion between the upper and lower lumbar TDR endplates during walking was 1.6 ° and 2.4 ° in the frontal and sagittal planes, respectively. These values were significantly different from zero and corresponded to 19% of the maximum static range of motion in each plane. Conclusion. Lumbar TDRs provide a degree of motion preservation at the operative level during moderate speed walking. The distribution of lumbar TDR motions during walking presented here will inform relevant standards for conducting standardized tests of lumbar TDRs, particularly wear assessments, and, hence, enable more realistic mechanical and computer-based wear simulations to be performed. [ABSTRACT FROM AUTHOR]

This is the 77th annual report of the British Trust for Ornithology's Ringing Scheme, incorporating the report of the Nest Record Scheme and covering work carried out and data processed in 2013. In recent years the schemes have focused on the collection of demographic data as part of our Integrated Population Monitoring programme. We expanded (from 10 to 17) the number of species for which we were able to construct integrated models and identified differences in the relative contributions of recruitment and adult survival to population change between increasing and decreasing species. Recruitment of young into the breeding population can be difficult to estimate. We investigated the use of proportions of birds in their second calendar year, or older, caught in the early summer using Blackbird Turdus merula as a model. Results showed that recruitment was a more important determinant of population change than survival. Changes in phenology are being documented widely and we carried out analyses looking at the timing of moult and reproduction in selected passerine species. Patterns in timing and duration of moult varied between resident species but were more aligned within migrant species, which also moulted faster. Temperature on spring breeding grounds accounts for more variation between years in breeding phenology than precipitation rates on the wintering grounds in 19 migrant species but neither climate variable affected clutch size. We continued to emphasise the value of targeted ringing and nest recording; increased participation in our structured ringing schemes has provided additional opportunities to improve the quality of demographic monitoring. Long-term (1984–2012) population trends derived from the Constant Effort Sites (CES) data have changed little in the past year. Three of the eight migrant species monitored by CES showed significant increases in productivity compared to the five-year average, although Sedge Warbler Acrocephalus schoenobaenus recorded its second-lowest productivity since CES began in 1983. Breeding performance of residents was mixed, with juvenile:adult ratios for some early breeders significantly lower than during the preceding five years, but significantly higher for some late breeders; one late-breeding resident species, Bullfinch Pyrrhula pyrrhula, had its highest productivity since CES began. Data were submitted for 124 sites. The number of active RAS projects in 2013 was 154, with 22 new projects, 13 of which involved RAS target species. The total number of birds ringed in 2013 decreased slightly (952,750) compared to 2012 and comprised 424,401 first-year birds, 355,278 adults (birds in their second calendar year or older), 19,776 unaged birds and 153,295 nestlings. In addition, there were 241,111 recaptures of ringed birds at or near the ringing site. The reduction in numbers ringed compared to 2012 was probably a result of weather events in 2013. In 2013, there were 465 colour-marking projects registered, covering a total of 110 species; 65 new projects were registered during the year. There were 21,275 recoveries of BTO-ringed birds: the highest total ever. A selection of recoveries that have extended our knowledge of movements is presented, as well as longevity records established during the year. In total, 40,384 nest records were submitted. Of these, 82% originated from England, 8% from Wales and 9% from Scotland, the remaining 1% divided between Northern Ireland and the Republic of Ireland. This was a reduction on the 2012 totals and probably reflected the poor start to the breeding season caused by the exceptionally cold weather in early spring. Long-term trends in nest productivity (fledglings per breeding attempt) were significant for 44 of the 72 species monitored. Of these, thirteen trends were negative, indicating a decline in breeding success over time. [ABSTRACT FROM AUTHOR]

This is the 76th annual report of the British Trust for Ornithology's Ringing Scheme, covering work carried out and data processed in 2012. Demographic integrated population monitoring has been the focus of the Scheme priorities in recent years and models that integrate ringing and nest record data and abundance trends were built for ten species for which sufficient data were available. Population drivers vary between species but they can be split between changes in breeding success, survival, or both. Multi-brooded species exhibited more seasonal variation in reproductive output than single-brooded species. In particular, migratory species showed a seasonal decrease in fledgling output, as do single-brooded species while residents generally showed a seasonal increase in productivity. Constant Effort Site (CES) data showed long-term (1984–2011) declines in four long-distance migrants and five resident species. However, four species (two short-distance migrants and two residents) have increased over the same period. Productivity of migrants monitored by CES was poor in 2012: seven of the eight species showed significant reductions in productivity compared to the five-year average and had the lowest productivity since CES began in 1983. Breeding performance of resident birds was low in 2012, with juvenile:adult ratios significantly lower than those calculated over the preceding five years for 10 of the 16 species. The number of CE sites increased in 2012, with data submitted for 125 sites, the highest total for a decade. The number of active RAS projects increased to 163 in 2012, with 21 new projects, eight of which involved RAS target species. In 2012 the total number of birds ringed (970,957) was the second highest recorded, and included 408,225 first-year birds, 377,199 adults (birds in their second calendar year or older), 23,772 unaged birds and 161,761 nestlings. In addition, there were 249,551 recaptures of ringed birds at or near the ringing site. The reduction in numbers ringed compared to 2012 was probably the result of the record wet weather that most of Britain & Ireland experienced in spring and summer 2012. A total of 18,693 BTO-ringed birds were recovered in 2012, which was lower than in 2011 but higher than in any previous year. This is the result of an increased number of birds ringed in the past 10 years, an increasing number of colour-ringed and tagged birds and subsequent resightings, more ringers within the Ringing Scheme, efforts to increase reports from members of the public of both metal and colour-ringed birds and an improvement in the way recoveries are processed. Recoveries of 22 BTO-ringed and 11 foreign-ringed individual birds that have extended our knowledge of movement of the species or constitute a new longevity record are presented. In total 44,895 nest records were submitted in 2012, the highest annual submission since the scheme began. Of these, 81% originated from England, 9% from Wales and 9% from Scotland, the remaining 1% divided equally between Northern Ireland and the Republic of Ireland. Submissions from England, Scotland and Northern Ireland have all risen by similar proportions since 2007 (18–22%), while those from Wales have increased by 34% over the same period. Long-term annual productivity trends have been calculated for three additional species. Long-term productivity trends were significant for 40 of the 72 species monitored and nine of these trends were negative, indicating a decline in breeding success over time. [ABSTRACT FROM AUTHOR]

Aim: To systematically review the scientific literature to determine the predictive validity of technology-assisted measures of observable infant movement in infants less than six months of corrected age (CA) to identify high-risk of motor disability.Method: A comprehensive search for randomised and non-randomised controlled trials, cohort studies and cross-comparison trials was performed on five electronic databases up to Feb 2021. Studies were included if they quantified infant movement before 6 months CA using some method of technology-assistance and compared the instrumented measure to a diagnostic clinical measure of neurodevelopment. Studies were excluded if they did not report a technology-assisted measure of infant movement. Methodological quality of the included studies was assessed using the Downs and Black scale.Results: 23 studies met the full inclusion and exclusion criteria. Methodological quality of the included papers ranged from 9 to 24 (out of 26) on the Downs and Black scale. Infant movement assessments included the General Movements Assessment (GMA) and domains of the Hammersmith Infant Neurological Assessment (HINE). Studies used 2D video recordings, RGB-Depth recordings, accelerometry, and electromagnetic motion tracking technologies to quantify movement. Analytical approaches and movement features of interest were individual and varied. Technology assisted quantitative assessments identified cases of later diagnosed CP with sensitivity 44-100 %, specificity 59-95 %, Area under the ROC Curve 82-93 %; and typical development with sensitivity range 30-46 %, specificity 88-95 %, Area under the ROC Curve 68 %.Interpretation: Technology-assisted assessments of movement in infants less than 6 months CA using current technologies are feasible. Validation of measurement tools are limited. Although methods and results appear promising clinical uptake of technology-assisted assessments remains limited. [ABSTRACT FROM AUTHOR]