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The aim of this study was to evaluate the effect of exposure to manganese (Mn) on fine motor functions. A total of 48 welders and 30 unexposed workers as controls completed questionnaires, underwent blood examinations, and a motor test battery. The shift exposure of welders to respirable Mn was measured with personal samplers. For all subjects accumulations of Mn in the brain were assessed with T1-weighted magnetic resonance imaging. Welders showed normal motor functions on the Movement Disorder Society-Sponsored Revision of the Unified Parkinson Disease Rating Scale part III. Furthermore welders performed excellent on a steadiness test, showing better results than controls. However, welders were slightly slower than controls in motor tests. There was no association between fine motor test results and the relaxation rates R1 in globus pallidus and substantia nigra as MRI-based biomarkers to quantify Mn deposition in the brain.

본 연구는 본 연구는 블록놀이가 뇌성마비 아동의 시공간적 기억능력과 소근육 기능 향상에 미치는 영향을 알아보기 위한 목적으로 수행되었다. 연구대상은 K시에 거주하고 있는 뇌성마비 아동 8명으로 실험집단 4명, 통제집단 4명으로 편의표집 하였으며, 연구방법은 12주간, 주 3회, 매회 50분으로 진행되었다. 자료의 분석은 통계프로그램 SPSS 21.0을 이용하였으며, 수집된 자료를 비모수 검정방식으로 처리한 결과 다음과 같은 결론을 얻었다. 첫째, 블록놀이 프로그램은 뇌성마비 아동의 시공간적 기억능력의 하위요인 중 IBS의 실험집단에서 유의한 차이를 보였으며, 실험집단이 비교집단에 비해 평균점수가 향상되었다. 둘째, 블록놀이 프로그램은 뇌성마비 아동의 소근육 기능 중 시각 · 운동기능에서 유의한 차이가 나타나며, 실험집단이 비교집단에 비해 평균이 높아진 것으로 보아 유의미함을 알 수 있었다. 따라서 블록놀이 참여는 뇌성마비 아동의 공간인식에 대한 즉각적인 작업기억과 소근육의 시각, 운동기능의 향상에 긍정적 영향을 미치는 것으로 여겨진다.

The gross motor coordination tasks are thought to be likely not linked to the fine motor coordination tasks. The authors aimed to investigate this matter through a network analysis linking graphomotor (by tablet PC tracing), gross coordination (by Körperkoordinationstest für Kinder items), and strength (by handgrip) parameters in school children. Interestingly, the authors found that “Hopping” was the strongest central node, with linkages to “Quality” and “Speed” on tracing test. Handgrip strength did not link to gross coordination and graphomotor parameters, except with “Pressure.” Graphomotor performances suggested substantial peculiarities in developmental trajectories. Sport participation did not influence gross coordination nor graphomotor performances. The authors suggest considering the functional link between hopping and graphomotricity both in planning physical education and in understanding coordination impairments, through the developmental trajectories.

Objective To observe the clinical effect of acupuncture plus occupation therapy for fine motor functions in children with spastic cerebral palsy.

Purpose: To elucidate the association between developmental stage of human figure drawing(HFD) and fine motor control, visual perception, and further investigate its potential to be used for screening developmental delay. Methods: Participants were 301 children at 5½ years of age, 176 born preterm and 125 at term, whose HFDs were categorized into six developmental stages. Motor-Free-Visual-Perception Test, Movement-ABC, Performance Intelligence Quotient (PIQ: Wechsler Scale), and the Visual-Motor Integration test were used. Fine motor functions were explored using ImageJ. Results: Age-expected HFDs were drawn by 87% of the children, while 13%, mostly preterm boys, drew immature ones. Stages of HFD were related to both PIQ and Movement-ABC. Visuomotor control and visual perception significantly explained the HFD. The sensitivity and specificity of HFD as a screening tool was moderate to good. Conclusions: HFD is influenced by visual perception and visuomotor control and can be used for screening developmental delay at preschool age.

Assessment of motor function is an essential part of most neuropsychological examinations (Lezak, 2004; Strauss, Sherman, & Spreen, 2006). Early impairments of fine motor function have frequently b...

Background: Affected patients exhibit alterations in psychomotor, intellectual, cognitive, emotional, behavioural and fine motor functions. Hepatic encephalopathy occurs as a complication of advance liver disease, either chronic or acute. Methods: 58 patients of hepatic encephalopathy was enrolled in our study which was done in Chhatrapati Shivagi Subharti hospital for the duration of 2 years to look for the correlation of grades of hepatic encephalopathy with serum ammonia levels. Results: In this study, the correlation of serum ammonia was significant with the grade of encephalopathy hence, the serum ammonia correlated well with the grade of encephalopathy for the patients during their hospital stay, suggesting that the serum ammonia level was an indicator of the clinical outcome of the patients during their hospital stay. Conclusions: In this study, we found that there is a strong correlation between serum ammonia level and severity of liver disease. Higher serum ammonia was found in severe liver disease. We found that High grade i.e. grade III and IV patients were having significantly raised ammonia level.

Objective of the study was t o assess the efficacy of S amvardhana ghrita orally and by Matra basti in motor disabilities of cerebral palsy in children. Study was carried out in the IPD of Dept. o f Kaumarabhritya, SDM College of Ayurveda & Hospital, Hassan, Karnataka , India . 40 children satisfying diagnostic criteria and age 2 - 10 years were included & randomly distributed into two groups of 20 patients each. Group A ( Samvardhana ghrita or ally ) treated with 5 g ms of Samvardhana ghrita with Madhu as a nupana twice daily for 48 days. In Group B (Samvardhana ghrita as matra bast i ), 20 ml of Samvardhana ghrita was administered through basti after local abhyanga with Moorchita Taila and local Swe dana with Nadisweda method. For oral and matrabasti route, Group A and B shown improvements in language and perfor mance (61.11% , 46.15% ), speech (66.66% , 56.25% ) and performance of skill (57.89% , 76.45% ) , in fine motor functions such as puts small object i n a container (58.88% , 66.66% ), throws ball in all direction (38.23% , 60.00% ), uses thumb and index finger ( 34.21 % , 68.75% ), retain 2 one inch cube in fist ( 34.21 % , 55.58% ), folds paper inserts into envelope (66.66% , 38.88% ), in gross motor functions such as in crawling (31.85% , 48.00% ), sitting (55.55% , 57.89% ), standing ( 36.36% , 61.90% ) , walking (34.61% , 44.00% ) and claps hands (44.44% , 63.41 % ) respectively . Both oral administration and basti route of samvardhana ghrita have pr omising result in managing m otor disabilities of cerebral palsy in children.

OBJECTIVE This study aimed to examine the relationship between fine and gross motor skills and cerebral palsy-specific quality-of-life in ambulatory children with cerebral palsy. DESIGN Thirty-nine children with cerebral palsy (29 boys, 10 girls; mean age ± SD, 8.8 ± 2.3 yrs) classified under Gross Motor Function Classification System Level I or II were enrolled. Health-related quality-of-life was evaluated using the Cerebral Palsy Quality of Life Questionnaire for Children (parent-proxy version). Motor functions were measured using the Bruininks-Oseretsky Test of Motor Proficiency. RESULTS Regression analysis for QOL revealed fine motor skills, including upper-limb speed and dexterity, which are positively correlated to functioning (r = 0.205, P < 0.01), and visual-motor control that is positively correlated to other domains, including social well-being and acceptance, participation and physical health, emotional well-being and self-esteem, and family health (r = 0.150-0.188, P < 0.05). CONCLUSIONS Fine motor functions, including upper-limb speed and dexterity and visual-motor control, were the most important motor factors associated with health-related quality-of-life in ambulatory children with cerebral palsy.

Background Sturge–Weber syndrome (SWS) with unilateral hemispheric involvement is a clinical model of early onset, chronic, often progressive hemispheric injury, resulting in variable neuro-cognitive impairment. Aims To evaluate if abnormal diffusion and metabolism of the thalamus, a central relay station with extensive cortical connections, may serve as a simple imaging marker of neuro-cognitive dysfunction in SWS. Methods We obtained both diffusion tensor imaging and FDG PET in 20 children (11 girls; age range: 3–12.4 years) with unilateral SWS. Diffusion parameters as well as FDG uptake were measured in thalami, compared to normal control values, and correlated with the extent of cortical hypometabolism, deep venous abnormalities and cognitive (IQ) as well as fine motor functions. Results Children with SWS had significantly higher thalamic glucose metabolic asymmetry than controls (p = 0.001). Thalamic metabolic asymmetries correlated positively with the asymmetry of thalamic diffusivity (p = 0.001) and also with the extent of cortical hypometabolism (p

Definition of cerebral palsy (CP) has become more precise in recent years and, even if CP remains an umbrella term, a simple classification system for CP types has been proposed. CP is the commonest motor impairment in childhood. New validated motor scales for gross and fine motor functions describe a third of children with CP as severely impaired. Children with CP may also have associated impairments, other than motor, that deserve particular attention and support at school and work, and which are responsible for lower survival rates. The prevalence of CP, 2 per 1000 children, has remained remarkably stable over the last 30 years, particularly for term children who represent half of all children with CP. However, recently, a consistent downward trend has been seen in moderately and very low birth weight children. Prevention measures still seems difficult to define since CP is the result of multifactorial events. Decreasing multiple births and specific health actions during early infancy may have an impact. Followup programmes have been implemented to assess how the consequences of CP are best reduced.

Development of fine motor functions, especially drawing and handwriting, are crucial for performance in school, autonomy in everyday life and the general human development. A variety of neurological and psychiatric conditions in childhood and adolescence stunt the normal development of fine motor skills. We sought to define the normal development of the kinematic parameters of fine motor movement and determine the influence of gender, laterality of handedness and extracurricular training on fine motor skills. One hundred and eighty-seven children and adolescents (mean age: 11.6 years (+/-S.D.: 3.58), range: 6-18 years) were included in the study. Participants performed drawing and handwriting tasks on a digitizing graphic tablet. Movement and pressure data were transferred to a computer using a sensor-equipped pen and post-processed using CSWIN. Movements were segmented into strokes and several kinematic parameters were calculated. The kinematic parameters that were analyzed represented speed (frequency and stroke peak velocity), automation (number of direction changes of velocity per stroke), variability (variation coefficient of stroke peak velocity) and pressure. Progression of kinematic parameters for each movement domain of the handwriting and circle drawing tasks correlated significantly with age (Pearson's correlation, p

The effects of age on basic fine motor functions were assessed using a kinematic analysis of simple repetitive drawing movements in a sample of 53 right-handed children aged 7 to 14 years 11 months and 16 adults aged 27 to 54 years with no detectable abnormality with neurological examination. Lines, circles, and half-circles were drawn at a self-chosen and maximum velocity with a pressure-sensitive pen on a computer graphics tablet. Patterns generated by finger, wrist, and arm movements, and those generated by combined finger-wrist movements with and without a change in the drawing direction were analysed. The frequencies of all movement patterns increased until adulthood: 0.1 Hz per year for half-circles, 0.15 to 0.2 Hz per year for circles and lines generated by arm and wrist movements. The greatest increase (0.35 Hz per year) was observed for lines produced by finger movements. Differences in movement frequencies between finger versus wrist or arm movements when drawing lines decreased from about 3 Hz in 7– to 8-year-olds to 0.5 to 1 Hz in adolescents. In adults the difference between maximum finger, wrist, and arm movement frequencies decreased to almost zero. In contrast, the differences in movement patterns with and without change in direction remained stable until adulthood. Based on these results it is hypothesized that the differential effects of finger and more proximally generated movements on age reflect maturation of distinct neuronal sites of the cortico-striatal-cerebellar circuit rather than acquisition of motor skills or myelinization of corticospinal pathways.

Space flights induce physiological, anatomical, biomechanical, psychological, and social changes in humans. Physiological changes include, among others, cardio-vascular and muscular deconditioning, bone formation, deteriosiation of the vestibular system, attenuations in sense of taste, tactile sense, reaction time, coarse and fine motor functions and are strongly related to the length of stay in space as well as mission goals (Low Earth Orbit, Moon, interplanetary missions, Mars). In this chapter the extant and time course of adaptations under micro-gravity conditions will be described and issues such as crew safety, health management, and the training programs will be discussed.

The fingernail serves many functions during everyday use of the hand that are often taken for granted. The perionychium is a multifaceted structure, the anatomic details and physiologic function complexities of which must be firmly grasped by those surgeons wishing to effectively treat injuries to the fingertip. The nail itself serves to protect the fingertip, regulate peripheral circulation, and enhance the tactile sensibilities that allow humans to perform very fine motor functions. Injuries to the nail apparatus cause functional deficits and cosmetic deformities. Because of the relative prominence of the nail on the fingertip, the perionychium is the most frequently injured part of the hand.

Extrapyramidalmotorische Symptome variabler Auspragung gehoren zur Klinik des Morbus Wilson. Therapeutisches Ziel ist die Ruckbildung bzw. Verhinderung dieser Symptomatik. Verlaufskontrollen sollen rechtzeitig eine Befundanderung erfassen. Bei 21 Patienten mit einem Morbus Wilson (12 Patienten der neurologischen Verlaufsform, 9 Patienten der nichtneurologischen Verlaufsform) wurden feinmotorische Messungen durchgefuhrt. Durch Aufzeichnung alternierender Wechselbewegungen (Diadochokinese und Zeigefingertapping) an dem Bewegungsmessplatz „Zebris” erfolgte die Bestimmung kinematischer Parameter (Geschwindigkeitswechsel, Beschleunigungswechsel, Frequenz). Im Ergebnis zeigt sich die hohere Sensitivitat der computergestutzten Bewegungsanalyse gegenuber einer Bewertung der extrapyramidalmotorischen Symptomatik durch einen klinischen Score. Als haufigster Befund treten vermehrte Beschleunigungswechsel auf, die zu einer Bewegungsverlangsamung fuhren. Insgesamt reflektieren die gestorten kinematischen Parameter einen verminderten Automatisierungsgrad der Bewegung. Trotz klinischer Besserung unter Therapie ist bei den neurologischen Patienten ein signifikant erniedrigter Automatisierungsgrad der Bewegungssteuerung nachweisbar und Ausdruck einer irreversiblen Lasion. Im Vordergrund steht dabei eine eingeschrankte zerebellare Funktion, die herabgesetzte basalganglionare Steuerung ist weniger ausgepragt. Auch ein Teil der nichtneurologischen Patienten besitzt Storungen kinematischer Parameter, die auf den Ubergang in eine neurologische Verlaufsform fruhzeitig hinweisen. Erganzend zur klinischen Beurteilung sollte die computergestutzte feinmotorische Bewegungsmessung zur Verlaufsfkontrolle dienen, da sie eine mogliche Befundanderung sensitiver erfasst. Extrapyramidal motor symptoms of varying degrees are part of the symptoms of Wilson's disease. The aim of therapy is to reduce or even prevent these symptoms. Follow-up is performed to spot any changes in findings. The fine motor functions of 21 patients with Wilson's disease (12 patients with a neurological form, and 9 with a non-neurological form) were measured. Kinematic parameters (changes in speed, changes in acceleration, frequency) were measured via a Zebris movement analysis system by recording alternating movements (diadochokinesis and index-finger tapping). Computer-assisted movement analysis proved to be more sensitive than assessing the extrapyramidal motor symptoms with a clinical score. The most common finding was a rise in acceleration changes, causing movement to slow down. Overall, the disorders in the kinematic parameters reflected a reduced degree of movement automation. Despite clinical improvement under therapy, both a significantly reduced degree of automation in movement control and indications of an irreversible lesion were observed in the neurological patients. The main factor was limited cerebellar function; reduced basal ganglionic control was less pronounced. Some of the non-neurological patients also exhibited disorders in their kinematic parameters, providing early indication of transition to a neurological form. Clinical assessment during follow-up should be augmented by measuring fine motor movements, which may register changes more sensitively.

This study describes the use of a neuroplasticity-principled speech treatment approach (LSVT(®)LOUD) with children who have dysarthria secondary to cerebral palsy. To date, the authors have treated 25 children with mild-to-severe dysarthria, a continuum of gross and fine motor functions, and variable cognitive abilities. From this data set, two case studies are presented that represent as weak or strong responders to LSVT LOUD. These case studies demonstrate how individual and environmental features may impact immediate and lasting responses to treatment. Principles that drive activity-dependent neuroplasticity are embedded in LSVT LOUD and may contribute to positive therapeutic and acoustic outcomes. However, examination of the response patterns indicated that intensity (within and across treatment sessions) is necessary but not sufficient for change. Weak responders may require a longer treatment phase, better timing (e.g., developmentally, socially), and a more prominent desire to communicate successfully during daily activities. Strong responders appear to benefit from the intensity and saliency of treatment as well as from intrinsic and extrinsic rewards for using the trained skills for everyday communication. Finally, possibilities are presented for technological solutions designed to promote accessibility to the intensive task repetition and maintenance required to drive lasting changes.

The purpose of this study is three-fold: First, to determine the levels of gross and fine motor functions in children before and after hemidecortication, using standardized measurement tools; second, to investigate if predictors of these outcomes can be characterized; and third, to explore if both clinical measures and functional magnetic resonance imaging (MRI) potentially can identify optimal timing of surgery. The Gross Motor Function Measure and the Quality of Upper Extremity Skills Test are shown to be comprehensive, standardized outcome measures of movement performance in affected children. Age at surgery and interval between age at seizure onset and age at surgery could be the most reliable predictors of clinical outcomes. Functional MRI studies are valuable in exploring the potential of the cortical reorganization that sustains residual sensorimotor function. The combination of clinical measures with functional MRI is a promising method of inquiry into developmental and plasticity processes. (J Child Neurol 1999;14:304-315).

Background: Cerebral palsy is a static encephalopathy that may be defined as a non-progressive disorder of posture and movement often associated with epilepsy and abnormalities in speech, vision and intellect resulting from a defect or lesion of the developing brain. There are 25 lakhs cerebral palsy affected children in India. Aim: To assess the efficacy of Rajayapana Basti (RB) and Baladi Yoga in motor disabilities of cerebral palsy in children. Materials and Methods: Total 98 children satisfying diagnostic criteria and between the age group of 2-10 years were included and randomly divided into two groups. In RB with Baladi group (n = 40) patients were treated with Mustadi Rajayapana Basti for 8 days, followed by oral administration of Baladi Yoga with honey and ghee for 60 days. Before administering Basti, patients were subjected to Sarvanga Abhyanga and Sastikashali Pinda Sveda. In the control group (n = 40), patients were given tablets of Godhuma Choorna for 60 days. Before administering the placebo tablet, the patients of the control group were given Sarvanga Abhyanga and Sastikashali Pinda Sveda for 8 days. The patients of the control group were given Basti with lukewarm water for 8 days. Results: RB group has shown improvements in understanding ability (13.43%), speech (10%) and performance skill (11.11%), in fine motor functions such as putting small object in to a container (14.3%), throws the ball in all direction (21.8%), use of thumb and index finger (10.93%), retaining 2 inch cube in fist (19.04%), folds paper and inserts into envelope (10.30%), in gross motor functions such as in crawling (26.7%), sitting (31.7%), standing (13.75%), walking (9.5%) and claps hands (13.9%) respectively. Conclusion: Mustadi RB along with Baladi Yoga provided a significant improvement in all the parameters and has promising result in managing motor disabilities of cerebral palsy in children .

Plexiform neurofibroma is common over the branches of trigeminal and cervical nerves over the face. Plexiform neurofibroma over palm is rare and affects the individuals with fine motor functions of hand. Here, we report a case of isolated plexiform neurofibroma over the palm with review of literature.

Eight infants with profound sensorineural hearing loss were studied for the development of gross motor function, and classified into two types by recordings of the damped rotation test on ENG. One group included four patients with normal vestibular reflex and the other four with poor vestibular reflex. Each patient was assessed by four major items of gross motor function, comprising 30 minor items, and 10 minor items of fine motor function.All patients with poor vestibular function revealed a delay of the development from two to eight months in each item of gross motor function and a slight delay in each item of fine motor function. However, all delays of gross motor function were developed by two years of age. On the other hand, all patients with normal vestibular function showed normal development of gross and fine motor functions.Our study demonstrated that gross motor function in young infants with labyrinth-hypoacctivity would be delayed, and that such delays would be acquired at least until two years of age. The mechanism of acquisition of motor function in these patients may depend on other spinal tracts that are controlled by the central nervous system.