Postural control and movement performance during upper limb tasks in children with developmental co-ordination disorder (DCD)

At least 6% of primary school aged children present with DCD, where co-ordination is substantially below the normal range for the child’s age and intelligence. Motor skill difficulties negatively affect academic achievement, recreation and activities of daily living. Poor upper-limb co-ordination is a common difficulty for children with DCD. A possible cause of this problem is deviant muscle timing in proximal muscle groups, which results in poor postural and movement control. While studies have been published investigating postural control in response to external perturbations, detail about postural muscle activity during voluntary movement is limited even in children with normal motor development. No studies have investigated the relationship between muscle timing, resultant arm motion and upper-limb coordination deficits. Objectives: To investigate the relationship between functional difficulties with upper-limb motor skills and neuromuscular components of postural stability and coordination. Specifically, to investigate onset-timing of muscle activity, timing of arm movement, and resultant three-dimensional (3D) arm co-ordination during rapid, voluntary arm movement and to analyse differences arising due to the presence of DCD. This study is part of a larger research program investigating postural stability and control of upper limb movement in children. Design: A controlled, cross-sectional study of differences between children with and without DCD. Methods: This study included 50 children aged eight to 10 years (25 with DCD and 25 without DCD). Children participated in assessment of motor skills according to the Movement ABC Test and a laboratory study of rapid, voluntary arm movements. Parameters investigated included muscle activation timing of shoulder and trunk muscles (surface electromyography), arm movement timing (light sensor) and resultant 3D arm motion (Fastrak). Results: A MANOVA is being used to analyse between-group differences. Preliminary results indicate children with DCD demonstrate altered muscle timing during a rapid arm raise when compared with the control group of children. Conclusion: Differences in proximal muscle timing in children with DCD support the hypothesis that altered proximal muscle activity may contribute to poor proximal stability and consequently poor arm movement control. This has implications for clinical physiotherapy.

Poracanthodid acanthodian from the Upper Silurian (Pridoli) of Nevada

Dissociated remains of the acanthodian Poracanthodes punctatus are described from Upper Silurian (Pridoli) limestones of the Roberts Mountains Formation at Pete Hanson Creek, Eureka County, Nevada. The vertebrate microremains in sample residues comprise scales, a dentigerous jaw bone fragment, and a fin spine fragment assigned to P. punctatus, plus one possible acanthothoracid placoderm scale. Some macroremains from the same locality are also assigned to P. punctatus. This taxon has been nominated as, a zone fossil for the Silurian vertebrate biozonal scheme, and its presence has been recorded throughout the circum-Arctic region. Identification of the taxon in Nevada extends its known geographic range.

Dysarthria and dysphagia following treatment for a fourth ventricle choroid plexus papilloma

The present case report describes the presence of a persistent dysarthria and dysphagia as a consequence of surgical intervention for a choroid plexus papilloma (CPP). WM was a nine year ten month old male who at the time of the present study was seven years post-surgery. A comprehensive perceptual and instrumental test battery was used to document the nature of the dysarthria incorporating all components of speech production including respiration, phonation, resonance, articulation, and prosody. The nature of the dysphagia was evaluated through the use of videofluoroscopic evaluation of swallowing (VFS). Assessments confirmed the presence of a LMN dysarthria, marked by deficits in phonation, respiration, and prosody. Dysphagia assessment revealed deficits in oral preparatory, oral and pharyngeal stages of the swallow. The presence of persistent dysarthria and dysphagia in this case has a number of important implications for the management of children undergoing surgery for fourth ventricle CPPs, in particular the need for appropriate treatment, as well as counselling prior to surgery of the possible negative outcomes related to speech and swallowing. (C) 2003 Elsevier Science Ltd. All rights reserved.

Treatment approaches for clients with a stroke-affected upper limb: Are we following evidence-based practice?

Stroke rehabilitation is an area of practice that many occupational therapists encounter during their career. The literature promotes a wide range of management techniques and support devices for people who have a stroke-affected upper limb, but little is known about the validity of those that occupational therapists actually use in practice. A questionnaire was sent to occupational therapists working in Queensland and northern New South Wales facilities (n = 35), in which adults with a stroke were likely to be treated. Eighteen respondents answered questions about the management techniques and support devices used in their facility, and their perception of the benefit of these devices in the reduction of hemiplegic shoulder pain. Results are discussed with reference to evidence-based practice and indicate an urgent need for the collation and dissemination of the best current evidence available for the management techniques and support devices used in this area, as well as further research to extend this evidence.

Haemodynamic response to TENS applied to upper thoracic nerve roots in normal subjects

This study investigated the haemodynamic response to the 90-minute application of 85 Hz transcutaneous electrical nerve stimulation (TENS) to the T1 and T5 nerve roots. Comparison was made between 20 healthy subjects who had TENS stimulation and a separate group of 20 healthy subjects who rested for 90 minutes. Pulse and blood pressure were measured just prior to the start of TENS stimulation, after 30 minutes of stimulation, and after 90 minutes of stimulation (immediately after stopping TENS) or at completion of the rest time depending on group allocation. The rate pressure product was calculated from the pulse and systolic blood pressure data. Multivariate repeated measures analysis showed a significant group effect for TENS (p = 0.048). Univariate repeated measures analyses showed a significant group by time effect due to TENS on systolic blood pressure over the 90-minute time period (p = 0.028). Separate group repeated measures ANOVA showed a significant decline in heart rate (p = 0.000), systolic blood pressure (p = 0.013) and rate pressure product (p = 0.000) for the TENS group, while the control resting group showed a significant decline in heart rate only (p = 0.04). The application of 85 Hz TENS to the upper thoracic nerve roots causes no adverse haemodynamic effects in healthy subjects.

Stratigraphy, facies architecture and tectonic implications of the Upper Devonian to Lower Carboniferous Campwyn Volcanics of the northern New England Fold Belt

Upper Devonian to Lower Carboniferous strata of the Campwyn Volcanics of east central Queensland preserve a substantial sequence of first-cycle volcaniclastic sedimentary and coeval volcanic rocks that record prolonged volcanic activity along the northern New England Fold Belt. The style and scale of volcanism varied with time, producing an Upper Devonian sequence of mafic volcano-sedimentary rocks overlain by a rhyolitic ignimbrite-dominated sequence that passes upward into a Lower Carboniferous limestone-bearing sedimentary sequence. We define two facies associations for the Campwyn Volcanics. A lower facies association is dominated by mafic volcanic-derived sedimentary breccias with subordinate primary mafic volcanic rocks comprising predominantly hyaloclastite and peperite. Sedimentary breccias record episodic and high energy, subaqueous depositional events with clastic material sourced from a mafic lava-dominated terrain. Some breccias contain a high proportion of attenuated dense, glassy mafic juvenile clasts, suggesting a syn-eruptive origin. The lower facies association coarsens upwards from a lithic sand-dominated sequence through a thick interval of pebble- to boulder-grade polymict volcaniclastic breccias, culminating in facies that demonstrate subaerial exposure. The silicic upper facies association marks a significant change in eruptive style, magma composition and the nature of eruptive sources, as well as the widespread development of subaerial depositional conditions. Crystal-rich, high-grade, low- to high-silica rhyolite ignimbrites dominate the base of this facies association. Biostratigraphic age controls indicate that the ignimbrite-bearing sequences are Famennian to lower-mid Tournaisian in age. The ignimbrites represent extra-caldera facies with individual units up to 40 m thick and mostly lacking coarse lithic breccias. Thick deposits of pyroclastic material interbedded with fine-grained siliceous sandstone and mudstone (locally radiolarian-bearing) were deposited from pyroclastic flows that crossed palaeoshorelines or represent syn-eruptive, resedimented pyroclastic material. Some block-bearing lithic-pumice-crystal breccias may also reflect more proximal subaqueous silicic explosive eruptions. Crystal-lithic sandstones interbedded with, and overlying the ignimbrites, contain abundant detrital volcanic quartz and feldspar derived from the pyroclastic deposits. Limestone is common in the upper part of the upper facies association, and several beds are oolitic (cf. Rockhampton Group of the Yarrol terrane). Overall, the upper facies association fines upward and is transgressive, recording a return to shallow-marine conditions. Palaeocurrent data from all stratigraphic levels in the Campwyn Volcanics indicate that the regional sediment-dispersal direction was to the northwest, and opposed to the generally accepted notion of easterly sediment dispersal from a volcanic arc source. The silicic upper facies association correlates in age and lithology to Early Carboniferous silicic volcanism in the Drummond (Cycle 1) and Burdekin Basins, Connors Arch, and in the Yarrol terranes of eastern Queensland. The widespread development of silicic volcanism in the Early Carboniferous indicates that silicic (rift-related) magmatism was not restricted to the Drummond Basin, but was part of a more substantial silicic igneous province.

Transitory increased blood pressure after upper airway surgery for snoring and sleep apnea correlates with the apnea-hypopnea respiratory disturbance index

A transitory increase in blood pressure (BP) is observed following upper airway surgery for obstructive sleep apnea syndrome but the mechanisms implicated are not yet well understood. The objective of the present study was to evaluate changes in BP and heart rate (HR) and putative factors after uvulopalatopharyngoplasty and septoplasty in normotensive snorers. Patients (N = 10) were instrumented for 24-h ambulatory BP monitoring, nocturnal respiratory monitoring and urinary catecholamine level evaluation one day before surgery and on the day of surgery. The influence of postsurgery pain was prevented by analgesic therapy as confirmed using a visual analog scale of pain. Compared with preoperative values, there was a significant (P < 0.05) increase in nighttime but not daytime systolic BP (119 ± 5 vs 107 ± 3 mmHg), diastolic BP (72 ± 4 vs 67 ± 2 mmHg), HR (67 ± 4 vs 57 ± 2 bpm), respiratory disturbance index (RDI) characterized by apnea-hypopnea (30 ± 10 vs 13 ± 4 events/h of sleep) and norepinephrine levels (22.0 ± 4.7 vs 11.0 ± 1.3 µg l-1 12 h-1) after surgery. A positive correlation was found between individual variations of BP and individual variations of RDI (r = 0.81, P < 0.01) but not between BP or RDI and catecholamines. The visual analog scale of pain showed similar stress levels on the day before and after surgery (6.0 ± 0.8 vs 5.0 ± 0.9 cm, respectively). These data strongly suggest that the cardiovascular changes observed in patients who underwent uvulopalatopharyngoplasty and septoplasty were due to the increased postoperative RDI.

Ajustes posturais para o alcance funcional dos membros superiores - migração do centro de pressão na posição de sentado

Objetivos: Pretende-se verificar as modificações neuromotoras após uma intervenção baseada no conceito de Bobath ao nível dos ajustes posturais durante o alcance funcional dos membros superiores, em três crianças com paralisia cerebral. Pretende-se também, verificar o efeito desta abordagem nas atividades e participação, bem como destacar os aspetos individuais das mesmas crianças com a capacidade de mudança após a intervenção. Metodologia: A avaliação foi realizada antes e três meses após a intervenção em fisioterapia segundo o conceito de Bobath. Optou-se por um registo observacional com uma Máquina Fotográfica Digital, um sistemas de Câmaras de Vídeo, uma Plataforma de Forças e, utilizaram-se ainda instrumentos como o Gross Motor Functional Measure– versão 88 itens, o Gross Motor Function Classification System, o Teste de Alcance Funcional Modificado e a ferramenta, Classificação Internacional de Funcionalidade, Incapacidade e Saúde – crianças e jovens. Resultados: Verificou-se um progresso nos ajustes posturais e na funcionalidade em geral, o que se repercutiu na restrição da participação e na limitação da actividade. A postura na posição de sentado, o deslocamento do centro de pressão, a capacidade de deslocamento no sentido anterior, bem como as capacidades motoras grosseiras modificaram-se em todas as crianças, tendo a criança B apresentado a maior e a criança A a menor capacidade de mudança após a intervenção. Conclusão: A intervenção segundo o Conceito de Bobath promoveu modificações neuromotoras, o que levaram a uma melhoria da funcionalidade geral, da mobilidade e do controlo postural da criança, refletindo-se nos ajustes posturais durante o alcance funcional dos membros superiores na posição de sentado. Verificou-se ainda, uma melhoria na restrição da participação e na limitação da actividade diária.

Cape Verde hotspot from the upper crust to the top of the lower mantle

We investigate the crust, upper mantle and mantle transition zone of the Cape Verde hotspot by using seismic P and S receiver functions from several tens of local seismograph stations. We find a strong discontinuity at a depth of similar to 10 km underlain by a similar to 15-km thick layer with a high (similar to 1.9) Vp/Vs velocity ratio. We interpret this discontinuity and the underlying layer as the fossil Moho, inherited from the pre-hotspot era, and the plume-related magmatic underplate. Our uppermost-mantle models are very different from those previously obtained for this region: our S velocity is much lower and there are no indications of low densities. Contrary to previously published arguments for the standard transition zone thickness our data indicate that this thickness under the Cape Verde islands is up to similar to 30 km less than in the ambient mantle. This reduction is a combined effect of a depression of the 410-km discontinuity and an uplift of the 660-km discontinuity. The uplift is in contrast to laboratory data and some seismic data on a negligible dependence of depth of the 660-km discontinuity on temperature in hotspots. A large negative pressure-temperature slope which is suggested by our data implies that the 660-km discontinuity may resist passage of the plume. Our data reveal beneath the islands a reduction of S velocity of a few percent between 470-km and 510-km depths. The low velocity layer in the upper transition zone under the Cape Verde archipelago is very similar to that previously found under the Azores and a few other hotspots. In the literature there are reports on a regional 520-km discontinuity, the impedance of which is too large to be explained by the known phase transitions. Our observations suggest that the 520-km discontinuity may present the base of the low-velocity layer in the transition zone. (C) 2011 Elsevier B.V. All rights reserved.

Relatório de estágio. Terapia manual ortopédica

Este estudo refere-se a uma paciente de 33 anos com paralisia do nervo toráxico longo direito e consequente atrofia do grande dentado A paciente foi acompanhada durante 7 meses no serviço de Fisioterapia e tratada segundo as guidelines para o tratamento desta patologia. Após estabilização de resultados, por não apresentar mais melhoria, foi sujeita a análise electromigráfica no sentido de perceber quais as estratégias utilizadas pela paciente para compensar o défice do grande dentado, na manutenção de 4 movimentos: Elevação anterior a 90º, elevação lateral a 90º, elevação lateral no plano da omoplata a 90º e no push-up contra a parede. Foram avaliados o trapézio superior, médio e inferior, bem como o grande dentado. Verificou-se que não existe um padrão de activação consistente dos estabilizadores da omoplata em cadeia cinética aberta, sendo que o padrão é mantido em cadeia cinética fechada.

Comportamento motor do tronco e membro superior, num sistema de posicionamento rígido e dinâmico, durante atividade

A funcionalidade dos indivíduos com Paralisia Cerebral está muitas vezes comprometida devido às alterações do movimento e do controlo postural. Dadas estas alterações, a posição de sentado oferece uma maior estabilidade sendo muitas das atividades de vida diária desempenhadas nesta posição. O objetivo mais importante de intervenção é obter o máximo de funcionalidade na posição de sentado, particularmente do membro superior. Este objectivo, na maioria das vezes, só pode ser atingido com o uso de sistemas de posicionamento que tentam colmatar as alterações posturais e do movimento. Assim, o objetivo deste estudo de caso é verificar se existem diferenças no comportamento motor do tronco e do membro superior, com um sistema de posicionamento rígido e com um sistema de posicionamento dinâmico, numa jovem com Paralisia Cerebral, aquando da ativação manual de um switch. Foi realizado um estudo de caso único em que foi feita uma análise cinemática do movimento do tronco e membro superior na ativação de um switch BigMack, em três posições de teste com distâncias diferentes. Simultaneamente mediu-se a distribuição do peso durante o movimento, através do mapa de pressão e foi registada, bilateralmente a atividade dos músculos trapézio (porção média), longuíssimo, recto abdominal e oblíquo externo. Os resultados obtidos apontam, neste caso em particular, para uma melhoria na qualidade do movimento e da distribuição de peso, com o sistema de posicionamento dinâmico, sem diferenças entre os dois sistemas relativamente à ativação muscular.