Interobserver agreement of the Gross Motor Function Classification System in an ambulant population of children with cerebral palsy

Gross Motor Function Classification System (GMFCS) level was reported by three independent assessors in a population of children with cerebral palsy (CP) aged between 4 and 18 years (n=184; 112 males, 72 females; mean age 10y 10mo [SD 3y 7mo]). A software algorithm also provided a computed GMFCS level from a regional CP registry. Participants had clinical diagnoses of unilateral (n=94) and bilateral (n=84) spastic CP, ataxia (n=4), dyskinesia (n=1), and hypotonia (n=1), and could walk independently with or without the use of an aid (GMFCS Levels I-IV). Research physiotherapist (n=184) and parent/guardian data (n=178) were collected in a research environment. Data from the child's community physiotherapist (n=143) were obtained by postal questionnaire. Results, using the kappa statistic with linear weighting (?1w), showed good agreement between the parent/guardian and research physiotherapist (?1w=0.75) with more moderate levels of agreement between the clinical physiotherapist and researcher (?1w=0.64) and the clinical physiotherapist and parent/guardian (?1w=0.57). Agreement was consistently better for older children (>2y). This study has shown that agreement with parent report increases with therapists'experience of the GMFCS and knowledge of the child at the time of grading. Substantial agreement between a computed GMFCS and an experienced therapist (?1w=0.74) also demonstrates the potential for extrapolation of GMFCS rating from an existing CP registry, providing the latter has sufficient data on locomotor ability.

Otras vías de aprendizaje: el reconocimiento de la experiencia profesional en la universidad. El caso de la UNED

Nadie cuestiona que una fuente de aprendizaje es el propio ámbito de trabajo, en el que todo profesional resuelve las funciones y tareas a las que se enfrenta diariamente a partir de su formación y de su experiencia. Reconocer esta experiencia en las titulaciones de Grado es un tema aún no resuelto. Pero este reconocimiento exige un proceso de evaluación, apoyado en metodologías y herramientas fiables y válidas, a partir del cual se valide que una persona ha adquirido un determinado nivel de logro en unas competencias en el marco de una cualificación profesional determinada. A raíz de los resultados obtenidos en 2 convocatorias dirigidas al reconocimiento de la experiencia profesional en el Grado en Educación Social impartido por la UNED, este articulo lleva a cabo un análisis de carácter descriptivo y en perspectiva comparada, entre ambas ediciones (2011-12 y 2012-13), con el fin de valorar la pertinencia de este proceso y la calidad de los resultados obtenidos. Con una muestra de 421 estudiantes hemos inferido la validez del procedimiento propuesto. Además, esta realidad nos muestra cuáles son las áreas de intervención más demandadas, los puntos fuertes y débiles de estos profesionales, las competencias más y menos consolidadas de acuerdo a la titulación que se imparte, etc. Disponer de estos datos, además de favorecer el desarrollo profesional de nuestros estudiantes, aporta una información clave para perfilar mejor las competencias específicas del título, trabajar de forma coordinada y colaborativa entre el mundo académico y el profesional, a la vez que responder a un derecho de nuestros estudiantes. 

Pupil participation in school life: an approach from the educational community

The Convention on the Rights of the Child (CRC, 1989) is currently the most ratified international treaty. Several authors have highlighted its potential for both a moral education and citizenship. However, paradoxically, different studies report its limited or occasional incorporation into school practices. This article explores experiences of participation in schools,the third P of the CRC, from the plurality of voices and actors of the educational community,by means of 14 discussion groups in 11 autonomous communities in Spain. Discourse analysis evidence low levels of student participation in school life. But, at the same time, a favorable educational environment for the development of projects that contribute to child participation is found, as well as for the incorporation of the CRC as a mover and a referential integrator of the different schools projects. However, it is also an educational background conductive to projects for its development, such as the incorporation of the CRC as a referential integrator of the schools projects.

Neuromuscular and biomechanical factors codetermine the solution to motor redundancy in rhythmic multijoint arm movement

How the CNS deals with the issue of motor redundancy remains a central question for motor control research. Here we investigate the means by which neuromuscular and biomechanical factors interact to resolve motor redundancy in rhythmic multijoint arm movements. We used a two-df motorised robot arm to manipulate the dynamics of rhythmic flexion-extension (FE) and supination-pronation (SP) movements at the elbow-joint complex. Participants were required to produce rhythmic FE and SP movements, either in isolation, or in combination (at the phase relationship of their choice), while we recorded the activity of key bi-functional muscles. When performed in combination, most participants spontaneously produced an in-phase pattern of coordination in which flexion is synchronised with supination. The activity of the Biceps Brachii (BB), the strongest arm muscle which also has the largest moment arms in both flexion and supination was significantly higher for FE and SP performed in combination than in isolation, suggesting optimal exploitation of the mechanical advantage of this muscle. In a separate condition, participants were required to produce a rhythmic SP movement while a rhythmic FE movement was imposed by the motorised robot. Simulations based upon a musculoskeletal model of the arm demonstrated that in this context, the most efficient use of the force-velocity relationship of BB requires that an anti-phase pattern of coordination (flexion synchronized with pronation) be produced. In practice, the participants maintained the in-phase behavior, and BB activity was higher than for SP performed in isolation. This finding suggests that the neural organisation underlying the exploitation of bifunctional muscle properties, in the natural context, constrains the system to maintain the

The role of the primary motor cortex during skill acquisition on a two-degrees-of-freedom movement task

One can partially eliminate motor skills acquired through practice in the hours immediately following practice by applying repetitive transcranial stimulation (rTMS) over the primary motor cortex. The disruption of acquired levels of performance has been demonstrated on tasks that are ballistic in nature. The authors investigated whether motor recall on a discrete aiming task is degraded following a disruption of the primary motor cortex induced via rTMS. Participants (N = 16) maintained acquired performance levels and patterns of muscle activity following the application of rTMS. despite a reduction in corticospinal excitability. Disruption of the primary motor cortex during a consolidation period did not influence the retention of acquired skill in this type of discrete visuomotor task.

Detecting motor abnormalities in preterm infants

As a consequence of the fragility of various neural structures, preterm infants born at a low gestation and/or birthweight are at an increased risk of developing motor abnormalities. The lack of a reliable means of assessing motor integrity prevents early therapeutic intervention. In this paper, we propose a new method of assessing neonatal motor performance, namely the recording and subsequent analysis of intraoral sucking pressures generated when feeding nutritively. By measuring the infant's control of sucking in terms of a new development of tau theory, normal patterns of intraoral motor control were established for term infants. Using this same measure, the present study revealed irregularities in sucking control of preterm infants. When these findings were compared to a physiotherapist's assessment six months later, the preterm infants who sucked irregularly were found to be delayed in their motor development. Perhaps a goal-directed behaviour such as sucking control that can be measured objectively at a very young age, could be included as part of the neurological assessment of the preterm infant. More accurate classification of a preterm infant's movement abnormalities would allow for early therapeutic interventions to be realised when the infant is still acquiring the most basic of motor functions. (C) Springer-Verlag 2000.

Experiencia colaborativa de enseñanza y aprendizaje entre estudiantes de diferentes ámbitos universitarios. Narrativa en torno a los Desayunos Donostia-Barcelona

El texto presenta una experiencia socioconstruccionista que une el trabajo entre estudiantes de Bellas Artes de la Universidad de Barcelona y de Magisterio de la Universidad del País Vasco. Un trabajo colaborativo entre docentes y estudiantes que conllevó compartir conocimientos y saberes a través del uso de nuevas tecnologías de la información y la comunicación (Skype y Blogs). El foco del artículo está situado en las relaciones de enseñanza y aprendizaje propias y singulares de una experiencia concreta, y en lo que se deriva de ello en el desarrollo de identidades de discentes y docentes; en esta línea, surgieron temas vinculados con: las posicionamientos emergentes, los modos de colocarse en los espacios de aprendizaje, las formas de relacionarse con los conocimientos, resistencias y potenciales del uso de nuevas tecnologías, etc. El texto está articulado en dos partes: una primera en la que brevemente se muestra el anclaje teórico que sustentó el trabajo (la investigación narrativa, y el trabajo educativo basado en Leaning by Desing); y una segunda parte que, llevando por título Desayunos Donostia–Barcelona y con una retórica basada en la novela de ficción, presenta experiencias significativas que hablan de los encuentros entre estudiantes y docentes. Dichas experiencias se inscriben dentro de las actividades de los grupos de innovación docente Indaga-t (2010PID-UB/33) y Elkarrikertuz (IT433-10), y es el resultado de trabajos colaborativos entre docentes e investigadores miembros de los mismos.El texto, que parte de la relación entre los grupos de innovación Indaga-t (2010PID-UB/33) y Elkarrikertuz (IT433-10), muestra una experiencia de colaboración que permite a los estudiantes establecer puentes entre diferentes comunidades y entre dos lugares de aprendizaje supuestamente alejados como son las facultades de Bellas Artes y Magisterio. Además nos ha ofrecido la oportunidad de construir experiencias de aprendizaje donde hemos aprendido a trabajar de un modo colaborativo entre docentes y estudiantes.