HIDING IN PLAIN SIGHT- Sustainable Physical Activity Program Development and Evaluation for Youth with Special Needs: An Evaluative Case Study

The purpose of my research was to contribute to the improvement and sustainability of the Special Needs Activity Program, and develop program implementation strategies that had practical outcomes. I conducted an evaluative case study of S.N.A.P in order to determine what a quality adapted physical activity (APA) program is, why S.N.A.P is considered a quality APA program, and what institutional policies and practices exist to support it. Data was collected via interviews, questionnaires, and observations. Data analysis involved inductive and deductive methods, and a SWOTAR evaluation. Results indicate that quality APA programs include: ‘people’, ‘environment’, and ‘expectations’; there are benefits of experiential learning; activity stations that promote creativity are valuable; several stakeholders do not know the details about S.N.A.P but recognize its value; the institution values what S.N.A.P provides, yet, there is nothing being done to sustain it. Future research should investigate the feasibility of implementing S.N.A.P in various contexts.

Contribution of tachykinin and kinin receptors in central autonomic control of blood pressure and behavioural activity in hypertensive rats

This work aims at studing the role of tachykinin NK-3 receptor (R) and kinin B1R in central autonomic regulation of blood pressure (BP) and to determine whether the B1R is overexpressed and functional in rat models of hypertension by measuring the effect of a B1R agonist on behavioural activity. Assumptions: (1) NK-3R located in the ventral tegmental area (VTA) modulates the mesolimbic dopaminergic system and has a tonic activity in hypertension; (2) B1R is overexpressed in the brain of hypertensive rats and has a tonic activity, which contributes to hypertension via a dopamine mechanism; (3) the inhibition of NK-3R and B1R with selective antagonists, reduces central dopaminergic hyperactivity and reverses hypertension. A model of genetic hypertension and a model of experimental hypertension were used: spontaneously hypertensive rats (SHR, 16 weeks) and Wistar-Kyoto (WKY) rats infused for 14 days with angiotensin II (Ang II) (200 ng / kg / min, subcutaneous (s.c.) with Alzet mini pump). The age-matched untreated WKY rats served as common controls. In the first study (article # 1), the cardiovascular response in SHR was evaluated following intracebroventricular (i.c.v.) and/or intra-VTA injection of an agonist (senktide) and antagonists (SB222200 and R-820) of NK-3R. These responses have also been characterized using selective dopamine antagonists DA-D1R (SCH23390), DA-D2R (raclopride) or non-selective dopamine DA-D2R (haloperidol). Also the VTA has been destroyed by ibotenic acid. The pressor response induced by senktide and the anti-hypertensive response induced by SB222200 or R-820 were more pronounced by intra-VTA. These responses were prevented by pre-treatment with raclopride and haloperidol. The lesion of the VTA has prevented the pressor response relayed by senktide (i.c.v.) and the anti-hypertensive effect of R-820 (i.c.v.). In addition, SB222200 (intra-VTA) prevented the pressor response of senktide (i.c.v.) and conversely, senktide (i.c.v.) prevented the antihypertensive effect of SB222200 (intra-VTA). The second study (article # 2) showed that the B1R antagonist (SSR240612) administered by gavage or i.c.v. reverses hypertension in both models. This anti-hypertensive effect was prevented by raclopride and haloperidol. In contrast, the two B1R antagonists (R-715 and R-954) injected s.c., which do not cross the blood-brain barrier reduced weakly blood pressure in hypertensive rats. In the third study (article # 3), the i.c.v. injection of a selective kinin B1R agonist Sar[DPhe8][des-Arg9]BK caused behavioural responses in SHR and Ang II-treated rats and had no effect in control WKY rats . The responses elicited by B1R agonist were blocked by an antagonist of NK-1 (RP67580), an antagonist of NMDA glutamate receptor (DL-AP5), an inhibitor of nitric oxide synthase (NOS) (L -NNA) as well as raclopride and SCH23390.The responses were modestly affected by the inhibitor of inducible NOS (iNOS). The B1R mRNA (measured by RT-PCR) was significantly increased in the hypothalamus, the VTA and the nucleus accumbens of hypertensive animals (SHR and treated with Ang II) compared with control rats. These neuropharmacological studies suggest that: (1) the NK-3R from the VTA is involved in the maintenance of hypertension in SHR by increasing DA transmission in the midbrain; (2) the B1R in SHR and Ang II-treated rats contributes to hypertension via a central mechanism involving DA-D2R; (3) the central B1R increases locomotor activity and nocifensive behaviours via the release of substance P (NK-1), DA and nitric oxide in both rat models of hypertension. Thus, the brain tachykinin NK-3R and kinin B1R represent potential therapeutic targets for the treatment of hypertension. The modulation of the mesolimbic/mesocortical dopaminergic pathway by these receptors suggests their involvement in other physiological functions (pleasure, motor activity, coordination of the response to stress) and pathophysiology (anxiety, depression).

Évaluation objective de la douleur chronique secondaire à l’arthrose chez le chat

La prévalence de l’arthrose féline augmente fortement avec l’âge atteignant plus de 80% des chats de plus de 11 ans. L'arthrose induit une douleur chronique s’exprimant par des changements de comportements et une diminution de la mobilité. Il n'existe aucun outil validé pour évaluer la douleur chronique associée à l’arthrose chez le chat. Conséquemment, aucun traitement ciblant cette douleur n’a pu être validé. Notre hypothèse de recherche est que la douleur arthrosique chez le chat induit des handicaps fonctionnels, des changements neurophysiologiques et un état d'hypersensibilité qu'il faut évaluer pour quantifier de manière fiable cette douleur et ses répercussions sur la qualité de vie de l'animal. Nos objectifs étaient 1) de développer des outils adaptés aux chats mesurant les handicaps fonctionnels grâce à des outils cinématiques, cinétiques et de suivi de l'activité motrice ; 2) de caractériser les changements fonctionnels et neurophysiologiques secondaires à la douleur arthrosique et de tester avec ces outils un traitement analgésique à base d'anti-inflammatoire non stéroïdien ; 3) de développer une technique adaptée aux chats pouvant caractériser la présence du phénomène de sensibilisation centrale à l'aide d'une évaluation de la sommation temporelle mécanique ; 4) de tester la possibilité de mesurer le métabolisme glucidique cérébral par tomographie d’émission par positrons comme marqueur des changements supraspinaux secondaires à la chronicisation de la douleur. Grâce au développement d’outils de mesure de douleur chronique objectifs, sensibles et répétables nous avons caractérisé la douleur chez les chats arthrosiques. Ils présentent des signes de boiterie quantifiée par une diminution de l’amplitude de l’articulation ou par une diminution de la force verticale d’appui au sol et une diminution de l’activité motrice quotidienne. Ces deux derniers outils ont permis de démontrer qu’un anti-inflammatoire non stéroïdien (le méloxicam) administré pendant quatre semaines réduit la douleur arthrosique. De plus, grâce au développement de tests sensoriels quantitatifs et à l'utilisation d'imagerie cérébrale fonctionnelle, nous avons démontré pour la première fois que la douleur arthrosique conduisait à des modifications du système nerveux central chez le chat. Particulièrement, les chats arthrosiques développent le phénomène de sensibilisation centrale mis en évidence par un seuil de retrait aux filament de von Frey diminué (mesure réflexe) mais aussi par une facilitation de la sommation temporelle mécanique (mesure tenant compte de la composante cognitive et émotionnelle de la douleur). L'augmentation du métabolisme cérébral dans le cortex somatosensoriel secondaire, le thalamus et la substance grise périaqueducale, souligne aussi l'importance des changements liés à la chronicisation de la douleur. Un traitement analgésique adapté à l’arthrose permettra d’améliorer la qualité de vie des chats atteints, offrira une option thérapeutique valide aux praticiens vétérinaires, et profitera aux propriétaires qui retrouveront un chat actif et sociable. La découverte de l'implication du phénomène de sensibilisation central combiné à l'investigation des changements cérébraux secondaires à la douleur chronique associée à l'arthrose par imagerie fonctionnelle ouvre de nouvelles avenues de recherche chez le chat (développement et/ou validation de traitements adaptés à l'état d'hypersensibilité) et les humains (potentiel modèle naturel de douleur chronique associée à l'arthrose).

Corticospinal excitability not affected by negative motor imagery or intention

Bien que l’imagerie motrice positive ait été bien étudiée et est utilisée en réhabilitation, l’effet de l’imagerie motrice négative est beaucoup moins connu. Le but de cette recherche était de définir si l’intention et/ou l’imagerie motrice négative serait en mesure de réduire l’effet d’une stimulation magnétique transcrânienne (SMT) sur le cortex moteur. Vingt participants ont reçu trente stimulations de SMT dans trois situations différentes : En restant passif, en portant une attention particulière aux sensations dans leur main ou en tentant de réduire l’effet de la SMT. La moitié des participants ont utilisé une stratégie d’imagerie motrice, l’autre moitié leur intention. Dans les deux cas, l’amplitude dans la condition de modulation n’a pas été réduite de façon significative.

L'actigraphie comme mesure de sommeil à l’âge préscolaire : liens avec la sécurité d’attachement et les comportements extériorisés

L’objectif général de la thèse était d’élargir les connaissances scientifiques sur le sommeil des enfants. La thèse est composée de quatre articles empiriques. Le premier visait à estimer la validité de l’actigraphie comme mesure de sommeil chez les enfants d’âge préscolaire en la comparant à la polysomnographie, et à examiner si son emplacement influence sa validité. 12 enfants âgés de 2 à 5 ans ont porté simultanément un actigraphe à la cheville et un au poignet pendant une nuit d’enregistrement polysomnographique. Les résultats démontrent que l’actigraphie permet une bonne détection du sommeil, mais qu’elle détecte moins bien l’éveil. Cet article suggère également que les jeunes enfants nécessitent un algorithme adapté à leur niveau d’activité nocturne. Enfin, la validité de l'actigraphie semble similaire pour le poignet et la cheville. Le deuxième article visait à comparer trois mesures de sommeil souvent utilisées avec de jeunes enfants, soit les agendas de sommeil, l’échelle des problèmes de sommeil du Child Behavior Checklist (CBCL) et l’actigraphie, afin de déterminer leurs similarités et leurs divergences quant aux variables de sommeil qui en sont dérivées. 80 familles ont participé à cette étude lorsque les enfants étaient âgés de 2 ans. Les enfants ont porté un actigraphe durant 72 heures consécutives et les mères ont complété un agenda de sommeil durant cette même période. Les deux parents ont aussi rempli le CBCL. Les résultats démontrent que ces mesures de sommeil évaluent des aspects différents du sommeil de l’enfant, et suggèrent une concordance particulièrement faible entre les mesures subjectives et objectives. Le troisième article visait à évaluer l’apport unique de la sécurité d’attachement dans la prédiction du sommeil de l’enfant. 62 dyades mère-enfant ont été rencontrées à deux reprises. La sécurité d’attachement et la dépendance ont été évaluées par observation à l’aide du Q-Sort d’attachement lorsque l’enfant avait 15 mois. À l’âge de 2 ans, les enfants ont porté un actigraphe durant 3 jours consécutifs. Les résultats indiquent que la sécurité d'attachement a une contribution unique à la prédiction de la durée du sommeil nocturne et de l'efficacité du sommeil nocturne. Ainsi, cette étude suggère que plus les enfants ont un attachement sécurisant envers leur mère, plus grandes sont la durée et la qualité de leur sommeil quelques mois plus tard. Le quatrième article visait à examiner la relation entre le sommeil et les comportements extériorisés. 64 familles ont participé à cette étude. À l’âge de 2 ans, les enfants ont porté un actigraphe durant 72 heures consécutives et les parents ont complété le CBCL. Lorsque les enfants étaient âgés de 4 ans, les parents ainsi que l’éducateur(trice) de garderie ont rempli le CBCL. Les résultats démontrent que le sommeil de l’enfant est associé aux comportements extériorisés concomitants et à l’augmentation de ceux-ci à travers le temps. Par ailleurs, les relations entre la qualité de sommeil et les comportements extériorisés étaient modérées par le sexe de l’enfant, c’est-à-dire significatives seulement chez les garçons. Les résultats des quatre articles sont finalement intégrés dans la discussion générale.

The role of corticospinal tract damage in chronic motor recovery and neurorehabilitation: a pilot study

Background. With diffusion-tensor imaging (DTi) it is possible to estimate the structural characteristics of fiber bundles in vivo. This study used DTi to infer damage to the corticospinal tract (CST) and relates this parameter to (a) the level of residual motor ability at least 1 year poststroke and (b) the outcome of intensive motor rehabilitation with constraint-induced movement therapy (CIMT). Objective. To explore the role of CST damage in recovery and CIMT efficacy. Methods. Ten patients with low-functioning hemiparesis were scanned and tested at baseline, before and after CIMT. Lesion overlap with the CST was indexed as reduced anisotropy compared with a CST variability map derived from 26 controls. Residual motor ability was measured through the Wolf Motor Function Test (WMFT) and the Motor Activity Log (MAL) acquired at baseline. CIMT benefit was assessed through the pre—post treatment comparison of WMFT and MAL performance. Results. Lesion overlap with the CST correlated with residual motor ability at baseline, with greater deficits observed in patients with more extended CST damage. Infarct volume showed no systematic association with residual motor ability. CIMT led to significant improvements in motor function but outcome was not associated with the extent of CST damage or infarct volume. Conclusion. The study gives in vivo support for the proposition that structural CST damage, not infarct volume, is a major predictor for residual functional ability in the chronic state. The results provide initial evidence for positive effects of CIMT in patients with varying, including more severe, CST damage.

Corticospinal tract integrity and lesion volume play different roles in chronic hemiparesis and its improvement through motor practice

Background. Initial evidence suggests that the integrity of the ipsilesional corticospinal tract (CST) after stroke is strongly related to motor function in the chronic state but not the treatment gain induced by motor rehabilitation. Objective. We examined the association of motor status and treatment benefit by testing patients with a wide range of severity of hemiparesis of the left and right upper extremity. Method. Diffusion tensor imaging was performed in 22 patients beyond 12 months after onset of stroke with severe to moderate hemiparesis. Motor function was tested before and after 2 weeks of modified constraint-induced movement therapy. Results. CST integrity, but not lesion volume, correlated with the motor ability measures of the Wolf Motor Function Test and the Motor Activity Log. No differences were found between left and right hemiparesis. Motor performance improved significantly with the treatment regime, and did so equally for patients with left and right arm paresis. However, treatment benefit was not associated with either CST integrity or lesion volume. Conclusion. CST integrity correlated best in this small trial with chronic long-term status but not treatment-induced improvements. The CST may play a different role in the mechanisms mediating long-term outcome compared to those underlying practice-induced gains after a chronic plateau in motor function.

Association between rhythmic masticatory muscle activity during sleep and masticatory myofascial pain: A polysomnographic study

Aims: To test for an association between rhythmic masticatory muscle activity during sleep, as assessed according to polysomnographic criteria for sleep bruxism (RMMA-SB), and myofascial pain (MFP), as well as the chance of occurrence of MFP in patients with RMMA-SB. Methods: Thirty MFP patients (diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders) and 30 age- and gender-matcbed asymptomatic controls underwent a polysomnographic examination. Also, any self-reporting of daytime clenching (DC) was registered in 58 of these subjects. Results: Most MFP patients reported mild or moderate pain (46.67% and 43.33%, respectively), and only 3 (10%) reported severe pain. Pain duration ranged from 2 to 120 months (mean 34.67 +/- 36.96 months). Significant associations were observed between RMMA-SB and MFP as well as between DC and MFP. Conclusions: (1) RMMA-SB is significantly associated with MFP; (2) although RMMA-SB represents a risk factor for MFP, this risk is low; and (3) DC probably constitutes a stronger risk factor for MFP than RMMA-SB.

Schistosoma mansoni: In vitro schistosomicidal activity of piplartine

Schistosomiasis is one of the world`s greatly neglected tropical diseases, and its control is largely dependent on a single drug, praziquantel. Here, we report the in vitro effect of piplartine, an amide isolated from Piper tuberculatum (Piperaceae), on Schistosoma mansoni adult worms. A piplartine concentration of 15.8 mu M reduced the motor activity of worms and caused their death within 24 h in a RPMI 1640 medium. Similarly, the highest sub-lethal concentration of piplartine (6.3 mu M) caused a 75% reduction in egg production in spite of coupling. Additionally, piplartine induced morphological changes on the tegument, and a quantitative analysis carried out by confocal microscopy revealed an extensive tegumental destruction and damage in the tubercles. This damage was dose-dependent in the range of 15.8-630.2 mu M. At doses higher than 157.6 mu M, piplartine induced morphological changes in the oral and ventral sucker regions of the worms. It is the first time that the schistosomicidal activity has been reported for piplartine. Published by Elsevier Inc.

Effects of elevated calcium on motor and exploratory activities of rats

The effects of serum and brain calcium concentration on rat behavior were tested by maintaining animals on either distilled water (N = 60) or water containing 1% calcium gluconate (N = 60) for 3 days. Animals that were maintained on high calcium drinking water presented increased serum calcium levels (control = 10.12 ± 0.46 vs calcium treated = 11.62 ± 0.51 µg/dl). Increase of brain calcium levels was not statistically significant. In the behavioral experiments each rat was used for only one test. Rats that were maintained on high calcium drinking water showed increased open-field behavior of ambulation (20.68%) and rearing (64.57%). on the hole-board, calcium-supplemented animals showed increased head-dip (67%) and head-dipping (126%), suggesting increased ambulatory and exploratory behavior. The time of social interaction was normal in animals maintained on drinking water containing added calcium. Rats supplemented with calcium and submitted to elevated plus-maze tests showed a normal status of anxiety and elevated locomotor activity. We conclude that elevated levels of calcium enhance motor and exploratory behavior of rats without inducing other behavioral alterations. These data suggest the need for a more detailed analysis of several current proposals for the use of calcium therapy in humans, for example in altered blood pressure states, bone mineral metabolism disorders in the elderly, hypocalcemic states, and athletic activities.

Is walking in daily life a moderate intensity activity in patients with chronic obstructive pulmonary disease?

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeito da intervenção em esteira motorizada na aquisição da marcha independente e desenvolvimento motor em bebês de risco para atraso desenvolvimental

OBJETIVO: Examinar o efeito de intervenção em esteira motorizada na idade de aquisição da marcha independente em bebês de risco para atraso de desenvolvimento. MÉTODOS: Estudo experimental com 15 lactentes a partir do 5º mês de idade, sendo cinco deles com risco de atraso de desenvolvimento submetidos a sessões de fisioterapia e intervenção em esteira motorizada (Grupo Experimental); cinco com risco de atraso de desenvolvimento submetidos apenas a sessões de fisioterapia (Grupo Controle de Risco); e cinco bebês sem risco de atraso (Grupo Controle Típico). As sessões de fisioterapia ocorreram duas vezes por semana, seguidas de intervenção em esteira motorizada para o grupo experimental. Todos os bebês foram avaliados mensalmente pela Alberta Infant Motor Scale e os participantes do grupo experimental foram filmados durante a realização das passadas na esteira. Comparações entre os grupos ao longo do tempo foram realizadas por análise de variância (ANOVA) e de multivariância (MANOVA). RESULTADOS: Os bebês do Grupo Experimental adquiriram a marcha independente aos 12,8 meses e os do Grupo Controle de Risco aos 13,8 meses de idade corrigida, sendo que a aquisição do Grupo Controle de Risco ocorreu mais tarde em relação ao Grupo Controle Típico (1,1 meses; p<0,05). Os bebês do grupo experimental apresentaram padrão alternado das passadas na esteira, que aumentou ao longo da intervenção (p<0,05), e mostraram melhora do desenvolvimento motor global em relação aos bebês do Grupo Controle de Risco. CONCLUSÕES: A esteira pode ser considerada um agente facilitador para a aquisição do andar independente e do desenvolvimento motor global de bebês com risco de atraso de desenvolvimento.

Short-Term Effects of Using Pedometers to Increase Daily Physical Activity in Smokers: A Randomized Trial

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Perception-action coupling in infants with down syndrome: Effects of experience and practice

This study examined the effects of experience and practice on the coupling between visual information and trunk sway in infants with Down syndrome (DS). Five experienced and five novice sitters were exposed to a moving room, which was oscillated at 0.2 and 0.5 Hz. Infants remained in a sitting position and data were collected on the first, fourth, and seventh days. On the first day, experienced sitters were more influenced by room oscillation than were novices. On the following days, however, the influence of room oscillation decreased for experienced but increased for novice sitters. These results suggest that the relationship between sensory information and motor action in infants with DS can be changed with experience and practice.

Síntomas depresivos y trastorno motor en pacientes con enfermedad de Parkinson

Introduction. Complex relations between brain and psychopathology have attracted the interest of researchers, aiming to clarify the neurobiological mechanisms of depression in Parkinson's disease, obviously in addiction to mental features. Aims. The association of motor impairment and decline of personal autonomy with severity of depressive symptoms was the hypothesis of the present study. Aiming to check this hypothesis, the objective of this study consisted in investigating relationships between the severity of depressive symptoms and motor characteristics of Parkinson's disease. Patients and methods. Thirty patients (53 to 80 year-old) with medical diagnosis of idiopathic Parkinson's disease in initial clinic stages were studied. The Unified Parkinson's Disease Rating Scale, Hoehn-Yahr Scale, and Schwab & England Scale were used to assess the clinic signs and symptoms. The depressive symptoms were identified by complete anamnesis, examination of mental condition, and the Hamilton Rating Scale for Depression and the Anxiety and Depression Scale. Statistical analysis was performed by Pearson's correlation and multiple regression analysis. Results. A significant correlation of severity of depression symptoms with disease stage (p < 0.02), with motor signs (p < 0.008), and with functional performance (p < 0.007) was found. Conclusion. There was significant association between motor impairment and severity of depressive symptoms, and between depression and early disease onset or prolonged duration of Parkinson's disease. © 2007, Revista de Neurología.