Stern v. Marshall Panel

The Stern v. Marshall Panel discussed the issues of the case and its potential impact on practitioners

Human treadmill walking needs attention

BACKGROUND: The aim of the study was to assess the attentional requirements of steady state treadmill walking in human subjects using a dual task paradigm. The extent of decrement of a secondary (cognitive) RT task provides a measure of the attentional resources required to maintain performance of the primary (locomotor) task. Varying the level of difficulty of the reaction time (RT) task is used to verify the priority of allocation of attentional resources. METHODS: 11 healthy adult subjects were required to walk while simultaneously performing a RT task. Participants were instructed to bite a pressure transducer placed in the mouth as quickly as possible in response to an unpredictable electrical stimulation applied on the back of the neck. Each subject was tested under five different experimental conditions: simple RT task alone and while walking, recognition RT task alone and while walking, walking alone. A foot switch system composed of a pressure sensitive sensor was placed under the heel and forefoot of each foot to determine the gait cycle duration. RESULTS: Gait cycle duration was unchanged (p > 0.05) by the addition of the RT task. Regardless of the level of difficulty of the RT task, the RTs were longer during treadmill walking than in sitting conditions (p < 0.01) indicating that an increased amount of resources are required for the maintainance of walking performance on a treadmill at a steady state. No interaction (p > 0.05) was found between the attentional demand of the walking task and the decrement of performance found in the RT task under varying levels of difficulty. This finding suggests that the healthy subjects prioritized the control of walking at the expense of cognitive performance. CONCLUSION: We conclude that treadmill walking in young adults is not a purely automatic task. The methodology and outcome measures used in this study provide an assessment of the attentional resources required by walking on the treadmill at a steady state

CONTRIBUTION A L'ETUDE DES MECANISMES DE LA SPASTICITE PAR L'ETUDE DE LA LOCOMOTION ET L'ETUDE ELECTROPHYSIOLOGIQUE DES CONSEQUENCES DE L'ADMINISTRATION INTRATHECALE DE CLONIDINE CHEZ L'HOMME BLESSE MEDULLAIRE

ORSAY-PARIS 11-BU Sciences (914712101) / SudocSudocFranceF

Automaticité de la locomotion chez l'homme (analyse par un paradigme de double tâche)

Dans un environnement stable, le contrôle de la locomotion est souvent considéré comme très automatisé, c'est-à-dire impliquant peu ou pas les fonctions cognitives. L'attention est associée à l'activation de certaines structures cérébrales. La contribution des ressources attentionnelles au maintien et au contrôle de performances motrices peut être évaluée par une méthodologie de double tâche, en utilisant une tâche de temps de réaction (TRs). Déterminer et évaluer la contribution des ressources attentionnelles au contrôle de la marche à vitesse stabilisée sur tapis roulant chez des adultes jeunes ou après une lésion du systéme nerveux central est le théme de notre recherche.Nos résultats montrent que la marche à vitesse stabilisée dans des conditions très automatisées, comme sur un tapis roulant, n'est pas un acte moteur purement automatique. La consommation de ressources attentionnelles pendant la marche sur tapîs roulant démontre la participation de structures cérébrales pour maintenir et contrôler les performances de la tâche locomotrice. L'action de ces structures dans le contrôle de la locomotion se produirait en particulier pendant la phase de double appui. Un côut supplémentaire en attention, observé chez les personnes présentant des lésions cérébrales ou médullaires, serait en relation avec l'importance du déficit des capacités locomotrices chez les patients.Un test utilisant des TRs pendant la marche sur tapis roulant pourrait être une mesure facile et peu coûteuse pour évaluer l'efficacité d'un traitement ou les progrés des patients au cours du temps sur les performances de marche.In a stable environment, the control of human locomotion is often regarded as very automated, with little or no involvement of cognitive function. Attention is associated with the activation of certain cerebral structures. The involvement of attentional resources in the control of motor performance can be evaluated by a dual -task paradigm, through use of a reaction time (RT) task. The aim of our research is to determine and evaluate the contribution of attentional resources required for gait control on a treadmill at a steady state in young healthy adults or after a central system nervous lesion.Our results show that walking at a confortable speed under very automated conditions, as on a treadmill, is not a purely automatic activity. The requirement of attentional resources during treadmill walking shows the participation of cerebral structures in the maintenance and control of the performance of the locomotor task. In the motor control of locomotion, these structures appear particularly involved during the double limb support phase. Compared to healthy young adults, the greater amount of resources consumed by patients after a cerebral or spinal injury while performing the walking task seems to be related to the importance of the locomotor impairment. An outcome measure using RTs during treadmill walking could be an easy and inexpensive tool for the evaluation of treatment effectiveness or patient progress in walking performance.ORSAY-PARIS 11-BU Sciences (914712101) / SudocSudocFranceF

Reliability and validity of the Dutch version of the Maternal Antenatal Attachment Scale

In this study, we investigated the psychometric qualities of the Dutch version of the Maternal Antenatal Attachment Scale (MAAS). In a monocentric prospective observational cohort study, 403 expectant mothers completed a booklet with questionnaires in the first (T1), second (T2), and third (T3) pregnancy trimesters. In addition to the MAAS (T1-T3), the following measures were used: the Marlowe-Crowne Social Desirability Scale (T1), the Parental Bonding Inventory (T1), the Relationship Questionnaire (T1) the Facilitator scale and the Regulator scale (T3), the Edinburgh Postnatal Depression Scale (T1-T3) and the Pregnancy Related Anxiety Questionnaire (T1-T3). In this study, the mean of the MAAS scales increased as the pregnancy progressed. Good internal reliabilities were found for the Total MAAS scale, the Quality subscale and the Preoccupation subscale. Small-to-moderate correlations were found with social desirability, maternal orientation, parental care and adult attachment. Maternal mood was weakly associated with the quality but not with the intensity of the maternal attachment feelings. Overall, our findings suggest that the Dutch version of the Maternal Antenatal Attachment Scale is a reliable and valid measure of the early emotional tie between a pregnant woman and her unborn child.status: publishe

Three self-report questionnaires of the early mother-to-infant bond: reliability and validity of the Dutch version of the MPAS, PBQ and MIBS

In this study, we investigated the reliability and validity of three self-report questionnaires measuring the early emotional bond between a mother and her newborn infant: the Maternal Postpartum Attachment Scale (MPAS), the Postpartum Bonding Questionnaire (PBQ) and the Mother-to-Infant Bonding Scale (MIBS). In a monocentric prospective observational cohort study, 263 mothers completed the MPAS, the PBQ and the MIBS at 8-12 and at 20-25 weeks postpartum. The participants also completed measures of mental health and, during their pregnancy, measures of recalled parental bonding, adult romantic attachment, antenatal attachment and social desirability. In our study, the internal reliabilities of the PBQ and the MPAS were high at 8-12 weeks postpartum but dropped significantly at 20-25 weeks postpartum. Moderately strong correlations between the scales of the PBQ, the MPAS and the MIBS supported their construct validity. Further, weak correlations were found with social desirability and adult attachment representations, whereas moderate correlations were found with antenatal feelings of attachment and antenatal attitudes to motherhood. Finally, maternal feelings of bonding were also moderately associated with maternal mood. Overall, our findings suggest that the MPAS, the PBQ and the MIBS provide a reliable and valid indication of the early emotional tie between a woman and her newborn infant.status: publishe

Anxiety in Pregnant and Postpartum Women. An exploratory study of the role of maternal orientations

BACKGROUND: Little is known about why some women are anxious during pregnancy but not in the postpartum period, or vice versa. We aimed to determine the influence of maternal antenatal orientations (Raphael-Leff, J. (2005) Psychological Processes of Childbearing, London, The Anna Freud Centre.) on the prevalence of general anxiety symptoms and specific anxiety in pregnant and postpartum women. METHODS: Four hundred and three pregnant women participated in a longitudinal study and completed general (HADS-A) and specific (PRAQ, MSAS) anxiety questionnaires and measures of maternal antenatal orientations, personality traits, cognitive and behavioural coping styles and attachment. RESULTS: Higher scores on the neuroticism and regulator orientation scale consistently predicted higher scores on the general and pregnancy related anxiety measures. Also, an interaction effect was found between the regulator scale and the neuroticism scale on the general anxiety symptoms and pregnancy related anxiety. Finally, the facilitator orientation scale and the neuroticism scale, predicted maternal separation anxiety in the postpartum period. CONCLUSION: Women differ in the risk factors, the nature and timing of heightened anxiety during the transition to motherhood. The anxieties of women tending to the regulator orientation are pregnancy related, whereas women tending to the facilitator orientation fear the separation from their child in the postpartum period.status: publishe

Depressive Symptomatology in Pregnant and Postpartum Women. An exploratory study of the role of maternal orientations

Little is known about how an expecting woman's view of pregnancy, the child, and motherhood relates to antenatal and postpartum depressive symptomatology. In this study, we investigated the influence of the maternal orientations, as described by Raphael-Leff (Psychological processes of childbearing. The Anna Freud Centre, London, 2005), on the prevalence of depressive symptoms in pregnant and postpartum women. Four hundred three pregnant women participated in a longitudinal study and completed the EPDS and the HADS-D in each pregnancy trimester and between 8 to 12 and 20 to 25 weeks postpartum. In addition, measures of maternal orientation (PPQ), personality (NEO-FFI), coping styles (UCL), adult attachment (RQ), and parental bonding (PBI) were completed antenatally. Bivariate and multivariate analyses revealed that Neuroticism and the Regulator orientation are positively associated with the EPDS and HADS-D in both pregnant and postpartum women. These associations decreased in strength but remained significant after controlling for previous responses on the EPDS and HADS-D. Small negative associations were found between the Facilitator orientation and the HADS-D scores during pregnancy and the early postpartum period. However, this association did not hold its statistical significance within the hierarchical multiple regression models. The maternal orientations have a small but significant and independent contribution in the variance of depressive symptomatology in pregnant and postpartum women.status: publishe

Assessing of imagined and real expanded Timed Up and Go tests in patients with chronic stroke: A case-control study

Objective: To assess temporal congruence (the difference in performance-time and time to imagine) between the sub-tasks of the Expanded Timed Up and Go (ETUG) and imagined ETUG (iETUG) tests in patients with hemiparesis following unilateral hemispheric stroke, and to compare the results with those for with healthy subjects. Design: Case-controlled study. Subject/patients: Twenty patients with chronic stroke and 20 healthy subjects. Methods: TUG, ETUG and iETUG test performance times were recorded for all participants. Temporal congruence was calculated with the following formula: (ETUG-iETUG)/[(ETUG+iETUG)/2]*100. Results: Patients’ performances were slower than those of healthy subjects for all 5 sub-tasks of the TUG, ETUG and iETUG tests. However, there was no significant difference in temporal congruence between healthy subjects and patients. Intragroup analysis showed significant differences between the executed and the imagined conditions for both groups for the “walking”, “turn around” and “sitting” phases (healthy subjects p = 0.01, p = 0.03, p = 0.03, and patients p = 0.01, p = 0.003, p = 0.003, respectively). Conclusion: Temporal congruence was similar for healthy subjects and patients for all sub-tasks of the ETUG test. Moreover, temporal congruence was reduced for the same sub-tasks of the ETUG test in patients and healthy subjects. This suggests that the motor imagery involved the same cerebral structures in both groups, probably including the cerebellum, since it was intact in all patients

Stern v. Marshall Panel

The Stern v. Marshall Panel discussed the issues of the case and its potential impact on practitioners