16 research outputs found
Predictive validity of the Hand Assessment for Infants in infants at risk of unilateral cerebral palsy
Aim: To evaluate the sensitivity, specificity, and predictive value of the Hand Assessment for Infants (HAI) in identifying infants at risk of being diagnosed with unilateral cerebral palsy(CP), and to determine cut-off values for this purpose.
Method: A convenience sample of 203 infants (106 females, 97 males) was assessed by the HAI at 3, 6, 9, and 12 months. Sensitivity, specificity, predictive values, and likelihood ratios were calculated using receiver operating characteristic curve analysis. Cut-off values were derived for different ages. The clinical outcome (unilateral CP yes/no) at 24 months or more served as an external criterion to investigate the predictive validity of HAI.
Results: Half of the infants developed unilateral CP. The area under the curve ranged from0.77 (95% CI [confidence interval] 0.63â0.91) to 0.95 (95% CI 0.90â1.00) across HAI scales and age intervals. Likewise, sensitivity ranged from 63% to 93%, specificity from 62% to 91%, and accuracy from 73% to 94%.
Interpretation: HAI scores demonstrated overall accuracy that ranged from very good to excellent in predicting unilateral CP in infants at risk aged between 3.5 and 12 months. This accuracy increased with age at assessment and the earliest possible prediction was at3.5 months of age, when appropriate HAI cut-off values for different ages were applied
Action observation training for rehabilitation in brain injuries: A systematic review and meta-analysis
Background : To systematically review and analyse the effects of Action Observation Training on adults and children with brain damage. Methods : Seven electronic databases (Cochrane, EBSCO, Embase, Eric, PubMed, Scopus and Web of Science) were searched up to 16 September 2018 to select Randomized Controlled Trials focused on adults and children with brain damage that included AOT training on upper and/or lower limb carried out for at least 1 week. Identification of studies and data extraction was conducted with two reviewers working independently. Oxford Centre for Evidence-based Medicine (March2009) â Levels of Evidence and Physiotherapy Evidence Database scale were used to grade studies. The data collected from the articles were analysed using software R, version 3.4.3. Hedgeâs g values were calculated and effect size estimates were pooled across studies. Separate meta-analyses were carried out for each ICF domain (i.e. body function and activity) for upper and lower limb. Results : Out of the 210 records identified after removing duplicates, 22 were selected for systematic review and 19 were included in the meta-analysis. Thirteen studies included in the meta-analysis focused on upper limb rehabilitation (4 in children and 9 in adults) and 6 on lower limb rehabilitation (only studies in adults). A total of 626 patients were included in the meta-analysis. An overall statistically significant effect size was found for upper limb body function (0.44, 95% CI: [0.24, 0.64], p<0.001) and upper limb activity domain (0.47, 95% CI: [0.30, 0.64], p<0.001). For lower limb, only the activity domain was analysed, revealing a statistically significant overall effect size (0.56, 95% CI: [0.28, 0.84], p<0.001). Conclusions : Action Observation Training (AOT) is an innovative rehabilitation tool for individuals with brain damage, which shows promising results in improving the activity domain for upper and lower limbs, and also the body function domain for the upper limb. However, the examined studies lack uniformity and further well-designed, larger controlled trials are necessary to determine the most suitable type of AOT particularly in childre
Predictive validity of the Hand Assessment for Infants in infants at risk of unilateral cerebral palsy
Aim: To evaluate the sensitivity, specificity, and predictive value of the Hand Assessment for Infants (HAI) in identifying infants at risk of being diagnosed with unilateral cerebral palsy (CP), and to determine cut-off values for this purpose. Method: A convenience sample of 203 infants (106 females, 97 males) was assessed by the HAI at 3, 6, 9, and 12 months. Sensitivity, specificity, predictive values, and likelihood ratios were calculated using receiver operating characteristic curve analysis. Cut-off values were derived for different ages. The clinical outcome (unilateral CP yes/no) at 24 months or more served as an external criterion to investigate the predictive validity of HAI. Results: Half of the infants developed unilateral CP. The area under the curve ranged from 0.77 (95% CI [confidence interval] 0.63â0.91) to 0.95 (95% CI 0.90â1.00) across HAI scales and age intervals. Likewise, sensitivity ranged from 63% to 93%, specificity from 62% to 91%, and accuracy from 73% to 94%. Interpretation: HAI scores demonstrated overall accuracy that ranged from very good to excellent in predicting unilateral CP in infants at risk aged between 3.5 and 12 months. This accuracy increased with age at assessment and the earliest possible prediction was at 3.5 months of age, when appropriate HAI cut-off values for different ages were applied
Upper limb children action-observation training (UP-CAT) study: design of a randomised clinical trial for children with hemiplegia
Objective: The purpose of the present study was to design
and test a Randomised Clinical Trial (RCT) for evaluating
the efficacy of action-observation therapy in improving the
upper limb (UL) activity in children with hemiplegia.
Background: Rehabilitation for children with hemiplegia to
improve function in the impaired UL uses a wide range of
intervention programs; researches using adequately powered
RCTs, rigorous methodology and valid outcome
measures are essential, to provide the highest level support
of therapy effectiveness.
Design/Methods: The trial was designed according to Consolidated
Standards of Reporting Trials (CONSORT)
Statement. It was a randomised, evaluator-blinded, matchpair
group trial. Children were randomised within pairs to
either experimental or control group. The experimental
group performed an ActionâObservation Therapy based
on watching video sequences of goal actions, chosen
according to their UL functional level, combined with
motor training with their hemiplegic UL. The control
group performed the same tailored actions after watching
computer games. A carefully revision of psychometric
properties (e.g. small detectable differences) of UL outcome
measures for hemiplegic children was performed.
Assisting Hand Assessment was chosen as primary measure
and based on its power calculation a sample size of 12
matched pairs was established. Moreover, Melbourne and
ABILHAND-Kids were included as secondary measures.
The time line of assessments was T0 (on the week preceding
the onset of the treatment), T1 and T2 (on the week
and 8 weeks after the end of the treatment, respectively).
Results: We were able to perform children recruitment and
testing in the 24 consecutive children according to above
experimental planning. The two experimental and control
groups differ only for the type of observation but the performed
actions were similar so that the changes induced by
observation should be measured.
Conclusions: To provide reliable results of program rehabilitation
effectiveness it is essential to design RCT studies
according to CONSORT guidelines