Services Received and Parental Perception of Quality of Life for Children with Autism Spectrum Disorder

With the rapid increase in the rate of children diagnosed with Autism Spectrum Disorder (ASD), there has been a surge in treatment interventions and outcome measures. Treatment interventions consist of evidence-based practices and programs that lack scientific validation. Parents’ selection of a treatment or multiple treatments is often based on the desire to maximize their child’s personal well-being (Pituch et al., 2011; Rodger, Braithwaite, & Keen, 2004). Current outcome measures provide valuable information and may demonstrate a change in a standard score. For example, a change in intelligence quotient, is not evidence that this change contributes to the child’s personal well-being or quality of life (QOL). Measures of QOL assesses aspects of health, happiness, self-esteem, mental health, and life satisfaction (Cummins, McCabe, Romeo, & Gullone, 1994). For decades these measures have been used as a means of identifying treatment objectives and improving outcomes for individuals with disability and adults with autism. However, such measures have not been used for selecting treatment or assessing the effect of treatment for young children with ASD. The purpose of this study was to investigate how parents of children with ASD rate their child’s quality of life and determine how specific interventions relate to parental perception of QOL for children with ASD. This study resulted in the development of a QOL scale, which includes indicators specific to characteristics of children with ASD. The scale demonstrated evidence of validity for each subscale as well as for the total instrument. The data show that the majority of parents (81.9%) perceived their child as having a good or excellent QOL. Parents selected and used between 0 and 9 types of treatment for their child with ASD during the past twelve months. The results of an analysis of variance showed that there was not a significant interaction effect on total number of treatments utilized and parental perception of their child’s QO

The effects of a three-week use of lumbosacral orthoses on trunk muscle activity and on the muscular response to trunk perturbations

<p>Abstract</p> <p>Background</p> <p>The effects of lumbosacral orthoses (LSOs) on neuromuscular control of the trunk are not known. There is a concern that wearing LSOs for a long period may adversely alter muscle control, making individuals more susceptible to injury if they discontinue wearing the LSOs. The purpose of this study was to document neuromuscular changes in healthy subjects during a 3-week period while they regularly wore a LSO.</p> <p>Methods</p> <p>Fourteen subjects wore LSOs 3 hrs a day for 3 weeks. Trunk muscle activity prior to and following a quick force release (trunk perturbation) was measured with EMG in 3 sessions on days 0, 7, and 21. A longitudinal, repeated-measures, factorial design was used. Muscle reflex response to trunk perturbations, spine compression force, as well as effective trunk stiffness and damping were dependent variables. The LSO, direction of perturbation, and testing session were the independent variables.</p> <p>Results</p> <p>The LSO significantly (<it>P </it>< 0.001) increased the effective trunk stiffness by 160 Nm/rad (27%) across all directions and testing sessions. The number of antagonist muscles that responded with an onset activity was significantly reduced after 7 days of wearing the LSO, but this difference disappeared on day 21 and is likely not clinically relevant. The average number of agonist muscles switching off following the quick force release was significantly greater with the LSO, compared to without the LSO (<it>P </it>= 0.003).</p> <p>Conclusions</p> <p>The LSO increased trunk stiffness and resulted in a greater number of agonist muscles shutting-off in response to a quick force release. However, these effects did not result in detrimental changes to the neuromuscular function of trunk muscles after 3 weeks of wearing a LSO 3 hours a day by healthy subjects.</p

Trunk muscle recruitment patterns in patients with low back pain enhance the stability

Study Design. A comparative study of trunk muscle recruitment patterns in healthy control subjects and patients with chronic low back pain was conducted. Objective. To assess trunk muscle recruitment in patients with low back pain. Summary of Background Data. Conflicting evidence has been reported on the level and pattern of trunk muscle recruitment in patients with low back pain. The disparities can be explained partly by methodologic differences. It was hypothesized that trunk muscle recruitment patterns may be altered in patients with low back pain to compensate for reduced spinal stability. Methods. For this study, 16 patients with low back pain and 16 matched control subjects performed slow trunk motions about the neutral posture and isometric ramp contractions while seated upright. Ratios of electromyographic amplitudes and estimated moment contributions of antagonist over agonist muscles and of segmentally inserting muscles over muscles inserting on the thorax and pelvis only were calculated. In addition, model simulations were performed to assess the effect of changes in muscle recruitment on spinal stability. Results. The ratios of antagonist over agonist, and of lumbar over thoracic erector spinae electromyographic amplitude and estimated moment contributions were greater in the patients than in the control subjects. The simulation model predicted that these changes would effectively increase spinal stability. Conclusions. Trunk muscle recruitment patterns in patients with low back pain are different from those in healthy control subjects. The differences are likely to be functional with respect to enhancement of spinal stability in the patients

Trunk muscle recruitment patterns in patients with low back pain enhance the stability of the lumbar spine

STUDY DESIGN: A comparative study of trunk muscle recruitment patterns in healthy control subjects and patients with chronic low back pain was conducted. OBJECTIVE: To assess trunk muscle recruitment in patients with low back pain. SUMMARY OF BACKGROUND DATA: Conflicting evidence has been reported on the level and pattern of trunk muscle recruitment in patients with low back pain. The disparities can be explained partly by methodologic differences. It was hypothesized that trunk muscle recruitment patterns may be altered in patients with low back pain to compensate for reduced spinal stability. METHODS: For this study, 16 patients with low back pain and 16 matched control subjects performed slow trunk motions about the neutral posture and isometric ramp contractions while seated upright. Ratios of electromyographic amplitudes and estimated moment contributions of antagonist over agonist muscles and of segmentally inserting muscles over muscles inserting on the thorax and pelvis only were calculated. In addition, model simulations were performed to assess the effect of changes in muscle recruitment on spinal stability. RESULTS: The ratios of antagonist over agonist, and of lumbar over thoracic erector spinae electromyographic amplitude and estimated moment contributions were greater in the patients than in the control subjects. The simulation model predicted that these changes would effectively increase spinal stability. CONCLUSIONS: Trunk muscle recruitment patterns in patients with low back pain are different from those in healthy control subjects. The differences are likely to be functional with respect to enhancement of spinal stability in the patients

Services Received And Parental Perception Of Quality Of Life For Children With Autism Spectrum Disorder

With the rapid increase in the rate of children diagnosed with Autism Spectrum Disorder (ASD), there has been a surge in treatment interventions and outcome measures. Treatment interventions consist of evidence-based practices and programs that lack scientific validation. Parents’ selection of a treatment or multiple treatments is often based on the desire to maximize their child’s personal well-being (Pituch et al., 2011; Rodger, Braithwaite, & Keen, 2004). Current outcome measures provide valuable information and may demonstrate a change in a standard score. For example, a change in intelligence quotient, is not evidence that this change contributes to the child’s personal well-being or quality of life (QOL). Measures of QOL assesses aspects of health, happiness, self-esteem, mental health, and life satisfaction (Cummins, McCabe, Romeo, & Gullone, 1994). For decades these measures have been used as a means of identifying treatment objectives and improving outcomes for individuals with disability and adults with autism. However, such measures have not been used for selecting treatment or assessing the effect of treatment for young children with ASD. The purpose of this study was to investigate how parents of children with ASD rate their child’s quality of life and determine how specific interventions relate to parental perception of QOL for children with ASD. This study resulted in the development of a QOL scale, which includes indicators specific to characteristics of children with ASD. The scale demonstrated evidence of validity for each subscale as well as for the total instrument. The data show that the majority of parents (81.9%) perceived their child as having a good or excellent QOL. Parents selected and used between 0 and 9 types of treatment for their child with ASD during the past twelve months. The results of an analysis of variance showed that there was not a significant interaction effect on total number of treatments utilized and parental perception of their child’s QO

Development of a collaborative model of low back pain: report from the 2017 NASS consensus meeting

Low back pain (LBP) is a multifactorial problem with complex interactions among many biological, psychological and social factors. It is difficult to fully appreciate this complexity because the knowledge necessary to do so is distributed over many areas of expertise that span the biopsychosocial domains.This study describes the collaborative modeling process, undertaken among a group of participants with diverse expertise in LBP, to build a model to enhance understanding and communicate the complexity of the LBP problem.The study involved generating individual models that represented participants' understanding of the LBP problem using fuzzy cognitive mapping (FCM), and 4 subsequent phases of consultation and consensus with the participants to characterize and refine the interpretation of the FCMs.The phases consisted of: proposal of Categories for clustering of model Components; preliminary evaluation of structure, composition and focal areas of participant's FCMs; refinement of Categories and Components with consensus meeting; generation of final structure and composition of individual participant's FCMs. Descriptive statistics were applied to the structural and composition metrics of individual FCMs to aid interpretation.From 38 invited contributors, 29 (76%) agreed to participate. They represented 9 disciplines and 8 countries. Participants' models included 729 Components, with an average of 25 (SD = 7) per model. After the final FCM refinement process (Components from separate FCMs that used similar terms were combined, and Components from an FCM that included multiple terms were separated), there were 147 Components allocated to ten Categories. Although individual models varied in their structure and composition, a common opinion emerged that psychological factors are particularly important in the presentation of LBP. Collectively, Components allocated to the "Psychology" Category were the most central in almost half (14/29) of the individual models.The collaborative modeling process outlined in this paper provides a foundation upon which to build a greater understanding and to communicate the complexity of the LBP problem. The next step is to aggregate individual FCMs into a metamodel and begin disentangling the interactions among its Components. This will lead to an improved understanding of the complexity of LBP, and hopefully to improved outcomes for those suffering from this condition

Tapering practices of New Zealand's elite raw powerlifters

Pritchard, HJ, Tod, DA, Barnes, MJ, Keogh, JW, and McGuigan, MR. Tapering practices of New Zealand's elite raw powerlifters. J Strength Cond Res 30(7): 1796-1804, 2016-The major aim of this study was to determine tapering strategies of elite powerlifters. Eleven New Zealand powerlifters (28.4 ± 7.0 years, best Wilks score of 431.9 ± 43.9 points) classified as elite were interviewed, using semistructured interviews, about their tapering strategies. Interviews were transcribed verbatim and content analyzed. Total training volume peaked 5.2 ± 1.7 weeks from competition while average training intensity (of 1 repetition maximum) peaked 1.9 ± 0.8 weeks from competition. During tapering, volume was reduced by 58.9 ± 8.4% while intensity was maintained (or slightly reduced) and the final weight training session was performed 3.7 ± 1.6 days out from competition. Participants generally stated that tapering was performed to achieve full recovery; that accessory work was removed around 2 weeks out from competition; and deadlifting takes longer to recover from than other lifts. Typically participants stated that trial and error, and changes based on "feel" were the sources of tapering strategies; equipment used and movements performed during tapering are the same as in competition; nutrition was manipulated during the taper (for weight cutting or performance aims); and poor tapering occurred when too long (1 week or more) was taken off training. These results suggest that athletes may benefit from continuing to strength train before important events with reduced volume and maintained intensity. Only exercises that directly assist sports performance should remain in the strength program during tapering, to assist with reductions in fatigue while maintaining/improving strength expression and performance

In vivo measurements of muscle specific tension in adults and children

This article is available open access through the publisher’s website at the link below. Copyright @ 2009 The Authors.To better understand the effects of pubertal maturation on the contractile properties of skeletal muscle in vivo, the present study investigated whether there are any differences in the specific tension of the quadriceps muscle in 20 adults and 20 prepubertal children of both sexes. Specific tension was calculated as the ratio between the quadriceps tendon force and the sum of the physiological cross-sectional area (PCSA) multiplied by the cosine of the angle of pennation of each head within the quadriceps muscle. The maximal quadriceps tendon force was calculated from the knee extension maximal voluntary contraction (MVC) by accounting for EMG-based estimates of antagonist co-activation, incomplete quadriceps activation using the interpolation twitch technique and magnetic resonance imaging (MRI)-based measurements of the patellar tendon moment arm. The PCSA was calculated as the muscle volume, measured from MRI scans, divided by optimal fascicle length, measured from ultrasound images during MVC at the estimated angle of peak quadriceps muscle force. It was found that the quadriceps tendon force and PCSA of men (11.4 kN, 214 cm2) were significantly greater than those of the women (8.7 kN, 152 cm2; P 0.05) between groups: men, 55 ± 11 N cm−2; women, 57.3 ± 13 N cm−2; boys, 54 ± 14 N cm−2; and girls, 59.8 ± 15 N cm−2. These findings indicate that the increased muscle strength with maturation is not due to an increase in the specific tension of muscle; instead, it can be attributed to increases in muscle size, moment arm length and voluntary activation level