I’m a 5, I’m Paralyzed, but I’m Learning to Move! Fostering the Development of Voluntary Motor Skills in Spastic Quadriplegic Cerebral Palsy Child using a Novel Psychomotor Sensory Substitution Paradigm : A case report

Background: Cerebral palsy, particularly spastic quadriplegia (SQ), severely impairs motor development. Developing voluntary motor skills is therefore one of the most challenging issues when considering these children! Movement relies on sensation, yet quadriplegia not only impairs motor control but also somatosensory sensitivity, particularly proprioception, hindering clear perception of body movement. Objective: The present project aims to evaluate the efficacy of a novel sensory substitution paradigm utilizing visuo-auditory feedback through a serious game (SG) in fostering the development of voluntary motor skills among SQ children. Methods: We tested one 5-year-old girl with severe motor disabilities due to SQ, who are unable to sit or control her head (GMFCS grade V, SATCo score 0) and demonstrate no manual ability (MACS grade V). She can only voluntarily control her eyes, moving and focusing on a target when asked. The child is non-verbal but can respond to simple questions by looking at basic communicative targets. Using an EMG device, muscle contractions were translated into visual and auditory feedback according to a sensory substitution paradigm. A right-arm contraction prompts the appearance of a cat on the right side of the screen, while a left arm contraction positions it on the left. Conversely, the onset of a spasm triggers a soothing melody. The child attended 9 bi-weekly 60-minute sessions at her institution. Data collection was conducted using video recordings reporting 1) the number of spasms versus voluntary movements event per minute, 2) movement pattern and 3) gaze orientation. A baseline before the intervention was established over 4 sessions of standard treatment for comparison. Results: our preliminary findings show that the sensory substitution SG we designed for this SQ CP child prove to be effective to provide visuo-auditive feedback to the child’s contractions and therefore allows the child to produce more controlled movements. Moreover, they highlight the potential of providing visuo-auditive feedback to the child's contractions as a substitute for impaired proprioception, restoring crucial cues for motor development and control

Distribution of Achromobacter species in 12 French cystic fibrosis centers in 2020 by a retrospective MALDI-TOF MS spectrum analysis

International audienceAchromobacter spp. are nonfermenting Gram-negative bacilli mainly studied among cystic fibrosis (CF) patients. The identification of the 19 species within the genus is time-consuming (nrdA-sequencing), thus data concerning the distribution of the species are limited to specific studies. Recently, we built a database using MALDI-TOF mass spectrometry (MS) (Bruker) that allows rapid and accurate species identification and detection of the multiresistant epidemic clones: A xylosoxidans ST137 spreading among CF patients in various French and Belgium centers, and A. ruhlandii DES in Denmark. Here, we first assessed whether species identification could be achieved with our database solely by analysis of MS spectra without availability of isolates. Then, we conducted a multicentric study describing the distribution of Achromobacter species and of the clone ST137 among French CF centers. We collected and analyzed with our local database the spectra of Achromobacter isolates from 193 patients (528 samples) from 12 centers during 2020. In total, our approach enabled to conclude for 502/528 samples (95.1%), corresponding to 181 patients. Eleven species were detected, only five being involved in chronic colonization, A. xylosoxidans (86.4%), A. insuavis (9.1%), A. mucicolens (2.3%), A. marplatensis (1.1%) and A. genogroup 3 (1.1%). This study confirmed the high prevalence of A. xylosoxidans in chronic colonizations and the circulation of the clone A. xylosoxidans ST137 in France: four patients in two centers. The present study is the first to report the distribution of Achromobacter species from CF patients samples using retrospective MALDI-TOF/MS data. This easy approach could enable future large-scale epidemiological studies