Objective: During the transitional phase (ambulatory to non-ambulatory), synergies characterize the evolution of Duchenne muscular dystrophy (DMD). This study was performed to describe and quantify compensatory movements while sitting down on/rising from the floor and climbing up/down steps. Method: Eighty videos (5 children × 4 assessments × 4 tasks) were recorded quarterly in the year prior to gait loss. Compensatory movements from the videos were registered based on the Functional Evaluation Scale for DMD. Results: The most frequently observed compensatory movements were upper limb support on lower limbs/floor/handrail during all the tasks and lumbar hyperlordosis, trunk support on handrail, equinus foot, increased base of support, non-alternated descent, and pauses while climbing up/down steps. Conclusion: Climbing up/down steps showed a higher number of compensatory movements than sitting down on/rising from the floor, which seemed to be lost before climbing up/down steps in ambulatory children with DMD.Keywords: Duchenne muscular dystrophy, evaluation, scales. RESUMOObjetivo: Durante a fase de transição (deambulador -não-deambulador), sinergias musculares caracterizam a evolução da distrofia muscular de Duchenne (DMD). Este estudo visou descrever e quantificar os movimentos compensatórios durante o sentar/levantar do solo, subir/descer degraus. Oitenta vídeos (5 crianças × 4 avaliações × 4 tarefas) foram gravados trimestralmente durante o ano que antecedeu a perda da marcha. Método: Os movimentos compensatórios dos vídeos foram registrados utilizando a Escala de Avaliação Funcional para DMD. Resultados: Os movimentos compensatórios mais frequentemente observados foram apoio de membros superiores nos membros inferiores/solo/corrimão durante todas as tarefas funcionais e hiperlordose lombar, apoio de tronco no corrimão, pés equinos, aumento da base de suporte, descida não alternada e pausas ao subir/descer degraus. Subir/descer degraus apresentou um número maior de movimentos compensatórios do que sentar/levantar do solo. Conclusão: Sentar/levantar do solo foram habilidades perdidas antes de subir/descer degraus em crianças com DMD.Palavras-chave: distrofia muscular de Duchenne, avaliação, escalas.
Rising from the floor, climbing up, and climbing down steps have some components in common, such as the demand for muscle strength and the recruitment of compensatory muscle synergies, as DMD progresses. To sit down on the floor, some children let themselves fall, resulting in a faster performance, but more compensatory movements.
Objective:To determine the responsiveness of the domain climbing up and going down stairs of the Functional Evaluation Scale for Duchenne Muscular Dystrophy (FES-DMD-D3) in a one-year follow-up study.Method:The study included 26 patients with DMD. Effect Size (ES) and Standardized Response Mean (SRM) described the scale’s responsiveness.Results:For climbing up stairs, ES showed that responsiveness was low in the three-month assessments (0.26; 0.35; 0.13; 0.17), low to moderate in the six-month assessments (0.58; 0.48; 0.33), moderate in the nine-month assessments (0.70; 0.68), and high in the 12-month assessment (0.88). SRM showed that responsiveness was low in the three-month assessments (0.29; 0.38; 0.18; and 0.19), low to moderate in the six-month assessments (0.59; 0.51; 0.36), moderate in the nine-month assessments (0.74 and 0.70), and high in the 12-month assessment (0.89). For going down stairs, ES showed that responsiveness was low in the three- and six-month assessments (0.16; 0.25; 0.09; 0.08 and 0.48; 0.35; 0.18, respectively), low to moderate in the nine-month assessments (0.59; 0.44), and moderate in the 12-month assessment (0.71). SRM showed that responsiveness was low in the three- and six-month assessments (0.25; 0.35; 0.12; 0.09 and 0.47; 0.38; 0.21, respectively), low to moderate in the nine-month assessment (0.62; 0.49), and moderate in the 12-month assessment (0.74).Conclusion:Climbing up stairs should be assessed at intervals of nine months or longer, when responsiveness is moderate to high. Going down stairs should be assessed annually because moderate responsiveness was observed in this period.
Currently, therapists have difficulty assessing and describing hand sensory deficits. The gold-standard tool to quantify hand tactile sensitivity is the esthesiometer. The Semmes-Weinstein esthesiometer presents nylon monofilaments of approximately the same length and of varying diameters. The diameter and length are used to control the force applied. The minimal diameter detected is used to classify the sensory function 1 . However, not only tactile sensitivity, but also the ability to detect weight and compressibility variations are involved in hand function.The sensation of touch on skin is provided by mechanoreceptors in the epidermis and dermis skin layers. There are four types of mechanoreceptors: Merkel receptors detect pressure from small objects, on a frequency between 0.3 and 3.0 Hz. Meissner corpuscles detect flutter, e.g. when rubbing objects against the skin or skin movement across a surface, on a frequency between 3.0 to 40.0 Hz. Ruffini cylinders detect pressure and stretching of the skin, on higher frequencies, between 15.0 and 400.0 Hz 2 . Merkel disks and Ruffini cylinders are associated with slowly adapting fibers that respond as long as the stimulus is present. Meissner corpuscles respond to stimulation with a burst of firing at the beginning and end of stimulation, therefore, they are called rapidly adapting fibers AbstrACtObjective: Hand sensory tests do not consider distinct physiological receptors, nor detect normal range variations concerning developmental or pathological changes. We developed an instrument with a set of tests with timing and scoring for assessing haptic perception, which is the interaction between sensory and motor systems, in surfaces exploration, by moving hands. Method: Firstly, group meetings were set for test/manual conception and materials testing. The test/manual were submitted to 30 reviewers in 3 stages (10 reviewers on each stage). Results: The Hand Haptic Perception Instrument (HHPI) evaluates hand sensorimotor performance on six domains: depression, elevation, texture, compressibility, weight (barognosis) and form perception. Each domain requires specific materials. Score ranges from 0 to 57, being 0 the worst rating. Conclusion: This methodological process allowed the development of six domains and instructions to assess haptic perception. This version of HHPI is a pilot model. Further studies will determine reliability and normality ranges.Keywords: touch perception, form perception, weight perception, evaluation, hands. resumo Objetivo: Testes de sensibilidade manual não consideram receptores fisiológicos distintos, tampouco variações do desenvolvimento normal ou patológico. Desenvolvemos um instrumento, com pontuação e tempo de desempenho, para avaliar percepção háptica, que é a interação sensório-motora na exploração de superfícies, pelo movimento das mãos. Método: Reuniões de grupo foram estabelecidas para desenvolver os testes/manual e testar materiais. O instrumento e seu manual foram submetidos a 30 revisores, em 3 estágios (com 10 revisores em cad...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.