BACKGROUND AND OBJECTIVE:The Adult Developmental Coordination Disorder/Dyspraxia Checklist (ADC) is widely used to operationalize Criterion B of Developmental Coordination Disorder (DCD). However, its factor structure appears context-dependent, and its cross-cultural equivalence remains underexplored. This study aimed to (1) develop a cross-culturally adapted version of the ADC for European Spanish, (2) assess its psychometric properties, and (3) determine normative percentile bands for Spanish young adults. Methods: A total of 957 adults aged 18-35 years participated (907 + 25 typically developing adults, 25 peers with attention-deficit/hyperactivity disorder, and 10 young adults with DCD), all of whom completed the cross-culturally adapted ADC-ES. Factor structure was examined using exploratory and confirmatory analyses. Reliability and validity evidence was assessed by analyzing internal consistency, test-retest reliability, and well-known group differences. Reference norms were developed using percentile bands. RESULTS:The ADC-ES comprises 28-items grouped into three dimensions: gross motor and perceptual-based activities; task organization, planning and sequencing; and writing. The instrument demonstrated excellent structural validity, high internal consistency and test-retest reliability, and strong construct and criterion validity. CONCLUSION:The ADC-ES is a cross-culturally equivalent, psychometrically sound tool for measuring functional difficulties aligned with Criterion B of DCD. The availability of normative percentile bands supports its application in clinical assessment and research, and facilitates international comparisons to understanding DCD in adulthood.
BACKGROUND AND OBJECTIVE:Children with Down syndrome experience delays in motor development. Open-area partial bodyweight support (PBWS) systems can help support motor development, but no study has objectively reported motor behavior changes, such as increased leg activity or time spent upright. This study quantified changes in physical activity and posture during exploratory play with a PBWS system for pre-ambulatory children with Down syndrome. We hypothesized that PBWS would increase both physical activity levels and upright posture duration. METHODS:This randomized, multisite crossover trial included children with Down syndrome who could sit independently but were not yet walking. Each child completed nine 30-minute play-based sessions with and without PBWS. Physical activity and posture were measured using shank-worn accelerometers, capturing the percentage of time spent in high physical activity and upright. Nonparametric Mann-Whitney U tests compared outcome measures between PBWS and non-PBWS conditions. RESULTS:Fifteen children (mean age: 19.4 months, range: 12-31 months) completed study procedures. Across all participants, high physical activity did not noticeably increase from the first to last session. The median change was -5.0% (IQR: -13.4- +9.05%) with PBWS and -2.53% (IQR: -13.7- +12.9%) without PBWS. Time spent on feet showed a median increase of +2.38% with PBWS (IQR: -0.96 - +12.24) and a decrease of -1.08% without PBWS (IQR: -7.70 - + 1.02%). A statistically significant difference between conditions (p = .042) indicated greater improvements in time on feet during PBWS sessions versus without. DISCUSSION:PBWS did not increase time spent in high physical activity, but did support increased upright posture over time. These findings suggest PBWS systems may provide a supportive environment for practicing upright postures in early motor development for children with Down syndrome. Longer interventions may be needed to evaluate the full impact of PBWS on motor development. This study adds to growing evidence supporting early, engaging, and accessible motor interventions for children with DS. TRIAL REGISTRATION:This study was registered at ClinicalTrials.gov (CT #NCT05307523).
OBJECTIVE:To examine differences in functional outcomes in the acute period following pediatric traumatic brain injury (TBI) as they relate to social determinants of health (SDoH). Setting: An inpatient rehabilitation program at a children's hospital in the Mountain West region of the United States. Participants: Eighty-nine patients with a diagnosis of moderate-to-severe TBI (ages 5-18 years old). DESIGN:Data were extracted from a clinical registry. Correlations and generalized linear regression were used to examine the relationships among injury characteristics, sociodemographic factors, and functional outcomes. MAIN MEASURES:Injury severity categorized by Glasgow Coma Score (GCS), inpatient length of stay (LOS), individual-level SDoH, community-level SDoH, and change in Functional Independence Measure for Children (WeeFIM) from admission to discharge. RESULTS:Using generalized linear regression with the change in WeeFIM as the dependent variable, there was a significant interaction of race/ethnicity and Area Deprivation Index (ADI) (standardized β = .72, p = 0.02). There was also a significant main effect of LOS (standardized β = 0.27, p = 0.01). CONCLUSIONS:Acute functional recovery after pediatric TBI is complex and related to a number of patient factors. Specifically, social advantage and race/ethnicity coalesced to help explain the variance in functional recovery.
BACKGROUND AND OBJECTIVE:Three-dimensional motion analysis has been used to quantitatively evaluate the components of upper extremity movements. The purpose of this review was to compare the results of upper extremity motion analysis of children with unilateral cerebral palsy and typically developing children during functional movements. METHODS:PubMed, Embase, CINAHL, Web of Science and IEEE Xplore were searched using combinations of upper extremity/upper limb, cerebral palsy and motion analysis/kinematic. Eleven studies involving unimanual and bimanual tasks were reviewed. Results of the analysis of kinematic and spatiotemporal variables for shoulder, elbow, forearm, wrist and hand for the two groups were compared. RESULTS:Both kinematic and spatiotemporal differences for unimanual and bimanual tasks were found between the two groups of children for many movements. However, the kinematic differences varied as function of motion and task analyzed. The variability in motion analysis procedures, tasks performed, motions analyzed and reporting of motions impeded across study comparisons. The spatiotemporal results were more consistent. Typically, the movement took longer, the path was less straight and less smooth, and the peak velocity was lower for the cerebral palsy group than the typically developing group. DISCUSSION:Upper extremity three-dimensional motion analysis was able to determine kinematic and spatiotemporal differences between children with unilateral cerebral palsy and typically developing children during functional tasks. Standardization of motion analysis procedures, tasks, joint motions, and reporting of results are needed to facilitate between-participant, between-group and between-study comparisons for clinical and research applications.
BACKGROUND AND OBJECTIVE:Children diagnosed with central nervous system (CNS) tumors frequently present with persistent motor impairments that compromise independence and participation. Although the Gross Motor Function Measure (GMFM-88) is widely used in pediatric neurology, evidence regarding its reliability and feasibility in pediatric neuro-oncology remains limited. Therefore, this study aimed to investigate the intra- and inter-rater reliability of the GMFM-88, its association with tumor volume, and evaluate the patient-centered clinical feasibility of the instrument. METHODS:This cross-sectional reliability study was conducted at a specialized cancer rehabilitation center. Participants were children with brain tumors confirmed by imaging and biopsy. Gross motor function was assessed using the GMFM-88 with all assessments video-recorded following a standardized protocol. Primary outcomes were intra- and inter-rater reliability. Intra-rater reliability was determined through the analysis of the video of the evaluation day, by the same rater after a four-week interval. Inter-rater reliability was assessed by a second, independent blinded rater who scored the same video recordings. Reliability was analyzed using intraclass correlation coefficients (ICC; two-way mixed-effects, absolute agreement). Secondary outcomes included the correlation between GMFM-88 total scores and tumor volume estimated via the ellipsoid method. To investigate the relationship between variables, Pearson's correlation coefficient was calculated. Furthermore, patient-centered clinical feasibility was assessed using a 7-point Likert scale addressing safety, administration speed, and acceptability. RESULTS:Thirty-two children were included (mean age 10.2 ± 3.7 years; 50% female). The GMFM-88 demonstrated excellent reliability, with an intra-rater ICC of 0.997 (95% CI: 0.993-0.998) and an inter-rater ICC of 0.999 (95% CI: 0.998-0.999). No significant association was observed between tumor volume and GMFM-88 total scores (r = 0.085; 95% CI: -0.27 to 0.42; p = .64). Feasibility ratings were high for safety (aggregate score 76/96) and acceptability (91/96), though administration speed was variable (64/96). DISCUSSION:The GMFM-88 is a highly reliable and clinically applicable tool for assessing gross motor function in pediatric neuro-oncology. The lack of correlation between tumor size and motor capacity suggests that functional outcomes may be more closely related to lesion topography in eloquent areas than volume alone. Major limitations include the single-center design and small sample size. However, these findings support its use as a standardized and clinically applicable outcome measure in pediatric neuro-oncological.
BACKGROUND AND OBJECTIVE:Research which will have a meaningful impact for young people with CP needs to be informed by individuals with lived experience so that issues and outcomes that are important for people with CP are prioritized. These consumer research partners (CRP) may experience barriers and facilitators which influence the productivity and authenticity of their involvement. A mentor program was implemented to support young adults with cerebral palsy (CP) in their roles as CRP. This study aimed to explore the mentor program from the perspectives of the CRP and mentors regarding aspects they found beneficial, unhelpful, or that needed improvement. METHODS:Qualitative description guided the study. Participants were CRP and mentors contributing to a CP-specific research group, CP-Achieve, who participated in semi-structured interviews. RESULTS:Six CRP (four females, two males) aged between 21 and 30 years of age (median = 23), and eight mentors/potential mentors (five females, two males, one preferred not to specify) aged between 28 and 39 years (median = 32.5) participated in the study. CRP identified that mentoring helped develop confidence in, and benefits beyond, their role. Mentors recognized the need to establish effective partnerships and skills which assisted in their role, and identified benefits and challenges. Themes common to both groups were a desire to improve and develop the mentor program, strategic use of technology and that one's own characteristics contributed to a successful mentoring relationship. DISCUSSION:The findings of this evaluation contribute to research about the implementation and experience of mentor programs from the perspective of young adults living with CP and their mentors. The mentor program appeared to be of benefit to both mentors and mentees. The study has provided recommendations to inform revision and development of the mentor program to optimize the experience for participants, and the impact of CRP, including enhancing matching and orientation to roles, clarity of expectations, ongoing monitoring and support for mentors and mentees, and orchestrating formal closure of mentor relationships. The sample represented fewer than half of potential participants and did not include perspectives of young adult CRP who had chosen not to work with a mentor.
BACKGROUND:Family-centered care is a foundational principle of early developmental neurorehabilitation; however, family-related outcomes are rarely assessed using instruments specifically developed for this context. The Family Outcome of Early Intervention Questionnaire (FOEI) is an interdisciplinary, family-reported outcome measure currently under development. OBJECTIVE:To examine selected psychometric properties of the developmental version of the FOEI in a methodological pilot study to inform further instrument refinement, and to provide preliminary evidence that should be interpreted in light of the instrument's developmental status. METHODS:In this methodological pilot study with a test-retest design, parents of infants and young children receiving ambulatory early neurorehabilitation completed the FOEI twice within an interval of 7-10 days. Test-retest reliability was assessed using intraclass correlation coefficients (ICC(2,1)). Discriminative validity was explored by comparing families receiving Coping with and Caring for Infants with Special Needs (COPCA®) - based family-centered intervention with those receiving conventional physiotherapy. Convergent validity was examined through correlations with the Family Empowerment Scale (FES). Ceiling effects were assessed using descriptive statistics. RESULTS:Test - retest reliability of the FOEI total score was moderate in the full sample (ICC(2,1) = 0.58, 95% CI 0.35-0.74) and higher after exclusion of two cases with implausible response patterns (0.79, 95% CI 0.64-0.88). FOEI scores were consistently higher in the COPCA® group, with small to moderate effect sizes, although no differences reached statistical significance after Bonferroni - Holm correction. Convergent validity with the FES was low (ρ = 0.06-0.27). CONCLUSION:The developmental FOEI version shows preliminary temporal stability in this pilot sample. Further refinement of items and response scaling is required, particularly in light of observed ceiling effects and limited discriminative performance, as part of an ongoing instrument development process.
BACKGROUND AND OBJECTIVE:This study focused on the community-based participation experiences of young people with cerebral palsy (CP), investigating the factors that make participation easier or harder. METHODS:Accessible methods were utilized to explore the perspectives of 15 young people with CP aged 15 to 26 years with diverse motor and communication abilities (Gross Motor Function Classification System I = 4, II = 6, III = 1, IV = 3, V = 1, Viking Speech Scale I = 7, II = 4, III = 3, IV = 1). Participants provided regular written reflections, photographs, or videos about their community-based participation. Data were analyzed using reflexive thematic analysis. RESULTS:Self-reported reflections were grouped inductively into 421 codes, then 22 subthemes and 6 themes: (i) My CP characteristics can make participation in the community more difficult; (ii) My own thoughts, emotions, confidence, and sense of achievement influence the things I do in the community; (iii) Accessibility of the environment and availability of equipment influences my participation in the community; (iv) The range of supports I have available influences my participation in the community; (v) Whether the community activity has been adjusted to include and involve me influences my participation; and (vi) The attitudes, actions, and level of acceptance from others in the community influences my participation. DISCUSSION:Key factors influencing community-based participation for young people included CP characteristics, thoughts, emotions, confidence, environment, equipment, supports, accommodations, attitudes, actions, and acceptance.
BACKGROUND:Receptive language difficulties are common in children with Autism Spectrum Disorder (ASD) and may reflect differences in underlying attentional and processing mechanisms rather than linguistic impairments alone. Visual attention plays a central role in guiding children toward linguistically relevant stimuli during language comprehension. Eye-tracking offers a noninvasive method to examine real-time visual attention; however, its association with standardized receptive language performance in children with ASD remains insufficiently understood. METHODS:This cross-sectional study included 33 children aged 4;0-7;11 years, comprising 16 children with ASD and 17 typically developing (TD) peers. Receptive language abilities were assessed using the receptive subtest of the Turkish Early Language Development Test (TEDİL). Visual attention during receptive language tasks was measured using a remote eye-tracking system. Eye-tracking indices included target looking proportion, time to first fixation on the target, and target fixation duration. Group differences were examined using analyses of covariance controlling for age. Within the ASD group, correlations and multiple linear regression analyses were conducted to examine associations between eye-tracking measures and receptive language performance. RESULTS:Children with ASD demonstrated significantly lower target looking proportions, longer latencies to first fixation, and shorter target fixation durations compared to TD peers. Within the ASD group, higher receptive language scores were significantly associated with greater target looking proportion and shorter time to first fixation. Regression analyses indicated that target looking proportion explained additional variance in receptive language performance beyond chronological age. CONCLUSIONS:Findings suggest that less efficient visual attention is associated with receptive language difficulties in children with ASD. Eye-tracking provides process-level information that complements standardized assessments by capturing attentional dynamics during language comprehension. Integrating eye-tracking measures into language assessment may support more sensitive identification of processing differences and inform targeted intervention approaches for children with ASD.
AIM:The aim of this study was to examine the community participation levels (frequency and involvement) of children with Down syndrome (DS) and the restrictive and supportive factors affecting their participation levels and compare them with typically developing (TD) children. METHODS:This cross-sectional study included parents of 70 children (35 with DS; 35 TD children) aged 8-17 years. Parents of all children completed the community module of the Participation and Environment Measure for Children and Youth, which is used to assess participation and environmental factors in the community. RESULTS:Children with DS participated less frequently (organizations, groups, clubs, or leadership activities and out-of-school classes and lessons) and less involved (getting together with children, organizations, groups, clubs, or leadership activities and out-of-school classes and lessons) in community activities compared to TD children, and parents of children with DS were less satisfied with their children's participation in community activities. Children with DS faced more barriers (the physical layout, the sensory quality and weather conditions) and had insufficient resources (information and supplies) compared to their TD peers in the community. After adjusting for the child's age, parental education level and average income, the group (DS vs. TD) had an independent effect on frequency, involvement and desire for change. CONCLUSIONS:Children with DS are negatively affected in terms of community participation (both) compared to TD children. Beyond sociodemographic factors, being a child with DS may reduce community participation (both). The community environmental factors were influential for the community participation of children with DS. Community participation of children with DS can be increased through environmental regulations.
BACKGROUND AND OBJECTIVE:Respiratory dysfunction is a prevalent but underrecognized problem in individuals with spastic cerebral palsy (CP). Despite extensive research on postural control, functional capacity, and activities of daily living (ADL), the role of respiratory muscle strength in these functional domains remains largely unexplored. This study aimed to examine whether respiratory muscle strength is associated with postural control, functional exercise capacity, and activities of daily living (ADL) in individuals with spastic CP. METHODS:In this cross-sectional study, 29 individuals with spastic cerebral palsy and 29 typically developing peers were evaluated. Respiratory muscle strength was assessed using maximal inspiratory (MIP) and expiratory (MEP) pressures. Postural control (Trunk Control Measurement Scale (TCMS), Pediatric Berg Balance Scale (PBBS)), functional skills (Pediatric Disability Assessment Inventory (PEDI)- Functional Skills Section (FSS)), and exercise capacity (2MWT) were recorded. RESULTS:Individuals with CP demonstrated significantly lower MIP, MEP, TCMS, PBBS, PEDI-FSS, and 2MWT scores compared to typically developing peers (p < .001). Moderate to high correlations were found between respiratory muscle strength and postural control, ADL performance, and functional exercise capacity (r = 0.44-0.88). MIP explained 32% of trunk control, 30% of functional skills, and 39% of exercise capacity. Discussion: Respiratory muscle strength is a key determinant of trunk stability, balance, functional capacity, and ADL performance in spastic CP. Systematic assessment and incorporation of respiratory muscle training into rehabilitation may enhance functional outcomes. CLINICALTRIALS.GOV IDENTIFIER:NCT05682079.
BACKGROUND:Parents of children with Autism Spectrum Disorder (ASD) often exhibit subclinical autistic traits, known as the Broad Autism Phenotype (BAP). While BAP is recognized as a familial characteristic associated with ASD, limited evidence exists regarding how specific parental traits relate to children's behavioral, adaptive, and developmental outcomes in low- and middle-income clinical settings. Understanding these associations may be relevant for developmental and neurorehabilitation contexts in which parent - child interaction plays an important role in the child's learning environment. METHODS:This descriptive cross-sectional study included 95 children (aged 2-12 years) newly diagnosed with ASD and both biological parents, recruited from a tertiary Child Development Center. Child autism severity was assessed using the Childhood Autism Rating Scale-2 (CARS-2); adaptive functioning using the Vineland Adaptive Behavior Scales - II (VABS-II); behavioral problems using the Child Behavior Checklist (CBCL); and developmental level using the Developmental Profile-3. Parental autistic traits were measured using the Autism-Spectrum Quotient (AQ). Correlation and regression analyses were used to examine associations between parental AQ traits and child outcomes. RESULTS:BAP (AQ ≥ 23) was present in 50% of mothers and 47% of fathers. Total parental AQ scores were not associated with child autism severity. However, higher parental communication-trait scores were associated with greater externalizing behavior in children (p < .05). Certain parental AQ subdomains, particularly communication and attention-to-detail traits, showed modest negative correlations with children's motor functioning and developmental level. In multivariable analysis, paternal communication traits remained independently associated with poorer motor skills (β = -0.276, p = .034). CONCLUSIONS:Parental BAP traits, particularly those related to communication and social reciprocity, may be associated with variability in behavioral, motor, and developmental outcomes in children with ASD. Although parental traits were not associated with autism severity, these findings suggest that considering family phenotype may be relevant when examining child developmental profiles within family-centered neurodevelopmental and rehabilitation frameworks. Further longitudinal research is needed to clarify the nature and direction of these relationships.
BACKGROUND:Cerebral palsy (CP) causes permanent motor impairments, limiting postural control and mobility. The Dubousset Functional Test (DFT) was developed to assess daily activity performance, but its reliability and validity in pediatric CP are unclear. This study aimed to evaluate its reliability, convergent and discriminative validity, and clinical utility in children with spastic CP at GMFCS Levels I - II. METHODS:Thirty-three children aged 6-15 years with spastic CP (GMFCS I - II) participated in this cross-sectional methodological study. The DFT (Rise-and-Walk, Step, Sit-to-Stand, and Dual Task subtests) was administered along with the Timed Up and Go (TUG), Dual-task TUG, 3-Meter Backward Walk Test (3MBWT), Functional Reach Test (FRT), and Pediatric Balance Scale (PBS). All assessments were conducted twice, seven days apart, by a single experienced physiotherapist. RESULTS:The DFT demonstrated excellent reliability, with ICC(3,2) values ranging from 0.91 to 0.95 and minimal measurement bias (-0.61 to 0.36 s). The smallest detectable change (SDC) ranged from 2.1 to 13.0 s, confirming high measurement precision. Strong correlations were observed between the DFT Dual Task and both TUG (r = 0.95, p < .001) and Dual-task TUG (r = 0.95, p < .001), supporting convergent validity. ROC analysis indicated excellent discriminative accuracy for identifying children with balance limitations (PBS < 45) (AUC = 0.82, sensitivity = 0.81, specificity = 0.78). CONCLUSION:The DFT is a reliable, valid, and clinically feasible tool for assessing balance and mobility in ambulatory children with spastic CP at GMFCS I - II, supporting routine rehabilitation use. TRIAL REGISTRATION:ClinicalTrials.gov (NCT06831591).
OBJECTIVE:To investigate the effects of combining aquatic therapy with a home exercise program on balance, functionality, and quality of life in children with DMD/BMD, compared with a home exercise program alone. METHODS:Sixteen patients aged 5-18 years with DMD/BMD were included. Those at the top of the waiting list were assigned to the intervention group (n = 8), and those further down to the control group (n = 8). The intervention group received 30-minute Halliwick-based aquatic therapy three times per week for five weeks in a 30°C pool, in addition to a home exercise program. The control group performed a home exercise program alone while awaiting aquatic therapy. The home exercise program consisted of joint range-of-motion and stretching exercises only (30 minutes/day, five days/week). Exercises were performed under caregiver supervision, and adherence was assessed by caregiver report and investigator questioning. Outcomes assessed at baseline and week 5 included weekly fall frequency, balance (Pediatric Berg Balance Scale; Functional Reach Test), activity (ACTIVLIM), physical performance (10-m walk; 4-step tests), quality of life (PedsQL Neuromuscular Module), and muscle strength (manual muscle testing) and joint range of motion. RESULTS:Significant improvements in balance, activity, physical performance, and quality of life were observed in the intervention group, alongside a reduction in weekly fall frequency (p < .05). In the control group, the only significant change was increased forward reach distance in the Functional Reach Test (p < .05). Between-group comparisons showed greater gains in balance, functionality, and quality-of-life scores in the intervention group (p < .01). Hip extensor strength increased significantly only in the intervention group. No adverse events occurred. CONCLUSION:Combining aquatic therapy with a home exercise program was safe and well tolerated and was associated with greater short-term improvements in balance, functionality, and quality of life than a home exercise program alone, with reduced fall frequency over five weeks. These findings support integrating aquatic therapy into DMD/BMD management and justify larger randomized controlled trials to confirm efficacy and guide optimal regimens. CLINICAL TRIAL REGISTRATION NUMBER:NCT06186310.
BACKGROUND:Autism spectrum disorder (ASD) is characterized by aberrant functional brain connectivity and deficits in network dynamics. Transcranial direct current stimulation (tDCS) has emerged as a promising intervention with potential therapeutic effects; however, its effects on both static and dynamic functional brain network organization remained insufficiently understood. METHODS:A total of 42 children with ASD aged 4-6 years were enrolled and randomly assigned to either active tDCS or sham stimulation groups. Resting-state electroencephalography (EEG) data were acquired before and after the intervention. Low-order functional connectivity (LOFC) and high-order functional connectivity (HOFC) networks were constructed, followed by graph-theoretical analyses to assess clustering coefficient, characteristic path length, global efficiency, and local efficiency. Furthermore, state entropy was employed to evaluate dynamic network transitions between integrated and segregated states. RESULTS:Active tDCS was associated with increased LOFC strength in the delta, alpha, and beta bands, and more widespread increases in HOFC across all examined frequency bands. Changes in network topology were primarily observed in HOFC, with reductions in characteristic path length and increases in global and local efficiency, particularly in the delta and theta bands. Dynamic network analysis indicated that tDCS modulated state entropy at specific time scales in both LOFC and HOFC networks. These findings suggest shifts in functional coordination and temporal variability among the recorded regions. Behavioral measures exhibited a trend toward improvement in the active group; however, these changes were not the focus of the present analysis, and their relationship to neural modulation remains to be clarified in future work. CONCLUSIONS:tDCS modulated functional interaction patterns and dynamic state characteristics among the recorded brain regions in children with ASD. These results provide preliminary neurophysiological evidence regarding the influence of tDCS on both static and dynamic network organization and highlight potential network-based markers to guide future individualized neuromodulation research. Further studies with larger samples and longitudinal follow-ups are needed to clarify the functional and clinical significance of these network-level changes.
BACKGROUND AND OBJECTIVE:Upper-extremity proprioception contributes to coordinated reaching and grasping, which are critical for functional independence; however, evidence on upper-limb proprioception in children with Duchenne muscular dystrophy (DMD) remains limited. Therefore, we aimed to compare wrist proprioception in children with DMD versus healthy peers and to examine its relationship with upper-limb function. METHODS:Cross-sectional observational study conducted at a pediatric neuromuscular clinic, enrolling children aged 6-15 years who were able to sit independently. Wrist proprioception at 45° flexion was assessed using verbal description, position verification, and ipsilateral/contralateral matching under two conditions (eyes open and eyes closed). Absolute angular error was calculated for each condition, and the open - closed difference was derived as the within-subject change between conditions; angles were measured using a goniometer. Secondary outcomes included elbow/wrist ROM limitation, grip strength, PUL 2.0, ABILHAND-Kids, and ACTIVLIM. RESULTS:Sixty-two children participated (42 DMD, 20 controls); 80.9% of the DMD group were ambulatory. Compared with controls, the DMD group had poorer wrist proprioception, showing larger EO - EC differences and higher EC errors (all p < .001), except for contralateral matching where the within-group EO - EC change was not significant (p = .156). Only location verification and ipsilateral matching correlated with elbow ROM limitation (p = .007-0.002), wrist ROM limitation (both p < .001), hand dexterity (ABILHAND-Kids p = .005-0.006), participation (ACTIVLIM p = .012-0.006), and upper-limb performance (PUL total p = .002-0.004). DISCUSSION:Children with DMD exhibit wrist proprioceptive deficits that are associated with joint ROM limitations and with measures of upper-limb performance and participation, supporting the inclusion of proprioceptive assessment in rehabilitation planning to help maintain distal function.
BACKGROUND & OBJECTIVE:Dynamic balance is a fundamental component of early motor development and is essential for functional movement and postural control in childhood. The Functional Reach Test (FRT) is widely used as a simple clinical measure of dynamic balance in pediatric populations; however, its relationship with objective postural control parameters, such as center of pressure (COP) displacement, remains unclear in preschool-aged children. The objective of this study was to examine the association between the FRT and forward COP displacement to explore the clinical utility of the FRT in healthy Japanese preschool-aged children. METHODS:This cross-sectional study included 98 typically developing Japanese children aged 3-6 years. Each participant performed two FRT trials while standing on a force platform, during which COP data were recorded simultaneously. The mean values of the two trials were used for analysis. Correlation analyses were conducted to evaluate the association between FRT performance and forward COP displacement. Data normality was confirmed prior to statistical analysis. RESULTS:A moderate positive correlation was observed between FRT performance and forward COP displacement (r = 0.566, p < .001). In age-stratified analyses, significant associations were maintained in the 3-, 4-, and 6-year-old groups, while the association was not statistically significant in the 5-year-old group. Children with greater reach distances tended to exhibit larger anterior COP excursions during the reaching task, indicating a meaningful association between clinical FRT performance and objective postural control measures. CONCLUSIONS:These findings provide supportive evidence regarding the clinical utility of the Functional Reach Test as a simple and clinically practical measure of dynamic balance in preschool-aged children. The FRT may serve as a useful screening tool for assessing balance development in early childhood, particularly in settings where laboratory-based posturography is not available.
OBJECTIVE:To evaluate the effectiveness and application value of moderate to high intensity badminton activities on the sleep quality of children with autism. METHODS:Forty-eight children with autism were randomly divided into experimental and control group (42 were included for data analysis). The experimental group underwent 8 weeks of moderate to high intensity badminton intervention (3 times/week, 80 min/time, 60 ~ 80% HRmax), the control group maintained daily routines. Sleep quality was assessed both objectively Children's Sleep Habits Questionnaire (CSHQ) and subjectively (ActigraPh wGT3X-BT triaxial accelerometer). RESULTS:After 8 weeks of moderate to high intensity badminton intervention, children in the experimental group showed decreased bedtime resistance, night wakings and total CSHQ scores, sleep latency, and wake after sleep onset were reduced. Conclusions: Eight weeks of moderate to high intensity badminton has significant effects on improving sleep quality in children with autism.
BACKGROUND AND OBJECTIVE:Children with Down syndrome (DS) experience delays across multiple developmental domains, including communication and motor coordination. While prior studies have investigated these domains separately, few have examined their interrelation using population-level data. This study aimed to evaluate (1) differences between young children with DS and typically developing (TD) peers in early communication skills and motor-coordination difficulties, and (2) whether the relationship between these domains is similar across groups. METHODS:This brief report used data from the 2021-2022 National Survey of Children's Health, a nationally representative U.S. dataset including children aged 0-5 years. Children were categorized as having DS (parent-reported diagnosis) or typical development (no developmental delays). Early communication skills were assessed using 11 parent-report items (five receptive, six expressive). Motor coordination was assessed using two items reflecting chronic difficulty using hands or moving around. Chi-square tests were used to compare group differences and to examine associations between motor coordination and communication milestones within each group. RESULTS:The sample included 90 children with DS and 24,988 TD children. Compared with TD peers, children with DS were less likely to achieve all early communication milestones and more likely to experience motor-coordination difficulties (p < .001). Within the DS group, those with motor-coordination difficulties were less likely to say one word (57.1% vs 80.6%), follow verbal directions (45.2% vs 72.2%), point to things (38.1% vs 69.4%), understand "in," "on," "under" (31.0% vs 58.3%), or use two words (19.0% vs 44.4%) compared to TD children (p < .05). The TD group showed significant associations between the acquisition of early communication skills and motor coordination difficulties for all the early communication skills recorded (p < .01). DISCUSSION:Findings indicate a dynamic, bidirectional relationship between early motor coordination and communication skill acquisition in young children with DS, mirroring patterns observed in TD peers. Population-level evidence underscores the need for early interventions targeting both domains concurrently. Future prospective studies using standardized developmental assessments are warranted to clarify temporal relationships and inform early intervention strategies.
