Evaluating the Effects of Performance-Focused Swimming Training on People with Cerebral Palsy Who Have High Support Needs – A Study Protocol Using Single-Case Experimental Design

2019 ◽  
Vol 21 (2) ◽  
pp. 217-234
Author(s):  
I. M. Dutia ◽  
M. J. Connick ◽  
E. M. Beckman ◽  
L. M. Johnston ◽  
P. J. Wilson ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Experimental Design ◽  
Single Case ◽  
Phase 1 ◽  
Maintenance Phase ◽  
Support Needs ◽  
Training Phase ◽  
Phase 2 ◽  
Swimming Training ◽  
High Support

AbstractBackground:People with cerebral palsy (CP) are less physically active than the general population and, consequently, are at increased risk of preventable disease. Evidence indicates that low-moderate doses of physical activity can reduce disease risk and improve fitness and function in people with CP. Para athletes with CP typically engage in ‘performance-focused’ sports training, which is undertaken for the sole purpose of enhancing sports performance. Anecdotally, many Para athletes report that participation in performance-focused sports training confers meaningful clinical benefits which exceed those reported in the literature; however, supporting scientific evidence is lacking. The aim of this paper is to describe the protocol for an 18-month study evaluating the clinical effects of a performance-focused swimming training programme for people with CP who have high support needs.Methods:This study will use a concurrent multiple-baseline, single-case experimental design across three participants with CP who have high support needs. Each participant will complete a five-phase trial comprising: baseline (A1); training phase 1 (B1); maintenance phase 1 (A2); training phase 2 (B2); and maintenance phase 2 (A3). For each participant, measurement of swim velocity, health-related quality of life and gross motor functioning will be carried out a minimum of five times in each of the five phases.Discussion:The study described will produce Level II evidence regarding the effects of performance-focused swimming training on clinical outcomes in people with CP who have high support needs. Findings are expected to provide an indication of the potential for sport to augment outcomes in neurological rehabilitation.

scholarly journals Effects of Dynamic Elastomeric Fabric Orthoses on Children with Cerebral Palsy

2009 ◽  
Vol 33 (4) ◽  
pp. 339-347 ◽  
Author(s):  
Martin John Matthews ◽  
Martin Watson ◽  
Barbara Richardson
Keyword(s):  
Cerebral Palsy ◽  
Single Case ◽  
Phase 1 ◽  
Functional Mobility ◽  
Gait Velocity ◽  
Controlled Study ◽  
Patient Specific ◽  
Spastic Diplegia ◽  
Cost Index ◽  
Beneficial Effects

This phase 1 exploratory study aimed to establish proof of concept of the effects of dynamic elastomeric fabric orthoses (DEFOs) on the gait of children with spastic diplegic cerebral palsy. Replicated single case experiments employing an ABA methodology were carried out on eight subjects (median age 5.5 years, range 3–13 years; 4 girls/boys) utilizing quantitative/qualitative data collection. Outcome measures were: Ten metre walking test (10MWT); physiological cost index (PCI); visual analogue scale (VAS) scoring of perceived gait changes; functional mobility changes using Patient Specific Functional Scale (PSFS); subject/carer perceptions recorded in daily diaries. Results identified following analysis of quantitative data indicated a treatment effect from the orthoses which could be corroborated by participant subjective impressions and comments. Statistically significant ( p < 0.05) intervention-related improvements in gait velocity and gait consistency were identified respectively in 5/8 and 4/8 subjects. Power calculations support the feasibility of a larger controlled study to further investigate this orthotic intervention. This study indicates that DEFO leggings can confer beneficial effects on the gait of some children with spastic diplegia resulting from CP. These findings have implications for orthotic intervention with this subject group.

scholarly journals Minimally Invasive SPML Surgery for Children with Cerebral Palsy: Program Development

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Dana L. Wild ◽  
Caroline W. Stegink-Jansen ◽  
Christine P. Baker ◽  
Kelly D. Carmichael ◽  
David A. Yngve
Keyword(s):  
Cerebral Palsy ◽  
Minimally Invasive ◽  
Phase 1 ◽  
Case Series ◽  
Functional Mobility ◽  
Phase 2 ◽  
Ankle Motion ◽  
Case Series Study ◽  
Reoperation Rates

Improvements in surgical and rehabilitation care are critical to lessen the burden of cerebral palsy (CP), the most common cause of severe physical disability in childhood. The selective percutaneous myofascial lengthening (SPML) surgical procedure is a minimally invasive method designed to improve ambulation by lengthening contracted musculoskeletal tissues. Information on surgical procedures, efficacy, and safety of SPML for children with CP is lacking. Phase 1 of our research is a “proof-of-principle” study for multisite SPML to improve functional mobility of children with CP, and Phase 2 assesses safety, reoperation rates, and efficacy over time in subsequent patient series. Phase 1 was a repeated measurement case series study of 17 children (mean age 7.6 years). One physical therapist, blinded to the surgeon’s measurements, measured bilateral knee and ankle motion before and after SPML procedures, using video recordings of a standardized gait path. Functional Mobility Scale (FMS) 5, 50, and 500 outcomes were taken pre- and postoperatively and via telephone follow-up. In Phase 2, multisite SPLM surgeries were implemented in larger successive cohorts from 2006 to 2017. Complications, reoperation rates, and efficacy were retrospectively analyzed. Phase 1 results showed improvement in the children’s knee and ankle motion while ambulating and improved FMS 5, 50, and 500 outcomes postoperatively (mean, 6.3 months). At second follow-up (mean 33.3 months), FMS 500 scores continued improvement, while FMS 5 and FMS 50 scores maintained. During Phase 2, the complication rate was 2.4%, and reoperation rates (including reoperations due to maturation) were between 8% and 13%. Improvements to correct ankle equinus were recorded in 498 cases. In conclusion, in a specialized center, single-event, multilevel SPML surgeries of children with CP safely improved ambulatory knee and ankle angle motion and daily mobility outcomes. Future educational studies of training needs for surgeons new to the approach are needed.

scholarly journals Development and Feasibility of a Kinect-Based Constraint-Induced Therapy Program in the Home Setting for Children With Unilateral Cerebral Palsy

2021 ◽  
Vol 9 ◽  
Author(s):  
Hao-Ling Chen ◽  
Szu-Yu Lin ◽  
Chun-Fu Yeh ◽  
Ren-Yu Chen ◽  
Hsien-Hui Tang ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Phase 1 ◽  
Training System ◽  
Phase 2 ◽  
Two Phase ◽  
Clinical Trial Registration ◽  
Home Setting ◽  
Therapy Program ◽  
Phase Study ◽  
Block Test

Introduction: Cerebral palsy (CP) is the leading cause of childhood-onset physical disability. Children with CP often have impaired upper limb (UL) function. Constraint-induced therapy (CIT) is one of the most effective UL interventions for children with unilateral CP. However, concerns about CIT for children have been repeatedly raised due to frustration caused by restraint of the child’s less-affected UL and lack of motivation for the intensive protocol. Virtual reality (VR), which can mitigate the disadvantages of CIT, potentially can be used as an alternative mediator for implementing CIT. Therefore, we developed a VR-based CIT program for children with CP using the Kinect system.Aims: The feasibility of the Kinect-based CIT program was evaluated for children with unilateral CP using a two-phase study design.Materials and Methods: In phase 1, ten children with unilateral CP were recruited. To confirm the achievement of the motor training goals, maximal UL joint angles were evaluated during gameplay. To evaluate children’s perceptions of the game, a questionnaire was used. In phase 2, eight children with unilateral CP were recruited and received an 8 weeks Kinect-based CIT intervention. Performance scores of the game and outcomes of the box and block test (BBT) were recorded weekly.Results: In phase 1, results supported that the design of the program was CIT-specific and was motivational for children with unilateral CP. In phase 2, game performance and the BBT scores began showing stable improvements in the fifth week of intervention.Conclusion: It suggested the Kinect-based CIT program was beneficial to the motor function of the affected UL for children with unilateral CP. According to the results of this feasibility study, larger and controlled effectiveness studies of the Kinect-based CIT program can be conducted to further improve its clinical utility.Clinical Trial Registration: ClinicalTrials.gov, NCT02808195; Comparative effectiveness of a Kinect-based unilateral arm training system vs. CIT for children with CP

scholarly journals Can we boost the Meta-cognitive Awareness of Prospective Teachers through Reflective Journals?

2020 ◽  
Vol V (II) ◽  
pp. 190-201
Author(s):  
Ghazal Khalid Siddiqui ◽  
Huma Lodhi ◽  
Kalsoom Ghazanfar
Keyword(s):  
Data Analysis ◽  
Experimental Design ◽  
Prospective Teachers ◽  
Phase 1 ◽  
Metacognitive Awareness ◽  
Phase 2 ◽  
Reflective Journals ◽  
Cognitive Awareness ◽  
Metacognitive Regulation ◽  
Two Phases

Metacognition and reflective teaching are concepts that complement each other if we refer to a reflective teacher. This study investigates whether metacognitive awareness of prospective teachers can be improved through reflective journals. In present study reflective journals are comprised of practice sheets through which the prospective teachers can practice their metacognitive thoughts consciously. The methodology followed is experimental research by using qusai-experimental design into two phases. Both, control and experimental groups were taught through a combination of teaching strategies that we normally use in our classes such as lecture, discussion, or through inquiry, etc., in phase 1. In phase 2, reflective journals, along with other strategies that were used in the 1st phase, were introduced. The results of data analysis revealed a significant enhancement of prospective teachers metacognitive awareness and its constituent factors e.g., metacognitive knowledge and metacognitive regulation.

Impact of a Novel Training Approach on Hemodynamic and Vascular Profiles in Older Adults

2021 ◽  
pp. 1-8
Author(s):  
Mary N. Woessner ◽  
Michael A. Welsch ◽  
Mitch D. VanBruggen ◽  
Neil M. Johannsen ◽  
Daniel P. Credeur ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Repeated Measures ◽  
Vascular Function ◽  
Aerobic Training ◽  
Phase 1 ◽  
Exercise Program ◽  
Functional Independence ◽  
Training Phase ◽  
Phase 2 ◽  
Older Individuals

Exercise training beneficially moderates the effects of vascular aging. This study compared the efficacy of Peripheral Remodeling through Intermittent Muscular Exercise (PRIME), a novel training regimen, versus aerobic training on hemodynamic profiles in participants ≥70 years at risk for losing functional independence. Seventy-five participants (52 females, age: 76 ± 5 years) were assessed for hemodynamic and vascular function at baseline, after 4 weeks of either PRIME or aerobic training (Phase 1) and again after a further 8 weeks of aerobic and resistance training (Phase 2). Data were analyzed using 2 × 2 repeated-measures analysis of variance models on the change in each dependent variable. PRIME demonstrated reductions in brachial and aortic mean arterial pressure and diastolic blood pressure (p < .05) from baseline after Phase 1, which were sustained throughout Phase 2. Earlier and greater reductions in blood pressure following PRIME support the proposal that peripheral muscular training could beneficial for older individuals commencing an exercise program.

Effects of a virtual reality-based training program for adolescents with disruptive behaviour problems on cognitive distortions and treatment motivation: Protocol for a multiple baseline Single-Case Experimental Design (Preprint)

2021 ◽  
Author(s):  
Renée E Klein Schaarsberg ◽  
Arne Popma ◽  
Ramón J L Lindauer ◽  
Levi van Dam
Keyword(s):  
Experimental Design ◽  
Cognitive Distortions ◽  
Single Case ◽  
Phase 1 ◽  
Behavioural Change ◽  
Behaviour Problems ◽  
Disruptive Behaviour ◽  
Treatment Motivation ◽  
Disruptive Behaviour Problems

BACKGROUND Serious disruptive behaviour among adolescents is a prevalent and often persistent problem. This highlights the importance of adequate and effective treatment to help adolescents with disruptive behaviour problems react less hostile and aggressive. In order to create a treatment environment in which behavioural change can actually be enhanced, treatment motivation plays an essential role. Regarding treatment itself, a focus on challenging self-serving cognitive distortions in order to achieve behavioural change is important. Street Temptations (ST) is a new training program that was developed to address both treatment motivation and cognitive distortions in adolescents with disruptive behaviour problems. One of the innovative aspects of ST is the use of virtual reality (VR) techniques to provide adolescents during treatment with visually presented daily social scenarios to activate emotional engagement and dysfunctional cognitions. By using the VR scenarios as an integral starting point of ST’s sessions and transferring the power of the VR experience into playful and dynamic exercises to practice social perspective-taking, adolescents are encouraged to reflect on both their own behaviour as on that of others. This focus on reflection is grounded in ST’s main treatment mechanism to influence treatment motivation and cognitive distortions, namely mentalizing (i.e., reflective functioning). OBJECTIVE Describing the research protocol to evaluate the effects of ST on treatment motivation and cognitive distortions. We take a closer look at the use of ST and the methodology used, namely the repeated Single-Case Experimental Design (SCED). METHODS The effects of ST are studied through a multiple baseline Single-Case Experimental Design, using both quantitative and qualitative data. In total, 18 adolescents from secure residential youth care and secondary special education are randomly assigned to one of three different baseline conditions. Throughout a baseline phase (1, 2, or 3 weeks), intervention phase (4 weeks) and follow-up phase (1, 2 or 3 weeks), daily measurements on treatment motivation and cognitive distortions are conducted. Secondary study parameters are assessed before baseline, after intervention and after follow-up. Qualitative data is collected after intervention, as wells as 3 and 6 months after intervention. RESULTS Data collection for this study is planned to be completed by June 2023. The results will be published in peer-reviewed journals and presented at national and international conferences. CONCLUSIONS ST aims to improve disruptive behaviour problems of adolescents. The study described in this article will be the first to gain insight into the effectiveness of ST. Strengths of this study include its thorough and individually focused design (SCED), the focus on a residential as well as a secondary special education setting, and the ecological validity. Implications for practice are discussed. CLINICALTRIAL The study is registered at the Central Committee on Research Involving Human Subjects (NL75545.029.20, 24-06-2021) and the Netherlands Trial Register NL9639; https://www.trialregister.nl/trial/9639 (11-08-2021).

scholarly journals The Pliocene Model Intercomparison Project (PlioMIP) Phase 2: scientific objectives and experimental design

2016 ◽  
Vol 12 (3) ◽  
pp. 663-675 ◽  
Author(s):  
Alan M. Haywood ◽  
Harry J. Dowsett ◽  
Aisling M. Dolan ◽  
David Rowley ◽  
Ayako Abe-Ouchi ◽  
...  
Keyword(s):  
Climate Change ◽  
Experimental Design ◽  
Boundary Conditions ◽  
Surface Topography ◽  
Phase 1 ◽  
Future Climate Change ◽  
Phase 2 ◽  
Model Intercomparison ◽  
Ice Surface ◽  
Intercomparison Project

Abstract. The Pliocene Model Intercomparison Project (PlioMIP) is a co-ordinated international climate modelling initiative to study and understand climate and environments of the Late Pliocene, as well as their potential relevance in the context of future climate change. PlioMIP examines the consistency of model predictions in simulating Pliocene climate and their ability to reproduce climate signals preserved by geological climate archives. Here we provide a description of the aim and objectives of the next phase of the model intercomparison project (PlioMIP Phase 2), and we present the experimental design and boundary conditions that will be utilized for climate model experiments in Phase 2. Following on from PlioMIP Phase 1, Phase 2 will continue to be a mechanism for sampling structural uncertainty within climate models. However, Phase 1 demonstrated the requirement to better understand boundary condition uncertainties as well as uncertainty in the methodologies used for data–model comparison. Therefore, our strategy for Phase 2 is to utilize state-of-the-art boundary conditions that have emerged over the last 5 years. These include a new palaeogeographic reconstruction, detailing ocean bathymetry and land–ice surface topography. The ice surface topography is built upon the lessons learned from offline ice sheet modelling studies. Land surface cover has been enhanced by recent additions of Pliocene soils and lakes. Atmospheric reconstructions of palaeo-CO2 are emerging on orbital timescales, and these are also incorporated into PlioMIP Phase 2. New records of surface and sea surface temperature change are being produced that will be more temporally consistent with the boundary conditions and forcings used within models. Finally we have designed a suite of prioritized experiments that tackle issues surrounding the basic understanding of the Pliocene and its relevance in the context of future climate change in a discrete way.

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