| 1. |
- Green, Dido, et al.
(författare)
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A multi-site study of functional outcomes following a themed approach to hand-arm bimanual intensive therapy for children with hemiplegia
- 2013
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Ingår i: Developmental Medicine & Child Neurology. - : John Wiley & Sons. - 0012-1622 .- 1469-8749. ; 55:6, s. 527-533
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Tidskriftsartikel (refereegranskat)abstract
- Aim:This study investigated the effects of a theme-based ('magic') variation of the hand-arm bimanual intensive therapy programme, in two different countries, in improving activity performance for children with hemiplegia, including those with severe movement restrictions.Method:Twenty-three children with spastic hemiplegia (13 males, 10 females; mean age 10y 7mo, range 7-15y; Manual Ability Classification System level I, two; level II, 13; level III, eight), participated in one of three, 2-week, summer camps. A within-participant experimental design was used with the Assisting Hand Assessment and Children's Hand Experience Questionnaire as primary outcome measures. Evaluations occurred immediately before the first day, on the last day, and 3 months after intervention. Two groups underwent additional assessments 2 weeks before the camp.Results:Significant intervention effects were seen on the Assisting Hand Assessment (p=0.002) and on the Children's Hand Experience Questionnaire (p<0.001), the latter maintained at follow-up. The affected hand was reported to be used in 25% of bimanual activities before the camp, progressing to 93% after camp, and decreasing to 86% at follow-up. Severity of impairment did not influence progress.Interpretation:This themed approach to intensive intervention showed positive results in bimanual use, with improvements in independence sustained at follow-up. Although children across camps and motor severity made progress, some questions remain about intensity and duration of intervention to optimize longer-term outcomes.
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| 2. |
- Green, Dido, et al.
(författare)
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A validation study of the Keyboard Personal Computer Style instrument (K-PeCS) for use with children
- 2012
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Ingår i: Applied Ergonomics. - : Elsevier. - 0003-6870 .- 1872-9126. ; 43:6, s. 985-992
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Tidskriftsartikel (refereegranskat)abstract
- This study examines a potential instrument for measurement of typing postures of children. This paper describes inter-rater, test-retest reliability and concurrent validity of the Keyboard Personal Computer Style instrument (K-PeCS), an observational measurement of postures and movements during keyboarding, for use with children. Two trained raters independently rated videos of 24 children (aged 7-10 years). Six children returned one week later for identifying test-retest reliability. Concurrent validity was assessed by comparing ratings obtained using the K-PECS to scores from a 3D motion analysis system. Inter-rater reliability was moderate to high for 12 out of 16 items (Kappa: 0.46 to 1.00; correlation coefficients: 0.77-0.95) and test-retest reliability varied across items (Kappa: 0.25 to 0.67; correlation coefficients: r = 0.20 to r = 0.95). Concurrent validity compared favourably across arm pathlength, wrist extension and ulnar deviation. In light of the limitations of other tools the K-PeCS offers a fairly affordable, reliable and valid instrument to address the gap for measurement of typing styles of children, despite the shortcomings of some items. However further research is required to refine the instrument for use in evaluating typing among children.
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| 3. |
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| 4. |
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| 5. |
- Green, Dido
(författare)
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Limitations of meta-analyses
- 2012
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Ingår i: Journal of autism and developmental disorders. - : Springer. - 0162-3257 .- 1573-3432. ; 42:8, s. 1774-1775
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 6. |
- Green, Dido, et al.
(författare)
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The risk of reduced physical activity in children with probable Developmental Coordination Disorder : A prospective longitudinal study
- 2011
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Ingår i: Research in Developmental Disabilities. - : Elsevier. - 0891-4222 .- 1873-3379. ; 32:4, s. 1332-1342
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the current study was to test the hypothesis that children with probable Developmental Coordination Disorder have an increased risk of reduced moderate to vigorous physical activity (MVPA), using data from a large population based study. Prospectively collected data from 4331 children (boys = 2065, girls = 2266) who had completed motor coordination testing at 7 years and accelerometry at 12 years were analysed from the Avon Longitudinal Study of Parents and Children (ALSPAC). Probable DCD (p-DCD) was defined, using criteria based on the DSM IV classification, as those children below the 15th centile of the ALSPAC Coordination Test at seven years who had a functional impairment in activities of daily living or handwriting, excluding children with a known neurological diagnosis or IQ < 70. Secondary exposure variables consisted of subtests from the ALSPAC Coordination test (manual dexterity, ball skills and balance). Objective measurement of the average daily minutes of MVPA was recorded as ≥3600 counts per minute (cpm) using actigraph accelerometry. Boys with p-DCD were less physically active than boys without DCD (mean difference in MVPA 4.36. cpm, t= 2.69; p= 0.007). For boys, targeting skill (bean bag toss) was related to increased MVPA, after adjustment for confounding factors including neonatal, family and environmental factors as well as Body Mass Index at age seven and 12 years (β= 0.76, t= 3.37, p< 0.001, CI 0.32-1.20). There was no difference in level of MVPA in girls with and without p-DCD (mean difference 1.35. min, t= 0.97, p= 0.31), which may reflect the low levels of MVPA of girls in this cohort. Our findings suggest that the presence of movement difficulties, particularly poor targeting (bean bag toss/ball skills), at a young age is a potential risk factor for reduced MVPA in boys.
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| 7. |
- Green, Dido
(författare)
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Translating evidence into practice
- 2014
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Ingår i: Developmental Medicine & Child Neurology. - : Blackwell Publishing Ltd. - 0012-1622 .- 1469-8749. ; 56:12, s. 1132-1133
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 8. |
- Green, Dido, et al.
(författare)
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Use of virtual reality in rehabilitation of movement in children with hemiplegia - A multiple case study evaluation
- 2012
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Ingår i: Disability and Rehabilitation. - : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 34:7, s. 593-604
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Tidskriftsartikel (refereegranskat)abstract
- Purpose:To evaluate the feasibility and therapeutic effect of engaging children of differing neuromotor and cognitive ability in a virtual reality (VR) tabletop workspace designed to improve upper-limb function.Method: Single-subject experimental design with multiple baselines was employed. Four children with hemiplegia participated in VR-based training between nine and 19, 30-minute sessions, over three-four weeks. Outcomes were assessed from the perspective of the International Classification of Functioning, Disability and Health; considering body function, activity performance and participation. Upper-limb performance was assessed using system-measured variables (speed, trajectory and accuracy) and standardized tests. Trend analyses were employed to determine trends on system variables between baseline phase and treatment phases. Standardised measures were compared between pre- and post-training.Results:Two children made progress across system variables with some translation to daily activities. Performance of the other two children was more variable, however, they engaged positively with the system by the end of the treatment phase.Conclusions:The VR (RE-ACTION) system shows promise as an engaging rehabilitation tool to improve upper-limb function of children with hemiplegia, across ability levels. Trade-offs between kinematic variables should be considered when measuring improvements in movement skill. Larger trials are warranted to evaluate effects of augmented feedback, intensity and duration of training, and interface type to optimise the system's effectiveness.Implications for Rehabilitation:The RE-ACTION system shows promise as a relatively low-cost solution to support therapies for upper-limb function and activity participation for children with hemiplegia and associated conditions. The combination of goal-directed tasks, augmented feedback, and engaging exploratory environments is a potentially quite powerful rehabilitation solution for children. Increased task engagement supported positive outcomes of the International Classification of Functioning, Disability and Health - Children and Youth version, including body function and activity levels as well as enhanced participation. Larger experimental trials are required to test the capacity of the system to progress the skills of children with multiple disabilities.
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| 9. |
- Green, Dido, et al.
(författare)
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Validation of the Elements/RE-ACTION System for use with children : Evaluation of performance across developmental stages
- 2011
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Ingår i: 2011 International Conference on Virtual Rehabilitation, ICVR 2011. - 9781612844749
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Konferensbidrag (refereegranskat)abstract
- The aim of this study was to ascertain the feasibility of using the Elements virtual reality (VR) System for children and determine the construct validity of the assessment mode of the system. These technologies were adapted for use with children, called the Re-Action system, to support motor learning. A mixed-approach design was used. Construct validity was evaluated by contrasting performance on system variables across different developmental stages (Kindergarten, Primary Education, Middle Education and Secondary Education). Four system-generated measures were recorded automatically by the Re-Action system: object placement accuracy, movement speed, movement efficiency, and response errors. These measures were obtained during goal based tasks ranging from predictable to random targets. Children's perceptions of the system were measured via the Short Feedback Questionnaire-Children (SFQ-C) to ascertain the levels of engagement of the children in the system which might support motivation and compliance. Seventy-three children aged between 4 and 16 years undertook 15 minutes of interaction with the system. Differences between developmental stages were identified on randomly presented stimuli indicating that the RE-ACTION system has some sensitivity to developmental trends in performance capacity. Subjective data from the SFQ-C revealed high levels of enjoyment and satisfaction with the tasks. These findings support an earlier case study evaluation of the Re-Action system for use with children with hemiplegia and suggest that the paediatric adaptation of the Elements System has the potential to support understanding of motor learning through childhood. The assessment mode of the system appears to be a valid movement assessment tool for children of different ages with the potential for documenting change as a result of development or intervention.
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| 10. |
- Gringras, P., et al.
(författare)
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Weighted blankets and sleep in autistic children - A randomized controlled trial
- 2014
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Ingår i: Pediatrics. - : American Academy of Pediatrics. - 0031-4005 .- 1098-4275. ; 134:2, s. 298-306
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:To assess the effectiveness of a weighted-blanket intervention in treating severe sleep problems in children with autism spectrum disorder (ASD).METHODS:This phase III trial was a randomized, placebo-controlled crossover design. Participants were aged between 5 years and 16 years 10 months, with a confirmed ASD diagnosis and severe sleep problems, refractory to community-based interventions. The interventions were either a commercially available weighted blanket or otherwise identical usual weight blanket (control), introduced at bedtime; each was used for a 2-week period before crossover to the other blanket. Primary outcome was total sleep time (TST) recorded by actigraphy over each 2-week period. Secondary outcomes included actigraphically recorded sleeponset latency, sleep efficiency, assessments of child behavior, family functioning, and adverse events. Sleep was also measured by using parent-report diaries.RESULTS:Seventy-three children were randomized and analysis conducted on 67 children who completed the study. Using objective measures, the weighted blanket, compared with the control blanket, did not increase TST as measured by actigraphy and adjusted for baseline TST. There were no group differences in any other objective or subjective measure of sleep, including behavioral outcomes. On subjective preference measures, parents and children favored the weighted blanket.CONCLUSIONS:The use of a weighted blanket did not help children with ASD sleep for a longer period of time, fall asleep significantly faster, or wake less often. However, the weighted blanket was favored by children and parents, and blankets were well tolerated over this period.
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