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Thirty-two children (50% female, 59.3% White, 7-60 months), from middle to high socioeconomic status families, participated in pilot feasibility and validity testing of the somatosensory test of reaching (STOR). STOR tested the child's accuracy of reach to visual and somatosensory targets. All children were able to complete the assessment. Statistically significant differences were found between age groups (p = .0001), showing developmental trends, and between test conditions (p.001), showing that the ability to reach to visible targets develops before somatosensory targets. STOR also showed a moderate correlation with the Developmental Assessment of Young Children 2nd edition. STOR appears to be a promising tool for assessing somatosensory processing in very young children, and it warrants additional testing in larger participant samples.

Date Presented 04/13/21 Proprioception is the subconscious and conscious awareness of one's body, usually referred to as a sense of self in space. This pilot study used an observational design to assess proprioception and motor performance and discovered a strong relationship between high scores on the BOT and successful performance. This research supports a relationship between proprioceptive deficits and motor proficiency. Our proprioceptive assessments can be further developed for clinical use. Primary Author and Speaker: Nouran Hussein Amin Additional Authors and Speakers: Cameron McCallister, Kate Poisson, David Pufki, Angelica Ramirez, Claire Rickley Contributing Authors: Victoria Scattini

Proprioception is the subconscious and conscious awareness of the spatial and mechanical status of the musculoskeletal framework. When working with children with motor delays and sensory integrative dysfunction, occupational therapists routinely assess the client's proprioceptive system. However, currently available assessments for occupational therapists are primarily observer-based and concerns have been raised about the reliability of observer-based assessments of sensation. The author's purpose was to review measures of proprioception currently available to occupational therapists and explore direct measures of proprioception from neuroscience and rehabilitation that can be adapted for pediatric clinical use. Observer-based and direct measurements of proprioception assessments complement each other in meeting clinical needs. A better understanding of both types of evaluation will improve proprioceptive evaluation.

Children with dystonia are characterized by highly variable and seemingly uncontrolled movements. An important question for any rehabilitative effort is whether these children can learn and improve their performance. This study compared children with dystonia due to cerebral palsy, typically developing children, and healthy adults in their ability to acquire a novel sensorimotor skill. Using a virtual setup, subjects threw a virtual ball tethered to a post to hit a virtual target. Multiple combinations of release angle and velocity of the arm at ball release could achieve a target hit-the task was redundant and afforded solutions with different sensitivity to variability. Subjects performed 200 trials for two target locations that presented different types of redundancy. We hypothesized that children with dystonia develop strategies that are tolerant to their high variability. Estimating this variability highlighted the insufficiency of traditional outcome measures. Therefore, additional analyses of data distributions and of ball release timing were applied. Results showed that: 1) children with dystonia reduced their performance error despite their high variability; 2) this improvement was brought about by finding error-tolerant solutions; and 3) they generated arm trajectories that created time windows for ball release that were tolerant to timing variability. While reduced in magnitude, the performance improvements in children with dystonia paralleled those in healthy children and adults. These findings demonstrate that children with dystonia are able to adapt their behavior to their high variability, an important basis for any rehabilitative intervention.

Importance: Given the importance of proprioception in motor coordination, the identification of sensory deficits contributing to motor challenges is crucial for appropriate intervention; however, objective proprioceptive tests are not currently available in pediatric clinical practice. Objective: To pilot test methods for assessing proprioception in children. Children with somatodyspraxia were predicted to have reduced proprioceptive awareness compared with age-matched control children. Design: Observational study. Setting: Individual clinic. Participants: Ten children identified as having somatodyspraxia and 10 typically developing children, ages 6–8 yr. Outcomes and Measures: Spatial awareness and force perception were assessed by having the children match arm positions and grip and pinch forces using electronic dynamometers. Results: All children were able to complete the proprioceptive assessments. Of those identified as having somatodyspraxia, 90% showed deficits in at least one area of proprioception. Children with somatodyspraxia performed more poorly on spatial awareness and force perception tests than typically developing children (p < .05). Conclusions and Relevance: Children with dyspraxia have difficulties with spatial awareness and force perception, confirming a somatosensory contribution to dyspraxia. What This Article Adds: This article presents a framework and methods to measure proprioception in children. These methods will allow occupational therapy practitioners to quantify the proprioceptive deficits common in children with dyspraxia.

Date Presented 03/26/20 This study examines sensory functions in children with ITW and establishes a framework to detect sensory differences underlying ITW. Our results showed that ITW is related to sensory-processing differences, particularly in the area of vestibular processing. A small number of participants also showed differences in tactile and proprioceptive processing. Identifying sensory functions that underpin toe walking will contribute to targeted treatments for ITW. Primary Author and Speaker: Virginia Chu Contributing Authors: Laura Anderson

In this study, we investigated the responses to tread perturbations during human stepping on a treadmill. Our approach was to test the effects of perturbations to a single leg using a split-belt treadmill in healthy participants and in participants with varying severity of spinal cord injury (SCI). We recruited 11 people with incomplete SCI and 5 noninjured participants. As participants walked on an instrumented treadmill, the belt on one side was stopped or accelerated briefly during midstance to late stance. A majority of participants initiated an unnecessary swing when the treadmill was stopped in midstance, although the likelihood of initiating a step was decreased in participants with more severe SCI. Accelerating or decelerating one belt of the treadmill during stance altered the characteristics of swing. We observed delayed swing initiation when the belt was decelerated (i.e., the hip was in a more flexed position at time of swing) and advanced swing initiation with acceleration (i.e., hip extended at swing initiation). Furthermore, the timing and leg posture of heel strike appeared to remain constant, reflected by a sagittal plane hip angle at heel strike that remained the same regardless of the perturbation. In summary, our results supported the current understanding of the role of sensory feedback and central drive in the control of stepping in participants with incomplete SCI and noninjured participants. In particular, the observation of unnecessary swing during a stop perturbation highlights the interdependence of central and sensory drive in walking control. NEW & NOTEWORTHY Using a novel approach with a split-belt treadmill, we tested the effects of hip angle perturbations to a single leg in healthy participants and participants with varying severity of spinal cord injury (SCI). A majority of participants initiated an unnecessary swing when the treadmill was stopped in midstance, although the likelihood of initiating a step decreased with the severity of SCI. Our results demonstrated interdependence of central and sensory drive in walking control.

Objective This study aimed to improve our understanding of static and dynamic lower extremity sensory perception and the impact of sensory impairments on the control of walking in stroke survivors. Methods Using a custom, real-time unloading system, we tested load perception at heel strike, mid stance and push off in 10 stroke survivors and compared their performance to 10 age-matched and 5 young adult control subjects. Dynamic load perception was based on a judgment of which leg was bearing more load, which was altered on a step by step basis. We also examined lower extremity static load perception, coordination, proprioception, balance, and gait symmetry. Results The stroke survivors performed significantly worse than the control subjects in dynamic load perception, coordination, proprioception, balance and gait symmetry. Gait symmetry correlated with static and dynamic load perception measures but not with age, proprioception, coordination, and balance. Conclusions Sensory deficits related to load detection in the impaired limb could result in an increased uncertainty of limb load and a gait strategy in which stroke survivors minimize loading of the impaired limb. Significance This new method of measuring lower extremity dynamic load perception provides a framework for understanding gait-related sensory impairments in stroke survivors.

Objective To investigate the effects of antispastic drugs baclofen and tizanidine on reflexes and volitional tasks. Design Double-blind, placebo-controlled, crossover, before-after trial, pilot study. Setting Research laboratory in a rehabilitation hospital. Participants Men with chronic (>6mo) motor incomplete spinal cord injury (N=10) were recruited for the study. Interventions Tizanidine, baclofen, and placebo were tested in this study. Agents were tested in separate experimental sessions separated by >1 week. Main Outcome Measures Reflex and strength were measured before and after the administration of a single dose of each intervention agent. Electromyographic and joint torque data were collected during assessments of plantar flexor stretch reflexes, maximum contraction during motor-assisted isokinetic movements, and maximum isometric knee extension and flexion. Results Reduced stretch reflex activity was observed after the administration of either tizanidine or baclofen. We observed that tizanidine had a stronger inhibitory effect on knee extensors and plantar flexors whereas baclofen had a stronger inhibitory effect on the knee flexors. The effects of these drugs on strength during isometric and isokinetic tasks varied across participants, without a consistent reduction in torque output despite decreased electromyographic activity. Conclusions These results suggest that antispastic drugs are effective in reducing stretch reflexes without substantially reducing volitional torque. Differential effects of tizanidine and baclofen on reflexes of flexors and extensors warrant further investigation into patient-specific management of antispastic drugs.

Crafts and Creative Media in Therapy is a book that discusses the role and use of crafts in occupational therapy. The book is true to its purpose, providing a history to crafts, describing its use ...

Date Presented 4/20/2018 This ongoing study is examining sensory functions in children with idiopathic toe walking (ITW) to establish a framework to detect sensory differences that underlie ITW. Identifying sensory functions that underpin toe walking is a valuable contribution to the development of targeted treatments for ITW. Primary Author and Speaker: Virginia Chu

Using cadium oxide (CdO) as the Cd precursor and tri-n-octylphosphine selenide (TOPSe) as the Se source, TOP-capped and TOP/tri-n-octylphosphine oxide (TOPO)-capped CdSe nanocrystals were synthesized without the use of an acid. The synthetic approach involved the addition of a TOPSe/TOP solution into a CdO/TOP solution with or without TOPO at one temperature and subsequent growth at a lower temperature. The temporal evolution of the optical properties, namely, absorption and luminescence, of the growing nanocrystals was monitored in detail. A comprehensive examination on the control of the photoluminescence (PL) properties was performed by systematically varying the TOP/TOPO weight ratio of the reaction media. Surprisingly, a rational choice of 100% TOP or 80% TOP was found to produce "quality" nanocrystals when monitored under the present experimental conditions and growth-time scale. The term "quality" is mainly based on the sharp features and rich substructure exhibited in the absorption spectra of the growing nanocrystals, as well as the sharp features in the emission spectra with narrow full width at half-maximum (fwhm). There are two distinguishable stages of growth: an early stage (

Successful reaching requires that we plan movements to compensate for variability in motor output. Previous studies have shown that healthy adults optimally incorporate estimates of motor variability when planning a pointing task. Children with dystonia have increased variability compared with healthy children. It is not known whether they are able to compensate appropriately for the increased variability and whether this compensation leads to changes in reaching behavior. We examined healthy children and those with increased motor variability due to secondary dystonia. Using a simple virtual display, children performed a motor task where the variability of their movements was manipulated. Results showed that both subject groups changed their movement strategies in response to changes in the level of perceived motor variability. Both groups changed their strategy in a way that improved performance relative to the perceived motor variability. Importantly, dystonic children faced with decreased motor variability adapted their movement strategy to perform better and more similarly to healthy children. These findings show that both healthy and dystonic children are able to respond to changes in motor variability and alter their movement strategies.

Date Presented 4/8/2016 We demonstrate new quantitative methods for assessing proprioception. These assessments show that some children with dyspraxia have difficulties with force perception and joint position sense. Quantitative assessments enable therapists to accurately isolate proprioceptive difficulties in children. Primary Author and Speaker: Virginia Way Tong Chu Additional Author and Speaker: Stefanie Bodison