Please enable JavaScript.

Coggle requires JavaScript to display documents.

Neuro Term Paper (What is the approach? ( 2 citations) (Briefly describe…

- - - - Article 1:
        
        SPIO vest: front is a double/triple layer of lycra fabric attached by velcro to the back panel which is made out of neoprene
        
        Adjustable compression around shoulder, trunk, and hips
- - - - Wearing SPIO for two hours during therapy or 6 hour group that wore it 4 hours outside of therapy. All groups received conventional exercise therapy (ROM, strength, trunk control, fine and gross motor skills) 2hr/day 7 days a week. After discharge ( 2 weeks), continued to wear SPIO at home.
      - 24 children with CP, 5 boys, 19 girls, mean age 61.1 months, range 35-105 months
      - Impaired trunk control, single blind, randomized controlled study
      - Use of lycra-based compression orthosis vest
        Does it improve trunk posture and hip lateralization in children with CP?
    - - Case Study of 5 yr old boy with CP: Simon, Gross motor function classifiation system Level 2, descreased postural control and involuntary movements affecting independent mobility and balance
      - Focus on postural control and impact on involuntary movements
      - Review of 10 studies
        
        CINAHL and MEDLINE databases
        
        Participants varied in GMFCS (classifies children with CP into 5 levels based on GM function)
        
        spatic, athetosis, dystonia, and ataxia as well as hemi, di, and quad
        
        One study: small randomized controlled trial, another was a combined descriptive study, cross-over and recipient control study, and 8 were case series
    - - Systematic review
        
        Three independent reviewers searched for experimental studies on MEDLINE, SciELO, BIREME, LILACS, PEDro and CENTRAL databases
        
        From the 13 studies, two evaluated the Full Body Suit, two tested the Dynamic Elastomeric Fabric Orthose, three evaluated TheraTogs and six tested the TheraSuit/AdeliSuit protocols
    - - Systematic review of 4 databases, 37 articles, Traffic lighting classification to rate effectiveness. 9 studies: orthotic interventions, 4 studies over 9 articles: treadmill interventions, remaining: compression garments, massage, motor and sensori-motor interventions, positioning and mobility interventions
      - Inclusion: 50% or more participants were explicity described as hypotonic or diagnosed with syndromes associated with hypotonia (Down Syndrome) and measured impact of PT and/or OT interventions on motor or sesnory outcomes.
      - American Academy of Cerebral Palsy and Developmental Medicine criteria was used to identify evidence level and AACPDM quality rating was used for individual studies evidence level I-III.
      - majority of individual studies were Down syndrome, while CP with hypotonia were repesented in fewer studies
  - - - Improves kyphotic posture, but not scoliosis and hip lateralization in children with CP
    - - This shows that there needs to be caution taken with recommending the use of therapeutic suits.
      - The quality of evidence for the Full Body Suit, the Dynamic Elastomeric Fabric Orthose and the TheraSuit/AdeliSuit protocols was very low for body structure and function outcomes, while the evidence for TheraTogs was low quality.
      - Regarding the activity outcomes, the Full Body Suit and TheraSuit showed very low quality evidence while the evidence for TheraSuit/AdeliSuit protocols were of low quality.
    - - There was a limited amount of evidence found in this research
        
        no significant results were found.
        
        A lot of the data found in this article was based off of observations
        
        were not randomized
        
        Improvements were found in some clients in their confidence of their physical abilities and participation in difficult activities.
    - - Intervention: 2-6hrs/day of Benik Vest
        
        No changes in GMFM score, but improved vision, alertness, head control, laughing and rolling
      - Other interventions were yellow light indicating that although positive results, outcomes should be measured to ensure benefit for individual children.
        
        Compression garments
        
        AASPDM Level of Evidence V(positive): ability to roll
        
        AACPDM level of evidence ( no change or inconclusive) V: GMFM
  - - - Small sample size, can’t draw a conclusion on the effects of the suit
        The effects of the suit on activity and participation were not evaluated (only body structure and function were measured)
    - - Most of the studies they found had small sample size
        
        Heterogeneity of population makes it difficult to generalize
        
        Relied heavily on observation and caregiver questionnaire, and few used standardized assessment tools for physical function
        
        only 1 randomized controlled trial, other studies used neither randomization or blinding
    - - Low external validity
        
        Low quality with blinding of subjects, therapists and examiners
        
        Low quality of evidence for body structure and function and activity outcomes
        
        Due to small number of randomized control trials
        
        Weak recommendations for the use of therapeutic suits
        
        Language exclusion when picking studies to review
        
        Difficulty with using the Checklist for Measuring Study Quality
        
        Not possible to make the a meta-analysis because of all the variety in type of studies reviewed.
    - - Of the 9 primary studies 6 used same data set and warrants caution in application of results
      - The low numbers of participants involved and
        
        low evidence level in the majority of studies included
        
        warrants caution in interpretation of results.
  - - - specific sub-populations of people with CP, use standardized outcome measures and larger sample sizes
      - Carryover effects after removal of garments
      - qualitative reports of family and client, insight into compliance and comfort tissues
- - - - "disturbance of posture and movement due to a non-progressive brain lesion acquired during early development"
      - CP: umbrella term, many different types that cause varying dysfunctions in motor skills, perceptual abilities, speech intelligibility, communicative competency, and cognition.
        
        Divided into spastic, dyskinetic, and ataxic subtypes
        
        Dyskinetic: variations in muscle tone and involuntary movements
        
        Ataxic: uncoordinated movements
        
        Spastic: increased muscle tone and hyperreflexia (makes up vast majority of cases). Further divided into: hemiplegic, diplegic, and quadriplegic subtypes.
  - - - Use SPIO to improve proximal stability
      - Provides extra-proprioceptive information which enhances body awareness and improves alignment
      - With proper alignment and intensive therapy-> brain able to recognize and form correct movement of the muscles
      - My conclusion: having proper alignment and being able to move correctly will improve their performance in ADLs
    - - "dynamic compression garments can reduce involuntary movements, and improve trunk stability, while reducing muscle tone in spastic and dystonic muscles."
      - NeuroBand Technology
        
        Touch tension tech: directional pull of Neurobands delivering upper extremity force kinetically to the body's core
        
        Neuroband tech: provides biomechanical and biofeedback stimulations to the muscles.
        
        Muscle-Map Design: creates the right amount of tension and support to the muscles. Longer design to support core muscle groups
      - "By applying deep pressure to specific areas, the garments are able to increase muscle awareness and activation similar to pressure applied by a therapist in treatment"
      - Types
        
        SPIO: uses deep pressure to assist with stability and proprioceptive deficits.Deep pressure seems to be important in somatic input for balance and movement.
        
        Theratogs: improves postural alignment and stability, movement skill and precision, joint stability and prolonged muscle stretch.
        
        Alignmend: focuses on anatomical alignment, which is key to increasing strength, stamina, balance, joint health, circulation, and overall well being.