The purpose of this study was to determine the effects of back and seat rest inclination on the kinematics of manual hand-rim wheelchair propulsion in subjects with spastic type cerebral palsy. Subjects ranged in age from nine to twenty-one and were classified as USCPAA Class III or IV functional ability. Subjects were required to propel a standardized wheelchair at six seat positions from combinations of back rest angles of 0, 3 and -5 degrees from vertical and thigh angles of 0 and 5 degrees from horizontal. Combinations of thigh/seat rest angles were 0/-5, 5/-5, 5/0, 5/3, 0/3, 0/0 constituting the six different conditions. Subjects were filmed while wheeling in each seat position. Wheeling was performed at two and three kilometers per hour on a low friction roller system. It was hypothesized that since individuals with spastic type cerebral palsy have improved functional upper extremity performance as the body center of mass is positioned over the ischial tuberocities and hip flexion angle is maintained at 90 degrees (0/0), that similar results would be found in wheelchair propulsion. Based on the results of kinematic data analyzed in this study there was no indication that the 0/0 seat position was superior for subjects with cerebral palsy under the conditions of this study. Larger elbow flexion/extension range of motion (p = .06) exhibited by the 5/3 and 5/0 seat orientations suggests that these positions provide a more effective wheelchair propulsion orientation for subjects in this study. / Graduation date: 1996

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

A recent development in the field of technical aids for the handicapped is electronic speech synthesis. Whereas this revolutionary advancement may have many benefits for persons whose speech is defective or for those individuals who have lost the use of their natural speech apparatus through physical trauma, a satisfactory analysis of language training models applicable to the instruction of the Phonic Mirror Handivoice model HC 120 had not yet been accomplished. In the present study, two non-vocal cerebral palsied subjects participated throughout a series of three experiments. It was considered important to examine intensively the performances of these selected individuals as they interacted with and learned about the various aspects of a unique form of vocal behavior. In the first experiment, a traditional paired-associates procedure, Method A, was the standard training method with which other methods were compared. Method B was essentially a paired-associates procedure that emphasized the personal histories of verbal behavior for each subject; Method C established discriminative control over vocal responses by natural features of the environment; Method D combined a paired-associates procedure with one in which the subject directly supplied supplementary verbal stimuli as part of the training procedure. The criterion for effectiveness was the number of training/testing cycles required for each S to achieve criterion (of 100% correct) on each word list. The results of these comparisons indicated that none of the three methods was any more or less effective than the traditional paired-associates procedures. Upon the completion of the second comparison (i.e., Method A and Method C), an informal retention survey was conducted. The responses from both subjects to this survey indicated poor retention for test stimuli established on early lists but increasing retention on the more recently trained lists. Experiment 2 was therefore designed to determine the replicability of this retention phenomenon both within and between the two S's, using Method A, across three different word lists. This experiment showed that when test stimuli were presented 24 hours after training, there was little or no loss of control over the appropriate word. An additional finding was that little or no retention was exhibited by either S for words which had not been retested at the 24 hour interval and whose retest intervals were 4, 5, and 6 days. A feature of the Experiment 2 survey was that the variables of time (elapsed from training to testing) and additional training were confounded. Therefore, Experiment 3, again using Method A, was conducted to separately (1)evaluate the effectiveness of a simple retraining procedure on extended retention, and (2)examine the effect of elapsed time on discriminative control over the previously established verbal responses. The results of the retraining procedure were positive. Whereas previous surveys of Experiment 2 had produced little or no evidence of retention beyond the 48 hour interval, 60% of the test stimuli in Experiment 3 discriminated their appropriate verbal responses. In contrast, the word lists which had not undergone retraining at the 24 hour interval nor had been followed by additional training of new word lists exhibited retention of either 0 or 20%. Two major outcomes of the present study were (1)the four training methods were all effective, but not differentially so, in teaching the numeric language of the HandiVoice, and (2)effective retention over a number of days could be achieved by a single retraining session. These findings offer several practical guidelines for future HandiVoice instructors to establish and maintain a new but important form of verbal behavior.

No description available.

The purpose of this study was to investigate the relationships between the arm joint angle at contact-release with peak velocity in experienced cerebral palsied athletes during wheelchair propulsion. The subjects (n = 5) exercised for a few minutes to familiarize themselves with the roller set up. After practice, each subject was asked to push the wheelchair as fast as possible up to 10 seconds. A tach-generator was attached to the core of the roller and interfaced to a computer via an eight bit A/D converter. The sampling rate of the roller speed was 200Hz. One video camera operating at 30 frames per second, and posisioned 7 m from the roller side was used. The data were analyzed for shoulder, elbow, and wrist angles with the Peak Performance program in I.B.M. compatible computer. Subjects' peak velocities were 8.85, 4.49, 4.19, 3.66, and 4.09 m/s, and the mean percent of contact and release times were 32.8% vs 67.2%. Shoulder, elbow, and wrist contact angles were not statisticaly in this study. Results indicate that contact-release angle on hand-handrim was effected for peak velocity. Also there was no significantrelationship between speed and cycle time.Key WordsRacing wheelchair, cerebral palsy, Peak velocity, Propulsion, Joint angle. / School of Physical Education

As more adults with cerebral palsy (CP) are surviving longer (1) an intervention is needed to help reduce spasticity and increase overall strength to improve mobility, and therefore life quality. Adults with CP are lacking a form of independent exercise that allows them to maintain or improve their ambulation skills (1, 2). A new approach to increase muscle strength and flexibility is called whole-body vibration (WBV). The goal of the current study was to determine the acute effects of using an individualized frequency (I-Freq) approach to WBV therapy on gait in adults with CP. In this study, eight adults with CP (age 20-51 years, six men, two women) participated in two sets of testing: the first set was used to determine their I-Freq and the second set to perform a 3D gait analysis before and after a WBV treatment. The WBV was administered in five sets of one minute of vibration followed by one minute of rest. The gait analyses included collection of kinematic and EMG data. Subjects experienced a significant increase in walking speed (P=0.047), stride length (P=0.017) and dynamic ankle range of motion (P=0.042) after the acute bout of WBV. These data show that WBV treatments at I-Freq could help adults with CP maintain their range of motion and overall mobility through an independent and cost effective means. 1. Murphy KP. The adult with cerebral palsy. Orthop Clin North Am2010 Oct;41(4):595-605. 2. Murphy KP, Sobus K, Bliss PM. The Adult with Cerebral Palsy: A Provider-Consumer Perspective. Physical Medicine and Rehabilitation Clinics of North America2009 Aug;20(3):509-+. / School of Physical Education, Sport, and Exercise Science

Providing adequate nutrition to children with severe neurological disabilities is extremely difficult due to the high prevalence of oral-motor dysfunction in this group. Short stature and light weight for height are common in disabled children and undernutrition is believed to play a role in this poor growth. This programme of study investigated the effect of gastrostomy-tube feeding in disabled children with oral-motor dysfunction and evaluated the energy balance and body composition of disabled children fed both orally and via gastrostomy-tube over twelve months. The Quality of Life of the children and their carers was also evaluated. Energy intake was measured using three-day dietary diaries and energy expenditure with indirect calorimetry and doubly labelled water. Total body water using oxygen-18 dilution was used to evaluate body composition along with standard anthropometry. Improved growth, nutritional status and general health were seen at six and twelve months after gastrostomy-tube placement. The Quality of Life of the children and their carers also significantly increased. Both energy intake and energy expenditure were found to be lower than reference standards, but energy balance was positive indicating that inadequate nutrition was not the sole cause of poor growth. Body composition was also found to be significantly different from reference. Fat-free mass was significantly low for age and for height. Fat mass was higher in gastrostomy-tube fed children, but lower or normal in disabled children fed orally. Physical activity levels were low for the entire group of disabled children yet the gastrostomy-tube fed children displayed much higher levels of disability. Gastrostomy-tube feeding has a positive impact upon the growth, health and Quality of Life of disabled children and their carers. Careful follow-up is critical in order to optimize health and body composition.

To investigate the relationship between birth asphyxia and neurological impairment a cohort of 184 infants with a low (≤3) one-minute Apgar score was studied. All were singletons, apparently normally formed, and born at term (≥37 weeks' gestation) in the John Radcliffe Hospital, between January 1984 and September 1985. The 181 cohort survivors were traced at the age of five years; 159 were assessed by a paediatrician on a battery of neurodevelopmental tests, and information about a further eight was obtained from other sources. Three infants in the cohort died neonatally with a diagnosis of birth asphyxia, and three had spastic quadriplegia, profound developmental delay and visual impairment. Examination of the perinatal histories of these six children, including their fetal heart rate patterns in labour and acid-base status at delivery, found convincing evidence of birth asphyxia. Only one other child in the cohort exhibited similar signs of birth asphyxia; he was unimpaired at the age of five. To assess the impact of birth asphyxia on the overall rate of cerebral palsy, all cases of cerebral palsy born to Oxford residents in the study period were identified. Of 30 cases of cerebral palsy, the three identified in the follow-up study were the only ones whose impairment could be attributed to birth asphyxia in a full-term birth. Birth asphyxia therefore accounted for 10% of all cases of cerebral palsy, a fraction that agrees with previous estimates. The frequency of cerebral palsy due to birth asphyxia was estimated as 1 in 3800 full-term livebirths. A detailed analysis of the test scores of the 159 children assessed by the paediatrician failed to show any association between their acid-base values at delivery and test scores, or between their fetal heart rate patterns in labour and test scores. These results conform with the view that birth asphyxia has an "all or nothing" effect, and that it presents as a cluster of abnormal neonatal signs, including persistent cerebral depression, severe acidaemia, neonatal encephalopathy, and multiorgan dysfunction.

No description available.

Thesis (M.S.)--University of Oregon, 2004. / Includes bibliographical references (leaves 56-58). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.