Many children with developmental disabilities (DD) have physical impairments and limitations in their participation. Rehabilitation research often focuses on either physical impairments or participation restrictions, when both need to be investigated. The purposes of these two studies were to evaluate an at home therapist directed video game balance training intervention on balance, gait velocity (GV), hip strength and activities of children with DD. The pilot study was a single-subject non-concurrent multiple baseline design. Balance measures included: weight bearing symmetry; center of pressure area and velocity; time to boundary mean minima and standard deviation; and timed up and go. The participant’s enjoyment and perceived difficulty was also explored. Five children (7 to 10 years) with cerebral palsy (CP) participated in a 6 week, 30 minute intervention 3 times per week, with four preselected balance games. Minimal improvements were found in balance, GV, and hip strength, and participants reported the intervention enjoyable and challenging. Three of five participants had significant increases in activities, as measured by the Activities Scale for Kids (ASK). The second study expanded on pilot study results and included 5 children (5 to 10 years) with different diagnoses. Another non-concurrent multiple baseline design was utilized, and the same measures of balance were used except single leg stance time was substituted for timed up and go. No changes were made to the intensity of intervention, but two games were added to the repertoire. There were minimal changes in balance and hip strength; and no changes were found in the ASK. A majority of participants increased GV, and reported the intervention was enjoyable and challenging. Positive changes were found in the combined results for: center of pressure area with eyes open and closed; time to boundary mean minima with eyes closed in the anterior-posterior direction; and GV. These studies suggest this intervention was insufficient to make improvements in the majority of balance measurements and hip strength for children with DD. Increased activities in children with CP were found in the pilot study. These results suggest video game balance training alone for children with DD was insufficient to demonstrate clinically meaningful change. KEYWORDS: Balance, Developmental Disabilities, Gait Velocity, Hip Strength, Activities and Participation

Background: When people walk while performing a cognitive dual-task, a decrease in gait velocity will occur because of the demand for some of the same cognitive resources. However, in a previous study they found an increase instead of a decrease in gait velocity when subjects walked on a self-paced treadmill while performing a color-word Stroop task. Aim: The aim of this study was to determine if the increase found in gait velocity in the previous study was a consequence of the subjects’ position. Additionally, it was investigated whether real-time feedback about the subjects’ position could substitute the lack of a reference point. Method: Position and gait velocity was measured in twelve healthy subjects during a trial consisting of eight control conditions and eight different interventions. Results: A significant difference was found in gait velocity between the interventions where the accelerations-line was moved furthest to the front and back (IzerolineA, IzerolineB) and in position between the original intervention and one with a neutral zone (Iorginal1, Ineutralzone). No differences were found in position or velocity with any of the feedback systems. Conclusion: From the results it could be concluded that the increase in gait velocity was a consequence of the subjects positioning themselves further in the forward direction on the treadmill. No conclusions could be drawn with the feedback systems.

Made available in DSpace on 2016-06-02T20:19:22Z (GMT). No. of bitstreams: 1 DissMCA.pdf: 1435645 bytes, checksum: b348869b2bd6bc22a699e39d6cb146ee (MD5) Previous issue date: 2005-02-25 / Universidade Federal de Minas Gerais / Osteoporosis is a metabolic bone disorder characterized by low bone mass and microarchitectural deterioration leading to skeletal fragility and increasing of fracture risk. Due to the lack of well defined protocols on the intensity and frequency of physical exercises to reduce multiple risk factors in falls, the purpose of this study was to propose, to apply and to analyze the effects of a physical exercise program in balance performance, gait velocity, ankle muscle torque and quality of life in women with densitometric diagnosis of osteoporosis. Subjects: 12 voluntary women (age 68.7 ± 2.7) were submitted to a physical evaluation. The group was re-evaluated after twelve weeks. The physical activity program was oriented by a physical therapist, during twelve weeks, with a frequency of three times per week and duration of 60 minutes. Each session included general stretching exercises; twentyminute walking, exercises to strengthen ankle dorsiflexors and plantar-flexors muscles, with 50% of 10-repetition maximum (10-RM) and balance training. The data were statistically analyzed by Wilcoxon non-parametric tests. The variables analyzed regarding to the balance performance, gait velocity, ankle muscle strength and pain, activities of daily living, flexibility modalities in the quality of life questionnaire showed significant improvement (p ≤ 0,05). Consequently, the results obtained in this study allow to conclude that the physical activity program was efficient to improve balance performance, gait velocity, ankle muscle strength and quality of life, suggesting to be an effective and safe training program to women suffering from osteoporosis. / A osteoporose é uma doença esquelética sistêmica caracterizada por massa óssea baixa e deterioração microarquitetural do tecido ósseo, com conseqüente aumento da fragilidade óssea e susceptibilidade à fratura. Devido a falta de protocolos bem definidos sobre intensidade e freqüência de exercícios físicos para reduzir os inúmeros fatores de risco para quedas, o objetivo deste estudo foi propor, aplicar e analisar os efeitos de um programa de atividade física no equilíbrio, velocidade da marcha, torque muscular dos dorsiflexores e flexores plantares e na qualidade de vida de mulheres com diagnóstico densitométrico de osteoporose. Sujeitos: 12 mulheres voluntárias (idade 68,7 ± 2,7) foram submetidas a uma avaliação física. O grupo foi reavaliado após 12 semanas. O programa de atividade física foi orientado por um fisioterapeuta, durante 12 semanas, com freqüência de três vezes por semana e duração de 60 minutos. Cada sessão incluiu exercícios de alongamentos gerais, 20 minutos de caminhada, exercícios para fortalecimento dos dorsiflexores e flexores plantares do tornozelo, com 50% de 10-repetições máximas (10-RM) e treino de equilíbrio. Os dados foram analisados estatisticamente através do teste não paramétrico de Wilcoxon. As variáveis analisadas equilíbrio, velocidade da caminhada, força muscular e as modalidade dor, capacidade de realizar atividades de vida diária e flexibilidade do questionário de qualidade de vida mostraram melhora significativa (p ≤ 0,05). Conseqüentemente, os resultados obtidos neste estudo permitem concluir que o programa de atividade física proposto foi eficiente para melhorar o equilíbrio, velocidade da caminhada, força muscular e a qualidade de vida, sugerindo que programa de treinamento é efetivo e seguro para mulheres portadoras de osteoporose.