Continuous inter-limb coordination is the movement relationship between body limb segments (e.g. an arm and a leg) (Magill & Anderson, 2014) and is organized within the framework of the characteristics of the environmental conditions, the task demands, and the limb dynamics (e.g. the action capabilities of the individual) (Holt et al., 2000). When maximal coordination is achieved, stability, which is the defined as the system’s ability to offset a perturbation (Li et al., 2005), is optimized (Meyns et al., 2012). Individual coordinative relationships provide insights into neuromuscular deficiencies and their corresponding coordination difficulties (Kurz & Stergiou, 2004), such as those affecting children with cerebral palsy (CP) (Meyns et al., 2012). CP describes a group of neurodevelopmental disorders attributed to a non-progressive disturbance in the developing brain (Bax et al., 2005). Children with unilateral spastic CP (USCP), the most common subtype (Odding et al., 2006), are affected on one side of their body, experience problems with bimanual coordination, and indicate lower levels of inter-limb coordination and stability compared to their typically developing peers. This can affect both their functional independence and quality of life (Steenbergen et al., 2008; Meyns et al., 2012). To date, no study has evaluated whether inter-limb coordination of this population during a gross motor task can be improved with treatment. The goals of this study were to evaluate continuous inter-limb coordination and stability in children with USCP compared to typically developing children (TDC) and to determine if coordination and stability of children with USCP could be improved with intensive upper extremity (UE) intervention. Constraint Induced Movement Therapy (CIMT) and Hand Arm Bimanual Intensive Therapy (HABIT) were employed to both improve UE function and determine whether inter-limb coordination and stability are also improved. A total of 33 age-matched children participated, divided evenly into three groups of Treatment (n=6, CIMT; n=5, HABIT), No-Treatment, and Typically Developing. Vicon 3-D motion capture was used to collect movement data. Continuous measures of coordination using relative phase analysis, including Mean Absolute Relative Phase (MARP) and Deviation Phase (DP) were used to quantify coordination (MARP) and stability (DP) during novel, gross motor tasks of standing and in-place marching with symmetric and asymmetric arm swing. Results indicated that children with USCP have a lower level of coordination compared to TDC (p<0.05), but there is no difference in the stability of their patterns (p>0.05). This indicates that all children have difficulty producing consistent cyclical movements with their arms, regardless of pathology. All children also demonstrated greater difficulty coordinating their UE during the in-place marching tasks compared to the standing tasks (p<0.05), which may be due to the inherent increase in degrees of freedom associated with the addition of the lower extremities to the task. Treatment of either CIMT or HABIT improved coordination between the arms (p<0.05), but also decreased stability between the more affected arm and leg during the in-place marching tasks (p<0.05) with symmetric and asymmetric arm swing, respectively. This decrease in stability may represent the children’s inability to consistently execute the same cyclical movements for an extended period of time due to their newly learned patterns resulting from improvements in UE function after treatment. This is the first study to identify similarities in stability between TDC and children with USCP and to demonstrate improvements in continuous, inter-limb coordination after intensive UE intervention in this pathologic population. The finding that TDC do not indicate greater stability in their motor patterns may imply that their patterns are not yet mature. Therefore, it may be efficacious to intervene at a young age to ensure correct coordinative patterns are learned and become stable as the child matures. Evidence that both function and continuous coordination between the arms are improved after intervention also suggests that with increased gross motor practice during the intervention, continuous inter-limb coordination may improve in a greater variety of tasks. Due to the prominence and accessibility of UE interventions, implementation of more gross motor tasks may be an economical way to advance coordination, which can positively impact activities of daily living and increase participation in community activities in children with USCP.

Schizophrenia is a serious mental illness affecting millions of Americans. It is characterized by positive and negative symptoms; cognitive impairments; and sensory, motor, and process skill deficits; as well as compromised motor learning, functional difficulties, and diminished quality of life. Neuroscientists attribute the above deficits to abnormal brain development, exaggerated synaptic pruning, and neurodegenerative processes, causing disrupted connectivity and diminished plasticity in the brain, neurotransmitter dysfunction, and impaired sensory processing. Presently, there is no cure for schizophrenia. Numerous medications and rehabilitation modalities exist; however, many of the affected individuals continue to struggle daily. Recovery of these individuals implies symptom management and environmental supports to foster integration into the society and improved quality of life. Occupational therapists (OTs) utilize occupation-based assessments and interventions to evaluate and treat functional impairments in clients with various conditions, including schizophrenia, and provide their clients with environmental adaptations/modifications to enhance function. An improved understanding of the skill deficits and their relationship with schizophrenia symptomatology is necessary to refine treatment and rehabilitation for this client population, and so far, several OT scholars have attempted to research this topic. This study employed the Adolescent/Adult Sensory Profile (AASP), Assessment of Motor and Process Skills (AMPS), and Brief Psychiatric Rating Scale (BPRS) to examine the sensory, motor, and process skills of stabilized adult patients with schizophrenia spectrum disorders in relation to their symptoms. It was hypothesized that the participants would present with deficient sensory, motor, and process skills, and significant relationships would be revealed between these skill deficits and the severity of psychiatric symptoms. Analysis of the data confirmed sensory, motor, and process skill deficits in the participants. It discovered correlations between low registration and sensory sensitivity, and anxiety/depression. Relationships were also found between sensory avoidance and motor and process skill deficits. Additional findings included correlations between sensory sensitivity and sensory avoidance, between motor and process skill deficits, and between different categories of psychiatric symptoms. Study findings support the idea that schizophrenia rehabilitation necessitates addressing the skill deficits with which it comes. The concept of impaired sensory processing underlying schizophrenia symptomatology and skill deficits needs further investigation.

Current research examining the effects of resistive exercise programs in children with cerebral palsy (CP) has not met national guidelines for the duration of training. The lack of improvement in gross motor abilities after resistive training may be attributed to insufficient duration. Additionally, plyometric training has not been used as a treatment, despite evidence suggesting that it can improve running, throwing, and jumping skills. The current study evaluated the optimum duration and effects on gross motor abilities of a plyometric training treatment for three participants with spastic, unilateral CP using a multiple baseline, multiple probe design. Treatment was designed using the National Strength and Conditioning Association’s guidelines for intensity, volume, frequency, and variety of training. Treatment resulted in improvements in GMFM 66 scores, agility, and broad jump distance for all three participants. Consistency preceded improvements in distance or height. The optimum duration was dependent on the individual child and the outcome measure. Ongoing training is necessary to maintain running speed. However,slight declines or maintenance of performance in the GMFM, agility, and power tests at follow-up may be attributed to inconsistency in performance rather than decline.

Abstract not available

[Tuncated abstract] Previous research has shown that associated movements (AMs) decrease with age in typically developing children. However, considerable variability has been found to exist between children of the same chronological age (Wolff et al., 1983; Largo et al., 2001) and the reasons for this variability are unclear. As AMs are considered to be a construct of motor behaviour it is possible that varying levels of motor ability may contribute to this variability. Only a few studies have investigated the relationship between motor ability and AM expression, and those have resulted in equivocal findings. Therefore, the aim of the first study in this research project was to investigate the relationship between motor ability and AMs using a large sample of normative children (N=165). Group 1 consisted of 19 boys and 33 girls in school year 1 with a mean age of 6 years and 4 months (SD = 4 months); Group 2 consisted of 28 boys and 29 girls in school year 3 with a mean age of 8 years and 3 months (SD = 3 months); and Group 3 consisted of 27 boys and 29 girls in school year 5 with a mean age of 9 years 11 months (SD = 5 months). Motor ability was established using the McCarron Assessment of Neuromuscular Development (MAND) (McCarron, 1982). Associated movements were measured using tasks adapted from the Zurich Neuromotor Assessment (Largo et al., 2002), the Fog Test (Fog & Fog, 1963), and Licari et al. (2006). '...' The second study in this research project continued to explore the relationship between motor ability and AMs by investigating whether increased severity of AMs previously reported in children with attention deficit hyperactivity disorder (ADHD) (Denckla & Rudel, 1978; Lazarus, 1994; Mostofsky et al., 2003) is reflective of symptoms associated with the disorder or movement difficulties co-occurring in some children with the disorder. Four groups of children participated in the study. Group 1 consisted of 13 children with Developmental Coordination Disorder (DCD) with a mean age of 7 years 3 months (SD = 9 months); Group 2 consisted of 13 children with ADHD with a mean age of 7 years 4 months (SD = 11 months); Group 3 consisted of 10 children with co-occurring DCD and ADHD with a mean age of 7 years 4 months (SD = 10 months); and, Group 4 was a normative sample 15 control children. The children undertook the same AM assessment protocol outlined for Study 1. The AM data was entered into the RUMM 2020 and person location estimates (Rasch AM scores) were created for each child based on the person location map from Study 1. A comparison of AM scores between the groups revealed that the DCD and DCD/ADHD groups showed significantly more (p <0.001) AMs than the children in the ADHD and control groups. No significant differences were found between children in the DCD and DCD/ADHD groups (p = 0.19) or the ADHD and control groups (p = 0.67). The findings of this research show that increased expression of AMs is not influenced by the symptoms of ADHD. In addition, the finding that increased expression of AMs in children with DCD extends the findings from Study 1 showing that AM expression is linked to motor ability. Overall this research has enhanced the understanding of a unique measure of motor behaviour.

Road fatalities related to marijuana intoxication have steadily increased over the last 10 years (Drummer, 1994; Drummer, 1998; Drummer & Gerostamoulos, 1999). This has led to the introduction of sobriety testing in Victoria, Australia to test for driving impairment caused by marijuana and other psychotropic drugs. Surveys have reported an increase in community concern in Australia over the use of marijuana and an increase in the prevalence and use of marijuana (National Campaign Against Drug Abuse Survey; 1985, 1988, 1991, 1993; National Drug Household Survey; 1995, 1998). Commensurate with the increase in the use of marijuana in society, road statistics indicated that the number of road accidents and deaths involving the presence of THC (the active ingredient in marijuana) in driver specimens has also increased (Drummer & Gerostamoulos, 1999). Consistent with these mortality statistics, past research examining the effects of THC on driving ability indicate that THC impairs both car control (Moskowitz, 1985), and the maintenance of the lateral position of a vehicle (Ramaekers et al., 2000). Intoxication by THC is more likely to result in the crashing into obstacles on a driving course than when not intoxicated (Hansteen et al., 1976). These findings indicate that marijuana impairs driving ability and since the prevalence of marijuana use is increasing this poses a significant risk on our roads. It is essential therefore, that a tool that detects levels of THC in drivers, similar to breath analysis instruments used for the detection of alcohol in drivers, is introduced. To date, there is no such reliable instrument, that could be used on the roadside, and that accurately measures the level of THC in humans. For this reason, some government departments have considered the use of sobriety tests to detect impaired driving. In particular, the Standardised Field Sobriety test (SFSTs) that comprises the Horizontal Gaze Nystagmus test (HGN), Walk and Turn test (WAT) and the One Leg Stand test (OLS) were implemented in Victoria, Australia from December 1st 2000. The validity of these tests have been previously examined by other researchers and their conclusions suggest that sobriety tests have a varied accuracy in detecting impairment caused by drugs, ranging from 44% to 94% (Heishman et al., 1996; Compton, 1986). The present study examines the efficiency of sobriety tests to detect impairment in driving caused by marijuana. The SFSTs were examined, as well as the Romberg Balance test (RB) and the Finger to Nose test (FTN) taken from the Drug Evaluation and Classification Program (DECP) (Los Angeles Police Department, USA). The present study was conducted by Swinburne University, Victoria, Australia. The National Institute on Drug Abuse in the USA (NIDA) provided the marijuana cigarettes. The major objectives of the study were to examine the influence of cannabis on driving performance and on performance on the sobriety tests. The relationship between simulated driving performance and sobriety test performance was then examined to establish the accuracy of sobriety tests to predict driving ability. The present study also examined whether any differences in performance either on the driving tests or on the sobriety tests exist between regular cannabis users and non-regular cannabis users. Driving stress was an additional variable assessed to establish whether individuals with low, normal or high driver stress perform differently on the driving task after the consumption of a low and high dose of cannabis. We tested 40 participants comprising 14 females and 26 males. All participants completed a medical examination questionnaire, demographics questionnaire, Frequency of Cannabis Use Questionnaire and Intoxication Rating Questionnaire. All participants completed 3 marijuana sessions involving the administration of a placebo cigarette (0% THC, weight 702mg, .000gm ∆-9-THC; 0.0mg/kg THC), the administration of a low THC cigarette (1.74% THC, weight 779mg, .813gm ∆-9-THC; 0.2mg/kg THC) and the administration of a high THC marijuana cigarette (2.93% THC, weight 790mg, 1.776gm ∆-9-THC; 0.73mg/kg THC). All sessions were randomised (using Latin-square design), counter-balanced and double-blind. In each session, participants completed 3 sobriety tests and 2 driving simulator tests. Sobriety tests were scored by allocating a score of 1 for each sign (error, e.g., hopping during test performance to maintain balance) observed by the administrator. Generally, a score of 2 or more constituted impairment to a degree equivalent to a blood alcohol concentration (BAC) above 0.10%. The driving simulator test comprised 36 variables. Each time the participant performed an error, a loading factor was added to the corresponding variable (e.g., collision (variable) loading factor is 10, if a collision occurred twice a score of 20 was allocated to this variable). The sum of all 36 variables constituted the level of overall driving impairment. Blood samples were taken throughout each session approximately 20 minutes apart. Intoxication Rating Questionnaires revealed that participants reported that the subjective effect of placebo cigarettes was much weaker than the cigarettes that they usually smoke and that no psychological (such as time distortion) and physiological (such as increased heart rate) changes were experienced. For the low THC cigarettes most participants described the strength, and the effects, as similar to cannabis that they usually smoke. The high THC cigarette was described by most participants as being much stronger, and having some different symptoms, when compared to cannabis that they usually smoked. There were however, some differences in the description of the low THC and the high THC cannabis cigarettes between regular and non-regular cannabis users. Regular users reported that the high THC cigarette was more similar to the cannabis that they usually smoke, whereas non-regular users stated that this was more likely to be the case for the low THC cigarette. Results from the driving simulator task revealed that THC impaired the driving variables: �straddling the solid line� and �straddling the barrier line�. The results indicated that increasing levels of THC increasingly impaired the ability to maintain the steady position of a vehicle within the correct traffic lane. The consumption of low and high doses of THC resulted in two or more wheels of the vehicle moving over a solid line marked out for traffic moving in the opposite direction. Low and high doses of THC also resulted in two or more wheels of the vehicle moving over a broken/barrier line marked out for traffic moving in the same direction. Increasing levels of THC appear to impair both balance and attention required to control the position of a vehicle in traffic. These results are consistent with past research that indicates that THC impairs car control (Moskowitz, 1985) and increases the standard deviation of the lateral position of a vehicle (Smiley et al., 1981; Ramaekers et al., 2000). Research into the effects of THC on brain cannabinoid receptors indicate that THC interferes with normal functioning of the cerebellum, the brain region responsible for balance, posture, and the coordination of movement (Childers & Breivogel, 1998). When driving ability was impaired the level of THC in the blood was between 3 and 5 ng/ml. These findings are consistent with previous research that has reported that driving is maximally impaired by THC plasma levels of 13 ng/ml (approximately 8ng/ml in blood, using a multiplication factor of 1.6 (Giroud, et al., 2001) (Berghaus et al., 1995). The results of the present study also indicated that THC impairs performance on sobriety tests with more individuals impaired with increasing levels of THC (e.g., at Time 1; placebo: 2.5%, low THC: 23.1%, and high THC: 46.2%). Performances on the sobriety tests RB and FTN were unrelated to the level of THC. The test most related to the level of THC was the OLS test, where almost all signs of this test were observed, after the consumption of both low and high THC cigarettes. The accuracy of a �new� sign in the scoring procedure of the HGN test: head moves/jerks (HMJ) was also identified. Including HMJ increased the percentage of individuals scored as impaired after the consumption of low and high THC cigarettes (e.g., at Time 1; placebo: 2.5%, low THC: 38.5% and high THC: 56.4%). Including HMJ as a sign significantly improved the accuracy of the SFSTs to detect impairment associated with the level of THC. The mean level of THC in the blood, when the highest number of participants were classified as impaired, was 70 ng/ml. Differences in performance were observed between regular cannabis users and nonregular cannabis users. Non-regular cannabis users were more impaired on the driving simulator task after the consumption of low and high levels of THC when compared to regular users. Non-regular users recorded significantly longer RTs to emergency situations, more collisions, and shorter distances between the vehicle and an object (after an emergency stop) when compared to regular cannabis users. Signs exhibited during sobriety test performance were related to the level of THC more often for nonregular users compared to regular users. The level of THC in the blood was higher in regular users, compared to non-regular users, at all times in both THC conditions. When driving ability was impaired and significantly related to the level of THC, the SFSTs were also related to level of THC. Sobriety test performance was related to driving impairment, because, as driving impairment increased with the level of THC, so did the number of signs present during the performance of the sobriety tests. Since nonregular users performed more poorly on the driving task compared to regular users, it is no surprise that they exhibited a larger number of signs during the sobriety testing. Although there was a positive linear relationship between driving ability and sobriety tests, such as the relationship between straddling barrier lines and the OLS test, the validity of sobriety tests to predict driving impairment in part depends upon the size of this relationship. Using performance on the SFSTs to assess �impairment�, 46.7% of individuals in the high THC condition were impaired. A discriminant analysis was performed to determine whether the remaining 53.3% of participants were also impaired but not classified as impaired, or whether the SFSTs correctly classified them as not impaired. The results indicated that the sobriety tests (SFSTs; HGN, WAT and OLS) correctly assessed 76.3% of participants in the high THC condition as either impaired on driving or not impaired on driving. Specifically, this percentage included the correct identification of 84% of impaired drivers as impaired, but only 61.5% of unimpaired drivers as unimpaired. The best predictor of driving impairment was the OLS test. In the low THC condition the sobriety tests correctly classified 100% of impaired drivers as impaired, but this occurred at the expense of falsely classifying most unimpaired drivers as also impaired. This finding suggests that sobriety tests detect the presence of THC even when driving is not impaired. Examining the utility of including the �new� sign HMJ in the SFSTs indicated that when identifying impairment on the driving task performed at Time 2, in both the low and high THC condition, the SFSTs were a better predictor of driving impairment when HMJ was included than when the sign was not included. This finding suggests that the inclusion of HMJ in SFSTs scoring procedure increases the likelihood of detecting drivers who are impaired by THC. In conclusion, the results suggest that THC impairs driving ability by reducing one�s ability to maintain a safe position in traffic. At this time THC blood levels are between 3 and 5 ng/ml. THC also impairs driving ability differently for non-regular and regular users of cannabis, where non-regular users are more impaired by THC than regular users. When this occurs, THC blood levels in non-regular users are between 2 and 12 ng/ml, and in regular users between 5 and 16 ng/ml. Performance on the sobriety tests is also impaired by increasing levels of THC. The OLS test is the most sensitive test in detecting the presence of THC. In the present study the SFST battery and each individual test that it comprises are moderate predictors of driving impairment but do misclassify 16% of impaired individuals and 38.5% of not impaired individuals. In addition, the results suggest that sobriety tests are more sensitive to the presence of THC than actual driving impairment. This was revealed by the large number of individuals judged as impaired on driving in the low and high THC conditions even when driving was unaffected. It is important to note that when this occurred, the sobriety tests were accurate in detecting 100% of impaired individuals. Finally, the introduction of the �new� sign HMJ is likely to increase the accuracy of the SFSTs to detect individuals impaired by THC and this sign should be considered for inclusion by policing agencies.

This study was designed to assess the relationship of selected factors to the developmental outcome of fundamental motor skill performance in young children ages 3 to 6 years residing in foster or adoptive care, and have a documented history of prenatal exposure to cocaine and other drugs. Using an ecological theory of child development and the person-process-context model, the study focused on the child's development in selected gross motor skills. Through multiple regression analysis, the study considered the contributions of the following on motor skill performance as measured by the Test of Gross Motor Development: child effortful control as measured by the Children's Behavior Questionnaire, the nonbiological mother's parental attitude as measured by the adapted Parent Attitude Survey, the amount of early intervention services as recorded in the child's medical chart. Participants included 28 children (15 males and 13 females) and their foster or adoptive mother. There is suggestive but inconclusive evidence for the hypothesis that fundamental motor skill performance is predicted by the interaction of the child's effortful control, the nonbiological mother's understanding and confidence, and the amount of early intervention service the child received, [F (7, 20)=2.24, p<0.07 ]. Trends in the data suggest gross motor performance increases with high levels of early intervention, given children with low effortful control and low levels of parental confidence and understanding. In addition, early gross motor scores did not predict fundamental motor skills, r=.10. Despite a 38% rate of identified early gross motor delay, no child was delayed in fundamental motor skill at ages 3 to 6 years. Fundamental motor skill performance ranged from average to superior, M=121.54. Motor performance was assessed in a clinical setting and caution is recommended when considering skill performance within group settings. Based on this study, children with prenatal exposure to cocaine/polydrugs are viewed as variable in temperamental control and gross motor performance, but perform at an average to above average level in gross motor skill. Further research is needed to validate trends, specifically regarding the interactive effects of child effortful control, parental attitude, and the amount of early intervention service received. / Graduation date: 1997

Thesis (Ph. D.)--Ohio State University, 1982. / Includes vita. Includes bibliographical references (leaves 82-86). Available online via OhioLINK's ETD Center.

Thesis (Ph.D.)--University of Delaware, 2006. / Principal faculty advisor: James C. Galloway, Dept. of Physical Therapy. Includes bibliographical references.

This study compared the effects of two conditions on the motor development of preschool children and investigated the relationship between preschool children's motor development and perceived competence. Specifically, it provided information for discerning: a) the relative effects of a sensory-motor condition and an unstructured activities condition on the motor development of preschool children immediately following the 20-week intervention; and b) whether perceived competence was related to motor development in the preschool children following termination of the treatment. Additionally, a teacher survey which addressed the teacher-consultant relationship was developed and piloted within the context of the study for use in future research. Subjects were 31 children enrolled in two preschool programs including: a) the curriculum group (N=16), and b) the non-curriculum group (N=l5). The Peabody Motor Developmental Scales and the Pictorial Scale of Perceived Competence and Social Acceptance were used to assess the children's motor development and perceived competence, respectively. All subjects were tested prior to the 20- week intervention period and immediately following the intervention. A series of 2 (group) X 2 (testing time) repeated measures analyses of variance were used to analyze the impact of the two conditions. Results revealed that the motor development of subjects in both groups changed significantly over time; however, there were no differences between groups. Product-moment correlations and linear regression analyses were used to assess the relationship between preschool children's motor development and perceived competence. Results revealed that perceived competence relative to motor development did not change over time; however a reciprocal relationship between motor development and perceived competence in preschool children was found. The piloted teacher survey showed potential for evaluation of service delivery models and as a tool for teacher-consultant communication in future studies. / Graduation date: 1991