Dimitra Koutsouki

Motor and Cognitive Performance Differences between Children with and without Developmental Coordination Disorder (DCD).

The current study adopts the PASS theory of information processing to investigate the probable differences in specific motor and cognitive abilities between children with and without developmental coordination disorder (DCD). Participants were 108 5- and 6-year-old preschoolers (54 children with DCD and 54 children without DCD). The Movement Assessment Battery for Children assessed motor function. Running speed and agility were measured using the Bruininks-Oseretsky Test of Motor Proficiency. Finally, the Planning, Attention and Simultaneous Scales from the Das-Naglieri Cognitive Assessment System evaluated cognitive ability. Children with DCD differed significantly from those without DCD performing at a lower level on all motor and cognitive tasks. A correlation analysis revealed significant relationships between cognitive processes and motor skills. Simultaneous cognitive processing and manual dexterity were significantly correlated for both groups. Furthermore, a significant relationship was revealed between planning cognitive processing and balance for the non-DCD group. Thus, early assessment might identify specific cognitive-motor difficulties. Furthermore, early intervention might prevent some of the developmental comorbidities in the academic and everyday lives of children with movement difficulties.

The effect of treadmill training on gross motor function and walking speed in ambulatory adolescents with cerebral palsy: a randomized controlled trial.

ObjectiveThe aim of this study was to evaluate the effect of a treadmill program on gross motor function, walking speed, and spasticity of ambulatory adolescents with spastic cerebral palsy (diplegia and tetraplegia). DesignIn this randomized controlled trial, 22 adolescents (13–19 yrs old) from a special school for children with physical disabilities were randomly allocated to the experimental and control training groups. The experimental training group underwent a treadmill program without body weight support at a comfortable speed. The control group received treatment with conventional physiotherapy, which consisted of three sets of exercises with mat activities, balance, gait training, and functional gross motor activities. The program lasted 12 wks with a frequency of three times per week for both groups. Pretest and posttest measurements of self-selected walking speed, gross motor function, and spasticity were conducted. ResultsThe analysis of covariance findings examining posttest differences between groups were significant with respect to self-selected walking speed (F = 8.545, P = 0.000) and gross motor function (F = 9.088, P = 0.007), whereas no significance was found for spasticity. ConclusionsTreadmill training may improve the walking speed and gross motor function of adolescents with spastic cerebral palsy, without adverse effects on spasticity.

The Effect of Physiotherapy-Based Breathing Retraining on Asthma Control

Background. The mechanism of the breathing retraining effect on asthma control is not adequately based on evidence. Objective. The present study was designed to evaluate the effect of physiotherapy-based breathing retraining on asthma control and on asthma physiological indices across time. Study design. A 6-month controlled study was conducted. Adult patients with stable, mild to moderate asthma (n = 40), under the same specialist’s care, were randomized either to be trained as one group receiving 12 individual breathing retraining sessions (n = 20), or to have usual asthma care (n = 20). The main outcome was the Asthma Control Test score, with secondary outcomes the end-tidal carbon dioxide, respiratory rate, spirometry, and the scores of Nijmegen Hyperventilation Questionnaire, Medical Research Council scale, and SF-36v2 quality-of-life questionnaire. Results. The 2 × 4 ANOVA showed significant interaction between intervention and time in asthma control (F = 9.03, p < .001, η2 = 0.19), end-tidal carbon dioxide (p < .001), respiratory rate (p < .001), symptoms of hypocapnia (p = .001), FEV1% predicted (p = .022), and breathlessness disability (p = .023). The 2 × 4 MANOVA showed significant interaction between intervention and time, with respect to the two components of the SF-36v2 (p < .001). Conclusion. Breathing retraining resulted in improvement not only in asthma control but in physiological indices across time as well. Further studies are needed to confirm the benefits of this training in order to help patients with stable asthma achieve the control of their disease.

COMPARISON OF SPORT ACHIEVEMENT ORIENTATION BETWEEN WHEELCHAIR AND ABLE-BODIED BASKETBALL ATHLETES

Differences in sport achievement orientations between 31 recreational wheelchair and 76 able-bodied basketball athletes were tested. Athletes from the New England region completed the three subscales of the Sport Orientation Questionnaire (competitiveness, win orientation, and goal orientation). Wheelchair athletes responded higher on the Competitiveness and Goal Orientation subscales. In discriminative function analysis competitiveness scores were the only significant discriminator between the two groups.

Use of the Sport Orientation Questionnaire with Wheelchair Athletes: Examination of Evidence for Validity

The factor structure of the Sport Orientation Questionnaire with three factors of competitiveness, win orientation, and goal orientation was examined in a sample of 243 wheelchair athletes from the USA. Based on sample-specific validity evidence theory, it was hypothesized that the exploratory and confirmatory factor analyses would yield evidence on validity for wheelchair athletes who were different from able-bodied athletes. Exploratory factor analysis confirmed the hypothesis with a clear fourth and a questionable fifth factor. A confirmatory factor analysis did not adequately explain the new five-factor model. The new emerging fourth and fifth factors separated the competitiveness element of the questionnaire in ‘self-referenced’ and ‘other-referenced’ elements of competitiveness. Results are discussed in terms of demographic characteristics of the sample of wheelchair athletes.

Factors Associated with BMI in Greek Adults with Asthma

Background. The association between asthma and obesity remains controversial and limited to a few studies. Objective. The present study was designed to examine the association between body mass index (BMI) and clinical measures of asthma morbidity in Greek asthma patients. Study Design. A cross-sectional study in 100 outpatients at the asthma department of the “Amalia Fleming” General Hospital in Athens, Greece, was conducted. Asthma diagnosis was confirmed by a specialist, according to Global Initiative for Asthma (GINA) guidelines. Participants were classified, with respect to BMI (kg/m2), in three groups: normal: <25.0, overweight: 25.0–29.9.0 and obese: ≥30.0. Data were modeled through multiple logistic regression analysis for the association of overweight/obesity with the study variables: demographics, asthma severity, smoking, pulmonary function (forced expiratory volume in one second; FEV1), asthma control (Asthma Control Test; ACT), disability associated with dyspnea (Medical Research Council [MRC] breathlessness scale), and physical activity in leisure time. Results. Overweight/obesity was detected in 56 participants (56%). Multivariate regression analysis resulted in an excess risk of overweight/obesity for older participants (odds ratio [OR]: 1.71, 95% confidence interval [CI]: 1.10–2.64 for a 10-year increase in age). Conclusion. Age seems to be highly associated with overweight/obesity in Greek adults with asthma who tend to maintain a similar body weight compared to the general population.

Cognitive process-based subtypes of developmental coordination disorder (DCD).

The purpose of the study was to identify the cognitive subtypes demonstrated by children with developmental coordination disorder (DCD) using the Planning-Attention-Simultaneous-Successive Processing (PASS) theory and the Cognitive Assessment System (D-N CAS). Participants were 108 children aged 5- and 6-years old, 54 with DCD and 54 without DCD, all attending typical kindergartens. They were examined on 31 cognitive-motor variables. Hierarchical-agglomerative and iterative partitioning cluster analyses including 9 motor and 7 cognitive variables revealed the following six subtypes: o C1 = children at risk (having considerable difficulty with jumping and minor difficulty with manual dexterity and simultaneous coding); o C2 = children on the mean (all cognitive-motor scores close to the mean); o C3 = free from cognitive-motor problems (all scores above average); o C4 = manual dexterity, planning and simultaneous coding difficulties; o C5 = manual dexterity, dynamic balance, and planning difficulties; o C6 = generalized cognitive-motor dysfunction (all scores considerably below average). It is well known that DCD is a heterogeneous condition. However, whenever cognitive processes were lower than average, cognitive-motor relationship was evident in subgroups C1, C4, C5 and C6. Early identification of task-specific cognitive-motor difficulties may be essential for early educational intervention practices in order to anticipate and improve learning, academic and performing difficulties.

Validity evidence of the Lateral Step Up (LSU) test for adolescents with spastic cerebral palsy

Purpose: The present study examined the concurrent and construct validity of the Lateral Step Up (LSU) test, for adolescents with CP. Method: A total of 35 adolescents, classified as GMFCS Levels I, II and III, were examined using LSU, GMFM – 88 (D & E), other functional mobility measures (TUG, STS, TUDS), body structures and functions (strength, ROM and spasticity). Results: LSU inter-correlations with: (i) GMFM – 88 (D & E) (r = 0.656), (ii) functional mobility measures (r = −0.567 to 0.721) and (iii) body structures and functions (r = 0.155 to 0.563) were at the appropriate range. The LSU differentiated adolescents with CP (F = 16.185, p = 0.000, η2 = 0.503), according to their GMFCS (I > II, II > III, I > III). Finally, 50.27% of the LSU variability was explained by GMFCS differences, with 65.7% of adolescents classified correctly across the three levels. Conclusions: The LSU may be perceived as a valid instrument for assessing the functional mobility of adolescents with CP. Implications for Rehabilitation LSU is valid for assessing functional mobility and strength in CP adolescents. LSU may be used in accordance with other functional mobility measures in the school environment. The LSU may be used from physical therapists to predict the functional mobility of CP adolescents at GMFCS Levels I–III.

Cognitive Processes in Children with Developmental Coordination Disorder

The purpose of the chapter is to describe the application of PASS theory and the Cognitive Assessment System to the cognitive assessment of children with Developmental Coordination Disorder (DCD). The chapter begins with a description of the characteristics of DCD and the interrelation of motor and cognitive development in both typically and atypically developing populations. Then the chapter reviews four theoretical approaches and conceptual views primarily derived from the cognitive psychology literature: the knowledge-based approach to motor development, the information processing model, the dynamical systems theory, and the PASS theory. The chapter then provides a thorough and comprehensive review of research employing PASS theory and the CAS as diagnostic tools for children with DCD, and presents the identification of distinct cognitive process-based subtypes of DCD using clustering methods. We briefly outline the field of intervention with emphasis on the educational domain; and we propose a cognitive-motor approach to intervention to enhance cognitive as well as motor performance of children with DCD. Finally, we propose that a combination of the PASS and knowledge-based approach theories will be effective for identification, assessment, and designing of intervention for children with DCD.

Cross-Cultural Aspects: Exploring Motor Competence Among 7- to 8-Year-Old Children From Greece, Italy, and Norway:

Motor development is affected by maturation and growth but also influenced by the specific environmental and cultural context. Therefore, cross-cultural research can provide information about how different cultural contexts, lifestyles, and physical activity contexts can influence the process of developing motor competence. The purpose of this study was to evaluate aspects of motor competence among children from different cultural backgrounds. The sample of 463 children from 6 to 8 years consisting of 132 Greek children (52.3 % boys), 126 Italian children (53.9 % boys), and 205 Norwegian children (52.7) completed the Test of Motor Competence (TMC) including two fine motor tasks—Placing Bricks and Building Bricks—and two gross motor tasks—Heel to Toe Walking and Walking/Running in Slopes. The results indicate that the Norwegian children performed better in all tests; the differences were statistically significant in all four tasks compared with Italian children and in two tasks compared with the Greek children (Building Bricks and Heel to Toe Walking). Greek children performed significantly better than the Italians in two tasks: Placing Bricks and Heel to Toe Walking. Italian children were significantly faster than the Greek ones in one task: Walking/Running in Slopes. The differences in terms of levels of basic fine and gross motor skills between children from the different countries may be a consequence of both different physical activity contexts and cultural policies, attitudes, and habits toward movement.