Vencita Priyanka Aranha

The four square step test in children with Down syndrome: Reliability and concurrent validity

Purpose: To estimate test-retest reliability, inter-rater reliability and validation of a method for measuring balance by stepping over four squares, four square step test (FSST) in children with Down syndrome (DS). Methods: A sample of 13 children with DS was recruited for the cross-sectional study. They were asked to perform FSST and the time taken was noted. For estimating test-retest reliability, FSST was done by principal investigator twice and Inter-rater reliability was assessed by principal investigator and second investigator with an interval of 7 days. FRT was used as the criterion dynamic balance measure to validate FSST. The data was tabulated and analysed statistically. Results: The test-retest reliability and inter-rater reliability of FSST are ICC(1,1) = 0.70 (0.64-0.90) and ICC(2,1) = 0.78 (0.62-0.91) respectively. The Bland-Altman limits of agreement were also satisfied. Concurrent validity between FRT and FSST with Spearmans ρ = −0.58 (−0.86 to −0.13). Conclusion: FSST has moderate to good concurrent validity and good reliability among the children with Down syndrome.

Motor cognitive processing speed estimation among the primary schoolchildren by deriving prediction formula: A cross-sectional study

Objectives: Motor cognitive processing speed (MCPS) is often reported in terms of reaction time. In spite of being a significant indicator of function, behavior, and performance, MCPS is rarely used in clinics and schools to identify kids with slowed motor cognitive processing. The reason behind this is the lack of availability of convenient formula to estimate MCPS. Thereby, the aim of this study is to estimate the MCPS in the primary schoolchildren. Materials and Methods: Two hundred and four primary schoolchildren, aged 6–12 years, were recruited by the cluster sampling method for this cross-sectional study. MCPS was estimated by the ruler drop method (RDM). By this method, a metallic stainless steel ruler was suspended vertically such that 5 cm graduation of the lower was aligned between the web space of the childs hand, and the child was asked to catch the moving ruler as quickly as possible, once released from the examiners hand. Distance the ruler traveled was recorded and converted into time, which is the MCPS. Multiple regression analysis of variables was performed to determine the influence of independent variables on MCPS. Results: Mean MCPS of the entire sample of 204 primary schoolchildren is 230.01 ms ± 26.5 standard deviation (95% confidence interval; 226.4–233.7 ms) that ranged from 162.9 to 321.6 ms. By stepwise regression analysis, we derived the regression equation, MCPS (ms) = 279.625–5.495 × age, with 41.3% (R = 0.413) predictability and 17.1% (R2 = 0.171 and adjusted R2 = 0.166) variability. Conclusion: MCPS prediction formula through RDM in the primary schoolchildren has been established.

Reaction time norms as measured by ruler drop method in school-going South Asian children: A cross-sectional study

This study aimed to estimate normative range for reaction time using ruler drop method for school-going South Asian children between 6 and 12 years of age. A cross-sectional study was used to evaluate the reaction time for 204 children. Normal values for each age group were obtained. The results of multiple linear regressions showed a decrease in the reaction time values with age, and a significant change occurring between six and eight years of age. No difference in reaction time was obtained between boys and girls. Ruler drop method is an easy to use test and the results of this study provide a normative data for age groups 6-12 years ranging from 214.2ms to 248.8ms. These values can serve as a reference to screen children with delayed reaction time.

Increasing cardiopulmonary aerobic activity improves motor cognitive response time: An inference from preliminary one-group pretest-posttest quasi-experimental study

Motor cognitive response time (MCRT) is the time elapsed between presenting a stimulus and the time taken by that individual to respond to that stimulus through a motor performance. After completing aerobic exercise, there are various changes that takes place, one of which might be change in cognitive function. Whether cardiopulmonary aerobic activity/capacity has an impact on MCRT is not explored yet.

Reliability and sensitivity to change of the timed standing balance test in children with down syndrome

Objective: To estimate the reliability and sensitivity to change of the timed standing balance test in children with Down syndrome (DS). Methods: It was a nonblinded, comparison study with a convenience sample of subjects consisting of children with DS (n = 9) aged 8–17 years. The main outcome measure was standing balance which was assessed using timed standing balance test, the time required to maintain in four conditions, eyes open static, eyes closed static, eyes open dynamic, and eyes closed dynamic. Results: Relative reliability was excellent for all four conditions with an Interclass Correlation Coefficient (ICC) ranging from 0.91 to 0.93. The variation between repeated measurements for each condition was minimal with standard error of measurement (SEM) of 0.21–0.59 s, suggestive of excellent absolute reliability. The sensitivity to change as measured by smallest real change (SRC) was 1.27 s for eyes open static, 1.63 s for eyes closed static, 0.58 s for eyes open dynamic, and 0.61 s for eyes closed static. Conclusions: Timed standing balance test is an easy to administer test and sensitive to change with strong absolute and relative reliabilities, an important first step in establishing its utility as a clinical balance measure in children with DS.

Multi-directional reach test in South Asian children: Normative reference scores from 5 year to 12 years old

Multi-directional reach test (MRT) emerged as a valid and reliable assessment tool for balance evaluation among elderly. The normative reference scores have been established in adults and elderly people, but they were not yet established for children. Hence, we aimed at establishing the normative reference scores of MRT among the school going children aged between 5 and 12 years. Children (N = 194; 124 males, 70 females) were recruited by the stratified random sampling for the normative study. MRT was performed by the custom made, multi-directional reach estimator. MRE device consists of three adjustable wooden frames with two metallic rulers each of 600 mm. Children were asked to reach maximum distance in forward reach (FR), backward reach (BR), right lateral reach (RLR) and left lateral reach (LLR) directions to obtain their maximum reaching ability. The mean of three readings were used to report the normative reference scores of MRT. Median age, height, weight and body mass index (BMI) were 8.5 years, 1240 mm, 27 kg and 17.24 kg/m2 respectively. The normative reference scores [median (95% confidence Interval, CI)] of MRT among the children aged 5-12 years old were FR [169.7 mm (CI, 166.1-183.3 mm)], BR [77.7 mm (CI, 78.0-85.5 mm)], RLR [122.0 mm (119.6-130.9 mm)] and LLR [107.0 (105.8-119.3 mm)] respectively.

Non-pharmacological therapies for primary open angle glaucoma: A quasi-experimental pilot study

Purpose: One of the major causes of blindness is Primary open angle glaucoma (POAG) and it has only surgical treatment and lifelong use of medication. Hence many side effects arise. To overcome this, the drugless approach is in practice but the importance of Muscle Energy Technique (MET) and Myofacial (MFR) Release is not explored. Hence, our objective was to determine the effectiveness of MET and MFR on POAG. Methods: A total of 12 patients with POAG were recruited from the tertiary care teaching hospital through criteria based convenience sampling for the study. But nine patients with POAG completed the study. The age of the patient with POAG ranges from 15 to 30 years. MET and MFR were given to the patient for 30 min/day, six days/week for three weeks. Intraocular pressure (IOP) was assessed with Tonometer as dependent variable by Ophthalmologist. Pre and post treatment IOP change was established. Result: Pre IOP and Post are 23.1 ± 1.9 mmHg and Post IOP is 20 ± 1.4 mmHg respectively. The mean pre-post difference is 3.1 ± 1.9 mmHg with significance difference of p = 0.002. Conclusion: MET and MFR reduce IOP. This proves to be one of the feasible and cost effective treatments in the management of POAG. Clinical Trial Registry: CTRI/2014/09/4986

Anaerobic fitness in children with Down syndrome: A pilot cross-sectional study

Background: Children with Down syndrome (CDS) have low health-related physical fitness levels. Since, bursts of high-intensity constitute a major part of children′s daily activities, it is important to determine the levels of anaerobic fitness in CDS. Aim: The aim of this study was to estimate the differences in anaerobic performance between CDS and typically developing children (TDC). Methods: Anaerobic performance was assessed in a group of twelve 8-16 year old CDS and their performance was compared to thirteen age-matched typically developing peers. The anaerobic performance of all children was measured using a field test-muscle power sprint test where children were asked to run six- 15 m sprints. The outcome measure was mean power (MP) that represented the average power output of all sprints. Results: The MP for CDS was 50.1 (25.03-75.2) W in comparison to 145.6 (114.6-176.7) W in TDC. Conclusions: The levels of anaerobic fitness are lower in CDS than in TDC. Implications: The rehabilitation strategies should emphasize strength training in adjunct to aerobic training to improve physical fitness in CDS.