Academic literature on the topic 'Alberta Motor Association'

Abstract Background Only a few studies have been conducted with the objective of creating norms of the Alberta Infant Motor Scale (AIMS) for the assessment of gross motor development of preterm infants. The AIMS performance of preterm infants has been compared with that of the Canadian norms of full-term infants, but not with that of full-term infants of the same nationality. Moreover, the possible impact of prematurity-related morbidity factors on AIMS performance is unknown. Objectives The aims of this study were: (1) to evaluate AIMS trajectory in a large population of Greek preterm infants and create norms, (2) to compare it with the AIMS trajectory of Greek full-term infants, and (3) to examine the possible influence of neonatal morbidity on AIMS scores in the preterm sample. Design This was a cross-sectional study. Methods Mean AIMS scores were compared, per month (1–19), between 403 preterm infants (≤32 weeks of age, corrected for prematurity) and 1,038 full-term infants. In preterm infants, the association of AIMS scores with respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH) of grade ≤III, bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and sepsis was assessed by hierarchical regression analysis. Results Alberta Infant Motor Scale scores were significantly lower in preterm infants than in full-term infants. Mean AIMS scores in preterm infants were significantly associated with RDS (b=−1.93; 95% CI=−2.70, −1.16), IVH (b=−0.97; 95% CI=−1.69, −0.25), and ROP (b=−1.12; 95% CI=−1.99, −0.24) but not with BPD or sepsis in hierarchical regression analysis. Conclusions Alberta Infant Motor Scale norms were created for Greek preterm infants. This study confirms that AIMS trajectories of preterm infants are below those of full-term infants of the same nationality. The influence of morbidity factors, including RDS, IVH, and ROP, should be taken into account when administering the AIMS in preterm infants.

***Motor development in the first year of life of premature infants according to birth weight***AIMS: To assess motor development in the first year of life of children born at 36 weeks' gestational age, comparing two groups, one with birth weight below 2500g and the other with 2500g or more.METHODS: A cross-sectional study evaluated the motor development of children enrolled in the Basic Health Units of Caxias do Sul and Porto Alegre, by the Alberta Infant Motor Scale. The sample consisted of infants born at 36 weeks' gestation, evaluated with a corrected chronological age of 0 to 12 months, divided into two groups: Low Birth Weight group (LBW group: birth weight below 2,500 g) and Adequate Birth Weight group (ABW group: birth weight of 2,500 g or more). The independent t-test, the chi-square test of Pearson and the Eta2 test (strong association> 0.60) were used to analyze the data. P <0.05 was considered significant.RESULTS: We evaluated 42 children, 21 in each group. Fifteen (71.42%) children with low birth weight were classified as small for gestational age. The mean motor development score percentile was 17.90±17.74 for the LBW group and 34.57±25.80 for the ABW group, indicating a better motor development of the second group (p=0.02) . There was a greater number of children with developmental delay in the LBW group (52.4%), whereas in the ABW group most were within the normal range (47.6%). The association was statistically significant between performance categories and birth weight groups, using the chi-square test (p=0.001), with Eta2=0.64 (strong association).CONCLUSIONS: In preterm infants with matched gestational age at 36 weeks, the low birth weight group had worse motor performance in the first year of life compared to the group with adequate birth weight.

Background Although preliminary studies have established a good psychometric foundation for the Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) for a broad population of youth with disabilities, additional validation is warranted for young children. Objective The study objective was to (1) examine concurrent validity, (2) evaluate the ability to identify motor delay, and (3) assess responsiveness of the PEDI-CAT Mobility domain and the Alberta Infant Motor Scale (AIMS). Methods Fifty-three infants and young children (&lt;18 months of age) admitted to a pediatric postacute care hospital and referred for a physical therapist examination were included. The PEDI-CAT Mobility domain and the AIMS were completed during the initial physical therapist examination, at 3-month intervals, and at discharge. A Spearman rank correlation coefficient was used to examine concurrent validity. A chi-square analysis of age percentile scores was used to examine the identification of motor delay. Mean score differences from initial assessment to final assessment were analyzed to evaluate responsiveness. Results A statistically significant, fair association (rs=.313) was found for the 2 assessments. There was no significant difference in motor delay identification between tests; however, the AIMS had a higher percentage of infants with scores at or below the fifth percentile. Participants showed significant changes from initial testing to final testing on the PEDI-CAT Mobility domain and the AIMS. Limitations This study included only young patients (&lt;18 months of age) in a pediatric postacute hospital; therefore, the generalizability is limited to this population. Conclusions The PEDI-CAT Mobility domain is a valid measure for young children admitted to postacute care and is responsive to changes in motor skills. However, further item and standardization development is needed before the PEDI-CAT is used confidently to identify motor delay in children &lt;18 months of age.

Introduction: Prematurity may act negatively in the course of some motor slill, such as the independent walking acquisition. Objective: It is about an identify the independent walking acquisition age in premature infants of different gestational ages, distinguish the period of independent walking acquisition among the lower economic classes and compare the independent walking acquisition with data in the literature. Method: This research is characterized as a developmental study. The sample is 21 premature infants of both sexes. Assessments and individual data collection were carried out monthly and at the end of the study, at the largest child´s living environment, and that every month the parents / caregivers previously received orientation and demonstration regarding the procedure for applying the stimulation protocol, presented in an illustrative and demonstrative primer. The instrument used for the monthly assessment was the Alberta Infant Motor Scale (AIMS) and the questionnaire of the Brazilian Association of Business and Research (ABEP), to get the socioeconomic status of the children´s family. The results were analyzed using the Shapiro-Wilk test. Analyzed the age of ability to walk due to the low socioeconomic level through the Kruskal-Wallis test (C1, C2 and D). Results: When comparing the independent walking acquisition age and gestational age, the group with less than 33 weeks of gestational age acquired independent walking later than the group with gestational age between 33-37 weeks. However, it was found that the children average age of independent walking in the study was 14 ± 2 months. Comparing independent walking acquisition age and low economic levels (C1, C2 and D), the group with higher socioeconomic status (C1) acquired independent walking two months before the group with the lowest economic level. Conclusion: influenced positively the motor performance of premature infants in the acquisition of independent walking.

Background and Objectives: The aim of this study was to analyze the presence of gestational diabetes mellitus (GDM) on maternal and fetal perinatal parameters, as well to evaluate the influence of GDM on neonatal early motoric development. Materials and Methods: In this prospective study, we evaluated 203 eligible participants that were admitted to obstetrics department for a labor. GDM was assessed by evaluation of maternal parameters, fetal parameters, as well its impact on infants early motoric development (Alberta Infant Motor Scale—AIMS). Results: Presence of GDM was significantly positively associated with: pre-pregnancy weight, obesity degree, weight at delivery, gestational weight gain (GWG), body mass index (BMI) at delivery, GWG and increased pre-pregnancy BMI, glucose levels in mother’s venous blood after the delivery, positive family history for cardiovascular disease, pregnancy-related hypertension, congenital thrombophilia, drug use in pregnancy, large for gestational age (LGA), mode of delivery (Cesarean section and instrumental delivery). Likewise, GDM association was detected for tested ultrasound parameters (biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femoral length (FL)), length at birth, birth weight, newborn’s head circumference, newborn’s chest circumference, AIMS supination and pronation at three months, AIMS supination, pronation, sitting and standing at six months. Only Amniotic Fluid Index and AIMS supination at three months of infant’s age remained significantly associated in multivariate regression model. Conclusion: The presence of significant positive association of numerous tested parameters in our study on perinatal outcomes and early motoric development, points to the necessity of establishing appropriate clinical decision-making strategies for all pregnant woman at risk and emphasize the importance of providing adequate glycaemia control options and further regular follow ups during the pregnancy.

Background and Purpose: Failure of early neurological improvement (fENI) despite successful mechanical thrombectomy in the anterior circulation is a clinically frequent occurrence. Purpose of this analysis was to define independent clinical, radiological, laboratory, or procedural predictors for fENI. Methods: Retrospective single-center analysis of patients treated for acute ischemic stroke in the anterior circulation ensuing successful mechanical thrombectomy between January 2014 and April 2019. Patients were compared according to fENI (equal or higher National Institutes of Health Stroke Scale) and ENI (lower National Institutes of Health Stroke Scale at discharge). Thirty-eight variables were examined in multivariable analysis for association with fENI. Results: Five hundred forty-nine out of 1146 patients experienced successful recanalization (modified Treatment in Cerebral Ischemia 2c-3). fENI occurred in 115/549 (20.9%) patients. Independent predictors of fENI were premorbid modified Rankin Scale (odds ratio [OR] per point [IC], 1.21 [1.00–1.46], P =0.049), end-stage renal failure (OR [IC], 12.18 [2.01–73.63], P =0.007), admission glucose (OR [IC], 1.018 [1.004–1.013] per mg/dL, P =0.001), bridging IV lysis (OR [IC], 0.57 [0.35–0.93], P : 0.024), time from groin puncture to final recanalization (OR [IC], 1.004 [1.001–1.007] per minute, P =0.015), general anesthesia during mechanical thrombectomy (OR, 2.41 [1.43–4.08], P <0.001), symptomatic intracranial hemorrhage (OR [CI], 6.81 [1.84–25.16], P =0.004), and follow-up Alberta Stroke Program Early CT Score (OR [IC], 0.76 [0.69–0.84] per point, P <0.001). In a secondary analysis, involvement of the regions internal capsule, M4 and M5 (motor cortex) were further independent predictors for fENI. Patients with ENI were more likely to experience a good outcome (modified Rankin Scale on day 90, 0–2: n=229/435 [52.8%] versus n=13/115 [11.3%]; P <0.001). Conclusions: The extent of infarction and the involvement of motor cortex and internal capsule as well as higher premorbid modified Rankin Scale, end-stage renal failure, high glucose level on admission, absence of bridging IV lysis, general anesthesia, and a longer therapy interval are presumably independent predictors for fENI in patients with successful mechanical thrombectomy.

AbstractBackground: Patients with arterial perinatal stroke often suffer long-term motor sequelae, difficulties in language, social development, and behaviour as well as epilepsy. Despite homogeneous lesions, long-term behavioural and cognitive outcomes are variable and unpredictable. Sleep-related epileptic encephalopathies can occur after early brain injury and are associated with global developmental delays. We hypothesized that sleep-potentiated epileptiform abnormalities are associated with worse developmental outcomes after perinatal stroke. Methods: Participants were identified from a population-based cohort (Alberta Perinatal Stroke Project). Inclusion criteria were magnetic resonance imaging–confirmed arterial perinatal stroke, age 4 to 18 years, electroencephalogram (EEG) including sleep, and comprehensive neuropsychological evaluation. Sleep-related EEG abnormalities were categorized by an epileptologist blinded to the cognitive outcome. Associations between EEG classification and neuropsychological outcomes were explored (t tests, Bonferroni correction for multiple comparisons). Results:Of 128 potentially eligible participants, 34 (53% female) had complete EEG (mean age, 8.1 years; range, 0.2-16.4) and neuropsychology testing (mean age, 9.8 years; range 4.4-16.7). Twelve (35%) were classified as having electrical status epilepticus in sleep. Patients with abnormal EEGs were more likely to have statistically worse scores when corrected for multiple comparisons, in receptive language (median, 1st percentile; IQR 1-7th percentile; p<0.05), and externalizing behaviours (median, 82nd percentile; IQR, 79-97th percentile; p<0.05). Conclusions: Developmental outcome in language and behaviour in children with arterial perinatal stroke is associated with electrical status epilepticus in sleep. Increased screening with sleep EEG is suggested, whereas further studies are necessary to determine if treatment of EEG abnormalities can improve outcome.

ObjectivesThe COVID-19 pandemic changed daily routines, including physical activity, which could influence physical and mental health. In our study, we describe physical activity and sedentary behaviour patterns in relation to the pandemic and estimate associations between anxiety and physical activity and sedentary behaviour in community-dwelling adults.DesignCross-sectional study.SettingCalgary, Alberta, Canada.ParticipantsBetween April and June 2020, a random sample of 1124 adults (≥18 years) completed an online questionnaire.Primary and secondary outcomesThe online questionnaire captured current walking, moderate intensity, vigorous intensity and total physical activity and sedentary behaviour (ie, sitting and leisure-based screen time), perceived relative changes in physical activity, sedentary and social behaviours since the pandemic, perceived seriousness and anxiety related to COVID-19, and sociodemographic characteristics. Differences in sociodemographic characteristics, perceived relative change in behaviour and current physical activity and sedentary behaviour were compared between adults with low and high anxiety.ResultsOur sample (n=1047) included more females (60.3%) and fewer older adults (19.2%). Most participants (88.4%) considered COVID-19 as extremely or very serious and one-third (32.9%) felt extremely or very anxious. We found no differences (p>0.05) in current physical activity or sedentary behaviour by anxiety level. The largest perceived change in behaviours included social distancing, driving motor vehicles, use of screen-based devices, watching television and interactions with neighbours. We found anxiety-related differences (p<0.05) in perceived changes in various behaviours.ConclusionsChanges in physical activity, sedentary behaviour and social behaviour occurred soon after the COVID-19 pandemic was declared, and some of these changes differed among those with low and high anxiety.

OBJECTIVEThe role of CT perfusion (CTP) in the management of patients with acute ischemic stroke (AIS) remains a matter of debate. The primary aim of this study was to evaluate the correlation between the areas of infarction and penumbra on CTP scans and functional outcome in patients with AIS.METHODSThis was a retrospective review of 100 consecutively treated patients with acute anterior circulation ischemic stroke who underwent CT angiography (CTA) and CTP at admission between February 2011 and October 2014. On CTP, the volume of ischemic core and penumbra was measured using the Alberta Stroke Program Early CT Score (ASPECTS). CTA findings were also noted, including the site of occlusion and regional leptomeningeal collateral (rLMC) score. Functional outcome was defined by modified Rankin Scale (mRS) score obtained at discharge. Associations of CTP and CTA parameters with mRS scores at discharge were assessed using multivariable proportional odds logistic regression models.RESULTSThe median age was 67 years (range 19–95 years), and the median NIH Stroke Scale score was 16 (range 2–35). In a multivariable analysis adjusting for potential confounding variables, having an infarct on CTP scans in the following regions was associated with a worse mRS score at discharge: insula ribbon (p = 0.043), perisylvian fissure (p < 0.001), motor strip (p = 0.007), M2 (p < 0.001), and M5 (p = 0.023). A worse mRS score at discharge was more common in patients with a greater volume of infarct core (p = 0.024) and less common in patients with a greater rLMC score (p = 0.004).CONCLUSIONSThe results of this study provide evidence that several CTP parameters are independent predictors of functional outcome in patients with AIS and have potential to identify those patients most likely to benefit from reperfusion therapy in the treatment of AIS.

<p><strong>CATEGORÍA PRESENTACION ORAL:</strong></p><p><strong>EFICACIA DE LA DEXAMETASONA EN SÍNDROME HELLP</strong></p><p>Javier Fonseca Pérez, Clara Messa, Juan Carlos Otero Pinto. Universidad del Valle y Hospital Universitario del Valle, Hospital General de Medellín y Universidad CES, Universidad Industrial de Santander y Hospital Universitario de Santander.</p><p>Correo electrónico: <a href="mailto:jaenfo@gmail.com">jaenfo@gmail.com</a></p><p><strong>Introducción:</strong> el objetivo del estudio fue determinar la eficacia de la dexametasona en el manejo del síndrome HELLLP clase 1, definido como plaquetas ≤ 50000/ml, transaminasa pirúvica ≥ 70U/ml y LDH ≥ 600 U/ml en pacientes con trastorno hipertensivo después de la semana 20 de gestación.</p><p><strong>Materiales y métodos:</strong> ensayo clínico controlado, multicéntrico (3 instituciones) con doble enmascaramiento, realizado con 87 pacientes (66 puérperas y 21 embarazadas), con asignación aleatoria (aleatorización por bloques de tamaño 4 y 6, estratificado por centro y estado al ingreso, embarazada o puérpera) a manejo con dexametasona o placebo. Las embarazadas recibieron 10 mg de dexametasona ev cada 12 horas hasta el parto, y luego 3 dosis adicionales en igual esquema. Las puérperas recibieron 3 dosis de 10 mg cada 12 horas. El placebo se administró forma idéntica. Las variables resultado principales fueron: tiempo de hospitalización y morbilidad materna compuesta (muerte materna, falla renal, edema pulmonar, infecciones, accidente cerebrovascular y ruptura hepática). Los resultados secundarios fueron: tiempo a recuperación de plaquetas, transaminasa y LDH. El cálculo de tamaño de muestra basado en error alfa 0,05; beta 0,2 y hazard ratio (HR) de 2,56 para estancia hospitalaria fue 120 pacientes, solo se incluyeron 87 por vencimiento del medicamento. Se obtuvo aval del comité de ética de todas las instituciones participantes; por ser una investigación con riesgo mayor al mínimo se obtuvo consentimiento informado escrito. Los análisis se realizaron de acuerdo con la intención de tratamiento y se realizó un análisis interino según los criterios de Obrien-Fleming con resultados similares a los finales.</p><p><strong>Resultados: </strong>entre octubre de 2009 a octubre de 2012, 45 pacientes recibieron placebo y 42 dexametasona. La mediana (RIQ) de hospitalización fue idéntica en ambos grupos (3; RIQ 3-5 días), y el promedio fue menor en las expuestas a dexametasona (4,28 <em>vs</em>. 4,14 días), sin diferencias significativas con un (HR = 1,16; IC 95 %: 0,69-1,99); 21,95 y 13,89 % de pacientes con placebo y dexametasona, respectivamente, desarrollaron alguna morbilidad (OR = 0,57; IC 95 %: 0,17-1,90), diferencias no significativas. Hubo 2 muertes en el grupo placebo en las primeras 12 horas de ingreso al estudio. No hubo diferencias en el tiempo de recuperación de plaquetas (HR = 0,98; IC 95 % 0,60-1,64), LDH (HR = 1,22; IC 95 %: 0,67-2,23) y transaminasa (HR = 1,38; IC 95 %: 0,75-2,53). No hubo diferencias en requerimiento de transfusiones sanguíneas entre los grupos, ni en complicaciones incluidas en la variable morbilidad, una vez se analizaron estas en forma individual (infecciones, falla renal y edema pulmonar).</p><p><strong>Conclusiones: </strong>hasta nuestro conocimiento, este es el primer ECC que evalúa la eficacia de la dexametasona en el manejo del síndrome HELLP 1. No se encontró benéfico del uso de dexametasona en ninguno de los resultados. Nuestros hallazgos son consistentes pues se encontró similar efecto en el análisis global y por subgrupos (embarazadas y puérperas). No se alcanzó el tamaño de muestra planeado, lo cual pudo afectar el poder del estudio.</p><p><strong>Palabras clave:</strong> HELLP clase 1, dexametasona, eficacia, ensayo clínico aleatorizado.</p><p><strong>CATEGORÍA POSTER:</strong></p><p><strong>TROMBOLISIS ENDOVENOSA DEL ATAQUE CEREBROVASCULAR ISQUÉMICO EN EL PUERPERIO</strong></p><p>José Luis Bustos Sánchez, Nadesha Tatiana Bonilla, Julio Alberto Velandia Escobar, Paula Rozo, Nelson Torres, Hospital San Rafael de Tunja, Boyacá.</p><p>Correo electrónico: <a href="mailto:jose.bustos@uptc.edu.co">jose.bustos@uptc.edu.co</a></p><p><strong>Introducción:</strong> la terapia trombolítica con activador tisular del plasminógeno recombinante (rTPA) es el tratamiento de primera elección en el manejo de fase aguda del ataque cerebrovascular (ACV) de tipo isquémico. Sin embargo, su uso durante el embarazo no está plenamente establecido. Presentamos un caso exitoso de trombolisis endovenosa con rTPA en una paciente con ACV quien lo presentó en el puerperio inmediato.</p><p><strong>Materiales y métodos:</strong> descriptivo, caso clínico. Mujer de 37 años, G4P4V4, sin antecedentes patológicos maternos de importancia, quien en puerperio inmediato 18 horas presentó pérdida súbita de emisión y compresión del lenguaje junto a déficit motor en hemicuerpo derecho. A las 3 horas de evolución es activado el Código de ACV; al examen físico presentó: TA 130/80, FC 66, FR 16, T 36.5, se encuentra alerta, con afasia mixta, hemiparesia 3/5 derecha. Tomografía simple de cráneo sin lesiones evidentes, NIHSS de 6, se toman paraclínicos según protocolo. Neurología considera que la paciente se encuentra en ventana para trombolisis y tras obtención de consentimiento informado se inicia el procedimiento a las 4,5 horas del inicio de los síntomas. Recibió TPA 61 mg IV (6 mg en bolo y 54 mg para pasar en la hora siguiente). Obstetricia previno la complicación de una hemorragia uterina posparto por lo que se activó profilácticamente el protocolo farmacológico de código rojo y el uso del balón Bakri.</p><p><strong>Resultados:</strong> evolucionó sin complicaciones mayores, choque hemorrágico leve compensado y con reversión total de los síntomas neurológicos al cabo de 14 horas postrombolisis, la tomografía de cráneo de control a las 24 horas fue normal.</p><p><strong>Conclusiones:</strong> el éxito del presente caso obedece a la sospecha en la activación del código de ACV y al manejo conjunto de Ginecología, Neurología y Cuidado Intensivo anticipándonos a la complicación mayor que se pudiera presentar (que de hecho se dio) como lo es la hemorragia obstétrica.</p><p>Las guías de la (AHA) y American Stroke Association no hacen referencia a la trombolisis del ACV en el embarazo, tampoco hay una contraindicación a este respecto.</p><p>En PubMed no se registran casos publicados de trombolisis en ACV isquémico agudo en puerperio (búsqueda: Puerperium AND stroke AND Trombolysis).</p><p>Los casos comunicados de trombolisis de ACV en embarazo están descritos con gestaciones activas identificando claramente los siguientes riesgos: hemorragias de tercer trimestre y hemorragia posparto (este último es el que nos interesa para nuestro caso).</p><p><strong>Palabras clave</strong>: trombolisis, puerperio, ataque cerebrovascular.</p><p><strong>CATEGORÍA VIDEO:</strong></p><p><strong>USO DE LÁSER THULIUM EN HISTEROSCOPIA</strong></p><p>Fernando Gómez Corredor, Sandra Gómez Ramos, Ivonne Díaz Yamal, Jimmy Castañeda Castañeda, Camila Giraldo Parra, Fundación Universitaria Sanitas/ Unidad Medicina Reproductiva, Procreación Médicamente Asistida - Clínica de Marly Bogotá.</p><p><strong>Correo electrónico:</strong> <a href="mailto:fergomezmd@hotmail.com">fergomezmd@hotmail.com</a></p><p><strong>Introducción:</strong> evaluar el uso de láser Thulium a través del histeroscopio de Bettocchi para el manejo de patología endometrial benigna.</p><p><strong>Materiales y métodos:</strong> el propósito del video es mostrar algunos de los procedimientos que se pueden hacer por histeroscopia con la aplicación de la tecnología láser Thulium, con una fibra de 600 micras que pueden pasar a través del canal operativo del histeroscopio diagnóstico.</p><p>Debido a su baja penetración del tejido (0,2 mm), este láser proporciona al cirujano un corte más preciso evitando lesiones a los tejidos circundantes y un efecto quirúrgico observable debido a su longitud de onda de 2010 nm.</p><p>Se puso a prueba en diferentes patologías, incluyendo miomas submucosos, septos uterinos, hemorragia uterina anormal y pólipo endocervical, con buenos resultados en todos los casos. El tiempo medio de la cirugía fue de 15 minutos, con cirugías que duraron solo 1 minuto y otra que duró 40 minutos; la potencia media utilizada fue de 20 vatios.</p><p><strong>Resultados:</strong> durante la valoración de cavidad uterina con el histeroscopio de Bettocchi se logró realizar manejo exitoso de las cuatro patologías halladas, mediante el uso el del láser Thulium.</p><p><strong>Conclusiones:</strong> el uso de la tecnología láser Thulium podría ser una opción quirúrgica en el tratamiento de la patología endometrial benigna proporcionando la hemostasia y la precisión necesarias en estos procedimientos.</p>