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ABSTRACTThe objective of this study was to evaluate the influence of the type of cerebral palsy (CP) and oral motor function (OMF) on the oral health status of children and adolescents with CP in Teresina, Piauí, Brazil. The sample consisted of 52 children with CP, aged 7 to 18 years. The data were statistically analyzed using chi‐square tests. In 73.1% of the sample, the subjects' caregivers carried out the daily oral care. There was a significant association between the frequency of daily care and the subject's level of oral hygiene (p= .037). A diagnosis of Class II malocclusion was made for 55.8% of the sample, and defects of enamel formation were found in 38.5% of the subjects. There was no significant correlation between DMFT (decayed, missing, filled teeth) and socioeconomic status of the subjects (r = .254, p= .069). A significant association was found between quadriplegia and OMF (χ2= 7.88, p= .019). The type of CP and OMF did not influence the levels of plaque and caries indices in the children with CP, but increased frequency of toothbrushing did result in an improved oral hygiene index.

Background: The urban environment may influence neurodevelopment from conception onwards, but there is no evaluation of the impact of multiple groups of exposures simultaneously. We investigated the association between early-life urban environment and cognitive and motor function in children. Methods: We used data from 5403 mother-child pairs from four population-based birth-cohorts (UK, France, Spain, and Greece). We estimated thirteen urban home exposures during pregnancy and childhood, including: built environment, natural spaces, and air pollution. Verbal, non-verbal, gross motor, and fine motor functions were assessed using validated tests at five years old. We ran adjusted multi-exposure models using the Deletion-Substitution-Addition algorithm. Results: Higher greenness exposure within 300 m during pregnancy was associated with higher verbal abilities (1.5 points (95% confidence interval 0.4, 2.7) per 0.20 unit increase in greenness). Higher connectivity density within 100 m and land use diversity during pregnancy were related to lower verbal abilities. Childhood exposure to PM2.5 mediated 74% of the association between greenness during childhood and verbal abilities. Higher exposure to PM2.5 during pregnancy was related to lower fine motor function (-1.2 points (-2.1, -0.4) per 3.2 μg/m3 increase in PM2.5). No associations were found with non-verbal abilities and gross motor function. Discussion: This study suggests that built environment, greenness, and air pollution may impact child cognitive and motor function at five years old. This study adds evidence that well-designed urban planning may benefit children's cognitive and motor development. ; This work was supported by funding from the European Community's Seventh Framework Programme [FP7/2007–206 n◦308333; the HELIX project]. This INMA cohort was funded by grants from Instituto de Salud Carlos III (Red INMA G03/176; CB06/02/0041; PI041436; PI081151 incl. FEDER funds, FIS PI06/0867, FIS-PI09/00090, FIS and FIS-PI18/01142 incl. FEDER funds, FIS-FEDER: PI03/1615, PI04/1509, PI04/1112, PI04/1931, PI05/1079, PI05/1052, PI06/1213, PI07/0314, PI09/02647, PI11/01007, PI11/02591, PI11/02038, PI13/1944, PI13/2032, PI14/00891, PI14/01687, PI16/1288, PI16/00118 and PI17/00663; FIS-FSE: 17/00260; Miguel Servet-FEDER CP11/00178, CP15/00025, CPII16/00051, and CPII18/00018), from UE (FP7-ENV-2011 cod 282957, HEALTH.2010.2.4.5-1, and H2020 n◦824989), Generalitat de Catalunya-CIRIT 1999SGR 00241, Fundació La marató de TV3 (090430), Generalitat Valenciana: FISABIO (UGP 15-230, UGP-15-244, and UGP-15-249), Alicia Koplowitz Foundation 2017, CIBERESP, Department of Health of the Basque Government (2013111089, 2009111069, 2013111089, 2015111065 and 2018111086), Provincial Government of Gipuzkoa (DFG06/002, DFG08/001, DFG15/221 and DFG 89/17) and annual agreements with the municipalities of the study area (Zumarraga, Urretxu , Legazpi, Azkoitia y Azpeitia y Beasain). We acknowledge support from the Spanish Ministry of Science and Innovation and the State Research Agency through the "Centro de Excelencia Severo Ochoa 2019-2023" Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program. The work was also supported by MICINN [MTM2015-68140- R] and Centro Nacional de Genotipado- CEGEN- PRB2- ISCIII (Spain).

Neck pain is a medical problem in modern military aviation. While neck exercises are recommended, clinical trials of neck motor function have been less investigated. The aims of the work presented in this thesis were to estimate potential flight-related and individual factors involved in helicopter pilots neck pain, to explore neck motor function in fighter pilots and helicopter pilots with different progression of neck pain and to evaluate the effect of an early neck/shoulder exercise intervention for neck pain in helicopter pilots. The subjects were volunteers recruited consecutively as the pilots reported to the Swedish Armed Forces Aeromedical Center for regular medical examinations (papers I and II) and from two operational air force helicopter bases in Sweden (papers III and IV). A survey estimated the prevalence of, and potential flight-related and individual risk indicators for, neck pain in helicopter pilots (paper I, N = 127). Experimental measures of neck motor function included neck extensor and flexor muscle strength, and electromyography (EMG) frequency parameters in extensors and sternocleidomastoid (SCM) muscles with the subject seated during sustained contraction against stipulated loads representing 50% of maximal strength (paper II, N = 60). EMG frequency parameters were also obtained for SCM in supine position against the weight of the head. Further, EMG activity in SCM during staged active craniocervical flexion when supine, as well as neck range of motion when seated, were assessed. Fear-avoidance beliefs about physical activity were rated (paper III, N = 72). A controlled trial evaluated a six-week, supervised, neck/shoulder exercise intervention. Intervention members and untreated controls were followed regarding the number of neck pain cases (defined as reported neck pain during the previous three months), SCM activity and rated fear-avoidance beliefs (paper IV, N = 68). The results showed the three-month prevalence of neck pain to be 57%. Previous neck pain and shoulder pain were associated risk factors, while use of helmet-mounted night-vision goggles indicated a risk. About half the neck pain cases reported that their pain occasionally interfered with flying duty and leisure, while only 25% had ever been on sick-leave related to neck pain. Experimental findings showed that fighter pilots with frequent pain had lower neck extensor strength than their pain-free controls, while no such differences were found for helicopter pilots. In seated position, EMG frequency shifts were less in SCM for helicopter pilots with frequent pain, while no significant effect emerged for helicopter pilots in supine. Helicopter pilots with acute ongoing pain as well as subacute pain had higher SCM activity during active craniocervical flexion than pain-free controls did, while the acute group, solely, had less range of motion and rated higher fear-avoidance beliefs than controls. A logistic regression entering EMG variables, range of motion and fear-avoidance suggested that SCM activity was the strongest predictor of neck pain. In the clinical trial, SCM activity at the highest contraction level of active craniocervical flexion was reduced in intervention members post-intervention while no betweengroup effect emerged for fear-avoidance beliefs. At a 12-month follow-up, the results indicated a reduction in number of neck pain cases among subjects allocated to the intervention. In conclusion, neck pain is common in air force helicopter pilots, and preventive action aiming to reduce the risk of a first neck pain episode seems important. In air force pilots, screenings of neck extensor strength and surface neck flexor activity appeared to be relevant measures of neck motor function for clinical understanding of pilots neck pain, but should be understood in the context of pilots specific exposure. A supervised neck/shoulder exercise intervention improved neck motor function to some extent and had a positive early preventive effect over a 12-month period in reducing the occurrence of neck pain in air force pilots.

The aim of this research was to examine the development of motor functions in children with visual impairment compared to children without visual impairment. The research included a sample of 70 respondents; 35 with impaired vision and 35 with no visual impairment. The research was conducted in Sarajevo at the Center for Blind and Visually Impaired Children and Youth "Nedzarici", and in Tuzla at the Elementary School "Centar". The results of the research have shown that respondents with visual impairment have less developed motor functions compared to respondents without visual impairment. The variables on which the respondents with visual impairment achieved the worst results, which refer to the quality of drawing and the speed of drawing, were especially singled out.

Objective. Stroke affects the expression of muscle synergies underlying motor control, most notably in patients with poorer motor function. The majority of studies on muscle synergies have conventionally approached this analysis by assuming alterations in the inner structures of synergies after stroke. Although different synergy-based features based on this assumption have to some extent described pathological mechanisms in post-stroke neuromuscular control, a biomarker that reliably reflects motor function and recovery is still missing. Approach. Based on the theory of muscle synergies, we alternatively hypothesize that functional synergy structures are physically preserved and measure the temporal correlation between the recruitment profiles of healthy modules by paretic and healthy muscles, a feature hereafter reported as the FSRI. We measured clinical scores and extracted the muscle synergies of both ULs of 18 chronic stroke survivors from the electromyographic activity of 8 muscles during bilateral movements before and after 4 weeks of non-invasive BMI controlled robot therapy and physiotherapy. We computed the FSRI as well as features quantifying inter-limb structural differences and evaluated the correlation of these synergy-based measures with clinical scores. Main results. Correlation analysis revealed weak relationships between conventional features describing inter-limb synergy structural differences and motor function. In contrast, FSRI values during specific or combined movement data significantly correlated with UL motor function and recovery scores. Additionally, we observed that BMI-based training with contingent positive proprioceptive feedback led to improved FSRI values during the specific trained finger extension movement. Significance. We demonstrated that FSRI can be used as a reliable physiological biomarker of motor function and recovery in stroke, which can be targeted via BMI-based proprioceptive therapies and adjuvant physiotherapy to boost effective rehabilitation. ; This study was funded by the Fortüne-Program of the University of Tübingen (2452-0-0/2), the Bundesministerium für Bildung und Forschung (AMORSA (FKZ-16SV7754), REHOME (V5GR2001M1007-01)), EUROSTARS (SubliminalHomeRehab (FKZ: 01QE2023C E! 113928)) and the Basque Government Science Program (SINICTUS (2018222036), MODULA (KK-2019/00018), Elkartek-EXOTEK (KK-2016/00083)). N Irastorza-Landa's work was funded by the Basque Government's scholarship for predoctoral students.

BackgroundPoor postural care can have severe and life‐threatening complications. This scoping review aims to map and summarize existing evidence regarding postural care for people with intellectual disabilities and severely impaired motor function.MethodStudies were identified via electronic database searches (MEDLINE, CINAHL, PsycINFO and Web of Science) covering January 1990 to March 2016, and email requests to researcher networks. Results were collated via descriptive numerical summary of studies and thematic analysis.ResultsTwenty‐three studies were identified and summarized narratively in relation to three themes: characteristics and prevalence, interventions and service related issues. The evidence base is small with significant gaps. Lack of evidence for night‐time positioning equipment and 24‐hr postural care needs to be addressed urgently.ConclusionFuture research should be clearly directed towards ascertaining how best postural care interventions can be employed to help improve the health and quality of life of people with intellectual disabilities.