Active clinical trials for "Apraxias"

Childhood Apraxia of Speech (CAS) is a severe speech-language disorder whose aetiological, neuroanatomical correlates are largely unknown. Furthermore, little is known about the neuroplastic effects induced by different treatment approaches and their relationships with the potential changes in the speech behavioural features that express the core deficit of CAS. Twenty four children with idiopathic CAS will be enrolled in a multidisciplinary study aimed at analysing the behavioural and neuroanatomical effects of a specific rehabilitative approach, PROMPT (PROMPTs for Restructuring Oral Muscular Phonetic Targets), that employs tactile-kinesthetic-proprioceptive cues vs a traditional speech-language treatment. The children will be allocated in two arms, one receiving a seven month cycle of individual PROMPT treatment, the other a traditional speech and language treatment for the same amount of time.The pre- and post-treatment speech and language performances and DTI and volumetric MR data will be compared in the two groups.

The study will use MRI brain imaging to identify brain changes associated in stroke patients after they receive speech-language treatment for their speech difficulties.

Epidemiological studies report that 85% of stroke survivors show hemiparesis and a percentage ranging from 55% to 75% report upper limb functional impairment. Early rehabilitation in stroke patients with motor disorders can be effective to restore the affected function and to improve the performance of daily activities. Up to now, different methods and techniques have been used to recover motor functions in stroke patients. However, none of these has been conclusively proven to be more effective than the others. The clinical benefits induced by motor rehabilitation are closely related to "neuroplasticity". The main aim of the present study is to assess the efficacy of action observation treatment, based on Mirror Neuron System (MNS), in the rehabilitation of upper limb motor functions in acute stroke patients. The study will also aim at assessing neuroplasticity within areas belonging to the MNS through functional magnetic resonance (fMRI).

The importance of play and physical activity include its many benefits on positively improving health and well-being, enhancing children's and young people's thinking and performance in school, improving their sleep and enabling confidence and skill building (Janssen and LeBlanc, 2010; Budde et al., 2008; Sallis and Patrick, 1994). However, children with movement difficulties (MD) and physical disabilities are at risk of decreased physical activity and subsequently decreased physical fitness and overall health and well-being as a result. To build upon current findings and to follow-up on a continuing study, looking at the impact (responses) and recovery during and following acute exercise at different intensities in children and adolescents with and without movement difficulties, this next phase aims to provide an intervention to improve fitness levels and health measures and to strategically provide a pathway for longer term participation in physical activity in young people. Implement and evaluate a pathway to sport for 14+ year old young people who do not regularly participate in sport due to Neurodevelopmental conditions, young people presenting with poor coordination and movement, and even children and adolescents with special educational needs. The pathway hopes to promote engagement, participation, inclusion and confidence (EPIC) in sport within local schools and the community through 1) targeted recruitment, 2) confidence and skill building (EPIC Club), 3) connection to sport ('Have a go days') and 4) exit to long term participation.

The purpose of this protocol is to enable access to intravenous infusions of banked autologous (a person's own) or sibling umbilical cord blood (CB) for children with various brain disorders. This is an expanded access protocol intended for patients who are unable to participate in a clinical trial involving their own or their sibling's cord blood. Children with cerebral palsy, congenital hydrocephalus, apraxia, stroke, hypoxic brain injury and related conditions will be eligible if they have normal immune function and do not qualify for, have previously participated in, or are unable to participate in an active cell therapy clinical trial at Duke Medicine. For the purpose of this protocol the term children refers to patients less than 26 years of age. The cord blood is thawed and then administered as an intravenous infusion. Recipients do not receive chemotherapy or immunosuppression. The mechanism of action is through paracrine signaling of cord blood monocytes inducing endogenous cells to repair existing damage.

To evaluate, in primary care, the sensitivity of Heterophory-Vertical-Labile (HV-Labile) in ambulatory screening for Specific Learning Disabilities (SLD) and Developmental Coordination Disorder (DCD). in children aged 8 to 12 years.

Alzheimer's disease (AD) and Lewy body's dementia (LBD) are two frequent neurodegenerative pathologies. They differ in their expression, their evolution but share same features which make their diagnosis uneasy. Constructional apraxia has been described in both disease.The underlying mechanisms have been less studied and could be different in AD and LBD. The definition of the constructional apraxia is purely descriptive and few models are inconclusive. It is admitted that drawing tasks involve visuo-perceptive and visuo-spatial abilities, executive functions and working memory as well as purely "constructive" skills. Regarding to different studies, visuo-perceptive abilities are more severely impaired in LBD than in AD and are considered as an early onset sign of the disease. Executive functions deficits are documented in AD and LDB and could contribute to the drawing impairment. It is possible to compensate the planning disorders in giving patient the best strategy to use. If drawing impairment persists, they should result of others mechanisms like visuo-perception, visuo-spatial or constructive deficits. The investigators suggest that giving the best planning strategy will help more AD patients who are supposed to fail in raison of an executive impairment, than the LDB group who is supposed to present visuo-perceptive deficits. An MRI will be proposed to study the cerebral areas involved in constructional apraxia.

Ideomotor apraxia, a disorder that affects patients with stroke and a variety of other brain lesions, features disturbed timing, sequence, and spatial organization of skilled movements. This study will look at how different areas of the human brain control fine hand movements. Thirty-five participants 21 years and older will be enrolled in this study-25 healthy, right-handed people, and 10 stroke patients. They will undergo two outpatient sessions, each lasting up to 3 hours. The first visit for the stroke patients will occur between 2 weeks and 3 months after the stroke; the second visit will be at least 6 months after the stroke. Participants will have a physical exam, give a medical history, and complete a questionnaire. Then they will undergo magnetic resonance imaging (MRI) scans. They will lie in the MRI scanner and will be asked to do a number of skilled hand movements using the right hand (such as pretending to use a hammer or waving goodbye) in response to directions that will appear on a screen mounted over their head. Their movements will be recorded on videotape during the procedures.

The purpose of this study is to examine and to compare gait characteristics under single- and dual-task conditions among healthy subjects together with AD patients at different stages of disease (i.e., pre-dementia, mild and moderate dementia stages).

The GAITRite® system is an instrumented with resistive pressure sensors gait analyzer. It was first validate in 2001 against paper-and-pencil (intraclass correlation coefficient [ICC] > 95%) for spatial measures and against video-based (ICC > 93%) for temporal measures, and was thus a reliable tools to measure step lengths and times in both walkway center and left-of-center measurements. It was considered as one of the gold standards in gait analyses. This gait analyze system may distinguish prospectively faller and non-faller older adults, but it can detect spatial, temporal, and spatiotemporal measures of gait and greater variability of gait parameters which were associated with and predictive of both global- and domain-specific cognitive decline. Moreover, spatiotemporal gait parameters analyzed using GAITRite® were more disturbed in the advanced stages of dementia, and more affected in the non-AD dementia than in AD suggesting that quantitative gait parameters could be used as a surrogate marker for improving the diagnosis of dementia. Nevertheless, GAITRite® is not a unique system and it comprises different walkways. One of these technologies was a roll-up system (platinum plus classic, RE, Basic and Safari), and the other was a system composed by a changeable association of plates (CIRFACE). In order to ensure a good comparability between studies using these different walkways, it appears important to compare the performances of these walkways in gait analysis. Thus, the main aim of this study was to compare the performances in gait analyze between the GAITRite® platinum plus classic and the GAITRite® CIRFACE among older adults. Secondary aims were to compare these parameters among patients with cognitive complaint, minor or major neurocognitive disorder (NCD) related to Alzheimer disease.