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      Successful Application of an Insole with a Metatarsal Inhibition Bar and Deep Heel Cup for Improving Gait Dysfunction in a Patient with Poor Coordination with Disrupted Corticoreticular Tracts: A Case Report

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          Abstract

          We report the successful management of gait dysfunction in a patient with coordination problems using an insole with a metatarsal inhibition bar (MIB) and a deep heel cup. Furthermore, we investigated the state of the neural tracts via diffusion tensor tractography (DTT). A 23-month-old boy with gait dysfunction presented with toe walking with a wide base and decreased hip flexion. Motor weakness or spasticity was not observed. Conventional brain magnetic resonance imaging did not reveal any abnormal findings, but DTT revealed disrupted bilateral corticoreticulospinal tracts (CRTs). No abnormalities were observed in the corticospinal tract or the medial lemniscus. We applied a custom-made insole with an MIB and a deep heel cup. Immediately after application, the patient’s gait pattern stabilized significantly and was nearly normalized. Our therapeutic experience indicates that the application of an insole with an MIB and deep heel cups could be beneficial for patients with coordination problems and gait dysfunction. Our DTT results showed that CRTs could be the causative brain pathology for gait dysfunction in patients with coordination problems.

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          Developmental coordination disorder: a review and update.

          Present in approximately 5-6% of school-aged children, developmental coordination disorder (DCD) is a neuromotor disability in which a child's motor coordination difficulties significantly interfere with activities of daily living or academic achievement. These children typically have difficulty with fine and/or gross motor skills, with motor performance that is usually slower, less accurate, and more variable than that of their peers. In this paper, we review the history of various definitions leading up to the current definition of DCD, prevalence estimates for the disorder, etiology, common co-morbidities, the impact of DCD on the child's life, and prognosis. As well, we briefly describe current interventions for children with the disorder and results of recent neuroimaging studies of the brains of children with DCD, including research by the authors of this paper. Copyright © 2012 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
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            EEG-Based Brain-Computer Interfaces Using Motor-Imagery: Techniques and Challenges

            Electroencephalography (EEG)-based brain-computer interfaces (BCIs), particularly those using motor-imagery (MI) data, have the potential to become groundbreaking technologies in both clinical and entertainment settings. MI data is generated when a subject imagines the movement of a limb. This paper reviews state-of-the-art signal processing techniques for MI EEG-based BCIs, with a particular focus on the feature extraction, feature selection and classification techniques used. It also summarizes the main applications of EEG-based BCIs, particularly those based on MI data, and finally presents a detailed discussion of the most prevalent challenges impeding the development and commercialization of EEG-based BCIs.
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              Dyspraxia or developmental coordination disorder? Unravelling the enigma.

              Dyspraxia is an enigma to many people, both professional and lay alike--what is it, how does it relate to developmental coordination disorder and associated conditions, how common is it, how is it recognised and diagnosed and how should it be managed? This article attempts to unravel this enigma by: dealing with the terminology of coordination difficulties from the "clumsy child syndrome" through "dyspraxia" to "developmental coordination disorder (DCD)"; briefly examining the debate as to whether dyspraxia or DCD should be regarded as a medical or social disorder; discussing the differential diagnosis of dyspraxia or DCD; considering the assessment of children with dyspraxia or DCD; reviewing the range of current treatment approaches in the UK.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Children (Basel)
                Children (Basel)
                children
                Children
                MDPI
                2227-9067
                22 April 2021
                May 2021
                : 8
                : 5
                : 320
                Affiliations
                Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu 42415, Korea; sumin430@ 123456hanmail.net (S.M.S.); jwlee22c@ 123456naver.com (J.W.L.)
                Author notes
                [* ]Correspondence: wheel633@ 123456gmail.com ; Tel.: +82-53-620-4682
                Author information
                https://orcid.org/0000-0002-7629-7213
                Article
                children-08-00320
                10.3390/children8050320
                8143587
                33921951
                16141dfa-c88e-4a13-90c6-1e368da86f3a
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 07 March 2021
                : 21 April 2021
                Categories
                Case Report

                coordination,insole,metatarsal inhibition bar,gait dysfunction,diffusion tensor tractography,corticoreticulospinal tract

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