Effect of caudal block on sevoflurane requirement for lower limb surgery in children with cerebral palsy

2011 ◽  
Vol 21 (4) ◽  
pp. 394-398 ◽  
Author(s):  
Soo Hwan Kim ◽  
Duk-Hee Chun ◽  
Chul Ho Chang ◽  
Tae Wan Kim ◽  
Young Mi Kim ◽  
...  
2019 ◽  
Vol 43 (4) ◽  
pp. 361-368 ◽  
Author(s):  
Vasileios C. Skoutelis ◽  
Anastasios Kanellopoulos ◽  
Stamatis Vrettos ◽  
Georgios Gkrimas ◽  
Vasileios Kontogeorgakos

Author(s):  
Arūnė Dūdaitė ◽  
Vilma Juodžbalienė

Research background. Virtual reality and visual feedback improve motor performance, motor function and balance, so we want to fnd if it affects the function of legs and balance of children with spastic hemiplegia. Research aim was to establish if the use of virtual reality and visual feedback with traditional physiotherapy improve the function of legs and balance of children with cerebral palsy. Methods. Nine children with cerebral palsy participated in the research. Participants were randomly divided into two groups – virtual reality group (n = 6) and control (n = 3). Virtual reality group practised exergaming and stretching exercises for 10 weeks, twice a week. Control group practiced conventional physiotherapy and stretching exercises for 6 weeks, twice a week. We measured the range of motion of the lower limb, spasticity of the lower limb using Modifed Ashworth’o Scale, static, dynamic balance, trunk coordination using Trunk Impairment Scale at the start and the end of the research, and balance using Pediatric Balance Scale. Results. Virtual reality and visual feedback reduced the spasticity of the lower limb, improved balance and postural control for children with cerebral palsy, but it did not improve the range of motion of the lower limb of children with cerebral palsy. Conclusions. Virtual reality and visual feedback did not improve the range of motion of the lower limb of children with cerebral palsy. Virtual reality and visual feedback reduced spasticity of the lower limb, improved balance and postural control for children with cerebral palsy.Keywords. Cerebral palsy, virtual reality, visual feedback, postural control, muscle architecture.


2018 ◽  
Vol 43 (1) ◽  
pp. 12-20 ◽  
Author(s):  
Ingrid Skaaret ◽  
Harald Steen ◽  
Terje Terjesen ◽  
Inger Holm

Background: Different types of ankle-foot orthoses are commonly used following lower limb surgery in children with bilateral spastic cerebral palsy. After three-dimensional gait analysis 1 year postoperatively, many children are recommended continued use of ankle-foot orthoses. Objectives: Our aims were to quantify the impact of ankle-foot orthoses on gait 1 year postoperatively and evaluate predictors for clinically important improvement. Study design: Prospective cohort study. Methods: A total of 34 ambulating children with bilateral cerebral palsy, with mean age 11 years (range 6–17), comprising 12 girls and 22 boys, were measured with three-dimensional gait analysis preoperatively (barefoot) and 1 year postoperatively (barefoot and with ankle-foot orthoses). Outcome was evaluated using gait profile score, key kinematic, kinetic and temporal–spatial variables in paired sample comparisons. Logistic regression was used to evaluate predictors for clinically important improvement with orthoses (⩾1.6° change in gait profile score). Results: Walking barefoot 1 year postoperatively, major improvements were seen in gait profile score and key variables. With ankle-foot orthoses, there were significantly improved step length and velocity, additional moderate reduction/improvement in gait profile score and knee moments and decreased stance ankle dorsiflexion compared to barefoot. Children using ground reaction ankle-foot orthoses ( n = 14) decreased stance knee flexion from 13.9° walking barefoot to 8.2° with orthoses. High gait profile score and more gait dysfunction preoperatively were significant predictors of clinically important improvement walking with orthoses. Conclusion: The results indicate improved gait function walking with ankle-foot orthoses versus barefoot 1 year after lower limb surgery. Stronger impact of ankle-foot orthoses was found in children with more pronounced gait dysfunction preoperatively. Clinical relevance The 1-year postoperative three-dimensional gait analysis is a useful method to assess treatment outcome after lower limb surgery in children with bilateral cerebral palsy and could also guide clinicians whether further treatment with ankle-foot orthoses is indicated, using clinically important differences as thresholds to evaluate their impact on gait.


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