scholarly journals Biomechanical Study of Walking and Vertical Posture in 4-6-year-old Children with Spastic Forms of Cerebral Palsy

2021 ◽  
Vol 20 (2) ◽  
pp. 49-61
Author(s):  
Natalia N. Rukina ◽  
Gennadiy E. Sheiko ◽  
Alexey N. Kuznetsov ◽  
Olga V. Vorobyova
Keyword(s):  
Cerebral Palsy ◽  
Center Of Pressure ◽  
Maximum Amplitude ◽  
Medical Rehabilitation ◽  
Vertical Posture ◽  
Spastic Diplegia ◽  
Healthy Children ◽  
Double Step ◽  
Wide Range ◽  
Flexion Extension

Rehabilitation of children with cerebral palsy (CP) requires a systematic approach and dynamic assessment of the results achieved. The development of methods for assessing the dynamics of motor disorders during medical rehabilitation is of great importance for modern medical rehabilitation. In recent years, there are more and more scientific papers devoted to the study of biomechanical disorders of locomotion in patients with CP. Aim. To assess the features of walking biomechanical characteristics and vertical pose stability in of children 4-6 years old with spastic forms of CP for further formation of rehabilitation groups, taking into account the identified functional disorders. Material and methods. The study included 20 patients (5.4±0.67 years) with spastic forms of CP. A comparative analysis of walking parameters and stabilography of children with spastic diplegia and hepiplegic CP among themselves and with a group of conditionally healthy children (norm group) (n=12) was performed. Results. A statistically significant decrease in the following indicators was found in children with hemi-and paraparesis: walking speed, double step length, and hip flexion/extension angle. Deviations of indicators are more pronounced in spastic diplegia, but are not always equivalent for both limbs; there is a violation step cycle proportions. the decrease in the length of the double step is more pronounced on the affected limb; there is a decrease in the angle of flexion/extension in the knee joint, more pronounced on a healthy limb in patients with hemiplegic CP. A wide range of stabilographic indicators values is observed in both study groups. However, only the average position of the pressure center relative to the frontal plane statistically significantly differs from the norm in the group of children with hemiparesis. In paraparesis, such differences from the norm are much more common: the area of the statokinesiogram, the maximum amplitude of fluctuations in the center of pressure and the energy of the frequency spectrum. The range of values for most indicators in paraparesis is wider. Conclusion. The revealed biomechanical features of walking and stability of the vertical posture of children with spastic forms of CP can serve as a basis for the development of rehabilitation programs. Clinical and rehabilitation groups of children with CP should be formed taking into account the severity of static-dynamic disorders present in patients. This approach will make it possible to plan further rehabilitation treatment of such patients and adequately assess the results obtained.

scholarly journals Accelerometry as an Estimate Of Energy Expenditure in Healthy Children and Children with Cerebral Palsy During Self-Paced Ambulation

2006 ◽  
Author(s):  
Joseph Norman
Keyword(s):  
Cerebral Palsy ◽  
Energy Expenditure ◽  
Therapeutic Interventions ◽  
Spastic Diplegia ◽  
Healthy Children ◽  
Caloric Expenditure ◽  
Wide Range ◽  
Walking Speeds ◽  
The Cost ◽  
Age Range

Oxygen consumption (VO2) is the criterion standard for determining energy expenditure during activity. Newer technologies have resulted in the development of portable metabolic gas analyzers capable of measuring VO2 during a wide range of physical activities in the field. Unfortunately, use of these devices is still limited due to the cost, availability and skill level required to utilize this newer technology. However, there is an instrument which may be utilized. Accelerometers are a type of physical activity monitor that provide estimates of energy expenditure and may potentially be of more practical use in the clinical setting. Purpose: This study was designed to compare estimates of energy expenditure using two different accelerometers to VO2 during self-paced walking speeds in children with spastic diplegia cerebral palsy (CP) and in healthy children (HLT). Methods: Ten HLT children and five children with spastic diplegia CP participated in this pilot study (age range: 7.5-17.5 years). Subjects ambulated at self-paced speeds on a level surface wearing a Caltrac accelerometer and a BioTrainer-Pro accelerometer, while VO2 was measured simultaneously with an AeroSport KB1-C portable metabolic gas analyzer. Results: Both accelerometers overestimated caloric expenditure in HLT children. In the children with spastic diplegia CP, we found no significant differences in the mean caloric expenditure estimated by the accelerometers and VO2 (p= 0.62). Conclusions: Preliminary findings suggest accelerometers may have potential as a means of estimating energy expenditure during ambulation in children with spastic diplegia CP, which could be useful to clinicians evaluating therapeutic interventions. Further research is indicated.

scholarly journals Nutritional status of children with infantile cerebral palsy

2021 ◽  
Vol 1 (1) ◽  
pp. 82-88
Author(s):  
Z. F. Mavlyanova
Keyword(s):  
Cerebral Palsy ◽  
Nutritional Status ◽  
Group Versus ◽  
Physical Development ◽  
Control Group ◽  
Spastic Diplegia ◽  
Fatty Tissue ◽  
Healthy Children ◽  
Anthropometric Parameters ◽  
Rate Of Increase

Purpose of the study. Reveal the typical disorders of nutritional status and identify characteristic disorders of the physical development of patients with cerebral palsy.Materials and methods. The features of the nutritional status of 128 children with various forms of cerebral palsy and 20 healthy children aged 3 to 14 years were studied. Physical development was assessed using standard public anthropometric parameters: weight, height, measurement of the circumference of the upper and lower extremities, determination of the thickness of the skin-fat fold using an electronic caliper according to the Durnin-Womersly method, as well as the calculated indices of Rohrer, Pigne, Vervac.Results. In children with cerebral palsy in compare with healthy children a decrease in the rate of increase in muscle mass, the absence of significant changes in the severity of subcutaneous fatty tissue and various variants of disharmonious types of development with characteristic anthropometric features were determined (85.9% in the main group versus 5% in the control group; Р <0.001). The most prominent disorders of the nutritional status were observed in patients with double hemiplegia and hyperkinetic form of cerebral palsy and were significant in relation to patients with hemiparetic, atonic-astatic forms and spastic diplegia (P <0.05–0.001)

scholarly journals Persisting inter‐limb differences in patients following total hip arthroplasty four to five years after surgery? A preliminary cross‐sectional study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Stefanie John ◽  
David Weizel ◽  
Anna S. Heumann ◽  
Anja Fischer ◽  
Katja Orlowski ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Center Of Pressure ◽  
Operation Time ◽  
Hip Strength ◽  
Total Hip ◽  
Control Subjects ◽  
Post Surgery ◽  
Flexion Extension ◽  
Hip Flexion

Abstract Background Total hip arthroplasty (THA) is an effective procedure for patients with end-stage hip osteoarthritis. However, whether or not pre-operatively existing functional deficits are persisting several years post-surgery in the affected limb has not been thoroughly researched. Therefore, the primary aim of this preliminary study was to include patients four to five years after undergoing THA and to investigate potential differences between the operated and non-operated leg in hip strength, range of motion (ROM), balance, and gait. The secondary aim was to compare these values from the operated leg of the patients to those of the legs of healthy subjects. Methods Sixteen patients (age: 65.20 ± 5.32 years) following unilateral THA (post-operation time: 4.7 ± 0.7 years) and ten, healthy, age-matched control subjects (age: 60.85 ± 7.57 years) were examined for maximum isometric hip muscle strength, active ROM of the hip joint, balance and gait on both limbs. Paired t-tests were used to assess the inter-limb differences in the THA group. Analyses of covariance (ANCOVA) were performed to compare groups, using age as a covariate. Results The analysis of inter-limb differences in patients following THA revealed significant deficits on the operated side for hip abduction strength (p = 0.02), for hip flexion ROM (p < 0.01) and for balance in terms of the length of center of pressure (COP) (p = 0.04). Compared to values of the control subjects, the patients demonstrated significantly reduced hip strength in flexion, extension and abduction (p < 0.05) on the operated leg as well as reduced ROM measures in hip flexion, extension and abduction (p < 0.05). Conclusions The first results of this explorative study indicated that inter-limb differences as well as reduced hip strength and hip ROM compared with control subjects were still present four to five years after THA. These persisting asymmetries and deficits in patients following THA may be one explanation for the decrease in health-related quality of life (HRQoL) seen in patients over the years after surgery. Further studies are required to replicate these findings with a larger sample size. Trial registration DRKS, DRKS00016945. Registered 12 March 2019 – Retrospectively registered,

Assessing the Ergonomic Benefits of a New Adjustable Forklift Backrest

2020 ◽  
Vol 64 (1) ◽  
pp. 976-980
Author(s):  
Pranav Madhav Kuber ◽  
Ehsan Rashedi
Keyword(s):  
Comparative Study ◽  
Motion Capture ◽  
Center Of Pressure ◽  
Body Movement ◽  
Pressure Change ◽  
Motion Capture System ◽  
Design Features ◽  
Wide Range ◽  
Body Sizes ◽  
The Mean

A new forklift backrest has been developed by incorporating adjustability concepts into the design to facilitate comfort to a wide range of users. We have conducted a comparative study between the new and original backrests to assess the effectiveness of design features. Using the phenomenon of restlessness, discomfort of the user was associated with the amount of body movement, where we have used a motion- capture system and a force platform to quantify the individuals’ movement for a wide range of body sizes. Meanwhile, subjective comfort and design feedback were collected using a questionnaire. Our results showed a reduction in the mean torso movement and the maximum center of pressure change of location by 300 and 6 mm, respectively, for the new design. Taking advantage of adjustability feature, the new backrest design exhibited enhanced comfort for longer durations and reduced magnitude of discomfort for a wide range of participants’ body sizes.

scholarly journals Standardized Outcomes Measures in Physical Therapy Practice for Treatment and Rehabilitation of Cerebral PALSY: A Systematic Review

2021 ◽  
Vol 11 (7) ◽  
pp. 604
Author(s):  
Maria Dolores Apolo-Arenas ◽  
Aline Ferreira de Araújo Jerônimo ◽  
Alejandro Caña-Pino ◽  
Orlando Fernandes ◽  
Joana Alegrete ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Physical Therapy ◽  
Gait Training ◽  
Physical Therapy Modalities ◽  
Spastic Diplegia ◽  
Evaluation Procedures ◽  
Outcomes Measures ◽  
Prisma Statement ◽  
Spastic Hemiplegia

Cerebral palsy (CP) treatment includes physical therapy and various complementary therapies to the standard clinical treatment. However, there are not many reviews that focus on the methods used and evaluation procedures. This study aims to analyze which tools are most suitable for the evaluation and methodology of patients with CP treated with physical therapy. Following the PRISMA statement, through a PICOS strategy, PubMed/MEDLINE, Web of Science (WOS), Scopus, Science Direct, and Scielo were searched with the following terms: cerebral palsy AND (physical therapy modalities OR therapeutics) AND outcome assessment. The methodological quality of the RCTs was assessed with the Evidence Project risk of bias tool. Thirty-seven RCTs and six RCT protocols, comprising 1359 participants with different types of CP: spastic hemiplegia/paresis, spastic diplegia/paresis, and spastic CP, met the inclusion criteria, uncovering 21 variables measured through 77 different instruments and several interventions. The therapies most widely used in CP are gaming or technology-assisted therapies, aerobic training, hippotherapy, music therapy, gait training, and aquatic exercises. This study provides an overview of what the authors used in the neurorehabilitation field through procedure evaluation and checking the technological advance that began to be used.

Evaluating upper body movements during gait in healthy children and children with diplegic cerebral palsy

2007 ◽  
Vol 16 (3) ◽  
pp. 175-180 ◽  
Author(s):  
Jacqueline Romkes ◽  
Wietske Peeters ◽  
Aidia M. Oosterom ◽  
Sara Molenaar ◽  
Iris Bakels ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Upper Body ◽  
Healthy Children ◽  
Body Movements

scholarly journals Effects of Dynamic Elastomeric Fabric Orthoses on Children with Cerebral Palsy

2009 ◽  
Vol 33 (4) ◽  
pp. 339-347 ◽  
Author(s):  
Martin John Matthews ◽  
Martin Watson ◽  
Barbara Richardson
Keyword(s):  
Cerebral Palsy ◽  
Single Case ◽  
Phase 1 ◽  
Functional Mobility ◽  
Gait Velocity ◽  
Controlled Study ◽  
Patient Specific ◽  
Spastic Diplegia ◽  
Cost Index ◽  
Beneficial Effects

This phase 1 exploratory study aimed to establish proof of concept of the effects of dynamic elastomeric fabric orthoses (DEFOs) on the gait of children with spastic diplegic cerebral palsy. Replicated single case experiments employing an ABA methodology were carried out on eight subjects (median age 5.5 years, range 3–13 years; 4 girls/boys) utilizing quantitative/qualitative data collection. Outcome measures were: Ten metre walking test (10MWT); physiological cost index (PCI); visual analogue scale (VAS) scoring of perceived gait changes; functional mobility changes using Patient Specific Functional Scale (PSFS); subject/carer perceptions recorded in daily diaries. Results identified following analysis of quantitative data indicated a treatment effect from the orthoses which could be corroborated by participant subjective impressions and comments. Statistically significant ( p < 0.05) intervention-related improvements in gait velocity and gait consistency were identified respectively in 5/8 and 4/8 subjects. Power calculations support the feasibility of a larger controlled study to further investigate this orthotic intervention. This study indicates that DEFO leggings can confer beneficial effects on the gait of some children with spastic diplegia resulting from CP. These findings have implications for orthotic intervention with this subject group.

Experimental Investigation of Subsonic Turbulent Flow Over Single and Double Backward Facing Steps

1962 ◽  
Vol 84 (3) ◽  
pp. 317-325 ◽  
Author(s):  
D. E. Abbott ◽  
S. J. Kline
Keyword(s):  
Experimental Investigation ◽  
Velocity Profile ◽  
Flow Pattern ◽  
Reynolds Numbers ◽  
Area Ratio ◽  
Single Step ◽  
Reattachment Length ◽  
Double Step ◽  
Wide Range ◽  
Geometric Variables

Results are presented for flow patterns over backward facing steps covering a wide range of geometric variables. Velocity profile measurements are given for both single and double steps. The stall region is shown to consist of a complex pattern involving three distinct regions. The double step contains an assymmetry for large expansions, but approaches the single-step configuration with symmetric stall regions for small values of area ratio. No effect on flow pattern or reattachment length is found for a wide range of Reynolds numbers and turbulence intensities, provided the flow is fully turbulent before the step.

Discontinuation of Antiepileptic Drug Treatment After Two Seizure-free Years in Children With Cerebral Palsy

PEDIATRICS ◽  
1996 ◽  
Vol 97 (2) ◽  
pp. 192-197
Author(s):  
Mauricio R. Delgado ◽  
Anthony R. Riela ◽  
Janith Mills ◽  
Alan Pitt ◽  
Richard Browne
Keyword(s):  
Cerebral Palsy ◽  
Mental Retardation ◽  
Antiepileptic Drug ◽  
Spastic Diplegia ◽  
Multiple Factors ◽  
Spastic Hemiparesis ◽  
Children With Cerebral Palsy ◽  
Epileptic Children ◽  
Seizure Relapse ◽  
Antiepileptic Drug Treatment

Objective. The risk of seizure relapse after antiepileptic drug (AED) discontinuation in children has been reported to vary between 6% and 40%. It has been suggested that neurologic deficit and mental retardation are poor prognostic factors for seizure relapse after AED discontinuation. Because epileptic children with cerebral palsy (CP) have neurologic deficits, and many have mental retardation, it is important to know their risk for seizure relapse. Methods. AED treatment was discontinued in 65 children with CP and histories of epilepsy after 2 seizure-free years. All of the patients were followed until they had seizure relapses or for at least 2 years without seizures after AEDs were stopped. Multiple factors were analyzed for possible association with seizure relapse. Results. Twenty-seven patients (41.5%) had seizure relapses. Patients with spastic hemiparesis had the highest relapse rate (61.5%), and those with spastic diplegia had the lowest rate (14.3%). No other factor correlated significantly with the risk of seizure relapse. Conclusions. Discontinuation of AEDs in children with CP can, and should, be practiced when possible after patients have been seizure-free for at least 2 years. AED discontinuation in patients with spastic hemiparesis is significantly more likely to lead to seizure relapse than in patients with other CP types, but no other factor is yet known to increase the chance of relapse.

scholarly journals Static analysis of a torsion motor generating flexion - extension motions of the elbow

2018 ◽  
Vol 178 ◽  
pp. 07005 ◽  
Author(s):  
Tudor Deaconescu ◽  
Andrea Deaconescu
Keyword(s):  
Static Analysis ◽  
Medical Rehabilitation ◽  
Biological Model ◽  
Neuronal Control ◽  
Pneumatic Muscles ◽  
Flexion Extension ◽  
Static Behaviour

The paper presents the construction and static analysis of a rotation module responsible for conducting flexion-extension motions as part of a medical rehabilitation device of the elbow. The rotation module is actuated by a torsion motor consisting of a pair of agonist-antagonist pneumatic muscles. The study concerning the static behaviour of the rotation module draws upon similarity to the biological model, considering the influence of the neuronal control quantities on the forces developed by the two muscles.

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