Background: Cerebral palsy (CP) children present complex and heterogeneous motor disorders that cause gait deviations. Clinical gait analysis (CGA) is used to identify, understand and support the ...management of gait deviations in CP. Children with CP often use ankle–foot orthosis (AFO) to facilitate and optimize their walking ability. The aim of this study was to assess whether the gait deviation index (GDI) and the gait variability index (GVI) results can reflect the changes of spatio-temporal and kinematic gait parameters in spastic hemiplegic CP children wearing AFO. Method: The study group consisted of 37 CP children with hemiparesis. All had undergone a comprehensive, instrumented gait analysis while walking, both barefoot and with their AFO, during the same CGA session. Kinematic and spatio-temporal data were collected and GVI and GDI gait indexes were calculated. Results: Significant differences were found between the barefoot condition and the AFO conditions for selected spatio-temporal and kinematic gait parameters. Changes in GVI and GDI were also statistically significant. Conclusions: The use of AFO in hemiplegic CP children caused a statistically significant improvement in spatio-temporal and kinematic gait parameters. It was found that these changes were also reflected by GVI and GDI. These findings might suggest that gait indices, such as GDI and GVI, as clinical outcome measures, may reflect the effects of specific therapeutic interventions in CP children.
The monitoring of children with cerebral palsy (CP) should include a precise assessment of the nutritional status to identify children and adolescents at risk of nutrition disorders. Available ...studies assessing the nutritional status of children with CP mainly focus on the relationship between body composition and the coexistence of motor dysfunctions, frequently overlooking the role of muscle tone. Therefore, the aim of this study was to assess the relationship between body composition and muscle tone in children with CP. In a case-control study (
= 118; mean age 11 y; SD = 3.8), the children with CP presented various stages of functional capacities, corresponding to all the levels in gross motor function classification system (GMFSC), and muscle tone described by all the grades in Ashworth scale. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. The children with CP were found with significantly lower mean values of fat-free mass (FFM kg = 29.2 vs. 34.5,
< 0.001), muscle mass (MM kg = 18.6 vs. 22.6,
< 0.001), body cell mass (BCM kg = 15.1 vs. 18.3,
< 0.001), and total body water (TBW L = 23.0 vs. 26.7,
< 0.001). The same differences in body composition were identified with respect to gender (
< 0.01 respectively). Moreover, children with higher muscle tone (higher score in Ashworth scale) were found with significantly lower values of fat mass (FM), FFM, MM, BCM, and TBW (
< 0.05). The findings showed lower parameters of body composition in the children with CP compared to the healthy children, and a decrease in the parameters coinciding with higher muscle tone in the study group. This observation suggests that it is necessary to measure muscle tone while assessing nutritional status of children with CP.
Introduction. The Six-Minute Walk Test (6MWT) is a widely used test to measure the physical performance of patients to assess the effectiveness of treatment, to qualify for rehabilitation, and to ...evaluate its effects.. Aim. This paper focuses on the assessment of the growth of a double product (DP) during the 6MWT and its diagnostic value in the assessment of patients with heart failure. Material and Methods. The paper has retrospective character. We analyzed medical records of 412 patients hospitalized for cardiac reasons, in whom a 6MWT was performed. The patients were divided into two groups: one with diagnosed heart failure and a control group. Results. The patients with diagnosed heart failure, compared to the control group, were characterized by a shorter walking distance and greater DP increase at equal walking intervals. After distinguishing the group with the preserved and decreased left ventricle ejection fraction, the value of the DP increase was still higher compared to the control group. The mean DP increase corresponding to one meter of walk was the only one that correlated negatively with the left ventricular ejection fraction. Conclusion. The assessment of the increase of the DP during the march test seems to be a better parameter reflecting the efficiency of the myocardium from the distance of the march.
Motor conversion disorder (CD) is a rare but very severe medical problem in children and adolescents. It often causes a risk of long-term disability, social restrictions, educational problems, ...increased psychiatric morbidity such as anxiety and depression, and the symptoms of pain and fatigue. Proper diagnosis and treatment coupled with strict compliance on the part of the patient and his family during therapy have a major impact on quick recovery. The most effective way of curing motor CD is to introduce simultaneously a multimodal treatment consisting of individual and family psychotherapy, education, physiotherapy procedures based on modifi ed behavioral principles, and pharmacology for co-morbid anxiety and depression disorders. A necessary condition for therapeutic success is to convince the child’s parents that the symptoms are psychogenic. This helps to gain their best cooperation. As conversion disorders are usually associated with a signifi cant burden for the child, family, and the health care system, we decided to draw attention in this article to the importance of multimodal rehabilitation procedures in motor CD treatment in order to achieve optimal therapeutic results.
Motor conversion disorder (CD) is a rare but very severe medical problem in children and adolescents. It often causes a risk of long-term disability, social restrictions, educational problems, ...increased psychiatric morbidity such as anxiety and depression, and the symptoms of pain and fatigue. Proper diagnosis and treatment coupled with strict compliance on the part of the patient and his family during therapy have a major impact on quick recovery. The most effective way of curing motor CD is to introduce simultaneously a multimodal treatment consisting of individual and family psychotherapy, education, physiotherapy procedures based on modified behavioral principles, and pharmacology for co-morbid anxiety and depression disorders. A necessary condition for therapeutic success is to convince the child's parents that the symptoms are psychogenic. This helps to gain their best cooperation. As conversion disorders are usually associated with a significant burden for the child, family, and the health care system, we decided to draw attention in this article to the importance of multimodal rehabilitation procedures in motor CD treatment in order to achieve optimal therapeutic results. Key words: motor conversion disorders, children, adolescents, rehabilitation Motoricki konverzivni poremecaj rijedak je ali ozbiljan medicinski problem u djece i adolescenata. On cesto predstavlja rizik za nastanak dugotrajnih teskoca, socijalnih ogranicenja, teskoca u obrazovanju, poremecaja poput anksioznosti i depresije te takoder simptoma poput bolova i umora. Ispravna dijagnoza i tretman te aktivna ukljucenost pacijenta i njegove obitelji znacajno utjecu na brzinu oporavka. Najucinkovitiji nacin lijecenja ovog poremecaja sastoji se u multimodalnom tretmanu koji ukljucuje individualnu i obiteljsku psihoterapiju, edukaciju, fizioterapijske postupke bazirane na modificiranim bihevioralnim nacelima te koristenje lijekova za lijecenje anskioznosti i depresije. Nuzan preduvjet uspjesne terapije jest uvjeriti roditelje da su djetetovi simptomi psihogeni, sto najvise pomaze u njihovom pridobivanju na suradnju. Buduci da konverzivni poremecaji predstavljaju znacajno opterecenje za dijete, obitelj i sustav zdravstvene skrbi, ovim radom zeljeli smo skrenuti pozornost na vaznost multimodalnih rehabilitacijskih postupaka u tretmanu motorickog konverzivnog poremecaja, kako bi se se postigli optimalni rezultati u terapiji. Kljucne rijeci: motoricki konverzivni poemecaj, djeca, adolescenti, rehabilitacija
The most common motor deficits in patients with conversion disorder are tremors, weakness of limbsand gait disturbance. The proper diagnosis and treatment aswell as the patient and their family's ...cooperation during therapy are essential to achieve fast recovery. The aim of this paper is to provide an overview of multidisciplinary interventions successfully applied in the treatment of conversion disorders in children, illustrated with an example of a case study.
Case report: The 9 years old boy, with trembling of the limbs, trunk ataxia, impaired balance, and significant disability in self-locomotion, caused by conversion disorders, was admitted to stationary rehabilitation treatment because of the lack of progress in the current, four-month treatment, which consisted of hydroxyzin administration and irregular psychotherapy. Behavioural modifications in rehabilitation, individual psychotherapy, family counselling and psychoeducation, and sertralinepharmacologicaltreatmentwereimplemented at the same time. Particular attention was paid to obtain the parents'approval for multidisciplinary therapy, considering that the previous treatment was ineffective because of parents being unconvinced about psychogenic causes of symptoms. They were focused on over diagnosing the child's symptoms making it difficult to manage the proper treatment.
After a three-week period of comprehensive treatment the patient recovered completely and returned to independent mobility and social functioning relative to his age.
The simultaneous implementation of multi-profile treatment is an effective approach in children motor conversion disorders. In order to achieve therapeutic success it is necessary to convince the parents about the psychogenic ground of the symptoms and a need of multi-profile treatment.
Burnout is most often referred to as a syndrome of characteristic mental and somatic symptoms, which are the result of chronic stress most often associated with professional work.
The aim of this ...study was to assess the prevalence of burnout syndrome among physiotherapists and its determinants related to sex, age, education, workplace, occupational activity, work experience and financial situation.
Eighty-six professionally active full-time physiotherapists participated in the study. Maslach Burnout Inventory (MBI) was used to measure burnout.
In the examined group of physiotherapists, we observed a low level of Emotional Exhaustion (x¯= 15.99) and Depersonalization level (x¯= 4.31), while Personal Accomplishment was moderate but approaching high level (x¯= 31.63). A significant relationship between sex, education, work experience, place of work, scope of professional activities, financial situation, and individual dimensions of burnout syndrome were observed.
A significantly reduced sense of personal accomplishment occurred commonly in a studied group of physiotherapists. Professional burnout is most likely to occur in men, in people with higher education, in those working in hospital departments with more work experience, and those in a poor financial situation. Employers should take care of their employees' mental health as a part of burnout prophylaxis.
Bóle okolicy lędźwiowo-krzyżowej (L-S) w wieku rozwojowym do niedaw-na traktowane były jako marginalny problem zdrowotny. Coraz częściej jednak zwraca się uwagę, że nawet epizodyczne dolegliwości tej ...okolicy u młodych osób stanowią wyraźną predyspozycję do ich występowania w przyszłości. Scharakteryzowanie modyfikowalnych czynników ryzyka może przyczynić się do ograniczenia częstości występowania tego prob-lemu w życiu dorosłym.
Ocena częstości występowania i czynników ryzyka bólów okolicy L-S u na-stolatków w wieku 11-14 lat w zależności od uwarunkowań środowiskowych, stylu życia oraz czynników psychicznych.
Na podstawie ankiety własnej oraz Kwestionariusza Mocnych Stron i Trudności Goodmana przeprowadzonych wśród 207 dzieci w wieku 11-14 lat z powiatów rzeszowskiego i strzyżowskiego poszukiwano związku występowania bólu okolicy L-S ze statusem ekonomicznym rodziny, sposobem przemieszczania się do szkoły, ciężarem teczki szkolnej, obciążeniami pracą fizyczną po szkole, formami spędzania czasu wolnego, pozio-mem codziennej aktywności fizycznej oraz stanem psychicznym badanych.
Bóle okolicy L-S zgłosiło 32, 9% uczniów. Występowały one bez związku z płcią, poziomem zamożności rodziny czy sposobem przemieszczania się do szkoły. Prze-ważały u dzieci z rejonów wiejskich wykonujących prace fizyczne po szkole. Istotny zwią-zek z bólami kręgosłupa L-S w tym wieku ma nadmierny ciężar teczki szkolnej, siedzący tryb życia, intensywne uprawianie sportu, a także trudnościami psychicznymi: zaburzenia emocji, zachowania, trudności w komunikacji z rówieśnikami oraz nadaktywność i zaburze-nia koncentracji uwagi.
Wśród czynników ryzyka bólów okolicy L-S w wieku młodzieńczym domi-nuje zarówno statyczne jak i dynamiczne przeciążenie kręgosłupa, dolegliwości częściej występują u dzieci z problemami psychicznymi.
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