Assessment of Five-Foot Plantar Morphological Pressure Points of Children with Cerebral Palsy Using or Not Dynamic Ankle Foot Orthosis.

People with spastic cerebral palsy (CP) often experience a decline in gait function and flexion. The children's posture and hip strategy, which leads to knee flexion, predisposes these children to increased contact area in the medial foot region. This study investigated the use of DAFO (dynamic ankle-foot orthosis) prescribed to patients with cerebral palsy (CP) to determine the plantar pressure distribution with orthosis use. Eight children with spastic CP (age 4-12 years) were classified as Gross Motor Function Classification System (GMFCS) levels I-II with a maximum spasticity level of 3 in their ankle muscles according to the Modified Ashworth Scale. We assessed the plantar distribution by using eight WalkinSense sensors in each trial and exported data from the proprietary software (WalkinSense version 0.96, Tomorrow Options Microelectronics, S.A.). The plantar pressure distribution was conducted under two conditions: only shoes and DAFO with shoes. The activation percentages for sensor number 1 under the 1st metatarsal and sensor number 4 under the lateral edge of the heel were significantly different under the DAFO condition. The 1-point sensor activation percentage significantly decreased, while the 4-point sensor activation percentage increased during DAFO walking. According to our study findings, there was an increase in pressure distribution in the lateral part of the foot during the stance phase in DAFO. DAFO improved the gait cycle and influenced the plantar foot pressure in children with mild cerebral palsy.

Paediatric flat foot and foot dimension in Central Anatolia.

BACKGROUND: Information on the foot structures of Central Anatolian children is limited. Foot structures of children aged 6-10 years were shown to be different according to sex and increasing age. OBJECTIVE: This study aimed to compare the foot anthropometric values by age and sex and collect the foot anthropometric data to reveal the relationship between pes planus and pes cavus in the arches of children according to age. METHODS: Footprints of 335 children (180 boys and 155 girls) aged 6-10 years were taken by the pedigraph method and evaluated using 18 different parameters. The TFL (Truncated foot length), FL (foot length), Arch Index, Chippaux Smirak Index, Staheli Arc Index, and foot rotation values of the children were examined. To examine the relationship between the parameters, normality values were examined. Independent samples t-test was used to analyze sex differences in terms of foot size and shape. RESULTS: Correlations between other parameters were determined using the correlations analysis method. TFL, metatarsal circumference, and FL were strongly correlated with age in the children. Foot rotation increased with body mass index in the girls compared to that in the boys. According to the evaluation results with the classification made with the Staheli arch index, 63.3% pes planus, 9.8% pes cavus and 27.7% of the normal arch structure were identified. CONCLUSIONS: Planning shoe production accordingly will contribute to the development of healthy feet in children. This article focused on foot structures of in Central Anatolia and to identify early foot deformities in children. This study found that the length of the TFL was smaller in boys than in girls.

Cadmium Stress Reprograms ROS/RNS Homeostasis in Phytophthora infestans (Mont.) de Bary.

Heavy metal pollution causes many soils to become a toxic environment not only for plants, but also microorganisms; however, little is known how heavy metal contaminated environment affects metabolism of phytopathogens and their capability of infecting host plants. In this study the oomycete Phytophthora infestans (Mont.) de Bary, the most harmful pathogen of potato, growing under moderate cadmium stress (Cd, 5 mg/L) showed nitro-oxidative imbalance associated with an enhanced antioxidant response. Cadmium notably elevated the level of nitric oxide, superoxide and peroxynitrite that stimulated nitrative modifications within the RNA and DNA pools in the phytopathogen structures. In contrast, the protein pool undergoing nitration was diminished confirming that protein tyrosine nitration is a flexible element of the oomycete adaptive strategy to heavy metal stress. Finally, to verify whether Cd is able to modify P. infestans pathogenicity, a disease index and molecular assessment of disease progress were analysed indicating that Cd stress enhanced aggressiveness of vr P. infestans towards various potato cultivars. Taken together, Cd not only affected hyphal growth rate and caused biochemical changes in P. infestans structures, but accelerated the pathogenicity as well. The nitro-oxidative homeostasis imbalance underlies the phytopathogen adaptive strategy and survival in the heavy metal contaminated environment.

Effects of heel height with backpack loading in young people.

BACKGROUND: There are many intrinsic and extrinsic factors that could affect posture. Two of them are backpack and heel height. The aim of this study is to investigate the immediate static effects on cervical and lumbosacral postural changes to determine the effects of heel and forefoot heights with backpack loading on both vertebral curves and posture. METHODS: Craniovertebral (CVA), pelvic tilt (APT), and ankle joint motion angles were measured from sagittal photographs of 20 university students in a static posture while carrying backpacks. The same measurements were taken and recorded conventional shoes with heel and forefoot heights. Postural analysis software (PAS/SAPO) was used to conduct angle assessments of the photos. RESULTS: Postural angles of the vertebral column on the cervical and lumbosacral regions are changed immediately up to the posterior thoracic load with backpacks in young people. CVA was an average of 52° only shoes and no load condition, while the angle was reduced to 49° with loading. In contrast, an increasing angle with additional heel height and zero heel height in conventional shoes were reported. CVA increased with heights to 53° for the heel and 55° at the forefoot. The average APT angle was 14° only shoes and no load condition, and this angle increased to 18.9° with the 20% BW load. Accordingly for the no load and load conditions, the significant increase in the APT angle was 21° with the 20% BW load with heel height and 23° for the 20% BW load along with forefoot height. The heights provided negative effects on the vertebral posture and ankle angle. CONCLUSIONS: The results of the study indicate that it may not be advisable for young people to wear shoes with high heels and negative heel height by taking into account the risk factors in the body and ankle postural compensation while carrying a backpack.

The relationship between the Trendelenburg position and cerebral hypoxia inpatients who have undergone robot-assisted hysterectomy and prostatectomy

Background/aim: This study aimed to evaluate the relationship between the Trendelenburg position and cerebral hypoxia in robot-assisted hysterectomy and prostatectomy.Materials and methods: A standardized mini-mental state examination was administered to 50 patients enrolled in the study 1 h before and after surgery. Near infrared spectroscopy (NIRS) values and hemodynamic and respiratory parameters were recorded after induction of anesthesia (baseline) and once every 20 min in the Trendelenburg position and supine positions. The relationship between the development of cerebral desaturation and the patient's position was examined. Results: For all patients, the baseline mean cerebral oxygen saturation (RSO2) on the right and left were 70.5 ± 7.3% and 70.6 ± 6.7%, respectively. Right RSO2 values at 20 min and 60 min in the Trendelenburg position decreased significantly, but they increased at 120 min. A significant positive correlation was found between right RSO2 and EtCO2 in the supine period following surgery, and between left RSO2 and EtCO2 at 60 min in the Trendelenburg and supine positions. The relationship between NIRS values and cognitive dysfunction was not significant.Conclusion: We found that cerebral saturation decreases as age increases, and cerebral desaturation may occur owing to the Trendelenburg position. There was no correlation between patients? cognitive function and NIRS values.