The Relationship Between Body Composition and Muscle Tone in Children with Cerebral Palsy: A Case-Control Study.

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 (n = 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, p < 0.001), muscle mass (MM kg = 18.6 vs. 22.6, p < 0.001), body cell mass (BCM kg = 15.1 vs. 18.3, p < 0.001), and total body water (TBW L = 23.0 vs. 26.7, p < 0.001). The same differences in body composition were identified with respect to gender (p < 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 (p < 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.

Burnout syndrome in physiotherapists working in the Podkarpackie province in Poland.

BACKGROUND: 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. OBJECTIVE: 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. MATERIAL AND METHODS: Eighty-six professionally active full-time physiotherapists participated in the study. Maslach Burnout Inventory (MBI) was used to measure burnout. RESULTS: 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. CONCLUSION: 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.

Multi-profile procedures for motor conversion disorders in children - a case report. / Wieloprofilowe postepowanie w konwersyjnych zaburzeniach ruchu u dzieci ­ opis przypadku.

OBJECTIVES: 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. METHODS: 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. RESULTS: After a three-week period of comprehensive treatment the patient recovered completely and returned to independent mobility and social functioning relative to his age. CONCLUSIONS: 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.

The Importance of the Double Product in the Six-Minute Walk Test to Predict Myocardial Function.

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.