The effects of a physiotherapeutic programme on bone mineral density, in individuals of postpuberty age (18--30 years), with cerebral palsy.

Celebral palsy (CP), unlike many other neurodevelopmental disorders, is associated with abnormalities of pregnancy and birth, particularly "birth asphyxia" and low birthweight. The aim of this research was to define and evaluate the degree up to which the physiotherapeutic treatment after puberty, when the musculoskeletal system is almost developed, can have a positive influence on bone mineral density (BMD). In the research 26 individuals having different forms of CP, 13 males and 13 females, participated. The percentage according to the form of the disease gender was tetraplegic 50% women, average age 25.4 years, diplegic 26.9% and 6 women, average age 27.2 years, hemiplegic 23.1% individuals), 3 men and 3 women, average age 27.2 years. Before the measurements there were clinical tests and EEG's. The program was conducted 3 times per week for twenty six (26) weeks and included energetic, energopathetic and energetic with resistance exercises. Each session consisted of a one-on-one program of exercise with the upper, lower extremities and lumbar region. Dual energy X-ray absorptiometry (DEXA) was used to assess bone mineral density (BMD) of the lumbar spine and femoral neck. To minimize operator-related variability, all scans were performed and analyzed by the same trained technologist. For the control of the statistical importance of the value changes the ANOVA test was used from the statistical package SPSS. After intervention, the physiotherapy group had a significantly greater increase in bone mineral density in femoral neck, compared with control subjects, but not in the lumbar region (L2-L4), where the physiotherapy program was not intense. The results of this investigation show that a 6-month physiotherapeutic program enhances bone mineral density in individuals with cerebral palsy. This supports the concept that a minimal period of exercise is successful in eliciting an osteogenic response in these groups. The therapeutic goal of physiotherapists and orthopaedics is to promote exercise, especially weight-bearing activity, to decrease fragility and susceptibility to fractures in patients with decreased activity.

The role of rehabilitation in the treatment of balance disorders.

The vestibular system registers changes in head position, gravity, vibration, acceleration and deceleration. This information is then transmitted to the central nervous system, where additional information from the visual and auditory systems, muscles, tendons, joints and skin, serve to regulate and maintain the equilibrium and orientation of the system. Vision plays the most obvious part in continual monitoring of the environment. Distances, speeds of linear and angular movement, and changes of direction, can all be estimated with experience and be integrated in the central nervous system with those received by other sensory systems. Light touch and pressure receptors in the skin detect bodily contact with the environment and are an essential source of data in walking, cycling, motoring, flying and other activities. Proprioception provides data regarding the instantaneous mechanical disposition of the musculoskeletal system as it relates to the force of gravity acting upon it. The functional recovery that occurs after unilateral vestibular lesions is referred to as "vestibular compensation" and consists of all the processes of neurological reorganization that allow recovering balance after a unilateral vestibular lesion. Exercises are particularly useful in helping patients to overcome disturbances, associated with balance disorders. The purpose of these selected exercises is to build up a tolerance mechanism in the brain, which will compensate for the unequal balance of the two ears.

Atrial natriuretic factor responses to submaximal and maximal exercise.

The aim of this study was to evaluate and compare the plasma concentration of atrial natriuretic factor (ANF), K+, Na+, blood lactate, heart rate, and blood pressure in moderately trained women. Ten healthy women were studied on a cycle ergometer during 20 min of constant submaximal and maximal exercise, as well as during recovery. The ANF concentration was determined by radioimmunoassay. The results show that, except for Na+, all the other variables increased significantly with an increase in the duration and intensity of the exercise (P < 0.05, P < 0.001). In recovery, the values fell (P < 0.01, P < 0.001). Submaximal and maximal exercise both cause increases in ANF and this increase is due to the duration and intensity of exercise. However, maximal exercise, rather than submaximal exercise, is the major stimulus for the concentration of plasma ANF. ANF concentration may be a useful test for evaluating the releasing function of ANF in the heart.

Knowledge of and attitudes towards children with special needs by selected groups.

To explore knowledge of and attitudes about children who have special needs, a questionnaire was submitted to 1145 persons (305 lyceum students, 94 teachers of secondary education, 247 medical students, 354 physical education students, and 145 persons having an exceptional child in their families). Questions concerned the knowledge of categories of children with special needs, acceptance of them in regular classrooms, and willingness to work with them. Analysis showed that most people including teachers had limited awareness of exceptional children, their problems, education, and integration. They showed partial acceptance of mainstreaming and desire to work with such children. Careful education for all, especially teachers, seems advisable.