Comparison of the efficacy of two interventions in ameliorating abdominal thickness and sitting function in children with diplegia.

Objective/Background: The abdominal muscles are extremely important in stabilizing the trunk and maximizing postural stability. The presence of apparent stiffness in children with spastic diplegia is associated with unsteadiness, impaired walking, and pelvic malrotation. The aim of this study was to compare the efficacy of hippotherapy and whole-body vibration in ameliorating abdominal muscle thickness and sitting function in children with diplegia. Methods: A total of 60 children with spastic diplegia were selected from the Faculty of Physical Therapy's outpatient clinic, Cairo University, and randomly allocated into two groups. Group A received conventional physical therapy for 1 h in addition to whole-body vibration, whereas group B received hippotherapy for 40 min. The same designed physical therapy program was administered for 12 weeks, three times per week, in both groups. Ultrasonography was used to measure abdominal thickness, and Gross Motor Function Measurement-88 was used to measure functional ability. Results: A significant improvement in abdominal muscle thickness and sitting function (p < 0.05) was observed in both groups, and greater improvements were observed in group B. Conclusion: Whole-body vibration and hippotherapy training may be recommended to facilitate sitting function and ameliorate abdominal thickness in children with diplegia. Hippotherapy is more effective than whole-body vibration in improving sitting function and abdominal muscle thickness.

The effect of two therapeutic interventions on balance in children with spastic cerebral palsy: A comparative study.

OBJECTIVES: Postural control involves controlling the position of the body in space to achieve stability and orientation. Core stability is needed to improve balance and postural control. Whole-body vibration is a unique strategy for muscle strengthening in various clinical situations. This study compared the effects of whole-body vibration and a core stability program on balance in children with spastic cerebral palsy, with an intervention period of 12 weeks. METHODS: A total of 72 children with spastic cerebral palsy (hemiplegic and diplegic), of both sexes (age, 5-8 years), were selected from the outpatient clinic of the Faculty of Physical Therapy, Cairo University. The children were randomly assigned to 2 groups. Group A underwent a core stability program for 30 min and group B underwent whole-body vibration training for 10 min, at 3 times a week for 12 weeks for both groups. Balance was assessed using the Biodex Balance System. RESULTS: A significant improvement in all variables (p < 0.05) was observed in each group, with greater improvement of all stability indices (anteroposterior, mediolateral, and overall) in group B. There were non-significant differences in all stability indices between hemiplegic and diplegic children (p > 0.05). CONCLUSION: Whole-body vibration and core stability exercises are recommended for the treatment of children with spastic cerebral palsy. Whole-body vibration was more effective than the core stability program in improving balance in children with spastic cerebral palsy.

Case report: Bilateral renal artery stenosis in a 7-year-old child.

We present a 7-year-old child with uncontrolled hypertension caused by bilateral renal artery stenosis. He underwent renal angioplasty on both sides. While the right side showed successful dilatation, the left side was unsuccessful, leaving a near total occlusion. Due to the lack of satisfactory control of his blood pressure, he was scheduled for an iliorenal bypass. Following surgery, all antihypertensive medications were withdrawn. Computed tomography angiography performed 18 months after surgery showed patent angioplasty on the right side and patent bypass on the left side. Both endovascular and open surgical treatments are feasible options with good results in this age group.

Role of clevidipine butyrate in the treatment of acute hypertension in the critical care setting: a review.

Acutely elevated blood pressure in the critical care setting is associated with a higher risk of acute end-organ damage (eg, myocardial ischemia, stroke, and renal failure) and perioperative bleeding. Urgent treatment and careful blood pressure control are crucial to prevent significant morbidity. Clevidipine butyrate (Cleviprex) is an ultrashort-acting, third-generation intravenous calcium channel blocker. It is an arterial-selective vasodilator with no venodilatory or myocardial depressive effects. Clevidipine has an extremely short half-life of approximately 1 minute as it is rapidly metabolized by blood and tissue esterases. These metabolites are then primarily eliminated through urine and fecal pathways. The rapid onset and the short duration of action permit tighter and closer adjustment of the blood pressure than is possible with other intravenous agents.