Ultrasound reference values for the calcaneus of children and adolescents at moderate altitudes in Peru

Abstract Objective: a) Establish reference values for bone parameters by using the speed of sound (SOS, m/s) of broadband ultrasound attenuation (BUA, dB/MHz) and establish a bone quality index (BQI = αSOS + βBUA) for children and adolescents living in a region of moderate altitude, b) compare bone parameters with an international standard (with different ethnic, socio-economic, and lifestyle backgrounds) by using ultrasound of the calcaneus (heel bone) (QUS). Methods: A descriptive cross-sectional study was carried out with children and adolescents between the ages of 6.0 and 16.9 years old. The sample was selected randomly. A total of 1322 subjects were studied. Weight, height, and bone parameters, using ultrasound of the calcaneus, were evaluated SOS, BUA, and BQI. Body Mass Index BMI was calculated. Results: The average age of males was 11.44 ± 0.35 years old, and for females, it was 11.43 ± 0.35 years old. The students in this research showed slightly higher values of SOS, BUA, and BQI for both sexes when compared with the international reference (the 50th percentile). Percentiles were generated (P3, P10, P25, P50, P75, P90, and P97) using the LMS method [median (M), standard deviation (S), and power of the Box-Cox transformation (L)] by age and sex. Conclusion: The students living at a moderate altitude showed slightly higher values in bone parameters in relation to the international reference. This pattern depicted a population with a better state of bone health. The proposed percentiles may be used to categorize adequate to at risk bone parameters based on age and sex.

Effect Of An Equine Therapy Program On Psychomotor Development In Children Belonging To The School Integration Program

Background: A large number of children with disabilities exist, who have special educational needs and a delay in psychomotor development; they are frequently incorporated into student integration programs (SIP), forming part of the regular class and receiving complimentary technical and educational assistance. The health system has historically handled these cases through traditional physical therapy; however, currently, other complementary treatment techniques have arisen that produce benefits in the physical, psychological, cognitive, and social aspects of the child. This study aimed to evaluate the impact of an Equine therapy program on the psychomotor development of SIP students. Methods: A quantitative study with a quasi-experimental design and convenience sampling was conducted. Eighteen students (ten men and eight women) from SIP were obtained to establish a control group (N=9) and an experimental group (N=9). The intervention consisted of an 18-weeks program of equine therapy with two sessions each week. Psychomotor development was assessed before and after the intervention with the “Test de Desarrollo y Aprendizaje” (TADI). Results: There was a significant improvement in psychomotor development (p<0,001) and in the cognitive and motor skills at the end of the intervention (p<0,05), the effect size obtained in the psychomotor development construct and the cognition and motor skills indicators were large (d> 0,8). Conclusion: Statistically significant changes were found in the experimental group comparing the initial and final values after the intervention through many variables. It is then possible to conclude that equine therapy has a moderate to large impact on psychomotor development of SIP students, which was also statistically significant.