Efficacy of neuromuscular electrical stimulation and interrupted serial casting in children with spastic diplegia.

Objectives: This research was aimed at comparing the effects of neuromuscular electrical stimulation (NMES) combined with interrupted serial casting (SC) versus SC alone on various aspects of lower limb function in children with diplegic cerebral palsy. SC is a clinical technique used to increase passive range of motion (ROM), decrease hypertonicity, and improve walking in children with cerebral palsy (CP). Methods: This randomized comparative trial involved 33 children with diplegic CP, who were randomly assigned to group A or group B at recruitment. Group A received SC along with a customized physical therapy program, whereas group B received the same interventions as group A along with NMES applied through cast windows during casting. Evaluations were based on ROM, the Modified Tardieu Scale, handheld dynamometer measurements, and the Observational Gait Scale. Assessments were conducted before and after 8 weeks of intervention. Results: Both groups exhibited significant improvements in dorsiflexion ROM, popliteal angle, gastrocnemius dynamic spasticity, and hamstring dynamic spasticity after the intervention (P = 0.0001 for all). However, significant differences (P < 0.05) in dorsiflexor strength, knee extensor strength, and observational gait scale score were observed between groups after the intervention, favoring group B. Conclusions: The use of NMES during SC may help overcome the substantial decrease in strength resulting from casting, thus achieving less reduction of tone, improving ROM without significantly decreasing strength, and attaining greater improvements in gait function.

Correlation between scapular alignment and upper extremity function in children with hemiparetic cerebral palsy.

OBJECTIVES: To investigate the relationship between scapular alignment and upper extremity function. METHODS: Eighty-five children (63 boys and 22 girls) with spastic hemiplegic cerebral palsy aged 3 to 6 years were included in the study. Scapular upward rotation was assessed using Postural Zone software, and upper extremity function was assessed using the Pediatric Arm Function Test. RESULTS: There was a significant difference (p = .0001) in the degree of upward scapular rotation between less affected and affected sides (-41.78 ± 4.87 and -26.42 ± 6.34, respectively). There was a significant difference (p = .0001) between the function of the upper extremity of the affected side and the less affected sides (48.15 ± 14.37, 62.1 ± 6.62, respectively). Pearson Correlation Coefficient (r) was calculated, and there was a strong negative significant correlation between the degree of scapular upward rotation of the affected side, a unilateral score of the affected side, and the total score of the Pediatric Arm Function Test (r = -0.976, p = .0001 and r = -0.973, p = .0001, respectively). The correlation between symmetry index and total score of the Pediatric Arm Function Test was a strong positive significant correlation (r = 0.946, p = .0001). CONCLUSION: The degree of upward scapular rotation was less on the affected side. Scapular alignment and symmetry may contribute to upper extremity function in children with hemiplegic cerebral palsy. Clinically, correction of scapular deviations may be considered in the rehabilitation program for children with hemiplegic cerebral palsy. This study suggests further experimental studies to find the cause and effect.

Role of EFNA1 SNP (rs12904) in Tumorigenesis and Metastasis of Colorectal Cancer: A Bioinformatic Analysis and HRM SNP Genotyping Verification.

OBJECTIVE: Colorectal cancer is a prevalent disease with a poor prognosis and is known as a heterogeneous disease with many differences in clinical Symptoms and molecular profiles. The present study aimed to systematically evaluate the association of SNPs in miRNA binding sites of target genes that are involved in CRC angiogenesis, epithelial to mesenchymal transition, and cytoskeleton organization with tumorigenesis and metastasis of CRC. METHODS: A case-control study was performed on 146 samples of CRC patients and 132 healthy samples. After that, the DNA of all samples was isolated by the salting-out method. Finally, the genotypes for EFNA1 SNP (rs12904) were identified by HRM (High-resolution melting analysis) method. In order to evaluate the results of genotyping, two samples from each genotype were sequenced using the sanger sequencing method. RESULT: The frequency of AA genotype and the frequency of GG for rs12904 in satge4 and other stages are different from each other (P-value <0.0001) (P-value = 0.008). Also, the frequency of AA genotype in patients with different grades is different from each other (P-value = 0.035), while the frequency of AG   genotype and the frequency of GG   genotype is not significantly different in patients with different grades (P-value = 0.377) (P-value = 0.284). CONCLUSION: Results of this study indicated that patients carrying the GA and GG genotypes reduced the risk of disease progression compared to the AA genotype. As a result, this polymorphism plays a key role in CRC pathogenesis and metastasis and could be used as a biomarker in molecular diagnosis and metastatic state prediction in the near future after further study of its signaling pathways and molecular mechanism.

Mechanical vestibular stimulation versus traditional balance exercises in children with Down syndrome.

Background: regaining balance control is the key to decrease risk of falls in children with Down syndrome. Objectives: To compare between the effect of mechanical vestibular stimulation and balance exercises on balance in children with Down syndrome. Methods: Thirty children participated in the study. They were divided randomly and equally into; group A and group B, both groups received the designed program with regular balance exercises for group A and mechanical vestibular stimulation for group B, treatment was conducted for one hour 3 times per week for 3 successive months. Balance as stability indexes (regarding anteroposterior, mediolateral and over all stability indexes) was evaluated before and after treatment by Biodex balance system. Results: T-test was conducted to compare the mean values of stability indexes between groups. Non-significant difference between groups was recorded before treatment (p value > 0.05), while improvement was recorded when comparing post and pretreatment results for both groups (p > 0.0001). More significant improvement was recorded for group B when comparing the post treatment results with group A (p > 0.05). Conclusion: Mechanical vestibular stimulation is better added to the rehabilitation program to improve balance in children with Down syndrome.

Stem Cell Aging in Lifespan and Disease: A State-of-the-Art Review.

Aging is considered as inevitable changes at different levels of genome, cell, and organism. From the accumulation of DNA damages to imperfect protein homeostasis, altered cellular communication and exhaustion of stem cells, aging is a major risk factor for many prevalent diseases, such as cancer, cardiovascular disease, pulmonary disease, diabetes, and neurological disorders. The cells are dynamic systems, which, through a cycle of processes such as replication, growth, and death, could replenish the bodies' organs and tissues, keeping an entire organism in optimal working order. In many different tissues, adult stem cells are behind these processes, replenishing dying cells to maintain normal tissue function and regenerating injured tissues. Therefore, adult stem cells play a vital role in preventing the aging of organs and tissues, and can delay aging. However, during aging, these cells also undergo some detrimental changes such as alterations in the microenvironment, a decline in the regenerative capacity, and loss of function. This review aimed to discuss age-related changes of stem cells in different tissues and cells, including skin, muscles, brain, heart, hair follicles, liver, and lung.

The effect of incentive spirometer training on oromotor and pulmonary functions in children with Down's syndrome.

OBJECTIVES: This study investigated the effect of incentive spirometry training on oromotor and pulmonary functions in children with Down's syndrome. METHODS: Thirty-four children with Down's syndrome were randomly divided into two groups; the children were of both sexes and aged between 6 and 12 years. Group A received only oromotor exercises, while Group B received oromotor exercises and incentive spirometry training. The pulmonary function test was performed using computerized spirometry model master screen that assessed pulmonary functions (peak expiratory flow, forced vital capacity, and forced expiratory volume in 1s), while the orofacial myofunctional evaluation with score (OMES) was used to evaluate oromotor function before and after treatment. RESULTS: The post treatment results showed significant difference in oromotor and pulmonary functions within both groups, but no significant differences were found between the two groups. CONCLUSIONS: Oromotor exercises are more effective than incentive spirometry training in improving both pulmonary and oromotor functions in children with Down's syndrome.