ABSTRACT
Background: Young children with spinal muscular atrophy type 1 (SMA1) have limited independent mobility and participation that may lead to cognitive development delays. Implementing early powered mobility in interventions may help them to learn self-initiated movement, play, and having fun to participate in natural settings. The aim of this study is to evaluate the effectiveness of an early power mobility intervention for increasing participation, functional ability, and quality of life in young children with SMA1. Methods: AMEsobreRuedas is a randomized waiting list controlled clinical trial. A sample of 24 children (10 months-5 years old, with SMA1) will be randomly allocated to two groups. The experimental group will perform a family-centered intervention with powered mobility for 16 weeks in their natural environment: a 12-week-structured program three times a week; and a 4-week follow-up with free use of the powered mobility device. The control group (waiting list) will keep their routine and will receive the same intervention after the experimental group. Five assessments will be carried out at baseline and weeks 4, 8, 12, and 16. Primary outcomes are participation (YC-PEM); functional ability (PEDI-CAT); and quality of life (PedsQL-Neuromuscular module). Results: It is expected that this study will provide further knowledge about the positive impact of powered mobility for the analyzed variables. Moreover, family engagement in the intervention and establishment of functional goals may help to add valuable information about real needs in future research. Conclusions: Early powered mobility could increase the opportunities for children with SMA1 to learn to move independently and participate in their natural environment.
ABSTRACT
Santa Lucía peloid is a sediment used in pelotherapy in Cuban primary health care services. Therefore, in addition to physicochemical regulated parameters, other analyses are required to complement their physicochemical characterization and understand potential element mobility, radiological risk, and toxicity as well as likely bioactive compounds present in Santa Lucía peloid. For these purposes, inorganic and organic elements and compounds were considered to evaluate Santa Lucía peloid's quality. This was accomplished through an integral approach that included (1) determination of physicochemical parameters (pH, electrical conductivity, oxidation-reduction potential, temperature, dissolved oxygen, elemental C, H, and N analyses, organic matter, and hexane removable substances content); (2) determination of total concentration of elements with biological and toxicological importance (i.e., Na, K, Ca, Mg, Fe, Mn, Cr, Cu, Ni, Pb, and Zn), as well as their distribution in operationally defined solid phases, mineralogy, particle size distribution, and total content of radionuclides and radiological dose calculations; and (3) its organic characterization. Results from this study showed that Santa Lucía peloid was non-contaminated and showed low metal mobility and acceptable radiological dose levels, being safe for therapeutic uses. Additionally, these results contribute to the understanding of the organic composition of peloides, provide strong evidences to scientifically explain the therapeutic action of peloids in the treatment of inflammatory diseases, and set a new frame to improve peloid guidelines in Cuba and other countries.