RESUMEN
Introduction. Cerebral palsy (CP) is caused by an injury to the developing brain, and abnormal gross motor function is a hallmark of CP. Properly structured exercises on land have been reported to be effective in improving functional performance in children with CP while only few have been documented on aquatic therapy. Objective. To investigate the effect of a 10-week aquatic exercise training program on gross motor function in children with spastic CP. Methods. Thirty participants aged 1 to 12 years were randomized into the experimental and control groups. Both groups received manual passive stretching and functional training exercises, depending on their level of motor impairment, either in water (temperature 28°C to 32°C) or on land. Each exercise training session lasted for about 1 hour 40 minutes, twice per week for 10 weeks in both groups. Measurement of gross motor function was done using Gross Motor Function Measure (GMFM-88) at baseline and after 4 weeks, 8 weeks, and 10 weeks of intervention. Both groups were compared for differences in change in gross motor function using Mann-Whitney U test. The level of significance was set at P < .05. Results. Only the experimental group showed significant improvement (P < .05) in all dimensions of gross motor function except for walking, running, and jumping (P = .112). Statistically significant difference (P < .05) was found between both groups for all dimensions of gross motor function after 10 weeks of intervention. Conclusion. Aquatic exercise training program is effective in the functional rehabilitation of children with spastic CP.
RESUMEN
A 31-year-old woman presented with persistent left leg pain 3 weeks after revision lumbar surgery. She had numbness of the leg immediately after surgery, followed by intense, spasmodic pain 4 days later, which was managed with analgesia. Subsequent computed tomographic angiography demonstrated occlusion of the left common iliac artery. This had been missed by her spinal surgeon and by physicians in our emergency department in 2 separate visits. Vascular complications of anterior spinal surgery can be limb- or life-threatening. A high index of suspicion is necessary.
Asunto(s)
Arteria Ilíaca/lesiones , Dolor de la Región Lumbar/cirugía , Vértebras Lumbares/cirugía , Complicaciones Posoperatorias , Fusión Vertebral/efectos adversos , Procedimientos Quirúrgicos Vasculares/métodos , Adulto , Angiografía , Femenino , Humanos , Arteria Ilíaca/diagnóstico por imagen , Arteria Ilíaca/cirugía , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos XRESUMEN
We present a case of pulmonary cement embolism during cement augmentation of pedicle screw fixation for severe degenerative scoliosis. During intra-operative C-arm fluoroscopy, a radio-opaque substance was incidentally noted to pulsate in synchrony with the patient's heartbeat. A diagnosis of pulmonary cement embolism was made. The patient was treated with coumarin for 6 months. He made a good recovery.
