Skin temperature measurement in individuals with spinal cord injury during and after exercise: Systematic review.

BACKGROUND: Athletes with spinal cord injury (SCI) have difficulties in maintaining thermal homeostasis during exercise due to their lower sweat capacity and skin vasodilation. Skin temperature (Tsk) assessment, as opposed to core temperature, has become more widely accepted due to its non-invasive nature. The aims of this systematic review was to collate research studies that measured Tsk of individuals with SCI during or after exercise, study their Tsk response, taking into account the method employed, the environmental and exercise conditions, and to identify the different cooling strategies and their effect during exercise. METHODS: Pubmed, Web of Science and Scopus databases were searched to identify the articles published since year 2000. Two reviewers working independently extracted data and assessed the quality of the articles included. If they disagreed, a third reviewer was consulted. ROBINS-I scale was used to assess the quality of the articles, and the review has been conducted in agreement with PRISMA guidelines. RESULTS: Twenty studies were included in this review. 84% of them presented moderate, serious or critical risk of bias. The entire of the studies assessed Tsk during exercise, but only seven studies measured it during rest or after exercise. Eighteen studies used contact thermometry to assess Tsk and the two remaining studies employed non-contact techniques. Seven studies were conducted in warm conditions (>31.5°C) and the remaining studies in moderate conditions (10°C to 26.6°C). According to cooling strategies, ice vests and water spray are effective in reducing Tsk and decreasing the risk of heat stroke. CONCLUSIONS: The 90% of the studies applied contact thermometry and due to their effect in the data assessed, it is necessary more research into the SCI population using infrared thermography due to its differences in characteristics, methodology, and applications. The methodological differences among studies make difficult to perform a meta-analysis.

Tratamiento combinado aplicado en parálisis cerebral infantil: presentación de un caso / Combined treatment applied in cerebral palsy: case report

Introducción. Es importante determinar una fisioterapia adecuada para las personas que presentan discapacidad de por vida, como es el caso de la parálisis cerebral (PC). El objetivo fue estudiar el efecto de la aplicación de terapia física combinada en las habilidades motoras gruesas. Descripción del caso. Se describe el caso clínico de una niña de 12 años diagnosticada de tetraparesia espástica tras PC y con déficit en las funciones cognitivas. Intervención. Durante 35 semanas se aplicó terapia física combinada que incluyó estiramientos, entrenamiento de la fuerza, equilibrio, trabajo de marcha en suspensión parcial y terapia miofascial. La evaluación se ha llevado a cabo al inicio y al final del tratamiento con el Gross Motor Function Measure (GMFM).Resultados y discusión: Se han observado mejorías clínicas en las dimensiones evaluadas con el GMFM. En el caso de la ‘bipedestación’ (de 17,95 por ciento al inicio a28,21 por ciento al final) y en la dimensión ‘caminar,correr y saltar’ (de 5,56 por ciento al inicio a 19,44 por ciento al final). Si bien las técnicas fisioterápicas utilizadas han demostrado ser útiles aplicadas de forma aislada, hemos observado que su uso combinado mejora la función motora gruesa en el caso presentado.

Background and Purpose. For people suffering from a lifelong disability such as cerebral palsy (CP), establishing an appropriate physiotherapy treatment is of great concern. The aim was to study the effect on gross motor skills of the application of a combined physical therapy. Case description. A case report of a 12-year-old female patient with a diagnosis of spastic tetraparesis after CP, who also showed a cognitive function disorder, is reported. Intervention. A combined physical therapy treatment was applied during 35 weeks. The protocol consisted of stretching, training of muscle resistance, balance, reeducation of gait in partial suspensión and myofascial therapy. Baseline and postintervention assessments were carried out by means of the Gross Motor Function Measure (GMFM). Results and discussion: A clinical improvement was observed in those dimensions of the GMFM which were lower rated at baseline. The dimension ‘standing’ (from 17,95 percent pre-intervention to 28,21 percent post-intervention) and the dimension ‘walking, running and jumping’ (from 5,56 percent pre-intervention to 19,44 percent postintervention). Though the proposed physiotherapy techniques have been shown to be useful separately, when combined, it was observed that the gross motor function clinically improved in our patient.