The role of Taylor Spatial Frame for the treatment of acquired and congenital tibial deformities in children.

This study evaluates the use of the Taylor Spatial Frame (TSF) for the correction of acquired and congenital tibial deformities in children. The purpose is to underline problems, obstacles and complications that can be observed during treatment to reveal the learning curve and potential risk factors and to propose solutions to avoid difficulties during its use 86 tibia deformities were corrected in 66 children during a period of 7 years and were classified according to anatomical and dominant type of deformity. Follow up was 54.2 months. Gradual correction was performed according to the individualized time schedule. We faced 42 difficulties: 29 problems, 10 obstacles and 3 complications, distributed across all years. Significant correlation was found between patient's age and number of difficulties. The incidence of the difficulties was equally spread over the different etiologies, but it was statistically significant across the years. Proximal tibia and complex multi-plane deformities seem to be related to an increased incidence of postoperative difficulties. TSF can yield accurate results, is easy to handle and provides an excellent concomitant 3-direction correction.

Improving health-related quality of life in middle-age children with cerebral palsy following selective percutaneous myofascial lengthening and functional physiotherapy.

INTRODUCTION AND OBJECTIVES: Children with cerebral palsy (CP) experience decreased health-related quality of life (HRQOL). This study aimed to assess the HRQOL of children with CP before versus after a combined program of minimally invasive selective percutaneous myofascial lengthening (SPML) and functional physiotherapy. MATERIAL AND METHODS: A single-group pre-posttest design was used. Twenty-six middle childhood children with spastic CP, aged 5-7 years, with Gross Motor Function Classification System levels II-IV underwent SPML surgery and 9 months of postoperative functional strength training therapy. The proxy version of the DISABKIDS-Smiley questionnaire was completed by one parent of each child. Dependent t-tests were used to compare mean pre- and post-measurement scores. RESULTS: After the 9-month intervention, the children with CP had significantly higher quality of life scores (mean difference, 11.06±9.05; 95% confidence interval [CI], 7.40-14.71; p<0.001). CONCLUSIONS: This study demonstrated that children with CP had better HRQOL after a combined program of minimally invasive SPML surgery and functional physiotherapy (ACTRN12618001535268).

Improving health-related quality of life in middle-age children with cerebral palsy following selective percutaneous myofascial lengthening and functional physiotherapy. / [Artículo traducido] Mejora de la calidad de vida relacionada con la salud en niños de mediana edad con parálisis cerebral después de un alargamiento miofascial percutáneo selectivo y fisioterapia funcional.

INTRODUCTION AND OBJECTIVES: Children with cerebral palsy (CP) experience decreased health-related quality of life (HRQOL). This study aimed to assess the HRQOL of children with CP before versus after a combined program of minimally invasive selective percutaneous myofascial lengthening (SPML) and functional physiotherapy. MATERIAL AND METHODS: A single-group pre-posttest design was used. Twenty-six middle childhood children with spastic CP, aged 5-7 years, with Gross Motor Function Classification System levels II-IV underwent SPML surgery and 9 months of postoperative functional strength training therapy. The proxy version of the DISABKIDS-Smiley questionnaire was completed by one parent of each child. Dependent t-tests were used to compare mean pre- and post-measurement scores. RESULTS: After the 9-month intervention, the children with CP had significantly higher quality of life scores (mean difference, 11.06 ± 9.05; 95% confidence interval [CI], 7.40-14.71; p < 0.001). CONCLUSIONS: This study demonstrated that children with CP had better HRQOL after a combined program of minimally invasive SPML surgery and functional physiotherapy (ACTRN12618001535268).

Improving health-related quality of life in middle-age children with cerebral palsy following selective percutaneous myofascial lengthening and functional physiotherapy / Mejora de la calidad de vida relacionada con la salud en niños de mediana edad con parálisis cerebral después de un alargamiento miofascial percutáneo selectivo y fisioterapia funcional

Introduction and objectives: Children with cerebral palsy (CP) experience decreased health-related quality of life (HRQOL). This study aimed to assess the HRQOL of children with CP before versus after a combined program of minimally invasive selective percutaneous myofascial lengthening (SPML) and functional physiotherapy. Material and methods: A single-group pre–posttest design was used. Twenty-six middle childhood children with spastic CP, aged 5–7 years, with Gross Motor Function Classification System levels II–IV underwent SPML surgery and 9 months of postoperative functional strength training therapy. The proxy version of the DISABKIDS-Smiley questionnaire was completed by one parent of each child. Dependent t-tests were used to compare mean pre- and post-measurement scores. Results: After the 9-month intervention, the children with CP had significantly higher quality of life scores (mean difference, 11.06±9.05; 95% confidence interval [CI], 7.40–14.71; p<0.001). Conclusions: This study demonstrated that children with CP had better HRQOL after a combined program of minimally invasive SPML surgery and functional physiotherapy (ACTRN12618001535268).(AU)

Introducción y objetivos: Los niños con parálisis cerebral (PC) experimentan una disminución de la calidad de vida relacionada con la salud (CVRS). El objetivo de este estudio fue evaluar la CVRS de niños con PC antes y después de un programa combinado de alargamiento miofascial percutáneo selectivo (SPML) y fisioterapia funcional. Material y métodos: Se utilizó un diseño de un solo grupo con pretest y postest. Veintiséis niños de mediana edad (5 a 7 años) con PC espástica, niveles II-IV del sistema de la clasificación de la función motora gruesa se sometieron a cirugía SPML y fisioterapia de funcional posquirúrgica durante 9 meses. La versión proxy del cuestionario DISABKIDS-Smiley fue completada por uno de los padres de cada niño. Se realizaron pruebas t dependientes para comparar las puntuaciones medias previas y posteriores a la medición. Resultados: Después de 9 meses de intervención, los niños con PC tenían puntuaciones de calidad de vida significativamente más altas desde el punto de vista estadístico (diferencia de medias: 11,06±9,05; intervalo de confianza del 95%: 7,40-14,71; p <0,001). Conclusión: Este estudio demostró que los niños con PC presentaron una mejor CVRS después de un programa combinado de cirugía SPML y fisioterapia funcional.(AU)

[Artículo traducido] Mejora de la calidad de vida relacionada con la salud en niños de mediana edad con parálisis cerebral después de un alargamiento miofascial percutáneo selectivo y fisioterapia funcional / Improving health-related quality of life in middle-age children with cerebral palsy following selective percutaneous myofascial lengthening and functional physiotherapy

Introduction and objectives: Children with cerebral palsy (CP) experience decreased health-related quality of life (HRQOL). This study aimed to assess the HRQOL of children with CP before versus after a combined program of minimally invasive selective percutaneous myofascial lengthening (SPML) and functional physiotherapy. Material and methods: A single-group pre–posttest design was used. Twenty-six middle childhood children with spastic CP, aged 5–7 years, with Gross Motor Function Classification System levels II–IV underwent SPML surgery and 9 months of postoperative functional strength training therapy. The proxy version of the DISABKIDS-Smiley questionnaire was completed by one parent of each child. Dependent t-tests were used to compare mean pre- and post-measurement scores. Results: After the 9-month intervention, the children with CP had significantly higher quality of life scores (mean difference, 11.06±9.05; 95% confidence interval [CI], 7.40–14.71; p<0.001). Conclusions: This study demonstrated that children with CP had better HRQOL after a combined program of minimally invasive SPML surgery and functional physiotherapy (ACTRN12618001535268).(AU)

Introducción y objetivos: Los niños con parálisis cerebral (PC) experimentan una disminución de la calidad de vida relacionada con la salud (CVRS). El objetivo de este estudio fue evaluar la CVRS de niños con PC antes y después de un programa combinado de alargamiento miofascial percutáneo selectivo (SPML) y fisioterapia funcional. Material y métodos: Se utilizó un diseño de un solo grupo con pretest y postest. Veintiséis niños de mediana edad (5 a 7 años) con PC espástica, niveles II-IV del sistema de la clasificación de la función motora gruesa se sometieron a cirugía SPML y fisioterapia de funcional posquirúrgica durante 9 meses. La versión proxy del cuestionario DISABKIDS-Smiley fue completada por uno de los padres de cada niño. Se realizaron pruebas t dependientes para comparar las puntuaciones medias previas y posteriores a la medición. Resultados: Después de 9 meses de intervención, los niños con PC tenían puntuaciones de calidad de vida significativamente más altas desde el punto de vista estadístico (diferencia de medias: 11,06±9,05; intervalo de confianza del 95%: 7,40-14,71; p <0,001). Conclusión: Este estudio demostró que los niños con PC presentaron una mejor CVRS después de un programa combinado de cirugía SPML y fisioterapia funcional.(AU)

The symmetry of the medial collateral and anterior cruciate ligament properties: a biochemical study in the rat hind limb.

The medial collateral (MCL) and the anterior cruciate ligament (ACL) of the rat's knee are frequently used in biomedical research and occasionally in ligament healing studies. The contralateral normal ligament serves as a control. In this study the presence of symmetry in the biomechanical properties of the MCL and the ACL was investigated. Bilateral femur-MCL-tibia and femur-ACL-tibia preparations were obtained from the hind limbs of sixty rats and were subjected to tensile testing to failure under the same loading conditions. Tensile load to failure, stiffness and energy absorption capacity were measured and the mode of failure was recorded. All biomechanical parameters were not significantly different between the two knees of the same animal, although significant individual variation was evident. The most common mechanism of failure was mid-substance tear. Symmetry seems to exist in the biomechanical properties of the MCL and the ACL in the rat knee. When ligament healing is evaluated, increased group size is necessary and the use of a normal control group may be advisable. The contralateral normal knee ligament may serve as a control when the properties of an injured ligament are evaluated and when the parameters of tensile testing failure under similar load conditions are applied.

Long lasting benefits following the combination of static night upper extremity splinting with botulinum toxin A injections in cerebral palsy children.

AIM: Botulinum toxin A injections and orthotics have been used to manage upper extremity spasticity in hemiplegic children. The authors performed a study to evaluate the necessity and effectiveness of a static night splint following outpatient botulinum toxin A treatment in children with upper limb spastic cerebral palsy. METHODS: Twenty children with upper limb spastic cerebral palsy were treated with botulinum toxin A injections. A static night splint was applied in half of them. Objective assessment of upper limb function was performed at baseline, at 2 and 6 months after botulinum toxin A injection using the Quality of Upper Extremity Skills Test. RESULTS: After botulinum toxin A treatment, both groups showed an improvement on their previous functional level of the injected upper extremity. At 2 months, children in group A showed a 15.4% improvement, whereas children in group B improved by 12.2% from baseline; these were not statistically significant (P=0.326). At 6 months, group A still maintained a 15.9% improvement in function compared to group B which differed only by 4.2% from prebotulinum toxin A baseline; these differences were statistically significant (P=0.000). Complications related to the botulinum toxin A injection were not observed. The static CONCLUSIONS: Static night splinting following botulinum toxin A injections has shown a definite treatment effect in reducing spasticity and improving function in children with upper limb spastic cerebral palsy.