Metal and Metal Oxides Nanoparticles as Nanofillers for Biodegradable Polymers.

Polymeric materials, despite their many undeniable advantages, nowadays are a major environmental challenge. Thus, in recent years biodegradable polymer matrices have been widely used in various sectors, including the medicinal, chemical, and packaging industry. Their widespread use is due to the properties of biodegradable polymer matrices, among which are their adjustable physicochemical and mechanical properties, as well as lower environmental impact. The properties of biodegradable polymers can be modified with various types of nanofillers, among which clays, organic and inorganic nanoparticles, and carbon nanostructures are most commonly used. The performance of the final product depends on the size and uniformity of the used nanofillers, as well as on their distribution and dispersion in the polymer matrix. This literature review aims to highlight new research results on advances and improvements in the synthesis, physicochemical properties and applications of biodegradable polymer matrices modified with metal nanoparticles and metal oxides.

Evaluation of Reliability of the Luna EMG Rehabilitation Robot to Assess Proprioception in the Upper Limbs in 102 Healthy Young Adults.

BACKGROUND Proprioception, the body's ability to perceive its own position and movement, is fundamental for motor control and coordination. Reliable assessment tools are essential, particularly for conditions affecting proprioceptive function. This study aimed to evaluate the external and internal compliance of the Luna EMG -multifunction robotic device in assessing proprioception. MATERIAL AND METHODS The study involved 102 healthy students (31 men and 71 women; mean age 22.2±1.46 years), assessing proprioception using the Luna EMG for the upper limbs. Two investigators conducted measurements, which were repeated after 2 weeks under identical conditions. RESULTS Based on the identified values of the interclass correlation coefficient (ICC) (ICC=0.969-0.997), which is a key measure of agreement between 2 assessments, the study shows a high agreement of measurements both between investigators (for right hand: P=0.3484 [Exam 1]; P=1.0000 [Exam 2]; for left hand: P=0.1092 [Exam 1]; P=0.7706 [Exam 2]) and between the examinations (for right hand: 0.1127 [Investigator 1]; 0.2113 [Investigator 2]; for left hand: P=0.0087 [Investigator 1]; P=0.1466 [Investigator 2]). The Bland-Altman analysis showed very small inter-rater deviations, approximately 0.05° in the first examination for the left side and 0.04° for the right side. The highest deviation between the examinations, amounting to 0.08°, was identified for the left side. CONCLUSIONS The study shows that the Luna EMG multifunction robotic device enables a reliable evaluation of upper limb proprioception. Measurements performed using this device show high internal and external consistency in the assessment of the proprioceptive senses of the upper limb in 102 healthy young adults.

Comparative Analysis of Mandibular and Cervical Mobility in Young Adults with Temporomandibular Joint Disorders: A Case-Control Study.

BACKGROUND Temporomandibular joint disorders (TMJD) affect the muscles of the mandible or the temporomandibular joint (TMJ). The objective of this case-control study was to compare mandibular and cervical joint mobility in young adults diagnosed with TMJD to a healthy control group. MATERIAL AND METHODS We enrolled 60 participants aged 18-30 years, split evenly between 30 TMJD patients and 30 healthy controls. We employed a millimeter gauge to measure TMJ mobility and a tape-based tool for assessing the range of cervical mobility. RESULTS Our data revealed that TMJD patients exhibited a significantly reduced range of mobility in both the TMJ and cervical spine compared to controls. Controls demonstrated a greater mean cervical mobility through left and right lateral flexion movements (P<0.01 and P<0.05 respectively), as well as right and left rotations (P<0.05). Additionally, they showed significantly higher mandibular mobility across all tested parameters (P<0.001). Within the TMJD group, we observed a significant correlation between cervical and mandibular mobility (P<0.05). CONCLUSIONS Our findings underline that TMJD patients possess significantly diminished mandibular and cervical mobility, particularly in lateral movements and rotations, compared to those without the disorder. The observed correlation between cervical and mandibular mobility in the TMJD group implies the necessity to consider these interconnected aspects when designing rehabilitation programs, thereby enhancing patient quality of life and impeding further mobility deterioration.

Removal of the Basic and Diazo Dyes from Aqueous Solution by the Frustules of Halamphora cf. salinicola (Bacillariophyta).

Industrial wastes with hazardous dyes serve as a major source of water pollution, which is considered to have an enormous impact on public health. In this study, an eco-friendly adsorbent, the porous siliceous frustules extracted from the diatom species Halamphora cf. salinicola, grown under laboratory conditions, has been identified. The porous architecture and negative surface charge under a pH of 7, provided by the various functional groups via Si-O, N-H, and O-H on these surfaces, revealed by SEM, the N2 adsorption/desorption isotherm, Zeta-potential measurement, and ATR-FTIR, respectively, made the frustules an efficient mean of removal of the diazo and basic dyes from the aqueous solutions, 74.9%, 94.02%, and 99.81% against Congo Red (CR), Crystal Violet (CV), and Malachite Green (MG), respectively. The maximum adsorption capacities were calculated from isotherms, as follows: 13.04 mg g-1, 41.97 mg g-1, and 33.19 mg g-1 against CR, CV, and MG, respectively. Kinetic and isotherm models showed a higher correlation to Pore diffusion and Sips models for CR, and Pseudo-Second Order and Freundlich models for CV and MG. Therefore, the cleaned frustules of the thermal spring-originated diatom strain Halamphora cf. salinicola could be used as a novel adsorbent of a biological origin against anionic and basic dyes.

Mesoporous Materials: Materials, Technological, and Environmental Applications.

Research on the synthesis and characterization of ordered mesoporous materials with uniquely functionalized external and internal surfaces has intensified in the last decade [...].

SBA-15- and SBA-16-Functionalized Silicas as New Carriers of Niacinamide.

Amorphous silica as a food additive (E 551) is used in food materials (e.g., sweeteners, dairy products) for its anti-caking properties. The physicochemical properties of SiO2 also make it suitable to serve as a carrier of active substances in functional foods, dietary supplements, and drugs. Deficiency of niacinamide (vitamin B3, niacin) leads to several pathologies in the nervous system and causes one of the nutritional diseases called pellagra. The present study focuses on the use of hybrid ordered mesoporous silicas (SBA-15/SBA-16) functionalized with amino groups introduced through grafting or co-condensation with (N-vinylbenzyl)aminoethylaminopropyltrimethoxysilane (Z-6032) as novel carriers of niacinamide. They combine the characteristics of a relatively stable and chemically inert amorphous silica matrix with well-defined structural/textural parameters and organic functional groups that give specific chemical properties. The highest degree of carrier loading with niacinamide (16 wt.%) was recorded for the unmodified SBA-15. On the other hand, the highest degree of niacinamide release characterizes the functionalized SBA-15 sample (60% after 24 h), indicating that the presence of amino groups affects the release profile of niacinamide from the structure of the mesoporous silica.

Photoremoval of Bisphenol A Using Hierarchical Zeolites and Diatom Biosilica.

Bisphenol A (4,4-isopropylidenediphenol, BPA) is an organic compound widely used, e.g., in the production of epoxy resins, plastics, and thermal receipt papers. Unfortunately, bisphenol A has negative effects on human health, which has prompted the search for an effective method of its removal. One of the most promising methods of its elimination is photocatalytic removal. The aim of this study was to design an effective method for the photocatalytic removal of bisphenol A using, for the first time, hierarchical zeolites and ruthenium ion-modified diatom biosilica, and silver as photocatalysts and optimization of the reaction conditions: temperature, pH, and composition of the reaction mixture as well as the electromagnetic wavelength. Additionally, for the first time, the electromagnetic wavelength that would be most suitable for the study was selected. All materials used were initially characterized by XRD and low-temperature nitrogen adsorption/desorption isotherms. Ruthenium ion-modified biosilica proved to be the most effective catalyst for bisphenol A removal, which occurred at a rate higher than 99%.

Nanotechnology-General Aspects: A Chemical Reduction Approach to the Synthesis of Nanoparticles.

The role of nanotechnology is increasingly important in our society. Through it, scientists are acquiring the ability to understand the structure and properties of materials and manipulate them at the scale of atoms and molecules. Nanomaterials are at the forefront of the rapidly growing field of nanotechnology. The synthesis of nanostructured materials, especially metallic nanoparticles, has attracted tremendous interest over the past decade due to their unique properties, making these materials excellent and indispensable in many areas of human activity. These special properties can be attributed to the small size and large specific surface area of nanoparticles, which are very different from those of bulk materials. Nanoparticles of different sizes and shapes are needed for many applications, so a variety of protocols are required to produce monodisperse nanoparticles with controlled morphology. The purpose of this review is firstly to introduce the reader to the basic aspects related to the field of nanotechnology and, secondly, to discuss metallic nanoparticles in greater detail. This article explains the basic concepts of nanotechnology, introduces methods for synthesizing nanoparticles, and describes their types, properties, and possible applications. Of many methods proposed for the synthesis of metal nanoparticles, a chemical reduction is usually preferred because it is easy to perform, cost-effective, efficient, and also allows control of the structural parameters through optimization of the synthesis conditions. Therefore, a chemical reduction method is discussed in more detail-each factor needed for the synthesis of nanoparticles by chemical reduction is described in detail, i.e., metal precursors, solvents, reducing agents, and stabilizers. The methods that are used to characterize nanomaterials are described. Finally, based on the available literature collection, it is shown how changing the synthesis parameters/methods affects the final characteristics of nanoparticles.

Assessment of Functional Performance in Children with Cerebral Palsy Receiving Treatment in a Day Care Facility: An Observational Study.

BACKGROUND The study assessed changes in functional performance of children with cerebral palsy (CP), immediately following treatment and 2 months later, in addition to investigating the relationship between therapy effect and sex, age, or comorbidities. MATERIAL AND METHODS Functional performance of 32 children with spastic diplegia CP, aged 9-16 years, was assessed for: 1) manual function (Box and Block test), motor capacities (Gross Motor Function Measure), sensory capacities (Finger Identification [FI] and Localisation of Tactile Stimuli test [LTC]), and 2) activity and participation, ie, independence in essential and more complex daily activities (Barthel Index; Paediatric Evaluation of Disability Inventory). Measurements were conducted before the start (Month 0), immediately after 6-month rehabilitation program (Month 6), and following a 2-month period with no therapy, ie, 8 months after baseline measurement (Month 8). RESULTS Comparison of Month 0 and Month 6 scores showed significant differences (P<0.001) in all measures. However, Month 8 scores were significantly worse in all the measures, except for sensory capacities assessed using FI and LTC (P<0.001). CONCLUSIONS Functional performance of children with CP was positively affected by 6-month therapy, but 2 months later these effects significantly deteriorated, except for the sensory capacities. This suggests that therapy focusing on functional performance should be included as a permanent component of rehabilitation programs. These findings may be important for clinical practice as they show that therapy of children with CP should be continuous and systematic, and this should be taken into account by those designing therapeutic programs.

Impact of a Rehabilitation Program on the Change in Components of Body Mass of the Upper and Lower Limbs in People After Ischemic Stroke.

BACKGROUND The aim of this study was to evaluate the effects of rehabilitation in terms of changes in the body mass composition in the upper and lower limbs depending on the length of time after stroke and the age of the patient. MATERIAL AND METHODS Eighty-two patients after ischemic stroke were tested 3 times: on admission, after 5 weeks, and 3 months after leaving the hospital (follow-up). During each examination, a segmental analysis of the components of the body mass of the upper limbs and lower limbs was performed, depending on the side of paresis. RESULTS Patients between 7 and 12 months after stroke with right-sided paresis had a reduction of fat (P=0.027) and an increase in muscle tissue in the lower (P=0.030) and upper limbs with paresis (P=0.037), as well as in the healthy upper limb (P=0.034) after rehabilitation. Only in the youngest age group (25-44 years) and in patients with left-sided paresis was there a decrease of adipose tissue in the healthy upper (P=0.012) and paresis limbs (P=0.032) and an increase in the muscle tissue mass in the right upper limb (P=0.010) after rehabilitation. CONCLUSIONS The rehabilitation program had a significant impact on the change in the composition of body mass in upper and lower limbs in people with right-sided paresis, particularly 7 to 12 months after stroke and in the youngest age group (25-44 years). These results may be useful in planning a rehabilitation program for stroke patients to consider the patient's dominant hand and neglect.

Perceptions of Polish and German physiotherapists about their professional education and development: a cross-sectional nonrandomized questionnaire cohort study.

BACKGROUND: The approach to the education and professional advancement of physiotherapists is particularly relevant today. To date, no studies have compared the perceptions of physiotherapists regarding professional issues in geographically close European countries such as Poland and Germany. Therefore, this study's purpose was to compare Polish and German physiotherapists' perceptions related to their profession, entry-level education, and career opportunities. METHODS: We recruited 565 physiotherapists from Poland and 560 physiotherapists from Germany. An opinion polling method based on a questionnaire was applied in the study. The survey was conducted in 48 facilities located throughout the territories of the two countries. The assessment focused on the following three issues: 1) professional education (form and content of educational programs, organizational aspects, and effects of education); 2) professional development and career opportunities; and 3) the relationship between years of service and perceptions of professional education, career satisfaction and advancement opportunities. RESULTS: German respondents rated specific aspects of their education, development opportunities and professional careers more highly than their Polish counterparts (p = 0.001). A highly significant negative correlation was identified in both groups between all the assessed aspects of professional education and years of service (0.9 ≤ |R| < 1, p = 0.001). CONCLUSIONS: Opinions on their professions expressed by physiotherapists from closely neighboring countries, namely, Poland and Germany, were surprisingly disparate. Compared to their Polish colleagues, German physiotherapists viewed their experiences more favorably vis-a-vis entry-level education, career opportunities, and professional status. Further study is needed to establish whether these findings reflect actual differences, sampling bias, or other factors.

Optimization of the Conditions of Solid Lipid Nanoparticles (SLN) Synthesis.

Solid lipid nanoparticles (SLNs) have been synthesized as potential drug delivery systems. They are classified as solid lipid nanocarriers that can successfully carry both hydrophilic and hydrophobic drugs. SLNs are based on a biocompatible lipid matrix that is enzymatically degraded into natural components found in the human body. Solid lipid nanoparticles are suitable for the incorporation of hydrophobic active ingredients such as curcumin. The study included the optimization of lipid nanoparticle composition, incorporation of the active compound (curcumin), a stability evaluation of the obtained nanocarriers and characterization of their lipid matrix. Through process optimization, a dispersion of solid lipid nanoparticles (solid lipid:surfactant­2:1.25 weight ratio) predisposed to the incorporation of curcumin was developed. The encapsulation efficiency of the active ingredient was determined to be 99.80%. In stability studies, it was found that the most suitable conditions for conducting high-pressure homogenization are 300 bar pressure, three cycles and a closed-loop system. This yields the required values of the physicochemical parameters (a particle size within a 200−450 nm range; a polydispersity index of <30%; and a zeta potential of about |±30 mV|). In this work, closed-loop high-pressure homogenization was used for the first time and compared to the currently preferred open-loop method.

Phytoecdysteroids from Serratula coronata L. for Psoriatic Skincare.

Phytoecdysones from Serratula coronata seem to be promising agents for skincare in patients with psoriasis. The aim of the study was to determine the effects of creams containing the extract of S. coronata on psoriatic lesions. Creams with different formulas were prepared: 0-Lekobaza®, 1-Lekobaza®, S. coronata, 2-Lekobaza®, Salicylic acid, 3-Lekobaza®, S. coronata, Salicylic acid. After examination of skin penetration and biosafety, the designated cream was applied twice daily for 6 weeks on 72 psoriatic plaques located on elbows or knees. The lesions were assessed at baseline and follow-up of 6 weeks. The lesions area was measured, and severity of scaling, erythema, and infiltration was assessed using a 5-point scale (from 0-none to 4-very severe). Skin hydration and structure, pH, transepidermal water loss, erythema, and melanin index were analyzed instrumentally. Creams 1, 2, and 3 significantly reduced the area of psoriatic plaques. Improvement in erythema and infiltration was observed for creams 1 and 3. Creams 1-3 reduced scaling. Our study confirmed a beneficial effect of creams containing S. coronata extract on psoriatic lesions.

Effects of Robotic Exoskeleton-Aided Gait Training in the Strength, Body Balance, and Walking Speed in Individuals With Multiple Sclerosis: A Single-Group Preliminary Study.

OBJECTIVE: To assess effects of 15 exoskeleton-assisted gait training sessions, reflected by the muscle strength of the lower limbs and by walking speed immediately after the training sessions and at the 6-week follow-up. DESIGN: Single-group longitudinal preliminary study. SETTING: Individuals with multiple sclerosis (MS) at a hospital neurology ward. PARTICIPANTS: Participants (N=14) included women and men aged from 36-61 years, with Expanded Disability Status Scale scores from 5.0-6.5. INTERVENTIONS: Exoskeleton-assisted walk training. MAIN OUTCOME MEASURES: Primary outcomes included dynamometric knee extensor and flexor strength (Biodex Pro4), postural balance, and center of pressure displacements (Zebris FMD-S). Secondary outcomes included walking speed measured with the timed 25-foot walk test and fatigue (Fatigue Severity Scale). Assessments were performed 4 times, that is, prior to the start of the program (T0), at the end of the physiotherapy without an exoskeleton (T1), at the end of the exoskeleton-assisted training (T2), and at 6-week follow-up (T3). RESULTS: At the end of exoskeleton-assisted gait training there was a statistically significant improvement in peak torque of knee extensor muscles compared with the period of exercise without an exoskeleton. No statistically significant change was identified in the value of peak torque of knee flexors at T1. Likewise, the assessment at T2 showed the change in peak torque of knee flexors was not significant. The participants presented significantly faster walking speed after exoskeleton-assisted gait training compared with T0 and T1. No improvement was found in body balance. The subjects reported lower fatigue after exoskeleton-assisted gait training; however, the differences between the assessments at T1 and T0 as well as at T2 and T1 were statistically insignificant. CONCLUSIONS: Individuals with MS and severe gait impairment participating in exoskeleton-assisted gait training achieved significant improvement in lower-limb muscle strength and increase in walking speed, yet the effect was not long-lasting.

Diatom Biosilica Doped with Palladium(II) Chloride Nanoparticles as New Efficient Photocatalysts for Methyl Orange Degradation.

A new catalyst based on biosilica doped with palladium(II) chloride nanoparticles was prepared and tested for efficient degradation of methyl orange (MO) in water solution under UV light excitation. The obtained photocatalyst was characterized by X-ray diffraction, TEM and N2 adsorption/desorption isotherms. The photocatalytic degradation process was studied as a function of pH of the solution, temperature, UV irradiation time, and MO initial concentration. The possibilities of recycling and durability of the prepared photocatalysts were also tested. Products of photocatalytic degradation were identified by liquid chromatography-mass spectrometry analyses. The photocatalyst exhibited excellent photodegradation activity toward MO degradation under UV light irradiation. Rapid photocatalytic degradation was found to take place within one minute with an efficiency of 85% reaching over 98% after 75 min. The proposed mechanism of photodegradation is based on the assumption that both HO• and O2•- radicals, as strongly oxidizing species that can participate in the dye degradation reaction, are generated by the attacks of photons emitted from diatom biosilica (photonic scattering effect) under the influence of UV light excitation. The degradation efficiency significantly increases as the intensity of photons emitted from biosilica is enhanced by palladium(II) chloride nanoparticles immobilized on biosilica (synergetic photonic scattering effect).

Loading, release profile and accelerated stability assessment of monoterpenes-loaded solid lipid nanoparticles (SLN).

Glycerol monostearate solid lipid nanoparticles (SLN) were produced by hot high-pressure homogenization technique to load alpha-pinene, citral, geraniol or limonene. SLN were composed of 1 wt.% monoterpene, 4 wt.% of Imwitor® 900K as a solid lipid and 2.5 wt.% of Poloxamer188 as a surfactant. Empty SLN consisted of 5 wt.% of Imwitor® 900K and 2.5 wt.% of Poloxamer188. The mean particles size (Z-Ave) and polydispersity index (PDI) of SLN were analyzed by dynamic light scattering (DLS), while the zeta potential (ZP) of each formulation were measured by electrophoretic light scattering. LUMiSizer® was applied to calculate the velocity distribution in the centrifugal field and instability index. Drug release profile from SLN was analyzed using Franz cell diffusion cells assayed by UV-Vis spectrophotometry, whereas the gas chromatography technique was applied to determine the encapsulation parameters of volatile monoterpenes. The matrix state, polymorphism and phase behavior of SLN were studied by X-ray diffraction (XRD, low and wide angles) and differential scanning calorimetry (DSC). Selected monoterpenes were successfully loaded in glycerol monostearate SLN. A burst release profile within the first 15 min was observed for all formulations, being the modified release profile dependent on the type of monoterpene and on the encapsulation efficiency.

Relationship Between Observational Wisconsin Gait Scale, Gait Deviation Index, and Gait Variability Index in Individuals Poststroke.

OBJECTIVE: To compare results of the observational Wisconsin Gait Scale (WGS) and global gait indexes such as Gait Deviation Index (GDI) and Gait Variability Index (GVI), constituting an objective method of assessing gait, and taking into account parameters identified during 3-dimensional gait analysis (3DGA). DESIGN: A validation study. SETTING: Rehabilitation clinic. PARTICIPANTS: A total of 50 individuals poststroke and 50 individuals without stroke and without gait disorders (N=100). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Gait was evaluated using the WGS. GDI and GVI values were acquired using a movement analysis system. The global gait indexes GDI and GVI were determined based on the kinematic and spatiotemporal parameters, respectively. RESULTS: The study showed statistically significant correlations between the parameters of GDI affected leg and WGS total score (R=-0.87), GVI affected leg and WGS total score (R=-0.93), GVI unaffected leg and WGS total score (R=-0.88), GVI affected/unaffected leg and the total score in the assessment of spatiotemporal parameters on the WGS (R=-0.81) as well as GDI affected leg and the total score in the assessment of kinematics parameters on the WGS (R=-0.85). All correlations were strong (0.7<|R|<0.9) or very strong (0.9<|R|<1). CONCLUSIONS: WGS scores have a strong or very strong correlation with GDI and GVI. The WGS may be recommended as a substitute tool to be used when 3DGA is unavailable, as it is a useful ordinal scale, enabling simple and accurate observational assessment of gait in patients poststroke, with effectiveness that is comparable to the GDI and GVI.

Assessment of Foot Shape in Children and Adolescents with Intellectual Disability: A Pilot Study.

BACKGROUND Available publications provide little evidence pertaining to assessment of foot shape in children with intellectual disability. The aim of this study was to assess the parameters of foot shape in children and adolescents with intellectual disability and to evaluate the relationship between the degree of disability and these parameters. MATERIAL AND METHODS The study involved 90 individuals aged 7-15 years, including 45 subjects with mild and moderate levels of intellectual disability (study group) and 45 peers with normal intellectual development (control group). Each participant was subjected to photogrammetric assessment of foot shape based on the projection moire effect. RESULTS Analysis of the relationship between the disability level and the assessed parameters showed that the length of the right (p=0.006) and left (p=0.004) foot, as well as Wejsflog's rate for the right (p<0.001) and left (p<0.001) foot, were significantly higher among children with mild disability, whereas GAMMA angle of the right (p=0.028) and left (p=0.006) foot was significantly higher among children with moderate disability. CONCLUSIONS The findings show a significant relationship between the degree of disability and the assessed foot parameters. Significant differences between the subjects with intellectual disability and the control group were identified in the basic parameters defining foot structure.

The paediatric version of Wisconsin gait scale, adaptation for children with hemiplegic cerebral palsy: a prospective observational study.

BACKGROUND: In clinical practice there is a need for a specific scale enabling detailed and multifactorial assessment of gait in children with spastic hemiplegic cerebral palsy. The practical value of the present study is linked with the attempts to find a new, affordable, easy-to-use tool for gait assessment in children with spastic hemiplegic cerebral palsy. The objective of the study is to evaluate the Wisconsin Gait Scale (WGS) in terms of its inter- and intra-rater reliability in observational assessment of walking in children with hemiplegic cerebral palsy. METHODS: The study was conducted in a group of 34 patients with hemiplegic cerebral palsy. At the first stage, the original version of the ordinal WGS was used. The WGS, consisting of four subscales, evaluates fourteen gait parameters which can be observed during consecutive gait phases. At the second stage, a modification was introduced in the kinematics description of the knee and weight shift, in relation to the original scale. The same video recordings were rescored using the new, paediatric version of the WGS. Three independent examiners performed the assessment twice. Inter and intra-observer reliability of the modified WGS were determined. RESULTS: The findings show very high inter- and intra-observer reliability of the modified WGS. This was reflected by a lack of systematically oriented differences between the repeated measurements, very high value of Spearman's rank correlation coefficient 0.9 ≤ |R| < 1, very high value of ICC > 0.9, and low value of CV < 2.5% for the specific physical therapists. CONCLUSIONS: The new, ordinal, paediatric version of WGS, proposed by the authors, seems to be useful as an additional tool that can be used in qualitative observational gait assessment of children with spastic hemiplegic cerebral palsy. Practical dimension of the study lies in the fact that it proposes a simple, easy-to-use tool for a global gait assessment in children with spastic hemiplegic cerebral palsy. However, further research is needed to validate the modified WGS by comparing it to other observational scales and objective 3-dimensional spatiotemporal and kinematic gait parameters. TRIAL REGISTRATION: anzctr.org.au , ID: ACTRN12617000436370 . Registered 24 March 2017.

Assessment of cervical range of motion in patients after axis fracture.

BACKGROUND: Surgical treatment of odontoid fractures with posterior C1/C2 fusion always leads to severe limitations in mobility of the cervical spine and head. PURPOSE: To assess the mobility of the cervical spine in patients treated with various surgical methods after an axis body fracture. MATERIAL AND METHODS: A group of 61 subjects receiving surgical treatment in a group of 214 subjects treated for odontoid fractures at one ward of neurosurgery at a regional hospital. Studies also included odontoid peg and Hangman fractures. The range of motion of the head was compared to standards by the International Standard Orthopedic Measurements (ISOM) and to head mobility in a control group of 80 healthy subjects without any pathologies or complaints associated with the cervical spine. Ranges of motion were measured with the CROM goniometre with regard to flexion, extension, right and left lateral flexion and right and left rotation. The functional status was evaluated with Neck Disability Index (NDI) standard questionnaires indicated for patients with cervical spine pain. RESULTS: Except for flexion and extension, patients after odontoid fractures had a statistically significantly smaller range of motion of the cervical spine in all planes compared to the control group and ISOM standards. CONCLUSIONS: Odontoid fractures lead to limitations in mobility of the cervical spine even after treatment with methods that in theory should preserve the C1/C2 mobility.