Preliminary study of robot-assisted ankle rehabilitation for children with cerebral palsy / 北京大学学报(医学版)

OBJECTIVE@#To propose a kind of robotic ankle-foot rehabilitation system for children with cerebral palsy and to preliminarily verify its feasibility in clinical application.@*METHODS@#A robot assisted ankle-foot rehabilitation system was specially designed and developed for children with cerebral palsy and a preliminary clinical study was conducted in Department of Rehabilitation Medicine, Peking University First Hospital. Modified Tardieu Scale and joint biomechanical properties (ankle plantar flexion resistance torque under different ankle dorsiflexion angles) were measured to analyze the muscle tone and soft tissue compliance of the ankle plantar flexors pre- and post-robotic training intervention. Six children with cerebral palsy (4 girls and 2 boys, mean age: 7 years) were recruited in this study. Each subject received 5 session robotic training and each session included 10-cycle passive stretching and static hold. SPSS 19.0 software was used for data statistical analysis.@*RESULTS@#Both R1 and R2 angles of Modified Tardieu Scale for ankle plantar flexors after training were significantly higher than those before the treatments (Gastrocnemius: PR1=0.003, PR2=0.029; Soleus: PR1=0.002, PR2=0.034). The difference between R2 and R1 was of no statistical difference before and after the training (P=0.067 and P=0.067, respectively). After training, the ankle plantar flexion resistance torque under different dorsiflexion angles (0°, 10°, 20°, 30°) were significantly reduced than those before training (P=0.001, P=0.001, P=0.014, P=0.002, respectively).@*CONCLUSION@#The robot assisted ankle-foot rehabilitation system can improve the contracture and soft tissue compliance of cerebral palsy children's ankle plantar flexors. All the children in the study were well tolerated and interested with the training, easy to accept and cooperate with it. This device may be suitable for application in the rehabilitation of children with cerebral palsy. However, further randomized clinical trials with larger sample size are still needed to verify the long term efficacy of this device.

Poliomyelitis: Pattern and Treatment Outcome in Niger Delta; Nigeria

Background: Poliovirus is an enterovirus in the family of Picornaviridae and consists of three antigenic types; 1; 2; and 3. All three types cause paralysis. It is a major cause of musculoskeletal deformity in many African communities including Nigeria. The deformities include muscle weakness; contractures; grotesque foot deformities and angular deformities around the knee; amongst others. Aim: To highlight 20 children with musculoskeletal deformities due to poliomyelitis treated in a private hospital in Port Harcourt. Methods: Twenty children with musculoskeletal deformities due to poliomyelitis were retrospectively studied. Results: The patients' ages ranged from1 to 16 years; with 95of them under 15 years of age. More than 50of the study group had poor immunisation status as 6 of them were unimmunised (30) and 5 (25) of them were incompletely immunised. Even though all school strata were represented; most of them were not schooling. The commonest deformity was contracture of the knees (100) and muscle wasting in the affected limbs. All of them had loss of muscle power in the lower limbs. Surgical correction was achieved by soft tissue release in 95of them and osteotomy in 5. The outcome was good; as acceptable extension of the knee was achieved post operatively. Conclusion: The musculoskeletal abnormalities of poliomyelitis contribute highly to physical disability. All patients affected by paralytic poliomyelitis become disabled to some extent and this increases the disease burden in Nigeria

Fiberglass Reinforced Plastic Orthotic Appliances

Orthotic technology has developed rapidly in recent decades m western countries. Korea has been confronted with the problems of purchasing the appropriate orthotic materials, training of orthotists and financial expense. The introduction of new materials and lamination technology for orthotic appliance will enable such problems to be solved. Fiberglass reinforced plastic (FRP), which was laminated with Korean made plastic resins and fiberglass, was superior to the mechanical properties of other plastic materials, such as acrylic, polypropylene and thermoplast. Lamination of the orthotic devices with FRP was introduced and it should be technically possible for an orthotist in a small workshop or a member of the house staff of a hospital to make an appliance on the premises.