Efficacy of neuromuscular electrical stimulation and interrupted serial casting in children with spastic diplegia.

Objectives: This research was aimed at comparing the effects of neuromuscular electrical stimulation (NMES) combined with interrupted serial casting (SC) versus SC alone on various aspects of lower limb function in children with diplegic cerebral palsy. SC is a clinical technique used to increase passive range of motion (ROM), decrease hypertonicity, and improve walking in children with cerebral palsy (CP). Methods: This randomized comparative trial involved 33 children with diplegic CP, who were randomly assigned to group A or group B at recruitment. Group A received SC along with a customized physical therapy program, whereas group B received the same interventions as group A along with NMES applied through cast windows during casting. Evaluations were based on ROM, the Modified Tardieu Scale, handheld dynamometer measurements, and the Observational Gait Scale. Assessments were conducted before and after 8 weeks of intervention. Results: Both groups exhibited significant improvements in dorsiflexion ROM, popliteal angle, gastrocnemius dynamic spasticity, and hamstring dynamic spasticity after the intervention (P = 0.0001 for all). However, significant differences (P < 0.05) in dorsiflexor strength, knee extensor strength, and observational gait scale score were observed between groups after the intervention, favoring group B. Conclusions: The use of NMES during SC may help overcome the substantial decrease in strength resulting from casting, thus achieving less reduction of tone, improving ROM without significantly decreasing strength, and attaining greater improvements in gait function.

Efficacy of dual-task training on stability and function in children with ataxia after medulloblastoma resection: A randomized controlled trial.

BACKGROUND/OBJECTIVE: In children, medulloblastoma (MB) is the most prevalent posterior fossa tumor. The first line of treatment is maximal safe resection. Therefore, symptoms of ataxia are commonly seen. Training the brain on balance and cognitive tasks makes balance more automatic than without cognitive tasks. The goal was to assess the effectiveness of dual-task practice on balance after MB excision in children with ataxia. METHODS: Thirty children with ataxia after MB resection at Children Cancer Hospital Egypt were randomized into two equal groups. Exercises for mobility, balance, and gait training were given to both groups. The research group underwent a specific dual-task program (balance and cognitive). The program ran 3 days per week for 8 weeks. Children were evaluated before and after the treatment regimen using the Scale of Assessment and Rating of Ataxia (SARA), the HUMAC Balance System, Pediatric Balance Scale, and Functional Independent Measurement. All children's legal guardians signed an ethical agreement. RESULTS: A notable improvement in balance was found in the dual group in Pediatric Balance Scale (PBS) (p = .028) and stability test (p = .0001) in favor of the study group. No discernible difference was observed in the Functional Independent Measurement score among the two groups (p = .158), although there was a statistically significant increase in both groups after treatment. CONCLUSION: Dual-task program is more effective than traditional physical therapy alone in improving balance in children with ataxia after MB resection.

Effects of a core stability exercise program on balance and coordination in children with cerebellar ataxic cerebral palsy.

OBJECTIVE: To evaluate the effects of a core stability exercise program on balance, coordination, and severity of ataxia in children with cerebellar ataxic cerebral palsy (CP). METHODS: Forty children with cerebellar ataxic CP (mean age: 6.75±1.35 years) were randomly assigned to a control group and an intervention group for 2 months of follow-up. The control group received a standard physical therapy program three times weekly (1 h per session), while the intervention group received a core stability program for 30 min, in addition to the selected physical therapy program. Both groups were evaluated pre-treatment and post-treatment using the Scale for the Assessment and Rating of Ataxia, the Balance Error Scoring Systems scale, Bruininks-Oseretsky tests of motor proficiency, and HUMAC balance system scores. RESULTS: We found statistically significant reductions in the severity of ataxia, as well as improved balance and coordination in both groups, with stronger effects observed in the intervention group (P<0.05). CONCLUSION: The core stability program can improve balance and coordination in children with cerebellar ataxic CP when incorporated with a standard physical therapy program.

Inspiratory Muscle Training and Physical Fitness in Children With Down Syndrome: A Randomized Controlled Trial.

OBJECTIVE: To investigate the effect of inspiratory muscle training (IMT) on physical fitness in children with Down syndrome (DS). DESIGN: Randomized control trial. SETTING: The study was conducted in a private physical therapy center. PARTICIPANTS: Forty boys and girls with DS aged between 7 and 10 years were enrolled in this study (N=40). They were randomly and equally divided into 2 groups (A and B). INTERVENTIONS: All participants received 30 minutes of aerobic exercise training 3 times per week for 12 weeks, whereas group B received an additional 30 minutes of IMT before each aerobic exercise session. MAIN OUTCOMES MEASURES: Maximal inspiratory pressure (MIP); maximal expiratory pressure (MEP); submaximal aerobic endurance; muscular strength; endurance. RESULTS: Among the group undergoing IMT, there were significant improvements in MIP, MEP, and submaximal aerobic endurance using the six-minute walk test (6MWT); strength and endurance using the curl-up, dumbbell press, trunk lift, standing long jump, seated push-up, pull-up, and flexed-arm hang; and back saver sit and reach tests (P > 0.05). CONCLUSIONS: Inspiratory muscle training and aerobic exercise training demonstrated more significant improvements in physical fitness than in those children who received only aerobic exercise training.

Cyclosporin A activates human hepatocellular carcinoma (HepG2 cells) proliferation: implication of EGFR-mediated ERK1/2 signaling pathway.

One of the most common causes of cancer mortality worldwide is hepatocellular carcinoma (HCC). Extracellular signal-regulated kinase (ERK1/2) pathway has been shown to play an important role in the development and progression of HCC. Here, we demonstrate that the immunosuppressive agent cyclosporin A (CsA) has the ability to increase the cellular growth in HCC (HepG2 cells) via activation of ERK1/2 signaling cascade. It was found that ERK1/2 phosphorylation induced by CsA was highly reduced in the presence of the reactive oxygen species (ROS) scavenger polyethylene glycol-superoxide dismutase (PEG-SOD). Furthermore, it was observed that inhibition of metalloproteinase activity using TAPI-2 prevents ERK1/2 activation by CsA. Moreover, a disintegrin and metalloproteinase domain 17 (ADAM-17) activity was found to be critical for ERK phosphorylation by CsA. In addition, CsA-induced ERK phosphorylation was highly reduced in the presence of either neutralizing anti-heparin-binding-epidermal growth factor (HB-EGF) antibody or UO126 (MEK inhibitor). By using the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor AG1478, it was found that EGFR is critical for ERK phosphorylation induced by CsA. Furthermore, CsA-induced cell proliferation was strongly reduced in the presence of either PEG-SOD or TAPI-2 or neutralizing anti-ADAM17 antibody or neutralizing anti-HB-EGF antibody or AG1478 or UO126. Collectively, these data demonstrate that CsA has the ability to activate ERK1/2 signaling cascade that could be translated into an increase in HepG2 cell proliferation. Furthermore, these data support the role of ROS, ADAM-17, and EGFR in ERK1/2 signaling activation and subsequent cell proliferation induced by CsA in HepG2 cells.

Effects of nicorandil on vascular and renal dysfunctions in adenine-induced nephropathy: Possible underlying mechanisms.

Vascular dysfunctions in chronic kidney disease (CKD) include endothelial dysfunctions and vascular calcification (VC). In the present study, we examined the possible protective effect of nicorandil (potassium channel opener) on renal and vascular dysfunctions in a rat model of adenine-induced nephropathy and its underlying mechanisms. Thirty-four male Sprague-Dawley rats were randomly allocated into 3 groups: Control group, Adenine group (animals received high-adenine diet for 4 weeks), and Nicorandil group (animals received adenine for 4 weeks and nicorandil 1 mg/kg per oral for 4 weeks). The results showed significant reduction in the body weight, heart rate (HR), hemoglobin contents, serum Ca2+ and reduction in the expression of mRNA of endothelial nitric oxide synthase (eNOS) and nuclear factor erythroid related factor 2 (nrf2) genes in aortic tissues with significant increase in arterial blood pressure (ABP), serum creatinine, blood urea nitrogen (BUN), plasma renin activity (PRA), K+ and phosphate (PO43-), urinary albumin excretion (UAE) and aortic VC in Adenine group compared to normal group (p < 0.05). On the other hand, coadminsitration of nicorandil caused significant improvement in the studied parameters compared to Adenine group (p < 0.05). We concluded that nicorandil has a potential protective effect against the vascular and renal impairment induced by adenine, which might be due to attenuation of vascular calcifications, activation of Nrf2 and eNOS genes in aortic tissues.

Effect of Core Stability Exercises and Treadmill Training on Balance in Children with Down Syndrome: Randomized Controlled Trial.

INTRODUCTION: Core stability exercises and treadmill training play a crucial role in physical therapy interventions and have an effect on balance in children with Down Syndrome (DS); however, whether core stability exercises or treadmill training has more effect on improving balance has not been investigated yet. The aim of the study was to investigate the effect of core stability training versus treadmill exercises on balance in children with Down Syndrome. METHODS: Forty-five children aged 4-6 years with Down Syndrome were included in the study. The children were equally divided randomly into three groups. Group A received traditional physical therapy intervention strategies to facilitate the balance of participating children. Group B received the same as group A and additional core stability exercise training. Group C received the same intervention strategies as group A in conjunction with a treadmill exercise program. The children's balance was evaluated using the Berg balance scale and the Biodex Balance System. Treatment sessions were for 60 min, thrice a week, for 8 consecutive weeks. RESULTS: There were significance improvements in the three groups in functional balance and over all stability indices in favor of groups B and C. CONCLUSIONS: Core stability and treadmill training improved balance in children with Down Syndrome and should be applied in conjunction with physical therapy programs.

Corrigendum to "Functional Stretching Exercise Submitted for Spastic Diplegic Children: A Randomized Control Study".

[This corrects the article DOI: 10.1155/2014/814279.].

The oncofetal protein IMP3 is an indicator of early recurrence and poor outcome in mucoepidermoid carcinoma of salivary glands.

OBJECTIVE: Mucoepidermoid carcinoma (MEC) is the most common primary malignancy of the salivary glands. Insulin-like growth factor-II mRNA-binding protein-3 (IMP3) is an important prognostic factor in some cancers and a tool that differentiates between benign and malignant pancreatic lesions. This study aimed to identify a relationship between the expression of IMP3 and the outcome of salivary gland MEC, as well as to differentiate MEC from pleomorphic adenoma (PA). METHODS: Tissue specimens from 70 cases of salivary gland MEC, 40 cases of PA, and 10 cases with normal salivary gland were examined immunohistochemically for IMP3. The association among the expression of IMP3, clinicopathological characteristics and patient's survival was assessed. RESULTS: IMP3 was present in 51.4% of MEC but absent in PA and normal salivary gland tissues. IMP3 expression was associated with age > 60 years, submandibular gland tumors, tumor size > 4 cm, high-grade tumors, lymph node metastasis, involvement of surgical margins, perineural invasion, distant metastasis, advanced TNM stage, tumor relapse, and death ( P<0.05). Increased expression of IMP3, tumors of the submandibular gland, and lymph node metastasis were independent prognostic factors of -free survival (DFS). In addition, IMP3 was a strong predictor of overall survival (OS) together with distant metastasis and intermediate and high-grade tumors. CONCLUSIONS: IMP3 expression is highly important in evaluating the outcome of MEC. IMP3 can be used to differentiate MEC from PA of salivary glands.

Cryolipolysis versus laser lipolysis on adolescent abdominal adiposity.

BACKGROUND: Noninvasive body contouring is one of the fastest growing segments of the cosmetic aesthetic industry. There is increased public demand for procedures with fewer side effects and shorter recovery times. Cryolipolysis and Laser lipolysis have been used as treatments for localized body contouring. OBJECTIVE: To compare the effect of Cryolipolysis versus Laser lipolysis on adolescent's abdominal adiposity. DESIGN: Randomized, controlled trial. SUBJECTS: Forty-five obese adolescents of both sexes ranged in age from 13 to 16 years participated in this study were to be categorized into three groups of equal number (each group 15 subjects) randomly selected from population. METHODS: Participants were randomly assigned to three groups. Group A was received (Cryolipolysis and diet), Group B was received (Laser lipolysis and diet), Group C was received (only diet) all groups were observed for 8 weeks. Weight and height scale for (change in weight), tape measurement for (waist-hip ratio), skinfold caliper, and MRI. RESULTS: There was no significant difference between three groups post-treatment in BMI and body weight P-value were (0.2, 0.42, 0.67), respectively. There was a significant improvement for Cryolipolysis group in waist-hip ratio, Suprailiac skin fold, and subcutaneous adipose tissue than other groups P-value (0.001). CONCLUSIONS: Cryolipolysis has a favorable effect than Laser lipolysis in the reduction of waist-hip ratio, skin folds at Suprailiac level and subcutaneous adipose tissue (SAT), there is no significant difference between them in the reduction of BMI and body weight. All groups did not have an effect on VAT.

Functional stretching exercise submitted for spastic diplegic children: a randomized control study.

Objective. Studying the effect of the functional stretching exercise in diplegic children. Design. Children were randomly assigned into two matched groups. Setting. Outpatient Clinic of the Faculty of Physical Therapy, Cairo University. Participants. Thirty ambulant spastic diplegic children, ranging in age from five to eight years, participated in this study. Interventions. The control group received physical therapy program with traditional passive stretching exercises. The study group received physical therapy program with functional stretching exercises. The treatment was performed for two hours per session, three times weekly for three successive months. Main Outcome Measure(s). H∖M ratio, popliteal angle, and gait parameters were evaluated for both groups before and after treatment. Results. There was significant improvement in all the measuring variables for both groups in favor of study group. H∖M ratio was reduced, popliteal angle was increased, and gait was improved. Conclusion(s). Functional stretching exercises were effectively used in rehabilitation of spastic diplegic children; it reduced H∖M ratio, increased popliteal angle, and improved gait.