ABSTRACT
INTRODUCTION: Cerebral palsy is a group of movement and posture development disorders. 90% of this population has gait impairment, often due to the presence of spasticity. A number of studies emphasize the importance of combined physical therapy with botulinum toxin A treatment. However, no consensus can be reached concerning the content of the physiotherapy program after treatment with botulinum toxin A. The purpose of the present study was to investigate, through a systematic review of the literature, the effects of physiotherapeutic intervention on gait after botulinum toxin application in children with cerebral palsy. EVIDENCE ACQUISITION: PubMed, Scielo, Cochrane Library, OTseeker, and PEDro databases were searched for randomized trial published between January 2000 and January 2017. EVIDENCE SYNTHESIS: Sixty-eight articles were identified, four of which met the eligibility criteria and were selected for the present systematic review. A table was created showing the main characteristics of the studies (groups, inclusion criteria, dosage, injection site, physiotherapeutic intervention, evaluation and outcomes). CONCLUSIONS: This study offers a view on the increase in the therapeutic effectiveness of botulinum toxin A on the lower limbs when used in conjunction with a physiotherapeutic intervention, with improvements in mobility, gait pattern, range of motion and spasticity, which are maintained after the end of the physical therapy protocol. The use of botulinum toxin A on the lower limbs when used in conjunction with a physiotherapeutic intervention, can improve muscle tone, allowing a combined treatment and intended to provide improvement of motor ability and functional skills, and potentially, delay the need for surgery.
Subject(s)
Botulinum Toxins, Type A/therapeutic use , Cerebral Palsy/physiopathology , Muscle Spasticity/drug therapy , Neuromuscular Agents/therapeutic use , Physical Therapy Modalities , Botulinum Toxins, Type A/administration & dosage , Child , Combined Modality Therapy , Gait , Humans , Neuromuscular Agents/administration & dosage , Range of Motion, ArticularABSTRACT
Differential scanning calorimetry (DSC), thermogravimetry (TG) and Fourier-transform infra-red spectroscopy (FT-IR) analyses were performed to investigate changes in the physico-chemical properties of botryosphaerans, a family of exopolysaccharides (EPS) produced by the fungus Botryosphaeria rhodina MAMB-05 grown on glucose (EPS(GLC)), sucrose (EPS(SUC)) and fructose (EPS(FRU)). A slight endothermic transition and small mass loss attributable to the removal of water of hydration were observed in the DSC and TG analyses, respectively, for the three EPS samples. The FT-IR spectra confirmed no structural changes occurred during thermal treatment. Viscometry was utilized to obtain information on the rheological behaviour of the EPS in aqueous solutions. The Power Law and Cross Equations determined the natural pseudoplastic characteristics of the EPS. Comparatively, results obtained for EPS produced when B. rhodina MAMB-05 was grown on each of the three carbohydrate sources demonstrated similar apparent viscosity values for EPS(GLC) and EPS(SUC), while EPS(FRU) displayed the lowest apparent viscosity of the three botryosphaerans, suggesting a higher degree of ramification and lower Mw. EPS(GLC) and EPS(SUC) possessed similar degrees of ramification. The slight differences found in their viscosities can be explained by the differences in the type of branching among the three botryosphaerans, thus varying the strength of intermolecular interactions and consequently, consistency and viscosity. The physico-chemical studies of botryosphaerans represent the originality of this work, and the knowledge of these properties is an important criterion for potential applications.
Subject(s)
Glucans/chemistry , Saccharomycetales/metabolism , Calorimetry, Differential Scanning , Culture Media, Conditioned , Fructose/metabolism , Glucans/isolation & purification , Glucans/metabolism , Glucose/metabolism , Molecular Weight , Rheology , Spectroscopy, Fourier Transform Infrared , Sucrose/metabolism , Thermogravimetry , ViscosityABSTRACT
Analysis of physical phenomena that occurs during tablet disintegration has been studied by several experimental approaches; however none of them satisfactorily describe this process. The aim of this study was to investigate the influence of compression force on the tablets by associating the AC Biosusceptometry with consolidated methods in order to validate the biomagnetic technique as a tool for quality control in pharmaceutical processes. Tablets obtained at five compression levels were submitted to mechanical properties tests. For uncoated tablets, water uptake and disintegration force measurements were performed in order to compare with magnetic data. For coated tablets, magnetic measurements were carried out to establish a relationship between physical parameters of the disintegration process. According to the results, differences between the compression levels were found for water uptake, force development and magnetic area variation measurements. ACB method was able to estimate the disintegration properties as well as the kinetics of disintegration process for uncoated and coated tablets. This study provided a new approach for in vitro investigation and validated this biomagnetic technique as a tool for quality control for pharmaceutical industry. Moreover, using ACB will also be possible to test these parameters in humans allowing to establish an in vitro/in vivo correlation (IVIVC).
