ABSTRACT
BACKGROUND: Children with cerebral palsy (CP) often have difficulty with activities that require the upper extremities secondary to deficits in strength and range of motion, spasticity, and poor timing and coordination of movement. This study aimed to identify and compare timing and coordination of the trunk and upper extremity in children with and without CP during a functional task. METHODS: Eighteen children, Nâ¯=â¯9 with CP and Nâ¯=â¯9 with typical development were enrolled. Participants were seated in a standard chair and instructed to drink from a glass placed at a distance of 75% of available arm length. The task was divided into 3 Phases: 1) reaching to the glass, 2) transporting the glass to the mouth, and 3) returning the glass to the table. The spatiotemporal and angular variables were analyzed with 3D kinematics of movement using a 4-camera Qualysis Motion System. FINDINGS: Children with CP demonstrated poor upper extremity timing and coordination. Despite significant trunk displacement used as a compensation in Phase 1, children with CP demonstrated a significantly lower mean velocity and velocity peak during Phases 2 and 3; and demonstrated less straight motion which required more time and movement units in all phases. INTERPRETATION: Children with CP demonstrated poor upper extremity timing and coordination when drinking (even when they successfully completed the task) measured by more trunk displacement, slower, less straight movements, and more movement units. Current rehabilitation strategies could consider training speed and use functional tasks that require different strategies across multiple phases.
Subject(s)
Arm/physiopathology , Cerebral Palsy/physiopathology , Drinking , Movement , Torso/physiopathology , Adolescent , Biomechanical Phenomena , Child , Child, Preschool , Female , Humans , Male , Muscle Spasticity/physiopathology , Range of Motion, ArticularABSTRACT
BACKGROUND: People with stroke excessively move their trunk, when reaching and grasping objects. OBJECTIVE: To determine if the addition of trunk restraint to modified constraint-induced movement therapy (mCIMT) was better than mCIMT alone in improving strength, function, and quality of life after stroke. METHODS: A pilot randomized double-blinded clinical trial was conducted. Twenty-two participants with chronic stroke were randomly assigned to an experimental group that received mCIMT plus trunk restraint, or a control group (only mCIMT). Primary outcomes were the amount of use and quality of movement of the paretic upper limb (UL), determined by the Motor Activity Log (MAL) scores. Secondary outcomes included the observed performance of the paretic UL during unimanual and bimanual tasks, kinematics of reaching, strength, and quality of life. RESULTS: Both groups demonstrated significant improvements in the MAL scores and in the time to perform bimanual activities immediately after the interventions. However, no between-group differences were observed. CONCLUSIONS: The addition of trunk restraint to mCIMT resulted in no additional benefits, compared with mCIMT alone with stroke individuals with mild to moderate impairments. Unimanual and bimanual improvements were observed after mCIMT, regardless of trunk restraint, and the intervention did not adversely affect their reaching patterns.
Subject(s)
Restraint, Physical , Stroke Rehabilitation , Stroke/physiopathology , Torso , Upper Extremity/physiopathology , Aged , Biomechanical Phenomena , Chronic Disease , Double-Blind Method , Female , Functional Laterality , Humans , Male , Middle Aged , Motor Activity , Muscle Strength , Paresis/etiology , Paresis/physiopathology , Paresis/rehabilitation , Physical Therapy Modalities , Pilot Projects , Psychomotor Performance , Quality of Life , Stroke/psychology , Treatment OutcomeABSTRACT
PIP: Methods for the indirect estimation of fertility developed by Brass and Arriaga are described and applied to data from the Brazilian censuses from 1940 to 1980. The applicability of Arriaga's method for use with survey data is also considered^ieng
Subject(s)
Demography , Fertility , Methods , Statistics as Topic , Americas , Brazil , Censuses , Data Collection , Developed Countries , Developing Countries , Latin America , Population , Population Dynamics , Research , South AmericaABSTRACT
PIP: Data from the 1970 and 1980 Brazilian censuses are analyzed by the methods of Brass and Arriaga to obtain information on Brazilian fertility by age group. The two techniques are compared, and the results obtained are discussed in relation to observed trends^ieng
Subject(s)
Age Factors , Demography , Fertility , Statistics as Topic , Americas , Brazil , Developed Countries , Developing Countries , Latin America , Population , Population Characteristics , Population Dynamics , Research , South AmericaABSTRACT
O autor estuda 50 casos de criancas portadoras de glomerulonefrite difusa aguda, ocorridos entre maio de 1973 e setembro de 1976 internados no Hospital Infantil Edith Gama Ramos- Florianopolis - todos com comprovacao anatomopatologica atraves de estudo histologico do material obtido por puncao biopsia renal. Foram analisados os dados relativos a sexo, cor, idade, distribuicao sazonal, infeccao previa, aspectos clinicos, laboratoriais urinarios e sanguineos, com estabelecimento de correlacao entre a gravidade clinica inicial e os dados anatomopatologicos. Encontrou-se os sinais classicos em frequencia elevada, destacando-se o edema. Concluiu-se que quando o edema e generalizado a GNDA esta complicada. As informacoes encontradas na sua maioria estao de acordo com a literatura. Ressalta-se que a gravidade do quadro clinico inicial, exteriorizado pelas complicacoes apresentadas como: insuficiencia renal aguda (IRA), insuficiencia cardiaca congestiva (ICC), edema agudo de pulmao (EAP), encefalopatia hipertensiva (EH), nao demonstrou correlacao direta com o tipo e intensidade da lesao anatomopatologica. Esta foi de proliferacao endocapilar isolada em todos os casos
Subject(s)
Infant , Child, Preschool , Child , Humans , Male , Female , GlomerulonephritisSubject(s)
Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Humans , Male , Female , Acid-Base Imbalance , Intensive Care Units , Water-Electrolyte ImbalanceABSTRACT
Os autores, apos analise dos aspectos clinicos causais e sintomatologicos da desidratacao aguda no lactente, apresentam os resultados obtidos pelo estudo de cem (100) criancas de um a 12 meses, desidratadas e internadas no Servico de Emergencia do Hospital Infantil, no periodo de 1o de janeiro a 30 de marco de 1977, sendo 58 do sexo masculino, 42 do sexo feminino e 93 da raca branca. Do total 81% dos casos ocorreram nos primeiros seis meses, sendo a maioria das criancas de nivel socio-economico baixo e oriundas de areas suburbanas ou rurais. O tempo de doenca previo a internacao, foi superior a 72 horas em 57% dos casos, sendo os sintomas desencadeantes diarreia, vomitos e febre. Os sinais classicos de desidratacao estiveram presentes em todos os casos, apresentando-se a maioria destes casos associados com choque, insuficiencia renal aguda funcional, acidose metabolica, e, principalmente, deplecao de potassio. Dois pacientes faleceram nas primeiras 24 horas e quatro, antes de completar 72 horas de tratamento
