Psychological Stress Induced by Prone Positioning among Adults with Severe Cerebral Palsy.

The purpose of this study was to investigate the psychological impact of various positionings in subjects with cerebral palsy (CP). The participants were 17 individuals with severe motor and intellectual disability due to CP. They began in a sitting position in their wheelchair, and were placed consecutively in prone or supine positions, with no intervals between placements. Physiological observations were made in each position, and included salivary α-amylase activity, pulse, percutaneous oxygen saturation, respiratory rate, learance or not of airway secretions, and occurrence or not of adverse events. Salivary α-amylase activity values were higher in the prone position than in the baseline and supine positions (p<0.05). Clearance of airway secretions was significantly more prevalent in the prone position than in the baseline and supine positions (p <0.05). The participants' pulse was significantly lower in the supine and prone positions than in the baseline position (p<0.05). Greater prevalence of airway secretion clearance and significantly higher stress levels as indicated by saliva amylase were observed in the prone position than in the other two positions. Therefore, when such patients are placed in a prone position, close attention to airway management and the potential for psychological stress may be necessary.

Physical therapist-led swimming lessons for children with cerebral palsy: a report of 2 cases.

[Purpose] The purpose of this study was to report that a physical therapist qualified for swimming instruction can provide swimming instruction to children with spastic paraplegia due to cerebral palsy. We examined the role of the physical therapist in the support. [Participants and Methods] Two elementary school children with cerebral palsy participated in this study. The swimming program consisting of 6 sessions was performed over 6 months in an indoor swimming pool. Each session lasted for 30 minutes and was instructed by a trained physical therapist. The 5 categories for evaluation were motor function, muscle tone, activities of daily living, swimming skill, and satisfaction level. [Results] Case A showed improvement in streamline floating distance and 15-m time. Case B could not swim 15 m in the first session but completed 15 m within 102 s in the last session. The 3 other categories besides swimming skills did not improve. [Conclusion] With a skilled physical therapist's instruction, children with cerebral palsy may improve their swimming skills over a limited number of sessions without any adverse events.

Incidence of cachexia in patients with advanced gastrointestinal cancer at the beginning of rehabilitation intervention.

[Purpose] We examined the incidence of cachexia at the beginning of rehabilitation in patients with advanced gastrointestinal cancer. [Participants and Methods] Patients with gastrointestinal cancer who were prescribed physical therapy and occupational therapy by their rehabilitation doctor and completed the survey item were targeted. We administered the cancer cachexia assessment and evaluated activities of daily living, and nutritional status in all participants. [Results] There were 15 patients in the normal group, 8 in the normal low-nutrition group, 16 in the pre-cachexia group, and 57 in the cachexia group. The cachexia group showed significantly lower nutritional status, and were less able to perform activities of daily living than the normal and pre-cachexia groups. [Conclusion] The incidence of cachexia among study participants was 17% in the pre-cachexia group and 59% in the cachexia group at the beginning of rehabilitation. Patients with advanced gastrointestinal cancer may have a higher incidence of cachexia at the beginning of rehabilitation.

Spatial distribution of mineralized bone matrix produced by marrow mesenchymal stem cells in self-assembling peptide hydrogel scaffold.

We evaluated the osteogenic differentiation of mesenchymal stem cells (MSCs) using a new class of synthetic self-assembling peptide hydrogels, RADA 16, as a scaffold for three-dimensional culture. MSCs derived from rat bone marrow were culture-expanded and seeded into the hydrogel and further cultured in osteogenic medium containing beta-glycerophosphate, ascorbic acid, and dexamethasone for 2-4 weeks. High alkaline phosphatase activity and osteocalcin (OC) contents were detected at both the protein and gene expression levels during the culture periods. Both calcium and the OC contents increased over time, indicating the growth of a mineralized extracellular matrix within the hydrogel. Moreover, the process of the growth of the mineralized matrix determined by three-dimensional microarchitecture images was obtained by confocal laser scanning microscopy. The findings show that MSCs can differentiate into mature osteoblasts to form mineralized matrices within the hydrogel scaffold. Importantly, the differentiation can occur three dimensionally within the hydrogel, indicating that RADA 16 can be considered attractive synthetic biomaterial for use in bone tissue engineering.