Therapeutic exercise to improve motor function among children with Down Syndrome aged 0 to 3 years: a systematic literature review and meta­analysis.

The effects and the prescription parameters of therapeutic exercise are not clear. For this reason, is needed to determine the effect of therapeutic exercises on the motor function of children with Down Syndrome (DS) aged 0 to 3 years. The present study is systematic review and meta-analysis of effectiveness outcomes in this population: gait, balance, motor development, fine motor skills, and executive functions. The databases of PubMed, PEDro, EMBASE, SCIELO, Lilacs, Cochrane library were searched from January to December 2019. We recruited Randomized Controlled Trials (RCTs) which met the inclusion criteria in our study. Six studies and 151 participants were included. Two types of therapeutic exercises, aerobic and neuromuscular, were identified. Both types of exercise were effective in improving outcomes. There were no differences between the modes of application of the exercise. No differences were identified between the treadmill and the physiotherapy plan for the reduction of the time to reach independent walking, Mean Difference (MD) 46.79, 95% Confidence Interval (IC) (- 32.60, 126.19), nor for the increase in walking speed MD 0.10 IC (- 0.02, 0.21) m/s. This study suggests that aerobic exercise therapy has a potentially effective role to promote the gait and motor development of children with DS aged 0 to 3 years when it is applied using a treadmill with a frequency of 5 days, a duration of 6-8 min, and an intensity of between 0.2 and 0.5 m/s. Studies with less heterogeneity and larger sample sizes are required.

Correction to: Thoracic index in adults with asthma: a study of validity and reliability.

[This corrects the article DOI: 10.1186/s12998-018-0187-x.].

Thoracic index in adults with asthma: a study of validity and reliability.

Background: The Thoracic Index (TI) is a useful tool for evaluating costal mobility as a component of respiritory mechanics in adults with asthma. In a review of the literature, however, few studies were found that reported the psychometrics of this test. The goal of this study is to evaluate the reproducibility and validity of the TI in adults with asthma. Methods: A cross-sectional study was conducted to evaluate the diagnostic tests. Measurements were done randomly by two independent evaluators. The variables measured included thoracic mobility (TI and photogrammetric analysis), sociodemographic and anthropometric variables, and other variables related to the disease. TI reliability included the determination of the intra- and inter-evaluator agreement and reproducibility using the Bland and Altman limits of agreement method and the Interclass Correlation Coefficient (ICC). The convergent validity was established using Pearson's correlation coefficient. The level of significance was p < 0.05. Results: Twenty-six adults with stable asthma participated in this study. The limits of the intra- and inter-evaluator agreement were found to be acceptable and good, respectively, with an average of differences close to zero in both cases. The intra-evaluator reproducibility was between poor and acceptable (TI between 0.57 and 0.93), while the inter-evaluator reproducibility was between acceptable and good (TI between 0.62 and 0.86). The convergent validity between the TI and photogrammetric analysis was between moderate and high (r between 0.55 and 0.73). Conclusions: The TI is a reliable and valid measurement that can be used to evaluate costal mobility in adults with asthma. In a clinical setting, it can contribute to a nonbiased measurement, and in a research environment, it is useful for documenting the results of interventions, reducing the probability that the results will be affected by any variability in measurement.

Effects of pulsed therapeutic ultrasound on the treatment of people with knee osteoarthritis.

[Purpose] The aim was to evaluate the effect of therapeutic ultrasound on the pain, joint mobility, muscle strength, physical function, and quality of life of people with knee OA. [Subjects and Methods] One-site, one-arm, before-after study that included people with Grade II or III tibiofemoral osteoarthritis. Ten therapeutic ultrasound sessions (duty cycle=20%, ERA=10 cm2, BNR=6:1, SATP=2.2 W/cm2, SATA=0.44 W/cm2, frequency=1 MHz, time=4 minutes) were applied. Assessments of primary outcome variables: pain intensity and function, and secondary variables: joint mobility, muscle strength and quality of life, were performed at onset and end of therapy; an additional intermediate evaluation was included for the primary variables. [Results] Means of repeated measurements of pain intensity (pain at rest, pain on palpation and pain after functional activities) and function showed significant differences. There was a significant reduction in pain intensity at the end of functional activities as well as a significant increase in function and in quadriceps muscle strength. [Conclusion] Therapeutic ultrasound applied in accordance with the parameters used, could be recommended during the treatment of individuals with knee osteoarthritis, because it significantly decreased the intensity of pain after the 5th session, and this reduction was maintained until the end of the intervention.