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Background: Patients with juvenile dermatomyositis (JDM) experience muscle weakness, tiredness, and loss of energy, which restrict their abilities in performance of their daily living activities. Objective: To explore the effect of aquatic‐based plyometric (Aqua‐PLYO) exercises on muscle strength, fatigue, and functional ability in patients with JDM. Methods: This was a randomized, single‐blind, crossover pilot study that included 16 patients with JDM (age 13.44 ± 2.85 years). They were assigned randomly to receive either the Aqua‐PLYO exercises (n = 8) or the standard outpatient care (SoC ; n = 8) first. After a 1‐month washout, the treatment was reversed. Lower limb muscle strength, fatigue perception, functional ability, and disease activity were evaluated before and after each treatment period. Results: Irrespective of the treatment order, the Aqua‐PLYO treatment yielded greater improvement in muscle strength (hip flexors and abductors [P < 0.001] or knee flexors [P < 0.001] and extensors [P = 0.0008]), fatigue perception (P < 0.001), functional ability (P = 0.009), and disease activity (P = 0.0001) than the SoC treatment. By using the shortest confidence intervals (100[1–2α]%) of the difference, the average bioequivalence of the Aqua‐PLYO and SoC has not been established at P = 0.05, because the upper and lower confidence bounds of all outcomes were not between the acceptance limits. No period or carryover effects were detected in all outcomes. Conclusion: The Aqua‐PLYO exercise protocol as implemented in this study is safe, feasible, and well‐tolerated in patients with JDM and seemingly useful to help increase muscle strength, reduce fatigue, and enhance functional ability in such a patient population. [ABSTRACT FROM AUTHOR]

BACKGROUND: Trunk-pelvic mal-alignment and postural control deficit are common problems facing children with cerebral palsy (CP). OBJECTIVE: The aim of this study was to investigate the relation of trunk and pelvic alignment with postural control in children with diplegic CP. METHODS: Seventy seven children with spastic diplegic CP, aged from 6 to 8 years with level II on Gross Motor Function Classification System, participated in this study. Trunk imbalance, lateral deviation of the spine and pelvic tilt were evaluated by using Formetric instrumentation system while postural control was assessed by using Pediatric Balance Scale. RESULTS: The results showed that there was a moderate negative correlation of trunk imbalance, lateral deviation of the spine and pelvic tilt with postural control (- 0.44, - 0.59 and - 0.57, respectively). CONCLUSIONS: Increased trunk imbalance, lateral deviation of the spine and pelvic tilt may be associated with decreased postural control ability in children with diplegic CP. [ABSTRACT FROM AUTHOR]

Background: For children with Erb's palsy, difficulties with fine motor control often present as a serious problem that affects their activity of daily lif ADL activities. Objectives: To examine the impact of mirror therapy on fine manual control in children with Erb's palsy. Subjects and Methods: Thirty children with Erb's palsy with their age ranged from 5 to 9 years participated in this study. They were at level 1 on Manual Ability Classification System (MACS) and they were able to follow instruction given to them, they were excluded if they had residual deformity and operation in the hand. They were randomized into two groups: control group (A) as well as study group (B). Both groups were given a designated physiotherapy program as well as control group were given program to improve the fine manual control, while study group were given the similar program but in front of mirror (mirror therapy). Fine manual control was evaluated before and after the treatment utilizing Bruininks Osertesky Test Bot-2, and the program was performed for an hour, 3 sessions per week for 3 consecutive months for all groups. Results: Both groups showed significant improvement in fine manual control post treatment. Significant improvement after treatment in the fine manual control was found favoring study group (p<0.05). Conclusion: Mirror therapy can be utilized in the treatment program of children with Erb's palsy to improve the fine manual control. [ABSTRACT FROM AUTHOR]

Background: Children with chronic liver disease (CLD) have significant impairment in physical function. Physical deconditioning and sarcopenia are two predictors of morbidity and mortality among children with CLD. Purpose: The present study was conducted to evaluate the effect of aerobic and strength training on aerobic capacity, muscle strength, anthropometric measures (height, weight, body mass index (BMI), triceps skin fold thickness (TST), mid upper arm circumference (MUAC), mid arm muscle circumference (MAMC) and mid upper leg circumference (MULC), health related quality of life (HRQOL) and fatigue in children with CLD. Methods: Eighteen children with CLD from both sexes aged from 7 to 14 years old included in the study, they were recruited from Hepatology Clinic of Children's Hospital, Cairo University. They received a designed physical therapy program of aerobic and strengthening exercises twice weekly for 8-weeks. The 6-minute walk test, hand held dynamometer (pneumatic and Lafayette hand held dynamometer), anthroplus software, pediatric quality of life inventory core scale and the pediatric multidimensional fatigue scale were used to assess aerobic capacity, grip and quadriceps strength, anthropometric measures, HRQOL and fatigue respectively pre and post treatment. Results: Comparing the changes from baseline to post-intervention, there was significant improvement in aerobic capacity, grip and quadriceps strength, HRQOL and fatigue (p < 0.05). In addition, there was significant improvement in height and weight Post treatment compared to that pretreatment (p < 0.01) while, there was no significant change in BMI, TST, MUAC, MAMC and MULC (p > 0.05). Conclusion: Aerobic and strength training can be added to rehabilitation program of children with CLD to improve their aerobic capacity, muscle strength and quality of life. [ABSTRACT FROM AUTHOR]

BACKGROUND: Children with spastic diplegia experience tonicity, lack of selective motor control, subnormal postural stability and delayed motor development. Selective dorsal rhizotomy followed by physical therapy is a permanent procedure aimed to alleviate hypertonicity. OBJECTIVE: To explore the efficacy of selective dorsal rhizotomy (SDR) followed by a physical training on gross motor function (GMF), functional balance, walking capacity, selective motor control (SMC) and energy cost of walking (ECW) of ambulant children with spastic diplegia. METHODS: Forty-two children with spastic diplegia aged 5 to 8 years were randomly assigned into the control or SDR-group. Both groups received a designed physical training of progressive functional strength training and standard orthotic management (SOM) 3 times a week for 6 months. GMF, functional balance, ECW, functional capacity and SMC were assessed by gross motor function measure (GMfM-88), pediatric balance scale (PBS), energy expenditure index (EEI), six-minute walking test (6MWT) and selective control assessment of lower extremity (SCALE), respectively. Assessment was carried out before the treatment (baseline), after 6 months (post I) and 1-year follow-up (post II). RESULTS: From baseline to post I and post II assessments, changes of GMF, functional balance, ECW, functional capacity and SMC within the control and SDR groups showed significant improvements (P < 0.001). Moreover, group comparison showed significant differences in favor of the SDR group. CONCLUSION: Integrated physical training followed SDR demonstrated qualitative changes and enhancement in motor function, achieved by spasticity reduction. [ABSTRACT FROM AUTHOR]

Purpose: The cardio-respiratory function is compromised in children recovering from burns, particularly, those who sustain a burn injury across the chest, which leads to further prejudicial effects on physical and psychosocial health. This study endeavored to explore the efficacy of 12 weeks of graded aerobic exercise (GAEx) on the cardiorespiratory capacity and physical and psychosocial functioning in children with burn sequelae of the chest.Methods: Thirty-six burn-injured children aged 10-18 years (%TBSA: 24.2 ± 4.9, and 38.8 ± 12.9 months since injury) were randomly assigned to GAEx group (n = 18; undergone a 12-week intensity- and time-graded aerobic exercise program plus standard rehabilitation) or control group (n = 18; received the standard rehabilitation only). The cardio-respiratory fitness [marked by the peak oxygen uptake (VO2peak), minute ventilation (VE), ventilatory equivalent of inhaled oxygen (VEq/VO2), oxygen pulse (O2P), respiratory exchange ratio (RER), maximum heart rate (HRmax), and the heart rate recovery at one minute (HRR1)] and physical and psychosocial functioning were assessed pre- and post-intervention.Results: Children in the GAEx group showed significant increases in VO2peak (P = 0.013), VE (P = 0.026), O2P (P = 0.034), HRmax (P = 0.035), and HRR1 (P = 0.04) and declines in VEq/VO2 (P = 0.009) and RER (P = 0.011) as compared to the control group. Additionally, the GAEx group reported higher physical (P = 0.029) and psychosocial (P = 0.012) functioning.Conclusion: Twelve weeks of GAEx has salutary effects on cardio-respiratory capacity and physical and psychosocial functioning in children with burn sequelae of the chest. These findings suggest that adding GAEx as a complementary therapy to the long-term rehabilitation protocol for this patient population is worthwhile. [ABSTRACT FROM AUTHOR]

To evaluate the effectiveness of a multimodal exercise program incorporating plyometric and balance training on muscle strength and postural stability in children with spastic hemiplegic cerebral palsy (SHCP). A total of 57 children with SHCP were enrolled in the study and randomly allocated into three treatment-based groups: plyometric exercises (PLYO group; n = 19), balance exercises (BAL group, n = 19), and combined plyometric and balance exercises (PLYO-BAL group; n = 19). The maximum isometric muscle strength (IMSmax) and postural stability [anterior-posterior stability index (AP-SI), mediolateral stability index (ML-SI), and overall stability index (O-SI)] were measured pre- and post-intervention. By applying the intention-to-treat analysis, the PLYO-BAL group showed greater post-treatment IMSmax than the PLYO and BAL groups for the quadriceps (p=.03 and p=.0002 respectively), hamstrings (p=.018 and p<.0001 respectively), and dorsiflexors (p=.006 and p<.0001 respectively). Also, the PLYO-BAL group achieved better post-intervention stability scores as compared to PLYO and BAL groups regarding AP-SI (p<.0001 and p=.0001 respectively), ML-SI (p=.001 and p=.015 respectively), and O-SI (p=.011 and p=.04 respectively). Incorporation of plyometric and balance exercises in a multimodal rehabilitation program could be an important consideration for enhancing muscle strength and boosting postural stability in children with SHCP. [ABSTRACT FROM AUTHOR]