Search

• Many beneficial rehabilitation therapies exist for patients with multiple sclerosis. • Patient-centred plans that include goal setting are crucial aspects of therapy. • Exercise therapy offers physical, cognitive and psychological benefits for patients. • Both in- and out-patient settings can provide patient condition-dependant benefits. • Measurable improvements should be seen in impairment, activity and participation. Multiple sclerosis (MS) is a chronic, debilitating disease characterised by demyelination of the nerves of the central nervous system that results in patients progressively losing the ability to perform daily tasks. As there is no cure for this disease, rehabilitation therapy is an important aspect of care; assisting patients to regain or retain function and improve their physical, mental and social wellbeing. At present there is no current consistent model of care for MS, likely due to the variable symptom presentation. Various forms of rehabilitation therapy are available, and these include physical rehabilitation methods, such as balance and gait therapy, speech and respiration rehabilitation, and occupational therapy. Contrary to previous understanding, exercise-based therapies have shown various benefits for patients with MS, and in addition to improving MS-related physical symptoms, have been shown to reduce the risk of developing cardiovascular disease and can improve cognitive function. Cognition rehabilitation therapy specifically focuses on behavioural tasks and is divided into two main forms: compensatory rehabilitation, which offers cognitive functioning benefits, and restorative rehabilitation, which offers memory benefits. Excitation therapies include cranial stimulation and other stimulation rehabilitation methods such as focal muscle vibration therapy and these non-invasive techniques may improve patient's physical ability. Additionally, more novel rehabilitation methods include robot-assisted gait therapy and telerehabilitation, both of which are expected to play progressively more prominent roles in the future of rehabilitation therapy. The structure of the care team has been found to impact patient outcomes, and both in- and out-patient care settings have been found to be beneficial, dependant on the patient's circumstances, with certain patients better suited to a particular setting. While a single point of care is recommended for patients, a multidisciplinary care team and regular reassessment is recommended to manage changing symptoms and ensure continuity of care. The importance of the critical components of rehabilitation have been identified, and these are of vital importance in achieving beneficial outcomes. These components include the patients' participation in the treatment, goal setting with a multidisciplinary care team, a guiding-light purpose for the patient, which focusses on recognizing their personal potential and obtaining improvements through a tailored plan. The final critical component of rehabilitation is the results measurement, which highlights the need for a quantifiable reduction in impairment and improvement in activity and participation. Overall, a lack of standardisation in outcome measurements makes comparison challenging. This is particularly important when comparing standard methods of care with more novel rehabilitation techniques. However, within the broad area of rehabilitation therapies, it is clear that patients with MS can benefit from rehabilitation practices; physically, mentally and socially. [ABSTRACT FROM AUTHOR]

Objective This study reports on the effects of botulinum toxin A (BoNT-A) injections in the upper extremity (UE) of children with unilateral Cerebral Palsy (uCP) combined with bimanual task oriented therapy (BITT) or either treatment modality performed separately on UE range of motion (ROM), spasticity and (functional) strength. Methods Thirty-five children, mean age 7.14 years (SD 2.63) of whom 11 had a Manual Ability Classification Score (MACS) I, 15 MACS II and 9 MACS III, participated. The trial started with four study groups: BoNT-A-only (n = 5), BITT-only (n = 11), BoNT-A + BITT (n = 13), and control (n = 6). Twenty-two children were randomized and, due to recruitment problems 13 children received their parents' preferred treatment: BoNT-A + BITT or BITT-only. Three comparisons were analysed: BITT (BoNT-A + BITT and BITT-only; n = 24) versus no BITT (BoNT-A-only and control; n = 11), BoNT-A (BoNT-A-only and BoNT-A + BITT; n = 18) versus no BoNT-A (BITT-only and control; n = 17), and the additional effect of BoNT-A (BoNT-A + BITT versus BITT-only). Results BoNT-A significantly decreased key grip strength and finger flexion tone, had a clinically relevant (additional) positive effect on active thumb abduction and supination and a significantly negative effect on unilateral functional strength. BITT + BoNT-A significantly increased active supination. BITT reduced elbow flexor tone and BITT-only resulted in more improvement than BoNT-A + BITT in functional unimanual and, to a lesser extent, in bimanual grip strength. Conclusions In comparison with BoNT-A + BITT, BITT-only gives more improvement on functional grip strength and, therefore, could possibly increase bimanual performance. In this case, the (additional) role of BoNT-A may be an increase in active supination and thumb abduction. [ABSTRACT FROM AUTHOR]

Objective: To evaluate how therapy with a fixed functional appliance affects airway dimensions, dentoalveolar changes, and tongue and hyoid positions. Materials and Methods: A retrospective study was carried out on 46 pre- and posttreatment lateral cephalometric radiographs of 23 post-peak Class II patients (12 girls, 11 boys) treated with a Forsus Fatigue Resistant Device (FRD) appliance. The radiographies were taken at the start and at the end of Forsus FRD appliance therapy when a Class I or overcorrected Class I canine and molar relationship was achieved. The process took an average of 5 months 13 days ± 1 month 4 days. Skeletal and dental parameters were measured using Dolphin software, and the sagittal airway area was measured by AutoCAD software. Results: Analyses of the pre- and posttreatment means revealed that there was no statistically significant skeletal correction of the sagittal malocclusion; increase of lower incisor inclination, decrease of upper incisor inclination, decrease of interincisal angle, and rotation of occlusal plane all contributed to the reduction of overjet. The tongue area and intermaxillary space area increased in response to these dentoalveolar changes; however, there was no statistically significant change in the hyoid position or the oropharyngeal area between the two time points. Conclusions: The dentoalveolar changes produced by Forsus FRD appliance did not cause any significant posterior airway changes in young adult patients. [ABSTRACT FROM AUTHOR]

Copyright of Mondo Ortodontico is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mondo Ortodontico is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective Cerebral palsy (CP) is one of the most common causes of activity limitation in children. Although the central nervous system (CNS) lesion, causing the disorder of posture and movement, is not progressive, the manifestations of the lesion however may change over time. The purpose of this study was to determine the effects of a functional therapy program on motor abilities of children with cerebral palsy. Materials & Methods In the year 2007, in a pre- and post design study, fifteen children, diagnosed with CP at the physiotherapy clinic of Zahedan University of Medical Sciences were recruited using simple non - probability sampling by consulting the child neurologist. Before and after intervention, subjects were classified with Gross Motor Function Classification System (GMFCS) to assess gross motor function with the Gross Motor Function Measure (GMFM). Muscle tonicity was graded, based on the Modified Ashworth Scale (MAS). A 24 session functional physical therapy program which lasted 12 weeks, twice per week, and 90 min per session was carried out. Results Fifteen children with CP (12 boys and 3 girls) aged 21.87±13.37 months were enrolled in this study; six of them were diplegic, 7 hemiplegic, and 2 quadriplegic. After treatment, muscle tonicity decreased from 1.93±0.59 to 0.87±0.64 (P<0.0001). The subjects' GMFM scores increased significantly from 30.52±28.99 to 49.27±26.9 (P<0.0001). Conclusion The results showed that a functional therapy program may be effective in increasing gross motor function and improving daily activities in children with cerebral palsy, thereby decreasing parent and nursing dependency following this program. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the skeletal, dental, and soft-tissue changes in late-adolescent patients treated with Jasper Jumpers applied with sectional arches. The study sample consisted of 30 subjects (15 treated, 15 untreated) with skeletal and dental Class II malocclusion. Our study was carried out on 75 lateral cephalometric films. Among these radiograms, 15 were taken before the leveling stage in the treatment group. Half of the remaining 60 were taken before placement and after removal of the Jasper Jumper appliance in the treatment group and the other half at the beginning and six months after in the control group. The patient selection criteria were Class II malocclusion caused by retrognathic mandible, normal or low-angle growth pattern, and postpeak growth period. The statistical assessment of the data suggests that the sagittal growth potential of the maxilla was inhibited. There were no significant changes in the vertical skeletal parameters. The mandibular incisors were protruded and intruded, whereas the maxillary incisors were retruded and extruded. The upper molars tipped distally as the lower molars tipped mesially. Because of these changes, the occlusal plane rotated in the clockwise direction. Overbite and overjet were reduced, and the soft-tissue profile improved significantly. The results revealed that, in late-adolescent patients, the Jasper Jumper corrected Class II discrepancies mostly through dentoalveolar changes. It is suggested that this treatment method could be an alternative to orthognathic surgery in borderline Class II cases. [ABSTRACT FROM AUTHOR]

This retrospective study (1) cephalometrically investigates the effectiveness of activator therapy, (2) evaluates the contribution of skeletal growth in the self-correction of the Class II malocclusion, and (3) analyzes separately the dental and skeletal responses to activator treatment and the differences between the incisor and molar areas. The subjects, all in the mixed dentition, were selected from a single center and were divided into a group of 40 Class II patients treated with an activator and an untreated group of 30 Class II patients. Dentoskeletal changes that occurred were compared on lateral cephalograms taken before the treatment/observation period and after 21 months (standard deviation, three months). When the activator patients were compared with the untreated control subjects, therapy promoted a combination of skeletal and dental changes that led to an improvement of the sagittal discrepancy. Other changes observed in the untreated Class II subjects did not bring about a correction of the malocclusion. An analysis of the corrective contributions in activator therapy in the posterior area showed that the orthopedic effects were greater than the dental effects in correcting the posterior occlusal relationship. In the anterior area of the arch, although both the skeletal and dental changes were favorable toward the sagittal correction, the skeletal contribution was greater than the dental contribution. In general, the skeletal contribution (140%) exceeded the dental correction (60%), and the mandibular changes (73%) exceeded the maxillary contribution (27%) both in the anterior and posterior regions. [ABSTRACT FROM AUTHOR]

Abstract: Functional jaw orthopedics is one of the commonest modalities for early correction of skeletal Class II malocclusion. Although the mandibular advancement may aid in the correction of disto-occlusion, the overall profile improvement may not be satisfactory because of microgenia. In this case report, an attempt has been made to correct this problem using an early surgical intervention with chin modification (advancement genioplasty) before complete cessation of growth in an adolescent female patient. [Copyright &y& Elsevier]