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Introduction. As a result of subjective functional assessment, disturbances in the symmetry of body weight distribution on the support plane are commonly observed in children and adolescents with idiopathic scoliosis. The objective of this study was to identify the relationship between the direction of the primary curvature and the body weight distribution on the ground in children with idiopathic scoliosis. Method. Two groups (the study group and the control group) of children aged 7–11 were included in the study. The study group consisted of 96 children rehabilitated due to scoliosis in rehabilitation centres. The control group included children of the corresponding age, height and weight in comparison to the study group. The main element of the study involved measurements of the percentage body weight distribution on the support plane between the “convex” and “concave” side of the body while maintaining a standing position on both legs. Results. Based on the value of the symmetry index and the direction of the primary curvature, the following subgroups were distinguished among the children with scoliosis: children with symmetrical body weight distribution on the support plane (21%); children with asymmetric body weight distribution on the support plane overloading the convex side (51%) and children overloading the concave side (28%). Conclusion. The occurrence of symmetry disorders in the body weight distribution on the support plane in children with idiopathic scoliosis requires taking these features into account in the early stage of rehabilitation of these children.

Introduction: The Pericapsular Nerve Group (PENG) block is a novel technique that allows for analgesia of the anterior hip capsule via the articular branches of the accessory obturator nerve and femoral nerve, which have a significant role in the innervation of the hip capsule. A PENG (Pericapsular Nerves Group) blockade is effective in both adult and pediatric patients. However, no studies on patients under five are available in the literature. Herein, we describe our experience with two pediatric patients with hip dysplasia. Purpose: This study aimed to evaluate the analgesic effect of the pericapsular nerves group (PENG) in preschool children undergoing hip surgery. Patients and methods: This study included two patients, aged 4 and 2 years old, who were qualified for hip surgery. Spinal or general anesthesia with the addition of a PENG block was performed. During the procedure, the basic hemodynamic parameters were monitored. The pain was assessed using the FALCC (Face, Legs, Activity, Cry, Consolability scale) score. A dose of 15 mg/kg−1 of metamizole was administered if the FLACC score was 3. In the case of a score of 4 on the FLACC scale, the application of 0.2 mg/kg−1 of nalbuphine was ordered. Results: After the surgery, the patients received 15 mg/kg−1 IV paracetamol every 6 h to prevent rebound pain. The patient's hemodynamic parameters were stable and within normal range. In the first 24 h period, the FLACC scores from all patients ranged from 0 to 3. One patient required metamizole 12 h after surgery. No evidence of block complications was observed. Conclusions: This case series showed that the PENG block assured opioid-free pain management and provided adequate postoperative analgesia. However, we are convinced that future randomized, controlled trials are needed in this field.

Introduction Total knee arthroplasty (TKA) is commonly performed in patients with end-stage osteoarthritis or rheumatoid arthritis of the knee to reduce joint pain, increase mobility and improve quality of life. However, TKA is associated with moderate to severe postoperative pain, which remains a significant clinical challenge. Surgeon-administered PAI and anesthesiologist-administered iPACK have proven viable alternatives to conventional peripheral nerve blocks. This review aims to discuss which IPACK block or periarticular injection, combined or not with different peripheral nerve blocks, has better effects on postoperative rehabilitation, patient satisfaction, and overall outcome. Material and Method The literature was reviewed through four electronic databases: PubMed, Cochrane Library, Google Scholar, and Embase. Results The initial search yielded 494 articles. Fifty-eight relevant articles were selected based on relevance, recentness, search quality, and citations. Six studies compared PAI to peripheral nerve block (PNB), and eight studies checked the effectiveness of adding PNB to PAI. Three studies compared iPACK to PNB, and ten studies checked the effectiveness of adding PNB to iPACK. Conclusions The best analgesic effect is obtained by combining PAI or iPACK with a peripheral nerve block, particularly with ACB, due to its analgesic and motor-sparing effect, and satisfactory analgesia

A review of the literature indicated that the greatest prognostic value for predicting motor impairment in high-risk infants is the absence of fidgety movements (FMs) at 3 months of post-term age. The purpose of the present study was to characterize a new posturometric test (PT) based on a center-of-pressure (CoP) movement analysis, in terms of design and construct validity, for the detection of postural control disturbances in pre-term infants. The comparative studies were carried out between pre-term infants who presented normal FMs (18 participants) and infants with absent FMs (19 participants), which consisted of the analysis of the CoP trajectory and CoP area in supine and prone positions using the force platform. New PT was performed simultaneously with GMs recorded using a force platform. Statistical analyses revealed significant differences between the groups of infants who presented absent FMs and normal FMs for almost all CoP parameters describing spontaneous sway in the supine position. Based on these preliminary results, it can be concluded, that the application of PT based on the analysis of CoP trajectory, area, and velocity in the supine position has been demonstrated to be valid for the detection of postural control disturbances in pre-term infants.

The aim of this study was to identify the correlations between segmental body composition and the spasticity level of the affected lower limb in children with unilateral cerebral palsy (spastic hemiplegia). Additionally, an attempt was made to identify the differences in composition between the affected and unaffected lower limbs using segmental body composition analysis. This case–control study included 31 children with spastic hemiplegia aged 8 to 16 years with differing severities of spasticity in the lower limbs. The reference group consisted of a control group which included 31 peers with corresponding age and sex to the tested group. Negative correlations obtained in the statistical analysis showed that higher spasticity level in the iliopsoas muscle is associated with lower limb fat-free mass and lower limb muscle mass. Our results showed that children with spastic hemiplegia have worse parameters of body composition in the affected limb than in the unaffected one. To confirm the importance of these results, further studies are needed in a larger population which includes non-ambulatory children.

Background:Women after mastectomy may decide to either have a breast reconstruction or use an external breast prosthesis. Aim: The aim of the presented research was to evaluate the influence of external breast prosthesis on postural stability in women after mastectomy. Methods and Procedures: In the study 52 women after unilateral mastectomy took part. The study consisted of 4 parts: 1) anthropometric measurements; 2) measurements of upper limb circumference; 3) assessment of weight-bearing (WB); and 4) posturographic tests (PT). Outcomes and Results: Differences in the arm circumferences on the amputated (A) and non-amputated (NA) sides did not confirm the occurrence of lymphedema in limb on amputated side. The results of the WB between the A and NA body sides in both tested conditions, i.e., with open and closed eyes, showed no significant differences between the test with and without an external prosthesis. No statistically differences have been observed between posturometric parameters with and without breast prosthesis during both PT. In comparing the posturometric parameters between the PT with open and closed eyes, the sway path of the center of pressure was statistically significantly longer when eyes were closed in both conditions, i.e., with and without breast prosthesis. Conclusion and Implications: The finding show that 1) external breast prosthesis does not have a significant influence on the symmetry of loading on the A and NA body sides and on the postural stability of women after unilateral mastectomy and 2) exclusion visual control during PT increases postural instability in women after unilateral mastectomy.

In Poland at the turn of 19th and 20th century a modernizing Jewish family appears quite frequently in anti-Semitic and non-anti-Semitic “Jewish novels”. In both cases a Jewish family is presented in rather pejorative light as a point of reference to a Polish family. In such comparison Polish culture and Poles are presented as a more attractive, more civilized and that is why their way of living is followed by the Jews. Jewish families try to undergo the process of assimilation but their effort are depicted in rather pejorative or even ridiculous way. There are some Jewish heroes presented as a role model, but they only prove the role. There is a huge gap between Poles and Jews who have to make an effort to change their personality and behaviour according to Polish expectations. In anti-Semitic novels a description of the process of modernization and assimilation of Jews had to prove its negative consequences. Jews were treated as enemies and novels’ plot revealed their main goal – the conquest of Poland. This kind of writing can be also seen as a warning against mix marriages to prevent Polish society from the integration with Jews, who are presented as the main threat of homogeneity of Polish nation.

Background: Bovine colostrum (BC) contains a myriad of bioactive molecules that are renowned for possessing unique medicinal benefits in children and adults, and BC supplements are considered safe and cost-effective options to manage/prevent the incidence of upper respiratory tract infections and gut-related problems in athletes. In this review, we will try to answer the question: How will BC supplementation ameliorate gut permeability problems among athletes? Methods: Literature searches were performed using PRISMA guidance to identify studies assessing the influence of BC supplements on gut permeability. Studies were selected using four databases: PubMed, Web of Science, Scopus, and EBSCO, and a total number of 60 articles were retrieved by using appropriate keywords. Results: Nine studies were selected that met the eligibility criteria for this review. The data analysis revealed that vigorous exercise profoundly increases intestinal permeability, and BC supplementation helps to reverse gut permeability in athletes. Conclusion: BC supplementation may be highly beneficial in improving gut permeability in athletes. However, well-designed, placebo-controlled, and randomized studies are needed to evaluate the long-term safety and efficacy and to determine the optimal dose schedules of BC supplementation in high-performance athletes.

Background Gut microbiota is considered to have a great impact on human health and disease. While it is widely recognized that the gut microbiota of healthy individuals differs from those with obesity, inflammatory bowel disease, metabolic syndrome, and other chronic diseases, the alterations of gut microbiota with physical activity are not fully understood. Accordingly, we performed this systematic review to address the question regarding the effects of mild and intense exercise on the gut microbiota in humans. Methods The comparative analyses of gut microbiota were conducted following the PRISMA protocol to determine the differences in the active vs. non-active individuals (phenotypes) (n = 11), including the influence of physical activity intervention on the human gut microbiota (n = 13); the differences in the gut microbiota of athletes vs. non-athletes (n = 8); and the microbiota status at different stages of athletic performance or intervention (n = 7), with various of physical activities, sport disciplines, and activity duration. Literature searches were completed using four databases: PubMed, Web of Science, Scopus, and EBSCO, and 2090 articles were retrieved by using appropriate keywords. The low heterogeneity of the studies hasn’t allowed us to prepare a meta-analysis. After excluding 2052 articles, we ultimately selected 38 articles that met the eligibility criteria for this review. Results The data analyses revealed that in non-athletes rising physical activity markedly influenced the relative abundance of short-chain fatty acid (SCFA). Aerobic training that lasted 60 min, and physical activity that characterized 60% HRmax or more also influenced beta diversity indexes. The results showed that athletes harbor a more diverse type of intestinal microflora than non-athletes, but with a relatively reduced abundance of SCFA- and lactic acid-producing bacteria, thereby suggesting an adverse effect of intense exercise on the population of gut microbiota. Conclusion It is concluded that the level of physical activity modulates the gastrointestinal microbiota in humans. For a long period, increasing the intensity and volume of exercise may lead to gut dysbiosis. Perhaps, proper supplementation should be considered to keep gut microbiota in large biodiversity and richness, especially under unfavorable gut conditions associated with intense exercise. Trial registration Prospero CRD42021264064.

IntroductionThis study aimed to investigate the relationship between prenatal, perinatal, and postnatal risk factors for neurodevelopmental impairment (NDI) with the outcomes of General Movement (GM) Assessment (GMA) in pre-term infants at 3–5 months of age. We sought to identify the risk factors associated with the predictors of psychomotor development in pre-term newborns, such as normal fidgety movements (FMs), absent FMs, or abnormal FMs, assessed during the fidgety period of motor development.MethodsThe SYNAGIS program (prophylactic of Respiratory Syncytial Virus Infection) was used to identify risk factors for the development of neuromotor deficits in 164 pre-term infants who were at high risk of developing these deficits. Based on the GMA, all participants were divided into three groups of infants who presented: (1) normal FMs; (2) absent FMs; and (3) abnormal FMs.ResultsThe results of the current study suggest that abnormal GMs not only indicate commonly known factors like birth asphyxia (BA), respiratory distress syndrome (RDS), periventricular leukomalacia (PVL), intraventricular hemorrhage (IVH) grades 3–4, but also predict the development of motor impairments. In the present study, several specific risk factors including bronchopulmonary dysplasia (BPD), infertility treatments, maternal acute viral/bacterial infections during pregnancy, and elevated bilirubin levels were identified as attributes of an atypical fidgety movement pattern.ConclusionsAdditional clinical data, such as risk factors for NDI associated with early predictors of psychomotor development in pre-term newborns, i.e., absent or abnormal FMs, may be helpful in predicting neurological outcomes in pre-term infants with developmental concerns in the 1st month of life.

Background: the current study aims to evaluate the reliability and repeatability of a new PT based on Center of Pressure (CoP) movement analysis in a repeated measures design. Methods: the examination consisted of two parts: (1) the videotaping of General Movements (GMs) and GMs assessment (GMA) and (2) Posturometric Tests (PT) in supine and prone positions. PTs were performed twice (by two investigators) in the supine and prone positions using a force plate. Based on the GMA results, infants were stratified into two groups: (1) infants with normal FMs (indicating normal future motor outcomes) (n = 18) and (2) infants with abnormal FMs (indicating later neurological dysfunction) (n = 19). Results: the comparative analysis between the groups of infants with normal FMs and abnormal FMs in PT in supine showed significant differences for all parameters that described spontaneous CoP displacement. The reliability analysis determined that all ICCs of the outcomes presented at least a moderate level of reliability. The ICCs were higher for outcomes of PT performed in the supine position than in the prone position. The ICCs were higher for outcomes of PT performed in infants with abnormal vs. normal FMs. Conclusions: although the current study yielded promising results, further longitudinal research in preterm infants should identify whether altered postural control parameters prognose future motor outcomes.

Cardiovascular diseases are the most common causes of death, in both Poland and the world. Their development and progression are largely influenced by the lifestyle with the presence/occurrence of classic, modifiable risk factors. Among them, low physical activity plays a significant role. The aim of the study was to evaluate the expression of the endothelin-1 gene and its type A receptor, taking into account physical activity (International Physical Activity Questionnaire—IPAQ) among patients with acute myocardial infarction. A total of 234 patients with acute myocardial infarction were examined, including 167 patients undergoing early post-hospital cardiac rehabilitation and 67 not participating in it. All of them were assessed with the IPAQ questionnaire and the quantitative real-time polymerase reaction method (QRT-PCR). Physical activity in the group of patients after early post-hospital cardiac rehabilitation increased after rehabilitation. Transcriptional activity of the endothelin-1 (ET-1) gene in both studied group of patients increased significantly, but in a group of patients not participating in early post-hospital cardiac rehabilitation more than in a group of patients participating in it. In our study, the expression of ET-1 was also significantly higher in the group of patients with acute myocardial infarction with ST-segment elevation, without diabetes, with lipid disorders, smoking, with normal body weight. Expression of the ENDRA (Endothelin receptor A) gene increased with age. These results prove the beneficial effect of rehabilitation and may indicate another pathomechanism of pro-atherogenic activity of above-mentioned factors.

We tested the hypothesis that a regular training program might reduce gait disturbances during dual cognitive-motor tasks in elderly women. This open-label experimental study comprised 53 postmenopausal women aged over 65, who were assigned to a 10-week training program (360 min/week). A BTS SMART system examination during free walking and during dual tasks [i.e., walking while performing either a simple (SCT) or a complex (CCT) cognitive task] was performed prior to the training program and again after it had finished. After the 10-week walking training program, a significant decrease was found in the duration of single support phase, double support phase, total support phase, and gait cycle, whereas values for such BTS parameters as swing speed, step length, and gait speed increased significantly. The greatest percentage deltas between the final and initial values of the respective BTS parameters concerned swing speed and gait speed irrespective of the kind of task undertaken while measurements were taken. A cognitive task, irrespective of the level of difficulty, performed during walking had the opposite effect on step width than expected. A 10-week training program significantly improved the cadency and manner of gait in elderly women, but did not change step width. Therefore, further study is needed to estimate the usefulness of cognitive-motor training programs for significant improvement in gait coordination during dual tasks in elderly women.

“HOW ENORMOUS IS SEMITIC POWER”: POETRY IN JAN JELEŃSKI’S ROLA Rola was the first antisemitic weekly in Poland published in Warsaw between 1883 and 1912. According to the nineteenth-century custom, not only journalism, but also novels published in weekly installments, as well as poems were included in the magazine. In poetry, lofty or religious topics were raised at the time of Christmas or Easter, or virulent antisemitic satire was published on various occasions. The antisemitic satire corresponded to the themes taken up in prose and journalism. The themes were dominated by the myth of Judeopolonia, issues of assimilation and social advancement of Jews, attacks on mixed marriages and mockery of Zionism, or the colonies established by Baron Hirsch in Argentina. It can be said that both prose and poetry were servile to journalism and strengthened the antisemitic content dominant in the weekly.

(1) Background: Excessive body weight is a global problem in the 21st century. Children and adolescents, in particular, are at risk. Recently, there has been an increasing interest in the relationship between aerobic capacity and body composition. Therefore, this study aimed to determine the association between the individual parameters of cardiopulmonary capacity obtained in cardiopulmonary exercise testing (CPET) and selected parameters of body mass composition in high-BMI children and children over the 85th percentile according to the WHO growth reference. (2) Materials and Method: The research included 100 children of school-age (7–15 years) with an excessive BMI, i.e., over the 85th percentile as per the WHO Growth Reference (BMI percentile 95.21 ± 4.65; Z-score BMI: 2.07 ± 0.94). The study consisted of three parts: anthropometric measurements, measurement of body mass composition using a body composition analyzer (TANITA MC-780 S MA) using the bioimpedance method, and a cardiopulmonary exercise test on a pediatric cycle ergometer (Corival Pediatric, Lode BV) using the Godfrey protocol; (3) Results: The correlation between BMI and fat mass (FM) was very high (rho = 0.83; p = 0.00) with moderate body fat percentage (BF%) (rho = 0.48; p = 0.00). There was a relevant correlation between the amount of fat-free mass in total body mass and cardiopulmonary capacity expressed as the absolute aerobic capacity (VO2peak) (rho = 0.55; p = 0.00). (4) Conclusions: In the case of children and youth with higher BMI, there was a correlation between the amount of fat-free mass in total body mass and cardiopulmonary capacity in terms of absolute aerobic capacity.

Andrzej Szopa,1 Małgorzata Domagalska-Szopa,2 Anetta Lasek-Bal,3 Amadeusz Żak3 1Department of Physiotherapy, 2Department of Medical Rehabilitation, School of Health Sciences in Katowice, 3Department of Neurology, Professor Leszek Giec Upper Silesian Medical Centre, Medical University of Silesia, Katowice, Poland Introduction: While the asymmetry of body posture and the asymmetrical nature of hemiparetic gait in poststroke (PS) patients are well documented, the role of weight shift asymmetry in gait disorders after stroke remains unclear. Objective: We examined the association of weight-bearing asymmetry (WBA) between paretic and nonparetic lower limbs during quiet standing with the degree of deviation of hemiplegic gait from normal gait evaluated by the Gillette Gait Index (GGI) incorporating 16 distinct clinically important kinematic and temporal parameters in chronic PS patients.Participants and methods: Twenty-two ambulatory patients with chronic stroke aged between 50 and 75 years were included in this study. Fourteen patients had hemiparesis on the nondominant side and 8 on the dominant side. The mean time PS was 2 years and 6 months. The reference group consisted of 22 students from the University of the Third Age presenting no neurological disorders. The examination consisted of posturographic weight-bearing (WB) distribution and 3-dimensional gait analyses.Results: A significant positive relationship between WBA and GGI was revealed. Moreover, we observed a significant negative association between WBA and paretic step length and walking speed. With regard to kinematic data, the range of motion of knee flexion and peak dorsiflexion in the swing phase of the paretic leg were significantly negatively associated with WBA.Conclusion: Although further research is needed to determine a causal link between postural control asymmetry and gait disturbance in hemiplegics, our findings support the inclusion of WB measurements between paretic and nonparetic body sides in early assessment after stroke. Keywords: stroke, weight-bearing, 3DGA, gait disturbances, Gillette Gait Index&nbsp

Background: The positive findings from our previous studies, which revealed the link between postural and gait patterns in children with unilateral cerebral palsy (CP) were very encouraging for recognition this relationship in children with bilateral cerebral palsy (CP). Therefore, the objective of this study was to evaluate whether different gait patterns corresponding to postural patterns in children with bilateral CP could be statistically significant according to a cluster analysis. Methods: Fifty-eight participants with bilateral CP and 45 matched children with typical growth and development. The participants walked barefoot along a treadmill at their own pace. Three-dimensional kinematic data were collected using the Measuring System for Motion Analysis. To characterize gait patterns, the Gillette Gait Index (GGI) and its 16 distinct gait parameters were used. The participants were divided into four subgroups according to their postural patterns. Results: A cluster analysis revealed 4 gait patterns corresponding to postural patterns: (1) normal gait pattern corresponded to neutral posture; (2) balanced gait pattern corresponded to balanced posture; (3) lordotic gait pattern corresponded to lordotic postural pattern; (4) swayback gait pattern corresponded to backward-leaning posture. There were significant differences in mean GGI and various clusters in the 8 GGI gait parameters: cadence, mean pelvic tilt; mean pelvic rotation, minimum hip flexion, peak hip abduction in swing; knee flexion at initial contact, and peak dorsiflexion in stance. Conclusion: Our results showed that gait discrepancies among children with bilateral CP were not simply a result of lower limb kinematic deviations in the sagittal plane. Information on different gait patterns could improve early therapy in children with bilateral CP before abnormal gait patterns are fully established.

Children with Cerebral Palsy (CP) show the postural constraints while standing, and gait disorders, resulting from both primary and secondary impairments of brain injury. In our previous studies, several characteristic postural and gait patterns in children with unilateral as well as with bilateral CP were defined, and the relationship between these patterns was demonstrated. The purpose of present study was to identify which features of body posture deviation during standing were strongly related to gait deviations in independently ambulatory children with CP. For this aim we explored the cross-relationship between features of body posture while standing examined by surface topography and the selected gait parameters from three-dimensional instrumented gait analysis in one hundred twenty children with cerebral palsy, aged between 7 and 13 years, who were able to walk independently. First, our study documented that that sagittal misalignment of the spine curvature was significantly related to kinematic deviations such as deviations of pelvic tilt, inadequate swing phase and knee flexion, and peak dorsiflexion in stance. Second, the study shows that the static asymmetry of pelvis and trunk was significantly associated with kinematic deviations during gait cycle such as pelvic rotation, hip abduction in swing, ROM of knee flexion, peak dorsiflexion in stance. Based on obtained results and referring to our previous findings it can be assumed that the first model of the relationship between postural deviation and gait disturbances, called 'postural and gait complex of disorders in sagittal plane', is related to children with bilateral CP, whereas the second model 'postural and gait complex of disorders in coronal plane' to children with unilateral CP. The clinical applications of this study relate to the early recognition of particular features of postural deviation using surface topography, instead of more difficult and demanding expensive tools 3-D gait analysis.

Postural control deficit is one of the most important problems in children with cerebral palsy (CP). The purpose of the presented study was to compare the effects of body posture asymmetry alone (i.e., in children with mild scoliosis) with the effects of body posture impairment (i.e., in children with hemiplegia) on postural stability. Forty-five outpatients with hemiplegia and 51 children with mild scoliosis were assessed using a posturography device. The examination comprised two parts: (1) analysis of the static load distribution; and (2) a posturographic test (CoP measurements) conducted in three postural conditions: standing, sitting and kneeling. Based on the asymmetry index of the unaffected/affected body sides while standing, the children with hemiplegia were divided into two different postural patterns: a pro-gravitational postural pattern (PGPP) and an anti-gravitational postural pattern (AGPP) (Domagalska-Szopa & Szopa (2013). BioMed Research International, 2013, 462094; (2014). Therapeutics and Clinical Risk Management, 10, 113). The group of children with mild scoliosis, considered as a standard for static body weight distribution, was used as the reference group. The results of present study only partially confirmed that children with hemiplegia have increased postural instability. Strong weight distribution asymmetry was found in children with an AGPP, which induced larger lateral-medial CoP displacements compared with children with scoliosis. In children with hemiplegia, distinguishing between their postural patterns may be useful to improve the guidelines for early therapy children with an AGPP before abnormal patterns of weight-bearing asymmetry are fully established.

Introduction Skiing being one of most popular sport disciplines has a long history and tradition. Snowboarding was counted into leading sport disciplines in the 1970s. Both disciplines popularity growth led to increase of injuries rate. Knowledge of risk factors, causes and injuries patterns allows to improve safety and decrease injuries and harmful effects. Aim Study aim was an attempt to characterize injuries patterns in skiing and snowboarding. Material and methods Study involved 100 people (60 females and 40 males), age range: 20–49 years (mean age: 30.95 ± 10.64). Participants were Upper Silesia Region inhabitants, 70% of them do skiing while 30% snowboarding. Study was based on self-prepared questionnaire. Results and discussion 45% of questioned sustained injury during skiing or snowboarding. In skiers knee joint injuries dominated (45%) while in snowboarders most frequently shoulder joint was affected (25%). Contusions predominately occurred in snowboarders (63%), in skiers sprains were most frequent (47%). Falls were main causes of injuries in both groups. Age, ability, fitness and physical activity level are factors increasing risk of injuries. Sex and weather conditions do not impact on injuries occurrence. Conclusions Anatomical localization and types of injuries occurring in skiing and snowboarding differentiates both disciplines.

Spasticity is a common impairment that interferes with motor function (particularly gait pattern) in children with cerebral palsy (CP). Gait analysis and clinical measurements are equally important in evaluating and treating gait disorders in children with CP. This study aimed to explore the relationship between the spasticity of lower extremity muscles and deviations from the normal gait pattern in children with CP. Thirty-six children with spastic CP (18 with spastic hemiplegia [HS] and 18 with spastic diplegia [DS]), ranging in age from 7 to 12 years, participated in the study. The children were classified as level I (n=24) or level II (n=12) according to the Gross Motor Function Classification System. Spasticity levels were evaluated with the Dynamic Evaluation of Range of Motion (DAROM) using the accelerometer-based system, and gait patterns were evaluated with a three dimensional gait analysis using the Zebris system (Isny, Germany). The Gillette Gait Index (GGI) was calculated from the gait data. The results show that gait pathology in children with CP does not depend on the static and dynamic contractures of hip and knee flexors. Although significant correlations were observed for a few clinical measures with the gait data (GGI), the correlation coefficients were low. Only the spasticity of rectus femoris showed a fair to moderate correlation with GGI. In conclusion, the results indicate the independence of the clinical evaluation and gait pattern and support the view that both factors provide important information about the functional problems of children with CP.

Background Standing postural alignment in children with cerebral palsy is usually altered by central postural control disorders. The primary aim of this study is to describe body alignment in a quiet standing position in ambulatory children with bilateral cerebral palsy compared with children with typical development. Methods Fifty-eight children with bilateral cerebral palsy (aged 7–13 years) and 45 age-matched children with typical development underwent a surface topography examination based on Moire topography and were classified according to their sagittal postural profiles. Findings The following eight grouping variables were extracted using a data reduction technique: angle of trunk inclination, pelvic tilt, and lordosis, the difference between kyphosis and lordosis, angle of vertebral lateral curvature, shoulder inclination, and shoulder and pelvic rotation. According to the cluster analysis results, 25% of the participants were classified into Cluster 1, 9% into Cluster 2, 49% in Cluster 3, and 17% in Cluster 4. Interpretation Three different postural patterns emerged in accordance with the sagittal postural profiles in children with bilateral cerebral palsy and were defined as follows: 1) a lordotic postural pattern corresponding to forward-leaning posture; 2) a swayback postural pattern corresponding to backward-leaning posture; and 3) a balanced postural pattern corresponding to balanced posture.

Summary Background Functional classification systems generally divide children with cerebral palsy (CP) into mild, moderate, and severe types. Although depending on functional limitations, they do not seem to evaluate abnormal postural patterns in standing. Since the most asymmetrical patterns can be observed in hemiplegia, the goal of this case series study was to provide their objective analysis and to establish any potential clinical value for evaluation and management of CP. Material/Methods A group of 36 children (aged 5–10 years) with spastic hemiplegic CP, who could stand and ambulate independently, were selected. The photogrammetric and pedobarographic studies were obtained for the postural analysis in standing. Results Two different anti- and pro- gravitational postural patterns were identified. They seem not only to affect functional status and rehabilitation potential, but also clinical value for evaluation and management of CP hemiplegia. Conclusions The importance of strong study design cannot be overemphasized. The 2 different postural patterns indicate dissimilar compensatory tendencies, which may help in prognosis of deformity and functional outcomes of rehabilitation. The use of objective photogrammetric and the pedobarographic studies may also help to develop a more specific therapeutic intervention in order to facilitate the pattern leading towards better outcome (orthosis in the anti-gravitational postural pattern vs focal spasticity management in the pro-gravitational postural pattern).

Children with cerebral palsy (CP) often have atypical body posture patterns and abnormal gait patterns resulting from functional strategies to compensate for primary anomalies that are directly attributable to damage to the central nervous system. Our previous study revealed two different postural patterns in children with unilateral CP: (1) a pattern with overloading of the affected body side and (2) a pattern with under-loading of the affected side. The purpose of present study was to test whether different gait patterns dependent on weight distribution between the affected and unaffected body sides could be detected in these children. The study included 45 outpatients with unilateral CP and 51 children with mild scoliosis (reference group). The examination consisted of two inter-related parts: paedobarographic measurements of the body mass distribution between the body sides and three-dimensional instrumented gait analysis. Using cluster analysis based on the Gillette Gait Index (GGI) values, three gait patterns were described: a scoliotic gait pattern and two hemiplegic gait patterns, corresponding to overloading/under-loading of the hemi-side, which are the pro-gravitational gait pattern (PGP) and the anti-gravitational gait pattern (AGP), respectively. The results of this study showed that subjects with AGP presented a higher degree of deviation from the normal gait than children with PGP. This proof that there are differences in the GGI between the AGP and PGP could be a starting point to identify kinematic differences between these gaits in a follow-up study.

Background Development of a reliable and objective test of spasticity is important for assessment and treatment of children with cerebral palsy. The pendulum test has been reported to yield reliable measurements of spasticity and to be sensitive to variations in spasticity in these children. However, the relationship between the pendulum test scores and other objective measures of spasticity has not been studied. The present study aimed to assess the effectiveness of an accelerometer-based pendulum test as a measurement of spasticity in CP, and to explore the correlation between the measurements of this test and the global index of deviation from normal gait in in children with cerebral palsy. Methods We studied thirty-six children with cerebral palsy, including 18 with spastic hemiplegia and 18 with spastic diplegia, and a group of 18 typically-developing children. Knee extensor spasticity was assessed bilaterally using the accelerometer-based pendulum test and three-dimensional gait analysis. The Gillette Gait Index was calculated from the results of the gait analysis. Results The data from the accelerometer-based pendulum test could be used to distinguish between able-bodied children and children with cerebral palsy. Additionally, two of the measurements, first swing excursion and relaxation index, could be used to differentiate the degree of knee extensor spasticity in the children with cerebral palsy. Only a few moderate correlations were found between the Gillette Gait Index and the pendulum test data. Conclusions This study demonstrates that the pendulum test can be used to discriminate between typically developing children and children with CP, as well as between various degrees of spasticity, such as spastic hemiplegia and spastic diplegia, in the knee extensor muscle of children with CP. Deviations from normal gait in children with CP were not correlated with the results of the pendulum test. Electronic supplementary material The online version of this article (doi:10.1186/1743-0003-11-166) contains supplementary material, which is available to authorized users.

Inhibiting casts, introduced to rehabilitation practice by NDT-Bobath therapists, are being used with increasing frequency in the physiotherapy of children with cerebral palsy (CP). In the literature these plaster casts are known as tone-reducing plasters, spasticity-reducing plasters, or short leg plaster casts. The casts are installed on the lower leg and foot in the form of plaster shoes to immobilize the foot and ankle joints in the proper position. This creates conditions for constant manipulation of the limb using key points located on the lower leg and foot. According to the NDT-Bobath concept, this enables positive changes in postural and locomotor patterns, as well as the distribution of postural tone. The construction and application of these inhibitive casts are not the same as in the standard plaster casts used to correct foot deformations. The casts are placed on both feet regardless of the type of paresis, for a period from one to three weeks, depending on the child's age. New casts can be applied repeatedly during the child's rehabilitation. Experience shows that inhibitive casts are a very important aid in the treatment of CP children. The decision to use plaster casting requires experience and detailed functional assessment for each individual child, in terms of muscle tone distribution, the necessary compensatory patterns, and disturbances in the coordination of motor patterns.