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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: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.

Background: One of the objective methods of assessing the level of cardiopulmonary capacity in overweight and obese children and adolescents is cardiopulmonary exercise testing (CPET).Aims: The purpose of present study is an evaluation of aerobic capacity in high body mass index (BMI) children and adolescents by comparing them with a normal weight control group by CPET.Methods and Procedures: The subjects were recruited from participants of the Program of Treatment for Overweight and Obese Children organized by a local pediatric rehabilitation center in Poland. Based on BMI for age and gender, two validation groups were selected: (1) a group of overweight children (n = 49) and (2) a group of obese children (n = 48). The study included also 53 normal weight participants as a reference group (REF). The study consisted of two parts: anthropometric measurements and CPET. The Godfrey protocol for CPET was applied.Outcomes and Results: In this study, obese children and adolescents showed similar absolute VO2peak values in liters per minute (1.64 L/min) compared to overweight children (1.48 L/min), but significantly higher than children with normal body weight (1.39 L/min). The obese children and adolescents presented lower VO2peak in relation to body weight (25.44 ml/kg/min) compared to their peers with normal body weight (36.5 ml/kg/min), and overweight children (29.18 ml/kg/min).Conclusion and Implications: The main finding of our study was recognition of significant differences between cardiopulmonary capacity parameters in obese children in comparison not only to normal weight peers, but to overweight, too.

This study investigated the effectiveness of whole-body vibration (WBV) training incorporated into a conventional physiotherapy (PT) program (WBV-assisted training) in improving blood flow in the lower limbs and range of motion in the lower limb joints of children with myelomeningocele (MMC). A total of 31 children with MMC (7–15 years old) underwent a 6 weeks treatment program consisting of 2 weeks of conventional PT followed by 4 weeks of WBV-assisted training. The assessment comprised two parts: evaluation of lower limb joint range of motion and Doppler ultrasonography of the superficial femoral, popliteal, and anterior tibial arteries and was performed three times for each of the participants (at baseline, after 10 sessions of PT but before WBV-assisted training, and after 20 sessions of WBV-assisted training). Our results showed that WBV-assisted training significantly improved lower limb circulation in patients with MMC, increasing velocity and reducing resistivity in all tested arteries. Moreover, WBV-assisted training alleviated lower-extremity contractures, especially of the knee. Thus, WBV-assisted training is effective as an adjunctive rehabilitation program for improving functional mobility in children with MMC.

Introduction: The vascular properties of individuals with myelomeningocele (MMC) are an underestimated problem, as evidenced by the lack of relevant research. Therefore, this study was conducted to assess the venous properties of the leg in children with MMC. This study compared the duration of retrograde flow (RF) of the distal and proximal sites of the great saphenous vein (GSV) in children with MMC and typically developing (TD) children. Additionally, the impact of MMC clinical features, such as the anatomical level of the spinal cord defect, muscle strength of the lower limbs, and level of gross motor functional abilities on the of GSV sufficiency were assessed.Methods: Thirty ambulant children between 7 and 12 years with MMC and an age- and sex-matched sample of thirty children with typical development (TD) were included in the study. All participants underwent a complete physical examination that included gross motor assessment, manual muscle testing, and duplex ultrasound examination of the GSV reflux. The duration of retrograde flow (RT) in the GSV was evaluated at four sites: P1: proximal thigh; P2: medial thigh; P3: upper leg; and P4: lower leg. The measurements were performed in two body positions: horizontal position (HP) and vertical position (VP).Results: Children with MMC showed increased duration of RT of both the proximal and peripheral sites of GSV, as compared with the TD peers. The prevalence of GSV reflux in peripheral segments was significantly higher than in the proximal segments. The severity of MMC (expressed by higher level of the spinal cord defect), deficit of thigh and leg muscle strength, and lower functional independence negatively influenced the GSV sufficiency in patients with MMC. Gravity directly influenced GSV reflux occurrence and reflux hemodynamic parameters in MMC.Conclusion: These findings may help better understand aspects concerning the risk of developing venous insufficiency in children with MMC and determine better screening, prevention, and treatment algorithms for venous insufficiency in patients with SB.

Background and Purpose: Children who have survived cancer are at risk of experiencing adverse effects of the cancer or its treatments. One of the adverse effects may be the limitation of ankle dorsiflexion (DF), which may result in “toe walking.” Although there is an increasing number of studies in pediatric oncology presenting evidences of different therapeutic interventions to improve DF function, none of these therapeutic interventions has been sufficiently documented. This case report shows the results of non-invasive neurodevelopmental treatment program combined with application of inhibiting casts in a pediatric cancer patient who presented with severe and persistent toe walking. The treatment was aimed to improve DF function and postural and gait pattern and to normalize weight distribution between forefoot and heel.Case Presentation: A 7-year-old girl with T-cell lymphoma, who presented with severe and persistent toe walking, was assessed 10 times over a course of 6 months by both clinical examination (ankle range of motion measurement) and neurophysiological measures (weight distribution between forefoot and hindfoot, postural sway, body posture, and gait).Outcomes: Neurodevelopmental treatment program combined with application of inhibiting casts for 3 months increased passive ankle DF by 10° in both lower limbs, normalized weight distribution between the forefoot and heel in both lower limbs, as well as established a heel-toe walking gait pattern. Improved ankle DF function and normalized postural and gait patterns were maintained in repeated examinations even 3 months after the removal inhibiting casts.Discussion: Early identification of toe walking in the female pediatric patient with T-cell non-Hodgkin's lymphoma and early physiotherapy intervention were beneficial in terms of her body posture and gait pattern development. Non-invasive neurodevelopmental treatment program combined with application of inhibiting casts as described in this study can be useful for managing treatment side effects in pediatric cancer patients.

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.