RESUMEN

PURPOSE: Provide an updated review regarding treatment dosage for children with cerebral palsy (CP) by examining the variables of type, time, frequency, and intensity. METHODS: A systematic review was performed with 30 articles meeting the inclusion criteria. Two authors independently extracted data including information about risk of bias. Ten articles were included in the review. RESULTS: Eight studies manipulated time, two studies manipulated frequency, and three studies manipulated both variables. No studies investigated intensity. Findings suggest that manipulating time and/or frequency may result in better motor function for higher total dosing; however, benefits were not consistent across studies and few showed clinically significant improvements. CONCLUSION: This most current evidence regarding the effect of dosage on motor function for children with CP suggests that there is insufficient evidence to support implementing high-dosage therapy. Further research is needed to clarify the relationship between dosage variables on motor function for children with CP.

Asunto(s)

RESUMEN

The kinetics and mechanism for the bleaching of Calmagite (H3CAL, 3-hydroxy-4-(2-hydroxy-5-methylphenylazo)naphthalene-1-sulfonic acid) in aqueous solution at pH 8.00 and 23 ± 1 °C using in situ generated H2O2 is described. Complete mineralisation of H3CAL results with turnover frequencies (TOF = moles of H3CAL bleached per mole of manganese per hour) of 40 h(-1). The monohydroxy azo dyes Me-H2CAL, Orange G and Orange II are not bleached which indicates that a requirement of dye bleaching is the coordination of the dye to the Mn centre. Spectroscopic studies show the formation of Mn(CAL)2 and Mn(CAL) species but in the presence of Tiron (1,2-dihydroxybenzene-3,5-disulfonate, disodium salt, monohydrate, Na2TH2·H2O), [Mn(CAL)(T)] is formed. It is proposed that a Mn(III)-hydroperoxide species is generated, [Mn(O2H)(CAL)(TQ)] from the in situ generated H2O2, where TQ represents the o-quinone form of Tiron, and this is the active species in the bleaching of coordinated CAL; the formation of this hydroperoxide species is supported by UV/VIS and ESI-MS data. The formation of a Mn(III) species is supported by EPR studies which also show some evidence for the presence of a labile d(5) Mn(II) species in the presence of the reducing substrate hydroxylamine (NH2OH). This would enable rapid ligand exchange for both in situ H2O2 generation and dye bleaching to occur; there is no evidence for the presence of Mn(IV)=O species. The virtue of low local concentrations of in situ generated H2O2 is shown to be important in preventing over oxidation of the catalyst and thus contributing to a robust catalytic system.

RESUMEN

The induction of strain in carbocycles, thereby increasing the amount of s-character in the C-H bonds and the acidity of these protons, has been probed with regard to its effect on the rate constants for the enolization of cyclobutanone. The second-order rate constants for the general base-catalyzed enolization of cyclobutanone have been determined for a series of 3-substituted quinuclidine buffers in D(2)O at 25 °C, I = 1.0 M (KCl). The rate constants for enolization were determined by following the extent of deuterium incorporation (up to ∼30% of the first α-proton) into the α-position, as a function of time. The observed pseudo-first-order rate constants correlated to the [basic form] of the buffer and yielded the second-order rate constants for the general base-catalyzed enolization of cyclobutanone for four tertiary amine buffers. A Brønsted ß-value of 0.59 was determined from the second-order rate constants determined. Comparison of the results for cyclobutanone to those previously reported for acetone and a 1-phenylacetone derivative, under similar conditions, indicated that the ring strain of the carbocycle appeared to have only a small effect on the general base-catalyzed rate constants for enolization. The similarity of the rate constants for the general base-catalyzed enolization of cyclobutanone to those determined for acetone allowed for an estimation of the limits of the rate constant for protonation of the enolate intermediate of cyclobutanone by the conjugate acid of 3-quinuclidinone (k(BH) = 5 × 10(8) - 2 × 10(9) M(-1) s(-1)). Combining the rate constants for deprotonation of cyclobutanone (k(B)) and protonation of the enolate of cyclobutanone (k(BH)) by 3-quinuclidinone and its conjugate acid, the pK(a) of the α-protons of cyclobutanone has been estimated to be pK(a) = 19.7-20.2.

Asunto(s)

RESUMEN

OBJECTIVE: The aims of this study were to (1) investigate the effectiveness of CIMT for children with hemiplegia, (2) determine the feasibility of using fMRI for describing brain activity patterns before and after CIMT and (3) describe changes in brain reorganization after CIMT in children with hemiplegia using fMRI. DESIGN: Before and after study with one group. METHODS: Ten children aged 7-14 years (M = 11.0, SD = 2.5) with hemiplegia received CIMT over a 2-week period using a before and after design. Clinical measures included the Melbourne Assessment of Unilateral Upper Limb Function, upper limb kinematics and parent questionnaire. Children were measured with fMRI before and after CIMT. RESULTS: Findings showed that CIMT may be effective at improving upper limb function in some, but not all children; those children with a moderate degree of impairment seemed to benefit the most. fMRI findings correlated moderately with clinical measures. CONCLUSION: Although unique challenges with fMRI data collection exist for this population, it provides potentially valuable information to better understand mechanisms of change after interventions such as CIMT.

Asunto(s)

RESUMEN

OBJECTIVE: This case report describes the use of modified constraint-induced movement therapy (CIMT) to improve upper-limb function in a 12-month-old child with right hemiplegia. It also describes parent concerns about CIMT and documents the short- and long-term effects of modified CIMT. METHOD: The participant was assessed 5 times over a 7.5-month period using the Peabody Developmental Motor Scales-2, Pediatric Motor Activity Log, Toddler Amount of Use Test, and Knox Parent Questionnaire. CIMT included a nonremovable cast worn on the unaffected arm and approximately 8 hr per week of occupational and physical therapy for 2 weeks. RESULTS: Benefits of improved upper-limb function measured immediately after CIMT were sustained at 6 months' follow-up. No adverse events related to cast use were reported. DISCUSSION: The findings from this case report suggest that CIMT was a safe intervention associated with improving upper-limb function for this young child with hemiplegia.

Asunto(s)

RESUMEN

BACKGROUND: A cost effective tool for the measurement of trunk reposition sense is needed clinically. This study evaluates the reliability and validity of a new clinical spine reposition sense device. METHODS: The first part of this three part investigation included 45 asymptomatic subjects examined in the first 20 repeated trials portion assessing spine reposition sense. The second portion, test-retest, examined 57 asymptomatic subjects. Initial testing consisted of subjects sitting on the device and performing 20 trials of a self-determined 2/3 trunk flexion position. The second portion of the study involved 7 trials of trunk flexion performed twice. The angular position for each trial was calculated and the mean reposition error from the initial 2/3 position was determined. For the third portion, the new device was compared to the Skill Technologies 6D (ST6D) Imperial Motion Capture and Analysis System. RESULTS: ICC (3,1) for trials 4-7 was 0.79 and 0.76 for time one and time two, respectively and the test-retest ICC (3,k) was 0.38. Due to the poor test-retest ICC, the Bland Altman method was used to compare test and retest absolute errors. Most measurement differences were small and fell within the 95% confidence interval. Comparable measures between the two methods were found using the Bland Altman method to compare the reposition sense device to the ST6D system. CONCLUSION: The device may be a cost effective clinical technique for sagittal trunk reposition sense measurement.

Asunto(s)

RESUMEN

Hydrogen peroxide (H(2)O(2)) generated from the manganese(II) catalysed reduction of dioxygen has been shown to efficiently oxidize Calmagite (3-hydroxy-4-(2-hydroxy-5-methylphenylazo)naphthalene-1-sulfonic acid) in aqueous solution at pH 8.0 and 20 +/- 1 degrees C with de-protonated Tiron (1,2-dihydroxybenzene-3,5-disulfonate, disodium salt) acting as an essential co-ligand.

Asunto(s)

RESUMEN

OBJECTIVE: The aim of this study was to investigate the effects of two interventions (sensorimotor and therapeutic practice) on handwriting and selected sensorimotor components in elementary-age children. METHOD: Thirty-eight children 6 to 11 years of age with handwriting dysfunction but no identified educational need were randomly assigned to one of the two intervention groups or a control group. Intervention groups met four times per week over 5 weeks. Handwriting was measured pre- and postintervention using the Test of Handwriting Skills. Visual perception (motor-reduced), visual-motor integration, proprioception, and in-hand manipulation were also measured. RESULTS: Children receiving therapeutic practice moderately improved handwriting whereas children receiving sensorimotor intervention declined in handwriting performance. The control group did not change significantly. Sensorimotor impairment was noted at pretest in three or four components and selected sensorimotor component function improved with intervention. CONCLUSION: Therapeutic practice was more effective than sensorimotor-based intervention at improving handwriting performance. Children who received sensorimotor intervention improved in some sensorimotor components but also experienced a clinically meaningful decline in handwriting performance.

Asunto(s)