Effect of a 10-Week Aquatic Exercise Training Program on Gross Motor Function in Children With Spastic Cerebral Palsy

Introduction. Cerebral palsy (CP) is caused by an injury to the developing brain, and abnormal gross motor function is a hallmark of CP. Properly structured exercises on land have been reported to be effective in improving functional performance in children with CP while only few have been documented on aquatic therapy. Objective. To investigate the effect of a 10-week aquatic exercise training program on gross motor function in children with spastic CP. Methods. Thirty participants aged 1 to 12 years were randomized into the experimental and control groups. Both groups received manual passive stretching and functional training exercises, depending on their level of motor impairment, either in water (temperature 28°C to 32°C) or on land. Each exercise training session lasted for about 1 hour 40 minutes, twice per week for 10 weeks in both groups. Measurement of gross motor function was done using Gross Motor Function Measure (GMFM-88) at baseline and after 4 weeks, 8 weeks, and 10 weeks of intervention. Both groups were compared for differences in change in gross motor function using Mann-Whitney U test. The level of significance was set at P < .05. Results. Only the experimental group showed significant improvement (P < .05) in all dimensions of gross motor function except for walking, running, and jumping (P = .112). Statistically significant difference (P < .05) was found between both groups for all dimensions of gross motor function after 10 weeks of intervention. Conclusion. Aquatic exercise training program is effective in the functional rehabilitation of children with spastic CP.

Clinical predictors of functional recovery at six month post-stroke

Aim: To investigate predictors of functional recovery at six-month among Nigerians with first-ever stroke. Methods: Participants with first ever stroke were recruited at stroke?onset from the University College Hospital, Ibadan, Nigeria. Stroke severity was measured using the National Institute of Health Stroke-Scale. Stroke was classified using the results of the CT scan of the brain. The weighted-standard values of Barthel Index and Frenchay Activities Index were combined to indicate Comprehensive Activities of Daily Living (CADL). The presence of depressive features and Trunk-Control (TC) were measured using the Centre for Epidemiological Scale-Depression and the Postural Assessment-Scale for Stroke?Patients respectively. Measurements were taken every month for six months. Data were analyzed using multivariate regression and survival analyses at p=0.05. Results: Sixty?five participants were recruited. Ten died within a week of stroke onset. Fifty-five (mean age = 57.4±14.8 years, 28 males) participants completed the study; Twenty-six (47.3%) had ischaemic stroke and 29 (52.7%) had haemorrhagic stroke. Forty of the 55 participants were married and of the 40, 31 reported spousal support. Type of stroke (β=7.5) and age (β=–0.4) significantly predicted functional recovery after controlling for co-morbidity (β=–2.1), brainstem lesion (β= –0.2), stroke severity (β= –0.6) and TC (β= 0.7) and the scores on depressive symptoms ratings (β= –0.1). Conclusion: Functional recovery at six?month is better in individuals who had haemorrhagic stroke. However, functional recovery decreases as age increases. The combination of haemorrhagic stroke with the presence of co-morbidity predicted death after stroke. DOI: http://dx.doi.org/10.3126/ajms.v6i1.5911 Asian Journal of Medical Sciences Vol.6(1) 2015 49-54

Relationship between balance performance in the elderly and some anthropometric variables

Ability to maintain either static or dynamic balance has been found to be influenced by many factors such as height and weight in the elderly. The relationship between other anthropometric variables and balance performance among elderly Nigerians has not been widely studied. The aim of this study was to investigate the relationship between these other anthropometric variables and balance performance among old individuals aged >60 years in Ibadan, Nigeria. The study used the ex-post facto design and involved two hundred and three apparently healthy (103 males and 100 females) elderly participants with ages between 60 years and 74 years, selected using multiple step-wise sampling techniques from churches, mosques and market place within Ibadan. They were without history of neurological problem, postural hypotension, orthopeadic conditions or injury to the back and/or upper and lower extremities within the past one year. Selected anthropometric variables were measured, Sharpened Romberg Test (SRT) and Functional Reach Test (FRT) was used to assess static balance and dynamic balance respectively. All data were summarized using range, mean and standard deviation. Pearson's product moment correlation coefficient was used to determine the relationship between the physical characteristics, anthropometric variables and performance on each of the two balance tests. The results showed that there were low but significant positive correlations between performance on FRT and each of height, weight, trunk length, foot length, shoulder girth and hip girth. (p<0.05). There was low significant and positive correlation between SRT with eyes closed and arm length, foot length and shoulder girth. (p<0.05) and there was low but significant positive correlation between SRT with eyes opened and shoulder girth and foot length (P<0.05). Anthropometric variables affect balance performances in apparently healthy elderly.

A three year review of sciatic nerve injection palsy in the Physiotherapy Department of a Nigerian Specialist Hospital

Sciatic Nerve palsy associated with intramuscular injection is a major cause of disability among children under 6-years-old in the developing Countries. A retrospective study was conducted with an objective to review cases of all patients with Injection induced sciatic nerve palsy managed at the Physiotherapy Department, State Specialist Hospital, Akure Ondo State over a period of 3 years (January 2004 and December 2006). The case notes of these patients were reviewed and the details of the patients' sex, age and presentations were obtained. Records of 160 patients presenting with Sciatic Nerve Injection Palsy were studied. Males accounted for 60% while 40% were females. They were aged from 3 months to 70 years with paediatric cases accounting for 90% of cases. All of the patients had intramuscular injections following febrile illness. Muscle paralysis with foot drop accounted for 41% cases while 59% had varying degrees of muscle paresis, without foot drop, and 4% had equinovarus deformity as a complication of the paralytic foot drop. Sciatic Nerve Injection Palsy especially in children is a common referral to the Physiotherapy Clinic. There is therefore need for caution in the administration of gluteal intramuscular injections particularly in children.