Postural Disorders Research Articles

Recent Trends and Growing Knowledge about Physiotherapy Mangement in Breast Cancer - Related Lymphedema

Breast cancer is the most common malignant tumor in women. Surgery often carries a lot of unwanted changesas follows: limitation of mobility in the shoulder joint on the operated side, secondary lymphoedema, reductionof muscle strength or disorders in body posture. Therefore, the implementation of physiotherapeutic activitiesthat are designed to prevent and eliminate postoperative complications seems very important. The main aim ofthis work was to present recent advances in the physiotherapeutic management in cancer treated women basedon the analysis of available literature. The purpose of the study was to analyse recent advances along with thecurrent techniques that are effective in the treatment of breast cancer related lymphedema (BCRL). The posterfocuses on spreading awareness about the recent PT management techniques to treat the problems. This study isa narrative review for which 50 articles were retrieved from different search engines out of which 8 are assessed.Articles included were published in last 5 years, included subjects with unilateral BCRL and PT interventionfor stage II BCRL and also had circumferential measurement as one of the primary outcome measure. Articlesincluding subjects with lymphedema due to any other condition, mixed approach towards lymphedema, andthose which provide inadequate knowledge about methodology were excluded. The articles analysed provedefficacy of new techniques i.e., kinesio taping, virtual reality and tele-rehabilitation in BCRL and continued tosupport the traditional methods (manual lymphatic drainage, strengthening exersices, pneumatic compression).This article is implied to spread awareness about recent trends being followed for the treatment of lymphedemaso that these techniques can be included in the physiotherapy treatment protocol.

Comparison of the Dynamic Postural Control During Lifting and Lowering an External Load in Low Back Pain: A Cross-Sectional Study

ObjectiveThis study aimed to compare dynamic postural control between individuals with and without chronic low back pain (LBP) through load lifting and lowering. MethodsThis cross-sectional study included 52 male patients with chronic LBP (age: 33.37 ± 9.23 years) and 20 healthy male individuals (age: 31.75 ± 7.43 years). The postural control parameters were measured using a force plate system. The participants were instructed to stand barefoot (hip-width apart) on the force plate and lift a box (10% of the weight of the participants) from the waist height to overhead and then lower it from overhead to waist height. The interaction between the groups and tasks was determined using a 2-way repeated-measures analysis of variance. ResultsThere was no significant interaction between the groups and tasks. Regardless of the groups, postural control parameters including amplitude (P = .001) and velocity (P < .001) in anterior-posterior (AP) direction, phase plane in medial-lateral (ML) direction (P = .001), phase plane in AP-ML direction (P = .001), and the mean total velocity (P < .001) were lesser during the lowering compared with lifting. The results indicated that, regardless of the tasks, the postural control parameters including velocity (P = .004) and phase plane in AP direction (P = .004), velocity in ML direction (P < .001), phase plane (AP-ML) (P = .028), and mean total velocity (P = .001) in LBP were lesser compared with the normal group. ConclusionDifferent tasks affected postural control differently in patients with LBP and healthy individuals. Moreover, postural control was more challenged during the load-lowering than the load-lifting task. This may have been a result of a stiffening strategy. It may be that the load-lowering task might be considered as a more influential factor for the postural control strategy. These results may provide a novel understanding of selecting the rehabilitation programs for postural control disorders in patients.

Relationship Between Functional Classification Systems in Children With Cerebral Palsy

Objective: Cerebral palsy refers to a group of postural and movement disorders that limit movements and can be related to a non-progressive disorder in the developing brain. The international classification of disability emphasizes the child's functional abilities and routine performance. Some classification tools have been developed to describe and evaluate child's functions in daily activities such as walking, manipulating objects, and everyday communication. The present study aimed to investigate the relationship between classification systems (gross motor function, manual ability, communication function, and eating and drinking ability) in children with cerebral palsy. Materials &amp; Methods: This study was performed by cross-sectional correlation method and of descriptive analytical type. Children with cerebral palsy aged 12-144 months were recruited by convenience sampling from patients referred to clinics and public and private rehabilitation centers in Tehran and Arak cities, Iran, in 2019-2020. After completing the demographic information questionnaire by the child's primary caregiver, the gross motor function classification system (GMFCS), manual ability classification system (MACS), Communication function classification system (CFCS), and eating and drinking ability classification system (EDACS) were completed by a child therapist. Results: In the present study, 154 children with a Mean±SD age of 49.45±32.22 months participated. also, 87 children (56.5%) were boys, and 67(43.5%) were girls. According to GMFCS, the highest percentage distributions at levels II and IV were 31.2% and 26%, respectively. In other words, more than 57% of children were distributed in these two levels. According to MACS, the distributions of the highest percentages at levels II, III, and IV were 28.6%, 22.1%, and 20.8%, respectively. In other words, more than 70% of the children were distributed in these three levels. According to EDACS, the distribution of almost all levels was equal except the V level, with 4.3% having the lowest percentage. According to CFCS, the distribution of the highest percentage at levels V and IV was 23.5%. In examining the relationship between functional systems, significant relationships were observed in all cases: MACS and GMFCS, r=0.672; CFCS and GMFCS, r=0.581; EADCS and GMFCS, r=0.593; CFCS and MACS, r=0.555; EADCS and MACS, r=664; EADCS and CFCS, r=0. 547 (P&lt;0.01). Conclusion: It seems that children with more motor function limitations show more limitations in other performance classification systems, too. Of course, the number of studies in this field is limited and needs further investigation.

Bir Öksüz Kızıl Geyik Yavrusunda (Cervus elaphus) Distal Metakarpus Kırığı ve Bandajlı Tedavisi (Olgu Sunumu)

In this case report, a 1-week-old female red fawn (Cervus elaphus), one of the largest deer species in the world, constituted the study material. In the clinical examination, posture disorder, severe lameness and malnutrition in young deer were determined in the anterior left and right feet. Radiographic examination of the case revealed a distal diaphyseal transversal fracture in the left metacarpal bone, and a fracture in the lateral 1st and medial 2nd phalanx distal in the right anterior extremity. General anesthesia was not preferred due to the lack of complicated fracture types and malnutrition in the young deer, and the treatment of the extremities, which were placed in a plaster bandage with mild sedation, was kept under follow-up. After the first week of 21-day plaster application, open wound formation on the foot was noticed and wound treatment was performed by opening a window on the plaster. It was aimed to inform our colleagues and other readers about the red deer phenomenon, which has been taken under protection because its population has decreased in Turkey, and to raise awareness.

The occurence of postural disorders and muscular imbalance in children from urban and rural environment

Background. Postural examination is considered to be one of the most important parts of the general examination and is therefore the basis for correct diagnosis and determining preventive measures or appropriate treatment procedures. Objective. The aim of the study was to evaluate the functional status of school-aged children. Methods: The study was carried out at selected primary schools in Slovakia, we examined 453 children. We assessed the quality of the postural system according to Thomas Klein´s evaluation, modified by Mayer, the presence of shortened and weakened muscles according to Janda. The following measurements were used to assess the range of motion of the spine: Otto’s inclination and reclination distance, Schober’s distance, Stibor’s distance and Thomayer’s distance. Results. A statistically significant difference was found in the examination of gluteal muscles strength l.dx. (p = 0.03), gluteal muscles l.sin. (p ≤ 0.001), with the children from urban environment having, on average, lower muscle strength. Statistically significant differences were found in the evaluation of m. trapesiusl.dx. at significance level p = 0.04, m. trapesiusl.sin. at the level of significance p ≤ 0,001, with higher average values found in children from the urban environment. Conclusion. Children from countryside show better postural outcomes and exhibit fewer postural disturbances than children from city backgrounds.

Synergistic effect of functional strength training and cognitive intervention on gross motor function in children with cerebral palsy

Background Cerebral palsy (CP) is a posture and movement disorder, however; it often includes disturbance of different aspects of cognitive function. This study aimed to investigate if combined functional strength training (FST) and cognitive intervention are more effective than either of them alone on gross motor function in children with spastic diplegic CP. Methods Sixty-four children with spastic diplegic CP, with ages ranging from 8 to 12 years, were assigned randomly into four treatment groups; Group I; FST, group II; cognitive training, group III; combined FST and cognitive training, group IV; conventional physical therapy. The Gross Motor Function Measure (GMFM-88) was used to assess gross motor function at baseline, post-treatment, and 6 months follow-up. Results Group III achieved a significant improvement in GMFM-88 when compared to other groups post-treatment and at follow-up. Conclusion This study suggests that combined lower limb FST and cognitive intervention had the potential to produce significantly more favorable effects than the single use of either of them on gross motor function in children with spastic diplegia.

Effects of MgSO4 Alone or Associated with 4-PBA on Behavior and White Matter Integrity in a Mouse Model of Cerebral Palsy: A Sex- and Time-Dependent Study.

Cerebral palsy (CP) is defined as permanent disorders of movement and posture. Prematurity and hypoxia-ischemia (HI) are risk factors of CP, and boys display a greater vulnerability to develop CP. Magnesium sulfate (MgSO4) is administered to mothers at risk of preterm delivery as a neuroprotective agent. However, its effectiveness is only partial at long term. To prolong MgSO4 effects, it was combined with 4-phenylbutyrate (4-PBA). A mouse model of neonatal HI, generating lesions similar to those reported in preterms, was realized. At short term, at the behavioral and cellular levels, and in both sexes, the MgSO4/4-PBA association did not alter the total prevention induced by MgSO4 alone. At long term, the association extended the MgSO4 preventive effects on HI-induced motor and cognitive deficits. This might be sustained by the promotion of oligodendrocyte precursor differentiation after HI at short term, which led to improvement of white matter integrity at long term. Interestingly, at long term, at a behavioral level, sex-dependent responses to HI were observed. This might partly be explained by early sex-dependent pathological processes that occur after HI. Indeed, at short term, apoptosis through mitochondrial pathways seemed to be activated in females but not in males, and only the MgSO4/4-PBA association seemed to counter this apoptotic process.

Digital models and tools for diagnosing three-dimensional spinal deformity based on stereophotogrammetry data

Scoliosis is the most common orthopedic disease in children, which most often leads to disability. An urgent task of the current stage of the development of spinal deformity diagnostics is the search and introduction of new available methods of non-invasive safe diagnosis of spinal deformity at early stages, since existing diagnostic methods can detect spinal column deformity in three planes during the development of scoliosis, however, they have a number of limitations for use, since either X-ray radiation or diagnostic installations are used for their implementation, requiring complex installation in a separate room and training of operating personnel. In this regard, there is an urgent need to develop digital tools for the diagnosis of spinal deformity, which would neutralize these difficulties in clinical practice. The aim of the study was to develop a mathematical algorithm for identifying the deformation of the spinal column in the horizontal plane according to the photogrammetric evaluation of a three-dimensional model of the surface of the human back, which was obtained from the results of the operation of the original software for a personal telecommunications device. The algorithm for assessing spinal column deformity is a sequence of four stages: reposition of the coordinate system, stratification of the spine line into segments, calculation of the rotation of V-segments, separation of the V-segment ratios to the physiological bends of the spine and visualization of spinal deformity in the horizontal plane. The developed algorithm has a number of advantages compared to those developed earlier: it allows to identify the rotation of individual vertebrae and torsion of the spine as a whole, is implemented in relation to all vertebrae of the thoracic and lumbar spine, thereby providing the possibility of differentiated diagnosis of forms of spinal deformity - from posture disorders to scoliosis. The described algorithm is a separate part for modular software that allows diagnostics of spinal column deformity using a personal telecommunication device. This algorithm can be used in a comprehensive assessment of posture disorders and scoliosis, monitoring the dynamics of spinal column deformity in the rehabilitation process.

Determinants of cognitive impairment in multiple system atrophy: Clinical and genetic study.

Classically, cognitive impairment (CI) was not considered as a paramount feature of multiple system atrophy(MSA) in both parkinsonian(MSA-P) and cerebellar(MSA-C) motor-subtypes. Yet, growing evidence indicates currently the commonness of such deficits among MSA patients in different populations. Our aim was to evaluate the cognitive profile of MSA Tunisian patients and to analyze the underlying clinical and genetic determinants. In a retrospective cross-sectional study, clinically-diagnosed MSA patients were included. All subjects underwent clinical and neuropsychological assessments to characterize their cognitive profile. The associations with their APOE genotype status were analyzed. Determinant of CI were specified. We included 71 MSA patients. Female gender(sex-ratio = 0.65) and MSA-P subtype(73%) were predominant. Mean age of disease onset was 59.1years. CI was found in 85.7% of patients(dementia in 12.7% and Mild cognitive impairment(MCI) in 73% of patients mainly of multiple-domain amnestic type(37.3%)). Mean MMSE score was lower among MSA-P compared to MSA-C(23.52 vs. 26.47;p = 0.027). Higher postural instability gait disorder(PIGD) and MDS-UPDRS-III scores were noted in demented MSA patients(p = 0.019;p = 0.015 respectively). The main altered cognitive domain was attention(64.8%). Executive functions and mood disorders were more affected in MSA-P(p = 0.029,p = 0.035 respectively). Clinical and neurophysiological study of dysautonomia revealed no differences across cognitive subtypes. APOE genotyping was performed in 51 MSA patients with available blood samples. Those carrying APOEε4 had 1.32 fold higher risk to develop CI, with lower MMSE score(p = 0.0001). Attention and language were significantly altered by adjusting the p value to APOEɛ4 carriers(p = 0.046 and p = 0.044 respectively). Executive dysfunction was more pronounced among MSA-PAPOEε4 carriers(p = 0.010). In this study, the main determinants of CI in Tunisian MSA patients were MSA-P motor-subtype, mainly of PIGD-phenotype, disease duration and APOEε4 carrying status, defining a more altered cognitive phenotype. This effect mainly concerned executive, attention and language functions, all found to be more impaired in APOEε4 carriers with variable degrees across MSA motor-subtypes.

Scapular dyskinesis and loss of cervical lordosis in myofascial pain syndrome and its effects on pain and posture disorders.

This study aimed to evaluate scapular dyskinesia and loss of cervical lordosis in myofascial pain syndrome and its effects on pain and posture disorders. In this cross-sectional study, 101 individuals (74 females, 27 males; mean age: 44.3±8.8 years; range, 25 to 60 years) with chronic neck pain were recruited between January 2021 and February 2021. Demographic and clinical data of the patients were recorded. Visual Analog Scale (VAS), posture evaluation form, the scapular dyskinesia test, the lateral scapular shift test, and Cobb's methods for cervical angle measurements were used in the evaluation of the patients. In the study population, 52.25% of patients had loss of cervical lordosis, and 44.5% of patients had scapular dyskinesia. It was observed that the VAS activity score was significantly higher in individuals with loss of cervical lordosis, all VAS scores and pain duration were significantly higher in individuals with scapular dyskinesia (p<0.05). Shoulder elevation, rounded shoulder, forward head posture, and kyphosis were significantly higher in patients with scapular dyskinesia, while thoracic kyphosis was significantly higher in patients with both scapular dyskinesia and loss of cervical lordosis (p<0.05). The presence of trigger points was found to be significantly higher in patients with scapular dyskinesia and in patients with both scapular dyskinesia and loss of cervical lordosis (p<0.05). In patients with chronic neck pain diagnosed with myofascial pain syndrome, the presence of loss of cervical lordosis and scapular dyskinesia have negative effects on pain and posture.

Evaluation of the effect of low-intensity rhythmic transcranial magnetic stimulation on motor and non-motor manifestations of Parkinson's disease

BACKGROUND: The use of repetitive transcranial magnetic stimulation as a method of non-drug therapy of Parkinson's disease has been actively studied over the past decades. The prevailing number of repetitive transcranial magnetic stimulation protocols in Parkinson's disease use a high intensity of stimulation (80120% of the value of the threshold of the evoked motor threshold from the muscles of the hand), while the choice of the stimulation intensity parameter was carried out empirically.&#x0D; AIM: to study the effectiveness of low-intensity unilateral repetitive transcranial magnetic stimulation on motor and non-motor symptoms of Parkinson's disease.&#x0D; MATERIAL AND METHODS:An open prospective non-randomized clinical trial included 37 patients with stage IIII Parkinson's disease according to HoehnYahr (1967), akinetic-rigid and mixed (akinetic-rigid-tremor) forms. All patients underwent repetitive transcranial magnetic stimulation according to the protocol: M1 stimulation zone, frequency 5 Hz, intensity 40% of the cortical motor threshold, on 6s, off 8s, total number of pulses per session 3000. The course of treatment is 10 procedures with 2 days (weekend) off.&#x0D; RESULTS: All patients completed the study in accordance with the protocol. When analyzing the results of the UPDRS scale (Unified Parkinson's disease rating scale), positive dynamics was noted in all parts of the questionnaire: part I ― from 2 (0; 3) to 0 (0; 1) points, p 0.05; part II ― from 9 (5.5; 12.5) to 4 (2; 6.5) points, p 0.05; part III ― with 11 (7; 14.5) to 6 (2; 7.5) points, p 0.05; part IV (Schwab and England scale) ― from 80% (70; 95) to 90% (85; 100), p 0.05. There was also a selective effect on non-motor symptoms.&#x0D; CONCLUSION: Low-intensity exposure (40% of the motor threshold) has a significant clinical effect on motor and non-motor symptoms of Parkinson's disease; stimulation of the primary motor cortex can have an antidepressant effect; repetitive transcranial magnetic stimulation has a selective effect on non-motor symptoms of Parkinson's disease: a predominant effect has been demonstrated with respect to olfactory, emotional, cognitive disorders, sleep disorders and hypersalivation; when assessing the dynamics of motor disorders, a more pronounced effect was noted with respect to rigidity, postural disorders, walking speed, and to a lesser extent, the effect on tremor was noted.

Posture correction in children 11-12 years old by means of swimming with elements of aquafitness

The article is devoted to the justification of the use of a physical therapy program using swimming equipment to improve the physical condition of children aged 11-12 years with postural disorders. The relevance of the study is due to the critical sharp increase in the incidence of disease among children all over the world, in particular, in Ukraine in recent years. The evaluation method was the measurement of Moshkov's rhombus, acromial, digital, iliac crest and lower angles of the scapula of the point. According to the results of the study, it was found that among boys aged 11-12 years under the influence of classes under the rehabilitation program using swimming equipment with elements of aquafitness, the number of people with an index of vertical curvature of the spine of 100.0-90.0% increased by 30.77%, among girls - by 38.46%. At the same time, the number of persons with a spine curvature index of 79.9-70.0% in the main groups of boys and girls decreased significantly compared to the control groups. The feasibility of using the proposed program of complex rehabilitation with the use of swimming equipment with the use of elements of aquafitness was proven due to a significant improvement in the indicators of posture assessment in the studied children 11-12 years old.

IMPAIRED VERTICALITY PERCEPTION IN PATIENTS WITH HEMISPHERIC STROKES: PREVALENCE, ASSOCIATED FACTORS (CROSS-SECTIONAL STUDY)

Introduction. In recent decades, among the causes of post-stroke postural balance disorders, a lot of attention has been paid to disorders of verticality perception. Impairments of verticality perception have different forms: from lateropulsion to pushing syndrome. Aim: to study the prevalence of verticality perception impairments during the 1st month after strokes and to determine the factors associated with this phenomenon. Material and methods. 205 patients with hemispheric strokes that occurred during the last month were examined. The Scale for Contraversive Pushing scale was used to assess the orientation of the body axis in relation to the force of gravity in the frontal plane. We determined socio-demographic factors, clinical and neurological characteristics, cognitive and psycho-emotional characteristics, neuroimaging parameters. Impaired verticality perception was diagnosed in 70 patients (34,2%): lateropulsion – in 61 (29,8%), pushing syndrome – in 9 patients (4,4%). No associations were found between impaired vertical perception and age, gender of patients, level of paresis, presence of apraxias and aphasias, NIHSS scale scores, modified Rankin scale scores, stroke type (ischemic/hemorrhagic), cognitive, anxiety and depressive disorders, fatigue, localization of cerebral infarction, level of leukoaraiosis, morphometric indicators of external and internal cerebral atrophy. On the other hand, patients with impaired verticality perception had significantly more often paresis (in case of lateropulsion - in 96.7%, in pushing syndrome - in 100%, in patients with normal verticality perception - in 75.6%), spatial hemineglect (70.5 %, 88.% and 17.8%, respectively), non-lacunar subtype of ischemic stroke (91.8%, 100% and 73.4%, respectively), lesions of the right hemisphere (73.8%, 77.7% and 57.0%, respectively), also they had significantly larger volumes of cerebral infarctions (20.3 (13.4-28.9) cm3, 24.1 (12.9-27.2) cm3 and 15.8 (8.5 -23.3) cm3, respectively). Conclusions. During the first month after stroke, impaired verticality perception is a common phenomenon associated with certain clinical and neuroimaging characteristics.

Level of Awareness and Attitude Toward Cerebral Palsy Among Parents in Al-Baha City, Saudi Arabia.

Background Cerebral palsy (CP) is a chronic disorder of motion, posture, and tone which occurs due to brain insult during the period of brain growth. It is a disabling disorder in both motor and intellectual aspects.Fortunately, CP is a manageable disease that can be managed in part by increasing the knowledge and understandingof the parents. Methodology This cross-sectional, prospective, community-based study aimed to assess the level of parents' knowledge and their attitude toward CP using an electronic questionnaire. The parents' knowledge was classified as good or poor based on an adopted scoring system. The parents' attitude was categorized as positive or negative. Results Our study results showed that good knowledge (those with a score more than 60% of the total score) was noted in 275 (61.1%) participants, whereas 175 of the participants had poor knowledge (38.9%), especially regarding awareness of the diagnosis of CP. Conclusions Most participants had an overall good knowledge of CP although they had insufficient knowledge of some aspects of the disease such as causes, disease course, clinical presentations, diagnosis, and prognosis. Although the results showed a positive attitude concerning playing with a child with CP, unfortunately, there was a negative attitude toward hiring a CP patient and a strongly negative attitude toward marrying a patient with CP.

Evaluation of the Functional Status of the Posture Control System in Children with Detected Disorders in Body Posture.

Screening tests for body posture defects and abnormalities conducted over the past several decades have revealed a significant and constantly increasing problem of health risks in children. A sedentary lifestyle, which is considered to be the primary cause, can result in proprioceptive disorders leading to postural instability. The aim of the study was to find the correlation between the level of proprioceptive control and the number of postural disorders. The study involved a representative group of 1090 children aged 8-10 years, from randomly selected primary schools. Subjects who scored from 1 to 5 points in a prior postural screening test were qualified for the examination of the postural control system. The examination of the postural control system was carried out using an electronic station enabling assessment of postural stability and proprioception. A single leg stance test showed that the number of postural disorders does not significantly impact proprioceptive control. Proprioceptive control was found to significantly increase with the age of the children, and girls presented significantly better proprioceptive control in relation to the boys in each age group.

The role of targeted physiotherapy in the group of patients diagnosed with epilepsy

Introduction: Epilepsy is a chronic disease characterised by a predisposition to the occurrence of recurrent and unprovoked seizures. Due to the unpredictability of the disease (due to the possibility of seizures occurring at any time), the quality of life of these patients is drastically reduced. Stigmatisation of patients with epilepsy is common all over the world and concerns not only developing countries, but also those already highly developed. Patients with epilepsy show less activity in many areas of everyday life, including physical activity (they exercise less than the general public), and also have a lower level of mobility. This may be a significant factor contributing to the observation of balance disorders this group (from discrete, unnoticeable by them and the environment, to clinically manifesting instability of posture). So far, however, this has not been possible to clearly document, and to date, the standards for rehabilitation in this group of patients have not been established. However, it is widely known that balance disorders, apart from epileptic seizures, decrease quality of life.In the control of postural disorders, the co-ordination of the visual, somatosensory and vestibular systems is necessary. The cortical representation of the visual and sensory systems can be analysed during electroencephalographic recording. Additionally, the Biodex Balance SD stabilometric platform is an objective tool used to confirm imbalances. The application of this diagnostic device allows to quickly determine the exact type of imbalance that can subsequently undergo targeted physiotherapy. Research objective: The aim of the study was to assess the impact of targeted physiotherapy in a group of patients diagnosed with epilepsy of unknown etiology and balance disorders. Materials and methods: Patients diagnosed with generalised epilepsy of unknown etiology took part in the study. They were treated at the neurology ward or clinic of John Paul II Specialist Hospital in Krakow. The patients were examined 3 times at monthly intervals using the following methods: - EEG testing, - SF-36 quality of life questionnaire, - Biodex SD stabilometric platform. In addition, between the 2nd and 3rd months of the study, the patients underwent physiotherapy for balance disorders (3 times a week for 1 month, each session lasting 30 minutes). Results: In 10 patients who were subjected to selective physiotherapy using the Biodex SD stabilometric platform, objective improvement in balance stability was noted. All patients also reported oral improvement in the sense of postural stability after the completion of the rehabilitative treatment. Conclusions: Targeted physiotherapy in a group of patients with diagnosed epilepsy of undetermined etiology, and accompanying balance disorders has a positive impact on their daily functioning.

Association of Nogo-A Gene Polymorphisms with Cerebral Palsy in Southern China: A Case-Control Study

Cerebral palsy (CP) is a motor and postural disorder syndrome caused by the nonprogressive dysfunction of the developing brain. Previous studies strongly indicated that the Nogo-A gene might be related to the pathogenesis of CP. The objective of this research was to explore the relationship between Nogo-A polymorphisms (rs1012603, rs12464595, and rs2864052) and CP in Southern China. The Hardy-Weinberg equilibrium (HWE) testing, allele and genotype frequencies analysis, and haplotype association analysis were applied to the genotyping of 592 CP children and 600 controls. The results showed that the allele and genotype frequencies of rs1012603 of CP group were significantly different from the control group. The haplotype “TTGGG” was significantly associated with an increased risk of CP. The allele frequencies of rs1012603 were significant differences between CP with spastic diplegia, female CP cases, and controls. Furthermore, significant differences in allele and genotype frequencies were also noticed between GMFCS I of CP and controls for rs1012603, and significant differences in allele and genotype frequencies were observed between the ADL (>9) of CP and controls for rs1012603 and rs12464595. This study showed that the SNPs rs1012603 of Nogo-A were significantly correlated with CP, and the correlations were also found in spastic diplegia, GMFCS I of CP, ADL (>9) of CP, and female subgroups, indicating that Nogo-A might mainly affect mild types of CP and there might be sex-related differences.

Method of correction of muscle balance of highly qualified volleyball players with posture disorders

Relevance. Nowadays, in sports medicine, the problem of diagnosing and correcting disorders of the musculoskeletal system is acute. Asymmetric sports, such as volleyball, clay shooting, football and a number of others, in which one of the body parts is predominantly used, provoke a change in muscle balance and, as a result, the development of posture disorders. The combination of these factors leads to pain syndromes, accelerated wear of the joints, decreased performance and sports longevity. The method of correction of muscle balance written by us, based on the collected knowledge of existing rehabilitation programs N.G. Melnikov in 2015, for highly qualified volleyball players with existing right-sided and leftsided scoliotic arches, allows for the prevention of diseases associated with decompensation of the mechanisms of posture regulation and maintains a high level of performance. Clinical examination methods and computer stabilometry were used to diagnose existing disorders for the purpose of the subsequent necessary selection of exercises.

Сomprehensive restorative treatment of posture disorders in children with connective tissue dysplasia

Aim is to develop a comprehensive program of restorative treatment of posture disorders in children against the background of connective tissue dysplasia. Materials and methods. Ninety children aged from 4 to 17 years were under observation. Of these, 60 patients with connective tissue dysplasia (CTD) were divided into an experimental group (30 children) and a comparison group (30 children). These CTD children were under medical supervision from 2010 to 2020. The reference group consisted of 30 conditionally healthy children of the same age. All children were comprehensively examined. All СTD patients during the entire period of dispensary observation underwent comprehensive restorative treatment using methods of physical therapy, swimming and teaching patients at the educational school “Posture Correction” for children. The data obtained were processed statistically. Results. Characteristic signs of hereditary disorders of connective tissue development were revealed in all CTD children. An increase in the concentration of oxyproline in the blood serum and an increase in urinary excretion of oxyproline and calcium were found. After 5 years from the start of rehabilitation measures, there was an increase in endurance of the back muscles, a minimum number of pathological manifestations, including arthritis, arthralgic syndromes, coccygodynia. Ten years later, at the age of 14 years, the children of the experimental group formed a good posture, a well-off muscular corset and a minimal number of complications. Patients of the comparison group during the observation process more often complained of a feeling of fatigue, prolonged, incurable pain in the thoracic and lumbar spine, weak muscle corset. Conclusion. If CTD signs are detected in children, long-term dispensary observation should be carried out in outpatient conditions with the inclusion of a set of exercises of physical therapy and other rehabilitation measures. With the initial CTD manifestations on the part of the spine, children should be recommended to use a back support or a semi-rigid corset for the duration of increased loads, lessons, and long training sessions.

The effects of vibration on the neuronal activity of lateral vestibular nuclei in unilaterally labyrinthectomized rats.

Unilateral labyrinthectomy causes distinct oculomotor and postural disorder syndromes that gradually deteriorate. Simultaneously, compensatory mechanisms for the suppression of pathological disorders were activated. The current study aimed to investigate the characteristics of impulse activity in the ipsilateral and contralateral neurons of the lateral vestibular nucleus of unilaterally labyrinthectomized rats during various periods of vibration exposure. A program analysis of the background impulse activity of theneurons in the right- and left-lateral vestibular nuclei of ratsunder normal condition and after right-sided labyrinthectomy was performed. The animals were subjected to different periods of vibration exposure 2days after surgery (5-, 10-, and 15-day periods). A comparison of the characteristics of the background impulse activity of neurons in both nuclei of intact rats revealed an initial asymmetry in the values of the mean impulse frequency and coefficient of variation of interimpulse intervals. After 5days of vibration exposure, the values of the mean impulse frequency of neurons in both Deiters' nuclei were almost equal in labyrinthectomized rats. The mean impulse frequency of neurons on the uninjured side was higher than that on the injured side on the days following vibration exposure. The characteristics and functional significance of the findings are discussed.