Tone In Children Research Articles

Selective dorsal rhizotomy reduces stretch hyperreflexia and possibly muscle tone in children with spastic cerebral palsy

Selective dorsal rhizotomy reduces stretch hyperreflexia and possibly muscle tone in children with spastic cerebral palsy

Analysis of Gait, Pelvic Movement, and Medial Gastrocnemius Structure according to Muscle Tone in Children with Delayed Motor Development

Analysis of Gait, Pelvic Movement, and Medial Gastrocnemius Structure according to Muscle Tone in Children with Delayed Motor Development

Diagnosis Of Endothelial Dysfunction In Children With Neurocirculatory Dystonia: Test With Reactive Hyperemia

The article examines the role of nitric oxide in the regulation of peripheral vascular tone in children with neurocirculatory dystonia. When using a functional test with reactive hyperemia, its high diagnostic significance was revealed; a decrease in the formation of nitric oxide in the vascular endothelium (endothelial dysfunction) was established in children with neurocirculatory dystonia (p <0.001).

Immediate effect of transcutaneous electrical nerve stimulation on muscle tone in children with spastic cerebral palsy: a pilot study

Immediate effect of transcutaneous electrical nerve stimulation on muscle tone in children with spastic cerebral palsy: a pilot study

The Impact of Myofascial Release Therapy and Deep Oscillation Therapy on Hamstring Muscle Length and tone in Children with Spastic Cerebral Palsy: A Comparative Study

BACKGROUND: As a result of restricted joint range of motion due to spasticity in patients with spastic cerebralpalsy, the patient’s ability to regain normal functioning may be hindered.PURPOSE: To evaluate the effectiveness of Myofascial Release Therapy (MFR) versus Deep Oscillation Therapy(DOT) in helping children with spastic cerebral palsy to relax and extend their hamstring range of motion.METHODOLOGY: A total of 32 individuals with spastic cerebral palsy, aged 2 to 10, were recruited for thiscomparative experimental study through a method of random sampling. Sixteen subjects were assigned to eachgroup. Group 1(N=16) received two sessions of MFR with conventional exercise per day, whereas Group 2(N=16)received a single session of DOT with conventional exercise per day. Throughout the course of four weeks, bothgroups got therapy five days per week. A universal goniometer was used to compare the knee extension passiverange of motion (PROM), active range of motion (AROM), and Popliteal angle (POP angle) measurements betweenthe pre- and post-treatment periods. Statistical analyses were conducted using ANOVA 2×2 and Post hoctables.RESULT: Both groups’ post-mean values for each of the dependent variables (AROM, PROM, and POP angle)statistically improved (p< 0.05). Both groups’ mean differences in the PROM and POP angles were statisticallysignificant, and Group 1’s spastic hamstring muscle was more improved than Group 2’s, but both groups’ AROMshowed almost equal improvement.CONCLUSION: In children with spastic cerebral palsy, both MFR and DOT, when combined with conventionaltherapy, reduce spasticity and increase length (AROM & PROM) in the hamstring muscle. However, our studyclearly shows that MFR is more successful than DOT.

Is Spastic Cerebral Palsy Common? Clinical Profile of Neuro-Motor Development: An Observational Study

According to different studies conducted in the world, the most common neuro developmental disorders are CP, intellectual disability; communication disorders, autism spectrum disorder; attention-deficit/hyperactivity disorder; neurodevelopmental motor disorders, which spastic cerebral palsy is the most common physiological type of CP. But this physiological type of CP is likely to be different in developing countries like India, where the leading cause is birth asphyxia, seizures, low birth weight, and hyper-bilirubinemia. However, the data from our country is scant. Objectives of the study were to check the tone in children with neurodevelopmental disorders by using an objective tool called HAT, to classify children on HAT, and to document the risk factors associated with NDD. One hundred children with NDD visiting tertiary care hospital were evaluated using HAT and other scales like Modified Modified Ashworth Scale, Movement Disorder Childhood Rating Scale, and the functional level was assessed using GMFM 66 and GMFCS level. Out of 100 children, the most common muscle tone was mixed CP (<i>n</i> = 63) followed by spastic CP (<i>n</i> = 32). The most common cause for mixed type was birth asphyxia (<i>n</i> = 32), for spastic type it was preterm birth (<i>n</i> = 12). Mixed CP was the most common type of tone in children with neurodevelopmental disorders when assessed on HAT. CP was the most common medically diagnosed condition and in them birth asphyxia, neonatal seizures, low birth weight, and neonatal jaundice. Preterm deliveries were the common factors or causes.

Cortical processing of Mandarin lexical tone in children with different language backgrounds

Bilingual experience modulates cognitive skills, particularly executive control. However, it is not clear if such modulation can be observed in automatic speech processing. Furthermore, it is unknown if bi-dialectal experience will enhance speech processing. This study aims to investigate whether and how early bilingual experience influences cortical sensitivity for automatic cortical processing of speech, specifically in the context of tonal and non-tonal languages. A passive listening oddball paradigm with two lexical tone contrasts were used and event-related potentials were recorded. An easy contrast (tone 1 versus tone 3) and a hard contrast (tone 2 versus tone 3) were used as the stimuli. Children between 5 and 10 years of age were tested. Preliminary results indicate that monolingual mainstream English, African-American English, and bilingual Mandarin-English learners all showed similar brain responses to the easy lexical tone contrast. However, there was an age effect across language groups. Such results suggest that biological factors such as age are stronger predictors of brain responses to lexical tone contrasts comparing to the factor of language background.

Acupuncture in the Treatment of Abnormal Muscle Tone in Children with Cerebral Palsy: A Meta-Analysis.

To analyse the clinical efficacy of acupuncture and routine treatment in improving dystonia in children with cerebral palsy. The randomized controlled trials published from the establishment of the databases to August 2022 on acupuncture in the treatment of dystonia in children with cerebral palsy were collected and comprehensively searched in China national knowledge infrastructure (CNKI), weipu (VIP), Wanfang, SinoMed, PubMed, Excerpta medica database (EMBASE), and Cochrane Library. The literature was selected according to the established standards, the quality of the included studies was evaluated, the heterogeneity of the included studies was evaluated with the I2 test, and the appropriate model was selected for analysis. Sensitivity analysis was used to evaluate the reliability of the results, and a funnel plot was used to evaluate the publication bias. Fifteen studies were included in the meta-analysis. The control group was treated with routine treatment and acupuncture combined with routine treatment. The outcome index showed that the effect in the treatment group was better: Modified Ashworth Scale score: -0.52, 95% confidence interval (CI) (-0.62 to -0.41), p < 0.01. The treatment group showed reduced muscle tension to a greater extent (integral eletromyographic (iEMG) score: standard mean square deviation = -2.97, 95% CI (-4.87 to -1.06), p < 0.01). The effective rate in the control group was 74.2% and that in the treatment group was 91.5%, odds ratio = 3.70, 95% CI (2.02-6.78), p < 0.01. The funnel plot showed publication bias. Acupuncture combined with routine training could improve muscle tension abnormalities and improve the efficiency of clinical treatment.

Intra-Rater and Inter-Rater Reliability Analysis of Muscle-Tone Evaluation Using a Myotonometer for Children with Developmental Disabilities.

Assessing muscle tone is an essential component of the diagnosis, prognosis, and treatment planning of developmental disabilities (DD) in children and is of great help in developing clinical diagnosis patterns. The purpose of this study was to investigate intra-rater and inter-rater reliability using the myotonometer, which is an assessment tool to measure muscle tone in children with DD. This study included 26 children diagnosed with DD. Two physical therapists measured the children's muscle tone using a myotonometer. For all the muscles measured, reliability was determined using the intra-class correlation coefficient (ICC), the standard measurement error (SEM), and the minimal detectable change (MDC). The intra-rater reliability for all muscles was excellent (ICC = 0.75~0.78), except for the biceps brachii (ICC = 0.68). The inter-rater reliability was also excellent for all muscles (ICC = 0.75~0.95), and the SEM and MDC showed small measurement errors. Therefore, the intra-rater and inter-rater reliability of measurements by the myotonometer was found to be good or excellent. This suggests that the myotonometer is a tool that can objectively assess muscle tone, and it can be utilized in clinical practice to quickly and conveniently measure muscle tone in children with DD.

Effects of bupropion and SSRI antidepressants on leg movement activity and chin muscle tone during sleep in adolescents.

To evaluate the effects of bupropion on periodic limb movements during sleep (PLMS) and chin electromyography tone in children taking it for their mood disorder, compared to the effects of selective serotonin reuptake inhibitors (SSRIs) and of bupropion combined with SSRIs. Six adolescents (aged 16.0 ± 0.63 years) taking bupropion alone and 6 adolescents (aged 15.9 ± 1.36 years) taking bupropion in combination with an SSRI antidepressant were recruited, along with 10 adolescents (aged 16.2 ± 0.2 years) taking different SSRIs, and they were also enrolled together with 17 age- and sex-matched control patients (aged 15.5 ± 1.26 years). Polysomnographic studies were obtained, and participants' leg movement activity during sleep and muscle tone were assessed quantitatively (atonia index) during all sleep stages. Participants taking SSRIs showed PLMS indices significantly higher than those of control patients, whereas adolescents taking bupropion showed only slightly increased indexes of nonperiodic leg movements during sleep. No differences in PLMS were observed between adolescents taking bupropion alone or in association with SSRIs. The atonia index showed, within each sleep stage, the lowest values in the 2 groups taking SSRIs and the highest in the control patients; adolescents taking bupropion alone tended to show values slightly smaller than those of the control patients. We found that similar to adults, in adolescents SSRIs but not bupropion are associated with increased PLMS. Bupropion also seems to counteract the SSRI-induced increase of PLMS, when administered in combination; thus, the dopaminergic effect of bupropion seems to outmatch the antidopaminergic action of SSRIs. Conversely, bupropion does not counteract the effects of SSRIs on chin electromyography tone. DelRosso LM, Mogavero MP, Fickensher A, Bruni O, Schenck CH, Ferri R. Effects of bupropion and SSRI antidepressants on leg movement activity and chin muscle tone during sleep in adolescents. J Clin Sleep Med. 2023;19(1):151-161.

Autonomic tone in children and adults: Pupillary, electrodermal and cardiac activity at rest

Considering the suspected involvement of the autonomic nervous system (ANS) in several neurodevelopmental disorders, a description of its tonus in typical populations and of its maturation between childhood and adulthood is necessary. We aimed to arrive at a better understanding of the maturation of the sympathetic (SNS) and parasympathetic (PNS) tonus by comparing children and adults at rest, via recordings of multiple ANS indices. We recorded simultaneously pupil diameter, electrodermal activity (EDA) and cardiac activity (RR interval and HRV: heart rate variability) in 29 children (6–12 years old) and 30 adults (20–42 years old) during a 5-min rest period. Children exhibited lower RR intervals, higher LF peak frequencies, and lower LF/HF (low frequency/high frequency) ratios compared to adults. Children also produced more spontaneous EDA peaks, reflected in a larger EDA AUC (area under the curve), in comparison with adults. Finally, children displayed a larger median pupil diameter and a higher pupillary hippus frequency than adults. Our results converged towards higher SNS and PNS tones in children compared to adults. Childhood would thus be characterized by a high autonomic tone, possibly reflecting a physiological state compatible with developmental acquisitions.

Influence of infrared radiation and high-frequency ultrasound on masticatory muscle tone in children

The aim of the study was to study the effectiveness of the method proposed by the authors to normalize the tone of the masticatory muscles using infrared irradiation in combination with ultrasound exposure.&#x0D; Materials and methods. On the basis of the Institute of Dentistry. E.V. Borovsky at the Department of Pediatric, Preventive Dentistry and Orthodontics and at the Department of Therapeutic Dentistry, 15 children aged 9—12 years were examined and treated, including 7 boys and 8 girls. All patients were diagnosed with a distal bite, and there were also violations of the masticatory muscle tone. The study explores a technique that affects the change in the tone of the masticatory muscles using infrared radiation in combination with high-frequency ultrasound, consisting of 10 procedures.&#x0D; Results. As a result of the use of 10 procedures for observing resonance with high-frequency ultrasound in 15 children aged 9—12 years with distal bite and hypertonicity of the masticatory muscles, according to electromyography, there was a normalization of the assessment of the tone of the temporal muscles to the masticatory muscles proper from 1:0.7 to 0 .9:1.&#x0D; It is concluded that the proposed physiotherapeutic method makes it possible to normalize the function of the masticatory muscles by creating an equal tone between the masticatory and temporal muscles proper. Thus, the harmonious development of the maxillofacial region becomes possible and the effectiveness of orthodontic treatment increases with an already developed malocclusion pathology.

1036-P: The Association between Maternal Gestational Weight Gain and Autonomic Nervous System Is Disturbed in GDM: Results from Two-Year-Old Children

Objective: The intrauterine environment is known to affect the offspring's long-term risk for obesity and diabetes. Previous data show that maternal metabolism and gestational weight gain (GWG) are associated with autonomic nervous system (ANS) function in fetuses in utero, which can be assessed with heart rate variability (HRV) . We have now examined whether this association is also present in 2-year-old children and addressed the impact of gestational diabetes (GDM) . Research Design and Methods: We examined children of participants of the ongoing PREG study (NCT04270578) who had a 5-point 75g oral glucose tolerance test during pregnancy. To assess HRV, a 10-minute ECG was recorded in the offspring. We analyzed time domain (beats per minute (BPM) , Root Mean Square of successive differences (RMSSD)) , Standard Deviation of RR-Intervals (SDNN) and frequency domain parameters (low frequency (LF) , high frequency (HF) and LF/HF) of HRV. Results: We examined 67 children (33 girls, 34 boys, age 25.3±1.6 months) . During pregnancy, 30 of their mothers had GDM, which was treated according to national guidelines. There were no differences between groups in birth weight, weight at age 2, and body fat. We observed statistically significant associations of GWG with heart rate, RMSSD, SDNN, HF power, and HF/LF, indicating a lower parasympathetic tone in children of mothers with low GWG. This association was attenuated in GDM-exposed children. ANS function correlated with body weight and body fat only in children from normoglycemic pregnancies (NGT) . Conclusion: We found an impact of maternal GWG on offspring ANS function, which was missing in the presence of treated GDM. The balance of the ANS was related to offspring body composition only in children from NGT pregnancies. Our results point towards a critical impact of maternal weight gain during pregnancy on the developing ANS with longstanding consequences for body composition. Disclosure L.Fritsche: None. H.Preissl: None. M.Heni: Advisory Panel; Boehringer Ingelheim International GmbH, Research Support; Boehringer Ingelheim International GmbH, Sanofi, Speaker's Bureau; Amryt Pharma Plc, Boehringer Ingelheim International GmbH, Novo Nordisk. J.Hartkopf: None. J.Hummel: None. D.Löffler: None. H.Häring: None. A.Peter: None. A.L.Birkenfeld: None. R.Wagner: Advisory Panel; Akcea Therapeutics, Daiichi Sankyo, Sanofi-Aventis Deutschland GmbH, Speaker's Bureau; Lilly, Novo Nordisk, Sanofi-Aventis Deutschland GmbH. A.Fritsche: Advisory Panel; Boehringer Ingelheim International GmbH, Novo Nordisk, Sanofi-Aventis Deutschland GmbH. Funding The PREG study is supported in part by a grant from the Federal Ministry of Education and Research (BMBF) (01GI0925) to the German Center for Diabetes Research (DZD) and by grant from the Deutsche Diabetes Stiftung (380/02/16) to LF

Commentary on "Pelvic Floor Muscle Resting Tone in Children With Dysfunctional Voiding Symptomology Following Simple Gross Motor Exercises".

Commentary on "Pelvic Floor Muscle Resting Tone in Children With Dysfunctional Voiding Symptomology Following Simple Gross Motor Exercises".

Pelvic Floor Muscle Resting Tone in Children With Dysfunctional Voiding Symptomology Following Simple Gross Motor Exercises.

The study aimed to understand the effects of a set of simple gross motor exercises on pelvic floor muscle (PFM) resting tone (RT) in children with dysfunctional voiding symptomology. The study compared PFM RT for a single-sample before and after 2 protocols: exercise versus relaxation (metric standard). Participants included 27 children ages 5.00 to 10.92 years. Preintervention PFM RT was similar between the interventions: 63% (exercise) and 78% (relaxation) of children decreased PFM RT following intervention. Between-intervention post-minus-prechanges in PFM RT were compared. Between-intervention differences were similar. Exercise and relaxation protocols were comparable in lowering PFM RT in children with voiding dysfunction. Findings are clinically worthy in that either exercises or relaxation prior to toileting may assist with more complete emptying in children with symptoms.

Premature cardiac beats in children with structurally normal heart: autonomic dysregulation.

Premature ventricular contractions and supraventricular contractions are common rhythm disorders requiring comprehensive investigation in children. The aim of the study was to evaluate the heart rate variability (HRV) in premature ventricular contractions (PVCs) and supraventricular contractions (PSVCs) in children. The study compared the characteristics of HRV in 175 children with PVCs and 160 children with PSVCs who underwent 24-h Holter monitoring, with 101 healthy children. Significant differences were found between standard deviation of all normal RR intervals (SDNN), standard deviation of average RR intervals in all 5 min segments of registration (SDANN), root mean square of the successive differences (rMSSD), and the proportion of NN50 divided by total number of NNs (pNN50) values of the patient and control groups. The PVCs group had a significantly lower high frequency (HF) and higher low frequency (LF)/HF ratio and the PSVCs group had a significantly higher LF and higher LF/HF ratio compared to the control group. No significant correlation existed between frequency and the SDNN index, rMSSD, and pNN50 values of the PVCs group. The receiver operating characteristics analysis showed a significantly changed LF/HF ratio when premature contractions exceeded 60 beats per hour in children with PVCs. This study indicated an increased sympathetic tone and a significantly decreased vagal tone in children with PVCs and PSVCs. HRV can be used increasingly as a non-invasive method in the follow-up of children with premature cardiac contractions.

The development of tonal duration in Mandarin-speaking children.

Developmental changes in suprasegmental tonal duration were investigated in monolingual Mandarin-speaking children. Tone durations were acoustically measured in five- and eight-year-old children and adults. Children's tone duration and variability decreased with age. Five-year-olds produced significantly longer tone durations than adults. Adult-like duration patterns existed in all children: Tone 4 was the shortest and tone 3 the longest. Duration differences between tones 2 and 3 became larger between five- and eight-year-olds. Results suggest a prolonged process of tone development beyond establishing phonological contrasts, which can be viewed as a hybrid of physiological production capacities and perceptual learning for maximal contrastivity.

Snake Eye Appearance; A Rare Radiology Presentation in Acute Flaccid Paralysis: A Case Report

Background: Acute flaccid paralysis (AFP) is defined by the acute onset of weakness or paralysis with reduced muscle tone in children. There are many non-infectious and infectious causes. Snake eye appearance (SEA) is a rare radiologic appearance and helps narrow down differential diagnoses in flaccid paralysis. Case Presentation: Here, we reported a 6 months-old girl who was admitted with sudden onset flaccid paralysis. She was lethargic and ill without any detectable deep tendon reflexes. She had a high fever that had started 3 days earlier with malaise, poor feeding and coryza. The first child of the family was a boy who expired with similar symptoms; however, the reason is still unknown. Her parents were relatives (cousins). The laboratory and cerebrospinal fluid tests analysis were normal. The brain MRI analysis revealed T1 dim Hypo intensity and T2 hyperintensity along with obvious ADC map hyperintensity in the brain stem. At first, the PCR tests analysis of stool samples for poliovirus and enterovirus were normal. Spinal MRI showed snake eye appearance and helped us narrow our differential diagnosis. We repeated the PCR tests of stool because of snake eye appearance in cervical MRI that was positive for poliovirus and indicated vaccine-associated Paralytic Poliomyelitis (VAPP). Unfortunately, she expired from vaccine associated poliomyelitis. Conclusion: Snake eye appearance is a rare radiologic appearance that can be seen in several pathological conditions; however, it is very rare in patients with acute flaccid paralysis. Radiology signs, especially in spinal cord MRI, can help recognizing abnormalities in images, and narrow the list of differential diagnosis in acute flaccid paralysis. Therefore, spinal cord MRI has an important role in the evaluation of patient with brain stem involvement in acute flaccid paralysis.

Increased chin muscle tone during all sleep stages in children taking selective serotonin reuptake inhibitor antidepressants and in children with narcolepsy type 1.

To assess if selective serotonin reuptake inhibitor (SSRI) antidepressants are able to modify the chin electromyogram (EMG) tone during sleep also in children. Twenty-three children and adolescents (12 girls, mean age 14.1 years, SD 2.94) under therapy with antidepressant for their mood disorder were consecutively recruited and had a PSG recording. Twenty-one were taking were taking SSRI and treatment duration was 2-12 months. An age- and sex matched group of 33 control children (17 girls, mean age 14.2 years, SD 2.83) and 24 children with narcolepsy type 1 (12 girls, mean age 13.7 years, SD 2.80) were also included. The Atonia Index was then computed for each NREM sleep stage and for REM sleep, also all EMG activations were counted. Atonia Index in all sleep stages was found to be significantly reduced in children with narcolepsy followed by the group taking SSRI antidepressants and the number of EMG activations was also increased in both groups. Fluoxetine, in particular, was found to be significantly associated with reduced Atonia index during NREM sleep stages N1, N2, and N3, and with an increased number of EMG activations/hour during sleep stage N3. Similarly to adults, SSRI antidepressants are able to modify the chin EMG tone in children during REM sleep, as well as during NREM sleep stages. Different pharmacological properties of the different SSRI might explain the differential effect on chin tone during sleep found in this study.

Параметры физического развития детей с особыми возможностями здоровья с различными типами исходного вегетативного тонуса

At present, the deterioration in the health status of children is a priority public health problem. Special (limited) health abilities are understood as insufficiency of physical and / or mental development, which, among other things, negatively affects the adaptive and adaptive abilities of the body of children. The study of physical development coupled with indicators of autonomic regulation allows us to evaluate the general biological development of the body and adaptive mechanisms. The aim of the study was to analyze the state of physical development in children with special health abilities associated with impaired intellectual development, depending on the initial type of autonomic regulation. 168 children of primary school age were examined. Of these, 54 are children with special health abilities (SHA) associated with intellectual disabilities (F70, F71), and 114 mentally healthy children as control group. It was found that in children with disabilities, sympathicotonic (33%) and hypersympathicotonic (24%) types of initial tone dominate. At the same time, the number of children with an eutonic type of IVT in the group with SHA is 2 times lower (26%) compared with the control group (47%). In the analysis of physical development, depending on the initial vegetative tone in children with SHA, the minimum values of anthropometric parameters were established with vagotonia. As sympathetic modulations increase, an increase in all anthropometric indicators is recorded. Also, in the group of children with SHA, the lag of anthropometric parameters in vagotonia and the predominance of the sympathicotonic type of IVT compared with the control group were revealed. Identified features can be taken into account when selecting an individual correctional program for children with special health abilities associated with intellectual developmental disorders.