Muscle Tonicity of Children with Spastic Cerebral Palsy: How Effective Is Swedish Massage?

ObjectiveMassage therapy is one of the most widely used complementary and alternative medicine therapies for children. This study was conducted to determine the effect of Swedish massage on the muscle tonicity of children with spastic cerebral palsy (CP).Materials & MethodsThis study was a single blind clinical trial conducted on forty children with spastic CP, recruited from clinics of the University of Social Welfare & Rehabilitation Sciences. They were randomly assigned to intervention and control groups. Routine occupational therapy techniques were performed during a 3 monthperiod in both groups, while the intervention group also received Swedish massage for 30 minutes before every rehabilitation session. Muscle tonicity was evaluated at the  beginning of the study and 3 months later using the Modified Ashworth Scale.ResultsThe average ages of children in the intervention (n=13) and control (n=14) groups were 49.5 and 42.1 months respectively. Although after intervention, tonicity of upper and lower limbs, trunk and neck in the intervention group in comparison with controls had no significant differences, there were statistically significant differences in reduction rate of tonicity in upper limbs and trunk between the two groups (P <0.05).ConclusionMassage therapy is not a panacea for improvement of spasticity in children with CP but the encouraging results of other studies on children with CP indicate that further studies are needed for more definite results

Effect of Lamotrigine on Prophylaxis of Pediatric Classic Migraine

ObjectiveThis study was conducted to evaluate the preventive effect of lamotringine on migraine aura and migraine attacks in children, afflicted with classic migraine.Material & MethodsConducted between October 2005 and April 2008 in the neurology clinic of Kashani hospital,  Shahrekord, this study was a clinical trial, aimed at evaluating the prophylactic effects of Lamotringine administered to 21 children suffering from migraine with aura.ResultsOf the subjects, 52.4% of patients were female. The most common type of aura was visual (42.9%). Following use of Lamotrigine, significant reductions were seen in the frequency (from 5 ± 0.83 to 3.04 ± 1.65) and in intensity (from 6. 33 ± 1.08 to 3.66 ± 1.1) of migraine aura (P= 0.002). After 6 months of drug usage 66.6% of patients were improved.ConclusionLamotringine is effective in reducing the migraine aura and intensity of attacks in patients suffering from migraine with aura, and is hence beneficial for prophylactic therapy in children with classic migraine.

Swedish massage and abnormal reflexes of children with spastic cerebral palsy

Objectives: Massage therapy is one of the most widely used complementary and alternative medicine therapies for children. This study was conducted to determine the effect of wedish massage on abnormal reflexes in children with spastic cerebral palsy (CP). Material and Methods: This study was a single blind clinical trial conducted on forty children with spastic CP who were recruited from clinics of the University of Social Welfare & Rehabilitation Sciences. They were randomly assigned to intervention and control groups. The routine occupational therapy (OT) techniques were performed during a 3 month-period in both groups. The intervention group also received Swedish massage for 30 minutes before every OT session. Primary, spinal, brain stem, midbrain, cortical and automatic reflexes were evaluated at the beginning of the study and 3 months later. The data analysis was done by parametric and nonparametric tests. Results: Finally, thirteen subjects in the intervention group and 14 subjects in the control group were remained and studied. The average ages in the intervention and control groups were 49.5 and 42.1 months respectively. There were no statistically significant differences in abnormal reflexes in the intervention group in comparison to the control (P > 0.05). Conclusion: Adding Swedish massage to traditional OT techniques had no significant effects on abnormal reflexes in children with spastic cerebral palsy. Evidently more research is required in order to completely reject the effects of Swedish massage on abnormal reflexes of children with CP

Motor Developmental Delay in 7500 Iranian Infants: Prevalence and Risk Factors

ObjectiveThe purpose of this study was to determine the prevalence and the most common risk factors of motor developmental delay in infants.Materials & MethodsFollowing ethical approval, a study was carried out on the prevalence and risk factors of infants with motor developmental delay. The first stage was conducted through a cross-sectional study to determine the prevalence of motor developmental delay on 7500 infants and the second stage was an analytic case - control survey to identify the most common risk factors on 140 infants, aged one month to three years with motor developmental delay. Data was collected using a demographic questionnaire, the Parents Evaluation of Developmental Status questionnaire, the Denver Developmental Screening Test II, a neurological assessment form, and the movement and tone assessment form.ResultsThe prevalence of motor developmental delay in 7500 infants was 18.7/1000. The most common risk factors in infants with motor developmental delay were prematurity (25.6%), low birth weight (19.2%), neonatal seizures (7.5%), hyaline membrane disease (6.7%), systemic infections of mothers during pregnancy (5.9%), severe neonatal hyperbilirubinemia (5%) in sequence. Motor developmental delay was significantly correlated with consanguinity of parents (p=0.001), prematurity (p=0.046), abnormal head circumference at birth (p=0.038), and low birth weight (p=0.026).ConclusionThe prevalence of motor developmental delay appears to be high and further studies should focus on different preventive strategies, controlling the most common risk factors and emphasizing on early detection and treatment of high risk infants.

A Comparison between Symmetry of Abdominal Muscle Size in Healthy Adolescents and Adolescents with Low Back Pain

BACKGROUND AND OBJECTIVE: Low back pain (LBP) is a musculoskeletal disorder and a relatively common complaint. Muscles, as the most important stabilizers of the spine, are impaired in patients with LBP. The aim of this study is to compare the symmetry of abdominal muscle size in the dominant and non-dominant sides as well as the painful and painless sides between healthy adolescents and adolescents with LBP. METHODS: This case-control study was conducted on 80 healthy adolescents and 80 adolescents with chronic nonspecific LBP, aged 15 to 18 years. Samples were chosen using convenience sampling method while being matched in terms of height, weight and body mass index. First, the demographic data were collected; then, their abdominal muscle size (transverse abdominus, internal oblique and external oblique) and intra-abdominal fat were measured by sonography. FINDINGS: The difference in mean value and possibility value for transverse abdominus (p=0.024 and 0.189), internal oblique (p=0.000 and 0.861), external oblique (p=0.031 and 0.287) and intra-abdominal fat (p=0.762 and 0.081) was significant between the two groups in term of abdominal muscle size while the difference in intra-abdominal fat size was not statistically significant. Results also revealed a statistically significant difference in abdominal muscle size (except for external oblique and intra-abdominal fat) between the dominant and non-dominant sides (p<0.05) and between the painful and painless sides in adolescents with LBP (p<0.05). CONCLUSION: The results of the present study demonstrated that abdominal muscle size in dominant and painful side is smaller than non-dominant and painless side

Comparing the Reliability of Abdominal Muscles Thickness Using Ultrasonography in Adolescents with Low Back Pain and Healthy Adolescents

BACKGROUND AND OBJECTIVE: Low back pain (LBP) is one of the relative prevalent musculoskeletal disorders in patients which increases with increasing age. Therefore, the purpose of this study was to investigate reliability of sonography in the assessment of abdominal muscles thickness in adolescents with LBP in comparison to healthy subjects. METHODS: This methodological study was carried out on thirty healthy girls and boys and 30 girls and boys with LBP. Transversus abdominis (TA), internal oblique (IO), external oblique (EO) and subcutaneous fat (SF) were evaluated in crook lying position using sonography at the end of exhalation. Two sets of images were taken on the same day to assess within-day reliability and the third measurement was taken one week later to evaluate between-day reliability. FINDINGS: The values of intra-class correlation coefficient (ICC), within-day and between-day reliability were high in two groups (ICC>0.80). ICC values were lower in patients with LBP compared with healthy subjects. Generally, within-day reliability was higher than between-day reliability. CONCLUSION: Reliability of sonography in the evaluation of abdominal muscles thickness and subcutaneous fat width was high in healthy adolescents and those who suffering from LBP