Faustyna Manikowska

The effect of a hippotherapy session on spatiotemporal parameters of gait in children with cerebral palsy - pilot study.

BACKGROUND Hippotherapy has been shown to produce beneficial effects by improving the most difficult motor functions, such as sitting, running, jumping, coordination, as well as balance and muscle strength in children with motor developmental delays. The aim of this study was to analyze the effect of hippotherapy on spatiotemporal parameters of gait in cerebrally palsied children. MATERIAL AND METHODS 16 ambulatory cerebrally palsied children (GMFCS Level I-III; Female: 10, Male: 6; Age: 5.7-17.5 years old) qualified for hippotherapy were investigated. Basic spatiotemporal parameters of gait, including walking speed, cadence, step length, stride length and the left-right symmetry, were collected using a three-dimensional accelerometer device (DynaPort MiniMod) before and immediately after a hippotherapy session. The Wilcoxon test was used to verify the differences between pre- and post-session results. RESULTS Changes of walking speed were statistically significant. With the exception of step length, all spatiotemporal parameters improved, i.e. were closer to the respective reference ranges after the session. However, these changes were not statistically significant. CONCLUSION One session of hippotherapy may have a significant effect on the spatiotemporal parameters of gait in cerebrally palsied children.

The impact of an external breast prosthesis on the gait parameters of women after mastectomy.

Background: An integral part of the recovery process after mastectomy involves the consideration of restorative options, including external prosthesis use; however, only few studies regarding the influence of breast prostheses on functional status have been done. Objective: This study aimed to determine whether wearing an external breast prosthesis affects gait in women after a mastectomy. Methods: Spatiotemporal gait parameters were collected in 40 women, postmastectomy, aged 37 to 70 years, divided into age subgroups of 37 to 54 years and 55 to 70 years, and in 38 healthy controls, women aged 38 to 69 years. Gait parameters were assessed with and without the breast prosthesis, including walking velocity, cadence, step length, step time, and left-right step time asymmetry. Results: Significant differences were found in the gait parameters of the younger age group with and without a prosthesis. No significant differences were found in the women of the older group with and without the prosthesis. Conclusion: Gait parameters of the younger age group were closer to those of the healthy control group when they were wearing an external prosthesis, as compared with when they were not. This suggests a positive influence of breast prosthesis use on the functional status of women after mastectomy. Implications for Practice: Clinical practitioners should be aware of the study results suggesting a positive influence of breast prosthesis use on gait parameters after mastectomy surgery, which could improve the patient’s functional status after surgery; however, further research is still needed on factors affecting changes in gait with a larger study population.

The influence of an external breast prosthesis on the posture of women after mastectomy

BACKGROUND Previous literatures showed no evidence that wearing an external breast prosthesis may prevent changes in body posture in women who underwent mastectomy. OBJECTIVE To determine whether the weight of an external breast prosthesis can contribute to posture changes in women post mastectomy. METHODS Fifty-one women with unilateral mastectomy (age 58 ± 11.39 years) were divided into 2 subgroups by their operation side. Asymmetry of body posture was evaluated by using the electromyography activity of erector spinae muscles with four different weights of breast prosthesis. RESULTS Despite the operation side, the erector spinae muscle activities on the operation side and non-operation side were significantly different. Overall, for patients who had operation on the left side, their erector spinae muscle activity imbalance will be smaller, compared to the imbalance among patients with right operation side. The weight of the external breast prosthesis did not influence the differences of erector spinae muscle activities on the operation side and non-operation side. CONCLUSIONS The weight of an external breast prosthesis for women after mastectomy may not be crucial when choosing a proper prosthesis.

Can the Weight of an External Breast Prosthesis Influence Trunk Biomechanics during Functional Movement in Postmastectomy Women

Introduction Recent papers indicate that one-side mastectomy can produce deleterious effects on the posture and musculoskeletal system. This study was conducted to better understand the underlying mechanisms involved in trunk motion in external prosthesis users. Objective The aim was to evaluate the changes in surface electromyographic (SEMG) activity of the erector spinae muscles (ES) in postmastectomy women with and without breast prostheses during functional body movement tests. Methods In 51 one-side postmastectomy women the SEMG muscle activity of bilateral ES was measured during symmetrical and asymmetrical dynamic activities in a counterbalanced manner with different weights of the breast prosthesis. Range-of-motion measurements were taken for forward bending, backward bending, lateral bending, and rotation. Results The mean level of the ES activity in the lumbar region was not affected by the weight of the external breast prosthesis during most of the functional body tests (P > 0.05). The activity of ES during functional body tests with and without different external breast prostheses did not differ between the two sides of the trunk (mastectomy and nonmastectomy) for most of the movement tests (P > 0.05). Conclusion The lumbar ES activity during functional tests is not associated with the weight of the external breast prosthesis in postmastectomy women.

The role of exaggerated patellar tendon reflex in knee joint position sense in patients with cerebral palsy.

The aim of this pilot study was to determine if exaggerated patellar tendon jerk affects knee joint position sense (JPS) in cerebral palsy (CP) patients, by comparing JPS of the knee between participants with normal and exaggerated reflexes. The thresholds for reflex classification were based upon the data from able-bodied volunteers. JPS was measured as the ability of a subject (with eyes closed) to replicate a knee joint position demonstrated by an examiner. Tendon jerk was measured as the moment of force in response to patellar tendon taps. Data was collected from 27 limbs of CP patients (N=14) and 36 limbs of able-bodied volunteers (N=18). JPS was less accurate (p=0.014) in limbs with non-exaggerated reflexes (50.28±43.63%) than in control limbs (11.84±10.85%). There was no significant difference (p=0.08) in JPS accuracy between limbs with exaggerated reflexes (18.66±15.50%) and control limbs. Our data suggests that one component of sensorimotor impairment, JPS, is not as commonly affected in CP patients as previously reported. JPS of the knee is reduced in limbs with non-exaggerated reflexes; however in limbs with exaggerated reflexes which is seen in the majority of CP patients, JPS is not affected.

The gait pattern in post-menopausal women. Pilot study.

BACKGROUND Aging brings about a number of degenerative changes in the body. The aging process in-creases its pace after the menopause. Women notice functional limitations in their daily lives, including mobility problems, as early as in their forties. Gait is one of the most reliable parameters reflecting the bodys overall function and condition. The aim of this study was to determine the effect of menopause on gait patterns in healthy women. MATERIAL AND METHODS The study involved a group of 48 healthy women (divided into Group A of pre-menopausal women and Group B of post-menopausal women). Gait parameters were acquired by a DynaPort MiniMod accelerometer. The pre- and post-menopausal womens gait data, including spatio-temporal parameters, gait cycle phases and the variability, were analysed. RESULTS There were no significant differences between Group A and B in walking speed, step length, cadence, and gait phase duration. Significant differences were only noted in gait cycle phases with regard to the onset of single-support of the right limb, the 1st double-support of the right limb and the 2nd double-support of the left limb. Gait variability did not show any significant differences between the groups. CONCLUSIONS 1. A prolonged stance phase during the gait cycle observed in the post-menopausal women in this study is a typical finding in aged people. 2. However, stride-to-stride variability of gait was not affected in the study.