I have developed "tennis elbow" from lugging this book around the past four weeks, but it is worth the pain, the effort, and the aspirin. It is also worth the (relatively speaking) bargain price. Including appendixes, this book contains 894 pages of text. The entire panorama of the neural sciences is surveyed and examined, and it is comprehensive in its scope, from genomes to social behaviors. The editors explicitly state that the book is designed as "an introductory text for students of biology, behavior, and medicine," but it is hard to imagine any audience, interested in any fragment of neuroscience at any level of sophistication, that would not enjoy this book. The editors have done a masterful job of weaving together the biologic, the behavioral, and the clinical sciences into a single tapestry in which everyone from the molecular biologist to the practicing psychiatrist can find and appreciate his or

Principles of Neural Science

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Cincinnati Children’s Hospital Medical Centerでの海外実習を終えて

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Muscles Testing And Function

Altered gait patterns follow
ing anterior cruciate ligament reconstruction (ACLR) may be associated with long-term impairments and post-traumatic osteoarthritis. This systematic review and meta-analysis compared lower limb kinematics and kinetics of the ACL reconstructed knee with (1) the contralateral limb and (2) healthy age-matched participants during walking, stair climbing, and running. The secondary aim was to describe the differences over time following ACLR for these biomechanical variables. Database searches were conducted from inception to July 2014 and updated in August 2015 for studies exploring peak knee angles and moments following ACLR during walking, stair negotiation, and running. Risk of bias was assessed with a modified Downs and Black quality index for all included studies, and meta-analyses were performed. Forest plots were explored qualitatively for recovery of gait variables over time after surgery. A total of 40 studies were included in the review; 26 of these were rated as low risk and 14 as high risk of bias. The meta-analysis included 27 studies. Strong to moderate evidence indicated no significant difference in peak flexion angles between ACLR and control groups during walking and stair ascent. Strong evidence was found for lower peak flexion moments in participants with ACLR compared with control groups and contralateral limb during walking and stair activities. Strong to moderate evidence was found for lower peak adduction moment in ACLR participants for the injured compared with the contralateral limbs during walking and stair descent. The qualitative assessment for recovery over time indicated a pattern towards restoration of peak knee flexion angle with increasing time from post-surgery. Peak knee adduction moments were lower within the first year following surgery and higher than controls during later phases (5 years). Joint kinematics are restored, on average, 6 years following reconstruction, while knee external flexion moments remain lower than controls. Knee adduction moments are lower during early phases following reconstruction, but are higher than controls, on average, 5 years post-surgery. Findings indicate that knee function is not fully restored following reconstruction, and long-term maintenance programs may be needed.

Movement Patterns of the Knee During Gait Following ACL Reconstruction: A Systematic Review and Meta-Analysis.

Background. Intensive bimanual training results in more improvement in hand function in children with unilateral spastic cerebral palsy (USCP) than lower intensity conventional interventions. However, it is not known whether combined upper and lower extremity training in an intensive protocol is more efficacious for upper and lower functional abilities than conventional therapies provided in usual customary care. Objective. To determine the efficacy of Hand and Arm Bimanual Intensive Therapy Including Lower Extremity (HABIT-ILE) for children with USCP. Methods. Twenty-four children with USCP were randomized into 2 groups: an immediate HABIT-ILE group (IHG, initially receiving HABIT-ILE, 10 days = 90 hours), and a delayed HABIT-ILE group (DHG), which continued their conventional/ongoing treatment for an intended total duration of 90 hours. In phase 2, children in the DHG were crossed over to receive HABIT-ILE and children of the IHG were followed in their ongoing conventional therapy. Children were assessed using the Assisting Hand Assessment (AHA, primary outcome), the ABILHAND-Kids, and the Pediatric Evaluation of Disability Inventory. Dexterity (Box and Blocks Test [BBT]) and pinch strength were also measured. Locomotor abilities were assessed with Six-Minute Walk Test (6MWT, primary outcome) and ABILOCO-kids. Social participation was measured with the Assessment of Life-HABITs. Results. A 2 (groups) × 3 (test sessions) analysis of variance indicated significant improvements for primary outcomes (AHA, P < .001; 6MWT, P = .002) and all secondary assessments except BBT, step length and bodyweight distribution following HABIT-ILE, but not conventional therapy. Conclusion. The findings suggest that combined upper and lower extremity in an intensive training protocol may be efficacious for improving both upper and lower extremity function in children with USCP.

https://journals.sagepub.com/doi/pdf/10.1177/1545968314562109

Hand and Arm Bimanual Intensive Therapy Including Lower Extremity (HABIT-ILE) in Children With Unilateral Spastic Cerebral Palsy: A Randomized Trial.

The relationship between clinical measurements and gait analysis data in children with cerebral palsy

Background
Functional classification systems generally divide children with cerebral palsy (CP) into mild, moderate, and severe types. Although depending on functional limitations, they do not seem to evaluate abnormal postural patterns in standing. Since the most asymmetrical patterns can be observed in hemiplegia, the goal of this case series study was to provide their objective analysis and to establish any potential clinical value for evaluation and management of CP.

https://www.researchgate.net/profile/Andrzej_Szopa/publication/49796016_A_descriptive_analysis_of_abnormal_postural_patterns_in_children_with_hemiplegic_cerebral_palsy/links/00b49531cbe3bab971000000.pdf

A descriptive analysis of abnormal postural patterns in children with hemiplegic cerebral palsy

Introduction While the asymmetry of body posture and the asymmetrical nature of hemiparetic gait in poststroke (PS) patients are well documented, the role of weight shift asymmetry in gait disorders after stroke remains unclear. Objective We examined the association of weight-bearing asymmetry (WBA) between paretic and nonparetic lower limbs during quiet standing with the degree of deviation of hemiplegic gait from normal gait evaluated by the Gillette Gait Index (GGI) incorporating 16 distinct clinically important kinematic and temporal parameters in chronic PS patients. Participants and methods Twenty-two ambulatory patients with chronic stroke aged between 50 and 75 years were included in this study. Fourteen patients had hemiparesis on the nondominant side and 8 on the dominant side. The mean time PS was 2 years and 6 months. The reference group consisted of 22 students from the University of the Third Age presenting no neurological disorders. The examination consisted of posturographic weight-bearing (WB) distribution and 3-dimensional gait analyses. Results A significant positive relationship between WBA and GGI was revealed. Moreover, we observed a significant negative association between WBA and paretic step length and walking speed. With regard to kinematic data, the range of motion of knee flexion and peak dorsiflexion in the swing phase of the paretic leg were significantly negatively associated with WBA. Conclusion Although further research is needed to determine a causal link between postural control asymmetry and gait disturbance in hemiplegics, our findings support the inclusion of WB measurements between paretic and nonparetic body sides in early assessment after stroke.

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The link between weight shift asymmetry and gait disturbances in chronic hemiparetic stroke patients.

Patients with unilateral cerebral palsy (CP) often have impaired movement coordination, reduced between-limb synchronization, and less weight bearing on the affected side, which can affect the maintenance of an upright weight-bearing position and gait. This study evaluated whether the different postural patterns of children with unilateral CP could be statistically recognized using cluster analysis. Forty-five outpatients with unilateral CP (mean age, 9 years and 5 months) and 51 able-bodied children with mild scoliosis (mean age, 9 years and 2 months) were included. One observer performed moire topography (MT) examinations using a CQ Electronic System (Poland) device. A weight distribution analysis on the base of support (BOS) between the body sides was performed simultaneously. A force plate dynamographic platform (PDM), ZEBRIS (Germany), with FootPrint software was used for these measurements. Cluster analysis revealed three groups: Cluster 1 (, 73.96%), Cluster 2 (, 8.33%), and Cluster 3 (, 17.71%). Based on the MT parameters (extracted using a data reduction technique), three typical asymmetrical postural patterns were described: (1) the postural pattern of children with mild scoliosis (SCOL), (2) the progravitational postural pattern (PGPP), and (3) the antigravitational pattern. Patterns two and three were identified in children with unilateral CP.

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Andrzej Szopa

Papers

The relationship between clinical measurements and gait analysis data in children with cerebral palsy

A descriptive analysis of abnormal postural patterns in children with hemiplegic cerebral palsy

The link between weight shift asymmetry and gait disturbances in chronic hemiparetic stroke patients.

Body Posture Asymmetry Differences between Children with Mild Scoliosis and Children with Unilateral Cerebral Palsy

Correlation between respiratory function and spine and thorax deformity in children with mild scoliosis.