Репозиторий Университета

© 2020 Sports Medicine Australia Objectives: Para athletes with brain impairment are affected by hypertonia, ataxia and athetosis, which adversely affect starting, sprinting and submaximal running. The aim was to identify and synthesise evidence from studies that have compared the biomechanics of runners with brain impairments (RBI) and non-disabled runners (NDR). Design: Systematic review. Methods: Five journal databases were systematically searched from inception to March 2020. Included studies compared the biomechanics of RBI (aged > 14 years) and NDR performing either block-starts, sprinting, or submaximal running. Results: Eight studies were included, analysing a total of 100 RBI (78M:22F; 18–38 years) diagnosed with either cerebral palsy (n = 44) or traumatic brain injury (n = 56). Studies analysed block-starts (n = 3), overground sprinting (n = 3) and submaximal running (n = 2), and submaximal treadmill running (n = 1). Horizontal velocity during starts, sprinting and self-selected submaximal speeds were lower in RBI. During sprinting and submaximal running, compared with NDR, RBI had shorter stride length, step length, and flight time, increased ground-contact time, increased cadence, and reduced ankle and hip range of motion. In submaximal running, RBI had decreased ankle-power generation at toe-off. Conclusions: There is limited research and small sample sizes in this area. However, preliminary evidence suggests that RBI had lower sprint speeds and biomechanical characteristics typical of submaximal running speeds in NDR, including increased ground-contact times and reduced stride length, step length, and flight times. Meaningful interpretation of biomechanical findings in RBI is impeded by impairment variability (type, severity and distribution), and methods which permit valid, reliable impairment stratification in larger samples are required.

© 2020 Sports Medicine Australia Objectives: Para athletes with brain impairment are affected by hypertonia, ataxia and athetosis, which adversely affect starting, sprinting and submaximal running. The aim was to identify and synthesise evidence from studies that have compared the biomechanics of runners with brain impairments (RBI) and non-disabled runners (NDR). Design: Systematic review. Methods: Five journal databases were systematically searched from inception to March 2020. Included studies compared the biomechanics of RBI (aged > 14 years) and NDR performing either block-starts, sprinting, or submaximal running. Results: Eight studies were included, analysing a total of 100 RBI (78M:22F; 18–38 years) diagnosed with either cerebral palsy (n = 44) or traumatic brain injury (n = 56). Studies analysed block-starts (n = 3), overground sprinting (n = 3) and submaximal running (n = 2), and submaximal treadmill running (n = 1). Horizontal velocity during starts, sprinting and self-selected submaximal speeds were lower in RBI. During sprinting and submaximal running, compared with NDR, RBI had shorter stride length, step length, and flight time, increased ground-contact time, increased cadence, and reduced ankle and hip range of motion. In submaximal running, RBI had decreased ankle-power generation at toe-off. Conclusions: There is limited research and small sample sizes in this area. However, preliminary evidence suggests that RBI had lower sprint speeds and biomechanical characteristics typical of submaximal running speeds in NDR, including increased ground-contact times and reduced stride length, step length, and flight times. Meaningful interpretation of biomechanical findings in RBI is impeded by impairment variability (type, severity and distribution), and methods which permit valid, reliable impairment stratification in larger samples are required.

AIM: To evaluate the efficacy and safety of zonisamide as an add-on therapy in structural focal epilepsy in children with cerebral palsy (CP). MATERIAL AND METHODS: Sixty-four patients (36 boys and 28 girls) with spastic CP and structural focal epilepsy with refractory seizures were followed up. Patients received zonisamide in a dose of 6-8.8 mg/kg/day for ≥6 months. Treatment efficacy was assessed by the reduction of seizures depending on CP form, type of epileptic seizures, combination of zonisamide with other drugs and adverse-effects. RESULTS AND CONCLUSION: A reduction of seizures by ≥50% was identified in 60.9% of children, 10.9% showed a better recovery. The best efficacy (35.9%) was demonstrated in the treatment of generalized seizures with focal onset and in the combination with levetiracetam (35.9%). Adverse effects of mild to moderate severity were noted in 26.5% of children. The treatment was discontinued in 7.8%. Therefore, zonisamide is an effective treatment for refractory structural focal epilepsy in children with CP and comorbid pathology, which reduces the frequency of seizures without severe side-effects.

© 2018, Media Sphera Publishing Group. All Rights Reserved. The careful differential diagnosis is very important in pediatric cases of multiple sclerosis (MS). It has special difficulties if MS started in patients with residual neurological pathology. Two cases of development of MS in children with cerebral palsy (CP) are presented. The clinical features and diagnostic difficulties in such comorbid situations are discussed.