SUMMARY The authors looked for differences in the energy expenditure patterns of ambulant children with cerebral palsy and spina bifida. Oxygen consumption was measured according to type of cerebral palsy or level of spina bifida lesion, and in healthy children. The rate of oxygen consumption (mL/kg/min) was significantly higher in the children with diplegia than in those with hemiplegia or with spina bifida or the healthy children. Oxygen cost (mL/kg/m) was significantly higher and velocity was significantly slower in all the groups with disability than in the healthy children. The reason children with diplegia consumed more oxygen than other children when walking may be that their abnormal equilibrium reactions impaired their balance and their ability to control their walking speed. RÉSUMÉ Consoinmation énergétique compareée enlre spina bifida et IMC: tine étude comparative Les auteurs ont recherché des différences dans l' aillure de la dépense énergétique chez les enfants marchant. avec IMC ou spina bifida. La consommation d' oxygene a été rapportée au type d' IMC, au niveau dc la lésion du spina bifida, et au fait que les enfants témoins étaient en bonne samé. Le taux de consommation d' oxygene (mL/k'g/min) était significativement plus élevé en cas de diplegie qu'en cas d' hémiplégie, dc spina bifida ou d' intégrité neurologique. Le coût en oxygène était significativement plus élevé et la vitesse significativement moindre chez les enfants avec incapacityé motrice par rapport aux enfants sans incapacityé. La raison pour laquclle les enfants diplégiques consomment plus d' oxygène à la marche que les autres enfants pourrait être que leurs réactions d' équilibre anormales altèrent leur tenue et leur capacityéà contrôler leur vitesse de marche. ZUSAMMENFASSUNG Energieverbrauch bei Kindern mil Spina bifida mid Cerebralparese: Eine Vergleiclisstttdie Die Autoren untersuchten Unterschiedc im Energieverbrauch bei ambulaten Kindern mit Cerebralparese und Spina bifida. Der Sauerstoffverbrauch wurde je nach Typ der Cerebralparese und Höhe der Spina bifida Läsion und bei gesunden Kindern gemessen. Die Rate des Sauerstoffverbrauchs (mL/kg/min) war bei Kindern mit Diplegie signifikant höher als bei denen mit Hemiplegie oder Spina bifida oder bei gesunden Kindern. Bei alien Kindern mit Behinderung war der Sauerstoffbedarf (mL/kg/m) signifikant höher und die Geschwindigkcit signifikant langsamer als bei den gesunden Kindern. Der Grund weshalb Kinder mit Diplegie beim Laufcn mehr Sauersloff verbrauchten als andere Kinder, mag darin liegen, daß ihre abnormen Gleichgewichtsreaktionen ihre Balance und ihre Fähigkeit, die Gcschwindigkeit zu kontrollieren. Beeinträchtigtcn. RESUMEN Consumo de energiu en niños con espina bifida v parálisis cerebral: estndio comparativo Los autorcs investigaron las difcrencias de los patrones de gasto de energia de niñas ambulantes con parálisis cerebral y espina bífida. El consumo de oxígcno se midió de acuerdo con el tipo dc parálisis cerebral o el nivel de la lesion medular y en niños sanos. El...
The antenatal diagnosis of fetuses with myelomeningocele (MMC) has focused the attention of those involved in the perinatal care on caesarean section delivery as a possible method of preserving neurological function. In this paper 25 infants with MMC were studied, 10 delivered by pre-labour caesarean section (PL C/S), and 15 by other methods. No difference in motor function was observed post natally with 50% of each group having neurological levels below L3. The PL C/S group was more heterogeneous. The feasibility of selecting a group of less impaired fetuses with good in utero leg movements for PL C/S in order to preserve neurological function depends on the ability of fetal USS to predict post natal neurological function. This preliminary report leaves unanswered the question whether C/S delivery improves neurological outcome in selected cases of open spina bifida.
Conductive education, an educational approach devised by Andras Petö in Hungary after the second world war, has attracted considerable media attention. Eight Northern Ireland families who recently had treatment for their disabled child at the Petö Institute in Budapest were identified. Six families returned postal questionnaires designed to look at parental experience of conductive education. An improvement in existing local services, as opposed to the wholesale introduction of this facility was the commonest parental hope for future provision for physically handicapped children.
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