[Purpose] This case series aims to evaluate the effects of hippotherapy on gait and
balance ability of children and adolescents with cerebral palsy using quantitative
parameters for physical activity. [Subjects and Methods] Three patients with gait
disability as a sequela of cerebral palsy (one female and two males; age 5, 12, and
25 years old) were recruited. Participants received hippotherapy for 30 min once a week
for 2 years. Gait parameters (step rate, step length, gait speed, mean acceleration, and
horizontal/vertical displacement ratio) were measured using a portable motion recorder
equipped with a tri-axial accelerometer attached to the waist before and after a 10-m
walking test. [Results] There was a significant increase in step length between before and
after a single hippotherapy session. Over the course of 2 year intervention, there was a
significant increase in step rate, gait speed, step length, and mean acceleration and a
significant improvement in horizontal/vertical displacement ratio. [Conclusion] The data
suggest that quantitative parameters derived from a portable motion recorder can track
both immediate and long-term changes in the walking ability of children and adolescents
with cerebral palsy undergoing hippotherapy.
Early brain injury/ischaemia (EBI) is a serious complication early after subarachnoid haemorrhage (SAH) that contributes to development of delayed cerebral ischaemia (DCI). This study aimed to determine the role of inotropic cardiac support using milrinone (MIL) on restoring acute cerebral hypoperfusion attributable to EBI and improving outcomes after experimental SAH. Forty-three male C57BL/6 mice were assigned to either sham surgery (SAH-sham), SAH induced by endovascular perforation plus postconditioning with 2% isoflurane (Control), or SAH plus isoflurane combined with MIL with and without hypoxia-inducible factor inhibitor (HIF-I) pretreatment. Cardiac output (CO) during intravenous MIL infusion (0.25-0.75 μg/kg/min) between 1.5 and 2.5 hours after SAH induction was monitored with Doppler echocardiography. Magnetic resonance imaging (MRI)-continuous arterial spin labelling was used for quantitative cerebral blood flow (CBF) measurements. Neurobehavioral function was assessed daily by neurological score and open field test. DCI was analyzed 3 days later by determining infarction on MRI. Mild reduction of cardiac output (CO) and global cerebral blood flow (CBF) depression were notable early after SAH. MIL increased CO in a dose-dependent manner (P<.001), which was accompanied by improved hypoperfusion, incidence of DCI and functional recovery than Control (P<.05). The neuroprotective effects afforded by MIL or Control were attenuated by hypoxia-inducible factor (HIF) inhibition (P<.05). These results suggest that MIL improves acute hypoperfusion by its inotropic effect, leading to neurobehavioral improvement in mice after severe SAH, in which HIF may be acting as a critical mediator.
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