Body composition and spasticity in children with bilateral cerebral palsy

Lawia Szkoda, Andrzej Szopa, Ilona Kwiecień-Czerwieniec, Małgorzata Domagalska-Szopa


Lawia Szkoda, Andrzej Szopa, Ilona Kwiecień-Czerwieniec, Małgorzata Domagalska-Szopa – Body composition and spasticity in children with bilateral cerebral palsy. Fizjoterapia Polska 2022; 22(2); 174-185

Abstract
Objective. The objective of this study was to identify the correlation between body composition of children with cerebral palsy and the degree of spasticity in the muscles of the lower limbs.
Material and methods. The study included a group of 59 independently walking children aged 8 to 16 with spastic diplegia. The control group included 59 children without central movement disorders – students at Primary School No. 25 in Sosnowiec. The research included: 1) assessment of body composition and its components using the TANITA MC-780 S MA scale; 2) assessment of the degree of spasticity according to the modified Ashworth scale; 3) calculations of BMI indices in accordance with the recommendations of the World Health Organization (WHO) and BMI OLAF developed by the Children’s Memorial Health Institute in Warsaw.
Results. The most severe spasticity, both in the right and left lower limbs, was observed in the extensors of the ankle joint. In turn, the mildest spasticity was observed in the group of flexors of the knee joint of the right and left lower limbs. The greater the degree of spasticity in the muscles of the lower limbs, the greater the deficit in fat-free mass and muscle mass in the lower limbs.
Conclusions. Children with CP have deficits in terms of muscle mass. The deficit of muscle tissue depends on the degree of spasticity of the proximal muscle groups of the lower limbs.
Key words:
body composition, spasticity, cerebral palsy
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Postural stability of children born prematurely in the perinatal risk group

Katarzyna Kniaziew-Gomoluch, Andrzej Szopa, Tomasz Łosień, Zenon Kidoń, Małgorzata Domagalska-Szopa


Katarzyna Kniaziew-Gomoluch, Andrzej Szopa, Tomasz Łosień, Zenon Kidoń, Małgorzata Domagalska-Szopa – Postural stability of children born prematurely in the perinatal risk group. Fizjoterapia Polska 2022; 22(2); 118-129

Abstract
Introduction. With advances in neonatal care, children born prematurely have a greater chance of survival, but their organ immaturity puts them at increased risk for central developmental disorders. The most common risk factors for such disorders are neonatal respiratory distress syndrome (RDS) and intraventricular hemorrhage (IVH grade III, IV).
Object. Based on the assumption that early central motor disorders are accompanied by impaired postural control, we compared measures of postural stability in infants born prematurely and at high risk for central motor disorders, i.e.: 1) IVH stage III or IV; or 2) RDS with infants born prematurely with normal brain ultrasound results and no perinatal burden (control group).
Materials and Methods. For this purpose, in a group of 76 prematurely born infants qualified for the SYNAGIS program, a posturometric examination was performed in a supine position using a stabilographic platform (device designed and manufactured in the Department of Biomedical Electronics of the Institute of Electronics of the Silesian University of Technology in Gliwice).
Results. Analysis of stability measures in individual subgroups showed that in both groups of infants with perinatal risk (IVH and RDS), the values of all evaluated posturometric parameters were lower than those presented by infants without perinatal stress.
Conclusions. 1. Evaluation of stability measures  in the supine position is an original proposal for the evaluation of postural control of infants born prematurely in the first months of life.
2. Differences in stability measures between children born prematurely with the risk of central disturbances due to hypoxia (RDS) or intraventricular hemorrhage (IVH) and their peers without perinatal stress with normal head ultrasound results may indicate the appearance of postural control development disorders in the former.
Key words:
prematurely born children, perinatal risk factors, infant postural control disorders, posturometry, stabilographic platform
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The impact of high body weight on children’s aerobic capacity in the primary school age

Agata Dobrowolska, Małgorzata Domagalska-Szopa, Agnieszka Ostrowska, Andrzej Szopa


Agata Dobrowolska, Małgorzata Domagalska-Szopa, Agnieszka Ostrowska, Andrzej Szopa – The impact of high body weight on children’s aerobic capacity in the primary school age. Fizjoterapia Polska 2022; 22(1); 222-232

Abstract
Introduction. Overweight and obesity are among the greatest global challenges of the 21st century. In Poland, the number of overweight children has tripled in the last 20 years. In order to determine the level of aerobic capacity as well as the selection of forms and intensity of physical training in children with excess body weight, many methods are used, e.g. 6-minute walk test (6MWT) or spiroergometric test (CPET).
Aim od the study. The aim of the study was to evaluate the performance parameters of children with excess body weight in comparison to children with proper body weight. Additionally, an attempt was made to answer the question whether the results of the indirect method efficiency assessment are consistent with the results of the spiroergometric test.
Material and methodology. The research was carried out in a group of 25 children with excess body weight (study group; BMI 93.7 ± 4.11 percentile) and 25 children with normal body weight (control group; BMI 28 ± 19.62 percentile) aged 8-12 years. The tests consisted of 3 parts: 1) measurement of body weight, body height and body weight composition; 2) ergospirometric test (CPET) carried out on a cycloergometer using the Godfrey ramp type protocol; 3) assessment of aerobic capacity based on the result of the 6MWT test.
Results. There were significant differences in the VO2 / kg result in the studied children between the study group (26.2 ± 4.32 ml / kg / min) and the control group (36.2 ± 5.75 ml / kg / min) and the results of the 6MTW test in the study group was 486.5 ± 86.35 m, and in the control group 519.6 ± 85.40 m.
Conclusions. There were no differences in the value of the VO2peak parameter in children from the study and control groups; however, differences in the result of VO2 / kg were noticed. Children with hight BMI characterized by a greater difference between the observed and expected value of 6MWT than children with proper body weight.
Key words:
children’s aerobic capacity, CPET, 6MWT, excess body weight, high BMI
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A congenital malformation syndrome – situs inversus, esophageal atresia

Sylwia Potępa-Kowalczyk, Agata Dobrowolska, Małgorzata Domagalska-Szopa, Andrzej Szopa

S. Potępa-Kowalczyk, A. Dobrowolska, M. Domagalska-Szopa, A. Szopa – A congenital malformation syndrome – situs inversus, esophageal atresia. Fizjoterapia Polska 2021; 21(4); 122-125

Abstract
Introduction. In case of a congenital malformation syndrome, a correct diagnosis is made on the basis of characteristic features. Situs inversus is a rare congenital condition. Its incidence with concomitant esophageal atresia is very low. Both disorders in body laterality formation and agenesis of esophagus might accompany various congenital malformations. When multiple defects are present, standard treatment options are unavailable.
Case Report. A child was diagnosed with a 45XX, rob(13,14)(q10,q10) karyotype and a congenital malformation syndrome including: situs inversus with dextrocardia, esophageal atresia with tracheoesophageal fistula, hydrocephaly, right lung hypoplasia, and atrial septal defect. As of now, an official clinical diagnosis of the child has not been confirmed.
Conclusions.  Treating this type of malformation syndrome is always challenging and requires an interdisciplinary approach. Comprehensive care provided to a child with congenital malformation syndrome should include treatment of the present disorders as well as prevention of possible complications.
Key words:
situs inversus, esophageal atresia, multiple defects, congenital malformation syndrome, dextrocardia
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Distribution of body mass on the support base in cerebral motor disorders children as an expression of antigravity unabilities

Andrzej Szopa, Małgorzata Domagalska, Janusz Nowotny

Andrzej Szopa, Małgorzata Domagalska, Janusz Nowotny – Distribution of body mass on the support base in cerebral motor disorders children as an expression of antigravity unabilities. Fizjoterapia Polska 2007; 7(3); 250-257

Abstract
Background. Normal postural tone is high enough to act against gravity at every stage of motor development, but also low enough to ensure mobility in a given position. All disturbances of adaptation of muscle activity to postural and motor tasks are the cardinal symptoms of actual or potential central dysfunctions. This study attempted to use an objective measure of quantified distribution of forces of body mass on the supporting base to examine the adaptation of muscle activity for different postural patterns. Material and methods. Three groups of 15 children each aged about 12 months were examined, including two groups of children diagnosed with dysfunction motorica origis centralis (DMOC) II° and III°, and a control group of children with bronchitis. Measurement were carried out with a Sensor-Mass-System developed by Lack GmbH and including a platform with 200 sensors and dedicated software. All children were tested twice on two consecutive days. The values of forces and distribution of body mass on the supporting base was determined in three basic positions: supine, prone and sitting. Results. A preliminary analysis showed differences in the values of forces of body mass between the three groups. Statistically significant differences between the results of the first and second measurements in the same position were a rule in the control group. In the group of children with mild DMOC pathology such differences appeared slightly less often and were not found in the group of children with severe DMOC. Children with severe DMOC displayed marked asymmetry of body mass distribution in the frontal plane and along the craniocaudal axis. The other groups were generally characterized by symmetrical postural patterns. Conclusions. While this pilot study was part of a more extensive research project, some general conclusions can be made: an evaluation of body weight distribution on a supporting base is an indirect but objective and reproducible tool for evaluating mus-cle tone distribution in different postural patterns. It can be a valuable addition to the assessment of postural pattern quality.
Key words:
cerebral motor disorders, postural patterns, support base, distribution of body mass
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Postural consequences of muscle tone disorders in children with cerebral palsy (hemiparesis)

Andrzej Szopa, Małgorzata Domagalska, Krzysztof Czupryna, Maciej Płaszewski

Andrzej Szopa, Małgorzata Domagalska, Krzysztof Czupryna, Maciej Płaszewski – Postural consequences of muscle tone disorders in children with cerebral palsy (hemiparesis). Fizjoterapia Polska 2007; 7(3); 241-249

Abstract
Background. The spontaneous adjustment of abnormal muscle tone in CP children leads to abnormal postural and motor patterns development. The aim of this work was to recognize and define some of compensatory postural patterns in CP children. Material and methods. The group of 18 children with hemiplegia, aged 5-14, were taken into the examination. The objective measurement of they postural patterns while standing, kneeling (of one and both legs) and sitting was done with a help of photogrammetry. In the same time using baroresistive platform a force distribution on the support base were measured. Results. In case of standing position two kinds of postural patterns were observed — the progravitational pattern and the anti-gravitational pattern. In every children with progravitional pattern lateral spine curvature were observed. Their values were significantly higher than similar in antigravitational pattern. In standing on one leg and half kneeing the arrangement of postural parameters were the same. In sitting in children with progravitional type mutual arrangement of shoulders and pelvis line was changed to parallel and in children with antygravitional type overloaded side changed to opposite. Conclusions. 1. The postural patterns through hemiparetic children are habitual and have differentiated character according to character of paresis. 2. Development of postural patterns is predictable, it is possible to steer the compensation during the treatment.
Key words:
cerebral palsy, compensatory antigravity mechanisms, postural patterns
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Postural problems of children with CP based on hemiparesis

Małgorzata Domagalska, Krzysztof Czupryna, Andrzej Szopa, Janusz Nowotny

Małgorzata Domagalska, Krzysztof Czupryna, Andrzej Szopa, Janusz Nowotny – Postural problems of children with CP based on hemiparesis. Fizjoterapia Polska 2008; 8(3); 253-259

Abstract
Background. Injury to the immature brain leads to impaired development of the antigravity mechanism. The adoption of progressively higher body positions is only possible due to compensatory mechanisms. The aim of the study was to diagnose postural disorders in children with CP with respect to the adopted compensatory mechanisms. Material and methods. Eighteen children with advanced hemiparesis, aged from 5 to 14, took part in the study. Objective posturometric measurements were taken while the patients maintained a standing position without assistance. Photogrammetric measurements was used to evaluate the spatial arrangement of individual body segments, with pressure forces on the support base being assessed simultaneously using a baroresistive platform. Results. Patients demonstrated two types of postural patterns: a progravity pattern and an antigravity pattern, which differed mainly in terms of the patient habitually overloading or unloading one of the lower limbs, changing the position of the centre of gravity projection on the support base and a characteristic relation of the shoulder and pelvic lines. Conclusions. The nature of postural disorders in CP children depends on the anti- or progravitational nature of the paresis. The development of postural disorders in CP children is predictable and should therefore be taken into account from the very beginning of rehabilitation
Key words:
cerebral palsy, compensatory antigravity mechanism, postural problems
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The influence of external loading on weight compensatory changes and pelvic behaviour during walking in scoliotic children

Olga Nowotny-Czupryna, Krzysztof Czupryna, Anna Brzęk, Małgorzata Domagalska, Andrzej Szopa

Olga Nowotny-Czupryna, Krzysztof Czupryna, Anna Brzęk, Małgorzata Domagalska, Andrzej Szopa – The influence of external loading on weight compensatory changes and pelvic behaviour during walking in scoliotic children. Fizjoterapia Polska 2008; 8(4); 436-444

Abstract
Background. Compensatory changes in the spatial arrangement of body segments are a characteristic sign of the development of scoliosis. Additional external loads may lead to intensification of existing signs in both static and dynamic conditions. The manner of carrying heavy objects on a daily basis is a key factor here. The aim of this paper was to assess some changes in static and dynamic parameters associated with carrying the school pack in children with scoliosis.Material and methods. Thirty-six children aged 8-15 years with low-grade scoliosis were examined. Foot pressure in static conditions was recorded using a force platform without additional loading, and with a 4 kg external load carried in a symmetric or asymmetric manner. Three-dimensional gait analysis was also performed using a Zebris® system. Parameters were registered during walking without and with the external load.Results. Signs of asymmetric foot pressures were observed that intensified during external loading of spine (both symmetric and asymmetric). These changes were not clearly related to body posture parameters. There were also signs of gait asymmetry that intensified during walking with asymmetrical external loading. The most marked changes were observed with respect to pelvis-related gait determinants. The magnitude of changes was related to the manner of carrying the school pack rather than to body posture parameters. Conclusions. External loads intensify the asymmetry of foot pressure distribution as a result of spontaneous and unpredictable compensatory dislocations. The manner of carrying the school pack is not irrelevant in children with scoliosis.
Key words:
scolioses, foot pressure, gait, locomotion, external loading, gait determinants
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Infant crawling and motor coordination level of children aged 4-7 years

Aleksandra Deninger, Urszula Nowacka-Gębosz, Kamila Pilok, Małgorzata Domagalska-Szopa, Andrzej Szopa

Aleksandra Deninger, Urszula Nowacka-Gębosz, Kamila Pilok, Małgorzata Domagalska-Szopa, Andrzej Szopa – Infant crawling and motor coordination level of children aged 4-7 years. Fizjoterapia Polska 2020; 20(5); 216-225

Abstract
Introduction. One of the stages of a child’s motor development in the first year of life is crawling, whose positive influence on psychomotor development has been supported by research. However, some children skip this stage of locomotion and start to move immediately in a standing position. The aim of the study was to assess the motor and visual-motor coordination of children who did not crawl in infancy and to compare the results with a group of children who did not omit this stage of motor development.
Material and methods. The study involved 53 healthy children aged 4-7 years attending preschool facilities in Upper Silesia. The control group consisted of 20 children, who did not crawl in infancy. The control group consisted of 33 children who were crawling in infancy. The research consist: author’s questionnaire and Ozierecki’s Test of motor and visual-motor coordination. Questionnaire concern five parts of information about health, development, and current motor skills level of children. The second stage of the study – Ozierecki’s Test (interpreted by A. Barański) was used to assess the motor and visual-motor coordination level of 4-16 years old children.
Results. The group of crawling children had a higher level of visual-motor coordination, but only in one of the examined skills (swinging). The presence of crawling does not significantly affect the motor abilities of an older child. In the study group, it is noted that the higher the value of Apgar points obtained at birth, the higher the motor skills and motor coordination.
Key words:
crawling, motor coordination and visual-motor coordination
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Characteristics of lateralization in children aged 5-7 years

Sylwia Potępa, Aleksandra Czaplińska, Alicja Salwach, Lawia Szkoda, Andrzej Szopa, Małgorzata Domagalska-Szopa

S.Potępa, A. Czaplińska, A. Salwach, L. Szkoda, A. Szopa, M. Domagalska-Szopa – Characteristics of lateralization in children aged 5-7 years. Fizjoterapia Polska 2019; 19(1); 60-68

Abstract
Autism spectrum disorder (ASD) represents an extensive class of symptoms manifested as deficiencies in such fields as communication, social development and stereotypical behavioural patterns. Autism symptoms appear in social interactions issues, mood disorders, somatosensory disorders, concentration problems. The conversion disorders are frequently diagnosed in autistic children. Maintaining the standing balance is an immensely important skill in the child’s development, which consists in controlling the centre of gravity over the support plane. Appropriate balance is necessary for successful performance of numerous daily actions. Retarded development of balance impedes the future motor development and affects the opportunity of the children’s involvement in interactions with peers.
The purpose of this paper was an impartial evaluation of balance skills in children with autism spectrum disorder.
Material and methods. 30 children 5-7 year-old with ASD, including 22 boys and 8 girls. Methods: The Scoring Form for Fullerton Advanced Balance (FAB) Scale test was used for evaluation of the balance.
Results. The lowest results were obtained in the tandem walk and stand on one leg test. The test results varied in specific age groups, however, the differences were not significant. Substantial differences were displayed in tandem gait test for specific age groups.
Conclusions. In children with ASD disorders in balance skills occur.

Key words:
lateralization, functional asymmetry, side dominance

 

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