The severity of chewing disorders is related to gross motor function and trunk control in children with cerebral palsy

Abstract

Purpose: The frequency of chewing disorders increases with decreasing level of gross motor function in children with cerebral palsy (CP). Besides its frequency, the severity of chewing disorders is also important. The aim of this study was to determine the relationship between chewing performance level and gross motor function, and trunk postural control in children with CP.

Materials and methods: The study included 119 children with CP (age 2–10 years). Chewing performance level was determined by the Karaduman Chewing Performance Scale (KCPS). The Gross Motor Function Classification System (GMFCS) was used to determine the level of gross motor function. Segmental Assessment of Trunk Control (SATCo) was used to measure trunk control.

Results: Children with spastic CP with a median age of 4?years were evaluated, of which 50.4% were male. The percentages of patients classified to GMFCS levels I to V were 43.7%, 6.7%, 9.2%, 5.0%, and 35.3%, respectively. The median KCPS score was 3 (min?=?0, max?=?4). A good correlation was found between KCPS and GMFCS (p?<?.001, r?=?0.70). Negative, excellent correlations between KCPS and SATCo static, SATCo active, and SATCo reactive postural controls were found (p?<?.001, r?=?–0.75, r?=?–0.77, r?=?–0.79; respectively).

Conclusions: The severity of chewing disorders is related to the level of gross motor function and trunk postural control in children with CP.

Clinical trial number: NCT03241160     

Electromyographic analysis of rectus femoris activity during seated to standing position and walking in water and on dry land in healthy children and children with cerebral palsy

Purpose: To analyze rectus femoris activity during seated to standing position and walking in water and on dry land comparing a group of children with the spastic diparesis type of cerebral palsy (CP) and a group of children without neurological disorders. Methods: This study included a group of nine children with CP and a control group of 11 children. The study compared the electromyographic activity of the rectus femoris during seated to standing position and walking, in water and on land. Results: A greater activation of the rectus femoris was observed in the group of children with CP compared with the control group when moving from a seated position to a standing position in water (p = 0.0039) and while walking on land (p = 0.0014) or in the pool (p = 0.007). Conclusion: This study demonstrated the activation of the rectus femoris while walking or standing up from a seated position in water was greater in the group of children with CP. Further studies should be performed to better understand the extent of muscular activation during body immersion in individuals with neurological disorders.     

Stiffness of hip adductor myofibrils is decreased in children with spastic cerebral palsy

Cerebral palsy (CP) is the result of a static brain lesion which causes spasticity and muscle contracture. The source of the increased passive stiffness in patients is not understood and while whole muscle down to single muscle fibres have been investigated, the smallest functional unit of muscle (the sarcomere) has not been. Muscle biopsies (adductor longus and gracilis) from pediatric patients were obtained (CP n = 9 and control n = 2) and analyzed for mechanical stiffness, in-vivo sarcomere length and titin isoforms. Adductor longus muscle was the focus of this study and the results for sarcomere length showed a significant increase in length for CP (3.6 µm) compared to controls (2.6 µm). Passive stress at the same sarcomere length for CP compared to control was significantly lower in CP and the elastic modulus for the physiological range of muscle was lower in CP compared to control (98.2 kPa and 166.1 kPa, respectively). Our results show that CP muscle at its most reduced level (the myofibril) is more compliant compared to normal, which is completely opposite to what is observed at higher structural levels (single fibres, muscle fibre bundles and whole muscle). It is noteworthy that at the in vivo sarcomere length in CP, the passive forces are greater than normal, purely as a functional of these more compliant sarcomeres operating at long lengths. Titin isoforms were not different between CP and non-CP adductor longus but titin:nebulin was reduced in CP muscle, which may be due to titin loss or an over-expression of nebulin in CP muscles.     

脑瘫伴癫痫儿童肠道菌群变化

目的 探讨脑瘫伴癫痫儿童肠道菌群的变化。方法 选择龙岗区社会福利中心诊断为脑瘫伴癫痫的31例患儿作为疾病组;另外选取同龄健康儿童30例作为健康组。留取受试者的粪便标本,提取总DNA,并对16S rRNA基因的V3‒V4可变区进行扩增,并在Illumina MiSeq平台进行高通量测序。结果 与健康儿童相比,疾病组儿童肠道内微生物多样性出现明显差异。在门水平优势菌群中,疾病组儿童放线菌的相对丰度明显高于健康组（32.87% vs 3.56%）,而拟杆菌的相对丰度明显低于健康组（22.66% vs 53.59%）。在属水平优势菌群中,疾病组儿童双歧杆菌属、副拟杆菌属的相对丰度均明显高于健康组（26.94% vs 2.61%,5.72% vs 1.90%）,其中肠杆菌属的相对丰度达6.00%,而拟杆菌属、粪杆菌属的相对丰度明显低于健康组（11.38% vs 45.16%,0.63% vs 12.78%）,普雷沃菌属的相对丰度也低于健康组（3.11% vs 5.30%）。结论 与同龄健康儿童相比,脑瘫伴癫痫儿童肠道菌群改变明显,菌群门水平和属水平均有明显差异。     

The energy cost of common tasks in rural Nepal: levels of energy expenditure compatible with sustained physical activity

Three hundred and six measurements of energy expenditure by indirect calorimetry of sitting at rest and self-paced activity were made on 41 men, 48 women and 6 adolescents in a mountain village of Nepal. Except for walking and carrying uphill, measured activities fell within the range of values for light to moderate effort, despite appearing physically demanding. Villagers tended to reduce travel speed when carrying heavy loads (54-102% of body mass on various inclines), averaging a moderate level of energy expenditure which could be sustained throughout the day. Such moderately demanding work was also assumed by pregnant, lactating women and young adolescents. Pregnant women worked more slowly at some tasks, but did not differentiate themselves from their non-pregnant, non-lactating counterparts for travel on the mountain side.     

Measurement of oxygen consumption in mouse aortic endothelial cells using a microparticulate oximetry probe

The purpose of this study was to determine the rate of oxygen consumption in mouse aortic endothelial cells (MAECs) and to determine the effect of a variety of inhibitors and stimulators of oxygen consumption measured by electron paramagnetic resonance (EPR) spectroscopy utilizing a new particulate oximetry probe. We have previously demonstrated that the octa-n-butoxy derivative of naphthalocyanine neutral radical (LiNc-BuO) enables accurate, precise, and reproducible measurements of pO(2) in cellular suspensions. In the current study, we carried out measurements to provide an accurate determination of pO(2) in small volume with less number of cells (20,000 cells) that has not been possible with other techniques. To establish the reliability of this method, agents such as menadione, lipopolysaccharide (LPS), potassium cyanide, rotenone, and diphenyleneiodonium chloride (DPI) were used to modulate the oxygen consumption rate in the cells. We observed an increase in oxygen consumption by the cells upon treatment with menadione and LPS, whereas treatment with cyanide, rotenone, and DPI inhibited oxygen consumption. This study clearly demonstrated the utilization of EPR spectrometry with LiNc-BuO probe for determination of oxygen concentration in cultured cells.     

Light dependence of oxygen consumption by blowfly eyes recorded with a magnetic diver balance

We measured the oxygen (O₂) consumption of isolated blowfly eyes using a magnetic diver balance, a device for high-resolution volumetric O₂ consumption measurements. The light-induced O₂ consumption is at most three times the value of the dark consumption, which is 0.6 nl O₂ s^–1 eye^–1, and is in good agreement with the estimates based on electrophysiological data. With longer stimuli the increase follows a double exponential time course. The respective time constants are approximately 2 and 20 s and show no dependence on light intensity, whereas the dependence of amplitudes can be fitted by a Hill equation. Decreasing the stimulus duration reveals that the peak in O₂ consumption overshoots the time course induced by long stimuli. We suggest this may be a general feature of mitochondrial activation. The dependence of the O₂ consumption peak on stimulus duration at high light intensity has a hump with stimulus durations of 10–20 ms, coinciding with the stimulus durations that start to induce the adaptation of the receptor potential.     

Effects of seat surface inclination on respiration and speech production in children with spastic cerebral palsy

Background

Respiratory and speech problems are commonly observed in children with cerebral palsy (CP). The purpose of this study was to identify if inclination of seat surface could influence respiratory ability and speech production in children with spastic diplegic CP.

Methods

Sixteen children with spastic diplegic CP, ages 6 to 12 years old, participated in this study. The subjects’ respiratory ability (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), and maximum phonation time (MPT)) were measured in three sitting conditions: a seat surface inclined 0°, anterior 15°, and posterior 15°.

Results

FVC was significantly different across three inclinations of seat surface, F(2, 45) = 3.81, P = 0.03. In particular, the subjects’ FVC at a seat surface inclined anterior 15° was significantly greater than at a seat surface inclined posterior 15° (P < 0.05). However, FEV1, PEF, and MPT were not significantly affected by seat surface inclination (P > 0.05).

Conclusions

The results suggest that anterior inclination of seat surface may provide a positive effect on respiratory function in children with spastic diplegic CP.     

Effect of dietary supplementation of l-tryptophan on thermal tolerance and oxygen consumption rate in Cirrhinus mrigala fingerlings under varied stocking density

A 60 day feeding trial was conducted to study the effect of dietary l-tryptophan on thermal tolerance and oxygen consumption rate of freshwater fish, mrigala, Cirrhinus mrigala reared under ambient temperature at low and high stocking density. Four hundred eighty fingerlings were distributed into eight experimental groups. Four groups each of low density group (10 fishes/75 L water) and higher density group (30 fishes/75 L water) were fed a diet containing 0, 0.68, 1.36 or 2.72% l-tryptophan in the diet, thus forming eight experimental groups namely, Low density control (LC) (basal feed +0% l-tryptophan); LT₁ (basal feed+0.68% l-tryptophan); LT₂ (basal feed+1.36% l-tryptophan); LT₃ (basal feed+2.72% l-tryptophan); high density control (HC) (basal feed+0% l-tryptophan); HT₁ (basal feed+0.68% l-tryptophan); HT₂ (basal feed+1.36% l-tryptophan); and HT₃ (basal feed+2.72% l-tryptophan) were fed at 3% of the body weight. The test diets having crude protein 34.33±0.23 to 35.81±0.18% and lipid 423.49±1.76 to 425.85±0.31 K Cal/100 g were prepared using purified ingredients. The possible role of dietary l-tryptophan on thermal tolerance and oxygen consumption rate was assessed in terms of critical thermal maxima (CT_Max), critical thermal minima (CT_Min), lethal thermal maxima (LT_Max) and lethal thermal minima (LT_Min). The CT_Max, CT_Min, LT_Max and LT_Min values were found to be significantly higher (p<0.05) in the treatment groups with CT_Max 42.94±0.037 (LT₂); LT _Max 43.18±0.070 (LT₂); CT_Min 10.47±0.088 (LT₂) and LT_Min 9.42±0.062 (LT₃), whereas the control group showed a lower tolerance level. The same trend was observed in the high density group (CT_Max 42.09±0.066 (LT₃); LT_Max 4₃ 23±0.067 (HT₃); CT_Min 10.98±0.040 (HT₃) and LT_Min 9.74±0.037 (HT₃). However, gradual supplementation of dietary l-tryptophan in the diet significantly reduced the oxygen consumption rate in both the low density group (Y=−26.74x+222.4, r²=0.915) and the high density group (Y=−32.96x+296.5, r²=0.8923). Dietary supplementation of l-tryptophan at a level of 1.36% improved the thermal tolerance level and reduced the oxygen consumption rate in C. mrigala fingerlings.     

Analysis of beat fluctuations and oxygen consumption in cardiomyocytes by scanning electrochemical microscopy

The contractile behavior of cardiomyocytes can be monitored by measuring their action potentials, and the analysis is essential for screening the safety of potential drugs. However, immobilizing cardiac cells on a specific electrode is considerably complicated. In this study, we demonstrate that scanning electrochemical microscopy (SECM) can be used to analyze rapid topographic changes in beating cardiomyocytes in a standard culture dish. Various cardiomyocyte contraction parameters and oxygen consumption based on cell respiration could be determined from SECM data. We also confirmed that cellular changes induced by adding the cardiotonic agent digoxin were conveniently monitored by this SECM system. These results show that SECM can be a potentially powerful tool for use in drug development for cardiovascular diseases.     

The role of co-activation in strength and force modulation in the elbow of children with unilateral cerebral palsy

To study the role of coactivation in strength and force modulation in the elbow joint of children and adolescents with cerebral palsy (CP), we investigated the affected and contralateral arm of 21 persons (age 8-18) with spastic unilateral CP in three tasks: maximal voluntary isokinetic concentric contraction and passive isokinetic movement during elbow flexion and extension, and sub-maximal isometric force tracing during elbow flexion. Elbow flexion-extension torque and surface electromyography (EMG) of the biceps brachii (BB) and triceps brachii (TB) muscles were recorded. During the maximal contractions, the affected arm was weaker, had decreased agonist and similar antagonist EMG amplitudes, and thus increased antagonist co-activation (% of maximal activity as agonist) during both elbow flexion and extension, with higher coactivation levels of the TB than the BB. During passive elbow extension, the BB of the affected arm showed increased resistance torque and indication of reflex, and thus spastic, activity. No difference between the two arms was found in the ability to modulate force, despite increased TB coactivation in the affected arm. The results indicate that coactivation plays a minor role in muscle weakness in CP, and does not limit force modulation. Moreover, spasticity seems particularly to increase coactivation in the muscle antagonistic to the spastic one, possibly in order to increase stability.     

Comparison of methods for measuring oxygen consumption in tumor cells in vitro

The oxygen consumption rate of tumor cells affects tumor oxygenation and response to therapies. Highly sensitive methods for determining cellular oxygen consumption are, therefore, needed to identify treatments that can modulate this parameter. We compared the performances of three different methods for measuring cellular oxygen consumption: electron paramagnetic resonance (EPR) oximetry, the Clark electrode, and the MitoXpress fluorescent assay. To compare the assays, we used K562 cells in the presence of rotenone and hydrocortisone, compounds that are known to inhibit the mitochondrial electron transport chain to different extents. The EPR method was the only one that could identify both rotenone and hydrocortisone as inhibitors of tumor cell oxygen consumption. The Clark electrode and the fluorescence assay demonstrated a significant decrease in cellular oxygen consumption after administration of the most potent inhibitor (rotenone) but failed to show any significant effect of hydrocortisone. EPR oximetry is, therefore, the most sensitive method for identifying inhibitors of oxygen consumption on cell assays, whereas the Clark electrode offers the unique opportunity to add external compounds during experiments and still shows great sensitivity in studying enzyme and chemical reactions that consume oxygen (non-cell assays). Finally, the MitoXpress fluorescent assay has the advantage of a high-sample throughput and low bulk requirements but at the cost of a lower sensitivity.     

Validation of manometric microrespirometers for measuring oxygen consumption in small arthropods

Scientists have used numerous techniques to measure organismal metabolic rate, including assays of oxygen (O(2)) consumption and carbon dioxide (CO(2)) production. Relatively few studies have directly compared estimates of metabolic rate on the same groups of animals as determined by different assay methods. This study directly compared measures of the metabolic rate of three lines of Drosophila simulans as determined either from direct measures of CO(2) production using infrared gas analysis (IRGA), or from estimates of O(2) consumption based on manometeric techniques. Determinations of metabolic rate of the same cohorts of flies using these two methods produced results that often differed widely. Typically metabolic rate as determined by the manometric method was significantly greater than that determined by CO(2) output. These differences are difficult to explain by simple biotic or abiotic factor(s). Because of the idiosyncratic nature of these differences it is not possible to use a simple factor to convert from metabolic rate measurements done using manometric techniques to those expected from direct measures of CO(2) output or O(2) consumption. Although manometric devices are simple to construct and use, measurements of metabolic rate made with this method can vary significantly from measurements made by directly assaying CO(2) production or O(2) consumption.     

Multivariate analysis of the selected metals in the hair of cerebral palsy patients versus controls

Seventeen metals were measured in scalp hair samples from cerebral palsy patients (CPPs) and controls. Samples were collected from 95 CPPs and 93 controls. The nitric acid-perchloric acid wet digestion procedure was used for quantification of the selected metals by flame atomic absorption spectrophotometry. The concentrations of Ag, Ca, Cd, Co, Cr, Li, and Mg were significantly higher and those of Cu, Fe, K, Mn, Na, Ni, Pb, and Sb were lower in the hair of CPPs compared with controls. A strong positive correlation was found between Ca and Mg in the hair of controls but not in that of CPPs. Antimony was found significantly negative in terms of its correlation with Co and Cu in CPPs group but not in the controls. Principal component analysis (PCA) of the data extracted seven factors for CPPs and six factors for controls. Cluster analysis (CA) was also used to support the PCA results. The study evidenced some specific source of Mg and Sb in the hair of CPPs.     

Myocardial oxygen consumption and mechanical efficiency of a perfused dogfish heart preparation

Summary Oxygen consumption of an in-pericardium heart preparation from the spiny dogfish (Squalus acanthias) was linearly related to cardiac power output. Basal oxygen consumption, predicted from the regression, was 0.127 l · s^-1 · g ventricle mass^-1 and increased by 0.189 l · s^-1 · g ventricle mass^-1 per milliwatt of power generated. From the relationship between cardiac power output and mechanical efficiency, mechanical efficiency was predicted to increase with cardiac power output to a maximum of 21 %. Mechanical efficiency was measured during volume loading and pressure loading at two power outputs (50% and 72% of maximum power output). At 50% of maximum power output, mechanical efficiency increased significantly by 2.87%, from 11.9±0.3% to 14.8±0.5% (n=7), when flow was halved and output pressure doubled to achieve the same power output. Similarly, at 72% of maximum power output, mechanical efficiency increased from 14.74±0.92% to 17.61±0.84% (n=6) when flow was halved and output pressure doubled to generate the same higher level of power output. The increased mechanical efficiency at higher output pressures is believed to result from cardiac myocytes working within a length range where they are able to generate the most tension during contraction and are most efficient. We speculate that the loss of mechanical efficiency associated with large changes in sarcomere length, when stroke volume is large, is a driving force behind the use of frequency as the principal means of increasing cardiac output as observed in more active fishes, birds and mammals.Abbreviations BM body mass - CO cardiac output - HR heart rate - P _i mean cardiac input pressure - P _o mean cardiac output pressure - PO partial pressure of oxygen - SV stroke volume of heart - VM ventricle mass     

Endogenous angiotensin II and the regulation of oxygen consumption and colonic temperature in rats

Previous studies have suggested that angiotensin II, a hormone known to regulate water and salt balance and blood pressure, may also regulate oxygen consumption and body temperature. In this study we investigated the role of endogenous angiotensin in the regulation of oxygen consumption and colonic temperature in rats under low (control) and high (water deprivation, administration of isoproterenol and hemorrhage) peripheral angiotensin conditions. Peripheral administration of losartan, an AT₁ receptor antagonist or enalapril, an angiotensin converting enzyme inhibitor, did not alter oxygen consumption or colonic temperature in control or water deprived rats. Peripheral administration of losartan did not alter the oxygen consumption and colonic temperature responses to the administration of isoproterenol or hemorrhage. Endogenous peripherally generated angiotensin II does not play an important role in regulating either oxygen consumption or colonic temperature in rats under either low or high angiotensin II levels. The reductions in oxygen consumption and colonic temperature that accompany hemorrhage in rats are not mediated by angiotensin II.     

Kinetic-based indexes for the functional evaluation of gait in diplegic children: a preliminary report

Abstract

We evaluated the feasibility of a set of indexes based on ground reaction forces to discriminate between the degree of severity of spastic diplegia, identified via Gross Motor Function Classification System (GMFCS). A stepwise discriminant ordinal regression analysis performed on a sample of 58 children returned a subset of variables related to the ratio between braking and propulsive vertical forces and anteroposterior timings. Rather, parameters concerning bilateral symmetry were poorly discriminating. The relative simplicity of the selected indexes allows for their easy implementation on existing gait analysis applications for screening purposes.     

Dynamic measurement of oxidase activity based on oxygen consumption in open systems

Oxidases catalyze the oxidation of a variety of substrates with the concomitant reduction of molecular oxygen as a final electron acceptor. UV‐visible spectrophotometry is a simple and high‐throughput method commonly used to measure oxidase activities. However, drawbacks such as light scattering exist especially concerning the activity assessment of enzymes immobilized on supports. Monitoring of the universal cosubstrate O₂ circumvents these drawbacks. This study aimed at developing a methodology that allows activity measurement of many types of oxidases based on O₂ consumption applicable to various open systems. Dissolved oxygen in the reaction medium was monitored by an O₂ sensor and the reaction rate was deduced from the O₂ mass balance equation correcting for atmospheric diffusion. Common activity units (μM_product min^?1 or U/L) could be subsequently derived using calibration curves. The sensitivity of the method toward temperature, atmospheric pressure, and ionic strength variations was evaluated, and made it possible to define operating windows for the simplification of the proposed methodology.