The Therapeutic Effects of Low-Amplitude, High-Frequency Perturbations on Neuromuscular Abnormalities Associated with Spasticity in Children with Cerebral Palsy

We aimed to investigate the impact of ankle joint therapy with low-amplitude, high-frequency perturbation training on neuromuscular abnormalities associated with spasticity in children with Cerebral Palsy (CP). Four spastic CP children (2 males and 2 females) received a 10-session training of high-frequency and low-amplitude perturbations superimposed on passive stretches over the range of motion of their ankle as well as local perturbations at dorsiflexion position. The associated passive parameters, including total passive range of motions, passive range of motions toward dorsiflexion, stiffness, energy loss and torque dynamic gain were evaluated at the baseline and after a 10 session training. Our findings indicate that passive range of motion increased, and passive reflex stiffness, which usually increases in CP children, decreased following the completion of training. Our results demonstrate that intensive sessions of perturbation therapy could be considered an effective therapeutic mean for the management of spasticity and contracture, and eventually the enhancement of mobility of CP children.

Impact of anti-gravity locomotion (AlterG) training on structure and function of corticospinal tract and gait in children with cerebral palsy

We aimed to characterize the impact of anti-gravity locomotion training on the structure and function of the corticospinal tract (CST) in cerebral palsy (CP). Fourteen CP children participated. Nine children were trained with an antigravity treadmill (Alter-G) and five children received occupational therapy (OT). Treatments were provided for 45 min each session, 3 sessions per week for 8 weeks. Diffusion tensor imaging (DTI) was used, and fractional anisotropy (FA), mean diffusivity (MD), radial (RD) and axial (AD) diffusivity was extracted to characterize the structure of the CST. Transcranial magnetic stimulation (TMS) was used and threshold, latency, and peak-peak amplitude of the MEP signal, elicited by the TMS, were used to quantify the function of the CST. Walking ability was evaluated by measuring gait speed, endurance, balance, and mobility. The evaluations were performed before and after the interventions. The results showed that FA improved in both sides of the brain for the AlterG group, but enhanced only in the less affected side of the OT group. MD, RD, and AD mostly improved in the more affected side of the AlterG group. The enhancement of the CST function was similar in both groups. Walking speed and endurance also enhanced in both groups, but the improvement was greater in the AlterG group. Our findings demonstrate that AlterG training can improve gait ability, and simultaneously result in brain neuroplasticity. The clinical implication is that AlterG training can be used as an effective rehabilitation approach to improve gait persistently.

The impact of AlterG training on balance and structure of vestibulospinal tract in cerebral palsy children

We aimed to investigate the effects of an antigravity treadmill (AlterG) on the balance and structure of the vestibulospinal tract. The AlterG can reduce the weightbearing of patients and hence can facilitate their locomotion. Three children with cerebral palsy (CP) received AlterG training three days per week for eight weeks with each session lasting 45 minutes. The balance of children was evaluated using the Berg balance test and the Timed Up and Go (TUG) test. The diffusion tensor imaging (DTI) method was employed to quantify changes of the structure of the vestibulospinal tract. Evaluations were performed before and after the 8-week training. DTI metrics including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD) were measured to evaluate the vestibulospinal tract structure. The results showed that the mean FA of the vestibulospinal tract increased and other metrics decreased for all subjects. Our findings indicated that the balance and structure of the vestibulospinal tract were improved up to 30% for all children following the 8-week AlterG training. This indicates that the balance improvement of the CP children following the AlterG training was accompanied with persistent neuroplasticity in their brain. The clinical implication is that the AlterG training has a potential to be used as an effective therapeutic tool for the treatment of balance impairment in CP children.

The Effects of Low Frequency Repetitive Transcranial Magnetic Stimulation on White Matter Structural Connectivity in Children with Cerebral Palsy

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive treatment technique for recovery of movement disorders by altering cortical plasticity. In this research, we studied the effects of low-frequency rTMS on white matter (WM) structural connectivity and clinical parameters in children with cerebral palsy (CP).,Four spastic hemiplegic CP children were randomly divided into experimental and control groups. In the experimental group, at first, 1Hz rTMS treatment was performed 4 days/week for 3 weeks on two hemiplegia patients over a contralesional primary motor cortex (M1). Then, 1Hz rTMS treatment was performed 4 days/week for 3 weeks followed by a 30min occupational therapy (OT). In the control group, two CP children received sham rTMS for 3 weeks and then sham rTMS combined with OT for 3 weeks in the same schedule as the experimental group. Evaluations performed using diffusion tensor imaging (DTI), and clinical measurements of gait performance before and after the treatment. Graph theoretical analysis was used to characterize topological changes of structural connectivity. Our findings demonstrate the 1Hz rTMS is effective in improving motor activity in spastic hemiplegic CP children, and is more effective when combined with OT.

Therapeutic effects of an anti-gravity locomotor training (AlterG) on postural balance and cerebellum structure in children with Cerebral Palsy

We evaluated the therapeutic effects of anti-gravity locomotor treadmill (AlterG) training on postural stability in children with Cerebral Palsy (CP) and spasticity, particularly in the lower extremity. AlterG can facilitate walking by reducing the weight of CP children by up to 80%; it can also help subjects maintain an appropriate posture during the locomotor AlterG training. Thus, we hypothesized that AlterG training, for a sufficient period of time, has a potential to produce cerebellum neuroplasticity, and consequently result in an effective permanent postural stability. AlterG training was given for 45 minutes, three times a week for two months. Postural balance was evaluated using posturography. The parameters of the Romberg based posturography were extracted to quantify the Center of Balance (CoP). The neuroplasticity of Cerebellum was evaluated using a Diffusion Tensor Imaging (DTI). The evaluations were done pre- and post-training. The Fractional Anisotropy (FA) feature was used for quantifying structural changes in the cerebellum. The results showed that AlterG training resulted in an increase in average FA value of the cerebellum white matter following the training. The results of the posturography evaluations showed a consistent improvement in postural stability. These results were consistent in all subjects. Our findings indicated that the improvement in the posture was accompanied with the enhancement of the cerebellum white matter structure. The clinical implication is that AlterG training can be considered a therapeutic tool for an effective and permanent improvement of postural stability in CP children.

Can an anti-gravity treadmill improve stability of children with cerebral palsy?

We aimed to study the effects of an anti-gravity treadmill (AlterG) training on balance and postural stability in children with cerebral palsy (CP). AlterG training was performed 3 days/week for 8 weeks, with up to 45 minutes of training per session. The subject was evaluated before and after the 8-week training. The effects of training on the balance and postural stability was evaluated based on the Romberg test that was performed by using a posturography device. The parameters quantifying Center-of-Pressure (CoP) were calculated using different analytical approaches including power spectral density and principal components analyses. All of the key parameters including the Stabilogram, the Fast Fourier Transform (FFT) Energy, the Eigenvectors, and the Eigenvalues of CoP were modified between 14%-84%. The results indicated that the balance features were improved substantially after training. The clinical implication is that the AlterG has the potential to effectively improve postural stability in children with cerebral palsy.

New study on the correlation between carbon dioxide concentration in the environment and radon monitor devices

The influence of high geogenic carbon dioxide concentrations on monitoring devices might present a significant challenge to the measurement of radon concentrations in environments with a high level of carbon dioxide concentration such as volcano sites, mofettes, caves, etc. In this study, the influence of carbon dioxide concentration on several different types of radon monitor devices - including Alpha Spectrometry (Sarad RTM 2200, EQF 3220, RAD7), Ionizing Chamber (AlphaGUARD PQ2000 PRO) and Active Cell (Active scintillation cell, Pylon 300A) - was examined to represent new aspects of radon measuring in environments with carbon dioxide. In light of the results, all measuring devices were exposed to variable conditions affected by carbon dioxide concentration, except for the AlphaGUARD, which was kept in a steady state throughout the experiment. It was observed that alpha spectroscopy devices were affected by carbon dioxide, since measured radon concentrations decreased in the presence of 70% and 90% carbon dioxide concentrations by 26.5 ± 2% and 14.5 ± 2.5% for EQF 3220, and 32 ± 2% and 35.5 ± 2% for RTM 2200. However, the ionizing chamber instrument was unaffected by changes in carbon dioxide concentration. It was determined that the RAD7 performed relatively inefficiently in the presence of carbon dioxide concentrations higher than 67% by an overall efficiency factor of approximately 0.52, confirming that it is not an admissible radon monitor instrument in environments with high carbon dioxide concentrations.

Radionuclide content of NORM by-products originating from the coal-fired power plant in Oroszlány (Hungary)

At the Thermal Power Plant in Oroszlány (Hungary), a huge amount of by-products have been produced since 1961. In this survey, coal and other by-products were examined (fly ash, bottom ash, fluidised bed bottom ash, gypsum and slurry-type ash). The natural isotopes were determined using an HPGe detector. It was found that the radionuclide content of coal was significantly lower ((226)Ra = 45.3±6.3, (232)Th = 26.3±5.7 and (40)K = 210±21 Bq kg(-1)) than that in the case of ashes other than the fluidised type. The average values of the bottom ash-deposited in the largest quantities-were three times higher than those for coal ((226)Ra = 144±18, (232)Th = 84.3±14 and (40)K = 260±25 Bq kg(-1)). In the case of fractionised bottom ash, the radionuclide content of <0.1 mm was 45 % higher than that of >1.6 mm and the massic radon exhalation of <0.1 mm was approximately four times higher than that above this range.

Calibration of CR-39-based thoron progeny device

Radon isotopes and their progenies have proven significant role in respiratory tumour formation. In most cases, the radiological effect of one of the radon isotopes (thoron) and its progenies has been neglected together with its measurement technique; however, latest surveys proved that thoron's existence is expectable in flats and in workplace in Europe. Detectors based on different track detector measurement technologies have recently spread for measuring thoron progenies; however, the calibration is not yet completely elaborated. This study deals with the calibration of the track detector measurement method suitable for measuring thoron progenies using different devices with measurement techniques capable of measuring several progenies (Pylon AB5 and WLx, Sarad EQF 3220). The calibration factor values related to the thoron progeny monitors, the measurement uncertainty, reproducibility and other parameters were found using the calibration chamber. In the future, the effects of the different parameters (aerosol distribution, etc.) will be determined.