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Biomedical subjects

D B Bertoti

Publications and source records attributed to D B Bertoti.

4 recordsLinked to original sources

Electrical stimulation: a reflection on current clinical practices.

This paper briefly reviews the basic principles of several clinical applications of electrical stimulation for therapeutic purposes. It is intended to facilitate the integration of electrical stimulation into routine clinical practice by clarifying the terminology and standard conventions of the field, explaining the delivery capabilities of common electrical stimulators commercially available for clinical use, summarizing several examples of evidence-based therapeutic applications, and providing guidelines for selection of most commonly used treatment parameters. Rather than an exhaustive survey of the field, the presentation touches broadly on guidelines for use of transcutaneous electrical stimulation employing surface electrodes for the purposes of analgesia (TENS), drug delivery (iontophoresis), or neuromuscular rehabilitation (NMES), as well as other selected clinical applications. The paper is a general review of common clinical practices of electrotherapy and should serve as an introduction to the important factors for clinicians to consider when contemplating electrical stimulation as a treatment option.

Central Nervous System Diseases↗

Evaluation of biofeedback seat insert for improving active sitting posture in children with cerebral palsy. A clinical report.

Biofeedback devices have been used successfully to improve head control and symmetrical standing in children with cerebral palsy. This clinical report describes a biofeedback seat insert developed to improve erect sitting posture in children with cerebral palsy who have inadequate trunk control. The seat insert is easily placed against the back of any seating device. A momentary-contact pressure switch on the seat insert is activated when the child exerts pressure on it by extending his trunk. The pressure switch then activates a videocassette recorder or can be adapted to activate a television or radio. Five children with spastic cerebral palsy participated in this evaluation of the biofeedback seat insert. The results of this evaluation show that the children used the biofeedback seat insert effectively to actively improve their sitting posture by voluntarily extending their trunk against the pressure switch. The biofeedback seat insert offers physical therapists a valuable therapeutic training tool to encourage carry-over of improved sitting posture away from the clinical setting for children with cerebral palsy.

Biofeedback, Psychology↗

Effect of therapeutic horseback riding on posture in children with cerebral palsy.

The purpose of this study was to measure postural changes in children with spastic cerebral palsy after participation in a therapeutic horseback riding program. Eleven children with moderate to severe spastic cerebral palsy, aged 2 years 4 months to 9 years 6 months, were selected for this study and underwent postural assessments according to a repeated-measures design. Assessment of posture was performed by a panel of three pediatric physical therapists, using a postural assessment scale designed by the author. A composite score for each test interval was calculated for each child, and a median score was calculated for the entire group at each test interval. Data were analyzed using a Friedman test, assuming an alpha level of .05. A statistically significant difference was found between the three test intervals with significant improvement occurring during the period of therapeutic riding. Clinical improvements were also noted in muscle tone and balance as evidenced by improved functional skills. These results constitute the first objective measure supporting the efficacy of therapeutic horseback riding on posture in children with cerebral palsy.

Animals↗

Effect of short leg casting on ambulation in children with cerebral palsy.

The purpose of this study was to compare and analyze changes in ambulation between two groups of children with cerebral palsy, with and without short leg casting. Sixteen children with spastic cerebral palsy, aged 10 to 108 months, were assigned randomly to either a short leg casted group or an uncasted group. All children were tested by me, before and after 10 weeks of neurodevelopmental treatment, by recording an ink print ambulation pattern on a length of paper fastened to the floor. Measurements of stride length, stride width, foot angle, and footprint clarity were taken to quantify the ambulation patterns. The percentage of improvement in stride length, stride width, and foot angle was analyzed using a t test, and the percentage of improvement in footprint clarity was analyzed using the Mann-Whitney U test. An alpha level of .05 was assumed to determine whether the differences between groups were large enough to be statistically significant. A significant difference was found in the percentages of improvement in stride length between the two groups, although the other results were nonsignificant. Short leg casting appears to be valuable in the management of spastic hemiplegia, diplegia, and quadriplegia. Clinical observations included improvement in muscle tone, trunk control, and symmetry. These results constitute the first objective measure, using a control group, supporting the therapeutic value of short leg casting for children with cerebral palsy.

Casts, Surgical↗