Suchergebnisse

Aim The aim of this systematic review was to investigate the effects of functional gait training on walking ability in children and young adults with cerebral palsy (CP). Method The review was conducted using standardized methodology, searching four electronic databases (PubMed, Embase, CINAHL, Web of Science) for relevant literature published between January 1980 and January 2017. Included studies involved training with a focus on actively practising the task of walking as an intervention while reporting outcome measures relating to walking ability. Results Forty‐one studies were identified, with 11 randomized controlled trials included. There is strong evidence that functional gait training results in clinically important benefits for children and young adults with CP, with a therapeutic goal of improved walking speed. Functional gait training was found to have a moderate positive effect on walking speed over standard physical therapy (effect size 0.79, p=0.04). Further, there is weaker yet relatively consistent evidence that functional gait training can also benefit walking endurance and gait‐related gross motor function. Interpretation There is promising evidence that functional gait training is a safe, feasible, and effective intervention to target improved walking ability in children and young adults with CP. The addition of virtual reality and biofeedback can increase patient engagement and magnify effects. ; ATCB is employed by Motek Medical in a position fully fundedby the PACE ITN, under the European Union's Horizon 2020research and innovation programme, Marie Skłodowska-Curiegrant agreement number 642961. PM was supported by the Euro-pean Union's Horizon 2020 research and innovation programmeas a Marie Skłodowska-Curie fellow, grant number 660458. FS isemployed by Motek Medical. All research direction and integrityis supervised by VU University Medical Center.

Measurements of ice temperature provide crucial constraints on ice viscosity and the thermodynamic processes occurring within a glacier. However, such measurements are presently limited by a small number of relatively coarse-spatial-resolution borehole records, especially for ice sheets. Here, we advance our understanding of glacier thermodynamics with an exceptionally high-vertical-resolution (~0.65 m), distributed-fiber-optic temperature-sensing profile from a 1043-m borehole drilled to the base of Sermeq Kujalleq (Store Glacier), Greenland. We report substantial but isolated strain heating within interglacial-phase ice at 208 to 242 m depth together with strongly heterogeneous ice deformation in glacial-phase ice below 889 m. We also observe a high-strain interface between glacial- and interglacial-phase ice and a 73-m-thick temperate basal layer, interpreted as locally formed and important for the glacier's fast motion. These findings demonstrate notable spatial heterogeneity, both vertically and at the catchment scale, in the conditions facilitating the fast motion of marine-terminating glaciers in Greenland. ; European Union's Horizon 2020 (Grant 683043)