To investigate how plyometric exercise (PLYO-Ex) affects mechanics and morphometrics of the plantar flexor musculotendinous unit in children with unilateral cerebral palsy, 38 participants (aged 10–16 years) were allocated at random to either the PLYO-Ex group (n = 19; received 24 sessions of plyometric muscle loading, conducted 2 times a week for 3 months in succession) or the control group (n = 19; underwent traditional physical therapy for the same frequency and duration). Measurements were taken pre- and post-intervention. Standard ultrasound imaging was applied to evaluate morphometrics of the gastrocnemius muscle and Achilles tendon unit and an isokinetic dynamometer was used to evaluate maximum voluntary isometric plantar flexors contraction (IVCmax). With controlling for pre-treatment values, significant post-treatment changes favoring the PLYO-Ex group were observed for morphological (tendon (p = 0.003, η2p = 0.23) length; belly length (p = 0.001, η2p = 0.27); tendon thickness (p = 0.035, η2p = 0.35); muscle thickness (p = 0.013, η2p = 0.17); fascicle length (p = 0.009, η2p = 0.18); pennation angle (p = 0.015, η2p = 0.16)) and mechanical and material properties (IVCmax (p = 0.009, η2p = 0.18); tendon’s elongation (p = 0.012, η2p = 0.17), stiffness (p = 0.027, η2p = 0.13); stress (p = 0.006, η2p = 0.20); strain (p = 0.004, η2p = 0.21)). In conclusion, plyometric exercise induces significant adaptations within the musculotendinous unit of the plantar flexors in children with unilateral cerebral palsy. These adaptations could improve muscular efficiency and consequently optimize physical/functional performance.

Background/Aim: The present study was directed to investigate the accuracy of ultrasound (USG) in early detection of developmental dysplasia of the hip (DDH) to prevent permanent complications. Material & Methods: A total of 276 infants was investigated; their ages range from 1 -6 months. Patients referred from the clinic based on clinical assessment (mainly Barlo & Ortolani maneuvers). Then the patient's hips were examined by expert radiologists in USG scan. After that, dynamic (coronal and transverse) & static ultrasound views evaluated by the same radiologist using Graf's criteria. Infants with abnormal ultrasound findings suggestive of DDH were followed up after 4 -6 weeks by the same investigator to monitor the progress. At the same time, the patient referred to a specialist for conservative management from the first positive findings. Results: Among the 276 referred patients, infants with normal stable hips (Graf Type I and Type II a+) were 221 (80%), 155 of them were female and 66 male infants. Infants with unstable hips based on Graf's criteria (Type II a-, II b, II c and Type III a) were 55 (20%). Out of 55 with abnormal findings, the affected hips on both sides, right and left were: 5 cases (1.8%), 7 (2.5%) and 43 hips (15.5%) consecutively. Out of 55 infants affected; 3 referred to tertiary centers for further surgical management while 52 managed conservatively. Conclusion: Delayed treatment rates of DDH and complications could be reduced by the usage of the USG after the first month of life. In addition to physical assessment, USG for high-risk infants will provide more accurate diagnosis and minimize complications.

Background. Congenital diaphragmatic hernia (CDH) is a life-threatening condition with long-term complications including respiratory tract infections, respiratory muscle weakness, and abnormal lung functions. This study was designed to ascertain the effects of chest resistance and chest expansion exercises on respiratory muscle strength, lung function, and chest mobility in children with post-operative CDH. Methods. This randomized controlled clinical study was conducted in the outpatient physiotherapy clinic at Prince Sattam bin Abdulaziz University. Thirty-two children with CDH aged 10–14 years between May 2020 and February 2021 were randomly allocated to the study group (n = 16) and the control group (n = 16). The control group underwent a usual chest physiotherapy program; however, the study group underwent a 12-week chest resistance exercise combined with chest expansion exercise in addition to usual chest physiotherapy, with three sessions per week. Respiratory muscle strength, lung function, and thoracic excursion were assessed pre- and post-treatment. Results. Using the 2 × 2 repeated ANOVA, significant time × group interactions were detected in favor of the study group, FVC (F = 4.82, 95% CI = −15.6 to −0.97, p = 0.005, and η2 = 0.16), FEV1 (F = 4.54, 95% CI = −11.99 to −2.8, p ˂ 0.001, and η2 = 0.14), PImax (F = 5.12, 95% CI = −15.71 to −5.3, p ˂ 0.001, and η2 = 0.15), and thoracic excursion (F = 4.41, 95% CI = −2.04 to −0.16, p = 0.036, and η2 = 0.17). Conclusions. Concurrent chest resistance and expansion exercises may improve respiratory muscle strength, lung function, and thoracic excursion in children with post-operative CDH. The study findings suggest that concurrent chest and chest expansion exercises be part of an appropriate pulmonary rehabilitation program in children with a history of CDH.