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Background: Alterations in spatiotemporal parameters during walking modify and limit movement capacity in children with obesity. This study aimed to describe and compare the alterations in spatiotemporal parameters in schoolchildren according to body weight during all phases of walking., Methods: We carried out a cross-sectional study of 94 schoolchildren aged 6 to 12 years and divided them into three study groups (normal weight, overweight, and obesity). Subsequently, we performed a gait study using a 3D motion analysis system and extracted the spatiotemporal parameters, and we compared the parameters obtained between the study groups., Results: The stride length in both limbs was lower in schoolchildren with obesity compared to the overweight group, with a mean difference of 0.08 m on the right side (CI 95% 0.01-0.16; p = 0.02) and 0.09 m on the left side (CI 95% 0.01-0.17; p = 0.02); also, on the left side, the swing speed (m/s) was lower in the children with obesity than in the normal weight group, with a mean difference of 0.23 m/s (CI 95% 0.03-0.43; p = 0.01). Lastly, the step width (m) was greater in the group of schoolchildren with obesity compared to the normal weight group, with a difference of 0.05 m (CI 95% 0.01-0.09; p = 0.01). A moderate positive correlation was found between the width of the step and the weight gain, r = 0.41 (p < 0.001). However, we found a poor correlation between right stride length (m), left side swing speed (m/s), left stride length (m), and weight gain, r = 0.26 (p = 0.01), r= -0.21 (p = 0.04) and r = 0.21 (p = 0.04), respectively., Conclusions: Spatiotemporal parameters such as stride length, swing speed, and step width were more altered in schoolchildren with obesity and correlated with body weight gain., Competing Interests: Declarations. Ethics approval and consent to participate: This study was approved by the Ethics and Research Committees of the Hospital Infantil de México Federico Gómez in Mexico City, with registration number HIM-2020-042, and all our investigation with human subjects included in this study was conducted by following the tenets of the Helsinki Declaration. Consent for publication: The present work does not include any individual person’s data; however, before conducting all the tests in this study, all participants and their respective tutors signed a consent and informed assent document. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Low back pain is a severe global health problem. To face this issue, testing interventions using rigorously performed randomized controlled trials is essential. However, it is unclear if a country's income level is related to the quality of trials conducted., Objective: To compare the frequency and methodological quality of randomized controlled trials of physical therapy interventions for low back pain conducted in countries with different income levels., Methods: This meta-epidemiological study retrieved trials from the Physiotherapy Evidence Database (PEDro), Literatura Latino Americana em Ciências da Saúde (LILACS), and Scientific Electronic Library Online (SciELO). The methodological quality was evaluated using the 0-10 PEDro scale. Then we calculated the mean differences with a 95% confidence interval and performed an ANOVA test with Bonferroni correction to compare the PEDro scores between income groups., Results: We included 2552 trials; 70.4% were conducted in high-income countries. The mean (standard deviation) PEDro score of all trials was 5.5 (0.03) out of 10. Trials from low- or lower-middle-income countries had lower methodological quality than those from upper-middle- and high-income countries, but the mean difference was small (-0.6 points (95% CI -0.9, -0.3), and -0.7 points (95% CI -1.1, -0.5) respectively)., Conclusion: Income level influences the methodological quality of trials of physical therapy intervention but is not the only factor. Implementing strategies to improve the methodological rigor of trials in patients with low back pain is necessary in all countries, regardless of income level., Competing Interests: Conflicts of interest The authors have no competing interest to declare., (Copyright © 2024 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Wear on the surface of the femoral head increases the risk of hip and femur fractures. Biomechanical experiments conducted on the femur are based on its bending and torsional rigidities. Studies regarding the deflection of the femur bone when the femoral head is coated with microfilms composed of durable and compatible biomaterials are poor. This study aimed to investigate the effects of different biomaterial microfilm coatings over the femoral head on the deflection of the human femur. We utilized 2023 R1 finite element analysis (FEA) software to model the directional deformation on the femoral head and examine the femur's deflection with varying microfilm thicknesses. The deflection of the femur bone was reported when the femoral head was uncoated and coated with titanium, stainless steel, and pure gold microfilms of different thicknesses (namely, 50, 75, and 100 μm). Our results show that the femur's minimum and maximum deflection occurred for stainless steel and gold, respectively. The deformation of the femur was lower when the femoral head was coated with a 50-micrometer microfilm of stainless steel, compared to the deformation obtained with gold and titanium. When the thickness of the microfilm for each of the materials was increased, the deformation continued to decrease. The minimum deformation of the femur occurred for a thickness of 100 μm with stainless steel, followed by titanium and gold. The difference in the directional deformation of the femur between the materials was more significant when the coating was 100 μm, compared to the thicknesses of 50 and 75 μm. The findings of this study are expected to significantly contribute to the development of advanced medical techniques to enhance the quality of life for patients with femur bone-related issues. This information can be used to develop more resilient coatings that can withstand wear and tear.

Background: Peripheral neuropathy due to chemotherapeutic drugs causes alterations in ankle movement during gait. This study aimed to describe the spatiotemporal parameters and ankle kinematics during gait in schoolchildren with acute lymphoblastic leukemia with clinically suspected peripheral neuropathy., Methods: In children with acute lymphoblastic leukemia in the maintenance phase, we calculated spatiotemporal and kinematic parameters of the ankle during gait using Kinovea® software. Furthermore, we identified alterations in the parameters obtained considering the values of the normality data from a stereophotogrammetry system as the reference values. Finally, we represented the kinematic parameters of the ankles calculated with Kinovea® compared to the normality values of the stereophotogrammetry., Findings: We evaluated 25 schoolchildren; 13 were male (52.0%) with a median age of 88.0months and a median of 60.0 weeks in the maintenance phase, and 54.8% were classified as standard risk. Spatiotemporal parameters: cadence (steps/min), bilateral step length (m), and average gait speed (m/s) in ALL children were significantly lower than reference values (p < 0.001). Except for right mid-stance and bilateral foot strike, initial swing showed that both ankles maintained plantar flexion values during gait, significantly lower in ALL patients (p < 0.05)., Interpretation: We identified spatiotemporal and kinematics alterations in schoolchildren with acute lymphoblastic leukemia during all phases of the gait suggestive of alteration in ankle muscles during movement, probably due to peripheral neuropathy; nevertheless, our results should be taken with caution until the accuracy and reliability of Kinovea® software as a diagnostic test compared to the stereophotogrammetric system in children with ALL and healthy peers is proven., Competing Interests: Declaration of competing interest Claudia Gutieérrez reports administrative support was provided by Hospital Infantil de México Federico Gómez. Claudia Gutiérrez reports a relationship with National Autonomous University of Mexico that includes: employment. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Aim: We evaluated fine motor skills; precision, motor integration, manual dexterity, and upper-limb coordination according to sex and risk stratification in children with Acute Lymphoblastic Leukaemia (ALL)., Methods: We evaluated twenty-nine children in the maintenance phase aged 6 to 12 years with the Bruininks-Oseretsky Test of Motor Proficiency-second edition (BOT-2), and sex and age-specific norm values of BOT-2 were used to compare our results., Results: We found lower scores on the upper-limb coordination subtest, p = 0.003 and on the manual coordination composite, p = 0.008, than normative values. Most boys performed "average" on both the subtests and the composites, but girls showed lower scores with a mean difference of 7.69 (95%CI; 2.24 to 3.14), p = 0.009. Girls' scale scores on the upper-limb coordination subtest were lower than normative values, with mean difference 5.08 (95%CI; 2.35 to 7.81), p = 0.006. The mean standard score difference in high-risk patients was lower than normative on the manual coordination composite, 8.18 (95%CI; 2.26 to 14.1), p = 0.015. High-risk children also performed below the BOT-2 normative on manual dexterity 2.82 (95%CI; 0.14 to 5.78), p = 0.035 and upper limb coordination subtest 4.10 (95%CI; 1.13 to 7.05), p = 0.028. We found a decrease in fine motor precision in children with a higher BMI, rho= -0.87, p = 0.056 and a negative correlation between older age and lower manual dexterity, r= -0.41 p = 0.026; however, we did not find any correlation with the weeks in the maintenance phase., Conclusions: Fine motor impairments are common in children with ALL in the maintenance phase; it is important to identify these impairments to early rehabilitation., (© 2023. BioMed Central Ltd., part of Springer Nature.)

This study aimed to describe absolute muscle strength and power in children and adolescents with obesity, overweight and normal weight, and the assessment tests and tools used. We retrieved observational studies from MEDLINE (PubMed), TripDataBase, Epistemonikos, EBSCO essentials, NICE, SCOPUS, and LILACs up to February 2023. In addition, we recovered data from studies with at least three comparison groups (obesity, overweight, normal weight) and with a description of the absolute muscle strength and power and the assessment tests and instruments used. The methodologic quality of the studies was assessed with the Joanna Briggs checklist, and the review was carried out using the PRISMA 2020 methodology. Eleven studies with 13,451 participants from 6 to 18 years of age were once included, finding that the absolute muscle strength of their upper extremities was greater when they were overweight or obese; however, in the same groups, absolute muscle strength was lower when they carried their body weight. In addition, lower limb absolute muscle strength was significantly lower in obese participants than in normal weight, regardless of age and gender. The most used tools to measure the absolute muscle strength of the upper limbs were the grip dynamometers and push-up exercises. In contrast, different jump tests were used to measure the power of the lower limbs. There are great differences in muscle strength and power between overweight or obese children and adolescents and those with normal weight. Therefore, it is recommended to use validated tests, preferably that assess strength through the load of the patient's body weight, either of the upper or lower limbs, for greater evaluation objectivity that facilitates the management of these children and adolescents., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Acute Lymphoblastic Leukemia (ALL) is the most common cancer in children and toxicities related to treatment are common. One of these adverse effects is related to the musculoskeletal system and especially to gross motor skills that allow body movements: walking, running, jumping, and balance. This systematic review aims to describe gross motor impairments in pediatric patients with ALL during and after chemotherapeutic treatment and to identify the most commonly used tools for their assessment. Multiple electronic databases were searched for observational studies describing gross motor skills in children with ALL and the assessment tool used. The STROBE checklist was used to assess the reporting quality of each study. Ten studies were included in this review with assessments of gross motor skills in children with ALL undergoing treatment and survivors. Evidence suggests impairments in the performance of daily life activities during intensification and maintenance and persists up to 5 to 6 years after treatment´s cessation. Balance problems are noted at the start of treatment when the cumulative dose of vincristine is low and, in the survivors, it was the most reported alteration. These skills are essential for an adequate performance of children in daily life activities, recreation and leisure. We emphasize the need to assess gross motor skills and implement interventions that include physiotherapy and occupational rehabilitation in children with ALL.

Low back pain is a global health problem. In Mexico it is one of the most common musculoskeletal conditions as well as the leading cause of disability. This review provides an overview of the challenges and complexities of managing low back pain in Mexico. It begins with an explanation of the Mexican healthcare system and an overview of the burden of low back pain. Usual care for low back pain in Mexico is then contrasted with recommended best practice care to highlight common evidence-practice gaps and drivers of poor care. Finally, solutions are proposed based on positive experiences from other countries. Delving into the Mexican health framework and the burden of low back pain will provide a better understanding of why it is important to pay attention to this musculoskeletal disorder. Potential steps required to reduce the burden are also outlined to benefit not only the people suffering from low back pain but also the Mexican economy and society.

Background: Understanding early-life complementary feeding dietary patterns and their determining factors could lead to better ways of improving nutrition in early childhood. The purpose of this review was to evaluate evidence of the association between sociodemographic factors and dietary patterns (DPs) in children under 24 months., Methods: Medline (PubMed), Cochrane Central, NICE guidelines, and Trip database were searched for observational studies that evaluated sociodemographic factors and their associations with DP., Results: Seven studies were selected for the present review. High education level among mothers was inversely associated with unhealthy DPs and positively associated with healthy DPs. Higher household income was negatively associated with unhealthy DPs. Four studies showed a positive association between low household income and unhealthy DPs and three studies showed a positive association between higher household income and healthy DPs. Additionally, in younger mothers, body mass index (BMI ≥ 30.0 kg/m 2 ) and number of children were positively associated with unhealthy DPs., Conclusions: This review provides evidence of a positive association between mothers' higher education level, higher household income, higher maternal age, and healthy dietary patterns as well as a negative association between these factors and unhealthy dietary patterns. Further studies from low- and middle-income countries are needed for comparison with associations showed in this review.

Background: Gaucher disease type 1 (GD1, OMIM# 230800), is a condition with high impact in patient's quality of life (QoL). We report the improvement in QoL of children with GD1 measured by Lansky play-performance scale (LS) after enzymatic replacement therapy (ERT) and to describe our experience in the treatment of children with GD1., Methods: Five children with diagnosis of GD1 received imiglucerase 60 mg/kg every two weeks. LS, hepatomegaly, splenomegaly, hemoglobin, platelets, and growth rate were measured every 6 months after beginning ERT for 30 months., Results: After ERT, LS increased significantly from 28 ± 16.48 points before ERT to 70 ± 10 (P = 0.0046) and 95 ± 10 (P = 0.0022) points after 6 and 30 months of ERT, respectively; hemoglobin and platelets changed significantly from 9.28 ± 0.61 to 12.40 ± 0.85 (P = 0.0198) and from 71.50 ± 14.89 to 205.00 ± 65.34 (P = 0.0428) after 30 months of ERT, respectively. All patients demonstrated decreased hepatic and splenic size with mean reductions of 66% and 80% at 30 months of treatment and the USG longitudinal axis was reduced in both liver and spleen after ERT., Conclusion: The use of ERT with imiglucerase 60 mg/kg every two weeks has substantial benefits and significantly improves QoL, assessed with Lansky Score, of the five children with GD1 studied., (© 2017 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals, Inc.)

Introduction: Velocardiofacial syndrome (VCFS) is the most common microdeletion syndrome with an incidence of 1:4000 live births. Its phenotype is highly variable with facial, velopharyngeal, cardiac, endocrine, immunologic and psychiatric abnormalities. It is caused by a microdeletion in chromosome 22q11.2., Objectives: We present 7 years of experience evaluating patients with VCFS regarding their main clinical characteristics., Material and Methods: The patients included were multidisciplinary evaluated and had a positive FISH analysis for del22q11.2., Results: A total of 62 patients were assessed, a 34 female/28 male ratio was observed with ages ranging from 9 days to 16 years, all but one patient had typical facial features. A diagnosis of congenital heart disease was established in 97% of the patients; other clinical characteristics were identified with different percentages such as cleft palate, and hypocalcaemia. Three cases had a familial presentation., Discussion: While the clinical findings of this study were in general terms in keeping with the literature, it is interesting the unexpectedly high percentage of congenital heart disease identified in Mexican children with VCFS that also was the main cause for clinical referral., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Objective: The aim of the study was to analyze mothers home practices among children with acute diarrhea., Methods: A cross sectional study was carried out in a group of 260 mothers of children with diarrhea. Mothers were requested to answer the "verbal biopsy" questionnaire to assess their practices concerning effective diarrhea management at home according to the World Health Organization and corresponding to the Norma Oficial Mexicana recommendations. Descriptive statistics and Chi square for differences were used., Results: Two groups of mothers' were identified: those who had consulted a physician before attending the hospital (n = 191), and those who came to the hospital as their first choice (n = 69). The first group used antibiotics, antiemetics, breast-feeding and Oral Hydration Therapy more frequently than the second group (p < 0.05)., Conclusions: The "verbal biopsy " instrument was useful to assess home management of children with diarrhea. This questionnaire was also useful to detect medical malpractice (unjustified prescription of antibiotics and antiemetics) as well as to identify best practices (continued breast feeding and oral hydration).

This report is of a community-based case control study to assess whether the severity of acute diarrhea by rotavirus (RV) in young children is associated with a particular VP7 (G) or VP4 (P) RV serotype. Five hundred twenty children younger than 2 years of age with diarrhea lasting less than 3 days were age and gender matched with 520 children with no diarrhea. The G and P serotypes were determined with specific monoclonal antibodies, and the VP4 serotype specificity in a subgroup was confirmed by genotyping. Infection with a G3 serotype led to a higher risk of diarrhea than infection with a G1 serotype. Infection with a G3-nontypeable-P serotype was associated with more severe gastroenteritis than infection with a G3 (or G1) P1A[8] serotype. A child with diarrhea-associated dehydration was almost five times more likely to be infected with a G3-nontypeable-P serotype than a child without dehydration (P < 0.001). Moreover, the two predominant monotypes within serotype P1A[8] had significantly different clinical manifestations. In this study, the severity of RV-associated diarrhea was related to different P serotypes rather than to G serotypes. The relationship between serotype and clinical outcomes seems to be complex and to vary among different geographic areas.

Objective: To evaluate the safety and effectiveness of two oral rehydration techniques., Material and Methods: A randomized clinical trial was conducted at the oral rehydration unit of Hospital Infantil de Mexico "Federico Gomez", between September 1998 and June 1999. Forty patients five-year old and younger children, dehydrated due to acute diarrhea, were given oral rehydration solution (ORS) ad libitum (AL group); another forty patients received ORS in fractionated doses (FD group). Clinical characteristics were similar in both groups. Results are presented as means, standard deviations and medians, according the distribution of simple and relative frequencies., Results: The mean stool output in the AL group was 11.0 +/- 7.5 g/kg/h; as compared to 7.1 +/- 7.4 in the FD group (p = 0.03). ORS intake, rehydration time, and mean diuresis values were similar in both groups (p > 0.05). Six patients in the AL group and five in the FD group had high stool output (> 10 g/kg/h), that improved after administration of rice starch solution. One patient in the AL group and two in the FD group had persistent vomiting that improved with gastroclisis. No patient required intravenous rehydration., Conclusions: These results suggest that ORS administration ad libitum under supervision, is a technique as safe and effective as the fractionated doses technique, for the treatment of dehydrated children due to acute diarrhea.

Objective: To compare the severity of rotavirus diarrhea (RV) and non-rotavirus diarrhea., Material and Methods: Between October 1994 and March 1995, a cross-sectional study was performed in 520 infants with acute diarrhea, at seven primary care level centers in five states of Mexico. Diagnosis of RV was done through immunoenzymatic assay or electrophoresis. Central tendency measures were used for data analysis. Results were presented as means and standard deviations, or median and variation., Results: RV was isolated from 264 children; most of them were males aged 6 months to 1 year. Differences in clinical manifestations were statistically significant between the rotavirus-positive group and the rotavirus-negative group, in the following variables: median number of stools/24 hours; frequency of vomiting; temperature > 38 degrees C; dehydration; and clinical severity scoring., Conclusions: These results showed a poorer prognosis and a higher severity of rotavirus diarrhea, as compared to non-rotavirus diarrhea in infants.