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Gait disturbances are one of the principal and most incapacitating symptoms of Parkinson's disease (PD). In addition, walking economy is impaired in PD patients and could contribute to excess fatigue in this population. An important number of studies have shown that treadmill training can improve kinematic parameters in PD patients. However, the effects of treadmill and overground walking on the walking economy remain unknown. The goal of this study was to explore the walking economy changes in response to a treadmill and an overground training program, as well as the differences in the walking economy during treadmill and overground walking. Twenty-two mild PD patients were randomly assigned to a treadmill or overground training group. The training program consisted of 5weeks (3 sessions/week).We evaluated the energy expenditure of overground walking, before and after each of the training programs.The energy expenditure of treadmill walking (before the program) was also evaluated. The treadmill, but not the overground training program, lead to an improvement in the walking economy (the rate of oxygen consumed per distance during overground walking at a preferred speed) in PD patients. In addition, walking on a treadmill required more energy expenditure compared with overground walking at the same speed. This study provides evidence that in mild PD patients, treadmill training is more beneficial compared with that of walking overground, leading to a greater improvement in the walking economy. This finding is of clinical importance for the therapeutic administration of exercise in PD. [ABSTRACT FROM AUTHOR]

Introduction: Spigelian hernias in childhood are extremely uncommon. The aim of this study was to analyse the pathogenetic factors of paediatric Spigelian hernias., Patients and Method: A retrospective review of worldwide literature for infants who had undergone surgical repair of a Spigelian hernia from 1950 to 2006. Descriptive statistical techniques were applied and percentages and means were calculated., Results: There were 33 patients in whom 40 Spigelian hernias were repaired, 26 males and 7 females, with a sex ratio of 3.7/1. The mean age was 2.7 years. 7 hernias are bilateral., Risk Factors: anal stenosis (n = 1). Associated defects: cryptorchidism (n = 22), inguinal hernia (n = 5), umbilical hernia (n = 2). The most common hernia contents are testicle (40%), small intestine ( 27.5%) and omentum (15%)., Conclusions: The mean age of Spigelian hernia in children was 2.7 years, which would suggest a congenital cause. Spigelian hernias in infants are more common in males. There were 21.2% bilateral hernias. No risk factors were detected. Combined hernias accounted for 15.1% of the total. The most frequent hernia content is the testicle (40%). Interestingly, 48.4% of those infants with Spigelian hernias had ipsilateral cryptorchidism, which may suggest a new syndrome.