Browsing by Author "Ramage, Barbara"

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    Physical Therapy Management for Children with Cerebral Palsy after Lower Limb Botulinum Toxin Type A Injections
    (2013-01-25) Benard, Laura; Ramage, Barbara
    Botulinum toxin type A (BtA) injections to reduce spasticity for children with cerebral palsy (CP) are often accompanied by physical therapy (PT) treatment. This series of studies examined current PT strategies across Canada using survey methodology, and evaluated outcomes after PT and BtA injections using single subject methodology. Survey results revealed that variation in therapy most often related to the child’s functional level and the goals of the intervention. Outcomes after PT and BtA injection indicated that PT may help prolong the effect of BtA on range of motion, but long term functional improvements were not sustained. Care pathways for PT treatment were developed, incorporating the literature, current practice and study results. More work is needed to identify the effectiveness of specific PT treatments for children with CP after lower limb BtA injections; this work will support ongoing updates and reviews of existing care pathways.
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    Side alternating vibration training in patients with mitochondrial disease: a pilot study
    (2017-08-08) Newell, Christopher; Ramage, Barbara; Robu, Ion; Shearer, Jane; Khan, Aneal
    Abstract Background Side alternating vibration training (SAVT) is a mechanical oscillation using a vibrating platform that simulates exercise. We hypothesized that patients with mitochondrial myopathies, who experience muscle weakness, may see an improvement in muscle power with SAVT. Methods Patients with mitochondrial disease started either a treatment (SAVT) or control phase (standing without vibration) for 12 weeks, then 12 weeks of washout, and then a 12-week cross-over. The main outcome measure was peak jump power (PJP). We compared this to a natural history cohort from clinic. Results Seven out of 13 patients completed at least 80% of their SAVT sessions and were analyzed. The ΔPJP after the control phase was −2.7 ± 1.7 W/kg (mean ± SEM), SAVT was +2.8 ± 0.6 W/kg (p < 0.05) and from the natural history cohort was −2.4 ± 0.8 W/kg/year. Conclusions SAVT is well tolerated and may improve muscle power in mitochondrial disease patients.
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    Side-Alternating Vibration Training Improves Muscle Performance in a Patient with Late-Onset Pompe Disease
    (2009-05-25) Khan, Aneal; Ramage, Barbara; Robu, Ion; Benard, Laura
    Side-alternating vibration training (SAVT) was used for 15 weeks in a patient with Late-onset Pompe disease who had never used enzyme replacement or chaperone therapy. Prior to the use of SAVT, the patient had experienced declining muscle performance and her 6-minute walk distance decreased from 210 to 155 metres in 6 months. After SAVT, her 6-minute walk distance increased 70% from 166 to 282 metres, muscle jumping power increased by 64% from 83 to 166 watts, isometric knee extensor strength increased 17% from 38 to 44 Nm, and she achieved a more normal pattern of ankle, knee, andjoint kinematics and kinetics. Her functional ability measured through the Rotterdam 9-item score was unchanged at 19/36. There were no elevations in serum creatine kinase or lactate. This is the first report, to our knowledge, of a performance improvement in a patient with Pompe disease using SAVT.
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    Side-Alternating Vibration Training ImprovesMuscle Performance in a Patient with Late-Onset Pompe Disease
    (Hindawi Publishing Corporation, 2009) Khan, Aneal; Ramage, Barbara; Robu, Ion; Benard, Laura