Clinical behavior of children with infantile cerebral palsy after ozone therapy
DOI:
https://doi.org/10.7203/jo3t.2.3.2018.11205Keywords:
ozone therapy, infantile cerebral palsy, rectal insufflation, muscle tone, muscle function, O’Brien scale
Abstract
Objective.
The aim of this study was to determine the usefulness of ozone therapy in the treatment of Infantile Cerebral Palsy (ICP).
Patients and methods.
A non-controlled clinical assay was made in the Ozone Research Center (CIO), Havana, Cuba from January 2013 to January 2014. The sample was constituted by patients remitted to pediatrics consultation of CIO, to whom inclusion and exclusion criteria were applied. The study group involved 45 patients, from 1 month of birth to 8 years, with cerebral palsy of hypoxic-ischemic cause. The evaluation criteria were: evolution of the motor disorder according to the Gross Motor Function Classification System (GMFCS) scale, modification of muscle tone (Ashworth modified scale) and response to treatment (O’Brien modified scale). The way of administration was rectal insufflation; concentrations between 15, 20, 25 and 30 mg/L were used, volumes varied according to age, making calculation of the dose of ozone according to kilograms of weight. Cycles of 20 sessions, every 3 months were indicated, until completing 4 in 16 months. Patients were clinically evaluated, according to the scales used, before and after each cycle.
Results and Discussion.
The best answer to treatment was obtained in the group aged ? 4 years. The variables analyzed showed a significant improvement when the ozone treatment concluded. With respect to the evolution of the motor disorder, in 65 % of cases it improved. In the group of children below 4 years, the response was better in relation to the muscle tone. Response to treatment, according to the relatives’ criteria, was of 70 % of the children with marked improvement in the tone and muscle function.
Conclusions.
The greatest percentage of patients improved in the evolution of the motor disorder; when the Manual Ability Classification System (MACS) scale was applied, more than half the patients showed an improvement. A high percentage of children get a satisfactory result regarding muscle tone and motor function. No side effects were present in any of the cases during the study.
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References
Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N, Dan B, et al. Proposed definition and classification of cerebral palsy. Dev Med Child Neurol. 2005;47(8):574-576.
Robaina-Castellanos G, Riesgo-Rodriguez S, Robaina-Castellanos MS. Evaluacion diagnostica del niño con paralisis cerebral [Diagnostic evaluation of the child with cerebral palsy]. Rev Cubana Pediatr. 2007;79(2). Available from: http://bvs.sld.cu/revistas/ped/vol79_02_07/ped07207.htm
Clark SL, Hankins GD. Temporal and demographic trends in cerebral palsy. Fact and fiction. Am J Obstet Gynecol. 2003;18(3):628-633.
Himmelmann K, Hagberg G, Beckung E, Hagberg B, Uvebrant P. The changing panorama of cerebral palsy in Sweden. IX. Prevalence and origin in the birth-year period 1995-1998. Acta Paediatr. 2005;94(3):287-294.
Platt MJ, Krageloh-Mann I, Cans C. Surveillance of Cerebral Palsy in Europe. Prevalence and characteristics of children with cerebral palsy in Europe. Dev Med Child Neurol. 2002;44(9):633-640.
Gainsborough M, Surman G, Maestri G. Validity and reliability of the guidelines of the Surveillance of Cerebral Palsy in Europe for the classification of cerebral palsy. Dev Med Child Neurol. 2008;50:828-831.
Robaina-Castellanos GR, Riesgo-Rodriguez S, Robaina-Castellanos MS. Definicion y clasificacion de la paralisis cerebral: ¿un problema ya resuelto? [Definition and classification of cerebral palsy: a problem already solved?]. Rev Neurol. 2007;45(2):110-117.
Papazian O, Alfonso I. Tratamiento de la paralisis cerebral [Treatment of cerebral palsy]. Rev Neurol. 1997;25:728-739.
Blair E, Stanley FJ. Intrapartum asphyxia: a rare cause of cerebral palsy. J Pediatr. 1988;112:515-519.
Nelson KB, Grether JK. Potentially asphyxiating conditions and spastic cerebral palsy in infants of normal birth weight. Obstet Gynecol. 1998;179:507-513.
MacLennan A. A template for defining a causal relation between acute intrapartum events and cerebral palsy: international consensus statement. BMJ. 1999;319:1054-1059.
Kuban KC, Leviton A. Cerebral palsy. N Engl J Med. 1994;330:188-195.
Kleinsteuber-Saa K, Avaria-Benapres M, Varela-Estrada X. Actualizacion en paralisis cerebral infantil [Update in child cerebral palsy]. Rev Pediatr. 2014;11(2):1-3.
Santamaria JP, Williams ET, Desautels DA. Hyperbaric oxygen therapy in pediatrics. Adv Pediatr. 1995;42:335-366.
Tibbles PM, Edelsberg JS. Hyperbaric-oxygen therapy. New England J Med. 1996;334:1642-1648.
Kitago T, Krakauer JW. Motor learning principles for neurorehabilitation. Handb Clin Neurol. 2013;110:93-103. doi: 10.1016/B978-0-444-52901-5.00008-3.
Mattern-Baxter K. Effects of a Group-Based Treadmill Program on children with neurodevelopmental impairment who are not yet ambulating. Pediatr Phys Ther. 2016;28(3):312-9. doi: 10.1097/PEP.0000000000000250.
Ferre CL, Brandao MB, Hung YC, Carmel JB, Gordon AM. Feasibility of caregiver-directed home-based hand-arm bimanual intensive training: A brief report. Dev Neurorehabil. 2015;18(1):69-74. doi: 10.3109/17518423.2014.948641.
Menendez S, Leon OS, Fernandez JL, Copello M, Weiser MT. Advances of Ozone Therapy in Medicine and Dentistry. La Habana: Palacio de las Convenciones; 2016.
Candelario E, Mohammed-Al-Dalain S, Leon OS, Menendez S, Perez G, Merino N, et al. Oxidative preconditioning affords protection against carbon tetrachloride-induced glycogen depletion and oxidative stress in rats. J Appl Toxicol. 2001;21:297-301. doi: 10.1002/jat.75.
Leon OS, Ajamieh HH, Berlanga J, Menendez S, Viebahn R, Re L, et al. Ozone oxidative preconditioning is mediated by A1 Adenosine receptors in a rat model of liver ischemia/reperfusion. Transpl Int. 2008;21:39-48. doi: 10.1111/j.1432-2277.2007.00568.x.
Calunga JL, Menendez S, Barber E, Merino N, Cruz E. Ozone biological response in kidneys of rats submitted to warm ischemia. Ozone Sci Eng. 2003;25(3):233-240.
Barber E, Menendez S, Leon OS, Barber MO, Merino N, Calunga JL, et al. Prevention of renal injury after induction of ozone tolerance in rats submitted to warm ischemia. Mediators Inflamm. 1999;8(1):37-41. doi: 10.1080/09629359990702.
Calunga JL, Zamora Z, Borrego A, del Rio S, , Barber E, Menendez S, et al. Protective Effect of ozone/oxygen mixture on rats submitted to subtotal nephrectomy: role of antioxidant system. Mediators Inflamm. 2005;2005(4):221-227. doi: 10.1155/MI.2005.221.
Rany M, Aparecida A, Dupas G. Interaction with children with cerebral palsy: communication and stigma. Esc Anna Nery. 2014;18(1):47-53. Available from: http://www.scielo.br/pdf/ean/v18n1/en_1414-8145-ean-18-01-0047.pdf
Sobrado M, Moro MA, Hurtado O. El papel de la glia tras la isquemia cerebral [Role of glia after brain ischemia]. In: Montaner J. Fisiopatologia de la isquemia cerebral [Pathophysiology of brain ischemia]. Barcelona (ES): Ed. Marge Medica Books; 2007.
Castellanos M, Sobrino T, Castillo J. Evolving paradigms for neuroprotection: molecular identification of ischemic penumbra. Cerebrovasc Dis. 2006;21(2):71-79. doi: 10.1159/000091706.
Torregrosa G, Salom JB, Jover-Mengual T, Alborch E. Fisiopatologia basica: De la oclusion arterial a la muerte neuronal [Basic pathophysiology: From arterial occlusion to neuronal death]. In: Joan Montaner. Fisiopatologia de la isquemia cerebral [Pathophysiology of brain ischemia]. Barcelona (ES): Ed. Marge Medical Books; 2007.
Castillo J, Rodriguez I. Biochemical changes and inflammatory response as markers for brain ischaemia: molecular markers of diagnostic utility and prognosis in human clinical practice. Cerebrovasc Dis. 2004;17(11):7-18. doi: 10.1159/000074791.
Cuenca MD, Brea D, Segura T, Galindo MF, Anton-Martinez D, Agulla J, et al. La inflamacion como agente terapeutico en el infarto cerebral: Respuesta inflamatoria celular y mediadores inflamatorios [Inflammation as a therapeutic agent in cerebral infarction: Inflammatory cellular response and inflammatory mediators]. Rev Neurol. 2010;50(6):349-359.
Palisano RJ, Hanna SE, Rosembau PL, Russell DJ, Walter SD, Wood EP, et al. Validation of the model gross motor function for children with cerebral palsy. Phys Ther. 2000;80(10):974-985.
Lundkvist A, Jarnlo GB, Gummesson C, Nordmark E. Longitudinal construct validity of the GMFM-88 total score and goal total score and the GMFM-66 score in a 5 years follow up study. Phys Ther. 2009;89(4):342-350. doi: 10.2522/ptj.20080037.
Belegui M. Factores asociados a paralisis cerebral Infantil en Veracruz en menores de 6 años de edad [Factors associated with cerebral palsy Children in Veracruz in children under 6 years of age] [thesis]. Veracruz: Universidad Veracruzana; 2013.
Peralta C, Leon OS, Xaus C, Prats N, Jalil EC, Planell ES, et al. Protective effect of ozone treatment on the injury associated with hepatic ischemia-reperfusion: antioxidant-prooxidant balance. Free Rad Res. 1999;31:191-196.
Calunga JL, Trujillo Y, Menendez S, Zamora Z, Alonso Y, Merino N, et al. Ozone oxidative postconditioning in acute renal failure. J Pharm Pharmacol. 2009;61(2):221-227. doi: 10.1211/jpp/61.02.0012.
Al-Dalain SM, Martinez G, Candelario-Jalil E, Menendez S, Re L, Giuliani A, et al. Ozone treatment reduces markers of oxidative and endothelial damage in an experimental diabetes model in rats. Pharmaceutical Research. 2001;44(5):391-396. doi: 10.1006/phrs.2001.0867.
Leon OS, Menendez S, Merino N, Castillo R, Sam S, Perez L, et al. Ozone oxidative preconditioning: a protection against cellular damage by free radicals. Mediators Inflamm. 1998;1998(7):289-294. doi: 10.1080/09629359890983.
Zamora Z, Borrego A, Lopez O, Delgado R, Gonzalez R, Menendez S, et al. Effects of ozone oxidative preconditioning on TNF-ɑ release and antioxidant-prooxidant intracellular balance in mice during endotoxic shock. Mediators Inflamm. 2005;2005(1):16-22. doi: 10.1155/MI.2005.16.
Ajamieh HH, Berlanga J, Merino N, Martinez Sanchez G, , Candelario-Jalil E, Menendez S, et al. Role of protein synthesis in the protection conferred by ozone oxidative preconditioning in hepatic ischaemia/reperfusion. Transpl Int. 2005;18(5):604-612. doi: 10.1111/j.1432-2277.2005.00101.x.
Ajamieh HH, Menendez S, Martinez-Sanchez G, Candelario-Jalil E, Re L, Giuliani A, et al. Effects of ozone oxidative preconditioning on nitric oxide generation and cellular redox balance in a rat model of hepatic ischaemia-reperfusion. Liver Int. 2004;24(1):55-62. doi: 10.1111/j.1478-3231.2004.00885.x.
Ajamieh HH, Menendez S, Merino N, Martinez G, Re L, Leon OS. Ischemic and ozone oxidative preconditioning in the protection against hepatic ischemic-reperfusion injury. Ozone Sci Eng. 2003;25(3):241-250.
Borrego A, Zamora Z, Gonzalez R, Romay C, Menendez S, Hernandez F, et al. Protection by ozone preconditioning is mediated by antioxidant system in cisplatin-induced nephrotoxicity in rats. Mediators Inflamm. 2004;13(1):13-19. doi: 10.1080/09629350410001664806.
Menendez S, Gonzalez R, Ledea OE, Leon OS, Hernandez F, Diaz M. Ozonoterapia: Aspectos basicos y aplicaciones clinicas [Ozone therapy: basic aspects and clinical applications]. La Habana: Editorial CENIC; 2008.
Calunga JL, Menendez S, Leon R, Chang S, Guanche D, Balbin A, et al. Application of Ozone Therapy in Patients with Knee Osteoarthritis. Ozone Sci Eng. 2012;34:469-475.
Dranguet J, Fraga A, Diaz MT, Mallok A, Viebahn R, Fahmy Z, et al. Ozone oxidative postconditioning ameliorates joint damage and decreases pro-inflammatory cytokine levels and oxidative stress in PG/PS-induced arthritis in rats. Eur J Pharmacol. 2013;714(1-3):318-24. doi: 10.1016/j.ejphar.2013.07.034.
Park HJ, Kim CH, Park ES, Park B, Oh SR, Oh MK, et al. Increased GABA-A receptor binding and reduced connectivity at the motor cortex in children with hemiplegic cerebral palsy: a multimodal investigation using 18F-fluoroflumazenil PET, immunohistochemistry, and MR imaging. J Nucl Med. 2013;54(8):1263-9. doi: 10.2967/jnumed.112.117358.
Lee JD, Park HJ, Park ES, Kim DG, Rha DW, Kim EY, et al. Assessment of regional GABA(A) receptor binding using 18F-fluoroflumazenil positron emission tomography in spastic type cerebral palsy. Neuroimage. 2007;34(1):19-25. doi: 10.1016/j.neuroimage.2006.09.004.
Kopec K. Cerebral palsy: pharmacologic treatment of spasticity. US Pharm. 2008;33(1):22-26.
Diaz MT, Fraga A, Dranguet J, Mallok A, Viebahn R, Menendez S, et al. Ozone oxidative postconditioning protects against the injury associated with alcohol withdrawal syndrome in rats. Ozone Sci Eng. 2012;34(6):425-431.
Diaz MT, Fraga A, Dranguet J, Mallok A, Viebahn R, Menendez S, et al. Ozone therapy ameliorates nervous system disorders and oxidative stress in patients during ethanol withdrawal. A pilot study. Ozone Sci Eng. 2012;34(6):432-437.
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