Response to Soft-plastic brace for lower limb fractures in patients with spinal cord injury

Physical problems caused by fractures, aging, stroke, and accidents can reduce foot power; these, in the long term, can dwindle the muscles of the waist, thighs, and legs. These conditions provide the basis for the invalidism of the harmed people. In this study, a saddle-walker was designed and evaluated to help people suffering from spinal cord injury and patients with lower limb weakness. This S-AD works based on body weight support against the previously report designs. This saddle-walker consisted of a non-powered four-wheel walker helping to walk and a powered mechanism for the sit-to-stand (STS) transfer. A set of experiments were done on the STS in the use of the standard walker and the saddle-assistive device(S-AD). A comparison of the results showed that this device could reduce the vertical ground reaction force (GRF) of the legs up to 70%. Using this device could help a wide range of patients with lower limb weakness and SCI patients in changing from sitting to standing.

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Massive Edema of the Lower Limbs in Patients after Spinal Cord Injury—One Picture, Different Diagnoses

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084219 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4219

Author(s):

Magdalena Mackiewicz-Milewska ◽

Małgorzata Cisowska-Adamiak ◽

Katarzyna Sakwińska ◽

Iwona Szymkuć-Bukowska ◽

Iwona Głowacka-Mrotek

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Heterotopic Ossification ◽

Lower Limb ◽

Bone Fractures ◽

Lower Limbs ◽

University Hospital ◽

Pain Sensation ◽

Vein Thrombosis ◽

Cord Injury

Diagnosis of the cause of massive edema of the lower limbs in patients after spinal cord injury (SCI) can be difficult because of loss of pain sensation, commonly occurring in this group of patients. This paper reviews several different pathologies that can lead to lower-limb edema and the associated diagnostic difficulties. We present four cases of patients with massive edemas of lower limbs at different times after SCI undergoing treatment in the Department of Rehabilitation, University Hospital in Bydgoszcz, Poland. All patients had a lack of pain sensation in the lower limbs and significantly elevated levels of D-dimer. In two cases, deep vein thrombosis (DVT) and intramuscular hematomas (IHs) were diagnosed. IHs were probably a consequence of antithrombotic treatments implemented due to the occurrence of DVT. Heterotopic ossification (HO) was diagnosed in a third case, and, in another patient, who was hospitalized for the longest period after injury, we found humeral bone fractures. Heterotopic ossification, intramuscular haematomas, and bone fractures of the lower limb can mimic DVT. Careful observation of the edema evolution is recommended, as the onset of new symptoms may indicate a different cause of edema from that initially established.

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"Effect of Locomotor Training with Body Weight Support on Gait and Lower Limb Strength in Incomplete Spinal Cord Injury-A Case Report"

International Journal of Physiotherapy ◽

10.15621/ijphy/2016/v3i4/111058 ◽

2016 ◽

Vol 3 (4) ◽

Author(s):

Parneet Kaur Bedi

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Body Weight ◽

Lower Limb ◽

Body Weight Support ◽

Locomotor Training ◽

Incomplete Spinal Cord Injury ◽

Weight Support ◽

Lower Limb Strength ◽

Cord Injury

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A STUDY OF RELATION OF LOWER LIMB SPASTICITY WITH LIPID PROFILE AND FASTING PLASMA GLUCOSE LEVELS IN CHRONIC MOTOR COMPLETE SPINAL CORD INJURY PATIENTS.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i1.1041 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Batra Amit ◽

Prakash Om ◽

Jindal Rajeshwari ◽

Batra Shivra

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Plasma Glucose ◽

Fasting Plasma Glucose ◽

Lower Limb ◽

Density Lipoprotein ◽

Fasting Plasma ◽

Cord Injury ◽

Limb Spasticity ◽

Lower Limb Spasticity

Background: Most common cause of spinal cord injury in India is fall from height followed by road accidents which may lead to incomplete or complete disruption of neural signal transmission across and below the level of injury. Spasticity is a common but not an inevitable complication following spinal cord injury. Study Objective: The present study tried to explore the correlation between the lower limb spasticity following spinal cord injury and the metabolic markers. Study design: Hospital-based cross-sectional study. Material and Methods: Fifty patients recruited from Department of Physical Medicine and Rehabilitation, Sawai Man Singh Hospital, Jaipur (Raj.), were categorized into mild (16),moderate (11), and severe (23)spastic groups based on assessment of ankle/knee extensor muscle group spasticity using the modified Ashworth scale. The metabolic profile markers such as Total Cholesterol (TC), Low-density Lipoprotein (LDL), High-Density Lipoprotein (HDL), Triglyceride (TG) and Fasting Plasma Glucose (FPG) were estimated and compared between the three groups. Results: The triglycerides, total cholesterol, low density lipoproteins and the fasting plasma glucose level were significantly negatively correlated with the grading of spasticity in lowerlimbs (P <0.001). The high density lipoproteins level was higher in a severe spastic group as compared to the mild and moderate spastic groups; but this result was statistically non-significant (P=0.14). Conclusion: Spasticity in motor complete SCI may have beneficial effects in preserving glucose homeostasis and defending rise in adiposity, rationalizing the need for its judicious management to maintain the crucial balance between its beneficial and problematic effects. Keywords: Spasticity, Modified Ashworth score, Spinal cord injury, lipid profile, fasting plasma glucose.

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Clinical and Radiological Outcomes After Surgical Treatment of Lower Limb Fractures in Patients With Spinal Cord Injury

Global Spine Journal ◽

10.1177/2192568219871019 ◽

2019 ◽

Vol 10 (6) ◽

pp. 715-719

Author(s):

Lars Ung ◽

Malte Ohlmeier ◽

Birger Jettkant ◽

Dennis Grasmücke ◽

Mirko Aach ◽

...

Keyword(s):

Surgical Treatment ◽

Internal Fixation ◽

Lower Limb ◽

Bone Consolidation ◽

Lower Limb Fractures ◽

Kaplan Meier ◽

Cord Injury ◽

Limb Fractures ◽

Consolidation Time ◽

Internal Group

Study Design: Retrospective observational study. Objectives: To analyze the clinical and radiological outcomes of lower limb fractures following surgical treatment in patients with chronic spinal cord injury (SCI). Methods: Between January 2003 and December 2015, 102 chronic SCI patients with a lower limb fracture were surgically treated at our hospital. A total of 58 patients met the inclusion criteria and were recruited for final analysis. Patients with 2-stage procedure or incomplete clinical records with lost-to-follow-up were excluded from the study. Patients were divided into 2 groups (group 1= internal fixation; group 2 = external fixation). Primary outcome measures were to identify the number of nonunions via Kaplan-Meier analysis and the time to bone consolidation. The diagnosis of a pseudarthrosis was made after more than 180 days of consolidation time. Considering the Kaplan-Meier analysis, pseudarthrosis was interpreted as treatment failure. Secondary outcome measure was to evaluate the complication rate with special focus on heterotopic ossification. Results: A total of 58 chronic SCI patients with closed bone fractures were included in this study. Fifty-two fractures (88%) were simple and 7 (12%) were complex (type C) fractures according to AO classification. The majority of patients (34 cases, 59%) developed femur fractures followed by 24 tibial fractures (41%). Seventeen patients received an external (29%) and 41 an internal fixation (71%). Bone consolidation was reported in 31 patients (53%) with a mean time interval of bone consolidation after 97 days (range from 45 to 160 days; SD = 30). The reported nonunion (pseudarthrosis) rate was 47%. Comparing the internal group (n = 15 patients) versus the external group (n = 14), we could not find any significant difference ( P = .939) concerning the bone consolidation time. The Kaplan-Meier analysis showed a 75% cumulative survivorship at 120 days (internal group) versus 111 days (external group). Most common postoperative complications occurred in the internal fixation group with Wound infections being predominantly observed (10%), followed by heterotopic ossifications (8%). Conclusions: Our results show that surgical treatment of lower limb fractures in chronic SCI patients is a challenging treatment with a high pseudarthrosis rate in both groups. The complication rate seems to be lower in the patients treated with external fixation. As a clinical recommendation, longer implants should be used for a stable osteosynthesis since SCI patients seem to have a higher load on the osteosynthesis material due to missing sensomotoric feedback.

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