scholarly journals Sensory Disturbance of the Lower Extremity after Sural Artery Flap Elevation

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Kaoru Tada ◽  
Seigo Suganuma ◽  
Mika Nakada ◽  
Masashi Matsuta ◽  
Atsuro Murai ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Lower Extremity ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Sural Nerve ◽  
Donor Site ◽  
Sensory Disturbance ◽  
Sensory Disturbances ◽  
The Difference ◽  
Sural Artery

Purpose. Elevation of the sural artery flap with the sural nerve is associated with donor-site morbidities, such as postoperative sensory disturbance of the lower extremity. We evaluated the sensory disturbance of the lower extremity after elevation of the sural artery flap. Methods. This study included 7 patients who underwent surgery using the sural artery flap. The sensory disturbances immediately after surgery and at present were evaluated on a 10-point scale. The influences of surgery on activities of daily living and patient satisfaction were also evaluated. Results. The sensory disturbance was 4.48 immediately after surgery and 2.24 presently, and the difference between the timepoints was not statistically significant. The influence of surgery on activities of daily living was 2.30, and the patient satisfaction was 7.90. Conclusion. It may be necessary to consider the sural artery flap, which does not include the sural nerve, to avoid unnecessary complications. When it is unavoidable to use the sural artery flap, including the sural nerve, it is important to thoroughly inform patients beforehand about the postsurgery sensory disturbance in the lower extremities.

The Relationship between Knee Extension Strength and Activities of Daily Living in Patients with Dementia

2011 ◽  
pp. 244-256
Author(s):  
Makoto Suzuki ◽  
Hikari Kirimoto ◽  
Atsushi Inamura ◽  
Yoshitsugu Omori ◽  
Sumio Yamada
Keyword(s):  
Lower Extremity ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Independence Measure ◽  
Knee Extensor ◽  
Functional Independence ◽  
Knee Extension ◽  
Daily Activities ◽  
Lower Body ◽  
Knee Extensor Strength

The purpose of this study was to examine the test-retest reliability of hand-held dynamometer measurements in patients with dementia and determine if predictions about a patient’s ability to perform daily activities can be made from knee extension strength measurements. This study was composed of two rounds of data collection. Sixty patients with dementia were enrolled in the first round to assess the reliability of hand-held dynamometer measurements, and 54 patients with dementia were enrolled in the second round for predicting their ability to perform daily activities. Knee extensor strength was measured twice, separated by a three minute interval, with hand-held dynamometer. The authors also assessed daily activities related to the patient’s lower extremities, including dressing the lower body, using the toile, transferring to the bed/toilet/shower, and walking. Lower extremity activities of the Functional Independence Measure were assessed by the nursing home caregiver that had the most regular contact with each subject. When the Functional Independence Measure score of each lower extremity function was =6 points, the subject was considered to be independent. The intraclass correlation coefficient was 0.97. Bland-Altman plots showed the 95% difference value to be within 2 SDs of the mean. The curves of negative and positive predictive values revealed the following threshold levels: 0.8 Nm/kg was the best predictor for dressing the lower body and using the toilet; 1.2 Nm/kg was the best predictor for transferring to the bed/toilet/shower; and 0.6 Nm/kg was the best predictor for gait performance. Strength measurements taken with a hand-held dynamometer were reliable in patients with dementia, and normalized knee extensor strength was found to be a predictor of the ability to perform activities of daily living.

scholarly journals Assessment of functional capacity in elderly residents of an outlying area in the hinterland of Bahia/Northeast Brazil

2010 ◽  
Vol 68 (1) ◽  
pp. 39-43 ◽  
Author(s):  
Gilson de Vasconcelos Torres ◽  
Luciana Araújo dos Reis ◽  
Luana Araújo dos Reis
Keyword(s):  
Activities Of Daily Living ◽  
Functional Capacity ◽  
Daily Living ◽  
Age Groups ◽  
The Elderly ◽  
Cross Sectional ◽  
Instrumental Activities ◽  
Significant Difference ◽  
The Difference ◽  
Outlying Area

OBJECTIVE: To assess the functional capacity and to determine the difference between the means of functional capacity (basic and instrumental activities of daily living) and the age groups of elderly residents in an outlying area in the hinterland of Bahia/Northeast of Brazil. METHOD: Analytical study with cross-sectional design and a sample of 150 elderly individuals enrolled in four Health Units in the municipality of Jequié, Bahia, Brazil. The instrument consisted of sociodemographic and health data, the Barthel Index and the Lawton scale. RESULTS: In all, 78.00% of the elderly were classified as dependent in the basic activities and 65.33% in the instrumental activities of daily living. Using the Kruskal-Wallis test, we found a statistically significant difference between the means of instrumental activities and the age groups (p=0.011). CONCLUSION: An elevated number of elderly were classified as dependent in terms of functional capacity and increased age is related to greater impairment in the execution of instrumental activities of daily living.

Conservative Treatment of Thoracic Outlet Syndrome Using an Orthosis

1995 ◽  
Vol 20 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Y. NAKATSUCHI ◽  
S. SAITOH ◽  
M. HOSAKA ◽  
S. MATSUDA
Keyword(s):  
Conservative Treatment ◽  
Activities Of Daily Living ◽  
Brachial Plexus ◽  
Daily Living ◽  
Thoracic Outlet Syndrome ◽  
Shoulder Girdle ◽  
Neurological Deficits ◽  
Sensory Disturbance ◽  
Motor Disturbance

We describe a strapping device for elevation of the shoulder in patients with thoracic outlet syndrome (TOS). The device was used by 86 patients with TOS whose symptoms had been alleviated by passively raising the shoulder. Symptoms of TOS were classified as proximal, including pain in the shoulder girdle, and distal, in which there were neurological deficits related to the brachial plexus. The device was more effective in patients with distal symptoms: pain disappeared or improved in 67% of patients; numbness in 85%; sensory disturbance in 84%; and motor disturbance in 80%. However, proximal symptoms were relieved in only 65% of the patients. The ability to perform activities of daily living was rated as excellent in 33% of patients, good in 44%, fair in 12%, and poor in 9%. The shoulder orthosis described in this report can counterbalance downward traction on the brachial plexus and reduce the tension on it, thereby relieving symptoms of TOS.

Home and Clinical Assessments of Instrumental Activities of Daily Living: What Could Explain the Difference between Settings in Frail Older Adults, If Any?

2009 ◽  
Vol 72 (8) ◽  
pp. 339-348 ◽  
Author(s):  
Véronique Provencher ◽  
Louise Demers ◽  
Isabelle Gélinas
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Occupational Therapists ◽  
Frail Older Adults ◽  
Clinical Assessments ◽  
Instrumental Activities ◽  
Current Content ◽  
The Difference ◽  
Discharge From Hospital

Background: Older patients are usually assessed by occupational therapists in hospital before going home. However, for many frail older adults, this assessment in an unfamiliar environment might not be as representative of their functional abilities as an assessment at home. The aim of this literature review was to determine if differences exist between home and clinical instrumental activities of daily living (IADL) assessments of frail older adults and identify factors that might explain those differences, if any. Method: The sources of the review data were Medline, CINAHL, AMED, PsycINFO, Embase and Current Content from 1988 to 2008. As few relevant studies concerning frail people were found, the search was extended to mixed-age and older adult populations. Ten articles were retained. Main findings: The results suggest differences in IADL assessment between settings for older adults without dementia. Some factors, such as familiarity with the environment and coping skills, might explain those differences. Based on this review, similar results might be expected with frail older people. Implications for practice: Given the dearth of literature on this topic, further research is needed to compare home and clinical assessments and measure relevant factors in a frail population. Helping occupational therapists to identify frail patients, who may show different abilities in unfamiliar settings, could mean more appropriate services after discharge from hospital.

scholarly journals Effectiveness of a Novel Contralaterally Controlled Neuromuscular Electrical Stimulation for Restoring Lower Limb Motor Performance and Activities of Daily Living in Stroke Survivors: A Randomized Controlled Trial

2022 ◽  
Vol 2022 ◽  
pp. 1-9
Author(s):  
Ying Shen ◽  
Lan Chen ◽  
Li Zhang ◽  
Shugang Hu ◽  
Bin Su ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Lower Extremity ◽  
Activities Of Daily Living ◽  
Motor Function ◽  
Daily Living ◽  
Neuromuscular Electrical Stimulation ◽  
Lower Extremity Function ◽  
Stroke Patients ◽  
Extremity Function ◽  
Subacute Stroke

Background. Contralaterally controlled neuromuscular electrical stimulation (CCNMES) is a novel electrical stimulation treatment for stroke; however, reports on the efficacy of CCNMES on lower extremity function after stroke are scarce. Objective. To compare the effects of CCNMES versus NMES on lower extremity function and activities of daily living (ADL) in subacute stroke patients. Methods. Forty-four patients with a history of subacute stroke were randomly assigned to a CCNMES group and a NMES group ( n = 22 per group). Twenty-one patients in each group completed the study per protocol, with one subject lost in follow-up in each group. The CCNMES group received CCNMES to the tibialis anterior (TA) and the peroneus longus and brevis muscles to induce ankle dorsiflexion motion, whereas the NMES group received NMES. The stimulus current was a biphasic waveform with a pulse duration of 200 μs and a frequency of 60 Hz. Patients in both groups underwent five 15 min sessions of electrical stimulation per week for three weeks. Indicators of motor function and ADL were measured pre- and posttreatment, including the Fugl–Meyer assessment of the lower extremity (FMA-LE) and modified Barthel index (MBI). Surface electromyography (sEMG) assessments included average electromyography (aEMG), integrated electromyography (iEMG), and root mean square (RMS) of the paretic TA muscle. Results. Values for the FMA-LE, MBI, aEMG, iEMG, and RMS of the affected TA muscle were significantly increased in both groups after treatment ( p < 0.01 ). Patients in the CCNMES group showed significant improvements in all the measurements compared with the NMES group after treatment. Within-group differences in all post- and pretreatment indicators were significantly greater in the CCNMES group than in the NMES group ( p < 0.05 ). Conclusion. CCNMES improved motor function and ADL ability to a greater extent than the conventional NMES in subacute stroke patients.

Range of Motion: AMA Guides, Sixth Edition

2015 ◽  
Vol 20 (3) ◽  
pp. 3-5
Author(s):  
James B. Talmage ◽  
Jay Blaisdell
Keyword(s):  
Lower Extremity ◽  
Physical Examination ◽  
Activities Of Daily Living ◽  
Range Of Motion ◽  
Daily Living ◽  
Lower Extremities ◽  
Upper Extremities ◽  
Sixth Edition

Abstract In the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, range of motion (ROM) is used to calculate the physical examination modifier when the diagnosis-based impairment (DBI) method is used, ie, Table 15-8, Physical Examination Adjustment: Upper Extremities, and Table 16-7, Physical Examination Adjustment: Lower Extremities. The DBI method is preferable for calculating upper and lower extremity ratings, but in instances specified by the regional grid, the evaluator may choose to use the ROM method, typically because it yields a higher impairment rating. The article outlines the steps for measuring ROM. Invalid results on the day of testing are declared after three consecutive efforts if the three measurements for a given plane of motion vary by more than 10 degrees from the average (mean) of these three measurements. The process can be tried again another day, or the DBI method can be used. All ROM measurements should be rounded to the nearest number ending in zero, and a figure provides examples of suitable annotations. Adjustments for functional history can be made if ROM is the only method used for rating, if results are deemed reliable and consistent with results from an activities of daily living questionnaire or other valid functional report, and if the current ROM impairment does not adequately capture the full impairment.

Resection of the Distal Scaphoid for Scaphotrapeziotrapezoid Osteoarthritis

1999 ◽  
Vol 24 (4) ◽  
pp. 448-452 ◽  
Author(s):  
M. GARCIA-ELIAS ◽  
A. L. LLUCH ◽  
A. FARRERES ◽  
F. CASTILLO ◽  
Ph. SAFFAR
Keyword(s):  
Patient Satisfaction ◽  
Soft Tissue ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Pinch Strength ◽  
Wrist Flexion ◽  
Flexion Extension ◽  
Preoperative Status

Twenty-one patients with symptomatic scaphotrapeziotrapezoid osteoarthritis were treated with partial distal scaphoid excision. In 12 wrists the joint defect was filled with either capsular or tendinous tissue, while in nine no fibrous interposition was done. At an average follow-up time of 29 (range, 12–61) months, 13 wrists were painfree, while eight had occasional mild discomfort. Mean wrist flexion-extension was 119°. Grip and pinch strength improved by an average of 26% and 40% respectively compared with their preoperative status. Fifteen patients returned to their original jobs, while six, who were unemployed, felt unrestricted for activities of daily living. Although patient satisfaction was comparable for both types of treatment, the wrists without fibrous interposition showed significantly greater wrist flexion-extension than patients with soft-tissue interposition. Removal of the distal scaphoid resulted in a DISI pattern of carpal malalignment in 12 wrists. At follow-up, none of these wrists showed further joint deterioration due to residual malalignment.

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