Plantarflexion Torque Following Reconstruction of Achilles Tendinosis or Rupture with Flexor Hallucis Longus Augmentation

2000 ◽  
Vol 21 (4) ◽  
pp. 324-329 ◽  
Author(s):  
Michael T. Monroe ◽  
David J. Dixon ◽  
Timothy C. Beals ◽  
Gregory Pomeroy ◽  
David L. Crowley ◽  
...  
Keyword(s):  
Primary Repair ◽  
Subjective Evaluation ◽  
Achilles Tendon Rupture ◽  
Peak Torque ◽  
Flexor Hallucis Longus ◽  
Ankle Motion ◽  
Achilles Tendinosis ◽  
Level Of Satisfaction ◽  
Significant Difference ◽  
High Level

Nine patients treated surgically for Achilles tendon rupture (7 patients) or tendinosis (2 patients) with primary repair or debridement and augmentation with the flexor hallucis longus muscle-tendon unit were evaluated at a mean of 19 months postoperative. Subjective evaluation revealed a high level of satisfaction. All patients returned to work and only two patients reported limitation in their recreational activities. The mean post-operative AOFAS Ankle-Hindfoot Score was 90 points. Four patients reported mild occasional pain and one patient complained of moderate daily pain. Motion assessment showed a 20% increase in the hallux MTP dorsiflexion compared to the non-operative side (p = 0.045). No difference in ankle motion was noted. Cybex II+ dynamic evaluation of plantarflexion peak torque was complete on both extremities. The torque deficit on the reconstructed extremity was 20% (p = 0.01) at 120 degrees per second and 26% (p = 0.003) at 30 degrees per second. There is no significant difference between the torque deficit recorded for patients with Achilles rupture and those with Achilles tendinosis. A trend toward improved torque production with longer follow up was observed.

scholarly journals Global Pathology Training in Residency and Fellowship: A Mutually Beneficial Intervention

2020 ◽  
Author(s):  
Lianna Goetz ◽  
Khadija Huggins ◽  
Wesley Greaves ◽  
Tricia Peters ◽  
Melanie Johncilla
Keyword(s):  
Global Health ◽  
Turnaround Time ◽  
Middle Income ◽  
Middle Income Countries ◽  
Level Of Satisfaction ◽  
Significant Difference ◽  
The Us ◽  
Clinician Satisfaction ◽  
High Level ◽  
Pathology Training

Context.— Most cancers occur in lower and middle income countries, where pathologists are scarce. Despite this, few pathology training programs offer global health electives, and trainees are not exposed to challenges associated with practicing in resource-restricted settings. Objective.— To implement a global health elective model aimed at exposing trainees to global health while alleviating overburdened pathologists in resource-restricted settings. Design.— For 1 year, trainees at 2 US institutions reviewed cases shipped weekly from a pathology lab serving Trinidad and Tobago and Guyana. Turnaround time, specimen type, and trainee and clinician satisfaction were assessed. Results.— Trainees reviewed an average of 16 cases per week. Average turnaround time was 6 days. There was no significant difference between the turnaround time for the US trainees and the pathologist based in the lab in Trinidad. Trainees and clinicians reported a high level of satisfaction, and the collaboration was fruitful, resulting in the publication of a case report. Conclusions.— We demonstrate that collaboration between US trainees and laboratories in resource-restricted settings, in the form of a global health elective, is mutually beneficial.

scholarly journals Compliance with treatment of patients with glaucoma

2014 ◽  
Vol 61 (4) ◽  
pp. 47-53
Author(s):  
Nevena Bjelovic ◽  
Ivan Sencanic ◽  
Goran Trajkovic
Keyword(s):  
Side Effects ◽  
Treatment Satisfaction ◽  
Treatment Effectiveness ◽  
Study Objective ◽  
Satisfaction Questionnaire ◽  
Level Of Satisfaction ◽  
Significant Difference ◽  
Patient Reported ◽  
Satisfaction With Treatment ◽  
High Level

Introduction: Glaucoma is progressive, chronic optic neuropathy, causing visual field damage and progressive loss of sight. This is a leading cause of preventable blindness and most often asymptomatic disease. Recommended management of glaucoma typically includes the use of medication(s). Compliance rates vary between 25 and 59%. Patient reported outcomes (PRO's) are an umbrella term, covering a broad range of health data reported by patients. PRO's self reported questionnaires are developed to assess several aspects of patient health status, including treatment satisfaction and adherence. Study objective: To assess patient satisfaction with medication effectiveness, medication side effects, convenience and overall treatment satisfaction. Material and method: Using a crosssectional study design, glaucoma patients had been recruited, and examined at the Centre for Sight "Oftalmika" in Belgrade, Serbia in the period between May 15th and June 15th 2011. The questionnaire used in research was the Treatment Satisfaction Questionnaire for Medication Version ii (TSQM). Results: Total of 73 glaucoma patients filled out the Treatment Satisfaction Questionnaire. The mean age was 62.8 years. Satisfaction score for TSQM subscales: Effectiveness, Side Effects, and Convenience and Overall Satisfaction have not showed statistically significant difference between the subscales. The participants are satisfied with the treatment effectiveness, independently on gender, age, level of the education, and the difference within the family life style. Participants from the secondary educational level (iSCED levels) showed significantly lower satisfaction with the side effects than others. Also, there is a significantly higher level of satisfaction with treatment, for the people who live alone. Overall, the study determined that there is a statistically significant positive linear correlation between overall satisfaction with treatment and its determinants. Conclusion: Our respondents showed a high level of satisfaction with therapy. Patients' satisfaction with treatment was higher in patients who believe that the therapy is effective, who are not bothered with the influence of side effects and are satisfied with the therapeutic schemes.

Arthroscopic, Single-Incision, and Double-Incision Approaches to Flexor Hallucis Longus Tendon Transfer Following Achilles Tendon Rupture: A Literature Review

2021 ◽  
Vol 111 (3) ◽  
Author(s):  
Ashley V. Mosseri ◽  
Phillip Calaj ◽  
Dominick J. Casciato ◽  
Bibi N. Singh
Keyword(s):  
Postoperative Complications ◽  
Achilles Tendon ◽  
Tendon Transfer ◽  
Tendon Rupture ◽  
Single Incision ◽  
Achilles Tendon Rupture ◽  
Athletic Injury ◽  
Flexor Hallucis Longus ◽  
Longus Tendon ◽  
Significant Difference

Achilles tendon rupture is a common athletic injury that results in a painful and antalgic gait. Flexor hallucis longus tendon transfer through arthroscopic, single-incision, or double-incision techniques is used as a treatment approach to address this rupture; however, no studies have compared postoperative complications between these three techniques. A systematic search of published articles was conducted using keywords “Achilles rupture,” “flexor hallucis tendon,” “transfer,” and “recovery.” Articles were then selected based on their title, abstract, and content following full-text review. From each article's reported surgical outcomes, a comparison was made between arthroscopic and single- and double-incision postoperative complications using a χ2 test with significance set at a value of P < .05 followed by post hoc analysis. The arthroscopic approach maintained the lowest rate of postoperative complications, followed by the single- and double-incision techniques. A significant difference in the number of postoperative complications was found between all incisional approaches. The pairwise comparisons, however, could not identify which incisional approaches significantly differed between each other. A reduction in postoperative complications places arthroscopy and the single-incision techniques as the preferred approaches for flexor hallucis longus tendon transfer following an Achilles tendon rupture. Although current literature shows arthroscopy to be superior to single- and double-incision methods, this review demonstrates the need for a greater number of published cases using arthroscopy to establish significance regarding postoperative complications.

Open Versus Minimal Invasive Repair With Achillon Device

2009 ◽  
Vol 30 (5) ◽  
pp. 391-397 ◽  
Author(s):  
Seref Aktas ◽  
Baris Kocaoglu
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Achilles Tendon Rupture ◽  
Minimal Invasive ◽  
Flexor Hallucis Longus ◽  
Significant Difference ◽  
Outcome Scores ◽  
End To End ◽  
Group 2 ◽  
Group 1

Background: We prospectively analyzed and compared the functional and clinical results of patients with standard open and minimally invasive repair with the Achillon suture system at mid-term followup. Materials and Methods: From February 2004 to May 2007, 40 consecutive patients were operated for the treatment of acute Achilles tendon rupture with two different methods. None of the cases required adjunctive procedures like plantaris, flexor hallucis longus or gastrocnemius augmentation (Lindholm, Bosworth) to allow for acceptable end to end apposition. The patients were divided equally into two groups. In Group 1, only Krakow end-to-end suturing technique and in Group 2, Minimal invasive repair with Achillon suture system (Integra Life Sciences Corporation, Plainsboro, NJ) was used respectively. The average age of the patients was 40 years. Patients in study groups were followed up at mean of 22.4 (range, 10 to 48) months after surgery. At the end of the followup time, functional outcome scores and complications were evaluated. Results: The AOFAS hindfoot clinical outcome scores were 98.7 in Group 1, 96.8 in Group 2. Although there was a numerical increase in AOFAS Scores in Group 1, there was no significant difference. The surgical outcome concerning local tenderness, skin adhesions, scar and tendon thickness was better in Group 2 than in Group 1 with statistical significance. Conclusion: Although functional outcomes of both treatment groups were the same, minimally invasive repair with the Achillon suture system provided safe, reliable and practical treatment with low risk of complications in the treatment of acute Achilles tendon ruptures.

scholarly journals Place of Work and Level of Satisfaction with the Lives of Polish Nurses

2020 ◽  
Vol 10 (2) ◽  
pp. 95-105
Author(s):  
Anna Bartosiewicz ◽  
Małgorzata Nagórska
Keyword(s):  
Life Satisfaction ◽  
Satisfaction With Life ◽  
Satisfaction With Life Scale ◽  
Specialist Care ◽  
Level Of Satisfaction ◽  
Significant Difference ◽  
Life Scale ◽  
Tukey Honestly Significant Difference ◽  
High Level ◽  
The Impact

Practicing as a nurse may be a factor influencing the overall level of satisfaction with life. The aim of the study was to assess the level of satisfaction with nurses’ lives in relation to the place of employment. The research was conducted among nurses working in hospitals, primary health care, and outpatient specialist care. The study was carried out with the use of the satisfaction with life scale (SWLS) scale. Statistical analysis included a quantitative and qualitative approach to life satisfaction of the nurses surveyed. The impact of independent variables, measured on nominal (qualitative) scales on the results of the SWLS scale in quantitative terms, was assessed using one-way analysis of variance (ANOVA). Pairwise comparisons were assessed with the assumption of equality of variance with the Tukey honestly significant difference test. The level of satisfaction with life of the surveyed nurses was average. The place where nurses worked significantly influenced the level of life satisfaction. Nurses working in a hospital had a high level of satisfaction with life more so than nurses working in primary care or outpatient specialist care. The workplace is a factor that significantly differentiates the level of life satisfaction of the surveyed nurses.

scholarly journals Isokinetic profile of subjects with the ruptured anterior cruciated ligament

2016 ◽  
Vol 73 (7) ◽  
pp. 631-635 ◽  
Author(s):  
Miodrag Drapsin ◽  
Damir Lukac ◽  
Predrag Rasovic ◽  
Patrik Drid ◽  
Aleksandar Klasnja ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Peak Torque ◽  
Acl Rupture ◽  
Thigh Muscle ◽  
Thigh Muscles ◽  
Significant Difference ◽  
Bilateral Differences ◽  
High Level

Background/Aim. All changes in the knee that appear after anterior cruciate ligament (ACL) lesion lead to difficulties in walking, running, jumping especially during sudden changes of the line of movement. This significantly impairs quality of life of these subjects and leads to decrease in physical activity. Knee injuries make 5% of all most severe acute sport injuries. The aim of the study was to determine strength of the thigh muscles in persons with unilateral rupture of the ACL and to evaluate potential bilateral differences between healthy and injured leg. Methods. This study involved 114 male athletes of different sport specialities with the clinical diagnosis of ACL rupture. Each subject had unilateral ACL rupture and the other leg was actually the control for this research. An isokinetic device was used to evaluate the muscle strength of thigh muscles. Testing was performed for two testing speeds, 60?/s and 180?/s. Results. Data analysis showed a statistically significant difference (p < 0.01) between the ACL and the healthy leg in the following parameters: peak torque for thigh extensors (Ptrq_E), angle to peak torque during extension (Ang_E), power of extension (Pow_E) and work during extension (Work_E). Analysing hamstrings to quadriceps (H/Q) ratio we found the unilateral disbalance of thigh muscle strength in ACL leg. Conclusion. A high level of validity makes isokinetic dynamometry the method for evaluation of thigh muscles strength and leaves this field of research open for new studies in order to improve both diagnostic and rehabilitation of patients with the insufficient ACL.

An Outcome Study of Chronic Achilles Tendinosis After Excision of the Achilles Tendon and Flexor Hallucis Longus Tendon Transfer

2005 ◽  
Vol 26 (9) ◽  
pp. 691-697 ◽  
Author(s):  
RobRoy L. Martin ◽  
Christopher M. Manning ◽  
Christopher R. Carcia ◽  
Stephen F. Conti
Keyword(s):  
United States ◽  
Achilles Tendon ◽  
Range Of Motion ◽  
Functional Status ◽  
Flexor Hallucis Longus ◽  
Modified Technique ◽  
Achilles Tendinosis ◽  
United States Population ◽  
Sf 36 ◽  
Significant Difference

Background: A number of operative techniques, including decompression with debridement and flexor hallucis longus (FHL) tendon augmentation, have been described for chronic degenerative Achilles tendinosis. Decompression with debridement has been shown to be effective; however, pain and functional limitation can persist in individuals with more severe tendon involvement. Augmentation with the FHL tendon can add mechanical support; however, difficulty in achieving proper tendon tensioning and the potential to leave behind painful diseased tendon are disadvantages of the technique. The purpose of this study was to present the results of a modified technique in which the Achilles tendon is completely excised and the FHL tendon is transferred. Methods: Fifty-six surgeries using this modified technique were done between October, 1994, and March, 2002, for patients with chronic degenerative Achilles tendinosis. Forty-four patients with and average age of 58.2 (SD 10.1) years and an average time of followup of 3.4 (SD 1.9) years were available for testing. All subjects were mailed a packet of standardized questionnaire information that included the Self-Reported Health Related Quality of Life measures Short Form (SF-36) and the subjective component of the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot Score. Nineteen patients returned to the clinic for objective assessment. Statistical analysis tested for a difference in the SF-36 scores between our subjects and the general United States population and for a difference in strength and range of motion between the involved and uninvolved lower extremities. Results: Pain decreased in 95.5% ( n = 42) patients, and 86.4% ( n = 38) patients were satisfied with the result. There was no significant difference ( p >.05) between the SF-36 scores obtained by our sample compared to the general United States population. The average AOFAS score for the 19 patients was 91.6 (SD 7.7). Dorsiflexion range of motion was not significantly different ( p = 0.17); however, significant deficits were found in plantarflexion range of motion ( p = 0.001) and plantarflexion strength ( p < 0.025). Strength deficits were 30% on average; however, all but one patient could do a heel raise. Conclusion: Complete Achilles tendon excision reduces pain while preserving functional status. Although strength deficits persisted, these deficits did not seem to affect the functional status in this sample of patients.

scholarly journals Students’Attitudes towards Foreign Languages

2017 ◽  
Vol 7 (2) ◽  
pp. 124 ◽  
Author(s):  
Mirjana M. Kovac ◽  
Ana Mrsic
Keyword(s):  
Adverse Effect ◽  
Subjective Evaluation ◽  
Foreign Languages ◽  
German Language ◽  
Attitudes And Beliefs ◽  
Professional Career ◽  
Significant Difference ◽  
Testing Tool ◽  
Similarities And Differences ◽  
High Level

This paper analyses similarities and differences in attitudes and beliefs towards learning the German and the Italian language. The testing tool used for evaluating the attitudes is a questionnaire composed in accordance with the questionnaires used for examining attitudes towards foreign languages. The obtained results indicate that the students of both languages highly agree with the statement that the knowledge of foreign languages leads to a better social status, more successful socialisation and benefit in one’s professional career. In addition, they highly agree with the statement that the teaching materials are miscellaneous, but would nevertheless want the materials to include more elements of the domicile culture. Furthermore, the results also indicate a high level of confidence in speaking both languages and a substantial level of awareness regarding the need to speak both languages. The analysis confirmed a significant difference between the learners of Italian and German; the learners of German perceive the language as more difficult than Italian. However, such subjective evaluation does not have an adverse effect on the attitudes towards the German language.

Decision making power of college girls in relation to clothing

2018 ◽  
Vol 9 (01) ◽  
Author(s):  
Parul Gill ◽  
Poonam Malik ◽  
Pankaj Gill
Keyword(s):  
Decision Making ◽  
Satisfaction Level ◽  
College Going ◽  
Level Of Satisfaction ◽  
High Level ◽  
Garment Design ◽  
Structured Questionnaire

The present study was undertaken to explore the decision making patterns of college girls in relation to clothing and their satisfaction level with these decision making patterns. Thirty under graduate college girls from Panipat city were approached to record their responses regarding decision making in relation to clothing and satisfaction level through a well structured questionnaire. It was found that most of the girls (56.66%) themselves made the decisions about the type of garment (Indian, western or both) they wear and majority of girls (70%) were highly satisfied with this decision making. Parents performed the role of buyers for their college going daughters' garments in most of the cases (63.33%) and the 73.33% girls had high level of satisfaction with this. In most of the cases (60%) the decision about the garment design was made by the girls themselves and they were highly satisfied with it. Keywords: clothing, college, girls, decision making.

Effectiveness of Brushing Associated with Oral Irrigation in Maintenance of Peri-Implant Tissues and Overdentures: Clinical Parameters and Patient Satisfaction.

2020 ◽  
Author(s):  
Marcela Moreira Salles ◽  
Viviane de Cássia Oliveira ◽  
Ana Paula Macedo ◽  
Claudia Helena Silva-Lovato ◽  
Helena de Freitas Oliveira Paranhos
Keyword(s):  
Patient Satisfaction ◽  
Analogue Scale ◽  
Ring System ◽  
Complete Dentures ◽  
Gingival Index ◽  
Prosthetic Rehabilitation ◽  
Mean Values ◽  
Probing Depth ◽  
Significant Difference ◽  
High Level

Implant-supported prostheses hygiene and peri-implant tissues health are considered to be predictive factors for successful prosthetic rehabilitation. Therefore, the purpose of this study was to evaluate the effectiveness of brushing associated with oral irrigation measured as biofilm-removing capacity, maintenance of healthy oral tissues, and patient satisfaction. A randomized, crossover clinical trial was conducted with 38 patients who wore conventional maxillary complete dentures and mandibular overdentures retained by the O-ring system. The patients were instructed to use the following hygiene methods for 14 days: mechanical brushing [MB (brush and dentifrice - Control)]; and MB with oral irrigation [WP (Waterpik - Experimental)]. Biofilm-removing capacity and maintenance of healthy oral tissues were evaluated by the Modified Plaque Index (PI), Gingival Index (GI), Probing Depth (PD), and Bleeding on Probing Index (BP) recorded at baseline and after each method. In parallel, patients answered a specific questionnaire using a Visual Analogue Scale after each hygiene method. Data were analyzed by Friedman and Wilcoxon tests (α=0.05). The results showed significantly lower PI, GI, PD, and BP indices after application of the hygiene methods (P&lt;0.001) than those observed at baseline. However, no significant difference was found between MB and WP. The satisfaction questionnaire responses to both methods showed high mean values for all questions, with no statistically significant difference found between the answers given after the use of MB and WP (P&gt;0.05). The findings suggest that WP was effective in reducing PI, GI, PD, and BP indices and provided a high level of patient satisfaction.

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