No difference in gait pattern between a short collum femoris-preserving and a conventional stem: 44 randomised total hip arthroplasty patients stem evaluated after 2 years

Background: The uncemented collum femoris-preserving (CFP) stem offers preservation of the femoral neck and a more conservative soft tissue resection, which may facilitate a more normal walking pattern. We used gait analysis to evaluate if patients operated with a CFP stem showed more favourable hip kinematics and kinetics when compared with a group of patients operated with a conventional uncemented stem. Methods: 44 patients randomised to receive either a CFP or a Corail stem were studied and were operated using a direct lateral incision. Gait analysis was performed 2 years after the operation with a 12-camera motion capture system and 2 force plates. Hip kinematics and kinetics were analysed and 66 subjects served as controls. Results: None of the variables: speed, stride, cadence and stance showed any statistical significant difference between the 2 study groups. Neither did the hip kinematics and kinetics. Compared to controls, patients operated with the CFP stem showed an increased stance (62.5% vs. 61.1%, p < 0.006) and decreased hip abduction (−2.1° vs. −6.5°). Patients operated with the Corail stem showed decreased speed (1.18 vs. 1.23 m/second), and stride length (1.26 vs. 1.33 m), decreased hip extension (−7.5° vs. −12.8°) and range of hip flexion/extension (38° vs. 40.9°), as well as their hip adduction that was increased (6.3° vs. 4°), whereas their hip abduction was reduced (−2.8° vs. −6.5°), ( p < 0.004) compared to the controls. Conclusions: Use of a CFP stem did not significantly influence any of the gait parameters studied when compared to a standard stem, but still both stems studied were associated with gait deviations when compared to controls. Whether these differences could be attributed to the stem used, the underlying hip disease, or both is still unknown.

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Effects of Medial Thrust Gait on Lower Extremity Kinetics in Patients with Knee Osteoarthritis

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/01.3001.0014.8141 ◽

2021 ◽

Vol 23 (2) ◽

pp. 115-120

Author(s):

Hamid Reza Bokaeian ◽

Fateme Esfandiarpour ◽

Shahla Zahednejad ◽

Hossein Kouhzad Mohammadi ◽

Farzam Farahmand

Keyword(s):

Lower Extremity ◽

Knee Osteoarthritis ◽

Center Of Pressure ◽

Reaction Force ◽

Gait Pattern ◽

Mean Difference ◽

Knee Adduction Moment ◽

Camera Motion ◽

Normal Gait ◽

Significant Difference

Background. Medial thrust (MT) gait is a nonsurgical approach for reducing the knee adduction moment (KAM) in patients with knee osteoarthritis. However, its usefulness is indeterminate due to scarcity of research about changes in lower extremity kinetics and the ground reaction force (GRF) which have been investigated in this study. Materials and methods. Twenty patients (6 males, 14 females, age: 56.2±6.2 years) with medial knee osteoarthritis participated in this cross-sectional study. A 12-camera motion analysis system and two force plates recorded kinematic and GRF data while participants walked barefoot along a 12m path with 1) their regular gait pattern and 2) MT gait pattern. The first peak adduction and flexion moments of the hip, knee, and ankle, and the sagittal and frontal GRF were measured. The center of pressure (CoP) location in the mediolateral direction at first KAM peak was also determined. Results. MT gait significantly reduced the first KAM peak (mean difference= 169.7, p<0.001) and the hip flexion moment (mean difference: 82.6, p= 0.020) compared to normal gait. The mediolateral CoP significantly shifted laterally during MT gait compared to normal gait (mean difference: -12% foot width, p<0.001). There was no significant difference in other kinetics variables between the two gait patterns (p>0.05). Conclusions. 1. Our findings show that MT gait can reduce the KAM with no significant increase in the GRF and other lower extremity moments. 2. The results suggest that the reduced KAM associated with MT gait is caused by a lateral shift of the CoP, resulting in a reduced GRF moment arm.

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The Effects of Femoral Derotation Osteotomy in Cerebral Palsy: A Kinematic and Kinetic Study

Hip International ◽

10.5301/hip.2011.8758 ◽

2011 ◽

Vol 21 (6) ◽

pp. 657-664 ◽

Cited By ~ 4

Author(s):

Veronica Cimolin ◽

Luigi Piccinini ◽

Nicola Portinaro ◽

Anna Carla Turconi ◽

Sonia Albonico ◽

...

Keyword(s):

Power Generation ◽

Cerebral Palsy ◽

Energy Consumption ◽

Gait Analysis ◽

Kinetic Study ◽

Gait Pattern ◽

Transverse Plane ◽

Healthy Children ◽

Derotation Osteotomy ◽

Kinematics And Kinetics

We attempted to quantify the effects of isolated femoral derotation osteotomies using clinical evaluation and gait analysis (kinematics and kinetics) in patients with cerebral palsy (CP). Twelve children with CP were evaluated before and 10 months after isolated femoral derotation osteotomy, and 15 healthy children were evaluated as controls. There were significant improvements on clinical examination. A better position of the hip and ankle in the transverse plane was evident and significant changes occurred in terms of hip and ankle kinetics after surgery. Improvements in kinematics and hip and ankle power are very important biomechanically. The correction of lever arm dysfunction and more physiological hip and ankle power generation result in an improvement in terms of energy consumption, leading to a more functional and economic gait pattern.

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A Thorax Marker Set Model to Analyse the Kinematics of Walking Without the Need to Place Markers on the Back

Journal of Biomechanical Engineering ◽

10.1115/1.4049160 ◽

2020 ◽

Author(s):

Eva Orantes-Gonzalez ◽

Jose Heredia-Jimenez ◽

Ambreen Chohan ◽

Jim D Richards

Keyword(s):

Angular Velocity ◽

Gait Analysis ◽

Research Question ◽

Intraclass Correlation ◽

Load Carriage ◽

Camera Motion ◽

Validity And Reliability ◽

Good Reliability ◽

Flexion Extension ◽

Angular Velocities

Abstract Background: Previous thorax models have been proposed for gait analysis, however these require markers to be placed on the back. This presents a limitation in the kinematic analysis of the thorax under load carriage conditions. Research question: This study evaluated the validity and reliability of a thorax marker set that does not require markers to be placed on the back (HubemaLab model) when compared to 3 previously published marker set models. Methods: 17 young adults were evaluated while walking at their self-selected speed. A 12 camera motion capture system was used to acquire the marker position data which was then processed using the respective models using Visual-3D. The level of agreement for the flexion/extension peak, right/left lateral peak and right/left rotation peak of the thorax angle and angular velocity; together with the range of motion and thorax angular velocities in the three planes was found between each thorax marker set, while the reliability was measured using the intraclass correlation coefficient. Results: The ICC results for the thorax angle ROM and the range of thorax angular velocity between the HubemaLab model and the other models showed excellent to good reliability in all three planes. While the ICCs for the peak flexion/extension, peak right/left lateral flexion and peak right/left rotation showed excellent to moderate reliability in all three planes. Conclusion: The new model could be potentially valuable for kinematic gait analysis under load carriage conditions which obscure markers placed on the back.

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The Effect of Electroacupuncture on Dynamic Balance during Stair Climbing for Elderly Patients with Knee Osteoarthritis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/3563584 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Meijin Hou ◽

Xiangbin Wang ◽

Jiao Yu ◽

Shengxing Fu ◽

Fengjiao Yang ◽

...

Keyword(s):

Electrical Stimulation ◽

Knee Osteoarthritis ◽

Dynamic Balance ◽

Stair Climbing ◽

Initial Contact ◽

Significant Difference ◽

Stair Negotiation ◽

Hip Kinematics ◽

Risk Factors For Falls ◽

Kinematics And Kinetics

Background. Poor balance is one of the risk factors for falls in patients with knee osteoarthritis (KOA), which is related to the symptoms. Electroacupuncture (EA) is one of the traditional Chinese conservative methods commonly used to improve the symptoms in patients with KOA. Objective. To assess whether EA increases the dynamic balance during stair negotiation among patients with KOA. Methods. A total of 40 KOA patients were assigned to two groups randomly (true electroacupuncture vs. mock electroacupuncture). Acupoints around the knee were selected in the true electroacupuncture (TEA) group with electrical stimulation (2 Hz). In the mock electroacupuncture (MEA) group, about 2 cm next to the above acupoints, the needles were inserted superficially without electrical stimulation. All the participants received 11 sessions of stimulation treatment in three weeks. The primary outcome was margin of stability (MOS). Secondary outcomes included hip kinematics and kinetics as well as pain. Results. There was no significant difference between the two groups for self-reported pain (p=0.585). During ascent, there was no difference between groups in MOS value in both directions, which was the anterior-posterior (A/P) direction and medial-lateral (M/L) direction at initial contact and toe-off as well as the midstance in the gait cycle, and no difference for the hip kinematics and kinetics between the groups was detected (p>0.05). For descent, at the toe-off event, the TEA group was more unstable as compared to the MEA group in the A/P direction (p=0.029) but not in the M/L direction, and the hip showed a larger internal rotator moment (p=0.049); at the midstance, the TEA group showed a lower abductor moment than the MEA group (p=0.003). Conclusions. Based on the assessment results from the chosen patients with KOA, the TEA did not demonstrate a significant effect in improving the dynamic balance during stair negotiation in comparison with the MEA. This finding does not support EA as a conservative treatment to improve the dynamic balance in such patients.

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Pengaruh Penggunaan Model Pembelajaran dan Konsep Diri terhadap Kemampuan Berpikir Kretif Mahasiswa

Formatif Jurnal Ilmiah Pendidikan MIPA ◽

10.30998/formatif.v3i3.129 ◽

2015 ◽

Vol 3 (3) ◽

Cited By ~ 1

Author(s):

Nurul Hikmah

Keyword(s):

Significant Interaction ◽

Creative Thinking ◽

Study Groups ◽

Learning Model ◽

Descriptive Statistics ◽

Self Concept ◽

Significant Interaction Effect ◽

Significant Difference ◽

Written Test ◽

Self Learning

The purpose of this study were to determine: 1) the influence of the learning model of creative thinking; 2) the influence of self-concept to think creatively, and 3) the influence of the interaction and the concept of self-learning model for creative thinking. The research method used was experimental method. A sample of 80 people selected at random from the 13 study groups. The data was collected by administering a written test questions to measure variables studied. Data analysis using descriptive statistics and 2-way ANOVA. The results showed: 1) a significant difference to the learning model with the ability to think creatively sig = 0.000; 2) there is a significant effect of self-concept of the ability to think creatively with sig = 0.000, and 3) there is a significant interaction effect of learning model and self-concept of the ability to think creatively with sig = 0.018.

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The Significance of Renal Function in Response to Cardiac Resynchronisation Therapy – The Piece of a Much Larger Puzzle

Current Vascular Pharmacology ◽

10.2174/1570161118666200414103432 ◽

2020 ◽

Vol 18 ◽

Author(s):

Agnieszka Dębska-Kozłowska ◽

Izabela Warchoł ◽

Marcin Książczyk ◽

Andrzej Lubiński

Keyword(s):

Renal Function ◽

Nyha Class ◽

Heart Association ◽

Cardiac Resynchronisation Therapy ◽

Study Groups ◽

Creatinine Concentration ◽

Significant Difference ◽

Cardiac Resynchronisation ◽

Resynchronisation Therapy

Background: Although cardiac resynchronisation therapy (CRT) is an important player in the treatment of heart failure (HF) patients, the proportion of CRT patients with no improvement in either echocardiographic or clinical parameters remains consistently high and accounts for about 30% despite meeting CRT implantation criteria. Furthermore, in patients suffering from HF, renal dysfunction accounts for as many as 30-60%. Accordingly, CRT may improve renal function inducing a systemic haemodynamic benefit leading to increased renal blood flow. Objectives: The aim of the present study was to evaluate the importance of renal function in response to resynchronisation therapy during a 12-month follow-up period. Materials and methods: The study consisted of 46 HF patients qualified for implantation of cardiac resynchronisation therapy defibrillator (CRT-D). A CRT responder is defined as a person without chronic HF exacerbations during observation whose physical efficiency has improved owing to New York Heart Association (NYHA) class improvement ≥1. Results: A statistically significant difference was noted between responders and non-responders regarding creatinine level at the 3rd month (p=0.04) and, particularly, at the 12th month (p=0.02) of follow-up (100±23 vs 139±78 μmol/l). Moreover, there was a remarkable difference between both study groups with regard to GFR CKD-EPI (glomerular filtration rate (GFR) assessed using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula) at the 6th (p=0.03) and 12th month (p=0.01) of follow-up. The reference values for initial creatinine concentrations (101 μmol/l) as well as GFR CKD-EPI (63 ml/min/1.73m2 ) were empirically evaluated to predict favourable therapeutic CRT response. Conclusions: Predictive value of GFR CKD-EPI and creatinine concentration for a positive response to CRT were found relevant.

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Success Rate of Obturation of Root Canals by Different Techniques in Primary Molars: A Comparative Clinical Study

Current Dentistry ◽

10.2174/2542579x02999200503032916 ◽

2020 ◽

Vol 2 (1) ◽

pp. 36-44

Author(s):

Satyawan G. Damle ◽

Ritika Bansal ◽

Dhanashree D. Sakhare

Keyword(s):

Success Rate ◽

Study Groups ◽

Primary Molars ◽

Control Group ◽

Second Primary ◽

Chi Square ◽

Exact Test ◽

Root Canals ◽

Significant Difference ◽

Comparative Clinical Study

Objective: To compare the success rate of different obturation procedures in primary mandibular second molars clinically and also by digital radiovisiography. Methods: A total of 40 children aged between 4-8 years with deeply carious mandibular second primary molars indicated for single session pulpectomy were selected. Canals were obturated with Metapex. The 3 study groups (Endodontic plugger, Handheld lentulospiral, Navi Tip syringe) were compared with the control group (reamer) both clinically and radiovisiographically. The data collected were statistically analyzed using Pearson’s Chi-square and Fisher’s exact test. Results: The use of Navi tip syringe led to the least number of voids followed by Endodontic plugger and Reamer and the highest number of voids was reported with Lentulospiral. Navitip presented maximum number of optimally filled cases followed by Endodontic plugger and Lentulospiral and least number of optimally filled cases with reamer. However, there was no statistically significant difference (p>0.05) in any of the groups with clinical (pain and tenderness to percussion) and radiographic parameters (presence or absence of voids and length of obturation). Conclusion: Within the limitations of the present study, though the clinical outcome was statistically insignificant, Navitip syringe exhibited encouraging results and is a promising option for obturation in primary teeth.

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Comparison of leucocyte profiles between healthy children and those with asymptomatic and symptomatic Plasmodium falciparum infections

Malaria Journal ◽

10.1186/s12936-020-03435-x ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Diana Ahu Prah ◽

Linda Eva Amoah ◽

Matthew P. Gibbins ◽

Yaw Bediako ◽

Aubrey J. Cunnington ◽

...

Keyword(s):

T Cells ◽

Plasmodium Falciparum ◽

Peripheral Blood ◽

Parasite Load ◽

Study Groups ◽

Healthy Children ◽

Peripheral Cell ◽

Peripheral Blood Leucocyte ◽

Cell Counts ◽

Significant Difference

Abstract Background The immune mechanisms that determine whether a Plasmodium falciparum infection would be symptomatic or asymptomatic are not fully understood. Several studies have been carried out to characterize the associations between disease outcomes and leucocyte numbers. However, the majority of these studies have been conducted in adults with acute uncomplicated malaria, despite children being the most vulnerable group. Methods Peripheral blood leucocyte subpopulations were characterized in children with acute uncomplicated (symptomatic; n = 25) or asymptomatic (n = 67) P. falciparum malaria, as well as malaria-free (uninfected) children (n = 16) from Obom, a sub-district of Accra, Ghana. Leucocyte subpopulations were enumerated by flow cytometry and correlated with two measures of parasite load: (a) plasma levels of P. falciparum histidine-rich protein 2 (PfHRP2) as a proxy for parasite biomass and (b) peripheral blood parasite densities determined by microscopy. Results In children with symptomatic P. falciparum infections, the proportions and absolute cell counts of total (CD3 +) T cells, CD4 + T cells, CD8 + T cells, CD19 + B cells and CD11c + dendritic cells (DCs) were significantly lower as compared to asymptomatic P. falciparum-infected and uninfected children. Notably, CD15 + neutrophil proportions and cell counts were significantly increased in symptomatic children. There was no significant difference in the proportions and absolute counts of CD14 + monocytes amongst the three study groups. As expected, measures of parasite load were significantly higher in symptomatic cases. Remarkably, PfHRP2 levels and parasite densities negatively correlated with both the proportions and absolute numbers of peripheral leucocyte subsets: CD3 + T, CD4 + T, CD8 + T, CD19 + B, CD56 + NK, γδ + T and CD11c + cells. In contrast, both PfHRP2 levels and parasite densities positively correlated with the proportions and absolute numbers of CD15 + cells. Conclusions Symptomatic P. falciparum infection is correlated with an increase in the levels of peripheral blood neutrophils, indicating a role for this cell type in disease pathogenesis. Parasite load is a key determinant of peripheral cell numbers during malaria infections.

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Comparative Study of Intralesional Dexamethasone Plus Hyaluronidase & Oral Colchicine in Patients with Oral Submucous Fibrosis

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v14i2.21542 ◽

2018 ◽

Vol 14 (2) ◽

pp. 60-65

Author(s):

Ganesh Prasad Neupane ◽

Maya Rai ◽

R. S. Rathore ◽

V. K. Bhargava ◽

A. K. Mahat ◽

...

Keyword(s):

Treatment Outcomes ◽

Oral Mucosa ◽

Oral Submucous Fibrosis ◽

Mouth Opening ◽

Study Groups ◽

T Test ◽

Significant Difference ◽

Intralesional Injections ◽

Submucous Fibrosis ◽

Larger Sample

Introduction: Oral Submucous Fibrosis (OSMF) is a precancerous condition of the oral mucosa. It is characterized by excessive production of collagen leading to inelasticity of the oral mucosa and atrophic changes of the epithelium.Aim and objective: To evaluate the efficacy of oral Colchicine in comparison to intralesional injections of Dexamethasone plus Hyaluronidase in the management of OSMF patients.Materials and Methods: Fourty patients with OSMF were randomly divided equally into two groups. 20 patients in Dexamethasone group received biweekly intralesional injections of Dexamethasone (4mg/ml) plus Hyaluronidase 1500 IU in buccal mucosa for a period of 12 weeks. Other 20 patients in Colchicine group received oral Colchicine 0.5 mg tablets twice daily for 12 weeks. Parameters taken in the study were burning sensation, and mouth opening. Descriptive statistics, paired t test and unpaired t test were used for statistical analysis.Results and Conclusions: The pre- and post-treatment differences were found to be statistically significant for both the groups (p<0.001) and for both the treatment outcomes. When the average difference of the treatment outcomes was compared between the two study groups, statistically highly significant difference was noted (p <0.001) only in mouth opening but not in burning sensation.These encouraging results should prompt further clinical trials with Colchicine on a larger sample size to broaden the therapeutic usefulness of the drug in the management of OSMF. JNGMC, Vol. 14 No. 2 December 2016, Page: 60-65

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The Role of Obesity in Predicting the Clinical Outcomes of COVID-19

Obesity Facts ◽

10.1159/000517180 ◽

2021 ◽

pp. 1-9

Author(s):

Serdar Sahin ◽

Havva Sezer ◽

Ebru Cicek ◽

Yeliz Yagız Ozogul ◽

Murat Yildirim ◽

...

Keyword(s):

Clinical Outcomes ◽

Health Care Providers ◽

Study Groups ◽

Normal Weight ◽

Overweight And Obesity ◽

Care Providers ◽

Significant Difference ◽

Group A ◽

Group B ◽

Group D

Introduction: The aim of this was to describe the predictors of mortality related to COVID-19 infection and to evaluate the association between overweight, obesity, and clinical outcomes of COVID-19. Methods: We included the patients >18 years of age, with at least one positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction. Patients were grouped according to body mass index values as normal weight <25 kg/m2 (Group A), overweight from 25 to <30 kg/m2 (Group B), Class I obesity 30 to <35 kg/m2 (Group C), and ≥35 kg/m2 (Group D). Mortality, clinical outcomes, laboratory parameters, and comorbidities were compared among 4 groups. Results: There was no significant difference among study groups in terms of mortality. Noninvasive mechanical ventilation requirement was higher in group B and D than group A, while it was higher in Group D than Group C (Group B vs. Group A [p = 0.017], Group D vs. Group A [p = 0.001], and Group D vs. Group C [p = 0.016]). Lung involvement was less common in Group A, and presence of hypoxia was more common in Group D (Group B vs. Group A [p = 0.025], Group D vs. Group A [p < 0.001], Group D vs. Group B [p = 0.006], and Group D vs. Group C [p = 0.014]). The hospitalization rate was lower in Group A than in the other groups; in addition, patients in Group D have the highest rate of hospitalization (Group B vs. Group A [p < 0.001], Group C vs. Group A [p < 0.001], Group D vs. Group A [p < 0.001], Group D vs. Group B [p < 0.001], and Group D vs. Group C [p = 0.010]). Conclusion: COVID-19 patients with overweight and obesity presented with more severe clinical findings. Health-care providers should take into account that people living with overweight and obesity are at higher risk for COVID-19 and its complications.

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