scholarly journals A Minimally Disruptive Surgical Technique for the Treatment of Osteitis Pubis in Athletes

2010 ◽  
Vol 2 (3) ◽  
pp. 211-215 ◽  
Author(s):  
Keith S. Hechtman ◽  
John E. Zvijac ◽  
Charles A. Popkin ◽  
Gregory A. Zych ◽  
Angie Botto-van Bemden
Keyword(s):  
Surgical Technique ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Wedge Resection ◽  
Case Series ◽  
Synthetic Mesh ◽  
Osteitis Pubis ◽  
Competitive Athletes ◽  
Return To Competition ◽  
Pelvic Instability

Background: Multiple surgical procedures exist for the treatment of osteitis pubis: curettage of the symphysis joint, wedge resection, complete resection of the joint, placement of extraperitoneal retropubic synthetic mesh, and arthrodesis of the joint. However, a paucity of literature has reported long-term successful outcomes with the aforementioned approaches. Patients treated operatively have reported recalcitrant pain resulting from iatrogenic instability. The article presents the results of a conservative operative technique that avoids disruption of adjacent ligaments. Hypothesis: Preserving the adjacent ligamentous structures will allow competitive athletes to return to competition and activities of daily living free of iatrogenic pelvic instability and pain. Study Design: Case series. Methods: Four competitive athletes (2 professional and 2 collegiate football players) diagnosed with osteitis pubis were treated conservatively for a minimum of 6 months. Patients underwent surgical intervention upon failure to respond to nonoperative management. The degenerative tissue was resected, allowing only bleeding cancellous bone to remain while preserving the adjacent ligaments. An arthroscope was used to assist in curettage, allowing the debridement to be performed through a small incision in the anterior capsule. Results: The symptoms of all 4 patients resolved, and they returned to competitive athletics. This ligament-sparing technique provided a solid, stable repair and pain relief. Conclusion: This surgical technique preserves the adjacent ligamentous structures and allows competitive athletes to return to competition and activities of daily living free of pain and void of pelvic instability. Clinical Relevance: This technique is a surgical treatment option for athletes with osteitis pubis who fail conservative treatment.

scholarly journals Absence of dementia in late-onset schizophrenia: a one year follow-up of a Brazilian case series

2006 ◽  
Vol 64 (4) ◽  
pp. 946-949 ◽  
Author(s):  
Jerson Laks ◽  
Leonardo F. Fontenelle ◽  
Adriana Chalita ◽  
Mauro V. Mendlowicz
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Negative Symptoms ◽  
Late Onset ◽  
Case Series ◽  
Developed Countries ◽  
End Point ◽  
One Year ◽  
State Examination

BACKGROUND: Cognitive deficits of late-onset schizophrenia (LOS) patients have been reported as stable, although some prospective studies show that a sub-group develop a significant cognitive decline. Data on LOS from developing countries are scarce. OBJECTIVE: To evaluate the cognitive performance of Brazilian patients with LOS over the course of one year. METHOD: Thirteen LOS patients were evaluated at baseline and after one year with the Mini-Mental State Examination (MMSE), the CAMCOG, the Positive and Negative Symptoms Scale, the Pfeffer’s Activities of Daily Living (ADL), and the Neuropsychiatric Inventory (NPI). RESULTS: Cognition and activities of daily living remained stable over the course of one year [baseline MMSE= 21.31 (4.87) and CAMCOG=80.31 (16.68); end-point MMSE=20.77 (3.86) and CAMCOG=82.92 (14.42) (Z=-0.831; p=0.40); baseline ADL=4.31 (5.65); end-point ADL= 5.92 (3.86) (Z=-0.831; p=0.40)]; end-point NPI=10.54 (10.69) (Z=-0.737; p=0.46]. CONCLUSION: Like patients from developed countries, Brazilian patients with LOS do not seem develop dementia, at least over the course of one year.

scholarly journals Development and Evaluation of a Prosthetic Ankle Emulator with an Artificial Soleus and Gastrocnemius

2021 ◽  
Author(s):  
David M Ziemnicki ◽  
Joshua M. Caputo ◽  
Kirsty A. McDonald ◽  
Karl E. Zelik
Keyword(s):  
Activities Of Daily Living ◽  
Soleus Muscle ◽  
Muscle Function ◽  
Knee Flexion ◽  
Daily Living ◽  
Case Series ◽  
Calf Muscle ◽  
Wide Range ◽  
Transtibial Prosthesis ◽  
Force Tracking

Abstract In individuals with transtibial limb loss, a contributing factor to mobility-related challenges is the disruption of biological calf muscle function due to transection of the soleus and gastrocnemius. Powered prosthetic ankles can restore primary function of the mono-articular soleus muscle, which contributes to ankle plantarflexion. In effect, a powered ankle acts like an artificial soleus. However, the biarticular gastrocnemius connection that simultaneously contributes to ankle plantarflexion and knee flexion torques remains missing, and there are currently no commercially-available prosthetic ankles that incorporate an artificial gastrocnemius. The goal of this work is to describe the design of a novel emulator capable of independently controlling artificial soleus and gastrocnemius behaviors for transtibial prosthesis users during walking. To evaluate the emulator's efficacy in controlling the artificial gastrocnemius behaviors, a case series walking study was conducted with 4 transtibial prosthesis users. Data from this case series showed that the emulator exhibits low resistances to the user's leg swing, low hysteresis during passive spring emulation, and accurate force tracking for a range of artificial soleus and gastrocnemius behaviors. The emulator presented in this paper is versatile and can facilitate experiments studying the effects of various artificial soleus and gastrocnemius dynamics on gait or other movement tasks. Using this system, it is possible to address existing knowledge gaps and explore a wide range of artificial soleus and gastrocnemius behaviors during gait and potentially other activities of daily living.

scholarly journals Boxing Training for Patients With Parkinson Disease: A Case Series

2011 ◽  
Vol 91 (1) ◽  
pp. 132-142 ◽  
Author(s):  
Stephanie A. Combs ◽  
M. Dyer Diehl ◽  
William H. Staples ◽  
Lindsay Conn ◽  
Kendra Davis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Activities Of Daily Living ◽  
Parkinson Disease ◽  
Training Program ◽  
Outcome Measures ◽  
Daily Living ◽  
Case Series ◽  
Short Term

Background and PurposeA nontraditional form of exercise recently applied for patients with Parkinson disease (PD) is boxing training. The primary purpose of this case series is to describe the effects of disease severity and duration of boxing training (short term and long term) on changes in balance, mobility, and quality of life for patients with mild or moderate to severe PD. The feasibility and safety of the boxing training program also were assessed.Case DescriptionsSix patients with idiopathic PD attended 24 to 36 boxing training sessions for 12 weeks, with the option of continuing the training for an additional 24 weeks (a seventh patient attended sessions for only 4 weeks). The 90-minute sessions included boxing drills and traditional stretching, strengthening, and endurance exercises. Outcomes were tested at the baseline and after 12, 24, and 36 weeks of boxing sessions (12-, 24-, and 36-week tests). The outcome measures were the Functional Reach Test, Berg Balance Scale, Activities-specific Balance Confidence Scale, Timed “Up & Go” Test, Six-Minute Walk Test, gait speed, cadence, stride length, step width, activities of daily living and motor examination subscales of the Unified Parkinson Disease Rating Scale, and Parkinson Disease Quality of Life Scale.OutcomesSix patients completed all phases of the case series, showed improvements on at least 5 of the 12 outcome measures over the baseline at the 12-week test, and showed continued improvements at the 24- and 36-week tests. Patients with mild PD typically showed improvements earlier than those with moderate to severe PD.DiscussionDespite the progressive nature of PD, the patients in this case series showed short-term and long-term improvements in balance, gait, activities of daily living, and quality of life after the boxing training program. A longer duration of training was necessary for patients with moderate to severe PD to show maximal training outcomes. The boxing training program was feasible and safe for these patients with PD.

Preliminary Experience With Polyvinyl Alcohol Hydrogel Implant for Pathology of the Second Metatarsal Head

2019 ◽  
Vol 40 (11) ◽  
pp. 1304-1308 ◽  
Author(s):  
Mark Glazebrook ◽  
Joel Morash ◽  
Meshal Alhadhoud ◽  
Timothy R. Daniels
Keyword(s):  
Surgical Technique ◽  
Polyvinyl Alcohol ◽  
Activities Of Daily Living ◽  
Range Of Motion ◽  
Daily Living ◽  
Short Form ◽  
Metatarsal Head ◽  
Sf 36 ◽  
Second Metatarsal

Background: There is no consensus regarding which surgical technique is most beneficial for pathology of the second metatarsophalangeal joint. We report the use of polyvinyl alcohol hydrogel synthetic cartilage implant hemiarthroplasty for pathology of the second metatarsal head that has failed nonoperative treatment and present 5 cases with a minimum 15 months of follow-up. Methods: The technique for synthetic cartilage hemiarthroplasty of the second metatarsal head is described. The postoperative protocol included weightbearing as tolerated for 2 weeks and moderate limitations in activities of daily living to respect wound healing, followed by physiotherapy for range of motion exercises. Charts for patients who underwent this procedure between 2015 and 2017 were retrospectively reviewed. Outcome measures collected postoperatively included a pain visual analog scale, Short-Form 36 (SF-36) Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, and Foot and Ankle Ability Measure (FAAM) Sports and Activities of Daily Living (ADL) current level of function percentages. Results: At 15 to 38 months of follow-up, patients reported little to no pain and good range of motion, with no complications. Mean outcome measure scores were 89 for FAAM ADL, 75 for FAAM Sports, 44.4 for SF-36 PCS, and 52.1 for SF-36 MCS. Conclusion: This preliminary study of synthetic cartilage hemiarthroplasty for treatment of joint-destructive conditions of the second metatarsal head demonstrated good outcomes and no complications in 5 cases at a mean 25 months of follow-up. Large prospective cohort studies are needed to prove the efficacy and safety of this new surgical technique for the treatment of pathology of the second metatarsal head. Level of Evidence: Level IV, retrospective case series.

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