Motor determinants of gait in 100 ambulatory patients with multiple sclerosis

2005 ◽  
Vol 11 (4) ◽  
pp. 485-491 ◽  
Author(s):  
P Thoumie ◽  
D Lamotte ◽  
S Cantalloube ◽  
M Faucher ◽  
G Amarenco
Keyword(s):  
Sensory Loss ◽  
Gait Velocity ◽  
Control Group ◽  
Strongly Correlated ◽  
Clinical Form ◽  
A Value ◽  
Individual Assessment ◽  
Gait Parameters ◽  
The Individual ◽  
Disability Level

A prospective analysis of gait and strength parameters was performed in 100 patients diagnosed with MS and pyramidal involvement admitted in a rehabilitation unit. The patients were divided into two groups based on their ability to walk in daily life (nonassisted or cane-assisted gait) and into four clinical subgroups depending on associated involvements such as sensory loss or cerebellar ataxia. Twenty healthy subjects were studied as a control group. Gait parameters were evaluated with a Locometre and muscle strength with an isokinetic dynamometer. The results showed that the average velocity and strength of the hamstring and quadriceps were strongly correlated and reduced in the MS group in comparison with the control, and in the cane-assisted group compared with the nonassisted group. Gait velocity tended to be more correlated to hamstring strength in the nonassisted group with a determination coefficient (r2) reaching a value of 0.44 in the sensory subgroup. These findings provide evidence that a correlation between strength reduction and gait impairment is obvious whatever the clinical form in patients with MS. This correlation is higher with hamstrings but may change depending on the disability level and the clinical form. This could be taken into account in the individual assessment of further rehabilitation programmes.

scholarly journals Assessment of Gait after Treatment of Tibial Nonunion with the Ilizarov Method

2021 ◽  
Vol 18 (8) ◽  
pp. 4217
Author(s):  
Łukasz Pawik ◽  
Felicja Fink-Lwow ◽  
Andżelika Pajchert Kozłowska ◽  
Łukasz Szelerski ◽  
Sławomir Żarek ◽  
...  
Keyword(s):  
Research Question ◽  
Social Dimension ◽  
Gait Velocity ◽  
Control Group ◽  
Ilizarov Method ◽  
Healthy Individuals ◽  
Time Step ◽  
Abnormal Gait ◽  
Gait Parameters ◽  
Tibial Nonunion

Background: Tibial nonunion is a common bone union disorder leading to abnormal gait, and thus reducing quality of life in the social dimension. Research question: The aim of our work was to comprehensively assess gait parameters of patients who had undergone Ilizarov treatment for tibial nonunion compared to a control group of healthy individuals. Methods: This study evaluated patients treated for aseptic tibial nonunion with the Ilizarov method. 24 patients with a mean age of 55.0 years were included in the study. The control group consisted of 32 healthy volunteers with no significant medical history who were selected to match the gender and age of patients in the study group so that the groups were homogeneous. A Zebris Medical GmbH pedobarographic platform was used to assess the gait parameters. Results: For all gait parameters examined, force forefoot max, force backfoot max, step length, stance phase, swing phase and step time, we observed statistically significant differences between the group that had undergone treatment and the control group. In the group of patients, statistically significant differences between the operated lower limb and the non-operated limb were only observed for the force forefoot max and step time parameters (p = 0.029 and p = 0.045, respectively). Patients presented a longer loading of the operated limb (0.720 s) than the non-operated limb (0.635 s). For the stride time, step cadence and gait velocity parameters, healthy subjects achieved much better results during locomotion, and these differences were statistically significant at p < 0.001. Significance: Treatment of tibial nonunion with the Ilizarov method did not restore normal gait parameters in our group of patients. In fact, the gait parameters of patients were significantly worse than the healthy individuals in the control group. Furthermore, gait parameters following treatment were not symmetrical, and the dynamics of the musculoskeletal system remained impaired.

The Students Value Attitude to Healthy Lifestyle

2019 ◽  
Vol 9 (4) ◽  
pp. 66-70
Author(s):  
Marina Anatolevna Mefodeva ◽  
Gulnara Firdusovna Valieva
Keyword(s):  
Healthy Lifestyle ◽  
Educational Institutions ◽  
A Value ◽  
The Individual

Abstract The relevance of the investigated problem is caused by the increased attention to the issues of a healthy lifestyle among students in Russia. Promotion of a healthy lifestyle, taking into account the individual interests and preferences of students can be embodied not only in the class but also in the framework of elective programs and courses, that are targeted on a healthy lifestyle. The authors reveal approaches, principles and pedagogical conditions for having a healthy lifestyle in the framework of training in educational institutions. The issues of bad habits influence the development and formation of a value attitude to a healthy lifestyle are considered.

PENGELUARAN KOLOSTRUM DENGAN PEMBERIAN PERAWATAN PAYUDARA DAN ENDORPHIN MASSAGE PADA IBU POST SEKSIO SESAREA

2019 ◽  
Vol 2 (1) ◽  
pp. 34-40
Author(s):  
Diah Evawanna Anuhgera ◽  
Eka Fitria Panjaitan ◽  
Desika Wali Pardede ◽  
Desika Wali Pardede ◽  
Nikmah Jalilah Ritonga ◽  
...  
Keyword(s):  
Experimental Study ◽  
Cesarean Section ◽  
Alternative Therapy ◽  
Control Group ◽  
Control Group Design ◽  
Group Design ◽  
A Value ◽  
Quasi Experimental ◽  
Breast Care ◽  
June July

Spending colostrum in post-cesarean section mothers is difficult in the first week postpartum. Efforts to overcome colostrum disruption can use non-pharmacological methods, namely breast care and endorphin massage. This study aims to determine the expenditure of colostrum by giving breast care and endorphin massage to post-cesarean mothers. This research is a quasi-experimental study with a nonequivalent design posttest control group design. This research was carried out in the midwifery room of the second floor of Grand Medistra Lubuk Pakam Hospital during the June-July 2019 period. There were 48 participants selected using purposive sampling, with 18 assigned in breast care, endorphin massage and combination of breast care and endorphin massage. The time of spending colostrum expenditure is assessed every day while the amount of colostrum expenditure is assessed after intervening. Analysis of the data used is one-way Annova. The results showed that the combination of breast care and endorphin massage was the most effective action in the time of spending colostrum and the amount of colostrum with a value of p = 0,000. The combination of breast care and endorphin massage could be applied as an alternative therapy post-cesarean mothers    

scholarly journals Efficacy of axial TheraTogs on gait pattern in children with dyskinetic cerebral palsy: a randomized controlled trial

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Shamekh Mohamed El-Shamy ◽  
Ehab Mohamed Abd El Kafy
Keyword(s):  
Cerebral Palsy ◽  
Physical Therapy ◽  
Muscle Tone ◽  
Controlled Trial ◽  
Gait Pattern ◽  
Controlled Study ◽  
Control Group ◽  
Randomized Controlled ◽  
Gait Parameters ◽  
Experimental Group

Abstract Background TheraTogs promotes proprioceptive sense of a child with cerebral palsy and improves abnormal muscle tone, posture alignment, balance, and gait. Therefore, the aim of this study was to investigate the efficacy of TheraTogs orthotic undergarment on gait pattern in children with dyskinetic cerebral palsy. Thirty children with dyskinetic cerebral palsy were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received TheraTogs orthotic undergarment (12 h/day, 3 days/week) plus traditional physical therapy for 3 successive months and (2) a control group that received only traditional physical therapy program for the same time period. Gait parameters were measured at baseline and after 3 months of intervention using Pro-Reflex motion analysis. Results Children in both groups showed significant improvements in the gait parameters (P < 0.05), with significantly greater improvements in the experimental group than in the control group. Conclusions The use of TheraTogs may have a positive effect to improve gait pattern in children with dyskinetic cerebral palsy. Trial registration This trial was registered in the ClinicalTrial.gov PRS (NCT03037697).

scholarly journals Primary dementia care based on the individual needs of the patient: study protocol of the cluster randomized controlled trial, DemStepCare

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Isabella Bablok ◽  
◽  
Harald Binder ◽  
Dominikus Stelzer ◽  
Klaus Kaier ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Dementia Care ◽  
Cluster Randomized Controlled Trial ◽  
Control Group ◽  
Care Model ◽  
Randomized Controlled ◽  
Individual Needs ◽  
Cluster Randomized ◽  
The Individual

Abstract Background Most people with dementia (PwD) are cared for at home, with general practitioners (GPs) playing a key part in the treatment. However, primary dementia care suffers from a number of shortcomings: Often, diagnoses are made too late and therapies by GPs do not follow the guidelines. In cases of acute crises, PwD are too often admitted to hospital with adverse effects on the further course of the disease. The aim of this study is to implement and evaluate a new GP-based, complex dementia care model, DemStepCare. DemStepCare aims to ensure demand-oriented, stepped care for PwD and their caregivers. Methods/design In a cluster randomized controlled trial, the care of PwD receiving a complex intervention, where the GP is supported by a multi-professional team, is compared to (slightly expanded) usual care. GPs are clustered by GP practice, with 120 GP practices participating in total. GP practices are randomized to an intervention or a control group. 800 PwD are to be included per group. Recruitment takes place in Rhineland-Palatinate, Germany. In addition, a second control group with at least 800 PwD will be formed using aggregated routine data from German health insurance companies. The intervention comprises the training of GPs, case management including repeated risk assessment of the patients’ care situation, the demand-oriented service of an outpatient clinic, an electronic case record, external medication analyses and a link to regional support services. The primary aims of the intervention are to positively influence the quality of life for PwD, to reduce the caregivers’ burden, and to reduce the days spent in hospital. Secondary endpoints address medication adequacy and GPs’ attitudes and sensitivity towards dementia, among others. Discussion The GP-based dementia care model DemStepCare is intended to combine a number of promising interventions to provide a complex, stepped intervention that follows the individual needs of PwD and their caregivers. Its effectiveness and feasibility will be assessed in a formative and a summative evaluation. Trial registration German Register of Clinical Trials (Deutsches Register Klinischer Studien, DRKS), DRKS00023560. Registered 13 November 2020 - Retrospectively registered. HTML&TRIAL_ID=DRKS00023560.

scholarly journals Human beta defensin levels and vaginal microbiome composition in post-menopausal women diagnosed with lichen sclerosus

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alexandra Brunner ◽  
Márta Medvecz ◽  
Nóra Makra ◽  
Miklós Sárdy ◽  
Kinga Komka ◽  
...  
Keyword(s):  
Lichen Sclerosus ◽  
Gardnerella Vaginalis ◽  
Control Group ◽  
Vaginal Microbiome ◽  
Microbiome Composition ◽  
Streptococcus Anginosus ◽  
Menopausal Women ◽  
Post Menopausal ◽  
The Individual ◽  
Level Production

AbstractHuman beta defensins (hBDs) may play an important role in the progression of lichen sclerosus (LS), due to their ability to induce excessive stimulation of extracellular matrix synthesis and fibroblast activation. The genetic ability of the individual to produce defensins, the presence of microbes influencing defensin production, and the sensitivity of microbes to defensins together regulate the formation of an ever-changing balance between defensin levels and microbiome composition. We investigated the potential differences in postmenopausal vaginal microbiome composition and vaginal hBD levels in LS patients compared to non-LS controls. LS patients exhibited significantly lower levels of hBD1 (p = 0.0003), and significantly higher levels of hBD2 (p = 0.0359) and hBD3 (p = 0.0002), compared to the control group. The microbiome of the LS patients was dominated by possibly harmful bacteria including Lactobacillus iners, Streptococcus anginosus or Gardnerella vaginalis known to initiate direct or indirect damage by increasing defensin level production. Our observations highlight that correcting the composition of the microbiome may be applicable in supplementary LS therapy by targeting the restoration of the beneficial flora that does not increase hBD2-3 production.

Aortic tortuosity index as a predictor of type A aortic dissection

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Scalbert ◽  
O Milleron ◽  
M Para ◽  
R Raffoul ◽  
Q Pellenc ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Ct Scans ◽  
Control Group ◽  
Type A Aortic Dissection ◽  
Total Length ◽  
A Value ◽  
Straight Line ◽  
Patients At Risk ◽  
Geometric Length

Abstract Introduction The risk ok type A aortic dissection (AAD) depends on the degree of aortic wall's alteration, which can result in dilatation or tortuosity. The estimate of this risk relies solely on the evaluation of the diameter of the ascending aorta. Purpose The purpose of this study is to evaluate the presence and importance of aortic tortuosity in patients with type A aortic dissection. Method Postoperative CT scans of patients with type A aortic dissection were compared with CT scans from controls matched for gender and age. After 3D reconstruction, total length (actual distance along aortic center line = Ltot) and geometric length (length of a straight line between start and end of the aortic segment = Lgeo) were measured to calculate the tortuosity index (TI = Ltot / Lgeo). Results Ltot, Lgeo and TI from different aortic segments of the AAD group were higher than in the control group. Ltot and TI of the whole aorta (from aortic valve to bifurcation) were greater in patients with type A aortic dissection (527.7±46.1 mm vs. 475.8±39.7, p&lt;0.0001; and 2.05±0.24 vs. 1.98±0.21, p=0.002 respectively). Total length and TI were greater after exclusion of the ascending part, and a value of this TI &gt;1.3 identifies AAD patients with an accuracy of 74.8% (AUC = 0.792, p&lt;0.0001). TI is altered by risk factors for aortic dissection: it increases with hypertension and age but not by tobacco use, and TI decreases in diabetes. Conclusions Type A aortic dissection is associated with longer aorta and increased aortic tortuosity. This index may help recognize patients at risk for type A aortic dissection. Calculation of tortuosity indexes Funding Acknowledgement Type of funding source: None

scholarly journals Robot-Assisted Gait Training in Patients with Multiple Sclerosis: A Randomized Controlled Crossover Trial

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 713
Author(s):  
Cristiano Sconza ◽  
Francesco Negrini ◽  
Berardo Di Matteo ◽  
Alberto Borboni ◽  
Gennaro Boccia ◽  
...  
Keyword(s):  
Crossover Trial ◽  
Gait Training ◽  
Treatment Session ◽  
Control Group ◽  
Walk Test ◽  
Robot Assisted ◽  
Randomized Controlled ◽  
Gait Parameters ◽  
Before And After

Background and Objectives: Gait disorders represent one of the most disabling aspects in multiple sclerosis (MS) that strongly influence patient quality of life. The improvement of walking ability is a primary goal for rehabilitation treatment. The aim of this study is to evaluate the effectiveness of robot-assisted gait training (RAGT) in association with physiotherapy treatment in patients affected by MS in comparison with ground conventional gait training. Study design: Randomized controlled crossover trial. Materials and Methods: Twenty-seven participants affected by MS with EDSS scores between 3.5 and 7 were enrolled, of whom seventeen completed the study. They received five training sessions per week over five weeks of conventional gait training with (experimental group) or without (control group) the inclusion of RAGT. The patients were prospectively evaluated before and after the first treatment session and, after the crossover phase, before and after the second treatment session. The evaluation was based on the 25-foot walk test (25FW, main outcome), 6 min walk test (6MWT), Tinetti Test, Modified Ashworth Scale, and modified Motricity Index for lower limbs. We also measured disability parameters using Functional Independence Measure and Quality of Life Index, and instrumental kinematic and gait parameters: knee extensor strength, double-time support, step length ratio; 17 patients reached the final evaluation. Results: Both groups significantly improved on gait parameters, motor abilities, and autonomy recovery in daily living activities with generally better results of RAGT over control treatment. In particular, the RAGT group improved more than control group in the 25FW (p = 0.004) and the 6MWT (p = 0.022). Conclusions: RAGT is a valid treatment option that in association with physiotherapy could induce positive effects in MS-correlated gait disorders. Our results showed greater effectiveness in recovering gait speed and resistance than conventional gait training.

Acquiring variable commands at home and abroad: Examining optatives and imperatives in L1 and L2 Spanish

2020 ◽  
Vol 13 (1) ◽  
pp. 79-113
Author(s):  
Farrah Neumann ◽  
Matthew Kanwit
Keyword(s):  
Second Language ◽  
Second Language Acquisition ◽  
Study Abroad ◽  
Language Teaching ◽  
Applied Linguistics ◽  
Future Research ◽  
Control Group ◽  
Before And After ◽  
The Individual ◽  
At Home

AbstractSince many linguistic structures are variable (i. e. conveyed by multiple forms), building a second-language grammar critically involves developing sociolinguistic competence (Canale and Swain. 1980. Theoretical bases of communicative approaches to second language teaching and testing. Applied Linguistics 1(1). 1–47), including knowledge of contexts in which to use one form over another (Bayley and Langman. 2004. Variation in the group and the individual: Evidence from second language acquisition. International Review of Applied Linguistics in Language Teaching 42(4). 303–318). Consequently, researchers interested in such competence have increasingly analyzed the study-abroad context to gauge learners’ ability to approximate local norms following a stay abroad, due to the quality and quantity of input to which learners may gain access (Lafford. 2006. The effects of study abroad vs. classroom contexts on Spanish SLA: Old assumptions, new insights and future research directions. In Carol Klee & Timothy Face (eds.), Selected proceedings of the 7th conference on the acquisition of Spanish and Portuguese as first and second languages, 1–25. Somerville, MA: Cascadilla Proceedings Project). Nevertheless, the present study is the first to examine native or learner variation between imperative (e. g. ven ‘come’) and optative Spanish commands (e. g. que vengas ‘come’). We first performed a corpus analysis to determine the linguistic factors to manipulate in a contextualized task, which elicited commands from learners before and after four weeks abroad in Alcalá de Henares, Spain. Their overall rates of selection and predictive factors were compared to local native speakers (NSs) and a control group of at-home learners.Results revealed that the abroad learners more closely approached NS rates of selection following the stay abroad. Nonetheless, for both learner groups conditioning by independent variables only partially approximated the NS system, which was more complex than previously suggested.

Feasibility and Preliminary Efficacy of Gait Training Assisted by Multichannel Functional Electrical Stimulation in Early Stroke Rehabilitation: A Pilot Randomized Controlled Trial

2021 ◽  
Vol 35 (2) ◽  
pp. 131-144
Author(s):  
Maijke van Bloemendaal ◽  
Sicco A. Bus ◽  
Frans Nollet ◽  
Alexander C. H. Geurts ◽  
Anita Beelen
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Step Length ◽  
Gait Training ◽  
Control Group ◽  
Significant Group ◽  
Gait Symmetry ◽  
Gait Parameters ◽  
Walking Capacity ◽  
Experimental Group

Background. Many stroke survivors suffer from leg muscle paresis, resulting in asymmetrical gait patterns, negatively affecting balance control and energy cost. Interventions targeting asymmetry early after stroke may enhance recovery of walking. Objective. To determine the feasibility and preliminary efficacy of up to 10 weeks of gait training assisted by multichannel functional electrical stimulation (MFES gait training) applied to the peroneal nerve and knee flexor or extensor muscle on the recovery of gait symmetry and walking capacity in patients starting in the subacute phase after stroke. Methods. Forty inpatient participants (≤31 days after stroke) were randomized to MFES gait training (experimental group) or conventional gait training (control group). Gait training was delivered in 30-minute sessions each workday. Feasibility was determined by adherence (≥75% sessions) and satisfaction with gait training (score ≥7 out of 10). Primary outcome for efficacy was step length symmetry. Secondary outcomes included other spatiotemporal gait parameters and walking capacity (Functional Gait Assessment and 10-Meter Walk Test). Linear mixed models estimated treatment effect postintervention and at 3-month follow-up. Results. Thirty-seven participants completed the study protocol (19 experimental group participants). Feasibility was confirmed by good adherence (90% of the participants) and participant satisfaction (median score 8). Both groups improved on all outcomes over time. No significant group differences in recovery were found for any outcome. Conclusions. MFES gait training is feasible early after stroke, but MFES efficacy for improving step length symmetry, other spatiotemporal gait parameters, or walking capacity could not be demonstrated. Trial Registration. Netherlands Trial Register (NTR4762).

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