scholarly journals Validation of the "Six Step Spot Test" for gait among patients with multiple sclerosis in Brazil

2010 ◽  
Vol 68 (2) ◽  
pp. 198-204 ◽  
Author(s):  
Karina Pavan ◽  
Charles Peter Tilbery ◽  
Sergio Lianza ◽  
Bruna Eriko Matsuda Marangoni

The clinical manifestations of multiple sclerosis (MS) are variable among patients, and the course of disease is not linear. Different symptoms are presented, with gradual accumulation of disability. These variations are difficult to quantify in clinical practice, and several studies have attempted to create instruments capable of measuring these disabilities. The Six Step Spot Test (SSST) was developed for quantitative evaluation of the lower limbs (LL) over time. Performance in this test reflects the complexity of sensory-motor function, including LL strength, spasticity, coordination and balance, going beyond vision and cognition. The aim of the present study was to validate the SSST in a population of MS patients in Brazil. This prospective study included 75 patients with MS, with EDSS 0 to 6.5 in the study group. Ninety-one healthy subjects were randomly selected for the control group. The results showed that the groups were similar, and that the SSST is a reliable and reproducible test. According to the statistical analysis on the data in this study, the SSST is a valid, reliable and reproducible tool for use in the Brazilian MS patient population.

Symmetry ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 349 ◽  
Author(s):  
Łukasz Pawik ◽  
Paweł Wietecki ◽  
Artur Leśkow ◽  
Andżelika Pajchert Kozłowska ◽  
Sławomir Żarek ◽  
...  

The aim of this study was to comprehensively assess the gait parameters in patients who had undergone treatment of pilon fractures by the Ilizarov method. We analyzed gait parameters in patients who had undergone treatment for pilon fractures by the Ilizarov method; 20 patients aged 47.0 years (25.2–78.6) were included in the study. The control group consisted of 32 healthy volunteers. Gait examination was performed using the pedobarographic platform. Statistically significant differences in the following gait parameters: maximum forefoot force (%), step length (cm), and step time (s) were found between the study group and the control group, between the nonoperated leg, and both the operated leg and the dominant limb. Statistically significant differences in the study group between the treated lower limb and the healthy lower limb were only observed in the case of the maximum forefoot force parameter (%). Healthy subjects from the control group obtained significantly higher values during locomotion for stride time, cadence step, and velocity than the patients, with stride time being statistically significantly shorter and the velocity and the cadence step higher. We observed symmetry in the gait parameters after treating pilon fractures by the Ilizarov method. This method of stabilization allows the restoration of gait parameters, with results similar to those obtained after the treatment of other motor organ pathologies described in the literature, although different from those observed in healthy subjects. In particular, the biomechanics of the lower limbs remain disturbed.


Author(s):  
Ross M. Neuman ◽  
Staci M. Shearin ◽  
Karen J. McCain ◽  
Nicholas P. Fey

Abstract Background Gait impairment is a common complication of multiple sclerosis (MS). Gait limitations such as limited hip flexion, foot drop, and knee hyperextension often require external devices like crutches, canes, and orthoses. The effects of mobility-assistive technologies (MATs) prescribed to people with MS are not well understood, and current devices do not cater to the specific needs of these individuals. To address this, a passive unilateral hip flexion-assisting orthosis (HFO) was developed that uses resistance bands spanning the hip joint to redirect energy in the gait cycle. The purpose of this study was to investigate the short-term effects of the HFO on gait mechanics and muscle activation for people with and without MS. We hypothesized that (1) hip flexion would increase in the limb wearing the device, and (2) that muscle activity would increase in hip extensors, and decrease in hip flexors and plantar flexors. Methods Five healthy subjects and five subjects with MS walked for minute-long sessions with the device using three different levels of band stiffness. We analyzed peak hip flexion and extension angles, lower limb joint work, and muscle activity in eight muscles on the lower limbs and trunk. Single-subjects analysis was used due to inter-subject variability. Results For subjects with MS, the HFO caused an increase in peak hip flexion angle and a decrease in peak hip extension angle, confirming our first hypothesis. Healthy subjects showed less pronounced kinematic changes when using the device. Power generated at the hip was increased in most subjects while using the HFO. The second hypothesis was not confirmed, as muscle activity showed inconsistent results, however several subjects demonstrated increased hip extensor and trunk muscle activity with the HFO. Conclusions This exploratory study showed that the HFO was well-tolerated by healthy subjects and subjects with MS, and that it promoted more normative kinematics at the hip for those with MS. Future studies with longer exposure to the HFO and personalized assistance parameters are needed to understand the efficacy of the HFO for mobility assistance and rehabilitation for people with MS.


2021 ◽  
Vol 13 (1S) ◽  
pp. 10-14
Author(s):  
L. B. Tlapshokova ◽  
A. R. Zikhova

Multiple sclerosis (MS) is a common autoimmune disease, which etiology includes a complex of genetic and environmental factors. Data suggests that their interaction can influence the age of the clinical manifestations and the course of the disease. Therefore, the study of risk factors of MS in regions with different ethnic compositions of the population and climatic and geographical characteristics is of considerable interest.Objective: to study MS risk factors prevalence in the Republic of Kabardino-Balkaria (RKB).Patients and methods. This case-control study of the representation of risk factors included a cohort of 112 MS patients living in two regions of the RKB (Nalchik and the Prokhladnensky district). The MS diagnosis was established with the McDonald criteria (2017). MS risk factors were assessed with a unified questionnaire. 112 respondents (matched by the main demographic characteristics and place of residence) were included in the control group.Results and discussion. MS patients from the Prokhladnensky district were significantly more likely to contact harmful chemical compounds, had higher consumption of smoked meat products; and suffered from viral infections more often (all differences were significant, p<0.05). More patients with MS, regardless of their place of residence, had a history of scarlet fever than the controls (n=23; 19.5% and n=14; 13.4%, ratio indicator 0.43 (95% CI 0.32–1.01), p=0.041), and the maximum significance of this factor was found in patients who suffered from scarlet fever after the age of 15 years (n=7; 6.3% and n=1; 0.9%, ratio indicator 2.45 (95% CI 1.92–3.21), p=0.041). More patients with MS had a history of chickenpox (n=70; 62.5% and n=55; 41.1%; ratio indicator 0.78 (95% CI 0.65–0.94, p=0.032), the frequency of this factor was most significant in early (up to 7 years) disease onset. Regardless of the place of residence, patients with MS were more likely to suffer from tonsillitis and sinusitis in childhood (p=0.032).Conclusion. In the RKB, as in other regions of the Russian Federation, the risk of MS, along with a genetic predisposition, is primarily determined by environmental factors, such as contact with potentially harmful chemicals, history of somatic diseases, characteristics of the ecological situation, etc. Therefore, MS risk is higher in people exposed to these factors before the age of 7 years and does not depend on the place of residence. 


Author(s):  
Bargale Sushant Sukumar ◽  
Tripathy T B ◽  
Shashirekha H K ◽  
Suhas Kumar Shetty

In Ayurveda, certain herbal formulas are considered to be Rasayana and they are typically taken over periods of time to regenerate both brain and body tissue. Ashwagandha (Withania Somnifera) is used as an adaptogen, antioxidant, immune modulator, free radical scavenger, anti stress, anti arthritic, antispasmodic, anti inflammatory, nervous tonic, nerve soothing and anticancer agent. Ashwagandha (WS) as a nutritional supplement is yet too established. Maximum oxygen uptake (VO2 max) is a gold standard of cardiopulmonary and muscle cell fitness is considered.  The study evaluated the efficacy of Ashwagandha to improve cardiorespiratory endurance (VO2 max) in healthy subjects. They randomized single blind controlled comparative clinical study. 54 health volunteers in each group, study group received Ashwagandha Choorna 12gm with milk (200ml) empty stomach in the morning and the control group only milk (200ml). Maximal capacity of oxygen intake in ml/kg/min (VO2 max) with Rockport fitness walking test of both study and control group were measured before intervention (0th day), after the intervention (60th day) and follow up (90th day). A significant improvement in the VO2 max (F=20.675, P <0.0001) and Hemoglobin (X2=74.150 P <0.0001) in the study group was found. Supplementation of Ashwagandha (Withania Somnifera) with milk improve hemoglobin and VO2 max (maximum aerobic capacity).


Sensors ◽  
2020 ◽  
Vol 20 (9) ◽  
pp. 2452
Author(s):  
Ana Cecilia Villa-Parra ◽  
Jessica Lima ◽  
Denis Delisle-Rodriguez ◽  
Laura Vargas-Valencia ◽  
Anselmo Frizera-Neto ◽  
...  

The goal of this study is the assessment of an assistive control approach applied to an active knee orthosis plus a walker for gait rehabilitation. The study evaluates post-stroke patients and healthy subjects (control group) in terms of kinematics, kinetics, and muscle activity. Muscle and gait information of interest were acquired from their lower limbs and trunk, and a comparison was conducted between patients and control group. Signals from plantar pressure, gait phase, and knee angle and torque were acquired during gait, which allowed us to verify that the stance control strategy proposed here was efficient at improving the patients’ gaits (comparing their results to the control group), without the necessity of imposing a fixed knee trajectory. An innovative evaluation of trunk muscles related to the maintenance of dynamic postural equilibrium during gait assisted by our active knee orthosis plus walker was also conducted through inertial sensors. An increase in gait cycle (stance phase) was also observed when comparing the results of this study to our previous work. Regarding the kinematics, the maximum knee torque was lower for patients when compared to the control group, which implies that our orthosis did not demand from the patients a knee torque greater than that for healthy subjects. Through surface electromyography (sEMG) analysis, a significant reduction in trunk muscle activation and fatigability, before and during the use of our orthosis by patients, was also observed. This suggest that our orthosis, together with the assistive control approach proposed here, is promising and could be considered to complement post-stroke patient gait rehabilitation.


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Monika Chorąży ◽  
Natalia Wawrusiewicz-Kurylonek ◽  
Edyta Adamska-Patruno ◽  
Olga Zajkowska ◽  
Katarzyna Kapica-Topczewska ◽  
...  

Purpose. Multiple sclerosis (MS) is an autoimmune disease, and genetic factors play an important role in its pathogenesis and progression. The aim of our study was to evaluate the frequencies of alleles and genetic variants of the T-cell homeostasis-related genes, in subjects with MS, as well as to investigate the association with MS clinical manifestations and disability. Methods. 94 subjects with MS and 160 healthy individuals have been genotyped for seven common single-nucleotide variants in IL-2RA, CTLA4, CD40, and PADI4 genes. The ages of onset, duration of the disease, and clinical condition of the MS subjects were analysed. We used the Chi2 test confirmed with Fisher’s exact test for statistical analysis. Results. The frequency of allele T and CT/TT genotypes (rs7093069) in the IL2RA gene, as well as the T allele and CT/TT genotypes in rs12722598, were significantly higher in the control group. The significant differences between studied groups we also found for the G allele and GG/GA genotypes of rs3087243 in CTLA4 gene, which were more common among the control group. The heterozygous genotype TC (rs1883832) of CD40 gene was more common in the control subjects, and the frequency of the alleles and genotypes in the rs1748033 of the PADI4 gene did not differ between the studied groups. Between the studied genotypes, we did not observe any significant differences in the age of onset and duration of disease, including sex stratification. Conclusion. Our results highlight the protective role of some of the T-cell homeostasis-related genetic variants in MS development, but not in its clinical manifestation.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Xuefeng Cao ◽  
Xixiu Wang ◽  
Xiaoliang Xu ◽  
Yanmin Lu ◽  
Baolei Zhao ◽  
...  

Background. Periampullary tumors (PT) may rarely present as acute pancreatitis (AP) or acute recurrent pancreatitis (ARP). Unlike other cases of AP and ARP, these conditions necessitate pancreaticoduodenectomy (PD), and timely diagnosis is crucial. Materials and Methods. A retrospective review of clinical, radiological, surgical, and pathological data was conducted for patients admitted to the Binzhou Medical University Hospital during the period from January 2010 to December 2017, for AP or ARP caused by PT. All patients included in the study group had undergone PD. The perioperative data for these patients was compared with data for patients with PT but without AP or ARP who underwent PD during the same period (control group). Results. During the study period, 412 patients with AP or ARP were treated; among this group, 15 patients had PT. Compared with controls, patients in the study group were younger in age and had a longer course of disease, more frequent hospitalizations, and more severe derangements in laboratory data (P<0.05). Operative time and intraoperative blood loss were significantly higher in the study group, but the incidence of postoperative outcomes such as pancreatic/biliary fistula, abdominal infection, postoperative hospital stay, and mortality were similar between groups (P>0.05). Conclusions. Neither AP nor ARP has any adverse impact on the outcomes of PD. However, in the treatment of younger patients suffering from AP or ARP, unexplained pancreatic duct dilation and weight loss should raise the suspicion of PT. EUS and EUS-FNA may be helpful in making the diagnosis.


2016 ◽  
Vol 19 (5) ◽  
pp. 296-300
Author(s):  
Evgeniya P. Opruzhenkova ◽  
O. A Sidorenko ◽  
L. A Anisimova ◽  
V. V Starostenko

The results of comparative analysis of the hormonal status from 75 women aged from 49 to 60 years old (average age 54.04 ± 1.28 year) in postmenopause with psoriasis type 2 (study group) and 50 women of control group of the same age and menstrual status without psoriasis are presented. There were two subgroups in the main group: subgroup 1 received basic therapy in combination with menopausal hormone therapy (MHT) (estradiol 1 mg + drospirenone 2 mg), subgroup 2 - basic therapy. Psoriatic process was assessed according to PASI index and was evaluated by the dermatology quality of the life index (DIQL) and the content of gonadotropic and sex hormones before treatment and after 3 and 6 months of starting treatment in patients of both subgroups. More pronounced clinical efficacy in combination with reduced FSH level is 13.2% (p < 0.001), increased content of estradiol 69.3% (p < 0.001) was observed in patients from 1 subgroup. MHT supplement to the basic treatment decreased the PASI index after 3 months of starting treatment for 50.9% (p fter 6 months - at 94% (p < 0.001), and reduced DIQL in subgroup 1 compared to 2 subgroup after 3 months - 15.3% (p < 0.05) and after 6 months - 20.8% (p < 0.05). In postmenopausal women with psoriasis favorable changes of indexes reflecting the clinical manifestations of the disease were associated with the correction of hormonal status in MHT estradiol 1 mg + drospirenone 2 mg.


2015 ◽  
Vol 130 (2) ◽  
pp. 162-165 ◽  
Author(s):  
O Kemal ◽  
T Müderris ◽  
F Başar ◽  
G Kutlar ◽  
F Gül

AbstractObjective:This study aimed to determine whether there was any relationship between tinnitus and mean platelet volume.Methods:This retrospective study was conducted between January 2013 and January 2014 in Ankara Atatürk Hospital and Ondokuz Mayıs University Hospital, Turkey, on a study group of 86 patients with tinnitus and a control group of 84 healthy subjects. Mean platelet volume was recorded and comparisons were made between the two groups.Results:Mean (± standard deviation) platelet volume was 7.67 ± 0.83 μm3 in the study group and 7.28 ± 0.56 μm3 in the control group. There was a statistically significant difference in mean platelet volume between the tinnitus patients and the healthy subjects (p < 0.05).Conclusion:The clinical findings indicated that tinnitus patients had a higher mean platelet volume than the healthy control subjects; however, the pathophysiological mechanism remains unclear.


2000 ◽  
Vol XXXII (3-4) ◽  
pp. 5-9
Author(s):  
A. A. Skorometz ◽  
L. G. Zaslavsky

Results of psychologic examination of 61 patient with multiple sclerosis diagnosed by Poser criteria are described. In most part of patients an increased level of both egocentric and reactive anxiety in comparison with findings of control group of healthy subjects and group of patients with some other neurologic pathology is with certainty determined. It is found that multiple sclerosis in patients with intense egocentric (congenital) anxiety is taking more malignant course. It is concluded that conducting psychologic testing of multiple sclerosis patients on the early stage for probable assessment of the further course of the disease and working out of more individual tactics of treatment is expedient.


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