scholarly journals NEUROORTHOPEDICAL APPROACH TO THE CORRECTION OF EQUINES CONTRACTURE IN PATIENTS WITH SPASTIC PARALYSIS

2014 ◽  
Vol 2 (1) ◽  
pp. 27-31
Author(s):  
Valery Vladimirovich Umnov ◽  
Alexei Vasilievich Zvozil
Keyword(s):  
Lower Limb ◽  
Lower Limbs ◽  
Spastic Paralysis ◽  
Triceps Muscle ◽  
Post Surgery ◽  
Long Term Result ◽  
Long Term Follow Up ◽  
Short Run ◽  
Operation Results

The frequency of recurrent contractures of the joints of the lower limb after their correction by means of tendon-muscle plasty remains significant. Therefore, the search for effective ways to correct contractures with the most resistant long-term result is relevant. The objective of the study is to improve treatment outcomes of equinus contracture in children with spastic paralysis. Materials and methods. We analyzed the results of correction of contractures in joints of lower limbs in 40 patients with cerebral palsy and the influence of spasticity of patognomonic muscles on them. The mean age was 6 years 7 months. In addition, for the correction of hypertonus of triceps muscle of tibia, the 330 lower limb segments were performed selective neurotomy of appropriate motor branches of the general tibial nerve. This operation in 304 cases was combined with achilloplastics or Strayer operation. Results. A mean degree of correlation between the degree of contracture in the ankle and increased tone of triceps tibia was determined (r value ranged from 0.451 to 0.487). Short-term results of the combined neuroorthopedic method for correction of contractures were good in estimating within 1 year post surgery, but a study of its short-run effect requires long-term follow-up.

scholarly journals COVID-19 era in long-term cardiac rehabilitation programs: how was muscle strenght and lean mass affected in cardiovascular patients?

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Borges ◽  
M Lemos Pires ◽  
R Pinto ◽  
G De Sa ◽  
I Ricardo ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Cardiac Rehabilitation ◽  
Lean Mass ◽  
Lower Limb ◽  
Lower Limbs ◽  
Phase Iii ◽  
Face To Face ◽  
Home Based ◽  
Lower Limb Strength

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Exercise prescription is one of the main components of phase III Cardiac Rehabilitation (CR) programs due to its documented prognostic benefits. It has been well established that, when added to aerobic training, resistance training (RT) leads to greater improvements in peripheral muscle strength and muscle mass in patients with cardiovascular disease (CVD). With COVID-19, most centre-based CR programs had to be suspended and CR patients had to readjust their RT program to a home-based model where weight training was more difficult to perform. How COVID-19 Era impacted lean mass and muscle strength in trained CVD patients who were attending long-term CR programs has yet to be discussed. Purpose To assess upper and lower limb muscle strength and lean mass in CVD patients who had their centre-based CR program suspended due to COVID-19 and compare it with previous assessments. Methods 87 CVD patients (mean age 62.9 ± 9.1, 82.8% male), before COVID-19, were attending a phase III centre-based CR program 3x/week and were evaluated annually. After 7 months of suspension, 57.5% (n = 50) patients returned to the face-to-face CR program. Despite all constraints caused by COVID-19, body composition and muscle strength of 35 participants (mean age 64.7 ± 7.9, 88.6% male) were assessed. We compared this assessment with previous years and established three assessment time points: M1) one year before COVID-19 (2018); M2) last assessment before COVID-19 (2019); M3) the assessment 7 months after CR program suspension (last trimester of 2020). Upper limbs strength was measured using a JAMAR dynamometer, 30 second chair stand test (number of repetitions – reps) was used to measure lower limbs strength and dual energy x-ray absorptiometry was used to measure upper and lower limbs lean mass. Repeated measures ANOVA were used. Results Intention to treat analysis showed that upper and lower limbs lean mass did not change from M1 to M2 but decreased significantly from M2 to M3 (arms lean mass in M2: 5.68 ± 1.00kg vs M3: 5.52 ± 1.06kg, p = 0.004; legs lean mass in M2: 17.40 ± 2.46kg vs M3: 16.77 ± 2.61kg, p = 0.040). Lower limb strength also decreased significantly from M2 to M3 (M2: 23.31 ± 5.76 reps vs M3: 21.11 ± 5.31 reps, p = 0.014) after remaining stable in the year prior to COVID-19. Upper limb strength improved significantly from M1 to M2 (M1: 39.00 ± 8.64kg vs M2: 40.53 ± 8.77kg, p = 0.034) but did not change significantly from M2 to M3 (M2 vs M3: 41.29 ± 9.13kg, p = 0.517). Conclusion After CR centre-based suspension due to COVID-19, we observed a decrease in upper and lower limbs lean mass and lower limb strength in previously trained CVD patients. These results should emphasize the need to promote all efforts to maintain physical activity and RT through alternative effective home-based CR programs when face-to-face models are not available or possible to be implemented.

scholarly journals Role of Total Ankle Arthroplasty in Stiff Ankles – Long Term Follow-Up

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0001
Author(s):  
James W. Brodsky ◽  
Justin M. Kane ◽  
Andrew W. Pao ◽  
David D. Vier ◽  
Scott Coleman ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Step Length ◽  
Total Ankle Arthroplasty ◽  
Ankle Arthritis ◽  
Ankle Arthroplasty ◽  
Post Surgery ◽  
Long Term Follow Up ◽  
Gait Function

Category: Ankle, Ankle Arthritis Introduction/Purpose: Operative treatment of end-stage ankle arthritis involves either ankle arthrodesis (AA) or total ankle arthroplasty (TAA). The theoretical benefit of TAA is the ability to preserve range of motion (ROM) at the tibiotalar joint. Previous studies have questioned whether it is justified to perform TAA over AA in stiff, arthritic ankles. However, a recent study showed that patients who underwent TAA with stiff ankles preoperatively experienced significant clinical improvement in range of motion and gait function compared to more flexible groups at 1-year follow-up. We retrospectively assessed these same gait and functional parameters to see if these improvements held up in long-term follow-up. Methods: A retrospective study of long-term, prospectively collected functional gait data in 33 TAA patients at a mean of 7.6 years postoperatively (range 4.8-13.3) used a multivariate regression model to determine the effect of ankle stiffness on the long- term, objective outcomes of TAA. Data was analyzed by quartiles (Q1, Q2+Q3, Q4) of preoperative sagittal ROM using one-way analysis of variance (ANOVA) to compare both preop and postop gait parameters. The two middle quartiles were combined to conform to distribution of the data. The multivariate analysis determined the independent effect of age, gender, BMI, years post- surgery, and preop ROM on every preop and postop parameter of gait. Results: Statistically significant differences were found in all three gait parameter categories, including temporal-spatial (step length and walking speed), kinematic (total sagittal ROM and maximum plantarflexion), and kinetic (peak ankle power). The stiffest ankles preoperatively (Q1) had the greatest absolute increase in total sagittal ROM postoperatively, +5.3o, compared to -1.3o (p<0.0174) in Q4 (most flexible). However, Q1 had the lowest absolute total postoperative sagittal ROM of 13.1 o, compared to 19.7 o (p<0.0108) in Q4. Q1 also had the lowest preoperative step length, walking speed, maximal plantarflexion, and peak ankle power when compared to the other subgroups. There was no difference in any of these same parameters postoperatively. BMI and years post-surgery had no effect on outcomes, while age and gender had a minimal effect. Conclusion: Preoperative range of motion was once again predictive of overall postoperative gait function in long-term follow-up at an average of 7.2 years. A greater degree of preoperative sagittal range of motion was predictive of greater postoperative sagittal range of motion in long-term follow-up. Patients with the stiffest ankles preoperatively once again had a statistically and clinically greater improvement in function as measured by multiple parameters of gait. This shows that the clinically meaningful improvement in gait function after total ankle arthroplasty holds up in long-term follow-up, even in the setting of limited preoperative sagittal range of motion.

scholarly journals ACLR GRAFT STRAND NUMBER: LONG-TERM FOLLOW-UP ON 400 PATIENTS

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0017
Author(s):  
Julien T Aoyama ◽  
Joshua T Bram ◽  
John Todd R. Lawrence ◽  
Theodore J Ganley
Keyword(s):  
Multivariate Regression ◽  
Normal Weight ◽  
Obese Patients ◽  
Long Term Outcomes ◽  
Post Surgery ◽  
Graft Rupture ◽  
Long Term Follow Up ◽  
Graft Diameter

Background: Studies on pediatric anterior cruciate ligament reconstructions (ACLRs) often focus on graft choice, as rates of these injuries have risen in recent years. Large multicenter studies have found younger age and smaller graft size to be risk factors for graft failure and contralateral tears, but despite large sample sizes these studies have not looked specifically at graft strand number. Therefore the purpose of this study was to use a large sample size to ask whether ACLR graft strand number affects long-term outcomes. Hypothesis/Purpose: Examine long-term effects of ACLR graft strand number using a large cohort. Methods: This was a retrospective comparison study of all patients presenting between 1/1/2008 and 12/31/16 for a first-time ACLR at a single pediatric hospital. After querying medical records for all ACLRs using CPT codes, graft strand number, graft diameter, and other variables were abstracted. Long-term outcomes on graft rupture, contralateral ACL tear, and subsequent meniscus injury were collected via phone calls and REDCap emails. Patient groups were compared for differences in graft strand number and diameter using bivariate analyses, and differences in long-term outcomes were analyzed using multivariate regression. Results: 436 patients met the inclusion criteria also completed the long-term follow-up on outcomes. Long-term follow-up ranged from 18 months post surgery to 10 years post surgery. Patients with larger graft diameter were significantly less likely to suffer a complication (graft rupture, contralateral ACL tear, or subsequent meniscus injury) in multivariate regression (p=0.03), while strand number, sex, weight, and age showed no significant difference. Transphyseal reconstructions had larger graft diameters (8.8mm) than partial hybrid (8.6mm) and all-epiphyseal reconstructions (8.3mm) (p<0.001), but had no differences in graft strand number. Males had larger graft diameters (8.9mm) than females (8.6mm) (p=0.03), but also had no differences in graft strand number. Obese patients had larger graft diameters (9.1mm) than overweight (8.9mm) and normal weight patients (8.6mm) (p=0.002). Obese patients also had more graft strands (6.9) than overweight (6.2) or normal weight patients (6.1), but this difference was not significant (p=0.051). Conclusion: This data supports the existing literature that pediatric ACLR patients with larger graft diameters are less likely to suffer long-term complications. Using both a large patient cohort and long-term follow-up, this data also showed that graft strand number was not significantly correlated with outcomes. This suggests that strand number is not important when constructing ACLR grafts, as long as sufficient graft diameter can be achieved.

EFFECT OF CYCLE ERGOMETER USING AN MR ROTARY BRAKE ON LOWER LIMB EXERCISE

2013 ◽  
Vol 13 (06) ◽  
pp. 1340017
Author(s):  
CHANG HO YU ◽  
MI YU ◽  
KYUNG KIM ◽  
TAE KYU KWON
Keyword(s):  
Visual Feedback ◽  
Lower Limb ◽  
Cycle Ergometer ◽  
Lower Limbs ◽  
Mechanical Resistance ◽  
Term Condition ◽  
Low Intensity ◽  
Feedback Mode ◽  
Cycle System

In this study, a new cycle ergometer system using a magneto-rheological (MR) rotary brake was developed to improve muscular strength and reduce asymmetric pedaling characteristics for the rehabilitation of hemiplegia patients. For evaluation of this cycle ergometer, the characteristics of lower limb muscles were analyzed according to three factor of cycle system with MR rotary brake: (1) the electrical current of MR rotary brake, (2) the intensity and duration of cycling, (3) the application of visual feedback. The results showed that muscle activity was significantly different for various levels of current applied to the MR rotary brake. A higher current was associated with a higher integrated electromyography (IEMG) of the lower limb muscle. In low-intensity and long-term condition, IEMG of RF, TA, VL and VAS increased in the late stage of exercise (compared to the early stage), however, decreased in high-intensity and short term condition. The asymmetry of pedaling between the dominant and non-dominant leg was 19.63% in the non-visual feedback mode and 1.97% in the visual feedback mode. Therefore, our new cycle system using an MR brake with real time control of mechanical resistance can be used to enhance muscle strength in patients with hemiplegia and elderly people. Increased muscular activity of the lower limbs in patients with hemiplegia and the elderly is expected with low-intensity training over a long-term period.

scholarly journals Results of the Puti-Platt Operation for Recurrent Anterior Dislocation of the Shoulder

2013 ◽  
Vol 9 (1-2) ◽  
pp. 51-57
Author(s):  
MS Islam ◽  
RR Kairy ◽  
M Islam ◽  
RM Manzur ◽  
NF Islam
Keyword(s):  
Operative Procedure ◽  
Anterior Dislocation ◽  
Prospective Clinical Study ◽  
Active Muscle ◽  
Tissue Handling ◽  
Long Term Result ◽  
Long Term Follow Up ◽  
Recurrent Anterior Dislocation

This was a prospective clinical trial carried out at NITOR, Dhaka from July 2004 to June 2006 involving 18 patients with recurrent anterior dislocation of the shoulder. All the cases were managed by Putti-Platt operative procedure. The aim of this study was to evaluate the effectiveness of the Putti-Platt procedure in the management of recurrent anterior dislocation of the shoulder. In this study, purposing sampling methods were followed irrespective of sex. Most common age group in this series was 21-30 years. This prospective clinical study comprised with 18 patients, 16 cases (88.88%) showed excellent and good results and 2 cases (11.11%) showed fair results. Therefore, Putti-Platt procedure can be considered as an effective procedure in the treatment of recurrent anterior dislocation of shoulder. Less tissue handling, close postoperative follow-up and active muscle exercise is essential for producing good result. The long-term result is beyond the scope of this study. Long-term follow up is needed to evaluate the final out come of these patients. DOI: http://dx.doi.org/10.3329/jsf.v9i1-2.14647 J. Sci. Foundation, 9(1&2): 51-57, June-December 2011

scholarly journals Long-Term Neuropsychological Outcomes Following Temporal Lobe Epilepsy Surgery: An Update of the Literature

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1156
Author(s):  
Ioanna Alexandratou ◽  
Panayiotis Patrikelis ◽  
Lambros Messinis ◽  
Athanasia Alexoudi ◽  
Anastasia Verentzioti ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Neuropsychological Function ◽  
Post Surgery ◽  
Long Term Follow Up ◽  
Neuropsychological Outcomes ◽  
Selective Surgery

We present an update of the literature concerning long-term neuropsychological outcomes following surgery for refractory temporal lobe epilepsy (TLE). A thorough search was conducted through the PubMed and Medline electronic databases for studies investigating neuropsychological function in adult patients undergoing resective TLE surgery and followed for a mean/median > five years period. Two independent reviewers screened citations for eligibility and assessed relevant studies for the risk of bias. We found eleven studies fulfilling the above requirements. Cognitive function remained stable through long-term follow up despite immediate post-surgery decline; a negative relation between seizure control and memory impairment has emerged and a possible role of more selective surgery procedures is highlighted.

scholarly journals ENDOVENOUS LAZER COAGULATION: LONG-TERM RESULT - CRITERION OF TRUTH

2018 ◽  
Vol 3 (4) ◽  
pp. 27-30
Author(s):  
A G Shalashov ◽  
A V Kazantsev
Keyword(s):  
Varicose Veins ◽  
Intraoperative Complications ◽  
Lower Limbs ◽  
Long Term Results ◽  
Laser Coagulation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Term Result ◽  
Varicose Disease

Objectives - to study the long-term results of endovenous laser coagulation in patients with varicose veins of the lower extremities. Material and methods. The study included 241 patients with varicose disease of the lower limbs veins, who underwent surgical treatment using the method of endovenous laser coagulation. Results. The technical success of the operation was achieved in all cases, which was confirmed by color duplex scanning. There were no intraoperative complications. Long-term outcome was studied in 174 (72.2%) patients in the period up to 5 years. During the follow-up period the GSV occlusion signs were detected in 168 (96.4%) patients, partial recanalization of the GSV was registered in 6 (3.5%) patients.

P2267CTEPH patients long term follow-up: results from a single center

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Mladoniczky ◽  
M Szegedi ◽  
Z S Piroth ◽  
J Nemeth ◽  
L Ablonczy ◽  
...  
Keyword(s):  
Nyha Class ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Walking Distance ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Post Surgery ◽  
Significant Difference ◽  
Long Term Follow Up

Abstract Background Chronic thromboembolic pulmonary hypertension (CTEPH) is a thrombotic pulmonary disease associated with pulmonary vasculopathy. Pulmonary endarterectomy (opus, PEA) is the first treatment choice in CTEPH, and specific PAH medication when there is a contraindication for surgery or residual pulmonary arterial hypertension (rPAH) occurs. In the presence of PAH balloon pulmonary angioplasty (BPA) might be also recommended if available. Objective We investigated the long term outcome of our CTEPH patients. Methods CTEPH from our institution retrospectively analyzed (data between 2003 and 2018). Baseline, treatment and outcome data were documented. We compared the outcome, together with mortality in those with and without surgery (PEA vs. non PEA group). NYHA class, 6 minutes walking distance (6MWD) and NT-proBNP were also reported during follow-up. Results Of 29 CTEPH patients (mean age was 62±19 years, 52% male) 16 (55%) were accepted for PEA, and further 12 of them had a long term follow-up post surgery (n=3 periop exit, n=1 waiting for surgery). Half of the PEA patients were cured (n=6) and the other half (n=6) required specific PAH treatment (n=1, in combination with BPA) for rPAH. All patients from the non-PEA group (n=13) were started on specific PAH treatment (n=1 in combination with BPA). Patients with or without PEA did not differ hemodynamically. At the late follow-up there was a significant improvement in PEA group for NYHA class and NT-proBNP (p<0,001, and p=0,046), and in non PEA group for NYHA class and the 6MWD (p=0,012, and 0,006). We found significant difference in mortality at 1,3,5 year (Kaplan-Meier survival analysis) follow-up, for PEA group 100%-100%-100% and non PEA group 100%-85%-78% (p=0,013), respectively. Conclusions 55% of CTEPH patients were suitable for PEA, and those who survived the surgery 50% were cured. Non PEA patients improved functionally on the long term, but had worse survival.

scholarly journals Long-term follow-up of percutaneous peripheral interventions in lower limb arteries in patients with acute coronary syndrome and diabetes

2010 ◽  
Vol 3 ◽  
pp. 117-121
Author(s):  
Stanisław Bartuś ◽  
Zbigniew Siudak ◽  
Michał Chyrchel ◽  
Tomasz Rakowski ◽  
Artur Dziewierz ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Lower Limb ◽  
Coronary Syndrome ◽  
Long Term Follow Up

A Prospective Randomized Trial of N-butyl-cyanoacrylate + Metacryloxysulfolane Adhesive versus Suture Alone for Grafting in Rhinoplasty: 9 year Follow-up

2020 ◽  
pp. 000348942094391
Author(s):  
Carmine Martino ◽  
Francesco Salzano ◽  
Diletta Martino ◽  
Massimo Ralli ◽  
Marco De Vincentiis ◽  
...  
Keyword(s):  
Graft Fixation ◽  
Fixation Time ◽  
Cyanoacrylate Glue ◽  
Post Surgery ◽  
Nasolabial Angle ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Time Required

Objective: Use of cyanoacrylate glue in facial plastic surgery is still controversial due to the absence of long-term follow up showing the results. Aim of our study is comparing the long-term outcomes of N-butyl-cyanoacrylate + Metacryloxysulfolane versus traditional sutures in rhinoplasty. Methods: Prospective comparative study. One hundred forty-two patients affected by ptotic nasal tip were included and randomized in two groups. In group A, the surgeon fixed the graft by using the glue and suture and in group B by using the traditional suture only. The following data were collected and compared by statistical analysis: nasolabial angle before and after surgery, dimensions of the graft, duration time (in minutes) for graft application during the surgery, number of sutures applied to fix the graft, presence of post-surgery negative outcomes. Results: All patients statistically improved their nasolabial angle after surgery (ANOVA: P < .0001) without statistically significant differences between the two groups both at short and long follow-up (χ: P = 1 and P = .9 respectively). A statistically significant difference in graft fixation time ( P < .00001) and number of sutures (t: P < .00001) used was observed between the two groups. No statistically significant difference was observed in prevalence of infection after surgery. Conclusion: N-butyl-cyanoacrylate + Metacryloxysulfolane could be a valid tool to reduce the necessary number of sutures and to reduce the time required for graft fixation graft fixation with consistent results in long-term follow-up.

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