scholarly journals Recovery And The Use Of Postoperative Physical Therapy After Total Hip Or Knee Replacement

2022 ◽  
Author(s):  
L. Groot ◽  
D.A.J.M. Latijnhouwers ◽  
M. Reijman ◽  
S.H.M. Verdegaal ◽  
T.P.M. Vliet Vlieland ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Odds Ratios ◽  
Multicenter Observational Study ◽  
Total Hip ◽  
Registration Number ◽  
Postoperative Physical Therapy ◽  
Sport And Recreation ◽  
The Impact ◽  
Physical Recovery

Abstract Background: To investigate the relation between recovery and postoperative physical therapy (PT) usage, including the presence of comorbidities, 6 months after total hip or knee arthroplasties (THA/TKA). Methods: Multicenter, observational study in primary THA/TKA patients who completed preoperative and 6 months postoperative assessments. The assessments included questions on PT use (yes/no and duration; long term use defined as ≥12 weeks), comorbidities (musculoskeletal, non-musculoskeletal, sensory comorbidities). Recovery was assessed with the HOOS/KOOS on all 5 subdomains. Logistic regression with long term PT as outcome was performed adjusted for confounding including an interaction term (comorbidity*HOOS/KOOS-subdomain).Results: In total, 1289 THA and 1333 TKA patients were included, of whom 95% received postoperative PT, 56% and 67% received postoperative PT ≥12 weeks respectively. In both THA and TKA group, less improvement on all HOOS/KOOS domain scores was associated with ≥12 weeks of postoperative PT (range Odds Ratios 0.97-0.99). In the THA group the impact of recovery was smaller in patient with comorbidities as non- musculoskeletal comorbidities modified all associations between recovery and postoperative PT duration (Odds Ratios range 1.01-1.05). Musculoskeletal comorbidities modified the associations between Function-in-Daily-Living-and Sport-and-recreation recovery and postoperative PT. Sensory comorbidities only had an effect on Sport-and-recreation recovery and postoperative PT. In the TKA group comorbidity did not modify the associations. Conclusion: Worse recovery was associated with longer duration of postoperative PT suggesting that PT provision is in line with patients’ needs. The impact of physical recovery on the use of long-term postoperative PT was smaller in THA patients with comorbidities. Trial registration: Registered in the Dutch Trial Registry on March 13, 2012. TRIAL ID NTR3348; registration number: P12.047. https://www.trialregister.nl/trial/3197.

scholarly journals Are physical therapy pain levels affected by surgical approach in total hip arthroplasty? A randomized controlled trial

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Dan-Viorel Nistor ◽  
Nicolae Ciprian Bota ◽  
Sergiu Caterev ◽  
Adrian Todor
Keyword(s):  
Physical Therapy ◽  
Controlled Trial ◽  
Direct Anterior Approach ◽  
Lateral Approach ◽  
Total Hip ◽  
Significant Difference ◽  
Postoperative Physical Therapy ◽  
Muscle Sparing ◽  
The Difference ◽  
Therapy Sessions

The main objective of this study was to evaluate the difference in pain levels during postoperative physical therapy pathways in patients who underwent a cement less total hip replacement either through a muscle sparing direct anterior approach (DAA), or the classic trans-gluteal lateral approach (LA). One hundred and twelve (112) patients were randomized into two equal groups. Baseline values of myoglobin levels were acquired prior to surgery and repeated at 6 hours postoperatively as a biomarker for muscle damage. Pain levels during the first passive and consecutive 3 active physical therapy sessions were noted using a visual analogue-numeric scale (VAS). Pain levels were also acquired at 6 weeks, 3 months, 6 months and 1 year, following a 20-meter (65.6 feet) walking test. Postoperative myoglobin (ng/mL) levels were significantly higher (p< 0.05) in the LA group (335.05±83.54) then the DAA group (237.71±57.54). Pain levels were significantly lower (p<0.001) in the DAA group for both passive (2.5±1.45 vs. 4.28±2.19) and active physical therapy sessions and there was a positive correlation between postoperative myoglobin levels and pain levels until 6 postoperative weeks. There was no significant difference in demographics between the two groups except for gender distribution. The direct anterior approach’s main advantage of being a minimally invasive muscle sparing technique is showing a better rehabilitation experience with lower pain levels during passive and active physical therapy when compared to the classic trans-gluteal lateral approach.

scholarly journals Effects of long-term vaccination against Coxiella burnetii on the fertility of high-producing dairy cows

2015 ◽  
Vol 63 (2) ◽  
pp. 223-233
Author(s):  
Irina Garcia-Ispierto ◽  
Irene López-Helguera ◽  
Joan Tutusaus ◽  
Ramón Mur-Novales ◽  
Fernando López-Gatius
Keyword(s):  
Dairy Cows ◽  
Coxiella Burnetii ◽  
Pregnancy Loss ◽  
Fetal Loss ◽  
Odds Ratios ◽  
Third Trimester ◽  
Final Study ◽  
Study Population ◽  
The Impact

The impact of long-term vaccination against Coxiella burnetii on the fertility of cows was studied. Double vaccinations three weeks apart at the start of the third trimester of gestation in each of two consecutive pregnancies were applied. The final study population consisted of 410 cows after the first vaccination round. Based on the odds ratios, the likelihood of early fetal loss (pregnancy loss following a positive pregnancy diagnosis before Day 90 of gestation) was higher in control cows (OR = 1.42) than in vaccinated cows. The final study population consisted of 336 cows after the second round of vaccination. According to the odds ratios, vaccinated C. burnetii seronegative cows were less likely to be subfertile (> 3 AI) (OR = 0.4) compared to non-vaccinated seronegative animals, and the likelihood of early fetal loss was lower in vaccinated C. burnetii seropositive animals (OR = 0.3) compared to non-vaccinated seronegative cows. Seropositivity to C. burnetii was positively related to twin pregnancy after the two rounds of vaccination (OR = 2.1 and 3.5, respectively). These results indicate that two consecutive vaccination rounds against C. burnetii in advanced gestation reduce subfertility and early fetal loss in dairy cows.

Performance milestones in postoperative physical therapy after total hip arthroplasty

2018 ◽  
Vol 29 (4) ◽  
pp. 308-315 ◽  
Author(s):  
Nicholas J. Vaudreuil ◽  
Timothy J. McGlaston ◽  
Catarina D. Gulledge ◽  
Allyn M. Bove ◽  
Brian A. Klatt
Keyword(s):  
Physical Therapy ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Postoperative Physical Therapy

scholarly journals Physical and functional complications after surgical treatment for breast cancer

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Amanda Estevão ◽  
Cinira Assad Simão Haddad ◽  
Samantha Karlla Lopes de Almeida Rizzi ◽  
Afonso Celso Pinto Nazário ◽  
Gil Facina
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Physical Therapy ◽  
Cross Sectional Study ◽  
Movement Amplitude ◽  
Cross Sectional ◽  
Prevalence Of Pain ◽  
In The Beginning ◽  
The Impact

Introduction: The ideal treatment for breast cancer should be carried out by a multidisciplinary team, aiming at the global approach of the patient. It is usually a prolonged process and can cause relevant changes in the lives of patients, such as limited shoulder movement, pain, lymphedema, adherence scarring, sensitive changes, phlebitis, among others. Physical therapy intervention plays an essential role and can prevent and minimize complications, besides enabling functional recovery. It is extremely important that the physical therapy service is aware of the prevalence of the main physical and functional complications and the impact of its intervention. Objective: To assess the main physical and functional complications in the post-surgical treatment of breast cancer. Methods: This is a cross-sectional study in which we analyzed the medical records of patients treated in the Physical Therapy Ambulatory from 2011 to 2016. We obtained data about the surgery, prevalence of pain, changes in perimeter, movement amplitude, evaluation of scapulohumeral rhythm and presence of axillary cording. Results: We assessed the data of 703 patients, whose mean age was 56 years; 50.1% were married, and body mass index pointed to overweight (mean: 26.8kg/m²). Sedentary lifestyle was prevalent (73.7%). The main surgery performed was quadrantectomy, followed by mastectomy. Pain was present, however, in extremely low levels (mean of pain in the Visual Analog Scale on the seventh postoperative day was 2.55); movement amplitude restrictions were higher in the beginning, and functionally reversed during follow-up; scapular dysfunction is also little prevalent (9.9%), with high percentage of long term resolution. The incidence of axillary cording was high (87.9%), which requires special attention. Conclusion: The study allowed to observe the main physical and functional complications after breast cancer treatment, and show the importance and necessity of early physical therapy.

scholarly journals A multicenter approach evaluating the impact of vitamin E-blended polyethylene in cementless total hip replacement

2014 ◽  
Vol 6 (2) ◽  
Author(s):  
Marcus Jäger ◽  
Andrea Van Wasen ◽  
Sebastian Warwas ◽  
Stefan Landgraeber ◽  
Marcel Haversath ◽  
...  
Keyword(s):  
Vitamin E ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Promising Alternative ◽  
Wear Rates ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty ◽  
The Impact

Since polyethylene is one of the most frequently used biomaterials as a liner in total hip arthroplasty, strong efforts have been made to improve design and material properties over the last 50 years. Antioxidants seems to be a promising alternative to further increase durability and reduce polyethylene wear in long term. As of yet, only <em>in vitro</em> results are available. While they are promising, there is yet no clinical evidence that the new material shows these advantages <em>in vivo</em>. To answer the question if vitamin-E enhanced ultra-high molecular weight polyethylene (UHMWPE) is able to improve long-term survivorship of cementless total hip arthroplasty we initiated a randomized long-term multicenter trial. Designed as a superiority study, the oxidation index assessed in retrieval analyses of explanted liners was chosen as primary parameter. Radiographic results (wear rate, osteolysis, radiolucency) and functional outcome (Harris Hip Scores, University of California-Los Angeles, Hip Disability and Osteoarthritis Outcome Score, Visual Analogue Scale) will serve as secondary parameters. Patients with the indication for a cementless total hip arthroplasty will be asked to participate in the study and will be randomized to either receive a standard hip replacement with a highly cross-linked UHMWPE-X liner or a highly cross-linked vitamin-E supplemented UHMWPE-XE liner. The follow-up will be 15 years, with evaluation after 5, 10 and 15 years. The controlled randomized study has been designed to determine if Vitamin-E supplemented highly cross-linked polyethylene liners are superior to standard XLPE liners in cementless total hip arthroplasty. While several studies have been started to evaluate the influence of vitamin-E, most of them evaluate wear rates and functional results. The approach used for this multicenter study, to analyze the oxidation status of retrieved implants, should make it possible to directly evaluate the ageing process and development of the implant material itself over a time period of 15 years.

scholarly journals Long-term quality-adjusted survival following therapeutic bronchoscopy for malignant central airway obstruction

Thorax ◽  
2018 ◽  
Vol 74 (2) ◽  
pp. 141-156 ◽  
Author(s):  
Philip Ong ◽  
Horiana B Grosu ◽  
Labib Debiane ◽  
Roberto F Casal ◽  
George A Eapen ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Technical Success ◽  
Related Quality ◽  
Registration Number ◽  
Health Related ◽  
Treatment Naïve ◽  
The Impact

BackgroundWhile therapeutic bronchoscopy has been used to treat malignant central (CAO) airway obstruction for >25 years, there are no studies quantifying the impact of therapeutic bronchoscopy on long-term quality-adjusted survival.MethodsWe conducted a prospective observational study of consecutive patients undergoing therapeutic bronchoscopy for CAO. Patients had follow-up at 1 week and monthly thereafter until death. Outcomes included technical success (ie, relief of anatomic obstruction), dyspnoea, health-related quality of life (HRQOL) and quality-adjusted survival.ResultsTherapeutic bronchoscopy was performed on 102 patients with malignant CAO. Partial or complete technical success was achieved in 90% of patients. At 7 days postbronchoscopy, dyspnoea improved (mean ∆Borg-day-7=−1.8, 95% CI −2.2 to −1.3, p<0.0001) and HRQOL improved (median prebronchoscopy 0.618 utiles, 25%–75% IQR 0.569 to 0.699, mean ∆utility-day-7+0.047 utiles, 95% CI +0.023 to 0.071, p=0.0002). Improvements in dyspnoea and HRQOL were maintained long-term. Compared with the prebronchoscopy baseline, HRQOL per day of life postbronchoscopy improved (mean ∆utility-long-term+0.036 utiles, 95% CI +0.014 to 0.057, p=0.002). Median quality-adjusted survival was 109 quality-adjusted life-days (QALDs) (95% CI 74 to 201 QALDs). Factors associated with longer quality-adjusted survival included better functional status, treatment-naïve tumour, endobronchial disease, less dyspnoea, shorter time from diagnosis to bronchoscopy, absence of cardiac disease, bronchoscopic dilation and receiving chemotherapy.ConclusionsTherapeutic bronchoscopy improves HRQOL as compared with baseline, resulting in approximately a 5.8% improvement in HRQOL per day of life. The risk-benefit profile in these carefully selected patients was very favourable.Trial registration numberResults; NCT03326570.

Suppressed, but Not Forgotten

2011 ◽  
Vol 70 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Beat Meier ◽  
Anja König ◽  
Samuel Parak ◽  
Katharina Henke
Keyword(s):  
Memory Trace ◽  
Thought Suppression ◽  
Test Phase ◽  
Indirect Test ◽  
Final Test ◽  
Test Experiment ◽  
And Control ◽  
Cue Words ◽  
The Impact

This study investigates the impact of thought suppression over a 1-week interval. In two experiments with 80 university students each, we used the think/no-think paradigm in which participants initially learn a list of word pairs (cue-target associations). Then they were presented with some of the cue words again and should either respond with the target word or avoid thinking about it. In the final test phase, their memory for the initially learned cue-target pairs was tested. In Experiment 1, type of memory test was manipulated (i.e., direct vs. indirect). In Experiment 2, type of no-think instructions was manipulated (i.e., suppress vs. substitute). Overall, our results showed poorer memory for no-think and control items compared to think items across all experiments and conditions. Critically, however, more no-think than control items were remembered after the 1-week interval in the direct, but not in the indirect test (Experiment 1) and with thought suppression, but not thought substitution instructions (Experiment 2). We suggest that during thought suppression a brief reactivation of the learned association may lead to reconsolidation of the memory trace and hence to better retrieval of suppressed than control items in the long term.

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