scholarly journals Mainz Foot-school: a course concept for prevention and treatment of foot disorders

2020 ◽  
Author(s):  
Martin Betz ◽  
Jürgen Konradi ◽  
Ulrich Betz ◽  
Philipp Drees

Abstract BackgroundPhysiotherapy offers an active approach to prevent and treat foot dysfunction, but it is currently rarely used. A Spiraldynamik®-inspired 6‒8-h educational program, called “Mainzer Fußschule” (Mainz Foot-school, MFS), was established to offer a framework for effective implementation. Elements of the courses are: knowledge transfer about anatomy and function, perception training, mobilization, as well as strengthening and coordination. In order to evaluate opinions of former participants about the course format and their subjective effects of course participation, we collected patient-reported outcomes (PROs).MethodsIn mid-2018, we conducted a retrospective, monocentric, questionnaire-based cohort study. The online-questionnaire comprised 23-items. All MFS attendees in 2015‒2017 who were contactable via e-mail (522; 90.3%) were approached. Finally, 350 completed questionnaires (67%) were returned.ResultsThe overall framework of the course was evaluated very positively by most participants, with 94.8% expressing a positive opinion about the course format, 97.2% about the theory vs. practice ratio, and 97.2% about the information content. PROs regarding the offering were equally positive, with 84.3% stating that their feet are now used and treated differently, and 63,9% that they still perform exercises learned in the MFS. Furthermore, the majority (67.9%) believes that the procedure had a positive effect on their existing foot problem. Feedback on the various other examined aspects was similarly positive.ConclusionsThe courses were rated positively by the majority of former participants, both in terms of format and subjective effects. Thus the MFS is a promising therapy option that should be included in an extended treatment concept with individual orthopedic examination and therapy options. Our results should be verified in a multicenter, randomized controlled study.Trial registrationThe Trial was approved by the ethical review committee of the Rhineland-Palatinate state chamber of physicians (18.04.2018). International Clinical Trials Registry Platform (ICTRP), DRKS00013890. Registered 11 May 2018, http://apps.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00013890.

2020 ◽  
Author(s):  
Martin Betz ◽  
Jürgen Konradi ◽  
Ulrich Betz ◽  
Philipp Drees

Abstract Background: Physiotherapy offers an active approach to prevent and treat foot dysfunction, but it is currently rarely used. A Spiraldynamik®-inspired 6‒8-h educational program, called “Mainzer Fußschule” (Mainz Foot-school, MFS), was established to offer a framework for effective implementation. Elements of the courses are: knowledge transfer about anatomy and function, perception training, mobilization, as well as strengthening and coordination. In order to evaluate opinions of former participants about the course format and their subjective effects of course participation, we collected patient-reported outcomes (PROs).Methods: In mid-2018, we conducted a retrospective, monocentric, questionnaire-based cohort study. The online-questionnaire comprised 23-items. All MFS attendees in 2015‒2017 who were contactable via e-mail (522; 90.3%) were approached. Finally, 350 completed questionnaires (67%) were returned.Results: The overall framework of the course was evaluated very positively by most participants, with 94.8% expressing a positive opinion about the course format, 97.2 % about the theory vs. practice ratio, and 97.2% about the information content. PROs regarding the offering were equally positive, with 84.3 % stating that their feet are now used and treated differently, and 63,9 % that they still perform exercises learned in the MFS. Furthermore, the majority (67.9 %) believes that the procedure had a positive effect on their existing foot problem. Feedback on the various other examined aspects was similarly positive.Conclusions: The courses were rated positively by the majority of former participants, both in terms of format and subjective effects. Thus the MFS is a promising therapy option that should be included in an extended treatment concept with individual orthopedic examination and therapy options. Our results should be verified in a multicenter, randomized controlled study.Trial registration: The Trial was approved by the ethical review committee of the Rhineland-Palatinate state chamber of physicians (18.04.2018). International Clinical Trials Registry Platform (ICTRP), DRKS00013890. Registered 11 May 2018, http://apps.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00013890.


2021 ◽  
Vol 12 ◽  
Author(s):  
Hannah Gibbs ◽  
Hauke Egermann

Nostalgic music is defined as that which evokes feelings of nostalgia through reminders of certain periods of life, places or people. Feelings of nostalgia are said to occur during times of hardship and difficult transitionary periods, such as the first COVID-19 lockdown in the United Kingdom in 2020. Here, the reassurance of the past might have held certainty that could sustain a sense of meaning and purpose in life and influence wellbeing. The aims of the presented study were to explore the nature of music-induced nostalgia during the lockdown, by analysing participants’ narratives conjured by the music and their emotional responses to them, and to determinethe extent that using nostalgic music listening as an emotion regulation strategy had an impact on wellbeing. Data was collected by means of an online questionnaire, which retrospectively investigated nostalgic music during the lockdown. Participants listened to a self-selected piece of music that they had listened to 3 months prior whichinduced feelings of nostalgia, reported their resulting emotion and the content of memories associated with their nostalgia, and completed a questionnaire rating their experienced effect of nostalgia in relation to their piece of music. Following this, we investigated the functions that nostalgic music tends to have in regulating emotions through means of a pre-validated scale. 570 participants (34% identified as male) were recruited (age years M = 44, SD = 16). Concurrent with existing research, the findings suggest that there are significant differences in the affective and narrative content of nostalgicmusic listening in relation to which emotion regulation strategy was used, and that employing nostalgic music listening as a form of approaching difficult emotions can have a positive impact on wellbeing.


2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199606
Author(s):  
Takeshi Mochizuki ◽  
Koichiro Yano ◽  
Katsunori Ikari ◽  
Ken Okazaki

Purpose: This study investigated the clinical effects of different patellar components without being affected by the femoral component design in total knee arthritis (TKA) for patients with knee osteoarthritis (OA). Methods: In total, 48 patients with OA who met the criteria of the American College of Rheumatology for OA were enrolled and randomly assigned in a 1:1 ratio to two groups according to the usage of patellar component design for TKA (medialized dome type [dome group] or medialized anatomic type [anatomic group]). To evaluate the clinical outcomes for TKA, knee range of motion (ROM), pain intensity of 0–100 mm visual analog scale (pain VAS), and the Japanese Knee Osteoarthritis Measure (JKOM) score were obtained at baseline and year 1. Results: The difference in knee ROM, pain VAS, or total JKOM score at year 1 was not significant between the dome and anatomic groups ( p = 0.398, 0.733 and 0.536, respectively). Moreover, similar results were obtained for changes in knee ROM, pain VAS, or total JKOM scores from baseline. In both groups, the pain VAS and total JKOM scores were significantly improved at year 1. Conclusion: Both dome and anatomic groups in TKA are significantly effective for pain and function using the JKOM score. However, their efficacy did not differ, according to the JKOM score. Results of this study are rare information focusing on the patellar component design and provide one of the insights into the TKA clinical management.


2021 ◽  
Vol 9 (4) ◽  
pp. 232596712110050
Author(s):  
Hanna Tigerstrand Grevnerts ◽  
Sofi Sonesson ◽  
Håkan Gauffin ◽  
Clare L. Ardern ◽  
Anders Stålman ◽  
...  

Background: In the treatment of anterior cruciate ligament (ACL) injuries, there is little evidence of when and why a decision for ACL reconstruction (ACLR) or nonoperative treatment (non-ACLR) is made. Purpose: To (1) describe the key characteristics of ACL injury treatment decisions and (2) compare patient-reported knee instability, function, and preinjury activity level between patients with non-ACLR and ACLR treatment decisions. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 216 patients with acute ACL injury were evaluated during the first year after injury. The treatment decision was non-ACLR in 73 patients and ACLR in 143. Reasons guiding treatment decision were obtained from medical charts and questionnaires to patients and orthopaedic surgeons. Patient-reported instability and function were obtained via questionnaires and compared between patients with non-ACLR and ACLR treatment decisions. The ACLR treatment group was classified retrospectively by decision phase: acute phase (decision made between injury day and 31 days after injury), subacute phase (decision made between 32 days and up to 5 months after injury), and late phase (decision made 5-12 months after injury). Data were evaluated using descriptive statistics, and group comparisons were made using parametric or nonparametric tests as appropriate. Results: The main reasons for a non-ACLR treatment decision were no knee instability and no problems with knee function. The main reasons for an ACLR treatment decision were high activity demands and knee instability. Patients in the non-ACLR group were significantly older ( P = .031) and had a lower preinjury activity level than did those in the acute-phase ( P < .01) and subacute-phase ( P = .006) ACLR decision groups. There were no differences in patient-reported instability and function between treatment decision groups at baseline, 4 weeks after injury, or 3 months after injury. Conclusion: Activity demands, not patient-reported knee instability, may be the most important factor in the decision-making process for treatment after ACL injury. We suggest a decision-making algorithm for patients with ACL injuries and no high activity demands; waiting for >3 months can help distinguish those who need surgical intervention from those who can undergo nonoperative management. Registration: NCT02931084 ( ClinicalTrials.gov identifier).


2021 ◽  
pp. 1-6
Author(s):  
Matthew Zaremba ◽  
Joel Martin ◽  
Marcie Fyock-Martin

Clinical Scenario: Knee pathologies often require rehabilitation to address the loss of knee-extensor (KE) strength, function, and heightened pain. However, in the early stages of rehabilitation, higher loads may be contraindicated. Blood flow restriction (BFR) resistance training does not require high loads and has been used clinically to promote strength improvements in a variety of injured populations. BFR resistance training may be an effective alternative to high-intensity resistance training during early rehabilitation of knee pathologies. Clinical Question: Following a knee injury, does BFR resistance training improve KE strength and function, and reduce patient-reported pain? Summary of Key Findings: Four randomized controlled trial studies met the inclusion criteria. Each included study evaluated the use of BFR resistance training on knee pathologies and the effects on KE strength, functional outcomes, and pain compared with high- or low-load resistance training. All 4 studies reported significant improvements in KE strength, function, and pain through a variety of outcome measures, following BFR resistance training use as the treatment. Clinical Bottom Line: There is consistent evidence to support the use of BFR resistance training as a treatment intervention following knee injury and as a means to improve KE strength and function and to reduce pain. Strength of Recommendation: Grade A evidence supporting the use of BFR resistance training for improvement in KE strength and function, and the reduction of patient-reported pain following an acute or chronic knee pathology.


2020 ◽  
Vol 22 (2) ◽  
pp. 146-150
Author(s):  
Mariana Lima da Costa Valente ◽  
Marcela Silva Costa ◽  
Paulo Marcos Bérgamo ◽  
Denise Tornavoi de Castro

Currently, aesthetics, and especially the smile, adds considerable social value. In this way, patients suffering from dental loss wish that their rehabilitation be performed quickly and safely. The aim of oral rehabilitation is to restore masticatory, phonetic, aesthetic and quality of life to the patient. The diagnostic step is one of the most important and relevant steps in establishing a correct treatment plan and, in this way, it is possible to obtain excellent results. The present study aimed to demonstrate the importance of diagnostic waxing in oral rehabilitation. Patient sought treatment at the Dental Prosthesis Specialization Course at Odonto School, due to complaints associated with aesthetics and function. To improve their quality of life, planning of case was carried out through diagnostic waxing and a prosthetic solution was proposed. At the end of treatment and during the follow-up of the case, the patient reported satisfaction and significant improvement in quality of life. It can be concluded that the diagnostic waxing presents customized solutions offering, through a previous study, an effective clinical resolution to the patient. Keywords: Mouth Rehabilitation. Dental Restoration, Temporary. Dental Restoration, Temporary. Resumo Atualmente, a estética, e em especial o sorriso, agregam um valor social considerável. Dessa forma, ao sofrerem a perda dental, os pacientes desejam que sua reabilitação seja realizada de forma rápida e segura. A reabilitação oral tem como objetivo devolver ao paciente a eficiência mastigatória, fonética, estética e a qualidade de vida. A etapa diagnóstica constitui um dos passos mais importantes e relevantes no estabelecimento de um correto planejamento do tratamento e, desta forma, torna-se possível obter resultados de excelência. O presente estudo teve como objetivo demonstrar a importância do enceramento diagnóstico na reabilitação oral. Paciente procurou tratamento no Curso de Especialização em Prótese Dentária da Odonto School, devido a queixas associadas a estética e função. Para melhorar sua qualidade de vida, foi realizado o planejamento do caso por meio do enceramento diagnóstico e uma solução protética foi proposta. Ao final do tratamento e durante o acompanhamento do caso, a paciente relatou satisfação e melhora significativa na qualidade de vida. Pode-se concluir que o enceramento diagnóstico apresenta soluções personalizadas oferecendo, por meio de estudo prévio, uma resolução clínica efetiva ao paciente. Palavras-chave: Reabilitação Bucal. Restauração Dentária Temporária. Prótese Dentária Temporária.


2021 ◽  
Author(s):  
William Anderst ◽  
Goeran Fiedler ◽  
Kentaro Onishi ◽  
Gina McKernan ◽  
Tom Gale ◽  
...  

Abstract • Background: Among the challenges of living with lower limb loss is the increased risk of long-term health problems that can be either attributed directly to the amputation surgery and/or prosthetic rehabilitation or indirectly to a disability-induced sedentary lifestyle. These problems are exacerbated by poorly fit prosthetic sockets. There is a knowledge gap regarding how the socket design affects in-socket mechanics, and how in-socket mechanics affect patient-reported comfort and function. The objectives of this study are: 1) to gain a better understanding of how in-socket mechanics of the residual limb in transfemoral amputees are related to patient-reported comfort and function, 2) to identify clinical tests that can streamline the socket design process, and 3) to evaluate the efficacy and cost of a novel, quantitatively informed socket optimization process.• Methods: Users of transfemoral prostheses will be asked to walk on a treadmill wearing their current socket plus 8 different check sockets with designed changes in different structural measurements that are likely to induce changes in residual limb motion, skin strain, and pressure distribution within the socket. Dynamic biplane radiography and pressure sensors will be used to measure in-socket residual limb mechanics. Patient-reported outcomes will also be collected after wearing each socket. The effects of in-socket mechanics on both physical function and patient-reported outcomes (aim 1) will be assessed using a generalized linear model. Partial correlation analysis will be used to examine the association between research grade measurements and readily available clinical measurements (aim 2). In order to compare the new quantitative design method to the Standard of Care, patient reported outcomes and cost will be compared between the two methods, utilizing the Wilcoxon Mann-Whitney non-parametric test (aim 3).• Discussion: Knowledge on how prosthetic socket modifications affect residual bone and skin biomechanics itself can be applied to devise future socket designs, and the methodology can be used to investigate and improve such designs, past and present. Apart from saving time and costs, this may result in better prosthetic socket fit for a large patient population, thus increasing their mobility, participation, and overall health-related quality of life. • Trial registration: clinicaltrials.gov: NCT05041998


2019 ◽  
Author(s):  
Cheng Zhu ◽  
Min Wang ◽  
Qian Hao

Abstract Background: Abernethy malformation is a kind of congenital malformation of portal vein system caused by abnormal portacaval anastomosis. It can be in combination with other congenital malformations. The major therapy of Abernethy malformation is surgery. There has been a limited number of patients since the first patient reported, leading to a limited view towards this kind of disease until now.Results: In August 2018 we treated a patient diagnosed with typeII Abernethy malformation complicated with both congenital polydactyly and enlargement of all cardiac chambers, which is extremely rare and can be a supplementary to the existing cases. Besides, the low white blood cell and platelet, the arrested megakaryocytic maturation and the positive platelet autoantibody in serum may result in misdiagnosis as immune thrombocytopenia, so we analyze the differential points between these two diseases. We treated this patient with silybin orally and advised him to make follow-up visits because of his mild liver function disorder, normal cardiac function and no other malformations or complications complicated. At the latest follow-up, we knew the condition of the patient was generally satisfactory, whether in terms of laboratory test results or his daily life experience.Conclusions: Because of some changes of spleen in form and function secondary to Abernethy malformation, in some cases, this disease has similarities with a part of blood diseases, which we should take into consideration for differential diagnosis, especially when other congenital malformations are found in combination at the same time. This case also suggests that simply conservative treatment with regular follow-up visits can be suitable for certain patients.


2021 ◽  
Vol 9 ◽  
Author(s):  
Kelly Guedes de Oliveira Scudine ◽  
Camila Nobre de Freitas ◽  
Kizzy Silva Germano Nascimento de Moraes ◽  
Silvana Bommarito ◽  
Rosana de Fátima Possobon ◽  
...  

It is well recognized that pacifier habit leads to occlusal and orofacial functional changes in children. However, the effects of the interruption of prolonged pacifier habit on the development of the dento-facial complex has not yet been fully characterized. Thus, the aim of this study was to investigate the influence of pacifier removal on aspects of oro-dentofacial morphology and function in preschool children. For that, a pacifier group (n = 28) and a control group (n = 32) of 4-year-old children with and without pacifier habit, respectively, were followed up by a group of dentists and speech therapists at baseline, 6 and 12 months after habit removal. Bite force and lip pressure were assessed using digital systems, and the evaluation of breathing and speech functions was performed using validated protocols, together with the measurements of dental casts and facial anthropometry. The Two-way mixed model ANOVA was used in data analysis. After 12 months, a decrease in malocclusion frequency was observed in pacifier group. Additionally, a change over time was observed in facial, intermolar and palate depth measurements, as well in bite and lip forces and speech function scores, increasing in both groups (p &lt; 0.01). The upper and lower intercanine widths and breathing scores differed between groups at baseline and changed over time reducing the differences. The presence of speech distortions was more frequent in the pacifier group at baseline and decreased over time (p &lt; 0.05). The interruption of pacifier habit improved the maxillary and mandibular intercanine widths, as well as the breathing and speech functions, overcoming the oro-dentofacial changes found.Trial Registration: This clinical trial was registered in the Brazilian Clinical Trials Registry (ReBEC; http://www.ensaiosclinicos.gov.br/), protocol no. RBR-728MJ2.


2019 ◽  
Vol 1 (Number 2) ◽  
pp. 11-14
Author(s):  
Md. Johurul Hoque ◽  
Muhammad Emam Zaman ◽  
Ripon Kumar Das ◽  
Mohammad Sayeed AL Mahmud ◽  
Mahbuba Khatun

This is a prospective comparative study to compare the efficacy of PRP injection versus corticosteroid injection for planter fasciitis. 35 male and 25 female (Mean Age 35.5 yrs.) presenting with planter fasciitis were randomized to receive there Platelet-rich plasma (PRP) injection (2ml PRP with 2ml of 2% xylocaine) given by a single surgeon. Patients were assessed before (Days0) and after (Days 30, 60, 90) treatment for chronic heel pain more than 6 months. Patients where followed up 1 year to assess heel pain over the calcaneal tuberocity. In the present study of 60 patients there were 35 male and 25 female. In the present study of 60 patients the mean age was 35.5 years (Range between 35 to 65 years). Infection, rupture of plantar fascia, heel pad atrophy and neurovascular damage where not found. Five patient reported pain for unto 9 days after PRP injection. In both groups heel pain improved dramatically after treatment, but the mode of improvement different. Compared with PRP injection. Corticosteroid injection improve at a faster rate over the first 30 days and then started to decline slightly until 90 days. After PRP injection heel pain, function improve steadily and where eventually better. PRP injection and Corticosteroid injection 30 days and faster rate 60 days of both group P-Value 0.0001. Almost high grater rate 60 days, group comparison with heel pain and function of the patients. PRP was more effective over the long term follow up period then corticosteroid injection in improving heel pain and function. That’s way we recommend PRP in a first line injection treatment because it is very simple, cheap and more effective.


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