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
Keyword(s):  
Subjective Effects ◽  
Controlled Study ◽  
Ethical Review ◽  
Online Questionnaire ◽  
Active Approach ◽  
Patient Reported ◽  
Therapy Option ◽  
Course Format ◽  
And Function ◽  
Clinical Trials Registry

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.

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
Keyword(s):  
Subjective Effects ◽  
Ethical Review ◽  
Online Questionnaire ◽  
Active Approach ◽  
Patient Reported ◽  
Therapy Option ◽  
Course Format ◽  
And Function ◽  
Clinical Trials Registry ◽  
Perception Training

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.

scholarly journals Music-Evoked Nostalgia and Wellbeing During the United Kingdom COVID-19 Pandemic: Content, Subjective Effects, and Function

2021 ◽  
Vol 12 ◽  
Author(s):  
Hannah Gibbs ◽  
Hauke Egermann
Keyword(s):  
Emotion Regulation ◽  
United Kingdom ◽  
Positive Impact ◽  
Subjective Effects ◽  
Music Listening ◽  
Online Questionnaire ◽  
The Past ◽  
The United Kingdom ◽  
Emotion Regulation Strategy ◽  
And Function

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.

scholarly journals Difference in patient-reported outcomes of various patellar component designs in total knee arthroplasty: A randomized clinical study

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199606
Author(s):  
Takeshi Mochizuki ◽  
Koichiro Yano ◽  
Katsunori Ikari ◽  
Ken Okazaki
Keyword(s):  
Knee Osteoarthritis ◽  
Clinical Effects ◽  
Patellar Component ◽  
American College Of Rheumatology ◽  
Randomized Clinical Study ◽  
Component Design ◽  
Patient Reported ◽  
Total Knee ◽  
The Difference ◽  
And Function

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.

scholarly journals Decision Making for Treatment After ACL Injury From an Orthopaedic Surgeon and Patient Perspective: Results From the NACOX Study

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712110050
Author(s):  
Hanna Tigerstrand Grevnerts ◽  
Sofi Sonesson ◽  
Håkan Gauffin ◽  
Clare L. Ardern ◽  
Anders Stålman ◽  
...  
Keyword(s):  
Decision Making ◽  
High Activity ◽  
Treatment Decision ◽  
Acl Injury ◽  
Treatment Decisions ◽  
Activity Level ◽  
Knee Instability ◽  
Acl Injuries ◽  
Patient Reported ◽  
And Function

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).

Does Blood Flow Restriction Resistance Training Improve Knee-Extensor Strength, Function, and Reduce Patient-Reported Pain? A Critically Appraised Topic

2021 ◽  
pp. 1-6
Author(s):  
Matthew Zaremba ◽  
Joel Martin ◽  
Marcie Fyock-Martin
Keyword(s):  
Blood Flow ◽  
Resistance Training ◽  
Knee Injury ◽  
Strength Function ◽  
Knee Extensor ◽  
Blood Flow Restriction ◽  
Flow Restriction ◽  
Patient Reported ◽  
And Function ◽  
Knee Pathology

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.

scholarly journals Importance of Diagnostic Waxing in Oral Rehabilitation: Case Report

2020 ◽  
Vol 22 (2) ◽  
pp. 146-150
Author(s):  
Mariana Lima da Costa Valente ◽  
Marcela Silva Costa ◽  
Paulo Marcos Bérgamo ◽  
Denise Tornavoi de Castro
Keyword(s):  
Quality Of Life ◽  
Treatment Plan ◽  
Dental Restoration ◽  
Oral Rehabilitation ◽  
Correct Treatment ◽  
Life Planning ◽  
End Of Treatment ◽  
Patient Reported ◽  
And Function

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.

scholarly journals Within-subjects Effects of Standardized Prosthetic Socket Modifications on Physical Function and Patient-Reported Outcomes

2021 ◽  
Author(s):  
William Anderst ◽  
Goeran Fiedler ◽  
Kentaro Onishi ◽  
Gina McKernan ◽  
Tom Gale ◽  
...  
Keyword(s):  
Physical Function ◽  
Patient Reported Outcomes ◽  
Design Method ◽  
Pressure Sensors ◽  
Residual Limb ◽  
Prosthetic Socket ◽  
Large Patient ◽  
Increased Risk ◽  
Patient Reported ◽  
And Function

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

scholarly journals A case report: Type II Abernethy malformation complicated with congenital polydactyly and enlargement of all cardiac chambers.

2019 ◽  
Author(s):  
Cheng Zhu ◽  
Min Wang ◽  
Qian Hao
Keyword(s):  
Congenital Malformations ◽  
Portacaval Anastomosis ◽  
Test Results ◽  
Abernethy Malformation ◽  
Form And Function ◽  
Laboratory Test Results ◽  
Number Of Patients ◽  
Patient Reported ◽  
And Function

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.

scholarly journals Life satisfaction and happiness in patients shielding from the COVID-19 global pandemic: A randomised controlled study of the ‘mood as information’ theory

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243278
Author(s):  
Alice O’Donnell ◽  
Lydia Wilson ◽  
Jos A. Bosch ◽  
Richard Borrows
Keyword(s):  
Information Theory ◽  
Life Satisfaction ◽  
Renal Transplant ◽  
Confidence Interval ◽  
Controlled Study ◽  
Care Providers ◽  
Patient Reported ◽  
Momentary Happiness ◽  
The Impact ◽  
Desire To Change

Objectives To extrapolate the ‘mood as information’ theory to the unique and ecologically relevant setting of the COVID-19 pandemic; the specific aim was to inform health care providers of the impact of bringing the pandemic to salience during life satisfaction evaluations, assessing whether this ‘prime’ results in increased or decreased reports of satisfaction which are derived unconsciously. Design Prospective Randomised Interventional Study. Setting Renal Transplant Department in a tertiary centre in the United Kingdom. Participants 200 Renal transplant patients aged between 20 and 88 years. Telephone interviews were undertaken between 1st May, 2020 and 29th May, 2020, at the height of ‘shielding’ from COVID-19. Interventions Participants were randomised into 2 groups, with 1 group receiving a simple ‘priming question’ regarding the COVID pandemic and the other group having no prior contact. Main outcome measurements Individuals were then asked to rate their own overall lifetime happiness; desire to change; overall life satisfaction and momentary happiness on a scale of 1 to 10 for each measure. Independent sample t-tests were used to compare results between the two groups, with a type 1 error rate below 5% considered statistically significant. Results Participants’ overall happiness with their life as a whole revealed that individuals who were primed with a question about COVID-19 reported increased overall happiness with their life compared to individuals who had not been primed (+0.88, 95% confidence interval 0.42 to 1.35, p = 0.0002). In addition, participants in the primed group reported less desire to change their life when compared to the non-primed group (-1.35, 95% confidence interval -2.06 to -0.65, p = 0.0002). Participants who were primed with the COVID-19 question also reported a higher overall satisfaction with their life than individuals who had not been primed (+1.01, 95% confidence interval 0.50 to 1.52, p = 0.0001). Finally, the participants who received the priming question demonstrated increased reported momentary happiness (+0.64, 95% confidence interval 0.03 to 1.24, p = 0.04). Conclusions The results demonstrated that bringing salience to the COVID-19 pandemic with a simple question leads to positive changes in both momentary happiness and other components of global life satisfaction, thereby extrapolating evidence for the application of the mood-as-information theory to more extreme life circumstances. Given the importance of patient-reported evaluations, these findings have implications for how, when and where accurate and reproducible measurements of life satisfaction should be obtained.

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