Preliminary clinical experience of a contracture correction device

Joint contractures which do not respond to conventional physiotherapy can be difficult to treat. Serial plastering has been used effectively but is expensive, inconvenient to the patient and does not permit daily hygiene or clinical inspection. A mechanical device has been developed consisting a hinged orthosis which spans the affected joint to which is attached a gas strut to provide a corrective moment about the anatomical joint. Such an arrangement enables prescribed corrective moments to be applied accurately following clinical assessment using routine physiotherapy techniques. The inherently low spring rate of a gas strut ensures that the specified corrective torque is maintained as correction occurs. Initial treatment experience under the control of the developers had generated wider interest in the system. A geographically distant independent orthotic supply centre was trained in the techniques of application. They treated nine elbow and three knee joints in patients who had not responded to physiotherapy treatment. All of the patients experienced improvement. The average for elbow joints was a reduction in the contracture of 25.6° with a corrective moment of 6.8Nm over a period of 3.9 weeks. For the knee joints the averages were a reduction in contracture of 10.7° with a corrective moment of 12.7Nm over a period of 4 weeks. The results confirmed the practicality of transferring the system to independent clinical centres and provide evidence to support funding for a formal prospective clinical trial of the treatment approach.

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Effect of Dual Task Cognitive Performance along with Conventional Physiotherapy Treatment on Gait Parameters in Patients with Ischemic Stroke: A Study Protocol of Randomized Clinical Trial

International Journal of Neurology and Neurosurgery ◽

10.21088/ijnns.0975.0223.7215.3 ◽

2015 ◽

Vol 7 (2) ◽

pp. 55-59

Author(s):

Pooja Kumari Digra ◽

◽

Manoj Kumar Deshmukh ◽

Senthil P. Kumar ◽

Divya Midha ◽

...

Keyword(s):

Clinical Trial ◽

Ischemic Stroke ◽

Randomized Clinical Trial ◽

Cognitive Performance ◽

Study Protocol ◽

Dual Task ◽

Physiotherapy Treatment ◽

Gait Parameters ◽

Conventional Physiotherapy

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The Penumbra System: A Mechanical Device for the Treatment of Acute Stroke due to Thromboembolism

Yearbook of Neurology and Neurosurgery ◽

10.1016/s0513-5117(09)79054-4 ◽

2009 ◽

Vol 2009 ◽

pp. 14-15

Author(s):

A. Rabinstein

Keyword(s):

Acute Stroke ◽

Mechanical Device ◽

System A

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A case of cutaneous necrosis due to intra-articular hyaluronic acid and treated with hyaluronidase

SAGE Open Medical Case Reports ◽

10.1177/2050313x211025110 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2110251

Author(s):

Michelle Aaron ◽

Yu Qing Huang ◽

Danielle Bouffard ◽

Jean-Pascal Costa ◽

Benoît Côté

Keyword(s):

Hyaluronic Acid ◽

Initial Treatment ◽

Treatment Approach ◽

Clinical State ◽

Dermal Fillers ◽

Ankle Osteoarthritis ◽

Cutaneous Necrosis ◽

Hyaluronic Acid Injection ◽

First Time ◽

Ankle And Foot

A 66-year-old woman presented to the hospital with cutaneous necrosis of her right ankle and foot. Her symptoms began immediately after an intra-articular injection of hyaluronic acid for ankle osteoarthritis, which was performed 6 days before. Histopathology showed an intra-vascular hyaluronic acid embolus. The initial treatment approach was conservative, but the patient’s clinical state degraded. She was thus treated with sub-cutaneous hyaluronidase, the enzyme that degrades hyaluronic acid, which yielded a moderate improvement even though it was administered 22 days after the initial hyaluronic acid injection. Although hyaluronic acid embolism and subsequent cutaneous necrosis are well-known complications of dermal fillers, there are few reported cases of embolism following intra-articular injection. To our knowledge, this is the first time hyaluronidase has been used in this setting.

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Upper limbs cycle ergometer increases muscle strength, trunk control and independence of acute stroke subjects: A randomized clinical trial

Neurorehabilitation ◽

10.3233/nre-210022 ◽

2021 ◽

pp. 1-10

Author(s):

Douglas Rafael da Rosa Pinheiro ◽

Maria Eduarda Parcianello Cabeleira ◽

Luigi Antonio da Campo ◽

Laís Andrielli Ferreira Gattino ◽

Kellen Sábio de Souza ◽

...

Keyword(s):

Clinical Trial ◽

Muscle Strength ◽

Randomized Clinical Trial ◽

Acute Phase ◽

Functional Independence ◽

Cycle Ergometer ◽

Upper Limbs ◽

Trunk Control ◽

Post Stroke ◽

Conventional Physiotherapy

BACKGROUND: Studies demonstrate the benefits of upper limbs cycle ergometer (ULCE) in subacute and chronic stroke subjects, but the literature still needs to explore the acute phase of the disease. OBJECTIVE: Verify the effects of ULCE on muscular strength, trunk control and independence of post-stroke subjects in hospital acute phase. METHODS: In this randomized clinical trial participants were allocated into two groups. The control group (CG) performed two daily sessions of conventional physiotherapy, while the intervention group (IG) had one daily session of conventional physiotherapy and one of ULCE. The interventions were carried out for 20 minutes for five days. Both groups were assessed before and after the treatment for upper limbs strength by manual dynamometer, trunk control by Trunk Impairment Scale and level of independence by the Modified Rankin Scale. RESULTS: Twenty subjects with mean ages of 63.5±4.5 were enrolled. There was a significant intra-group difference of palmar grip, shoulder abductors, elbow flexor and wrist extensor strength, trunk control and functional independence only in IG. Inter-group difference for all variables showed superiority in IG. CONCLUSIONS: ULCE is an effective device for increasing muscle strength, trunk control and consequently improving the independence of post-stroke subjects in the acute hospital phase.

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