Plantar Pressure and Contact Area Measurement of Foot Abnormalities in Stroke Rehabilitation

Background: Evaluation of plantar pressure in stroke patients is a parameter that could be used for monitoring and comparing how the timing of starting a rehabilitation program effects patient improvement. Methods: We performed the following clinical and functional evaluations: initial moment (T1), intermediate (T2), and final evaluation at one year (T3). At T1 we studied 100 stroke patients in two groups, A and B (each 50 patients). The first group, A, started rehabilitation in the first three months after having a stroke, and group B started after three months from the time of stroke. Due to the impediments observed during rehabilitation, we made biomechanic evaluation for two lots, I and II (each 25 patients). Assessment of the patient was carried out by clinical (neurologic examination), functional (using the Tinetti Functional Gait Assessment Test for classifying the gait), and biomechanical evaluation (maximal plantar pressure (Pmax), contact area (CA), and pressure distribution (COP)). Results: The Tinetti scale for gait had the following scores: for group A, from 1.34 at the initial moment (T1) to 10.64 at final evaluation (T3), and for group B, 3.08 at initial moment (T1) to 9 at final evaluation (T3). Distribution of COP in the left hemiparesis was uneven at T1 but evolved after rehabilitation. The right hemiparesis had uniform COP distribution even at T1, explained by motor dominance on the right side. CA and Pmax for lot I increased more than 100%, meaning that there is a possibility for favorable improvement if the patients start the rehabilitation program in the first three months after stroke. For lot II, increases of the parameters were less than lot I. Discussions: The recovery potential is higher for patients with right hemiparesis. Biomechanic evaluation showed diversity regarding compensatory mechanisms for the paretic and nonparetic lower limb. Conclusions: CA and Pmax are relevant assessments for evaluating the effects on timing of starting a rehabilitation program after a stroke.

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DeVega versus ring annuloplasty in severe functional tricuspid insufficiency and their impact on the right ventricle

The Egyptian Cardiothoracic Surgeon ◽

10.35810/ects.v1i4.89 ◽

2019 ◽

Vol 1 (4) ◽

pp. 133-139

Author(s):

Yasser Hamdy ◽

Mohammed Mahmoud Mostafa ◽

Ahmed Elminshawy

Keyword(s):

Right Ventricular ◽

Tricuspid Valve ◽

Tricuspid Regurgitation ◽

Early Postoperative Period ◽

Tricuspid Valve Repair ◽

Ring Annuloplasty ◽

Significant Difference ◽

Group A ◽

Group B ◽

The Right

Background: Functional tricuspid valve regurgitation secondary to left-sided valve disease is common. DeVega repair is simple, but residual regurgitation with subsequent impairment of the right ventricular function is a concern. This study aims to compare tricuspid valve repair using DeVega vs. ring annuloplasty and their impact on the right ventricle in the early postoperative period and after six months. Methods: This is a prospective cohort study of 51 patients with rheumatic heart disease who underwent tricuspid valve repair for secondary severe tricuspid regurgitation. Patients were divided into two groups: group A; DeVega repair (n=34) and group B; ring annuloplasty repair (n=17). Patients were assessed clinically and by echocardiography before discharge and after six months for the degree of tricuspid regurgitation, right ventricular diameter and tricuspid annular plane systolic excursion (TAPSE). Results: Preoperative echocardiographic assessment showed no difference in left ventricular end-systolic diameter, end-diastolic diameter, ejection fraction and right ventricular diameter, however; group A had significantly better preoperative right ventricular function measured by TAPSE (1.96 ± 0.27 vs1.75 ± 0.31 cm; p=0.02). Group B had significantly longer cardiopulmonary bypass time (127.65 ± 13.56 vs. 111.74 ± 18.74 minutes; p= 0.003) and ischemic time (99.06 ± 11.80 vs. 87.15 ± 16.01 minutes; p= 0.009). Pre-discharge, there was no statistically significant difference in the degree of tricuspid regurgitation, but the right ventricular diameter was significantly lower in group B (2.66 ± 0.41 and 2.40 ± 0.48 cm; p=0.049). After six months of follow up, the degree of tricuspid regurgitation (p= 0.029) and the right ventricular diameter were significantly lower in the ring annuloplasty group (2.56 ± 0.39 and 2.29 ± 0.44 cm; p=0.029). Although there was a statistically significant difference in preoperative TAPSE, this difference disappeared after six months. Conclusion: Both DeVega and ring annuloplasty techniques were effective in the early postoperative period, ring annuloplasty was associated with lesser residual regurgitation and better right ventricular remodeling in severe functional tricuspid regurgitation than DeVega procedure after 6-months of follow up.

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The effect of nano-hydroxyapatite/chitosan scaffolds on rat calvarial defects for bone regeneration

International Journal of Implant Dentistry ◽

10.1186/s40729-021-00327-w ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Emmanouil Chatzipetros ◽

Spyros Damaskos ◽

Konstantinos I. Tosios ◽

Panos Christopoulos ◽

Catherine Donta ◽

...

Keyword(s):

Bone Regeneration ◽

Mean Value ◽

Parietal Bone ◽

Female Rats ◽

Sprague Dawley ◽

Post Surgery ◽

Group A ◽

The Mean ◽

Group B ◽

The Right

Abstract Background This study aims at determining the biological effect of 75/25 w/w nano-hydroxyapatite/chitosan (nHAp/CS) scaffolds on bone regeneration, in terms of fraction of bone regeneration (FBR), total number of osteocytes (Ost), and osteocyte cell density (CD), as well as its biodegradability. Methods Two critical-size defects (CSDs) were bilaterally trephined in the parietal bone of 36 adult Sprague-Dawley rats (18 males and 18 females); the left remained empty (group A), while the right CSD was filled with nHAp/CS scaffold (group B). Two female rats died postoperatively. Twelve, 11, and 11 rats were euthanized at 2, 4, and 8 weeks post-surgery, respectively. Subsequently, 34 specimens were resected containing both CSDs. Histological and histomorphometric analyses were performed to determine the FBR, calculated as [the sum of areas of newly formed bone in lateral and central regions of interest (ROIs)]/area of the original defect, as well as the Ost and the CD (Ost/mm2) in each ROI of both groups (A and B). Moreover, biodegradability of the nHAp/CS scaffolds was estimated via the surface area of the biomaterial (BmA) in the 2nd, 4th, and 8th week post-surgery. Results The FBR of group B increased significantly from 2nd to 8th week compared to group A (P = 0.009). Both the mean CD and the mean Ost values of group B increased compared to group A (P = 0.004 and P < 0.05 respectively). Moreover, the mean value of BmA decreased from 2nd to 8th week (P = 0.001). Conclusions Based on histological and histomorphometric results, we support that 75/25 w/w nHAp/CS scaffolds provide an effective space for new bone formation.

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Effectiveness of rehabilitation in post-COVID compared with post-cardiosurgery patients. A single Center experience

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.385 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

GQ Villani ◽

A Rosi ◽

D Corbellini ◽

V Schettino ◽

A Bosoni ◽

...

Keyword(s):

Barthel Index ◽

Rehabilitation Program ◽

Walking Test ◽

Rehabilitative Treatment ◽

Funding Sources ◽

Single Center Experience ◽

Clinical Complexity ◽

Significant Disability ◽

Group A ◽

Group B

Abstract Funding Acknowledgements Type of funding sources: None. The COVID 19 disease is frequently associated with significant disability related to intensive care unit-acquired weakness, decontitioning, myopathies and neuropathies. However there are no data on the results of a specific rehabilitative treatment in this group of patients. The aim of our work was to evaluate the effectiveness f a personalized rehabilitative therapy in group of post-COVID patients (A, 47 patients, average age 65.3± 11.6 y, 27 M,) comparing the results with a group of post-cardiosurgical patients COVID 19 negative (B, 47 patients, average age 63.5± 10.3 y, 29 M) evaluating the degree of clinical complexity (Rehabilitation Complexity Scale, RCS-E V13) and the degree of autonomy recovery (Six-minute walking test SMWT, Barthel Index, BI) pre and post-treatment. In Group A patients the Rehabilitation program is associated with a significant improvement in autonomy recovery (BI admission 29.7 ± 20 vs discharge 72.7 ± 28.6 p <0.005, SMWT admission 146 ± 25 vs 318 ± 18 m, p <0.005) and in clinical complexity (RCS admission 10.9 ± 1.1 vs discharge 5.3, p< 0.05) Conclusions Post-COVID patients show a greater loss of autonomy than post-cardiosurgery patients. Rehabilitative treatment has proven effective in ensuring adequate functional recovery with similar results to those obtained in the population of cardiological subjects COVID 19 negative. Group A vs Group B Group A Group B p pre-rehabilitation hospital stay (days) 31 ± 5 8 ± 2 0.005 RCS admission 10.9 ± 1.1 11.6 ± 1.2 ns BI admission 29.7 ± 20 47.7 ± 19 0.05 SMWT admission (m) 146 ± 25 255 ± 18 0.05 Rehabilitation duration (days) 29.7 ± 12.8 29.6 ± 10.1 ns RCS discharge 5.3 ± 2 6.5 ± 2 ns BI discharge 72.7 ± 28 71.5 ± 22.5 ns SMWT discharge (m) 385 ± 18 410 ± 25 ns RCS rehabilitation complexity scale, BI: Barthel Index, SMWT: six-minute walking test

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EFFICACY OF ROLLING BOARD PERTURBATION TRAINING ON BALANCE AMONG HEMIPARETIC STROKE PATIENTS - A COMPARATIVE STUDY

THE RESEARCH RESERVOIR ◽

10.47211/trr.2020.v06i01.016 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Dr. Senthil kumar ◽

Dr. Franklin Shaju M.K m k ◽

Dr. Vijaya Senthil Kumar kumar ◽

Dr. A. velmurugan

Keyword(s):

Public Health Problem ◽

Berg Balance Scale ◽

Major Public Health Problem ◽

Stroke Patients ◽

Perturbation Training ◽

Before And After ◽

Group A ◽

Hemiparetic Stroke ◽

Conventional Physiotherapy ◽

Group B

Background of the study: Stroke is a major public health problem that ranks in the top four causes of death in most of the countries and is responsible for a large proportion of the burden of neurologic disorders. Patients with stroke have poor balance because they cannot control dynamically the size of the base of support or the location of the line of gravity. Perturbation training undergoes the maximal sway possible without losing his balance. Objective of the study: The objective of the study is to find the effects of rolling board perturbation training on balance among hemiparetic stroke patients. Methodology: Thirty clinically diagnosed hemiparetic stroke patients were selected based on the inclusion and exclusion criteria. They were randomly allocated into two groups (Group A and Group B) consists of 15 subjects each. Group A received conventional physiotherapy alone and group B received rolling board perturbation training along with conventional physiotherapy. Intervention lasted for 4 weeks, three days in a week and one hour per day. Balance was measured before and after 4 weeks of intervention by berg balance scale. Conclusion: Both conventional physiotherapy alone and rolling board perturbation training along with conventional physiotherapy significantly improved balance among hemiparetic stroke patients. When comparing both rolling board perturbation training along with conventional physiotherapy is more effective than conventional physiotherapy alone in improving balance among hemiparetic stroke patients.

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Prolonged Sinus Pauses upon Termination of Paroxysmal Atrial Fibrillation: Abnormal Right Atrial Electrophysiologic and Electroanatomic Findings

Texas Heart Institute Journal ◽

10.14503/thij-15-5493 ◽

2017 ◽

Vol 44 (2) ◽

pp. 107-114 ◽

Cited By ~ 1

Author(s):

Zhengyu Bao ◽

Hongwu Chen ◽

Bing Yang ◽

Michael Shehata ◽

Weizhu Ju ◽

...

Keyword(s):

Atrial Fibrillation ◽

Sinus Node ◽

P Wave ◽

Right Atrial ◽

Control Group ◽

Paroxysmal Supraventricular Tachycardia ◽

Group A ◽

Group B ◽

Activation Times ◽

The Right

The efficacy of pulmonary vein antral isolation for patients with prolonged sinus pauses (PSP) on termination of atrial fibrillation has been reported. We studied the right atrial (RA) electrophysiologic and electroanatomic characteristics in such patients. Forty patients underwent electroanatomic mapping of the RA: 13 had PSP (group A), 13 had no PSP (group B), and 14 had paroxysmal supraventricular tachycardia (control group C). Group A had longer P-wave durations in lead II than did groups B and C (115.5 ± 15.4 vs 99.5 ± 10.9 vs 96.5 ± 10.4 ms; P=0.001), and RA activation times (106.8 ± 13.8 vs 99 ± 8.7 vs 94.5 ± 9.1 s; P=0.02). Group A's PP intervals were longer during adenosine triphosphate testing before ablation (4.6 ± 2.3 vs 1.7 ± 0.6 vs 1.5 ± 1 s; P <0.001) and after ablation (4.7 ± 2.5 vs 2.2 ± 1.4 vs 1.6 ± 0.8 s; P <0.001), and group A had more complex electrograms (11.4% ± 5.4% vs 9.3% ± 1.6% vs 5.8% ± 1.6%; P <0.001). Compared with group C, group A had significantly longer corrected sinus node recovery times at a 400-ms pacing cycle length after ablation, larger RA volumes (100.1 ± 23.1 vs 83 ± 22.1 mL; P=0.04), and lower conduction velocities in the high posterior (0.87 ± 0.13 vs 1.02 ± 0.21 mm/ms; P=0.02) and high lateral RA (0.89 ± 0.2 vs 1.1 ± 0.35 mm/ms; P=0.04). We found that patients with PSP upon termination of atrial fibrillation have RA electrophysiologic and electroanatomic abnormalities that warrant post-ablation monitoring.

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Abstract TP52: Endovascular Therapy in Patients Over 80 Years of Age With Acute Ischemic Stroke

Stroke ◽

10.1161/str.51.suppl_1.tp52 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Janhavi M Modak ◽

Syed Daniyal Asad ◽

Jussie Lima ◽

Amre Nouh ◽

Ilene Staff ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Symptom Onset ◽

Time Window ◽

Extended Time ◽

Stroke Patients ◽

Stroke Outcomes ◽

Stroke Treatment ◽

Group A ◽

Group B

Introduction: Acute ischemic stroke treatment has undergone a paradigm shift, with patients being treated in the extended time window (6-24 hours post symptom onset). The purpose of this study is to assess outcomes in stroke patients above 80 years of age undergoing endovascular treatment (EVT) in the extended time window. Methods: Acute ischemic stroke patients presenting to Hartford Hospital between January 2017 to June 2019 were considered for the study. Stroke outcomes in patients above 80 years of age with anterior circulation ischemic strokes presenting in the extended time window (Group A, n=30) were compared to a younger cohort of patients below 80 years (Group B, n=31). Patients over 80 years treated in the traditional time window (within 6 hours of symptom onset) served as a second set of controls (Group C, n=40). Statistical analysis was performed with a significance level of 0.05 Results: For angiographic results, there were no statistically significant differences in terms of good outcomes (TICI 2b-3) among patients of Group A, when compared to Groups B or C (p>0.05). For the endovascular procedures, no significant differences were noted in the total fluoroscopy time (Median Group A 44.05, Group B 38.1, Group C 35.25 min), total intra-procedure time (Median Group A 144, Group B 143, Group C 126 min) or total radiation exposure (Median Group A 8308, Group B 8960, Group C 8318 uGy-m 2 ). For stroke outcomes, a good clinical outcome was defined as modified Rankin score of 0-2 at discharge. Significantly better outcomes were noted in the younger patients in Group B - 35.4%, when compared to 13.3% in Group A (p=0.03). Comparative outcomes differed in the elderly patients above 80 years, Group A -13.3% vs Group C - 25%, although not statistically significant (p=0.23). There was a significant difference in mortality in patients of Group A - 40% as compared to 12% in the younger cohort, Group B (p= 0.01). Conclusions: In the extended time window, patients above 80 years of age were noted to have a higher mortality, morbidity compared to the younger cohort of patients. No significant differences were noted in the stroke outcomes in patients above 80 years of age when comparing the traditional and the extended time window for stroke treatment.

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A stabilization period of 5 minutes is adequate when measuring pulmonary artery pressures after turning

American Journal of Critical Care ◽

10.4037/ajcc1993.2.6.474 ◽

1993 ◽

Vol 2 (6) ◽

pp. 474-477 ◽

Cited By ~ 2

Author(s):

PA Shinners ◽

MO Pease

Keyword(s):

Pulmonary Artery ◽

Pulmonary Artery Pressure ◽

Supine Position ◽

Surgical Intensive Care Unit ◽

Pressure Measurements ◽

Artery Pressure ◽

Group A ◽

Group B ◽

The Right ◽

Stabilization Period

OBJECTIVE: To compare hemodynamic measurements made before turning and at 5 and 30 minutes after turning, and to determine whether the stabilization period affects the difference between supine and side-lying pulmonary artery pressures. METHODS: This study was performed in the cardiothoracic surgical intensive care unit of a midwestern university hospital. The 31 postoperative open-heart surgical patients, 26 men and 5 women aged 41 to 76 years (64 +/- 9.3, mean +/- SD) with pulmonary artery catheters in place, were divided into two groups to compare supine to side-lying pressures and the time intervals between the position changes. The supine-first subjects (Group A) were placed in the supine position for baseline measurements and turned to either the right or left side-lying position for the 5- and 30-minute pulmonary artery pressure measurements. The side-first subjects (Group B) were placed in either the right or left side-lying position for baseline measurements and then in the supine position for the 5- and 30-minute pulmonary artery pressure measurements. RESULTS: Pulmonary artery pressures, heart rate and arterial pressure were not significantly different at 5 and 30 minutes. Supine pulmonary artery pressures in Group A were not significantly different from supine pressures in Group B. Side-lying pulmonary artery pressures in Group A were not significantly different from side-lying pressures in Group B. Side-lying vs supine pulmonary artery pressures were significantly different in both Group A and Group B. CONCLUSION: The current practice of turning and settling the patient, zeroing the transducer and proceeding to make the pulmonary artery pressure readings appears to be valid. The stabilization period after turning does not explain the differences found between side-lying and supine pulmonary artery pressures.

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Electrical Stimulation of Intact or Split Steer or Cow Carcasses

Journal of Food Protection ◽

10.4315/0362-028x-43.10.795 ◽

1980 ◽

Vol 43 (10) ◽

pp. 795-798 ◽

Cited By ~ 15

Author(s):

F. K. McKEITH ◽

C. G. SMITH ◽

T. R. DUTSON ◽

J. W. SAVELL ◽

R. L. HOSTETLER ◽

...

Keyword(s):

Electrical Stimulation ◽

Structural Damage ◽

Troponin T ◽

Protein Subunits ◽

Versus Group ◽

Group A ◽

Group B ◽

The Right ◽

And Control ◽

Group D

Fifteen carcasses, 10 from steers and 5 from cows, were used for the present study. Five steer carcasses (group A) were electrically stimulated as intact, unsplit carcasses. The left sides of 5 steer carcasses (group B) and of 5 cow carcasses (group C) were electrically stimulated; the right sides of the same 5 steer carcasses (group D) and of the same 5 cow carcasses (group E) were used as controls and were not electrically stimulated. Electrically stimulated carcasses and sides (groups A and B) had brighter, more youthful colored lean, less “heat-ring” and produced more tender and more palatable rib steaks than did control sides (group D). Electrical stimulation did not (P > .05) affect ultimate pH or sarcomere length in steers or cows. Light and electron micrographs revealed increased (P < .05) structural damage (more severe contracture bands) in steer or cow muscles from electrically stimulated sides than in muscles from control sides; however, structural damage was not (P >.05) increased when intact steer carcasses were electrically stimulated and compared to unstimulated sides. Troponin-T was reduced in SDS gels of muscle from electrically stimulated, as compared to control, sides of cow carcasses (group C versus group E); no differences in percentage of protein subunits were observed between electrically stimulated and control sides of steer carcasses (group B versus group D). Electrical stimulation can be done on intact carcasses or sides of young beef to improve USDA lean maturity and lean color scores, to reduce “heat-ring” incidence and to improve tenderness.

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A postmortem study on the weight of the human adrenal glands

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v9i4.6686 ◽

1970 ◽

Vol 9 (4) ◽

pp. 204-207 ◽

Cited By ~ 1

Author(s):

Dilruba Siddiqua ◽

Shamim Ara ◽

Abu Sadat Mohammad Nurunnabi ◽

Rukshana Ahmed ◽

Ara Parven Hosne

Keyword(s):

Adrenal Gland ◽

Adrenal Glands ◽

Medical Science ◽

Age Groups ◽

Cross Sectional ◽

Medical College ◽

Group A ◽

Group B ◽

The Right ◽

Group D

Objective: A cross-sectional descriptive type of study was designed to find out the difference in weight of the right and left adrenal glands of Bangladeshi people in relation to age and to compare with the previous studies. Materials & Methods: The study was done in the Department of Anatomy, Dhaka Medical College, Dhaka from July 2008 to June 2009 and performed on 140 post mortem human adrenal glands collected from 70 unclaimed dead bodies which were in the morgue under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into four age-groups including group A (11-20 years), group B (21-30 years), group C (31-40 years) & group D (41-60 years) and the weight of the adrenal glands were measured and recorded. Results: There was no difference found in weight in between the right and the left adrenal glands in any age group. For the right adrenal gland, the differences in weight between group A & group B and group A & group D were statistically significant (p<0.05). For the left adrenal gland, the differences in weight between group A & group D and group C & group D were statistically significant (p<0.05). Key words: Adrenal gland; weight of adrenal gland. DOI: 10.3329/bjms.v9i4.6686Bangladesh Journal of Medical Science Vol.09 No.4 July 2010 pp.204-207

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Use of an Elastomeric Knee Brace in Patellofemoral Pain Syndrome: Short-Term Results

Joints ◽

10.1055/s-0038-1661339 ◽

2018 ◽

Vol 06 (02) ◽

pp. 085-089 ◽

Cited By ~ 1

Author(s):

Francesco Uboldi ◽

Paolo Ferrua ◽

Daniele Tradati ◽

Pietro Zedde ◽

Jim Richards ◽

...

Keyword(s):

Controlled Trial ◽

Return To Sport ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Rehabilitation Program ◽

Return To Sports ◽

Level Of Evidence ◽

Group A ◽

Group B

Purpose This article verifies the effectiveness of a new brace on patellofemoral pain syndrome (PFPS) in adjunct to a specifically developed rehabilitation program. Methods Two groups of 30 patients with PFPS were prospectively and randomly allocated to a rehabilitation protocol, with (group A) or without (group B) the use of a specific brace. All the patients were assessed at 3, 6, and 12 months using the disease-specific Kujala scale and a visual analog scale (VAS) for pain; time to return to sport and patient satisfaction with the brace were also recorded. Results Kujala scale's values showed constant and progressive improvement. The mean score at 6 months was 79.8 ± 6.8 points in group A and 76.8 ± 8.6 in group B, rising at 12 months to 80.9 ± 7.5 in group A and 78.4 ± 8.3 in group B. VAS scores significantly differed (p < 0.05) between the two groups at both 6 and 12 months; the score recorded at 12 months was 0.9 ± 1.3 in the brace-treated group and 1.8 ± 1.6 in the controls. The patients who used a brace showed a quicker return to sports and 75% of the patients in this group were satisfied. Conclusion All the scores improved progressively in both groups. The most significant improvement concerned pain, showing that the brace used in this study may allow a better subjective outcome and a quicker return to sport. Level of Evidence Level II, prospective randomized controlled trial.

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