scholarly journals Association between the Use of Backpack and Static Foot Posture in Schoolchildren with Static Pronated Foot Posture: A 36-Month Cohort Study

Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 800
Author(s):  
Pilar Alfageme-García ◽  
Julián Fernando Calderón-García ◽  
Alfonso Martínez-Nova ◽  
Sonia Hidalgo-Ruiz ◽  
Belinda Basilio-Fernández ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Multivariate Analysis ◽  
Cohort Study ◽  
Prospective Study ◽  
Odds Ratio ◽  
Univariate Analysis ◽  
Foot Posture ◽  
The Mean ◽  
The Impact

Background: Schoolchildren often spend a lot of time carrying a backpack with school equipment, which can be very heavy. The impact a backpack may have on the pronated feet of schoolchildren is unknown. Aims: The objective of this study was to evaluate the association of the backpack use on static foot posture in schoolchildren with a pronated foot posture over 36 months of follow-up. Methods: This observational longitudinal prospective study was based on a cohort of consecutive healthy schoolchildren with pronated feet from fifteen different schools in Plasencia (Spain). The following parameters were collected and measured in all children included in the study: sex, age, height, weight, body mass index, metatarsal formula, foot shape, type of shoes, and type of schoolbag (non-backpack and backpack). Static foot posture was determined by the mean of the foot posture index (FPI). The FPI was assessed again after 36 months. Results: A total of 112 participants used a backpack when going to school. Over the 36-month follow-up period, 76 schoolchildren who had a static pronated foot posture evolve a neutral foot posture. Univariate analysis showed that the schoolchildren using backpacks were at a greater risk of not developing neutral foot (odds ratio [OR]: 2.09; 95% CI: 1.08–4.09). The multivariate analysis provided similar results, where the schoolchildren using a backpack (adjusted OR [aOR]: 1.94; 95% CI: 1.02–3.82) had a significantly greater risk of not developing a neutral foot posture. Conclusions: A weak relationship was found between backpack use and schoolchildren aged from five to eleven years with static pronated feet not developing a neutral foot posture over a follow-up period of 36 months.

scholarly journals Arthroscopic Treatment of Focal Osteochondral Lesions of the First Metatarsophalangeal Joint

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0006
Author(s):  
Ersin Kuyucu ◽  
Barış Gülenç ◽  
Mehmet Erdil ◽  
Yavuz Kocabey
Keyword(s):  
Prospective Study ◽  
Daily Life ◽  
Hallux Rigidus ◽  
Arthroscopic Treatment ◽  
Osteochondral Lesions ◽  
First Metatarsophalangeal Joint ◽  
Functional Scores ◽  
The Mean ◽  
The Impact

Background: This study aimed to assess the arthroscopic treatment, one of the surgical treatment options, for early grade focal osteochondral lesions of the first MTP joint, and to determine the impact of the arthroscopic microdrill hole surgery on foot function and daily life in a patient group with failed conservative treatment. Materials-Methods: This prospective study reviewed 27 patients having hallux rigidus with osteochondral injury of the first MTP joint who were operated with first MTP joint arthroscopy. Six patients had Coughlin-Shurnas grade 4 hallux rigidus and were excluded from the study; 5 patients were excluded due to having an arthroscopic kissing lesion, and 3 patients were excluded for not having attended regular follow-up after third month. After excluding the above patients, the study was completed with 14 patients Results: The mean hallux vagus angle was 13.29⁰ (±1.93 SD) and the mean intermetatarsal angle was 9.14⁰ (±0.86 SD). Apart from joint arthroscopy, no soft tissue procedure and/or any procedure requiring osteotomy was intended in any patient. The median operative duration was 27.8 (19-56) minutes.The patients had mean preoperative VPS and AOFAS-Hallux scores of 8.14±0.86 SD and 48.64±4.27, respectively; the corresponding postoperative values of both scores were 1.86±0.66 SD and 87.00±3.70. Both VPS and AOFAS-Hallux scores changed significantly (p<0.01) Discussion: In this prospective study we explored the impact of arthroscopic microdrill hole surgery on foot functions and daily life activities in patients with focal osteochondral lesions of the first MTP joint. Our results indicated significant improvements in VAS and AOFAS scores with this treatment. The micro drill technique we applied in this study is based on the principle of opening 4-6-mm long tunnels to enable stem cells to migrate to the defected area and achieve cure by differentiation in full-thickness chondral injuries with exposed subchondral bone.In conclusion, arthroscopic microhole drill technique can be applied with impressive functional scores and without any complication in persons who failed conservative therapy for hallux rigidus with focal chordal injury, a common foot problem. There is a need for comparative studies with long follow-up period in this field.

Impact of Body Mass Index and Comorbidities on Outcomes in Upper Extremity Nerve Transfers

2021 ◽  
Author(s):  
Linden K. Head ◽  
Maria C. Médor ◽  
Aneesh Karir ◽  
Gerald Wolff ◽  
Kirsty U. Boyd
Keyword(s):  
Body Mass Index ◽  
Cohort Study ◽  
Upper Extremity ◽  
Body Mass ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Nerve Transfer ◽  
Nerve Transfers ◽  
The Impact

Abstract Background There is a paucity of research investigating the impact of patient comorbidities, such as obesity and smoking, on nerve transfer outcomes. The objective of this retrospective cohort study was to evaluate the impact of body mass index (BMI) and comorbidities on the clinical outcomes of upper extremity nerve transfers. Methods A retrospective cohort study was executed. Patients were eligible for inclusion if they had an upper extremity nerve transfer with a minimum of 12-months follow-up. Data was collected regarding demographics, comorbidities, injury etiology, nerve transfer, as well as preoperative and postoperative clinical assessments. The primary outcome measure was strength of the recipient nerve innervated musculature. Statistical analysis used the Mann-Whitney U test, Wilcoxon signed-rank test, and Spearman's rho. Results Thirty-eight patients undergoing 43 nerve transfers were eligible for inclusion. Patients had a mean age of 48.8 years and a mean BMI of 27.4 kg/m2 (range:19.7–39.0). Injuries involved the brachial plexus (32%) or its terminal branches (68%) with the most common etiologies including trauma (50%) and compression (26%). Anterior interosseous nerve to ulnar motor nerve (35%) was the most common transfer performed. With a mean follow-up of 20.1 months, increased BMI (p = 0.036) and smoking (p = 0.021) were associated with worse postoperative strength. Conclusion This retrospective cohort study demonstrated that increased BMI and smoking may be associated with worse outcomes in upper extremity nerve transfers—review of the literature yields ambiguity in both regards. To facilitate appropriate patient selection and guide expectations regarding prognosis, further experimental and clinical work is warranted.

Transmetatarsal Amputation: Predictors of Healing

2006 ◽  
Vol 72 (10) ◽  
pp. 973-977 ◽  
Author(s):  
Tien H. Nguyen ◽  
Ian L. Gordon ◽  
Delores Whalen ◽  
Samuel E. Wilson
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Pressure Ratio ◽  
Univariate Analysis ◽  
Arterial Occlusion ◽  
Smoking History ◽  
Transmetatarsal Amputation ◽  
The Mean ◽  
The Difference

The objective of this study is to determine the predictors of healing after transmetatarsal amputations (TMA) and factors leading to a higher level of amputation. A total of 33 TMA was performed in 31 patients during the 5 years between January 2000 and Jul 2005. All patients were men between the ages of 44 and 82 years (mean, 68 years). The mean follow-up period was 36 months (range, 1–65 months). Twelve (40%) TMA required a subsequent higher level of amputation. Seventeen (57%) TMA were successful. The average time until further proximal amputation after TMA was 3.5 months. Risk factors for subsequent higher amputation by univariate analysis included infrapopliteal arterial occlusion (P < 0.05), tobacco smoking greater than 20 years (P < 0.05), and further TMA debridement (P < 0.05). Upon multivariate analysis, only patients undergoing further TMA debridement were at risk for TMA failure (P = 0.01). The difference in ankle-to-brachial pressure ratio (ABI) between the higher amputation group (ABI = 0.51) and the successful TMA group (ABI = 0.54) was not significant. There were no perioperative deaths after TMA. Five (18%) deaths occurred at a mean of 8.2 months after the TMA. In patients who are walking preoperatively, aggressive TMA is warranted in an attempt to maintain ambulation, recognizing that requirement for further debridement, smoking history, and infrapopliteal occlusion may be predictors of nonhealing and subsequent higher amputation.

scholarly journals Backpacks Effect on Foot Posture in Schoolchildren with a Neutral Foot Posture: A Three-Year Prospective Study

2020 ◽  
Vol 17 (19) ◽  
pp. 7313
Author(s):  
Pilar Alfageme-García ◽  
Julián Fernando Calderón-García ◽  
Alfonso Martínez-Nova ◽  
Sonia Hidalgo-Ruiz ◽  
Mariana Martínez-Álvarez ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Positive Association ◽  
Follow Up Study ◽  
Longitudinal Observational Study ◽  
Study Results ◽  
Foot Posture ◽  
The Mean ◽  
Prospective Longitudinal ◽  
The Relationship

Background: There is a paucity of data on the relationship between backpack use and foot posture in children. The aim of this study was to assess the effects of a backpack on foot posture in children with neutral foot posture during three years of follow-up. Methods: A prospective longitudinal observational study was conducted in a sample of 627 children with neutral foot. For each participant included in the study, age, sex, weight, height, body mass index, type of schoolbag (backpack or non-backpack), foot shape, metatarsal formula and type of shoes were recorded. Foot posture was described by the mean of the foot posture index (FPI) and reassessed after three years in a follow-up study. Results: The average age of the children was 8.32 ± 1.32 years. A total of 458 used a backpack when going to school. Over the three-year follow-up period, 50 children who had neutral foot developed supinated foot (n = 18) or pronated foot (n = 32). Univariate and multivariate analysis showed that the children using a backpack were at a higher risk of developing pronated foot (adjusted Odds Ratio (aOR) = 2.05, 95% IC: 1.08–3.89, p = 0.028). Backpack use was not associated with the change from neutral foot to supinated foot. Conclusions: We found a positive association between using a backpack and the risk of developing pronated but not supinated foot. Clinical trials should be conducted to analyze the effect of backpack use on the foot among schoolchildren.

scholarly journals The Impact of Insulin-Like Growth Factor Index and Biologically Effective Dose on Outcomes After Stereotactic Radiosurgery for Acromegaly: Cohort Study

Neurosurgery ◽  
2020 ◽  
Vol 87 (3) ◽  
pp. 538-546 ◽  
Author(s):  
Christopher S Graffeo ◽  
Diane Donegan ◽  
Dana Erickson ◽  
Paul D Brown ◽  
Avital Perry ◽  
...  
Keyword(s):  
Cohort Study ◽  
Growth Factor ◽  
Effective Dose ◽  
Stereotactic Radiosurgery ◽  
Univariate Analysis ◽  
Biologically Effective Dose ◽  
Insulin Like Growth Factor ◽  
Biochemical Remission ◽  
The Impact

Abstract BACKGROUND Stereotactic radiosurgery (SRS) is a safe and effective treatment for acromegaly. OBJECTIVE To improve understanding of clinical and dosimetric factors predicting biochemical remission. METHODS A single-institution cohort study of nonsyndromic, radiation-naïve patients with growth hormone-producing pituitary adenomas (GHA) having single-fraction SRS between 1990 and 2017. Exclusions were treatment with pituitary suppressive medications at the time of SRS, or &lt;24 mo of follow-up. The primary outcome was biochemical remission—defined as normalization of insulin-like growth factor-1 index (IGF-1i) off suppression. Biochemical remission was assessed using Cox proportional hazards. Prior studies reporting IGF-1i were assessed via systematic literature review and meta-analysis using random-effect modeling. RESULTS A total of 102 patients met study criteria. Of these, 46 patients (45%) were female. The median age was 49 yr (interquartile range [IQR] = 37-59), and the median follow-up was 63 mo (IQR = 29-100). The median pre-SRS IGF-1i was 1.66 (IQR = 1.37-3.22). The median margin dose was 25 Gy (IQR = 21-25); the median estimated biologically effective dose (BED) was 169.49 Gy (IQR = 124.95-196.00). Biochemical remission was achieved in 58 patients (57%), whereas 22 patients (22%) had medication-controlled disease. Pre-SRS IGF-1i ≥ 2.25 was the strongest predictor of treatment failure, with an unadjusted hazard ratio (HR) of 0.51 (95% CI = 0.26-0.91, P = .02). Number of isocenters, margin dose, and BED predicted remission on univariate analysis, but after adjusting for sex and baseline IGF-1i, only BED remained significant—and was independently associated with outcome in continuous (HR = 1.01, 95% CI = 1.00-1.01, P = .02) and binary models (HR = 2.27, 95% CI = 1.39-5.22, P = .002). A total of 24 patients (29%) developed new post-SRS hypopituitarism. Pooled HR for biochemical remission given subthreshold IGF-1i was 2.25 (95% CI = 1.33-3.16, P &lt; .0001). CONCLUSION IGF-1i is a reliable predictor of biochemical remission after SRS. BED appears to predict biochemical outcome more reliably than radiation dose, but confirmatory study is needed.

scholarly journals Lipoabdominoplasty: repercussions for diaphragmatic mobility and lung function in healthy women

2019 ◽  
Vol 45 (3) ◽  
Author(s):  
Sandra Fluhr ◽  
Armèle Dornelas de Andrade ◽  
Emanuel José Baptista Oliveira ◽  
Taciano Rocha ◽  
Ana Irene Carlos Medeiros ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cohort Study ◽  
Lung Function ◽  
Tidal Volume ◽  
Preoperative Period ◽  
Short Term ◽  
Healthy Women ◽  
The Mean ◽  
The Impact ◽  
Tidal Volume Breathing

ABSTRACT Objective: To evaluate the impact of lipoabdominoplasty on diaphragmatic mobility (DM) and lung function in healthy women. Methods: This was a prospective cohort study using high-resolution ultrasound and forced spirometry to assess DM and lung function, respectively, prior to lipoabdominoplasty, as well as on postoperative day (POD) 10 and POD 30. DM was measured under two conditions: during tidal volume breathing and during a VC maneuver. Results: The sample consisted of 20 women, with a mean age of 39.85 ± 7.52 years and a mean body mass index of 26.21 ± 2.0 kg/m2. Comparing the preoperative and postoperative periods, we found that DM and lung function values were significantly lower after lipoabdominoplasty, the mean DM on POD 10 being 17% and 15% lower during tidal volume breathing and during the VC maneuver, respectively, in comparison with the preoperative mean (p = 0.009 and p < 0.001, respectively). In addition, FEV1, FVC, and PEF were significantly lower on POD 10 than in the preoperative period (p = 0.046, p = 0.002, and p < 0.001, respectively), returning to preoperative values by POD 30. Conclusions: Lipoabdominoplasty appears to have negative short-term repercussions for DM and lung function in healthy women. However, lung function and DM are both apparently restored to preoperative conditions by POD 30. (ClinicalTrials.gov identifier: NCT02762526 [http://www.clinicaltrials.gov/])

Impact of leucocyte modifications in patients with locally advanced cervical treated by chemoradiotherapy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18014-e18014
Author(s):  
Christine Gennigens ◽  
Marjolein de Cuypere ◽  
Annelore Barbeaux ◽  
Frederic Forget ◽  
Johanne Hermesse ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Cox Regression ◽  
External Beam Radiotherapy ◽  
Linear Regression Analysis ◽  
Univariate Analysis ◽  
Locally Advanced ◽  
White Blood Cells ◽  
Polymorphonuclear Neutrophils ◽  
The Impact

e18014 Background: Concomitant cisplatin-based chemoradiotherapy (CCRT), followed by image guided-adaptive brachytherapy (IGABT) is the recommended treatment for patients suffering from locally advanced cervical cancer (LACC). Methods: Between January 2010 and May 2017, 103 patients with LACC (FIGO 2009-stages IB2-IVA) received CCRT followed by IGABT. The objectives of this study were to evaluate the impact of white blood cells (WBC) and polymorphonuclear neutrophils (PMN) counts variations on outcomes. This variable was calculated by substraction between WBC or PMN levels at the first cycle (CB) and the last cycle (CL) of chemotherapy (CT)(DCB-CL). The data were reviewed retrospectively, with Cox regression for univariate and multivariate analysis. Results: The median age at diagnosis was 50 years. The median tumor size at diagnosis was 47mm. The majority of the patients had FIGO stage II (60.2%) or stage I (21.4%) disease with squamous histology (88.3%). Patients received a median dose of external-beam radiotherapy (EBRT) of 45 Gy (range 40-50.4 Gy) by 1.8-2 Gy fractions, with a median cumulative dose of all the radiotherapy of 85 Gy. The median duration of EBRT+IGABT was 51 days (range 31-94). All patients received at least one cycle of cisplatin, but the majority received 5 (40.4%) or 6 (39.4%) cycles. The median follow-up time for all patients was 30.1 months. The overall survival (OS) and recurrence-free survival (RFS) at 3 years was 81,4% and 76,8% respectively. Univariate analysis associated higher DCB-CL WBC and DCB-CL PMN with better OS and RFS. Multivariate analysis confirmed that DCB-CL WBC (HR, 0.856; 95% CI, 0.737-0.986; p = 0.018) and DCB-CL PMN (HR, 0.863; 95% CI, 0.750-0.994; p = 0.041) were associated with better OS and RFS respectively. A linear regression analysis was performed to cross the DCB-CL WBC/PMN and the number of CT cycles. This analysis reveals that an increasing number of CT cycles is linked to an increased DCB-CL WBC/PMN. Conclusions: Our study reveals the impact of DCB-CL WBC and PMN on outcomes. These two tests could become biomarkers during CCRT to discuss adjuvant treatments, but also to adapt our follow-up.

scholarly journals POS0515 FIBROMYALGIA IN MEXICAN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 491.1-492
Author(s):  
L. D. Fajardo Hermosillo
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Multivariate Analysis ◽  
Disease Activity ◽  
Functional Status ◽  
Univariate Analysis ◽  
The Mean ◽  
The Impact ◽  
Mexican Patients

Background:Rheumatoid Arthritis (RA) is a disabling chronic inflammatory disease that shows an unpredictable and severe clinical course [1]. Global assessment, functional status and disease activity of patients with RA can be influenced also by non-inflammatory factors as concomitant presence of fibromyalgia (FM) [1,2]. FM occur up to 20% in RA patients, who present chronic widespread pain, fatigue and cognitive symptoms that impacts achieving a complete disease remission, having more comorbidities, bearing a higher medical cost and finally exhibiting a worse quality of life [1,3,4]. Range of manifestations of FM varies according ethnical and cultural differences between patients [1]. Here is presented the impact of fibromyalgia in Mexican patients with RA.Objectives:To determinate the frequency and factors associated to fibromyalgia in Mexican RA patients.Methods:624 patients with RA that fulfilled ACR/EULAR 2010 criteria (≥18 years) from a Mexican population recruited from 2012 to 2020 were examined. Patients with or without presence of FM diagnosed by ACR 2010/2011 criteria were included. Demographic factors, clinical features, disease activity measured using DAS28 (Disease Activity Score 28-joint counts), functional status evaluated by HAQ (Health Assessment Questionnaire), comorbidities and pharmacologic treatments were explored for RA patients with and without FM. Charlson’s comorbidity index (CCI) was used to analyze comorbidities. Chi-square, Student´s-t, U Mann-Whitney tests were performed by univariate analysis and logistic regression was executed by multivariate analysis adjusted for age and gender. Statistical tests were conducted at 5% level of significance.Results:Of 624 patients with RA 88.8% were women. The mean age [standard deviation (SD)] was 55.0 (12.3) years. The mean of time at onset of RA (SD) was 11.2 (9.1) years. A total of 311(49.8%) patients had FM; of them 91.6% were women and the mean age (SD) was 54.5 (12.2) years. In the univariate analysis RA patients with FM were more likely to be older and smokers, have seropositive RA, higher body mass index and longer time at onset of RA, show worse functional status by HAQ and more radiographic progression, present more extra-articular and Sicca manifestations, exhibit increased demand of hip and knee arthroplasty, also reveal a higher frequency of comorbidities including depression, osteoporosis and type 2 diabetes mellitus, besides to use a greater number of disease-modifying anti-rheumatic drugs (DMARDs), more biologic agents and higher doses of corticosteroids. Also, CCI was higher in RA patients with FM. Nevertheless, no differences were found for RA disease activity in both groups. In multivariate analysis, higher score of CCI (OR 1.21, 95% CI 1.01–1.44, p=0.037) remained significant in RA patients with FM.Conclusion:This study suggests that RA patients from Mexico have high prevalence of the FM. Those with FM have a worse functional status, a higher frequency and score of comorbidities that impact in a reduction of their quality of life. On the other hand, no differences were found for RA disease activity in both groups. However, these observations must be confirmed in larger and prospective studies.References:[1]Zhao SS et al. Best Pract Res Clin Rheumatol. 2019;33(3):101423;[2]Duffield SJ et al. Rheumatology (Oxford). 2018;57(8):1453;[3]Kim H et al. Arthritis Care Res (Hoboken) 2017;69(12):1871;[4]Salaffi Fet al. Rheumatol Int. 2017;37(12):2035.Disclosure of Interests:None declared

Sound Production Treatment for Acquired Apraxia of Speech: An Examination of Dosage in Relation to Probe Performance

2020 ◽  
pp. 1-16
Author(s):  
Julie L. Wambaugh ◽  
Lydia Kallhoff ◽  
Christina Nessler
Keyword(s):  
Retrospective Analysis ◽  
Sound Production ◽  
Apraxia Of Speech ◽  
Practice Schedule ◽  
Practice Schedules ◽  
Baseline Performance ◽  
The Mean ◽  
Number Of Treatment ◽  
The Impact

Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12–14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190

Cognitive Impairment and Physical Activity in Old Age: The Impact on All-Cause Mortality in a 15-Year Follow-Up of the Bambuí Cohort Study of Aging

2020 ◽  
Author(s):  
Erico Castro-Costa ◽  
Jerson Laks ◽  
Cecilia Godoi Campos ◽  
Josélia OA Firmo ◽  
Maria Fernanda Lima-Costa ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cohort Study ◽  
Cognitive Impairment ◽  
Old Age ◽  
All Cause Mortality ◽  
The Impact
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