Transdisciplinary Clinical Practice between Physiotherapists and Traumatologists in Orthopaedic Medicine

Introduction: The transdisciplinary scope is conceived as an emerging practice and corpus of knowledge since it comes from the interactions between different disciplines. Transdisciplinarity emerges to solve in a more efficient way health problems of humanity that overcome the traditional biomedical interdisciplinary attention model. In this article, the transdisciplinary physiotherapist is exposed as the beginning of an authentic dialogue between the physiotherapist and the traumatologist in the care of the orthopedic patient that includes all treatment phases of integral rehabilitation, as well as its factors to consider the possible advantages and dares that this scope may present to the health services. Objective: This paper aims to propose to the scientific community the context of transdisciplinary clinical practice between traumatologists and physical therapists. Methods: It is performed a grounded theory approach to develop a thesis based on our observations and a reflection of literature that intends to explain transdisciplinary clinical practice phenomenon between traumatologists and physical therapists and pose the potential outcomes of this interactions and its implications. Conclusion: Exist theoretical and practical background to support the clinical practice of transdisciplinary care in Orthopedic and Physical Therapy attention; which make possible professionals to develop transdisciplinary clinical skills, and team shared decision making. Transdisciplinary clinical practice, as with any educational process, should ideally foster specific shared competencies in healthcare professionals, including teamwork, leadership, consensus building, the ability to identify and achieve common patient care goals and variable shared practical skills that may even include other specialization areas.

The orthopedic patient and limb amputation: impact of traditional beliefs on acceptance in Port Harcourt, Nigeria

Background: Aim of the study was to ascertain the awareness on surgical limb amputation and establish the existence of traditional beliefs that impacts on acceptance of surgical limb amputation in tertiary healthcare facilities in Port Harcourt. Surgical limb amputation is a form of treatment recommended in conditions of dead, dying, dangerous limb or damn nuisance, in which the appendage is removed surgically and permanently from the rest of the body.Methods: A cross-sectional descriptive study was carried out among patients and patients’ relatives in the two government-owned tertiary health care facilities that offered orthopedic surgical services in Port Harcourt using self-administered questionnaires. Data obtained was analyzed using the Statistical Package for the Social Sciences (SPSS) version 20.0.Results: Safe removal of a disease limb from the rest of the body was considered by 217 respondents (93.1%) as the meaning of limb amputation. Some community beliefs on amputated limb were: risk of incomplete body in the “next world”, burying of persons with amputated limb in the evil forest when they die, stigmatization as outcasts in some communities. Eighty-two respondents (35.2%) opined that traditional bone setters should be encouraged to continue their work.Conclusions: There was high awareness on limb amputation among respondents. Though expressed by few respondents, the twin factors of patronage of traditional bone setters and the practice of community stigmatization of amputees / social isolation among others explains patients decline of offer of limb amputation in the care of orthopedic patients in our society.

Nutritional Orthopedics and Space Nutrition as Two Sides of the Same Coin: A Scoping Review

Since the Moon landing, nutritional research has been charged with the task of guaranteeing human health in space. In addition, nutrition applied to Orthopedics has developed in recent years, driven by the need to improve the efficiency of the treatment path by enhancing the recovery after surgery. As a result, nutritional sciences have specialized into two distinct fields of research: Nutritional Orthopedics and Space Nutrition. The former primarily deals with the nutritional requirements of old patients in hospitals, whereas the latter focuses on the varied food challenges of space travelers heading to deep space. Although they may seem disconnected, they both investigate similar nutritional issues. This scoping review shows what these two disciplines have in common, highlighting the mutual features between (1) pre-operative vs. pre-launch nutritional programs, (2) hospital-based vs. space station nutritional issues, and (3) post-discharge vs. deep space nutritional resilience. PubMed and Google Scholar were used to collect documents published from 1950 to 2020, from which 44 references were selected on Nutritional Orthopedics and 44 on Space Nutrition. Both the orthopedic patient and the astronaut were found to suffer from food insecurity, malnutrition, musculoskeletal involution, flavor/pleasure issues, fluid shifts, metabolic stresses, and isolation/confinement. Both fields of research aid the planning of demand-driven food systems and advanced nutritional approaches, like tailored diets with nutrients of interest (e.g., vitamin D and calcium). The nutritional features of orthopedic patients on Earth and of astronauts in space are undeniably related. Consequently, it is important to initiate close collaborations between orthopedic nutritionists and space experts, with the musculoskeletal-related dedications playing as common fuel.

Kinetic gait analysis in healthy dogs and dogs with osteoarthritis: An evaluation of precision and overlap performance of a pressure-sensitive walkway and the use of symmetry indices

In veterinary practice, a thorough gait examination is essential in the clinical workup of any orthopedic patient, including the large population of dogs with chronic pain as a result of osteoarthritis. The traditional visual gait examination is, however, a subjective discipline, and systems for kinetic gait analysis may potentially offer an objective alternative for gait assessment by the measurement of ground reaction forces. In order to avoid unnecessary testing of patients, a thorough, stepwise evaluation of the diagnostic performance of each system is recommended before clinical use for diagnostic purposes. The aim of the study was to evaluate the Tekscan pressure-sensitive walkway system by assessing precision (agreement between repetitive measurements in individual dogs) and overlap performance (the ability to distinguish dogs with lameness due to osteoarthritis from clinically healthy dogs). Direction of travel over the walkway was investigated as a possible bias. Symmetry indices are commonly used to assess lameness by comparing ground reaction forces across different combinations of limbs in each dog. However, SIs can be calculated in several different ways and specific recommendations for optimal use of individual indices are currently lacking. Therefore the present study also compared indices in order to recommend a specific index preferable for future studies of canine osteoarthritis. Forty-one clinically healthy dogs and 21 dogs with osteoarthritis were included in the study. High precision was demonstrated. The direction of travel over the walkway was excluded as a possible bias. A significant overlap was observed when comparing ground reaction forces measured in dogs with osteoarthritis compared to clinically healthy dogs. In some affected dogs, symmetry indices comparing contralateral limbs differed from clinically healthy dogs, but in general, the overlap performance was insufficient and, consequently, general use of this method for diagnostic purposes in dogs with osteoarthritis cannot be recommended.