Features of walking in patients with knee arthrosis before and after arthroplasty according to the GAITRite system

Background. Hardware examinations are the key to standardizing the assessment of the patient’s condition, they reduce the doctor’s error, make it possible to obtain digital material, which can be used to determine the functional ability of the patient. One of such studies is the GAITRite system, the purpose of which is to assess the parameters of a person’s walking. The study was aimed to determine the basic parameters of walking in patients with gonarthrosis before and after the endoprosthesis. Materials and methods. There were examined 23 patients with gonarthrosis after unilateral endoprosthesis. The studies carried out concern the analysis of temporal, geometric parameters of walking, as well as the assessment of the functional ability of patients with degenerative diseases of the hip joint before treatment and one year after arthroplasty. Results. Before treatment for knee arthrosis, patients experience a violation of walking in the form of asymmetry of steps. There is a decrease in the time of support on the foot of the impaired limb and, therefore, an increase in the time of transfer of the foot of this limb. Changes in the impaired limb are reflected in the opposite one. After surgery, the changes in the parameters of walking in patients were as follows: an increase in the time of support on the prosthetic limb, and, therefore, a decrease in the time of support on the foot of the opposite limb that manifested in an increase in the symmetry of the parameters of steps. Reduction of pain syndrome and restoration of limb support ability increase the indicator of gait functionality. Osteoarthritis is a systemic disease and develops more often in both knee joints, and other structures of the skeleton are often involved in the degenerative process. Therefore, in elderly patients, FAP after arthroplasty reaches only satisfactory values. We examined patients after endoprosthesis on one knee joint, and this does not always give the expected good result immediately. Conclusions. Instrumental methods of studying patients’ gait make it possible to determine the degree of impairment of dynamics. Knee arthroplasty eliminates pain and restores limb resistance, which improves gait. This method of assessing walking allows determining the degree of recovery of patients and to adjust the need for further methods of correcting walking or a plan for further treatment.

Effect of Blood Circulation in the Upper Limb after Flossing Strategy

A very popular method in the field of prevention, sports, and therapy is flossing, working with an elastic band. A number of effects have been reported with this approach, but there are so far only a few studies to objectivize the declared effects. The aim of our study was to determine the change in the blood supply to the musculus biceps brachii during and after the flossing method applied to the upper limb in the area of the shoulder joint. The study recruited 27 healthy respondents (23.3 ± 2.8 years old). Measurement of the blood flow was performed on a Précisé 8008 (Ulrichstein, Germany) a device for measuring transcutaneous oxygen (tcpO2) before, during the 2-min compression therapy applied in the area of the shoulder joint, and after. We noted that both upper limbs, the limb where the application was performed and the opposite limb reached significant changes in the blood flow in musculus biceps brachii. Due to the significant depression of perfusion after only 2 min of flossing, great caution is required when performing the flossing method. The “sponge effect,” which means that after the occlusion is removed, the perfusion increases rapidly, was not confirmed by our study.

Histologic and Functional Outcomes of Conduit Wrapping for Peripheral Nerve Repair: Early Results in a Rat Model

Background The concept of utilizing a nerve conduit for augmentation of a primary nerve repair has been advocated as a method to prevent neural scarring and decrease adhesions. Despite clinical use, little is known about the effects of a nerve conduit wrapped around a primary repair. To better understand this, we investigated the histologic and functional effects of use of a nerve conduit wrapped around a rat sciatic nerve repair without tension. Methods Twenty Lewis' rats were divided into two groups of 10 rats each. In each group, unilateral sciatic nerve transection and repair were performed, with the opposite limb utilized as a matched control. In the first group, direct repair alone was performed; in the second group, this repair was augmented with a porcine submucosa conduit wrapped around the repair site. Sciatic functional index (SFI) was measured at 6 weeks with walking track analysis in both groups. Nonsurvival surgeries were then performed in all animals to harvest both the experimental and control nerves to measure histomorphometric parameters of recovery. Histomorphometric parameters assessed included total number of neurons, nerve fiber density, nerve fiber width, G-ratio, and percentage of debris. Unpaired t-test was used to compare outcomes between the two groups. Results All nerves healed uneventfully but compared with direct repair; conduit usage was associated with greater histologic debris, decreased axonal density, worse G-ratio, and worse SFI. No significant differences were found in total axon count or gastrocnemius weight. Conclusion In the absence of segmental defects, conduit wrapping primary nerve repairs seem to be associated with worse functional and mixed histologic outcomes at 6 weeks, possibly due to debris from conduit resorption. While clinical implications are unclear, more basic science and clinical studies should be performed prior to widespread adoption of this practice.

Mental Rotation Ability: Right or Left Hemisphere Competence? What We Can Learn from Callosotomized and Psychotic Patients

Mental rotation is an abstract operation whereby a person imagines rotating an object or a body part to place it in a different position. The ability to perform mental rotation was attributed to right hemisphere for objects, to the left for one’s own body images. Mental rotation seems to be basic for imitation in anatomical mode. Previous studies showed that control subjects, callosotomized and psychotic patients chose the mirror-mode when imitating without instructions; when asked to use the same or opposite limb as the model, controls chose the anatomical mode, callosotomized patients mainly used mirror mode, psychotic patients were in between. The preference of callosotomized subjects is likely due to defective mental rotation, because of the lack of the corpus callosum (CC), thus suggesting an asymmetry in the hemispheric competence for mental rotation. Present research investigated the mental rotation ability in control subjects, callosotomized and psychotic patients. All subjects were shown pictures of a model, in first or third person perspective, with a cup in her right or left hand. They had to indicate which model’s hand held the cup, by answering with a verbal or motor modality in separate experimental sessions. In both sessions, control subjects produced 99% of correct responses, callosotomy patients 62%, and psychotic patients 91%. The difference was statistically significant, suggesting a role of the CC in the integration of the two hemispheres’ asymmetric functions in mental rotation.

Potato Protein Isolate Stimulates Muscle Protein Synthesis at Rest and with Resistance Exercise in Young Women

Skeletal muscle myofibrillar protein synthesis (MPS) increases in response to protein feeding and to resistance exercise (RE), where each stimuli acts synergistically when combined. The efficacy of plant proteins such as potato protein (PP) isolate to stimulate MPS is unknown. We aimed to determine the effects of PP ingestion on daily MPS with and without RE in healthy women. In a single blind, parallel-group design, 24 young women (21 ± 3 years, n = 12/group) consumed a weight-maintaining baseline diet containing 0.8 g/kg/d of protein before being randomized to consume either 25 g of PP twice daily (1.6 g/kg/d total protein) or a control diet (CON) (0.8 g/kg/d total protein) for 2 wks. Unilateral RE (~30% of maximal strength to failure) was performed thrice weekly with the opposite limb serving as a non-exercised control (Rest). MPS was measured by deuterated water ingestion at baseline, following supplementation (Rest), and following supplementation + RE (Exercise). Ingestion of PP stimulated MPS by 0.14 ± 0.09 %/d at Rest, and by 0.32 ± 0.14 %/d in the Exercise limb. MPS was significantly elevated by 0.20 ± 0.11 %/d in the Exercise limb in CON (p = 0.008). Consuming PP to increase protein intake to levels twice the recommended dietary allowance for protein augmented rates of MPS. Performance of RE stimulated MPS regardless of protein intake. PP is a high-quality, plant-based protein supplement that augments MPS at rest and following RE in healthy young women.

Features of Arthroplasty in Bilateral Knee Osteoarthritis

Introduction. Hip and knee arthroplasty are the two of the most frequently used methods of surgical treatment. The techniques of drug support in the perioperative period, as well as the rehabilitation component, are of primary importance. However, due to the increase in number of operations the number of complications is also growing. At the same time, surgical approaches to the treatment of bilateral knee OA are still not sufficiently studied. The literature describes intervals between arthroplasty operations on knee joints from 3 months to 5 years. The epidemiological and pathogenetic aspects of functional recovery in bilateral knee OA patients are also in need of further research.Materials and methods. Authors analysed outcomes in 124 patients with gonarthrosis treated with arthroplasty. 32 patients underwent arthroplasty of the contralateral joint. The outcomes were evaluated with the KSS score and X-ray imaging at 1, 3 and 6 months postop.Results and discussions. In the first month after the operation functional recovery was noted due to the relief of pain, recovery of the muscle tone and regional hemodynamics in the area of the knee joint. It was also noted that the recovery of function in the period from month 1 to month 3 in patients with bilateral gonarthrosis occurs less intensively due to decompensation of the contralateral joint.Conclusion. The study demonstrates the recovery of function in patients in the postoperative period. There is, however, the issue of functional decompensation in the opposite limb, which in turn reduces the effectiveness of motor rehabilitation and leads to the need for endoprosthetic replacement of the second joint.

Vision does not always help stroke survivors compensate for impaired limb position sense

Background Position sense is commonly impaired after stroke. Traditional rehabilitation methods instruct patients to visualize their limbs to compensate for impaired position sense. Objective Our goal was to evaluate how the use of vision influences impaired position sense. Methods We examined 177 stroke survivors, an average of 12.7 days (+/− 10 days (SD)) post-stroke, and 133 neurologically-intact controls with a robotic assessment of position sense. The robot positioned one limb (affected) and subjects attempted to mirror-match the position using the opposite limb (unaffected). Subjects completed the test without, then with vision of their limbs. We examined three measures of position sense: variability (Var), contraction/expansion (C/E) and systematic shift (Shift). We classified stroke survivors as having full compensation if they performed the robotic task abnormally without vision but corrected performance within the range of normal with vision. Stroke survivors were deemed to have partial compensation if they performed the task outside the range of normal without and with vision, but improved significantly with vision. Those with absent compensation performed the task abnormally in both conditions and did not improve with vision. Results Many stroke survivors demonstrated impaired position sense with vision occluded [Var: 116 (66%), C/E: 91 (51%), Shift: 52 (29%)]. Of those stroke survivors with impaired position sense, some exhibited full compensation with vision [Var: 23 (20%), C/E: 42 (46%), Shift: 32 (62%)], others showed partial compensation [Var: 37 (32%), C/E: 8 (9%), Shift: 3 (6%)] and many displayed absent compensation (Var: 56 (48%), C/E: 41 (45%), Shift: 17 (33%)]. Stroke survivors with an affected left arm, visuospatial neglect and/or visual field defects were less likely to compensate for impaired position sense using vision. Conclusions Our results indicate that vision does not help many stroke survivors compensate for impaired position sense, at least within the current paradigm. This contrasts with historical reports that vision helps compensate for proprioceptive loss following neurologic injuries.

Side-to-side elbow range of movement variability in an ulnar neurodynamic test sequence variant in asymptomatic people

Background: Range of motion (ROM) asymmetry between sides is one indicator of a positive neurodynamic test, but this has been less well studied for the ulnar nerve. Objective: The purpose of this study was to investigate side-to-side variation in elbow ROM during an ulnar neurodynamic test sequence, including contralateral cervical side flexion, in 40 asymptomatic subjects. Methods: A traditional goniometer was used to measure elbow flexion ROM at two end points, onset of resistance ([Formula: see text]1) and symptom onset ([Formula: see text]1). Two repeated measures of [Formula: see text]1 and [Formula: see text]1 were taken on each side. Results: Reliability for [Formula: see text]1 and [Formula: see text]1 was found to be good (ICC [Formula: see text], SEM [Formula: see text]) with no significant difference in mean ROM between sides. A significant relationship between sides was seen ([Formula: see text] values [Formula: see text]) and [Formula: see text] values [Formula: see text]; this indicates at least 23% of the variance observed in one limb was accounted for by range in the opposite limb. This relationship was slightly stronger for [Formula: see text]1 than [Formula: see text]1. Lower bound scores indicate that intra-individual ROM difference [Formula: see text] for [Formula: see text]1 and 22° for [Formula: see text]1 would exceed normal ROM asymmetry. Conclusion: These findings provide clinicians with background information of ROM asymmetry during the ulnar neurodynamic test.