Pub Date : 2021-06-17eCollection Date: 2021-01-01DOI: 10.2340/20030711-1000062
Diego Longo, Marco Lombardi, Paolo Lippi, Daniela Melchiorre, Maria Angela Bagni, Francesco Ferrarello
Introduction: Physiotherapy plays a key role in cerebral palsy rehabilitation, through addressing body function/structure deficits, minimizing activity limitations, and encouraging participation. The muscle shortening manoeuvre is an innovative therapeutic technique, characterized by the ability to induce changes in muscle strength in a short time.
Objective: To describe the applicability and estimate the effect of the muscle shortening manoeuvre applied to improve motor weakness and joint excursion of the ankle in children with hemiplegic cerebral palsy.
Methods: Nine children with hemiplegic cerebral palsy received 3 intervention sessions in one week. Muscle strength, passive and active range of motion were assessed before, during and after the training, and at 1-week follow-up.
Results: The children experienced an immediate increase in muscle strength and joint excursion of the ankle; the improvements were still present at follow-up after 7 days.
Conclusion: The muscle shortening manoeuvre may be an effective intervention to induce an immediate increase in muscle strength and range of motion of the ankle in children affected by hemiplegia due to cerebral palsy, thus promoting better physical functioning.
{"title":"THE MUSCLE SHORTENING MANOEUVRE: APPLICABILITY AND PRELIMINARY EVALUATION IN CHILDREN WITH HEMIPLEGIC CEREBRAL PALSY: A RETROSPECTIVE ANALYSIS.","authors":"Diego Longo, Marco Lombardi, Paolo Lippi, Daniela Melchiorre, Maria Angela Bagni, Francesco Ferrarello","doi":"10.2340/20030711-1000062","DOIUrl":"https://doi.org/10.2340/20030711-1000062","url":null,"abstract":"<p><strong>Introduction: </strong>Physiotherapy plays a key role in cerebral palsy rehabilitation, through addressing body function/structure deficits, minimizing activity limitations, and encouraging participation. The muscle shortening manoeuvre is an innovative therapeutic technique, characterized by the ability to induce changes in muscle strength in a short time.</p><p><strong>Objective: </strong>To describe the applicability and estimate the effect of the muscle shortening manoeuvre applied to improve motor weakness and joint excursion of the ankle in children with hemiplegic cerebral palsy.</p><p><strong>Methods: </strong>Nine children with hemiplegic cerebral palsy received 3 intervention sessions in one week. Muscle strength, passive and active range of motion were assessed before, during and after the training, and at 1-week follow-up.</p><p><strong>Results: </strong>The children experienced an immediate increase in muscle strength and joint excursion of the ankle; the improvements were still present at follow-up after 7 days.</p><p><strong>Conclusion: </strong>The muscle shortening manoeuvre may be an effective intervention to induce an immediate increase in muscle strength and range of motion of the ankle in children affected by hemiplegia due to cerebral palsy, thus promoting better physical functioning.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b9/1f/JRMCC-4-1000062.PMC8259804.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39165993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-14eCollection Date: 2021-01-01DOI: 10.2340/20030711-1000065
Carlos Cordero-GarcÍa, María Del Mar SÁEnz De Tejada SÁnchez
Objective: To describe a case of early management of post-stroke spasticity treated with incobotulinumtoxinA (IncoA) in a patient with SARS-CoV-2 (COVID-19). Scarce information is available on this subject, as the COVID-19 pandemic has necessitated postponement of interventions in infected and clinically suspicious patients.
Case report: A 58-year-old woman presenting with ischaemic stroke, was infected with SARS-CoV-2 virus due to nosocomial contact. Despite clinical improvement, the patient developed early spasticity. Modified Ashworth Scale (MAS) was grade II in her left elbow, wrist flexors and left gastrocnemius. IncoA was injected, using ultrasound guidance, in her upper and lower limbs. No complications were reported after the procedure. Two weeks afterwards, there was an improvement in her motor balance and spasticity, MAS was graded I in the left elbow, wrist flexors, and II in the left gastrocnemius. At 12 weeks, the patient reported improvement at a global level, with increasing independence and functionality.
Conclusion: This case indicates the benefits and safety of IncoA for early treatment of post-stroke spasticity in a patient with confirmed SARS-CoV-2. Despite the current status of national healthcare systems due to the COVID-19 pandemic, increased efforts should be made to avoid discontinuation of treatment for spasticity.
{"title":"BENEFIT AND SAFETY OF INCOBOTULINUMTOXINA FOR EARLY MANAGEMENT OF POST-STROKE SPASTICITY IN A PATIENT WITH SARS-COV-2: A CASE REPORT.","authors":"Carlos Cordero-GarcÍa, María Del Mar SÁEnz De Tejada SÁnchez","doi":"10.2340/20030711-1000065","DOIUrl":"https://doi.org/10.2340/20030711-1000065","url":null,"abstract":"<p><strong>Objective: </strong>To describe a case of early management of post-stroke spasticity treated with incobotulinumtoxinA (IncoA) in a patient with SARS-CoV-2 (COVID-19). Scarce information is available on this subject, as the COVID-19 pandemic has necessitated postponement of interventions in infected and clinically suspicious patients.</p><p><strong>Case report: </strong>A 58-year-old woman presenting with ischaemic stroke, was infected with SARS-CoV-2 virus due to nosocomial contact. Despite clinical improvement, the patient developed early spasticity. Modified Ashworth Scale (MAS) was grade II in her left elbow, wrist flexors and left gastrocnemius. IncoA was injected, using ultrasound guidance, in her upper and lower limbs. No complications were reported after the procedure. Two weeks afterwards, there was an improvement in her motor balance and spasticity, MAS was graded I in the left elbow, wrist flexors, and II in the left gastrocnemius. At 12 weeks, the patient reported improvement at a global level, with increasing independence and functionality.</p><p><strong>Conclusion: </strong>This case indicates the benefits and safety of IncoA for early treatment of post-stroke spasticity in a patient with confirmed SARS-CoV-2. Despite the current status of national healthcare systems due to the COVID-19 pandemic, increased efforts should be made to avoid discontinuation of treatment for spasticity.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ab/cb/JRMCC-4-1000065.PMC8215229.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39196091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-14eCollection Date: 2021-01-01DOI: 10.2340/20030711-1000061
Christoph Gutenbrunner, Alessandro Stievano, David Stewart, Howard Catton, Boya Nugraha
Evidence shows that, in order to attain optimum outcomes, rehabilitation interventions should be delivered by multi-professional teams. A rehabilitation nurse is one of the relevant rehabilitation professionals. The model of nursing care has shifted from the traditional model (a passive role of patients) to a complex and modern concept of nursing in supporting patients to independently and actively perform self-care. This paper briefly introduces the role of nurses in rehabilitation, from the point of view of rehabilitation service delivery, which is relevant in all phases and types of rehabilitation care, including acute rehabilitation, post-acute rehabilitation, long-term rehabilitation, nursing home and geriatric care, and in community- based rehabilitation service.
{"title":"ROLE OF NURSING IN REHABILITATION.","authors":"Christoph Gutenbrunner, Alessandro Stievano, David Stewart, Howard Catton, Boya Nugraha","doi":"10.2340/20030711-1000061","DOIUrl":"https://doi.org/10.2340/20030711-1000061","url":null,"abstract":"<p><p>Evidence shows that, in order to attain optimum outcomes, rehabilitation interventions should be delivered by multi-professional teams. A rehabilitation nurse is one of the relevant rehabilitation professionals. The model of nursing care has shifted from the traditional model (a passive role of patients) to a complex and modern concept of nursing in supporting patients to independently and actively perform self-care. This paper briefly introduces the role of nurses in rehabilitation, from the point of view of rehabilitation service delivery, which is relevant in all phases and types of rehabilitation care, including acute rehabilitation, post-acute rehabilitation, long-term rehabilitation, nursing home and geriatric care, and in community- based rehabilitation service.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/01/c4/JRMCC-4-1000061.PMC8215228.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39196145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-31eCollection Date: 2021-01-01DOI: 10.2340/20030711-1000063
Holly King, Max Forrester
Phantom limb pain is clinically defined as the perception of pain or discomfort in a limb that no longer exists. Most amputees will experience phantom limb pain, which is associated with a low health-related quality of life. Phantom limb pain represents an important challenge in finding an effective therapy. The scientific evidence for best practice is weak, and is characterized by various clinical reports describing the pragmatic use of drugs and interventional techniques. Recent approaches to restore the sensory motor input have shown promise. One such technique is electroacupuncture. We report here a case study of a male in his 30s who sustained severe injuries, including a high transfemoral amputation, as a result of being hit by a car. An electroacupuncture treatment protocol was used. Over the course of 3 months, electroacupuncture alleviated the patient's phantom limb pain, minimized his use of drugs, and improved his sleep and quality of life. The effect of electroacupuncture treatment lasted for 3-4 months, and successful top-up treatment maintained his pain relief. The results are in line with a study comparing massage and electroacupuncture in patients with spinal cord injury with neurogenic pain; a limited number of patients treated with electroacupuncture were significantly alleviated of their pain for months. This case report suggests that electroacupuncture may be useful in patients with phantom limb pain.
{"title":"Electroacupuncture For Alleviation Of Phantom Limb Pain.","authors":"Holly King, Max Forrester","doi":"10.2340/20030711-1000063","DOIUrl":"https://doi.org/10.2340/20030711-1000063","url":null,"abstract":"<p><p>Phantom limb pain is clinically defined as the perception of pain or discomfort in a limb that no longer exists. Most amputees will experience phantom limb pain, which is associated with a low health-related quality of life. Phantom limb pain represents an important challenge in finding an effective therapy. The scientific evidence for best practice is weak, and is characterized by various clinical reports describing the pragmatic use of drugs and interventional techniques. Recent approaches to restore the sensory motor input have shown promise. One such technique is electroacupuncture. We report here a case study of a male in his 30s who sustained severe injuries, including a high transfemoral amputation, as a result of being hit by a car. An electroacupuncture treatment protocol was used. Over the course of 3 months, electroacupuncture alleviated the patient's phantom limb pain, minimized his use of drugs, and improved his sleep and quality of life. The effect of electroacupuncture treatment lasted for 3-4 months, and successful top-up treatment maintained his pain relief. The results are in line with a study comparing massage and electroacupuncture in patients with spinal cord injury with neurogenic pain; a limited number of patients treated with electroacupuncture were significantly alleviated of their pain for months. This case report suggests that electroacupuncture may be useful in patients with phantom limb pain.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a9/0c/JRMCC-4-1000063.PMC8278009.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39196090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-21eCollection Date: 2021-01-01DOI: 10.2340/20030711-1000060
Nienke Roux, Jan Willem VAN DER Windt, Wouter Akkerman, Marco Toor
Pain, stiffness and joint deformity can result in significantly reduced hand function in people with osteoarthritis. Characteristic finger deformities in osteoarthritis are swan neck deformity and boutonnière deformity. Several studies have reported that an orthosis decreases pain and increases function during daily activities for patients with arthritis. The aim of this study was to review patient-reported outcomes of current conservative therapeutic management with silver ring splints (silversplints) for patients with osteoarthritis of the hand. There was a 76% improvement in overall daily functioning and a 74% reduction in pain. Several questions concerned daily activities with different types of hand function and with different types of grip and use of fingers. The results show a major improvement in both the more open grip of the hand and activities requiring fine motor skills. The ability to use force with the hand, even when wearing an orthosis, is an important result. Patients who experienced "no problems or minor problems" had significantly increased functioning in several activities of daily living, but the largest improvement in functioning was seen in "household chores" (243%), "opening jars" (150%) and "lifting groceries" (143%). Overall, silversplints appear to serve as a suitable support for the joints in osteoarthritis of the hand, providing pain relief by preventing the joint from moving through its full range of motion. Use of silversplints to treat patients with osteoarthritis of the hand should be considered as a useful, non-surgical method.
{"title":"PATIENT-REPORTED OUTCOMES FOR USE OF SILVERSPLINTS IN OSTEOARTHRITIS OF THE HAND.","authors":"Nienke Roux, Jan Willem VAN DER Windt, Wouter Akkerman, Marco Toor","doi":"10.2340/20030711-1000060","DOIUrl":"10.2340/20030711-1000060","url":null,"abstract":"<p><p>Pain, stiffness and joint deformity can result in significantly reduced hand function in people with osteoarthritis. Characteristic finger deformities in osteoarthritis are swan neck deformity and boutonnière deformity. Several studies have reported that an orthosis decreases pain and increases function during daily activities for patients with arthritis. The aim of this study was to review patient-reported outcomes of current conservative therapeutic management with silver ring splints (silversplints) for patients with osteoarthritis of the hand. There was a 76% improvement in overall daily functioning and a 74% reduction in pain. Several questions concerned daily activities with different types of hand function and with different types of grip and use of fingers. The results show a major improvement in both the more open grip of the hand and activities requiring fine motor skills. The ability to use force with the hand, even when wearing an orthosis, is an important result. Patients who experienced \"no problems or minor problems\" had significantly increased functioning in several activities of daily living, but the largest improvement in functioning was seen in \"household chores\" (243%), \"opening jars\" (150%) and \"lifting groceries\" (143%). Overall, silversplints appear to serve as a suitable support for the joints in osteoarthritis of the hand, providing pain relief by preventing the joint from moving through its full range of motion. Use of silversplints to treat patients with osteoarthritis of the hand should be considered as a useful, non-surgical method.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/82/a7/JRMCC-4-1000060.PMC8192887.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39196144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The consequences and optimal treatment of quadriceps fibrosis following intramuscular quinine injection during childhood remain unclear. We report here a case of a 17-year-old girl who experienced unilateral quadriceps fibrosis following intramuscular injection of quinine as a baby. This case report describes the evolution of the condition during the child's growth, the long-term impact of early fibrosis on range of motion, muscle volumes, strength, gait, and activities of daily living. Rehabilitation involved orthoses and physiotherapy from the age of 6 years, when her knee flexion was reduced to 90°. A Judet quadricepsplasty was performed at 12 years because of continued loss of knee range with consequences for gait. At 16 years, knee range was satisfactory and gait variables were normalized. Functional evaluations and quality of life scales showed excellent recovery. Isometric strength of the involved quadriceps remained lower than the expected age-matched strength. Magnetic resonance imaging identified amyotrophy of the quadriceps, specifically the vastus intermedius. Despite being a focal impairment, quadriceps fibrosis had wider consequences within the involved limb, the uninvolved limb and functioning. This case report illustrates how children with quadriceps fibrosis can have a good prognosis, with excellent functional results at the end of the growth period, following early and appropriate management.
{"title":"A Multidisciplinary Approach to Optimizing Long-Term Functional Prognosis of A Girl With Quadriceps Fibrosis.","authors":"Jessica Luthringer, Marc Garetier, Mathieu Lempereur, Laetitia Houx, Valérie Burdin, Juliette Ropars, Douraied Ben Salem, Camille Printemps, Sylvain Brochard, Christelle Pons","doi":"10.2340/20030711-1000054","DOIUrl":"https://doi.org/10.2340/20030711-1000054","url":null,"abstract":"<p><p>The consequences and optimal treatment of quadriceps fibrosis following intramuscular quinine injection during childhood remain unclear. We report here a case of a 17-year-old girl who experienced unilateral quadriceps fibrosis following intramuscular injection of quinine as a baby. This case report describes the evolution of the condition during the child's growth, the long-term impact of early fibrosis on range of motion, muscle volumes, strength, gait, and activities of daily living. Rehabilitation involved orthoses and physiotherapy from the age of 6 years, when her knee flexion was reduced to 90°. A Judet quadricepsplasty was performed at 12 years because of continued loss of knee range with consequences for gait. At 16 years, knee range was satisfactory and gait variables were normalized. Functional evaluations and quality of life scales showed excellent recovery. Isometric strength of the involved quadriceps remained lower than the expected age-matched strength. Magnetic resonance imaging identified amyotrophy of the quadriceps, specifically the vastus intermedius. Despite being a focal impairment, quadriceps fibrosis had wider consequences within the involved limb, the uninvolved limb and functioning. This case report illustrates how children with quadriceps fibrosis can have a good prognosis, with excellent functional results at the end of the growth period, following early and appropriate management.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/83/JRMCC-4-1000054.PMC8205268.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39196141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-06eCollection Date: 2021-01-01DOI: 10.2340/20030711-1000059
Jorik Nonnekes, Noël Keijsers, Angelique Witteveen, Alexander Geurts
Objective: Toe walking due to progressive shortening of the calf muscles is common in people with hereditary spastic paraplegia. Achilles tendon lengthening is a treatment option, but clinicians are often hesitant to use this procedure, as it may result in weakening of the calf muscles and, subsequently, in reduced ankle power and knee instability during the stance phase of gait. We report here a case report supporting that these negative side-effects can be avoided in well-selected people with hereditary spastic paraplegia.
Method: Bilateral Achilles tendon lengthening, combined with bilateral tenotomy of the tibialis posterior and toe flexors, was performed in a 29-year-old woman with uncomplicated hereditary spastic paraplegia who experienced progressive gait instability due to shortening of the soleus and gastrocnemius muscles (resulting in irreducible pes equinus).
Results: Bilateral Achilles tendon lengthening resulted in improvement in both subjective and objective outcomes. Self-selected gait speed improved from 0.75 m/s before surgery to 1.07 m/s after surgery (p < 0.001). Knee instability during the stance phase did not occur post-surgery. The ankle moment trajectories normalized after surgery, while peak ankle powers increased.
Conclusion: Correction of bilateral irreducible pes equinus by Achilles tendon lengthening may improve gait capacity in well-selected subjects with hereditary spastic paraplegia.
目的:在遗传性痉挛性截瘫患者中,由于小腿肌肉进行性缩短而导致脚趾行走是常见的。跟腱延长是一种治疗选择,但临床医生通常不愿使用这种方法,因为它可能导致小腿肌肉减弱,随后在站立步态阶段踝关节力量减弱和膝关节不稳定。我们在这里报告一个病例报告,支持这些负面的副作用可以避免在精心挑选的人遗传性痉挛性截瘫。方法:对一名29岁无并发症的遗传性痉挛性截瘫女性患者进行双侧跟腱延长,并联合双侧胫骨后肌和趾屈肌肌腱切断术,该患者由于比目鱼肌和腓骨肌缩短而出现进行性步态不稳定(导致马蹄形无法复位)。结果:双侧跟腱延长导致主观和客观结果的改善。自选步态速度由术前的0.75 m/s提高到术后的1.07 m/s (p < 0.001)。站立期的膝关节不稳定在术后未发生。术后踝关节力矩轨迹恢复正常,踝关节峰值力量增加。结论:选择遗传性痉挛性截瘫患者,采用跟腱延长矫治双侧不可复位马足可改善其步态能力。
{"title":"Improved Gait Capacity after Bilateral Achilles Tendon Lengthening for Irreducible Pes Equinus Due to Hereditary Spastic Paraplegia: a Case Report.","authors":"Jorik Nonnekes, Noël Keijsers, Angelique Witteveen, Alexander Geurts","doi":"10.2340/20030711-1000059","DOIUrl":"https://doi.org/10.2340/20030711-1000059","url":null,"abstract":"<p><strong>Objective: </strong>Toe walking due to progressive shortening of the calf muscles is common in people with hereditary spastic paraplegia. Achilles tendon lengthening is a treatment option, but clinicians are often hesitant to use this procedure, as it may result in weakening of the calf muscles and, subsequently, in reduced ankle power and knee instability during the stance phase of gait. We report here a case report supporting that these negative side-effects can be avoided in well-selected people with hereditary spastic paraplegia.</p><p><strong>Method: </strong>Bilateral Achilles tendon lengthening, combined with bilateral tenotomy of the tibialis posterior and toe flexors, was performed in a 29-year-old woman with uncomplicated hereditary spastic paraplegia who experienced progressive gait instability due to shortening of the soleus and gastrocnemius muscles (resulting in irreducible pes equinus).</p><p><strong>Results: </strong>Bilateral Achilles tendon lengthening resulted in improvement in both subjective and objective outcomes. Self-selected gait speed improved from 0.75 m/s before surgery to 1.07 m/s after surgery (<i>p</i> < 0.001). Knee instability during the stance phase did not occur post-surgery. The ankle moment trajectories normalized after surgery, while peak ankle powers increased.</p><p><strong>Conclusion: </strong>Correction of bilateral irreducible pes equinus by Achilles tendon lengthening may improve gait capacity in well-selected subjects with hereditary spastic paraplegia.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/95/2f/JRMCC-4-1000059.PMC8192886.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39196143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-04eCollection Date: 2021-01-01DOI: 10.2340/20030711-1000058
Andrew M Edwards, Ulric S Abonie, Florentina J Hettinga, David B Pyne, Tomasina M Oh, Remco C J Polman
For special populations such as people with a mental health issue or learning disability, a disconnect between the ability to accurately monitor and regulate exercise behaviour can lead to reduced levels of physical activity, which, in turn, is associated with additional physical or mental health problems. Activity pacing is a strategy used in clinical settings to address issues of pain amelioration, while self-pacing research is now well addressed in sport and exercise science literature. It has been proposed recently that these overlapping areas of investigation collectively support the development of self-regulatory, lifestyle exercise skills across broad population groups. Activity pacing appears to have substantial application in numerous development and rehabilitation settings and, therefore, the purpose of this short communication is to articulate how an activity pacing approach could be utilized among population groups in whom self-regulatory skills may require development. This paper provides specific examples of exercise practice across 2 discrete populations: children, and people with mental health and learning difficulties. In these cases, homeostatic regulatory processes may either be altered, or the individual may require extrinsic support to appropriately self-regulate exercise performance. A support-based exercise environment or approach such as programmatic activity (lifestyle) pacing would be beneficial to facilitate supervised and education-based self-regulation until such time as fully self-regulated exercise is feasible.
{"title":"Practical and Clinical Approaches Using Pacing to Improve Selfregulation in Special Populations such as Children and People with Mental Health or Learning Disabilities.","authors":"Andrew M Edwards, Ulric S Abonie, Florentina J Hettinga, David B Pyne, Tomasina M Oh, Remco C J Polman","doi":"10.2340/20030711-1000058","DOIUrl":"https://doi.org/10.2340/20030711-1000058","url":null,"abstract":"<p><p>For special populations such as people with a mental health issue or learning disability, a disconnect between the ability to accurately monitor and regulate exercise behaviour can lead to reduced levels of physical activity, which, in turn, is associated with additional physical or mental health problems. Activity pacing is a strategy used in clinical settings to address issues of pain amelioration, while self-pacing research is now well addressed in sport and exercise science literature. It has been proposed recently that these overlapping areas of investigation collectively support the development of self-regulatory, lifestyle exercise skills across broad population groups. Activity pacing appears to have substantial application in numerous development and rehabilitation settings and, therefore, the purpose of this short communication is to articulate how an activity pacing approach could be utilized among population groups in whom self-regulatory skills may require development. This paper provides specific examples of exercise practice across 2 discrete populations: children, and people with mental health and learning difficulties. In these cases, homeostatic regulatory processes may either be altered, or the individual may require extrinsic support to appropriately self-regulate exercise performance. A support-based exercise environment or approach such as programmatic activity (lifestyle) pacing would be beneficial to facilitate supervised and education-based self-regulation until such time as fully self-regulated exercise is feasible.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/02/64/JRMCC-4-1000058.PMC8101060.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38965545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-29eCollection Date: 2021-01-01DOI: 10.2340/20030711-1000057
Erwin C Baars, Jan H Geertzen, Pieter U Dijkstra
Objective: To assess satisfaction of prosthesis users with their prostheses, and the problems they experience with the residual limb, using a checklist, in order to evaluate potential benefits of checklist use and to summarize issues and problems with the prosthesis and/or residual limb presented by prosthesis users.
Design: Cross-sectional study.
Subjects: Participants were adult trans-tibial prosthesis users (n = 82) and certified prosthetist orthotist (n = 19) experienced in fitting lower-limb prostheses.
Methods: Prosthesis users reported their reasons for consultation and factors concerning prosthesis (dis)satisfaction and residual limb problems, using a checklist. Checklist use was evaluated by certified prosthetist orthotists and prosthesis users and the significance of evaluation scores was determined.
Results: Checklist use identified 126 issues/problems, most of which concerned prosthesis fit (33%) and pressure points on the residual limb skin (26%). Evaluation scores were significantly higher than neutral regarding the checklist helping the certified prosthetist orthotist to gather more information and to make clear with which issues the prosthesis user was dissatisfied. Prosthesis users reported that checklist use made them feel more understood by the certified prosthetist orthotist.
Conclusion: Checklist use in the assessment of trans-tibial prostheses is beneficial in identifying factors related to dissatisfaction, and improves the quality of certified prosthetist orthotists' consultation. The implementation of checklist use is, however, challenging.
{"title":"CHECKLIST USE FOR ASSESSMENT OF SATISFACTION WITH TRANS-TIBIAL PROSTHESES.","authors":"Erwin C Baars, Jan H Geertzen, Pieter U Dijkstra","doi":"10.2340/20030711-1000057","DOIUrl":"https://doi.org/10.2340/20030711-1000057","url":null,"abstract":"<p><strong>Objective: </strong>To assess satisfaction of prosthesis users with their prostheses, and the problems they experience with the residual limb, using a checklist, in order to evaluate potential benefits of checklist use and to summarize issues and problems with the prosthesis and/or residual limb presented by prosthesis users.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Subjects: </strong>Participants were adult trans-tibial prosthesis users (<i>n</i> = 82) and certified prosthetist orthotist (<i>n</i> = 19) experienced in fitting lower-limb prostheses.</p><p><strong>Methods: </strong>Prosthesis users reported their reasons for consultation and factors concerning prosthesis (dis)satisfaction and residual limb problems, using a checklist. Checklist use was evaluated by certified prosthetist orthotists and prosthesis users and the significance of evaluation scores was determined.</p><p><strong>Results: </strong>Checklist use identified 126 issues/problems, most of which concerned prosthesis fit (33%) and pressure points on the residual limb skin (26%). Evaluation scores were significantly higher than neutral regarding the checklist helping the certified prosthetist orthotist to gather more information and to make clear with which issues the prosthesis user was dissatisfied. Prosthesis users reported that checklist use made them feel more understood by the certified prosthetist orthotist.</p><p><strong>Conclusion: </strong>Checklist use in the assessment of trans-tibial prostheses is beneficial in identifying factors related to dissatisfaction, and improves the quality of certified prosthetist orthotists' consultation. The implementation of checklist use is, however, challenging.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6d/07/JRMCC-4-1000057.PMC8091939.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38963981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-16eCollection Date: 2021-01-01DOI: 10.2340/20030711-1000049
Henk Stam, Kristian Borg
{"title":"Journal of Rehabilitation Medicine - Clinical Communications is now Included in Pubmed: Who Cares??","authors":"Henk Stam, Kristian Borg","doi":"10.2340/20030711-1000049","DOIUrl":"https://doi.org/10.2340/20030711-1000049","url":null,"abstract":"","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/72/c2/JRMCC-4-1000049.PMC8054750.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38817838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}