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Κυριακή 13 Αυγούστου 2017
20Q: Cochlear Synaptopathy - Interrupting Communication from Ear to Brain
An overview of cochlear synaptopathy based on new insights from animal studies of noise-induced and age-related hearing loss, with implications for audiology practice. 
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20Q: Cochlear Synaptopathy - Interrupting Communication from Ear to Brain
An overview of cochlear synaptopathy based on new insights from animal studies of noise-induced and age-related hearing loss, with implications for audiology practice.
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20Q: Cochlear Synaptopathy - Interrupting Communication from Ear to Brain
An overview of cochlear synaptopathy based on new insights from animal studies of noise-induced and age-related hearing loss, with implications for audiology practice.
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Ginkgo Biloba Tinnitus
Please note: the following information does not constitute professional medical advice, and is provided for general informational purposes only. Please speak to your doctor if you have tinnitus.
For those who suffer from the devastating effects of tinnitus, they are always on the lookout for a new type of treatment that can bring them relief. While there are many treatments available, one that has gained the attention of many people in recent years has been ginkgo biloba. A popular supplement, it’s a top-selling herbal medicine and is available in capsules, tablets, and liquid extract. While used to treat blood disorders and memory problems, ginkgo biloba tinnitus treatments have been mixed at best.
Clinical Trials
To see if ginkgo biloba tinnitus treatments can be effective for patients, a series of clinical trials have been conducted. In these trials, some groups of patients were given placebos, while others were given small amounts of ginkgo biloba over a two-week period. After the studies were completed, the trials reached mixed conclusions. While some patients reported improvement with their tinnitus, others seemed unchanged. Due to these results, researchers have been unable to conclude that ginkgo biloba is an effective treatment for tinnitus.
Current Treatment Options
While some tinnitus patients have continued to use ginkgo biloba as a treatment option, others have chosen instead to go with more conventional treatment methods. While there are many types of treatments available, some of the most popular include:
–Hearing Aids
–Medications including corticosteroids and benzodiazepines
–Counseling
–Tinnitus Retraining Therapy
Unfortunately, while some patients have used ginkgo biloba as a treatment for tinnitus, it usually needs to be used in conjunction with some of the above-mentioned treatment options.
Not A Wonder Drug
Despite being one of the oldest herbal remedies used around the world, tinnitus patients should remember that ginkgo biloba is not a wonder drug. Because of this, they should not have unrealistic expectations when using it in an effort to improve their tinnitus symptoms. In many of the studies, researchers found a number of flaws related to studying the effects of ginkgo biloba tinnitus treatment, making the conclusions that were reached even more confusing. In one study after another, there were few if any differences between placebo patients and those who were given ginkgo biloba.
Rely On Conventional Treatments
With evidence showing ginkgo biloba to be at best an modest help in treating tinnitus symptoms, it’s clear patients should still discuss conventional treatment options with their doctor. Rather than be disappointed when a supposed miracle treatment does not deliver the results they seek, working with healthcare professionals trained in treating tinnitus will yield better results.
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Σάββατο 12 Αυγούστου 2017
The potential of an automated system to identify the upper limb component of a controlled sitting posture
Publication date: October 2017
Source:Gait & Posture, Volume 58
Author(s): María B. Sánchez, Ian Loram, John Darby, Paul Holmes, Penelope B. Butler
Full trunk control in sitting is demonstrated only when the head-trunk are aligned and upper limbs remain free of contact from mechanical support. These components represent a Controlled Kinetic Chain and can be evaluated in people with neuromotor disability using the Segmental Assessment of Trunk Control (SATCo) when a therapist provides manual trunk support at different segmental levels. However, the SATCo, as with other clinical assessments of control, is subjective. The SATCo was translated to objective rules relating the position of the hands and elbows to the head-trunk and then tested to determine the extent to which this automated objective method replicated the clinical judgement.Clinical evaluation used video to determine whether the upper limb was free of mechanical support while the objective evaluation used 3D motion capture of the trunk and upper limbs with a classification rule. The agreement between clinical and objective classification was calculated for three conditions of a distance-from-support-surface threshold parameter in five healthy adults and five children with cerebral palsy.The unfitted (zero-threshold values) method replicated the clinical judgement in part (68.26%±15.7, adults, 48.3%±33.9 children). The fitted (level-of-support determined) agreement showed that the process could be refined using trial specific parameters (88.32%±5.3 adults, 89.84%±10.2 children). The fixed-values agreement showed high values when using general group parameters (80.80%±3.1 adults, 74.31%±21.5 children).This objective classification of the upper limb component of trunk control largely captures the clinical evaluation. It provides the first stages in development of a clinically-friendly fully automated method.
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Source:Gait & Posture, Volume 58
Author(s): María B. Sánchez, Ian Loram, John Darby, Paul Holmes, Penelope B. Butler
Full trunk control in sitting is demonstrated only when the head-trunk are aligned and upper limbs remain free of contact from mechanical support. These components represent a Controlled Kinetic Chain and can be evaluated in people with neuromotor disability using the Segmental Assessment of Trunk Control (SATCo) when a therapist provides manual trunk support at different segmental levels. However, the SATCo, as with other clinical assessments of control, is subjective. The SATCo was translated to objective rules relating the position of the hands and elbows to the head-trunk and then tested to determine the extent to which this automated objective method replicated the clinical judgement.Clinical evaluation used video to determine whether the upper limb was free of mechanical support while the objective evaluation used 3D motion capture of the trunk and upper limbs with a classification rule. The agreement between clinical and objective classification was calculated for three conditions of a distance-from-support-surface threshold parameter in five healthy adults and five children with cerebral palsy.The unfitted (zero-threshold values) method replicated the clinical judgement in part (68.26%±15.7, adults, 48.3%±33.9 children). The fitted (level-of-support determined) agreement showed that the process could be refined using trial specific parameters (88.32%±5.3 adults, 89.84%±10.2 children). The fixed-values agreement showed high values when using general group parameters (80.80%±3.1 adults, 74.31%±21.5 children).This objective classification of the upper limb component of trunk control largely captures the clinical evaluation. It provides the first stages in development of a clinically-friendly fully automated method.
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Predictive simulation of diabetic gait: Individual contribution of ankle stiffness and muscle weakening
Publication date: October 2017
Source:Gait & Posture, Volume 58
Author(s): Gilmar F. Santos, Aline A. Gomes, Isabel C.N. Sacco, Marko Ackermann
Diabetic neuropathic individuals present massive muscle strength reduction at the ankle plantar- and dorsiflexors and increased joint stiffness. Our aim is to investigate the adaptation strategies to these musculoskeletal alterations during walking by means of predictive simulations. We used a seven segment planar musculoskeletal model actuated by eight Hill-type muscles in each leg. The effect of all passive tissue in muscles and other joint structures was modeled by net passive joint moment curves. The predictive simulations were generated by solving an optimal control problem that minimized a cost function, including effort and tracking terms, using direct collocation and a commercial optimal control package. We simulate four conditions to represent the weakening of the distal muscles triceps sural (TS) and tibialis anterior (TA), and five conditions to represent the effect of increasing nonlinear ankle stiffness in flexion. The weakening of the distal muscles leads to a delayed action of the TS and a progressive decrease of the gastrocnemius peak force in the push-off phase. This distal deficit is compensated by a larger hip flexion moment resulting from an increase in the iliopsoas muscle force in this phase, known as the hip strategy. The adaptation mechanisms observed in response to an increase in ankle stiffness include the hip strategy and the exploitation of the passive joint structures as springs, which store energy during midstance and release it during push-off, reducing TS force and power in this phase and leading to a consistent decrease in the overall muscle force levels.
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Source:Gait & Posture, Volume 58
Author(s): Gilmar F. Santos, Aline A. Gomes, Isabel C.N. Sacco, Marko Ackermann
Diabetic neuropathic individuals present massive muscle strength reduction at the ankle plantar- and dorsiflexors and increased joint stiffness. Our aim is to investigate the adaptation strategies to these musculoskeletal alterations during walking by means of predictive simulations. We used a seven segment planar musculoskeletal model actuated by eight Hill-type muscles in each leg. The effect of all passive tissue in muscles and other joint structures was modeled by net passive joint moment curves. The predictive simulations were generated by solving an optimal control problem that minimized a cost function, including effort and tracking terms, using direct collocation and a commercial optimal control package. We simulate four conditions to represent the weakening of the distal muscles triceps sural (TS) and tibialis anterior (TA), and five conditions to represent the effect of increasing nonlinear ankle stiffness in flexion. The weakening of the distal muscles leads to a delayed action of the TS and a progressive decrease of the gastrocnemius peak force in the push-off phase. This distal deficit is compensated by a larger hip flexion moment resulting from an increase in the iliopsoas muscle force in this phase, known as the hip strategy. The adaptation mechanisms observed in response to an increase in ankle stiffness include the hip strategy and the exploitation of the passive joint structures as springs, which store energy during midstance and release it during push-off, reducing TS force and power in this phase and leading to a consistent decrease in the overall muscle force levels.
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In vivo kinematics of early-stage osteoarthritic knees during pivot and squat activities
Publication date: October 2017
Source:Gait & Posture, Volume 58
Author(s): Keisuke Matsuki, Kei O. Matsuki, Tomonori Kenmoku, Satoshi Yamaguchi, Takahisa Sasho, Scott A. Banks
Kinematic changes have been shown to accompany severe knee osteoarthritis, but no studies have analyzed early-stage osteoarthritic knee kinematics in the transverse plane during functional activities. The purpose of this study was to analyze kinematics of early-stage osteoarthritic knees using model registration techniques. Fifteen early-stage osteoarthritic knees from eight females with a mean age of 52 years old (range, 43–57years old) were involved in this study. A radiologist confirmed with plain radiographs that knees had Kellgren-Lawrence grade-1 or −2 arthritic changes. Fluoroscopic images of squat and pivot activities were recorded for each subject. Three-dimensional surface models of the distal femur and proximal tibia were created from CT images, and anatomic coordinate systems were embedded in each model. The three-dimensional position and orientation of the femur and the tibia were determined using model-image registration techniques, and tibial anteroposterior translation and internal/external rotation relative to the femur were calculated. The contact points of the medial and lateral femoral condyle were also computed. Compared to healthy knees, osteoarthritic knees showed lateral contact points that were significantly shifted anteriorly in both pivot (P<0.001) and squat (P=0.001) activities and greater tibial external rotation in pivot activity (P=0.007). The medial contact point location was similar to healthy knees, but the amount of anteroposterior translation was smaller (P<0.001). These kinematic changes might change stress distributions in the medial compartment during weight-bearing activities. The changes in kinematics possibly have some influence on initiation or progression of knee osteoarthritis.
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Source:Gait & Posture, Volume 58
Author(s): Keisuke Matsuki, Kei O. Matsuki, Tomonori Kenmoku, Satoshi Yamaguchi, Takahisa Sasho, Scott A. Banks
Kinematic changes have been shown to accompany severe knee osteoarthritis, but no studies have analyzed early-stage osteoarthritic knee kinematics in the transverse plane during functional activities. The purpose of this study was to analyze kinematics of early-stage osteoarthritic knees using model registration techniques. Fifteen early-stage osteoarthritic knees from eight females with a mean age of 52 years old (range, 43–57years old) were involved in this study. A radiologist confirmed with plain radiographs that knees had Kellgren-Lawrence grade-1 or −2 arthritic changes. Fluoroscopic images of squat and pivot activities were recorded for each subject. Three-dimensional surface models of the distal femur and proximal tibia were created from CT images, and anatomic coordinate systems were embedded in each model. The three-dimensional position and orientation of the femur and the tibia were determined using model-image registration techniques, and tibial anteroposterior translation and internal/external rotation relative to the femur were calculated. The contact points of the medial and lateral femoral condyle were also computed. Compared to healthy knees, osteoarthritic knees showed lateral contact points that were significantly shifted anteriorly in both pivot (P<0.001) and squat (P=0.001) activities and greater tibial external rotation in pivot activity (P=0.007). The medial contact point location was similar to healthy knees, but the amount of anteroposterior translation was smaller (P<0.001). These kinematic changes might change stress distributions in the medial compartment during weight-bearing activities. The changes in kinematics possibly have some influence on initiation or progression of knee osteoarthritis.
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