Changes in postural sway and gait characteristics as a consequence of anterior load carriage

Publication date: Available online 31 August 2018

Source: Gait & Posture

Author(s): Matthew Roberts, Christopher Talbot, Anthony Kay, Michael Price, Mathew Hill

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Gait Analysis of Patients with Continuous Proximal Sciatic Nerve Blockade in Flexion Contractures after Primary Total Knee Arthroplasty

Publication date: Available online 31 August 2018

Source: Gait & Posture

Author(s): Meng Zhou, Shuai An, Mingli Feng, Zheng Li, Huiliang Shen, Kuan Zhang, Jun Sun, Guanglei Cao

Abstract

Background

The main objective of total knee arthroplasty is to relieve pain, restore normal knee function, and improve gait stability. Significant flexion contractures can severely impair function after surgery. The purpose of this study is to evaluate the efficacy of implementing a continuous proximal sciatic nerve block in conjunction with aggressive physical therapy to treat patients with persistent flexion contractures that were recalcitrant to rehabilitation efforts following primary total knee arthroplasty (TKA).

Methods

From December 2012 to January 2016, the following subjects were enrolled in this study: 20 patients (15 females and 5 males aged between 62 and 78 years old; median age = 65.7 y) with flexion contractures ranging from 15° to 25° (19.2°±5.6°) that persisted for at least 1.5 months following total knee arthroplasty and showed no significant improvement in response to conventional therapeutic methods. Demographic data, the passive range of motion, flexion contracture, pain score during stretching, and the Hospital for Special Surgery knee score were recorded. A portable motion analyzer was used to obtain the corresponding gait parameters from the flexion contractures group and control group. Repeated measurement ANOVA was used to compare the clinical results.

Results

In combination with 2 to 4 (2.5 ± 1.3) months of aggressive knee stretching exercises, 16 out of 18 knees achieved full extension, and 2 out of 18 improved to within 5° of the full extension. An average of the 12 to 48 (26.6 ± 10.7) month follow-up showed that this improved range of motion was maintained for all the corresponding patients, and that there were no reoccurrences of deformity. The mean Hospital for Special Surgery knee scores improved from 61.2 to 93.2 points (p < 0.001). After six months of continuous proximal sciatic nerve blockage, all gait parameters for the flexion contractures group exhibited significant improvement.

Conclusion

A continuous proximal sciatic nerve block could be a useful adjunct to a physical therapy regimen for patients with knee flexion contractures, especially for patients with difficult-to-treat cases of knee flexion contracture that are recalcitrant to conservative therapy.

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Changes in postural sway and gait characteristics as a consequence of anterior load carriage

Publication date: Available online 31 August 2018

Source: Gait & Posture

Author(s): Matthew Roberts, Christopher Talbot, Anthony Kay, Michael Price, Mathew Hill

from #Audiology via ola Kala on Inoreader https://ift.tt/2PphzaQ
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Gait Analysis of Patients with Continuous Proximal Sciatic Nerve Blockade in Flexion Contractures after Primary Total Knee Arthroplasty

Publication date: Available online 31 August 2018

Source: Gait & Posture

Author(s): Meng Zhou, Shuai An, Mingli Feng, Zheng Li, Huiliang Shen, Kuan Zhang, Jun Sun, Guanglei Cao

Abstract

Background

The main objective of total knee arthroplasty is to relieve pain, restore normal knee function, and improve gait stability. Significant flexion contractures can severely impair function after surgery. The purpose of this study is to evaluate the efficacy of implementing a continuous proximal sciatic nerve block in conjunction with aggressive physical therapy to treat patients with persistent flexion contractures that were recalcitrant to rehabilitation efforts following primary total knee arthroplasty (TKA).

Methods

From December 2012 to January 2016, the following subjects were enrolled in this study: 20 patients (15 females and 5 males aged between 62 and 78 years old; median age = 65.7 y) with flexion contractures ranging from 15° to 25° (19.2°±5.6°) that persisted for at least 1.5 months following total knee arthroplasty and showed no significant improvement in response to conventional therapeutic methods. Demographic data, the passive range of motion, flexion contracture, pain score during stretching, and the Hospital for Special Surgery knee score were recorded. A portable motion analyzer was used to obtain the corresponding gait parameters from the flexion contractures group and control group. Repeated measurement ANOVA was used to compare the clinical results.

Results

In combination with 2 to 4 (2.5 ± 1.3) months of aggressive knee stretching exercises, 16 out of 18 knees achieved full extension, and 2 out of 18 improved to within 5° of the full extension. An average of the 12 to 48 (26.6 ± 10.7) month follow-up showed that this improved range of motion was maintained for all the corresponding patients, and that there were no reoccurrences of deformity. The mean Hospital for Special Surgery knee scores improved from 61.2 to 93.2 points (p < 0.001). After six months of continuous proximal sciatic nerve blockage, all gait parameters for the flexion contractures group exhibited significant improvement.

Conclusion

A continuous proximal sciatic nerve block could be a useful adjunct to a physical therapy regimen for patients with knee flexion contractures, especially for patients with difficult-to-treat cases of knee flexion contracture that are recalcitrant to conservative therapy.

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Stimulus-specific adaptation in the anesthetized mouse revealed by brainstem auditory evoked potentials

Publication date: Available online 31 August 2018

Source: Hearing Research

Author(s): Daniel Duque, Rui Pais, Manuel S. Malmierca

Abstract

Neural responses to sensory inputs in a complex and natural environment must be weighted according to their relevance. To do so, the brain needs to be able to deal with sudden stimulus fluctuations in an ever-changing acoustic environment. Stimulus-specific adaptation (SSA) is a phenomenon of some neurons along the auditory pathway that show a reduced response to repetitive sounds while responsive to those that occur rarely. SSA has been shown from the inferior colliculus to auditory cortex, but has not been detected in the cochlear nucleus. To discover where SSA is first generated along the auditory pathway, auditory brainstem responses (ABRs) to pure tones were evaluated in anesthetized mice using an oddball paradigm. Using a typical narrow band-pass filter, changes in the ABRs suggest unspecific short-term adaptation may occur as early as the auditory nerve fibers. Furthermore, after applying a wide band-pass filter –allowing the visualization of a late slow wave in the ABR– we found a reduction of the amplitude of the response to repetitive sounds, compared to rare ones, in the slow wave component P₀ that follow the fast wave V. Previous studies have shown the P₀ shows temporal correlation with the sustained responses of inferior colliculus, thus we suggest that this nucleus is the first to show stimulus specific adaptation in the auditory pathway.

Graphical abstract

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Stimulus-specific adaptation in the anesthetized mouse revealed by brainstem auditory evoked potentials

Publication date: Available online 31 August 2018

Source: Hearing Research

Author(s): Daniel Duque, Rui Pais, Manuel S. Malmierca

Abstract

Neural responses to sensory inputs in a complex and natural environment must be weighted according to their relevance. To do so, the brain needs to be able to deal with sudden stimulus fluctuations in an ever-changing acoustic environment. Stimulus-specific adaptation (SSA) is a phenomenon of some neurons along the auditory pathway that show a reduced response to repetitive sounds while responsive to those that occur rarely. SSA has been shown from the inferior colliculus to auditory cortex, but has not been detected in the cochlear nucleus. To discover where SSA is first generated along the auditory pathway, auditory brainstem responses (ABRs) to pure tones were evaluated in anesthetized mice using an oddball paradigm. Using a typical narrow band-pass filter, changes in the ABRs suggest unspecific short-term adaptation may occur as early as the auditory nerve fibers. Furthermore, after applying a wide band-pass filter –allowing the visualization of a late slow wave in the ABR– we found a reduction of the amplitude of the response to repetitive sounds, compared to rare ones, in the slow wave component P₀ that follow the fast wave V. Previous studies have shown the P₀ shows temporal correlation with the sustained responses of inferior colliculus, thus we suggest that this nucleus is the first to show stimulus specific adaptation in the auditory pathway.

Graphical abstract

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Residual Cochlear Function in Adults and Children Receiving Cochlear Implants: Correlations With Speech Perception Outcomes

Objectives: Variability in speech perception outcomes with cochlear implants remains largely unexplained. Recently, electrocochleography, or measurements of cochlear potentials in response to sound, has been used to assess residual cochlear function at the time of implantation. Our objective was to characterize the potentials recorded preimplantation in subjects of all ages, and evaluate the relationship between the responses, including a subjective estimate of neural activity, and speech perception outcomes. Design: Electrocochleography was recorded in a prospective cohort of 284 candidates for cochlear implant at University of North Carolina (10 months to 88 years of ages). Measurement of residual cochlear function called the “total response” (TR), which is the sum of magnitudes of spectral components in response to tones of different stimulus frequencies, was obtained for each subject. The TR was then related to results on age-appropriate monosyllabic word score tests presented in quiet. In addition to the TR, the electrocochleography results were also assessed for neural activity in the forms of the compound action potential and auditory nerve neurophonic. Results: The TR magnitude ranged from a barely detectable response of about 0.02 µV to more than 100 µV. In adults (18 to 79 years old), the TR accounted for 46% of variability in speech perception outcome by linear regression (r2 = 0.46; p

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