Daily Activities Of Patients Research Articles

Relationship Between Morphofunctional Alterations of the Foot and Its Functionality in Patients with Fibromyalgia Syndrome: A Case-Control Study.

Objective: To evaluate the morphofunctional alterations in the foot and their association with functionality, considering aspects such as disability, pain, and limitations in daily activities in patients with fibromyalgia syndrome (FMS). Methods: A case-control study was conducted in patients with FMS (case group) and without FMS (control group), matched by age and sex. Foot posture was assessed using the foot posture index (FPI), along with the presence of hallux valgus (HV), trigger points, hyperkeratosis, and dorsiflexion of the first metatarsophalangeal joint and ankle. Foot functionality was evaluated using the foot function index (FFI) questionnaire. Results: A total of 100 women with FMS and 100 women without FMS, with a mean age of 61.97 ± 9.26 years, were recruited. HV (p < 0.001), hyperkeratosis (p < 0.001), pronated and supinated foot (p < 0.001), as well as limitations in dorsiflexion of the first metatarsophalangeal joint (p < 0.001) and the ankle with the knee flexed (p < 0.001) and extended (p < 0.001), along with the activity of the flexor hallucis brevis (p = 0.006), adductor hallucis (p = 0.006), and dorsal interosseous (p = 0.002) muscles, were significantly associated with the FFI, being higher in individuals with FMS, indicating greater impairment of foot functionality in these patients. Multivariate analysis revealed a statistical association between FMS and low educational level (OR = 2.57, 95% CI 1.05-5.72), the presence of another rheumatic disease (OR = 5.07, 95% CI 2.34-11), and the presence of any active trigger point (OR = 11.15, 95% CI 3.97-31.31). Conclusions: The study highlights the relationship between morphofunctional foot alterations, specifically the presence of active myofascial trigger points, and functionality in patients with FMS.

Assessing Daily Function and Sleep Disorders in Hemodialysis Patients with End-Stage Renal Disease.

Chronic, end-stage renal disease significantly impacts patients' daily activities and sleep quality, particularly those undergoing hemodialysis. However, there is limited research on the extent of these challenges and their correlation with this population. This study aims to assess the level of activity of daily living and the prevalence of sleep disturbances in patients with end-stage renal disease undergoing hemodialysis. A cross-sectional study involved 130 patients receiving hemodialysis in two public General Hospitals in Greece. The Barthel Index was used to measure daily living activity, while the Athens Insomnia Scale assessed sleep disorders. The data were analyzed using SPSSV25.0. Of the 210 questionnaires, 130 were returned fully completed (response rate 62%). Most of the sample participants suffered from comorbidities (76.9%). The total Barthel Index score showed moderate dependence for patients, significantly related to the years and hours of dialysis (p = 0.007 and p = 0.000, respectively). The total score of the Athens Insomnia Scale was also significantly associated with age (p = 0.029), marital status (p = 0.015) and the years and hours of hemodialysis (p = 0.004 and p = 0.001, respectively). A statistically significant difference was recorded between the daily activity of patients with end-stage renal failure and their sleep quality (p = 0.000) Finally, the physical activity level of the participants was related to the existence of another physical health (p = 0.000) or mental health problem (p = 0.000). Hemodialysis patients with chronic, end-stage renal disease experience significant challenges in maintaining daily activities and are prone to sleep disorders. These findings suggest a need for integrated care strategies that address both physical function and sleep quality to improve the overall well-being of this population.

Designs of Upper Limb Tremor Suppression Orthoses: Efficacy and Wearer's Comfort

Abstract Tremor is a rhythmic, involuntary oscillatory movement that significantly impacts various aspects of a patient's daily activities. The utilization of wearable tremor-suppressing orthoses has emerged as an efficacious and non-invasive treatment approach for managing tremors. This paper reviews recent advancements in upper limb tremor suppression orthoses, with the objective of laying a groundwork for future investigations. Through an analysis of the operational mechanisms, degrees of freedom, weight, and efficacy of tremor suppression across different orthotic designs, the following insights are gleaned: Disparities in operational mechanisms and the quantity of suppression directions are correlated with the device's weight, whereby weight emerges as a primary determinant influencing the comfort level of the orthoses. The interplay between the quantity and mass of quantity of suppression directions significantly influences the efficacy of orthoses equipment. Striking a balance among these three factors is poised to be a pivotal emphasis in forthcoming research endeavors. Furthermore, researchers are increasingly prioritizing the wearer's comfort in the evolution of these orthotic devices.

Real-Time Prediction of Resident ADL Using Edge-Based Time-Series Ambient Sound Recognition.

To create an effective Ambient Assisted Living (AAL) system that supports the daily activities of patients or the elderly, it is crucial to accurately detect and differentiate user actions to determine the necessary assistance. Traditional intrusive methods, such as wearable or object-attached devices, can interfere with the natural behavior of patients and may lead to resistance. Furthermore, non-intrusive systems that rely on video or sound data processed by servers or the cloud can generate excessive data traffic and raise concerns about the security of personal information. In this study, we developed an edge-based real-time system for detecting Activities of Daily Living (ADL) using ambient noise. Additionally, we introduced an online post-processing method to enhance classification performance and extract activity events from noisy sound in resource-constrained environments. The system, tested with data collected in a living space, achieved high accuracy in classifying ADL-related behaviors in continuous events and successfully generated user activity logs from time-series sound data, enabling further analyses such as ADL assessments. Future work will focus on enhancing detection accuracy and expanding the range of detectable behaviors by integrating the activity logs generated in this study with additional data sources beyond sound.

Efficacy and safety of using a unilateral lower limb exoskeleton combined with conventional treatment in post-stroke rehabilitation: a randomized controlled trial.

The incidence of hemiplegia caused by stroke is high. In particular, lower limb dysfunction affects the daily activities of patients, and lower limb robotic devices have been proposed to provide rehabilitation therapy to improve balance function in this patient population. To assess the effectiveness of the LiteStepper® unilateral lower limb exoskeleton (ULLE) combined with conventional treatment for balance function training in patients with post-stroke hemiplegia. This multicenter randomized controlled trial, conducted in the convalescent rehabilitation ward of four hospitals, involved 92 patients in their post-stroke phase. Participants were randomized into an experimental group (EG) or a conventional group (CG). The EG adopted the LiteStepper® ULLE combined with conventional treatment for 21days. The CG underwent a standard daily rehabilitation routine for 21days. The Berg Balance Scale (BBS), Functional Ambulation Category scale (FAC), 6-min walk test (6MWT), and Barthel Index (Barthel) were used for evaluations before and after 21days of rehabilitative training. The BBS scores in EG was significantly elevated compared to CG, exhibiting a profound statistical difference (P< 0.0001). Notably, these disparities persisted at both day 21 (P < 0.0001) and day 14 (P < 0.0047) post-intervention, underscoring the efficacy of the treatment in the EG. The EG demonstrated a markedly greater improvement in BBS scores from pre-rehabilitation to 21days post-training, significantly outperforming the CG. Furthermore, at both day 14 and day 21, functional assessments including the FAC, 6MWT, and Barthel revealed improvements in both groups. However, the improvements in the EG were statistically significant compared to the CG at both time points: day 14 (FAC, P = 0.0377; 6MWT, P = 0.0494; Barthel, P = 0.0225) and day 21 (FAC, P = 0.0015; 6MWT, P = 0.0005; Barthel, P = 0.0004). These findings highlight the superiority of the intervention in the EG in enhancing functional outcomes. Regarding safety, the analysis revealed a solitary adverse event (AEs) related to the LiteStepper®ULLE device during the study period, affirming the combination therapy's safety profile when administered alongside conventional balance training in post-stroke hemiplegic patients. This underscores the feasibility and potential of incorporating LiteStepper®ULLE into rehabilitation protocols for this patient population. The LiteStepper® ULLE combined with conventional treatment is effective and safe for balance function training in patients with post-stroke hemiplegia.

Asuhan Keperawatan Pada Nn. S dengan Post Operasi Hernioraphy : Hernia Inguinalis Lateralis Dextra di Ruang Mawar 2 RSUD dr. Soeselo Kabupaten Tegal

Inguinal hernia is a condition where an organ protrudes into a cavity through a thin or weak part of the wall. The small intestine is usually the organ that enters the cavity, causing the protrusion. In 2018, hernia ranked 8th in Indonesia with a total of 18,145 cases or around 1.05%. The number of hernia cases in Central Java is estimated to be over 500, or approximately 1.01% of cases. If an inguinal hernia is not treated promptly, it will continue to grow and exert significant pressure on the surrounding tissues. A common consequence of untreated hernia is that it will enlarge and interfere with the patient's daily activities. One of the complications of hernia is swelling around the lump. One of the treatments for hernia is surgery. The writer is expected to provide optimal nursing care for patient. S, who has experienced a right lateral inguinal hernia post- operatively following herniorraphy in Mawar 2 ward of dr. Soeselo Regional Hospital, Tegal Regency.

805. BOCHDALEK HERNIA - CASE REPORT

Abstract Introduction Bochdalek hernia is a rare type of diaphragmatic hernia congenital and is quite uncommon in adulthood, representing only 0.17-6% of all diaphragmatic hernias. The objective of the present study is to report the technique surgery performed on a patient with a bochdalek hernia. Methods The information was obtained through medical record review, interview with the patient and literature review. Results/Discussion A 49-year-old female patient was admitted to a hospital in Natal (RN- Brazil) with vomiting for seven months, average of 3-4 vomits daily after meals, associated with dysphagia, epigastric pain and weight loss of 26 kg during this period. The physical examination, she was dehydrated, emaciated and with a flaccid abdomen and painless. Laboratory exams, she presented high levels of ureia and hypokalemia. CT scan of the chest and abdomen with contrast showed a hernia right posterolateral diaphragm with insinuation of the transverse colon and portion distal part of the stomach, in addition to significant gastric stasis, without signs of ischemia. Vigorous hydration was carried out and fasting was maintained, in addition, was inserted nasogastric tube and began parenteral nutrition. After ten days of parenteral nutrition and correction of hydro electrolyte disorders, there was an improvement in symptoms with laboratory normalization. So, she undergo a surgical intervention by videolaparoscopy. Surgical intervention took place with the pneumoperitoneum with Veress needle and trocars inserted (2 10-inch trocars). mm and 3 of 5 mm). Introduction of 30° optics. Cavity inventory identified massive right posterolateral diaphragmatic hernia, containing transverse colon and part of the stomach. Hepatic retractor was positioned to retracted the right hepatic lobe. Completely reduced the hernia through the Bochdalek foramen, after undoing content adhesions with the diaphragm. Afterwards, the closing of the defect with 2-0 Ethibond thread and a biocompatible mesh placed over the suture (Phasix) 10x10 cm and fixed with the same thread in separate stitches. Left drain blake type number 24 Fr, was left in the right hemithorax. The procedure was done uneventful. Conclusions Bochdalek hernia is a structural defect in the diaphragm, which can cause the passage of practically any intra-abdominal organ to the chest. Surgical repair of the defect is the only existing treatment option. In this case, we have a late presentation and in a complicated form. We opted for clinical stabilization of the patient, with nutrition and timely videolaparoscopy on the tenth day of hospitalization. The correction of hernia laparoscopically allows wide access to the workplace and with good mobility for dissection of the hernial sac, in addition to unquestionable acceleration of postoperative recovery and reduction of surgical trauma and size of the incisions. This way, we have a shorter hospitalization time with early return to the patient's daily activities.

Efficacy and safety of mesenchymal stem cell therapies for ischemic stroke: a systematic review and meta-analysis.

The efficacy and safety of mesenchymal stem cells (MSCs) in the treatment of ischemic stroke (IS) remains controversial. Therefore, this study aimed to evaluate the efficacy and safety of MSCs for IS. A literature search until May 23, 2023, was conducted using PubMed, EMBASE, the Cochrane Library, and the Web of Science to identify studies on stem cell therapy for IS. Interventional and observational clinical studies of MSCs in patients with IS were included, and the safety and efficacy were assessed. Two reviewers extracted data and assessed the quality independently. The meta-analysis was performed using RevMan5.4. Fifteen randomized controlled trials (RCTs) and 15 non-randomized trials, including 1217 patients (624 and 593 in the intervention and control arms, respectively), were analyzed. MSCs significantly improved patients' activities of daily living according to the modified Rankin scale (mean difference [MD]: -0.26; 95% confidence interval [CI]: -0.50 to -0.01; P = .04) and National Institutes of Health Stroke Scale score (MD: -1.69; 95% CI: -2.66 to -0.73; P < .001) in RCTs. MSC treatment was associated with lower mortality rates in RCTs (risk ratio: 0.44; 95% CI: 0.28-0.69; P < .001). Fever and headache were among the most reported adverse effects. Based on our review, MSC transplantation improves neurological deficits and daily activities in patients with IS. In the future, prospective studies with large sample sizes are needed for stem cell studies in ischemic stroke. This meta-analysis has been registered at PROSPERO with CRD42022347156.

The impact of pain on daily activities in patients with idiopathic inflammatory myopathies: Report from the OMERACT myositis working group

BackgroundInternational focus groups with patients with idiopathic inflammatory myopathies (IIM) conducted by the OMERACT Myositis Working Group over the years demonstrated the pain as an important symptom experienced by these patients. In this study, we aimed to examine the frequency and degree of pain interference, the aspects of daily life impacted by pain, and the factors associated with pain interference in adults with IIM. MethodsThis was a prospective observational study with two visits. The patients who fulfilled the probable/definite IIM (ACR/EULAR Myositis Classification Criteria) were enrolled. Pain interference was assessed with PROMIS pain interference form (6a). Myositis core set measures and PROMIS fatigue (7a) and physical function (8b) were obtained at both visits. Logistic regression and linear mixed models were performed to assess the association between pain interference and other parameters. ResultsA total of 129 patients with IIM (60 % females) were recruited from U.S., South Korea, Netherlands, Sweden, and Australia. Approximately 71 % reported pain interference. The patients in the greater pain interference group were more likely to be female, had significantly worse patient/physician global disease activity, fatigue, and physical function than those in the lower pain interference group. The most commonly impacted life aspect was household chores. Manual muscle testing, patient/physician global disease activity, fatigue, and physical function were all significantly associated with pain interference score >60. ConclusionThe majority of the patients with IIM experience the impact of pain on their daily activities, particularly household chores. Myositis disease activity, duration, and subtype could be associated with greater pain interference.

Cytoplasmic PPARγ Significantly Correlates With P53 Immunohistochemical Expression and Tumor Size in Localized Tenosynovial Giant Cell Tumor.

Tenosynovial giant cell tumor (TGCT)is a monoarticular fibrohistiocytic benign or locally aggressive soft tissue tumor that originates from the synovium of joints, bursae, and tendon sheaths.It has an inflammatory neoplastic nature, with a clinical presentationranging from pain, swelling, stiffness, and limited range of movement to joint instability and blockage. Its uncommon incidence leads to a poorly understood pathogenesis. Localized formsof TGCT (LTGCT) can cause significant morbidity, interfere with daily patient activities, and decrease the patient's quality of life in challenging cases. This study aimed to investigate the immunohistochemical expression of PPARγ (peroxisome proliferator-activated receptor gamma) and P53 in LTGCT to understand the disease better and offer potential therapeutic targets. The study is cross-sectional, in which 27 LTGCT cases were collectedfrom the Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.Solitary and multiple LTGCT cases retrieved between January 2018 and December 2022 were included, and immunohistochemically stained with anti-PPARγ and P53 antibodies. The TGCT samples were excluded if they were insufficient for sectioning, processing, and interpretation, over-fixed, had process artifacts, or were of the diffuse TGCT type. Scoring of stain expression was performed by ImageJ (National Institutes of Health, Bethesda, MD) analysis using the threshold method and was expressed in percent area/high power field. Clinicopathological correlations were analyzed. All the 27 collected LTGCT cases were located in the small joints of patients' hands. Cases with solitary LGTCTs constituted 55.6%(n = 15), while 44.4% (n = 12) had multipleLTGCTs related to one affected site/case (e.g., multiple tumors in one finger). PPARγ was expressed in the cytoplasm of mononuclear and multinucleated tumor cells and foamy histiocytes, while P53 expression was mainly in mononuclear cells' nuclei. PPARγ significantly correlated with P53 expression (r = 0.9 and P = 0.000). PPARγ (r = 0.4 and P = 0.02) and P53 (r = 0.5 and P = 0.01) were positively correlated with tumor size. Only P53 expression was positively correlated with tumor multiplicity (r = 0.4 and P = 0.03). Using the receiver operating characteristic curve test, the P53 cutoff score detecting the multiplicity of TGCTs was ≥20.5%, with a 75% sensitivity and 80% specificity. PPARγ and P53 have a significant role in LTGCT growth, while P53 plays a role in tumor multiplicity. They can be possible targets in LTGCTs unfit for excision.

Cosmetic gloves from natural rubber latex for upper limb prostheses: Preparation and physicochemical, mechanical and biological characterization

Upper limb amputations are frequently the result of traumatic events, often associated with car accidents or incidents involving industrial machinery. The development of prosthetic technologies is essential to provide physical assistance to amputees and offer psychological support. In such circumstances, cosmetic gloves can be utilized to improve personal and social comfort by enhancing visual characteristics similar to those of a biological hand. In this work, we developed formulations based on natural rubber latex (NRL) with antibacterial properties by the incorporation of an additive consisting of zinc oxide coated with silver nanoparticles to manufacture cosmetic gloves designed for upper limb prostheses. The dispersion efficiency of the additive was investigated by microscopic techniques. Tensile and tear strength tests, Shore A hardness measurements, swelling indices, hydrophobicity and inhibition of bacterial growth were also conducted to ascertain the suitability and adaptability of the developed material for integration into the daily activities of patients. Moreover, processing parameters for the immersion molding production of cosmetic gloves were assessed and validated, highlighting the crucial relationship between manufacturing techniques and material properties. Overall, the results indicated that the combination of the additive with a high crosslinking density of NRL effectively improved the material mechanical properties, resulting in a tensile strength of up to 20.7 MPa and a tear strength of approximately 40 kN m−1. In addition, and according to the antibacterial tests, the gloves exhibited bacteriostatic effects against Staphylococcus aureus and bactericidal effects against Escherichia coli. As a conclusion, the dataset indicates that the manufactured cosmetic gloves can be used to covering upper limb prostheses. Additionally, it underscores the considerable potential for the cosmetic glove manufacturing industry through the use of appropriate formulations and processing techniques for NRL.

INCIDENCE OF ORAL CANDIDIASIS IN FIXED ORTHODONTIC APPLIANCES

Introductions: Oral candidiasis is most often caused by Candida albicans, followed by C. glabrata. In European countries, an analysis showed that more than half of candidiasis cases were caused by C. albicans and the infection rate caused by other candida strains was 14% for C. glabrata and C. parapsilosis, 7% for C. tropicalis and 2% for C. krusei. According to a study in Brazil, C. albicans accounted for 40.9% of cases followed by C. tropicalis (20.9%), C. parapsilosis (20.5%) and C. glabrata (4.9%). Meanwhile, in Indonesia, there is no national data regarding the epidemiology of oral candidiasis in Indonesia. Hospital Dr. Hasan Sadikin (RSHS) Bandung conducted research from 2010-2014 and found that during that period 49 patients had oral candidiasis. In general, side effects can be felt by patients who are in fixed orthodontic treatment which affects comfort and quality of life, namely 42.79% experience a sensation of pain in the area of the oral cavity, while 51.80% complain of discomfort when chewing food and this can indicate that Orthodontic appliances are mainly the patient's daily activities, the second is related to chewing food, phonetics and smile lines. The purpose of this study was to determine the incidence of candidiasis on orthodontic appliances. This study was to determine the incidence of candidiasis on fix orthodontic appliances. Material and Methods: In this study, 80 samples were obtained from the total population, namely medical students who use fixed orthodontics with metal materials. Methods with SWAB examination on the surface of the bracket and the oral mucosa that intersect with the ortho-adhesive device. The results were recorded and then data analysis was carried out. Then the specimens were put in a microbiology incubator for 48 hours at room temperature. If candida albicans grows on the petridish then it is assessed that candidiasis is present. Results: From the study, it was found that 80% incidence of candidiasis, 20% is normal. Conclussions: There is a high incidence of oral candidiasis in patients using fix orthodontics appliances.

Clinical and radiological aspects of the forearm in children with congenital radioulnar synostosis: a cohort study

Introduction The upper limb functional limitations in congenital radioulnar synostosis may significantly affect the daily activities of patients. Classifications of the condition are descriptive and have limited practical application.Purpose Determine a functionally significant quantitative criterion for anatomical changes in the forearm.Material and methods 92 children (136 forearms) with congenital radioulnar synostosis were examined for limitations in activities of daily living (ADL), health-related quality of life measured with PedsQL questionnaire; pronation of the forearm and radiographic parameters. A comparative and correlation analysis, ROC analysis were performed to determine the relationship between the forearm pronation and limitations of ADL.Results Statistically significant correlations were revealed between symptoms and the forearm alignment (p &lt; 0.01, rxy = 0.5); subluxation of the ulnar head and forearm alignment (p &lt; 0.001, rxy = 0.6); bowing deformity of the radius, forearm alignment and subluxation of the ulnar head and between the length of the forearm bones and bowing deformity of the radius (p &lt; 0.05, rxy = 0.4 and rxy = 0.5). A statistically significant inverse correlation was revealed between symptoms and PedsQL scores (p = 0.038, rxy = –0.4). Pronation of 45° was the threshold value of the forearm alignment with a high risk of ADL limitation. The area under the ROC curve corresponding to the relationship between symptoms and the forearm alignment was 0.955 ± 0.021 (95 % CI: 0.915–0.995). There was a statistically significant (p &lt; 0.01) decrease in the lumen of the medullary canal in the middle third of the ulnar shaft with the radius lumen being unchanged. Dorsal subluxation of the ulnar head was detected In 30 % of cases.Discussion The characteristics identified demonstrated changes in the forearm bones with functional impairments being correlated with the forearm pronation.Conclusion The correlation between the patient’s symptoms and the forearm alignment must be taken into account in the classification and when determining indications for surgical treatment distinguishing between functional (&lt; 45° pronation) and dysfunctional (≥ 45° pronation) options.

Cataract surgery in patients with diabetes mellitus. Prevention and optimisation of the diabetic macular edema therapy

Diabetes mellitus (DM) is a major public health problem, with approximately one third having signs of diabetic retinopathy (DR). In such patients, cataracts develop at an earlier age and 2–5 times more frequently. The incidence of macular edema (ME) after phacoemulsification of cataracts (FEC) in patients with diabetes has been shown to increase by 1.80 times and, in the presence of DR by 6.23. The critical period for retinal deterioration is 2 months after FEC, which requires an active therapy and monitoring. For patients with pre-existing diabetic macular edema (DME), If the cataract does not affect daily activities of patients with a pre-existing DME and the optical clarity is adequate, it is preferable to postpone surgical treatment in order to maximize retinal stabilization on OCT at two consecutive visits with a month’s interval between. In the case of severe impairment of lens transparency, FEC with an intravitreal injection of anti-VEGF 28 days or steroids 1 month before surgery under strict monitoring of the retinal condition using OCT is recommended. If macular changes are absent and there is a risk of developing DME, the use of nonsteroid anti-inflammatory drugs is necessary. Prophylactic intravitreal therapy is unacceptable in the absence of MO.

Bone tissue engineering based on sustained release of MiR29c-modified framework nucleic acids from an injectable hydrogel

Bone defects affect the daily activities of patients and are prevalent complications of various skeletal disorders. The miR29 family regulates bone physiology and pathological processes. MiR29c can inhibit Dickkopf-1 (DKK1) expression, up-regulate the Wnt-signaling pathway, and modify the intracellular microenvironment. However, its application is hindered by poor stability and low bioavailability. This study sought to optimize the nano miR29c delivery system, enable enhanced drug effects, stable drug in situ retention, and sustained drug release. Tetrahedral framework nucleic acids (tFNAs), which have excellent drug-loading ability, endocytic capacity, and stability, were used with sticky ends to deliver miR29c (i.e., stFNAs-miR29c). Porous gelatin methacryloyl (GelMA) was selected as a scaffold for the in situ sustained release of stFNAs-miR29c and to provide a growth environment for bone marrow mesenchymal stem cells (BMSCs). This research developed a miR29c sustained-release system in situ: GelMA-stFNAs-miR29c and demonstrated its osteogenesis in vitro and in vivo. GelMA, stFNAs, and miR29c can function synergistically at nano-, micro-, and macro- scales that achieves high stability and efficiency on microRNA nano-delivery, regulates the local microenvironment, maintains the macro-osteogenic space, accelerates the osteogenic process, and ensures excellent osteogenesis effects, contributing to the broader application of miRNAs in biomedicine and improved bone regeneration in situ.

Physiotherapy Management For Pedicled Ld Flap And Stsg E.C Soft Tissue Tumor : A Case Report

Background: Pedicled LD Flap and STSG are reconstructive measures to cover defects in extensive tumor conditions in the brachii region, especially the elbow. In this case, physiotherapy management is given to accelerate recovery to be more optimal, reduce the risk of complications and improve functional results in the brachii region. Methods: In this study using the Case report method conducted at Prof. Dr. I.G.N.G Ngoerah Bali Hospital in a male patient aged 15 post Pedicled LD Flap and STSG with complaints of pain in the surgical scar area, limited joint motion, and impaired functional ability. Given exercise, infrared modality, and ADL training with 1x a week for 2 weeks. Results: Overall there was an increase in sinistra AGA muscle strength, increased joint motion scope, and improved functional ability with the SPADI Index. Conclusion: Based on research using this case report, it shows that physiotherapy management in post Pedicled LD Flap and STSG E.C Soft Tissue Tumor conditions given infrared, exercise, and ADL training can be concluded to be able to reduce pain, reduce stiffness, increase the scope of joint motion, increase muscle strength, and improve joint functional abilities and daily activities of patients.

In Vivo 3-Dimensional Dynamic Evaluation of Shoulder Kinematics After the Latarjet Procedure: Comparison With the Contralateral Healthy Shoulder.

Researchers have attempted to understand the underlying mechanism of the Latarjet procedure; however, its effects on shoulder kinematics have not been well studied. The purpose was to analyze shoulder kinematics after the Latarjet procedure. It was hypothesized that the nonanatomic transfer of the coracoid process during the procedure would affect normal shoulder kinematics. Controlled laboratory study. The study included 10 patients (age range, 20-52 years) who underwent the modified Latarjet procedure between June 2016 and November 2021. Computed tomography and fluoroscopy were conducted on both shoulder joints of all patients, and 3-dimensional models were reconstructed. The 3-dimensional coordinates were encoded on the reconstructed models, and shoulder kinematics were analyzed through a 3-dimensional-2-dimensional model-image registration technique. Scapular rotation parameters (scapular upward rotation, posterior tilt, external rotation, and scapulohumeral rhythm) were compared between the Latarjet and the nonsurgical contralateral sides during humeral abduction, as was anteroposterior (AP) translation relative to the glenoid center during active humeral external rotation. The Latarjet side displayed significantly higher values of scapular upward rotation at higher degrees of humeral elevation (130°, 140°, and 150°) compared with the nonsurgical side (P = .027). Posterior tilt, external rotation, and scapulohumeral rhythm were not significantly different between sides. AP translation at maximal humeral rotation was not significantly different between sides (Latarjet, -0.06 ± 5.73 mm vs nonsurgical, 5.33 ± 1.60 mm; P = .28). Interestingly, on the Latarjet side, AP translation increased until 40° of humeral rotation (4.27 ± 4.64 mm) but began to decrease from 50° of humeral rotation. The Latarjet side demonstrated significant changes in scapular upward rotation during higher degrees of humeral elevation compared with the contralateral shoulder. Posterior movement of the humeral head at >50° of humeral rotation could be the desired effect of anterior stabilization; however, researchers should evaluate long-term complications such as osteoarthritis. Analysis of shoulder kinematics after the Latarjet procedure could provide information regarding long-term outcomes and whether the procedure would affect the daily activities of patients.

Effectiveness of range of motion therapy to improve muscle strength in postoperative limb fracture patients

Intoduction: A fracture or fracture is a separation or tear in bone continuity caused by trauma. Fracture fixation surgery is one of the procedures in handling fractures. However, there are still many short-term and long-term complications that can be experienced by patients, one of which is a decrease in range of motion which results in a decrease in muscle strength. Range Of Motion (ROM) is one of the therapies that can be done to improve and maintain the perfection of the ability to move joints completely and to increase muscle time and tone. Objective: To increase muscle strength in postoperative limb fracture patients can apply Range of Motion therapy. Methods: The method used in this study uses case studies with pre and post intervention. Range of Motion therapy is carried out 2 times a day in 3 consecutive days starting from the second day postoperatively. The patient was given ROM therapy on the second day postoperatively passively. On the third and fourth postoperative days, patients are asked to do ROM actively as taught on the first day. Results: Results showed that there was an increase in muscle strength in patients postoperative limb fractures after Range of Motion therapy. Conclusion: Range of motion therapy with appropriate procedures and performed routinely can improve muscle strength and daily activities in patients with postoperative limb fractures.

The effects of an electronic head-mounted display in vision rehabilitation for patients with tunnel vision

PurposeTo investigate the effect of a new head-mounted electronic visual aid-Acesight on improving visual function and daily activities in patients with tunnel vision.Methods57 patients with tunnel vision participated in this study. The visual field (VF), visual acuity (VA), search ability, time of finding people from the side (TFPS), walking ability, and the subjective feelings of patients with and without Acesight were measured.Results15 (36%) patients thought Acesight was “helpful”, 16 (28%) thought it was “a little help”, and 26 (46%) believed that it was “not helpful.” The proportion of people aged < 60 years found Acesight helpful was higher. When wearing Acesight, the average horizontal VF diameter (°) (35.54[8.72]) and vertical VF diameter (°) (26.63[5.38]) were larger than those without visual aids (20.61[9.22], 18.19[6.67]) (P all < 0.001). The average TFPS before and while wearing the Acesight was 1.77s(0.32) and 1.19s(0.29), respectively (t = 14.28, P < 0.001). The average search times, number of collisions, walking speeds when wearing the Acesight were not statistically different from those without visual aids (P all > 0.05).ConclusionMore than half of patients with tunnel vision found the Acesight helpful, and a higher proportion of those aged < 60 years old found it helpful. Acesight can expand the horizontal and vertical VF of patients with tunnel vision and can enable patients to detect objects coming from the side earlier.Trial registrationChiCTR2000028859; Date of registration: 2020/1/5; URL: http://www.chictr.org.cn/showproj.aspx?proj=47129

Evaluation of single and multiple hyaluronic acid injections at different concentrations with high molecular weight in the treatment of knee osteoarthritis

BackgroundKnee osteoarthritis is severe progressive and most commonly diagnosed articular disease and its incidence is increasing around the world depending on age. This pathologic condition which limits daily activity of patients can be characterized by degeneration of cartilage and inflammation. Although non-steroidal anti-inflammatory (NSAII) agents and other analgesics are routinely used treatment options, the potential effects of intraarticular injections including hyaluronic acid (HA) have also been demonstrated by various studies. However, few studies compare the efficacy of a single high molecular weight (HMW) high dose and a triple HMW low dose. This study aimed to compare the efficacy of single high molecular weight (HMW) high dose (2 mL / 60 mg) and triple HMW low dose (2 mL /30 mg) intra-articular injection of HA in knee osteoarthritis (OA) patients by evaluating function and pain parameters during 12 months.MethodsThis is a single-center, retrospective clinical study that included and involved 128 patients. Group I (n=64) patients received triple 30 mg HA injections (SEMICAL®) with one-week intervals, while Group II (n=64) patients received a single 60 mg HA injection (SEMICAL®). Lequesne Index, WOMAC and VAS scores were recorded to assess pain and function during a 12-month period.ResultsThere was no significant difference in characteristics of patient demographics. Our finding indicate that WOMAC, VAS score, and Lequesne Index values during follow-up visits exhibited a decrease, signifying improvement in the clinical condition. Notably, scores were significantly more favorable with the 30 mg of HA injection compared to the 60 mg of HA injection.ConclusionThis study suggests that the triple low-dose injection of HMW HA is more effective in improving WOMAC, VAS scores and Lequesne Index values than a single high-dose injection.