Lift Interventions Research Articles

The Role of Sole Lift in Treating Pediatric Idiopathic Scoliosis with Mild Thoracolumbar/Lumbar Curve.

Lower limb discrepancy (LLD) was frequently observed in patients with idiopathic scoliosis (IS), potentially associated with etiopathogenesis. Although sole lifts had been proposed as a conservative treatment for IS, evidence supporting their efficacy was limited. This study aimed to assess the effects of sole lift intervention on pediatric patients with mild IS, specifically focusing on thoracolumbar/lumbar (TL/L) curvature. Twenty patients, with an average age of 12.3 ± 3.1 years and presenting mild TL/L curve (15.6° ± 6.2°), were selected from a pool of 267 pediatric IS patients in the outpatient of our spine center from February 2023 to August 2023. Inclusion criteria comprised a main TL/L curve ranging between 10° and 40°, the lower limb positioned at the convexity of the main curve, and LLD of less than 2 cm; individuals requiring bracing or surgical intervention were excluded. Custom sole lifts were used to address the shorter lower limb with the objective of leveling the pelvis. Radiographic evaluations were conducted both before and after intervention using standing full spine posteroanterior radiographs and full leg length radiographs. Statistical analysis was undertaken to evaluate curve correction and its associations with other influencing factors. The mean structural and functional LLD were 7.1 ± 4.5 mm and 7.1 ± 4.1 mm, respectively. Among the 20 patients, four exhibited structural LLD greater than 10 mm. The average follow-up duration was 6.4 ± 1.9 months (range: 3-8 months). Following sole lift intervention (7.0 ± 3.0 mm), a significant reduction was observed in the TL/L curve compared to the pre-sole lifting measurements (15.6° ± 6.2° vs. 12.1° ± 7.2°, p < 0.001), as well as a notable decrease in the thoracic curve (12.2° ± 4.0° vs. 8.6° ± 6.3°, p = 0.064). Nine patients experienced a significant curve reduction of ≥5°, while eight showed a reduction between 0° and 5°; however, two patients exhibited no change in curve magnitude. Furthermore, the correction rate of the TL/L curve correlated significantly with functional LLD (r = -0.484, p = 0.030) and pelvic obliquity (r = -0.556, p = 0.011), highlighting the active pelvic compensation in maintaining balance between the spine and lower limbs. Conversely, no significant correlation was observed between curve correction and structural LLD (p > 0.05). Additionally, even after adjusting for other influencing factors, the TL/L Cobb angle remained significantly different between pre- and post-sole lifting (p = 0.037). This study confirmed the effectiveness of sole lift intervention in correcting TL/L and thoracic curves among the mild IS children with a main TL/L curve, providing a supplementary conservative treatment option for patients with the lower limb at the convexity of the main curve. Moreover, our findings underscored the active compensation of the lower limbs and the pelvis in the etiopathogenesis of IS, highlighting the importance of considering their influence in treatment strategies.

Autologous Materials in Regenerative Dentistry: Harvested Bone, Platelet Concentrates and Dentin Derivates.

The jawbone is a peculiar type of bone tissue, unique for its histological, anatomical and physiological characteristics. Therefore, a defect in the maxilla or in the mandible, because of pathological sequelae is difficult to prevent and to restore. Several biomaterials have been and are currently being developed to respond to the demands of regenerative medicine. A specific group of biomaterials used in regenerative dentistry is represented by the autologous materials. Platelet concentrates harvested bone and dentin derivates are indeed used in an attempt to minimise the alveolar resorption or in vertical ridge augmentation procedures or in sinus lift interventions. The aim of this review is to examine the properties of the above-listed materials, to compare them and to indicate eventual clinical applications.

Optimizing a self-directed mobile mindfulness intervention for improving cardiorespiratory failure survivors' psychological distress (LIFT2): Design and rationale of a randomized factorial experimental clinical trial

IntroductionAlthough as many as 75% of the >2 million annual intensive care unit (ICU) survivors experience symptoms of psychological distress that persist for months to years, few therapies exist that target their symptoms and accommodate their unique needs. In response, we developed LIFT, a mobile app-based mindfulness intervention. LIFT reduced distress symptoms more than either a telephone-based mindfulness program or education control in a pilot randomized clinical trial (LIFT1). ObjectiveTo describe the methods of a factorial experimental clinical trial (LIFT2) being conducted to aid in the development and implementation of the version of the LIFT intervention that is optimized across domains of effect, feasibility, scalability, and costs. Methods and analysisThe LIFT2 study is an optimization trial conceptualized as a component of a larger multiphase optimization strategy (MOST) project. The goal of LIFT2 is to use a 2 × 2 × 2 factorial experimental trial involving 152 patients to determine the ideal components of the LIFT mobile mindfulness program for ICU survivors across factors including (1) study introduction by call from a therapist vs. app only, (2) response to persistent or worsening symptoms over time by therapist vs. app only, and (3) high dose vs. low dose. The primary trial outcome is change in depression symptoms 1 month from randomization measured by the PHQ-9 instrument. Secondary outcomes include anxiety, post-traumatic stress disorder, and physical symptoms; measures of feasibility, acceptability, and usability; as well as themes assessed through qualitative analysis of semi-structured interviews with study participants conducted after follow up completion. We will use general linear models to compare outcomes across the main effects and interactions of the factors.

The Effect of Heel Lifts on Postural Stability in Individuals with Parkinson’s Disease

Our purpose was to investigate if accommodating plantar flexion contractures will improve postural alignment, patient perceived stability, and balance in individuals with Parkinson’s disease (PD), and the correlation of plantarflexion (PF) contractures and the Falls Efficacy scale (FES). This was a single session pretest posttest study with subject as their own control. We recruited a convenience sample of 32 participants with PD who could independently ambulate 20 feet without assistive devices. The Institutional Review Board approved the study, and informed consent was obtained from all participants prior to their participation. The outcome measures included: sagittal plane posture photo, verbal numeric rating of perceived stability, 1-minute recording of double leg stance on an interface pressure map, functional reach test (FRT) and the Falls Efficacy Scale (FES). The intervention was the use of bilateral Adjust-a-Lift heel lifts worn inside the participants’ shoe. Assigned heel lift thickness was based on PF contracture severity, determined via passive talocrural dorsiflexion measurement. Photographic posture analysis was completed with free image measurement software. Sway measurements were taken of center of gravity tracing with Tekscan software. Statistical analysis included Paired t-tests for outcome measures and Pearson product correlation between the FES and PF contracture data. We found significant changes (p<.05) in increase in height (mean 1.00 cm), an anterior translation of the pelvis (mean 2.3cm), a more upright trunk angle (mean 1.37 degrees) and a more upright head angle (mean 2.61 degrees). Perceived stability significantly increased (mean 0.75) and functional reach significantly decreased (mean 2.22cm). Significant correlations (r=0.36–0.50) were found between the degree of PF contracture and the total scale score as well as reported fear of falling for questions that required walking on the FES. This study showed accommodating PF contractures with heel lift intervention significantly improved postural alignment and perceived stability, but decreased participants’ functional reach.

Prosthodontic Management of Velopharyngeal Dysfunction in Speakers With Neurological Conditions

The purpose of this article is to describe the use of palatal lift and nasal obturator interventions for children and adults with velopharyngeal dysfunction due to neurological conditions. These intervention procedures are illustrated with brief summaries of an adult and a child with velopharyngeal dysfunction due to traumatic brain injury. The use of 3D printing to produce nasal obturators is introduced.

Technology Update: Rethinking Gas Lift Intervention

Technology Update Gas lift is an artificial lift technique used in wells in which the natural reservoir pressure is insufficient to deliver fluids to the surface in the initial production stage or has depleted to the point of being incapable of bringing fluids to the surface. Gas is delivered from surface-based compressors by way of the annulus between the casing and production tubing to a series of gas lift mandrels (conduits), which are positioned at strategic points within the production tubing string. When a predetermined gas pressure is reached, valves that are set within the mandrels open, causing gas to be “injected” into the production tubing, thus reducing the density of produced fluid and enabling flowback to the surface. Various types of valves are used in gas lift mandrels, depending on the need of the well. These valves are typically preinstalled and deployed with the production tubing string during well completion and may need replacement later in the life of the well. This will require an intervention. When designing a gas lift completion, engineers must consider a range of factors such as the availability of gas and the infrastructure on surface to process and deliver the gas into the well. Placement of the mandrel within the completion string is also critical when planning for production optimization and future intervention strategy. The industry remains cautious when designing gas lift completions, tending to place gas lift mandrels in areas of the well that are considered accessible when using standard slickline techniques. Most operators, if possible, place mandrels at no more than a 60° deviation within the completion string. However, this approach can lead to a suboptimal gas lift completion, with the benefit of optimizing production rates, by placing mandrels at greater true vertical depth, sacrificed for ensuring the ease of intervention access. Effective gas lift remediation has been a major challenge for the well intervention service industry and has not advanced significantly in terms of technique or operational efficiency. Slickline tools and methods are generally the same as those used when gas lift was introduced to the market about 40 years ago. Kickover tools deployed by slickline are used to undertake the vast majority of gas lift valve maintenance. The kickover tool is attached to the bottom of a standard tool string, which includes stem (mass) and mechanical jars that are positioned just above the tool. The mechanical jars deliver a critical upward and downward shock load during valve setting and retrieval. The tool string may also include power jars to deliver a significant upward jarring force when retrieving valves, if required.

Barriers and Facilitators Affecting the Adoption of Ceiling Lift Interventions in Nursing Homes

Ceiling lifts have been implemented in skilled nursing facilities to reduce the physical demands associated with patient-handling activities. However, despite the apparent ergonomic advantages of using such interventions, multiple studies have reported the reluctance of health care professionals to use the provided ceiling lifts. This study investigated factors that affect the adoption of ceiling lift interventions and considered a process that involves individuals progressing through multiple stages of change that ultimately lead to an intervention’s use. Eighteen participants from three nursing homes, who have had opportunity to use ceiling lifts, completed a survey and were interviewed afterwards. Four physically demanding tasks where ceiling lifts would benefit the healthcare provider were examined with regard to their adoption stages and the factors that affect their use. The findings show that for obviously physically demanding tasks, most participants fully adopt the use of a ceiling lift. However, when using a ceiling lift leads to a decrease in work efficiency or could result in adverse effects, a participant’s tolerance of physical demands increases beyond recommended levels and results in the use of compromised lift methods.

Musculoskeletal pain among critical-care nurses by availability and use of patient lifting equipment: An analysis of cross-sectional survey data

BackgroundPatient handling is a major risk factor for musculoskeletal injuries among nurses. Lifting equipment is a main component of safe patient handling programs that aim to prevent musculoskeletal injury. However, the actual levels of lift availability and usage are far from optimal. ObjectiveTo examine the effect of patient lifting equipment on musculoskeletal pain by level of lift availability and lift use among critical-care nurses. Design and participantsA cross-sectional postal survey of a random sample of 361 critical-care nurses in the United States. MethodsThe survey collected data on low-back, neck, and shoulder pain, lift availability, lift use, physical and psychosocial job factors, and sociodemographics. Musculoskeletal pain was assessed by three types of measures: any pain, work-related pain, and major pain. Multivariable logistic regressions were used to examine the associations between musculoskeletal pain and lift variables, controlling for demographic and job factors. ResultsLess than half (46%) of respondents reported that their employer provided lifts. Of 168 nurses who had lifts in their workplace, the level of lift availability was high for 59.5%, medium for 25.0%, and low for 13.7%; the level of lift use was high for 32.1%, medium for 31.5%, and low for 31.5%. Significant associations were found between lift availability and work-related low-back and shoulder pain. Compared to nurses without lifts, nurses reporting high-level lift availability were half as likely to have work-related low-back pain (OR=0.50, 95% CI 0.26–0.96) and nurses reporting medium-level lift availability were 3.6 times less likely to have work-related shoulder pain (OR=0.28, 95% CI 0.09–0.91). With respect to lift use, work-related shoulder pain was three times less common among nurses reporting medium-level use (OR=0.33, 95% CI 0.12–0.93); any neck pain was three times more common among nurses reporting low-level use (OR=3.13, 95% CI 1.19–8.28). ConclusionsGreater availability and use of lifts were associated with less musculoskeletal pain among critical-care nurses. These findings suggest that for lift interventions to be effective, lifts must be readily available when needed and barriers against lift use must be removed.

An Investigation into the Effect of a Pre-performance Strategy on Jump Performance

The aim of this study was to explore the effect that different components, making up a commonly used pre-performance preparation strategy, have on jump height performance. Sixteen male collegiate athletes (age, 21.38 ± 0.52 years; height, 1.79 ± 0.07 m; and body mass, 75.1 ± 5.26 kg) performed a preparation strategy involving a cycle ergometer warm-up, followed by a dynamic stretch component, and finishing with heavy back squats. This intervention was repeated to test countermovement, squat or drop jump performance after each component of the preparation strategy, with electromyographic activity measured during each jump test. Significant increases (p < 0.05) in jump height and electromyographic activity were noted, with a stepwise increase in performance from pre- to post-warm-up, increased further by the dynamic stretch component and again increased after the back squat. It was also noted that the increases in performance, attributed to the stretch and lift components, were significantly greater (p < 0.05) than the increases in jump height associated with the active warm-up. It seems likely that the initial active warm-up raised core temperature, helping to increase the jump performance. The specific movements employed in the stretch and lift interventions seemed to potentiate the agonistic muscles involved in jumping, shown by increases in electromyographic activity in the prime movers for the jumps explored. This could be an example of postactivation potentiation, where muscles are primed to increase performance beyond changes linked to an active warm-up.

Changes in Pain and Disability Secondary to Shoe Lift Intervention in Subjects With Limb Length Inequality and Chronic Low Back Pain: A Preliminary Report

Preassessment and postassessment of treatment intervention. To determine the changes in pain and disability secondary to shoe lift intervention for subjects with chronic low back pain (LBP) who have a limb length inequality (LLI). Previous reports have suggested that LLI may be a cause of LBP Most prior studies of lift therapy for management of LLI in patients with LBP have lacked clear guidelines for clinicians regarding the implementation of shoe lift intervention. Twelve subjects (6 male, 6 female) between the ages of 19 and 62 years with LLI (6.4-22.2 mm) and chronic LBP (1-30 years) participated. Visual analog scale pain ratings and disability questionnaire scores were acquired before and after lift intervention. Subjects determined their lift height based on resolution of LBP symptoms. Subjects experienced relief of general pain symptoms (P = .0006) and pain associated with standing (P= .002) following lift intervention, with minimally clinically important (MCID) reductions in general pain for 9 of 12 subjects and MCID reductions in standing pain for 8 of 10 subjects. Subjects also had less disability on the disability questionnaire (P = .001) following the intervention, with 9 of 12 subjects experiencing MCID reductions in disability. Shoe lifts may reduce LBP and improve function for patients who have chronic LBP and an LLI. Randomized controlled trials are needed to assess the efficacy of this intervention.

The three-year economic benefits of a ceiling lift intervention aimed to reduce healthcare worker injuries

Ceiling lifts are frequently advocated to mitigate risk of injury to healthcare workers when lifting, transferring, or repositioning patients. A longitudinal case-study was conducted in an extended care facility to evaluate the efficacy of overhead lifts in reducing the risk of injury beyond that previously reported for the first year post-intervention (Am. Assoc. Occup. 50 (3) (2002) 120–127, 128–134). Analysis of injury trends spanning 3 years pre-intervention and 3 years post-intervention, found a significant and sustained decrease in days lost, workers’ compensation claims, and direct costs associated with patient handling injuries. The payback period was estimated assuming that pre-intervention injury costs would either continue to increase (0.82 years) or plateau (2.50 years) in the year immediately preceding intervention. The rapid economic gains and sustained reduction in the frequency and cost of patient handling injuries beyond the first year strongly advocate for ceiling lift programs as an intervention strategy.

Variations in Achilles Tendon Loading with Heel Lift Intervention in Heel-Toe Runners

This study investigated the influence of heel lift interventions on the loading of the Achilles tendon for heel-toe runners. It was hypothesized that the peak Achilles tendon force and peak rate of loading would be reduced by the increase in heel lift, and that the peak Achilles tendon force would occur significantly later in stance. Achilles tendon forces were determined by calculating sagittal-plane ankle joint moments using inverse-dynamics techniques and dividing these moments by Achilles tendon moment arm lengths. Methods for estimating Achilles tendon moment arm length using skin markers were justified via MRI data for one participant. Seven participants underwent running trials under three heel lift conditions: zero, 7.5-mm, and 15-mm heel lift. Average magnitude and occurrence time of peak Achilles tendon force and peak rate of loading were determined for each condition over the 7 participants. Despite group reductions in peak Achilles tendon force and peak rate of loading for the increased heel lift conditions, statistical analysis (ANOVA) revealed no significant differences for these variables, p &gt; 0.05. Individual participant observations highlighted varied responses to heel lift; both increases and decreases in peak Achilles tendon force were observed. For the group data, the time of peak impact force occurred significantly later in the 15-mm heel lift condition than in the zero heel lift, p &lt; 0.05. It is suggested that the success of increased heel lift in treating Achilles tendon injury may be due to a later occurrence of peak Achilles tendon force in response to this intervention, reducing Achilles tendon average rate of loading. In addition, the individuality of Achilles tendon peak force changes with heel lift intervention highlights the need for individual participant analysis.