Sliding Technique Research Articles

Comparison of Z-Technique and Sliding Technique for Achilles Tendon Lengthening in Cerebral Palsy with Equinus Deformity: A Meta-Analysis

Comparison of Z-Technique and Sliding Technique for Achilles Tendon Lengthening in Cerebral Palsy with Equinus Deformity: A Meta-Analysis

A Comparison of the Effectiveness of Neurodynamic Sliding Technique and Self-Myofascial Release Technique for Reducing Hamstring Tightness in Healthy Individuals: A Prospective Study.

Hamstring tightness is prevalent among college-going students aged 18-25 years, leading to an increased risk of recurrent injury, reduced athletic performance, post-exercise soreness, and decreased coordination. Myofascial release and neurodynamic sliding technique are two interventions used to alleviate this issue. Myofascial release is a concept that involves pain originating from the muscle and fascia. The neurodynamic sliding technique is a method of producing sliding movement of neural structures relative to their mechanical interfaces. This study involved 70 individuals with hamstring tightness who met the inclusion and exclusion criteria. Participants were assigned to Group A or Group B using a convenient sampling method. Group A received neurodynamic sliding technique treatment, while Group B received a self-myofascial release. Both interventions were administered for two months. The outcome measures used in this study were active knee extension and lower extremity functional scale, which were evaluated before and after the intervention. Within-group comparisons indicated that both Group A and Group B showed significant improvements in hamstring flexibility. Between-group comparisons of active knee extension (AKE) and lower extremity functional scale (LEFS) immediately after the intervention showed statistically significant results. These findings suggest that both the neurodynamic sliding technique and self-myofascial release are effective in improving hamstring flexibility. This study has implications for clinical practice, as both interventions may be used to address hamstring tightness. Our study found that both the neurodynamic sliding technique and self-myofascial release can improve hamstring flexibility. However, the neurodynamic sliding technique was found to be more effective than self-myofascial release. Further research is necessary to determine the optimal protocol for these interventions and their effectiveness in clinical populations with hamstring tightness or injury.

Sliding technique through a non-degloving approach for Peyronie's Disease: 2-surgeon experience

ABSTRACT Introduction The sliding technique (ST) has been used to restore penile size in patients with penile atrophy secondary to severe Peyronie's Disease (PD) and erectile dysfunction (ED). When combined with degloving, this procedure carries a potential risk of causing ischemia or necrosis to the glans penis. Objective We hereby present a detailed surgical technique of the non-degloving approach for the ST and penile prosthesis (PP) placement. Methods Retrospective review of databases from 2 surgeons and report patient outcomes after PP placement with sliding technique for the correction and size restoration of severe PD and ED from January 2015 to September 2019. Results A total of 39 patients had significant penile atrophy and/or curvature >60 degrees and underwent PP placement with grafting procedures between 2 surgeons. 11 of those patients underwent ST of which 9 had the procedure performed through a non-degloving ventral incision. Mean degree of curvature prior to ST was 62 degrees (45 to 90 degrees) Mean penile length gain was 2.47 cm (2.0 to 3.0 cm). At a mean follow up of 12.4 months (3 to 31 months) only 1 patient had residual curvature, which was minimal at 15 degrees. There were no infections or vascular complications in our series. Conclusion There are reports of ischemic injury in PD patients undergoing penile prothesis placement in addition to the ST with a circumcision and penile degloving. The non-degloving technique with a ventral incision provides for an alternative method to perform the ST in patients with penile atrophy secondary to severe PD and ED. This approach could theoretically minimize the risk of glans ischemia by maintaining dartos and skin continuity to the glans penis while still allowing for adequate surgical exposure. Disclosure Work supported by industry: no. A consultant, employee (part time or full time) or shareholder is among the authors (Jonathan Clavell Hernandez: Consultant for Coloplast and Boston Scientific, Run Wang is consultant for Boston scientific and Coloplast ).

Comparison of Effectiveness of Passive Hamstring Stretching Technique and Neurodynamic Sciatic Nerve Sliding Technique in Low Back Pain

Objective: Low back pain (LBP) is a very common health problem worldwide having global point prevalence of 9.4%. Correlations have been found between decreased length of the hamstrings and LBP. It was found that improving the flexibility of hamstrings can significantly reduce chronic LBP. This study compared the effectiveness of two techniques i.e. passive hamstring stretching technique (PHS) and neurodynamic sciatic nerve sliding technique (NDS) on hamstring flexibility and pain in non-radiating LBP patients. Methods: 26 patients between the age group of 25-45 years having non-radiating LBP were recruited in the study. Group A (n=13) were given passive hamstring stretching while Group B (n=13) performed neurodynamic sciatic nerve sliding technique under guidance of the researcher. Baseline data were obtained for hamstring length and pain before and after intervention. Pain was assessed using ‘visual analogue scale’ and hamstring length was measured using ‘passive knee extension test’. Intervention was performed on alternate days for three sessions with 48 hours rest period in between each session. Results: Data were analysed for hamstring length and pain between both the groups using ‘unpaired t’ test. NDS technique was statistically significantly more effective in improving pain (p =0.03 at 95%CI= -2.07 to -0.09). There was no statistically significant difference in the effectiveness of both techniques in improving hamstring length (p =0.08 at 95%CI= -3.4 to 0.25). Conclusions: Both the techniques are equally effective in improving hamstring length, however NDS was more effective in improving pain in low back pain patients as compared to PHS. Keywords: Low back pain; Neural sliders; Static hamstring stretch; Hamstring flexibility .

Effect of neurodynamic sliding technique on bilateral hamstring flexibility and balance in normal elderly population

The objective of this study was to determine the effectiveness of Neurodynamic sliding technique on hamstring flexibility and postural balance in elderly population. This study was randomized experimental trial. A total of 30 subjects (14 females and16 males), confirmed by the subject specialist were selected on the basis of exclusion and inclusion criteria. All subjects began with a single measure of passive SLR on their dominant leg. Range of motion was less than 75° and balance was assessed by Berg Balance Scale. Measurements were performed on very first day of the intervention. Subjects were then treated with Neurodynamic Sliding Technique on 6 different days over two weeks. Results were noted and compared on the 1 day (pre) and after 2 weeks (post). Data was analysed using MS EXCEL. Student’s test was applied for the comparison of all variable in elderly population treated with Neurodynamic Sliding Technique in improving balance and straight leg raise. The evaluation of results was done pre and post intervention on the two parameters which were balance by BBS and passive range of motion of SLR by Goniometer. It showed improvement in PROM (SLR) test and berg balance score on the subsequent days i.e. day 1 (Before) and 2 weeks (After). Results from this study show that an isolated Neurodynamic Intervention provides a greater immediate increase in Passive Straight Leg Raise. The results confirmed our initial hypothesis that an isolated neurodynamic sliding technique would provide a greater immediate improvement in hip flexion, assessed by Passive Straight Leg Raise. Limitation of the study was Small sample size and lack of control group. It was concluded that Neurodynamic sliding technique was effective in increasing the hamstring flexibility and improving postural balance in elderly population.

Assessment of the Algorithms for Diagnostics and the Possibilities of Treating Patients with a Penile Dysmorphie Disorder

The article discusses issues related to the choice of diagnostic algorithms and planning tactics for treating patients with penile dysmorphophobia. The psychological characteristics of this group of patients, methods of diagnosis, psychotherapy correction and the choice of surgical tactics are sounded.
 The manifestations of penile dysmorphophobia and dysmorphomania, as disorders of a deeper level, are considered as an integrative problem solved from the standpoint of urology, psychotherapy, and aesthetic surgery. In conjunction with an andrologist, the involvement of a psychotherapist and, if necessary, a psychiatrist is required. At the initial stages of working with a patient, narrowly focused psychotherapy is used. The next level of correction is cognitive behavioral psychotherapy (CBT) with the technique of “exposure and prevention of reactions” or “cognitive restructuring”. The “mindfulness CBT” technique is considered important for teaching the patient the ability to stop subjective perception of personal experiences.
 To consolidate the result, individual hypnosuggestational therapy and group (family) psychotherapy are used. The indications for surgical enlargement of the penis are divided into medical, functional and aesthetic. Penile dysmorphophobia is an aesthetic indication for surgery. Contradictions in carrying out such interventions include the lack of standardized methods with a high positive prognosis, overestimated patient expectations, and the lack of a result to improve a man’s self-esteem even with a positive result of the operation.
 The clinic of the Department of Sexopathology and Andrology of the State Institution «Institute of Urology of the National Academy of Medical Sciences of Ukraine» uses a ligamentotomy technique to lengthen the penis and implant a polypropylene mesh under the superficial fascia of the penis to thicken it. For patients with manifestations of penile dysmorphophobia simultaneously with severe forms of erectile dysfunction, a number of operations have been proposed for the simultaneous installation of penile implants and augmentation of the tunica albuginea using a graft: corporoplasty with a circular graft, Sliding Technique, modification of the sliding technique (MoST), Multiple-slid-Technique (MuST) augmentation technique.
 These techniques are not included in the list of recommendations offered by the urological community; they have high predictable risks of complications requiring urgent explantation of the prosthesis and irreversible loss of penile length.

Denting the FRTB‐IMA Computational Challenge via Orthogonal Chebyshev Sliding Technique

In this paper we introduce a new technique based on high-dimensional Chebyshev Tensors that we call orthogonal Chebyshev sliding technique. We implemented this technique inside the systems of a tier-one bank, and used it to approximate Front Office pricing functions in order to reduce the substantial computational burden associated with the capital calculation as specified by FRTB IMA. In all cases, the computational burden reductions obtained were of more than 90 percent, while keeping high degrees of accuracy. The latter obtained as a result of the mathematical properties enjoyed by Chebyshev tensors.

Optimization of structural and mechanical engineering problems using the enriched ViS-BLAST method

In this paper, an enhanced Violation-based Sensitivity analysis and Border-Line Adaptive Sliding Technique (ViS-BLAST) will be utilized for optimization of some well-known structural and mechanical engineering problems. ViS-BLAST has already been introduced by the authors for solving truss optimization problems. For those problems, this method showed a satisfactory enactment both in speed and efficiency. The Enriched ViS-BLAST or EVB is introduced to be vastly applicable to any solvable constrained optimization problem without any specific initialization. It uses one-directional step-wise searching technique and mostly limits exploration to the vicinity of FNF border and does not explore the entire design space. It first enters the feasible region very quickly and keeps the feasibility of solutions. For doing this important, EVB groups variables for specifying the desired searching directions in order to moving toward best solutions out or inside feasible domains. EVB was employed for solving seven numerical engineering design problems. Results show that for problems with tiny or even complex feasible regions with a larger number of highly non-linear constraints, EVB has a better performance compared to some records in the literature. This dominance was evaluated in terms of the feasibility of solutions, the quality of optimum objective values found and the total number of function evaluations performed.

Prioritizing community environmental concerns with a hybrid approach to multi-criteria decision-making – a case study of Newport News, Virginia, USA

Local communities can play a very important role in evaluating their environmental conditions and in developing innovative, practical, and effective solutions to improve community environmental health. Thus, community involvement in decision-making is one of the keys to improving environmental and public health. However, such a process is unquestionably complicated and demands well-organized collaboration between local communities and authoritative partners, as well as suitable decision-aiding methods/tools that facilitate a multiple-step decision process, starting from the identification and prioritization of hazards, risks and concerns, to the development and ranking of potential solutions. We introduce a new multi-criteria decision-making method named BESTMAP (Bounding, Eliciting, and Sliding Technique for Multi-Criterion Analysis of Priorities). BESTMAP inherits the strengths of several popular MCDM models and retains their respective merits by tackling myriad concerns with a practical, yet rigorous, approach to derive preference. BESTMAP has been developed in a familiar (offline) web-browser interface to facilitate stakeholder use. Integrating practicality and methodological rigor, BESTMAP serves as an effective model for MCDM applications, especially those with a large number of criteria and alternatives in general, and for prioritizing concerns for community environmental health in particular, where the list of concerns is often numerous, unclear, and diverse between different stakeholders.

Flap Sliding Technique for Managing Flap Striae following Laser In Situ Keratomileusis.

Purpose To assess the efficacy and safety of a simple, noninvasive, “flap-sliding” technique for managing flap striae following laser in situ keratomileusis (LASIK). Methods This prospective, interventional study included eyes with post-LASIK flap striae. All eyes underwent flap sliding 1-2 days after surgery. Following flap edge epithelialisation, a cellulose sponge was used to gently slide the flap perpendicular to the striae direction. This technique allows for flap striae treatment without flap lifting, avoiding any associated lifting complications. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and refractive error were monitored one day after the flap-sliding procedure. Results Fifteen eyes (15 patients) with post-LASIK flap striae were managed using the flap-sliding technique. The procedure did not successfully relocate the flap striae in 1 eye, and flap elevation and floating (using a balanced salt solution) were required. Therefore, 14 eyes were included in post-flap-sliding analyses. The UDVA improved in all patients the first day after the flap-sliding procedure was performed, with 11 of 14 eyes (78.57%) reaching an UDVA of 20/25 or better. Complications following flap sliding occurred in 2 eyes (14.29%). One eye had intraoperative epithelial abrasion, and 1 eye had residual postoperative striae outside of the optical zone. Conclusion The flap-sliding technique is a simple, noninvasive, efficient, and safe technique for managing post-LASIK flap striae that develop after epithelial healing in the early post-LASIK period. This trial is registered with NCT04055337.

СОВЕРШЕНСТВОВАНИЕ ТЕХНИКИ СКОЛЬЖЕНИЯ НА КОНЬКАХ ЮНЫХ ХОККЕИСТОВ

СОВЕРШЕНСТВОВАНИЕ ТЕХНИКИ СКОЛЬЖЕНИЯ НА КОНЬКАХ ЮНЫХ ХОККЕИСТОВ

Effect of Neurodynamic Sliding Technique on Hemiplegic Stroke Subjects with Hamstring Tightness

Effect of Neurodynamic Sliding Technique on Hemiplegic Stroke Subjects with Hamstring Tightness

Arthroscopic-Assisted Suspensionplasty Using the Palmaris Longus Tendon for Osteoarthritis of the Thumb Carpometacarpal Joint

Osteoarthritis of the thumb carpometacarpal joint is common, especially in postmenopausal women. Numerous surgical techniques, including ligament reconstruction, partial or complete trapeziectomy, arthrodesis, and arthroplasty have been introduced. Suspensionplasty combined with trapeziectomy has been introduced to prevent proximal subsidence of the first metacarpal. To prevent excessive release of periarticular capsuloligamentous tissues, resection of the proximal part of the trapezium, and the cosmetically unappealing bump, arthroscopic partial trapeziectomy has been used as a less-invasive treatment option. With advanced techniques and devices, arthroscopic suspensionplasty with the autograft can be performed; thus far, there have been no series reporting on arthroscopic treatment options for this common condition. The purpose of this article is to present a technique for arthroscopic-assisted suspensionplasty using the palmaris longus tendon to reinforce the graft–bone interface, based on the concept of the tension slide technique to treat thumb carpometacarpal osteoarthritis.

Denting the FRTB IMA Computational Challenge via Orthogonal Chebyshev Sliding Technique

In this paper we introduce a new technique based on high-dimensional Chebyshev Tensors that we call Orthogonal Chebyshev Sliding Technique. We implemented this technique inside the systems of a tier-one bank, and used it to approximate Front Office pricing functions in order to reduce the substantial computational burden associated with the capital calculation as specified by FRTB IMA. In all cases, the computational burden reductions obtained were of more than 90%, while keeping high degrees of accuracy, the latter obtained as a result of the mathematical properties enjoyed by Chebyshev Tensors.

Penile Size Restoration With Nondegloving Approach for Peyronie’s Disease: Initial Experience

IntroductionThe sliding technique (ST), commonly done with a subcoronal circumcising incision with penile degloving, has been used to restore penile size in patients with severe Peyronie’s disease (PD) and erectile dysfunction, but with a potential risk of ischemic injury to the glans penis. AimTo provide detailed surgical techniques regarding the nondegloving ventral incision and report our initial experience with this approach to perform the ST and penile prosthesis placement in patients with severe PD. MethodsThis was a retrospective review of patient outcomes after penile prosthesis placement with penoplasty for severe PD and erectile dysfunction from January 2015 to December 2017. Main Outcome MeasuresPrimary outcomes included straightening rates, penile measurement, along with immediate and late complications. Secondary outcomes include operative time and overall patient satisfaction. Results12 Patients had significant penile atrophy and/or curvature >60 degrees and underwent inflatable penile prosthesis placement with grafting procedure. Significant penile atrophy was determined by a combination of the patient’s subjective report and the surgeon’s objective assessment through stretched penile length. 7 (58.3%) of those patients underwent ST, of which the last 5 had the procedure performed through a nondegloving ventral incision. Mean degree of curvature prior to ST was 66 degrees (45–90 degrees). Mean penile length gain was 2.6 cm (2.0–3.0 cm). At a mean follow-up of 15.5 months (3–31 months), only 1 patient had minimal residual curvature of 15 degrees. There were no vascular complications. Clinical ImplicationsThis nondegloving technique theoretically maintains blood flow continuity to the glans penis by preserving the continuity of the skin, dartos fascia, and neurovascular bundle. Strengths & LimitationsStrengths of this study include the novel nature of this approach, no incidence of vascular complications, and adaptability to other grafting procedures during penile prosthesis placement. Limitations include the use of 5-item International Index of Erectile Function scores to assess preoperative erectile function on PD, small population, longer incision, and a possible steep learning curve. ConclusionWhile ischemic complications of ST and penile prosthesis implantation are rare, there are reports of ischemic injury in patients undergoing a subcoronal circumcising incision with penile degloving. The non-degloving technique with ventral incision provides for an alternative method for ST and penile prosthesis placement to maintain dartos and skin continuity to the glans penis while still allowing for adequate surgical exposure.Clavell-Hernández J, Wang R. Penile Size Restoration With Nondegloving Approach for Peyronie’s Disease: Initial Experience. J Sex Med 2018;15:1506–1513.

Posterior “Double Cannular Sliding Technique” for Resection of Posterior Septum of the Knee Joint

We introduce the posterior double cannular sliding technique, which is an easy, fast, safe, and reproducible method for posterior septum resection of the knee joint. Several posterior compartment procedures have been developed. Procedures with anterior-posterior approaches (transnotch approach) and posterior-posterior approaches have become possible for arthroscopic total synovectomy and loose body removal. For resection of the posterior septum with posterior-posterior approaches, several authors have used various methods. However, although previous studies reported posterior septum resection in the posterior portal, or perforation of the posterior septum by blind vision or transnotch approach, specific postperforation techniques to resect the posterior septum have not been reported. Furthermore, methods of posterior septum resection remain difficult to perform using posterior portal arthroscopy, with difficulties in the approach and in achieving reproducible outcomes. Thus, we introduce the posterior double cannular sliding technique, which is a reproducible method that uses 2 transparent cannulas and a switching stick under direct visualization control with a transnotch approach, thereby minimizing the risk of potential neurovascular or posterior cruciate ligament injury for all procedures in posterior septum resection.

Effect of neurodynamic mobilization on fluid dispersion in median nerve at the level of the carpal tunnel: A cadaveric study

ObjectivesTo evaluate the effect of neurodynamics mobilization (NDM) on an artificially induced edema in the median nerve at the level of the carpal tunnel in unembalmed cadavers and to assess whether NDM tensioning techniques (TT) and NDM sliding techniques (SLT) induce similar effects on intraneural fluid dispersion. DesignFourteen upper extremities of seven unembalmed cadavers were used in this study. A biomimetic solution was injected directly under the epineurium of the median nerve at the level of the proximal transverse carpal ligament. The initial dye spread was allowed to stabilize and measured with a digital caliper. Tensioning and sliding techniques were applied following a randomized crossover design to each upper extremity and were performed for a total of 5 min each. Post-intervention dye spread measurements were taken after each technique. ResultsAfter the first mobilization, the mean longitudinal dye spread (7.5 ± 6.6 mm) was significantly greater (p = 0.024) compared to the stabilized dye spread. There was a significant longitudinal diffusion effect with both, TT (p = 0.018) and SLT (p = 0.016), with no statistically significant difference between techniques (p = 0.976). The order in which techniques were administered did not influence the diffusion. ConclusionFive minute of passive NDM in the form of tensioning or sliding technique induced significant fluid dispersion in the median nerve at the carpal tunnel of unembalmed human cadavers. This study provides support for clinical mechanism of NDM in reducing intraneural edema.

Modified Data Duplication Algorithm to Minimizethe Redudancy of Data in Medical Database

Objective: To secure and reduce the data duplication in medical databases using Modified Sliding and Windowing proposed method. Method: Here we proposed Modified Sliding and Windowing technique (MSW). It enables the users to command entry of outsourced information notwithstanding though the proprietorship changes progressively by misusing randomized merged encryption, secures possession aggregate key appropriation. This counteracts information spillage not exclusively to denied user despite the fact that they already possessed that information, additionally to a legit however inquisitive distributed storages servers. Findings/ Results: The MSW method gives higher Effectiveness and lesser delay for finding duplication. This method consumes less Memory and provide greater accuracy than the existing duplication algorithms. The comparison is done with NS2 (Network Simulator2) using different dataset. Hence this proposed research can be used to reduce the data duplication in advanced databases with lesser correlations and parameters. Application/ Improvements: Data duplication algorithm can be improved in future by adding more parameters with higher accuracy based on severe attacks in future.

Comparative Study of the Effects of Neurodynamic Sliding vs Suboccipital Muscle Inhibition Technique on Flexibility of Hamstring in Asymptomatic Subjects with Hamstring Syndrome

Objective: The purpose of this study is to research the effects of the Neurodynamics sliding (NDS) and sub-occipital muscle inhibition technique (SMI) on flexibility of hamstring in asymptomatic subjects with hamstring syndrome. Method: According to finger floor test and SLR test thirty male subjects were selected subjects were randomly allocated to Neurodynamics sliding group and sub-occipital muscle inhibition group of 15 each. Neurodynamic sliding and Sub occipital inhibition technique were applied to the groups. For analysis straight leg raise (SLR) finger floor test (FFT) and range of motion (ROM) of knee joint were used. Outcome measures were assessed before and after intervention at end of two weeks. Result:There is a significant change in SLR, FFT and ROM measures in both SMI and NDS groups. When compared the Neurodynamics sliding group measures show significant changes than the sub-occipital muscle inhibition group. Conclusion: Application of NDS& SMI to persons with short hamstring syndrome resulted in increases in flexibility of the hamstring. However the NDS technique was more effective.

Distal Inside-Out Epineural Sliding Technique to Repair Segmental Nerve Defects.

Background: The repair of a segmental peripheral nerve injury is a clinical challenge. Several studies have been performed to determine superior methods for overcoming nerve gaps. The purpose of this study was to investigate if the inside-out slided epineurium of the distal segment of an injured nerve can serve as a conduit to bridge a short nerve defect (10 mm). Methods: Nineteen sciatic nerves in Sprague-Dawley rats were transected, and a 10-mm gap was left between the ends. A section of distal epineurium was pulled inside out to bridge the gap. Walking track analysis was performed, and the sciatic function index (SFI) was calculated. Wet muscle mass and withdrawal reflex were measured. The density of axon fibers at different levels of repaired nerves was determined, and histological analysis was performed at 16 weeks. Results: The mean SFI improved from -81.0 at 4 weeks to 36.3 at 16 weeks. The axon densities showed regeneration through the epineural tube, and 5 of the rats demonstrated a withdrawal reflex. The weight of the tibialis anterior muscle of the injured limb at 16 weeks was 59% that of the uninjured side. Conclusions: The distal epineural sheath tube provided a size-matched conduit between the nerve stumps, with no histological donor-site morbidity. Histologically, regeneration occurred through the epineural tube without neuroma formation, and functional recovery was comparable to that of previous studies of nerve repair techniques. Technique may be an addition to the armamentarium of tools used to treat segmental nerve defects.