Walking Aids Research Articles

Axial Postural Abnormalities in Parkinsonism: Gaps in Predictors, Pathophysiology, and Management.

Axial Postural Abnormalities in Parkinsonism: Gaps in Predictors, Pathophysiology, and Management.

The incidence, risk factors, and outcomes of symptomatic avascular necrosis of bone among Chinese pediatric patients with acute lymphoblastic leukemia

Avascular necrosis (AVN) of bone is a debilitating complication of pediatric patients with acute lymphoblastic leukemia (ALL). While it is extensively studied and reported in Western population, studies focused on Orientals are limited. This study aims to evaluate the incidence, risk factors, and clinical outcomes of AVN among Chinese children with ALL. This study is a retrospective, territory-wide population-based cohort study of pediatric patients with ALL enrolled on one of the three consecutive ALL study protocols (ALL-IC-BFM 2002, CCLG-ALL 2008, and CCCG-ALL 2015). A total of 24 out of 533 pediatric subjects with ALL (4.5%) had symptomatic AVN. Age was the single most important risk factor associated with the development of AVN. Only three patients were below age of 10 at the time of diagnosis of ALL. The incidences of AVN in patients aged above and below 10 years were 18.2% ± 3.6% and 0.8% ± 0.5%, respectively, and were significantly different (p < 0.005). Treatment protocol, immunophenotype, and gender were not predictive of AVN. Among the 24 patients, five required orthopedic interventions in view of progressive and severe disease. For subjects with hip joints involvement, follow-up assessments showed 12 of 22 hip joints had radiological progression over a median duration of 3.63 years. Seventeen of them did not have pain at the latest follow-up and among patients with pain (n=7), five did not experience any limitation on activities of daily living while two required use of walking aids or wheelchair. The incidence of symptomatic AVN in Chinese ALL patients was comparable to other studies in Western population. Adolescent age more than 10 years old was recognized to be the most important factor for development of AVN. Significant proportion of patients had radiological progression over time with a small percentage of subjects had daily activities affected.

Interaction between cognitive and motor disorders for risk screening of incident falls: results of an elderly population-based observational cohort study.

This study aims to examine (1) the association of "Emergency Room Evaluation and Recommendations" (ER2) cognitive and motor items with incident falls (i.e., ≥ 1), their recurrence (i.e., ≥ 2) and post-fall fractures and (2) the performance criteria (i.e., sensitivity, specificity) of the greater identified association for each incident fall outcome in older community dwellers. 7147 participants (80.5 ± 3.8; 100% female) of the EPIDémiologie de l'OStéoporose (EPIDOS) observational population-based cohort study were recruited in France. Inability to name the day's date and the use of a walking aid and/or anhistory of falls were recorded at baseline. Incident outcomes, which were ≥ 1 fall, ≥ 2 falls and post-fall fractures, were collected every 4months over a period of 4years. The overall incidence of ≥ 1 fall was 26.4%, 6.4% for ≥ 2 falls, and 19.1% for post-fall fractures. Cox regressions revealed that the use of a walking aid and/or anhistory of falls [Hazard ratio (HR) ≥ 1.03 with P ≤ 0.011], inability to name the day's date (HR ≥ 1.05 with P ≤ 0.003), and their combination (HR ≥ 1.37 with P ≤ 0.002) were significantly associated with both incident falls, regardless of their recurrence, and post-fall fractures. A significant positive association between ER2 cognitive and motor items, both, respectively, and in combination, with an overall incidence of falls, regardless of their recurrence, as well as with post-fall fractures was demonstrated. However, the low sensitivity and high specificity of the combination of ER2 items suggest that these items cannot be used for risk screening of fall outcomes in the older population.

APLIKASI ARDUINO PADA SMARTSTICK BAGI PENYANDANG TUNA NETRA

The development of science and technology is so rapid today, so that various ideas appear in the field of electronics. Then to help human life, we have tried to apply electronic technology to simple systems. This research is intended to examine the use of Smartstick (assisting stick) for people with visual impairments. So far it is known that walking aids for blind people are very simple, they do not use electronic devices. Furthermore, the Arduino application is applied to this tool, namely this stick is equipped with 3 sensors that operate 180°, then sound alarm, vibration and GPS. When a blind person approaches an object, the alarm will sound and inform the distance between the blind person and the object. With a sensor range of 180 degrees, objects that are below the middle and even above will be detected, so that the Smartstick user will be able to avoid the possible distance until the warning alarm goes offautomatically. Therefore, blind people don't have to worry about crashing into other unwanted objects.

Factors Influencing the Use of Walking Aids by Frail Elderly People in Senior Day Care Centers.

Senior day care centers in Japan are the most commonly used insurance service for frail elderly people, and it is important to examine the factors that influence the use of walking aids at these centers. We aimed to investigate the factors affecting the use of walking aids by frail elderly patients in senior daycare centers. A total of 131 frail elderly people (mean age 82.7 ± 6.4 years) formed our study population. They were divided into two groups: solo walking (n = 87) and walking aid (n = 44). Individuals with cognitive decline were excluded. All participants were assessed using Functional Independence Measure Motor (FIM-M) sub-scores. Grip strength, knee extension strength, the 10 s Chair Stand test for Frail elderly (Frail CS-10), Single Leg Standing (SLS), and Timed Up and Go (TUG) tests were measured and compared between the two groups. The walking aid group scored significantly lower than the solo walking group for five items: FIM-M, knee extension muscle strength, Frail CS-10, SLS, and TUG (p < 0.05). Logistic regression analysis revealed that knee extension muscle strength was the only factor that affected the use or disuse of walking aids (p < 0.05). The cut-off value of the knee extensor muscle strength-to-weight ratio for walking alone was 28.5%. Knee extensor muscle strength was the most important factor in determining the use of a walking aid.

Anoctamin-5 related muscle disease: Clinical and genetic findings in a large European cohort.

Anoctamin-5 related muscle disease is caused by biallelic pathogenic variants in the anoctamin-5 gene (ANO5) and shows variable clinical phenotypes: limb-girdle muscular dystrophy type 12 (LGMD-R12), distal muscular dystrophy type 3 (MMD3), pseudometabolic myopathy, or asymptomatic hyperCKemia. In this retrospective, observational, multicentre study we gathered a large European cohort of patients with ANO5-related muscle disease to study the clinical and genetic spectrum and genotype-phenotype correlations. We included 234 patients from 212 different families, contributed by 15 centres from 11 European countries. The largest subgroup was LGMD-R12 (52.6%), followed by pseudometabolic myopathy (20.5%), asymptomatic hyperCKemia (13.7%), and MMD3 (13.2%). In all subgroups, there was a male predominance, except for pseudometabolic myopathy. Median age at symptom onset of all patients was 33 years [23-45]. The most frequent symptoms at onset were myalgia (35.3%) and exercise intolerance (34.1%), while at last clinical evaluation most frequent symptoms and signs were proximal lower limb weakness (56.9%) and atrophy (38.1%), myalgia (45.1%), and atrophy of the medial gastrocnemius muscle (38.4%). Most patients remained ambulatory (79.4%). At last evaluation, 45.9% of LGMD-R12 patients additionally had distal weakness in the lower limbs and 48.4% of MMD3 patients also showed proximal lower limb weakness. Age at symptom onset did not differ significantly between males and females. However, males had a higher risk of using walking aids earlier (P = 0.035). No significant association was identified between sportive versus non-sportive lifestyle before symptom onset and age at symptom onset nor any of the motor outcomes. Cardiac and respiratory involvement that would require treatment occurred very rarely. Ninety-nine different pathogenic variants were identified in ANO5 of which 25 were novel. The most frequent variants were c.191dupA (p.Asn64Lysfs*15) (57.7%), and c.2272C > T (p.Arg758Cys) (11.1%). Patients with two loss-of function variants used walking aids at a significantly earlier age (P = 0.037). Patients homozygous for the c.2272C > T variant showed a later use of walking aids compared to patients with other variants (P = 0.043). We conclude that there was no correlation of the clinical phenotype with the specific genetic variants, and that LGMD-R12 and MMD3 predominantly affect males that have a significantly worse motor outcome. Our study provides useful information for clinical follow up of the patients and for the design of clinical trials with novel therapeutic agents.

Fibula pro tibia and cancellous allograft vitalised with autologous bone for non-union of the distal tibia diaphysis: Surgical technique

BackgroundThe management of medium-sized osseous defects and pseudoarthrosis of the tibia is challenging. This surgical technique aims to bridge medium-sized tibial defects using the fibula as a lead structure. The fibula and cancellous bone graft fuse with the tibia leading to synostosis. MethodsCortico-cancellous bone is harvested from the anterior iliac crest. The bone is shredded into small pieces of about 5 mm and mixed with stem cell-rich blood from the situs. Additionally, cancellous allografts can be used for expansion. The approach is extended along the interosseous membrane to reach the tibial defect. The pseudarthrosis is debrided and the tibial bone adjacent to the defect is decorticated. A 3.5 mm 1/3 tube plate is positioned to the fibula and fixed. Four quadricortical screws are positioned. Autograft is secured into the tibial bone defect and between the fibula and the tibia directly on the anterior surface of the interosseous membrane. Results15 patients were followed up for a mean of 17 months. Osseous consolidation was achieved in 73.3% of all cases. On average, bone healing has occurred 17 weeks postoperatively. These patients did not have any pain walking with full weight bearing and without any walking aids at the last follow-up. ConclusionThe fibula pro tibia procedure is a sufficient tool for treating non-unions of the mid and distal third of the tibia diaphysis in cases with a bony defect size of 1 cm–6 cm.

Use of the Heracles straight blade in the treatment of intertrochanteric hip fractures: a prospective study with a 1-year follow-up.

The treatment of intertrochanteric fractures in the elderly remains challenging for orthopedic surgeons, due to aging, comorbidities, and poor bone quality. The Heracles straight blade has proven a lower rate of cut-out and femoral head displacement in biomechanical studies; however, there are currently no published clinical studies using this nail. To analyze the clinical and radiological results of the Heracles nail with the straight cephalic Heracles blade as a device to treat osteoporotic intertrochanteric fractures of the proximal femur. A total of 136 patients with trochanteric hip fractures were operated on by the same surgeon, using the Heracles nail with a straight cephalic blade. However, only 86 patients completed the 1-year follow-up both clinically and radiologically. According to the Association of Osteosynthesis classification, 38 patients (44.1%) had 31-A1, 36 patients (41.6%) had 31-A2, and 12 patients (14.1%) had 31-A3. Functional outcomes were assessed according to the Katz and Barthel scores, finding that 58% of patients recovered their original functional level, According to Barthel score, a mean loss of 11.8 points was found. The mean hospital stay was 8.22 days (mean preoperative stay of 2.71 days). The mean tip-apex distance was 15.2 mm. During the follow-up, 6 complications (6.96%) were detected: 4 cut-out, 1 cut-in, and 1 nail breakage. According to the Katz score, 58% of the patients recovered their previous functional status and 20.58% needed an additional walking aid. The mean loss in the Barthel score was 11.8 points. The Heracles nail using a cephalic straight blade has proven to be a valid treatment of trochanteric fractures, due to the functional recovery of the patients and low level of complications.

KINESIOPHOBIA AND QUALITY OF LIFE IN THE WEAN-OFF PHASE WITH WALKING AID USERS IN ARTHROSCOPIC REPAIRS: A CORRELATION STUDY.

Background: Avoidance of activity is a natural reaction that allows an injury to heal, but in patients following arthroscopic surgery, avoidance behavior is found to last longer than the actual injury. This can result in kinesiophobia, an irrational, crippling, and devastating fear of movement, affecting the patients' quality of life. Hence, this correlation study aimed to determine how the domains and subdomains of Kinesiophobia (TSK17) and Quality of Life (WHOQoL-BREF) interact in patients attempting to wean themselves off of walking aids. With the ethical Methodology: permission and informed consent of 42 arthroscopic patients who fullled the inclusion and exclusion criteria, two scales were administered to assess kinesiophobia (TSK-17) and QOL (WHOQoL-BREF). Data was gathered and statistically analyzed using Pearson's correlation coefcient. Results: The ndings show that 71% of the study population had clinically signicant kinesiophobia. Kinesiophobia was found to have a moderate negative correlation with the physical (r= -0.73) and psychological (r= -0.74) domains, a mild negative correlation with the environmental (r= - 0.33) domain, and no correlation with the social (r= -0.10) domain. This study found a statisticall Conclusion: y signicant inverse relationship between Kinesiophobia and the domains of quality of life. Thus, kinesiophobia merits further research during the weaning phase, and effective intervention strategies to reduce its impact on quality of life should be implemented

Assessment patient satisfaction after total hip replacement in Indian population

Background: We aim to assess the satisfaction of patients after total hip replacement in Indian population. Nоwаdаys tоtаl hiр аrthrорlаsty is the finаl treаtment орtiоn рrоvided tо раtients with unsаlvаgeаble, severely аrthritiс, раinful аnd defоrmed hiрs. Раtient sаtisfасtiоn hаs been meаsured in multiрle оrthораediс рrосedures, inсluding tоtаl hiр аrthrорlаsty. THА is а соmmоn surgiсаl рrосedure thаt imрrоves the lives оf раtients with end-stаge аrthritis by deсreаsing раin, аnd imрrоving mоtоr function and mоbility аs measured by vаlidаted heаlth-relаted оutсоme tооls. Methods: Patients were assessed at OPD visit or with telephonic conversation scores are calculated and mentioned in excel sheet. Post-surgery satisfaction score is the score created to measure the satisfaction after total hip replacement. This score contains different questionnaires. These questions include inquiry about relieve of pain, ability to do daily routine activities, requirement of walking aids etc. Score contains total 7 questions with answers. Results: Out of 95 patients we found through this study that about 92.63% of patients are satisfied after total hip replacement. 7.37% of patients are dissatisfied. Satisfaction rate is more as compared to dissatisfaction rate. Conclusions: In present study we have tried to eliminate other factors responsible for dissatisfaction such as hospital ward cleanliness, hospital administration, patient and hospital staff communication. We recommend total hip replacement surgery for end stage arthritis and is more beneficial to the patients in terms of improvement in post-operative pain and function.

Profiles of socially isolated community-dwelling older adults during the COVID-19 pandemic: A latent class analysis

ObjectiveTo identify different profiles of socially isolated older adults during the first wave of COVID-19 in Quebec, Canada. Study designCross-sectional data were obtained through a telehealth socio-geriatric risk assessment tool, ESOGER, administered to adults aged 70 years or more between April and July 2020 in Montreal, Canada. MeasuresThose living alone with no social contacts in the last few days were considered socially isolated. Latent class analysis was performed to identify profiles of socially isolated older adults based on: age, sex, polypharmacy, use of home care, use of a walking aid, recall of current year/month, anxiety level (scale 0–10), and need for follow-up from a healthcare provider. ResultsThree-hundred and eighty (380) older adults identified as socially isolated were analyzed, of whom 75.5 % were female and 56.6 % were over 85. Three classes were identified: Class 1 (“physically frail older females”) had the highest proportion of polypharmacy, walking aid, and home care use. Class 2 (“anxious, relatively younger males”) were predominantly males who used the least home care but had the highest anxiety levels. Class 3 (“seemingly well older females”) had the highest proportion of females, lowest proportion of polypharmacy, lowest anxiety level, and none used a walking aid. Recall of current year/month was similar across the three classes. ConclusionsThis study found heterogeneity among socially isolated older adults during the first wave of the COVID-19 pandemic with varying levels of physical and mental health. Our findings may contribute to the development of targeted interventions to support this vulnerable population during and after the pandemic.

Validation of an Activity Type Recognition Model Classifying Daily Physical Behavior in Older Adults: The HAR70+ Model

Activity monitoring combined with machine learning (ML) methods can contribute to detailed knowledge about daily physical behavior in older adults. The current study (1) evaluated the performance of an existing activity type recognition ML model (HARTH), based on data from healthy young adults, for classifying daily physical behavior in fit-to-frail older adults, (2) compared the performance with a ML model (HAR70+) that included training data from older adults, and (3) evaluated the ML models on older adults with and without walking aids. Eighteen older adults aged 70-95 years who ranged widely in physical function, including usage of walking aids, were equipped with a chest-mounted camera and two accelerometers during a semi-structured free-living protocol. Labeled accelerometer data from video analysis was used as ground truth for the classification of walking, standing, sitting, and lying identified by the ML models. Overall accuracy was high for both the HARTH model (91%) and the HAR70+ model (94%). The performance was lower for those using walking aids in both models, however, the overall accuracy improved from 87% to 93% in the HAR70+ model. The validated HAR70+ model contributes to more accurate classification of daily physical behavior in older adults that is essential for future research.

Long-term favorable prognosis in late onset dominant distal titinopathy: Tibial muscular dystrophy.

Tibial muscular dystrophy (TMD) is a dominant late onset distal titinopathy. It was first described in Finnish patients 3 decades ago. TMD patients with several other TTN mutations occur in many European populations. In this retrospective study, we were able to obtain longitudinal follow-up data of the disease progression over 15 years in 137 TMD patients. We retrieved clinical data retrospectively from three examinations spanning a period of 15 years. The data were analyzed in R. Frequencies, percentages, and median values were used to describe data. Probability values were determined with the chi-squared test. In the cohort, the first symptoms were walking difficulties (97.8%) and weakness in distal lower limbs (98.5%). The progression of the weakness in distal lower limbs was moderate, and in the proximal lower limbs and proximal upper limbs it was mild. The distal upper limbs were not affected. Magnetic resonance imaging results indicated fatty degeneration preferentially in lower leg anterior muscles, gluteus minimus, and hamstring muscles. Serum creatine kinase values in the cohort were mostly normal (40.7%) or mildly elevated (53.7%). The data suggest that 50% of patients need walking aids by the age of 88 years. Despite individual variability of severity, the overall disability due to walking difficulties and upper limb weakness remained moderate even at very advanced ages, and cardiomyopathy did not develop due to the titin defect alone. The acquired results promote the correct identification of TMD, and the obtained trajectories of disease evolution can be used as natural history data for any therapeutic intervention.

Analysis on Key Points of Safety and Effectiveness Evaluation of Wearable Rehabilitation Walking Aid Robot

To analyze the key points of evaluation on the safety and effectiveness of wearable rehabilitation walking aid robot, then improve its quality control ability. Combined with the functional and structural characteristics of the wearable rehabilitation walking aid robot, the key points of quality evaluation were analyzed from the aspects of electrical safety and main performance. Some reasonable suggestions were put forward for the design and development of the robot. The key points of safety and effectiveness evaluation of wearable rehabilitation aid walking robot focused on battery, protection device, operation parameters, static load strength, network security, environmental adaptability and other aspects. By analyzing the key points of safety and effectiveness evaluation of wearable rehabilitation walking aid robot, certain ideas are provided for the design and development of such products, and reference is provided for the improvement of product quality evaluation system.

Symptoms of Sarcopenia and Physical Fitness through the Senior Fitness Test.

Physical fitness concerns a set of attributes related to the ability to perform physical activity that may justify the symptoms reported by the elderly in the context of sarcopenia. This study aimed to investigate the relationship between the perception (symptomatology) of physical functioning (what the person thinks they are capable of) and the capacity itself for physical functioning in elderly people in northern Brazil. Cross-sectional study that analyzed 312 elderly people (72.6 ± 7.8 years) from the city of Novo Aripuanã, Amazonas, Brazil. Sarcopenia symptomatology was assessed using the SARC-F, a 5-item questionnaire designed for screening sarcopenia in older individuals in five domains: strength, walking aids, difficulty getting up from a chair, difficulty climbing stairs, and falls. Physical fitness was assessed by the Senior Fitness Test (SFT) battery including balance evaluated with the short version of the Fullerton Advanced Balance scale (FAB). ROC curve analysis revealed that the tests with the greatest ability to discriminate participants with significant symptoms for sarcopenia (≥4 points on SARC-F) were arm curl and 6 min walk: the probability of suspected sarcopenia increased exponentially with an arm curl < 11.5 reps for men (se = 71%; sp = 69%; AUC = 0.706, 95% CI: 0.612-0.788; p = 0.013) and women (se = 81%; sp = 51%; AUC = 0.671, 95% CI: 0.601-0.735; p ≤ 0.001) or with a 6-min walk <408.5 m for men (se = 71%; sp = 63%; AUC = 0.720, 95% CI: 0.628-0.690; p = 0.001) and <366.0 m for women (se = 69%; sp = 58%; AUC = 0.692, 95% CI: 0.623-0.755; p = 0.0001). Physical fitness assessed through the senior fitness test, particularly the 30-s-arm curl test and the 6-min walk test, can discriminate for suspected symptoms of sarcopenia.

The relationship between self-reported physical frailty and sensor-based physical activity measures in older adults – a multicentric cross-sectional study

BackgroundThe decline in everyday life physical activity reflects and contributes to the frailty syndrome. While especially self-reported frailty assessments have the advantage of reaching large groups at low costs, little is known about the relationship between the self-report and objective measured daily physical activity behavior.The main objective was to evaluate whether and to what extent a self-reported assessment of frailty is associated with daily physical activity patterns.MethodsDaily activity data were obtained from 88 elderly participants (mean 80.6 ± 9.1 years) over up to 21 days. Acceleration data were collected via smartwatch. According to the results of a self-report frailty questionnaire, participants were retrospectively split up into three groups, F (frail, n = 43), P (pre-frail, n = 33), and R (robust, n = 12). Gait- and activity-related measures were derived from the built-in step detector and acceleration sensor and comprised, i.a., standard deviation of 5-s-mean amplitude deviation (MADstd), median MAD (MADmedian), and the 95th percentile of cadence (STEP95). Parameters were fed into a PCA and component scores were used to derive behavioral clusters.ResultsThe PCA suggested two components, one describing gait and one upper limb activity. Mainly gait related parameters showed meaningful associations with the self-reported frailty score (STEP95: R2 = 0.25), while measures of upper limb activity had lower coefficients (MADmedian: R2 = 0.07). Cluster analysis revealed two clusters with low and relatively high activity in both dimensions (cluster 2 and 3). Interestingly, a third cluster (cluster 1) was characterized by high activity and low extent of ambulation. Comparisons between the clusters showed significant differences between activity, gait, age, sex, number of chronic diseases, health status, and walking aid. Particularly, cluster 1 contained a higher number of female participants, whose self-reports tended towards a low health status, the frequent use of a walking aid, and a higher score related to frailty questions.ConclusionsThe results demonstrate that subjective frailty assessments may be a simple first screening approach. However, especially older women using walking aids may classify themselves as frail despite still being active. Therefore, the results of self-reports may be particularly biased in older women.

Telephone-based assessment of the fear of falling in older people and factors associated.

This study aimed to validate the telephone-based application of the Falls Efficacy Scale-International (FES-I) for the assessment of the fear of falling in older people, and to investigate, among personal and environmental factors, which ones can explain this fear in this population. Participants answered the FES-I on two randomized occasions, face-to-face and by telephone. Intraclass correlation coefficient (ICC 3,1 ) was used to investigate the levels of agreement between the two occasions. The possible factors associated were sex, age, previous history of falls, family arrangement, practice of physical activity, presence of orthopedic pathologies, use of walking aids, presence of visual impairment, and presence of stairs in the home environment. Linear regression analysis was applied to investigate which of these factors could explain the fear of falling in older people. One hundred twenty-two individuals were included. There was no significant difference in the mean difference obtained between the two applications of the FES-I (1 point; 95% confidence interval, -4 to 6), with a high level of agreement (ICC = 0.88). Sex and presence of orthopedic pathologies explained 14% of the model. The FES-I showed to be a reliable scale to be applied for telephone assessments of fear of falling in older people. In addition, women with orthopedic pathologies are the profile of older people with most afraid of falling.

Gait Characteristics Associated with Fear of Falling in Hospitalized People with Parkinson's Disease.

Fear of falling (FOF) is common in Parkinson's disease (PD) and associated with distinct gait changes. Here, we aimed to answer, how quantitative gait assessment can improve our understanding of FOF-related gait in hospitalized geriatric patients with PD. In this cross-sectional study of 79 patients with advanced PD, FOF was assessed with the Falls Efficacy Scale International (FES-I), and spatiotemporal gait parameters were recorded with a mobile gait analysis system with inertial measurement units at each foot while normal walking. In addition, demographic parameters, disease-specific motor (MDS-revised version of the Unified Parkinson's Disease Rating Scale, Hoehn & Yahr), and non-motor (Non-motor Symptoms Questionnaire, Montreal Cognitive Assessment) scores were assessed. According to the FES-I, 22.5% reported low, 28.7% moderate, and 47.5% high concerns about falling. Most concerns were reported when walking on a slippery surface, on an uneven surface, or up or down a slope. In the final regression model, previous falls, more depressive symptoms, use of walking aids, presence of freezing of gait, and lower walking speed explained 42% of the FES-I variance. Our study suggests that FOF is closely related to gait changes in hospitalized PD patients. Therefore, FOF needs special attention in the rehabilitation of these patients, and targeting distinct gait parameters under varying walking conditions might be a promising part of a multimodal treatment program in PD patients with FOF. The effect of these targeted interventions should be investigated in future trials.

CORR Insights®: A Qualitative Study of Psychosocial Factors in Patients With Knee Osteoarthritis: Insights Learned From an Asian Population.

CORR Insights®: A Qualitative Study of Psychosocial Factors in Patients With Knee Osteoarthritis: Insights Learned From an Asian Population.

Donor site morbidity after computer assisted surgical reconstruction of the mandible using deep circumflex iliac artery grafts: a cross sectional study

BackgroundComputer Assisted Design and Computer Assisted Manufacturing (CAD/CAM) have revolutionized oncologic surgery of the head and neck. A multitude of benefits of this technique has been described, but there are only few reports of donor site comorbidity following CAD/CAM surgery.MethodsThis study investigated comorbidity of the hip following deep circumflex iliac artery (DCIA) graft raising using CAD/CAM techniques. A cross-sectional examination was performed to determine range of motion, muscle strength and nerve disturbances. Furthermore, correlations between graft volume and skin incision length with postoperative donor site morbidity were assessed using Spearman's rank correlation, linear regression and analysis of variance (ANOVA).ResultsFifteen patients with a mean graft volume of 21.2 ± 5.7 cm3 and a mean incision length of 228.0 ± 30.0 mm were included. Patients reported of noticeable physical limitations in daily life activities (12.3 ± 11.9 weeks) and athletic activities (38.4 ± 40.0 weeks in mean) following surgery. Graft volume significantly correlated with the duration of the use of walking aids (R = 0.57; p = 0.033) and impairment in daily life activities (R = 0.65; p = 0.012). The length of the scar of the donor-site showed a statistically significant association with postoperative iliohypogastric nerve deficits (F = 4.4, p = 0.037). Patients with anaesthaesia of a peripheral cutaneous nerve had a larger mean scar length (280 ± 30.0 mm) than subjects with hypaesthesia (245 ± 10.1 mm) or no complaints (216 ± 27.7 mm).ConclusionsDespite sophisticated planning options in modern CAD/CAM surgery, comorbidity of the donor site following iliac graft harvesting is still a problem. This study is the first to investigate comorbidity after DCIA graft raising in a patient group treated exclusively with CAD/CAM techniques. The results indicate that a minimal invasive approach in terms of small graft volumes and small skin incisions could help to reduce postoperative symptomatology.Trial registration Retrospectively registered at the German Clinical Trials Register (DRKS-ID: DRKS00029066); registration date: 23/05/2022