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[PMID]:29384920
[Au] Autor:Li Z; Li G; Chen C; Li Y; Yang C; Li M; Xu W; Zhu X
[Ad] Endereço:Department of Orthopedics, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai.
[Ti] Título:The radiographic parameter risk factors of rapid curve progression in Lenke 5 and 6 adolescent idiopathic scoliosis: A retrospective study.
[So] Source:Medicine (Baltimore);96(52):e9425, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Various parameters related to growth and maturity have been shown to be risk factors for scoliosis curve progression. We previously identified correlations between curve progression and radiographic parameters in clinical practice, but there is a lack of research.The aim of this study was to investigate and identify the radiographic parameters that are risk factors for rapid curve progression in Lenke 5 or 6 adolescent idiopathic scoliosis (AIS).A retrospective review of patients who were prospectively enrolled at the initiation of brace wear and followed through completion of bracing or surgery was performed. The inclusion criteria were as follows: a Lenke type 5 or 6 classification, Risser sign grade 0 or 1 at the initial outpatient examination, a follow-up period of 6 months including a minimum of 4 follow-ups, At each visit, the whole spine x-ray was completed, the following data were measured and collected: angle of the lumbar curve (LC), rotation of the apical vertebra (RAV) in the LC, deviation of the apical vertebra (DAV) in the lumbar curve, clavicle angle, L5 tilt angle (TA), body mass index, flexibility of the LC (FLC), and peak angle velocity (PAV). A binary logistic regression analysis was used to assess the contribution of each variable to PAV onset. The touch types for the determination of the lowest instrumented vertebra (LIV) were compared at both the PAV and final follow-up.Thirty-six AIS patients were recruited. The binary logistic regression model indicated that the following variable values significantly contributed to a high risk of PAV occurrence: LC ≥30° (OR = 6.153, 95%CI = 1.683-22.488, P = .006), RAV ≥III (OR = 15.484, 95%CI = 4.535-52.865, P <.001), DAV ≥40 mm (OR = 8.599, 95%CI = 2.483-29.784, P <.001), and TA ≥10° (OR = 2.223, 95%CI = 3.094-27.563, P <.001). The touch types for LIV determination changed in 12 of 36 patients, with at least 1 segment added as the LIV between the PAV and the final visit.LC ≥30°, RAV ≥III, DAV ≥40 mm, and L5 TA≥10° were radiographic parameters associated with an increased risk of curve progression in Lenke 5 and 6 AIS. The orthopedic surgery performed at the PAV is the ideal timing, and it will preserve 1 active segment than later surgery.Level of evidence was 4.
[Mh] Termos MeSH primário: Escoliose/diagnóstico por imagem
Escoliose/terapia
[Mh] Termos MeSH secundário: Adolescente
Braquetes
Criança
Progressão da Doença
Feminino
Seres Humanos
Masculino
Seleção de Pacientes
Radiografia
Estudos Retrospectivos
Fatores de Risco
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009425


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[PMID]:29320560
[Au] Autor:Dessery Y; Pallari J
[Ad] Endereço:Research & Development department, Peacocks Medical Group, Newcastle upon Tyne, United Kingdom.
[Ti] Título:Measurements agreement between low-cost and high-level handheld 3D scanners to scan the knee for designing a 3D printed knee brace.
[So] Source:PLoS One;13(1):e0190585, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Use of additive manufacturing is growing rapidly in the orthotics field. This technology allows orthotics to be designed directly on digital scans of limbs. However, little information is available about scanners and 3D scans. The aim of this study is to look at the agreement between manual measurements, high-level and low-cost handheld 3D scanners. We took two manual measurements and three 3D scans with each scanner from 14 lower limbs. The lower limbs were divided into 17 sections of 30mm each from 180mm above the mid-patella to 300mm below. Time to record and to process the three 3D scans for scanners methods were compared with Student t-test while Bland-Altman plots were used to study agreement between circumferences of each section from the three methods. The record time was 97s shorter with high-level scanner than with the low-cost (p = .02) while the process time was nine times quicker with the low-cost scanner (p < .01). An overestimation of 2.5mm was found in high-level scanner compared to manual measurement, but with a better repeatability between measurements. The low-cost scanner tended to overestimate the circumferences from 0.1% to 1.5%, overestimation being greater for smaller circumferences. In conclusion, 3D scanners provide more information about the shape of the lower limb, but the reliability depends on the 3D scanner and the size of the scanned segment. Low-cost scanners could be useful for clinicians because of the simple and fast process, but attention should be focused on accuracy, which depends on the scanned body segment.
[Mh] Termos MeSH primário: Braquetes
Imagem Tridimensional/instrumentação
Articulação do Joelho/diagnóstico por imagem
Impressão Tridimensional
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Imagem Tridimensional/métodos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180206
[Lr] Data última revisão:
180206
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190585


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[PMID]:29318284
[Au] Autor:Grossman DC; Curry SJ; Owens DK; Barry MJ; Davidson KW; Doubeni CA; Epling JW; Kemper AR; Krist AH; Kurth AE; Landefeld CS; Mangione CM; Phipps MG; Silverstein M; Simon MA; Tseng CW; US Preventive Services Task Force
[Ad] Endereço:Kaiser Permanente Washington Health Research Institute, Seattle.
[Ti] Título:Screening for Adolescent Idiopathic Scoliosis: US Preventive Services Task Force Recommendation Statement.
[So] Source:JAMA;319(2):165-172, 2018 01 09.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Adolescent idiopathic scoliosis, a lateral curvature of the spine of unknown cause with a Cobb angle of at least 10°, occurs in children and adolescents aged 10 to 18 years. Idiopathic scoliosis is the most common form and usually worsens during adolescence before skeletal maturity. Severe spinal curvature may be associated with adverse long-term health outcomes (eg, pulmonary disorders, disability, back pain, psychological effects, cosmetic issues, and reduced quality of life). Early identification and effective treatment of mild scoliosis could slow or stop curvature progression before skeletal maturity, thereby improving long-term outcomes in adulthood. Objective: To update the 2004 US Preventive Services Task Force (USPSTF) recommendation on screening for idiopathic scoliosis in asymptomatic adolescents. Evidence Review: The USPSTF reviewed the evidence on the benefits and harms of screening for and treatment of adolescent idiopathic scoliosis. Findings: The USPSTF found no direct evidence on screening for adolescent idiopathic scoliosis and health outcomes and no evidence on the harms of screening. The USPSTF found inadequate evidence on treatment with exercise and surgery. It found adequate evidence that treatment with bracing may slow curvature progression in adolescents with mild or moderate curvature severity (Cobb angle <40° to 50°); however, evidence on the association between reduction in spinal curvature in adolescence and long-term health outcomes in adulthood is inadequate. The USPSTF found inadequate evidence on the harms of treatment. Therefore, the USPSTF concludes that the current evidence is insufficient and that the balance of benefits and harms of screening for adolescent idiopathic scoliosis cannot be determined. Conclusions and Recommendation: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for adolescent idiopathic scoliosis in children and adolescents aged 10 to 18 years. (I statement).
[Mh] Termos MeSH primário: Programas de Rastreamento
Guias de Prática Clínica como Assunto
Medicina Preventiva
Escoliose/diagnóstico
[Mh] Termos MeSH secundário: Adolescente
Comitês Consultivos
Braquetes
Criança
Feminino
Seres Humanos
Masculino
Programas de Rastreamento/efeitos adversos
Escoliose/terapia
Sensibilidade e Especificidade
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.19342


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[PMID]:29318283
[Au] Autor:Dunn J; Henrikson NB; Morrison CC; Blasi PR; Nguyen M; Lin JS
[Ad] Endereço:Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Research Affiliates Evidence-based Practice Center, Seattle, Washington.
[Ti] Título:Screening for Adolescent Idiopathic Scoliosis: Evidence Report and Systematic Review for the US Preventive Services Task Force.
[So] Source:JAMA;319(2):173-187, 2018 01 09.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Adolescent idiopathic scoliosis (AIS), a spinal curvature of 10° or more, is the most common form of scoliosis, with a prevalence of 1% to 3%. Curves progress in approximately two-thirds of patients with AIS before skeletal maturity, and large curves (>50°) may be associated with adverse health outcomes. Objective: To systematically review evidence on benefits and harms of AIS screening for the US Preventive Services Task Force (USPSTF). Data Sources: Cochrane Central Register of Controlled Trials, MEDLINE, ERIC, PubMed, CINAHL, and relevant systematic reviews were searched for studies published from January 1966 to October 20, 2016; studies included in a previous USPSTF report were also reviewed. Surveillance was conducted through July 24, 2017. Study Selection: Fair- and good-quality studies that evaluated the accuracy of screening children and adolescents aged 10 to 18 years for AIS, the benefits of AIS treatment, the harms of AIS screening or treatment, or long-term health outcomes. Data Extraction and Synthesis: Two investigators independently reviewed abstracts and full-text articles and extracted data into evidence tables. Results were qualitatively summarized. Main Outcomes and Measures: Health outcomes and spinal curvature in adolescence and adulthood, accuracy of screening for AIS, any harm of AIS screening or treatment. Results: Fourteen studies (N = 448 276) in 26 articles were included. Accuracy of AIS screening was highest (93.8% sensitivity; 99.2% specificity) in a cohort study of a clinic-based program using forward bend test, scoliometer, and Moiré topography screening (n = 306 082); accuracy was lower in cohort studies of 6 programs using fewer modalities (n = 141 161). Four controlled studies (n = 587) found evidence for benefit of bracing on curve progression compared with controls. A randomized clinical trial and a nonrandomized trial of exercise treatment (N = 184) found favorable reductions in Cobb angle of 0.67° to 4.9° in the intervention group compared with increases of 1.38° to 2.8° in the control group. Two cohort studies (n = 339) on long-term outcomes found that braced participants reported more negative treatment experience and body appearance compared with surgically treated or untreated participants. A study that combined a randomized clinical trial and cohort design (n = 242) reported harms of bracing, which included skin problems on the trunk and nonback body pains. There was no evidence on the effect of AIS screening on adult health outcomes. Conclusions and Relevance: Screening can detect AIS. Bracing and possibly exercise treatment can interrupt or slow progression of curvature in adolescence. However, there is little or no evidence on long-term outcomes for AIS treated in adolescence, the association between curvature at skeletal maturity and adult health outcomes, the harms of AIS screening or treatment, or the effect of AIS screening on adult health outcomes.
[Mh] Termos MeSH primário: Braquetes
Terapia por Exercício
Programas de Rastreamento
Medicina Preventiva
Escoliose/diagnóstico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Braquetes/efeitos adversos
Criança
Progressão da Doença
Feminino
Seres Humanos
Masculino
Programas de Rastreamento/efeitos adversos
Guias de Prática Clínica como Assunto
Escoliose/cirurgia
Escoliose/terapia
Sensibilidade e Especificidade
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, U.S. GOV'T, P.H.S.; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.11669


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[PMID]:29228056
[Au] Autor:Misterska E; Glowacki J; Okret A; Laurentowska M; Glowacki M
[Ad] Endereço:Department of Pedagogy and Psychology, University of Security, Poznan, Poland.
[Ti] Título:Back and neck pain and function in females with adolescent idiopathic scoliosis: A follow-up at least 23 years after conservative treatment with a Milwaukee brace.
[So] Source:PLoS One;12(12):e0189358, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We aimed to explore the long-term outcomes of back and neck pain and functionality in adult females with adolescent idiopathic scoliosis (AIS), who had been treated with a Milwaukee brace, in a follow-up study a minimum of 23 years after the completion of the treatment, using radiological, clinical and socio-demographical data. Thirty AIS patients (scoliosis group-SG), were included in the study based on an extensive search of Pediatric Orthopedics and Traumatology Clinic charts. All treatments were successfully completed between 1974 and 1990. In all cases, scoliosis had not been detected before the age of 10 and was not combined with any major spinal deformities at the time when the brace treatment was implemented. In those patients, the Risser sign 4 and minimum two years post-menarche was defined as a maturity, after that time the brace treatment was completed. Patients were excluded from the study if they, at the time of the follow-up examinations, suffered from any other disease leading to trunk deformity. Forty patients met the criteria for inclusion, but due to change some personal details, not all of them were contacted. Finally, 30 women returned for a follow-up evaluation. Patients' follow-up period was mean 27.77 yrs. ± SD 3.30 (range 23-35). Curvature change from the end of the treatment until the present day was mean 9.1 degrees ± SD 7.64 (range 0-27). A control group of 42 healthy females (healthy controls group-HG) matching the age profile of the patient group was randomly selected for comparative purposes.Both SG and HG completed the Polish versions of the Revised Oswestry Lower Back Pain Disability Index (RODI), the Rolland-Morris Questionnaire (RMQ), the Quebec Back Pain Disability Scale (QDS), the Neck Disability Index (NDI) and the Copenhagen Neck Functional Disability Scale (CNFDS). Descriptive statistics were calculated for demographics and baseline questionnaire scores. To determine if the investigated sample sizes are equivalent, the chi-square test was used. The chi-square test was used to compare qualitative features between persons with scoliosis and healthy controls. In addition, a Mann-Whitney test was utilized to compare differences between both groups in regard to quantitative characteristics. To establish relations between quantitative data such as e.g. age, duration of brace application, apical translation, Cobb angle, and questionnaire results, we used Spearman's rank correlation (marked as rS). To determine dependency between quantitative and qualitative characteristics, e.g. between questionnaire numerical data and marital status, place of residence or curve type, ANOVA Kruskal-Wallis test was used. A p<0.05 indicates statistical significance. Statistical calculations were performed by Statistica software. In regards to RODI, RMQ, QDS, NDI and CNFDS (both for total scores and particular sub-sections), statistically significant differences (p <0.001) between both samples were found, indicating higher levels of pain and neck and lower back pain-related disability among persons with scoliosis. Associations exist between RODI and RMQ (rS = 0.76) QDS (rS = 0.70), NDI (rS = 0.69) and CNFDS (rS = 0.60). RMQ was associated with QDS (rS = 0.71) and NDI (rS = 0.69), whereas QDS correlated with NDI (rS = 0.80) and CNFDS (rS = 0.60). NDI was also associated with CNFDS (rS = 0.81). Persons with scoliosis treated in adolescence with a Milwaukee brace display significant restrictions in everyday activities, due to lower back pain (LBP) and neck-related disabilities, compared to healthy controls. In addition, back pain is associated with curve progression in long-term follow-up after conservative treatment. Moreover, LBP-related disability coexists with restrictions experienced due to neck pain.
[Mh] Termos MeSH primário: Dor nas Costas/fisiopatologia
Braquetes
Tratamento Conservador
Cervicalgia/fisiopatologia
Escoliose/complicações
[Mh] Termos MeSH secundário: Adolescente
Adulto
Dor nas Costas/etiologia
Feminino
Seguimentos
Seres Humanos
Cervicalgia/etiologia
Escoliose/terapia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180104
[Lr] Data última revisão:
180104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189358


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[PMID]:29182132
[Au] Autor:Kailis V; Hariga H; Docquier PL
[Ti] Título:Prevention of re-fractures of both bones of the forearm in children.
[So] Source:Acta Orthop Belg;82(4):872-875, 2016 Dec.
[Is] ISSN:0001-6462
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The aim of this study was to observe if the re-fracture rate after forearm both bones was decreased by protecting the forearm with a preventive brace for 6 months following the fracture and by ceasing all physical activities. METHODS: We performed a retrospective study in 75 consecutive cases of diaphyseal fracture of both bone of forearms, in 52 boys and 23 girls aged from 6 months to 11 years. It concerned a first episode of fracture in 84% of cases and a re-fracture in 17%. RESULTS: Re-fracture rate was 0% in the group where a protective brace was worn while it was 20% in the group without brace. CONCLUSIONS: Both the wearing of a protective brace and absence of sport for 6 months may decrease the re-fracture rate to 0%, if the patient is compliant by wearing it and by ceasing all physical activities.
[Mh] Termos MeSH primário: Braquetes
Fraturas do Rádio/prevenção & controle
Volta ao Esporte
Prevenção Secundária/métodos
Fraturas da Ulna/prevenção & controle
[Mh] Termos MeSH secundário: Moldes Cirúrgicos
Criança
Pré-Escolar
Redução Fechada/métodos
Diáfises/lesões
Diáfises/cirurgia
Feminino
Traumatismos do Antebraço/diagnóstico por imagem
Traumatismos do Antebraço/prevenção & controle
Traumatismos do Antebraço/cirurgia
Seres Humanos
Imobilização/métodos
Lactente
Masculino
Fraturas do Rádio/complicações
Fraturas do Rádio/diagnóstico por imagem
Fraturas do Rádio/cirurgia
Recidiva
Estudos Retrospectivos
Fraturas da Ulna/complicações
Fraturas da Ulna/diagnóstico por imagem
Fraturas da Ulna/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171228
[Lr] Data última revisão:
171228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


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[PMID]:29182110
[Au] Autor:Ersen O; Bilgic S; Koca K; Ege T; Oguz E; Bilekli AB
[Ti] Título:Difference between Spinecor brace and Thoracolumbosacral orthosis for deformity correction and quality of life in adolescent idiopathic scoliosis.
[So] Source:Acta Orthop Belg;82(4):710-714, 2016 Dec.
[Is] ISSN:0001-6462
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:Although there are several conservative treatment options, only bracing has been found to be effective in preventing curve progression and a subsequent need for surgery in adolescent idiopathic scoliosis. The objective of this study is to compare the results of SpineCor brace and thoracolumbosacral orthosis (TLSO) for treatment of adolescent idiopathic scoliosis radiologically and clinically. Sixty-four patients with adolescent idiopathic scoliosis treated with brace included in this study. Height, T1-Coccygx distance, and gibbosity were measured. Rib hump deformity was evaluated with a scoliometer. An SRS-22 questionnaire was used to determine the quality of life of patients after the first year of brace treatment. Differences in Cobb angles and gibbosity were insignificant for both groups. SRS-22 questionnaire results showed significant differences in pain, self-image and function/activity subgroups. Patients' mental health and satisfaction scores were insignificant. These braces have a similar effect on deformity correction. The surgery rates and success rates of braces are approximately equal. The major difference between SpineCor and TLSO is health-related quality of life.
[Mh] Termos MeSH primário: Braquetes
Qualidade de Vida
Escoliose/reabilitação
[Mh] Termos MeSH secundário: Adolescente
Criança
Feminino
Seres Humanos
Masculino
Aparelhos Ortopédicos
Radiografia
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171228
[Lr] Data última revisão:
171228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


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[PMID]:29182109
[Au] Autor:Dar RA; Rashid M; Bhat MR; Yaseen M; Ashraf A; Kawoosa AA
[Ti] Título:Factors affecting outcome after the use of the Ponseti method for the management of idiopathic clubfoot, a retrospective study in an orthopaedic referral institute.
[So] Source:Acta Orthop Belg;82(4):705-709, 2016 Dev.
[Is] ISSN:0001-6462
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:TIn the last few decades Ponseti method has replaced soft tissue releases as the gold standard in the management of idiopathic clubfoot. However, the recurrence of the deformity is common without post tenotomy bracing. The purpose of this study was to retrospectively see various attributes of the patients associated with poor outcome after use of Ponseti method in idiopathic clubfoot management. Seventy nine consecutive patients with one hundred and twenty three idiopathic clubfeet treated with Ponseti method by single orthopaedic surgeon were followed for a period of two years and recurrence of the deformity was studied in relation to age of patient at presentation (< 3 months or more), sex of the patient, severity of the deformity ( moderate to severe verses (Vs.) very severe), compliance to post tenotomy bracing (compliant Vs. non compliant), educational level of parents (high school or less) and access of parents to internet (Yes or No) and odds ratio for recurrence and level of significance determined for each using Fisher's exact t-test. Non compliance in seventeen patients (17.7%) with post tenotomy bracing was the most important factor related to the recurrence, with an odds ratio of 6.22 (P =0.0059). Educational level (less than high school) of parents (36.7%) was the second most important factor with odds ratio of 5.5 (P=0.0073). Fifteen patients with severe Demiglio scoring feet had an odds ratio of 5.3 (P= 0.0097) for the recurrence of the deformity. Inaccess of the parents to the internet had an odds ratio of 6.33 (P =0.011) for the recurrence of the deformity. Age and sex of the patients was not found to have a significant effect on the recurrence of the deformity. In conclusion, the risk factors associated with recurrence of the idiopathic clubfoot deformity except severity of the deformity are modifiable and extra minutes can be spent with risk group parents during follow up visits to prevent a recurrence by making them understand natural history of the corrected foot without post tenotomy bracing, encouraging them for regular follow up visits, arranging interactive sessions with other patients who are regular in their follow up and compliant with bracing, and encouraging the literate parents to update their information about clubfoot from internet.
[Mh] Termos MeSH primário: Braquetes
Pé Torto Equinovaro/cirurgia
Cuidados Pós-Operatórios/métodos
Tenotomia/métodos
[Mh] Termos MeSH secundário: Proteínas de Drosophila
Escolaridade
Feminino
Seguimentos
Seres Humanos
Imobilização
Lactente
Internet
Masculino
Proteínas de Membrana
Razão de Chances
Cooperação do Paciente
Recidiva
Estudos Retrospectivos
Fatores de Risco
Índice de Gravidade de Doença
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Drosophila Proteins); 0 (Membrane Proteins); 0 (expanded protein, Drosophila)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171228
[Lr] Data última revisão:
171228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


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[PMID]:28459164
[Au] Autor:Nouman M; Leelasamran W; Chatpun S
[Ad] Endereço:1 Institute of Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
[Ti] Título:Effectiveness of Total Contact Orthosis for Plantar Pressure Redistribution in Neuropathic Diabetic Patients During Different Walking Activities.
[So] Source:Foot Ankle Int;38(8):901-908, 2017 Aug.
[Is] ISSN:1944-7876
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Using a total contact orthosis (TCO) is an effective method to offload in diabetic patients with foot neuropathy. However, the redistribution of peak plantar pressure is mostly observed during level walking, which may differ from other walking activities. The aim of this study was to investigate the plantar pressure from 4 regions of the foot during different walking activities (level walking, ramp ascending, ramp descending, stair ascending, and stair descending) in neuropathic diabetic patients with and without a TCO. METHODS: Sixteen neuropathic diabetic patients aged 40 to 60 years with calluses and hallux valgus were included in this study and were provided with TCOs made up of multifoam, Plastazote, and microcellular rubber. The plantar pressure and contact area with the TCO and without the TCO were recorded using the Pedar X system during different walking activities. RESULTS: A significant reduction of plantar pressure during different walking activities at the toes and forefoot regions was observed while walking with the TCO compared with walking without the TCO (control condition). Plantar pressure increased at the midfoot region when walking with the TCO, and no significant difference was observed at the hindfoot region between the control and TCO conditions. Furthermore, maximum contact area was observed during level walking with the TCO compared with other walking activities. CONCLUSION: The TCO significantly reduced and redistributed the peak plantar pressure from the sites where the ulceration rate is higher at the toes and forefoot compared with the other regions of the foot. LEVEL OF EVIDENCE: Therapeutic level II, lesser quality randomized controlled trial.
[Mh] Termos MeSH primário: Braquetes/normas
Pé Diabético/fisiopatologia
Neuropatias Diabéticas/fisiopatologia
/fisiologia
Antepé Humano/fisiopatologia
Hallux Valgus/fisiopatologia
Aparelhos Ortopédicos/normas
Dedos do Pé/fisiopatologia
Caminhada/fisiologia
[Mh] Termos MeSH secundário: Fenômenos Biomecânicos
Pé Diabético/terapia
Seres Humanos
Pressão
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1177/1071100717704427


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[PMID]:28858119
[Au] Autor:Shirai Y; Wakabayashi K; Wada I; Tsuboi Y; Ha M; Otsuka T
[Ad] Endereço:aDepartment of Orthopaedic Surgery bDepartment of Rehabilitation Medicine, Nagoya City University Graduate School of Medicine, Nagoya, Aichi, Japan.
[Ti] Título:Flatfoot in the contralateral foot in patients with unilateral idiopathic clubfoot treated using the foot abduction brace.
[So] Source:Medicine (Baltimore);96(35):e7937, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:While the foot abduction brace (FAB) plays an important role in the Ponseti method, the true function of the FAB in the treatment of idiopathic clubfoot remains unknown. In our clinical experience, we have noted that many patients with unilateral idiopathic clubfoot developed significant flatfoot in the contralateral foot during brace treatment. The purpose of this study was to investigate the natural history of the contralateral foot development during and after brace wear. We also discuss the effect of the FAB on the contralateral foot.We retrospectively reviewed 21 contralateral feet of 21 patients with unilateral idiopathic clubfoot who were treated using the Ponseti method and were conservatively followed up until the FAB was taken off (6 years of age or older). We evaluated flatfoot indicators of the contralateral foot on standing radiographs during and after brace wear and compared them against the normal reference ranges. We also evaluated the changes in the flatfoot indicators of the contralateral foot during and after brace wear.Although there was a significant difference in the flatfoot indicators between the contralateral foot and normal reference ranges during brace wear, there was no significant difference in the flatfoot indicators after brace wear. While there was no significant improvement in flatfoot indicators of the contralateral foot during brace wear, there was a significant improvement or a trend to improve after brace wear. There was no significant correlation between the contralateral flatfoot and original joint laxity.Significant flatfoot deformity was observed in the contralateral foot during brace wear. The contralateral flatfoot persisted during brace wear and improved to within normal reference ranges after brace wear. Our findings suggest that the FAB may influence the development of the contralateral foot, leading to the flatfoot.
[Mh] Termos MeSH primário: Braquetes/efeitos adversos
Pé Torto Equinovaro/terapia
Pé Chato/etiologia
Órtoses do Pé/efeitos adversos
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Pé Torto Equinovaro/complicações
Pé Chato/diagnóstico por imagem
Seguimentos
Seres Humanos
Lactente
Radiografia
Recidiva
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007937



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