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[PMID]:28842073
[Au] Autor:Nijmeijer R; Voesten HGJM; Geertzen JHB; Dijkstra PU
[Ad] Endereço:Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: rachellenijmeijer@hotmail.com.
[Ti] Título:Disarticulation of the knee: Analysis of an extended database on survival, wound healing, and ambulation.
[So] Source:J Vasc Surg;66(3):866-874, 2017 Sep.
[Is] ISSN:1097-6809
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: This study analyzed survival of the amputee patients, wound healing, and ambulation after knee disarticulation (KD). METHODS: Between July 1989 and October 2015, 153 KDs in 138 patients were performed at Nij Smellinghe Hospital, Drachten. Data were retrieved from hospital medical records. Wound healing was analyzed using nonparametric tests. Ambulation was recorded according to the Special Interest Group Amputation Medicine Workgroup Amputation and Prosthetics mobility scale. RESULTS: Survival at 1, 6, and 12 months was 86%, 65%, and 55%, respectively. Wounds healed in 91% of patients. Wounds healed primarily in 57% of residual limbs, and healing was delayed in 33%. A transfemoral amputation (TFA) was performed in 10%. Patients with sagittal flaps had significantly poorer primary wound healing and delayed wound healing more often than patients with a dorsal-myocutaneous (dorsomyocutaneous) flap (P < .027). In total, 62% of patients were provided with a prosthesis. Preoperatively, 71% of the patients had intention to ambulate with prosthesis, of which 91% received prosthesis. Of these, 35% walked without the help of others. KD amputee patients who underwent a reamputation at the transfemoral level were significantly less ambulant than amputee patients who did not (P < .021). CONCLUSIONS: If feasible, the dorsomyocutaneous flap technique seems to be the treatment of choice in KD. Because the wound complication rate of the group with a dorsomyocutaneous flap and the percentage of amputee patients who received prosthesis after KD fell within the same range as TFA amputee patients, KD may be an appropriate alternative when surgeons consider a TFA.
[Mh] Termos MeSH primário: Amputados
Membros Artificiais
Deambulação com Auxílio
Desarticulação/métodos
Articulação do Joelho/cirurgia
Limitação da Mobilidade
Doença Arterial Periférica/cirurgia
Retalhos Cirúrgicos
Cicatrização
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Bases de Dados Factuais
Desarticulação/efeitos adversos
Desarticulação/mortalidade
Feminino
Seres Humanos
Estimativa de Kaplan-Meier
Articulação do Joelho/fisiopatologia
Masculino
Registros Médicos
Meia-Idade
Países Baixos
Seleção de Pacientes
Doença Arterial Periférica/diagnóstico
Doença Arterial Periférica/mortalidade
Doença Arterial Periférica/fisiopatologia
Recuperação de Função Fisiológica
Estudos Retrospectivos
Fatores de Risco
Retalhos Cirúrgicos/efeitos adversos
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170827
[St] Status:MEDLINE


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[PMID]:28755534
[Au] Autor:Valentín-Gudiol M; Mattern-Baxter K; Girabent-Farrés M; Bagur-Calafat C; Hadders-Algra M; Angulo-Barroso RM
[Ad] Endereço:Department of Physical Therapy, Universitat Internacional de Catalunya, Barcelona, Spain.
[Ti] Título:Treadmill interventions in children under six years of age at risk of neuromotor delay.
[So] Source:Cochrane Database Syst Rev;7:CD009242, 2017 07 29.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Delayed motor development may occur in children with Down syndrome, cerebral palsy, general developmental delay or children born preterm. It limits the child's exploration of the environment and can hinder cognitive and social-emotional development. Literature suggests that task-specific training, such as locomotor treadmill training, facilitates motor development. OBJECTIVES: To assess the effectiveness of treadmill interventions on locomotor development in children with delayed ambulation or in pre-ambulatory children (or both), who are under six years of age and who are at risk for neuromotor delay. SEARCH METHODS: In May 2017, we searched CENTRAL, MEDLINE, Embase, six other databases and a number of trials registers. We also searched the reference lists of relevant studies and systematic reviews. SELECTION CRITERIA: We included randomised controlled trials (RCTs) and quasi-RCTs that evaluated the effect of treadmill intervention in the target population. DATA COLLECTION AND ANALYSIS: Four authors independently extracted the data. Outcome parameters were structured according to the International Classification of Functioning, Disability and Health model. MAIN RESULTS: This is an update of a Cochrane review from 2011, which included five trials. This update includes seven studies on treadmill intervention in 175 children: 104 were allocated to treadmill groups, and 71 were controls. The studies varied in population (children with Down syndrome, cerebral palsy, developmental delay or at moderate risk for neuromotor delay); comparison type (treadmill versus no treadmill; treadmill with versus without orthoses; high- versus low-intensity training); study duration, and assessed outcomes. Due to the diversity of the studies, only data from five studies were used in meta-analyses for five outcomes: age of independent walking onset, overall gross motor function, gross motor function related to standing and walking, and gait velocity. GRADE assessments of quality of the evidence ranged from high to very low.The effects of treadmill intervention on independent walking onset compared to no treadmill intervention was population dependent, but showed no overall effect (mean difference (MD) -2.08, 95% confidence intervals (CI) -5.38 to 1.22, 2 studies, 58 children; moderate-quality evidence): 30 children with Down syndrome benefited from treadmill training (MD -4.00, 95% CI -6.96 to -1.04), but 28 children at moderate risk of developmental delay did not (MD -0.60, 95% CI -2.34 to 1.14). We found no evidence regarding walking onset in two studies that compared treadmill intervention with and without orthotics in 17 children (MD 0.10, 95% CI -5.96 to 6.16), and high- versus low-intensity treadmill interventions in 30 children with Down syndrome (MD -2.13, 95% -4.96 to 0.70).Treadmill intervention did not improve overall gross motor function (MD 0.88, 95% CI -4.54 to 6.30, 2 studies, 36 children; moderate-quality evidence) or gross motor skills related to standing (MD 5.41, 95% CI -1.64 to 12.43, 2 studies, 32 children; low-quality evidence), and had a negligible improvement in gross motor skills related to walking (MD 4.51, 95% CI 0.29 to 8.73, 2 studies, 32 children; low-quality evidence). It led to improved walking skills in 20 ambulatory children with developmental delay (MD 7.60, 95% CI 0.88 to 14.32, 1 study) and favourable gross motor skills in 12 children with cerebral palsy (MD 8.00, 95% CI 3.18 to 12.82). A study which compared treadmill intervention with and without orthotics in 17 children with Down syndrome suggested that adding orthotics might hinder overall gross motor progress (MD -8.40, 95% CI -14.55 to -2.25).Overall, treadmill intervention showed a very small increase in walking speed compared to no treadmill intervention (MD 0.23, 95% CI 0.08 to 0.37, 2 studies, 32 children; high-quality evidence). Treadmill intervention increased walking speed in 20 ambulatory children with developmental delay (MD 0.25, 95% CI 0.08 to 0.42), but not in 12 children with cerebral palsy (MD 0.18, 95% CI -0.09 to 0.45). AUTHORS' CONCLUSIONS: This update of the review from 2011 provides additional evidence of the efficacy of treadmill intervention for certain groups of children up to six years of age, but power to find significant results still remains limited. The current findings indicate that treadmill intervention may accelerate the development of independent walking in children with Down syndrome and may accelerate motor skill attainment in children with cerebral palsy and general developmental delay. Future research should first confirm these findings with larger and better designed studies, especially for infants with cerebral palsy and developmental delay. Once efficacy is established, research should examine the optimal dosage of treadmill intervention in these populations.
[Mh] Termos MeSH primário: Peso Corporal
Técnicas de Exercício e de Movimento/métodos
Transtornos das Habilidades Motoras/reabilitação
Destreza Motora/fisiologia
Caminhada
[Mh] Termos MeSH secundário: Paralisia Cerebral/complicações
Paralisia Cerebral/reabilitação
Desenvolvimento Infantil/fisiologia
Pré-Escolar
Deambulação com Auxílio
Síndrome de Down/complicações
Síndrome de Down/reabilitação
Técnicas de Exercício e de Movimento/instrumentação
Seres Humanos
Lactente
Locomoção/fisiologia
Transtornos das Habilidades Motoras/prevenção & controle
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170730
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD009242.pub3


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[PMID]:28502539
[Au] Autor:McDermott MM; Polonsky TS; Kibbe MR; Tian L; Zhao L; Pearce WH; Gao Y; Guralnik JM
[Ad] Endereço:Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill. Electronic address: mdm608@northwestern.edu.
[Ti] Título:Racial differences in functional decline in peripheral artery disease and associations with socioeconomic status and education.
[So] Source:J Vasc Surg;66(3):826-834, 2017 Sep.
[Is] ISSN:1097-6809
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The objective of this study was to determine whether blacks with lower extremity peripheral artery disease (PAD) have faster functional decline than whites with PAD. METHODS: Participants with ankle-brachial index <0.90 were identified from Chicago medical centers and observed longitudinally. Mobility impairment and the 6-minute walk were assessed at baseline and every 6 to 12 months. Mobility loss was defined as becoming unable to walk up and down a flight of stairs or to walk » mile without assistance. RESULTS: Of 1162 PAD participants, 305 (26%) were black. Median follow-up was 46.0 months. Among 711 PAD participants who walked 6 minutes continuously at baseline, black participants were more likely to become unable to walk 6 minutes continuously during follow-up (64/171 [37.4%] vs 156/540 [28.9%]; log-rank, P = .006). Black race was associated with becoming unable to walk 6 minutes continuously, adjusting for age, sex, ankle-brachial index, comorbidities, and other confounders (hazard ratio, 1.45; 95% confidence interval, 1.05-1.99; P = .022). This association was attenuated after adjustment for income and education (P = .229). Among 844 participants without baseline mobility impairment, black participants had a higher rate of mobility loss (64/209 [30.6%] vs 164/635 [25.8%]; log-rank, P = .009). Black race was associated with increased mobility loss, adjusting for potential confounders (hazard ratio, 1.42; 95% confidence interval, 1.04-1.94; P = .028). This association was attenuated after additional adjustment for income and education (P = .392) and physical activity (P = .113). There were no racial differences in average annual declines in 6-minute walk, usual-paced 4-meter walking velocity, or fast-paced 4-meter walking velocity. CONCLUSIONS: Black PAD patients have higher rates of mobility loss and becoming unable to walk for 6 minutes continuously. These differences appear related to racial differences in socioeconomic status and physical activity.
[Mh] Termos MeSH primário: Afroamericanos
Escolaridade
Grupo com Ancestrais do Continente Europeu
Disparidades nos Níveis de Saúde
Extremidade Inferior/irrigação sanguínea
Doença Arterial Periférica/etnologia
Fatores Socioeconômicos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Índice Tornozelo-Braço
Chicago/epidemiologia
Deambulação com Auxílio
Progressão da Doença
Tolerância ao Exercício
Feminino
Seres Humanos
Estudos Longitudinais
Masculino
Meia-Idade
Limitação da Mobilidade
Doença Arterial Periférica/diagnóstico
Doença Arterial Periférica/fisiopatologia
Estudos Retrospectivos
Fatores de Risco
Fatores de Tempo
Teste de Caminhada
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170516
[St] Status:MEDLINE


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[PMID]:28320671
[Au] Autor:Zhang H; Ye C
[Ti] Título:An Indoor Wayfinding System Based on Geometric Features Aided Graph SLAM for the Visually Impaired.
[So] Source:IEEE Trans Neural Syst Rehabil Eng;25(9):1592-1604, 2017 Sep.
[Is] ISSN:1558-0210
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This paper presents a 6-degree of freedom (DOF) pose estimation (PE) method and an indoor wayfinding system based on the method for the visually impaired. The PE method involves two-graph simultaneous localization and mapping (SLAM) processes to reduce the accumulative pose error of the device. In the first step, the floor plane is extracted from the 3-D camera's point cloud and added as a landmark node into the graph for 6-DOF SLAM to reduce roll, pitch, and Z errors. In the second step, the wall lines are extracted and incorporated into the graph for 3-DOF SLAM to reduce X , Y , and yaw errors. The method reduces the 6-DOF pose error and results in more accurate pose with less computational time than the state-of-the-art planar SLAM methods. Based on the PE method, a wayfinding system is developed for navigating a visually impaired person in an indoor environment. The system uses the estimated pose and floor plan to locate the device user in a building and guides the user by announcing the points of interest and navigational commands through a speech interface. Experimental results validate the effectiveness of the PE method and demonstrate that the system may substantially ease an indoor navigation task.
[Mh] Termos MeSH primário: Bengala
Deambulação com Auxílio
Imagem Tridimensional/instrumentação
Sistemas de Identificação de Pacientes/métodos
Equipamentos de Autoajuda
Interface Usuário-Computador
[Mh] Termos MeSH secundário: Desenho de Equipamento
Análise de Falha de Equipamento
Seres Humanos
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
Navegação Espacial
Resultado do Tratamento
Pessoas com Deficiência Visual/reabilitação
Tecnologia sem Fio/instrumentação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171101
[Lr] Data última revisão:
171101
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170322
[St] Status:MEDLINE
[do] DOI:10.1109/TNSRE.2017.2682265


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[PMID]:28216361
[Au] Autor:Lu K; Farber A; Schermerhorn ML; Patel VI; Kalish JA; Rybin D; Doros G; Siracuse JJ
[Ad] Endereço:Division of Vascular and Endovascular Surgery, Department of Surgery, Boston University School of Medicine, Boston Medical Center, Boston, Mass.
[Ti] Título:The effect of ambulatory status on outcomes of percutaneous vascular interventions and lower extremity bypass for critical limb ischemia in the Vascular Quality Initiative.
[So] Source:J Vasc Surg;65(6):1706-1712, 2017 Jun.
[Is] ISSN:1097-6809
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Ambulatory status has been shown to be an important predictor of postoperative morbidity and mortality for a variety of surgical procedures. We sought to assess contemporary practice patterns in treating critical limb ischemia (CLI) and outcomes based on ambulatory status. METHODS: The Vascular Quality Initiative (2010-2015) was queried for patients undergoing percutaneous vascular interventions (PVIs) or lower extremity bypass (LEB) for CLI. Ambulatory status was classified as ambulatory, ambulatory with assistance, and nonambulatory (composite of wheelchair bound and bedridden). Perioperative and postoperative outcomes were recorded. Multivariable analyses were performed to identify the effect of ambulatory status. RESULTS: There were 11,522 ambulatory (PVI, 63%; LEB, 37%), 4443 ambulatory with assistance (PVI, 67%; LEB, 33%), and 1732 nonambulatory (PVI, 77%; LEB, 23%) patients with CLI treated (P < .01 across ambulatory status groups). Perioperative mortality for PVI and LEB for ambulatory, ambulatory with assistance, and nonambulatory status was 1.5% and 1.7%, 3.0% and 3.1%, and 4.7% and 4.9%, respectively (P < .01 across ambulatory status groups). Worsening ambulatory status was associated with higher perioperative complications with PVI and LEB. Multivariable analysis showed that worsening ambulatory status predicted higher postprocedural mortality, amputation or death, and major adverse limb events or death. CONCLUSIONS: In the Vascular Quality Initiative, as ambulatory status declines, perioperative morbidity and mortality increase. Impaired ambulatory patients are more likely to receive PVI than LEB for the treatment of CLI, although even among nonambulatory patients, there are still a significant number who receive LEB.
[Mh] Termos MeSH primário: Deambulação com Auxílio
Procedimentos Endovasculares/efeitos adversos
Isquemia/terapia
Extremidade Inferior/irrigação sanguínea
Limitação da Mobilidade
Doença Arterial Periférica/terapia
Procedimentos Cirúrgicos Vasculares
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Amputação
Distribuição de Qui-Quadrado
Estado Terminal
Bases de Dados Factuais
Procedimentos Endovasculares/mortalidade
Feminino
Seres Humanos
Isquemia/diagnóstico por imagem
Isquemia/mortalidade
Isquemia/fisiopatologia
Salvamento de Membro
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Doença Arterial Periférica/diagnóstico por imagem
Doença Arterial Periférica/mortalidade
Doença Arterial Periférica/fisiopatologia
Padrões de Prática Médica
Estudos Retrospectivos
Medição de Risco
Fatores de Risco
Fatores de Tempo
Resultado do Tratamento
Estados Unidos
Procedimentos Cirúrgicos Vasculares/efeitos adversos
Procedimentos Cirúrgicos Vasculares/mortalidade
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170619
[Lr] Data última revisão:
170619
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170221
[St] Status:MEDLINE


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[PMID]:27914920
[Au] Autor:Lee SY; Han EY; Kim BR; Chun MH; Lee YK
[Ad] Endereço:Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Republic of Korea.
[Ti] Título:Can Lowering the Guidance Force of Robot-Assisted Gait Training Induce a Sufficient Metabolic Demand in Subacute Dependent Ambulatory Patients With Stroke?
[So] Source:Arch Phys Med Rehabil;98(4):695-700, 2017 Apr.
[Is] ISSN:1532-821X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess the effects of guidance force (GF) and gait speed (GS) on cardiorespiratory responses and energy cost in subacute dependent ambulatory patients with stroke. DESIGN: Cross-sectional study. SETTING: University rehabilitation hospital. PARTICIPANTS: Patients with subacute stroke (N=10; mean age, 64.50±19.20y) who were dependent ambulators (functional ambulation category ≤2). INTERVENTIONS: Patients participated in cardiorespiratory tests during robot-assisted gait training. Subjects walked at a fixed percentage (50%) of body weight support and various percentages of GF (100%, 80%, and 60%) and GS (1.4 and 1.8km/h). The therapist encouraged patients to maximize their locomotor ability. MAIN OUTCOME MEASURES: During the cardiorespiratory tests, oxygen consumption (VË™o ), heart rate, and respiratory exchange ratio were measured continuously to assess cardiometabolic demands. RESULTS: There were no significant differences in cardiometabolic demands according to GS (1.4 vs 1.8km/h). There were no significant differences in cardiometabolic demands according to GF at a GS of 1.4km/h. However, lowering GF decreased VË™o when comparing GFs of 100% (6.89±2.38mL/kg/min), 80% (6.46±1.73mL/kg/min), and 60% (5.77±1.71mL/kg/min) at a GS of 1.8km/h (P=.03). CONCLUSIONS: Lowering the GF of robot-assisted gait training at a higher GS cannot induce a sufficient cardiometabolic demand for subacute dependent ambulatory patients with stroke. This implies that it is important to take the patient's functional ability into consideration when choosing training protocols.
[Mh] Termos MeSH primário: Metabolismo Energético/fisiologia
Teste de Esforço/métodos
Transtornos Neurológicos da Marcha/metabolismo
Transtornos Neurológicos da Marcha/reabilitação
Aptidão Física/fisiologia
Robótica/métodos
Reabilitação do Acidente Vascular Cerebral/métodos
Acidente Vascular Cerebral/metabolismo
Acidente Vascular Cerebral/fisiopatologia
[Mh] Termos MeSH secundário: Atividades Cotidianas
Adulto
Idoso
Idoso de 80 Anos ou mais
Estudos Transversais
Deambulação com Auxílio
Feminino
Frequência Cardíaca/fisiologia
Seres Humanos
Masculino
Meia-Idade
Consumo de Oxigênio/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161205
[St] Status:MEDLINE


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[PMID]:27892796
[Au] Autor:Leach SJ; Magill RA; Maring JR
[Ad] Endereço:a Department of Physical Therapy and Health Care Sciences , The George Washington University , Washington , DC , USA.
[Ti] Título:Using a divided-attention stepping accuracy task to improve balance and functional outcomes in an individual with incomplete spinal cord injury: A case report.
[So] Source:Physiother Theory Pract;33(1):72-81, 2017 Jan.
[Is] ISSN:1532-5040
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:A spinal cord injury (SCI) frequently results in impaired balance, endurance, and strength with subsequent limitations in functional mobility and community participation. The purpose of this case report was to implement a training program for an individual with a chronic incomplete SCI using a novel divided-attention stepping accuracy task (DASAT) to determine if improvements could be made in impairments, activities, and participation. The client was a 51-year-old male with a motor incomplete C4 SCI sustained 4 years prior. He presented with decreased quality of life (QOL) and functional independence, and deficits in balance, endurance, and strength consistent with central cord syndrome. The client completed the DASAT intervention 3 times per week for 6 weeks. Each session incorporated 96 multi-directional steps to randomly-assigned targets in response to 3-step verbal commands. QOL, measured using the SF-36, was generally enhanced but fluctuated. Community mobility progressed from close supervision to independence. Significant improvement was achieved in all balance scores: Berg Balance Scale by 9 points [Minimal Detectable Change (MDC) = 4.9 in elderly]; Functional Reach Test by 7.62 cm (MDC = 5.16 in C5/C6 SCI); and Timed Up-and-Go by 0.53 s (MDC not established). Endurance increased on the 6-Minute Walk Test, with the client achieving an additional 47 m (MDC = 45.8 m). Lower extremity isokinetic peak torque strength measures were mostly unchanged. Six minutes of DASAT training per session provided an efficient, low-cost intervention utilizing multiple trials of variable practice, and resulted in better performance in activities, balance, and endurance in this client.
[Mh] Termos MeSH primário: Atenção
Vértebras Cervicais/fisiopatologia
Atividade Motora
Modalidades de Fisioterapia
Equilíbrio Postural
Traumatismos da Medula Espinal/reabilitação
[Mh] Termos MeSH secundário: Fenômenos Biomecânicos
Doença Crônica
Deambulação com Auxílio
Teste de Esforço
Tolerância ao Exercício
Seres Humanos
Masculino
Meia-Idade
Limitação da Mobilidade
Força Muscular
Qualidade de Vida
Recuperação de Função Fisiológica
Traumatismos da Medula Espinal/diagnóstico
Traumatismos da Medula Espinal/fisiopatologia
Traumatismos da Medula Espinal/psicologia
Torque
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170530
[Lr] Data última revisão:
170530
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161129
[St] Status:MEDLINE
[do] DOI:10.1080/09593985.2016.1247932


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[PMID]:26911974
[Au] Autor:Kiatisevi P; Piyaskulkaew C; Kunakornsawat S; Sukunthanak B
[Ad] Endereço:Orthopaedic Oncology Service, Institute of Orthopaedics, Lerdsin General Hospital, 190 Silom Road, Bangrak, Bangkok, Thailand. Piyamd@yahoo.com.
[Ti] Título:What Are the Functional Outcomes After Total Sacrectomy Without Spinopelvic Reconstruction?
[So] Source:Clin Orthop Relat Res;475(3):643-655, 2017 Mar.
[Is] ISSN:1528-1132
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: After total sacrectomy, many types of spinopelvic reconstruction have been described with good functional results. However, complications associated with reconstruction are not uncommon and usually result in further surgical interventions. Moreover, less is known about patient function after total sacrectomy without spinopelvic reconstruction, which may be indicated when malignant or aggressive benign bone and soft tissue tumors involved the entire sacrum. QUESTIONS/PURPOSES: (1) What is the functional outcome and ambulatory status of patients after total sacrectomy without spinopelvic reconstruction? (2) What is the walking ability and ambulatory status of patients when categorized by the location of the iliosacral resection relative to the sacroiliac joint? (3) What complications and reoperations occur after this procedure? METHODS: Between 2008 and 2014, we performed 16 total sacrectomies without spinopelvic reconstructions for nonmetastatic oncologic indications. All surviving patients had followup of at least 12 months, although two were lost to followup after that point (mean, 43 months; range, 12-66 months, among surviving patients). During this time period, we performed total sacrectomy without reconstruction for all patients with primary bone and soft tissue tumors (benign and malignant) involving the entire sacrum with no initial metastasis. The level of resection was the L5-S1 disc in 14 patients and L4-L5 disc in two patients. We classified the resection into two types based on the location of the iliosacral resection. Type I resections went medial to or through or lateral but close to the sacroiliac joint. Type II resections were far lateral (more than 3 cm from the posterior iliac spine) to the sacroiliac joint. Musculoskeletal Tumor Society (MSTS) scores, physical function assessments, and complications were gleaned from chart review performed by the treating surgeons (PK, BS). Video documentation of patients walking was obtained at followup in eight patients. RESULTS: The mean overall MSTS scores was 17 (range, 5-27). Thirteen patients were able to walk, five without walking aids, two with a cane and sometimes without a walking aid, three with a cane, and three with a walker. Thirteen of 14 patients who had bilateral Type I resections or a Type I resection on one side and Type II on the contralateral side were able to walk, five without a walking aid, and had a mean MSTS score of 19 (range, 13-27). Two patients with bilateral Type II resection were only able to sit. Complications included wound dehiscences in 13 patients (which were treated with reoperation for drainage), sciatic nerve injury in seven patients, a torn ureter in one patient, and a rectal tear in one patient. CONCLUSIONS: Without spinopelvic reconstruction, most patients in this series who underwent total sacrectomy were able to walk. Good MSTS scores could be expected in patients with bilateral Type I resections and patients with a Type I on one side and a Type II on the contralateral side. Total sacrectomy without spinopelvic reconstruction should be considered as a useful alternative to reconstructive surgery in patients who undergo Type I iliosacral resection on one or both sides. LEVEL OF EVIDENCE: Level IV, therapeutic study.
[Mh] Termos MeSH primário: Procedimentos Neurocirúrgicos
Osteotomia
Sacro/cirurgia
Neoplasias de Tecidos Moles/cirurgia
Neoplasias da Coluna Vertebral/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Fenômenos Biomecânicos
Deambulação com Auxílio
Avaliação da Deficiência
Feminino
Seres Humanos
Masculino
Registros Médicos
Meia-Idade
Limitação da Mobilidade
Procedimentos Neurocirúrgicos/efeitos adversos
Osteotomia/efeitos adversos
Complicações Pós-Operatórias/etiologia
Complicações Pós-Operatórias/fisiopatologia
Complicações Pós-Operatórias/cirurgia
Procedimentos Cirúrgicos Reconstrutivos
Recuperação de Função Fisiológica
Reoperação
Estudos Retrospectivos
Sacro/diagnóstico por imagem
Sacro/fisiopatologia
Neoplasias de Tecidos Moles/diagnóstico por imagem
Neoplasias de Tecidos Moles/fisiopatologia
Neoplasias da Coluna Vertebral/diagnóstico por imagem
Neoplasias da Coluna Vertebral/fisiopatologia
Fatores de Tempo
Tomografia Computadorizada por Raios X
Resultado do Tratamento
Caminhada
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160226
[St] Status:MEDLINE
[do] DOI:10.1007/s11999-016-4729-z


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[PMID]:26849366
[Au] Autor:Verrusio W; Gianturco V; Cacciafesta M; Marigliano V; Troisi G; Ripani M
[Ad] Endereço:Department of Cardiovascular, Respiratory, Nephrological, Anestesiological and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy. walter.verrusio@uniroma1.it.
[Ti] Título:Fall prevention in the young old using an exoskeleton human body posturizer: a randomized controlled trial.
[So] Source:Aging Clin Exp Res;29(2):207-214, 2017 Apr.
[Is] ISSN:1720-8319
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Fall risk in elderly has been related with physical decline, low quality of life and reduced survival. AIM: To evaluate the impact of exoskeleton human body posturizer (HBP) on the fall risk in the elderly. METHODS: 150 subjects (mean age 64.85; 79 M/71 F) with mild fall risk were randomized into two groups: 75 for group treated with human body posturizer (HBP group) and 75 for physical training without HBP group (exercise group). The effects of interventions were assessed by differences in tests related to balance and falls. Medically eligible patients were screened with Tinetti balance and Gait evaluation scale, short physical performance battery and numeric pain rating scale to determine fall risk in elderly people. RESULTS: In the HBP group there was a significant improvement in short physical performance battery, Tinetti scale and Pain Numeric rating scale with a significant reduction in fall risk (p < 0.05). In the exercise group we observed only minimal variations in the test scores. DISCUSSION: The results at the sixth and twelfth months show a twofold positive effect in the HBP group reducing fall risk and improving quality of life by reducing pain. CONCLUSION: The use of exoskeleton human body posturizer seems to be a new significant device for prevention of fall in elderly patients. Further research should be carried out to obtain more evidence on effects of robotic technology for fall prevention in the elderly.
[Mh] Termos MeSH primário: Acidentes por Quedas/prevenção & controle
Envelhecimento
Marcha/fisiologia
Equilíbrio Postural/fisiologia
Qualidade de Vida
Equipamentos de Autoajuda
[Mh] Termos MeSH secundário: Idoso
Envelhecimento/fisiologia
Envelhecimento/psicologia
Deambulação com Auxílio/fisiologia
Terapia por Exercício/métodos
Feminino
Avaliação Geriátrica/métodos
Seres Humanos
Masculino
Exame Neurológico/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170522
[Lr] Data última revisão:
170522
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160206
[St] Status:MEDLINE
[do] DOI:10.1007/s40520-016-0540-7


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[PMID]:27741123
[Au] Autor:Han EY; Im SH; Kim BR; Seo MJ; Kim MO
[Ad] Endereço:aDepartment of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University College of Medicine, Jeju bDepartment of Physical & Rehabilitation Medicine, Inha University, School of Medicine, Inha University Hospital, Incheon, Republic of Korea cDepartment of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam.
[Ti] Título:Robot-assisted gait training improves brachial-ankle pulse wave velocity and peak aerobic capacity in subacute stroke patients with totally dependent ambulation: Randomized controlled trial.
[So] Source:Medicine (Baltimore);95(41):e5078, 2016 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Brachial-ankle pulse wave velocity (baPWV) evaluates arterial stiffness and also predicts early outcome in stroke patients. The objectives of this study were to investigate arterial stiffness of subacute nonfunctional ambulatory stroke patients and to compare the effects of robot-assisted gait therapy (RAGT) combined with rehabilitation therapy (RT) on arterial stiffness and functional recovery with those of RT alone. METHOD: The RAGT group (N = 30) received 30 minutes of robot-assisted gait therapy and 30 minutes of conventional RT, and the control group (N = 26) received 60 minutes of RT, 5 times a week for 4 weeks. baPWV was measured and calculated using an automated device. The patients also performed a symptom-limited graded exercise stress test using a bicycle ergometer, and parameters of cardiopulmonary fitness were recorded. Clinical outcome measures were categorized into 4 categories: activities of daily living, balance, ambulatory function, and paretic leg motor function and were evaluated before and after the 4-week intervention. RESULTS: Both groups exhibited significant functional recovery in all clinical outcome measures after the 4-week intervention. However, peak aerobic capacity, peak heart rate, exercise tolerance test duration, and baPWV improved only in the RAGT group, and the improvements in baPWV and peak aerobic capacity were more noticeable in the RAGT group than in the control group. CONCLUSION: Robot-assisted gait therapy combined with conventional rehabilitation therapy represents an effective method for reversing arterial stiffness and improving peak aerobic capacity in subacute stroke patients with totally dependent ambulation. However, further large-scale studies with longer term follow-up periods are warranted to measure the effects of RAGT on secondary prevention after stroke.
[Mh] Termos MeSH primário: Terapia por Exercício/métodos
Transtornos Neurológicos da Marcha/reabilitação
Marcha/fisiologia
Recuperação de Função Fisiológica/fisiologia
Robótica
Reabilitação do Acidente Vascular Cerebral/métodos
Acidente Vascular Cerebral/complicações
[Mh] Termos MeSH secundário: Atividades Cotidianas
Idoso
Índice Tornozelo-Braço
Deambulação com Auxílio
Tolerância ao Exercício
Feminino
Transtornos Neurológicos da Marcha/etiologia
Transtornos Neurológicos da Marcha/fisiopatologia
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170224
[Lr] Data última revisão:
170224
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161015
[St] Status:MEDLINE



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