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World Neurosurgery Apr 2022To analyze cervical spine injuries resulting from recreational activity in shallow ocean water amid high-energy breaking waves.
OBJECTIVE
To analyze cervical spine injuries resulting from recreational activity in shallow ocean water amid high-energy breaking waves.
METHODS
Single-center 10-year review of patients who sustained cervical injuries at the beach in Long Island, New York, USA. A systematic review following the PRISMA guidelines was also performed.
RESULTS
Nineteen patients (age 17-79 years) sustained cervical injury from high-energy breaking waves while in shallow beach water. Six patients dived into a wave; 6 patients were struck by a large wave while standing upright; and 7 tumbled in the waves while engaged in nonspecified recreational activity. All 7 patients with subaxial cervical AO Spine Injury Score (AO-SIS) >10 had cervical spine injury with cord signal change and required operative management. Diving mechanism, AO-SIS >10, and cord signal change all predicted significant disability or death at 12 months (P < 0.01). The present study and 7 additional studies reporting on 534 patients (mean age, 45.4 years) were analyzed. Within the reported literature, most patients (94.2%) sustained a spinal cord injury. On long-term follow-up, an estimated 64.8% of patients had permanent neurologic injury and 12.5% had permanent quadriplegia.
CONCLUSIONS
We offer the first description of cervical injuries sustained in water-related recreational activity using the AO-SIS. The morphology of injuries varied significantly and seemed to depend on body position and wave kinetic energy. Patients presenting with cervical injury in this setting and yielding AO-SIS >10 are likely to have poor functional recovery.
Topics: Adolescent; Adult; Aged; Cervical Vertebrae; Humans; Middle Aged; Retrospective Studies; Spinal Cord Injuries; Spinal Fractures; Spinal Injuries; Trauma Centers; Young Adult
PubMed: 35074543
DOI: 10.1016/j.wneu.2022.01.055 -
Journal of Back and Musculoskeletal... 2022Imbalance or decreased trunk strength has been associated with non-specific low back pain (NSLBP). (Review)
Review
BACKGROUND
Imbalance or decreased trunk strength has been associated with non-specific low back pain (NSLBP).
OBJECTIVE
This systematic review aimed (I) to evaluate the quality of evidence of studies evaluating the reliability of trunk strength assessment with an isokinetic dynamometer in NSLBP patients, (II) to examine the reliability of trunk strength assessment using an isokinetic dynamometer in NSLBP patients and (III) to determine the most reliable protocol for trunk strength assessment in NSLBP patients.
METHOD
PRISMA guidelines were followed. Three databases were used: PubMed, Scopus, and Web of Science with the following keywords: Isokinetic, Dynamometer, Trunk strength testing, Muscle testing, Isokinetic measurement, CORE, Abdominal muscles, Abdominal wall, Torso, Trunk, Spine, Reliability and, Reproducibility. We included only test-retest studies, focused on the reliability of isometric and isokinetic strength assessed with an isokinetic dynamometer in NSLBP adults' patients, published in English and from inception to March 30, 2021. The methodological quality was evaluated with the CAT scale and QAREL checklist.
RESULTS
Five hundred and seventy-seven articles were retrieved, of which five are included in this review. Three articles provide good quality of evidence, the reliability of trunk strength assessment in NSLBP patients is excellent, and the most reliable protocol for isometric assessment is in a seated position (ICC = 0.94-0.98) and for isokinetic strength in standing position, at 60∘/s and 120∘/s (ICC = 0.98).
CONCLUSION
There is good quality evidence regarding the trunk strength assessment's reliability. Reliability is excellent in NSLBP patients; however, a familiarization process should be considered to obtain clinically reliable data. The most reliable protocol is in a seated position for isometric strength and a standing position for isokinetic strength.
Topics: Humans; Low Back Pain; Muscle Strength; Muscle Strength Dynamometer; Muscle, Skeletal; Reproducibility of Results
PubMed: 35213350
DOI: 10.3233/BMR-210261 -
Journal of Investigative Surgery : the... Jan 2022: Platypnoea-Orthodeoxia Syndrome is an uncommon phenomenon characterized by dyspnea/arterial desaturation in the standing position, resolving in recumbency. Some...
: Platypnoea-Orthodeoxia Syndrome is an uncommon phenomenon characterized by dyspnea/arterial desaturation in the standing position, resolving in recumbency. Some patients present with Platypnoea-Orthodeoxia Syndrome in the early-or-late post-operative period after major lung resection (lobectomy/pneumonectomy). The main cause of Platypnoea-Orthodeoxia Syndrome is an intracardiac anomaly (Patent Foramen Ovalis/Atrial Septal Defect) leading to right-to-left shunt.: To identify the causes of post-lobectomy Platypnoea-Orthodeoxia Syndrome, and the possible pathophysiologic mechanism. A Pubmed database-EMBASE systematic review was performed in order to find all reports, reporting the occurrence of dyspnea/hypoxemia after lobectomy.: 8 studies were found concerning ten patients during the period from 1983-2019.There was 6 male/4 female. The mean age was 62 years. All patients underwent resection of the right lung. The time-interval between the operation and the Platypnoea-Orthodeoxia Syndrome was from 2 days to 3 years. A Patent Foramen Ovalis was present in 90% and in 10% an Atrial Septal Defect was diagnosed. The mean Right Atrial Pressure was 7.5 mmHg, the mean Left Atrial Pressure was 6.6 mmHg and the mean Pulmonary artery pressure was 18.5 mmHg. The mean size of the interatrial communication was 1.62 cm. The inter-atrial communication was closed by open-chest surgical procedure in 3 cases (30%) and in 7 patients (70%) a percutaneous transcatheter device was implanted.: Platypnoea-Orthodeoxia Syndrome after lobectomy is a rare cause of post-operative dyspnea/hypoxia. It is the result of right-to-left shunt via an interatrial communication. Mediastinal relocation, stretching of the atrial septum and aortic root dilatation are among the functional elements necessary for the Platypnoea-Orthodeoxia Syndrome manifestation.
Topics: Achilles Tendon; Female; Foramen Ovale, Patent; Humans; Hypoxia; Lung; Male; Middle Aged; Posture; Surgeons
PubMed: 33263463
DOI: 10.1080/08941939.2020.1825883 -
Sports Biomechanics Apr 2023The aim was to know if cycling affects spinal morphology in postures off the bicycle, such as adapting the spinal curvatures on the bicycle depending on the handlebar...
The aim was to know if cycling affects spinal morphology in postures off the bicycle, such as adapting the spinal curvatures on the bicycle depending on the handlebar type and position on the handlebars. A systematic review was conducted following the PRISMA guidelines. The studies selected met the following criteria: a) the study design was cross-sectional or longitudinal (experimental or cohorts); b) the study evaluated the sagittal morphology of the spine on the bicycle; c) the study included healthy and trained participants without injuries or cyclists reporting low back pain. Fifteen studies reported that a greater pelvic tilt was observed that when the handlebar was in a lower position. Sixteen studies found that lumbar kyphosis was greater when the handlebar grip was lower and farther from the saddle. Twelve studies reported that a tendency towards greater thoracic flexion as the time spent pedalling on the bicycle increased. In conclusion, the practice of cycling produces adaptations in the morphology of the spine of the cyclist compared to non-cyclists, such as an increase in pelvic tilt and a greater capacity for lumbar flexion in trunk flexion positions, and a greater thoracic kyphosis in the standing position.
Topics: Humans; Bicycling; Biomechanical Phenomena; Cross-Sectional Studies; Kyphosis; Posture; Spine; Longitudinal Studies; Range of Motion, Articular
PubMed: 35440291
DOI: 10.1080/14763141.2022.2058990 -
Sports Medicine (Auckland, N.Z.) Sep 2022Research has shown the effectiveness of sedentary behaviour interventions on reducing sedentary time. However, no systematic review has studied where the reduced... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Research has shown the effectiveness of sedentary behaviour interventions on reducing sedentary time. However, no systematic review has studied where the reduced sedentary time after such interventions is displaced to.
OBJECTIVE
Our objective was to synthesize the evidence from interventions that have reduced sedentary behaviour and test the displacement of sedentary time into physical activity (light physical activity [LPA], moderate-to-vigorous physical activity [MVPA], standing, and stepping).
METHODS
Two independent researchers performed a systematic search of the EBSCOhost, PubMed, Scopus, and Web of Science electronic databases. Meta-analyses were performed to examine the time reallocated from sedentary behaviour to physical activity during working time and the whole day in intervention trials (randomized/non-randomized controlled/non-controlled).
RESULTS
A total of 36 studies met all the eligibility criteria and were included in the systematic review, with 26 studies included in the meta-analysis. Interventions showed a significant overall increase in worksite LPA (effect size [ES] 0.24; 95% confidence interval [CI] 0.05 to 0.43; P < 0.013) and daily LPA (ES 0.62; 95% CI 0.34 to 0.91; P = 0.001). A statistically significant increase in daily MVPA was observed (ES 0.47; 95% CI 0.26 to 0.67; P < 0.001). There was a significant overall increase in worksite standing time (ES 0.76; 95% CI 0.56 to 0.95; P < 0.001), daily standing time (ES 0.52; 95% CI 0.38 to 0.65; P < 0.001), and worksite stepping time (ES 0.12; 95% CI 0.04 to 0.20; P = 0.002).
CONCLUSIONS
Effective interventions aimed at reducing sedentary behaviour result in a consistent displacement of sedentary time to LPA and standing time, both at worksites and across the whole day, whereas changes in stepping time or MVPA are dependent on the intervention setting. Strategies to reduce sedentary behaviour should not be limited to worksite settings, and further efforts may be required to promote daily MVPA.
TRIAL REGISTRATION
PROSPERO registration number CRD42020153958.
Topics: Exercise; Humans; Sedentary Behavior; Standing Position; Workplace
PubMed: 35567719
DOI: 10.1007/s40279-022-01682-3 -
Journal of Bodywork and Movement... Jul 2023Older adults are benefited from the continuous tactile information to enhance postural control. Therefore, the aim was to evaluate the effect of the haptic anchors... (Review)
Review
BACKGROUND
Older adults are benefited from the continuous tactile information to enhance postural control. Therefore, the aim was to evaluate the effect of the haptic anchors during balancing and walking tasks in older adults.
METHODS
The search strategy (up to January 2023) was based on the PICOT (older adults; anchor system during balance and walking tasks; any control group; postural control measurements; short and/or long-term effect). Two pairs of reviewers independently examined all titles and abstracts for eligibility. The reviewers independently extracted data from the included studies, assessed the risk of bias, and certainty of the evidence.
RESULTS
Six studies were included in the qualitative synthesis. All studies used a 125-g haptic anchor system. Four studies used anchors when standing in a semi-tandem position, two in tandem walking on different surfaces, and one in an upright position after plantar flexor muscle fatigue. Two studies showed that the anchor system reduced body sway. One study showed that the ellipse area was significantly lower for the 50% group (reduced frequency) in the post-practice phase. One study showed that the reduction in the ellipse area was independent of the fatigue condition. Two studies observed reduced trunk acceleration in the frontal plane during tandem waking tasks. The studies had low to moderate certainty of evidence.
CONCLUSION
Haptic anchors can reduce postural sway during balance and walking tasks in older adults. Also, positive effects were seen during the delayed post-practice phase after the removal of anchors only in individuals who used a reduced anchor frequency.
Topics: Humans; Aged; Haptic Technology; Walking; Postural Balance; Muscle Fatigue; Muscle, Skeletal
PubMed: 37330805
DOI: 10.1016/j.jbmt.2023.04.035 -
Work (Reading, Mass.) 2020Prolonged sitting has been shown to induce transient low back pain (LBP). Height adjustable office desks now present the opportunity to replace sitting with standing in... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Prolonged sitting has been shown to induce transient low back pain (LBP). Height adjustable office desks now present the opportunity to replace sitting with standing in the workplace. Since standing has also been associated with LBP, this may not be an advisable alternative.
OBJECTIVE
To determine if objectively measured prolonged exposures to desk work while standing, compared to sitting, results in lower perceived LBP in healthy adults.
METHODS
A systematic search of several databases was conducted. Two independent reviewers screened titles/abstracts and conducted a quality assessment. The results of three studies were pooled using an inverse variance random-effects meta-analysis. Heterogeneity was tested using the Chi-squared test and I2 statistic.
RESULTS
Objectively measured prolonged standing postures during desk work did not induce significantly less perceived LBP compared to seated postures (standardized mean difference 0.60, 95% CI -0.68 to 1.87, p = 0.36.) There was significant heterogeneity, I2 = 90%).
CONCLUSIONS
It appears that replacing seated desk work postures with standing for prolonged periods of time would not be recommended. Larger studies, including a wider age range and health history, conducted in the field with objective measures is recommended to obtain more generalizable data on which to base ergonomic standards for work postures.
Topics: Adult; Ergonomics; Humans; Low Back Pain; Posture; Standing Position; Workplace
PubMed: 33074206
DOI: 10.3233/WOR-203292 -
Neurosciences (Riyadh, Saudi Arabia) Jul 2020To find out new assessment tools for sitting, in patients with neurological and neuromuscular conditions, to be recommended for rehabilitation practice locally in Saudi...
OBJECTIVE
To find out new assessment tools for sitting, in patients with neurological and neuromuscular conditions, to be recommended for rehabilitation practice locally in Saudi Arabia and internationally.
METHODS
Four databases were used: PubMed, Web of Science, Ovid Medline, and Cochrane. Inclusion criteria were articles published between the years 2009-2019; sitting, not standing or walking; assessment not intervention; published in English and studies on adults only. Exclusion criteria were any assessment that measures the standing/walking ability or has items for that, and studies that include pediatric or adolescent or both.
RESULTS
Ten articles met our criteria including 464 patients and divided into 3 main neurological conditions (stroke, SCI, and MS). One assessment (Function in Sitting Test) showed promising potential being implemented with both stroke and multiple sclerosis, Cronbach`s alpha, alpha were 0.91 and 0.98 indicating high internal consistency. It was used with SCI patients, however, no access was available to include this study in this review.
CONCLUSION
This review indicates an extension of what was carried out by previous systematic reviews with neurological conditions. It seems that Function in Sitting Test is the most frequent assessment in this review with multiple neurological conditions (stroke, MS and SCI) with high internal consistency and high quality studies according to available data. However, this review showed that there is an absence of evidence for individuals with brain injury and muscular dystrophy. Further work needs to be carried out to address such groups of patients to extend the choices that clinicians can use in rehabilitation sittings.
Topics: Humans; Multiple Sclerosis; Neurologic Examination; Neuromuscular Diseases; Postural Balance; Sitting Position; Spinal Cord Injuries; Stroke
PubMed: 32683409
DOI: 10.17712/nsj.2020.3.20190592 -
Gait & Posture Jul 2022People with cerebral palsy (CP) often have difficulties related to maintaining body balance in their daily living activities. Accelerometers are low-cost wearable...
BACKGROUND
People with cerebral palsy (CP) often have difficulties related to maintaining body balance in their daily living activities. Accelerometers are low-cost wearable devices with potential use to objectively assess balance.
RESEARCH QUESTION
What are the main characteristics and findings from protocols used in research aiming to investigate standing or dynamic body balance stability through trunk accelerometry in people with CP?
METHOD
We searched in December 2021 seven databases, Pubmed, Embase, Cochrane, Science Direct, Scopus, PEDro, and Lilacs, with descriptors related to cerebral palsy, accelerometer, and balance.
RESULTS
Ten studies were included, with a total of 197 evaluated people with CP. These studies were classified as moderate or high methodological quality. We found convergence on the use of the sensor at the lumbar region (L3), with sampling frequency at 100 Hz. For balance assessment, 60 % of the reviewed studies used the 10-m walk test, while the other studies used different walking distances, or the quiet standing test. For data processing, the low-pass filter at 20 Hz has been used predominantly, and the most commonly used variable to evaluate balance stability has been root mean square of trunk acceleration. Children and adolescents with CP had higher acceleration values and greater gait complexity than typically developing children. Individuals with bilateral impairment had greater anteroposterior and mediolateral trunk accelerations than those with unilateral impairment. Trunk acceleration was shown to be sensitive to improvement in gait stability from interventions, and acceleration-based measures have been found to correlate with qualitative balance assessment tools.
SIGNIFICANCE
Trunk accelerometry in quiet posture and dynamic tasks was shown to be a valid and sensitive measurement to evaluate balance stability in children and adolescents with CP. It is a small, light, low-cost and easy-to-handle tool that is effective for measuring body balance on different tasks in this population.
Topics: Accelerometry; Activities of Daily Living; Adolescent; Cerebral Palsy; Child; Gait; Humans; Postural Balance; Posture; Standing Position
PubMed: 35820240
DOI: 10.1016/j.gaitpost.2022.06.017 -
Sexual Medicine Reviews Sep 2023Organ-sparing surgery (OSS) in penile cancer management aspires to maintain organ form and function and preserve health-related quality of life (HRQoL), yet there is a...
INTRODUCTION
Organ-sparing surgery (OSS) in penile cancer management aspires to maintain organ form and function and preserve health-related quality of life (HRQoL), yet there is a lack of integrated evidence exploring these outcomes.
OBJECTIVES
The aim sought to review HRQoL, functional, aesthetic, and psychological outcomes following OSS or radical penectomy for penile cancer.
METHODS
A systematic review of MEDLINE and Cochrane databases included studies reporting on function (sexual, urinary or sensory), genital appearance or HRQoL/psychological well-being following surgical treatment of primary penile cancer. English-language reports (2000-2022), incorporating patient-reported or objective clinical outcome measures, were eligible. Studies of nonsurgical treatment strategies and those in the context of metastatic disease were excluded. Data were compiled and analyzed.
RESULTS
Twenty-six studies were included. Sexual function was the most studied outcome (754 pooled respondents; 19 studies), most frequently with the original 15-item and abridged 5-item International Index of Erectile Function. Preservation of erectile function following OSS is generally described, with some reduction in overall sexual satisfaction cited. Heterogeneous assessment of voiding function with little preoperative evaluation render interstudy comparison difficult. Most patients appear able to void from a standing position following OSS, with spraying the most common symptom. Maintenance of some sensory function is described with both split-thickness skin grafting and urethral glanduloplasty following radical glansectomy. Limited studies suggest reasonable patient satisfaction with genital cosmesis post-OSS. A negative impact on HRQoL is described in most studies following penile cancer surgery, variably correlated with aggressiveness of penile surgery and addition of lymphadenectomy. Anxiety, depression, and reduced self-esteem have been reported in penile cancer survivors. Relationship well-being varies, with some survivors reporting this to be unchanged.
CONCLUSION
OSS can preserve elements of sexual, urinary, and sensory function, supporting advantages over radical penectomy for eligible patients. However, a comprehensive understanding remains limited due to small, heterogeneous patient cohorts, challenges in obtaining premorbid data, and variability in outcome measures. Standardization of patient-reported outcomes following OSS is desirable.
Topics: Male; Humans; Penile Neoplasms; Erectile Dysfunction; Quality of Life; Penis; Penile Erection
PubMed: 37204120
DOI: 10.1093/sxmrev/qead021