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Medical Science Monitor : International... Jun 2024BACKGROUND Congenital hypoplasia of the thumb type IV, also known as floating thumb, is a condition in which 2 small phalanges are attached to the hand with a thin skin...
BACKGROUND Congenital hypoplasia of the thumb type IV, also known as floating thumb, is a condition in which 2 small phalanges are attached to the hand with a thin skin bridge. Surgical management options for this condition vary from amputation to flap reconstruction. MATERIAL AND METHODS This retrospective study analyzed 11 infants with congenital hypoplasia of the thumb type IV who underwent surgical reconstruction using a modified vascularized polydactylous hallux flap. The study included 6 male and 5 female infants, aged 6 to 24 months. Functional evaluations and radiographic studies were conducted postoperatively. RESULTS All 11 patients underwent the complete surgical protocol. Successful vascular and nerve anastomoses were performed during the initial procedure, ensuring sufficient blood supply and neural connectivity to the transferred toes. The second operation showed promising outcomes, including improvements in thumb opposition, grasp strength, and overall function. Postoperative assessments demonstrated satisfactory radiographic alignment and no major complications during the follow-up period. CONCLUSIONS The modified vascularized polydactylous hallux flap reconstruction is a viable surgical option for managing congenital hypoplasia of the thumb type IV in infants. This technique effectively restores thumb opposition, grasp strength, and overall hand function, with satisfactory radiographic alignment and minimal complications. The study findings support the efficacy and safety of this surgical approach in addressing this rare congenital anomaly.
Topics: Humans; Thumb; Male; Female; Retrospective Studies; Infant; Surgical Flaps; Plastic Surgery Procedures; Treatment Outcome; Child, Preschool; Radiography; Hand Strength; Hand Deformities; Hand Deformities, Congenital
PubMed: 38944680
DOI: 10.12659/MSM.943686 -
Brazilian Journal of Physical Therapy Jun 2024Functional capacity impairment is a crucial consequence of chronic obstructive pulmonary disease (COPD). Although it can be identified with simple tests, such as the...
Functional capacity using sit-to-stand tests in people with chronic obstructive pulmonary disease and its relationship with disease severity-a cross-sectional study with matched controls.
BACKGROUND
Functional capacity impairment is a crucial consequence of chronic obstructive pulmonary disease (COPD). Although it can be identified with simple tests, such as the sit-to-stand tests, its prevalence, relation with disease severity, and the characteristics of people presenting this impairment remain unknown.
OBJECTIVE
To explore the functional capacity of people with COPD.
METHODS
A cross-sectional study with people with COPD and age-/sex-matched healthy controls was conducted. Functional capacity was assessed with the 5-repetitions (5-STS) and the 1-minute (1-minSTS) sit-to-stand tests. People with COPD were grouped according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classifications. Comparisons between people with COPD and healthy controls, and among GOLD groups were established. Associations between symptoms, muscle strength, quality of life, and measures of functional capacity were explored.
RESULTS
302 people with COPD [79% male; mean (SD) 68 (10) years old] and 304 healthy controls [75% male; 66 (9) years old] were included. 23% of people with COPD presented impairment in the 5-STS and 33% in the 1-minSTS. People with COPD from all GOLD classifications presented significantly lower functional capacity than healthy controls (5-STS: COPD median [1st quartile; 3rd quartile] 8.4 [6.7; 10.6] versus healthy 7.4 [6.2; 9.3] s; 1-minSTS: COPD 27 [21; 35] vs healthy 35 [29; 43] reps). Correlations with symptoms, muscle strength, and quality of life were mostly weak (5-STS: r [-0.34; 0.33]; 1-minSTS: r [-0.47; 0.40]).
CONCLUSION
People with COPD have decreased functional capacity independently of their GOLD classifications. The prevalence of functional impairment is 23-33%. Because impaired functional capacity is a treatable trait not accurately reflected by other outcomes, comprehensive assessment and management is needed.
PubMed: 38943740
DOI: 10.1016/j.bjpt.2024.101090 -
Journal of Back and Musculoskeletal... Jun 2024Sarcopenia and frailty may develop at varying rates depending on the metabolic, structural, and functional changes in the muscle structure after stroke.
BACKGROUND
Sarcopenia and frailty may develop at varying rates depending on the metabolic, structural, and functional changes in the muscle structure after stroke.
OBJECTIVE
To evaluate the prevalence of sarcopenia and frailty in patients with stroke and affecting clinical parameters.
METHODS
This was a cross-sectional and analytical study. Twenty-six (49.1%) women and 27 men (50.9%) with stroke with an average age of 60.2 ± 10.3 (median = 62) years were included in the study. To evaluate physical performance, balance, and mobility, we used the 4-meter walk test (4-MWT), timed up and go test, chair sit and stand test, and the Berg Balance Scale (BBS). Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 criteria. The SARC-F scale was used for sarcopenia.
RESULTS
The average stroke duration was 21.6 ± 18.2 months. Prefrailty was present in 14 (26.4%) patients, frailty was present in 34 (64.2%) patients, and two (3.8%) patients were normal. Sarcopenia was detected in 28 (52.8%) patients. According to handgrip strength, the prevalence of low muscle strength was 17% (n= 9). In the sarcopenic group, female sex (p= 0.005) was more frequent, 4-MWT was longer (p= 0.003), chair stand test results were lower (p< 0.001), the clinical frailty scale (CFS) was higher (p< 0.001), fall risk was higher compared with the BBS (p< 0.001), there was lower HG strength (p= 0.009), lower malnutrition scores (PNI, prognostic nutritional index, p< 0.001), and lower lymphocyte counts (p= 0.037). EAT-10 scores and dysphagia presence (p= 0.026), the presence of malnutrition (p< 0.021) and Nottingham Health Profile score (p< 0.001) were higher in the sarcopenic group.
CONCLUSION
Sarcopenia and frailty frequently develop in patients with chronic stroke, with low lymphocyte counts, physical performance, muscle strength, and mobility and balance scores, and it is associated with poor prognostic factors including high disease severity, dysphagia, malnutrition, risk of falling, and poor quality of life.
PubMed: 38943381
DOI: 10.3233/BMR-230423 -
Journal of Orthopaedic Surgery and... Jun 2024Our study aims to assess the effectiveness of multicomponent supervised tele-rehabilitation compared to home-based self-rehabilitation management in patients following... (Comparative Study)
Comparative Study Randomized Controlled Trial
Multicomponent supervised tele-rehabilitation versus home-based self-rehabilitation management after anterior cruciate ligament reconstruction: a study protocol for a randomized controlled trial.
INTRODUCTION
Our study aims to assess the effectiveness of multicomponent supervised tele-rehabilitation compared to home-based self-rehabilitation management in patients following anterior cruciate ligament reconstruction (ACLR).
METHODS
The current study is designed as a single-center, single-blinded, randomized controlled, two-arm trial. Participants will be randomized and allocated at a 1:1 ratio into either a multicomponent supervised tele-rehabilitation group or a home-based self-rehabilitation group. All participants receive uniform preoperative education through the HJT software. Participants in the intervention group undergo multicomponent supervised tele-rehabilitation, while those in the control group follow a home-based self-rehabilitation program. All the participants were assessed and measured for the included outcomes at the outpatient clinic before the procedure, and in 2, 4, 8, 12, and 24 weeks after ACLR by two assessors. The primary outcome was the percentage of patients who achieve a satisfactory active ROM at the 12 weeks following the ACLR. The satisfactory active ROM was also collected at 2, 4, 8, and 24 weeks after ACLR. The secondary outcomes were active and passive range of motion (ROM), pain, muscle strength, and function results.
REGISTRATION DETAILS
Ethical approval has been obtained from the West China Hospital Ethics Committee (approval number 2023-1929, December 2023). The trial has been registered on ClinicalTrials.gov (registration number NCT06232824, January 2024).
Topics: Humans; Anterior Cruciate Ligament Reconstruction; Telerehabilitation; Single-Blind Method; Range of Motion, Articular; Treatment Outcome; Adult; Male; Female; Young Adult; Home Care Services; Randomized Controlled Trials as Topic; Anterior Cruciate Ligament Injuries; Muscle Strength; Adolescent
PubMed: 38943178
DOI: 10.1186/s13018-024-04871-0 -
BMC Sports Science, Medicine &... Jun 2024The aim of the present study was to compare the effects of resistance training through full range of motion and static stretching (SS) of the hip and lower back...
BACKGROUND
The aim of the present study was to compare the effects of resistance training through full range of motion and static stretching (SS) of the hip and lower back extensors on flexibility and strength in healthy, physically active, adults.
METHODS
Eighteen participants (age: 24.2 ± 3.0 years, body mass: 71.3 ± 8.9 kg, height: 172.8 ± 7.5 cm) were randomly assigned to either a Resistance Training (RT) (n = 6), SS (n = 6), or control (CON) group (n = 6). The sit & reach (S&R) flexibility test and maximum isometric straight legged deadlift (ISLDL) at 95% and 50% range of motion (ROM) were tested pre- and post-intervention with significance set at p < 0.05. Both groups conducted four to eight sets per session. Within each set, the RT group performed eight repetitions each lasting four seconds, while the SS group stretched continuously for 32 s. The rest periods between each set were 60-90 s. Consequently training volume and rest times were matched between the groups.
RESULTS
The RT and SS groups achieved significant, large magnitude improvements in the S&R test compared to the CON group (p < 0.01 g = 2.53 and p = 0.01, g = 2.44), but no differences were observed between the RT and SS groups (p = 1.00). Furthermore, the RT group demonstrated a larger improvement in 50% and 95% ROM ISLDL compared to SS (p < 0.01, g = 2.69-3.36) and CON (p < 0.01, g = 2.44-2.57).
CONCLUSION
Resistance training through a full ROM was equally effective as SS for improving S&R flexibility, but improved hip- and lower back extensor strength more than SS and the CON. The authors recommend using large ROM resistance training to improve hip and lower back extensor flexibility and muscle strength.
TRIAL REGISTRATION
ISRCTN88839251, registered 24. April 2024, Retrospectively registered.
PubMed: 38943165
DOI: 10.1186/s13102-024-00934-1 -
BMC Geriatrics Jun 2024Malnutrition of older individuals, leads to significant functional decline, reducing their quality of life. Lifestyle interventions; dietary improvements and... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Malnutrition of older individuals, leads to significant functional decline, reducing their quality of life. Lifestyle interventions; dietary improvements and supplementation are explored to enhance the physical function of older adults. The current study aimed to assess the impact of oral nutritional supplements (ONS) on the functional and activity levels of Sri Lankan older adults.
METHODS
This randomized controlled trial included; an intervention group (IG) receiving 200 mL of ONS providing 247 kcal per serving, for 12 weeks and a control group (CG) receiving an equivalent volume of water. Changes in handgrip strength, knee extension strength, gait speed, functional and activity levels were assessed.
RESULTS
The IG showed significant improvements in handgrip strength (43.96 ± 18.61 kg vs. 32.81 ± 17.92 kg; p < 0.001) and knee extension strength (23.45 ± 2.29 kg vs. 16.41 ± 2.09 kg; p < 0.001) following 12 weeks compared to the CG. The IG also exhibited significant improvements in gait speed (1.31 ± 0.52 m/s vs. 0.87 ± 0.26 m/s), Barthel index score, (0.30 ± 0.47 vs. -0.18 ± 0.66), PASE score (0.52 ± 17.79 vs. -1.60 ± 21.77) and IPAQ categories.
CONCLUSIONS
ONS was found to be effective in improving the functional and physical activity levels of malnourished older adults.
TRIAL REGISTRATION
Sri Lanka Clinical Trial Registry SLCTR/2022/021. Registered on 06/10/2022.
Topics: Humans; Male; Aged; Female; Dietary Supplements; Malnutrition; Exercise; Hand Strength; Sri Lanka; Walking Speed; Physical Functional Performance; Aged, 80 and over; Middle Aged; Administration, Oral
PubMed: 38943086
DOI: 10.1186/s12877-024-05164-1 -
Research Quarterly For Exercise and... Jun 2024The present study aimed to identify parameters that best discriminate between high-level and scholar-level players for the Brazilian 13-14-year-old girl's handball and...
The present study aimed to identify parameters that best discriminate between high-level and scholar-level players for the Brazilian 13-14-year-old girl's handball and propose a mathematical model to identify sports talent for handball. The sample was made up of all available handball players comprising these two groups: 100 girls who participated in the high-level handball championship in Brazil and 53 girls (age 13-14 years) as finalists of the school-level games in one region of Brazil. We assess the anthropometric profile, maturity offset, physical fitness, and technical skills for handball. To propose the equation, the Discriminant Function Analysis method was used. The discriminant function was significant ( ≤ .05), had a good canonical correlation (0.590), and still had an average Wilk Lambda (0.652). The variables considered in the talent identification model included: 1. flexibility, 2. abdominal strength, 3. lower limbs muscle power, 4. agility, 5. defensive movement and 6. slalom with ball. The values from the equation for identifying school-age athletes with high motor skills and performance for handball can be classified by a cutoff point (Y = 0.192). The results showed that the mathematical-model obtained was able to select school-age athletes with high motor skills for handball, and with the profile for participation in high-level championships.
PubMed: 38941625
DOI: 10.1080/02701367.2024.2358962 -
Neurological Sciences : Official... Jun 2024Home-based rehabilitation is a cost-effective means of making services available for patients. The aim of this study is to determine the evidence in the literature on... (Review)
Review
BACKGROUND
Home-based rehabilitation is a cost-effective means of making services available for patients. The aim of this study is to determine the evidence in the literature on the effects of home-based neurostimulation in patients with stroke.
METHOD
We searched PubMED, Embase, Web of Science, Scopus, and CENTRAL for randomized controlled trials on the subject matter using keywords such as stroke, electrical stimulation and transcranial direct current stimulation. Information on participants' characteristics and mean scores on the outcomes of interest were extracted. Risks of bias and methodological quality of the included studies were assessed using Cochrane Risks of bias tool and PEDro scale respectively. The data was analyzed using both narrative and quantitative syntheses. In the quantitative synthesis, meta-analysis was carried out using random effect model analysis.
RESULT
The results showed that, home-based neurostimulation is superior to the control at improving upper limb muscle strength (SMD = 0.72, 95% CI = 0.08 to 1.32, p = 0.03), functional mobility (SMD = -0.39, 95% CI = -0.65 to 0.14, p = 0.003) and walking endurance (SMD = 0.33, 95% CI = 0.08 to 0.59, p = 0.01) post intervention; and upper limb motor function (SMD = 0.9, 95% CI = 0.10 to 1.70, p = 0.03), functional mobility (SMD = -0.30, 95% CI = -0.56 to -0.05, p = 0.02) and walking endurance (SMD = 0.33, 95% CI = 0.08 to 0.59, p = 0.01) at follow-up.
CONCLUSIONS
Home-based neurostimulation can be used to improve upper and lower limb function after stroke.
PubMed: 38940876
DOI: 10.1007/s10072-024-07633-2 -
Alternative Therapies in Health and... Jun 2024To evaluate the effectiveness of FLS model nursing in the rehabilitation of elderly patients after femoral neck fracture surgery.
OBJECTIVE
To evaluate the effectiveness of FLS model nursing in the rehabilitation of elderly patients after femoral neck fracture surgery.
METHODS
We retrospectively analyzed data from 89 elderly patients treated surgically for femoral neck fractures, comparing outcomes between those receiving routine nursing (control group, n=44) and FLS model nursing interventions (observation group, n=45). Key metrics included rehabilitation process indicators, hip joint function, self-efficacy, perceived burden, limb stability, and adverse reactions.
RESULTS
The observation group showed significantly shorter first out-of-bed time, time for pain disappearance, and length of hospital stay compared to the control group. The observation group also exhibited significantly higher scores in pain, gait, functional activities, and deformity/mobility assessments after the intervention compared to the control group. The GSES score was significantly higher and the SPB score was significantly lower in the observation group after the intervention compared to the control group. The observation group demonstrated significantly higher levels of dynamic balance ability, lower limb muscle strength, and mobile walking ability than the control group. The incidence of adverse reactions was significantly lower in the observation group (8.89%) compared to the control group (36.36%).
CONCLUSION
FLS model nursing intervention has a significant positive effect on the rehabilitation of elderly patients undergoing surgery for femoral neck fractures. Compared to routine nursing intervention, the FLS model nursing intervention can further promote postoperative recovery of hip joint function, improve self-efficacy, alleviate the self-perceived burden, shorten the rehabilitation process, and reduce the risk of adverse postoperative reactions. These findings suggest the FLS model nursing approach holds promise for broader clinical adoption and implementation.
PubMed: 38940811
DOI: No ID Found -
Alternative Therapies in Health and... Jun 2024To observe the application of micro-implant anchorage (MIA) combined with Proxomed Tergumed (PT) system in patients with malocclusion combined with lumbar disc...
OBJECTIVE
To observe the application of micro-implant anchorage (MIA) combined with Proxomed Tergumed (PT) system in patients with malocclusion combined with lumbar disc herniation (LDH).
METHODS
60 patients with malocclusion combined with LDH from February 2021 to December 2022 were randomly divided into two groups. 30 cases in Group A were treated with MIA combined with conventional training, while 30 cases in Group B were treated with MIA combined with rehabilitation training of the PT system. All patients in the two groups received intervention for 30 days. The clinical efficacy, waist, and back function [Oswestry Disability Index (ODI)], low back pain [visual analogue scale (VAS)], and waist and back muscle-related indicators [Range of motion (ROM) and isometric strength (IMS)] of the two groups were compared.
RESULTS
Group B had better overall treatment efficacy and a higher overall response rate compared to Group A (P < .05). There was no significant difference in ODI, VAS scores of lumbago, ROM, and IMS between the two groups before the treatment (P > .05). On the second week of treatment and at the end of treatment, the ODI and VAS scores of Group B were significantly lower than those of Group A (P < .05). At the end of treatment, the ROM and IMS of Group B were significantly higher than that of Group A (P < .05).
CONCLUSION
PT system rehabilitation training combined with MIA can improve the clinical efficacy of patients with malocclusion combined with LDH, which is conducive to improving the patients' lumbar back muscle function and relieving low back pain. It is recommended to be used in patients with clinically related complications.
PubMed: 38940804
DOI: No ID Found