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Journal articles on the topic 'Orthopedic impairments'

Author: Grafiati
Published: 4 June 2021
Last updated: 1 February 2022

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1

Biastro, Leslie, Heather Frank, and Karen H. Larwin. "Looking at the Social Activity for Adolescents with Orthopedic Impairments." International Journal of Evaluation and Research in Education (IJERE) 4, no. 3 (September 1, 2015): 106. http://dx.doi.org/10.11591/ijere.v4i3.4500.

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Adolescents with identified orthopedic impairments are often less likely to participate in social activities outside of the school setting. However, the adolescents who are able to participate in activities have higher social skills, more academic successes, and show more satisfaction in their roles as family member or friend. The aim of this study was to look at adolescents with orthopedic impairments and their level of participation in social activities. Also looked at was the adolescent’s report of a higher level of fulfillment in their family or friend role if they participated in social activities. Responses of adolescents from a national school-based survey were used in the study. The results revealed that students with orthopedic impairments were just as happy as their peers when they participated in social activities.
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2

Raveica, Ionel Crinel, Cristina Mohora, Gabriela Raveica, and Andra Elena Pena. "Using AutoCAD Application as Instrument for Biomechanical Assessment of Orthopedic Impairments." Applied Mechanics and Materials 436 (October 2013): 277–84. http://dx.doi.org/10.4028/www.scientific.net/amm.436.277.

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The aim of our study was to identify if the AutoCAD application may be useful for evaluation during active movements of the body segments (lower limb), and how an orthopedic problem influence the normal pathway. The assement of range of motion is still problematic, especially when the body components is moving. Determining changes in the angles of motion dynamic is important in guiding the intervention plan. The evaluation methods are not enough objective all the time and many details could be not observed during different ADL (activities daily living). The AutoCAD (Auto Computer Aid Design) application was a valid instrument in order to realise the biomechanical analyse in case of knee arthritis. The analyze of moving components is possible using video frames and AutoCAD processing.
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Lee, Tae Sik, and Sam Up Ji. "Study of Participation of Individuals with Orthopedic Impairments on Marine Sports." Journal of Sport and Leisure Studies 18 (November 30, 2002): 663–74. http://dx.doi.org/10.51979/kssls.2002.11.18.663.

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4

Müller, F., K. Alomar, and P. Journeau. "Musculoskeletal anomalies in children with Mucopolysaccaridoses." Genij Ortopedii 27, no. 4 (August 2021): 446–49. http://dx.doi.org/10.18019/1028-4427-2021-27-4-446-449.

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Introduction The accumulation of glycosaminoglycan (GAGs) in the tissues in Mucopolysaccharidoses (MPS) can lead to skeletal anomalies (DYSOSTOSIS MULTIPLEX) and to soft tissue impairments (neural or medullar compression, joint stiffness, tenosynovitis). Here is a review of orthopedic issues frequently encountered in patients with MPS. Material and methods Surgery may be justified at different age and according to the type of MPS. Different surgical approaches and their indications are exposed in the article. Results The article exposes indications and techniques for orthopedic issues in MPS children: cervical stenosis, cervical instability, kyphosis, hip dysplasia and hip dislocation, genu valgum. Conclusion Various musculoskeletal anomalies can be found in patients with mucopolysaccharidoses. Neurological impairments are frequently seen due to cervical stenosis or instability and should be early detected with regular MRI of the cervical spine. Well-codified management should lead to favorable functional results and maintain functional and walking abilities.
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Shogren, Karrie A., William Kennedy, Chantelle Dowsett, Mauricio Garnier Villarreal, and Todd D. Little. "Exploring Essential Characteristics of Self-Determination for Diverse Students Using Data From NLTS2." Career Development and Transition for Exceptional Individuals 37, no. 3 (May 16, 2013): 168–76. http://dx.doi.org/10.1177/2165143413486927.

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This study explored the impact of race/ethnicity on three of the four essential characteristics of self-determination—autonomy, self-realization, and psychological empowerment—directly assessed in the National Longitudinal Transition Study-2. Specifically, the impact of race/ethnicity was examined with six disability groups established in previous research: high incidence disabilities (learning disabilities, emotional disturbances, speech language impairments, and other health impairments), sensory disabilities (visual and hearing impairments), cognitive disabilities (autism, multiple disabilities, and deaf-blindness); intellectual disability, traumatic brain injury, and orthopedic impairments. Measurement equivalence was established across groups, but significant differences in the latent means, variances, and covariances were found suggesting a complex pattern of differences based on race/ethnicity within disability groups. Implications for future research and practice are discussed.
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MALIK, MUHAMMAD RAZZAQ, MUHAMMAD AZEEM, and MUHAMMAD ZAFAR IQBAL. "ORTHOPEDIC INJURIES AMONG ELDERLY PERSONS." Professional Medical Journal 18, no. 04 (December 10, 2011): 615–20. http://dx.doi.org/10.29309/tpmj/2011.18.04.2649.

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Background: Pakistan is experiencing a rise in its elderly population leading to increase burden of orthopedic injuries. With meager resources and a poor understanding of elderly health problems; Pakistan faces many challenges in caring for its elderly population. Objectives: The objectives of this study were to, “Assess the frequency of orthopedic injuries among elderly persons and the associated risk factors at Sheikh Zayed Medical College/ Hospital Rahim Yar Khan”. Study design and duration: This was an analytical observational study conducted among the elderly patients above the age of 60 years, admitted in the Orthopedic Department of Sheikh Zayed Medical College/ Hospital Rahim Yar Khan. Methodology: The data was collected regarding the frequency, causes and pattern of orthopedic injuries in elderly patients admitted in the Orthopedic Department of Sheikh Zayed Hospital / Medical College Rahim Yar Khan. The data regarding age, sex, education, occupation, geographical origin, and mechanism of injury were obtained by questionnaire. The data was analyzed on SPSS version 16. Results: There were total 1589 patients admitted in the Orthopedic Unit during the study period. The elderly persons above the age of 60 years were 291(18.31%). There were 184(63.24%) males and 107(36.76%) females. The average age was 64.52 years in urban residents and 66.34 years in rural residents’ patients. Among the frequency of injuries, the femoral neck and inter-trochanter region were most commonly involved. The proportion of injuries in males it was 44.02% and in females it was higher that was 49.53%. The majority (68.29%) of the elderly persons was dependent and was not satisfied with socio-economic condition and status in the family (p < 0.000). Conclusions: Elderly patients who have experienced trauma are at increased risk of subsequent injury. Interventions to reduce the likelihood of trauma recurrence should focus on those with chronic illnesses and functional impairments.
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7

Withaar, Frederiec K., and Wiebo H. Brouwer. "Divided Attention After Closed Head Injury." Zeitschrift für Neuropsychologie 14, no. 3 (January 2003): 203–11. http://dx.doi.org/10.1024/1016-264x.14.3.203.

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Abstract: One of the most persisting sequelae of closed head injury (CHI) is a general slowing of information processing. With neuropsychological testing, the effect is already apparent in simple reaction time tests. The slowing is more pronounced in complex tasks requiring divided attention. This study aims at explaining impairments in divided attention in terms of reduced speed of information processing, and impaired mental flexibility. Three types of mental flexibility are proposed: Stimulus driven (four choice reaction time and auditory reaction time task), memory driven (Trailmaking B test), and strategy driven flexibility tasks (continuous tracking task and arrow identification task). Divided attention paradigms were studied in 26 subacute CHI patients and 25 orthopedic control subjects. Results demonstrated that a reduced speed of information processing was largely responsible for divided attention impairments. Additional impairments in complex divided attention tasks only emerged in the most complex tasks (that is in the strategy driven flexibility task).
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8

Wong, Rita A., Britta Schumann, Rose Townsend, and Crystal A. Phelps. "A Survey of Therapeutic Ultrasound Use by Physical Therapists Who Are Orthopaedic Certified Specialists." Physical Therapy 87, no. 8 (August 1, 2007): 986–94. http://dx.doi.org/10.2522/ptj.20050392.

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Background and Purpose For many years, ultrasound (US) has been a widely used and well-accepted physical therapy modality for the management of musculoskeletal conditions. However, there is a lack of scientific evidence on its effectiveness. This study examined the opinions of physical therapists with advanced competency in orthopedics about the use and perceived clinical importance of US in managing commonly encountered orthopedic impairments. Subjects Four hundred fifty-seven physical therapists who were orthopaedic certified specialists from the Northeast/Mid-Atlantic regions of the United States were invited to participate. Methods A 77-item survey instrument was developed. After face and content validity were established, the survey instrument was mailed to all subjects. Two hundred seven usable survey questionnaires were returned (response rate=45.3%). Results According to the surveys, the respondents indicated that they were likely to use US to decrease soft tissue inflammation (eg, tendinitis, bursitis) (83.6% of the respondents), increase tissue extensibility (70.9%), enhance scar tissue remodeling (68.8%), increase soft tissue healing (52.5%), decrease pain (49.3%), and decrease soft tissue swelling (eg, edema, joint effusion) (35.1%). The respondents used US to deliver medication (phonophoresis) for soft tissue inflammation (54.1%), pain management (22.2%), and soft tissue swelling (19.8%). The study provides summary data of the most frequently chosen machine parameters for duty cycle, intensity, and frequency. Discussion and Conclusion Ultrasound continues to be a popular adjunctive modality in orthopedic physical therapy. These findings may help researchers prioritize needs for future research on the clinical effectiveness of US.
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Hughes, Jason, Ying-Chih Wang, Teal Benevides, Pamalyn Kearney, Michael Iwama, and Leigh Lehman. "Risk Stratification of Patients With Elbow, Wrist, or Hand Orthopedic Impairments Seeking Outpatient Therapy Services." American Journal of Occupational Therapy 73, no. 4_Supplement_1 (August 1, 2019): 7311515323p1. http://dx.doi.org/10.5014/ajot.2019.73s1-po2022.

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10

Cervantes, Carlos M., and David L. Porretta. "Physical Activity Measurement Among Individuals With Disabilities: A Literature Review." Adapted Physical Activity Quarterly 27, no. 3 (July 2010): 173–90. http://dx.doi.org/10.1123/apaq.27.3.173.

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This review examined the literature on physical activity measurement among individuals with disabilities utilizing Yun and Ulrich’s (2002) view on measurement validity. Specific inclusion criteria were identified. The search produced 115 articles; however, only 28 met all specified criteria. Findings revealed that self-reports and accelerometers were the most common approaches to measuring physical activity, and individuals with orthopedic impairments, those with mental retardation, and those with other health impairments received the most attention. Of the 28 articles, 17 (61%) reported validity and reliability evidence. Among those studies reporting validity, criterion-related evidence was the most common; however, a number of methodological limitations relative to validity were observed. Given the importance of using multiple physical activity measures, only five (18%) studies reported the use of multiple measures. Findings are discussed relative to conducting future physical activity research on persons with disabilities.
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11

Robinson, James, Dennis C. Turk, and John D. Loeser. "Pain Evaluation: Fifth Edition Approaches." Guides Newsletter 7, no. 1 (January 1, 2002): 1–5. http://dx.doi.org/10.1001/amaguidesnewsletters.2002.janfeb01.

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Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, stresses that impairment assessment should be based on objective evidence of organ dysfunction. Using this model, pain-related impairment (PRI) such as migraine headache not associated with definable organ dysfunction is difficult to reconcile with patients’ reports of limitations in their activities of daily living (ADL). Chapter 18 of the AMA Guides, Fifth Edition, systematically addresses PRI and differs from previous editions by allowing examiners to award both quantitative and qualitative impairments. PRI is challenging to integrate with other chapters of the AMA Guides, which provide conventional impairment ratings (CIR) based on objectively measurable organ dysfunction. Examining physicians should consider PRI when performing an impairment evaluation on an individual who has a condition associated with pain, including almost any orthopedic condition and most neurological conditions. The examiner must determine if an individual's PRI should be considered as incorporated in the CIR or if the PRI increases the burden of illness above that acknowledged in the CIR—and only in the latter case should the physician use Chapter 18. This chapter distinguishes ratable vs unratable PRI, but better terminology may be uncontroversial and controversial PRI, respectively. Ten steps are involved in a PRI assessment and require the examining physician to use a multiaxial approach, synthesize information from multiple sources, and carefully assess the individual's credibility and pain behavior.
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12

Brigham, Christopher R., J. Mark Melhorn, Charles N. Brooks, Steven D. Feinberg, and James B. Talmage. "Carpal Tunnel Syndrome and Trigger Fingers in a Patient with Rheumatoid Arthritis and Systemic Lupus Erythematosus: Case Example." Guides Newsletter 21, no. 3 (May 1, 2016): 10–14. http://dx.doi.org/10.1001/amaguidesnewsletters.2016.mayjun03.

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Abstract Causation analysis involves determining what conditions are related to a compensable injury or illness; apportionment is the allocation of responsibility among two or more probable causes; and assessing impairment is based on the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). These three are separate activities, but sometimes all three must be addressed in a single evaluation and may be required for a specified jurisdiction (eg, California). Evaluators thus must ask if jurisdictional issues dictate or influence the approach to causation and apportionment; which edition of the AMA Guides to use; and how to approach causation and apportionment in the present case example: A 63-year-old woman with rheumatoid arthritis and systemic lupus erythematosus is assessed by an orthopedic surgeon who is the agreed medical evaluator (AME). In addition to her pre-existing rheumatoid arthritis and lupus, the individual also had Sjogren's syndrome, osteoarthritis, degenerative disc disease, left carpal tunnel syndrome, osteopenia, and obesity. She has undergone multiple surgical procedures, and treatment for her collagen vascular disease includes leflunomide (immunosuppressant), hydroxychloroquine, and prednisone. In this case, impairments were not the result of “cumulative trauma” but rather were secondary to underlying chronic inflammatory disease, and her occupational permanent impairment rating accordingly would be zero.
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Harper, Dennis C. "Children's Attitudes to Physical Differences among Youth from Western and Non-Western Cultures." Cleft Palate-Craniofacial Journal 32, no. 2 (March 1995): 114–19. http://dx.doi.org/10.1597/1545-1569_1995_032_0114_csatpd_2.3.co_2.

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Children with visible physical impairments (cosmetic and orthopedic) are known to experience difficulties in social interaction with peers. Some of these social difficulties are related to attitudes toward visible physical features of children. Several research studies from Western and non-Western countries are reviewed, focusing on children's attitudes toward children with facial disfigurement. Specific social preferences for particular disabilities are noted which are related to cultural and economic factors. Children's attitudes toward facial disfigurement reflect generally low preference for social interaction in the majority of cultures studied. Children's attitudes reflect both positive and negative attributions toward facial disfigurement.
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Lobet, Sébastien, Christine Detrembleur, Firas Massaad, and Cedric Hermans. "Three-Dimensional Gait Analysis Can Shed New Light on Walking in Patients with Haemophilia." Scientific World Journal 2013 (2013): 1–7. http://dx.doi.org/10.1155/2013/284358.

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In patients with haemophilia (PWH) (from Greek “blood love”), the long-term consequences of repeated haemarthrosis include cartilage damage and irreversible arthropathy, resulting in severe impairments in locomotion. Quantifying the extent of joint damage is therefore important in order to prevent disease progression and compare the efficacy of treatment strategies. Musculoskeletal impairments in PWH may stem from structural and functional abnormalities, which have traditionally been evaluated radiologically or clinically. However, these examinations are performed in a supine position (i.e., non-weight-bearing condition). We therefore suggest three-dimensional gait analysis (3DGA) as an innovative approach designed to focus on the functional component of the joint during the act of walking. This is of the utmost importance, as pain induced by weight-bearing activities influences the functional performance of the arthropathic joints significantly. This review endeavors to improve our knowledge of the biomechanical consequences of multiple arthropathies on gait pattern in adult patients with haemophilia using 3DGA. In PWH with arthropathy, the more the joint function was altered, the more the metabolic energy was consumed. 3DGA analysis could highlight the effect of an orthopedic disorder in PWH during walking. Indeed, mechanical and metabolic impairments were correlated to the progressive loss of active mobility into the joints.
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Driscoll, A., R. Joshi, and M. Johnson. "ORTHOPEDIC CONSIDERATIONS IN THE MANAGEMENT OF A PATIENT WITH NEUROLOGICALLY INDUCED IMPAIRMENTS OF THE FOOT and ANKLE." Journal of Neurologic Physical Therapy 29, no. 4 (December 2005): 205–6. http://dx.doi.org/10.1097/01.npt.0000282373.72441.13.

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Power-deFur, Lissa. "Serving Students With Dysphagia in the Schools? Educational Preparation Is Essential!" Language, Speech, and Hearing Services in Schools 31, no. 1 (January 2000): 76–78. http://dx.doi.org/10.1044/0161-1461.3101.76.

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Speech-language pathologists employed in public schools are increasingly being faced with serving students with dysphagia because schools are serving students who may have previously been served in health care or institutional facilities. Students with significant health problems, severe disabilities, or orthopedic impairments may require the services of a school team—a team that may not include any person with adequate training in swallowing evaluation and treatment. Speechlanguage pathologists should not provide services to students with dysphagia without pursuing continuing education to acquire the necessary knowledge and skills. To do so would compromise the speech-language pathologist's ethical standards, jeopardize the student's health, and create undue liability for the school division.
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De Kegel, Alexandra, Inge Dhooge, Wim Peersman, Johan Rijckaert, Tina Baetens, Dirk Cambier, and Hilde Van Waelvelde. "Construct Validity of the Assessment of Balance in Children Who Are Developing Typically and in Children With Hearing Impairments." Physical Therapy 90, no. 12 (December 1, 2010): 1783–94. http://dx.doi.org/10.2522/ptj.20100080.

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Background Children with hearing impairments have a higher risk for deficits in balance and gross motor skills compared with children who are developing typically. As balance is a fundamental ability for the motor development of children, a valid and reliable assessment to identify weaknesses in balance is crucial. Objective The purpose of this study was to investigate the construct validity of posturography and clinical balance tests in children with hearing impairments and in children who are developing typically. Methods The study involved 53 children with typical development and 23 children with hearing impairments who were between 6 and 12 years of age and without neuromotor or orthopedic disorders. All participants completed 3 posturography tests (modified Clinical Test of Sensory Interaction of Balance [mCTSIB], unilateral stance, and tandem stance) and 4 clinical balance tests (one-leg stance with eyes open and with eyes closed, balance beam walking, and one-leg hopping). Results Three conditions of the mCTSIB, unilateral stance, and 2 clinical balance tests were able to distinguish significantly between the 2 groups. Children with hearing impairments showed more difficulties in balance tasks compared with children who were developing typically when 1 or 2 types of sensory information were eliminated or disturbed. The study showed only low to moderate correlations among the different methods of evaluating balance. Conclusions Clinical balance tests and posturography offer different but complementary information. An assessment protocol for balance consisting of posturography and clinical balance tasks is proposed. Static and dynamic balance abilities could not be differentiated and seem not to be a valid dichotomy.
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Raghubar, Kimberly P., Marcia A. Barnes, Mary Prasad, Chad P. Johnson, and Linda Ewing-Cobbs. "Mathematical Outcomes and Working Memory in Children With TBI and Orthopedic Injury." Journal of the International Neuropsychological Society 19, no. 3 (November 20, 2012): 254–63. http://dx.doi.org/10.1017/s1355617712001312.

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AbstractThis study compared mathematical outcomes in children with predominantly moderate to severe traumatic brain injury (TBI;n= 50) or orthopedic injury (OI;n=47) at 2 and 24 months post-injury. Working memory and its contribution to math outcomes at 24 months post-injury was also examined. Participants were administered an experimental cognitive addition task and standardized measures of calculation, math fluency, and applied problems; as well as experimental measures of verbal and visual-spatial working memory. Although children with TBI did not have deficits in foundational math fact retrieval, they performed more poorly than OIs on standardized measures of math. In the TBI group, performance on standardized measures was predicted by age at injury, socioeconomic status, and the duration of impaired consciousness. Children with TBI showed impairments on verbal, but not visual working memory relative to children with OI. Verbal working memory mediated group differences on math calculations and applied problems at 24 months post-injury. Children with TBI have difficulties in mathematics, but do not have deficits in math fact retrieval, a signature deficit of math disabilities. Results are discussed with reference to models of mathematical cognition and disability and the role of working memory in math learning and performance for children with TBI. (JINS, 2013,19, 1–10)
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Demeter, Stephen L., Christopher Brigham, James B. Talmage, J. Mark Melhorn, and Steven D. Feinberg. "Apportionment of Musculoskeletal Injuries." Guides Newsletter 20, no. 5 (September 1, 2015): 3–11. http://dx.doi.org/10.1001/amaguidesnewsletters.2015.sepoct01.

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Abstract When they apportion impairment in musculoskeletal cases, evaluators encounter a variety of unique issues and problems. The first step in apportionment is scientifically based causation analysis. Arbitrary or opinion-based unscientific apportionment estimates that amount to little more than speculation should be avoided. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth and Fifth Editions, are similar in their assessment of orthopedic impairment, but significant differences exist between these and the Sixth Edition. Individuals may experience impairments on several occasions. For example, if the first injury was rated using an earlier edition of the AMA Guides and a second injury occurs and is rated using a more current edition, then the most recent edition in the current jurisdiction is used to recalculate the rating for the first injury. Regarding which edition of the AMA Guides to use, evaluators should be aware of the jurisdictional requirements and also the timing to ensure that the individual is at maximum medical improvement. If the issue to be determined is apportioning the cause of the injury and not the impairment rating, then different criteria are used and the AMA Guides to the Evaluation of Disease and Injury Causation, Second Edition, is an invaluable resource. Extensive sidebars discuss qualitative vs qualitative apportionment and steps that evaluators can take to ensure that body regions and conditions are not confused (ie, that an apples-to-apples comparison is taking place).
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Sadeghi, Heydar, Paul Allard, and Morris Duhaime. "Contributions of Lower-Limb Muscle Power in Gait of People Without Impairments." Physical Therapy 80, no. 12 (December 1, 2000): 1188–96. http://dx.doi.org/10.1093/ptj/80.12.1188.

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AbstractBackground and Purpose. Although gait asymmetry in rehabilitation has been documented, little is known about propulsion and control tasks performed by each limb and how these tasks are managed between the lower limbs. The purpose of this study was to test the hypothesis that the leading limb contributes mainly to forward progression, whereas the trailing limb provides control and propels the lower limb to a lesser extent. Subjects. Nineteen men with an average age of 26.2 years (SD=3.2, range=21–34) and no history of orthopedic ailments participated in the study. Methods. Muscle power was determined using an 8-camera high-speed video system synchronized with 2 force plates. The principal-component analysis method was applied to reduce and classify 52 gait variables for each limb, and Pearson correlations were used to determine the interactions within the data sets for each limb. Results. Gait propulsion was initiated by the hip of the leading limb shortly after heel-strike and was maintained throughout the stance phase. Control was the main task of the trailing limb, as evidenced by the power absorption bursts at the hip and knee. Conclusion and Discussion. Within-limb interaction further emphasized the functional relationship between forward progression and control tasks and highlighted the importance of frontal- and transverse-plane actions during gait.
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Chernenko, T. V. "To the issue of teaching children with orthopedic impairments in Ukraine in the late nineteenth and early twentieth century." Research Notes, no. 4 (December 2, 2019): 142–50. http://dx.doi.org/10.31654/2663-4902-2019-pp-4-142-150.

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Frueh, B. Christopher, Alok Madan, J. Christopher Fowler, Sasha Stomberg, Major Bradshaw, Karen Kelly, Benjamin Weinstein, Morgan Luttrell, Summer G. Danner, and Deborah C. Beidel. "“Operator syndrome”: A unique constellation of medical and behavioral health-care needs of military special operation forces." International Journal of Psychiatry in Medicine 55, no. 4 (February 13, 2020): 281–95. http://dx.doi.org/10.1177/0091217420906659.

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Objective U.S. military special operation forces represent the most elite units of the U.S. Armed Forces. Their selection is highly competitive, and over the course of their service careers, they experience intensive operational training and combat deployment cycles. Yet, little is known about the health-care needs of this unique population. Method Professional consultations with over 50 special operation forces operators (and many spouses or girlfriends) over the past 6 years created a naturalistic, observational base of knowledge that allowed our team to identify a unique pattern of interrelated medical and behavioral health-care needs. Results We identified a consistent pattern of health-care difficulties within the special operation forces community that we and other special operation forces health-care providers have termed “Operator Syndrome.” This includes interrelated health and functional impairments including traumatic brain injury effects; endocrine dysfunction; sleep disturbance; obstructive sleep apnea; chronic joint/back pain, orthopedic problems, and headaches; substance abuse; depression and suicide; anger; worry, rumination, and stress reactivity; marital, family, and community dysfunction; problems with sexual health and intimacy; being “on guard” or hypervigilant; memory, concentration, and cognitive impairments; vestibular and vision impairments; challenges of the transition from military to civilian life; and common existential issues. Conclusions “Operator Syndrome” may be understood as the natural consequences of an extraordinarily high allostatic load; the accumulation of physiological, neural, and neuroendocrine responses resulting from the prolonged chronic stress; and physical demands of a career with the military special forces. Clinical research and comprehensive, intensive immersion programs are needed to meet the unique needs of this community.
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Sawicka, K., K. Rooks, A. Dzus, and J. Norton. "D.11 Trends in cerebral palsy in Saskatoon, Saskatchewan in the last four decades." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 43, S2 (June 2016): S16. http://dx.doi.org/10.1017/cjn.2016.84.

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Background: Cerebral Palsy (CP) is a neurological condition arising from a perinatal or intra-uterine stroke. In the past 25 years there has been a revolution in neonatal care. For over 40 years children with CP in and around Saskatoon have been treated through the Kinsman Childrens’ Centre (KCC). This is a unique population database covering all CP patients in the region. We analyzed the KCC database to determine if the recent changes in neonatal care were correlated with the incidence of CP co-morbidities. Methods: A retrospective study using a Saskatchewan database of cerebral palsy data from the last four decades. Results: Over the last 40 years the incidence of visual disturbance and diagnoses of epilepsy in children with CP have remained stable regardless of advances in neonatal care. However, incidences of spine and hip issues requiring orthopedic intervention have halved. Conclusions: We hypothesize that advances in neonatal care have been successful in decreasing the incidence of gross motor impairments however have yet to significantly impact impairments relating to cortical network function. Although improvements in care have resulted in a decreased burden of disability, there remains opportunity for further improvements, especially in the settings of epilepsy and long-term visual function.
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Sobeck, Corey, Lichelle Lenk, Sarah Knipper, Adam Rhoda, Laurie Stickler, and Paul Stephenson. "The effectiveness of functional massage on pain and range of motion measurements in patients with orthopedic impairments of the extremities." International Musculoskeletal Medicine 38, no. 1 (January 2, 2016): 21–25. http://dx.doi.org/10.1080/17536146.2016.1173342.

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Jette, Alan M., Stephen M. Haley, Wei Tao, Pengsheng Ni, Richard Moed, Doug Meyers, and Matthew Zurek. "Prospective Evaluation of the AM-PAC-CAT in Outpatient Rehabilitation Settings." Physical Therapy 87, no. 4 (April 1, 2007): 385–98. http://dx.doi.org/10.2522/ptj.20060121.

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Background and PurposeThe purpose of this study was to prospectively evaluate the practical and psychometric adequacy of the Activity Measure for Post-Acute Care (AM-PAC) “item bank” and computerized adaptive testing (CAT) assessment platform (AM-PAC-CAT) when applied within orthopedic outpatient physical therapy settings.MethodThis was a prospective study with a convenience sample of 1,815 patients with spine, lower-extremity, or upper-extremity impairments who received outpatient physical therapy in 1 of 20 outpatient clinics across 5 states. The authors conducted an evaluation of the number of items used and amount of time needed to complete the CAT assessment; evaluation of breadth of content coverage, item exposure rate, and test precision; as well as an assessment of the validity and sensitivity to change of the score estimates.ResultsOverall, the AM-PAC-CAT's Basic Mobility scale demonstrated excellent psychometric properties while the Daily Activity scale demonstrated less adequate psychometric properties when applied in this outpatient sample. The mean length of time to complete the Basic Mobility scale was 1.9 minutes, using, on average, 6.6 items per CAT session, and the mean length of time to complete the Daily Activity scale was 1.01 minutes, using on average, 6.8 items.Background and ConclusionOverall, the findings are encouraging, yet they do reveal several areas where the AM-PAC-CAT scales can be improved to best suit the needs of patients who are receiving outpatient orthopedic physical therapy of the type included in this study.
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Mosler, Dariusz. "APPLICATION OF TAEKWONDO PARALYMPIC RULES FOR SPARRING COMPETITION IN TERMS OF SPECIAL NEEDS PHYSICAL EDUCATION FOR REDUCTION OF CHALLENGING BEHAVIOUR." SOCIETY. INTEGRATION. EDUCATION. Proceedings of the International Scientific Conference 3 (May 25, 2018): 117. http://dx.doi.org/10.17770/sie2018vol3.3419.

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Aim of the study: Para Taekwondo is divided into competition of sparring (kyorugi) and patterns of defense-and-attack motions (poomse). The first one is limited to orthopedic-like disabilities, while the other also include intellectual and visual impairments. The aim of this study is to analyze rules of sparring competitions to propose a pattern of sparring-like exercises for people with intellectual disability for the purpose of reducing aggressive like behaviors that often occurs in this group. Methods: Analysis of the competition rules were compared with existing intervention and knowledge about reducing aggressive behaviors in a group of intellectually disabled people. Results: Limited area of striking, which exclude head and punishment for disobeying rules serve as similar intervention as in behavioral therapy for reducing aggressiveness. Conclusions: Limiting striking zone during practice may induce subconscious restriction in aggressive behavior, improving social adjustment for people with intellectual disability.
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Bodrova, R. A., E. I. Aukhadeev, R. R. Akhunova, and E. R. Khusainova. "Approaches to the technical means of rehabilitation selection using the ICF." Physical and rehabilitation medicine, medical rehabilitation 1, no. 4 (December 15, 2019): 64–71. http://dx.doi.org/10.36425/2658-6843-2019-4-64-71.

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The international classification of functioning, disability and health (ICF)is a classification of health components, allows to objectively determine the health status of patients, make a forecast of impaired functions and helps to assess the effectiveness of rehabilitation activities. The article describes the approach to the choice of technical means of rehabilitation with the help of ICF. UF allows you to objectively determine the health status of patients and to choose technical means of rehabilitation depending on the degree of disability: if an absolute dysfunction (96-100%) - functional beds, anti-bedsore mattress, gel cushion, wheelchair with headrest and armrests, the absorbent means absorbent diaper, chair - chair with sanitary equipment, a rigid splint with fixation of multiple joints, etc.; in severe functional disorders (50-95%) - anti-bedsore mattress, wheelchair with manual drive to move at home, wheelchair with manual drive to move on the street, anti-bedsore pillow, chair-chair with sanitary equipment, adsorbing agents, absorbent diapers, orthopedic shoes with a hard back, hard splint with fixation of several joints, walkers, anti-bedsore pillow, chair - chair with sanitary equipment, absorbent means absorbent diaper, orthopedic shoes with a hard heel, a hard splint with fixation of multiple joints, etc.; at moderate impairments (25-49%) - cane 4-point with a wide base, the axillary crutches with the device anti-skid bandage on the shoulder and the knee joint, the splint on the hand, stopiteration, etc.; in milder disorders (5-24%) - cane single-bearing alternator, the functional brace with shoulder and ankle etc.
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Wozencroft, PhD, CTRS, Angela J., Julie L. Pfeiffer, MS, and Clare E. Milner, PhD, FACSM. "Understanding knee biomechanics during physical activity and the implications for individuals with knee osteoarthritis and total knee replacements." American Journal of Recreation Therapy 12, no. 4 (August 24, 2017): 39. http://dx.doi.org/10.5055/ajrt.2013.0057.

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Evidence-based research on pain management techniques, exercise, and aquatic therapy programs provides guidance for recreation therapists working with patients with orthopedic impairments such as osteoarthritis (OA) and total knee replacements (TKRs). However, substantiated recommendations for specific physical activities to be used with this population are not available. This leaves recreation therapy (RT) practitioners with inadequate direction on the appropriate activities to prescribe to their patients. This research note is an abbreviation of a larger study (J.L.P. et al., unpublished data, 2014) and examines the knee joint kinematics and kinetics in healthy older adults during golf and bowling with comparisons made between those experienced during walking and stair ascent and descent. Understanding the knee biomechanics in a healthy population is an important first step in gathering scientific evidence needed to advance our field. Future research examining knee biomechanics related to various recreation activities will be instrumental in allowing RT specialists to develop practice guidelines for men and women with OA and TKR in the future.
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S. Jamall, Aysha, and Faizan Masood. "A MULTIDISCIPLINARY APPROACH TO MEDICALLY FRAGILE CHILDREN." Pakistan Journal of Rehabilitation 4, no. 1 (July 10, 2015): 12–14. http://dx.doi.org/10.36283/pjr.zu.4.1/004.

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Progress is determined by motivation and motivation is determined by confidence. In managing children with multiple deficits, it is necessary to extract underlying obstacles in order to make therapy most effective. The client, a ten year old girl presents with significant fear of movement. She presents with multiple fractures secondary to distal renal tubular acidosis and osteopenia. After confining herself to bed, post orthopedic surgery, she was referred to the Director of Programme of Circle of Care, a center catering to children with special needs and promoting inclusion. Individual and parental counseling along with movement and art instruction yielded mobility and improved management of activities of daily life with moderate support from equipment and family members. As a result of collaborative work and systemic awareness, client was able to exit her state of immobility and become independent in problem-solving. A multimodal approach accounts for the physical impairments as well as the social limitations presented in a child. Multidisciplinary approach with importance on counseling makes therapy effective and progress visible particularly in children who present with multiple or frail disorders/diseases.
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McCAULEY, STEPHEN R., CLAUDIA PEDROZA, SANDRA B. CHAPMAN, LORI G. COOK, GILLIAN HOTZ, ANA C. VÁSQUEZ, and HARVEY S. LEVIN. "Event-based prospective memory performance during subacute recovery following moderate to severe traumatic brain injury in children: Effects of monetary incentives." Journal of the International Neuropsychological Society 16, no. 2 (January 29, 2010): 335–41. http://dx.doi.org/10.1017/s135561770999138x.

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AbstractThere are very few studies investigating remediation of event-based prospective memory (EB-PM) impairments following traumatic brain injury (TBI). To address this, we used 2 levels of motivational enhancement (dollarsvs.pennies) to improve EB-PM in children with moderate to severe TBI in the subacute recovery phase. Children with orthopedic injuries (OI;n= 61), moderate (n= 28), or severe (n= 30) TBI were compared. Significant effects included Group × Motivation Condition (F(2, 115) = 3.73,p< .03). The OI (p< .002) and moderate TBI (p< .03) groups performed significantly better under the high-versuslow-incentive condition; however, the severe TBI group failed to demonstrate improvement (p= .38). EB-PM performance was better in adolescents compared to younger children (p< .02). These results suggest that EB-PM can be significantly improved in the subacute phase with this level ofmonetaryincentives in children with moderate, but not severe, TBI. Other strategies to improve EB-PM in these children at a similar point in recovery remain to be identified and evaluated. (JINS, 2010,16, 335–341.)
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Juchli, RMT, Lydia. "Effectiveness of Massage Including Proximal Trigger Point Release for Plantar Fasciitis: a Case Report." International Journal of Therapeutic Massage & Bodywork: Research, Education, & Practice 14, no. 2 (April 9, 2021): 22–29. http://dx.doi.org/10.3822/ijtmb.v14i2.635.

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Background: Plantar fasciitis (PF) is a common degenerative condition of the plantar fascia. Symptoms include tenderness on the plantar surface of the foot, pain on walking after inactivity, and difficulty with daily activities. Rest, non-steroidal anti-inflammatories, and manual therapies are frequently used treatments for PF. Trigger point release (TrPR) for PF has been found as a viable treatment option. Objective: To determine the effects of massage, including proximal TrPR, for pain and functional limitations in a patient with PF. Method: A student massage therapist from MacEwan University administered five massages, one initial and one final assessment over five weeks to a 46-yearold female with diagnosed PF. She complained of unilateral plantar heel pain (PHP) and deep pulling from mid-glutes to the distal lower limb bilaterally. Evaluation involved active and passive range of motion, myotomes, dermatomes, reflexes, and orthopedic tests. The treatment aim was to decrease PHP by releasing active trigger points (TrPs) along the posterior lower extremity to the plantar surface of the foot, lengthening the associated muscles and plantar fascia. Hydrotherapy, Swedish massage, TrPR, myofascial release, and stretches were implemented. Pain was measured using the numerical rating scale pre- and post-treatments, and the Foot Function Index was used to assess function at the first, middle, and last appointments to assess the effectiveness of massage including proximal TrPR for PF. Results: PHP and functional impairments decreased throughout the fiveweek period. Conclusion: The results indicate massage, including proximal TrPR, may decrease pain and functional impairments in patients with PF. Further research is necessary to measure its efficacy and confirm TrPR as a treatment option.
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Wu, Qingcong, Xingsong Wang, Fengpo Du, and Ruru Xi. "Modeling and position control of a therapeutic exoskeleton targeting upper extremity rehabilitation." Proceedings of the Institution of Mechanical Engineers, Part C: Journal of Mechanical Engineering Science 231, no. 23 (September 14, 2016): 4360–73. http://dx.doi.org/10.1177/0954406216668204.

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The applications of robotics and automation technology to the therapies of neuromuscular and orthopedic impairments have received increasing attention due to their promising prospects. In this paper, we present an actuated upper extremity exoskeleton aimed to facilitate the rehabilitation training of the disable patients. A modified sliding mode control strategy incorporating a proportional-integral-derivative sliding surface and a fuzzy hitting control law is developed to ensure robust and optimal position control performance. Dynamic modeling of the exoskeleton as well as the human arm is presented and then applied to the development of the fuzzy sliding mode control algorithm. A theoretical proof of the stability and convergence of the closed-loop system is presented using the Lyapunov theorem. Three typical real-time position control experiments are conducted with the aim of evaluating the effectiveness of the proposed control scheme. The performances of the fuzzy sliding mode control algorithm are compared to those of conventional proportional-integral-derivative controller and conventional sliding mode control algorithm. The experimental results indicate that the position control with fuzzy sliding mode control algorithm has a bandwidth about 4 Hz during operation. Furthermore, this control approach can guarantee the best control performances in term of tracking accuracy, response speed, and robustness against external disturbances.
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Gorman, Stephanie, Marcia A. Barnes, Paul R. Swank, Mary Prasad, and Linda Ewing-Cobbs. "The Effects of Pediatric Traumatic Brain Injury on Verbal and Visual-Spatial Working Memory." Journal of the International Neuropsychological Society 18, no. 1 (October 12, 2011): 29–38. http://dx.doi.org/10.1017/s1355617711001251.

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AbstractThe purpose of this study was to investigate the effects of pediatric traumatic brain injury (TBI) on verbal and visual-spatial working memory (WM). WM tasks examined memory span through recall of the last item of a series of stimuli. Additionally, both verbal and visual-spatial tests had a dual-task condition assessing the effect of increasing demands on the central executive (CE). Inhibitory control processes in verbal WM were examined through intrusion errors. The TBI group (n= 73) performed more poorly on verbal and visual-spatial WM tasks than orthopedic-injured children (n= 30) and non-injured children (n= 40). All groups performed more poorly on the dual-task conditions, reflecting an effect of increasing CE load. This effect was not greater for the TBI group. There were no group differences in intrusion errors on the verbal WM task, suggesting that problems in WM experienced by children with TBI were not primarily due to difficulties in inhibitory control. Finally, injury-related characteristics, namely days to follow commands, accounted for significant variance in WM performance, after controlling for relevant demographic variables. Findings suggest that WM impairments in TBI are general rather than modality-specific and that severity indices measured over time are better predictors of WM performance than those taken at a single time point. (JINS, 2012,18, 29–38)
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Gagner, Charlotte, Catherine Landry-Roy, Annie Bernier, Jocelyn Gravel, and Miriam H. Beauchamp. "Behavioral consequences of mild traumatic brain injury in preschoolers." Psychological Medicine 48, no. 9 (November 27, 2017): 1551–59. http://dx.doi.org/10.1017/s0033291717003221.

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AbstractBackgroundPediatric traumatic brain injury (TBI) is a leading cause of long-term disability in children and adolescents worldwide. Amongst the wide array of consequences known to occur after pediatric TBI, behavioral impairments are among the most widespread and may particularly affect children who sustain injury early in the course of development. The aim of this study was to investigate the presence of internalizing and externalizing behavioral problems 6 months after preschool (i.e. 18–60 months old) mild TBI.MethodsThis work is part of a prospective, longitudinal cohort study of preschool TBI. Participants (N = 229) were recruited to one of three groups: children with mild TBI, typically developing children and orthopedic injured (OI) children. Mothers of children in all three groups completed the Child Behavior Checklist as a measure of behavioral outcomes 6-month post-injury. Demographics, injury-related characteristics, level of parental distress, and estimates of pre-injury behavioral problems were also documented.ResultsThe three groups did not differ on baseline characteristics (e.g. demographics and pre-injury behavioral problems for the mild TBI and OI groups) and level of parental distress. Mothers’ ratings of internalizing and externalizing behaviors were higher in the mild TBI group compared with the two control groups. Pre-injury behavioral problems and maternal distress were found to be significant predictors of outcome.ConclusionOur results show that even in its mildest form, preschool TBI may cause disruption to the immature brain serious enough to result in behavioral changes, which persist for several months post-injury.
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Finley, Margaret A., Laura Dipietro, Jill Ohlhoff, Jill Whitall, Hermano I. Krebs, and Christopher T. Bever. "The Effect of Repeated Measurements Using an Upper Extremity Robot on Healthy Adults." Journal of Applied Biomechanics 25, no. 2 (May 2009): 103–10. http://dx.doi.org/10.1123/jab.25.2.103.

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We are expanding the use of the MIT-MANUS robotics to persons with impairments due exclusively to orthopedic disorders, with no neurological deficits. To understand the reliability of repeated measurements of the robotic tasks and the potential for registering changes due to learning is critical. Purposes of this study were to assess the learning effect of repeated exposure to robotic evaluations and to demonstrate the ability to detect a change in protocol in outcome measurements. Ten healthy, unimpaired subjects (mean age = 54.1 ± 6.4 years) performed six repeated evaluations consisting of unconstrained reaching movements to targets and circle drawing (with and without a visual template) on the MIT-MANUS. Reaching outcomes were aiming error, mean and peak speed, movement smoothness and duration. Outcomes for circle drawing were axis ratio metric and shoulder–elbow joint angles correlation metric (was based on a two-link model of the human arm and calculated hand path during the motions). Repeated-measures ANOVA (p≤ .05) determined if difference existed between the sessions. Intraclass correlations (R) were calculated. All variables were reliable, without learning across testing sessions. Intraclass correlation values were good to high (reaching,R≥ .80; circle drawing,R≥ .90). Robotic measurement ability to differentiate between similar but distinct tasks was demonstrated as measured by axis ratio metric (p< .001) and joint correlation metric (p= .001). Outcome measures of the MIT-MANUS proved to be reliable yet sensitive to change in healthy adults without motor learning over the course of repeated measurements.
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Kim, Bu Hwan, Jong In Im, Yong Gyun Im, and Young Jin Ahn. "Impairment Grading in Orthopedic Certificates." Journal of the Korean Orthopaedic Association 33, no. 7 (1998): 1957. http://dx.doi.org/10.4055/jkoa.1998.33.7.1957.

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Ostir, Glenn V., Pamela M. Smith, David Smith, Janida L. Rice, and Kenneth J. Ottenbacher. "Orthopedic Impairment After Medical Rehabilitation." American Journal of Physical Medicine & Rehabilitation 84, no. 10 (October 2005): 763–69. http://dx.doi.org/10.1097/01.phm.0000179440.91045.f9.

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Garkavenko, Yury Garkavenko, Mikhail G. Semyonov, and Darya О. Troschieva. "A multidisciplinary approach for the treatment of complication of hematogenous osteomyelitis in children." Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 4, no. 2 (June 15, 2016): 29–36. http://dx.doi.org/10.17816/ptors4229-36.

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Background.Severe orthopedic complications of osteomyelitis occurred in 22%–71.2% of children with osteomyelitis in previous studies. At the same time 26.5% of children with complications of osteomyelitis, according to data of The Turner Scientific and Research Institute for Children’s Orthopedics, have multiple bone lesions. The challenges involved in the orthopedic treatment of musculoskeletal system disorders are diverse and complex. In some cases, inadequate attention is paid to the need to treat the facial bones of the skull, temporomandibular joint (TMJ), and jaw bones.Aim.The aim of this paper is to demonstrate the need for a variety of options and to determine the best strategies for comprehensive medical rehabilitation, involving orthopedic and maxillofacial surgeons and other healthcare providers, for children with complications of osteomyelitis, who had destruction of the long tubular bones of the jaw.Materials and methods.Between 2011 and 2015 26 children (10 males and 16 females) aged 1.5–17 years with multiple localized lesions after osteomyelitis were treated in The Turner Scientific and Research Institute for Children’s Orthopedic. In addition to severe orthopedic disorders, there has been a loss of TMJ, which resulted in severe functional impairment and impaired development of the facial bones of the skull.Results.There was a individualized approach to the treatment of pediatric patients with complications of osteomyelitis. Early diagnosis and proper treatment prevented severe changes in the musculoskeletal system and maxillofacial area in pediatric patients.Conclusion.The modern concept of comprehensive medical rehabilitation of children with complications of osteomyelitis should include an interdisciplinary approach involving orthopedic and maxillofacial surgeons. Early diagnosis in children ensures the timely formation of individualized rehabilitation programs, designed to improve the anatomical and functional characteristics of the affected bones. Along with comprehensive orthopedic treatment, bone-reconstructive surgery of the facial bones of the skull should be focused on restoration of chewing function, external respiration, speech, and facial esthetics.
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Coulon, Christian L., and Dennis Landin. "Lyme Disease as an Underlying Cause of Supraspinatus Tendinopathy in an Overhead Athlete." Physical Therapy 92, no. 5 (May 1, 2012): 740–47. http://dx.doi.org/10.2522/ptj.20110220.

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Background and Purpose Supraspinatus tendinopathy is a common cause of shoulder pain seen in overhead athletes, but there appear to be no published cases that present Lyme disease as the underlying cause of tendinopathy. Lyme disease is diagnosed primarily by clinical signs and symptoms and then supported by laboratory tests, including enzyme-linked immunosorbant assay (ELISA) and Western blot testing. This case demonstrates the importance of a physical therapist's input and clinical role in reaching the correct diagnosis in an athlete with Lyme disease who had a diagnosis of rotator cuff impingement and tendinitis. Case Description A 34-year-old male tennis player was seen for physical therapy for right shoulder impingement and tendinitis diagnosed by an orthopedic surgeon. He was unable to participate in sporting activities due to impairments in strength and pain. Initial examination revealed distal supraspinatus impingement and tendinopathy. Outcomes The patient was not progressing with commonly accepted interventions and began to have “arthritis-like” shoulder pain in the uninvolved left shoulder. Suspicious of an underlying condition, the physical therapist informed the physician of the patient's updated status and referred the patient to the physician to discuss the current symptoms in therapy. After testing, the patient was diagnosed with chronic Lyme disease and underwent antibiotic therapy. Discussion Many active patients spend time in the outdoors, increasing their risk of exposure to a vector for Borrelia burgdorferi. Physical therapists spend a larger portion of time with patients than other health care professionals and due to this extended contact and musculoskeletal knowledge are able to recognize atypical musculoskeletal disorders or musculoskeletal manifestations of unusual pathologies, including Lyme disease.
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Brüssau, Tim, Robert Oehring, Stephan B. Felix, Marcus Dörr, and Martin Bahls. "Cardiorespiratory and metabolic responses to exercise testing during lower-body positive pressure running." Journal of Applied Physiology 128, no. 4 (April 1, 2020): 778–84. http://dx.doi.org/10.1152/japplphysiol.00328.2019.

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Exercise reduces the future cardiometabolic disease risk. However, not everyone can participate in routine physical activity because of obesity or orthopedic impairments. Body weight-supported (BWS) exercise may be an option for these individuals. Unfortunately, very little data are available with regard to BWS running in untrained healthy individuals. Yet, this information is important to assess the potential use of lower-body positive pressure (LBPP) treadmill running for the prevention of cardiometabolic disease. Twenty healthy but untrained participants (10 females, mean age 31.5 yr) were included in this study. Participants completed two exercise tests (one with 100% and one with 60% body wt) in randomized order on a LBPP treadmill. Expired gas data and heart rate (HR) were collected continuously. Blood lactate, blood pressure (BP), pulse wave velocity (PWV), and rating of perceived exertion (RPE) were measured during a 2-min break after each stage. Oxygen uptake increased significantly independent of BWS but was lower with BWS. Furthermore, we identified a significant correlation between HR and RPE independent of BWS. BP and PWV showed a large heterogeneity in response to BWS. The lower O2 requirement when running with BWS may help untrained individuals to adapt to an exercise regimen. Future research needs to explore the heterogenetic response of blood pressure and pulse wave velocity to LBPP BWS between individuals. NEW & NOTEWORTHY Lower-body positive pressure body weight-supported exercise has a lower metabolic and cardiovascular demand. Furthermore, heart rate and rating of perceived exertion are highly correlated independent of body weight support. Our data support the further examination of lower-body positive pressure exercise training for cardiovascular disease risk groups.
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Bernal Carrillo, Carissa, Christopher Barr, and Stacey George. "Cognitive Status and Outcomes of Older People in Orthopedic Rehabilitation? A Retrospective-Cohort Study." Geriatrics 5, no. 1 (March 2, 2020): 14. http://dx.doi.org/10.3390/geriatrics5010014.

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Background: Cognitive function of older people is not routinely assessed in orthopedic rehabilitation, after elective and non-elective surgery. The aim of this study was to assess cognitive impairment and its impact on both length of stay and functional outcomes, of older people admitted to orthopedic rehabilitation. Methods: Retrospective audit, inclusion criteria: aged >65 years, orthopedic diagnosis, discharged from hospital. Results: 116 files were audited, mean age of 82.3 (SD = 7.5) years. Diagnostic groups: fractured neck of femur, (n = 44, 37.98%); elective surgery (n = 42, 36.21%); and other orthopedic conditions (n = 30, 25.86%). Overall 71.55% (n = 83) had cognitive impairment, with a median of mild cognitive impairment across all diagnoses. Both measures of cognition (MoCA/FIM Cognitive) were significantly associated with length of stay (p < 0.01), function (p < 0.05), and discharge destination (p = 0.01). Conclusions: A high percentage of older orthopedic patients in rehabilitation with both elective and non-elective diagnoses have cognitive impairment. Cognitive screening is recommended for all older orthopedic patients in rehabilitation, to inform an individualized rehabilitation plan to improve outcomes and length of stay. Further research is required to explore cognitive strategies to maximize rehabilitation outcomes in the geriatric orthopedic population.
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Waryasz, Gregory R., Joseph A. Gil, Lindsay R. Kosinski, Daniel Chiou, and Jonathan R. Schiller. "Patient comprehension of hip arthroscopy: an investigation of health literacy." Journal of Hip Preservation Surgery 7, no. 2 (June 15, 2020): 340–44. http://dx.doi.org/10.1093/jhps/hnaa024.

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Abstract Several studies have demonstrated that patients have significant impairments in understanding their injury and appropriate course of management in orthopedic surgery. The purpose of this investigation is to determine if patients are able to obtain a fundamental understanding of the requisite care associated with hip arthroscopy. Any patient who elected to have hip arthroscopy was prospectively recruited to participate in the study. All patients were told they would be asked to complete a questionnaire about their surgery and post-operative instructions. The answers to each question of the questionnaire they would receive at the first post-operative visit were verbally given to each patient during the pre-operative visit. They were also given a post-operative instruction sheet on the day of surgery that contained answers to the questionnaire. At the first post-operative visit, all patients were then asked to complete a multiple-choice questionnaire prior to seeing the surgeon. A total of 56 patients (14 males, 42 females) were enrolled. All patients reported they had read the post-operative instruction sheet. The average number of correct answers was 6.5 ± 0.6 (95% CI 6 − 7) out of 11 questions (59% correct response rate ±18% [95% CI 52 − 66%]). Although we made significant pre-operative oral and written efforts to help patients achieve an elementary level of health literacy regarding their forthcoming hip arthroscopy, many patients did not achieve satisfactory comprehension. Even with instruction and information given verbally and physically (via post-operative instruction sheet) patients did not obtain satisfactory comprehension of their surgical procedure. New ways (through video, simplified cartoons or verbal explanations) must be considered in educating patients concerning surgical procedures to increase comprehension and health literacy.
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Bressel, Eadric, and Peter J. McNair. "The Effect of Prolonged Static and Cyclic Stretching on Ankle Joint Stiffness, Torque Relaxation, and Gait in People With Stroke." Physical Therapy 82, no. 9 (September 1, 2002): 880–87. http://dx.doi.org/10.1093/ptj/82.9.880.

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Abstract Background and Purpose. Continuous passive motion (cyclic stretching applied to the subject's limb) has been used for the rehabilitation of some orthopedic impairments; however, few researchers have considered its application in the management of neurological disorders such as stroke. The purpose of this study was to examine the short-term effects of prolonged static and cyclic calf stretching on passive ankle joint stiffness, torque relaxation, and gait in people with ischemic stroke. Subjects. Ten community-dwelling people (mean age=64.6 years, SD=8.76, range=53–76) who were diagnosed with a cerebrovascular accident volunteered to be subjects. Methods. Participants engaged in one 30-minute static stretch and one 30-minute cyclic stretch of the calf muscle, using an isokinetic dynamometer that also collected torque and angle measurements. Before and after treatments, 10-m walking times were collected. Ankle joint stiffness was calculated from the slope of the torque and angle curves before and immediately after treatments, and torque relaxation was calculated as the percentage of decrease in peak passive torque over the 30-minute stretch durations. Results. Ankle joint stiffness decreased by 35% and 30% after the static and cyclic stretches, respectively. Stiffness values and 10-m walk times were not different between conditions. The amount of torque relaxation was 53% greater for static stretching than for cyclic stretching. Discussion and Conclusion. These preliminary data from a very small sample of people with stroke indicate that ankle joint stiffness decreases after both prolonged static and cyclic stretches; however, neither technique appears to be better at reducing stiffness in people with stroke. Torque relaxation is greater after static stretching than after cyclic stretching, and walking speed does not appear to be influenced by the stretching treatments used in our study.
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Jackson, James C., Amy L. Kiehl, and Jennifer E. Jutte. "Cognitive Impairment After Trauma and Orthopedic Injury." Techniques in Orthopaedics 31, no. 4 (December 2016): 222–27. http://dx.doi.org/10.1097/bto.0000000000000197.

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McCrone, Angela, Angela Smith, Julie Hooper, Richard A. Parker, and Andy Peters. "The Life-Space Assessment Measure of Functional Mobility Has Utility in Community-Based Physical Therapist Practice in the United Kingdom." Physical Therapy 99, no. 12 (October 2, 2019): 1719–31. http://dx.doi.org/10.1093/ptj/pzz131.

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Abstract Background The Life-Space Assessment (LSA) has demonstrable validity and reliability among people sampled from nonclinical settings. Its properties in clinical settings, especially physical therapy services, are less well established. Objective The aim of this study was to test the construct/convergent validity, responsiveness, and floor/ceiling effects of the LSA among patients who had musculoskeletal, orthopedic, neurological, or general surgical presentations and were receiving individually tailored, community-based physical therapist interventions to address gait/balance impairments in an urban location in the United Kingdom. Design A prospective, repeated-measures, comparative cohort design was used. Methods Two hundred seventy-six community-dwelling, newly referred patients were recruited from three cohorts (outpatients; domiciliary, nonhospitalized; and domiciliary, recent hospital discharge). Data were collected from the LSA and the Performance-Oriented Mobility Assessment (POMA1) at initial assessment and discharge. Two hundred twenty-eight participants were retained at follow-up. Results The median age was 80.5 years, 73.6% were women, and the median number of physical therapist contacts over 53 days was five. LSA scores at assessment and changes over treatment distinguished between cohorts, even after adjustment for covariates. Weak correlations (0.14–0.41) were found between LSA and POMA1 scores. No LSA floor/ceiling effects were found. Significant improvements in the LSA score after the intervention were found for each cohort and for the sample overall. For the whole sample, the mean change in the LSA score was 10.5 points (95% CI = 8.3–12.8). Limitations The environmental demands participants faced were not measured. Caregivers answered the LSA questions on behalf of participants when necessary. Assessors were not always masked with regard to the measurement point. Conclusions The LSA has utility as an outcome measure in routine community-based physical therapist practice. It has satisfactory construct validity and is sensitive to change over a short time frame. The LSA is not a substitute for the POMA1; these measures complement each other, with the LSA bringing the added value of measuring real-life functional mobility.
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Berry, Michael J. "Medical Orthopedics: Conservative Management of Musculoskeletal Impairments." Medicine & Science in Sports & Exercise 36, no. 1 (January 2004): 178. http://dx.doi.org/10.1097/00005768-200401000-00032.

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Foley, Brian S. "Medical Orthopedics: Conservative Management of Musculoskeletal Impairments." American Journal of Physical Medicine & Rehabilitation 83, no. 4 (April 2004): 291. http://dx.doi.org/10.1097/00002060-200404000-00009.

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Berry, Michael J. "Medical Orthopedics: Conservative Management of Musculoskeletal Impairments." Medicine & Science in Sports & Exercise 36, no. 1 (January 2004): 178. http://dx.doi.org/10.1249/00005768-200401000-00032.

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Corrigan, B. "Medical Orthopedics Conservative Management of Musculoskeletal Impairments." Internal Medicine Journal 34, no. 4 (April 2004): 209. http://dx.doi.org/10.1111/j.1444-0903.2004.00525.x.

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Direnfeld, Lorne, James Talmage, and Christopher Brigham. "Impairment Tutorial: Functionally Limiting Upper Extremity Pain: Controversies in Impairment Rating." Guides Newsletter 8, no. 5 (September 1, 2003): 4–12. http://dx.doi.org/10.1001/amaguidesnewsletters.2003.sepoct02.

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Abstract:
Abstract This article was prompted by the submission of two challenging cases that exemplify the decision processes involved in using the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). In both cases, the physical examinations were normal with no evidence of illness behavior, but, based on their histories and clinical presentations, the patients reported credible symptoms attributable to specific significant injuries. The dilemma for evaluators was whether to adhere to the AMA Guides, as written, or to attempt to rate impairment in these rare cases. In the first case, the evaluating neurologist used alternative approaches to define impairment based on the presence of thoracic outlet syndrome and upper extremity pain, as if there were a nerve injury. An orthopedic surgeon who evaluated the case did not base impairment on pain and used the upper extremity chapters in the AMA Guides. The impairment ratings determined using either the nervous system or upper extremity chapters of the AMA Guides resulted in almost the same rating (9% vs 8% upper extremity impairment), and either value converted to 5% whole person permanent impairment. In the second case, the neurologist evaluated the individual for neuropathic pain (9% WPI), and the orthopedic surgeon rated the patient as Diagnosis-related estimates Cervical Category II for nonverifiable radicular pain (5% to 8% WPI).
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