Bilateral Diabetic Charcot Foot.

Bilateral diabetic Charcot foot.

Aust Fam Physician. 2013 Jan-Feb; 42(1-2): 55-6
Fauzi AA, Yang CT

Case study Max, a school teacher aged 52 years, presented with 5 days of left midfoot swelling. It was initially painless, but over the past 2 days had become painful after walking. He reported no fevers or other joint swelling and had no recollection of recent trauma. He had been diagnosed 17 years previously with type 2 diabetes mellitus, which was now complicated by nephropathy and retinopathy. HubMed – rehab


Cross-education for improving strength and mobility following distal radius fractures: A preliminary randomized controlled trial.

Arch Phys Med Rehabil. 2013 Mar 22;
Magnus CR, Arnold CM, Johnston G, Dal-Bello Haas V, Basran J, Krentz JR, Farthing JP

OBJECTIVE: To evaluate the effects of cross-education (contralateral effect of unilateral strength training) during recovery from unilateral distal radius fractures on muscle strength, range of motion (ROM), and function. Design: Randomized controlled trial (26 week follow-up). SETTING: Hospital, Orthopeadic fracture clinic. PARTICIPANTS: Women over age 50 with a unilateral distal radius fracture. INTERVENTIONS: Participants were randomized to standard rehabilitation (Control), or standard rehabilitation plus strength training (Train). Standard rehabilitation included forearm casting for 40.4(±6.2days), and hand exercises for the fractured extremity. Non-fractured hand strength training for the training group began immediately post fracture, and was conducted at home 3 times/week for 26 weeks. MAIN OUTCOME MEASURES: The primary outcome measure was peak force (handgrip dynamometer). Secondary outcomes were ROM (flexion/extension; supination/pronation) via goniometer and the Patient Rated Wrist Evaluation Questionnaire (PRWE) for the fractured arm. RESULTS: Fifty-one participants were randomized and 39 participants were included in the final data analysis. For the fractured hand, the training group (17.3±7.4kg) was significantly stronger than the control group (11.8±5.8kg) at 12 weeks post-fracture; p<0.017. There were no significant strength differences between the training and control groups at 9 (12.5±8.2kg; 11.3±6.9kg) or 26 weeks (23.0±7.6kg; 19.6±5.5kg) post-fracture, respectively. Fractured hand ROM showed the training group had significantly improved wrist flexion/extension (100.5±19.2°) than the control group (80.2±18.7°) at 12 weeks post-fracture; p<0.017. There were no significant differences between the training and control groups for flexion/extension ROM at 9 (78.0±20.7°; 81.7±25.7°) or 26 weeks (104.4±15.5°; 106.0±26.5°) or supination/pronation ROM at 9 (153.9±23.9°; 151.8±33.0°), 12 (170.9±9.3°; 156.7±20.8°;) or 26 weeks (169.4±11.9°; 162.8±18.1°), respectively. There were no significant differences in PRWE between the training and control groups at 9 (54.2±39.0) (65.2±28.9), 12 weeks (36.4±37.2) (46.2±35.3) or 26 weeks (23.6±25.6), (19.4±16.5), respectively. CONCLUSIONS: Strength training the non-fractured limb after a distal radius fracture was associated with improved strength and ROM in the fractured limb at 12 weeks post-fracture. These results may have important implications for rehabilitation strategies following unilateral injuries. HubMed – rehab


Development and assessment of a Community Follow-up Questionnaire for the Rick Hansen Spinal Cord Injury Registry.

Arch Phys Med Rehabil. 2013 Mar 22;
Noreau L, Cobb J, Bélanger LM, Dvorak MF, Noonan VK, Leblond J

OBJECTIVE: To develop a comprehensive community follow-up questionnaire for participants enrolled in the Rick Hansen Spinal Cord Injury Registry (RHSCIR). DESIGN: Development and preliminary assessment of measurement properties (reliability and validity) of instruments used during a community follow-up and aligned with the International Classification of Functioning, Disability and Health (ICF). SETTING: General community setting across Canada. PARTICIPANTS: People with spinal cord injury living in the community. Intervention(s): Not applicable. MAIN OUTCOME MEASURE(S): A comprehensive follow-up questionnaire referred to as the RHSCIR Community Follow-up Questionnaire V2.0 (CFQ-V2.0) includes eight instruments. Four new instruments were developed, two existing instruments were modified and two previously published instruments were included RESULTS: Intra- and inter-rater reliability statistics (Gwet’s AC1) support the psychometric value of the new and modified instruments. Correlations between new and existing instruments and between groups based on severity of injury support the construct validity of the secondary complications and Person-perceived Participation Questionnaires. CONCLUSION: (s): The RHSCIR CFQ-V2.0 is a comprehensive community follow-up questionnaire thataligns to the ICF. Initial study results suggest that it covers all relevant aspects of community living and the measurement properties are promising. HubMed – rehab


Learning to Live With a Loved One With Mild Cognitive Impairment: Effectiveness of a Waiting List Controlled Trial of a Group Intervention on Significant Others’ Sense of Competence and Well-being.

Am J Alzheimers Dis Other Demen. 2013 Mar 25;
Joosten-Weyn Banningh LW, Vernooij-Dassen MJ, Vullings M, Prins JB, Olde Rikkert MG, Kessels RP

This controlled study examines the efficacy of a comprehensive group program aimed at care partners of patients with mild cognitive impairment (MCI), which comprises elements of psychoeducation, cognitive rehabilitation, and cognitive behavioral therapy. Pre- and posttreatment quantitative and qualitative data were collected in the significant others of 84 patients with MCI, 27 of whom had first been assigned to a waiting list, thus serving as their own control group. Also, the significant others rated their sense of competence, well-being, distress, acceptance, helplessness, and awareness. Quantitative data analysis did not reveal statistically significant differences between the control and the intervention condition, but qualitative results suggest that at program completion the significant others reported gains in knowledge, insight, acceptance, and coping skills. In the present sample of significant others, the group intervention was not proven effective. Suggestions for program adjustments and alternative outcome measures are discussed. HubMed – rehab



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