Biomechanical Properties of the Plantar Flexor Muscle-Tendon Complex 6 Months Post-Rupture of the Achilles Tendon.

Biomechanical Properties of the Plantar Flexor Muscle-Tendon Complex 6 Months Post-Rupture of the Achilles Tendon.

J Orthop Res. 2013 May 6;
McNair P, Nordez A, Olds M, Young SW, Cornu C

We compared the effects of a non-weight bearing protocol (NWB) and a weight bearing (WB) protocol on energy stored, stiffness, and shock absorption in the plantar flexor muscle-tendon unit of patients managed non-operatively following an Achilles tendon rupture. Thirty-eight subjects were randomized to a WB cast fitted with a Bohler iron or a traditional non-weight-bearing cast. At a 6-month follow-up, a biomechanical assessment utilizing an isokinetic dynamometer allowed measurement of peak passive torque, energy stored, shock absorption, and stiffness. The WB group had greater peak passive torque (?20%). Irrespective of group, peak passive torque in unaffected legs was greater (?26%) than affected legs. Across the groups, energy stored in the NWB group was 74% of the WB group. The energy stored in affected legs was 80% of that in unaffected legs. Shock absorption was not significantly different across legs or groups. Irrespective of group, affected legs had significantly less stiffness (20-40%). While the augmentation of plaster with a Bohler iron to allow increased weight bearing had positive effects, deficits in affected compared to unaffected legs irrespective of group were notable, and should be addressed prior to participation in vigorous physical activities. © 2013 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res XX:XXX-XXX, 2013. HubMed – rehab


The occlusal guard: a simplified technique for fabrication and equilibration.

Gen Dent. 2013 May-Jun; 61(3): 49-54
Antonelli J, Hottel TL, Siegel SC, Brandt R, Silva G

Hard occlusal guards have been used effectively to treat myofacial pain originating from parafunctional activities. Also, they can protect the natural dentition when it opposes porcelain restorations, help to evaluate changes in occlusal vertical dimension during full mouth rehabilitation, minimize further tooth loss in patients with abfraction lesions, and redirect occlusal loads more favorably onto dental implant-supported prostheses. A simplified technique is described to fabricate a properly designed wax model of an occlusal guard that can be processed in acrylic in the same manner used to construct a complete denture. HubMed – rehab


[Cochlear implants in children and adolescents].

HNO. 2013 May; 61(5): 388-98
Mlynski R, Plontke S

Cochlear implants (CI) have become standard in the treatment of prelingual, postlingual and perilingual deafness and hearing loss in children. Bilateral implants are considered standard for bilaterally affected children. The benefits for speech and language development, as well as speech intelligibility brought by CI-enabled hearing are greatest if these are received as soon after diagnosis as possible. Continued improvements in preoperative diagnostics, electrode design, speech coding strategies and surgical techniques, have broadened the CI applications spectrum. Nowadays-with the exception of cochlear- and cochlear nerve aplasia-almost all malformations are manageable with CIs. New indications concern partial and unilateral deafness. Treatment with CIs requires exceptional team work. In addition to ongoing medical care of the children, the involvement of parents and relatives in the cooperation between surgeons, audiologists, teachers and specialist centers is important for successful rehabilitation. HubMed – rehab


The cooperative international neuromuscular research group Duchenne natural history study: Glucocorticoid treatment preserves clinically meaningful functional milestones and reduces rate of disease progression as measured by manual muscle testing and other commonly used clinical trial outcome measures.

Muscle Nerve. 2013 Feb 6;
Henricson EK, Abresch RT, Cnaan A, Hu F, Duong T, Arrieta A, Han J, Escolar DM, Florence JM, Clemens PR, Hoffman EP, McDonald CM,

Introduction: Glucocorticoid (GC) therapy in Duchenne muscular dystrophy (DMD) has altered disease progression, necessitating contemporary natural history studies. Methods: The Cooperative Neuromuscular Research Group (CINRG) DMD Natural History Study (DMD-NHS) enrolled 340 DMD males, ages 2-28 years. A comprehensive battery of measures was obtained. Results: A novel composite functional “milestone” scale scale showed clinically meaningful mobility and upper limb abilities were significantly preserved in GC-treated adolescents/young adults. Manual muscle test (MMT)-based calculations of global strength showed that those patients <10 years of age treated with steroids declined by 0.4±0.39 MMT unit/year, compared with -0.4±0.39 MMT unit/year in historical steroid-naive subjects. Pulmonary function tests (PFTs) were relatively preserved in steroid-treated adolescents. The linearity and magnitude of decline in measures were affected by maturational changes and functional status. Conclusions: In DMD, long-term use of GCs showed reduced strength loss and preserved functional capabilities and PFTs compared with previous natural history studies performed prior to the widespread use of GC therapy. Muscle Nerve, 2013. HubMed – rehab