Diaphragm Depth in Normal Subjects.

Diaphragm depth in normal subjects.

Muscle Nerve. 2013 Jul 19;
Shahgholi L, Baria MR, Sorenson EJ, Harper CJ, Watson JC, Strommen JA, Boon AJ

Introduction: Needle EMG of the diaphragm carries the potential risk of pneumothorax. Knowing the approximate depth of the diaphragm should increase the test’s safety and accuracy. Methods: Distances from the skin to the diaphragm and from the outer surface of the rib to the diaphragm were measured using B mode ultrasound in 150 normal subjects. Results: When measured at the lower intercostal spaces, diaphragm depth varied between 0.78 and 4.91 cm beneath the skin surface and between 0.25 and 1.48 cm below the outer surface of the rib. Using linear regression modeling, BMI could be used to predict diaphragm depth from the skin to within an average of 1.15 mm. Discussion: Diaphragm depth from the skin can vary by more than 4cm. When image guidance is not available to enhance accuracy and safety of diaphragm EMG, it is possible to reliably predict the depth of the diaphragm based on BMI. © 2013 Wiley Periodicals, Inc. HubMed – rehab

Microendoscopic discectomy in athletes.

J Orthop Sci. 2013 Jul 20;
Yoshimoto M, Takebayashi T, Ida K, Tanimoto K, Yamashita T

Management of lumbar disc herniation in athletes is challenging because a prolonged period of postoperative rehabilitation prevents the athlete from participating in sporting activity, resulting in loss of competitive form. No study reporting the clinical results of microendoscopic discectomy (MED) in athletes was identified in a literature search through PubMed, in spite of the relatively long history of this treatment. The objective of this study was to evaluate the efficacy of MED for athletes, focusing on their ability to quickly resume their sports activity.Twenty-five competitive athletes, who underwent MED participated in this study. The level of sporting activity patients were capable of achieving, and the time until complete return to competitive level were assessed. The Japanese Orthopaedic Association (JOA) score and short form 36 (SF-36) were also evaluated.Two patients did not return to sporting activity for reasons unrelated to the lumbar diseases. Among the remaining 23 cases, 19 (82.6 %) successfully returned to their original levels of sporting activity. One patient (4.4 %) could not return to his pre-injury level of sporting activity because of residual pain. He changed his field from a high school sports team to a low-level sports society. The mean period until complete return to competition was 10.8 weeks (range 5-16 weeks). Three patients (13.0 %) could not resume sporting activity because of residual pain. The mean improvement rate of JOA score at final follow-up was 80.4 %. Significant improvements in SF-36 were observed in all subscales except in general health perceptions.MED is a well-balanced technique which offers a high probability of return and an early return to the same level of sporting activity, both of which are optimal aims in treatment of athletes with lumbar disc herniation. HubMed – rehab

United States Hospital Admissions for Lumbar Spinal Stenosis: Racial and Ethnic Differences, 2000 through 2009.

Spine (Phila Pa 1976). 2013 Jul 18;
Skolasky RL, Maggard AM, Thorpe RJ, Wegener ST, Riley LH

Study Design. Retrospective analysis of Nationwide Inpatient Sample and US Census data.Objectives. To: (1) document national trends in surgical hospitalizations with the primary diagnosis of lumbar spinal stenosis from 2000 through 2009; and (2) evaluate how those trends relate to race and ethnicity.Summary of Background Data. In the US, the rate of lumbar spinal stenosis surgery is increasing, and understanding how changing demographic trends impact hospitalization rates for this surgery is important.Methods. Multi-variable regression models were used to determine associations between race and ethnicity and the rates of surgical hospitalization for lumbar spinal stenosis. All models were adjusted for age, sex, insurance, income status, geographic location, and comorbidities.Results. From 2000 through 2009, the overall surgical hospitalization rate increased 30%. Surgical hospitalization rates for lumbar spinal stenosis in the US varied substantially across racial and ethnic groups. In 2009, white, non-Hispanics had the highest rate (1.074 per 1,000) compared with black, non-Hispanics (0.558 per 1,000, P < 0.001) and Hispanics (0.339 per 1,000, P < 0.001). The relative differences persisted across time.Conclusions. There were substantial differences in rates of surgical hospitalization among individuals of different racial and ethnic groups. Possible causes were: (1) differences in clinical decision making among spine care providers with regard to offering surgical care to minority populations; (2) differences in access to care because of financial, educational, or geographic barriers; and (3) differences in attitudes toward surgical care among those of different racial and ethnic groups. HubMed – rehab

Rehabilitation of patients with obstructive sleep apnea syndrome.

Int J Rehabil Res. 2013 Jul 18;
Chwie?ko-Minarowska S, Minarowski L, Kuryliszyn-Moskal A, Chwie?ko J, Chyczewska E

The current treatment of obstructive sleep apnea syndrome (OSAS) focuses on alleviation of symptoms by increasing airway patency during sleep through positive airway pressure, oral appliances, changes in sleep position, weight loss, or surgical treatment. Continuous positive airway pressure (CPAP) is currently the treatment of choice and prevents upper airway obstruction, resulting in improved sleep architecture and daytime symptoms. Despite proven efficacy, adherence to CPAP treatment is still not efficient. The new methods of rehabilitation (exercise training programs, hypoglossal nerve stimulation) for patients with OSAS are currently modified. The aim of the present study was to present recent developments in the field of selected aspects of rehabilitation in patients with OSAS. Database search was focused on exercise training programs and electrostimulation of genioglossus muscle. The search for articles on the rehabilitation interventions for OSAS was performed using the PubMed database from 1966 to 2013. Most of the findings have shown beneficial effects of rehabilitation. In detail, we describe the recent developments and potential adverse effects of electrostimulation and physical exercises. According to the results of studies presented, the above therapy might support conventional treatment or may be an alternative for patients with poor compliance to CPAP therapy, mandibular advancement devices, or ineffective results of surgical procedures as well. HubMed – rehab