Effects of Balance Training on Functional Outcome After Total Knee Replacement in Patients With Knee Osteoarthritis: A Randomized Controlled Trial.

Effects of balance training on functional outcome after total knee replacement in patients with knee osteoarthritis: a randomized controlled trial.

Clin Rehabil. 2013 Mar 5;
Liao CD, Liou TH, Huang YY, Huang YC

Objective:To evaluate the effectiveness of additional balance training on mobility and function outcome in patients with knee osteoarthritis after total knee replacement.Design:A prospective intervention study and randomized controlled trial.Setting:A university-based teaching hospital.Participants:Patients who received total knee replacement surgery were recruited sequentially from the orthopedic department. They were randomly assigned to either the experimental group or control group.Interventions:The control group received conventional function training for eight weeks. The experimental group not only received the same conventional training as the control group, but also received additional balance exercises in each admission.Main outcome measures:Before and after training we took the following measurements: distance of functional forward reach; duration of single leg stance; timed sit-to-stand test; timed up-and-down stair test; timed 10-m walk; timed up-and-go test; and the Western Ontario and McMaster Universities Osteoarthritis Index score.Results:58 patients in the experimental group with a mean (SD) age of 71.4 (6.6) years and 55 in the control group with mean (SD) age of 72.9 (7.3) years, completed the study. After eight-weeks intervention with additional balance exercises, the experimental group demonstrated significant changes in 10-m walk (P < 0.001, 95% confidence interval (CI): 3.6 to 4.4 seconds) and in timed up-and-go (P < 0.001, 95% confidence interval: 2.6 to 3.4 seconds) tests. Significant changes of all other measures and Western Ontario and McMaster Universities Osteoarthritis Index score were also observed in the experimental group (all P < 0.001).Conclusion:Additional balance training exerted a significant beneficial effect on the function recovery and mobility outcome in patients with knee osteoarthritis after total knee replacement. HubMed – rehab


Electrophysiological and ultrasonographic findings in ulnar neuropathy with martin-gruber anastomosis.

Muscle Nerve. 2012 Aug 3;
Cho NS, Kim DH, Kim MY, Park BK

INTRODUCTION: It is important to understand the presence of Martin-Gruber anastomosis in patients with complete ulnar neuropathy at the elbow. Case Report: We describe a patient with complete ulnar neuropathy at the elbow and Martin-Gruber anastomosis in the forearm, mimicking incomplete ulnar neuropathy with complete conduction block in the forearm segment. Ultrasonography of the ulnar nerve around the elbow demonstrated severe swelling of the ulnar nerve, which was compatible with severe ulnar neuropathy at the elbow. Conclusions: This case report demonstrates that combination of ultrasonography with electrophysiological studies can provide more detailed information about the changes of nerve structures and lesion sites. Muscle Nerve, 2013. HubMed – rehab


Perspectives of Aging Among Persons Living With Chronic Obstructive Pulmonary Disease.

West J Nurs Res. 2013 Mar 4;
Low G, Ross C, Stickland M, Wilson D, Wong E

Among pulmonary rehabilitation attendees, we explored their tendency to downplay versus acknowledge physical and psychosocial health limitations, and the subsequent impact either strategy had on how they perceive their own aging process. Participants (N = 87) were 44 to 82 years of age, and diagnosed with chronic obstructive pulmonary disease (COPD). The St. George’s Respiratory Questionnaire measured their health limitations. The Attitudes to Aging Questionnaire captured their perspectives of aging. Participants downplayed their symptoms and psychosocial impact, and remained most positive about psychosocial loss and carefully reserved about psychological growth. Acknowledged activity impairment had negative consequences, however, for their perspectives of physical change. These findings signify a balanced identity and perspective of aging that supports the Identity Process Theory. We encourage nurses and other practitioners, and researchers in pulmonary rehabilitation setting, to use this theory to better understand how people with COPD adapt to aging. HubMed – rehab


What are the Exercise-Based Injury Prevention Recommendations for Recreational Alpine Skiing and Snowboarding? : A Systematic Review.

Sports Med. 2013 Mar 6;
Hébert-Losier K, Holmberg HC

BACKGROUND: Skiing and snowboarding are two activities that significantly contribute to the total number of sports-related injuries reported per year. Strength, endurance and cardiovascular fitness are central components in sports injury prevention. Providing exercises and training recommendations specific to recreational skiers and snowboarders is important in both injury prevention and reducing the prevalence and cost associated with alpine winter sports injuries. OBJECTIVE: The aim of this paper was to systematically review the literature for injury prevention recommendations specific to recreational alpine skiers and snowboarders. The focus was to discern recommendations that targeted physical fitness, exercise and/or training in the prevention of musculoskeletal injuries in these two sports. DATA SOURCES: Fourteen electronic databases were searched in October 2011 using relevant MeSH terms and key words. STUDY SELECTION: Articles were included if they addressed injury prevention, recreational alpine skiing or snowboarding and musculoskeletal injuries. Only original research articles published in peer-reviewed journals, and in the English-language, were reviewed. Articles on elite athletes were excluded. STUDY APPRAISAL AND SYNTHESIS METHODS : Two independent reviewers quality assessed articles meeting inclusion criteria using a modified version of the Downs and Black Quality Assessment Checklist. Data on study population, study design, study location and injury prevention recommendation(s) were extracted from articles using a standard form and subsequently categorized to facilitate data synthesis. RESULTS: A total of 30 articles met the inclusion criteria and were reviewed, having an average ± standard deviation quality score of 72 % ± 17 % (range: 23-100 %). Overall, 80 recommendations for the prevention of musculoskeletal injuries in recreational alpine skiers and snowboarders were identified and classified into five main groups: equipment (n = 24), education and knowledge (n = 11), awareness and behaviour (n = 15), experience (n = 10) and third-party involvement (n = 20). No recommendations pertained to physical fitness, exercise and/or training per se, or its role in preventing injury. LIMITATIONS: A comprehensive meta-analysis was not possible because several articles did not report data in sufficient detail. CONCLUSIONS: The importance of targeting physical fitness in injury prevention is accepted in sports medicine and rehabilitation; yet, there was a paucity of articles included in this review that explicitly investigated this aspect with regards to recreational alpine skiing and snowboarding. The most frequent recommendations for preventing skiing and snowboarding injuries concerned equipment or the involvement of third parties. The dominance of equipment-related measures in the injury prevention literature may be rationalized from a sports biomechanics viewpoint, as these activities involve high velocities and impact forces. Nonetheless, this also indicates a need for appropriate levels of strength, endurance and conditioning to meet the technical demands of these sports. Bearing this in mind, future research is encouraged to investigate the role of physical fitness, exercise and training in decreasing the incidence and severity of skiing and snowboarding injuries in recreational athletes. HubMed – rehab