Rehab Centers: Gait Analysis With Cognitive-Motor Dual-Tasks to Distinguish Fallers From Non Fallers Among Rehabilitating Stroke Patients.

Gait analysis with cognitive-motor dual-tasks to distinguish fallers from non fallers among rehabilitating stroke patients.

Filed under: Rehab Centers

Arch Phys Med Rehabil. 2012 Nov 24;
Baetens T, Dekegel A, Palmans T, Oostra K, Vanderstraeten G, Cambier D

OBJECTIVE: To evaluate fall risk in stroke patients based on single and dual-task gait analyses. To investigate the difference between two cognitive tasks in the dual-task paradigm. DESIGN: Prospective cohort study. SETTING: (Rehabilitation) hospitals. PARTICIPANTS: Sub-acute stroke patients, able to walk independently with or without walking aids, while performing a verbal task. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Functional gait measures were Functional Ambulation Categories (FAC) and use of a walking aid. Gait measures were evaluated by the GaitRite® under single and dual task (DT)-conditions. For the single-task subjects were instructed to walk at their usual speed. One of the DT was a verbal fluency-task (DT-verb) whereby subjects had to walk while simultaneously enumerate as many different animals as possible. For the other DT (DT-count) participants had to walk while performing serial subtractions. After inclusion, participants kept a 6-month falls diary. RESULTS: From the 32 included patients 18 (56.3%) fell. Ten (31.3%) were single fallers (SF), and 8 (25.0%) were multiple fallers (MF). Fallers (F) more frequently used a walking aid and more frequently needed an observatory person for walking safely (FAC 3) than non-fallers (NF). Two gait decrement parameters in DT-count could distinguish potential F from NF; decrement in stride length % (P=0.043) and non-paretic step length % (p=0.047). Regarding the division in three groups (NF, SF and MF) only MF had a significant higher percentage of decrement for paretic step length (P=0.023) than SF. CONCLUSIONS: Examining the decrement of spatial gait characteristics (stride length, paretic and non-paretic step length) during a DT addressing the working-memory can identify fall prone sub-acute stroke patients.
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Can balance in children with cerebral palsy improve through use of an activity promoting computer game?

Filed under: Rehab Centers

Technol Health Care. 2012 Jan 1; 20(6): 501-10
Ramstrand N, Lygnegård F

Introduction: This study aimed to evaluate if use of an activity promoting computer game, used in the home (Nintendo Wii Fit; Nintendo Co Ltd, Japan), could influence balance related outcome measures in children with cerebral palsy. Method: Eighteen children with hemiplegic or diplegic cerebral palsy were recruited for the study. A randomised cross-over design was used with children tested at baseline, after five weeks of playing Wii Fit games and after five weeks without any intervention. Outcome measures of interest included: performance on the modified sensory organisation test, reactive balance test and rhythmic weight shift test. Results: No significant difference was observed between testing occasions for any of the balance measures investigated (p > 0.05). Conclusion: Our results suggest that use of a Nintendo Wii balance board and Wii Fit software for a minimum of thirty minutes per day in the patient’s own home, over a five week period, is not effective as a balance training tool in children with cerebral palsy.
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Simultaneous bilateral trochanteric fractures—a report of four cases.

Filed under: Rehab Centers

Chin J Traumatol. 2012 Dec 1; 15(6): 360-3
Verma V, Kundu ZS, Batra A, Singh R, Sangwan SS, Gupta P

Simultaneous bilateral intertrochanteric fractures are very rare. There is a paucity of data in current literature documenting patients with such kind of hip fractures. It is severe and potentially life-threatening, associated with a high morbidity. The major determinants of successful outcome are high vigilance, early single stage stabilization and mobilization as well as management of associated comorbid conditions that may influence the long term rehabilitation of patients. Here we reported 4 cases of concurrent bilateral trochanteric fractures along with review of the literature. Our study aimed to discover its frequency, identify the injury mechanisms as well as factors present in the pathogenesis of these fractures, and outline the available treatment modalities.
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