Surgical Rehabilitation of Paralytic Lagophthalmus by Platinum Chain Lid Loading: Focusing on Patient Benefit and Health-Related Quality of Life.
Surgical Rehabilitation of Paralytic Lagophthalmus by Platinum Chain Lid Loading: Focusing on Patient Benefit and Health-Related Quality of Life.
Filed under: Rehab Centers
Otol Neurotol. 2012 Oct 28;
Braun T, Batran H, Zengel P, Berghaus A, Hempel JM
OBJECTIVE: To evaluate patient benefit and health-related quality of life after lid loading with platinum chains in adult patients with facial palsy. STUDY DESIGN: Retrospective data collection. SETTING: Germany’s largest university clinic for otorhinolaryngology, head and neck surgery. SUBJECTS AND METHODS: Thirty-five patients received validated questionnaires determining the effects of the operation on the patients’ health-related quality of life (Glasgow Benefit Inventory). Scores can range from -100 (maximal adverse effect), through 0 (no effect), to 100 (maximal positive effect). Furthermore, satisfaction, complaints, and complications regarding the platinum chain implant were inquired. RESULTS: Twenty-two patients (63 %) returned a valid questionnaire. The mean follow-up time was 31.5 months. A complete coverage of the cornea was achieved in 95% of the patients after the first operation and in the remaining patients after a revision with implantation of a heavier weight. Complete symmetry to the nonaffected eye was perceived by 64%. Recurrent conjunctivitis was complained preoperatively by 18% and postoperatively only by a single patient. In 2 patients, a mild pseudoptosis was found postoperatively, and a single patient complained about blurred vision. The median total Glasgow Benefit Inventory score was 27.8 (p < 0.001). The health-related quality of life was raised in 91% of the patients; 87% were fully satisfied with the functional result, and 91% with the aesthetical result. 100% would again decide in favor of platinum chain lid loading. CONCLUSION: Platinum chain lid loading in facial palsy patients can significantly increase patients' health-related quality of life and leads to a high rate of patient satisfaction. HubMed – rehab
Rehabilitation of fecal incontinence: What is the influence of anal sphincter lesions?
Filed under: Rehab Centers
Tech Coloproctol. 2012 Oct 31;
Pucciani F, Raggioli M, Gattai R
BACKGROUND: The aim of this study was to evaluate the results of rehabilitative treatment of incontinent patients with anal sphincter lesions in order to verify whether these lesions influence the outcome of rehabilitation. METHODS: Between January 2008 and June 2011, 48 patients [36 women, age range 51-77 years; 12 men, age range 57-70 years] affected by fecal incontinence were included in the study. After a preliminary clinical evaluation, including the Fecal Incontinence Severity Index (FISI) score, all patients were studied by means of endoanal ultrasound and anorectal manometry. Two patients groups were identified: Group 1 comprised 27 patients with sphincter lesions and Group 2 had 21 patients without sphincter lesions. All 48 underwent a multimodal rehabilitation program. At the end of the rehabilitation program, all patients were reassessed by means of clinical evaluation and anorectal manometry and their data were analyzed. RESULTS: Although we obtained an overall significantly lower FISI score in all patients after rehabilitation (p < 0.001) when compared with pre-treatment values, our study revealed that patients with sphincter lesions had a significantly worse post-rehabilitative FISI score (p < 0.003) when compared with those patients with intact anal sphincters and that there is a linear relationship between post-rehabilitative FISI scores and severity of sphincter lesions (? (s) 0.69). CONCLUSIONS: These data suggest that rehabilitation may be less effective in patients affected by sphincter defects. HubMed – rehab
Physical activity of moderately impaired elderly stroke patients during rehabilitation.
Filed under: Rehab Centers
Physiol Meas. 2012 Oct 31; 33(11): 1923-1930
Lindemann U, Jamour M, Nicolai SE, Benzinger P, Klenk J, Aminian K, Becker C
In older adults, physical activity (PA) is promoted for public health preventive effort. It is also a major target in the rehabilitation process. Existing assessment tools in the clinical routine do not include any aspects of PA or participation and are often prone to floor or ceiling effects. The aim of this study was to document the process of rehabilitation by activity monitoring without floor or ceiling effects. Ninety-two stroke patients of a geriatric rehabilitation unit (mean age 82 years, ±6.21 years, 61% women) were included in an observational study to assess physical capacity (balance, chair rise, gait speed) and PA at admission and two weeks thereafter. PA was measured through an ambulatory activity monitor based on accelerometers and gyroscopes and showed no floor or ceiling effects. Floor effects were however documented for measures of physical capacity (admission 5-11%; follow-up 2-9%) and ceiling effects were registered for the balance test (admission 17.4%; follow-up 22.8%). Improvements were documented for measures of physical capacity as well as for PA (all p < 0.001). We conclude that the assessment of PA by activity monitoring is a valuable measure to document objectively the process of rehabilitation without floor or ceiling effects. HubMed – rehab
Cortical and Trabecular Bone Adaptation to Incremental Load Magnitudes Using the Mouse Tibial Axial Compression Loading Model.
Filed under: Rehab Centers
Bone. 2012 Oct 27;
Weatherholt AM, Fuchs RK, Warden SJ
The mouse tibial axial compression loading model has recently been described to allow simultaneous exploration of cortical and trabecular bone adaptation within the same loaded element. However, the model frequently induces cortical woven bone formation and has produced inconsistent results with regards to trabecular bone adaptation. The aim of this study was to investigate bone adaptation to incremental load magnitudes using the mouse tibial axial compression loading model, with the ultimate goal of revealing a load that simultaneously induced lamellar cortical and trabecular bone adaptation. Adult (16week old) female C57BL/6 mice were randomly divided into three load magnitude groups (5, 7 and 9N), and had their right tibia axially loaded using a continuous 2-Hz haversine waveform for 360cycles/d, 3 d/wk for 4 consecutive weeks. In vivo peripheral quantitative computed tomography was used to longitudinally assess midshaft tibia cortical bone adaptation, while ex vivo micro-computed tomography and histomorphometry were used to assess both midshaft tibia cortical and proximal tibia trabecular bone adaptation. A dose response to loading magnitude was observed within cortical bone, with increasing load magnitude inducing increasing levels of lamellar cortical bone adaptation within the upper two thirds of the tibial diaphysis. Greatest cortical bone adaptation was observed at the midshaft where there was a 42% increase in estimated mechanical properties (polar moment of inertia) in the highest (9N) load group. A dose response to load magnitude was not clearly evident within trabecular bone, with only the highest load (9N) being able to induce measureable adaptation (31% increase in trabecular bone volume fraction at the proximal tibia). The ultimate finding was that a load of 9N (engendering a tensile strain of 1,833 ?? on medial surface of the midshaft tibia) was able to simultaneously induce measurable lamellar cortical and trabecular bone adaptation when using the mouse tibial axial compression loading model in 16week old female C57BL/6 mice. This finding will help plan future studies aimed at exploring simultaneous lamellar cortical and trabecular bone adaptation within the same loaded element.
HubMed – rehab
New devices and drugs on the horizon in pain management.
Filed under: Rehab Centers
J Neurosurg Sci. 2012 Dec; 56(4): 313-22
Saulino M, Shaw E
Chronic pain is a common condition that confers a substantial burden – physical, psychological, and economic – to individuals and society. There are a wide variety of interventions available for this condition. Chronic pain that is refractory to conventional treatment remains a challenge to physicians and patients alike. The purpose of this review is to describe recent developments for chronic pain management including pharmaceutical interventions and medical device therapy. For drug therapy, this review will focus on three classes of medications: antidepressants, opiates and antiepileptic medications. For device therapy, the utility of electrical stimulation to neural structures (dorsal column, peripheral nerve and deep brain) and intrathecal therapy for chronic pain will be described.
HubMed – rehab
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