The Effect of Repetitive Rhythmic Precision Grip Task-Oriented Rehabilitation in Chronic Stroke Patients: A Pilot Study.

The effect of repetitive rhythmic precision grip task-oriented rehabilitation in chronic stroke patients: a pilot study.

Filed under: Rehab Centers

Int J Rehabil Res. 2013 Mar; 36(1): 81-7
Dispa D, Lejeune T, Thonnard JL

Most chronic stroke patients present with difficulty in the manipulation of objects. The aim of this study was to test whether an intensive program of precision grip training could improve hand functioning of patients at more than 6 months after a stroke. This was a cross-over study; hence, at inclusion, the patients were randomly divided into two groups: one group started with the bilateral movement therapy and the other group started with the unilateral movement therapy. The patients were assessed on four separate occasions across a 12-week period: (a) at inclusion in the study, (b) 4 weeks later, immediately before the first rehabilitation session, (c) after 4 weeks of one therapy, and (d) after a further 4 weeks of the other therapy. Ten patients completed two consecutive 4-week sessions (1 h, 3 days/week) of therapy. The therapy comprised unilateral and bilateral repetitive grip-lift task-oriented rehabilitation with rhythmic auditory cueing. The grip-lift force coordination, digital dexterity, manual ability, and the level of satisfaction (with activities and participation) were assessed. A one-way repeated-measure analysis of variance across the four evaluations did not detect any objective improvement in the measured variables after 8 weeks of specific intensive training. Precision grip training was shown to not generate significant improvement in the grip-lift task, digital dexterity, manual ability, or satisfaction in chronic stroke patients.
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PRM programmes of care and PRM care pathways: European approach, developments in France.

Filed under: Rehab Centers

Int J Rehabil Res. 2013 Mar; 36(1): 1-5
Korvin Gd, Yelnik AP, Ribinik P, Calmels P, Moine FL, Delarque A

The development of European Union of Medical Specialists (UEMS) physical and rehabilitation medicine programmes of care (PRMPC) and physical and rehabilitation medicine care pathways (PRMCP) in France is a good example of the positive interaction between European and national organizations. PRMPC were defined at the European level to offer a robust template for the description and assessment of physical and rehabilitation medicine (PRM) clinical activity in various fields and contexts. An accreditation procedure was organized as a peer review. It has started to provide very informative documents. In France, discussions on this topic began in 2000. At the end of the same decade, the European approach fostered the interest of French PRM organizations in a period of negotiating with public authorities about two crucial issues: specifications required for reimbursement of functional instrumental assessments in PRM practice and funding of PRM care in postacute facilities. The French Society of PRM (SOFMER) decided to describe the PRM scope in a systematic way, emphasizing the best balance between patient needs, rehabilitation goals, relevant means and justified funding. Nine ‘PRMCP’ have been published since 2010 and others are in progress. PRMPC and PRMCP share the same concern about the best response offered by PRM to patients’ needs. The first approach is the description of a local organization with respect to both scientific evidence and local conditions. The latter is an outline of PRM intervention related to a multidimensional pattern of patients’ situations. Both enhance the role of PRM doctors, whose expertise is necessary for making a synthesis of medical diagnosis and functional assessment, for setting up a patient-centred care strategy and for supervising the rehabilitation team’s intervention.
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Benign lytic lesions of the femoral neck: mid-term results of extended curettage and sartorius muscle pedicle bone grafting.

Filed under: Rehab Centers

Arch Orthop Trauma Surg. 2013 Feb 3;
Kundu ZS, Gogna P, Sangwan SS, Garg R, Kamboj P, Singla R

INTRODUCTION: Benign lytic lesions of bone encompass a group of neoplastic or developmental disorders of human skeleton. They may involve different sites with varied clinical presentation and pattern of aggressiveness for which the treatment strategy needs to be tailored accordingly. Planning a treatment protocol for a lytic lesion in the femoral neck is a matter of concern for the operating surgeon with due consideration to the risks involved. PATIENTS AND METHOD: This prospective study comprised of 16 patients (9 females and 7 males) with an average age of 23.37 years (range 14 to 35) who presented with lytic lesion in the neck of femur. Only those lesions which were involving the anterior or the inferior aspect of the femoral neck in which the destruction was more than 50 % of the cortex in a single view or there was a pathological fracture were included in this study. There were six cases of giant cell tumour, five cases of fibrous dysplasia, four cases of aneurysmal bone cyst and one case of benign fibrous histiocytoma. All the lesions were operated using anterior approach, and after extended curettage, the cavity was packed with bone chips and sartorius-based muscle pedicle bone grafting (MPBG) was done. Four patients presented with pathological fracture in which the fibula strut grafting was done in addition to MPBG. The patients were assessed using Musculoskeletal Tumour Society (MSTS) score. The mean follow-up period was 32 months (range 26-74 months). RESULTS: The average time to clinical healing was 8 weeks (range 6-12 weeks) in patients without pathological fracture at the presentation. At final follow-up, the average MSTS score was 28.2 and full radiological consolidation had occurred in all but one patient who developed recurrence. There was no evidence of avascular necrosis or pathological fracture in any of the cases. CONCLUSIONS: Sartorius muscle pedicle bone grafting using anterior approach is a good and reliable option in patients presenting with benign lytic lesion in the neck of femur.
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Immediate Placement of Tapered Effect (TE) Implants: 5-Year Results of a Prospective, Multicenter Study.

Filed under: Rehab Centers

Int J Oral Maxillofac Implants. 2013 Jan; 28(1): 261-9
Wilson TG, Roccuzzo M, Ucer C, Beagle JR

Purpose: To evaluate the success and survival of immediately placed tapered implants to support fixed restorations in the maxilla and mandible. Materials and Methods: The study was a prospective, multicenter, non-interventional study of patients requiring tooth extraction who requested an implant-supported restoration in the maxilla or mandible. Patients received at least one tapered implant (either immediately after tooth extraction or at a later time point). Abutments were placed 42 to 56 days after surgery, and prostheses were placed after a further 14 days. Treatment and implant success were the primary effectiveness criteria, and secondary parameters included radiographic bone loss, patient satisfaction, and gingival health. Results: A total of 436 patients were enrolled, of whom 376 were included in the safety analysis. Single implants were placed in 77% of patients, two implants in 16%, and three or more implants in the remainder. The cumulative implant survival rates for immediately placed implants were 98.3% after 1 year and 97.7% from 2 to 5 years. Patient satisfaction was good or excellent in most patients and the majority of implants showed no or < 1-mm change in bone level for up to 5 years. Conclusions: The survival rate of immediately placed tapered implants was comparable to that found in other studies. Immediate implant placement with tapered implants can allow rapid rehabilitation with no adverse impact on implant survival. HubMed – rehab


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