Urinary Bag Decontamination for Long-Term Use: A Systematic Review.

Urinary Bag Decontamination for Long-term Use: A Systematic Review.

J Wound Ostomy Continence Nurs. 2013 May-Jun; 40(3): 299-308
Wilde MH, Fader M, Ostaszkiewicz J, Prieto J, Moore K

A systematic review of research on urinary drainage bag decontamination methods was conducted to evaluate existing evidence for practice related to long-term urinary catheter users. Six trials were found that met inclusion criteria. In addition, 9 clinical practice guidelines about urinary catheter care from 3 English-speaking countries were examined. Two studies were of modest quality; they included a randomized trial of 54 persons in a rehabilitation hospital and a laboratory comparison of 5 decontamination products. Three other articles included in the review were case series. All were published between 1985 and 1994. Bleach (NaClO) solutions of varying concentrations (0.06%-1%) were most often tested, and results were similar in controlling microbial contamination in the drainage bags. However, the studies often lacked definitions or standardization of key outcome measures such as safety and ease of the procedure and integrity of the drainage bag. The clinical practice guidelines differed in advice on bag decontamination, and some did not address it. Further research is recommended to evaluate the efficacy of decontamination procedures in patients with long-term indwelling catheters and drainage bags. HubMed – rehab


The effect of limitation in ankle dorsiflexion on knee joint function. A pilot study.

Ortop Traumatol Rehabil. 2013 Apr 30; 15(2): 159-68
Dudzi?ski K, Mulsson M, Cabak A

Background A restriction in ankle dorsiflexion is a common complication of ankle fractures. This kind of dysfunction, if severe, can significantly influence gait. A restriction in ankle dorsiflexion (forward movement of the shin relative to the foot) can cause, among others, hyperextension of the knee during the stance phase. The length of leading leg step is shortened and alternant walk downstairs is very difficult. The aim of this study was to examine the correlation between the range of dorsiflexion in the ankle joint and the range of extension (hyperextension) in the knee joint. Material and Methods The study enrolled 17 patients after ankle joint fractures treated conservatively or surgically. The extension ranges of motion in the ankle and knee joints were assessed by goniometry to compare these values in injured vs. healthy limbs. Non-parametric methods (the Wilcoxon signed-rank test) were used for the analysis. Results The results showed limitation in ankle dorsiflexion in the fractured limb, which amounted to 4.40 vs. 16.00 in healthy limbs in all patients. This difference was statistically significant (p<0.001). There was also a significantly (p<0.001) greater range of knee hyperextension on the side of injury (5.00 vs. 1.90 in healthy limbs). Conclusions 1. Post-traumatic restriction of ankle dorsiflexion can cause knee joint overload. 2. Examinations of knee function during walking should be carried out in patients with trauma-related dysfunctions of the ankle joint in order to prevent secondary musculoskeletal abnormalities. HubMed – rehab


Dry needling as a method of tendinopathy treatment.

Ortop Traumatol Rehabil. 2013 Apr 30; 15(2): 109-16
Nagraba L, Tuchalska J, Mitek T, Stolarczyk A, Deszczy?ski J

Tendinopathy is a broad concept that describes any painful condition that occurs in or around a tendon.The ideal treatment for tendinopathy is still nebulous. Dry needling is a treatment method in which a special needle is placed into the focus of tendinosis. The aim of this procedure is to form fenestrations which may initiateadvantageous bleeding and thus bring about the influx of growth factors (activating healing and regeneration). Relevant clinical studies have often combineddry needling with autologous blood injection therapy. Results from these studies are encouraging. This review of English-language literature aims to present this noteworthy method of tendino- and enthesopathytreatmentm by describing the results of several trials, hypotheses explaining the underlying mechanism and the application of dry needling in other fields of medicine. HubMed – rehab


Hip fracture prevention with a multifactorial educational program in elderly community-dwelling Finnish women.

Osteoporos Int. 2013 May 8;
Pekkarinen T, Löyttyniemi E, Välimäki M

Guidelines suggest identification of women at fracture risk by bone density measurement and subsequently pharmacotherapy. However, most women who sustain a hip fracture do not have osteoporosis in terms of bone density. The present non-pharmacological intervention among elderly women unselected for osteoporosis reduced hip fracture risk by 55 % providing an alternative approach to fracture prevention. INTRODUCTION: Hip fractures are expensive for society and cause disability for those who sustain them. We studied whether a multifactorial non-pharmacological prevention program reduces hip fracture risk in elderly women. METHODS: A controlled trial concerning 60- to 70-year-old community-dwelling Finnish women was undertaken. A random sample was drawn from the Population Information System and assigned into the intervention group (IG) and control group (CG). Of the 2,547 women who were invited to the IG, 1,004 (39 %) and of the 2,120 invited to the CG, 1,174 (55 %) participated. The IG participated in a fracture prevention program for 1 week at a rehabilitation center followed by review days twice. The CG received no intervention. During the 10-year follow-up, both groups participated in survey questionnaire by mail. Outcome of interest was occurrence of hip fractures and changes in bone-health-related lifestyle. RESULTS: During the follow-up, 12 (1.2 %) women in the IG and 29 (2.5 %) in the CG sustained a hip fracture (P?=?0.039). The determinants of hip fractures by stepwise logistic regression were baseline smoking (odds ratio (OR) 4.32 (95 % confidence interval [CI] 2.14-8.71), age OR 1.15/year (95 % CI 1.03-1.28), fall history OR 2.7 (95 % CI 1.24-5.9), stroke history OR 2.99 (95 % CI 1.19-7.54) and participating in this program OR 0.45 (95 % CI 0.22-0.93). Starting vitamin D and calcium supplement use was more common in the IG compared with the CG. CONCLUSIONS: The results suggest that this non-pharmacological fracture prevention program may reduce the risk of hip fractures in elderly Finnish women. HubMed – rehab