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BACKGROUND: Pain is one of the prevalent Long COVID Symptoms (LCS). Pain interferes with the quality of life (QoL) and induces disease burden. PURPOSE: The study aimed to elicit the clinical presentation of pain and determine the relationships between QoL and pain in LCS. METHODS: This household cross-sectional study of 12,925 SARS-CoV-2 cases between July and December 2021 was carried out in eight administrative divisions of Bangladesh. Stratified random sampling from the cases retrieved from the Ministry of Health was employed. Symptom screening was performed through COVID-19 Yorkshire Rehabilitation Scale, and long COVID was diagnosed according to World Health Organization (WHO) criteria. The analyses were conducted using IBM SPSS (Version 20.00). RESULTS: The prevalence of pain in long COVID was between 01 and 3.1% in the studied population. The study also found five categories of pain symptoms as LCS in Bangladesh: muscle pain 3.1% (95% CI; 2.4-3.8), chest pain 2.4% (95% CI; 1.8-3.1), joint pain 2.8% (95% CI; 2.2-2.3), headache 3.1% (95% CI; 2.4-3.8), and abdominal pain 0.3% (95% CI; 0.01-0.5). People with LCS as pain, multiple LCS, and longer duration of LCS had significantly lower quality of life across all domains of the WHOQOL-BREF (P < 0.001) compared to asymptomatic cases. CONCLUSION: Three out of ten people with long COVID experience painful symptoms, which can significantly reduce their quality of life. Comprehensive rehabilitation can improve the symptoms and reduce the burden of the disease.
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COVID-19 , SARS-CoV-2 , Humanos , Bangladesh/epidemiología , COVID-19/epidemiología , Estudios Transversales , Cefalea/epidemiología , Cefalea/etiología , Síndrome Post Agudo de COVID-19 , Calidad de VidaRESUMEN
BACKGROUND: Children undergoing DDH correction surgery may experience gait abnormalities following soft tissue releases and bony procedures. The purpose of this study was to compare the residual gait changes, radiological outcomes, and functional outcomes in children who underwent DDH surgery with those in healthy controls. METHODS: Inertial motion sensors were used to record the gait of 14 children with DDH and 14 healthy children. Pelvic X-ray was performed to determine the Severin classification and the presence of femoral head osteonecrosis (Bucholz-Odgen classification). For functional evaluation, the Children's Hospital Oakland Hip Evaluation Scale (CHOHES) was used. RESULTS: There was no difference in spatial parameters between the two groups. In terms of temporal parameters, the DDH-affected limbs had a shorter stance phase (p < 0.001) and a longer swing phase (p < 0.001) than the control group. The kinematic study showed that the affected limb group had smaller hip adduction angle (p = 0.002) and increased internal rotation (p = 0.006) with reduced upward pelvic tilt (p = 0.020). Osteonecrosis was graded II, III, and IV in five, three, and one patients, respectively. Five patients had no AVN changes. The Severin classification was grade I, II, and III for six, three, and five patients, respectively. Most patients had good functional outcomes on the CHOHES, with a mean total score of 96.64 ± 5.719. Multivariate regression analysis revealed that weight, height, and femoral osteotomy were independent predictors for gait, radiological and functional outcome. CONCLUSION: Despite good functional scores overall, some children had poor radiological outcomes and gait abnormalities. Our results identified the risk factors for poor outcomes, and we recommend specified rehabilitative strategies for long-term management.
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Displasia del Desarrollo de la Cadera , Luxación Congénita de la Cadera , Osteonecrosis , Humanos , Niño , Resultado del Tratamiento , Displasia del Desarrollo de la Cadera/diagnóstico por imagen , Displasia del Desarrollo de la Cadera/cirugía , Luxación Congénita de la Cadera/diagnóstico por imagen , Luxación Congénita de la Cadera/cirugía , Marcha , Osteonecrosis/cirugíaRESUMEN
BACKGROUND: Diabetic foot ulcer is commonly seen in people with diabetes mellitus. Inadequate plantar pressure offloading has been identified as a contributing factor to development of diabetic foot ulcers. Various pressure off-loading footwear are widely available in the market but poor compliance has been reported especially for indoor usage. StepEase™ diabetic socks have been designed using Ethylene Vinyl Acetate (EVA) microspheres for better redistribution of plantar pressure. The objective of this study was to determine the efficacy of StepEase™ in redistributing the foot plantar pressure and to assess patients' satisfaction on the usage of the socks. METHODS: This was a prospective non randomized clinical trial conducted on 31 patients with diabetes mellitus with high risk foot (King's classification stage II) over a 12 weeks period. Dynamic foot plantar pressure reading was recorded at day 0, 6 weeks and 12 weeks intervals, both barefoot and with StepEase™, using Novel Pedar-X system (Novel GmbH, Munich, Germany). Patients' satisfaction and usage practice were assessed by a questionnaire. RESULTS: The mean age of subjects was 57.9 years with mean body mass index (BMI) of 26 kg/m2. The mean duration of diagnosis with diabetes mellitus was 10.2 years. The mean peak plantar pressure was found to be highest at the right forefoot and left heel region, 267.6 kPa (SD113.5 kPa) and 266.3 kPa (SD 94.6 kPa) respectively. There was a statistically significant reduction of mean peak pressure (P < 0.0001 to P = 0.024) in all masked regions except the left toe region ranging from 22.3 to 47.5% (53.2-117.4 kPa). The highest reduction was seen in the right toe region (47.5%). The reduction of peak pressure was still significant (P < 0.0001 to P = 0.034) at 6 weeks ranging from 24.7% to 46.8% (46.1-100.6 kPa) and at 12 weeks, which was 22.2-49.2% (40.6-91.9 kPa). Mean usage of the socks was 4.39 days per week (SD 1.82), with the mode of 4-6 h per day. Most of the subjects were satisfied or very satisfied with the StepEase™ socks (77.4%) while 87.1% agreed to continue using the socks. None had any new ulcer development or fall during the study period. CONCLUSION: StepEase™ was significantly effective as an indoor foot pressure relieving footwear. It resulted in significant peak plantar pressure reduction by up to 49.2% and the effect was maintained for at least 12 weeks duration.
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Pie Diabético/prevención & control , Pie Diabético/terapia , Adulto , Femenino , Pie/fisiopatología , Alemania , Humanos , Masculino , Persona de Mediana Edad , Presión/efectos adversos , Estudios ProspectivosRESUMEN
In peripheral nerve injuries, Schwann cells (SC) play pivotal roles in regenerating damaged nerve. However, the use of SC in clinical cell-based therapy is hampered due to its limited availability. In this study, we aim to evaluate the effectiveness of using an established induction protocol for human bone marrow derived-MSC (hBM-MSCs) transdifferentiation into a SC lineage. A relatively homogenous culture of hBM-MSCs was first established after serial passaging (P3), with profiles conforming to the minimal criteria set by International Society for Cellular Therapy (ISCT). The cultures (n = 3) were then subjected to a series of induction media containing ß-mercaptoethanol, retinoic acid, and growth factors. Quantitative RT-PCR, flow cytometry, and immunocytochemistry analyses were performed to quantify the expression of specific SC markers, that is, S100, GFAP, MPZ and p75 NGFR, in both undifferentiated and transdifferentiated hBM-MSCs. Based on these analyses, all markers were expressed in undifferentiated hBM-MSCs and MPZ expression (mRNA transcripts) was consistently detected before and after transdifferentiation across all samples. There was upregulation at the transcript level of more than twofolds for NGF, MPB, GDNF, p75 NGFR post-transdifferentiation. This study highlights the existence of spontaneous expression of specific SC markers in cultured hBM-MSCs, inter-donor variability and that MSC transdifferentiation is a heterogenous process. These findings strongly oppose the use of a single marker to indicate SC fate. The heterogenous nature of MSC may influence the efficiency of SC transdifferentiation protocols. Therefore, there is an urgent need to re-define the MSC subpopulations and revise the minimal criteria for MSC identification.
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Biomarcadores/metabolismo , Células Madre Mesenquimatosas/metabolismo , Células de Schwann/metabolismo , Adolescente , Adulto , Forma de la Célula , Transdiferenciación Celular , Células Cultivadas , Perfilación de la Expresión Génica , Humanos , Células Madre Mesenquimatosas/citología , Fenotipo , ARN Mensajero/genética , ARN Mensajero/metabolismo , Células de Schwann/citología , Adulto JovenRESUMEN
[Purpose] The aim of the present study was to investigate the accuracy of a digital weight scale relative to the Wii in limb loading measurement during static standing. [Methods] This was a cross-sectional study conducted at a public university teaching hospital. The sample consisted of 24 participants (12 with osteoarthritis and 12 healthy) recruited through convenient sampling. Limb loading measurements were obtained using a digital weight scale and the Nintendo Wii in static standing with three trials under an eyes-open condition. The limb load asymmetry was computed as the symmetry index. [Results] The accuracy of measurement with the digital weight scale relative to the Nintendo Wii was analyzed using the receiver operating characteristic (ROC) curve and Kolmogorov-Smirnov test (K-S test). The area under the ROC curve was found to be 0.67. Logistic regression confirmed the validity of digital weight scale relative to the Nintendo Wii. The D statistics value from the K-S test was found to be 0.16, which confirmed that there was no significant difference in measurement between the equipment. [Conclusion] The digital weight scale is an accurate tool for measuring limb load asymmetry. The low price, easy availability, and maneuverability make it a good potential tool in clinical settings for measuring limb load asymmetry.
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INTRODUCTION: With an increasing number of people experiencing limitations in functioning during their life course, the need for comprehensive rehabilitation services is high. In 2017, the WHO Rehabilitation 2030 initiative noted that the need for the establishment and expansion of rehabilitation services is paramount in order to obtain well-being for the population and to ensure equal access to quality healthcare for all. The organization of rehabilitation services is however facing challenges especially in low-and middle-income countries with a very small proportion of people who require rehabilitation actually getting them. Various surveys conducted in low-and -middle income countries have revealed existing gaps between the need for rehabilitation services and the actual receipt of these services. This systematic review aimed to determine the barriers and facilitators for increasing accessibility to rehabilitation services in low- and middle-income countries. Recommendations for strengthening rehabilitation service organization are presented based on the available retrieved data. EVIDENCE ACQUISITION: In this systematic review, an electronic search through three primary databases, including Medline (PubMed), Scopus and Web of Science (WOS) was conducted to identify original studies reporting on barriers and facilitators for rehabilitation service organization in low-and middle-income countries. Date of search: 25th April 2021 (PubMed), 3rd May 2021 (Scopus and Web of Science). All studies including barriers or/and facilitators for rehabilitation services in low- and middle income countries which were written in English were included in the review. The articles written in other languages and grey literature, were excluded from this review. EVIDENCE SYNTHESIS: Total of 42 articles were included from year 1989 to 2021. Numerous barriers were identified that related to education, resources, leadership, policy, technology and advanced treatment, community-based rehabilitation (CBR), social support, cultural influences, political issues, registries and standards of care. National health insurance including rehabilitation and funding from government and NGOs are some of the facilitators to strengthen rehabilitation service organization. Availability of CBR programs, academic rehabilitation training programs for allied health professionals, collaboration between Ministry of Heath (MOH) and Non-governmental Organizations (NGOs) on telerehabilitation services are amongst other facilitators. CONCLUSIONS: Recommendations for improving and expanding rehabilitation service organization include funding, training, education, and sharing of resources.
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Países en Desarrollo , Accesibilidad a los Servicios de Salud , Humanos , Rehabilitación/organización & administración , Rehabilitación/normas , Calidad de la Atención de Salud , Personas con Discapacidad/rehabilitaciónRESUMEN
BACKGROUND: Spinal cord injury (SCI) is a consequence of significant disability and health issues globally, and long COVID represents the symptoms of neuro-musculoskeletal, cardiovascular and respiratory complications. PURPOSE: This study aimed to identify the symptom responses and disease burden of long COVID in individuals with spinal cord injury. METHODS: This case-control study was conducted on patients with SCI residing at a specialised rehabilitation centre in Bangladesh. Forty patients with SCI with and without long COVID symptoms (LCS) were enrolled in this study at a 1:1 ratio according to WHO criteria. RESULT: Twelve LCS were observed in patients with SCI, including fatigue, musculoskeletal pain, memory loss, headache, respiratory problems, anxiety, depression, insomnia, problem in ADL problem in work, palpitation, and weakness. The predictors of developing long COVID include increasing age (p<0.002), increasing BMI (p<0.03), and longer duration of spinal cord injury (p<0.004). A significant difference (p<0.01) in overall years of healthy life lost due to disability (YLD) for non-long COVID cases was 2.04±0.596 compared to long COVID (LC) cases 1.22±2.09 was observed. CONCLUSION: Bangladeshi patients of SCI presented 12 long COVID symptoms and have a significant disease burden compared to non long COVID cases.
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COVID-19 , Personas con Discapacidad , Traumatismos de la Médula Espinal , Humanos , Traumatismos de la Médula Espinal/complicaciones , Traumatismos de la Médula Espinal/epidemiología , Masculino , Femenino , COVID-19/complicaciones , COVID-19/epidemiología , Estudios de Casos y Controles , Adulto , Persona de Mediana Edad , Bangladesh/epidemiología , SARS-CoV-2/aislamiento & purificación , Síndrome Post Agudo de COVID-19RESUMEN
Purpose: Anterior cruciate ligament injury (ACL) commonly occurs during sporting events. It causes pain, instability and reduction in range of movement of the knee which results in altered balance, reduced strength as well as loading to the involved knee. The challenge to get the patient back to competitive sports level much depends on the rehabilitation process. Post ACLR rehabilitation is challenging due to the long rehabilitation time as well as boring repetitive exercises. The aim of this study is to compare between the effectiveness of using immersive virtual reality (PlayStation VR) in addition to the conventional rehabilitation as an aid in rehabilitation of patients after ACLR in terms of objective functional assessment and pain and subjective knee function scoring. Methods: This randomised controlled trial was undertaken in a tertiary hospital in Malaysia from July 2019 until July 2020. Thirty patients were randomised into a group undergoing purely conventional rehabilitation (Group 1) and a group undergoing both conventional rehabilitation and immersive virtual reality assisted rehabilitation (Group 2). The immersive virtual reality assisted rehabilitation was started at 3 months post operatively for 3 months duration. Limb loading, balance, range of motion, functional hop tests of the knee, pain and subjective scoring of the knee with the International Knee Documentation Committee (IKDC) Scores were measured preoperatively and at 6 months. Results: There were significant differences in terms of improvement of pain scores (p = 0.012) as well as IKDC Scores (p = 0.024) in Group 2 as compared to Group 1. However, there were no significant differences with regards to limb loading, balance, range of motion and functional hop tests of the knee (p > 0.05). No adverse events were observed during the study period. Conclusion: Immersive virtual reality can be used as an adjunct in rehabilitation of patients after ACL reconstruction in terms of improving their pain as well as their subjective knee evaluation. Large randomised control trial is recommended to further investigate the efficacy.
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OBJECTIVE: MLC601/MLC901 has demonstrated neuroprotective and neuroregenerative properties that enhance neurological recovery in stroke and traumatic brain injury. We aimed to evaluate its safety and potential efficacy in patients with severe spinal cord injury. METHODS: Patients with American Spinal Injury Association (ASIA) Impairment Scale (AIS) A and B were included in an open-label cohort study. Each received a course of MLC601/MLC901 for 6 months in addition to standard care and rehabilitation. Key endpoints were safety, AIS grade and motor scores at month 6 (M6). RESULTS: Among 30 patients included (mean age 42.2 ± 17.6 years, 24 men), 20 patients had AIS A while 10 patients had AIS B at baseline. Ten patients experienced 14 adverse events including one serious adverse event and six deaths, none were considered treatment-related. AIS improved in 25% of AIS A and 50% of AIS B. Improvement in ASIA motor score was seen most with cervical injury (median change from baseline 26.5, IQR: 6-55). These findings appear to be better than reported rates of spontaneous recovery for SCI AIS A and B. CONCLUSION: MLC601/MLC901 is safe and may have a role in the treatment of patients with SCI. A controlled trial is justified.
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Medicamentos Herbarios Chinos , Traumatismos de la Médula Espinal , Adulto , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Estudios de Cohortes , Recuperación de la Función , Traumatismos de la Médula Espinal/rehabilitación , Resultado del TratamientoRESUMEN
An increase in population and chronic conditions leading to disability require increasing emphasis on rehabilitation and health intervention. Poorer countries do not usually have the rehabilitation workforce needed to promote societal inclusion and participation. The roles of the rehabilitation workforce were often not clearly defined, leading to task shifting among rehabilitation professionals. Barriers to capacity building were poor availability of human resources and insufficient training program/supports for their professional development. Facilitators were local government support and international non-governmental organizations collaboration. Recommendations for capacity building effort are for collaboration with the developed nations to encourage funding, training, education, and sharing of resources.
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Creación de Capacidad , Países en Desarrollo , Personas con Discapacidad/rehabilitación , Rehabilitación/educación , Recursos Humanos , Política de Salud , HumanosRESUMEN
This article reviews the epidemiology, rehabilitation intervention strategies, and rehabilitation resources for persons with disabilities (PWD) in Malaysia. Currently, the registered number of PWD is 409,269 individuals, 1.3% of the total population, which is far less than the World Health Organization estimation of 10%. The rehabilitation implementation strategies include health policies, health promotion, and prevention programs. Health-related services for PWD are provided by many government agencies, including health, welfare, education, manpower, housing, and the private sector and nongovernment organizations. It is hoped national health programs can ensure special care and rehabilitation for PWD, optimizing self-reliance and social integration.
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Servicios de Salud Comunitaria/tendencias , Personas con Discapacidad/rehabilitación , Planificación en Salud/tendencias , Política de Salud/tendencias , Programas Nacionales de Salud/tendencias , Medicina Física y Rehabilitación/tendencias , Necesidades y Demandas de Servicios de Salud , Humanos , MalasiaRESUMEN
We investigated the efficacy of a muscle-stuffed vein (MSV) seeded with neural-transdifferentiated human mesenchymal stem cells as an alternative nerve conduit to repair a 15-mm sciatic nerve defect in athymic rats. Other rats received MSV conduit alone, commercial polyglycolic acid conduit (Neurotube®), reverse autograft, or were left untreated. Motor and sensory functions as well as nerve conductivity were evaluated for 12 weeks, after which the grafts were harvested for histological analyses. All rats in the treatment groups demonstrated a progressive increase in the mean Sciatic Functional Index (motor function) and nerve conduction amplitude (electrophysiological function) and showed positive withdrawal reflex (sensory function) by the 10th week of postimplantation. Autotomy, which is associated with neuropathic pain, was severe in rats treated with conduit without cells; there was mild or no autotomy in the rats of other groups. Histologically, harvested grafts from all except the untreated groups exhibited axonal regeneration with the presence of mature myelinated axons. In conclusion, treatment with MSV conduit is comparable to that of other treatment groups in supporting functional recovery following sciatic nerve injury; and the addition of cells in the conduit alleviates neuropathic pain. Impact Statement It is shown that pretreated muscle-stuffed vein conduit is comparable to that of commercial nerve conduit and autograft in supporting functional recovery following peripheral nerve injury. The addition of neural-differentiated mesenchymal stem cells in the conduit is shown to alleviate neuropathic pain.
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Músculo Esquelético/fisiología , Regeneración Nerviosa , Nervio Ciático/fisiopatología , Andamios del Tejido/química , Venas/fisiología , Adolescente , Adulto , Animales , Axones/metabolismo , Biomarcadores/metabolismo , Rastreo Celular , Fenómenos Electrofisiológicos , Proteínas Fluorescentes Verdes/metabolismo , Humanos , Masculino , Actividad Motora , Vaina de Mielina/ultraestructura , Fibras Nerviosas/metabolismo , Fibras Nerviosas/ultraestructura , Ratas Desnudas , Nervio Ciático/trasplante , Adulto JovenRESUMEN
CASE: A 22-year-old man sustained a laceration that measured 180 cm, after debridement, over the anterolateral aspect of the right leg following a road traffic accident. The wound was treated with MyDerm (Universiti Kebangsaan Malaysia), a cell-based, bilayered, bioengineered dermal substitute that contains no animal-derived components and is fully autologous. For its construction, only a small area of skin was harvested from the left groin, which was closed primarily with absorbable sutures. CONCLUSION: MyDerm is an alternative option for the treatment of a massive skin defect in patients who desire removal of only a negligible amount of skin from the donor site and when use of an autograft is insufficient.
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Laceraciones/cirugía , Traumatismos de la Pierna/cirugía , Procedimientos de Cirugía Plástica/instrumentación , Piel Artificial , Trasplante Autólogo/instrumentación , Adulto , Humanos , Pierna/patología , Pierna/cirugía , Masculino , Ingeniería de Tejidos , Adulto JovenRESUMEN
BACKGROUND: Down syndrome (DS) is a genetic disorder caused by presence of extra copy of human chromosome 21. It is characterised by several clinical phenotypes. Motor dysfunction due to hypotonia is commonly seen in individuals with DS and its etiology is yet unknown. Ts1Cje, which has a partial trisomy (Mmu16) homologous to Hsa21, is well reported to exhibit various typical neuropathological features seen in individuals with DS. This study investigated the role of skeletal muscles and peripheral nerve defects in contributing to muscle weakness in Ts1Cje mice. RESULTS: Assessment of the motor performance showed that, the forelimb grip strength was significantly (P<0.0001) greater in the WT mice compared to Ts1Cje mice regardless of gender. The average survival time of the WT mice during the hanging wire test was significantly (P<0.0001) greater compared to the Ts1Cje mice. Also, the WT mice performed significantly (P<0.05) better than the Ts1Cje mice in the latency to maintain a coordinated motor movement against the rotating rod. Adult Ts1Cje mice exhibited significantly (P<0.001) lower nerve conduction velocity compared with their aged matched WT mice. Further analysis showed a significantly (P<0.001) higher population of type I fibres in WT compared to Ts1Cje mice. Also, there was significantly (P<0.01) higher population of COX deficient fibres in Ts1Cje mice. Expression of Myf5 was significantly (P<0.05) reduced in triceps of Ts1Cje mice while MyoD expression was significantly (P<0.05) increased in quadriceps of Ts1Cje mice. CONCLUSION: Ts1Cje mice exhibited weaker muscle strength. The lower population of the type I fibres and higher population of COX deficient fibres in Ts1Cje mice may contribute to the muscle weakness seen in this mouse model for DS.
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Síndrome de Down/patología , Fibras Musculares Esqueléticas/metabolismo , Debilidad Muscular/metabolismo , Conducción Nerviosa/fisiología , Animales , Modelos Animales de Enfermedad , Síndrome de Down/complicaciones , Síndrome de Down/metabolismo , Complejo IV de Transporte de Electrones/metabolismo , Femenino , Regulación de la Expresión Génica , Genotipo , Fuerza de la Mano/fisiología , Masculino , Ratones , Actividad Motora/fisiología , Fibras Musculares Esqueléticas/patología , Debilidad Muscular/complicaciones , Debilidad Muscular/patología , Músculo Esquelético/metabolismo , Músculo Esquelético/patología , Proteína MioD/metabolismo , Factor 5 Regulador Miogénico/metabolismoRESUMEN
Open fracture Gustilo-Anderson grade IIIC is associated with higher risk of infection and problems with soft tissue coverage. Various methods have been used for soft tissue coverage in open fractures with large skin defect. We report a case of a patient who had grade IIIC open fracture of the tibia with posterior tibial artery injury. The patient underwent external fixation and reduction. Because of potential compartment syndrome after vascular repair, fasciotomy of the posterior compartment was performed. This wound, however, became infected and because of further debridement, gave rise to a large skin defect. A tissue engineered skin construct, MyDermTM was employed to cover this large defect. Complete wound closure was achieved 35 days postimplantation. The patient then underwent plating of the tibia for nonunion with no adverse effect to the grafted site. The tibia eventually healed 5 months postplating, and the cosmetic appearance of the newly formed skin was satisfactory.
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Fracturas Abiertas/cirugía , Trasplante de Piel/métodos , Piel Artificial/estadística & datos numéricos , Traumatismos de los Tejidos Blandos/cirugía , Fracturas de la Tibia/cirugía , Adulto , Clavos Ortopédicos , Placas Óseas , Terapia Combinada , Desbridamiento/métodos , Estudios de Seguimiento , Fijación Interna de Fracturas/métodos , Fracturas Abiertas/diagnóstico por imagen , Humanos , Puntaje de Gravedad del Traumatismo , Masculino , Radiografía/métodos , Medición de Riesgo , Traumatismos de los Tejidos Blandos/diagnóstico , Fracturas de la Tibia/diagnóstico por imagen , Cicatrización de Heridas/fisiologíaRESUMEN
This study investigated the therapeutic effects of connective tissue manipulation (CTM) in diabetic foot ulcer (DFU). A total of 20 participants (10 in CTM group and 10 in conventional treatment group (CG)) with DFU underwent the conventional DFU treatment. In addition, the CTM group received CTM twice per week for 6 weeks. The percentage wound area reduction (PWAR) and bacterial colonization count (BCC) in log10 colony-forming units (CFU) per ml wound fluid was evaluated at baseline and six weeks. Results showed a significant change in PWAR in CTM (p < 0.05, t = 3.82, Df = 9, CI L = 0.98 U = 3.81) and CG (p < 0.05, t = 2.97, Df = 9,CI L = 0.26 U = 1.98). Mean reduction of BCC showed a significant reduction (p < 0.05), with percentage of BCC reduction higher in CTM group (6.45%) than CG (3.55%). The findings suggest CTM as an effective adjunct therapy for DFU to enhance conventional treatments.
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Tejido Conectivo/fisiología , Pie Diabético/terapia , Manipulaciones Musculoesqueléticas/métodos , Cicatrización de Heridas/fisiología , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Spinal cord injury (SCI) is a devastating condition with limited therapeutic options despite decades of research. Current treatment options include use of steroids, surgery, and rehabilitation. Nevertheless, many patients with SCI remain disabled. MLC601 (NeuroAiD), a combination of natural products, has been shown to be safe and to aid neurological recovery after brain injuries and may have a potential role in improving recovery after SCI. OBJECTIVE: The aim of this study is to evaluate the safety and efficacy of NeuroAiD amongst people who sustain SCI in the study setting. METHODS: Spinal Cord Injury-Assessing Tolerability and Use of Combined Rehabilitation and NeuroAiD (SATURN) is a prospective cohort study of patients with moderately severe to severe SCI, defined as American Spinal Injury Association (ASIA) Impairment Scale (AIS) A and B. These patients will be treated with open-label NeuroAiD for 6 months in addition to standard care and followed for 24 months. Anonymized data will be prospectively collected at baseline and months 1, 3, 6, 12, 18, and 24 and will include information on demographics; main diagnostics; and neurological and functional state assessed by the Spinal Cord Independence Measure, ASIA-International Standard for Neurological Classification Spinal Cord Injury, and Short Form (SF-8) Health Survey. In addition, NeuroAiD treatment, compliance, concomitant therapies, and side effects, if any, will be collected. Investigators will use a secured online system for data entry. The study is approved by the ethics committee of Hospital University Kebangsaan Malaysia. RESULTS: The coprimary endpoints are safety, AIS grade, and improvement in ASIA motor score at 6 months. Secondary endpoints are AIS grade, ASIA motor scores and sensory scores, Spinal Cord Independence Measure (SCIM), SF-8 Health Survey, and compliance at other time points. CONCLUSIONS: SATURN investigates the promising role of NeuroAiD in SCI especially given its excellent safety profile. We described here the protocol and online data collection tool we will use for this prospective cohort study. The selection of moderately severe to severe SCI provides an opportunity to investigate the role of NeuroAiD in addition to standard rehabilitation in patients with poor prognosis. The results will provide important information on the feasibility of conducting larger controlled trials to improve long-term outcome of patients with SCI. TRIAL REGISTRATION: Clinicaltrials.gov NCT02537899; https://clinicaltrials.gov/ct2/show/NCT02537899 (Archived by WebCite at http://www.webcitation.org/6m2pncVTG).
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OBJECTIVE: The aim of this study was to investigate the intra- and inter-rater reliability of ultrasonography (US) to measure anterior translation of the humeral head (ATHH) among healthy subjects and patients with sacroiliac joint dysfunction. METHODS: The study included a total of 22 shoulder joints from 11 subjects. Six subjects were healthy and 5 had sacroiliac joint dysfunction. Anterior translation of the humeral head was measured twice using US by two different investigators. Intraclass correlation coefficient (ICC3,1), standard error of measurements (SEMs), coefficient of variations (CVs) and Bland-Altman plot were used as analytical tests to investigate intra- and inter-rater reliability, amount of error and agreeability of the measurements between investigators. RESULTS: Intraclass correlation coefficient was 0.94, showing a high level of intra-rater reliability of the first investigator with SEMs (0.01 cm) and CV (5.1%) in measuring ATHH. Intra-rater reliability of the second investigator was 0.84 with SEMs (0.03 cms) and CV (9.6%), indicating a high level of reliability. Inter-rater reliability was high, with an ICC value of 0.92 with SEMs (0.02 cms) and CV (5.9%). CONCLUSION: The use of US as a measurement of ATHH has good levels of intra- and inter-rater reliability in clinical practice.
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Cabeza Humeral/diagnóstico por imagen , Artropatías , Articulación del Hombro/diagnóstico por imagen , Adulto , Femenino , Humanos , Artropatías/diagnóstico , Artropatías/fisiopatología , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Reproducibilidad de los Resultados , Estadística como Asunto , Evaluación de Síntomas/métodos , Evaluación de Síntomas/normas , Ultrasonografía/métodos , Ultrasonografía/normasRESUMEN
We evaluated bridging of 15 mm nerve gap in rat sciatic nerve injury model with muscle-stuffed vein seeded with olfactory ensheathing cells as a substitute for nerve autograft. Neurophysiological recovery, as assessed by electrophysiological analysis was faster in the constructed biological nerve conduit compared to that of autograft.
Asunto(s)
Regeneración Nerviosa , Nervio Ciático/fisiopatología , Ingeniería de Tejidos , Animales , Femenino , Músculo Esquelético/patología , Conducción Nerviosa , Nervio Olfatorio/patología , Traumatismos de los Nervios Periféricos/terapia , Ratas Sprague-Dawley , Medicina Regenerativa , Nervio Ciático/patología , Venas/patologíaRESUMEN
Quantitative measurement of limb loading is important in orthopedic and neurological rehabilitation. In current practice, mathematical models such as Symmetry index (SI), Symmetry ratio (SR), and Symmetry angle (SA) are used to quantify limb loading asymmetry. Literatures have identified certain limitations with the above mathematical models. Hence this study presents two new mathematical models Modified symmetry index (MSI) and Limb loading error (LLE) that would address these limitations. Furthermore, the current mathematical models were compared against the new model with the goal of achieving a better model. This study uses hypothetical data to simulate an algorithmic preliminary computational measure to perform with all numerical possibilities of even and uneven limb loading that can occur in human legs. Descriptive statistics are used to interpret the limb loading patterns: symmetry, asymmetry and maximum asymmetry. The five mathematical models were similar in analyzing symmetry between limbs. However, for asymmetry and maximum asymmetry data, the SA and SR values do not give any meaningful interpretation, and SI gives an inflated value. The MSI and LLE are direct, easy to interpret and identify the loading patterns with the side of asymmetry. The new models are notable as they quantify the amount and side of asymmetry under different loading patterns.