Novel effects of Rosa damascena extract on memory and neurogenesis in a rat model of Alzheimer's disease.

The number of older people who are suffering from memory impairment is increasing among populations throughout the world. Alzheimer's disease (AD) affects about 5% of people over 65 years old. The hippocampus, a brain area critical for learning and memory, is especially vulnerable to damage in the early stages of AD. Emerging evidence suggests that loss of neurons and synapses are correlated with dementia in this devastating disease. Therefore, neurogenesis and synaptogenesis in adulthood could serve as a preventive as well as a therapeutic target for AD. This study investigated the effect of Rosa damascena extract on neurogenesis and synaptogenesis in an animal model of AD. Molecular, cellular, and behavioral experiments revealed that this treatment could induce neurogenesis and synaptic plasticity and improve memory in AD. Our study suggests that R. damascena is a promising treatment for mild memory impairments and AD.

Effect of T3 hormone on neural differentiation of human adipose derived stem cells.

Human adult stem cells, which are capable of self-renewal and differentiation into other cell types, can be isolated from various tissues. There are no ethical and rejection problems as in the case of embryonic stem cells, so they are a promising source for cell therapy. The human body contains a great amount of adipose tissue that contains high numbers of mesenchymal stem cells. Human adipose-derived stem cells (hADSCs) could be easily induced to form neuron-like cells, and because of its availability and abundance, we can use it for clinical cell therapy. On the other hand, T3 hormone as a known neurotropic factor has important impressions on the nervous system. The aim of this study was to explore the effects of T3 treatment on neural differentiation of hADSCs. ADSCs were harvested from human adipose tissue, after neurosphere formation, and during final differentiation, treatment with T3 was performed. Immunocytochemistry, real-time RT-PCR, Western blotting techniques were used for detection of nestin, MAP2, and GFAP markers in order to confirm the effects of T3 on neural differentiation of hADSCs. Our results showed an increase in the number of glial cells but reduction in neuronal cells number fallowing T3 treatment.

Co-culture with neurotrophic factor secreting cells induced from adipose-derived stem cells: promotes neurogenic differentiation.

Adipose-derived stem cells (ADSCs) and bone marrow stem cells (BMSCs) can be equally proper in the treatment of neurodegenerative diseases. However, ADSCs have practical benefits. In this study, we attempted to induce the secretion of neurotrophic factors (NTF) in human ADSCs. We then evaluated the effects of co-culture with NTF secreting cells in neural differentiation of human ADSCs. Isolated human ADSCs were induced to neurotrophic factors secreting cells. To evaluate the in vitro effects of NTF-secreting ADSCs on neurogenic differentiation of ADSCs, we used neurogenic induction medium (control group), the combination of neurogenic medium and conditioned medium, or co-cultured NTF-secreting ADSCs which were encapsulated in alginate beads (co-culture) for 7 days. ELISA showed increased (by about 5 times) release of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) in NTF-secreting ADSCs compared to human ADSCs. Real time RT-PCR analysis revealed that NTF-secreting ADSCs highly expressed NGF and BDNF. In addition, co-culture with NTF-secreting ADSCs could also promote neuronal differentiation relative to gliogenesis. Overall, NTF-secreting ADSCs secrete a range of growth factors whose levels in culture could promote neuronal differentiation and could support the survival and regeneration in a variety of neurodegenerative diseases.

Effect of leukemia inhibitory factor on the myelinogenic ability of Schwann-like cells induced from human adipose-derived stem cells.

The Schwann cells (SCs) may be obtain from nerve biopsies for autologous transplantation. However, it is difficult to obtain sufficient amount of SCs for clinical applications. Human adipose-derived stem cells (ADSCs) can be induced to differentiate into Schwann-like cells (S-like cells) and used for autologous transplantation. However, effect of leukemia inhibitory factor (LIF) on the myelinogenic ability of SC-like cells induced from human ADSC is not investigated yet. The aim of this study was to evaluate of the effect of exogenous LIF on myelinogenic potential of differentiated cells in vitro. ADSCs were harvested from human fat tissue and characterized using flow cytometry. Human ADSCs were treated for sphere formation and LIF was added to terminal differentiation medium. GFAP/S100ß and MBP markers were used to confirm differentiation of human ADSCs, and myelinogenic ability of SC-like cells, respectively, using both immunostaining and real-time RT-PCR analysis. The analysis for GFAP(+)/S100ß(+) revealed that LIF can increase both differentiated cells rates and the percentage of myelinating SC-like cells (p < 0.05). Our data showed that SC-like cells induced from human ADSCs were able to generate myelin when exposed to LIF and these cells could be a potential source for the treatment of peripheral and central axonal injuries.

Validity and Reliability of the Persian Version of Barriers to Physical Activity Questionnaire for People With Mobility Impairments.

BACKGROUND: Although physical activity (PA) is an important determinant of health, physically disabled individuals tend to have a sedentary lifestyle. The Barriers to Physical Activity Questionnaire for People with Mobility Impairments (BPAQ-MI) is a self-report instrument evaluating PA barriers. This study was intended to evaluate the validity and reliability of the Persian version of BPAQ-MI (P-BPAQ-MI) and to report the prevalence and severity of PA barriers among Persian-speaking individuals. METHODS: The translation and back translation of the BPAQ-MI was conducted according to an internationally accepted guideline and tested on 163 participants to assess its reliability and validity. Internal consistency and test-retest reliability were analyzed using Cronbach alpha and Spearman correlation coefficient. Convergent construct validity was established by comparing the scores of P-BPAQ-MI and The Baecke Habitual Physical Activity Questionnaire. Known-groups construct validity was assessed with regard to type of assistive device and sex of the individual. Prevalence and severity of the barriers were reported by computing the percentage and means of "yes" answers. RESULTS: The P-BPAQ-MI domains demonstrated very good internal consistency (Cronbach alpha of .77-.95) and excellent test-retest reliability (Spearman rho of .73-.96) with a significant inverse small correlation with Baecke Habitual Physical Activity Questionnaire indexes. The P-BPAQ-MI successfully discriminated between individuals with different assistive devices and sex. Community Built Environment barriers were the most prevalent and severe. CONCLUSIONS: The P-BPAQ-MI is a valid and reliable instrument to assess the PA barriers of people with physical disability. The community barriers were the most frequently reported obstacles to PA.

Effect of Vitamin E on Apoptosis of the Endothelial Cells of the Carotid Arteries in Hypercholesterolemic Male Rabbits.

INTRODUCTION: Cardiovascular disease is the principal cause of mortality and morbidity in developed countries, leading to the formation of atherosclerosis plaques and thrombosis. Apoptosis of endothelial cells is one of the primary factors in vascular thrombosis. Lipids, when oxidized by endothelial cells, result in an increased thickness of the arterial wall. Iron is also recognized as an atherogenic element that induces atherosclerosis. There remains uncertainty about the antioxidative role of vitamin E in the formation of atherosclerosis. In this study, the authors evaluated the effect of iron and vitamin E on the apoptosis of endothelial cells in the carotid arteries of hypercholesterolemic male rabbits. METHOD: Thirty white male rabbits were randomly divided into five groups and fed the following diet for six weeks: Group 1: control, Group 2: cholesterol (1%), Group 3: cholesterol (1%) + vitamin E (50 mg/kg), Group 4: cholesterol (1%) + Iron (50 mg/kg), and Group 5: cholesterol (1%) + vitamin E (50 mg/kg) + Iron (50 mg/kg). Serum cholesterol, TG, HDL, and LDL levels were assessed after six weeks. Finally, the animals were sacrificed with ketamine, and carotid arteries were removed. The samples were fixed in 10% formalin, and TUNEL staining was used after the tissue processing. Cell counts were carried out under a light microscope. RESULTS: Vitamin E decreased Serum cholesterol and apoptotic endothelial cells in the hypercholesterolemic + vitamin E diet (P< 0.05). However, they increased significantly in the interference groups compared to the control group (P< 0.05). CONCLUSION: According to our findings, vitamin E showed to have a beneficial effect on preventing cardiovascular diseases and may play a positive role in the prevention of atherosclerosis.

Seroprevalence of Herpes Simplex Viruses Types 1 and 2 in a Population, Age 15-35 Years, of Mashhad City.

Background: Considering the high prevalence and clinical importance of herpes simplex virus (HSV) infection worldwide, we aimed to evaluate the seroprevalence of HSV-1 and HSV-2 in a population aged between 15 and 35 years in Mashhad, Iran. Methods: This cross-sectional study was conducted on 916 cases composed of 288 (31.4%) men and 628 (68.6%) women. Using ELISA method, the presence of IgM and IgG antibodies against HSV-1 and HSV-2 was assessed. Results: Among the population studied, 681 (74.3%) cases were positive for anti-HSV antibodies, while 235 (25.7%) cases were negative. Moreover, no IgMs were found and all positive subjects had IgG antibodies. Age (p < 0.001), occupation (p < 0.001), education (p = 0.006), smoking (p = 0.029), and BMI (p = 0.004) demonstrated a significant association with HSV-1 and HSV-2 infection. Conclusion: Our study indicates a high seroprevalence of HSV infection; however, there was no cases positive for IgM antibodies, suggesting the high prevalence of latent infection.

Effects of FGF-2 on human adipose tissue derived adult stem cells morphology and chondrogenesis enhancement in Transwell culture.

Injured cartilage is difficult to repair due to its poor vascularisation. Cell based therapies may serve as tools to more effectively regenerate defective cartilage. Both adult mesenchymal stem cells (MSCs) and human adipose derived stem cells (hADSCs) are regarded as potential stem cell sources able to generate functional cartilage for cell transplantation. Growth factors, in particular the TGF-b superfamily, influence many processes during cartilage formation, including cell proliferation, extracellular matrix synthesis, maintenance of the differentiated phenotype, and induction of MSCs towards chondrogenesis. In the current study, we investigated the effects of FGF-2 on hADSC morphology and chondrogenesis in Transwell culture. hADSCs were obtained from patients undergoing elective surgery, and then cultured in expansion medium alone or in the presence of FGF-2 (10 ng/ml). mRNA expression levels of SOX-9, aggrecan and collagen type II and type X were quantified by real-time polymerase chain reaction. The morphology, doubling time, trypsinization time and chondrogenesis of hADSCs were also studied. Expression levels of SOX-9, collagen type II, and aggrecan were all significantly increased in hADSCs expanded in presence of FGF-2. Furthermore FGF-2 induced a slender morphology, whereas doubling time and trypsinization time decreased. Our results suggest that FGF-2 induces hADSCs chondrogenesis in Transwell culture, which may be beneficial in cartilage tissue engineering.

Comparison of the Modified Lumbar Pelvic Belt with the Current Belt on Low Back and Pelvic Pain in Pregnant Women.

Background: Low back pain is one of the most common problems for pregnant women during pregnancy. Most belts are designed for supporting the surface of the symphysis pubis or upper anterior iliac spine without any support in the lumbar region. Objective: This study aimed to compare the related effects between the new design and the current belt on the pain and function of pregnant women. Material and Methods: In this randomized control trial study, 48 pregnant women with pelvic and lumbar pain participated. The participants were randomly divided into three groups: current belt, modified belt, and control. Pain intensity assessment, pelvic girdle (PG), and Oswestry disability index (ODI) questionnaires were utilized at the beginning of the study and three weeks later. Results: The pain intensity decreased more in the modified belt group than in the current belt group. ODI and PG scores decreased in two belt groups after three weeks of follow-up. However, this decrease was greater in the modified belt group, there was no statistically significant difference. Conclusion: The disability decreased in both groups using the belts, and their function was improved. Accordingly, the use of a modified belt with lumbar and PG support can significantly reduce back and pelvic pain in pregnant women compared to the current pelvic belt.

Impact of Intraventricular Human Adipose-Derived Stem Cells Transplantation with Pregnenolone Treatment on Remyelination of Corpus Callosum in A Rat Model of Multiple Sclerosis.

OBJECTIVE: Multiple sclerosis (MS) is known as a nerve tissue disorder, which causes demyelination of central nervous system (CNS) fibers. Cell-based treatment is a novel strategy for the treatment of demyelinating diseases such as MS. Adipose-derived stem cells (ADSCs) have neuroprotective and neuroregenerative effects and pregnenolone as a neurosteroid has remarkable roles in neurogenesis. We intend to examine the impact of intraventricular transplantation of human ADSCs and systemic injection of pregnenolone on the remyelination of a rat model cuprizone-induced demyelination. MATERIALS AND METHODS: This experimental study was performed on 36 male Wistar rats that received a regular diet and a cuprizone diet for 3 weeks for M.S. induction. Through lipoaspirate surgery, human-ADSCs (hADSCs) were obtained from a patient. Six groups of rats (n=6): healthy, MS, sham, pregnenolone injection, ADSCs transplantation, and pregnenolone injection/ADSCs transplantation were included in this study. For assessment of remyelination, transmission electron microscopy (TEM), immunohistochemistry staining, real-time reverse transcription-polymerase chain reaction (RT-PCR), and enzyme-linked immunosorbent assay (ELISA) were performed. RESULTS: TEM outcomes revealed an increase in the thickness of the fibers myelin in the treatment groups (P<0.05). We also observed a significant upregulation of MBP, PDGFR-α, and MOG after treatment with hADSCs and pregnenolone compared to other study groups (P<0.001). These results were confirmed by immunostaining analysis. Moreover, there was no significant difference between the ADSCs/pregnenolone group and the control group regarding the level of MBP, A2B5, and MOG proteins in ELISA. CONCLUSION: Our data implied that the remyelination and cell recovery were more improved by intraventricular ADSCs transplantation and pregnenolone injection after inducing a rat model of MS.

The effect of toe-only rocker sole shoes on gait variability of the elderly.

Gait variability could associate with fall risk in older people. Rocker sole shoes are commonly prescribed to reduce plantar pressure and facilitate forward movement. Thus, it may affect gait stability. The purpose of this study was to investigate the effects of toe-only rocker shoes on gait variability in the elderly. Seventeen healthy elderly participants walked on a treadmill under six different conditions including barefoot (BF), normal shoe (NS), and four types of toe-only rocker sole shoes with various degrees of rocker angle (RS10, RS20, RS30, and RS40). Then the step length variability (SLV), the step time variability (STV), the step width variability (SWV), and the stance time variability were measured. Increasing rocker angle in toe-only rocker did not significantly affect gait variability more than the standard shoe. It seems that different rocker angles in toe-only rocker sole shoes do not pose a threat to gait variability compared to the standard shoes in healthy elderly. Findings of the study suggested that the toe-only rocker sole can be used to facilitate forward progression in the elderly. Further investigation is also required to examine the long-term effects of toe-only rocker sole shoes on gait variability in frail elderly.

Design and evaluation of a prosthetic socket for a patient with diabetic-related transtibial amputation: A case report.

This is a report of a diabetic transtibial amputee with severe pain and ulcer in the antero-distal of the tibia. A novel prosthetic socket with an antero-distal silicone wall was designed. The result showed that the patient's satisfaction was increased and the average peak pressure was reduced by using the new socket design.

Nonlinear analysis of dynamic stability in walking with toe-only rocker sole shoes in elderly.

BACKGROUND: Elderly subjects are at the risk of falling. One type of shoe intervention used for this group of the subjects is the shoe with rocker. The aim of this study was to investigate the effects of shoes with various degrees of rockers on dynamic stability of elderly subjects while walking. METHOD: 15 elderly subjects were recruited in this study. A motion analysis system was used to record the motions of body while walking on a treadmill. The local dynamic stability (LDS) was evaluated based on use of Lyapunov exponent of center of mass (COM) movement. The subjects were asked to walk barefoot, with shoe with no rocker and with shoe with various rockers (10, 20, 30 and 40°). RESULTS: The mean values of LDS (λmax-S) in anteroposterior direction were 0.95 ± 0.46, 0.78 ± 0.51 and 0.74 ± 0.54 in bare foot, shoes with no rocker and shoe with 10° rocker, respectively. The mean value of LDS (λmax-S) in vertical direction varied between 1.21 and 1.23. There was no significant difference between LDS of elderly subjects while walking with shoes with various rocker angles. DISCUSSION: Use of shoes with various rocker angles dose not influence on dynamic stability of elderly subjects while walking. Therefore, it is recommended to use this kind of shoe intervention for other trapeutic purposes.

Evaluation of Edaravone effects on the differentiation of human adipose derived stem cells into oligodendrocyte cells in multiple sclerosis disease in rats.

AIMS: Among all the treatments for Multiple Sclerosis, stem cell transplantation, such as ADSCs, has attracted a great deal of scientific attention. On the other hand, Edaravone, as an antioxidant component, in combination with stem cells, could increase the survival and differentiation potential of stem cells. MAIN METHODS: 42 rats were divided into: Control, Cuprizone (CPZ), Sham, Edaravone (Ed), hADSCs, and Ed/hADSCs groups. Following induction of cuprizone, induced MS model, behavioral tests were designed to evaluate motor function during. Luxal fast blue staining was done to measure the level of demyelination and remyelination. Immunofluorescent staining was used to evaluate the amount of MBP, OLIG2, and MOG proteins. The mRNA levels of human MBP, MOG, and OLIG2 and rat Mbp, Mog, and Olig2 were determined via RT-PCR. KEY FINDINGS: Flow cytometry analysis exhibited that the extracted cells were positive for CD73 (93.8 ± 3%) and CD105 (91.6 ± 3%), yet negative for CD45 (2.06 ± 0.5%). Behavioral tests, unveiled a significant improvement in the Ed (P < 0.001), hADSCs (P < 0.001), and Ed/hADSCs (P < 0.001) groups compared to the others. In the Ed/hADSCs group, the myelin density was significantly higher than that in the Ed treated and hADSCs treated groups (P < 0.01). Edaravone and hADSCs increased the expression of Mbp, Mog, and Olig2 genes in the cuprizone rat models. Moreover, significant differences were seen between the Ed treated and hADSCs treated groups and the Ed/hADSCs group (P < 0.05 for Mbp and Olig2 and P < 0.01 for Mog). SIGNIFICANCE: Edaravone in combination with hADSCs reduced demyelination and increased oligodendrogenesis in the cuprizone rat models.

Comparison of TGF-ß3 and avocado/soybean unsaponifiable on chondrogenesis of human adipose-derived stem cells on poly (lactic-co-glycolic) acid/ hyaluronic acid hybrid scaffold.

OBJECTIVES: Avocado/soybean unsaponifible (ASU) possesses properties including chondroprotective, anticatabolic, and anabolic. The goal behind this research was to detect the effect of ASU and TGF-ß3 on the chondrogenesis of human adipose-derived stem cells (hADSCs) on poly (lactic-co-glycolic) acid (PLGA)/ hyaluronic acid (PLGA/HA) hybrid scaffold. MATERIALS AND METHODS: First hADSCs were seeded in PLGA/Hyaluronic acid scaffold and cultured in chondrogenic media. These cells were assigned into 4 groups: control, TGFß-3, ASU, and TGFß-3+ASU. The viability was assessed separately by MTT. Real-time PCR was used to quantify the expression of chondrogenic specific genes [Sox9, collagen type II (ColII), Aggrecan (AGG)] and collagen type X (ColX). Moreover, Western blotting was employed to evaluate protein expression levels of collagens type II and X. RESULTS: These findings indicated a significant increase in the proliferation and survival of hADSCs differentiated cells by ASU compared with the control group (P=0.008). Real-time PCR results revealed significant differences in the expression of AGG, SOX9, ColII, and ColX genes in the control group when compared with other groups (ASU, TGF-ß3, and TGF-ß3+ASU). ColII protein production significantly dropped in the TGF-ß3 group in comparison with the TGF-ß3+ASU group (0.000). The ColII (P=0.002) and ColX (P=0.002) protein production proved significantly higher in the TGF-ß3+ASU group compared with the ASU group. CONCLUSION: Using the synergist form TGFß-3, ASU induces chondrogenesis in hADSCs in PLGA/HA composite scaffold. This can be deduced with reduction of special markers of hyaline cartilage in comparison with ASU and decreased hypertrophic marker compared with TGF-ß3.

Determination of the correlation between muscle forces obtained from OpenSim and muscle activities obtained from electromyography in the elderly.

Measurement of muscle forces related to aging can help to better identify the gait impairment mechanisms in the elderly. To this end, musculoskeletal modeling has been developed to estimate muscle forces. This study aimed to check the validity of OpenSim modeling (i.e., computed muscle control) approach in elderly subjects. Kinematic and kinetic data and Electromyography (EMG) signals for four different muscles were collected in nine healthy elderly males during walking. Dynamic simulation was done within OpenSim. Correlation analysis was performed to quantitatively compare the maximum estimated muscle forces with maximum measured muscle activities during the first double limb support, single limb support, and the second double limb support phases. The area-time plots of OpenSim and EMG data during gait cycle were obtained for qualitative assessment. In quantitative assessment, a low to moderate correlation was observed for the peak of muscle force and muscle activation of four muscles during sub phases of gait. The muscle forces pattern from OpenSim was found to be relatively similar to the muscle activity pattern from EMG especially for Gastrocnemius Medialis. A low to moderate consistency between OpenSim and EMG in the elderly can be explained by using a single mathematical estimation approach.

Novel method to obtain highly enriched cultures of adult rat Schwann cells.

Schwann cells (SCs) can be used to repair both the peripheral and central nervous systems. Therefore, establishment of a procedure to obtain activated, highly proliferative SCs, in an appropriate time for clinical applications, is a prerequisite. Purification is complicated by contamination with fibroblasts which often become the predominant cell type in an in vitro SC culture. This study describes a novel and efficient method to enrich SCs by utilizing the differential detachment properties of the two cell types. In culture, cells were treated with two different media and the chelator, EGTA, which detached SCs faster than fibroblasts and allowed for easy isolation of SCs. Within seven days, high yields of SCs with a purity of greater than 99% were achieved. This was confirmed by immunostaining characterization and flow-cytometric analyses using an antibody against the p75 low affinity nerve growth factor receptor (p75LNGFR). The entire procedure was completed in approximately 21 days. This method has the advantage of being technically easier, faster, and more efficient than other previously described methods. An SC culture that was about 99% homogenous was achieved.

Improvement of Remyelination in Demyelinated Corpus Callosum Using Human Adipose-Derived Stem Cells (hADSCs) and Pregnenolone in the Cuprizone Rat Model of Multiple Sclerosis.

Adipose-derived stem cells (ASCs) have neuroprotective effects, and their repair ability has been approved in neurodegenerative studies. Pregnenolone as a neurosteroid plays significant roles in neurogenesis. We aimed to consider the effect of ADSCs and pregnenolone injection on the multiple sclerosis (MS) model created by cuprizone. Male Wistar rats (n = 36) were fed with an ordinary diet or a diet with cuprizone (0.6%) for 3 weeks. H-ADSCs were taken from patients with lipoaspirate surgery. The rats were divided into six groups (n = 6): healthy, MS, sham, pregnenolone injection, ADSCs injection, pregnenolone and ADSCs injection. Behavioral test, histological examination and TEM were conducted. The specific markers for myelin and cell differentiation were assessed using immunohistochemistry staining. Additionally, the measure of MBP and MOG gene expression and the amount of related proteins were determined using real-time RT-PCR and ELISA techniques, respectively. Histologic results showed that induced demyelination in corpus callosum fibers. TEM revealed an increased thickness of myelin in fibers in the treated groups (P < 0.05). Injection of hADSC and pregnenolone significantly increased the expression levels of MBP and MOG (P < 0.001). The mean percentage of MOG and MBP markers were significantly increased in the treated groups compared to MS and sham groups (P < 0.05). Moreover, the OD level of MBP and MOG proteins showed that their values in the ADSCs/pregnenolone group were close to those of the control group without a significant difference. Our data indicated the remyelination potency and cell differentiation can improve with ADSCs and pregnenolone treatments in the multiple sclerosis model which created by cuprizone in rats.

Development and preliminary evaluation of a new anatomically based prosthetic alignment method for below-knee prosthesis.

The objectives of current study were to a) assess similarities and relationships between anatomical landmark-based angles and distances of lower limbs in unilateral transtibial amputees and b) develop and evaluate a new anatomically based static prosthetic alignment method. First substudy assessed the anthropometrical differences and relationships between the lower limbs in the photographs taken from amputees. Data were analyzed via paired t-test and regression analysis. Results show no significant differences in frontal and transverse planes. In the sagittal plane, the anthropometric parameters of the amputated limb were significantly correlated to the corresponding variables of the sound limb. The results served as bases for the development of a new prosthetic alignment method. The method was evaluated on a single-subject study. Prosthetic alignment carried out by an experienced prosthetist was compared with such alignment adjusted by an inexperienced prosthetist but with the use of the developed method. In sagittal and frontal planes, the socket angle was tuned with respect to the shin angle, and the position of the prosthetic foot was tuned in relation to the pelvic landmarks. Further study is needed to assess the proposed method on a larger sample of amputees and prosthetists.

Effects of Two Different Hip-Knee-Ankle-Foot Orthoses on Postural Stability in Subjects with Spinal Cord Injury: A Pilot Study.

STUDY DESIGN: Pilot study. PURPOSE: Evaluation of two different hip-knee-ankle-foot orthoses (HKAFOs; medial linkage reciprocating gait orthosis [MLRGO] and isocentric reciprocating gait orthosis [IRGO]) using gait and postural stability analysis in four subjects with spinal cord injury (SCI). OVERVIEW OF LITERATURE: To the best of our knowledge, no study has evaluated postural stability in subjects with SCI when using MLRGO and IRGO. METHODS: The relative efficacy of each orthosis was evaluated with relevant gait parameters, and an assessment of postural stability and sway during usage was made. Each analysis was conducted following an appropriate period of training and acclimatization. The gait parameters employed in the study were walking speed, cadence, and endurance; these were recorded and analyzed using current, validated methods. Postural stability was assessed using a verified force plate measurement system, and a modified Falls Efficacy Scale (mFES) was used for the measurement of postural sway and the perceived fear of falling. RESULTS: Walking speed, cadence, and endurance increased with the use of both HKAFOs. When the two types of HKAFOs were compared, all the parameters showed a slight (but not significant) increase with the use of MLRGO compared with the use of IRGO. In contrast, there were slight but insignificant improvements in postural sway with the use of IRGO. However, although there were no significant differences between the two sets of mFES scores, there was a slightly reduced fear of falling with the use of MLRGO compared with the use of IRGO in the static standing position. CONCLUSIONS: It is noteworthy that meaningful interpretations of results can only be drawn if a larger sample is employed. This pilot study showed no significant data; however, the results indicate that the use of MLRGO is superior to that of IRGO in terms of potential improvement in the mobility and confidence levels of subjects with SCI.