RESUMEN
In the surgical treatment of foot and ankle abnormality, many problems require bone grafting for successful osseous union. Nonunion, reconstruction, and arthrodesis procedures pose specific challenges due to bony defects secondary to trauma, malunions, or previous surgery. Nonunion in foot and ankle arthrodesis is a significant risk and is well documented in recent literature. This article is a review of the recent literature regarding the use of bone graft and orthobiologics in foot and ankle surgery.
Asunto(s)
Traumatismos del Tobillo , Terapia Biológica/métodos , Trasplante Óseo/métodos , Traumatismos de los Pies , Traumatismos del Tobillo/complicaciones , Traumatismos del Tobillo/fisiopatología , Traumatismos del Tobillo/terapia , Deformidades Adquiridas del Pie/etiología , Deformidades Adquiridas del Pie/fisiopatología , Deformidades Adquiridas del Pie/terapia , Traumatismos de los Pies/complicaciones , Traumatismos de los Pies/fisiopatología , Traumatismos de los Pies/terapia , Curación de Fractura/fisiología , HumanosRESUMEN
The appearance of the skin on this woman's face, hands, and feet helped us to recognize an advanced case of an autoimmune disease.
Asunto(s)
Facies , Deformidades Adquiridas del Pie/etiología , Deformidades Adquiridas de la Mano/etiología , Pulmón , Calidad de Vida , Esclerodermia Sistémica , Terapia Combinada , ADN-Topoisomerasas de Tipo I , Diagnóstico Diferencial , Femenino , Humanos , Inmunosupresores/uso terapéutico , Pulmón/diagnóstico por imagen , Pulmón/fisiopatología , Persona de Mediana Edad , Proteínas Nucleares/análisis , Terapia PUVA/métodos , Radiografía , Pruebas de Función Respiratoria/métodos , Esclerodermia Sistémica/complicaciones , Esclerodermia Sistémica/diagnóstico , Esclerodermia Sistémica/inmunología , Esclerodermia Sistémica/fisiopatología , Esclerodermia Sistémica/psicología , Esclerodermia Sistémica/terapia , Pruebas Serológicas/métodos , Resultado del TratamientoRESUMEN
BACKGROUND: Muay Thai kickboxing is a common sport that uses the foot and ankle in fighting. Muay Thai kickboxing trainees usually receive training in Thailand Foot and ankle problems in this group ofpeople who usually train barefoot remain unexplored OBJECTIVE: To evaluate the prevalence of common foot and ankle problems in Muay Thai kick boxers. MATERIAL AND METHOD: The present study is a cross-sectional survey of Muay Thai kick boxers practicing in northern Thailand. Interviews were conducted and foot and ankle examinations were evaluated Foot morphology was examined using a Harris mat footprint. RESULTS: One hundred and twenty-three Muay Thai kickbox ersinnine training gyms were included in this study. Common foot and ankle problems found in the Muay Thai kick boxers were callosity (59%), gastrocnemius contracture (57%), toe deformities (49.3%), wounds (10%) and heel pain (9%). Callosity was most commonly found on the forefoot (77.5%), on the plantar first metatarsal (55.3%) and on the big toe (33.3%). An association was found between a tight heel cord and a history of foot injury with prolonged periods of weekly training. Toe deformities such as hallux rigidus (37.6%) were also associated with prolonged periods of training (p = 0.001). No correlation was found between type of foot arch and foot and ankle problems. CONCLUSION: Plantar forefoot callosities and wounds as well as toe deformities including tight heel cords are some of the foot and ankle problems commonly found in Muay Thai kick boxers. They are associated with prolonged periods of barefoot training. The unique pattern of training and of the kicks in Muay Thai might be a path mechanism, leading to the development of foot and ankle problems.
Asunto(s)
Traumatismos del Tobillo/etiología , Callosidades/etiología , Deformidades Adquiridas del Pie/etiología , Traumatismos de los Pies/etiología , Artes Marciales , Adolescente , Adulto , Atletas , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tailandia , Adulto JovenAsunto(s)
Deformidades Adquiridas del Pie/prevención & control , Dermatosis del Pie/terapia , Queratosis/terapia , Enfermedades de la Uña/terapia , Conducta Cooperativa , Tabla de Aranceles , Deformidades Adquiridas del Pie/economía , Deformidades Adquiridas del Pie/etiología , Dermatosis del Pie/diagnóstico , Dermatosis del Pie/economía , Dermatosis del Pie/etiología , Alemania , Humanos , Comunicación Interdisciplinaria , Queratosis/diagnóstico , Queratosis/economía , Queratosis/etiología , Enfermedades de la Uña/diagnóstico , Enfermedades de la Uña/economía , Enfermedades de la Uña/etiología , Uñas Malformadas/diagnóstico , Uñas Malformadas/economía , Uñas Malformadas/etiología , Uñas Malformadas/terapia , Programas Nacionales de Salud/economía , Podiatría , Mecanismo de Reembolso/economía , ZapatosRESUMEN
BACKGROUNDS: Treatment for bone defect remains a challenge for orthopedists. Bone transport gives an effective alternative, which can be performed with an external fixator alone or combined with an intramedullary nail. Each has its advantages and disadvantages. We present a retrospective study to find out the optimal choice by evaluating the outcomes of treatment for femoral bone defect with two methods. METHODS: Two groups of patients, the monolateral external fixator alone (group A, n = 13) and the monolateral external fixator combined with intramedullary nail (group B, n = 15), were compared. Duration of the external fixator, external fixator index, radiographic consolidation index, complication, and total cost for treatment was also recorded. A modified classification of the Association for the Study and Application of the Method of Ilizarov (ASAMI) was used to assess results in two groups of patients; another SF-36 health survey questionnaire was used to assess the life qualities patients of two groups. RESULTS: Healing was achieved in 13/13 and 13/15 of the two groups, respectively. The rates of complications were significantly higher in the group A. Two patients performed amputations because of persistent deep infections in group B. Statistically significant difference was found when comparing ASAMI scores and categories of the SF-36 health survey. CONCLUSIONS: Bone transport by monolateral external fixator with the use of intramedullary nail reduces the incidence of complication and the duration of external fixator time that give patients a better life quality in both physical and emotional. However, if chronic osteitis exists, bone transport should be treated with monolateral external fixator alone due to a lower rate of amputations.
Asunto(s)
Fémur , Deformidades Adquiridas del Pie , Técnica de Ilizarov/estadística & datos numéricos , Osteogénesis por Distracción , Complicaciones Posoperatorias/prevención & control , Adulto , Clavos Ortopédicos , China , Investigación sobre la Eficacia Comparativa , Fijadores Externos , Femenino , Fémur/diagnóstico por imagen , Fémur/cirugía , Deformidades Adquiridas del Pie/diagnóstico , Deformidades Adquiridas del Pie/etiología , Deformidades Adquiridas del Pie/psicología , Deformidades Adquiridas del Pie/cirugía , Humanos , Fijadores Internos , Masculino , Osteogénesis por Distracción/efectos adversos , Osteogénesis por Distracción/instrumentación , Osteogénesis por Distracción/métodos , Osteogénesis por Distracción/estadística & datos numéricos , Evaluación de Procesos y Resultados en Atención de Salud , Calidad de Vida , Radiografía , Estudios Retrospectivos , Encuestas y CuestionariosRESUMEN
BACKGROUND: According to the verdict of the Supreme Court in 2005, an employer may dismiss an employee if their conduct (including dress) exposes the employer to losses or threatens his interests. The aim of the study was a holistic assessment of the pleiotropic effects of high-heeled pointed shoes on the health condition of women's feet, wearing them at work, in accordance with the existing rules of the "business dress code". MATERIALS AND METHODS: A holistic multidisciplinary analysis was performed. It takes into account: 1) women employees of banks and other large corporations (82 persons); 2) 2D FEM computer model developed by the authors of foot deformed by pointed high-heeled shoes; 3) web site found after entering the code "business dress code". RESULTS: Over 60% of women in the office wore high-heeled shoes. The following has been found among people walking to work in high heels: 1) reduction in the quality of life in about 70% of cases, through periodic occurrence of pain and reduction of functional capacity of the feet; 2) increase in the pressure on the plantar side of the forefoot at least twice; 3) the continued effects the forces deforming the forefoot. CONCLUSIONS: 1. An evolutionary change of "dress code" shoes is necessary in order to lead to a reduction in non-physiological overload of feet and the consequence of their disability. 2. These changes are particularly urgent in patients with so-called "sensitive foot".
Asunto(s)
Deformidades Adquiridas del Pie/etiología , Deformidades Adquiridas del Pie/psicología , Enfermedades Profesionales/psicología , Calidad de Vida/psicología , Zapatos/efectos adversos , Zapatos/legislación & jurisprudencia , Mujeres Trabajadoras/legislación & jurisprudencia , Adulto , Simulación por Computador , Femenino , Pie/diagnóstico por imagen , Deformidades Adquiridas del Pie/diagnóstico por imagen , Salud Holística , Humanos , Modelos Biológicos , Enfermedades Profesionales/diagnóstico por imagen , Dolor/etiología , Polonia , Tomografía Computarizada por Rayos X , Salud de la MujerRESUMEN
The most frequent foot and ankle anatomical alterations in the pediatric population are found in the little toes. Several treatments are proposed for these conditions, ranging from total phalangeal resections, phalangeal osteotomies, osteosynthesis, and soft tissue management. We propose a surgical technique based on the diaphysectomy of the proximal phalanx and the release of soft tissues that are under tension. The purpose is to assess the functional foot results after surgical treatment consisting of proximal phalanx diaphysectomy and soft tissue release using the functional AOFAS scale in pediatric patients. A prospective, longitudinal, descriptive, non-comparative clinical study was conducted from March 2008 to December 2010, with a follow-up of up to six months. Twenty patients (35 toes) were included; 15 females and five males, with a mean age of 14.65 years. Fifteen (30 toes) had bilateral involvement; 88.56% had greater involvement of the fifth toe. The surgical indication was determined based on the degree of functional disability for gait and the type of footwear. The functional assessment was conducted using the AOFAS criteria and a subjective assessment scale with a total score of 100 to assess the metatarsophalangeal and the interphalangeal joints of the smallest toes. Scores were as follows: < 50 points, poor; 51-70 points, fair; 71-90, good, and > 91, excellent. The assessment was done preoperatively and at postoperative month six. The mean preoperative score was 73.55 and the mean postoperative score was 85.75, with a 12.2 point difference (p > 0.5). Results were: 11 excellent, seven good and two fair. There were four relapses, so a salvage procedure was performed with the Ruiz-Mora technique; excellent results were obtained in all four. One case had soft tissue infection. Proximal phalanx diaphysectomy and soft tissue release provides appropriate alignment of the affected toes and relief of soft tissues under tension, thus avoiding broad resections leading to both esthetic and functional alterations. This is a simple and effective technique for the treatment of little toe deformities as it improves function and alignment.
Asunto(s)
Deformidades Congénitas del Pie/cirugía , Síndrome del Dedo del Pie en Martillo/cirugía , Procedimientos Ortopédicos/métodos , Falanges de los Dedos del Pie/cirugía , Adolescente , Anestesia Local , Diáfisis/cirugía , Femenino , Pie/cirugía , Deformidades Adquiridas del Pie/cirugía , Humanos , Masculino , Estudios Prospectivos , Recuperación de la Función , Reoperación , Índice de Severidad de la Enfermedad , Dedos del Pie/cirugía , Resultado del TratamientoRESUMEN
BACKGROUND: Drop foot deformity is a common problem with severe restrictions in quality of life and impairment of daily activities. A technique of posterior tibial tendon transfer through the interosseus membrane and fixation to the anterior tibial and the long peroneal tendon "Bridle procedure" (stirrup-plasty) offers a physiological alternative to surgical correction. METHODS: Data of 53 consecutive patients treated by stirrup-plasty were acquired from patient's charts; 31 were interviewed with standardized questionnaires; 20 were examined physically; 19 received pedobarography, and 8 underwent dynamometric muscle function tests. Follow-up time averaged 6.5 years. RESULTS: The mean range of motion (ROM) in the ankle joint was 8° dorsiflexion and 15° plantar flexion. Most patients achieved plantigrade foot position and the majority developed gait without orthotic devices. As expected, maximum dorsiflexion torque averaged a third of the non-operated leg, according to reduced muscle diameter and strength of the transferred muscle. Pressure distribution of the sole during gait was not relevantly altered by the tendon transfer compared to the non-operated leg. Most patients were satisfied with the operative results and reported a significant increase in quality of life. CONCLUSIONS: Fusion of the transposed posterior tibial, anterior tibial and the peroneus longus tendon prevents drop foot deformity sufficiently. The stirrup mechanism, in combination with tenodesis of the toe extensors, provides a balanced foot and avoids equinovarus and cavus deformity without immobilizing the ankle joint. Improvements in quality of life parameters justify the risk of the operative procedure for the patient.
Asunto(s)
Deformidades Adquiridas del Pie/cirugía , Trastornos Neurológicos de la Marcha/cirugía , Calidad de Vida , Rango del Movimiento Articular/fisiología , Transferencia Tendinosa/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Articulación del Tobillo , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Deformidades Adquiridas del Pie/diagnóstico , Trastornos Neurológicos de la Marcha/diagnóstico , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Fuerza Muscular/fisiología , Dinamómetro de Fuerza Muscular , Neuropatías Peroneas/fisiopatología , Neuropatías Peroneas/cirugía , Cuidados Posoperatorios/métodos , Procedimientos de Cirugía Plástica/métodos , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
Skewfoot is a rare deformity characterized by forefoot adduction and hindfoot valgus. Its etiology and natural history are unknown, although congenital and syndromic forms are observed. Currently, there is no consent about the treatment of skewfoot. Due to its potential resistance to the effects of therapy, it must be differentiated from other, more common deformities. Treatment involves conservative and, most often, operative measures.
Asunto(s)
Deformidades del Pie/clasificación , Deformidades del Pie/terapia , Antepié Humano/anomalías , Metatarso/anomalías , Osteotomía/métodos , Tendones/cirugía , Articulación del Tobillo/diagnóstico por imagen , Articulación del Tobillo/cirugía , Moldes Quirúrgicos , Terapia Combinada , Fijadores Externos , Femenino , Deformidades del Pie/diagnóstico por imagen , Deformidades del Pie/etiología , Deformidades Adquiridas del Pie/diagnóstico por imagen , Deformidades Adquiridas del Pie/terapia , Deformidades Congénitas del Pie/diagnóstico por imagen , Deformidades Congénitas del Pie/terapia , Antepié Humano/cirugía , Humanos , Masculino , Osteopatía , Metatarso/cirugía , Pronóstico , Radiografía , Procedimientos de Cirugía Plástica/métodos , Anomalía Torsional/diagnóstico por imagen , Anomalía Torsional/terapia , Resultado del TratamientoRESUMEN
The boutonniere deformity is a well-known deformity in the fingers, however, its appearance on a lessor toe is extremely rare. In the present case, the deformity resulted from a rupture of the central slip of the extensor tendon and the shift of the lateral bands to the planter side after reduction of a traumatic planter dislocation of the PIP joint of the second toe. Surgical repair of the extensor mechanism brought good results.
Asunto(s)
Deformidades Adquiridas del Pie/cirugía , Luxaciones Articulares/cirugía , Dedos del Pie/lesiones , Dedos del Pie/cirugía , Adolescente , Humanos , Masculino , Artes Marciales/lesionesRESUMEN
OBJECTIVE: To increase the transparency of decision making about treatment in patients with equinovarus deformity poststroke. DESIGN: The analytic hierarchy process (AHP) was used as a structured methodology to study the subjective rationale behind choice of treatment. SETTING: An 8-hour meeting at a centrally located rehabilitation center in The Netherlands, during which a patient video was shown to all participants (using a personal computer and a large screen) and the patient details were provided on paper. PARTICIPANTS: A panel of 10 health professionals from different backgrounds. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The performance of the applicable treatments on outcome, impact, comfort, cosmetics, daily effort, and risks and side effects of treatment, as well as the relative importance of criteria in the choice of treatment. RESULTS: According to the model, soft-tissue surgery (.413) ranked first as the preferred treatment, followed by orthopedic footwear (.181), ankle-foot orthosis (.147), surface electrostimulation (.137), and finally implanted electrostimulation (.123). Outcome was the most influential consideration affecting treatment choice (.509), followed by risk and side effects (.194), comfort (.104), daily effort (.098), cosmetics (.065), and impact of treatment (.030). CONCLUSIONS: Soft-tissue surgery was judged best on outcome, daily effort, comfortable shoe wear, and cosmetically acceptable result and was thereby preferred as a treatment alternative by the panel in this study. In contrast, orthosis and orthopedic footwear are usually preferred in daily practice. The AHP method was found to be suitable methodology for eliciting subjective opinions and quantitatively comparing treatments in the absence of scientific evidence.
Asunto(s)
Terapia por Estimulación Eléctrica/métodos , Pie Equino/terapia , Procedimientos Ortopédicos/métodos , Aparatos Ortopédicos , Accidente Cerebrovascular/complicaciones , Articulación del Tobillo/fisiopatología , Toma de Decisiones , Técnicas de Apoyo para la Decisión , Pie Equino/etiología , Medicina Basada en la Evidencia , Femenino , Estudios de Seguimiento , Deformidades Adquiridas del Pie/etiología , Deformidades Adquiridas del Pie/terapia , Humanos , Masculino , Guías de Práctica Clínica como Asunto , Rango del Movimiento Articular/fisiología , Factores de Riesgo , Sensibilidad y Especificidad , Accidente Cerebrovascular/diagnóstico , Resultado del TratamientoRESUMEN
BACKGROUND: The immunosuppressant FK506 has been reported to increase the rate of peripheral nerve regeneration in nerve crush injury and nerve allograft models. The purpose of this study was to determine whether low doses of FK506 and mycophenolate mofetil had a neuroregenerative effect in revascularized peripheral nerve allografts in a rat hind limb transplantation model. METHODS: Wistar Furth rat recipients received limbs from syngeneic Wistar Furth donors (group 1, n = 4) or from allogeneic August X Copenhagen Irish rat donors (group 2, n = 6). Wistar Furth recipients received limbs from August X Copenhagen Irish donors and were treated with FK506/mycophenolate mofetil for 5 months (group 3, n = 7). At the end of the follow-up period, histomorphometric analysis of sciatic and tibial nerves from transplanted and intact hind limbs was conducted. Sciatic and tibial nerves were examined at the level of coaptation and near the neuromuscular junction, respectively. RESULTS: Transplanted limbs in groups 1 and 3 completed the study without rejection, while the limbs in group 2 were rejected within a few days. Sciatic and tibial nerve analysis in groups 1 and 3 limbs showed myelinated axons of various diameters but in significantly fewer numbers than in nontransplanted contralateral nerves. The number and size of myelinated axons of transplanted nerves at corresponding levels were not significantly different between syngeneic and allogeneic (FK506/mycophenolate mofetil-treated) transplants. CONCLUSIONS: The authors conclude that long-term neuroregeneration of revascularized peripheral nerves using low-dose FK506/mycophenolate mofetil was similar to that of syngeneic transplants. The occurrence of acute rejection episodes with low-dose FK506/mycophenolate mofetil did not appear to benefit nor impair neuroregeneration.
Asunto(s)
Nervio Femoral/fisiología , Miembro Posterior/trasplante , Inmunosupresores/farmacología , Ácido Micofenólico/análogos & derivados , Regeneración Nerviosa/efectos de los fármacos , Nervio Ciático/fisiología , Tacrolimus/farmacología , Anastomosis Quirúrgica , Animales , Axones/ultraestructura , Contractura/etiología , Evaluación Preclínica de Medicamentos , Quimioterapia Combinada , Nervio Femoral/irrigación sanguínea , Nervio Femoral/cirugía , Deformidades Adquiridas del Pie/etiología , Rechazo de Injerto/prevención & control , Miembro Posterior/inervación , Inmunosupresores/administración & dosificación , Inmunosupresores/uso terapéutico , Masculino , Microcirugia , Ácido Micofenólico/administración & dosificación , Ácido Micofenólico/farmacología , Ácido Micofenólico/uso terapéutico , Vaina de Mielina/fisiología , Vaina de Mielina/ultraestructura , Complicaciones Posoperatorias/etiología , Ratas , Ratas Endogámicas , Ratas Endogámicas WF , Nervio Ciático/irrigación sanguínea , Nervio Ciático/cirugía , Técnicas de Sutura , Tacrolimus/administración & dosificación , Tacrolimus/uso terapéutico , Trasplante HomólogoRESUMEN
Foot orthoses are commonly prescribed by health professionals as a form of intervention for the symptomatic foot in rheumatoid arthritis. However, there is a limited evidence base to support the use of foot orthoses in this patient group. This article provides a critical review of the use of foot orthoses in the management of rheumatoid arthritic foot pathologies. A search was conducted in the Cochrane Controlled Trials Register (current issue of the Cochrane Library), Physiotherapy evidence database (PEDro), Medline, The Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Allied and Complementary Medicine (AMED) and from reference lists in journal articles. The language was restricted to English. Searching of the databases was undertaken between December 2004 and March 2005. The results indicated there is no consensus of opinion on the choice of foot orthoses used for the management of pathology in the rheumatoid foot, although there is strong evidence that foot orthoses do reduce pain and improve functional ability. The type of foot orthoses used ranged from simple cushioned insoles to custom-made rigid cast devices. Methodological issues raised included small sample size and poor use of valid and reliable outcome measures. There is limited evidence pertaining to cost-effectiveness. The results indicated a need for further investigation into the most clinically and cost-effective foot orthoses to prescribe in the management of the rheumatoid arthritic foot. This review highlights the need to identify the various types of foot orthoses that are most effective in the management of the established rheumatoid arthritic foot.
Asunto(s)
Artritis Reumatoide/rehabilitación , Deformidades Adquiridas del Pie/rehabilitación , Aparatos Ortopédicos , Artritis Reumatoide/complicaciones , Análisis Costo-Beneficio , Deformidades Adquiridas del Pie/etiología , Marcha , Humanos , Dolor/prevención & controlRESUMEN
"Leprosy control and Basic health service Project" was terminated at March 2005 within the scope of the period. I was assigned to develop the Plantar protect footwear for neuropathic feet, which called "Myanmar Sandals" in common. These sandals are not made by new technologies but made by basic knowledge. I would like to report about this activity as which is a part of distinguished strategy of ODA (Official Development Assistance) for developing country, but not as the technical report of these sandals. There is only one National Leprosy Hospital in Myanmar. At the time this project started, there were only two footwear technicians for the people who had disabilities by after effect of Hansen's disease in this country. And, it would appear that the number of the people is over 50,000. Furthermore, the budget of national hospital is not enough to refill necessary consumable supplies and materials. Although, I should instruct new technique which like making in Japan in ordinary circumstances, I could not think that such technical transfer by using costly imported materials woud bring beneficial effect and be continued. We were bound to be anxious about such situations when we made the plan. As a result of examining a plan based on these situations, we reached the conclusion that development of the simplified ready-made footwear was pressing need.
Asunto(s)
Úlcera del Pie/etiología , Úlcera del Pie/terapia , Lepra/complicaciones , Zapatos , Ensayos Clínicos como Asunto , Países en Desarrollo , Diseño de Equipo , Deformidades Adquiridas del Pie/etiología , Deformidades Adquiridas del Pie/terapia , Humanos , Mianmar , Programas Nacionales de SaludRESUMEN
OBJECTIVE: Analysis of the available evidence on the improvement of walking in stroke patients with a dropped foot when using peroneus stimulation. METHODS: A systematic review was performed to identify trials that investigated the orthotic effect of functional electrical stimulation (FES) on walking in stroke patients with a dropped foot. Two independent raters scored the methodological quality of the included articles. Walking speed and physiological cost index (PCI) were selected as the primary outcome measures. Studies that measured walking speed were pooled and a pooled difference including confidence interval was calculated. RESULTS: Eight studies were included in the review, of which one was a randomized controlled trial. Methodological score ranged from 8 to 18 out of 19. Six studies measured walking speed. The pooled improvement in walking speed was 0.13 m/s (0.07-0.2) or 38% (22.18-53.8). CONCLUSIONS: The present review suggests a positive orthotic effect of functional electrical stimulation on walking speed.
Asunto(s)
Terapia por Estimulación Eléctrica/métodos , Trastornos Neurológicos de la Marcha/rehabilitación , Neuropatías Peroneas/rehabilitación , Rehabilitación de Accidente Cerebrovascular , Adulto , Femenino , Deformidades Adquiridas del Pie/etiología , Deformidades Adquiridas del Pie/rehabilitación , Trastornos Neurológicos de la Marcha/etiología , Humanos , Masculino , Persona de Mediana Edad , Aparatos Ortopédicos , Neuropatías Peroneas/etiología , Pronóstico , Ensayos Clínicos Controlados Aleatorios como Asunto , Recuperación de la Función , Medición de Riesgo , Accidente Cerebrovascular/complicaciones , Resultado del Tratamiento , Caminata/fisiologíaRESUMEN
The purpose of this collective review is to study the techniques, usage, methods, and clinical results of functional electrical stimulation applied to the peroneal nerve in the treatment of dropped foot. When stimulation is applied through surface electrodes, clinical reports have documented the therapeutic and orthotic benefits of functional electrical stimulation. Clinical trials are now being undertaken in which implantable electrodes are being used to stimulate the peroneal nerve in patients with dropped foot.
Asunto(s)
Terapia por Estimulación Eléctrica/instrumentación , Electrodos Implantados , Deformidades Adquiridas del Pie/rehabilitación , Marcha/fisiología , Paraplejía/rehabilitación , Rehabilitación de Accidente Cerebrovascular , Anciano , Ensayos Clínicos como Asunto , Terapia por Estimulación Eléctrica/métodos , Femenino , Estudios de Seguimiento , Deformidades Adquiridas del Pie/etiología , Humanos , Masculino , Persona de Mediana Edad , Paraplejía/etiología , Nervio Peroneo/fisiopatología , Recuperación de la Función , Accidente Cerebrovascular/complicaciones , Resultado del TratamientoRESUMEN
Adaptive restriction rules based on fuzzy logic have been developed to eliminate errors and to increase stimulation safety in the foot-drop correction application, specifically when using adaptive logic networks to provide a stimulation control signal based on neural activity recorded from peripheral sensory nerve branches. The fuzzy rules were designed to increase flexibility and offer easier customization, compared to earlier versions of restriction rules. The rules developed quantified the duration of swing and stance phases into states of accepting or rejecting new transitions, based on the cyclic nature of gait and statistics on the current gait patterns. The rules were easy to custom design for a specific application, using linguistic terms to model the actions of the rules. The rules were tested using pre-recorded gait data processed through a gait event detector and proved to reduce detection delay and the number of errors, compared to conventional rules.
Asunto(s)
Terapia por Estimulación Eléctrica , Deformidades Adquiridas del Pie/rehabilitación , Lógica Difusa , Marcha , Paraplejía/rehabilitación , Pie/fisiología , Humanos , Modelos Teóricos , Factores de Tiempo , CaminataRESUMEN
Throughout history, members of human societies have gone barefoot, and those societies seemingly had a low incidence of foot deformities and pain. Only one study has addressed the problem of infection through injury to the bare foot; otherwise, the unshod foot seems to have had minimal problems. Initially shoes were made in the shape of the foot and were sandals. Over time, shoes became decorative items and symbols of status and vanity. As the shape of shoes changed, they became deforming forces on the foot and the source of pain. Recent studies by the Council on Women's Footwear of the American Orthopaedic Foot and Ankle Society have tried to document the problems caused by shoes on the feet of American women. Attempts should continue to educate women on appropriate shoes and proper fit.