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1.
J Frailty Aging ; 9(3): 179-184, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32588034

RESUMO

BACKGROUND: Physical frailty and impaired executive function of the brain show similar pathophysiology. Both of these factors lead to dysfunction of neuromuscular and abilities in elderly. High-speed power training (HSPT) has been determined to have positive effects on neuromuscular function and gait performance, as well as executive function in the elderly. OBJECTIVES: The purpose of this study was to investigate the effects of 8-week HSPT on neuromuscular, gait and executive functions in frail elderly with mild cognitive impairment (MCI). DESIGN, SETTING AND PARTICIPANTS: We performed a randomized controlled trial of frail elderly from community and medical center in republic of Korea. Forty-two physically frail elderly with MCI were randomly allocated to control (n=22, age=74.22±4.46) and intervention groups (n=18, age=73.77±4.64). The intervention group was subjected to HSPT, 3 times weekly for 8 weeks. MEASUREMENTS: Isometric contraction of knee extension and flexion with electromyography (EMG) was measured to determine the neuromuscular function such as knee extensor strength, rate of torque development, movement time, pre-motor time, motor time, rate of EMG rise, and hamstrings antagonist co-activation. Additionally, the 4.44-meter gait and timed up-and-go (TUG) test were administered to assess gait performance. A frontal assessment battery was measured in this study. RESULTS: The 8-week HSPT regimen improved the knee extensor strength from 1.13±0.08 to 1.25±0.07 (p<0.05), the 200-ms RTD from 3.01±0.3 to 3.55±0.24 (p<0.05) and the rate of EMG rise from 166.48±13.31 to 197.94±11.51 (p<0.05), whereas the movement time and motor time were statistically decreased from 921.69±40.10 to 799.51±72.84, and 271.40±19.29 to 181.15±38.08 (p<0.05), respectively. The 4.44-m gait speed and TUG significantly decreased from 6.39±0.25 to 5.5±0.24, and 11.05±0.53 to 9.17±0.43 respectively (p<0.05). CONCLUSION: The findings of this study suggest the favorable effects of 8-week HSPT on the neuromuscular function and the gait performance in the frail elderly with MCI without increase in the executive function.


Assuntos
Disfunção Cognitiva/terapia , Função Executiva/fisiologia , Terapia por Exercício/métodos , Idoso Fragilizado/psicologia , Marcha/fisiologia , Músculo Esquelético/fisiologia , Fenômenos Fisiológicos do Sistema Nervoso , Idoso , Disfunção Cognitiva/epidemiologia , Idoso Fragilizado/estatística & dados numéricos , Humanos , República da Coreia/epidemiologia , Resultado do Tratamento
2.
Bone Joint J ; 102-B(6_Supple_A): 129-137, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32475284

RESUMO

AIMS: A retrospective longitudinal study was conducted to compare directly volumetric wear of retrieved polyethylene inserts to predicted volumetric wear modelled from individual gait mechanics of total knee arthroplasty (TKA) patients. METHODS: In total, 11 retrieved polyethylene tibial inserts were matched with gait analysis testing performed on those patients. Volumetric wear on the articular surfaces was measured using a laser coordinate measure machine and autonomous reconstruction. Knee kinematics and kinetics from individual gait trials drove computational models to calculate medial and lateral tibiofemoral contact paths and forces. Sliding distance along the contact path, normal forces and implantation time were used as inputs to Archard's equation of wear to predict volumetric wear from gait mechanics. Measured and modelled wear were compared for each component. RESULTS: Volumetric wear rates on eight non-delaminated components measured 15.9 mm3/year (standard error (SE) ± 7.7) on the total part, 11.4 mm3/year (SE ± 6.4) on the medial side and 4.4 (SE ± 2.6) mm3/year on the lateral side. Volumetric wear rates modelled from patient gait mechanics predicted 16.4 mm3/year (SE 2.4) on the total part, 11.7 mm3/year (SE 2.1) on the medial side and 4.7 mm3/year (SE 0.4) on the lateral side. Measured and modelled wear volumes correlated significantly on the total part (p = 0.017) and the medial side (p = 0.012) but not on the lateral side (p = 0.154). CONCLUSION: In the absence of delamination, patient-specific knee mechanics during gait directly affect wear of the tibial component in TKA. Cite this article: Bone Joint J 2020;102-B(6 Supple A):129-137.


Assuntos
Artroplastia do Joelho , Remoção de Dispositivo , Marcha , Prótese do Joelho , Modelos Teóricos , Falha de Prótese , Idoso , Idoso de 80 Anos ou mais , Fenômenos Biomecânicos , Feminino , Previsões , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Polietileno , Estudos Retrospectivos
3.
Rev Lat Am Enfermagem ; 28: e3282, 2020.
Artigo em Português, Espanhol, Inglês | MEDLINE | ID: mdl-32491121

RESUMO

OBJECTIVE: to know the relationship between the sensory function, gait ability, and cognitive function with dependency in older adults. METHOD: a descriptive cross-sectional design, 146 older adults took part. MEASUREMENTS: Snellen chart, Audiometer, Stereognosia tests, Semmes-Weinstein monofilament, basic aromas and flavors, GAITRite system, Montreal Cognitive Assessment Test, the Barthel Index, and the Lawton and Brody Index. RESULTS: sensory function, cognitive function and gait explain 25% dependence on basic activities of daily life and 21% dependence on instrumental activities of daily life. The variables that influence dependence on basic activities were taste (p=.029), gait speed (p=.009), cadence (p=.002) and step length (p=.001) and, in instrumental activities, gait speed (p=.049), cadence (p=.028) and step length (p=.010). CONCLUSION: gait speed, cadence and stride length are variables that influence both dependence on basic and instrumental activities of daily life.


Assuntos
Cognição/fisiologia , Marcha/fisiologia , Atividades Cotidianas , Idoso , Estudos Transversais , Feminino , Análise da Marcha , Humanos , Masculino , Pessoa de Meia-Idade , Velocidade de Caminhada/fisiologia
4.
Am J Vet Res ; 81(7): 551-556, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32584174

RESUMO

OBJECTIVE: To evaluate the analgesic and tissue effects of liposomal bupivacaine administered SC as an abaxial sesamoid nerve block in horses with experimentally induced lameness. ANIMALS: 6 healthy mature light-breed horses. PROCEDURES: In a randomized crossover study, a circumferential hoof clamp was applied to a forelimb to induce reversible lameness. An abaxial sesamoid nerve block of the lame forelimb was performed by SC perineural injection of 10 mg of liposomal bupivacaine or bupivacaine HCl/site. Quantitative gait data were objectively obtained with a body-mounted inertial sensor system before (baseline) and at 30-minute intervals after treatment. Time to return to 85% of baseline lameness was determined. After a minimum 4-day washout period, procedures were repeated with the alternate limb and treatment. Lastly, the palmar digital nerves and perineural tissues were collected and examined histologically. RESULTS: SC perineural injection of liposomal bupivacaine ameliorated forelimb lameness in 5 of 6 horses. The median duration of analgesia was not significantly different between liposomal bupivacaine (4.5 hours) and bupivacaine HCl (3.0 hours). Histologically, mild inflammation was noted in 3 of 10 sites injected with liposomal bupivacaine and in none of the sites injected with bupivacaine HCl. CONCLUSIONS AND CLINICAL RELEVANCE: SC perineural injection of 10 mg of liposomal bupivacaine/site ameliorated experimentally induced forelimb lameness in some horses. At milligram-equivalent doses, liposomal bupivacaine had a similar duration of analgesia to that of bupivacaine HCl. Further investigation is required before recommending clinical use of liposomal bupivacaine for nerve blocks in horses.


Assuntos
Bupivacaína , Doenças dos Cavalos , Coxeadura Animal , Analgésicos , Animais , Estudos Cross-Over , Membro Anterior , Marcha , Cavalos
5.
PLoS One ; 15(4): e0232246, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32353030

RESUMO

INTRODUCTION: Observational gait analysis is a widely used skill in physical therapy. Meanwhile, the skill has not been investigated using objective assessments. The present study investigated the differences in eye movement between professionals and trainees, while observing gait analysis. METHODS: The participants included in this study were 26 professional physical therapists and 26 physical therapist trainees. The participants, wearing eye tracker systems, were asked to describe gait abnormalities of a patient as much as possible. The eye movement parameters of interest were fixation count, average fixation duration, and total fixation duration. RESULTS: The number of gait abnormalities described was significantly higher in professionals than in trainees, overall and in limbs of the patient. The fixation count was significantly higher in professionals when compared to trainees. Additionally, the average fixation duration and total fixation duration were significantly shorter in professionals. Conversely, in trunks, the number of gait abnormalities and eye movements showed no significant differences between groups. CONCLUSIONS: Professionals require shorter fixation durations on areas of interest than trainees, while describing a higher number of gait abnormalities.


Assuntos
Movimentos Oculares/fisiologia , Marcha/fisiologia , Feminino , Fixação Ocular/fisiologia , Análise da Marcha/métodos , Humanos , Masculino , Apoio ao Desenvolvimento de Recursos Humanos/métodos
6.
PLoS One ; 15(5): e0232901, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32396578

RESUMO

During pregnancy, an array of changes occurs in women body to enable the growth and development of the future baby and the consequent delivery. These changes are reflected in the range of motion of trunk, pelvis, lower limbs and other body segments, affect the locomotion and some of these changes may persist to the postpartum period. The aim of this study was to describe the changes affecting the gait during pregnancy and to determine the effect of tested footwear on kinematic gait characteristics during pregnancy as previous studies indicate that special orthopaedic insoles and footwear might be useful in prevention of the common musculoskeletal pain and discomfort related to pregnancy. Participants from the control group (n = 18), without any intervention, and the experimental group (n = 23), which was wearing the tested shoes, were measured at their 14, 28 and 37 gestational weeks and 28 weeks postpartum to capture the complete pregnancy-related changes in gait. The gait 3D kinematic data were obtained using Simi Motion System. The differences between the control and experimental group at the first data collection session in most of the analysed variables, as well as relatively high standard deviations of analysed variables indicate large individual differences in the gait pattern. The effect of tested footwear on kinematic gait pattern changes may be explained by its preventive effect against the foot arches falling. In the control group, changes associated previously with the foot arches falling and hindfoot hyperpronation were observed during advanced phases of pregnancy and postpartum, e.g. increase in knee flexion or increase in spinal curvature. For the comprehensive evaluation of the tested footwear on pregnancy gait pattern, future studies combining the kinematic and dynamic plantographic methods are needed.


Assuntos
Desenho de Equipamento/métodos , Marcha/fisiologia , Dor Musculoesquelética/prevenção & controle , Período Pós-Parto/fisiologia , Adulto , Fenômenos Biomecânicos , Estudos de Casos e Controles , Feminino , Órtoses do Pé , Idade Gestacional , Humanos , Gravidez , Complicações na Gravidez/prevenção & controle
7.
PLoS One ; 15(5): e0232328, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32428037

RESUMO

Digital natives developed in an electronic dual tasking world. This paper addresses two questions. Do digital natives respond differently under a cognitive load realized during a locomotor task in a dual-tasking paradigm and how does this address the concept of safety? We investigate the interplay between cognitive (talking and solving Raven's matrices) and locomotor (walking on a treadmill) tasks in a sample of 17 graduate level participants. The costs of dual-tasking on gait were assessed by studying changes in stride interval time and its variability at long-range. A safety index was designed and computed from total relative change between the variability indices in the single walking and dual-task conditions. As expected, results indicate high Raven's scores with gait changes found between the dual task conditions compared to the single walking task. Greater changes are observed in the talking condition compared to solving Raven's matrices, resulting in high safety index values observed in 5 participants. We conclude that, although digital natives are efficient in performing the dual tasks when they are not emotional-based, modification of gait are observable. Due to the variation within participants and the observation of high safety index values in several of them, individuals that responded poorly to low cognitive loads should be encouraged to not perform dual task when executing a primate task of safety to themselves or others.


Assuntos
Uso do Telefone Celular , Cognição , Locomoção/fisiologia , Adolescente , Adulto , Encéfalo/fisiologia , Feminino , Marcha/fisiologia , Humanos , Masculino , Adulto Jovem
8.
Am J Vet Res ; 81(5): 394-399, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32343179

RESUMO

OBJECTIVE: To compare the speed of onset and analgesic effect of mepivacaine deposited within or immediately outside the neurovascular bundle at the base of the proximal sesamoid bones in horses. ANIMALS: 6 horses with naturally occurring forefoot-related lameness. PROCEDURES: In a crossover study design, horses were randomly assigned to receive 1 of 2 treatments first, with the second treatment administered 3 to 7 days later. Trotting gait was analyzed with an inertial sensor-based motion analysis system immediately before treatment to determine degree of lameness. Afterward, ultrasound guidance was used to inject 2% mepivacaine hydrochloride around the palmar digital nerves of the affected forelimb at the level of the base of the proximal sesamoid bones either within the subcircumneural space or outside the circumneural sheath. After injection, gait was reevaluated at 5-minute intervals for 45 minutes. RESULTS: Mepivacaine deposition outside the circumneural sheath did not resolve lameness in any horse; for 3 horses, the mean time to 70% reduction of initial vertical head movement was 13.3 minutes, and the remaining 3 horses had no such reduction at any point. Mepivacaine deposition within the subcircumneural space resulted in a mean time to 70% reduction of initial vertical head movement of 6.7 minutes and mean time to resolution of lameness of 21.7 minutes. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that when peripheral nerves of horses lie within a sheath, local anesthetic solution should be deposited within the sheath for an effective nerve block. If local anesthetic solution is deposited outside the sheath, the nerve block may yield erroneous results.


Assuntos
Doenças dos Cavalos , Ossos Sesamoides , Analgésicos/farmacologia , Animais , Estudos Cross-Over , Membro Anterior , Marcha/efeitos dos fármacos , Cavalos , Coxeadura Animal , Mepivacaína/farmacologia
9.
PLoS One ; 15(4): e0231334, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32275736

RESUMO

Subthreshold stochastic vestibular stimulation (SVS) is thought to enhance vestibular sensitivity and improve balance. However, it is unclear how SVS affects standing and walking when balance is challenged, particularly when the eyes are open. It is also unclear how different methods to determine stimulation intensity influence the effects. We aimed to determine (1) whether SVS affects stability when balance is challenged during eyes-open standing and overground walking tasks, and (2) how the effects differ based on whether optimal stimulation amplitude is derived from sinusoidal or cutaneous threshold techniques. Thirteen healthy adults performed balance-unchallenged and balance-challenged standing and walking tasks with SVS (0-30 Hz zero-mean, white noise electrical stimulus) or sham stimulation. For the balance-challenged condition, participants had inflatable rubber hemispheres attached to the bottom of their shoes to reduce the control provided by moving the center of pressure under their base of support. In different blocks of trials, we set SVS intensity to either 50% of participants' sinusoidal (motion) threshold or 80% of participants' cutaneous threshold. SVS reduced medial-lateral trunk velocity root mean square in the balance-challenged (p < 0.05) but not in the balance-unchallenged condition during standing. Regardless of condition, SVS decreased step-width variability and marginally increased gait speed when walking with the eyes open (p < 0.05). SVS intensity had minimal effect on the standing and walking measures. Taken together, our results provide insight into the effectiveness of SVS at improving balance-challenged, eyes-open standing and walking performance in healthy adults.


Assuntos
Marcha , Equilíbrio Postural , Vestíbulo do Labirinto/fisiologia , Adulto , Feminino , Humanos , Masculino , Modelos Neurológicos , Postura , Limiar Sensorial , Processos Estocásticos , Potenciais Evocados Miogênicos Vestibulares
10.
PLoS One ; 15(4): e0231984, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32348346

RESUMO

Freezing of gait (FOG) is a devastating motor symptom of Parkinson's disease that leads to falls, reduced mobility, and decreased quality of life. Reliably eliciting FOG has been difficult in the clinical setting, which has limited discovery of pathophysiology and/or documentation of the efficacy of treatments, such as different frequencies of subthalamic deep brain stimulation (STN DBS). In this study we validated an instrumented gait task, the turning and barrier course (TBC), with the international standard FOG questionnaire question 3 (FOG-Q3, r = 0.74, p < 0.001). The TBC is easily assembled and mimics real-life environments that elicit FOG. People with Parkinson's disease who experience FOG (freezers) spent more time freezing during the TBC compared to during forward walking (p = 0.007). Freezers also exhibited greater arrhythmicity during non-freezing gait when performing the TBC compared to forward walking (p = 0.006); this difference in gait arrhythmicity between tasks was not detected in non-freezers or controls. Freezers' non-freezing gait was more arrhythmic than that of non-freezers or controls during all walking tasks (p < 0.05). A logistic regression model determined that a combination of gait arrhythmicity, stride time, shank angular range, and asymmetry had the greatest probability of classifying a step as FOG (area under receiver operating characteristic curve = 0.754). Freezers' percent time freezing and non-freezing gait arrhythmicity decreased, and their shank angular velocity increased in the TBC during both 60 Hz and 140 Hz STN DBS (p < 0.05) to non-freezer values. The TBC is a standardized tool for eliciting FOG and demonstrating the efficacy of 60 Hz and 140 Hz STN DBS for gait impairment and FOG. The TBC revealed gait parameters that differentiated freezers from non-freezers and best predicted FOG; these may serve as relevant control variables for closed loop neurostimulation for FOG in Parkinson's disease.


Assuntos
Estimulação Encefálica Profunda , Marcha , Doença de Parkinson/fisiopatologia , Idoso , Área Sob a Curva , Estudos de Casos e Controles , Feminino , Transtornos Neurológicos da Marcha/fisiopatologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Curva ROC , Inquéritos e Questionários , Caminhada
11.
Can Vet J ; 61(4): 389-395, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32255824

RESUMO

This study describes clinical and ultrasonographic findings and outcomes of horses with lameness associated with muscle tears. Records of horses diagnosed with muscle tears were retrospectively evaluated. Horses in which one or more muscle tears were confirmed ultrasonographically and lameness was associated with the tear were included in the study (n = 14). Eight horses had tearing of a single muscle, 6 horses had 2 or more muscles involved. Twelve of 14 horses survived to discharge and were alive at follow-up (8 to 90 months). Recovery time ranged from 6 to 52 weeks (mean: 19.8 weeks); 6 to 16 weeks for single muscle injuries and 12 to 52 weeks for multiple muscle injuries. Of the 12 long-term survivors 3 had chronic lameness/stiffness preventing return to their previous activity level and 9 returned to equal or greater level of activity. No statistically significant difference existed between outcomes and location of injury or number of muscles injured. Key clinical message: This study indicates that conservative management of muscle tears can result in favorable long-term outcomes.


Assuntos
Doenças dos Cavalos , Doenças Musculares/veterinária , Animais , Marcha , Cavalos , Coxeadura Animal , Estudos Retrospectivos
12.
Medicine (Baltimore) ; 99(15): e19555, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32282704

RESUMO

To identify basic gait features and abnormal gait patterns that are common to different neurological or musculoskeletal conditions, such as cerebral stroke, Parkinsonian disorders, radiculopathy, and musculoskeletal pain.In this retrospective study, temporal-spatial, kinematic, and kinetic gait parameters were analyzed in 424 patients with hemiplegia after stroke, 205 patients with Parkinsonian disorders, 216 patients with radiculopathy, 167 patients with musculoskeletal pain, and 316 normal controls (total, 1328 subjects). We assessed differences according to the condition and used a community detection algorithm to identify subgroups within each condition. Additionally, we developed a prediction model for subgroup classification according to gait speed and maximal hip extension in the stance phase.The main findings can be summarized as follows. First, there was an asymmetric decrease of the knee/ankle flexion angles in hemiplegia and a marked reduction of the hip/knee range of motion with increased moment in Parkinsonian disorders. Second, three abnormal gait patterns, including fast gait speed with adequate maximal hip extension, fast gait speed with inadequate maximal hip extension, and slow gait speed, were found throughout the conditions examined. Third, our simple prediction model based on gait speed and maximal hip extension angle was characterized by a high degree of accuracy in predicting subgroups within a condition.Our findings suggest the existence of specific gait patterns within and across conditions. Our novel subgrouping algorithm can be employed in routine clinical settings to classify abnormal gait patterns in various neurological disorders and guide the therapeutic approach and monitoring.


Assuntos
Marcha , Dor Musculoesquelética/fisiopatologia , Transtornos Parkinsonianos/fisiopatologia , Radiculopatia/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Idoso , Algoritmos , Fenômenos Biomecânicos , Classificação , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
13.
PLoS One ; 15(4): e0232064, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32330162

RESUMO

Clinical gait analysis is widely used in clinical routine to assess the function of patients with motor disorders. The proper assessment of the patient's function relies greatly on the repeatability between the measurements. Marker misplacement has been reported as the largest source of variability between measurements and its impact on kinematics is not fully understood. Thus, the purpose of this study was: 1) to evaluate the impact of the misplacement of the lateral femoral epicondyle marker on lower limb kinematics, and 2) evaluate if such impact can be predicted. The kinematic data of 10 children with cerebral palsy and 10 aged-match typical developing children were included. The lateral femoral epicondyle marker was virtually misplaced around its measured position at different magnitudes and directions. The outcome to represent the impact of each marker misplacement on the lower limb was the root mean square deviations between the resultant kinematics from each simulated misplacement and the originally calculated kinematics. Correlation and regression equations were estimated between the root mean square deviation and the magnitude of the misplacement expressed in percentage of leg length. Results indicated that the lower-limb kinematics is highly sensitive to the lateral femoral epicondyle marker misplacement in the anterior-posterior direction. The joint angles most impacted by the anterior-posterior misplacement were the hip internal-external rotation (5.3° per 10 mm), the ankle internal-external rotation (4.4° per 10 mm) and the knee flexion-extension (4.2° per 10 mm). Finally, it was observed that the lower the leg length, the higher the impact of misplacement on kinematics. This impact was predicted by regression equations using the magnitude of misplacement expressed in percentage of leg length. An error below 5° on all joints requires a marker placement repeatability under 1.2% of the leg length. In conclusion, the placement of the lateral femoral epicondyle marker in the antero-posterior direction plays a crucial role on the reliability of gait measurements with the Conventional Gait Model.


Assuntos
Fenômenos Biomecânicos/fisiologia , Análise da Marcha/métodos , Joelho/fisiopatologia , Adolescente , Algoritmos , Articulação do Tornozelo/fisiopatologia , Paralisia Cerebral/fisiopatologia , Criança , Feminino , Fêmur/fisiopatologia , Marcha/fisiologia , Articulação do Quadril/fisiopatologia , Humanos , Articulação do Joelho/fisiopatologia , Extremidade Inferior/fisiopatologia , Masculino , Amplitude de Movimento Articular/fisiologia , Reprodutibilidade dos Testes
14.
J Am Vet Med Assoc ; 256(6): 696-700, 2020 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-32125237

RESUMO

CASE DESCRIPTION: An 11-month-old mixed-breed dog was evaluated because of a 2-day history of acute-onset, intermittent vocalization and collapse several days after ingesting metallic wire foreign material. CLINICAL FINDINGS: Physical examination findings were initially unremarkable. After a brief period of hospitalization, the patient acutely developed non-weight-bearing lameness with signs of severe pain localized to the left thoracic limb and inability or refusal to rise. Results of cervical, thoracic, and abdominal radiography revealed a linear metallic foreign body at the thoracic inlet and a single metallic foreign body in the cranial aspect of the abdomen. Neuropathic pain at the level of the left brachial plexus was suspected. Results of a subsequent CT scan were consistent with a metallic foreign body in the left axilla with associated abscess formation and neuritis and an additional metallic foreign body within the omental fat near the pyloroduodenal junction. TREATMENT AND OUTCOME: Intraoperative fluoroscopy was used to facilitate localization and surgical removal of the axillary foreign body. The intra-abdominal foreign body was removed laparoscopically. Complete resolution of clinical signs was observed before discharge from the hospital the following day. On telephone follow-up 8 months after surgery, the owners reported the patient had no signs of lameness or complications. CLINICAL RELEVANCE: Migrating metallic foreign bodies may be identified as incidental findings with the potential to cause harm in the future or may be a cause for severe clinical signs. Migrating foreign bodies should be considered as a differential diagnosis for patients reported to have acute collapse or lameness and consistent clinical history.


Assuntos
Doenças do Cão , Corpos Estranhos/veterinária , Animais , Cães , Marcha , Tomografia Computadorizada por Raios X
15.
Rev Med Liege ; 75(3): 180-184, 2020 Mar.
Artigo em Francês | MEDLINE | ID: mdl-32157844

RESUMO

Psychomotor disadaptation syndrome (PDS) was first described by the Geriatrics School of Dijon (France), three decades ago, under the name «psychomotor regression syndrome¼. Over time, the original clinical features remained unchanged. However, progress has been made in its pathophysiology understanding and care, hence the new name, PDS, appeared in the 1990s. The PDS is also called sub-cortico-frontal dysfunction syndrome since the 2000s. It corresponds to a decompensation of posture, gait and psychomotor automatisms, related to an alteration of the postural and motor programming, which is a consequence of sub-cortico-frontal lesions. The clinical features of PDS associate backward disequilibrium, nonspecific gait disorders and neurological signs (akinesia, reactional hypertonia, impaired reactive postural responses and protective reactions, etc.). Psychological disorders of PDS are a fear of standing and walking in its acute form (the post-fall syndrome), or a bradyphrenia and anhedonia in its chronic form. The PDS occurrence results from the combination of three factors implicated in the reduction in functional reserves related to the alteration of the sub-cortico-frontal structures: ageing, chronic afflictions and acute situations, which induce a decrease in cerebral blood flow. The PDS management must be multidisciplinary, including the physician, the physiotherapist, the psychologist, nurses and care assistants.


Assuntos
Acidentes por Quedas , Equilíbrio Postural , Postura , Adaptação Fisiológica , França , Marcha , Humanos , Transtornos das Sensações , Síndrome
16.
PLoS One ; 15(3): e0229775, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32142524

RESUMO

INTRODUCTION: Altered trunk shape and body alignment in Lenke 1 thoracic adolescent idiopathic scoliosis (AIS) may affect the body's balance control during activities. The current study aimed to identify the effects of Lenke 1 thoracic AIS on the balance control during level walking in terms of the inclination angles (IA) of the center of mass (COM) relative to the center of pressure (COP), the rate of change of IA (RCIA), and the jerk index of IA. The association between the Cobb angle, IA and RCIA was also evaluated. MATERIALS AND METHODS: Sixteen adolescents with AIS (age: 14.0±1.8 years, height: 154.8±4.7 cm, mass: 42.0±7.5 kg) and sixteen healthy controls (age: 14.4±2.0 years, height: 158.4±6.2 cm, body mass: 48.6±8.9 kg) performed level walking in a gait laboratory. The kinematic and ground reaction force data were measured for both concave-side and convex-side limb cycles, and used to calculate the IA and RCIA, the jerk index of IA, and the temporal-spatial parameters. Correlations between the Cobb angle, IA and RCIA were quantified using Pearson's correlation coefficients (r). RESULTS: The patients showed less smooth COM-COP motion with increased jerk index of IA in the sagittal plane during single limb support (SLS) of the concave-limb (p = 0.05) and in the frontal plane during double limb support (DLS) (p < 0.05). The patients also showed significantly increased posterior RCIA on both the concave and convex side during initial (p = 0.04, p = 0.03) and terminal (p = 0.04, p = 0.03) DLS when compared to healthy controls. In the frontal plane, the patients walking on the concave-side limb showed decreased IA over SLS (p = 0.01), and at contralateral toe-off (p<0.01) and contralateral heel-strike (p = 0.02), but increased mean IA magnitude over terminal DLS (p = 0.01). The frontal IA at contralateral toe-off and SLS for AIS-A showed a moderate to strong correlation with Cobb angles (r = -0.46 and -0.61), and the sagittal RCIA over the initial DLS for AIS-A also showed a significant, strong correlation with Cobb angles (r = -0.50). CONCLUSIONS: The patients with Lenke 1 thoracic scoliosis in the current study showed altered and jerkier COM-COP control during level walking when compared to healthy controls. During DLS, the patients increased the posterior RCIA in the sagittal plane with increased IA jerk index in the frontal plane for both the concave- and the convex-side limb, indicating their difficulty in maintaining a smooth transfer of the body weight. During SLS of the concave-side limb, the patients adopted a conservative COM-COP control strategy, as indicated by a decreased IA in the frontal plane, but showed a jerky COM-COP control in the sagittal plane. The COM-COP control of the patients was associated with the severity of the spinal deformity. The current results suggest that this patient group should be monitored for signs of an increased risk of loss of balance during weight transfer on the concave-side limb.


Assuntos
Marcha , Equilíbrio Postural , Escoliose/fisiopatologia , Adolescente , Fenômenos Biomecânicos , Feminino , Humanos
17.
PLoS One ; 15(3): e0230019, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32163463

RESUMO

Falls cause negative impacts on society and the economy. Slipping is a common initiating event for falling. Yet, individuals differ in their ability to recover from slips. Persons experiencing mild slips can accommodate the perturbation without falling, whereas severe slipping is associated with inadequate or slow pre- or post-slip control that make these individuals more prone to fall. Knowing the discrepancies between mild and severe slippers in kinematic and kinetic variables improves understanding of adverse control responsible for severe slipping. This study examined differences across these participants with respect to center of mass (COM) height, sagittal angular momentum (H), upper body kinematics, and the duration of single/double phase. Possible causality of such relationships was also studied by observing the time-lead of the deviations. Twenty healthy young adults performed walking trials in dry and slippery conditions. They were classified into mild and severe slippers based on their heel slipping speed. No inter-group differences were observed in the upper extremity kinematics. It was found that mild and severe slippers do not differ in the studied variables during normal gait; however, they do show significant differences through slipping. Compared to mild slippers, sever slippers lowered their COM height following a slip, presented higher H, and shortened their single support phase (p-value<0.05 for all). Based on the time-lead observed in H over all other variables suggests that failure to control angular momentum may influence slip severity.


Assuntos
Acidentes por Quedas/prevenção & controle , Caminhada , Adulto , Fenômenos Biomecânicos , Feminino , Pé/fisiologia , Marcha , Humanos , Masculino , Ombro/fisiologia , Adulto Jovem
18.
PLoS One ; 15(3): e0229640, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32160212

RESUMO

Dinosaur fossils from the Middle Jurassic are rare globally, but the Isle of Skye (Scotland, UK) preserves a varied dinosaur record of abundant trace fossils and rare body fossils from this time. Here we describe two new tracksites from Rubha nam Brathairean (Brothers' Point) near where the first dinosaur footprint in Scotland was found in the 1980s. These sites were formed in subaerially exposed mudstones of the Lealt Shale Formation of the Great Estuarine Group and record a dynamic, subtropical, coastal margin. These tracksites preserve a wide variety of dinosaur track types, including a novel morphotype for Skye: Deltapodus which has a probable stegosaur trackmaker. Additionally, a wide variety of tridactyl tracks shows evidence of multiple theropods of different sizes and possibly hints at the presence of large-bodied ornithopods. Overall, the new tracksites show the dinosaur fauna of Skye is more diverse than previously recognized and give insight into the early evolution of major dinosaur groups whose Middle Jurassic body fossil records are currently sparse.


Assuntos
Dinossauros/classificação , Animais , Biodiversidade , Dinossauros/anatomia & histologia , Dinossauros/fisiologia , Fósseis , Marcha/fisiologia , História Antiga , Locomoção/fisiologia , Paleontologia , Escócia
19.
Invest Ophthalmol Vis Sci ; 61(3): 30, 2020 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-32186671

RESUMO

Purpose: To investigate the association between balance and gait measures with fall rates in glaucoma patients. Methods: Balance and gait were measured for 239 participants with glaucoma or suspected glaucoma. Daily falls were evaluated over 24 months. Annual accelerometer trials captured average daily steps. Multivariable negative binomial models evaluated balance and gait associations with average daily steps and rates of falls per time or step, as well as whether balance and gait parameters mediated the association between integrated visual field (IVF) sensitivity and falls. Results: Average age was 70.5 years (SD = 7.6), and 22% of the participants had moderate to severe visual field damage. Over the first 12 months of the follow-up, the cumulative probability of falling one or more times was 44.8%, and the cumulative probability of falling two or more times was 17.7%. Gait deficits were associated with fewer daily steps (P < 0.03), but no balance parameters were (P > 0.19). Worse balance was associated with a higher rate of falls per year and step (P < 0.03). No gait measures were associated with the rate of falls per year (P > 0.17). More time in double support and greater swing time variability were associated with higher falls per step, and higher velocity and faster cadence were associated with fewer falls per step (P < 0.05 for all). Neither gait nor balance measures mediated the relationship between visual field damage and fall rates. IVF remained an independent predictor of falls per step (rate ratio = 1.36 to 1.48; P < 0.001 to P < 0.005) in multivariable models including individual balance/gait parameters. Conclusions: Although balance and gait measures are associated with fall rates, they do not explain why persons with greater visual field damage fall more frequently, suggesting the importance of other potential factors such as hazard perception.


Assuntos
Acidentes por Quedas/estatística & dados numéricos , Marcha/fisiologia , Glaucoma/fisiopatologia , Equilíbrio Postural/fisiologia , Idoso , Feminino , Glaucoma/epidemiologia , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Hipertensão Ocular/epidemiologia , Hipertensão Ocular/fisiopatologia , Estudos Prospectivos , Medição de Risco , Inquéritos e Questionários , Transtornos da Visão/epidemiologia , Transtornos da Visão/fisiopatologia , Campos Visuais/fisiologia
20.
Acta Chir Orthop Traumatol Cech ; 87(1): 17-23, 2020.
Artigo em Tcheco | MEDLINE | ID: mdl-32131966

RESUMO

INTRODUCTION The anterior cruciate ligament (ACL) reconstruction is a tried and tested method in treating knee joint instability which brings valuable results in an acceptable time frame. In the long-term follow-up, however, a higher risk of knee osteoarthritis development is described. One of the possible reasons is considered to be the abnormal kinematics of the operated knee. The purpose of our study was to determine the degree to which the ACL reconstruction helps restore the correct gait cycle compared to the healthy limb. MATERIAL AND METHODS The study included patients after the ACL reconstruction performed in the period from 1 January 2016 to 31 March 2018. With the use of strict criteria, 11 patients were selected for kinematic analysis, who underwent examinations in a gait laboratory and were also evaluated using the Tegner and Lysholm rating systems and the IKDC (International Knee Documentation Committee) knee score, namely preoperatively and at 6 and 12 months postoperatively. The kinematic assessment of gait was carried out using the Vicon MX system with the placement of reflexive markers in line with the Plug-In Gait model. RESULTS The clinical outcomes (namely the score according to Tegner, Lysholm as well as the IKDC) during the first year postoperatively showed a major improvement in knee function and the achievement of the pre-injury activity level. The kinematic analysis revealed lower knee extension at the stance phase and lower overall range of motion of the limb with the injured ACL compared to the healthy limb. The follow-up evaluation at 6 and 12 months postoperatively showed a persisting between-limbs difference in knee extension, whereas the range of motion gradually improved during the year. CONCLUSIONS Although our study confirmed that the ACL reconstruction is an efficient method to treat knee joint instability, it also indicated that even at one year after the ACL reconstruction, the kinematics of the operated knee was not fully restored to the level of the heathy knee. The persisting limb-difference in gait kinematics could contribute to the gradual development of degenerative changes in the operated knee joint. Key words: anterior cruciate ligament deficiency, anterior cruciate ligament reconstruction, knee kinematics during gait, knee osteoarthritis.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Articulação do Joelho , Fenômenos Biomecânicos , Seguimentos , Marcha , Humanos , Articulação do Joelho/fisiologia , Resultado do Tratamento
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