Non-Powered automatic velocity-controlled wheeled walker improves gait and satisfaction in patients with hip fracture when walking downhill: A cross-over study.

BACKGROUND: A standard four-wheeled walker is commonly used after surgery for hip fracture to aid ambulation. However, elderly patients experience some difficulties and are at risk for falls; therefore, attempts are being made to address these issues. RESEARCH QUESTION: Does the non-powered automatic velocity-controlled (NPAVEC) wheeled walker improves the gait and satisfaction of patients with hip fractures when walking downhill using it? METHODS: In this cross-over study, 21 participants performed three trials of walking downhill with two walkers (an NPAVEC wheeled walker and a standard four-wheeled walker) at a self-selected speed. We compared the lower limb surface electromyography data and self-reported satisfaction scores for both walkers. RESULTS: Regarding the affected limb, the NPAVEC wheeled walker increased contraction in the vastus medialis (p = 0.003) and tibialis anterior (p = 0.014), and biceps femoris of the unaffected limb (p = 0.01). Additionally, participants reported greater satisfaction when using the NPAVEC wheeled walker (p < 0.001). SIGNIFICANCE: An NPAVEC wheeled walker, compared to a four-wheeled walker, can assist patients recovering from hip fracture when walking downhill by improving the gait and increasing satisfaction.

[Needs, uses, cons-pros, good practices and opportunities about walker in elderly with loss of autonomy]. / Besoins, usages, bénéfices-inconvénients, bonnes pratiques et perspectives en matière de déambulateurs chez les sujets âgés dépendants.

Non-use of the walker may be secondary to an initial inappropriate prescribing, a lack of adequate training, a lack of monitoring and side effects of using. Improving both stability and mobility in users is due to several biomechanical mechanisms. The benefits of walker are: general physiological effects, more confidence, better social life and decrease in the burden of care. The disadvantages of walker are: technical or practical aspects criticized by users, musculoskeletal disorders, delayed reaction time, fall risk and stigma. Few scientific data evaluating the interest of the walker concerning mobility exist, thus recommendations are low grade and are often taken from professional clinical experiences. The choice of technical walking assistance depends on the pathology and biomechanical mechanism. The walker robots are few distributed.

Análisis de las ayudas técnicas y del material de Fisioterapia solicitadas en la consejería de educación de la comunidad autónoma de Murcia / Analysis of technical devices and physiotherapy equipment requested in the ministry of education of the region of Murcia

Objetivo La atención del alumnado con discapacidad motora en la escuela en la comunidad autónoma de Murcia requiere de la intervención de diferentes profesionales, entre los que destaca el fisioterapeuta pediátrico para valorar la dificultad que presenta el niño y las ayudas técnicas que necesita en el entorno escolar. El objetivo del estudio ha sido realizar un análisis de las ayudas técnicas solicitadas por los centros escolares en la Consejería de Educación de la Región de Murcia. Material y método Los datos fueron recogidos a través del modelo establecido al efecto, durante los meses de enero a julio de 2010. Realizamos un análisis descriptivo de los datos y se valoró la relación entre distintas variables. Resultados El número total de solicitudes revisadas es de 143, con una edad media de 6,92 años. Los equipos de Murcia presentan el mayor porcentaje (27,3%). En relación con el sexo, un 38,5% de solicitudes corresponden a niñas. En relación con el diagnóstico médico y el diagnóstico funcional, las enfermedades no degenerativas y las tetraplejías presentan el mayor porcentaje. Existe un mayor número de solicitudes referidas a ayudas técnicas individuales, mobiliario, fisioterapia y movilidad. Conclusiones Se han encontrado relaciones significativas entre el diagnóstico médico, el sexo y las etapas educativas. Es necesario profundizar en los factores sociales y en la mejora de la calidad de vida para valorar el grado de aceptación de las ayudas técnicas en el entorno del niño (AU)

Background Care of students with physical disabilities in the school requires the intervention of several professionals. Of importance among them is the pediatric physiotherapist who evaluates the child's difficulties and the technical devices needed in the school environment. This study has aimed to analyze the technical devices requested in the Ministry of Education in the Region of Murcia. Material and method The data were collected using the model established for this purpose during the months of January to July 2010. A descriptive analysis was made of the data and the relationships between variables were assessed. Results A total of 143 requests were reviewed with a mean age of the children of 6.92 years. Murcia Teams had the highest percentage (27.3%). In relation to sex, 38.5% of the requests were for girls. Non-degenerative diseases and tetraplegia had the highest percentage regarding medical and functional diagnosis. There is a higher number of requests for individual technical devices, furniture, physiotherapy and mobility. Conclusions Differences were found between medical diagnosis, sex and educational levels. It is necessary go into greater depth regarding the social factors and the environment to improve the quality of life of children with motor disabilities (AU)

Palliative care concepts in respiratory disease.

Many respiratory diseases besides lung cancer are still not curable. There is an unmet need for palliative care, especially in non-malignant conditions. In this article we focus on symptomatic treatment of typical symptoms in respiratory disease beyond causal treatment.

Assistive devices for the adult patient with orthopaedic dysfunction. Why physical therapists choose what they do.

The more common types of assistive devices seen in the orthopaedic setting are described. Also included are descriptions of patient factors that guide the physical therapist in deciding which of these devices to try for which patients. Examples of typical patient problems are also included to help the nurse understand the decisions that therapists make. A simple decision tree contained in this article helps further this understanding.

Do baby walkers delay onset of walking in young children?

Baby walkers have been a source of considerable controversy. Some people suggest developmental benefit from their use while others focus on the potential harm that stems from accidents and even suggest developmental delay. This mini-review aimed to determine if use of a baby walker delays affects the onset of walking. The Cochrane library, Embase, CINAHL and Medline were searched for randomized controlled trials (RCTs) and cohort studies, which compared the onset of walking in infants who used baby walkers with a group who did not. Two RCTs and two cohort studies were identified and available for consideration. All of the studies examined the effect of infant walkers on the onset of walking. The results of the two RCTs did not demonstrate a significant effect on the onset of walking. The cohort studies suggest that the use of infant walkers delayed the onset of walking in young children and a pooled analysis of the four studies suggested a delay of between 11 and 26 days. Although the quality of the studies was relatively poor these studies lend no support to the argument that walkers aid the development of walking. The significance of a delay of this magnitude is however unclear. Further work is required to determine whether walkers are an independent causal factor in accidents.