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1.
《The journal of spinal cord medicine》2013,36(4):498-504
AbstractObjectiveTo determine the reliability and validity of the capabilities of upper extremity test (CUE-T), a measure of functional limitations, in patients with chronic tetraplegia.DesignRepeated measures.SettingOutpatient rehabilitation center.ParticipantsFifty subjects (36 male/14 female) with spinal cord injury (SCI) of ≥1-year duration participated. Subjects were 17–81 years old (mean 48.1 ± 18.2); neurological levels ranged from C2 through T6, American Spinal Injury Association Impairment Scale grades A–D.InterventionsNot applicable.Outcome measuresIntraclass correlation coefficients (ICC), weighted kappa and repeatability values for CUE-T; Spearman correlations of CUE-T with upper extremity motor scores (UEMS), and self-care and mobility portions of the Spinal Cord Independence Measure, vIII (SCIM III).ResultsScore ranges for UEMS were 8–50, CUE-T 7–135, self-care SCIM 0–20, and mobility SCIM 0–40. The ICC values for total, right, and left side scores were excellent (0.97–0.98; 95% confidence interval 0.96–0.99). Item weighted kappa values were ≥0.60 for all but five items, four of which were right and left pronation and supination. Repeatability of total score was 10.8 points, right and left sides 6.3 and 6.1 points. Spearman correlations of the total CUE-T with the UEMS and SCIM self-care and mobility scores were 0.83, 0.70, and 0.55 respectively.ConclusionsThe CUE-T displays excellent test–retest reliability, and good–excellent correlation with impairment and capacity measures in persons with chronic SCI. After revising pronation and supination test procedures, the sensitivity to change should be determined. 相似文献
2.
Bruno Luk?ic Ivo Juric Vladimir Boschi Zenon Pogorelic Josip Bekavac 《Canadian journal of surgery》2015,58(1):24-30
Background
Our aim was to determine the effectiveness of a new surgical technique for olecranon fractures using a tension plate (TP) designed by the operating surgeon.Methods
We included patients with olecranon fractures treated between September 2010 and August 2013 in our study. Treatment involved a new implant and operative technique, which combined the most favourable characteristics of 2 frequently used methods, tension band wiring and plate osteosynthesis, while eliminating their shortcomings. The new method was based on the newly constructed implant.Results
Twenty patients participated in our study. We obtained the following functional results with our TP: median flexion 147.5° (interquartile range [IQR] 130°–155°), median extension 135°/deficit 10° (IQR 135°–145°), median pronation 90° (IQR 81.3°–90°), median supination 90° (IQR 80°–90°). Implant-related complications were noted in 1 patient, and implants were removed in 3 patients. The mean functional Mayo elbow performance score was 94.8 (range 65–100). The removal of the implant was considerably less frequent in patients operated using the new method and implant than in patients operated using conventional methods at our institution (p < 0.001). Mean duration of follow-up was 8 months.Conclusion
Our TP for the treatment of olecranon fractures is safe and effective. Functional results are very good, with significantly decreased postoperative inconveniences and need to remove the implant. Less osteosynthetic material was used for TP construction, but stability was preserved. 相似文献3.
Jia-Chi Wang Rai-Chi Chan Yun-An Tsai Wen-Cheng Huang Henrich Cheng Han-Lin Wu Shih-Fong Huang 《The journal of spinal cord medicine》2015,38(5):587-592
Objective
To assess whether functional activity, perceived health, and depressive symptoms differ between individuals with traumatic paraplegia with and without shoulder pain.Design
Cross sectional and comparative investigation using the unified questionnaire.Setting
Neural Regeneration and Repair Division unit of Taipei Veterans General Hospital in Taiwan.Participants
Seventy-six patients with paraplegia (23 with and 53 without shoulder pain) who had experienced spinal cord injury at American Spinal Injury Association Impairment Scale T2 to T12 neurologic level (at least 6 months previously).Outcome measures
Spinal Cord Independence Measure (SCIM), a single item from the Medical Outcomes Study 36-Item Short-Form Health Survey, and Patient Health Questionnaire-9 (PHQ-9) depression scale.Results
Shoulder pain was prevalent in 30% patients. Patients with shoulder pain had significantly worse perceived health and greater depressive symptoms than those without. No significant difference was found in functional ability between groups. Greater shoulder pain intensity was related to higher depressive scores (r = 0.278, P = 0.017) and lower self-perceived health scores (r = −0.433, P < 0.001) but not SCIM scores (P = 0.342).Conclusion
Although shoulder pain was unrelated to functional limitation, it was associated with lower perceived health and higher depressive mood levels. 相似文献4.
A. R. Knutsen T. Avoian S. N. Sangiorgio S. L. Borkowski E. Ebramzadeh L. E. Zionts 《Clinical orthopaedics and related research》2015,473(5):1737-1743
Background
Idiopathic clubfoot correction is commonly performed using the Ponseti method and is widely reported to provide reliable results. However, a relapsed deformity may occur and often is treated in children older than 2.5 years with repeat casting, followed by an anterior tibial tendon transfer. Several techniques have been described, including a whole tendon transfer using a two-incision technique or a three-incision technique, and a split transfer, but little is known regarding the biomechanical effects of these transfers on forefoot and hindfoot motion.Questions/purpose
We used a cadaveric foot model to test the effects of three tibialis anterior tendon transfer techniques on forefoot positioning and production of hindfoot valgus.Methods
Ten fresh-frozen cadaveric lower legs were used. We applied 150 N tension to the anterior tibial tendon, causing the ankle to dorsiflex. Three-dimensional motions of the first metatarsal, calcaneus, and talus relative to the tibia were measured in intact specimens, and then repeated after each of the three surgical techniques.Results
Under maximum dorsiflexion, the intact specimens showed 6° (95% CI, 2.2°–9.4°) forefoot supination and less than 3° (95% CI, 0.4°–5.3°) hindfoot valgus motion. All three transfers provided increased forefoot pronation and hindfoot valgus motion compared with intact specimens: the three-incision whole transfer provided 38° (95% CI, 33°–43°; p < 0.01) forefoot pronation and 10° (95% CI, 8.5°–12°; p < 0.01) hindfoot valgus; the split transfer, 28° (95% CI, 24°–32°; p < 0.01) pronation, 9° (95% CI, 7.5°–11°; p < 0.01) valgus; and the two-incision transfer, 25° (95% CI, 20°–31°; p < 0.01) pronation, 6° (95% CI, 4.2°–7.8°; p < 0.01) valgus.Conclusion
All three techniques may be useful and deliver varying degrees of increased forefoot pronation, with the three-incision whole transfer providing the most forefoot pronation. Changes in hindfoot motion were small.Clinical Relevance
Our study results show that the amount of forefoot pronation varied for different transfer methods. Supple dynamic forefoot supination may be treated with a whole transfer using a two-incision technique to avoid overcorrection, while a three-incision technique or a split transfer may be useful for more resistant feet. Confirmation of these findings awaits further clinical trials. 相似文献5.
Naaz M. Kapadia Shaghayegh Bagher Milos R. Popovic 《The journal of spinal cord medicine》2014,37(6):734-743
Objectives
The primary objective was to compare the benefits of single (COT1) versus double (COT2) dose of conventional occupational therapy (COT) in improving voluntary hand function in individuals with incomplete, sub-acute C3–C7 spinal cord injury (SCI). The secondary objective was to compare these two interventions versus functional electrical stimulation therapy plus COT (FES + COT).Design
Retrospective analysis.Setting
Inpatient spinal cord rehabilitation center, Toronto.Participants
Individuals with traumatic incomplete sub-acute SCI.Interventions
Data from Phases I and II (ClinicalTrials.gov ID ) randomized control trials were pooled together for the purpose of this study. Participants in the COT1 group received 45 hours of therapy, the COT2 group received 80 hours of therapy, and the FES + COT group received 40 hours of COT therapy +40 hours of FES therapy. NCT00221117Outcome measures
We analyzed the functional independence measure (FIM) and the spinal cord independence measure (SCIM) self-care sub-scores.Results
The mean change scores on the FIM self-care sub-score for the COT1, COT2, and FES + COT groups were 12.8, 10, and 20.1 points, respectively. Similarly, the mean change scores on the SCIM self-care sub-score for the COT1, COT2, and FES + COT groups were, 2.6, 3.16, and 10.2 points, respectively.Conclusion
Increased rehabilitation intensity alone may not always be beneficial. The type of intervention plays a significant role in determining functional changes. In this instance, receiving one (COT1) or two (COT2) doses of COT resulted in similar outcomes, however, FES + COT therapy yielded much better outcomes compared to COT1 and COT2 interventions. 相似文献6.
Naaz Kapadia MSc Vera Zivanovic MD Molly Verrier MHSc Milos R. Popovic PhD 《Topics in spinal cord injury rehabilitation》2012,18(2):167-186
Purpose:
The objective of this study was to evaluate the interrater reliability, construct validity, and sensitivity of Toronto Rehabilitation Institute–Hand Function Test (TRI-HFT), within an interventional randomized control trial.Method:
Twenty-one participants with subacute C4 to C7 spinal cord injury (SCI) were recruited. Based on randomization, participants were allocated to either the functional electrical stimulation therapy group or the conventional occupational therapy group. Baseline and follow-up assessments of participants were videotaped. For testing interrater reliability, videotaped images were transferred to DVDs that were later observed by 2 observers. Construct validity was determined by comparing total scores on TRI-HFT to self-care subscore components of the Spinal Cord Independence Measure (SCIM) and FIM. To establish sensitivity of TRI-HFT, we compared pre- and posttreatment scores on all 3 measures (ie, TRI-HFT, FIM, and SCIM).Results:
TRI-HFT was found to have high interrater reliability with an intercorrelation coefficient (ICC) of 0.98. Moderate to strong correlations were found between TRI-HFT total scores and self-care components of FIM and SCIM for both hands individually post therapy. Due to a floor effect of the FIM and SCIM, there was weak correlation between pretherapy scores of the said measures and TRI-HFT. TRI-HFT was found to be highly sensitive in determining difference in function pre and post therapy.Conclusions:
This study demonstrated that the TRI-HFT is a reliable and sensitive measure to assess unilateral hand gross motor function in persons with tetraplegia, with moderate to strong construct validity. 相似文献7.
Kyeong-Jin Han Kyung-Soo Oh Nam-Su Chung Yu Sang Lee Sangjin Youn 《International orthopaedics》2012,36(12):2501-2506
Purpose
Treatment of comminuted fractures of the radial head is controversial, and considerable effort has been made to restore optimal function of the elbows, either by surgical reconstruction or prosthetic replacement. This report presents our experiences in treatment of unreconstructable radial head or neck fractures using osteochondral autografts harvested from the base of the second metatarsal bones.Methods
Five patients with radial head and one with a radial neck fracture underwent treatment with osteochondral autografts. After excision of the unreconstructable radial head, the second metatarsal base was harvested and transplanted to the radius using the intramedullary nailing technique.Results
The reconstructed elbows were examined clinically and radiographically for a mean period of 44.8 months (range, 24–72 months). At the last follow-up, in flexion-extension, the mean elbow mobility was 130°/10°. In supination-pronation, the mean elbow mobility was 73.3°/66.7°, with a mean loss of supination of 19.2° and loss of pronation of 12.5°. Grip strength was 91%, compared with the contralateral limb. The mean Mayo Elbow Performance Score was 94.2. The mean score of AOFAS rating system to the lesser toe was 93.7 points.Conclusion
Radial head arthroplasty with an osteochondral autograft from the second metatarsal base appears to be an effective alternative for treatment of unreconstructable radial head fractures. A larger group of patients and a longer follow-up period will be required in order to ease concerns regarding the donor site; however, none of the patients who underwent this procedure showed any complications during follow-up. 相似文献8.
Charlesnika T. Evans Jennifer N. Hill Marylou Guihan Amy Chin Barry Goldstein Michael S. A. Richardson Vicki Anderson Kathleen Risa Susan Kellie Kenzie A. Cameron 《The journal of spinal cord medicine》2014,37(2):152-161
Objectives
To assess the feasibility and effect of a nurse-administered patient educational intervention about Methicillin-resistant Staphylococcus aureus (MRSA) prevention on knowledge and behavior of Veterans with spinal cord injuries and disorders (SCI/D).Design
Blinded, block-randomized controlled pilot trial.Setting
Two Department of Veterans Affairs (VA) SCI Centers.Participants
Veterans were recruited March–September 2010 through referral by a healthcare provider from inpatient, outpatient, and residential care settings.Intervention
Thirty participants were randomized to the nurse-administered intervention and 31 to the usual care group. The intervention included a brochure and tools to assist nurses in conducting the education.Outcome measures
Pre- and post-intervention measurement of knowledge and behaviors related to MRSA and prevention strategies and feasibility measures related to implementation.Results
Participants were primarily male (95.1%), white (63.9%), with tetraplegia (63.9%) and mean age and duration of injury of 64.3 and 20.5 years, respectively. The intervention groups mean knowledge score significantly increased between pre- and post-test (mean change score = 1.70, 95% confidence interval, CI 0.25–3.15) while the usual care groups score did not significantly change (mean change score = 1.45, 95% CI −0.08–2.98). However, the mean knowledge change between intervention and usual care groups was not significantly different (P = 0.81). Overall behavior scores did not significantly differ between treatment groups; however, the intervention group was more likely to report intentions to clean hands (90.0% vs. 64.5%, P = 0.03) and asking providers about MRSA status (46.7% vs. 16.1%, P = 0.01). Nurse educators reported that the quality of the intervention was high and could be implemented in clinical care.Conclusions
A targeted educational strategy is feasible to implement in SCI/D clinical practices and may improve some participants’ knowledge about MRSA and increase intentions to improve hand hygiene and engagement with providers about their MRSA status. 相似文献9.
E. Carlos Rodríguez-Merchán Primitivo Gómez-Cardero ángel Martínez-Lloreda 《Journal of Clinical Orthopaedics and Trauma》2015,6(1):19-23
Background
Revision knee arthroplasty with a rotating-hinge design could be an option for the treatment of instability following total knee arthroplasty (TKA) in elderly patients.Purpose
To evaluate the clinical and radiographic results of revision arthroplasties in TKAs with instability using a rotating-hinge design in elderly patients.Methods
We retrospectively reviewed 96 rotating-hinge arthroplasties. The average age of the patients was 79 years (range, 75–86 years); the minimum follow-up was 5 years (mean, 7.3 years; range, 5–10 years). Patients were evaluated clinically (Knee Society score) and radiographically (position of prosthetic components, signs of loosening, bone loss).Results
At a minimum followup of 5 years (mean, 7.3 years; range, 5–10 years), Knee Society pain scores improved from 37 preoperatively to 79 postoperatively, and function scores improved from 34 to 53. ROM improved on average from −15° of extension and 80° of flexion before surgery to −5° of extension and 120° of flexion at the last followup (p = 0.03). No loosening of implants was observed. Nonprogressive radiolucent lines were identified around the femoral and tibial components in 2 knees. One patient required reoperation because of a periprosthetic infection.Conclusions
Revision arthroplasty with a rotating-hinge design provided substantial improvement in function and a reduction in pain in elderly patients with instability following TKA.Level of evidence
Level IV, therapeutic study. 相似文献10.
Valery A. Danilack Kelly L. Stolzmann David R. Gagnon Robert Brown Carlos G. Tun Leslie R. Morse Eric Garshick 《The journal of spinal cord medicine》2014,37(6):662-669
Objective
Identify factors associated with chest illness and describe the relationship between chest illness and mortality in chronic spinal cord injury (SCI).Design
Cross-sectional survey assessing chest illness and a prospective assessment of mortality.Methods
Between 1994 and 2005, 430 persons with chronic SCI (mean ± SD), 52.0 ± 14.9 years old, and ≥4 years post SCI (20.5 ± 12.5 years) underwent spirometry, completed a health questionnaire, and reported any chest illness resulting in time off work, indoors, or in bed in the preceding 3 years. Deaths through 2007 were identified.Outcome measures
Logistic regression assessing relationships with chest illness at baseline and Cox regression assessing the relationship between chest illness and mortality.Results
Chest illness was reported by 139 persons (32.3%). Personal characteristics associated with chest illness were current smoking (odds ratio =2.15; 95% confidence interval =1.25–3.70 per each pack per day increase), chronic obstructive pulmonary disease (COPD) (3.52; 1.79–6.92), and heart disease (2.18; 1.14–4.16). Adjusting for age, subjects reporting previous chest illness had a non-significantly increased hazard ratio (HR) for mortality (1.30; 0.88–1.91). In a multivariable model, independent predictors of mortality were greater age, SCI level and completeness of injury, diabetes, a lower %-predicted forced expiratory volume in 1 second, heart disease, and smoking history. Adjusting for these covariates, the effect of a previous chest illness on mortality was attenuated (HR = 1.15; 0.77–1.73).Conclusion
In chronic SCI, chest illness in the preceding 3 years was not an independent risk factor for mortality and was not associated with level and completeness of SCI, but was associated with current smoking, physician-diagnosed COPD, and heart disease history. 相似文献11.
William A Bauman Run-Lin Zhang Nancy Morrison Ann M Spungen 《The journal of spinal cord medicine》2009,32(4):398-403
Background:
Some people with chronic spinal cord injury (SCI) have low vitamin D levels and secondary hyperparathyroidism.Objective:
To determine whether, and to what extent, an acute calcium infusion decreased levels of N-telopeptide (NTx), a marker of osteoclastic activity, in individuals with chronic SCI.Study Design:
Case series.Subjects:
Eight men with chronic SCI. A relatively low serum 25 hydroxyvitamin D concentration (25[OH]D ≤20 ng/mL) and/or a high parathyroid hormone (PTH) (>55 pg/mL) was a prerequisite for study inclusion.Methods:
Calcium gluconate bolus 0.025 mmol elemental calcium/kg over 20 minutes followed by a constant infusion of 0.025 mmol/kg per hour for 6 hours was infused; blood samples were collected every 2 hours for measurement of serum total calcium, creatinine, NTx, and PTH.Results:
All results are expressed as means (± SDs). Baseline serum 25-hydroxyvitamin D level was 14.5 ± 3.5 ng/mL (range: 10.2–19.6 ng/mL); PTH, 70 ± 25 pg/mL (range: 37–100 pg/mL); and NTx, 21 ± 7 nM bone collagen equivalents (BCE) (range: 14–34 nM). At 2, 4, and 6 hours after the calcium infusion, serum calcium rose from 9.3 ± 0.2 to 10.8 ± 0.9, 10.5 ± 0.8, and 10.6 ± 0.6 mg/d; PTH was suppressed from 70 ± 25 pg/mL to 18 ± 12, 16 ± 9, and 15 ± 9 pg/mL, respectively; NTx fell from 21 ± 8 nM BCE to 17 ± 5, 12 ± 4, and 12 ± 3 nM BCE, respectively.Conclusions:
Serum NTx is a marker for bone collagen catabolism, and its reduction suggests that bone turnover was decreased. A relative deficiency of vitamin D associated with chronically elevated levels of PTH would be expected to increase bone turnover and to worsen the bone loss associated with immobilization. 相似文献12.
Ying Gao Jian-guo Shi Hong Ye Zhi-rong Liu Long-bao Zheng Zhi-ming Ni Liang-quan Fan Jian Wang Zhen-hai Hou 《The journal of spinal cord medicine》2014,37(6):774-781
Objective
This study aims to investigate the effects of sudden load changes (expected and unexpected imbalance) on the activity of muscles of the lumbar spine and their central motor control strategy in military personnel with or without chronic low back pain (LBP).Design
Bilateral sudden imbalance was examined (2 × 2 factorial design).Setting
The 117th PLA Hospital, Hangzhou, ChinaParticipants
Twenty-one male subjects with lower back pain and 21 male healthy control subjects were active members of the Nanjing Military Region land forces.Outcome measures
Independent variables: LBP vs. healthy controls and imbalance anticipation (expected and unexpected imbalance). Dependent variables: rapid reaction time (RRT) and intensity of rapid reaction (IRR) of bilateral lumbar (L3–L4) erector spinae (ES), lumbar (L5–S1) multifidus (MF), and abdominal external oblique muscles.Results
Under expected or unexpected sudden imbalance conditions, subjects with LBP demonstrated significantly greater IRR than healthy controls in ipsilateral and contralateral ES and MF, respectively (P < 0.05 for all). IRR of contralateral ES was significantly larger than that of the ipsilateral ES. A significant group effect of RRT of both ipsilateral and contralateral ES muscles and a significant time expectation effect on RRT of contralateral MF muscles were also observed. RRT of the contralateral ES muscles was significantly lower than that of the ipsilateral ES muscles (P < 0.001).Conclusions
Sudden imbalance prolonged RRT of selected trunk muscles in patients with chronic LBP. The activation amplitude increased. The results may provide a theoretical basis for a study on the pathogenesis of chronic LBP. 相似文献13.
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15.
Nicole Mittmann Sander L. Hitzig B. Catharine Craven 《The journal of spinal cord medicine》2014,37(5):548-555
Context/Objective
Health preference values relate to a person''s state of well-being, and is a single metric anchored at 0 (death) and 1 (perfect health). Health preference plays a key role in health economics and health policy, particularly in interpreting the results of cost-effectiveness studies, and supports the allocation of healthcare resources. The current study used elements of the International Classification of Functioning, Disability and Health (ICF) framework to predict health preference in persons with spinal cord injury (SCI).Methods
Data were collected by telephone survey on (1) demographics, (2) impairment (etiology, neurological level of injury, and ASIA impairment scale), (3) secondary health conditions (SHCs) using the SCI-Secondary Conditions Scale-Modified, (4) functional abilities using the Spinal Cord Independence Measure (SCIM), and (5) health preference using the Health Utilities Index-Mark III (HUI-Mark III) among adults with chronic SCI. Variables were categorized according to ICF headings and hierarchical regression analyses were used to predict HUI-Mark III scores.Results
Adults with chronic traumatic or non-traumatic SCI (N = 357) reported a mean health preference score of 0.27 (±0.27). In predicting health preference, our model accounted for 55.1% of the variance with “body functions and structure”, and “activity and participation”, significantly contributing to the model (P < 0.0001). In particular, older age, being employed, and having higher SCIM scores were positively associated with health preference. Conversely, a higher SHC impact score was associated with poorer health preference.Conclusions
Variables representative of “activity and participation” largely influence health preference among persons with chronic SCI, which may be amenable to intervention. These findings could be applied to advocate for health promotion and employment support programs to maximize well-being in persons aging with chronic SCI in the community. 相似文献16.
Kevin A. Jacobs Patricia Burns Jochen Kressler Mark S. Nash 《The journal of spinal cord medicine》2013,36(5):427-435
Context/objective
To describe and compare substrate oxidation and partitioning during voluntary arm ergometry in individuals with paraplegia and non-disabled individuals over a wide range of exercise intensities.Design
Cross-sectional study.Setting
Clinical research facility.Participants
Ten apparently healthy, sedentary men with paraplegia and seven healthy, non-disabled subjects.Interventions
Rest and continuous progressive voluntary arm ergometry between 30 and 80% of peak aerobic capacity (VO2peak).Outcome measures
Total energy expenditure and whole body rates of fat and carbohydrate oxidation.Results
A maximal whole body fat oxidation (WBFO) rate of 0.13 ± 0.07 g/minute was reached at 41 ± 9% VO2peak for subjects with paraplegia, although carbohydrate became the predominant fuel source during exercise exceeding an intensity of 30–40% VO2peak. Both the maximal WBFO rate (0.06 ± 0.04 g/minute) and the intensity at which it occurred (13 ± 3% VO2peak) were significantly lower for the non-disabled subjects than those with paraplegia.Conclusion
Sedentary individuals with paraplegia are more capable of oxidizing fat during voluntary arm ergometry than non-disabled individuals perhaps due to local adaptations of upper body skeletal muscle used for daily locomotion. However, carbohydrate is the predominant fuel source oxidized across a wide range of intensities during voluntary arm ergometry in those with paraplegia, while WBFO is limited and maximally achieved at low exercise intensities compared to that achieved by able-bodied individuals during leg ergometry. These findings may partially explain the diminished rates of fat loss imposed by acute bouts of physical activity in those with paraplegia. 相似文献17.
M. van Heumen P. J. C. Heesterbeek B. A. Swierstra G. G. Van Hellemondt J. H. M. Goosen 《Journal of orthopaedics and traumatology》2015,16(1):15-20
Background
A dual mobility cup has the theoretic potential to improve stability in primary total hip arthroplasty (THA) and mid-term cohort results are favorable. We hypothesized that use of a new-generation dual mobility cup in revision arthroplasty prevents dislocation in patients with a history of recurrent dislocation of the THA.Materials and methods
We performed a retrospective cohort study of patients receiving an isolated acetabular revision with a dual mobility cup for recurrent dislocation of the prosthesis with a minimum follow-up of 1 year. Kaplan–Meier survival analyses were performed with dislocation as a primary endpoint and re-revision for any reason as a secondary endpoint.Results
Forty-nine consecutive patients (50 hips) were included; none of the patients was lost to follow-up. The median follow-up was 29 months (range 12–66 months). Two patients died from unrelated causes. Survival after 56 months was 100 % based on dislocation and 93 % (95 % CI 79–98 %) based on re-revision for any reason. Radiologic analysis revealed no osteolysis or radiolucent lines around the acetabular component during the follow-up period.Conclusion
The dual mobility cup is an efficient solution for instability of THA with a favorable implant survival at 56 months.Level of evidence
Level 4, retrospective case series. 相似文献18.
Sharon Gabison Molly C. Verrier Sylvie Nadeau Dany H. Gagnon Audrey Roy Heather M. Flett 《The journal of spinal cord medicine》2014,37(5):537-547
Context
Trunk control is essential to engage in activities of daily living. Measuring trunk strength and function in persons with spinal cord injury (SCI) is difficult. Trunk function has not been studied in non-traumatic SCI (NTSCI).Objectives
To characterize changes in trunk strength and seated functional reach in individuals with NTSCI during inpatient rehabilitation. To determine if trunk strength and seated reach differ between walkers and wheelchair users. To explore relationships between trunk and hip strength and seated functional reach.Design
Observational study.Setting
Two SCI rehabilitation facilities.Participants
32 subacute inpatients (mean age 48.0 ± 15.4 years).Outcome measures
Isometric strength of trunk and hip and function (Multidirectional Reach Test: MDRT) were assessed at admission and within 2 weeks of discharge. Analysis of variance was conducted for admission measures (MDRT, hip and trunk strength) between walkers and wheelchair users. Changes in MDRT, hip and trunk strength were evaluated using parametric and non-parametric statistics. The level of association between changes in values of MRDT and strength was also examined.Results
Significant differences between walkers and wheelchair users were found for strength measures (P < 0.05) but not for MDRT. Left- and right-sided reaches increased in wheelchair users only (P < 0.05). Associations between changes in hip strength, trunk strength, and reach distance were found (R = 0.67–0.73).Conclusion
In clinical settings, it is feasible and relevant to assess trunk, hip strength, and MRDT. Future studies require strategies to increase the number of participants assessed, in order to inform clinicians about relevant rehabilitation interventions. 相似文献19.
20.
Hanne Gregersen Mille Lyb?k Inger Lauge Johannesen Pernille Leicht Ulla Vig Nissen Fin Biering-S?rensen 《The journal of spinal cord medicine》2015,38(2):161-169