Decreasing subthalamic deep brain stimulation frequency reverses cognitive interference during gait initiation in Parkinson’s disease

Objective

Freezing of gait (FOG) represents a major burden for Parkinson’s disease (PD) patients. High-frequency (130-Hz) subthalamic deep-brain-stimulation (STN-DBS) has been reported to aggravate FOG whereas lowering the frequency to 60–80?Hz improves FOG. To further understand the effects of STN-DBS on FOG, we assessed the effects of 80-Hz and 130-Hz STN-DBS on gait initiation performance, in relation to motor and executive function processing.

中央轴空病的康复治疗:1例报告

目的:探讨中央轴空病的康复治疗效果。方法:对1例9岁中央轴空病患儿进行康复治疗4个月,比较治疗前后的肌力、平衡功能、步态分析和残疾儿童综合运动功能评定的变化,2年后随访。结果:治疗后双下肢挛缩得以改善,步态分析各参数基本恢复正常,双下肢关键肌的肌力提高11.5%—18.5%,Berg平衡功能评分提高22.5%,残疾儿童综合功能评分提高42%。随访时前述指标仍在继续提高,分别较治疗前肌力提高19.0%—33.3%,Berg平衡功能评分提高40.0%,残疾儿童综合功能评分提高52.0%,患儿运动功能基本恢复正常。结论:对中央轴空病患儿早期进行康复干预,能最大限度地促进儿童运动系统的正常发育,规避因骨关节系统发育畸形可能手术导致恶性高热的风险。     

踝足矫形器对脑卒中患者躯体运动及其步行能力的影响

摘要 目的：探讨踝足矫形器（AFO）对脑卒中患者躯体运动和步行能力的影响及其之间的相互关系。 方法：20例可以独立步行10m以上的慢性偏瘫患者,采用三维步态分析系统评测佩戴AFO前后的最大步行速度及躯体运动学参数。 结果：佩戴AFO前后最大步行速度、身体重心垂直和侧方运动、骨盆前后倾斜和旋转运动差异有显著性意义（P<0.01）;步行能力的提高与身体重心运动和骨盆旋转运动改善显著相关（P<0.01）。 结论：佩戴AFO可以改善脑卒中偏瘫患者躯体运动的稳定性,并且与提高患者的步行能力相关。     

胸段完全性脊髓损伤患者的三维步态分析

目的通过对胸段完全性脊髓损伤(TCSCI)患者配戴交互式步行矫形器(RGO)的三维步态分析,比较分析脊髓损伤(SCI)平面与步行能力之间的关系,探讨重建SCI患者步行能力的量化指标。方法选择在本中心住院且配戴RGO进行步行训练3个月以上的TCSCI患者10例,采用Vicon三维步态分析系统进行步态检测与分析。应用Spearman秩和相关系数对TCSCI患者的不同SCI平面与其步态的运动学和时空参数等的相关性进行统计学检验。结果步频和跨步长分别为(37.4±2.15) 步/min和(91.6±9.09) cm;髋关节摆动角度及髋关节伸展和屈曲时相的角速度分别为(42.57 °±5.43 °)、(20.88 °±2.18 °)/s和(124.75 °±9.31 °)/s。步速(r=0.80,P<0.01)、跨步长(r=0.78,P<0.01)、助行架的压力峰值(r=0.82,P<0.01)、髋关节摆动角度(r=0.77,P<0.01)、助行架的压力均值(r=-0.67,P<0.05)和髋关节伸展的角速度(r=0.75,P<0.05)与SCI平面之间均有显著的相关性。结论TCSCI患者双上肢过度负载和髋关节摆动幅度受限是其步行能力受限的主要原因;降低过度负载的康复训练方法有助于改善重建的步行功能。     

Accurate Osteotomy for the Treatment of a Rare Case of Postaxial Polydactyly of the Foot That Originated From a Deformed Calcaneus Using a 3D-Printed Guiding Plate

Polydactyly is a common congenital deformity of the foot that can be categorized as preaxial, central, or postaxial. Current treatments involve resecting the supernumerary toe(s) and repairing the normal toe(s) and soft tissue. Here, we present the first published report describing a very rare case of polydactyly of the foot, in which the supernumerary toe originated from a deformed calcaneus, which formed an abnormal bony bump. Preoperatively, 3-dimensional (3D) computed tomography reconstruction images revealed the morphology of the deformed toe and calcaneus, and gait analysis showed an abnormal weightbearing zone in the left foot. The 3D printing technology and a specially designed 3D-printed guiding plate were used for osteotomy. Postoperatively, x-ray showed that the calcaneus had a normal shape and surface, whereas gait analysis showed that the left foot was uniformly loaded and the area of pain was eliminated. Our findings should raise awareness among clinicians that a 3D-printed guiding plate is useful in the treatment of such an unusual deformity.     

Patient‐Specific Functional Analysis: The Key to the Next Revolution Towards the Treatment of Hip and Knee Osteoarthritis

Lower extremity joint arthroplasty surgery remains one of the most successful interventions in orthopaedics. While improvements in patient mobility and physical functioning following surgery are well‐documented, there remains significant post‐operative functional deficits in many patients. This highlights a need and an opportunity towards improving functional and patient‐reported outcomes of arthroplasty surgery. This review summarizes key opportunities arising from the recent 2018 Orthopaedic Research Society Meeting in New Orleans, USA. In this review, the Canadian Orthopaedic Research Society (i.e., CORS) highlights key research advances, case examples, scientific messages, and personalized medical care approaches toward improving physical functioning in our knee and hip joint arthroplasty patients. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1754–1759, 2019