分期大动脉调转手术的左室退化定量评估

目的 探讨左室退化的定量标准,分析影响左室训练效果的因素,评估动脉调转手术(ASO)效果.方法 收集在我院就诊的室间隔完整型完全性大动脉转位患儿86例,43例接受左室训练术和分期ASO(A组),43例接受一期ASO(B组).测量并计算两组患儿左室前后径及其Z值、左室质量指数(LV mass指数)、左室压力退化率、LV ...     

Gait retraining for runners with patellofemoral pain: A protocol for systematic review and meta-analysis

Introduction:Patellofemoral pain (PFP) is highly prevalent in runners. Physical therapies were proved to be effective in the treatment of PFP. Gait retraining is an important method of physical therapy, but its effectiveness and safety for PFP remained controversial. Previous review suggests gait retraining in the treatment of PFP warrants consideration. However, recent publications of randomized controlled studies and case series studies indicated the positive effect of gait retraining in clinical and functional outcomes, which re-raise the focus of gait retraining. This paper will systematically review the available evidence, assessing the safety and effectiveness for the use of gait retraining for runners with PEP.Method and analysis:A systematic review of relevant studies in Pubmed, Embase, SCOPUS, and Cochrane Library were synthesized. Inclusion criteria are studies evaluating clinical outcomes (i.e., changes to pain and/or function) following running retraining interventions in symptomatic running populations; Studies with less than 10 participants in total or in the running retraining intervention group were excluded. The primary outcomes measured will be pain score, Lower extremity functional scale and training related injuries or complications. Review Manager (Revman Version 5.3) software will be used for data synthesis, sensitivity analysis, meta regression, subgroup analysis and risk of bias assessment. A funnel plot will be developed to evaluate reporting bias and Begg and Egger tests will be used to assess funnel plot symmetries. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of evidence.Ethics and dissemination:Our aim is to publish this systematic review in a peer-reviewed journal. Our findings will provide information about the safety of gait retraining and their effect on reliving pain and improving function of lower limb on runners with PEP. This review will not require ethical approval as there are no issues about participant privacy.     

Relationship between kinematic gait parameters during three gait modifications designed to reduce peak knee abduction moment

PurposeGait modifications designed to change a single kinematic parameter have reduced first peak internal knee abduction moment (PKAM). Prior research suggests unintended temporospatial and kinematic changes occur naturally while performing these modifications. We aimed to investigate i) the concomitant kinematic and temporospatial changes and ii) the relationship between gait parameters during three gait modifications (toe-in, medial knee thrust, and trunk lean gait).MethodsUsing visual real-time biofeedback, we collected 10 trials for each modification using individualized target gait parameters based on participants’ baseline mean and standard deviation. Repeated measures ANOVA was performed to determine significant differences between conditions. Mixed effects linear regression models were then used to estimate the linear relationships among variables during each gait modification. All modifications reduced KAM by at least 5%.ResultsModifications resulted in numerous secondary changes between conditions such as increased knee abduction during toe-in gait and increased knee flexion with medial knee thrust. Within gait modifications, relationships between kinematic parameters were similar for toe-in gait and medial knee thrust (i.e. increased toe-in and decreased knee abduction), while increased trunk lean showed no relationship with any other kinematic parameters during trunk lean trials.ConclusionTwo main mechanisms were found as a result of this investigation; the first being a pattern of toeing-in, knee abduction, flexion, and internal hip rotation, while trunk lean modification presented as a separate gait pattern with limited secondary changes. Future studies should consider providing feedback on multiple linked parameters, as it may feel more natural and optimize KAM reductions.     

Comparative study between nail retraining with gauze bandaging and the nail remodeling with acrylics as a conservative treatment for stage I and IIa onychocryptosis

Objective

Onychocryptosis is one of the most prevalent onychopathies, being a frequent reason for consultation in podiatric clinical practice. Conservative treatments are the first therapeutic choice, with nail remodeling using clotrimazole gel emerging as an alternative, although its medium-term effectiveness is unknown. The objective of this study was therefore to compare the efficacy of the technique of nail retraining using gauze bandaging with that of nail remodeling for the conservative treatment of stage I and IIA onychocryptosis.

Methods

An analytical, randomized clinical trial study was performed following a longitudinal and prospective design. A sample was selected of 20 subjects presenting stage I and IIA onychocryptosis. Of these, 10 cases formed the group of nail retraining using gauze bandaging, and the other 10 the nail remodeling group. The presence of recurrence in a 3-month period was evaluated.

Results

Before the intervention, the patients in the retraining group presented pain of 6.7 ± 1.9 vs. 6.8 ± 1.6 in the remodeling group, with no significant difference between the two (p = 0.900). After the 3-month follow-up period, seven of the retraining group patients presented recurrence of onychocryptosis vs. only one in the remodeling group.

Conclusion

The technique of nail remodeling has a lower recurrence rate than that of nail retraining with gauze bandaging, with the pain, inflammation, and infection reported being less, and with greater patient satisfaction.