排序方式: 共有17条查询结果,搜索用时 31 毫秒
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Yuichi Hoshino MD PhD Freddie H. Fu MD DSc James J. Irrgang PT PhD ATC FAPTA Scott Tashman PhD 《Clinical orthopaedics and related research》2013,471(9):2924-2931
Background
Rotational kinematics has become an important consideration after ACL reconstruction because of its possible influence on knee degeneration. However, it remains unknown whether ACL reconstruction can restore both rotational kinematics and normal joint contact patterns, especially during functional activities.Questions/purposes
We asked whether knee kinematics (tibial anterior translation and axial rotation) and joint contact mechanics (tibiofemoral sliding distance) would be restored by double-bundle (DB) or single-bundle (SB) reconstruction.Methods
We retrospectively studied 17 patients who underwent ACL reconstruction by the SB (n = 7) or DB (n = 10) procedure. We used dynamic stereo x-ray to capture biplane radiographic images of the knee during downhill treadmill running. Tibial anterior translation, axial rotation, and joint sliding distance in the medial and lateral compartments were compared between reconstructed and contralateral knees in both SB and DB groups.Results
We observed reduced anterior tibial translation and increased knee rotation in the reconstructed knees compared to the contralateral knees in both SB and DB groups. The mean joint sliding distance on the medial compartment was larger in the reconstructed knees than in the contralateral knees for both the SB group (9.5 ± 3.9 mm versus 7.5 ± 4.3 mm) and the DB group (11.1 ± 1.3 mm versus 7.9 ± 3.8 mm).Conclusions
Neither ACL reconstruction procedure restored normal knee kinematics or medial joint sliding.Clinical Relevance
Further study is necessary to understand the clinical significance of abnormal joint contact, identify the responsible mechanisms, and optimize reconstruction procedures for restoring normal joint mechanics after ACL injury. 相似文献6.
The purpose of this study was to evaluate the functional outcomes of persons who underwent simultaneous bilateral total knee arthroplasty (TKA) compared to subjects who underwent unilateral TKA and a healthy control group. Fifteen subjects who underwent primary bilateral TKA and 15 sex, age, and body mass index-matched subjects who underwent primary unilateral TKA were observed prospectively for 2 years. Subjects in both surgical groups showed significant improvement in Knee Outcome Scores, Short Form 36 physical component scores, Timed Up and Go, and stair-climbing tasks (P ≤ .004). No differences in final outcomes were found between surgical groups. In addition, most 2-year clinical measures were no different between the surgical and control groups. Subjects medically appropriate for bilateral TKA should be afforded this option. 相似文献
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Wen‐Ni Wennie Huang PhD PT Subashan Perera PhD Jessie VanSwearingen PhD PT FAPTA Stephanie Studenski MD MPH 《Journal of the American Geriatrics Society》2010,58(5):844-852
OBJECTIVES: To assess the predictive value of five performance‐based measures for the onset of difficulty in activities of daily living (ADLs). DESIGN: A prospective cohort study; home visits every 6 months for 18 months. SETTING: Community‐based. PARTICIPANTS: Community‐dwelling older adults, n=110, (mean age 80.3±7.0; range 67–98) who reported no difficulty in basic ADLs. MEASUREMENTS: The Short Physical Performance Battery (SPPB), gait speed, Berg Balance Scale (BBS), grip strength, and Timed Up and Go Test (TUG) were evaluated at baseline. Seven ADL items were assessed at baseline and 6, 12, and 18 months. The onset of ADL disability was self‐report of difficulty in any of the seven ADL items. Logistic regression models were fitted for each of the physical performance measures to predict onset of ADL difficulty at 6, 12, and 18 months. RESULTS: After controlling for age, comorbid conditions, and sex, the BBS was the most consistent and best predictor for the onset of ADL difficulty over an 18‐month period (6 months, c‐statistic=0.725, (95% confidence interval (CI)=0.60–0.85; 12 months, c‐statistic=0.840 95% CI=0.75, 0.93; 18 months, c‐statistic=0.821, 95% CI=0.71, 0.93). The SPPB showed excellent predictive value for the onset of difficulty at 12 months. Ninety‐five, 89, and 75 older adults completed the 6, 12, and 18‐month follow‐up visits, respectively. CONCLUSION: BBS, followed by SPPB, TUG, gait speed, and grip strength, were predictive of the onset of ADL difficulty over an 18‐month period in community‐dwelling older adults. Screening nondisabled older adults with simple performance tests could allow clinicians to identify those at risk for ADL difficulty and may help to detect early functional decline. 相似文献
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A Person‐Centered Approach to Poststroke Care: The COMprehensive Post‐Acute Stroke Services Model
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Cheryl D. Bushnell MD MHS Pamela W. Duncan PhD PT FAHA FAPTA Sarah L. Lycan NP MSN Christina N. Condon MSN NP‐C Amy M. Pastva PT PhD Barbara J. Lutz PhD RN Jacqueline R. Halladay MPH MD Doyle M. Cummings PharmD Martinson K. Arnan MD Sara B. Jones PhD Mysha E. Sissine MSPH Sylvia W. Coleman MPH BSN Anna M. Johnson MSPH PhD Sabina B. Gesell PhD Laurie H. Mettam MEd Janet K. Freburger PT PhD Blair Barton‐Percival MSW Karen M. Taylor MPT Janet Prvu‐Bettger ScD FAHA Gladys Lundy‐Lamm MA Wayne D. Rosamond MS PhD 《Journal of the American Geriatrics Society》2018,66(5):1025-1030
Many individuals who have had a stroke leave the hospital without postacute care services in place. Despite high risks of complications and readmission, there is no standard in the United States for postacute stroke care after discharge home. We describe the rationale and methods for the development of the COMprehensive Post‐Acute Stroke Services (COMPASS) care model and the structure and quality metrics used for implementation. COMPASS, an innovative, comprehensive extension of the TRAnsition Coaching for Stroke (TRACS) program, is a clinician‐led quality improvement model providing early supported discharge and transitional care for individuals who have had a stroke and have been discharged home. The effectiveness of the COMPASS model is being assessed in a cluster‐randomized pragmatic trial in 41 sites across North Carolina, with a recruitment goal of 6,000 participants. The COMPASS model is evidence based, person centered, and stakeholder driven. It involves identification and education of eligible individuals in the hospital; telephone follow‐up 2, 30, and 60 days after discharge; and a clinic visit within 14 days conducted by a nurse and advanced practice provider. Patient and caregiver self‐reported assessments of functional and social determinants of health are captured during the clinic visit using a web‐based application. Embedded algorithms immediately construct an individualized care plan. The COMPASS model's pragmatic design and quality metrics may support measurable best practices for postacute stroke care. 相似文献
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Potential Benefits for Caregivers of Stroke Survivors Receiving BTX‐A and Exercise for Upper Extremity Spasticity
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Physical Therapy or Advanced Imaging as First Management Strategy Following a New Consultation for Low Back Pain in Primary Care: Associations with Future Health Care Utilization and Charges
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Julie M. Fritz P.T. Ph.D. FAPTA Gerard P. Brennan P.T. Ph.D. Stephen J. Hunter D.P.T. 《Health services research》2015,50(6):1927-1940