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https://www.readbyqxmd.com/read/28817701/effect-of-exoskeletal-joint-constraint-and-passive-resistance-on-metabolic-energy-expenditure-implications-for-walking-in-paraplegia
#1
Sarah R Chang, Rudi Kobetic, Ronald J Triolo
An important consideration in the design of a practical system to restore walking in individuals with spinal cord injury is to minimize metabolic energy demand on the user. In this study, the effects of exoskeletal constraints on metabolic energy expenditure were evaluated in able-bodied volunteers to gain insight into the demands of walking with a hybrid neuroprosthesis after paralysis. The exoskeleton had a hydraulic mechanism to reciprocally couple hip flexion and extension, unlocked hydraulic stance controlled knee mechanisms, and ankles fixed at neutral by ankle-foot orthoses...
2017: PloS One
https://www.readbyqxmd.com/read/28817167/body-mass-index-50-kg-m2-and-beyond-perioperative-care-of-pregnant-women-with-superobesity-undergoing-cesarean-delivery
#2
Marcela Carolina Smid, Sarah K Dotters-Katz, Robert M Silver, Jeffrey A Kuller
Importance: Superobesity, defined as body mass index 50 kg/m(2) or greater, is the fastest-growing obesity group in the United States. Currently, 2% of pregnant women in the United States are superobese, and 50% will deliver via cesarean delivery. Objective: To review evidence of perioperative care during cesarean delivery among superobese women. Evidence Acquisition: We performed an evidence-based review of maternal and neonatal risks of cesarean delivery and of intraoperative management and immediate postpartum care of superobese pregnant women...
August 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28817160/extensor-mechanism-reconstruction-for-chronic-patellar-fracture
#3
Antonio Cusano, Emily J Curry, Lee N Marinko, Xinning Li
Patients with displaced patellar fractures typically present with disruption to the extensor mechanism requiring acute surgical intervention. Chronic patellar fractures with disruption of the extensor mechanism are uncommon, and few surgical options are available. The authors present a patient who sustained a fracture to the inferior pole of the patella in Africa 5 years prior that was managed conservatively with bands and a brace. He decided to pursue surgical intervention because of difficulties with leg extension, weakness, and ambulation...
August 17, 2017: Orthopedics
https://www.readbyqxmd.com/read/28815160/the-burden-of-spine-fractures-in-india-a-prospective-multicenter-study
#4
Ilyas S Aleem, Dylan DeMarco, Brian Drew, Parag Sancheti, Vijay Shetty, Mandeep Dhillon, Clary J Foote, Mohit Bhandari
STUDY DESIGN: Prospective cohort study. OBJECTIVES: The objectives of this study were (1) to determine the characteristics of patients sustaining spinal trauma in India and (2) to explore the association between patient or injury characteristics and outcomes after spinal trauma. METHODS: In affiliation with the ongoing INternational ORthopaedic MUlticentre Study (INORMUS), 192 patients with spinal injuries were recruited during an 8-week period (November 2011 to June 2012) from 14 hospitals in India and followed for 30-days...
June 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28814045/across-user-adaptation-for-a-powered-lower-limb-prosthesis
#5
John A Spanias, Ann M Simon, Levi J Hargrove
Pattern recognition algorithms have been used to control powered lower limb prostheses because they are capable of identifying the intent of the amputee user and therefore can provide a method for seamlessly transitioning between the different locomotion modes of the prosthesis. However, one major limitation of current algorithms is that they require subject-specific data from the individual user. These data are difficult and time-consuming to collect and consequently these algorithms do not generalize well across users...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28814042/portable-haptic-device-for-lower-limb-amputee-gait-feedback-assessing-static-and-dynamic-perceptibility
#6
M A B Husman, H F Maqbool, M I Awad, A A Dehghani-Sanij
Loss of joints and severed sensory pathway cause reduced mobility capabilities in lower limb amputees. Although prosthetic devices attempt to restore normal mobility functions, lack of awareness and control of limb placement increase the risk of falling and causing amputee to have high level of visual dependency. Haptic feedback can serve as a cue for gait events during ambulation thus providing sense of awareness of the limb position. This paper presents a wireless wearable skin stretch haptic device to be fitted around the thigh region...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28814014/bio-inspired-control-of-joint-torque-and-knee-stiffness-in-a-robotic-lower-limb-exoskeleton-using-a-central-pattern-generator
#7
Stefan O Sobrade, Yannik Nager, Amy R Wu, Roger Gassert, Auke Ijspeert
Robotic lower limb exoskeletons are becoming increasingly popular in therapy and recreational use. However, most exoskeletons are still rather limited in their locomotion speed and the activities of daily live they can perform. Furthermore, they typically do not allow for a dynamic adaptation to the environment, as they are often controlled with predefined reference trajectories. Inspired by human leg stiffness modulation during walking, variable stiffness actuators increase flexibility without the need for more complex controllers...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813975/a-lightweight-robotic-ankle-prosthesis-with-non-backdrivable-cam-based-transmission
#8
Tommaso Lenzi, Marco Cempini, Jeremy Newkirk, Levi J Hargrove, Todd A Kuiken
Below-knee level amputation significantly impacts the ability of an individual to ambulate. Transtibial amputees are typically prescribed energetically passive ankle-foot prostheses that behave as a spring or controlled damper, and therefore cannot fully replace the function of the missing limb. More recently, fully-powered devices have been proposed to more closely match the power generation ability of intact limbs. However, these fully-powered devices are significantly heavier than passive devices, thus increasing the stress on the socket-residual limb interface...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28812475/rise-in-acid-attacks-prompts-call-for-guidelines-for-emergency-staff
#9
(no author information available yet)
Emergency department clinicians and ambulance crews should have clear guidance on dealing with acid attacks, leading emergency doctors say.
August 16, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28811991/systematic-review-of-the-outcomes-of-surgical-treatment-of-prostate-metastases-to-the-spine
#10
REVIEW
Michelle J Clarke, Camilo A Molina, Daryl R Fourney, Charles G Fisher, Ziya L Gokaslan, Meic H Schmidt, Laurence D Rhines, Michael G Fehlings, Ilya Laufer, Shreyaskumar R Patel, Y Raja Rampersaud, Jeremy Reynolds, Dean Chou, Chetan Bettegowda, Ehud Mendel, Michael H Weber, Daniel M Sciubba
STUDY DESIGN: Systematic review. OBJECTIVE: Surgical decompression and reconstruction of symptomatic spinal metastases has improved the quality of life in cancer patients. However, most data has been collected on cohorts of patients with mixed tumor histopathology. We systematically reviewed the literature for prognostic factors specific to the surgical treatment of prostate metastases to the spine. METHODS: A systemic review of the literature was conducted to answer the following questions: Question 1...
August 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28811806/comparison-of-right-and-left-trans-radial-catheterization-for-coronary-angiography-and-intervention-in-patients-with-acute-myocardial-infarction
#11
Hongying Wang, Shijin Song
OBJECTIVE: To compare the clinical characteristics between the right and left radial approach in treating acute myocardial infarction, helping physicians make treatment strategies correctly. METHODS: The patients admitted at our institution and undergoing percutaneous coronary angiography and interventional procedures by left or right radial approach between November 2013 and July 2016 were retrospectively reviewed. The access time, compression time, ambulation time, the amount of contrast material used, fluoroscopy time, interventional procedural time, the number of catheters used, the percentage of procedures completed using the assigned approach and the major vascular complications were recorded and compared between the two groups...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28810277/-concepts-to-optimize-home-care-of-patients-with-mechanical-ventilation
#12
Miranda Nafe, Kristian Herberger, Barbara Wiesner, Christian Grohé
The care of patients with extraclinical mechanical ventilation has to be improved particularly with regard to their specialist care. One care option is the empowering of clinicians at the respiratory centers to enable ambulant care of patients and home visits. An intersectoral linkage in the form of transfer management is the basis for competent coordination. Aim is to ensure the necessary multidisciplinary collaboration in the outpatient care of multimorbid chronically ill patients. For the optimal care of chronically ill patients, sectoral limits should become more permeable...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28806436/effectiveness-of-a-timing-and-coordination-group-exercise-program-to-improve-mobility-in-community-dwelling-older-adults-a-randomized-clinical-trial
#13
Jennifer S Brach, Subashan Perera, Sandra Gilmore, Jessie M VanSwearingen, Deborah Brodine, Neelesh K Nadkarni, Edmund Ricci
Importance: Timing and coordination exercises may be an important addition to community-based health promotion exercise programs to improve walking in older adults. Objective: To compare the effectiveness of the On the Move group exercise program, which focuses on the timing and coordination of movement, with a seated strength, endurance, and flexibility program (usual care) at improving function, disability, and walking ability of older adults. Design, Setting, and Participants: Cluster-randomized, single-blind intervention trial...
August 14, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28803817/6mwt-can-identify-type-3-sma-patients-with-neuromuscular-junction-dysfunction
#14
REVIEW
Maria Carmela Pera, Marco Luigetti, Marika Pane, Giorgia Coratti, Nicola Forcina, Lavinia Fanelli, Elena S Mazzone, Laura Antonaci, Leonardo Lapenta, Concetta Palermo, Domiziana Ranalli, Giuseppe Granata, Mauro Lomonaco, Serenella Servidei, Eugenio Mercuri
The aim of the study was to establish if the decrease in gait velocity on the 6 minute walk test relates to signs of neuromuscular junction dysfunction in spinal muscular atrophy type 3 patients. 6 minute walk test and low-rate repetitive nerve stimulation test were performed in fifteen ambulant patients with spinal muscular atrophy type 3 of age between 9 and 66 years. The 6 minute walk distance ranged between 66 and 575 m. The difference between the first and the 6th minute ranged between 0 and -69%. The low-rate repetitive nerve stimulation test measured in % of loss ranged between -31...
July 14, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/28803710/intrathecal-2-hydroxypropyl-%C3%AE-cyclodextrin-decreases-neurological-disease-progression-in-niemann-pick-disease-type-c1-a-non-randomised-open-label-phase-1-2-trial
#15
Daniel S Ory, Elizabeth A Ottinger, Nicole Yanjanin Farhat, Kelly A King, Xuntian Jiang, Lisa Weissfeld, Elizabeth Berry-Kravis, Cristin D Davidson, Simona Bianconi, Lee Ann Keener, Ravichandran Rao, Ariane Soldatos, Rohini Sidhu, Kimberly A Walters, Xin Xu, Audrey Thurm, Beth Solomon, William J Pavan, Bernardus N Machielse, Mark Kao, Steven A Silber, John C McKew, Carmen C Brewer, Charles H Vite, Steven U Walkley, Christopher P Austin, Forbes D Porter
BACKGROUND: Niemann-Pick disease, type C1 (NPC1) is a lysosomal storage disorder characterised by progressive neurodegeneration. In preclinical testing, 2-hydroxypropyl-β-cyclodextrins (HPβCD) significantly delayed cerebellar Purkinje cell loss, slowed progression of neurological manifestations, and increased lifespan in mouse and cat models of NPC1. The aim of this study was to assess the safety and efficacy of lumbar intrathecal HPβCD. METHODS: In this open-label, dose-escalation phase 1-2a study, we gave monthly intrathecal HPβCD to participants with NPC1 with neurological manifestation at the National Institutes of Health (NIH), Bethesda, MD, USA...
August 10, 2017: Lancet
https://www.readbyqxmd.com/read/28802444/identifying-the-critical-physical-demanding-tasks-of-paramedic-work-towards-the-development-of-a-physical-employment-standard
#16
Steven L Fischer, Kathryn E Sinden, Renee S MacPhee
Public safety related occupations including police, fire and military commonly apply physical employment standard (PES) to facilitate job matching, an approach to evaluate if candidates demonstrate acceptable physical capabilities as required to perform the job safely and effectively. In Canada, paramedics remain as one of the few public safety occupations without an evidence-based, validated PES. The purpose of this study was to document and describe the physical demands of paramedic work and to identify the most physically demanding tasks...
November 2017: Applied Ergonomics
https://www.readbyqxmd.com/read/28802429/paramedics-working-strategies-while-loading-a-stretcher-into-an-ambulance
#17
J Prairie, A Plamondon, D Larouche, S Hegg-Deloye, P Corbeil
For paramedics, loading a stretcher into an ambulance is an activity with a high risk of back injury and accidents. The objective of this study was to document strategies paramedics use at work while loading a powered stretcher into an ambulance. A total of 249 stretcher loading operations performed by 58 paramedics, and 51 semistructured post-intervention interviews were analyzed. Almost three quarters of loading operations required additional actions (e.g., raising the shoulders and additional lifting) to insert the stretcher into the cot fastener system in the ambulance...
November 2017: Applied Ergonomics
https://www.readbyqxmd.com/read/28801484/predicting-outcomes-in-traumatic-out-of-hospital-cardiac-arrest-the-relevance-of-utstein-factors
#18
Ben Beck, Janet E Bray, Peter Cameron, Lahn Straney, Emily Andrew, Stephen Bernard, Karen Smith
BACKGROUND: Given low survival rates in cases of traumatic out-of-hospital cardiac arrest (OHCA), there is a need to identify factors associated with outcomes. We aimed to investigate Utstein factors associated with achieving return of spontaneous circulation (ROSC) and survival to hospital in traumatic OHCA. METHODS: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify cases of traumatic OHCA that received attempted resuscitation and occurred between July 2008 and June 2014...
August 11, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28800714/sagittal-subtalar-and-talocrural-joint-assessment-during-ambulation-with-controlled-ankle-movement-cam-boots
#19
Benjamin D McHenry, Emily L Exten, Janelle A Cross, Karen M Kruger, Brian Law, Jessica M Fritz, Gerald Harris
BACKGROUND: The purpose of the current study was to determine sagittal plane talocrural and subtalar kinematic differences between barefoot and controlled ankle movement (CAM) boot walking. This study used fluoroscopic images to determine talar motion relative to tibia and calcaneal motion relative to talus. METHODS: Fourteen male subjects (mean age 24.1 ± 3.5 years) screened for normal gait were tested. A fluoroscopy unit was used to collect images at 200 Hz during stance...
August 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28800341/robotic-assisted-gait-training-combined-with-transcranial-direct-current-stimulation-in-chronic-stroke-patients-a-pilot-double-blind-randomized-controlled-trial
#20
Han Gil Seo, Woo Hyung Lee, Seung Hak Lee, Youbin Yi, Kwang Dong Kim, Byung-Mo Oh
BACKGROUND: Although robotic-assisted gait training (RAGT) is becoming a standard method in stroke rehabilitation, its effect on chronic stroke patients is uncertain. OBJECTIVE: This study aimed to investigate whether anodal tDCS (transcranial direct current stimulation) enhances the effect of RAGT on functional ambulation in chronic stroke patients. METHODS: Chronic hemiplegic stroke patients with a Functional Ambulatory Category (FAC) score≤4 were randomly assigned to either the RAGT with anodal tDCS (Anodal) group or the sham tDCS (Sham) group...
August 11, 2017: Restorative Neurology and Neuroscience
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