Journal articles on the topic 'Musculoskeletal system Wounds and injuries Patients Rehabilitation'
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1
Holly, Janet T., and Lyne G. Lavallee. "Use of Preparatory Stability Exercises with Chronic Obstructive Pulmonary Disease Patients (COPD) to Prevent Iatrogenic Injuries during Rehabilitation." Clinical & Investigative Medicine 30, no. 3 (June 1, 2007): 40. http://dx.doi.org/10.25011/cim.v30i3.1744.
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Background: The increasing incidence of injuries sustained by clients during pulmonary rehabilitation, created a need to develop a prevention strategy. A pre-pulmonary rehabilitation stability exercise class was created based on best practice principles from the orthopaedic literature. It has been discussed in the literature that patients who have COPD have poor stability strategies based on the dominance of the need to drive the respiratory system. If successful, it was felt that this program would decrease the incidence of injury, decrease length stay and help to optimize outcomes.
Methods: Six months of data recording the incidence and severity of injuries from participants in the pulmonary rehabilitation program was collected in order to obtain comparative statistics and demonstrate the need for this program. A literature review was performed to determine the risk of injury in this population. In a 6 month period, 17% of COPD clients admitted to the Rehabilitation Centre for pulmonary rehabilitation have had musculoskeletal issues that proved a significant enough barrier to rehabilitation to require treatment or pulmonary rehabilitation modification. Wait list clients for pulmonary rehabilitation were assessed using the PSFS, NPRS, the 6-minute walk test, the Active Straight Leg Raise, Sitting Arm Lift and the non-stop walk test. Clients participated in six one-hour group exercise sessions. The exercises included neck stabilizers, pelvic floor muscles, trunk stabilizers, and scapular stabilizers derived from published literature.
Results: Clients were re-evaluated using the same outcome tools as well as noting any injuries sustained and capacity to participate. This data was compared with historical data.
Conclusion: The data will help With patient selection for participation in the exercise class as well as refinement of the outcome tools and exercise protocol. This project illustrates the opportunities that exist to share and transfer knowledge from one area of physiotherapy expertise to another to meet the needs of practice. It is essential that this integrated approach to treatment be fostered by clinicians, educators and researchers alike to improve the overall outcomes for the clients.
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Wilson, Jonathan B., Christopher A. Rábago, Carrie W. Hoppes, Phaidra L. Harper, Jin Gao, and Elizabeth Russell Esposito. "Should I Stay or Should I Go? Identifying Intrinsic and Extrinsic Factors in the Decision to Return to Duty Following Lower Extremity Injury." Military Medicine 186, Supplement_1 (January 1, 2021): 430–39. http://dx.doi.org/10.1093/milmed/usaa350.
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ABSTRACT Introduction Rehabilitation research of wounded service members (SMs) commonly focuses on physical ability to return to duty (RTD) as a measure of successful recovery. However, numerous factors or barriers may influence a SM’s ability and/or desire to RTD after lower extremity musculoskeletal trauma. SMs themselves as well as the clinical care team that works with them daily, often for years at a time, both offer unique perspectives on the influential factors that weigh into decisions to RTD. The purpose of this study was to identify the intrinsic and extrinsic factors patients and clinicians recognized as influencing the decision to RTD after severe lower extremity trauma. Materials and Methods Thirty-two SMs with severe lower extremity trauma (amputation and lower limb salvage) and 30 providers with at least 2 years’ experience caring for SMs with similar injuries participated separately in either a SM or provider/clinician focus group. Open-ended questions on factors influencing RTD and other rehabilitation success were discussed. Data analysis consisted of qualitative transcription and participatory active sorting, followed by thematic coding and grouping of qualitative data. Results Individual (health condition, personal traits, and career consideration), interpersonal (clinician’s impact, family influence, and peer influence), health care system (systems of care, transdisciplinary rehabilitation, and innovation availability), and institutional (policy, benefits, and unit/commander) themes emerged amongst SM patients and clinicians. Expected frequently occurring themes common to both groups were the influence of the team and family unit, as well as career trajectory options after a severe injury. An unexpected theme was acknowledgment of and dissatisfaction with the recent dismantling of institutional systems that support wounded SMs. Patients placed less emphasis on severity of injury and greater emphasis on system and policy barriers than did clinicians. Conclusions Characterization and classification of these clinician and SM-identified factors that influence the decision to RTD after severe lower extremity trauma is expected to improve the efficacy of future rehabilitation efforts and clinical practice guidelines by providing the clinical team the knowledge necessary to recognize modifiable barriers to patient success. A better understanding of factors influencing RTD decision-making may support policies for mitigating RTD barriers, better monitoring of the changing landscape of RTD after lower extremity trauma, improving systems of health care, and/or reducing turnover and facilitating force readiness.
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Altaf, Shafaq. "TECHNOLOGICAL ADVANCEMENTS IN NEUROREHABILITATION." Rehabilitation Journal 3, no. 2 (December 31, 2019): 105–6. http://dx.doi.org/10.52567/trj.v3i02.14.
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It has been a few decades since neurological rehabilitation is recognized as a formal technique for therapeutic treatment of stroke patients or individuals suffering disabilities following spinal cord injuries. Despite the nervous system having a plasticity mechanism that facilitates spontaneous recovery to some extent, it is essential for most patients to receive specialized treatment protocol, to restore their motor function, including physical therapy and occupational therapy. More recently, experts of neurological rehabilitation have inculcated specialized therapies making use of computer and electronic devices to positively influence cortical excitability of damaged parts of cerebral hemispheres in order to improve neuroplasticity.1 The advancements aim to take advantage of the functionally preserved neuromuscular structures in compensating for the functions of the damaged areas as well as restoring function of the affected brain tissue; something for which the use of technology was not seen being implemented around two decades back.1, 2 While traditional approach to neuro-rehabilitation would focus on preventing worsening of a functional limitation through exercises such as passive range of motion and stretching,2 a better understanding of neuroplasticity has swung the rehabilitation pendulum in favor of use of several electrotherapeutic devices including transcranial magnetic stimulation modality, robot for limb training, robotic lower extremity orthoses and brain-computer interfaces which offer benefits for patients with neuronal injury.1 Non-invasive brain stimulation facilitates perceptual learning as well motor and cognitive performance in case of brain lesions.2 In order to ensure adherence to various therapies in the process of rehabilitation, interactive treatment strategies are being developed. These include the application of virtual and augmented reality systems which not only motivate the patient but make the repetitive exercise interesting in a controlled environment.3, 4 This approach has challenged the traditional paradigm by the use of biosensors as biofeedback tools to enlighten the patients about internal activities by them visualizing their muscle activity eventually helping them control their bodies better by knowing which muscles to contract to produce the correct movement.5 A proven successful mode of rehabilitation includes virtual reality (VR) technology, which is practical to use at homes, however, requires professional input when it comes to software development and application. Along with ensuring safety and effectiveness, new strategies are being developed which would allow clinicians who do not hold programming expertise to create game-based VR tasks and make further advancements in the field of neurological rehabilitation.6 Amongst the many causes of disability including trauma and musculoskeletal degenerative changes, nervous system disorders are most prevalent resulting in physical, cognitive, linguistic and behavioral issues all at the same time. According to a report by World Health Organization in year 2006, up to 1 billion people are suffering from neurological disorders worldwide constituting around 6% of the global burden of disease and is only escalating since then. Lower-income countries are significantly more affected than high-income countries as 80% disability- stricken individuals live in low-income countries.7 Considering rehabilitation, particularly the neurological aspect, as being relatively young medical specialty, improvement have been made in the years especially in the developed world with better quality rehabilitation services being offered by multidisciplinary teams consisting of highly trained physicians and physical therapists along with supporting staff.8 We are gradually, however, surely moving in the direction of figuring out new and effective approaches to neurorehabilitation by not only compensating for disabilities following neurological injuries but trying to reduce T Rehabili. J. Volume 03, Issue 02 2019 106 impairments by restoring neuronal structure and function.2 The technological advancements made in the developing countries are slow paced; however, keeping in mind the available resources, the responsibility lies with the clinicians to select and provide a comprehensive rehabilitation program which cost-efficient and easy to implement in the long run 9. In a nutshell, a truly effective neuro-rehabilitative program would focus on strategies to fully enable an individual to carry out activities of daily life, increase mobility, improve the ability to function independently and be an integral part of society.
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Mansur, Nacime S., Lucas Fonseca, Eduardo S. Maciel, Thiago Inojossa, Cesar de Cesar Netto, and Diego C. Astur. "Characterization of Motor Performance in 200 Normal Ankles Through Isokinetic Evaluation." Foot & Ankle Orthopaedics 7, no. 1 (January 2022): 2473011421S0033. http://dx.doi.org/10.1177/2473011421s00335.
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Category: Ankle; Sports Introduction/Purpose: The isokinetic test has been used diffusely as a way to evaluate the functional results after the rehabilitation of musculoskeletal injuries. In the ankle, in particular, most studies are related to lateral ligament injuries and Achilles tendon's injuries. However, different protocols are used and a lack of normative values is observed in the literature. The aim of this work is to perform a global isokinetic evaluation on healthy ankles in order to propose reference values for future patients. Methods: We evaluated 100 participants (200 ankles) using the Biodex 3 System for the eversion, inversion, dorsiflexion and plantar flexion movements of the ankle. The sample consisted of individuals aged 20-60 years, with an active life and practice of recreational physical activity (non-athlete) and without previous injuries. Five repetitions for strength (N / m) and work (J) at a speed of 30° / sec and 10 repetitions for power (W) at a speed of 120° / sec were performed in our protocol. Agonist / antagonist ratio and the Muscle Deficiency Index, which globally assesses the balance between the sides for each movement, were also evaluated, as well as the demographic variables. Different statistical analyzes were performed for each parameter. Results: The mean age was 38.5 years and BMI 25.8 (CI 2.7 and 0.8 respectively). The non-dominant side was consistently stronger (higher peak torque) in all movements (p <0.001 -). The mean values obtained for force in each movement were 29.9N / m (CI 1.4) for eversion, 34.8N / m (CI 1.6) for inversion, 48.6N / m (2.0) for dorsiflexion and 140.2 N / m (CI 6.1) for plantar flexion. There was no correlation between age or BMI with the maximum torque (N / m). The ratio of eversors / inverters was 88.8% (CI 3.1) and that of dorsiflexors / plantar flexors was 36.1% (1.3). The Muscle Deficiency Index showed a balance between the sides for each movement (p 0.062), with an average global difference of less than 10% between them (eversion 8.66 [CI 3.17], inversion 4.2 [3, 48], dorsiflexion 3.41 [3.04] and plantar flexion 5.18 [2.51]. Conclusion: As far as we know, this is the largest isokinetic assessment of normal ankles ever performed. The sample, although not stratified, was considered homogeneous (coefficient of variation <50%), which allows to propose several normative values for a non-athlete population in the isokinetic evaluation. It would be interesting to compare these data in the future with the functional results in patients after the treatment of certain injuries.
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Baindurashvili, Alexei G., Klara I. Shapiro, Anatoliy V. Kagan, Alexander N. Vishniakov, Sergey V. Fedorov, and Lyudmila A. Drozhzhina. "The characteristics of patients and hospital procedures for pediatric trauma in Saint Petersburg." Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 4, no. 2 (June 15, 2016): 45–53. http://dx.doi.org/10.17816/ptors4245-53.
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This study presents health statistics for a specialized trauma department in a large pediatric hospital in St. Petersburg. Data relating to patients treated in the trauma department for any injuries and with injuries of the musculoskeletal system were analyzed separately. Injuries of the musculoskeletal system, accounted for 67.3% of all children hospitalized in the trauma department. We also identified patients with injuries of the musculoskeletal system who were treated in non-specialized departments of the hospital (accounting for 4.1% of patients in these departments). Detailed characteristics of the pediatric trauma departments, the characteristics of children hospitalized with injuries of the musculoskeletal system, methods for diagnosis, treatment, and rehabilitation are described. The challenges of rehabilitation for children with injuries and the need to increase the hospital capacity are also described.
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Cadner, P., and E. R. Mattis. "Some principles of organizing orthopedic care in Germany." N.N. Priorov Journal of Traumatology and Orthopedics 2, no. 1-2 (December 28, 1995): 79–82. http://dx.doi.org/10.17816/vto99608.
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Orthopedic care in Germany provides for the prevention, diagnosis and treatment of congenital and acquired functional disorders, diseases, injuries and consequences of injuries of the musculoskeletal system, as well as rehabilitation treatment (rehabilitation) of patients with pathology of the musculoskeletal system, i.e. in its content, orthopedics as a discipline in Germany corresponds to traumatology and orthopedics in Russia.
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Brych, V. V. "PRIMARY DISABILITY CAUSED BY INJURIES AND DISEASES OF THE MUSCULOSKELETAL SYSTEM AS ONE OF THE PREDICTORS OF THE NEED FOR THE PROVISION OF REHABILITATION SERVICES TO THE POPULATION OF THE REGION." Art of Medicine 23, no. 3 (October 18, 2022): 22–27. http://dx.doi.org/10.21802/artm.2022.3.23.22.
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Diseases of the musculoskeletal system and injuries are identified as one of the main causes of disability of the country's population, which leads to a permanent loss of working capacity of adults. This leads to an increase in production losses, an increase in social benefits, an increase in the share of costs for restorative treatment and ensuring an adequate quality of life for the particular part of the population. Strengthening the rehabilitation direction in the health care system may be a possible solution to the problem. A systematic analysis of the levels of primary disability of the population as a result of injuries and diseases of the musculoskeletal system can become a reliable basis for determining the need for rehabilitation services in the region and planning the appropriate amount of resources for their provision.
The aim: to study the features of changes in the levels of disability of the population of the Transcarpathian region during 2011-2020 and to provide an assessment of the needs for rehabilitation services for people with injuries and diseases of the musculoskeletal system in the region.
Materials and methods. The data of the Centre for Medical and Social Expertise of the Transcarpathian region for the years from 2011 to 2020 served as research materials. The medical-statistical method and the method of structural-logical analysis were used during the study.
The results. It was established that in the region the third and fourth places in the structure of causes of disability for ten years were stably taken by diseases of the musculoskeletal system (13.0-16.9%) and injuries (9.4-10.8%). In total, 3,807 people were recognized as disabled for the first time as a result of these pathologies, and their average annual number was 983±49 people. The positive increase in the absolute number of cases of disability due to diseases of the musculoskeletal system and injuries during 2011-2019 outweighed the negative by 37.8%. With a fairly insignificant increase in the number of cases of newly established disability due to diseases of the musculoskeletal system, their share in the structure of causes of general disability increased from 13.0% to 16.9%, and the decrease of 23.6% in cases of annual disability due to injuries was also accompanied by a decrease in their share in the structure of causes of disability from 10.2% to 9.7%, which is connected with the trends of changes in the total number of cases of disability.
The results of the analysis showed the preservation of the relevance of diseases of the musculoskeletal system and injuries as causes of permanent disability, which requires the response of the health care system of the Transcarpathian region by creating effective methods to improve the situation, one of which can be the provision of timely, full-fledged and high-quality rehabilitation assistance to such patients.
The used methodological approach to the analysis and interpretation of the dynamics of the population's disability levels can serve as a management tool for regular calculations of the region's population's need for rehabilitation services.
Conclusions. Disability of the population of the Transcarpathian region due to injuries and diseases of the musculoskeletal system remains an important issue for the regional health care system, which causes a high level of rehabilitation needs. Administrative analysis of the average annual number of people with a newly established disability for the specified reasons and a detailed interpretation of the dynamics of disability levels will allow to plan the rehabilitation services and their resource provision in accordance with the needs of the population.
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K.A., Tilyakov,, Tilyakov, A.B., Shamsiev, J.Z., Rabimov, F.K., Rustamov, Z.A.U., and Sattarov, S.S. "Our experience with the results of surgical treatment of victims with concomitant injuries of the pelvis and femur." CARDIOMETRY, no. 24 (November 30, 2022): 217–25. http://dx.doi.org/10.18137/cardiometry.2022.24.217225.
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Hip fractures with damage to the pelvic bones are one of the most severe combined injuries of the musculoskeletal system. This article presents the results of our studies in 130 patients, which demonstrated that the active tactics of minimally invasive methods of treatment of femoral fractures combined with pelvic bone fractures looks quite reasonable. In favor of early stabilization of fractures, such strong arguments are put forward as the possibility of early activation of the patient, the prevention of threatening hypostatic complications. Combining the terms of consolidation and rehabilitation contributed to obtaining positive functional results, which significantly reduced the number of patients with severe consequences of injuries to the musculoskeletal system.
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Lyadov, K. V., T. V. Shapovalenko, P. S. Snopkov, and Elizaveta Sergeevna Koneva. "The experience with the distant remote rehabilitative treatment of the patients presenting with the severe injury and multiple lesions of the musculo - skeletal system: a review of the clinical reports." Russian Journal of Physiotherapy, Balneology and Rehabilitation 15, no. 3 (June 15, 2016): 160–64. http://dx.doi.org/10.18821/1681-3456-2016-16-3-160-164.
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The problem of providing a continuous staged rehabilitation treatment of patients with severe associated injuries musculoskeletal system is an urgent and important task. This article describes two clinical cases of successful comprehensive medical rehabilitation of disabled persons with severe combined trauma and multiple injuries skeleton in need of long-term continuous rehabilitation program which was successfully launched at the stage of hospital care and continued remotely, through on - line technologies in a familiar patient home medium. As a result of rehabilitation treatment was observed: increased mobility of patients and level of independence in daily life, increased range of motion in the affected joints, increase muscle strength of the affected limbs, improving psycho - emotional status of patients resocialization and adaptation to the familiar home environment.
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Pelletier, René, Johanne Higgins, and Daniel Bourbonnais. "Addressing Neuroplastic Changes in Distributed Areas of the Nervous System Associated With Chronic Musculoskeletal Disorders." Physical Therapy 95, no. 11 (November 1, 2015): 1582–91. http://dx.doi.org/10.2522/ptj.20140575.
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Present interventions utilized in musculoskeletal rehabilitation are guided, in large part, by a biomedical model where peripheral structural injury is believed to be the sole driver of the disorder. There are, however, neurophysiological changes across different areas of the peripheral and central nervous systems, including peripheral receptors, dorsal horn of the spinal cord, brain stem, sensorimotor cortical areas, and the mesolimbic and prefrontal areas associated with chronic musculoskeletal disorders, including chronic low back pain, osteoarthritis, and tendon injuries. These neurophysiological changes appear not only to be a consequence of peripheral structural injury but also to play a part in the pathophysiology of chronic musculoskeletal disorders. Neurophysiological changes are consistent with a biopsychosocial formulation reflecting the underlying mechanisms associated with sensory and motor findings, psychological traits, and perceptual changes associated with chronic musculoskeletal conditions. These changes, therefore, have important implications in the clinical manifestation, pathophysiology, and treatment of chronic musculoskeletal disorders. Musculoskeletal rehabilitation professionals have at their disposal tools to address these neuroplastic changes, including top-down cognitive-based interventions (eg, education, cognitive-behavioral therapy, mindfulness meditation, motor imagery) and bottom-up physical interventions (eg, motor learning, peripheral sensory stimulation, manual therapy) that induce neuroplastic changes across distributed areas of the nervous system and affect outcomes in patients with chronic musculoskeletal disorders. Furthermore, novel approaches such as the use of transcranial direct current stimulation and repetitive transcranial magnetic stimulation may be utilized to help renormalize neurological function. Comprehensive treatment addressing peripheral structural injury as well as neurophysiological changes occurring across distributed areas of the nervous system may help to improve outcomes in patients with chronic musculoskeletal disorders.
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Dumani, Selman, Alfred Ibrahimi, Ermal Likaj, Laureta Dibra, Ali Refatllari, Devis Pellumbi, and Arben Baboci. "Cardiac Trauma. Management Strategies short panoramic View." Albanian Journal of Trauma and Emergency Surgery 7, no. 1 (January 20, 2023): 1189–95. http://dx.doi.org/10.32391/ajtes.v7i1.318.
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Introduction; Trauma is the leading cause of death in United States in the younger population. National Trauma Data Bank in 2017 reported that 140 000 Americans dies and 80 000 are permanently disabled as a result of trauma each year. Cardiac trauma is identified in less than 10% of all trauma admissions but is associated with a much higher mortality than other organ system injuries. Considering the lethality of this type of injury, better guidelines should exist to direct management. We have analyzed data from pub med, surgery books, reviews and original presentations from many institutions to present actuality in management strategies of cardiac injuries.
Cardiac injuries are classified penetrating and blunt. Penetrating trauma includes stab or guns wounds. All patients with a penetrating wound anywhere near the heart should be considered to have a cardiac injury. The penetrating cardiac traumas is a surgical emergency while the blunt injuries treatment consists mainly in observation.
With early aggressive management only 1/3 of patient that arrive at hospital can be saved and this number can arise to more than 70 % if the patient survives until operating room. The results of treatment depend from infrastructural health system to the clinical presentation of the patients. Penetrating cardiac wounds mortality varies 5 % to 76 %. Blunt cardiac injuries are encountered mostly during motor vehicle accidents. The incidence of cardiac injuries in blunt trauma is 2.3-4.6 %. Overall mortality varies 11.4-24.5 %. Myocardial contusion is the most frequent type of blunt cardiac injuries.
The diagnose of the cardiac trauma include: clinical assessment, physical examinations, chest radiographs, echocardiography, cardiac enzymes, ECG, CT scan and even chest drainage. Despite many diagnostic tools we have, it is very important the right management of these tools and the time.
Conclusion: The surgery teams should be familiar with the management of the cardiac injuries and continuing education about this topic is the success key to manage better these emergencies.
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Korzh, Mykola, Volodymyr Tankut, and Olena Shevchenko. "Modern approach to the rehabilitation of patients with joint disabilities due to gunshot injuries of the musculoskeletal system." ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS, no. 1 (April 9, 2019): 31–37. http://dx.doi.org/10.15674/0030-59872019131-37.
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Kungwengwe, Tanaka, and Richard Evans. "Sana: A Gamified Rehabilitation Management System for Anterior Cruciate Ligament Reconstruction Recovery." Applied Sciences 10, no. 14 (July 16, 2020): 4868. http://dx.doi.org/10.3390/app10144868.
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The anterior cruciate ligament (ACL) provides stabilization support for the back and forth motion of the knee joint. ACL ruptures account for 50% of all sports-related knee injuries with approximately 76.6% of them requiring reconstructive surgery, necessitating long-term patient rehabilitation. Compliance with rehabilitation management programs, following ACL reconstruction, is fundamental for the successful restoration of the knee’s kinematics and reducing the risk of secondary osteoarthritis. Existing recovery programs are often paper-based and require patients to perform exercises at home, unsupervised, resulting in a low level of self-efficacy; by promoting self-efficacy in home-based settings, rehabilitation outcomes can improve. This paper reports the design development of the Sana system, a mobile and wearable application that adopts behavioral design principles and gamification theory to improve long-term post-operative outcomes for ACL reconstruction recovery. A feasibility study was conducted from 15 October 2019–13 May 2020, employing the double diamond framework and a human-centered design approach (BS EN ISO 9241-210: 2019). Eighteen participants were recruited, including eight domain experts (in fields such as user experience design, human factors, and physiotherapy), and ten representative users who had undergone long-term rehabilitation for musculoskeletal injuries.
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Rhon, Daniel I., Gail D. Deyle, and Norman W. Gill. "Clinical Reasoning and Advanced Practice Privileges Enable Physical Therapist Point-of-Care Decisions in the Military Health Care System: 3 Clinical Cases." Physical Therapy 93, no. 9 (September 1, 2013): 1234–43. http://dx.doi.org/10.2522/ptj.20120148.
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Background and Purpose Physical therapists frequently make important point-of-care decisions for musculoskeletal injuries and conditions. In the Military Health System (MHS), these decisions may occur while therapists are deployed in support of combat troops, as well as in a more traditional hospital setting. Proficiency with the musculoskeletal examination, including a fundamental understanding of the diagnostic role of musculoskeletal imaging, is an important competency for physical therapists. The purpose of this article is to present 3 cases managed by physical therapists in unique MHS settings, highlighting relevant challenges and clinical decision making. Case Description Three cases are presented involving conditions where the physical therapist was significantly involved in the diagnosis and clinical management plan. The physical therapist's clinical privileges, including the ability to order appropriate musculoskeletal imaging procedures, were helpful in making clinical decisions that facilitate timely management. The cases involve patients with an ankle sprain and Maisonneuve fracture, a radial head fracture, and a pelvic neoplasm referred through medical channels as knee pain. Outcomes Clinical pathways from point of care are discussed, as well as the reasoning that led to decisions affecting definitive care for each of these patients. In each case, emergent treatment and important combat evacuation decisions were based on a combination of examination and management decisions. Discussion Physical therapists can provide important contributions to the primary management of patients with musculoskeletal conditions in a variety of settings within the MHS. In the cases described, advanced clinical privileges contributed to the success in this role.
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Patel, Bhumin J., Madison R. Heath, Christian S. Geannette, Peter D. Fabricant, and Harry G. Greditzer. "When the Wave Breaks You: Magnetic Resonance Imaging Findings After Surfing Injuries." Sports Health: A Multidisciplinary Approach 12, no. 1 (November 5, 2019): 88–93. http://dx.doi.org/10.1177/1941738119880863.
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Background: There are approximately 2.1 million recreational surfers in the United States. However, little has been reported on surfing-related injuries and, to date, no study has utilized magnetic resonance imaging (MRI) to characterize injury patterns. Objective: To use MRI to perform a descriptive analysis of surfing injuries in patients who presented to an urban tertiary care musculoskeletal hospital. This was not a hypothesis-driven study. Study Design: Case series. Level of Evidence: Level 4. Methods: A retrospective review of the picture archiving and communication system as well as the electronic medical record was performed to identify patients with surfing-related injuries who presented to a tertiary care musculoskeletal hospital for treatment. The search included participants over a 10-year period who presented between January 1, 2009, and August 1, 2018. Descriptive data analyses were performed to determine frequency of body part injured, diagnosis, and operative versus nonoperative treatment. Results: The search yielded 109 patients with surfing-related injuries and MRIs. A total of 90 patients presented within 6 months of their surfing injury and were included in the final analysis. The median age was 36 years (range, 12-66 years). A majority of the patients included were male (74%; n = 67). Acute surfing injuries were diagnosed via imaging in 72% (n = 65) of patients. The joints injured most commonly were the shoulder (46%; n = 30) and the knee (28%; n = 18). Only 17% (n = 11) of acute surfing injuries required surgery, while 83% (n = 54) were treated nonoperatively. Conclusion: The most common surfing-related injuries occurred in the shoulder and knee. Clinical Relevance: This study helps characterize the risk of injury for surfers and informs healthcare providers on common surfing injuries.
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Polyaev, B. A. "S.P. Mironov, M.B. Tsykunov. Fundamentals of rehabilitation of athletes and ballet dancers with injuries and diseases of the musculoskeletal system (M., 1998)." N.N. Priorov Journal of Traumatology and Orthopedics 5, no. 4 (December 15, 1998): 65. http://dx.doi.org/10.17816/vto104873.
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The publication of the book under review should be considered very timely: until now only translated editions were published on this problem, as a rule, intended for coaches and physicians of sports teams. At the same time, the pathology of musculoskeletal system of sportsmen and ballet dancers is studied by orthopedists-traumatologists, who, even if they are familiar with the specifics of surgical treatment of this contingent of patients, most of them have no clear idea of how rehabilitation process should proceed, what rehabilitation actions can be, what are general indications and contraindications for application of any means of rehabilitation.
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Lynall, Robert C., Timothy C. Mauntel, Ryan T. Pohlig, Zachary Y. Kerr, Thomas P. Dompier, Eric E. Hall, and Thomas A. Buckley. "Lower Extremity Musculoskeletal Injury Risk After Concussion Recovery in High School Athletes." Journal of Athletic Training 52, no. 11 (November 1, 2017): 1028–34. http://dx.doi.org/10.4085/1062-6050-52.11.22.
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Context: Although an association between concussion and musculoskeletal injury has been described in collegiate and professional athletes, no researchers have investigated an association in younger athletes. Objective: To determine if concussion in high school athletes increased the risk for lower extremity musculoskeletal injury after return to activity. Design: Observational cohort study. Setting: One hundred ninety-six high schools across 26 states. Patients or Other Participants: We used data from the National Athletic Treatment, Injury and Outcomes Network surveillance system. Athletic trainers provided information about sport-related concussions and musculoskeletal injuries in athletes in 27 sports, along with missed activity time due to these injuries. Main Outcome Measure(s): Three general estimating equations were modeled to predict the odds of sustaining (1) any lower extremity injury, (2) a time-loss lower extremity injury, or (3) a non–time-loss lower extremity injury after concussion. Predictors were the total number of previous injuries, number of previous concussions, number of previous lower extremity injuries, number of previous upper extremity injuries, and sport contact classification. Results: The initial dataset contained data from 18 216 athletes (females = 39%, n = 6887) and 46 217 injuries. Lower extremity injuries accounted for most injuries (56.3%), and concussions for 4.3% of total injuries. For every previous concussion, the odds of sustaining a subsequent time-loss lower extremity injury increased 34% (odds ratio [OR] = 1.34; 95% confidence interval [CI] = 1.13, 1.60). The number of previous concussions had no effect on the odds of sustaining any subsequent lower extremity injury (OR = 0.97; 95% CI = 0.89, 1.05) or a non–time-loss injury (OR = 1.01; 95% CI = 0.92, 1.10). Conclusions: Among high school athletes, concussion increased the odds of sustaining subsequent time-loss lower extremity injuries but not non–time-loss injuries. By definition, time-loss injuries may be considered more severe than non–time-loss injuries. The exact mechanism underlying the increased risk of lower extremity injury after concussion remains elusive and should be further explored in future research.
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Фролов, V. Frolov, Кононова, and V. Kononova. "Medical rehabilitation of the patients with chronic somatoform dorsalgias." Journal of New Medical Technologies. eJournal 8, no. 1 (November 5, 2014): 0. http://dx.doi.org/10.12737/7225.
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The patho-biomechanical changes in the 45 patients with somatoform dorsalgia are described in this article. It has been noted that the dorsalgia in the patients with borderline mental disorders has only psychogenic nature, in the 100% cases the pathology of the musculoskeletal system was detected. The manual therapy effect on the state of the terminal bloodstream with the use of the biomicroscopy of the conjunctiva method has been studied. It has been demonstrated that the recovery of the tone and power balance of muscles contribute to the reduction of pathologic vasomotor reactions in the vertebral-basilar system and the system of carotid arteries. After 1,5 month from the beginning of the treatment, a decrease by 45% of the integral index of microcircu-latory injuries (from 0,51+0,03 standard units down to 0,28+0,02 standard units) of the patients of the treat-ment group, with whom the correction of patho-biomechanical disorders together with pharmacotherapy was conducted, has been observed. The analogous index of the patients of the control group after the pharmacotherapy, decreased by 24% (from 0,50+0,03 standard units down to 0,38+0,03 standard units). According to the data of the visual analog scale of pain, the improvement of the indexes of cerebral hemodynamics and musculo-fascial correction contribute to the decrease of the level of pain of the patients of the treatment group by 39,5% more compared to the patients of the control group.
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Johnson-Kunjukutty, Swapna, and Carmel Delille. "Impact of chronic osteomyelitis on wound healing and the quality of life of the patient with a chronic wound." WCET Journal 39, no. 2 (2019): 34–40. http://dx.doi.org/10.33235/wcet.39.2.34-40.
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Spinal cord injury (SCI) patients have a higher risk of developing pressure injury secondary to limited mobility and lack of sensation. The James J Peters Medical Center is one of several regional spinal cord injury centres in the Veterans Affairs System. Veterans with SCI receive comprehensive care. Hospital- and community-acquired pressure injuries (HAPIs and CAPIs) can progressively advance to chronic stage IV pressure injury complicated with osteomyelitis. Chronic wounds that become infected can lead to sepsis if the wounds are not managed properly. The management of chronic wounds represents a significant financial burden for any health care system and a challenge for providers whose goals are to avoid prolongation of hospital stay, avoid complications, and minimise disruption in the patient’s life. A focus of the primary physician is to establish a rehabilitation plan that facilitates the patient to resume activities of daily living post injury and have a productive life in their community. However, despite the collaborative effort of the SCI team, the sudden change in the patient’s mobility can also have a detrimental impact on the patient’s mental status as well.
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Chiou, Shean-Juinn, Hsien-Ru Chu, I.-Hsum Li, and Lian-Wang Lee. "A Novel Wearable Upper-Limb Rehabilitation Assistance Exoskeleton System Driven by Fluidic Muscle Actuators." Electronics 12, no. 1 (December 31, 2022): 196. http://dx.doi.org/10.3390/electronics12010196.
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This paper proposed a novel design using a torsion spring mechanism with a single fluidic muscle actuator (FMA) to drive a joint with one degree-of-freedom (DOF) through a steel wire and a proportional pressure regulating valve (PRV). We developed a 4-DOF wearable upper-limb rehabilitation assistance exoskeleton system (WURAES) that is suitable for assisting in the rehabilitation of patients with upper-limb injuries. This system is safe, has a simple mechanism, and exhibits upper-limb motion compliance. The developed WURAES enables patients with upper-limb musculoskeletal injuries and neurological disorders to engage in rehabilitation exercises. Controlling the joint is difficult because of the time-varying hysteresis properties of the FMA and the nonlinear motion between standard extension and flexion. To solve this problem, a proxy-based output feedback sliding mode control (POFSC) was developed to provide appropriate rehabilitation assistance power for the upper-limb exoskeleton and to maintain smooth and safe contact between the WURAES and the patient. The POFSC enables the overdamped dynamic of the WURAES to recover motion to be aligned with the target trajectory without a significant error overshoot caused by actuator saturation. The experimental results indicate that the proposed POFSC can control the designed WURAES effectively. The POFSC can monitor the exoskeleton system’s total disturbance and unknown state online and adapt to the exterior environment to enhance the control capability of the designed system. The results indicate that a single FMA with a torsion spring module exhibits a control response similar to a dual FMA configuration.
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Padilla-Castañeda, Miguel A., Edoardo Sotgiu, Michele Barsotti, Antonio Frisoli, Piero Orsini, Alessandro Martiradonna, Cristina Laddaga, and Massimo Bergamasco. "An Orthopaedic Robotic-Assisted Rehabilitation Method of the Forearm in Virtual Reality Physiotherapy." Journal of Healthcare Engineering 2018 (August 1, 2018): 1–20. http://dx.doi.org/10.1155/2018/7438609.
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The use of robotic rehabilitation in orthopaedics has been briefly explored. Despite its possible advantages, the use of computer-assisted physiotherapy of patients with musculoskeletal injuries has received little attention. In this paper, we detailed the development and evaluation of a robotic-assisted rehabilitation system as a new methodology of assisted physiotherapy in orthopaedics. The proposal consists of an enhanced end-effector haptic interface mounted in a passive mechanism for allowing patients to perform upper-limb exercising and integrates virtual reality games conceived explicitly for assisting the treatment of the forearm after injuries at the wrist or elbow joints. The present methodology represents a new approach to assisted physiotherapy for strength and motion recovery of wrist pronation/supination and elbow flexion-extension movements. We design specific game scenarios enriched by proprioceptive and haptic force feedback in three training modes: passive, active, and assisted exercising. The system allows the therapist to tailor the difficulty level on the observed motion capacity of the patients and the kinesiology measurements provided by the system itself. We evaluated the system through the analysis of the muscular activity of two healthy subjects, showing that the system can assign significant working loads during typical physiotherapy treatment profiles. Subsequently, a group of ten patients undergoing manual orthopaedic rehabilitation of the forearm tested the system, under similar conditions at variable intensities. Patients tolerated changes in difficulty through the tests, and they expressed a favourable opinion of the system through the administered questionnaires, which indicates that the system was well accepted and that the proposed methodology was feasible for the case study for subsequently controlled trials. Finally, a predictive model of the performance score in the form of a linear combination of kinesiology observations was implemented in function of difficult training parameters, as a way of systematically individualising the training during the therapy, for subsequent studies.
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Russek, Leslie N., Patricia Stott, and Jane Simmonds. "Recognizing and Effectively Managing Hypermobility-Related Conditions." Physical Therapy 99, no. 9 (June 3, 2019): 1189–200. http://dx.doi.org/10.1093/ptj/pzz078.
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AbstractHypermobility spectrum disorder (HSD) and hypermobile Ehlers-Danlos syndrome (hEDS) can cause widespread or chronic pain, fatigue, and proprioceptive and coordination deficits resulting in functional restrictions. These conditions are common and often unrecognized, and patients are likely to present in physical therapy for musculoskeletal injuries, pain, or coordination deficits. Although physical therapy is considered central to managing these conditions, many patients report pain and iatrogenic injuries due to inappropriate interventions. The diagnostic classification for these conditions was revised in 2017 to supersede previous diagnostic categories of Joint Hypermobility Syndrome and Ehlers-Danlos Syndrome—hypermobility type/type III. It is now known that these conditions affect multiple body systems and not just joints and that patients require a holistic approach. This Perspective article will describe the 2017 diagnostic classification system, clinical presentation, examination, evaluation, and management of patients with HSD/hEDS. Both adult and pediatric cases are presented to illustrate the patient management concepts discussed. This knowledge can lead to more effective management of this patient population.
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Collier, Zachary J., Katherine J. Choi, Ian F. Hulsebos, Christopher H. Pham, Haig A. Yenikomshian, and Justin Gillenwater. "123 A Novel Way of Thinking About Blast Injury Classification." Journal of Burn Care & Research 42, Supplement_1 (April 1, 2021): S82—S83. http://dx.doi.org/10.1093/jbcr/irab032.127.
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Abstract Introduction Blast injuries present unique challenges to civilian and military healthcare providers because of the complex and often severe nature of injuries spanning numerous anatomical regions, tissue types, and organ systems. Due to these factors, we devised a novel wound-focused classification system for implementation during triage and management of blast injuries to optimize outcomes and applied this system to patients treated at an ABA-certified burn center over 5 years. Methods A retrospective analysis of patients treated by an ABA-certified burn center for blast-related injuries from September 1, 2014 to October 31, 2019 was performed. Demographics, mechanism and distribution of injuries, interventions, and outcomes were evaluated. Injuries were classified using a wound-focused classification comprised of four zones: 1) areas closest to blast epicenter that had total or near-total tissue loss from the blast; 2) adjacent areas with thermal and chemical burns; 3) distant sites with shrapnel-related wounds; 4) injuries arising from barotrauma. Results We identified 64 patients who were mostly male (84%), averaging 38 ± 14 years old. Injury mechanisms included fireworks (19%), industrial accidents (16%), volatile fuels and drug labs (45%), and others including can, battery, lighter explosions (20%). All mechanisms had equivalent frequency of Zone 2 injuries with an average TBSA of 17 ± 18%. Drug-related blasts caused the highest TBSA (34 ± 23%) and the most full-thickness burns (33% vs average 23%). Fireworks had over five times (17% vs. 3%) more Zone 3 and three times (25% vs 8%) more Zone 4 injuries compared to the other mechanisms. Upper extremities were involved at twice the rate of other body regions (43% vs 19%). Patients presenting to our burn team over 24 hours after initial injury had infections in 50% of cases – a four-fold increase compared to non-delayed presentations (50% vs 13%). Overall, 45% required surgery (32% grafting, 3% flaps) but 100% of the drug-related blasts needed surgical intervention. Some patients (58%) required ICU admission with the highest rate (83%) in the drug-related group. Conclusions Blast injuries most often required admission for management of the Zone 2 component. Each blast mechanism resulted in distinct distributions of injury although fireworks had the greatest number of Zone 1, 3, and 4 injuries. Firework blasts were often less severe and more likely to present delayed with infectious complications. Larger blast mechanisms including drug-related lab explosions as well as industrial blasts had the highest rates of ICU admission, TBSA, full thickness depth, upper extremity involvement, and need for surgical intervention.
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Ball, Shane, Mark Halaki, and Rhonda Orr. "Movement Demands and Injury Characteristics in Under-20-Years University Rugby Union Players." Journal of Athletic Training 55, no. 4 (April 1, 2020): 376–83. http://dx.doi.org/10.4085/1062-6050-575-18.
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Context Rugby union is a field-based collision sport with high injury rates. Associations between injury characteristics and global positioning system–derived movement demands in rugby union athletes are yet to be investigated. Objective To investigate associations between match injuries and movement demands, anthropometrics, and physical performance in under-20-years university-level rugby union players. Design Descriptive epidemiology study. Setting Competition season. Patients or Other Participants Rugby union players (n = 34, age = 19.3 ± 0.6 years) from a university club were recruited. Main Outcome Measure(s) Acute medical attention non–time-loss (NTL), medical-attention time-loss (TL), and total medical-attention (MA) injuries sustained were recorded. Principal component (PC) analysis was performed on player-movement demand variables to identify independent-movement demand components. Pearson correlation and bivariate linear regression were used to test associations between match injuries and PCs. Anthropometric and physical performance measures were tested as predictors of match injuries using a forward stepwise multiple regression analysis. Results Backs had lower anthropometric and performance measures than forwards (P < .05), whereas forwards performed fewer weekly movement demands than backs (P < .05). Increases in body mass and skinfold thickness were associated with more injuries (P < .05). Principal component analysis revealed 3 PCs representing overall performance, high-intensity running (HIR) performance, and impacts. Increases in HIR were associated with decreases in NTL upper limb and trunk (r = −0.32, P = .03), NTL musculoskeletal (r = −0.36, P = .05), NTL total (r = −0.46, P < .01), TL musculoskeletal (r = −0.30, P = .05), MA musculoskeletal (r = −0.41, P < .01), and MA total (r = −0.48, P < .01) injuries. Increases in impacts were associated with increased TL (r = 0.32, P = .03) and MA (r = 0.33, P = .03) head or neck injuries. Conclusions Backs experienced greater weekly movement demands than forwards. Increases in HIR demands were associated with decreased acute injuries in university rugby players. Increases in impacts were associated with more acute head or neck injuries. Positional differences in movement demands, anthropometrics, and physical performance highlight the need for position-specific training.
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Kasnakova, Petya. "METHODOLOGY OF PLAYING ACTIVITY IN REHABILITATION PRACTICE." Knowledge International Journal 28, no. 7 (December 10, 2018): 2543–48. http://dx.doi.org/10.35120/kij28072543p.
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The games play a special role in rehabilitation practice. The positive emotions they cause in patients cannot be achieved by other methods and means of modern rehabilitation. The role of game playing activity in practice is crucial to the achievement of one of the important tasks in implementing rehabilitation measures, namely to evacuate the patient from the depressed mental state, to distract him from the disease process and to focus on mobilizing his healing powers. The mood, the emotional charge and the dynamics that the games create are particularly suited to awakening the patient's interest in the healing process, their attraction and their active involvement in the rehabilitation activities. The connection between the actions in the game and the movements in the analytical exercises accelerates the formation of motor habits, physical qualities and skills not only in children but also in adult patients with various pathological injuries. Rehabilitation games are suitable for all ages by enhancing the health of the occupants, developing their mental qualities, improving the activity of the vestibular, visual and motor analyzers. The basis of the motor movement training game methodology and the improvement of motor movement skills is the activation of the thought processes and emotional experiences, the development of the functions of the musculoskeletal system, the cardiovascular system and the respiratory system.
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Kasnakova, Petya. "METHODOLOGY OF PLAYING ACTIVITY IN REHABILITATION PRACTICE." Knowledge International Journal 28, no. 7 (December 10, 2018): 2543–48. http://dx.doi.org/10.35120/kij29082543p.
Full textAbstract:
The games play a special role in rehabilitation practice. The positive emotions they cause in patients cannot be achieved by other methods and means of modern rehabilitation. The role of game playing activity in practice is crucial to the achievement of one of the important tasks in implementing rehabilitation measures, namely to evacuate the patient from the depressed mental state, to distract him from the disease process and to focus on mobilizing his healing powers. The mood, the emotional charge and the dynamics that the games create are particularly suited to awakening the patient's interest in the healing process, their attraction and their active involvement in the rehabilitation activities. The connection between the actions in the game and the movements in the analytical exercises accelerates the formation of motor habits, physical qualities and skills not only in children but also in adult patients with various pathological injuries. Rehabilitation games are suitable for all ages by enhancing the health of the occupants, developing their mental qualities, improving the activity of the vestibular, visual and motor analyzers. The basis of the motor movement training game methodology and the improvement of motor movement skills is the activation of the thought processes and emotional experiences, the development of the functions of the musculoskeletal system, the cardiovascular system and the respiratory system.
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Malakhov, O. A., A. M. Cherkashov, and O. P. Pyzhevskaya. "Experience in the treatment of scoliosis in children and adolescents in a rehabilitation center." N.N. Priorov Journal of Traumatology and Orthopedics 4, no. 3 (July 29, 1997): 60–61. http://dx.doi.org/10.17816/vto108563.
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The rehabilitation center operates on the basis of the sanatorium boarding school No. 25 at the CITO. The sanatorium boarding school was organized in 1992 and is designed for the education and treatment of 150 children aged 6 to 16-17. A typical school building after a major overhaul was converted into an educational and medical institution. The boarding school works on a five-day week, children spend weekends at home. Unlike other similar institutions that exist in Moscow and some regions of Russia, boarding school No. 25 does not specialize in the rehabilitation treatment of patients with pathology of any one system of the musculoskeletal system (spine, large joints, etc.). The main task of the center is to provide qualified rehabilitation assistance to children suffering from a wide variety of orthopedic pathologies, as well as those who have suffered injuries of the joints, limbs, spine, etc. This report is devoted to the analysis of treatment at the center for children suffering from scoliosis. This contingent of patients here is about 60% of the total number of patients.
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Makolinets, Vasyl, Tamara Grashenkova, Volodymyr Moseichuk, Kyrylo Makolinets, and Vladyslav Moseichuk. "Molecular hydrogen as a possible therapeutic factor in complex rehabilitation therapy in patients with muscular skeletal disorders (literature review)." ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS, no. 1 (October 5, 2021): 92–97. http://dx.doi.org/10.15674/0030-59872021192-97.
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The paper presents an analysis of foreign scientific and medical data on the therapeutic factor — molecular hydrogen. The effectiveness of its application in the complex therapy of many diseases is revealed. The effect is achieved due to the small size of the molecule, which passes through biological membranes and inhibits dangerous free radicals in the mitochondria, as well as in the nucleus, which reduces the possibility of DNA damaging. Molecular hydrogen neutralizes oxidants in the brain due to its ability to cross the blood-brain barrier. It normalizes the functions and metabolic processes in the body and, as an antioxidant, is selective: it does not affect the useful free radicals involved in important metabolic processes and selectively eliminates only the most dangerous oxidants — hydroxyl radicals. Interacting with them, hydrogen converts them into water molecules without the formation of by-products and chain reactions. Unlike other known antioxidants, molecular hydrogen does not disrupt normal metabolism, does not cause negative changes in cells, activates the body’s own antioxidant systems. The possibility and expediency of the use of molecular hydrogen in the case of pathology of the musculoskeletal system has been confirmed. The peculiarities of its effect on bone and cartilage tissue in the experiment are shown. It has been determined that the use of molecular hydrogen is a new pharmacological strategy aimed at the selective removal of ONOO—, and can be an effective method in the treatment of joint diseases. Because cartilage receives nutrients through a diffusion-loading mechanism, and molecular hydrogen penetrates rapidly into tissues, it can be useful for the prevention of diseases of joints of degenerative origin. It reduces oxidative stress and slows down the reduction of matrix proteins and inhibition of proteinase degradation. Its effectiveness has been proven after injuries to the spinal cord, muscles and tendons, comorbid diseases such as hypertension, coronary heart disease, diabetes and metabolic syndrome. Key words. Molecular hydrogen, hydrogen water, hydrogen inhalations, joint diseases, consequences of musculoskeletal injuries, comorbid pathology.
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Vall, Janaína, Carlos Mauricio de Castro Costa, Terezinha de Jesus Teixeira Santos, and Samuel Bovy de Castro Costa. "Neuropathic pain characteristics in patients from Curitiba (Brazil) with spinal cord injury." Arquivos de Neuro-Psiquiatria 69, no. 1 (February 2011): 64–68. http://dx.doi.org/10.1590/s0004-282x2011000100013.
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This was a descriptive cross-sectional study on patients with spinal cord injuries living in Curitiba, Paraná, Brazil. The aim was to evaluate the pain characteristics among such patients seen at referral care centers for spinal cord injury patients in Curitiba. A total of 109 adults with spinal cord injury in this city were evaluated regarding the presence of pain, especially neuropathic pain. Neuropathic pain was evaluated using the DN4 questionnaire, a universal instrument that has been translated and validated for Portuguese. A visual analog scale (VAS) was used to evaluate the intensity of pain. The prevalence of pain among these 109 patients was 31.2% (34 patients). The nociceptive pain presented was classified as musculoskeletal pain (nine patients), visceral pain (four patients) and mixed pain (one patient), thus totaling 14 patients (12.8%). Another 20 patients (18.3%) showed symptoms of neuropathic pain and fulfilled the criteria for neuropathic pain with scores greater than 4 out 10 in the DN4 questionnaire. Regarding the characteristics of the patients with neuropathic pain, most of them were male, younger than 40 years of age and paraplegic with incomplete lesions. They had become injured from 1 to more than 5 years earlier. The predominant etiology was gunshot wounds, and the intensity of their pain was high, with VAS scores greater than 5. This study partially corroborates other studies conducted on this subject. Studies of this type are important for understanding the profile of these patients, for the purpose of designing strategies for their rehabilitation, with a focus on the appropriate treatment and management of pain.
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Knapik, Joseph, and Ryan Steelman. "Risk Factors for Injuries During Military Static-Line Airborne Operations: A Systematic Review and Meta-Analysis." Journal of Athletic Training 51, no. 11 (November 1, 2016): 962–80. http://dx.doi.org/10.4085/1062-6050-51.9.10.
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Objective: To identify and analyze articles in which the authors examined risk factors for soldiers during military static-line airborne operations. Data Sources: We searched for articles in PubMed, the Defense Technical Information Center, reference lists, and other sources using the key words airborne, parachuting, parachutes, paratrooper, injuries, wounds, trauma, and musculoskeletal. Study Selection: The search identified 17 684 potential studies. Studies were included if they were written in English, involved military static-line parachute operations, recorded injuries directly from events on the landing zone or from safety or medical records, and provided data for quantitative assessment of injury risk factors. A total of 23 studies met the review criteria, and 15 were included in the meta-analysis. Data Extraction: The summary statistic obtained for each risk factor was the risk ratio, which was the ratio of the injury risk in 1 group to that of another (baseline) group. Where data were sufficient, meta-analyses were performed and heterogeneity and publication bias were assessed. Data Synthesis: Risk factors for static-line parachuting injuries included night jumps, jumps with extra equipment, higher wind speeds, higher air temperatures, jumps from fixed-wing aircraft rather than balloons or helicopters, jumps onto certain types of terrain, being a female paratrooper, greater body weight, not using the parachute ankle brace, smaller parachute canopies, simultaneous exits from both sides of an aircraft, higher heat index, winds from the rear of the aircraft on exit entanglements, less experience with a particular parachute system, being an enlisted soldier rather than an officer, and jumps involving a greater number of paratroopers. Conclusions: We analyzed and summarized factors that increased the injury risk for soldiers during military static-line parachute operations. Understanding and considering these factors in risk evaluations may reduce the likelihood of injury during parachuting.
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Fedorenko, S. М., M. S. Balazh, V. V. Vitomskyi, О. B. Lazarіeva, and M. V. Vitomskа. "Economic components of the morbidity and rehabilitation of the musculoskeletal system as factors of the organization of the system of physical therapy at the ambulatory stage." Health, sport, rehabilitation 6, no. 1 (June 6, 2020): 57. http://dx.doi.org/10.34142/hsr.2020.06.01.07.
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<p><strong>The aim</strong>: to consider the economic consequences of morbidity and rehabilitation of the musculoskeletal system (MSS) among the able-bodied population to confirm the economic feasibility of using physical therapy and the development of its system in the country in order to reduce losses from MSS pathologies in Ukraine.</p><p><strong>Material and methods</strong>: the data of 63 literature sources on the prevalence of MSS diseases among the working population, their economic consequences (payments for treatment, employers' losses), the role of rehabilitation, physical therapy in reducing financial costs, and the needs of the population in rehabilitation and physical therapy were analyzed.</p><p><strong>Results.</strong> Occupational diseases of the MSS are characterized by long-term disability and a high incidence of disability. The effectiveness of rehabilitation, including economic, with injuries and diseases of the MSS was given great attention in the works of domestic and foreign authors. A significant amount of research has confirmed that the funds spent on the implementation of rehabilitation are reimbursed many times by reducing the periods of temporary and permanent loss of working capacity.</p><p><strong>Conclusion.</strong> The economic feasibility of directing the funds for rehabilitation and physical therapy in pathologies of the MSS is reflected in the short duration of disability, the period of adaptation of patients to work, and the need for rehabilitation. Therefore, channeling funds into building a rehabilitation and physical therapy system in Ukraine is appropriate in the framework of medical reform and will have long-term positive economic consequences.</p>
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Lurie, D. M. "Experience of joint use of physiotherapeutic treatment and complex bioregulatory medicines in the multidisciplinary clinic practice." Meditsinskiy sovet = Medical Council, no. 11 (August 8, 2020): 219–23. http://dx.doi.org/10.21518/2079-701x-2020-11-219-223.
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Sports injuries of the musculoskeletal system of different localization represent actual problems of modern traumatology and rehabilitation. Despite the large number of proposed methods of therapy, the question of the management of injuries in athletes remains open. The main goal is to identify effective and safe approach to drug and non-pharmacological treatment and rehabilitation of athletes, allowing them to restore damaged structures and functional capabilities of the body to the initial level in a short time, as well as reduce the risk of relapse and repeated injury of athletes of any age. This review of clinical cases demonstrates a modern approach to this problem based on recent breakthroughs in the inflammation resolution. Particular attention is paid to the role of complex bioregulatory medicines Traumeel S and Zeel T in the management of sport injuries. Four clinical cases of patients of different ages and sexes are presented for consideration, two of them had knee injury, one patient presented with acromioclavicular joint injury, and the last one was suffering from achilles tendon rupture. The treatment algorithms based on the complex bioregulatory medicines Traumeel S and Zeel T in different forms (injectables, ointment and tablet) are actively used in multidisciplinary clinic. In these settings patients can receive the necessary therapy according to clinical experience of other colleagues that was published in scientific articles. Abovementioned clinical cases demonstrate that complex bioregulatory medicines and various physiotherapeutic methods may be considered as an effective treatment option in sport injuries.
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Stubblefield, Michael D., Katarzyna Ibanez, Elyn R. Riedel, Ori Barzilai, Ilya Laufer, Eric Lis, Yoshiya Yamada, and Mark H. Bilsky. "Peripheral nervous system injury after high-dose single-fraction image-guided stereotactic radiosurgery for spine tumors." Neurosurgical Focus 42, no. 3 (March 2017): E12. http://dx.doi.org/10.3171/2016.11.focus16348.
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OBJECTIVE The object of this study was to determine the percentage of high-dose (1800–2600 cGy) single-fraction stereotactic radiosurgery (SF-SRS) treatments to the spine that result in peripheral nervous system (PNS) injury. METHODS All patients treated with SF-SRS for primary or metastatic spine tumors between January 2004 and May 2013 and referred to the Rehabilitation Medicine Service for evaluation and treatment of neuromuscular, musculoskeletal, or functional impairments or pain were retrospectively identified. RESULTS Five hundred fifty-seven SF-SRS treatments in 447 patients resulted in 14 PNS injuries in 13 patients. All injures resulted from SF-SRS delivered to the cervical or lumbosacral spine at 2400 cGy. The overall percentage of SF-SRS treatments resulting in PNS injury was 2.5%, increasing to 4.5% when the thoracic spine was excluded from analysis. The median time to symptom onset following SF-SRS was 10 months (range 4–32 months). The plexus (cervical, brachial, and/or lumbosacral) was affected clinically and/or electrophysiologically in 12 (86%) of 14 cases, the nerve root in 2 (14%) of 14, and both in 6 (43%) of 14 cases. All patients experienced pain and most (93%) developed weakness. Peripheral nervous system injuries were CTCAE Grade 1 in 14% of cases, 2 in 64%, and 3 in 21%. No dose relationship between SF-SRS dose and PNS injury was detected. CONCLUSIONS Single-fraction SRS to the spine can result in PNS injury with major implications for function and quality of life.
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Foster, Kevin N., Sarah J. Jacobsen, Arpana Jain, Michael Peck, and Karen J. Richey. "582 A Survey of Burn Care Providers Regarding the Utility of Telehealth to Provide Outpatient Burn Care." Journal of Burn Care & Research 42, Supplement_1 (April 1, 2021): S142—S143. http://dx.doi.org/10.1093/jbcr/irab032.232.
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Abstract Introduction Telehealth is purported to be the wave of the future, offering improved access to care by overcoming geographical and other logistical challenges while simultaneously improving efficiencies within the healthcare system. As the global COVID-19 pandemic swept through our state, we were abruptly forced to take our burn clinic to a telehealth platform for most patients. The purpose of this study was to evaluate our experience with telehealth in managing burn wounds and other complex skin defects. Methods A 16-item survey was developed using the framework outlined by the National Quality Forum for the development of telehealth measures. The survey was distributed to direct care providers and focused on the domains of experience and effectiveness and the subdomains of efficiency and satisfaction. Results There were a total of 14 respondents, including physicians, allied healthcare professionals, therapists and nurses. Seventy-seven percent of participants felt that overall, the system was efficient in the 4 categories of time required for scheduling, check-in, visit conduct and care coordination. Telehealth was deemed moderately to very effective by 80% in providing the patient access to care and the provider’s ability to educate the patient. However, providers, therapists and nurses uniformly found telehealth to be either not at all effective or slightly effective in assessing wounds, musculoskeletal function and developing a plan of care. When rating satisfaction with connectivity and overall quality of the clinic visit 70% of respondents were either dissatisfied/neither satisfied nor dissatisfied with the platform. Conclusions The operational aspects of our burn clinic telehealth program implemented during the COVID-19 pandemic were found to be largely satisfactory, with the exception of connectivity issues. However, the clinical aspects of the program were found to be largely unsatisfactory and, notably, were judged to be inferior to in-person visits.
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Andrade-Silva, Fernando Brandão, Renan Lyuji Takemura, Renato Tavares Bellato, Marcos de Camargo Leonhardt, Kodi Edson Kojima, and Jorge dos Santos Silva. "VALIDITY AND RELIABILITY OF THE MANCHESTER SCALE USED IN THE ORTHOPEDIC EMERGENCY DEPARTMENT." Acta Ortopédica Brasileira 27, no. 1 (February 2019): 50–54. http://dx.doi.org/10.1590/1413-785220192701191577.
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ABSTRACT Objectives: To describe the clinical utility of the Manchester triage scale adapted for orthopedic emergency departments and to evaluate its validity in identifying patients with the need for hospital care and its reliability when reproduced by different professionals. Methods: Five triage flowcharts were developed based on the Manchester scale for the following orthopedic disorders: traumatic injuries, joint pain, vertebral pain, postoperative disorders, and musculoskeletal infections. A series of patients triaged by two orthopedists was analyzed to assess the concordance between the evaluators (reliability) and the validity of the Manchester scale as predictive of severity. Results: The reliability analysis included 231 patients, with an inter-observer agreement of 84% (Kappa = 0.77, p <0.001). The validity analysis included 138 patients. The risk category had a strong association with the need for hospital care in patients with trauma (OR = 6.57, p = 0.001) and was not significant for non-traumatic disorders (OR = 2.42; p = 0.208). The overall sensitivity and specificity were 64% and 76%, respectively. Conclusion: The evaluated system presented high reliability. Its validity was adequate, with good sensitivity for identifying patients requiring hospital care among those with traumatic lesions. However, the sensitivity was low for patients with non-traumatic lesions. Level of Evidence III, Retrospective Study.
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Mcgory, Marcia, H. Gill Cryer, Charles Chandler, Marilyn Cohen, and Jonathan R. Hiatt. "The Santa Monica Crash: An Urban Multicasualty Event." American Surgeon 70, no. 10 (October 2004): 886–89. http://dx.doi.org/10.1177/000313480407001012.
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Mass casualty events provide dramatic challenges for trauma centers and trauma systems. We analyzed the management of victims and assessed the response of the UCLA Healthcare System to the Santa Monica multicasualty event of July 16, 2003, when an elderly man drove his car through a crowded outdoor market and injured 73 people, 10 of whom died (eight at the scene). Of the victims, 26 were treated at UCLA (n = 15) and Santa Monica (n = 11) Medical Centers. Fourteen patients (54%) were female; average age was 41.9 years (range 7 months to 88 years). Fifteen patients were treated in the ER only, and 11 patients required admission. Of the latter, 10 (91%) had multisystem injuries, most commonly musculoskeletal, which occurred in nine patients (82%). Seven patients required immediate operations (orthopedic in six and a pericardial window in one). Three patients required delayed operations (orthopedic and plastic surgery). Most surgical and medical specialties were needed in consultation. Average LOH was 11.8 (range 2–23) days. Mean ISS was 21.2 (range 1–75). There were six complications (three early and three late) and one death from head injury. Seven patients (64%) required rehabilitation. We conclude that mass casualty victims have multisystem injuries of variable severity, which underscores the importance of trauma centers and trauma systems. The large trauma scene and particular need for orthopedic services were notable features of this event.
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Ma, Jiahui, Tamera Smith, Macy Fitzgerald, and Bernadette McCrory. "Understanding Work-Related Injury Risk Among Montana Rehabilitation Clinicians." Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care 9, no. 1 (September 2020): 125. http://dx.doi.org/10.1177/2327857920091013.
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Background: Rehabilitation clinicians face a high risk of occupational injury. Work-related musculoskeletal disorders (WMSDs) are one of the most frequent injuries for these rehabilitation clinicians due to repeated heavy lifting and other forceful tasks. The objective of this study was to identify factors which caused or contributed to WMSDs for clinicians specifically working in rehabilitation settings (e.g., acute care, inpatient rehabilitation, long-term care, skilled nursing, outpatient therapy). Methods: A multifaceted pilot survey was conducted of Montana physical and occupational therapists working at a rural, Montana community hospital. Information on general workload, work-related pain or discomfort, patient handling and clinical experience were gathered using both a scripted interview questionnaire and a semi-scripted post-interview discussion. The survey contained five different categories and took approximately 20 minutes to complete. Six therapists from a local community hospital participated in the pilot survey. Results: Subjects (n=6) were all female and had an average age of 43 with standard deviation of 10. On average, these acute care rehabilitation therapists spent five to eight hours per day delivering “hands on” care to patients. During a typical workday, therapists spent 32% of the time heavy lifting, 37% kneeling/squatting, and 39% bending/twisting. Around half suffered musculoskeletal pain or discomfort but continued to work during the past year. Most pain was caused by transferring and repositioning patients. The clinicians’ necks, middle backs and wrists/hands suffered the most severe pain or discomfort. Adequate mobile floor and overhead lifting equipment as well as a shortage of therapeutic lifting device were reported from the survey. Non-mechanical lifting aids like sit-to-stand aids, friction reducing device and multi-handled gait belts was reflected inadequate for clinicians. Discussion: Physical therapists and occupational therapists are at higher risk for WMSDs due to patient handling tasks. There is limited inpatient therapy resources throughout Montana. More user-friendly and therapeutic patient handling equipment and therapeutic training are required. Application: This study highly followed the principle of core competencies for public health professionals to provide evidence-based results and systematic design to assess the risk of patient handling. Future Research: To study causal factors of WMSDs related to patient handling, additional interviews will be collected across Southwest Montana’s health system.
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Hanigan, William. "The development of military medical care for peripheral nerve injuries during World War I." Neurosurgical Focus 28, no. 5 (May 2010): E24. http://dx.doi.org/10.3171/2010.3.focus103.
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Although the clinical and electrical diagnoses and treatments of peripheral nerve injuries (PNIs) had been described prior to World War I, many reports were fragmented and incomplete. Individual physicians' experiences were not extensive, and in 1914 the patient with a PNI remained a subject of medical curiosity, and was hardly a focus of comprehensive care. World War I altered these conditions; casualties with septic wounds and PNIs swamped the general hospitals. By 1915, specialized hospitals or wards were developed to care for neurological injuries. In the United Kingdom, Sir Robert Jones developed the concept of Military Orthopedic Centres, with coordinated specialized care and rehabilitation. Military appointments of neurologists and electrotherapists sharpened clinical diagnoses and examinations. Surgical techniques were introduced, then discarded or accepted as surgeons developed skills to meet the new conditions. The US Surgeon General, William Gorgas, and his consultant in neurosurgery, Charles Frazier, went a step further, with the organization of a research laboratory as well as the establishment of a Peripheral Nerve Commission and Registry. Despite these developments and good intentions, postwar follow-up for PNIs remained incomplete at best. Records were lost, personnel transferred, and patients discharged from the system. The lack of a standardized grading system seriously impaired the ability to record clinical changes and compare outcomes. Nevertheless, specialized treatment of a large number of PNIs during World War I established a foundation for comprehensive care that influenced military medical services in the next world war.
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Brusco, A. T., and V. P. Omelchuk. "Experimental and theoretical substantiation of the mechanism of the trophic influence of a function on the structural organization of the bone. Physiological restructuring." N.N. Priorov Journal of Traumatology and Orthopedics 6, no. 1 (March 12, 1999): 29–35. http://dx.doi.org/10.17816/vto98432.
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In biomechanical experiments on isolated fresh and wet long bones of dogs, the features of the distribution of compressive and tensile mechanical stresses were studied, the hydrodynamic effects of elastic deformations were visualized, and their dependence on the nature, magnitude and frequency of variable loads was established. The conditions for adaptation of long bones to persistent changes in the functional load have been clarified. Based on the data obtained, it was established that the influence of the mechanical factor is realized through the hydrodynamic effects of elastic deformations, which are considered as an important physiological mechanism for the regulation of intraosseous microcirculation, and, consequently, bone tissue trophism. From these positions, the significance of the functional factor in the physiological restructuring of the bone, the occurrence of certain types of orthopedic pathology, and its role in the rehabilitation of patients with diseases and injuries of the musculoskeletal system are explained.
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Miromanov, Aleksandr Mikhailovich, and Sergey Olegovich Davydov. "6<sup>th</sup> Congress of Traumatologists and Orthopedists of the Far Eastern Federal District." N.N. Priorov Journal of Traumatology and Orthopedics 28, no. 3 (November 15, 2021): 101–6. http://dx.doi.org/10.17816/vto81561.
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The short message provides information on the 6th Congress of Traumatologists and Orthopedists of the Far Eastern Federal District held on September 1617, 2021 in Chita together with the All-Russian Scientific and Practical Conference with international participation Traumatology, Orthopedics, and Rehabilitation Medicine of the Far East: Achievements, problems, prospects. The work of the 6th Congress was held in a dynamic and fruitful format, which made it possible to achieve the goals set: modern issues of prevention, diagnosis, treatment of injuries, diseases and conditions of the musculoskeletal system, medical rehabilitation of patients were considered, which made it possible to improve existing or master new knowledge, skills, and abilities and the competence of students to carry out high-quality professional activities in the specialty Traumato-logy and Orthopedics, which will ultimately form labor functions in accordance with the professional standard Traumatologist-orthopedist. At the end of the Congress, the delegates adopted a resolution reflecting the most problematic aspects of the service, the solution of which will significantly increase the availability and quality of the provision of traumatological and orthopedic care in the Far Eastern Federal District.
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Gasimzade, Javid, Farida Takhavieva, Said Ksembaev, and Oleg Ivanov. "KINESIO TAPING AND THE POSSIBILITY OF IT’S ADMINISTRATION IN TRAUMATIC INJURIES OF THE MAXILLOFACIAL REGION." Actual problems in dentistry 16, no. 1 (May 14, 2020): 87–92. http://dx.doi.org/10.18481/2077-7566-20-16-1-87-92.
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Subject. A literature review is devoted to the urgent problem of maxillofacial surgery and surgical dentistry ― improving the efficiency of rehabilitation of patients with fractures of the lower jaw using kinesiotape.
The goal is to study the materials of publications devoted to kinesiotape during traumatic injuries of the maxillofacial region.
Methodology. The mechanisms of action of a kinesiological teip applied in the form of applications on the skin are described in detail, which lead to the creation of favorable conditions for sanogenetic processes that are realized in normalizing microcirculation, reducing edema and the severity of pain. An increase in the number of publications on the use of this method in the prevention and treatment of injuries of the musculoskeletal system in athletes was noted. Moreover, at present, kinesioteiping is also used in clinical medicine, for example, in the practice of neurology and orthopedics. According to modern scientific research, the use of kinesiotape in patients with chronic back pain, subacromial impingement syndrome, acute whiplash injury of the cervical spine can significantly reduce the severity of pain.
Results. Despite the rather widespread use of the method of kinesiotapeing in sports and clinical medicine, in the available literature there is a small number of works devoted to its use in maxillofacial surgery, in particular for fractures of the lower jaw. The use of the method of kinesiotherapy after surgery for osteosynthesis of fragments of the lower jaw has significantly reduced the level of inflammatory edema and the intensity of the pain syndrome.
Conclusions. The presented literature review results indicate that kinesiotherapy is a promising, simple, non-traumatic method of rehabilitation after surgical treatment of lower jaw fractures, which does not have side effects and complications and significantly improves the quality of life of patients.
However, scientific studies devoted to the analysis of the use of kinesiotherapy for traumatic injuries of the maxillofacial region are not enough for this period.
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Гращенкова, А. Н., С. Н. Пузин, О. Т. Богова, В. Н. Потапов, Е. Е. Ачкасов, and Л. В. Иванова. "EFFECTIVENESS OF MEDICAL REHABILITATION OF ELDERLY PATIENTS WHO HAVE SUFFERED A MYOCARDIAL INFARCTION." Успехи геронтологии, no. 4 (September 17, 2021): 581–85. http://dx.doi.org/10.34922/ae.2021.34.4.011.
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На всех этапах восстановления после инфаркта миокарда (ИМ) увеличение физической активности пациентов пожилого возраста - одна из важных составляющих реабилитационного процесса. Безусловно, на ранних стадиях ИМ определенные ограничения физической активности позволяют уменьшить нагрузку на миокард, снизить его потребности в кислороде и создать условия для скорейшего заживления. В последующем, в зависимости от динамики и показателей работы сердечно-сосудистой системы, пациента пожилого возраста переводят с одной ступениактивностинадругую, оцениваютуровень АД, ЧСС, наличие аритмии, данные электрокардиограммы, данные эхо-КГ показателей, а также индивидуальную переносимость нагрузок. На сегодняшний день для медицинской реабилитации пациентов пожилого возраста, перенесших ИМ, актуальным является применение различных вариантов механотерапии. Представляет интерес применение механотерапии по программе комплекса David Back Concept (силовая тренировка). Он представляет собой комплект из тренажеров для работы над мышцами спины. Настоящий лечебно-диагностический комплекс предназначен для диагностики, лечения и профилактики патологий опорно-двигательной системы, а также для реабилитации пациентов после хирургических вмешательств и травм позвоночника. Для восстановления физического статуса до оптимально достижимого уровня, определяемого возможностями адаптационных механизмов пожилого человека, в программе медицинской реабилитации пациентов пожилого возраста с ИБС и после перенесенного ИМ нами применен программный комплекс David Back Concept и оценено его влияние на гемодинамические показатели. At all stages of recovery after myocardial infarction (MI), the expansion of physical activity of elderly patients is one of the most important components. Of course, certain restrictions can reduce the load on the myocardium, reduce its oxygen needs and create conditions for early healing. Subsequently, depending on the dynamics and indicators of the cardiovascular system, the elderly patient is transferred from one stage of activity to another, the level of blood pressure, the number of heartbeats, the presence of arrhythmia, electrocardiogram data, EchoCG data, as well as individual load tolerance are evaluated. To date, there is a huge selection of optimal options for selecting methods of medical rehabilitation for elderly patients who have suffered a MI, and one of them is mechanotherapy. The mechanical therapy program of the David Back Concept complex - strength training is a set of simulators for working on the back muscles. The medical and diagnostic complex is designed for the diagnosis, treatment and prevention of pathologies of the musculoskeletal system, as well as for the rehabilitation of patients after surgical interventions and spinal injuries. Medical rehabilitation of elderly patients with coronary heart disease and after a MI through mechanotherapy, the program of the David Back Concept complex, provides for the restoration of their physical and social status to an optimally achievable level, determined by the capabilities of adaptive mechanisms.
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SAKOVETS, TATIANA G., ENVER I. BOGDANOV, GULNARA R. KHUZINA, and ELENA N. BARYSHEVA. "ANALYSIS OF THE SPECIFIC FEATURES OF THE USE OF PHYSIOTHERAPEUTIC METHODS IN PATIENTS WHO UNDERWENT ARTHROSCOPIC OPERATIONS ON THE KNEE JOINT IN 2018–2019 AT THE MEDICAL UNIT OF THE MINISTRY OF INTERNAL AFFAIRS OF RUSSIA IN THE REPUBLIC OF TATARSTAN." Bulletin of Contemporary Clinical Medicine 14, no. 5 (October 2021): 51–55. http://dx.doi.org/10.20969/vskm.2021.14(5).51-55.
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Background. Diseases of the musculoskeletal system are the most common cause of disability in the modern world, and the prevalence of these diseases is increasing at an alarming rate. Currently, various types of arthroscopic operations on the knee joint are performed – for meniscus damage (including meniscus suture), instability of the knee joint, damage to the cruciate complex, articular cartilage, patellar instability, free joint bodies, pathological folds, synovitis, knee arthrosis, and rheumatoid arthritis. Medical rehabilitation after arthroscopic surgery traditionally includes administration of nonsteroidal anti-inflammatory drugs, opioids, local anesthetics, therapeutic exercise using isometric active exercises, hydrokinesis therapy, and various physical therapy methods. Aim. Study of the use of physiotherapeutic methods in the treatment of patients who underwent atroscopic surgery on the knee joint in the physiotherapy department at the Ministry of Internal Affairs of Russia for the Republic of Tatarstan Clinical Hospital in 2018–2019. Material and methods. The frequency of prescription of therapeutic physical factors for patients who underwent arthroscopic surgeries on the knee joint at the physiotherapy department at the Medical Unit of Ministry of Internal Affairs of Russia for the Republic of Tatarstan Clinical Hospital in 2018–2019 was investigated. The patients were accordingly divided into two groups: in 2018, 37 patients were prescribed physiotherapeutic procedures, in 2019 there were 48 patients. The age of the patients in 2018 was (33,9±9,4) years, in 2019 it was (34,2±9,1) years. Statistica 6 software package by StatSoft was used for statistical processing. Differences were considered statistically significant at p<0,05. Results and discussion. Paraffin therapy, treatment using Nuga-Best bed, amplipulse therapy, UHF therapy, cryotherapy, oxygen cocktails containing medicinal herbs were prescribed with less frequency in the treatment of patients operated for knee joint injuries in 2018 than in 2019. Despite the proven effectiveness of whirlpool baths and darsonvalization in treating musculoskeletal disorders were not prescribed for the rehabilitation of patients who underwent atroscopic surgeries at the physiotherapy department of Medical Unit of Ministry of Internal Affairs of Russia for the Republic of Tatarstan Clinical Hospital in 2019. Conclusion. When rehabilitating patients who have undergone arthroscopic intervention on the knee joint, it is advisable to thoroughly consider the use of therapeutic physical factors to improve the operation of the physiotherapy department.
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Bunin, A. V. "Research on the effectiveness and safety of kinesiotaping in middle-aged and elderly military patients for reducing acute and chronic myofascial pain." Russian Osteopathic Journal, no. 3-4 (February 11, 2020): 23–29. http://dx.doi.org/10.32885/2220-0975-2019-3-4-23-29.
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Introduction. In a medical center for rehabilitation treatment, the vast majority of military patients are people of middle age (45–59 years according to the WHO classifi cation) and older. Many of them participated in combat activities, special operations, and had injuries of various limitation periods. With age, the number of degenerative changes in the connective tissue, musculoskeletal system, and nervous system increases, which creates biomechanical conditions for the occurrence of acute and chronic pain syndrome of varying intensity. The goal of research — to study the effectiveness and safety of kinesiotherapy in patients of middle and older age groups with acute and chronic pain syndrome.Materials and methods. From February 2017 to July 2018, a prospective study was carried out in the Medical Center for Rehabilitation Treatment (Korolev), P. V. Mandryka Central Military Clinical Hospital. Patient selection and sampling was carried out by the continuous method. 154 military patients underwent treatment at the Medical Center for Rehabilitation Treatment (Korolev), P. V. Mandryka Central Military Clinical Hospital under our supervision. All patients suffered from acute and chronic pain. Kinesiotherapy was used as a treatment method. All patients were assessed for the severity of pain before treatment, on the fi rst and fi fth days. The safety of the method was evaluated by observing local irritation reactions and systemic allergic reactions.Results. Kinesiotherapy in the treatment of military patients with acute and chronic pain syndrome allows to reduce the severity of pain, in accordance with the results of the assessment on the fi rst and the fi fth days (differences are statistically signifi cant, p<0,05, Student′s t-test). This treatment method showed high (69,4 %) effectiveness and safety (not a single case of systemic allergic reactions, 4,1 % of cases with local irritation reactions).Conclusion. This treatment method can be used in cases of acute and chronic myofascial pain syndrome in a hospital setting in middle-aged and older patients. Its use is possible both for quick and prolonged improvement (during 5 days) of the patients′ condition.
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Bahramizadeh, Mahmood, and Hanieh Khaliliyan. "Efficacy of Different Types of Foot Orthoses on Postural Control in Subjects With Lateral Ankle Sprain: A Systematic Review." Iranian Rehabilitation Journal 20, no. 3 (November 1, 2022): 287–96. http://dx.doi.org/10.32598/irj.20.3.1719.1.
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Objectives: Lateral ankle sprain is one of the most common injuries to the musculoskeletal system, especially among active people. This injury causes complex complications, such as recurrent sprain because of reduced postural control. Foot orthoses are among the interventions used to improve postural control in this population. This review aims to investigate foot orthoses to improve postural control among patients with an acute or chronic lateral ankle sprain. Methods: Four electronic databases (Scopus, PubMed, Web of Sciences, and Google scholar) were searched for experimental studies. Articles were selected using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) method. The articles were reviewed for their quality based on the standards for reporting diagnostic accuracy statements and then entered into this review. Results: The search results in all databases provided a total of 48 articles. After reviewing the documents, we excluded 38 articles that did not pass the inclusion criteria, resulting in 10 remaining articles. Data extraction from population, interventions, and outcome measures was done for these 10 articles. Discussion: Foot orthoses are effective in improving the postural control of individuals with an acute or chronic lateral ankle sprain. Considering the existence of mechanical and functional instability, foot orthosis which is made to affect the proprioception and follow the biomechanics of the body seems to be the most effective in this field; however, more studies are required to confirm this
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Nagorny, E. B., A. L. Smetanin, Yu V. Ishchyk, O. G. Korosteleva, I. A. Konovalova, and Z. V. Plakhotskaya. "The role of therapeutic nutrition and dietary supplements in the prevention and treatment of osteoarthritis at the initial stages of the disease in military personnel." Bulletin of the Russian Military Medical Academy 22, no. 3 (December 15, 2020): 111–16. http://dx.doi.org/10.17816/brmma50545.
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Аbstract. Factors predisposing to the development of osteoarthritis in military personnel are analyzed. The physical stress inherent in military labor, for example, in the airborne troops, creates a high load on the joints and can cause the early dismissal of military personnel from the ranks of the Armed Forces of the Russian Federation. Based on the pharmacodynamics of chondroprotectors (stimulation of chondrocyte function, cartilage tissue regeneration processes, inhibition of the synthesis of inflammatory mediators, etc.), it can be argued that they have a significant effect on the pathogenetic mechanisms of the development of osteoarthritis, i.e. the mechanism of action of chondrocytes is reduced to the suppression of catabolic and stimulation of anabolic processes in the joints. The main principles of therapeutic nutrition for osteoarthritis are, a decrease in calorie intake, limiting the amount of carbohydrates, animal fats and salt consumed. A balanced diet, including sufficient macro- and micronutrients, has a therapeutic effect in patients with complaints of joint pain, helping to restore the damaged structure of the elements of the musculoskeletal system. The inclusion of dietary supplements in the diets of patients with complaints of joint diseases ensures the intake of nutrients necessary for the synthesis of glycosaminoglycans. These factors accelerate the rehabilitation of patients after extreme physical exertion and injuries of the musculoskeletal system inherent in military labor. An analysis of the materials of a clinical study a comparative study of the effectiveness of the treatment of osteoarthritis of the knee joint at the initial stage of the disease with the help of a representative of the group of chondroprotectors Аrthra containing chondroitin sulfate, glucosamine and non-steroidal anti-inflammatory drugs, is carried out. The introduction of chondroprotectors as a means of preventing osteoarthritis in the diets of military personnel experiencing extreme joint loads will strengthen the ligamentous-articular apparatus by normalizing cartilage moisture saturation, inhibiting the action of proteolytic enzymes and stimulating the synthesis of glucuronic acid, which improves the elasticity of connective tissue.
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Pastora-Bernal, Jose M., Rocío Martín-Valero, Francisco J. Barón-López, Noelia G. Moyano, and María-José Estebanez-Pérez. "Telerehabilitation after arthroscopic subacromial decompression is effective and not inferior to standard practice: Preliminary results." Journal of Telemedicine and Telecare 24, no. 6 (April 27, 2017): 428–33. http://dx.doi.org/10.1177/1357633x17706583.
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Background Telerehabilitation promises to improve quality, increase patient access and reduce costs in health care. Physiotherapy with exercises is generally recommended to restore function after surgery in patients with chronic subacromial syndrome. Relatively few studies have investigated the feasibility of telerehabilitation interventions in musculoskeletal and orthopaedic disorders. The aim of this study was to evaluate the feasibility and effectiveness of a customizable telerehabilitation intervention and compare with traditional care. Methods This research includes 18 consecutive patients with subacromial impingement who underwent arthroscopic subacromial decompression in a controlled clinical prospective study. Patients were randomized to either a 12-week telerehabilitation programme or the usual face-to-face physical therapy for immediate postoperative rehabilitation. We have developed a telerehabilitation system to provide services to patients who have undergone shoulder arthroscopy. An independent blinded observer performed postoperative follow-up after 4, 8, and 12 weeks. Results The preliminary efficacy of this telerehabilitation programme in terms of both physical and functional objective outcome measures was assessed on eight patients. Using the Constant–Murley score to evaluate functional outcome, patients in the telerehabilitation group were shown to have improved from a mean 43.50 ± 3.21 points to a mean 68.50 ± 0.86 points after 12 weeks. The physical and functional improvements in the telerehabilitation group were similar to those in the control group ( p = 0.213). There was a non-significant trend for greater improvements in the telerehabilitation group for most outcome measurements. Conclusion The results of this study provide evidence for the efficacy of telerehabilitation after shoulder arthroscopy in shoulder impingement syndrome. A telerehabilitation programme with range of motion, strengthening of the rotator cuff and scapula stabilizers exercises seems to be similar and not inferior to traditional face-to-face physiotherapy after subacromial arthroscopic decompression. Through this study, we are developing our preliminary dataset to evaluate the efficacy of telerehabilitation programmes following surgical procedures in musculoskeletal injuries and for comparison with more traditional interventions.
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Khomenko, V. М., and О. B. Nekhanevych. "Physical Therapy of Footballers with Joints Hypermobility Signs after Ankle Sprains." Ukraïnsʹkij žurnal medicini, bìologìï ta sportu 6, no. 3 (June 26, 2021): 310–16. http://dx.doi.org/10.26693/jmbs06.03.310.
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Ankle sprains are one of the most common injuries in both athletes and the general population. The peculiarity of the consequences of injuries of this localization is the high probability of repeated injuries. Of particular interest are athletes with hypermobility of the joints. The systematic involvement of connective tissue in hypermobility of the joints affects the condition of the musculoskeletal system, in particular the ligament, can determine the effects of damage to the ankle and be a criterion for the differentiated use of physical therapy. The high percentage of recurrent ankle sprains injuries and significant structural, functional and professional consequences for footballers indicate an insufficient study of this problem both in terms of the mechanisms of recurrence of injuries and appropriate rehabilitation measures, which requires further scientific research and justification. The purpose of the study was to investigate the effectiveness of the developed physical therapy program of ankle sprains in football players with signs of hypermobility of the joints. Materials and methods. To achieve this goal, the data of 46 high-class football players of the Youth and the National Football Team of Azerbaijan aged 16 to 34 with acute damage to the communication apparatus of the ankle were analyzed. Patients were divided into study groups (main and control) of 23 individuals each using a simple randomization procedure. The main group used the proposed differentiated method of physical therapy taking into account the degree of hypermobility of the joints, which included early mobilization of ankle in the antero-posterior direction, stabilization of ankle due to early inclusion of exercises to train static balance, proprioceptive and plyometric training. Particular attention was paid to early neuromuscular control training. In the control group, athletes underwent rehabilitation according to generally accepted methods. The duration of the intervention was 4 weeks. Results and discussion. The degree of hypermobility of the joints, the volume of movements in the ankle, the limitations of daily and sports activity, pain levels, impaired sensorio-motor and postural control, static and dynamic balance were assessed. The results of the study indicate a high frequency of recurrence of ankle sprains in football players, accompanied by a complex of morphological, functional, sensory-perceptual disorders and disorders of neuromuscular control and, as a consequence, leads to limitations of daily life and sports activity. Conclusion. The application of the developed method of physical therapy in football players, taking into account the degree of systemic involvement of connective tissue is an effective means of preventing recurrent injuries, leading to faster restoration of morphological and functional integrity of the joint
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Dahab, Katherine, Morgan N. Potter, Aaron Provance, Jay Albright, and David R. Howell. "Sport Specialization, Club Sport Participation, Quality of Life, and Injury History Among High School Athletes." Journal of Athletic Training 54, no. 10 (October 1, 2019): 1061–66. http://dx.doi.org/10.4085/1062-6050-361-18.
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Context Many factors can affect the injury risk and quality of life among high school athletes. Early sport specialization and club sport participation may be components to consider when assessing the injury risk and quality of life. Objective To investigate patient-reported quality-of-life and injury-history measures among adolescent athletes at different sport-specialization levels and to compare these measures between those who did and those who did not report participating in club sports. Design Cross-sectional study. Setting High school athletic facility. Patients or Other Participants High school student athletes 13 to 18 years of age were recruited and tested during their annual preseason athletic physical examinations. Main Outcome Measure(s) Our primary grouping variables were sport-specialization level (classified as low, moderate, or high) and club sport participation (organized sport outside of traditional school athletics). Our outcome variables were the Patient-Reported Outcome Measurement Information System Pediatric Profile-37 rating, Severity Measure for Depression–Child score, and injury history. Results A total of 97 individuals participated (mean age = 15.2 ± 1.1 years; 38% female). Relatively similar proportions of individuals reported participating at each level of sport specialization (low = 34%, moderate = 40%, high = 26%). Forty-six (48%) participants stated they participated in club sports. No differences were evident in quality of life (P values = .15–.92 across domains), depression (P = .60), or injury history (P > .70) among the specialization groups. Those who described participating in club sports had a higher proportion of time-loss musculoskeletal injuries (63% versus 29%; P = .002) and of injuries requiring imaging, injection, a cast, a brace, or crutches (72% versus 46%; P = .013) than those who did not. Conclusions Although no injury-history differences were found among the sport-specialization groups, a higher proportion of club sport athletes than nonclub sport athletes reported a history of injury. Club sports are generally seen as more competitive, and the higher number of injuries seen in this setting could be related to a higher level of play among club sport athletes.
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Thomson, Calum, and Anjani Singh. "A Virtual Clinic and a One Stop Acute Tendo-achilles Clinic." Foot & Ankle Orthopaedics 3, no. 3 (July 1, 2018): 2473011418S0049. http://dx.doi.org/10.1177/2473011418s00490.
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Category: Trauma Introduction/Purpose: Patients with acute tendo-achilles (TA) rupture require prompt diagnosis, investigation and treatment in order to ensure optimum outcomes. This can be prevented by delay in review of patients within secondary care. We present our experience of treating such injuries by establishing a “virtual” fracture clinic (VFC) and a one stop dedicated TA specialist clinic. Patients are referred to the service via the emergency department (ED) and are triaged remotely by the VFC, at which all orthopaedic cases including suspected TA injuries are reviewed by a consultant orthopaedic surgeon using all available medical records and imaging. Suitable patients are then diverted directly to the specialist TA clinic for definitive treatment. We wished to establish the speed and efficiency of this care pathway. Methods: Using our institutions prospectively maintained database, we identified patients treated in the specialist TA clinic between September 2016 and August 2017. We recorded demographic details, injury mechanism, time from injury to diagnosis, ultrasound scan findings, and the speed of progress of the patient along the agreed rehabilitation pathway. Results: Sixty two patients were referred to the VFC with suspected TA injury. Mean age was 49 years, M: F (44:18 female). Mean time to triage in the VFC was 3.5 days (with 42% of patients triaged in the VFC on the same day as initial ED presentation). Mean time from ED consultation to assessment in our TA clinic was 11.7 days. Patients were assessed by a specialist foot and ankle surgeon, supported by a same day musculoskeletal ultrasound service. 45 patients (74%) were diagnosed with TA rupture, of which 69% were acute complete ruptures. Eight patients fulfilled criteria for surgical repair. Mean time from ED consultation to surgery was 13.25 days. Three further patients treated non-operatively developed secondary ruptures requiring delayed operative intervention. Conclusion: We recommend the use of a virtual triage service and a one stop TA clinic led by a dedicated specialist team to improve the accuracy of diagnosis and efficacy of treatment of acute TA rupture. This service provides a robust system for avoiding mis-diagnoses and delays in treatment, as well as ensuring effective implementation of our local care pathway under specialist supervision in a one stop clinic. This also establishes an effective system for monitoring as well as maintaining a research database for further prospective studies.