Rehab Centers: The Evolution of Extracorporeal Life Support as a Bridge to Lung Transplantation.
The evolution of extracorporeal life support as a bridge to lung transplantation.
Filed under: Rehab Centers
ASAIO J. 2013 Jan; 59(1): 3-10
Diaz-Guzman E, Hoopes CW, Zwischenberger JB
The use of extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation was reported for the first time more than three decades ago; nevertheless, its use in lung transplantation was largely abandoned because of poor patient survival and frequent complications. The outcomes of patients bridged to lung transplantation using ECMO have substantially improved in the last 5 years. Recent advances in extracorporeal life support technology now allow patients with end-stage lung disease to be successfully supported for prolonged periods of time, preventing the use of mechanical ventilation and facilitating physical rehabilitation and ambulation while the patients awaits lung transplantation. This review briefly describes the evolution of ECMO use in lung transplantation and summarizes the available technology and current approaches to provide ECMO support.
HubMed – rehab
The treatment of patellar tendinopathy.
Filed under: Rehab Centers
J Orthop Traumatol. 2012 Dec 28;
Rodriguez-Merchan EC
BACKGROUND: Patellar tendinopathy (PT) presents a challenge to orthopaedic surgeons. The purpose of this review is to revise strategies for treatment of PT MATERIALS AND METHODS: A PubMed (MEDLINE) search of the years 2002-2012 was performed using “patellar tendinopathy” and “treatment” as keywords. The twenty-two articles addressing the treatment of PT with a higher level of evidence were selected. RESULTS: Conservative treatment includes therapeutic exercises (eccentric training), extracorporeal shock wave therapy (ESWT), and different injection treatments (platelet-rich plasma, sclerosing polidocanol, steroids, aprotinin, autologous skin-derived tendon-like cells, and bone marrow mononuclear cells). Surgical treatment may be indicated in motivated patients if carefully followed conservative treatment is unsuccessful after more than 3-6 months. Open surgical treatment includes longitudinal splitting of the tendon, excision of abnormal tissue (tendonectomy), resection and drilling of the inferior pole of the patella, closure of the paratenon. Postoperative inmobilisation and aggressive postoperative rehabilitation are also paramount. Arthroscopic techniques include shaving of the dorsal side of the proximal tendon, removal of the hypertrophic synovitis around the inferior patellar pole with a bipolar cautery system, and arthroscopic tendon debridement with excision of the distal pole of the patella. CONCLUSION: Physical training, and particularly eccentric training, appears to be the treatment of choice. The literature does not clarify which surgical technique is more effective in recalcitrant cases. Therefore, both open surgical techniques and arthroscopic techniques can be used.
HubMed – rehab
Differences in Spring-Mass Characteristics Between One- and Two-Legged Hopping.
Filed under: Rehab Centers
J Appl Biomech. 2012 Dec 27;
Hobara H, Kobayashi Y, Kato E, Ogata T
Although many athletic activities and plyometric training methods involve both unilateral and bilateral movement, little is known about differences in the leg stiffness (Kleg) experienced during one-legged hopping (OLH) and two-legged hopping (TLH) in place. The purpose of this study was to investigate the effect of hopping frequencies on differences in Kleg during OLH and TLH. Using a spring-mass model and data collected from 17 participants during OLH and TLH at frequencies of 2.0, 2.5, and 3.0 Hz, Kleg was calculated as the ratio of maximal ground reaction force (Fpeak) to the maximum center of mass displacement (?COM) at the middle of the stance phase measured from vertical ground reaction force. Both Kleg and Fpeak were found to be significantly greater during TLH than OLH at all frequencies, but type of hopping was not found to have a significant effect on ?COM. These results suggest that Kleg is different between OLH and TLH at a given hopping frequency and differences in Kleg during OLH and TLH are mainly associated with differences in Fpeak but not ?COM.
HubMed – rehab
Variation in Temporal Measures of Swallowing: Sex and Volume Effects.
Filed under: Rehab Centers
Dysphagia. 2012 Dec 28;
Molfenter SM, Steele CM
Temporal measures of healthy swallowing appear to be variably sensitive to bolus and participant factors based on a recent meta-analysis of studies in the deglutition literature. In this carefully controlled study of healthy young volunteers, balanced for sex and height, we sought to understand the influence of bolus volume and participant sex on the three durations and three intervals most frequently reported in the deglutition literature. Three boluses per target volume (5, 10, and 20 ml) were repeated for each participant (n = 20, 10 male) using a spontaneous swallow paradigm in lateral view videofluoroscopy. None of the temporal durations or intervals was found to be correlated with participant height above an a priori cutoff point of r ? 0.3. Further, none of the temporal durations or intervals varied significantly by participant sex. Bolus volume significantly impacted upper esophageal sphincter (UES) opening duration, laryngeal closure duration, the laryngeal closure-to-UES opening interval, and the pharyngeal transit time interval, but not hyoid movement duration or the stage transition duration interval. When participants are sampled in such a manner as to represent the range of height reported to be typical for both sexes in the population, sex does not significantly influence temporal measures of swallowing.
HubMed – rehab
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