A Comparison of 1-Level Versus 2-Level Prodisc Arthroplasty Patients: A Prospective Study With Minimum of 5-Year Follow-Up.

A Comparison of 1-Level Versus 2-Level Prodisc Arthroplasty Patients: A Prospective Study With Minimum of 5-Year Follow-Up.

Filed under: Rehab Centers

Spine (Phila Pa 1976). 2013 Feb 7;
Yue J, Zhang K, Bai HX, Du J, Cammisa F, Abjornson C, Mo F

ABSTRACT: Study Design. Analysis of data collected prospectively from the US FDA IDE clinical trial for the 1 and 2 Level ProDisc-L arthroplasty patients performed at two study centers.Objective. To determine if there is any clinical or radiographic differences between 1-level ProDisc-L patients and 2-level ProDisc-L patients with a minimum follow-up of 5 years.Summary of Background Data. Recent prospective US FDA clinical trial results have been published showing efficacy of the ProDisc prosthesis in both single and two level surgical procedures. Results of these prospective, randomized multicenter FDA IDE clinical trials showed safety, efficacy and superiority over circumferential fusion.Methods. Patients were part of the FDA clinical trial for the ProDisc-L versus circumferential fusion study at two institutions. We identified 20 patients who received ProDisc-L at 1 level and 21 who received it at 2 levels for a total of 41 patients. Pre- and post-operative pain, clinical function and range of motion (ROM) were measured. An unpaired t-test was done to compare the 2-verus 1-level disc replacement patients.Results. All patients had more than 60 months of clinical follow-up. The mean scores on the VAS were 37.1 and 28.7 respectively (P = 0.33) for one and two level patients. ODI scores were 33 and 29.1 respectively for one and two level patients (P = 0.60); and SF36 physical scores were 43 and 43.9 respectively for one and two level patients (P = 0.81); SF-36 mental scores were 46.2 and 46.6 respectively for one and two level patients (p = 0.923). The average final follow-up post-op ROM for one and two level TDR were 6.0º and 5.4º respectively (p = 0.632).Conclusion. This study was unable to identify statistical differences in all clinical and radiographic outcomes between 1- and 2-level ProDisc arthroplasty patients in a cohort from two centers. Future studies with longer-term follow-up are needed to confirm these results.
HubMed – rehab

Real-time Estimate of Body Kinematics During a Planar Squat Task Using a Single Inertial Measurement Unit.

Filed under: Rehab Centers

IEEE Trans Biomed Eng. 2013 Feb 5;
Bonnet V, Mazza C, Fraisse P, Cappozzo A

This study aimed at the real-time estimation of the lower-limb joint and torso kinematics during a squat exercise, performed in the sagittal plane, using a single inertial measurement unit placed on the lower back. The human body was modeled with a three-degrees-of-freedom planar chain. The planar IMU orientation and vertical displacement were estimated using one angular velocity and two acceleration components and a weighted Fourier linear combiner. The ankle, knee and hip joint angles were thereafter obtained through a novel inverse kinematic module based on the use of a Jacobian pseudo-inverse matrix and null-space decoupling. The above-mentioned algorithms were validated on a humanoid robot for which the mechanical model used and the measured joint angles virtually exhibited no inaccuracies. Joint angles were estimated with a maximal error of 1.5 deg. The performance of the proposed analytical and experimental methodology was also assessed by conducting an experiment on human volunteers and by comparing the relevant results with those obtained through the more conventional photogrammetric approach. The joint angles provided by the two methods displayed differences equal to 3±1deg. These results, associated with the real-time capability of the method, open the door to future field applications in both rehabilitation and sport.
HubMed – rehab

Responsiveness and Predictive Validity of the Hierarchical Balance Short Forms in Patients With Stroke.

Filed under: Rehab Centers

Phys Ther. 2013 Feb 7;
Yu WH, Chen KL, Chou YT, Hsueh IP, Hsieh CL

BACKGROUND: The responsiveness and predictive validity of the Hierarchical Balance Short Forms (HBSF) in patients with stroke is unknown, which limits the HBSF’s utility in both clinical and research settings. OBJECTIVE: The purpose of this study was to investigate the responsiveness and predictive validity of the HBSF in inpatients with stroke receiving rehabilitation. DESIGN: A prospective cohort study was conducted. METHOD: Sixty-six participants completed both the 6-item HBSF and the 12-item Postural Assessment Scale for Stroke patients (PASS) after admission to the rehabilitation ward and before hospital discharge. Effect size (ES) and standardized response mean (SRM) were used to investigate the internal responsiveness of the HBSF and PASS. The changes in the Barthel Index (BI) and the mobility subscale of the Stroke Rehabilitation Assessment of Movement (MO-STREAM) were used as the external criteria for examining external responsiveness. Moreover, the admission scores of the HBSF and PASS and the discharge scores of the BI and MO-STREAM were analyzed to investigate the predictive validity of the two balance measures. RESULTS: The internal responsiveness of the HBSF was high (ES>0.9; SRM>1.6). The SRM of the HBSF was significantly larger than that of the PASS, whereas the ES of the HBSF was not significantly larger than that of the PASS. The external responsiveness and predictive validity of the HBSF were sufficient and similar to those of the PASS (external responsiveness: r?0.35; predictive validity: r?0.67). LIMITATIONS: The convenience sampling of inpatients with stroke may limit the generalization of the results. CONCLUSIONS: The HBSF has sufficient responsiveness and predictive validity in inpatients with stroke receiving rehabilitation and is thus recommended for both clinicians and researchers.
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Pain Treatment for Patients With Osteoarthritis and Central Sensitization.

Filed under: Rehab Centers

Phys Ther. 2013 Feb 7;
Lluch Girbés E, Nijs J, Torres-Cueco R, López Cubas C

Osteoarthritis is one of the most frequent, disabling and costly pathologies of modern society. One of the main aims of osteoarthritis management is pain control and functional ability improvement. The exact cause of osteoarthritis pain remains unclear. In addition to the pathological changes in articular structures, changes in central pain processing or central sensitization appear to be involved in osteoarthritis pain. The latter calls for a broader approach to the management of patients with osteoarthritis. Yet the scientific literature offers few information addressing the treatment of central sensitization specifically in osteoarthritis patients. Interventions like cognitivebehavioral therapy and neuroscience education potentially target cognitive-emotional sensitization (and descending facilitation), while centrally acting drugs and exercise therapy can improve endogenous analgesia (descending inhibition) in patients with osteoarthritis. Future studies should assess these new treatment avenues.
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