Anti-Gravity Treadmills Are Effective in Reducing Knee Forces.

Anti-gravity treadmills are effective in reducing knee forces.

Filed under: Rehab Centers

J Orthop Res. 2012 Dec 13;
Patil S, Steklov N, Bugbee WD, Goldberg T, Colwell CW, D’Lima DD

Lower body positive pressure (LBPP) treadmills permit significant unweighting of patients and have the potential to enhance recovery following lower limb surgery. We determined the efficacy of an LBPP treadmill in reducing knee forces in vivo. Subjects, implanted with custom electronic tibial prostheses to measure forces in the knee, were tested on a treadmill housed within a LBPP chamber. Tibiofemoral forces were monitored at treadmill speeds from 1.5?mph (0.67?m/s) to 4.5?mph (2.01?m/s), treadmill incline from -10° to +10°, and four treadmill chamber pressure settings adjusted to decrease net treadmill reaction force from 100% to 25% of the subject’s body weight (BW). The peak axial tibiofemoral force ranged from 5.1 times BW at a treadmill speed of 4.5?mph (2.01?m/s) and a pressure setting of 100% BW to 0.8 times BW at 1.5?mph (0.67?m/s) and a pressure setting of 25% BW. Peak knee forces were significantly correlated with walking speed and treadmill reaction force (R(2) ?=?0.77, p?=?0.04). The LBPP treadmill might be an effective tool in the rehabilitation of patients following lower-extremity surgery. The strong correlation between tibiofemoral force and walking speed and treadmill reaction forces allows for more precisely achieving the target knee forces desired during early rehabilitation. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
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Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women: Shortened version of a Cochrane systematic review.

Filed under: Rehab Centers

Neurourol Urodyn. 2012 Dec 12;
Herderschee R, Hay-Smith EC, Herbison GP, Roovers JP, Heineman MJ

BACKGROUND: Feedback and biofeedback (BF) are common adjuncts to pelvic floor muscle training (PFMT) for women with stress, urgency, and mixed urinary incontinence (UI). An up to date systematic review of adjunctive feedback or BF was needed to guide practice and further research. OBJECTIVES: To determine whether feedback or BF add benefit to PFMT for women with UI. METHODS: The Cochrane Incontinence Group Specialised Trials Register was searched (May 2010) for randomised or quasi-randomized trials in women with stress, urgency or mixed UI regardless of cause, which compared PFMT versus PFMT augmented with feedback or BF. Two reviewers independently undertook eligibility screening, risk of bias assessment and data extraction. Analysis was in accordance with the Cochrane Handbook for Systematic Reviews of Intervention (version 5.0.2). RESULTS: Twenty-four trials were included, and many were at moderate to high risk of bias. Women who received BF were less likely to report they were not improved (RR 0.75, 95% CI: 0.66-0.86), although there was no statistically significant difference for cure (RR 0.92, 95% CI: 0.81-1.05) and marginal statistical significance for leakage episodes (mean difference: -0.12 leaks/day, 95% CI: -0.22 to -0.01). It is possible the results are confounded because women in the BF group commonly had more contact with the health professional than those in the PFMT only arm. CONCLUSION: BF may add benefit to PFMT but the observed effect could well be related to another variable, such as the amount of health professional contact rather than the BF per se. Neurourol. Urodynam. © 2012 Wiley Periodicals, Inc.
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Knee Muscle Strength and Visual Acuity are the Most Important Modifiable Predictors of Falls in Patients after Hip Fracture Surgery: A Prospective Study.

Filed under: Rehab Centers

Calcif Tissue Int. 2012 Dec 14;
Yau DT, Chung RC, Pang MY

Our purpose was to identify risk factors for falls among older adults who had recently undergone hip fracture surgery. The subjects in this study were 69 older adults (aged 65 years or more) who had sustained a hip fracture and were admitted to an orthopedic rehabilitation ward after surgery. Potential fall risk factors were assessed using the physiological profile assessment, timed-up-and-go test, berg balance test, and activities-specific balance confidence scale at discharge from the hospital. Each individual was followed for a period of 6 months to obtain information on the incidence of falls. Receiver operating characteristic curves were constructed to determine the optimal cutoff score for each potential risk factor identified. Multivariate logistic regression was then used to identify the significant predictors of falls and their odds ratios (ORs). During the 6-month follow-up period, 10 of the 69 patients experienced one or more falls. The results showed that fallers were older than nonfallers (p = 0.009). Fallers also had poorer performance in the high-contrast visual acuity test (p = 0.015) and lower knee flexor (p = 0.021) and knee extensor (p = 0.005) muscle strength values. Multivariate logistic regression analysis showed that high-contrast visual acuity (cutoff score Z = -2.280, OR = 6.14, 95 % CI 1.13-33.29, p = 0.035) and knee extensor muscle strength (cutoff score Z = -1.835, OR = 4.81, 95 % CI 1.04-22.33, p = 0.045) were predictors of falls. Poor visual acuity and knee muscle weakness are modifiable predictors of falls and should be the key target areas in fall-prevention programs for older adults with hip fractures.
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