Functional Outcomes and Patient Satisfaction After Fasciotomy for Chronic Exertional Compartment Syndrome.
Functional Outcomes and Patient Satisfaction After Fasciotomy for Chronic Exertional Compartment Syndrome.
Filed under: Rehab Centers
Am J Sports Med. 2013 Feb; 41(2): 430-436
Packer JD, Day MS, Nguyen JT, Hobart SJ, Hannafin JA, Metzl JD
BACKGROUND: Patients with chronic exertional compartment syndrome who have failed nonoperative treatment are evaluated with pre-exertion and postexertion compartment pressure testing and may be treated with fasciotomy. Failure rates of up to 20% have been reported and may be related to factors such as age, sex, postexertion compartment pressures, compartment(s) released, and duration of symptoms. HYPOTHESIS: Higher preoperative postexertion compartment pressures are correlated with higher success and patient satisfaction rates after fasciotomy. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: From 1999 to 2008, patients with clinical symptoms of chronic exertional compartment syndrome with failed nonoperative management underwent standardized pre-exertion and postexertion compartment pressure measurements. Patients were then offered continued nonoperative treatment or referral to an orthopaedic surgeon for compartment release. Patients with a minimum 2-year follow-up were given a telephone questionnaire describing their pretreatment and posttreatment conditions including quality and duration of symptoms, analog pain scale, symptomatic and functional responses to treatment, and satisfaction with treatment. Medical records and operative reports were reviewed. RESULTS: The mean follow-up period for the nonoperative treatment group (n = 27) was 5.6 years (range, 2.1-10.6) and for the operative group (n = 73) was 5.2 years (range, 2.0-11.3). The operative group had a higher success rate (81%) compared with the nonoperative group (41%) (P < .001), and the operative group had a higher patient satisfaction rate (81%) compared with the nonoperative group (56%) (P = .011). There was no significant correlation between compartment pressures and patient outcomes. Patients with combined anterior and lateral compartment releases had an increased failure rate compared with isolated anterior release (31% vs 0%, respectively; P = .035). Surgical patients who were post-college had a lower satisfaction rate (66%) compared with high school (89%) and college patients (94%) (P = .017). CONCLUSION: High school and college patients (age <23 years) and isolated anterior compartment release (compared with anterior/lateral release) were factors associated with improved subjective function and satisfaction after fasciotomy. We recommend the avoidance of lateral release unless symptoms or postexertion compartment pressures are clearly indicative of lateral compartment involvement. HubMed – rehab
Arm-eye coordination test to objectively quantify motor performance and muscles activation in persons after stroke undergoing robot-aided rehabilitation training: a pilot study.
Filed under: Rehab Centers
Exp Brain Res. 2013 Feb 1;
Song R, Tong KY, Hu X, Li L, Sun R
This study designed an arm-eye coordination test to investigate the effectiveness of the robot-aided rehabilitation for persons after stroke. Six chronic poststroke subjects were recruited to attend a 20-session robot-aided rehabilitation training of elbow joint. Before and after the training program, subjects were asked to perform voluntary movements of elbow flection and extension by following sinusoidal trajectories at different velocities with visual feedback on their joint positions. The elbow angle and the electromyographic signal of biceps and triceps as well as clinical scores were evaluated together with the parameters. Performance was objectively quantified by root mean square error (RMSE), root mean square jerk (RMSJ), range of motion (ROM), and co-contraction index (CI). After 20 sessions, RMSE and ROM improved significantly in both the affected and the unaffected side based on two-way ANOVA (P < 0.05). There was significant lower RMSJ in the affected side at higher velocities (P < 0.05). There was significant negative correlation between average RMSE with different tracking velocities and Fugl-Meyer shoulder-elbow score (P < 0.05). There was also significant negative correlation between average RMSE and average ROM (P < 0.05), and moderate nonsignificant negative correlation with RMSJ, and CI. The characterization of velocity-dependent deficiencies, monitoring of training-induced improvement, and the correlation between quantitative parameters and clinical scales could enable the exploration of effects of different types of treatment and design progress-based training method to accelerate the processes of recovery. HubMed – rehab
Thalamocortical tract between anterior thalamic nuclei and cingulate gyrus in the human brain: diffusion tensor tractography study.
Filed under: Rehab Centers
Brain Imaging Behav. 2013 Jan 31;
Jang SH, Yeo SS
Most portions of the Papez circuit have been identified by diffusion tensor tractography (DTT). However, no DTT study on the proportion of the Papez circuit between the anterior thalamic nuclei and cingulate gyrus has been reported. We attempted to reconstruct the thalamocortical tract between the anterior thalamic nuclei and cingulate gyrus using DTT. All the reconstructed thalamocortical tracts originated from the anterior thalamic nuclei, ascended through the genu of the internal capsule, the anterior limb of the internal capsule, and the white matter around the anterior horn of the lateral ventricle in the anterior and lateral direction, and then terminated at the anterior cingulate gyrus. In terms of FA, MD, and tract volume, no significant differences were observed between hemispheres (p?>?0.05). We reconstructed the thalamocortical tract between the anterior thalamic nucleus and cingulate gyrus in the human brain using DTT. We believe that the methodology and results of this study will be helpful to researchers investigating the Papez circuit.
HubMed – rehab
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