Rehab Centers: Balance and Walking Involvement in Facioscapulohumeral Dystrophy: A Pilot Study on the Effects of Custom Lower Limb Orthoses.
Balance and walking involvement in facioscapulohumeral dystrophy: a pilot study on the effects of custom lower limb orthoses.
Filed under: Rehab Centers
Eur J Phys Rehabil Med. 2012 Nov 9;
Aprile I, Bordieri C, Gilardi A, Lainieri Milazzo M, Russo G, De Santis F, Frusciante R, Iannaccone E, Erra C, Ricci E, Padua L
BACKGROUND:Autosomal dominant facioscapulohumeral dystrophy (FSHD), the third most common muscular dystrophy, is characterised by asymmetric and highly variable muscle weakness. In FSHD patients, the coupling of the ankle muscles impairment with the knee, hip and abdominal muscles impairment, causes complex alterations of balance and walking with deterioration of quality of life (QoL). AIM: The aim of this pilot study is to evaluate the effects of custom orthoses (foot orthosis-FO and ankle foot orthosis-AFO) on balance, walking and QoL of FSHD patients through a multidimensional approach. DESIGN: Pilot study. SETTING: Outpatient Rehabilitation Department of Don Gnocchi Foundation. POPULATION: Fifteen patients with facioscapulohumeral muscular dystrophy were studied. METHODS: On 15 FSHD patients clinical evaluation (Manual Muscle Test-MMT, Clinical Severity Score), performance tests (10 meter Walking test-10mWT and 2 minute Walking Test-2minWT), instrumental assessment (stabilometric evaluation), disability (Rivermead Mobility Index- RMI, Berg Balance Scale-BBS) and patient-oriented (Medical Outcome Study 36-item Short Form-SF-36, North American Spine Society-NASS and Visual Analogue Scale-VAS) measures were performed. Patients were evaluated first, wearing their shoes and then wearing their shoes plus orthoses. This evaluation was performed 1 month after wearing the orthoses. RESULTS: The shoes plus orthoses evaluation, performed after one month in which the patients daily wore the custom lower limb orthoses, showed a significant improvement of walking performance (10-mWT p<0.01), balance (Romberg Index p<0.05; Medio-Lateral Velocity p<0.05) and QoL (PCS p<0.01). CONCLUSION: This pilot study shows that in FSHD patients' custom lower limb orthoses (foot-orthoses and ankle-foot-orthoses); evaluated by using a multidimensional approach, improve walking, balance and QoL. Clinical Rehabilitation Impact. These preliminary results suggest that custom lower limb orthoses could reduce the risk of falling with a positive effect on our patients' safety. Our results should encourage the scientific community to do efficacy study on this hot topic. HubMed – rehab
Playing-related musculoskeletal disorders in music students-associated musculoskeletal signs.
Filed under: Rehab Centers
Eur J Phys Rehabil Med. 2012 Nov 9;
Steinmetz A, Möller H, Seidel W, Rigotti T
BACKGROUND: Pain and overuse are common problems for musicians. Up to 80% of professional musicians suffer from playing-related musculoskeletal disorders (PRMD). The prevalence rate in music students is very high as well. Sufficient data on the underlying musculoskeletal dysfunctions however is scarce. Additionally, the self-assessment of health in musicians seems to differ compared to non-musicians, which might influence their attitudes concerning preventive strategies. AIM: Evaluation of frequency of PRMD in music students, investigation of signs and symptoms in music students compared to non-music controls, comparison of self-reported health and well-being between the two groups. DESIGN: Prospective, cross-sectional, case control, non-randomized. SETTING: Other (University volunteers). POPULATION:Music students in comparison to a non-music control group. METHOD: Musculoskeletal examination and questionnaire of 36 volunteers of a music university and 19 volunteer students of an university of education were analyzed. The total number of musculoskeletal dysfunctions and differences between the student groups were examined. The personal pain and health self-rating were compared between music and non-music students. RESULTS:Eighty one percent of musicians experienced PRMD. Musicians experienced 6.19 pain regions on average compared to 4.31 of non-musicians. Musicians experiencing PRMD reported significantly (P<0.05) more pain locations than musicians without. Music students presented with nearly the double amount (8.39 versus 4.37) of musculoskeletal dysfunctions per person compared to the non-music control group. Nevertheless, musicians significantly (P<0.05) rated their health more positively than the controls. CONCLUSION:Musicians presented with more pain regions and a higher amount of musculoskeletal dysfunctions. Further studies evaluating the clinical relevance and their role in the development of PRMD are warranted. CLINICAL REHABILITATION IMPACT.Screening of musicians for musculoskeletal dysfunction may identify those musicians at increased risk. Early treatment may prevent PRMD in musicians. Additional research is needed to confirm our hypothesis. HubMed – rehab
Is walking in daily life a moderate intensity activity in patients with chronic obstructive pulmonary disease?
Filed under: Rehab Centers
Eur J Phys Rehabil Med. 2012 Nov 9;
Vitorasso R, Camillo CA, Cavalheri V, Aparecida Hernandes N, Cortez Verceze A, Sant’anna T, Ferreira Monteiro F, Ramos EM, Pitta F
BACKGROUND: So far there are no studies investigating whether the time spent walking in daily life by patients with COPD corresponds to an activity of at least moderate intensity according to the recommendations of the American College of Sports Medicine (ACSM). aim: To quantify in patients with COPD the time spent/day in physical activity of at least moderate intensity according to the ACSM (TPA>moderate); and to compare their TPA>moderate with the total time spent walking/day in daily life (TW). design:Cross-sectional study. SETTING:Patients entering in a pulmonary rehabilitation program at a University Hospital in Brazil. POPULATION: Seventy-three patients with COPD (FEV1 40±15% pred; 65±9 years). METHODS: TW and TPA>moderate were respectively assessed with the DynaPort and SenseWear activity monitors for 12 hours/day during 2 days. RESULTS: There was significant difference between TW and TPA>moderate (53 [36-80] versus 12 [3-33] minutes/day, respectively; P<0.0001). Although 84% of patients reached more than 30 minutes/day of TW, only 29% reached more than 30 minutes/day of TPA>moderate. TPA>moderate correlated modestly with TW (r= 0.52; P<0.0001). CONCLUSION:The majority of patients with moderate-very severe COPD walk more than 30 minutes/day; however this does not mean that they are physically active, since less than 1/4 of their time spent walking can be considered as moderate-intensity activity. Clinical rehabilitation impact. Moderate-intensity physical activity in patients with COPD is more reduced than previously known. There is a clear need to increase their daily physical activity and lead a higher proportion of this population to comply with the minimum recommendations. HubMed – rehab
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