Virtual Walking Training Program Using a Real-World Video Recording for Patients With Chronic Stroke: A Pilot Study.
Virtual Walking Training Program Using a Real-world Video Recording for Patients with Chronic Stroke: A Pilot Study.
Am J Phys Med Rehabil. 2013 May; 92(5): 371-384
Cho KH, Lee WH
OBJECTIVE: The purpose of this study was to investigate the effectiveness of the virtual walking training program using a real-world video recording on walking balance and spatiotemporal gait parameters in patients with chronic stroke. DESIGN: Fourteen patients with chronic stroke were randomly assigned to either the experimental group (n = 7) or the control group (n = 7). The subjects in both groups underwent a standard rehabilitation program; in addition, the experimental group participated in the virtual walking training program using a real-world video recording for 30 mins a day, three times a week, for 6 wks, and the control group participated in treadmill gait training for 30 mins a day, three times a week, for 6 wks. Walking balance was measured using the Berg Balance Scale (BBS) and the Timed Up and Go test. Gait performance was measured using an electrical walkway system. RESULTS: In walking balance, greater improvement on the Berg Balance Scale (experimental group: 4.14 vs. control group: 1.85) and the Timed Up and Go test (-2.25 vs. -0.94) was observed in the experimental group compared with the control group (P <; 0.05). In the spatiotemporal gait parameters, greater improvement on velocity (25.40 vs. 9.74) and cadence (26.71 vs. 11.11) was observed in the experimental group compared with the control group (P <; 0.05). CONCLUSIONS: This study demonstrated the positive effects of the virtual walking training program using a real-world video recording on gait performance. These findings suggest that the virtual walking training program using a real-world video recording may be a valid approach to enhance gait performance in patients with chronic stroke. HubMed – rehab
Maximizing Safety in Screw Placement for Posterior Facet Fixation in Calcaneus Fractures: A Cadaveric Radio-Anatomical Study.
Foot Ankle Int. 2013 Apr 18;
Phisitkul P, Sullivan JP, Goetz JE, Marsh JL
BACKGROUND: Successful screw fixation of reduced posterior facet fragments to the unexposed, nondisplaced sustentaculum tali avoids breaching the subtalar joint or disrupting surrounding soft tissue structures. Safe passage for screw fixation through this narrow bony corridor has not been rigorously defined. METHODS: Computed tomography scans of 8 cadaveric feet were digitally reconstructed in 3-D; 3.5-mm-diameter screws were simulated, aiming at the center of the sustentaculum tali from 5 locations (0%, 25%, 50%, 75%, and 100%) along the posterolateral facet joint. The range of entry points, screw paths trajectories, and screw lengths that did not breach the subtalar joint or the medial calcaneal cortex were evaluated. RESULTS: To prevent violation of the subtalar joint or the medial calcaneal cortex while reaching the center of the sustentaculum tali, screws must be inserted at least 5 mm below the joint line. Screw placement 15 ± 1 mm below the posterior facet measured perpendicular to the joint line provided the widest safe corridor with the trajectory of the ranges from 6 to 36 degrees parallel to the joint depending on the location along the posterior facet and 20 ± 2 degrees perpendicular to the joint at all locations. The average maximal length of screws placed at the ideal entry points ranged from 44 to 46 mm, longest at the 100% location and shortest at the 25% location. CONCLUSIONS: Operative guidelines facilitating instrumentation into the sustentaculum tali have been defined applying to most calcanei, assuming the fractures are well reduced: screws, approximately 40 mm in length, should be started 15 mm below the posterior facet measured perpendicular to the joint line and aimed 20 degrees perpendicular to the joint line toward the joint and 6 to 36 degrees anteversion parallel to the joint line increasing at each position from anterior to posterior. CLINICAL RELEVANCE: The operative guidelines described in this study may assist surgeons in the placement of screws for the fixation of posterior facet fragments to the sustentaculum tali. HubMed – rehab
Reimbursement for Thrombectomy Devices in Patients Who Are Ineligible for Intravenous Tissue-Type Plasminogen Activator.
Stroke. 2013 Apr 18;
Broderick JP, Tomsick TA,