Electrical stimulation with non-implanted electrodes for overactive bladder in adults

Peer reviewedPublisher PD

Systematic review and economic modelling of the effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence

Peer reviewedPublisher PD

Applications of EMG in Clinical and Sports Medicine

This second of two volumes on EMG (Electromyography) covers a wide range of clinical applications, as a complement to the methods discussed in volume 1. Topics range from gait and vibration analysis, through posture and falls prevention, to biofeedback in the treatment of neurologic swallowing impairment. The volume includes sections on back care, sports and performance medicine, gynecology/urology and orofacial function. Authors describe the procedures for their experimental studies with detailed and clear illustrations and references to the literature. The limitations of SEMG measures and methods for careful analysis are discussed. This broad compilation of articles discussing the use of EMG in both clinical and research applications demonstrates the utility of the method as a tool in a wide variety of disciplines and clinical fields

Effects of dance therapy on balance, gait and neuro-psychological performances in patients with Parkinson's disease and postural instability

Postural Instability (PI) is a core feature of Parkinson’s Disease (PD) and a major cause of falls and disabilities. Impairment of executive functions has been called as an aggravating factor on motor performances. Dance therapy has been shown effective for improving gait and has been suggested as an alternative rehabilitative method. To evaluate gait performance, spatial-temporal (S-T) gait parameters and cognitive performances in a cohort of patients with PD and PI modifications in balance after a cycle of dance therapy

The effect of cycling using active passive trainers on spasticity, cardiovascular fitness, function and quality of life in people with moderate to severe Multiple Sclerosis

Background: Exercise is an important treatment strategy for people with Multiple Sclerosis (MS). However, exercise options are limited for those with higher levels of disability, as is the evidence to support the benefits. Lower limb active passive trainers (APTs) are used for people with higher levels of disability but there is little evidence on their efficacy. The aim of this thesis was to investigate the effects of lower limb APTs on spasticity, cardiovascular fitness, function and quality of life in people with moderate to severe MS. Included studies: The first study included was a systematic review of the effects of cycling using lower limb APTs on spasticity, cardiovascular fitness, function and quality of life in people with neurological conditions. The second was anintervention study to explore the effects of a four-week programme of lower limb APT cycling on spasticity, cardiovascular fitness, function and quality of life in people with moderate to severe MS. The final study was to determine if a single session of APT cycling reduced spasticity, measured using neurophysiology (Hoffmans reflex/H-reflex), in people with moderate to severe MS. Main findings: The systematic review identified that APT interventions may improve walking endurance (6MWT performance, p<0.001) but not walking speed(p=0.31), however this meta-analysis only included a small number of stroke studies. The effects in other conditions and on other outcomes was unclear, as was whether electrically stimulated cycling was more beneficial than APT cycling alone. The intervention study found APT cycling to be safe and feasible in people with moderate to severe MS. Improvements were noted in the majority of outcome measures, although no significant group differences were found. The APT group also showed significant improvements in their average speed, power output and distance cycled (all p<0.001). It was felt some of the outcome measures used lacked sensitivity, especially for spasticity. The H-reflex study found that a single session of APT cycling did not change spasticity measured using H-reflex, clinical scales or patient reported measures. The H-reflex was found to be a feasible and safe outcome measure, however it appeared to be easily influenced by other factors and was time consuming to complete. Conclusion: This thesis highlighted that APT cycling is a safe and feasible intervention in people with moderate to severe MS, however measuring the effects of the intervention especially in relation to spasticity remain challenging. In addition, the dose, intensity and frequency required to improve symptoms, function and quality of life remains unclear. Further research is merited regarding the benefits of APT interventions and outcomes used in people with higher disability levels associated with MS

IX Malta Medical School Conference

Abstracts of papers presented at the 9th Malta Medical School Conference held at the Hilton Malta Hotel, Portomaso, St. Julians between 3rd and 5th December 2015.peer-reviewe