Environmental characteristics of older people attending physical medicine and rehabilitation outpatient clinics

Objective: A residential environment refers to the physical and social characteristics in a neighbourhood. The physical characteristics include interior housing qualities, exterior neighbourhood characteristics, and the accessibility of essential facilities and services outside the neighbourhood. Older adults especially may be vulnerable to the negative impacts of the residential environment. The aim of this study is to elucidate the problems ageing people face in their neighbourhoods, buildings and public areas. Methods: The study group consisted of a total of 1,001 people over the age of 65 who were admitted to physical medicine and rehabilitation clinics in Turkey and consented to participate. A questionnaire covering demographic, social and environmental information was used. Results: Of the study group, 58.6% was living in an apartment building, but only 23.6% of these buildings had an elevator, and the stairs were inconvenient in 46.7% of the buildings. Only 49% of the elderly people went for a walk regularly. The most frequent complaint about the hospitals, community health centres and other public areas was the inappropriate restroom conditions. Eighty-six percent of the study group were not members of an organization, a foundation or a group, and 73.6% did not have personal hobbies. Conclusions: The layouts of buildings and surroundings are inappropriate for older people, and the opportunities for them to participate in social activities are limited. Health and social programmes and governmental and local policies for older people are needed, and public awareness about this issue should be raised

Masticatory Muscle Activity in Subjects Having Different Vertical Facial Patterns: An Electromyographic Study

Aim:To investigate bilateral masseter and anterior temporalis muscle activities during swallowing, chewing and maximum intercuspitation (MI) in skeletal open and deep-bite groups using electromyography (EMG) method.Subjects and Methods:Surface EMG recordings of the masseter and anterior temporalis muscles were obtained from subjects having skeletal open-bites (8 male, 8 female, mean age 12.6±2.5 years) and skeletal deep-bites (10 male, 5 female, mean age 11.6±2.1 years) during swallowing, chewing and maximum intercuspitation by using surface disc electrodes. Peak-to-peak amplitude values were measured in microvolts (uV). The mean value of the three recordings was calculated for each function. Statistical analysis of the data obtained was conducted using repeated measurement analysis of variance and Duncan's tests.Result:The masseter and anterior temporalis muscle activities were found distinct in all functions (P<0.01). This difference can be generalized as masseter muscle activity was higher than the anterior temporalis muscle. During swallowing, masticatory muscle activities were found similar in open/deep-bite groups. During chewing, masseter and anterior temporalis muscle activities were found statistically different in open/deep-bite groups (P<0.05). In MI, the interaction between muscle type (masseter and anterior temporalis) and groups (open and deep-bite) were distinct (P<0.01).Conclusion:EMG activities of the masseter and anterior temporalis muscles are distinct during different functions and in subjects with different vertical facial patterns

Evaluation of pain and flexor reflex responses and their association with clinical parameters in patients with fibromyalgia

Objectives: In the present study, we aimed to evaluate electrophysiological outcomes of flexor reflexes (FR) emerging in response to painful stimuli in fibromyalgia (FM) patients. Patients and methods: This study included a total of 21 female FM patients (mean age 36.8 +/- 8.0 years; range, 20 to 50 years) and 28 healthy female controls (mean age 37.3 +/- 8.8 years; range, 22 to 53 years). Clinical features of the patients, Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) scores were recorded. Electrophysiological stimulation threshold, visual analog scale (VAS) scores of generated pain after each stimulation, current intensity, flexor responses obtained from muscles, and electrophysiological measurement of these responses were noted. Results: The threshold for perception of electrical current was higher and resistance level to maximum electrical current was lower in FM patients (p<0.05). The VAS scores of FM patients under maximum electrical current were higher than the control group (p<0.05), while the lowest current value in which FR response obtained in FM patients was lower (p<0.05). The latency was lower, amplitude was higher, and response area was wider in FM patients (p<0.05). No significant relationship between the FIQ, BDI, BAI scores and stimulant perception threshold levels was found in FM patients (p>0.05). Conclusion: Based on these findings, FR responses may be useful as an electrophysiological parameter in FM diagnosis

The effect of elbow position on biceps tendon reflex

Background: Testing of tendon (T) reflex is the basic method used in the diagnostic procedure of clinical neurology. Measurement of T reflexes precisely can be a valuable adjunct to clinical examination. Quantification of T reflexes may provide more accurate results. Aims: To analyze the effect of elbow position on biceps T reflex. Settings and Design: A self-controlled clinical trial of biceps T reflex testing at the Electrophysiology Unit of the Department of Physical Medicine and Rehabilitation. Methods and Materials: Biceps T reflex was obtained utilizing a hand-held electronic reflex hammer in 50 extremities of 25 healthy volunteers and the effect of elbow position (at 90°, 120° and 150°) on reflex response was evaluated. Statistical Analysis: Repeated-measures analysis of variance by the General Linear Model and Pearson correlation test procedures. Results: Onset latency was significantly shorter at 120° of elbow position. The maximum amplitude value of biceps T reflex was obtained at 90° of elbow position. Onset latency of the reflex correlated significantly with the height and arm length but not with age. Conclusions: The electrophysiological measurement of T reflexes is an easy and useful method in the quantification of reflexes, supplying more objective data. However, when performing T reflex studies, the position of the extremity should be taken into consideration to achieve more reliable results

Femoral Nerve Injury Following a Lumbar Plexus Blockade

Background: Lumbar plexus blockade (LPB) combined with sciatic nerve block (SNB) is frequently used for lower extremity surgery. Perioperative nerve injury is a rarely encountered complication of peripheral nerve blocks (PNB). Case Report: Here we report a 44-year-old male patient who developed a partial femoral nerve injury (FNI) following a LPB which was performed before the surgery of a patellar fracture. The clinical and electroneuromyographic findings of the patient were recovered almost completely within the following six months. Conclusion: The presented case demonstrated a FNI despite the absence of any pain or paresthesia sensation, with the disappearance of motor response under 0.3 mA of neurostimulation in the experienced hands

Comparison of multimodal intraoperative neurophysiological monitoring efficacy in early childhood and school aged children undergoing spinal surgery.

The aim of this study was to compare the performance of multimodal intraoperative neurophysiological monitoring (MIONM) in children below and over 6 years of age

Reliability of a Novel Visual Feedback System Developed for Increasing the Efficiency of Posterior Pelvic Tilt Exercise

Objectives: This study aimed to develop and assess the reliability of a visual feedback system intended to improve the patient's perception and the performance of posterior pelvic tilt [PPT] exercises. The feedback setup designed and constructed by the authors included a bed covered with a mat with three embedded force sensors corresponding to the lumbosacral region of the subject lying supine; a data acquisition card to collect and convert data; and two monitors, one above the subject and one on the physician's table. Software was developed to monitor the force exerted vertically upon the force sensors during PPT to be followed both by the physician and the subject

ENVIRONMENTAL CHARACTERISTICS OF OLDER PEOPLE ATTENDING PHYSICAL MEDICINE AND REHABILITATION OUTPATIENT CLINICS

WOS: 000548269300005PubMed: 32228814Objective: A residential environment refers to the physical and social characteristics in a neighbourhood. the physical characteristics include interior housing qualities, exterior neighbourhood characteristics, and the accessibility of essential facilities and services outside the neighbourhood. Older adults especially may be vulnerable to the negative impacts of the residential environment. the aim of this study is to elucidate the problems ageing people face in their neighbourhoods, buildings and public areas. Methods: the study group consisted of a total of 1,001 people over the age of 65 who were admitted to physical medicine and rehabilitation clinics in Turkey and consented to participate. A questionnaire covering demographic, social and environmental information was used. Results: of the study group, 58.6% was living in an apartment building, but only 23.6% of these buildings had an elevator, and the stairs were inconvenient in 46.7% of the buildings. Only 49% of the elderly people went for a walk regularly. the most frequent complaint about the hospitals, community health centres and other public areas was the inappropriate restroom conditions. Eighty-six percent of the study group were not members of an organization, a foundation or a group, and 73.6% did not have personal hobbies. Conclusions: the layouts of buildings and surroundings are inappropriate for older people, and the opportunities for them to participate in social activities are limited. Health and social programmes and governmental and local policies for older people are needed, and public awareness about this issue should be raised

Comparison of multimodal intraoperative neurophysiological monitoring efficacy in early childhood and school aged children undergoing spinal surgery

Objective: The aim of this study was to compare the performance of multimodal intraoperative neurophysiological monitoring (MIONM) in children below and over 6 years of age. Methods: 43 children, diagnosed with spinal pathologies were divided into two cohorts according to their age and enrolled in the study. Those under the age of 6 consisted group A, whereas those between the age of 6 and 11 consisted group B. All patients underwent spinal surgical procedures according to their diagnosis. A standard anesthesia protocol was given to both groups. Baseline somatosensory evoked potentials (SSEPs) and transcranial electrical motor evoked potentials (tcMEPs) were recorded and evaluated at specific time points for each patient. Results: Except for the SSEPs in three cases, tcMEPs and SSEPs were recorded for all patients. There was no false-negative whereas 9 false positive recordings due to physiological conditions that all recovered intraoperatively. In 10 patients, MIOMN recorded more than \%50 decrement, in which 8 had the kyphosis component. The tcMEPs fully recovered by the end of the operation except for the patient with posttuberculosis kyphosis. There was no statistically significant difference in the mean threshold values with regard to transcranial stimulus intensity for the tcMEPs between the two groups. Conclusion: Compared to school aged children, both SSEPs, tcMEPs recordings are feasible and MIONM is effective for early childhood patients undergoing spinal surgery. Level of evidence: Level III, Diagnostic Study. (C) 2016 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license

Comparison of multimodal intraoperative neurophysiological monitoring efficacy in early childhood and school aged children undergoing spinal surgery

The aim of this study was to compare the performance of multimodal intraoperative neurophysiological monitoring (MIONM) in children below and over 6 years of age. 43 children, diagnosed with spinal pathologies were divided into two cohorts according to their age and enrolled in the study. Those under the age of 6 consisted group A, whereas those between the age of 6 and 11 consisted group B. All patients underwent spinal surgical procedures according to their diagnosis. A standard anesthesia protocol was given to both groups. Baseline somatosensory evoked potentials (SSEPs) and transcranial electrical motor evoked potentials (tcMEPs) were recorded and evaluated at specific time points for each patient. Except for the SSEPs in three cases, tcMEPs and SSEPs were recorded for all patients. There was no false-negative whereas 9 false positive recordings due to physiological conditions that all recovered intraoperatively. In 10 patients, MIOMN recorded more than %50 decrement, in which 8 had the kyphosis component. The tcMEPs fully recovered by the end of the operation except for the patient with post-tuberculosis kyphosis. There was no statistically significant difference in the mean threshold values with regard to transcranial stimulus intensity for the tcMEPs between the two groups. Compared to school aged children, both SSEPs, tcMEPs recordings are feasible and MIONM is effective for early childhood patients undergoing spinal surgery. Level III, Diagnostic Study