Balance and proprioception impairment, assessment tools, and rehabilitation training in patients with total hip arthroplasty: a systematic review

Background: Osteoarthritis and subsequent total hip arthroplasty (THA) lead to damages to hip joint mechanoceptors, which in turns lead to impairments in proprioception. One of the abilities mainly affected by an altered joint proprioception is balance. The aim of this work was to investigate the balance and proprioception impairments, current assessment tools, and rehabilitation training after THA. Methods: A systematic literature revision was conducted on PubMed, Web of Science and Cochrane databases. Articles reporting balance and proprioception impairments, current assessment tools, or rehabilitation interventions were included. Methodological quality was assessed using the Downs and Black checklist. A total of 41 articles were included, 33 discussing balance and proprioception assessment, and 8 dealing with training. Data related to type of surgical approach, type and timing of assessment protocols, assessment instrumentation, and type, volume and duration of the rehabilitation training were extracted from each study. Results: Thirty-one studies were of high quality, 2 of moderate quality and 8 of low-quality. Literature review showed an improvement in balance following THA in comparison with the pre-operative performance, although balance abnormalities persist up to 5 years after surgery, with THA patients showing an increased risk for falls. Balance training is effective in all the rehabilitation phases if specifically structured for balance enhancement and consistent in training volume. It remains unclear which assessments are more appropriate for the different rehabilitation phases, and if differences exist between the different surgical procedures used for THA. Only two studies assessed proprioception. Conclusion: Balance and proprioception show impairments up to 5 years after THA, increasing the risk of falls. However, patients with THA may benefit of an adequate balance training. Further research is needed to investigate the gaps in balance and proprioception assessment and training following THA surgery

numerical modelling of breaker depth index

The breaker depth index, γb, is commonly used to determine the wave height to water depth ratio where the wave will break (Horikawa, 1988). In the present study, γb has been calculated using a fully nonlinear Boussinesq Type Equations (BTE) wave model with implemented BCI (Breaking Celerity Index). The BCI is a phase-resolving type breaking criterion for calculating the incipient wave breaking conditions (D’Alessandro and Tomasicchio, 2008). The model suitability in predicting γb has been verified against physical data from an experimental investigation conducted with incident regular waves propagating along uniform 1:20 and 1:50 slope beaches (G.V. dos Reis, 1992), and estimates of γb from five existing empirical formulae (Battjes, 1974; Ostendorf and Madsen, 1979; Singamsetti and Wind, 1980; Smith and Kraus, 1990; Goda, 2010). The comparisons showed that BCI presents a better agreement with the physical data with respect to the other investigated formulae in determining the value of γb, independently from the breaker type. In addition, the verification of the BCI in determining γb has been extended to the observed data from a large-scale laboratory experiment on wave hydrodynamics performed over a fixed-bed barred beach (Tomasicchio and Sancho, 2002)

Fetal brain hemodynamics in pregnancies at term: correlation with gestational age, birthweight and clinical outcome

Introduction: The primary aim of this study was to ascertain the strength of association between cerebral blood flow assessed in anterior (ACA), middle (MCA), and posterior (PCA) cerebral arteries and the following clinical outcomes: small for gestational age (SGA), induction of labor (IOL) for oligohydramnios and caesarean section (CS) for nonreassuring fetal status (NRFS) during labor. Material and methods: Retrospective analysis of prospectively collected data on consecutive singleton pregnancies from 40 0/7 to 41 6/7 week of gestation. UA, ACA, MCA, PCA pulsatility index (PI) were measured from 40 weeks of gestations. Furthermore, the ratios between cerebral blood flow and UA (CPR, ACA/UA and PCA/UA) were calculated and correlated with the observed outcomes. Results: Two hundred twenty-four singleton pregnancies were included in the study. Mean PI of either ACA (p = .04), MCA (p = .008), and PCA (p = .003) were lower in the SGA compared to non-SGA group; furthermore, mean PCA PI was significantly lower than MCA PI (p = .04). Furthermore, CPR (p = .016), ACA/UA (p = .02), and PCA/UA (p = .003) were significantly lower in the SGA group compared to controls. UA, ACA, MCA, and PCA PI were higher in women undergoing IOL for oligohydramnios compared to controls. Logistic regression analysis showed that CPR and PCA/UA ratio were independently associated with SGA. SGA, ACA PI, and ACA/UA were independently associated with CS for NRFS. Finally, birthweight centile, were independently associated with IOL oligohydramnios. Despite this, the predictive accuracy of Doppler in detecting any of the explored outcome was only poor to moderate. Conclusion: Redistribution of cerebral blood flow at term is significantly associated with SGA, IOL for oligohydramnios and CS for NRFS in labor. However, the predictive accuracy of Doppler at term is only poor to moderate, thus advising against its use in clinical practice as a standalone screening test for adverse perinatal outcome in pregnancies at term. Key Message Redistribution of cerebral blood flow at term is significantly associated with SGA, IOL for oligohydramnios and CS for NRFS in labor

Analisi sperimentale sull'interazione non lineare tra moto ondoso regolare e barriere sommerse

Il lavoro rivolge la propria attenzione ai caratteri dell'interazione non lineare tra moto ondoso periodico e barriere sommerse. Particolare attenzione viene prestata ai fenomeni di interferenza associati alla produzione di super-armoniche libere nell'area protetta

Submerged breakwaters as non linear device: experimental investigation

Il lavoro discute gli aspetti non lineari dell'interazione tra onde periodiche e barriere sommerse

Experimental and Numerical Investigation On Wave Transmission Past Rubble-Mound Submerged Breakwaters

In this paper the wave transmission past submerged breakwaters is investigated with the use of a 2D Boussinesq-type model (BOUSS-2D) developed by the U.S. Army Corps of Engineers (USACE) included in the AquaveoTM Surface-water Modelling System (SMS). Due to the nature of the model the submerged barrier has been treated as surface-piercing porous structure implemented in the model as a porous layer boundary. The numerical model has been calibrated and validated against 2D physical model tests (Ciardulli, 2009) performed at the LInC Laboratory of University of Naples “Federico II”. A simple method to derive the porous layer parameters has been proposed providing engineers with guidelines for the use of porous layer to predict transmission coefficient behind submerged structures when using Boussinesq-type 2D (horizontal) numerical model. Numerical predictions have been found to be in good agreement with measurements (R2 statistics around 0.9) as well as with outcomes of the semi-empirical equations by Buccino and Calabrese and d’Angremond et al. (maximum difference 0.08)

ONE LAYER CONCRETE ARMOR UNITS WITH A ROCK-LIKESKIN:WAVE REFLECTION AND RUN-UP

In 2008 the authors investigated the performances of a coastal defense project to be built along the NW coast of Sicily (Italy, Calabrese et al., 2011). The intervention consists of shore parallel breakwaters armored with a relatively new eco-friendly system: ECOPODETM. In that context the idea arose of conducting an exhaustive experimental investigation on the “ hydraulic response “ of these units, including wave run-up, wave overtopping, wave transmission and wave reflection observations. The latter has been performed in 2010 at the LInC Laboratory of University of Naples “Federico II”. In this paper results on wave run-up and reflection are presented and discussed