Results of angular-stable locked intramedullary nails in the treatment of distal tibia fractures

AbstractIntroductionIntramedullary nailing in distal tibial fracture is controversial because of a lack of stability. The present study sought to assess radiological and clinical results for a new “angular-stable” locking system in difficult indications for intramedullary nailing.Material and methodA prospective study recruited 41 patients (41 tibias) with distal tibial fracture consecutively managed using angular-stable locked intramedullary nails. Radiologic assessment comprised AP and lateral lower-limb views, taken postoperatively and through to last follow-up. The mean distance was measured between fracture and joint line. Fusion, with or without malunion, primary reduction defect, non-union and secondary displacement were recorded, as were all complications.ResultsMean follow-up was 18±5 months; 3 patients were lost to follow-up. Mean fracture distance from the joint line was 63±25mm. Fusion was achieved within 3 months in 29 cases (76%); delayed fusion in 7 patients (18%) required secondary dynamization at a mean 3 months, with favorable evolution. Revision surgery was required in 2 cases: 1 for secondary displacement exceeding 10°, and 1 for non-union at 7 months. Other complications mainly comprised 4 malunions of less than 10° due to primary reduction defect.ConclusionAngular-stable locked lower-limb intramedullary nailing provided a very satisfactory fusion rate, with few complications. It is, however, a demanding procedure, especially as regards fracture reduction and nail positioning in the distal fragment.Prospective cohort studylevel IV

THE EFFECT OF A NOVEL REHABILITATION PROGRAM ON WALKING PERFORMANCE IN PERSONS WITH MULTIPLE SCLEROSIS

The current study examined the effects of the NewGait™ device on walking performance in persons with multiple sclerosis (MS). Eight MS patients participated in this study. Pre- and post-testing assessed kinematic gait variables (step width, length, and speed), ankle range of motion, and rating of perceived exertion (RPE). Participants completed an 8-week physical therapy (PT) protocol aimed to improve gait and balance, with the experimental group wearing the NewGait™ device. Repeated measures mixed ANOVA showed no main effects between the gait variables or between groups. Post-hoc paired t-tests indicated that the NewGait™ device elicited meaningful change in left and right step length and speed. The NewGait™ device may be a promising rehabilitation device to help induce positive walking performance changes in persons with MS

THE EFFECT OF A NOVEL REHABILITATION DEVICE ON MUSCLE ACTIVATION DURING GAIT IN PERSONS WITH MULTIPLE SCLEROSIS

This study examined the acute effect of a novel rehabilitation device, NewGait™, on muscle activation in persons with Multiple Sclerosis. Through electromyography, muscle activation of the vastus medialis (VM), gastrocnemius lateralis (GL) and tibialis anterior (TA) was measured in seventeen patients (n=17). Three trials were conducted in each condition: a 10-meter control walk and 10-meter NewGait™ walk. Results showed a non-significant change in muscle activity with moderate effect sizes in the right VM (increase of 39.72% MVC, p=0.082, d=0.626) and right TA (decrease of 12.71% MVC, p=0.069, d=0.427). In general, no change in muscle activation was noted when wearing the NewGait™ device. Future research should include a larger sample size and differentiation between the stance phases to accurately measure the outcomes of the NewGait™ device on muscle activation

CHANGES IN GAIT AND COORDINATION VARIABILITY IN PERSONS WITH MULTIPLE SCLEROSIS FOLLOWING A REHABILITATION PROGRAM

This study investigated changes in gait and coordination variability in persons with Multiple Sclerosis (MS) after an 8-week rehabilitation intervention. Data for eight participants (Control: 4, Intervention: 4) were analyzed via Cortex Motion Analysis software and Visual 3D to calculate knee and ankle joint angles as well as discrete spatiotemporal parameters. The knee and ankle joint angles were further analyzed using a vector coding technique to quantify coordination between these joints and how they produce a functional gait pattern. No significant changes in gait or coordination variability were found after rehabilitation, but some meaningful changes with large and moderate effect sizes were present. This study demonstrated a comprehensive overview of the relationship between process and outcome variability in a clinical population

Elastic Stable Intramedullary Nailing (ESIN), Orthoss® and Gravitational Platelet Separation - System (GPS®): An effective method of treatment for pathologic fractures of bone cysts in children

<p>Abstract</p> <p>Background</p> <p>The different treatment strategies for bone cysts in children are often associated with persistence and high recurrence rates of the lesions. The safety and clinical outcomes of a combined mechanical and biological treatment with elastic intramedullary nailing, artificial bone substitute and autologous platelet rich plasma are evaluated.</p> <p>Methods</p> <p>From 02/07 to 01/09 we offered all children with bone cysts the treatment combination of elastic intramedullary nailing (ESIN), artificial bone substitute (Orthoss^®) and autologous platelet rich plasma, concentrated by the Gravitational Platelet Separation (GPS^®) - System. All patients were reviewed radiologically for one year following the removal of the intramedullary nailing, which was possible because of cyst obliteration.</p> <p>Results</p> <p>A cohort of 12 children (4 girls, 8 boys) was recruited. The mean patient age was 11.4 years (range 7-15 years). The bone defects (ten humeral, two femoral) included eight juvenile and four aneurysmal bone cysts. Five patients suffered from persistent cysts following earlier unsuccessful treatment of humeral bone cyst after pathologic fracture; the other seven presented with acute pathologic fractures. No peri- or postoperative complications occurred. The radiographic findings showed a total resolution of the cysts in ten cases (Capanna Grade 1); in two cases a small residual cyst remained (Capanna Grade 2). The intramedullary nails were removed six to twelve months (mean 7.7) after the operation; in one case, a fourteen year old boy (Capanna Grade 2), required a further application of GPS^®and Orthoss^®to reach a total resolution of the cyst. At follow-up (20-41 months, mean 31.8 months) all patients showed very good functional results and had returned to sporting activity. No refracture occurred, no further procedure was necessary.</p> <p>Conclusions</p> <p>The combination of elastic intramedullary nailing, artificial bone substitute and autologous platelet rich plasma (GPS^®) enhances the treatment of bone cysts in children, with no resulting complications.</p

New Insights on Hardiness in the Military Context

status: publishe

Hardiness differentiates military trainees on behavioural persistence and physical performance

© 2016, © 2016 International Society of Sport Psychology. Hardiness is a personality trait that drafts courage and motivation during adversity. Research showed that hardiness differentiates elite athletes from their lower rank competitors. In the domain of sport psychology, hardiness also strongly predicts physical performance. Because the military occupation requires resilience and excellence in physical performance, researchers investigated hardiness and behavioural persistence during training. However, in those studies, hardiness’ impact was weak. Besides, military researchers seldom addressed hardiness’ effect on physical performance. We investigated the influence of hardiness on behavioural persistence and physical performance during the military basic training. Participants were 233 trainees involved in a 22-week long basic training. They completed hardiness measures at the beginning of the training and then, two months later, we registered who stayed involved and who had dropped out. The remaining trainees participated in a self-defence exercise and their trainers evaluated their performance. Our analysis indicated that hardiness significantly predicted behavioural persistence: the trainees still involved in the training after two months scored significantly higher on the hardiness scale than those who dropped out (EXP(B) = 1.08; p <.05). Our results however confirm that hardiness has a weak direct effect on persistence of military trainees. During the self-defence exercise, hardiness positively predicted physical performance (x22df = 9.87; p <.05). We discuss the possible relation of hardiness with other major persistence predictors in the military, such as health, health practices, and social support. Our study is the first to indicate a strong relationship between hardiness and soldiers’ physical performance.status: publishe

Endurance after propranolol in the human execution of a general dynamic exercise

The effects of a single oral dose of 40 mg propranolol on endurance time and on the maximum oxygen consumption were studied in eight healthy young men. They were running on a motor-driven treadmill (work rate from 80 to 150% VO2 max. The VO2 max and endurance time were decreased to an average of 10 and 30% of controls respectively. The relationship between the endurance time and the relative work load (VO2/VO2 max) remained unchanged after beta-adrenoceptor blockade. The reduction of the endurance time following beta-adrenoceptor blockade is a consequence of the reduction of the VO2 max

Soutenir les étudiants de BA-1: béquille ou clé vers l'autonomie?

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