Análisis funcional y cinemático de la marcha en un paciente con lesión medular lumbar incompleta

Este estudio de investigación pretende analizar la evolución de la marcha en un paciente con lesión medular incompleta, tras ser sometido a un programa de entrenamiento de la marcha de forma asistida con soporte parcial del peso corporal con el sistema Lokomat®. Para ello se ha realizado una exploración física y funcional con las escalas de evaluación más utilizadas a éste nivel, conjuntamente con el análisis videográfico, permitiéndonos observar correlaciones entre los datos obtenidos en los apartados de pasos por minuto, velocidad y longitud de paso. Para poder corroborar estos datos, se ha realizado un estudio cinemático utilizando dos cámaras de alta definición, con una velocidad de filmación fijada en 100 imágenes por segundo, procesadas directamente a un ordenador, y realizando la Transformación de 2D a 3D, con el método Direct Linear Transformation (DLT) dado por el Performance Analysis System (APAS).The aim of this research study is to analyze the evolution of gait in a patient with incomplete lumbar spine injury, who was placed on an assisted gait training program with partial body-weight support using the Lokomat® system. A physical and functional assessment was carried out taking into account standard evaluation scales together with video analysis, which allowed us to observe correlations between the data collected for steps per minute, step speed and step length. To corroborate these data, a kinematic study was carried out using two high-resolution cameras with a shooting speed fixed at 100 images per second. Images were transferred directly to a computer and converted from 2D to 3D using the Direct Linear Transformation (DLT) method in the Ariel Performance Analysis System (APAS).Peer Reviewe

Alternativa ecológica en la evaluación del salto de longitud de atletas paralímpicos

Los Juegos Paralímpicos constituyen el máximo exponente a nivelmundial del deporte de competición practicado por personas con discapacidad.En este trabajo exponemos la investigación realizada en los JuegosParalímpicos de Londres 2012, analizando las acciones de los atletas ciegosen el salto de longitud. Para la toma de datos se utilizaron 4 cámaras ExilimF1 (Casio, Japan), grabando 2 en alta velocidad (512x384 píxeles a 300 Hz)y 2 en alta definicón (1280x720 pixeles a 30 Hz), permitiendo no interferiren la competición. El tratamiento y extracción de datos cinemáticos de lasimágenes se realizó con el programa Kinovea 0.8.15 (disponible en http://kinovea.org). Las variables analizadas en el último paso de la carrera deaproximación fueron: velocidad de paso, Vp (m/s); velocidad resultante, Vr(m/s); frecuencia de paso, Fp (Hz); longitud de paso, Lp (m); tiempo decontacto, Tc (s); tiempo de vuelo, Tv (s), tiempo de paso, Tp; altura delcentro de masas, BCM h1(m); ángulo de batida, a1(º); y la duración dela batida, Tc0 (s). Se ha observado una influencia positiva en las variablesTc1, Tv1 y Vp1 y negativas en a1, Lp1, Tp1 y Tc0. Los resultados obtenidoshan permitido identificar las variables determinantes del rendimiento ensalto de longitud de atletas ciegos y comparar éstas con los ya existentes dedeportistas sin discapacidad y de similar habilidad técnica. La metodologíautilizada se ha mostrado fiable, válida y precisa, siendo de gran utilidad enlos ámbitos competitivos por no interferir en el espacio deportivo

Multicentre, randomised, open-label, phase IV-III study to evaluate the efficacy of cloxacillin plus fosfomycin versus cloxacillin alone in adult patients with methicillin-susceptible Staphylococcus aureus bacteraemia: Study protocol for the SAFO trial

Introduction Methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia is a frequent condition, with high mortality rates. There is a growing interest in identifying new therapeutic regimens able to reduce therapeutic failure and mortality observed with the standard of care of beta-lactam monotherapy. In vitro and small-scale studies have found synergy between cloxacillin and fosfomycin against S. aureus. Our aim is to test the hypothesis that cloxacillin plus fosfomycin achieves higher treatment success than cloxacillin alone in patients with MSSA bacteraemia. Methods We will perform a superiority, randomised, open-label, phase IV-III, two-armed parallel group (1:1) clinical trial at 20 Spanish tertiary hospitals. Adults (=18 years) with isolation of MSSA from at least one blood culture =72 hours before inclusion with evidence of infection, will be randomly allocated to receive either cloxacillin 2 g/4-hour intravenous plus fosfomycin 3 g/6-hour intravenous or cloxacillin 2 g/4-hour intravenous alone for 7 days. After the first week, sequential treatment and total duration of antibiotic therapy will be determined according to clinical criteria by the attending physician. Primary endpoints: (1) Treatment success at day 7, a composite endpoint comprising all the following criteria: patient alive, stable or with improved quick-Sequential Organ Failure Assessment score, afebrile and with negative blood cultures for MSSA at day 7. (2) Treatment success at test of cure (TOC) visit: patient alive and no isolation of MSSA in blood culture or at another sterile site from day 8 until TOC (12 weeks after randomisation). We assume a rate of treatment success of 74% in the cloxacillin group. Accepting alpha risk of 0.05 and beta risk of 0.2 in a two-sided test, 183 subjects will be required in each of the control and experimental groups to obtain statistically significant difference of 12% (considered clinically significant). Ethics and dissemination Ethical approval has been obtained from the Ethics Committee of Bellvitge University Hospital (AC069/18) and from the Spanish Medicines and Healthcare Product Regulatory Agency (AEMPS, AC069/18), and is valid for all participating centres under existing Spanish legislation. The results will be presented at international meetings and will be made available to patients and funders. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ