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The loss of an upper limb significantly limits the functional activities of daily living. A huge emphasis is placed on the manipulation, shape, weight, and comfort of a prosthesis, to enable its use as an inherent body part. Even with technological advances, customized upper-extremity myoelectric prosthesis remain heavy and expensive. The high cost of upper-extremity prosthesis is an especially steep economic barrier for patients. Three-dimensional (3D) printing is a promising avenue for reducing the cost of prosthesis. We applied 3D-printed pressure-sensored prosthetics to a traumatic transradial amputee, and compared the hand functions with a customized myoelectric prosthesis. The 3D-printed pressure-sensored prosthetics showed low grip strength and decreased dexterity compared to the conventional myoelectric prosthesis. Although there were a few limitations, the fabrication of prosthesis with 3D printing technology can overcome previous problems such as high production cost, long fabrication period and heavy weight.
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To identify the effects of a custom-made rigid foot orthosis (RFO) in children over six years old with pes planus.
The medical records of 39 children (mean age, 10.3±4.09 years) diagnosed with pes planus, fitted with RFOs, and had who more than two consecutive radiological studies were reviewed. The resting calcaneal stance position (RCSP), anteroposterior talocalcaneal angle (APTCA), lateral talocalcaneal angle (LTTCA), the lateral talometatarsal angle (LTTMA), and calcaneal pitch (CP) of both feet were measured to evaluate foot alignment. After diagnosis, children were fitted with a pair of RFOs and recommended to walk with heel strike and reciprocal arm swing to normalize the gait pattern. A follow-up clinical evaluation with radiological measurements was performed after 12-18 months and after 24 months of RFO application. Post-hoc analysis was used to test for significant differences between the radiological indicators and RCSP.
With RFOs, all radiological indicators changed in the corrective direction except LTTCA. RCSP and CP in the third measurement showed significant improvement in comparison with the second and baseline measurements. Additionally, APTCA and LTTMA revealed improvements at the third measurement versus the baseline measurements.
This study revealed that radiological indicators improved significantly after 24 months of RFO application. A prospective long-term controlled study with radiographical evaluation is necessary to confirm the therapeutic effects of RFOs and to determine the optimal duration of wear in children with pes planus.
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The mobile thrombus in the aortic arch is a rare condition, which becomes rarer when associated with cerebral infarction, resulting in disabling complications. Transesophageal echocardiography is useful for detecting the source of thrombi in the heart and aortic arch. Here, we report a case of a patient who suffered from recurrent cerebral infarction four times during the previous 18 months due to mobile thrombus in the aortic arch despite anticoagulant therapy. The thrombus with rocking motion (9.6 and 8 mm) was laid in the top of the aortic arch, and surgical resection was not allowed due to the location. We began anticoagulation therapy initially with heparin followed by a combination of warfarin, aspirin, and atorvastatin with an international normalized ratio between 2 and 3. The size of the aortic thrombi was significantly decreased by 3 mm and stabilized after 18 months.
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To investigate the changes of ankle strength and range of motion with aging and which of the ankle strength and range of motion are contributed to balance.
Sixty healthy people (24 men and 36 women) have undergone tests for ankle strength and range of motion, using Biodex System 4 Pro; a one-leg balance, including postural sway and stability index using a Balance System; in which data were collected in a self-reported Desmond fall risk questionnaire.
Participants are classified into 3 groups by age (group 1, 20-40 years; group 2, 40-65 years; group 3, over 65 years). Stability index and postural sway is significantly increased with aging. Ankle plantarflexor strength and ankle eversion range of motion is significantly decreased with aging. Pearson's correlation revealed that ankle plantarflexor strength is significantly correlated with anterior/posterior sway, and ankle eversion range of motion is significantly correlated with medial/lateral sway in the aged group (over 65 years).
Stability, ankle plantarflexor strength, and eversion range of motion is declined with aging. In addition, strength of ankle plantarflexor and eversion range of motion is significantly correlated with balance stability. Further studies are needed for programs to improve the strength of plantarflexor, and range of motion of eversion of the ankle are beneficial in improving balance, stability, and prevention of falling in the elderly.
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Spinal cord injury (SCI) without radiographic abnormality (SCIWORA) is estimated to account for 1-9% of the occurrence of SCI. Of these, cervical SCIWORA in children is common, but thoracic SCIWORA delayed onset in adult is much less common. We experienced a case of 38-years old male patient with lower extremity weakness; he had fallen down a week earlier before the investigation. At the time of admission, motor grade was 4 with voiding incontinence and ambulated with cane. He presented progressive weakness from G4 to G3 and hypoesthesia was below T8 dermatome and ambulated with wheelchair. Whole spine and lumbar MRI findings showed no abnormality and electrodiagnostic findings showed normal NCS, however, abnormal SEP on both the tibial nerves. After steroid therapy and proper rehabilitation program for 2 weeks, lower extremity strength was improved from G4 to G3, voiding was continent, and ambulation reached cane gait.
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