Rehabilitation of the weak hand is an important aspect of improving daily activities post-stroke. iPad applications have opened new opportunities for rehabilitation by facilitating goal-oriented, repetitive and motivating hand movements. This pilot study assessed the suitability of the iPad for improving hand function post-stroke. Eleven individuals with and 11 without stroke experienced existing iPad apps and motor abilities were measured. Significant differences between groups and correlations between the app performances to the motor abilities of the weak hand were found. These preliminary findings point to the potential of using apps in the process of post-stroke hand rehabilitation.
Abstract Daily life activities often involve decision-based reaching movements in different contexts and circumstances. These activities span a wide array of cognitive load types we face while executing motor functions. Here we use a virtual reality-based neurocognitive testing platform to assess cognitive-induced changes in motor behavior as reflected by modulations in head-hand coordination. Our paradigm is based on the Color Trails Test (CTT), which is designed to assess two types of cognitive functions: Trails A —sustained visual attention (SVA), and Trails B —divided attention (DA). The virtual reality CTT adaptation (VR-CTT) requires execution of large multi-directional hand movements and head rotations. We employed a cross-correlation analysis on hand and head kinematics data collected from 122 healthy participants (ages: 20–90 years; divided as follows: young, middle-aged, and older adults) who completed the VR-CTT. The level of spatial coherence of head-hand movements was found to be high (R ≥ 0.76) in both Trails A and B, in all age groups. However, assessing head-hand phase shifts revealed longer time lags (i.e., in which head leads hand) in Trails B versus Trails A, in all age groups. We conclude that allocating cognitive resources to DA task reduces head-hand synchrony as compared to SVA conditions.
Open reduction and internal fixation are the current trends of treatment for comminuted calcaneal fractures. Assessing treatment results is often difficult due to discrepancy between objective parameters such as range of movement, and subjective results such as pain.To test the reliability of footprint analysis as an adjuvant method of postoperative assessment of patients who sustained calcaneal fractures.Dynamic and static footprint analysis was used as an adjuvant additional method to objectively assess operative results. This method is simple and is independent of the patient's initiatives. This modality was used in 22 patients followed-up 9-90 months postoperatively.We found a good correlation between footprint analysis and objective and subjective parameters of results expressed by American Orthopedic Foot and Ankle Society hind foot score. In certain cases, this method can be used to distinguish between uncorrelated parameter results, such as malingering, and workmens' compensation claims.We recommend the use of this simple, non-invasive objective test as an additional method to assess the results of ankle and foot surgery treatment.
Introduction: To follow fracture healing, radiography is commonly used, but it is not sensitive to the early stages of this healing process when nonossified callus is formed. Hence, radiography can lag behind the physiological events of bone healing by some weeks. Although the use of ultrasound for fracture diagnosis has been reported previously, mainly in children, the clinical use of ultrasound to follow fracture healing has rarely been commented on. The goal of the current study was to test the efficiency and efficacy of ultrasound as an alternative method for follow-up of fracture healing. Material and Methods: During a one-year period, 12 patients—six with proximal fibula fracture and six with proximal metatarsal fractures—were followed by ultrasonographic examination in parallel with the routine radiographs. Results: The ultrasound examinations revealed callus formation after one month, with the early signs of healing after ten days. Early callus was first seen on radiographs after a month. Conclusion: Ultrasound was found to be a good modality to follow up fracture healing in long bones. This modality can reduce the amount of radiation received by the patients in the follow-up of fractures, and may shorten the immobility period and hence the recovery time of returning to normal function.
Elastofibroma is a rare type of lesion consisting of elastic fibers within a stroma of collagen and fatty tissue. It is usually located on the lower scapular region attached firmly to the thoracic cage, often causing debilitating pain. Its clinical presentation mimics a soft tissue tumor.To evaluate the diagnosis and treatment results of elastofibroma.Clinical and radiographic evaluations were performed in 11 patients with thoracic wall mass. In five of them a biopsy was taken before surgery. All patients were operated and the diagnosis of elastofibroma was confirmed by histology.Two patients had a postoperative seroma that resolved spontaneously within a few days. All patients reesumed their preoperative activities, including sports.Considering the slow-growing nature of this tumor and its typical presentation, we believe that when this diagnosis is suspected, investigation does not necessitate staging (as in sarcomas). Also, marginal surgical excision is sufficient. Observation is an acceptable alternative to surgery.
The objective of the study was to evaluate the safety and tolerance of use of the ReWalk™ exoskeleton ambulation system in people with spinal cord injury. Measures of functional ambulation were also assessed and correlated to neurological spinal cord level, age, and duration since injury.Case series observational study.A national spinal cord injury centre.Six volunteer participants were recruited from the follow-up outpatient clinic. Safety was assessed with regard to falls, status of the skin, status of the spine and joints, blood pressure, pulse, and electrocardiography (ECG). Pain and fatigue were graded by the participants using a visual analogue scale pre- and post-training. Participants completed a 10-statement questionnaire regarding safety, comfort, and secondary medical effects. After being able to walk 100 m, timed up and go, distance walked in 6 minutes and 10-m timed walk were measured.There were no adverse safety events. Use of the system was generally well tolerated, with no increase in pain and a moderate level of fatigue after use. Individuals with lower level of spinal cord injury performed walking more efficiently.Volunteer participants were able to ambulate with the ReWalk™ for a distance of 100 m, with no adverse effects during the course of an average of 13-14 training sessions. The participants were generally positive regarding the use of the system.
