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This study evaluates the long-term donor site outcomes after second toe transfers for congenital hand differences performed during childhood. In total, 25 toe transfers in 18 patients were followed up for a mean period of 17.4 years. We examined the patients clinically, radiologically and with a gait analysis system. Patient-reported outcome measures were collected. The patients were asymptomatic and there were no problematic clinical or radiological findings. Patients expressed high levels of satisfaction. The results were consistent, regardless of the resection level in the toe transfer or whether the operation was unilateral or bilateral. No postoperative complications or late reoperations on the foot were observed.Level of evidence IV.
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OBJECTIVE: The aim of this study was to investigate changes in trunk muscle strength 12 months after lumbar spine fusion (LSF) compared to preoperative strength. METHODS: A total of 194 patients (mean±standard deviation [SD] age, 61±21 years) who underwent LSF participated in this prospective longitudinal study. Physical measurements of the participants were made before surgery and 12 months postoperatively. Isometric trunk extension and flexion strength was measured using a strain-gauge dynamometer in the standing position. Strength changes were calculated. Regression analysis was performed to explore which factors predicted strength levels at 12 months postoperatively. RESULTS: The preoperative mean±SD extension strength was 205±144 N, which increased to 258±142 N (p<0.001) at the 12-month follow-up. Flexion strength increased from 295±172 N to 364±164 N (p<0.001). The preoperative extension/flexion strength ratio was 0.75±0.38 and remained similar (0.73±0.26) at 12 months postoperatively (p=0.39). CONCLUSION: Although trunk muscle strength increased by 26% for extension and 23% for flexion at the 12-month postoperative follow-up, both values remained objectively low. In addition, flexion strength remained higher than extension strength, which indicates an imbalance between those muscle groups. Age, severe back pain, and low trunk muscle strength before surgery predicted low trunk muscle strength at 1 year after spinal fusion.
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PURPOSE: To analyze trunk muscle function pre- and postoperatively in patients undergoing lumbar spine fusion. Associations between changes in trunk muscle strength and disability were also studied. METHOD: A total of 114 patients undergoing lumbar spine fusion participated in the study. The flexion and extension strength of the trunk was measured preoperatively and 3 months after surgery using a strain-gauge dynamometer. Disability and pain during the past week was evaluated with the Oswestry disability index (ODI) and visual analog scale (VAS), respectively. RESULTS: Preoperative trunk extension and flexion strength levels were 319 N and 436 N in males, respectively, and 160 N and 214 N in females, respectively. In females 3 months postoperatively, the trunk extension strength increased by 39 N (p < 0.001) and flexion by 38N (p < 0.001), whereas it remained unchanged in males. The preoperative extension/flexion strength ratio was 0.79 in females and 0.76 in males. Three months postoperatively, the strength ratio decreased to 0.66 in males (p = 0.02). The mean ODI improved by 47% and back pain decreased by 65% (both p < 0.001). The changes in the ODI correlated with changes in trunk extension (r = -0.38) and flexion (r = -0.43) strength. CONCLUSIONS: Patients undergoing lumbar spine fusion had low trunk muscle strength and strength imbalance. Back fusion surgery leads to considerable relief of pain and disability, but patients still have low trunk extension and flexion strength levels 3 months postoperatively. Therefore, there is need for a proper progressive strength training protocols to normalize back function.
Asunto(s)
Dolor de Espalda/rehabilitación , Personas con Discapacidad/rehabilitación , Vértebras Lumbares/cirugía , Fuerza Muscular/fisiología , Músculo Esquelético/fisiología , Fusión Vertebral/métodos , Adulto , Anciano , Dolor de Espalda/fisiopatología , Evaluación de la Discapacidad , Femenino , Estudios de Seguimiento , Humanos , Vértebras Lumbares/fisiopatología , Masculino , Persona de Mediana Edad , Dinamómetro de Fuerza Muscular , Dimensión del Dolor , Dolor Postoperatorio/etiología , Dolor Postoperatorio/rehabilitación , Estudios Prospectivos , Rango del Movimiento Articular , Recuperación de la Función , Fusión Vertebral/efectos adversos , Encuestas y Cuestionarios , Factores de Tiempo , Torso , Resultado del TratamientoRESUMEN
The aim of this study is to describe the experiences of people with severe chronic obstructive pulmonary disease (COPD) in their everyday lives by using the World Health Organization's International Classification of Functioning, Disability, and Health. Five people with COPD and four spouses participated in the study. The data were collected by thematic personal interviews and were analyzed by deductive content analysis. The findings describe the impairment of body function of people with COPD, they provide knowledge of those factors that promote the well-being of people with COPD, how they cope on a daily basis, and the importance of their spouse. Knowledge about COPD for all health-care professionals is a precondition to ensure that people receive the help they need. People with COPD found it important to have a care relationship with their own treatment unit. The findings of the present study showed that peer support was an important matter.