Relationship between Obesity and Balance in the Community-Dwelling Elderly Population: A Cross-Sectional Analysis
Introduction Although there are similar characteristics between obese individuals and fall-susceptible population, little is known about relationships between body weight and risk factors for fall, particularly in the elderly population. The objective of this study was to determine whether body mass index (BMI) based obesity is associated with decreased balance and whether instability has relationships with the main risk factors for falls. Methods A total of 317 participants were categorized based on their BMI. Clinical balance assessments were performed using the Berg Balance Scale, Timed Up and Go test and Short Physical Performance Battery. The knee extensor strength of each individual was measured using a dynamometer. Total sway distance (TSD) was calculated on Inbody posturography® in 4 conditions. Results The results of 3 clinical balance assessment tools showed significant correlation with BMI. The obese group showed decreased isokinetic knee extensor muscle strength and had a higher TSD than the normal-weight group. Conclusions The elderly population with obesity exhibits poor balance performing ability and it is associated with the decreased strength of the lower extremities and impaired postural stability. The logistic regression analysis of our study showed that BMI based obesity can be regarded as a fall risk. Corresponding author : Jinmann Chon, MD, Department of Rehabilitation Medicine, Kyung Hee University Medical Center, 32 Kyunheedae-ro, Dongdaemoon-gu, Seoul 142-884, Korea (kkangmann@naver.com) Tel: +82-2-958-8565, Fax: +82-2-958-8560 Funding This study was supported by a grant of the InBody CO., LTD (Seoul, Korea) and Seoul Business Agency, a government-affiliated organization. (PS150024) This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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A Single Dose Injection of Ozone is not an Alternative of Corticosteroid Injection in Shoulder Impingement Syndrome
No abstract available
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The Certainty behind reporting a Significance Result: What the Clinician Should Know
The p-value is the most common method utilized in medical literature for the result of a statistical test. It is the probability of the data with a true null hypothesis and is calculated using a formal statistical test after the appropriate model has been determined to analyze study data. The p-value is dependent upon the effect size, sample size and a measure of variability within the outcomes. For many years, the p-value has been set at 0.05, which is an arbitrary cutoff. It is important to understand that setting the cutoff at 0.05 may be correct for some study designs but not in others. Therefore, we recommend that in addition to the p-value another metric should be reported that specifies the magnitude of the effect such as effect size, Confidence Interval of the effect size or fragility index. Corresponding Authour: Dinesh Kumbhare, MD, PhD, FRCPC, FAAPMR, University of Toronto, Suite 7-131, 550 University Avenue, Toronto, Ontario M5G 2A2 dinesh.kumbhare@uhn.ca 416-597 3422 X4612 Author Disclosures: All the authors report no conflict of interest for the completion of this manuscript. Also, no funding was received. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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Glenoid Labral Detachment during Dynamic Ultrasonography in a Patient with Posterosuperior Labral Tear
No abstract available
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Stener Lesion; An uncommon variant of Skier’s thumb
No abstract available
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Strength and range of motion in the contralateral side to pain and pain-free regions in unilateral chronic non-specific neck pain patients
Objective To determine if strength and range of motion (ROM) deficits are present in patients with unilateral chronic neck pain (CNP) at contralateral side to pain (CSP) and at other regions. Design Forty-nine patients with unilateral CNP and 98 asymptomatic subjects participated in this case-control study. ROM and muscle strength of the cervical, shoulder, trunk and hip regions were assessed bilaterally using inclinometer and dynamometer, respectively. Results CNP patients demonstrated reduced cervical, shoulder and trunk ROM in their ipsilateral side to pain (ISP) comparing the asymptomatic participants(P<0.05). The ISP cervical and shoulder ROM were also significantly lower than the CSP (P<0.05). Significant differences were also observable in the CSP comparing the asymptomatic group (P<0.05). Cervical, shoulder and scapulothoracic muscles were found weaker both in the ISP and CSP comparing the asymptomatic group (P<0.05). ISP and CSP hip flexors were also found to be significantly weaker than the asymptomatic group (P<0.01). Conclusion The results revealed ROM and strength deficits in the pain-free regions of the body in unilateral CNP patients. Findings support the regional interdependence theory and emphasize the need for managing seemingly intact neighboring and more remote regions in unilateral CNP patients. Correspondence: Address correspondence to Amir Massoud Arab, Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Koodakyar Street, Daneshjoo Blvd., Evin., Postal Code: 1985713831, Tehran, Iran. E-mail: arabloo_masoud@hotmail.com Tel: (98) 21 22180039 (Office) Fax: (98) 21 22180039 Conflicts of Interest and Source of Funding: none declared The study protocol was approved by the Human Ethical Committee of the University of Social Welfare and Rehabilitation Sciences (Approval Code: IR.USWR.REC.1394.224) and the clinical trials government (NCT02789631). Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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Effects of Adding a Neurodynamic Mobilization to Motor Control Training in Patients with Lumbar Radiculopathy due to Disc Herniation: A Randomized Clinical Trial
Objective To investigate the effects of the inclusion of neural mobilization into a motor control exercise program on pain, related-disability, neuropathic symptoms, straight leg raise (SLR), and pressure pain threshold (PPT) in lumbar radiculopathy. Design A randomized clinical trial. Methods Individuals with LBP, with confirmed disc herniation, and lumbar radiculopathy were randomly assigned to receive 8 sessions of either neurodynamic mobilization plus motor control exercises (n=16) or motor control exercises alone (n=16). Outcomes included pain, disability, neuropathic symptoms, SLR, and PPT at baseline, after 4 visits, after 8 visits, and after 2-months. Results There were no between-groups differences for pain, related-disability, or PPT at any follow-up period since both groups get similar and large improvements. Patients assigned to the neurodynamic program group experienced better improvements in neuropathic symptoms and the SLR compared to the motor control exercise group (P<0.01). Conclusion The addition of neurodynamic mobilization to a motor control exercise program leads to reductions in neuropathic symptoms and mechanical sensitivity (SLR), but did not result in greater changes of pain, related-disability, or PPT over motor control exercises program alone in subjects with lumbar radiculopathy. Future trials are needed to further confirm these findings since between-groups differences did not reach clinically relevance. Address for reprint requests / corresponding author: César Fernández de las Peñas Facultad de Ciencias de la Salud Universidad Rey Juan Carlos Avenida de Atenas s/n 28922 Alcorcón, Madrid, SPAIN E-mail address: cesarfdlp@yahoo.es Disclosures: The authors have no conflicts of interest to declare. Funding: No funds were received for this study Trial registration:http://www.clinicaltrials.gov, ClinicalTrials.gov, NCT03620864 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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Case Report: Fluctuating mental status and new paradoxical left hemispatial neglect during inpatient rehabilitation for left temporo-occipital intracerebral hemorrhage with intraventricular hemorrhage
No abstract available
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A Clinical Vignette of Insidious Shoulder Pain and Weakness
No abstract available
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Neural tract injuries revealed by diffusion tensor tractography in a patient with severe heat stroke: a case report
Neurologic sequelae of heat stroke are prevalent among patients with severe heat stroke who require admission to an intensive care unit. Radiologic diagnosis of the condition is challenging because not every patient with clinical deficits shows abnormalities in computed tomography or magnetic resonance imaging. In this case review, we report a patient who had been diagnosed with a severe heat stroke and showed gait disturbance, language disorder, and cognitive impairment although conventional magnetic resonance imaging did not reveal significant findings that correlated with his symptoms. Diffusion tensor tractography has been reported to be a useful tool for evaluating the neural status of white matter tracts across a wide range of conditions. The corticospinal tract, the corticoreticular pathway, the cingulum, the fornix, the medial lemniscus, and the arcuate fasciculus of the patient were reconstructed using diffusion tensor tractography. A narrowing, discontinuation, and decreased fractional anisotropy and fiber volume of the examined neural tracts were observed, which correlated well with his symptoms. These results suggest that diffusion tensor tractography might be a useful tool for the detection of neurologic deficits even when conventional brain magnetic resonance imaging reveals no significant abnormality, and in establishing appropriate rehabilitation strategies for patients with neurologic symptoms after a heat stroke. Correspondence: Soyoung Kwak Department of Physical Medicine & Rehabilitation College of Medicine, Yeungnam University Address: 170, Hyeonchung-ro, Nam-gu, Daegu, Republic of Korea 42415 TEL: 82-53-620-4098 FAX: 82-53-620-4098 Email: soyoung.kwak@daum.net Acknowledgement This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (Ministry of Science and ICT) (2018R1C1B5046706). Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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