Study protocol for a randomised controlled trial to determine the efficacy of an intensive seated postural intervention delivered with robotic and rigid trunk support systems.

Introduction: Children with cerebral palsy (CP) classified as gross motor function classification system (GMFCS) levels III-IV demonstrate impaired sitting and reaching control abilities that hamper their overall functional performance. Yet, efficacious interventions for improving sitting-related activities are scarce. We recently designed a motor learning-based intervention delivered with a robotic Trunk-Support-Trainer (TruST-intervention), in which we apply force field technology to individualise sitting balance support.

Promoting Functional and Independent Sitting in Children With Cerebral Palsy Using the Robotic Trunk Support Trainer.

Seated postural abilities are critical to functional independence and participation in children with cerebral palsy, Gross Motor Functional Classification System (GMFCS) levels III-IV. In this proof-of-concept study, we investigated the feasibility of a motor learning-based seated postural training with a robotic Trunk-Support-Trainer (TruST) in a longitudinal single-subject-design (13y, GMFCS IV), and its potential effectiveness in a group of 3 children (6-14y, GMFCS III-IV). TruST is a motorized-cable driven belt placed on the child's trunk to exert active-assistive forces when the trunk moves beyond stability limits.

Symptomatic cervical spinal stenosis in spastic cerebral palsy.

Aim: To describe the prevalence of symptomatic cervical spinal stenosis (CSS) in spastic cerebral palsy (CP) and associated characteristics.

Method: This cross-sectional study of adults (>18y) with CP (2006-2016) at a single institution compared the patient characteristics (demographics, comorbidities, surgical history, medications, Gross Motor Function Classification System [GMFCS] level, and CP type) of patients with and without CSS.

Results: Of 424 patients (mean age 33y 4mo, SD 13y 6mo, range 18-78y; 225 females, 199 males), 32 patients (7.

The Seated Postural & Reaching Control Test in Cerebral Palsy: A Validation Study.

Children with moderate-severe cerebral palsy (CP) show postural control deficits that affect their daily activities, like reaching. The Seated Postural and Reaching Control test (SP&R-co) was developed to address the need for clinical measures that objectively identify dimensions of postural imbalance and corresponding reaching limitations in children with CP. SP&R-co documentation was designed for test validity and rater training.

Reduction in upper-extremity tone after lumbar selective dorsal rhizotomy in children with spastic cerebral palsy.

Object: Randomized clinical trials have established that lumbar selective dorsal rhizotomy (SDR) reduces lower-extremity tone and improves functional outcome in children with spastic cerebral palsy. Significant data exist to support a secondary effect on upper-extremity function in patients with upper-extremity spasticity. The effects of SDR on upper-extremity tone, however, are not well characterized.

Gamma irradiation of HIV-1.

The potential for transmission of human immunodeficiency virus (HIV) type 1 has created serious concern for the continued clinical use of bone and soft-tissue allografts. Tissue banks have employed 1.5-2.

An anatomical basis for the degree of displacement of the distal chevron osteotomy in the treatment of hallux valgus.

The purpose of this study was to define the amount of lateral displacement of the chevron osteotomy to obtain a 50% displacement of the capital fragment. While mathematical analyses exist to predict the degree of correction of the intermetartarsal 1-2 angle with a distal metatarsal osteotomy, no guidelines exist regarding the degree of displacement (translation) that allows sufficient bone contact to enhance union and maintain stability of the osteotomy. We have addressed this concern based on anatomical parameters.

A case of germinal center formation by CD45RO T and CD20 B lymphocytes in rheumatoid arthritic subchondral bone: proposal for a two-compartment model of immune-mediated disease with implications for immunotherapeutic strategies.

In rheumatoid arthritis (RA) disease activity occurring as joint destruction of cartilage and bone is thought to be driven by inflammatory reactions which are initiated by exogenous microbial mechanisms and perpetuated by endogenous autoimmune mechanisms. According to the synovial model of RA, these reactions originate in the adjacent synovial tissues. The following set of observations is presented herein to suggest an alternate model involving subchondral bone.

Comparison of antibiotic release from polymethylmethacrylate beads and sponge collagen.

The rates of elution of tobramycin in vitro were compared for polymethylmethacrylate beads impregnated with the powder form and an alternative biodegradable substance, sponge collagen. The impregnated polymethylmethacrylate beads initially had a lower zone of inhibition, but the rate of release was slow in comparison with that of the impregnated sponge collagen. The sponge collagen delivered a higher dose faster and with a shorter duration than the polymethylmethacrylate beads with the same antibiotic concentration in vitro, but the beads delivered a therapeutic concentration for longer periods.

Prediction of angular deformity and leg-length discrepancy after anterior cruciate ligament reconstruction in skeletally immature patients.

Injuries to the anterior cruciate ligament (ACL) in young children and adolescents are becoming more common as more youngsters participate in organized sports. The dilemma for the orthopaedic surgeon is that untreated ACL ruptures may result in meniscal damage and joint degeneration, whereas surgical treatment may result in physeal arrest, with shortening and angular deformity. To help determine the appropriate timing for ACL repair in skeletally immature patients, graphs have been developed to predict the amount of shortening and angular deformity to expect after repair.

Leg length discrepancy associated with vivid cutis marmorata.

Cutis marmorata telangiectatica congenita (CMTC), a rare benign condition usually present at birth, is characterized by areas of cutaneous marbling that often become more pronounced with low temperatures. The skin lesions typically become less prominent with age, but may be associated with a variety of abnormalities. Reported are three patients with vivid cutis marmorata who had leg length discrepancies (LLD) which, unlike most limb discrepancies caused by vascular malformations, involved relative growth retardation of the affected leg.

Effect of fetal thyroid hormone (RT3) on sarcoma cells in culture.

Fetal thyroid hormone (RT3) is considered metabolically inactive and is present in high concentration in fetuses and in some patients with end-stage malignant disease. In a virus-induced erythroleukemia cell model, RT3 was found to stimulate the growth of the erythroleukemia cells in culture. The focus of this research was to test the effect of RT3, at several concentrations, on the growth of naturally occurring human sarcomas in cell culture.

The Chevron bunionectomy: a trigonometric analysis to predict correction.

A trigonometric analysis was developed in an attempt to predict the postoperative hallux valgus angles and intermetatarsal angles after Chevron bunionectomy. This analysis was used in 20 feet to predict postoperative angles, and these predicted values were compared with actual measured roentgenographic values. The postoperative intermetatarsal angles were evaluated to determine their correction to postoperative hallux valgus angles of 20 degrees or less.

Tissue distribution of 125I-labeled fetal thyroid hormone in nude mice xenografted with Ewing sarcoma.

Biodistribution of fetal thyroid hormone (RT3) was studied in nude mice with Ewing's sarcoma xenografts. At 30 min and 1, 2, 4, 8, and 12 hr after injection, blood, tumor and normal organs were measured to determine the amount of radioactivity per gram of tissue. The amount of radioactivity in the blood of tumor-bearing mice decreased sharply from 7.

Neurologic complications after K-wire fixation of supracondylar humerus fractures in children.

A retrospective review of 143 supracondylar humerus fractures in children treated with K-wire fixation disclosed four neurologic complications after treatment. There were two late ulnar neuropraxias. One ulnar nerve injury and one radial nerve injury resulted from direct trauma during insertion of a K-wire.

Radiation exposure to patients receiving routine scoliosis radiography measured at depth in an anthropomorphic phantom.

Concern about the amount of radiation received during scoliosis evaluation and treatment led us to measure radiation exposure in an anthropomorphic phantom to determine the increased risk of breast cancer in young women with scoliosis. Assuming that 22 radiographic examinations were performed over the course of scoliosis treatment, the increased relative risk of breast cancer was determined to be 0.22% in these patients.

Fracture-dislocation of the articular surface of the third metatarsal head.

Fracture of the metatarsal head is uncommon, and reports are rare of isolated osteochondral fracture of the articular surface of the metatarsal head, as occurred in the 18-year-old man reported here. Good results were obtained with closed reduction by manipulation and traction, followed by cast immobilization for 6 weeks.