The relationship between walking speed, step parameters, and margins of stability in individuals after stroke.

Background: Individuals after stroke walk with different step parameters and consequently with different margins of stability compared to able-bodied peers. These differences might be a side effect of lower preferred walking speeds or primary limitations in regulating step parameters and margins of stability after stroke.

Methods: Twenty-eight individuals after stroke (separated into more impaired and less impaired based on speed) and fourteen able-bodied peers completed five walking trials on an instrumented treadmill at 70 %, 85 %, 100 %, 115 %, and 130 % of their preferred speed.

Clinical indications and protocol considerations for selecting initial body weight support levels in gait rehabilitation: a systematic review.

Background: Body weight support (BWS) training devices are frequently used to improve gait in individuals with neurological impairments, but guidance in selecting an appropriate level of BWS is limited. Here, we aim to describe the initial BWS levels used during gait training, the rationale for this selection and the clinical goals aligned with BWS training for different diagnoses.

Method: A systematic literature search was conducted in PubMed, Embase and Web of Science, including terms related to the population (individuals with neurological disorders), intervention (BWS training) and outcome (gait).

Fatigue-related gait adaptations in children with cerebral palsy.

Aim: To obtain insights into the effects of fatigue on the kinematics, kinetics, and energy cost of walking (ECoW) in children with cerebral palsy (CP).

Method: In this prospective observational study, 12 children with CP (mean age 12 years 9 months, SD 2 years 7 months; four females, eight males) and 15 typically developing children (mean age 10 years 8 months, SD 2 years 4 months; seven females, eight males) followed a prolonged intensity-based walking protocol on an instrumented treadmill, combined with gas analysis measurements. The protocol consisted of consecutive stages, including a 6-minute walking exercise (6MW) at comfortable speed, 2 minutes of moderate-intensity walking (MIW) (with a heart rate > 70% of its predicted maximal), and 4 minutes walking after MIW.

The effect of prolonged walking on muscle fatigue and neuromuscular control in children with cerebral palsy.

Background: Muscle fatigue of the lower limbs is considered a main contributor to the perceived fatigue in children with cerebral palsy (CP) and is expected to occur during prolonged walking. In adults without disabilities, muscle fatigue has been proposed to be associated with adaptations in complexity of neuromuscular control.

Research Question: What are the effects of prolonged walking on signs of muscle fatigue and complexity of neuromuscular control in children with CP?

Methods: Ten children with CP and fifteen typically developing (TD) children performed a standardised protocol on an instrumented treadmill consisting of three stages: six-minutes walking at preferred speed (6 MW), moderate-intensity walking (MIW, with two minutes at heart rate > 70% of predicted maximal heart rate) and four-minutes walking at preferred speed (post-MIW).

General estimates of the energy cost of walking in people with different levels and causes of lower-limb amputation: a systematic review and meta-analysis.

Background: Energy cost of walking (ECw) is an important determinant of walking ability in people with a lower-limb amputation. Large variety in estimates of ECw has been reported, likely because of the heterogeneity of this population in terms of level and cause of amputation and walking speed.

Objectives: To assess (1) differences in ECw between people with and without a lower-limb amputation, and between people with different levels and causes of amputation, and (2) the association between ECw and walking speed.

Rapid telehealth implementation into an otolaryngology practice during the COVID-19 pandemic.

Objective: Report outcomes of rapid implementation of telehealth across an academic otolaryngology-head and neck surgery department during the COVID-19 pandemic.

Methods: This is a retrospective, single-institution study of rapid deployment of telehealth during the COVID-19 pandemic. Characteristics of patients were compared between those who agreed and those who declined telehealth care.

Development and Assessment of an Otolaryngology-Specific Surgical Priority Scoring System.

Objective: To develop and assess an otolaryngology-specific surgical priority scoring system that incorporates varying levels of mucosal involvement.

Study Design: Retrospective cohort.

Setting: Academic medical center.

Advanced pneumatic compression for treatment of lymphedema of the head and neck: a randomized wait-list controlled trial.

Purpose: Lymphedema associated with head and neck cancer (HNC) therapy causes adverse clinical outcomes. Standard treatment includes professionally administered complete decongestive therapy (CDT). Cost and availability of trained therapists are known barriers to therapy.

Indications for Surgical Repair of Type 1 Laryngeal Cleft.

Objectives: Type 1 laryngeal cleft (T1LC) is a congenital deficiency in the posterior glottis, resulting in a communication between the hypopharynx and glottis. No consensus treatment paradigm exists for timing and criteria for patient selection for surgical repair. Our goal is to assess whether patient characteristics can help predict improvement after surgery.

Gastric volvulus complication in an infant with undiagnosed congenital diaphragmatic hernia presenting with acute respiratory distress.

Introduction: Congenital diaphragmatic hernia is an embryologic defect that creates a passage for herniation of abdominal structures into the thoracic cavity. This can lead to a variety of complications, including gastric volvulus that can present acutely with epigastric distention and vomiting. In cases of late-onset congenital diaphragmatic hernia, symptoms may be vague and often necessitate further investigation.

The prevalence of diabetes in a series of patients with subglottic stenosis.

Diabetes, which is present in 4 to 8% of adults in the United States, is a risk factor for surgical failure in laryngotracheal airway operations. We conducted a retrospective study to characterize a population of patients with subglottic stenosis-including the prevalence of diabetes, which has not been widely reported. We performed a retrospective chart review of 30 patients--22 women and 8 men, aged 17 to 77 years (mean: 47.

Perceptual voice analysis of patients with subglottic stenosis.

Objectives: To characterize the perceptual assessment of vocal quality in subglottic stenosis (SGS) patients and to identify risk factors for dysphonia.

Study Design And Setting: Retrospective review, academic center.

Methods: Perceptual voice assessment using GRBAS scale (Grade, Roughness, Breathiness, Asthenia, Strain); patient characteristics determined for 31 SGS cases.

Association of airway abnormalities and risk factors in 37 subglottic stenosis patients.

Objectives: The study objective is to characterize the airway abnormalities in a series of patients with subglottic stenosis (SGS) as they relate to etiology and risk factors.

Study Design And Setting: Retrospective review, academic medical center. Airway characteristics, patient demographics, and suspected risk factors were recorded from a database of SGS cases from 2001 to 2004.

Mitomycin-c application in airway stenosis surgery: analysis of safety and costs.

Objective: This study describes a large series of patients receiving topical mitomycin-c (MMC) during airway surgery, including complications, and carries out a cost analysis for its use in laryngotracheal stenosis.

Study Design And Setting: Retrospective review, tertiary center. Airway patients receiving MMC are reviewed for demographics, stenosis characteristics, and MMC usage.

Maxillary osteoplastic flap technique for the treatment of pediatric pterygopalatine fossa neoplasms.

Pterygoid fossa neoplasms in children are rare. Management of these neoplasms has been challenging because of tumor vascularity, difficult surgical access and complex anatomy from which these tumors arise. Surgical approach depends upon tumor extension and ability to obtain adequate exposure for successful tumor excision.

Magnetic resonance imaging of the levator veli palatini muscle before and after primary palatoplasty.

Objective: To explore the application of magnetic resonance imaging (MRI) in the evaluation of patients with cleft palate before and after primary palatoplasty with particular attention focused on the levator veli palatini muscle.

Design: Prospective study using MRIs of subjects before and after primary cleft palate surgery.

Setting: Hospital and university based.

Laryngocele resection by combined external and endoscopic laser approach.

Options in the management of laryngoceles include observation, endoscopic resection, and resection via an external approach. We introduce a combined endoscopic and external approach that we have employed on several occasions to ensure complete removal of the laryngocele and the saccule from which it originated. A case is presented to help define the technique.

Magnetic resonance imaging of the levator veli palatini muscle during speech.

Objective: To obtain detailed anatomic information on the levator veli palatini (LVP) muscle from magnetic resonance imaging (MRI). Quantitative measures of the configuration of the LVP muscle at rest and during speech activities were obtained.

Design: Prospective study using MRI of adult subjects with normal velopharyngeal mechanisms to determine anatomic and physiologic parameters of the levator muscle.

Magnetic resonance imaging in the evaluation of occult submucous cleft palate.

Objective: To explore the application of magnetic resonance imaging (MRI) in the evaluation of patients with occult submucous cleft palate and to use the MRI information obtained to aid in the treatment decision to perform surgery versus behavioral speech therapy.

Design: Prospective study with magnetic resonance (MR) images of subjects suspected of having occult submucous cleft palate.

Setting: Hospital and university-based.

Ultrasonic quantification of geniohyoid cross-sectional area and tissue composition: a preliminary study of age and radiation effects.

Background: This study developed and used a new, noninvasive approach to quantify cross-sectional area and tissue composition within the geniohyoid (GH) muscle in normal adults and head and neck cancer patients.

Methods: B-mode ultrasound was used to measure GH cross-sectional area at rest and during four speech gestures and GH tissue composition at rest in normal young adults, patients with SCC head and neck cancer treated with primary radiotherapy, and normal older adults age matched with the patients.

Results: Patients exhibited significantly greater GH cross-sectional area than young subjects at rest and in effortful conditions.

Respiratory and acoustic signals associated with bolus passage during swallowing.

In order to advance our understanding of the relation between respiration and deglutition, simultaneous videofluoroscopy and respirodeglutometry was performed. Fifteen normal, healthy, young adults (20-29 years of age) were connected to a respirodeglutometer and positioned for simultaneous videofluoroscopic assessment in the lateral plane. Subjects performed three swallows each of a 5-ml and a 10-ml bolus of liquid barium and a 5-ml bolus of paste barium, for a total of nine swallows per subject.

A quantitative histologic study of the normal human adult soft palate.

This study was designed to re-examine the same soft palates studied qualitatively in a previous investigation (Kuehn and Kahane, 1990), using a true-color image analysis system. The quantified measures of the areas of specific tissue types are reported. The results indicate that: (a) tendinous tissue is prominent anteriorly and comprises about 10% of total tissue in that region, (b) the relative proportion of glandular and connective tissue is fairly uniform across the length of the soft palate, averaging 22% and 36% respectively, (c) muscle tissue shows a pattern of increasing then decreasing amount from anterior to posterior with a maximum proportion of 23% in the midportion of the soft palate, (d) adipose tissue comprises 22% of total tissue area in the anterior segment and 17% of total tissue area in the posterior segment of the soft palate, (e) other tissue, primarily epithelium and vascular tissue, was found to be fairly constant anteriorly and increased in relative proportion to almost 30% of the total tissue area at the uvular base.