Quantitative characterization of regenerating axons after end-to-side and end-to-end coaptation in a rat brachial plexus model: a retrograde tracer study.

The efficacy of end-to-side repair as a method of nerve reconstruction has been questioned, and most studies that characterize the mode of re-innervation are marred by inappropriate experimental design and lack quantitative analysis. This makes characterization of re-innervating neurons confusing and consequently controversy remains as to the extent and source of reinnervating axons. In an experimental brachial plexus rat model, we transected the musculocutaneous nerve, labeled its neuron pool with Fast-Blue and joined the distal stump to the side of the intact ulnar nerve, or to the proximal stump of the divided ulnar nerve, to characterize neurons that reinnervate the recipient nerve.

Hand-held dynamometry for muscle strength measurement in children with cerebral palsy.

The aim of this study was to investigate the reliability of hand-held dynamometry for measuring isometric lower-limb muscle strength in children with cerebral palsy (CP). Twenty-three children (14 males, nine females) with CP (spastic diplegia; Gross Motor Function Classification System Levels I-III) aged 5 years 7 months to 14 years 5 months (mean 9 y 6 mo [SD 2 y 8 mo]) attended two test sessions 1 week apart. A 'make' test, using a gradual build-up of force to a maximum isometric contraction, was employed and peak values were normalized to body weight for analyses.

Severe lactic acidosis and rhabdomyolysis following metformin and ramipril overdose.

We report the case of a 46-yr-old male who developed severe lactic acidosis, cardiorespiratory arrest, and rhabdomyolysis following an overdose of metformin and ramipril. The lactic acidosis was successfully treated with early high-volume continuous veno-venous haemofiltration. Rhabdomyolysis and lower limb compartment syndrome developed later.

Comparison of visual and objective quantification of elbow and shoulder movement in children with obstetric brachial plexus palsy.

Background: The Active Movement Scale is a frequently used outcome measure for children with obstetric brachial plexus palsy (OBPP). Clinicians observe upper limb movements while the child is playing and quantify them on an 8 point scale. This scale has acceptable reliability however it is not known whether it accurately depicts the movements observed.

Correction of severe crouch gait in patients with spastic diplegia with use of multilevel orthopaedic surgery.

Background: Severe crouch gait in patients with spastic diplegia causes excessive loading of the patellofemoral joint and may result in anterior knee pain, gait deterioration, and progressive loss of function. Multilevel orthopaedic surgery has been used to correct severe crouch gait, but no cohort studies or long-term results have been reported, to our knowledge.

Methods: In order to be eligible for the present retrospective cohort study, a patient had to have a severe crouch gait, as defined by sagittal plane kinematic data, that had been treated with multilevel orthopaedic surgery as well as a complete clinical, radiographic, and instrumented gait analysis assessment.

Gait and balance impairment in early multiple sclerosis in the absence of clinical disability.

This study evaluated the gait and balance performance of two clinically distinct groups of recently diagnosed and minimally impaired multiple sclerosis (MS) patients (Expanded Disability Status Scale range 0-2.5), compared to control subjects. Ten MS patients with mild pyramidal signs (Pyramidal Functional Systems 1.

Reliability of the V-scope system in the measurement of arm movement in children with obstetric brachial plexus palsy.

This study reports on a novel methodology using the V-scope to quantify elbow and shoulder movement in young children with obstetric brachial plexus palsy (OBPP), and the intra- and interreliability of this method. The V-scope, a portable, inexpensive movement analysis system, was configured in an L-shape, with two transmitting towers placed on the floor and one 1.35m off the ground.

Functional effects of intramembranous proline substitutions in the staphylococcal multidrug transporter QacA.

The QacA multidrug transporter is encoded on Staphylococcus aureus multidrug resistance plasmids and confers broad-range antimicrobial resistance to more than 30 monovalent and bivalent lipophilic, cationic compounds from at least 12 different chemical classes. QacA contains 10 proline residues predicted to be within transmembrane regions, several of which are conserved in related export proteins. Proline residues are classically known as helix-breakers and are highly represented within the transmembrane helices of membrane transport proteins, where they can mediate the formation of structures essential for protein stability and transport function.

EphA4 regulates central nervous system vascular formation.

Molecules involved in axon guidance have recently also been shown to play a role in blood vessel guidance. To examine whether axon guidance molecules, such as the EphA4 receptor tyrosine kinase, might also play a role in development of the central nervous system (CNS) vasculature and repair following CNS injury, we examined wild-type and EphA4 null mutant (-/-) mice. EphA4-/- mice exhibited an abnormal CNS vascular structure in both the cerebral cortex and the spinal cord, with disorganized branching and a 30% smaller diameter.

Telerehabilitation in spinal cord injury persons: a novel approach.

The care of a spinal cord injury (SCI) person constitutes a great challenge for the provider: SCI persons are mobility impaired, and they are prone to develop multiple comorbidities such as diabetes mellitus, hypertension, obesity, bladder infections, wounds, and depression. Furthermore, disease manifestations can be misleading depending on the level of injury. The utilization of telemedicine to monitor patients and deliver care has opened a new horizon for SCI persons.

Seek first to understand--a foray into research.

Unlabelled: PHCRED funds a number of 'research clinicians' who choose a project to research for a year. This article explores one researcher's perspective of the transition from clinician to researcher, including motivation for researching, challenges of research and hopes for research.

Conclusion: research is engrossing, frustrating and exciting.

Local influence in comparative calibration models under elliptical t-distributions.

In this paper we consider applications of local influence (Cook, 1986) to evaluate small perturbations in the model or data set in the context of structural comparative calibration (Bolfarine and Galea, 1995) assuming that the measurements obtained follow a multivariate elliptical distribution. Different perturbation schemes are investigated and an application is considered to a real data set, using the elliptical t-distribution.

Reliability of pelvic floor muscle strength assessment using different test positions and tools.

Aims: The aims of this study were to determine the intra-therapist reliability for digital muscle testing and vaginal manometry on maximum voluntary contraction strength and endurance. In addition, we assessed how reliability varied with different tools and different testing positions.

Methods: Subjects included 20 female physiotherapists.

Sagittal spine and lower limb movement during sit-to-stand in healthy young subjects.

This study aimed to determine the sagittal movement relationships between thoracic, lumbar spine and hip joints during sit-to-stand (STS). Forty-seven healthy young adults were videotaped performing STS at their preferred speed from a chair set at 100% knee height. Forward trunk lean prior to buttock lift-off (LO) was accomplished by concurrent lumbar and hip flexion (1:3).

Effect of test position on pelvic floor muscle assessment.

The aims of this study were to analyse the effect of different body positions on pelvic floor muscle (PFM) assessment using digital muscle testing, manometry and transabdominal ultrasound. In addition, subject acceptance of each testing position was recorded. Subjects were 20 women's health physiotherapists.

Investigation of transabdominal real-time ultrasound to visualise the muscles of the pelvic floor.

Clinical measurement of pelvic floor muscle activity commonly involves techniques that are both physically and psychologically invasive. This study investigated transabdominal application of ultrasound to measure pelvic floor muscle action. The specific aims were to establish the face validity of ultrasound measures of displacement of the posterior bladder wall as a reflection of pelvic floor muscle contraction, and the reliability of measurement between raters and between testing occasions.

Investigation of the timed 'up & go' test in children.

The timed 'Up & Go' test (TUG) is a test of basic or functional mobility in adults which has rarely been used in children. Functional mobility was defined for this study as an individual's ability to manoeuvre his or her body capably and independently to accomplish everyday tasks. Reliability and validity of TUG scores were examined in 176 children without physical disabilities (94 males, 82 females; mean age 5y 9mo [SD 1y 8mo]; range 3 to 9y) and in 41 young people with physical disabilities due to cerebral palsy or spina bifida (20 males, 21 females; mean age 8y 11mo [SD 4y 3mo], range 3 to 19y).

Survey of clinical practice: pre- and postoperative physiotherapy for pelvic surgery.

Background: The objective of this survey was to obtain information about current physiotherapy practice for patients undergoing pelvic surgery. The aims were to evaluate whether differences exist in service provision between women's health physiotherapists (WHPTs) and hospital physiotherapists (HPTs) and in the guidelines used by physiotherapists to direct their service delivery. METHODS.

Axonal regeneration and lack of astrocytic gliosis in EphA4-deficient mice.

Spinal cord injury usually results in permanent paralysis because of lack of regrowth of damaged neurons. Here we demonstrate that adult mice lacking EphA4 (-/-), a molecule essential for correct guidance of spinal cord axons during development, exhibit axonal regeneration and functional recovery after spinal cord hemisection. Anterograde and retrograde tracing showed that axons from multiple pathways, including corticospinal and rubrospinal tracts, crossed the lesion site.

Segmental degeneration in the cervical spine and associated changes in dorsal root ganglia.

Degenerative change in cervical segments C5-C7 was documented to determine whether osteo-ligamentous adaptations were age-related. In addition, companion morphological studies were carried out to determine whether parallel changes occurred in related soft tissues, including DRG. Independent of the provoking stimulus, aberrant soft tissue change may be expected with segmental degeneration.

Sagittal gait patterns in spastic diplegia.

Classifications of gait patterns in spastic diplegia have been either qualitative, based on clinical recognition, or quantitative, based on cluster analysis of kinematic data. Qualitative classifications have been much more widely used but concerns have been raised about the validity of classifications, which are not based on quantitative data. We have carried out a cross-sectional study of 187 children with spastic diplegia who attended our gait laboratory and devised a simple classification of sagittal gait patterns based on a combination of pattern recognition and kinematic data.

Uptime as a measure of recovery in children postappendectomy.

Purpose: The aim of this study was to objectively measure recovery time after open and laparoscopic appendectomy using an activity monitor (PAL 1).

Methods: The PAL 1 records the amount of time that the subject is upright (uptime). Children wore the PAL 1 for 10 days continuously, beginning within the first 48 hours postoperatively.