Comparative Analysis of Three Posterior-Only Surgical Techniques for Isthmic L5-S1 Spondylolisthesis.

Objective: To compare adults with isthmic L5-S1 spondylolisthesis who were treated with three different surgical techniques: PS-only, TS, and transforaminal lumbar interbody fusion/posterior lumbar interbody fusion (TLIF/PLIF).

Methods: This is a retrospective analysis of adults with L5-S1 isthmic spondylolisthesis (grade ≥2) who underwent primary all-posterior operations with pedicle screws. Patients were excluded if they had <1 year follow-up, anterior approaches, and trans-sacral fibular grafts.

Follistatin Protein Enhances Satellite Cell Counts in Reinnervated Muscle.

Muscle recovery following peripheral nerve repair is sup-optimal. Follistatin (FST), a potent muscle stimulant, enhances muscle size and satellite cell counts following reinnervation when administered as recombinant FST DNA via viral vectors. Local administration of recombinant FST protein, if effective, would be more clinically translatable but has yet to be investigated following muscle reinnervation.

Effects of 4-week impairment-based rehabilitation on jump-landing biomechanics in chronic ankle instability patients.

Objective: To determine effects of 4-weeks of impairment-based rehabilitation on lower extremity neuromechanics during jump-landing.

Design: Descriptive laboratory study.

Participants: Twenty-six CAI subjects (age = 21.

Effects of rehabilitation on joint-coupling in patients with chronic ankle instability.

Chronic ankle instability (CAI) is associated with kinematic changes in the lower extremity. Alterations in joint-coupling have been identified during gait in patients with CAI. Rehabilitation remains the gold-standard for clinical treatment of CAI but little is known on the effects of rehabilitation on joint-coupling variability.

The effect of body weight reduction using a lower body positive pressure treadmill on plantar pressure measures while running.

Objective: To evaluate the effects of body weight reduction at 10% intervals on pressure distribution variables across regions of the foot while running.

Study Design: Crossover Study Design.

Setting: Laboratory.

Side-to-side supercharging nerve allograft enhances neurotrophic potential.

Introduction: Critical limitations of processed acellular nerve allograft (PNA) are linked to Schwann cell function. Side-to-side bridge grafting may enhance PNA neurotrophic potential.

Methods: Sprague-Dawley rats underwent tibial nerve transection and immediate repair with 20-mm PNA (n = 33) or isograft (ISO; n = 9) or 40-mm PNA (n = 33) or ISO (n = 9).

Viral vector delivery of follistatin enhances recovery of reinnervated muscle.

Introduction: Poor recovery following nerve repair is due to progressive temporal loss of muscle function. Follistatin (FS), a glycoprotein with anabolic properties, may enhance muscle recovery following reinnervation.

Methods: Seventy-two male Sprague-Dawley rats underwent temporary (3 or 6 month) denervation or sham denervation.

Step-Down Task Identifies Differences in Ankle Biomechanics Across Functional Activities.

Currently, there is no clinical exam to evaluate ankle frontal plane kinematics. The purpose of this study was to determine whether individuals identified as "lateral" landing during a video-recorded step-down task have differences in ankle inversion as measured with 3-dimensional motion capture during walking, step-down, and jump-landing tasks compared to individuals identified as "non-lateral". Fifty-seven recreationally active adults completed the descriptive laboratory study.

Lower Extremity Biomechanics During a Drop-Vertical Jump in Participants With or Without Chronic Ankle Instability.

Context:   Chronic ankle instability (CAI) is a condition characterized by range-of-motion, neuromuscular, and postural-control deficits and subjective disability, reinjury, and posttraumatic osteoarthritis. Differences have been reported in kinematics, kinetics, surface electromyography (EMG), and ground reaction forces during functional tasks performed by those with CAI. These measures are often collected independently, and the research on collecting measures simultaneously during a movement task is limited.

Effect of Impairment-Based Rehabilitation on Lower Leg Muscle Volumes and Strength in Patients With Chronic Ankle Instability: A Preliminary Study.

Patients with chronic ankle instability (CAI) have demonstrated atrophy of foot and ankle musculature and deficits in ankle strength. The effect of rehabilitation on muscle morphology and ankle strength has not previously been investigated in patients with CAI. Our objective was to analyze the effect of impairment-based rehabilitation on intrinsic and extrinsic foot and ankle muscle volumes and strength in patients with CAI.

Variability in center of pressure position and muscle activation during walking with chronic ankle instability.

Chronic ankle instability (CAI) patients exhibit altered gait mechanics. The objective was to identify differences in stride-to-stride variability in the position of the center of pressure (COP) and muscle activity during walking between individuals with and without CAI. Participants (17 CAI;17 Healthy) walked on a treadmill at 1.

Acute lateral ankle sprain to chronic ankle instability: a pathway of dysfunction.

Lateral ankle sprains (LAS) have been reported as one of the most common musculoskeletal injuries observed in sports and in individuals who are recreationally active. Approximately 40% of individuals who sustain a LAS develop a condition known as chronic ankle instability (CAI). Years of research has identified numerous impairments associated with CAI such as decreases in range of motion (ROM), strength, postural control, and altered movement patterns during functional activities when compared to individuals with no LAS history.

Validating Center-of-Pressure Balance Measurements Using the MatScan® Pressure Mat.

Context: Measurements of center-of-pressure (COP) excursions during balance are common practice in clinical and research settings to evaluate adaptations in postural control due to pathological or environmental conditions. Traditionally measured using laboratory force plates, pressure-mat devices may be a suitable option for clinicians and scientist to measure COP excursions.

Objective: Compare COP measures and changes during balance between MatScan® pressure mat and force plate.

Gait training for chronic ankle instability improves neuromechanics during walking.

A novel gait-training device has been shown to improve gait patterns while patients with chronic ankle instability (CAI) are using the device and our current objective was to analyze the effect of structured gait training with the device on plantar pressure and surface electromyography (sEMG) following repeated gait training sessions. Sixteen CAI patients participated. Plantar pressure and sEMG were collected simultaneously during walking pre- and post-gait training.

Relationship between ankle frontal plane kinematics during different functional tasks.

Increased inversion following lateral ankle sprain and in patients with chronic ankle instability (CAI) is thought to contribute to recurrent injury and feelings of instability, however, there are no biomechanic assessment tools readily available to evaluate for excessive inversion prior to or following lateral ankle sprains. Before establishing a clinically useful biomechanic assessment tool, it is important to understand whether there is a relationship in the extent of ankle frontal plane motion across various tasks to help determine if one task or a combination of tasks would be most appropriate when evaluating patients. The purpose of this preliminary study was to analyze the relationship between ankle frontal plane kinematics during walking, step-down, and jump-landing tasks.

Does partial muscle reinnervation preserve future re-innervation potential?

Introduction: Late revision nerve surgery for incomplete motor recovery due to partial reinnervation would improve muscle function if all muscle fibers were protected from developing denervation atrophy.

Methods: Sixty immature Sprague-Dawley rats underwent the following tibial nerve manipulations (n = 15/group): group A, partial denervation (two thirds of nerve resected and the remaining one third crushed), revision repair at 8 months; group B, partial denervation; group C, complete denervation, immediate reconstruction; group D, complete denervation, reconstruction at 8 months; and group E, control. Final testing at 11 months included muscle force, weight, and histology.

CLINICAL COMMENTARY ON MIDFOOT AND FOREFOOT INVOLVEMENT IN LATERAL ANKLE SPRAINS AND CHRONIC ANKLE INSTABILITY. PART 2: CLINICAL CONSIDERATIONS.

Lateral ankle sprains (LAS) and chronic ankle instability (CAI) are common musculoskeletal injuries that are a result of inversion injury during sport. The midfoot and forefoot is frequently injured during a LAS, is often overlooked during clinical examination, and maybe contributory to the development of CAI. The purpose of part two of this clinical commentary and current concept review is to increase clinician's awareness of the contribution of midfoot and forefoot impairment to functional limitation and disability of individuals who experience LAS and CAI and to facilitate future research in this area.

MIDFOOT AND FOREFOOT INVOLVEMENT IN LATERAL ANKLE SPRAINS AND CHRONIC ANKLE INSTABILITY. PART 1: ANATOMY AND BIOMECHANICS.

Unlabelled: The modern human foot is the culmination of more than five million years of evolution. The ankle-foot complex absorbs forces during loading, accommodates uneven surfaces, and acts as a lever for efficient propulsion. The ankle-foot complex has six independent functional segments that should be understood for proper assessment and treatment of foot and ankle injuries: the shank, rearfoot, midfoot, lateral forefoot, and the medial forefoot.

Intrinsic Foot Muscle Activation During Specific Exercises: A T2 Time Magnetic Resonance Imaging Study.

Context: The intrinsic foot muscles maintain the medial longitudinal arch and aid in force distribution and postural control during gait. Impaired intrinsic foot-muscle function has been linked to various foot conditions. Several rehabilitative exercises have been proposed to improve it; however, literature that identifies which individual muscles are activated during specific intrinsic foot-muscle exercises is lacking.

Surgical treatment of Lenke 5 adolescent idiopathic scoliosis: Comparison of anterior vs posterior approach.

Aim: To compare the posterior vs anterior approaches for fusion of Lenke 5 adolescent idiopathic scoliosis curves, matched for curve magnitude and for the distal level of fixation (dLOF) standardized to the third lumbar vertebrae (L3).

Methods: A prospectively collected multicenter database was used for this retrospective comparative study. Our dependent variables included sagittal and coronal radiographic measurements, number of fused vertebrae, estimated blood loss, length of hospitalization and SRS total and individual domain scores at the two-year follow-up.

Diminished Foot and Ankle Muscle Volumes in Young Adults With Chronic Ankle Instability.

Background: Patients with chronic ankle instability (CAI) have demonstrated altered neuromuscular function and decreased muscle strength when compared with healthy counterparts without a history of ankle sprain. Up to this point, muscle volumes have not been analyzed in patients with CAI to determine whether deficits in muscle size are present following recurrent sprain.

Purpose: To analyze intrinsic and extrinsic foot and ankle muscle volumes and 4-way ankle strength in young adults with and without CAI.

Effects of ankle destabilization devices and rehabilitation on gait biomechanics in chronic ankle instability patients: A randomized controlled trial.

Unlabelled: Patients with chronic ankle instability (CAI) have altered gait patterns, which are characterized by increased inversion positioning during gait. Ankle destabilization devices increase peroneus longus muscle activation during gait, which may increase eversion.

Objective: To determine whether incorporating destabilization devices into a 4-week impairment-based rehabilitation program has beneficial effects on gait biomechanics and surface electromyography (sEMG) compared to impairment-based rehabilitation without destabilization devices in CAI patients.

Surface electromyography and plantar pressure changes with novel gait training device in participants with chronic ankle instability.

Background: Rehabilitation is ineffective at restoring normal gait in chronic ankle instability patients. Our purpose was to determine if a novel gait-training device could decrease plantar pressure on the lateral column of the foot in chronic ankle instability patients.

Methods: Ten chronic ankle instability patients completed 30s trials of baseline and gait-training walking at a self-selected pace while in-shoe plantar pressure and surface electromyography were recorded from their anterior tibialis, peroneus longus, medial gastrocnemius, and gluteus medius.

Current Trends in the Management of Lateral Ankle Sprain in the United States.

Objective: To characterize trends in the acute management (within 30 days) after lateral ankle sprain (LAS) in the United States.

Design: Descriptive epidemiology study.

Patients: Of note, 825 718 ankle sprain patients were identified; 96.

Patterns of congenital bony spinal deformity and associated neural anomalies on X-ray and magnetic resonance imaging.

Purpose: Congenital malformations of the bony vertebral column are often accompanied by spinal cord anomalies; these observations have been reinforced with the use of magnetic resonance imaging (MRI). We hypothesized that the incidence of cord anomalies will increase as the number and complexity of bony vertebral abnormalities increases.

Methods: All patients aged ≤13 years (n = 75) presenting to the pediatric spine clinic from 2003-2013 with congenital bony spinal deformity and both radiographs and MRI were analyzed retrospectively for bone and neural pathology.