1
|
Gao JY, Duan YS, Zheng JQ, Wang QY, Li CL, Xu J. Perioperative position management of 46 cases with simultaneous bilateral auricle reconstruction: A summary of experience. Int J Pediatr Otorhinolaryngol 2024; 179:111905. [PMID: 38493660 DOI: 10.1016/j.ijporl.2024.111905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/01/2023] [Accepted: 02/27/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES The primary problem in simultaneous bilateral auricle reconstruction is the fragility of the reconstructed ear structure. Postoperative pressure is strictly prohibited to ensure the operation's effectiveness. The study aimed to summarize the experience of perioperative postural management in simultaneous bilateral auricular reconstruction. METHOD This study summarizes the experience of perioperative postural management, providing preoperative sleeping posture adaptability training, neck movement training, standardization of the head position angles and the head suspension time in surgery, using protective headrests, paying attention to the transfer and handover procedures, and using specially designed pillows. RESULTS The comprehensive nursing approach in simultaneous bilateral auricular reconstruction significantly reduced complications, improved patient comfort, and optimized postoperative adaptation. Preoperative posture training, standardized intraoperative head positions, and vigilant postoperative care played pivotal roles, demonstrating positive outcomes in 46 cases. DISCUSSION Perioperative position management can reduce the risk of complications and pressure injuries, improving patients' postoperative comfort, emotional state, tolerance, and adaptability. CONCLUSION All ears were viable and in good shape after long-term follow-up. The experiences discussed in this study can be broadly applied to technically mature ear reconstruction teams.
Collapse
Affiliation(s)
- Jia-Ying Gao
- Department of Nursing, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Ya-Shan Duan
- ENT Institute, Eye & ENT Hospital, Fudan University, Shanghai, China; Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Jie-Qing Zheng
- Department of Nursing, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Qian-Ying Wang
- Department of Nursing, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Chen-Long Li
- ENT Institute, Eye & ENT Hospital, Fudan University, Shanghai, China; Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China.
| | - Jing Xu
- Department of Nursing, Eye & ENT Hospital, Fudan University, Shanghai, China.
| |
Collapse
|
2
|
Suslov VM, Lieberman LN, Carlier PG, Ponomarenko GN, Ivanov DO, Rudenko DI, Suslova GA, Adulas EI. Efficacy and safety of hydrokinesitherapy in patients with dystrophinopathy. Front Neurol 2023; 14:1230770. [PMID: 37564736 PMCID: PMC10410449 DOI: 10.3389/fneur.2023.1230770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/05/2023] [Indexed: 08/12/2023] Open
Abstract
Duchenne muscular dystrophy (DMD) is one of the most common forms of hereditary muscular dystrophies in childhood and is characterized by steady progression and early disability. It is known that physical therapy can slow down the rate of progression of the disease. According to global recommendations, pool exercises, along with stretching, are preferable for children with DMD, as these types of activities have a balanced effect on skeletal muscles and allow simultaneous breathing exercises. The present study aimed to evaluate the effectiveness of regular pool exercises in patients with Duchenne muscular dystrophy who are capable of independent movement during 4 months of training. 28 patients with genetically confirmed Duchenne muscular dystrophy, who were aged 6.9 ± 0.2 years, were examined. A 6-min distance walking test and timed tests, namely, rising from the floor, 10-meter running, and stair climbing and descending, muscle strength of the upper and lower extremities were assessed on the baseline and during dynamic observation at 2 and 4 months. Hydrorehabilitation course lasted 4 months and was divided into two stages: preparatory and training (depend on individual functional heart reserve (IFHR)). Set of exercises included pool dynamic aerobic exercises. Quantitative muscle MRI of the pelvic girdle and thigh was performed six times: before training (further BT) and after training (further AT) during all course. According to the results of the study, a statistically significant improvement was identified in a 6-min walking test, with 462.7 ± 6.2 m on the baseline and 492.0 ± 6.4 m after 4 months (p < 0.001). The results from the timed functional tests were as follows: rising from the floor test, 4.5 ± 0.3 s on the baseline and 3.8 ± 0.2 s after 4 months (p < 0.001); 10 meter distance running test, 4.9 ± 0.1 s on the baseline and 4.3 ± 0.1 s after 4 months (p < 0.001); 4-stair climbing test, 3.7 ± 0.2 s on the baseline and 3.2 ± 0.2 s after 4 months (p < 0.001); and 4-stair descent test, 3.9 ± 0.1 s on the baseline and 3.2 ± 0.1 s after 4 months (p < 0.001). Skeletal muscle quantitative MRI was performed in the pelvis and the thighs in order to assess the impact of the procedures on the muscle structure. Muscle water T2, a biomarker of disease activity, did not show any change during the training period, suggesting the absence of deleterious effects and negative impact on disease activity. Thus, a set of dynamic aerobic exercises in water can be regarded as effective and safe for patients with DMD.
Collapse
Affiliation(s)
- V. M. Suslov
- Department of Rehabilitation, Federal State Budgetary Educational Institution of Higher Education Saint-Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia
| | - L. N. Lieberman
- Department of Rehabilitation, Federal State Budgetary Educational Institution of Higher Education Saint-Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia
| | - P. G. Carlier
- University Paris-Saclay, CEA, Frédéric Joliot Institute for Life Sciences, SHFJ, Orsay, France
| | - G. N. Ponomarenko
- Federal State Budgetary Institution Federal Scientific Center of the Rehabilitation of the Disabled Named After G. A.Albrecht of the Ministry of Labour and Social Protection of the Russian Federation, Saint Petersburg, Russia
| | - D. O. Ivanov
- Department of Rehabilitation, Federal State Budgetary Educational Institution of Higher Education Saint-Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia
| | - D. I. Rudenko
- Department of Rehabilitation, Federal State Budgetary Educational Institution of Higher Education Saint-Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia
| | - G. A. Suslova
- Department of Rehabilitation, Federal State Budgetary Educational Institution of Higher Education Saint-Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia
| | - E. I. Adulas
- Department of Rehabilitation, Federal State Budgetary Educational Institution of Higher Education Saint-Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia
| |
Collapse
|
3
|
Paris MT, McNeil CJ, Power GA, Rice CL, Dalton BH. Age-related performance fatigability: a comprehensive review of dynamic tasks. J Appl Physiol (1985) 2022; 133:850-866. [PMID: 35952347 DOI: 10.1152/japplphysiol.00319.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Adult ageing is associated with a myriad of changes within the neuromuscular system, leading to reductions in contractile function of old adults. One of the consequences of these age-related neuromuscular adaptations is altered performance fatigability, which can limit the ability of old adults to perform activities of daily living. Whereas age-related fatigability of isometric tasks has been well characterized, considerably less is known about fatigability of old adults during dynamic tasks involving movement about a joint, which provides a more functionally relevant task compared to static contractions. This review provides a comprehensive summary of age-related fatigability in dynamic contractions, where the importance of task specificity is highlighted with a brief discussion of the potential mechanisms responsible for differences in fatigability between young and old adults. The angular velocity of the task is critical for evaluating age-related fatigability, as tasks which constrain angular velocity (i.e., isokinetic) produce equivocal age-related differences in fatigability, whereas tasks involving unconstrained velocity (i.e., isotonic-like) consistently induce greater fatigability of old compared to young adults. These unconstrained velocity tasks, that are more closely associated with natural movements, offer an excellent model to uncover the underlying age-related mechanisms of increased fatigability. Future work evaluating the mechanisms of increased age-related fatigability of dynamic tasks should be evaluated using task-specific contractions (i.e., dynamic), particularly for assessment of spinal and supra-spinal components. Advancing our understanding of age-related fatigability is likely to yield novel insights and approaches for improving mobility limitations in old adults.
Collapse
Affiliation(s)
- Michael T Paris
- School of Kinesiology, University of Western Ontario, London, ON, Canada
| | - Chris J McNeil
- School of Health and Exercise Science, University of British Columbia, Kelowna, BC, Canada
| | - Geoffrey A Power
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Charles L Rice
- School of Kinesiology, University of Western Ontario, London, ON, Canada.,Department of Anatomy and Cell Biology, University of Western Ontario, London, ON, Canada
| | - Brian H Dalton
- School of Health and Exercise Science, University of British Columbia, Kelowna, BC, Canada
| |
Collapse
|
4
|
Ha PL, Dalton BE, Alesi MG, Smith TM, VanDusseldorp TA, Feito Y, Hester GM. No sex differences in evoked contractile properties after fatiguing isometric and isotonic exercise for the plantar flexors. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2022; 22:504-513. [PMID: 36458388 PMCID: PMC9716306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Females tend to fatigue less than males after isometric exercise, but less is clear for isotonic exercise. Further, there have been relatively few sex comparisons for fatigability of the plantar flexors (PFs). We sought to investigate potential sex differences in contractile properties after a sustained maximal voluntary isometric contraction (MVIC) and isotonic contractions. METHODS Twenty-seven physically active males (n=14; 22±2 yrs) and females (n=13; 21±2 yrs) randomly performed a 2 min MVIC and 120 concentric isotonic (30% MVIC) contractions for the PFs on separate visits. Before and after each fatiguing task, muscle activation was obtained from brief MVICs, which was followed (~2 sec) by tibial nerve stimulation at rest. Contractile properties including peak twitch, absolute and normalized time to peak twitch, and half relaxation time were calculated. RESULTS No sex differences existed for fatigue-induced changes in muscle activation (p=0.09-0.41; d=0.33-0.69) or contractile properties (p=0.19-0.96; d=0.06-0.94). CONCLUSIONS Peripheral fatigue, as indicated by contractile parameters, did not differ between sexes after isometric or isotonic exercise. The PFs similar fiber type proportions between sexes or greater fiber type heterogeneity may explain why sex differences in fatigability, though common in other muscle groups (e.g., knee extensors), were not expressed in this muscle group.
Collapse
Affiliation(s)
- Phuong L. Ha
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA
| | - Benjamin E. Dalton
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA
| | - Michaela G. Alesi
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA
| | - Tyler M. Smith
- Department of Molecular and Cellular Biology, Kennesaw State University, Kennesaw, GA, USA
| | - Trisha A. VanDusseldorp
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA;,Bonafide Health, LLC, Research and Development, Harrison, NY, USA
| | - Yuri Feito
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA;,American College of Sports Medicine, Indianapolis, IN, USA
| | - Garrett M. Hester
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA;,Corresponding author: Garrett M. Hester, Kennesaw State University, 520 Parliament Garden Way NW, Kennesaw, GA 30144, USA E-mail:
| |
Collapse
|
5
|
Deschenes MR, Patek LG, Trebelhorn AM, High MC, Flannery RE. Juvenile Neuromuscular Systems Show Amplified Disturbance to Muscle Unloading. Front Physiol 2021; 12:754052. [PMID: 34759841 PMCID: PMC8573242 DOI: 10.3389/fphys.2021.754052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/27/2021] [Indexed: 11/21/2022] Open
Abstract
Muscle unloading results in severe disturbance in neuromuscular function. During juvenile stages of natural development, the neuromuscular system experiences a high degree of plasticity in function and structure. This study aimed to determine whether muscle unloading imposed during juvenile development would elicit more severe disruption in neuromuscular function than when imposed on fully developed, mature neuromuscular systems. Twenty juvenile (3 months old) and 20 mature (8 months old) rats were equally divided into unloaded and control groups yielding a total of four groups (N = 10/each). Following the 2 week intervention period, soleus muscles were surgically extracted and using an ex vivo muscle stimulation and recording system, were examined for neuromuscular function. The unloading protocol was found to have elicited significant (P ≤ 0.05) declines in whole muscle wet weight in both juvenile and mature muscles, but of a similar degree (P = 0.286). Results also showed that juvenile muscles displayed significantly greater decay in peak force due to unloading than mature muscles, such a finding was also made for specific tension or force/muscle mass. When examining neuromuscular efficiency, i.e., function of the neuromuscular junction, it again was noted that juvenile systems were more negatively affected by muscle unloading than mature systems. These results indicate that juvenile neuromuscular systems are more sensitive to the effects of unloading than mature ones, and that the primary locus of this developmental related difference is likely the neuromuscular junction as indicated by age-related differences in neuromuscular transmission efficiency.
Collapse
Affiliation(s)
- Michael R Deschenes
- Department of Kinesiology and Health Sciences, College of William & Mary, Williamsburg, VA, United States.,Program in Neuroscience, College of William & Mary, Williamsburg, VA, United States
| | - Leah G Patek
- Department of Kinesiology and Health Sciences, College of William & Mary, Williamsburg, VA, United States
| | - Audrey M Trebelhorn
- Department of Kinesiology and Health Sciences, College of William & Mary, Williamsburg, VA, United States
| | - Madeline C High
- Program in Neuroscience, College of William & Mary, Williamsburg, VA, United States
| | - Rachel E Flannery
- Department of Kinesiology and Health Sciences, College of William & Mary, Williamsburg, VA, United States
| |
Collapse
|
6
|
Rabello R, Nodari C, Scudiero F, Borges I, Fitarelli L, Bianchesse J, Rodrigues R. Effects of task and hip-abductor fatigue on lower limb alignment and muscle activation. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-021-00854-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Abstract
Purpose
Fatigue-induced hip-abductor weakness may exacerbate lower-limb misalignments during different dynamic single-leg tasks. We sought to evaluate the effects of fatigue and task on lower limb kinematics and muscle activation and to find associations between measurements obtained in two tasks.
Methods
One-group pretest–posttest design. Seventeen healthy adults (9 W) performed the single-leg squat (SLSQUAT) and the single-leg hop (SLHOP) before and after a hip-abduction fatigue protocol. Hip adduction, knee frontal plane projection angle (knee FPPA) and heel inversion displacement were measured during the eccentric phase of the SLSQUAT and the SLHOP, as well as activation of the gluteus medius (GMed), tensor fascia latae (TFL), peroneus longus (PER) and tibialis anterior (TA). Moments and tasks were compared using a repeated-measures two-way ANOVA. Correlation between tasks was evaluated using Spearman’s correlation.
Results
No differences in kinematics or activation were found between moments. Hip-adduction displacement (P = 0.005), GMed (P = 0.008) and PER (P = 0.037) activation were higher during SLSQUAT, while TA activation was higher during SLHOP (P < 0.001). No differences were found between tasks in knee FPPA and heel inversion. Hip-adduction and knee FPPA were not correlated between tasks, while ankle inversion displacement was positively correlated (rs = 0.524–0.746).
Conclusion
Different characteristics of SLSQUAT (slower and deeper) seem to have led to increased hip adduction displacement, GMed, and PER activation and decreased TA activation, likely due to higher balance requirements. However, hip-abductor fatigue didn’t influence lower-limb alignment during the tasks. Finally, evaluations should be performed with different single-leg tasks since they don’t give the same lower-limb alignment information.
Collapse
|