Kneeling is often difficult after a total knee arthroplasty. However, the reasons behind kneeling difficulties are not yet fully understood. According to several studies, a lateral incision reduces ...perceptual deficits and improves kneeling performance. This study compared two different skin incisions (lateral and midline) as they relate to postoperative perceptual deficits, as well as kneeling on a mat or in daily life following TKA, and demonstrates the advantage of the lateral incision in postoperative kneeling ability.
This study included 99 patients with lateral incisions and 104 patients with midline incisions. Sensory disturbance was evaluated with a brush on the nine subdivisions of the kneeling area. Patients were tested in the outpatient clinic to determine whether they could kneel on a mat. The level of discomfort in the kneeling area was assessed using a visual analog scale. Questionnaires were used to assess kneeling ability.
Compared to a midline incision, a lateral incision significantly reduced the perceptual deficits in the center of the kneeling area and the discomfort associated with kneeling on a mat. There was no significant difference between the two groups in kneeling on a mat in the clinic or kneeling in daily activities. However, less than 30% of patients in both groups could kneel in daily living. The reasons for being unable to kneel were mainly anxiety and pain, rather than numbness.
Lateral incisions alone did not improve kneeling in patients' daily living following TKA.
•Kneeling is often difficult after total knee arthroplasty.•A lateral incision reduces postoperative perceptual deficits in kneeling area.•A lateral incision improves discomfort while kneeling on a mat.•A lateral incision alone is insufficient to improve kneeling in daily life.
Background
Individuals with neurodegenerative diseases such as Parkinson disease (PD) and Alzheimer’s (AD) disease often present with perceptual impairments at an early clinical stage. Therefore, ...early identification and quantification of these impairments could facilitate diagnosis and early intervention.
Objectives
This study aimed to compare proprioceptive and olfactory sensitivities in individuals diagnosed with PD and mild cognitive impairment (MCI).
Methods
Proprioception in the forearm and olfactory function were measured in neurotypical older adults, individuals with PD, and individuals with MCI. Position and passive motion senses were assessed using a passive motion apparatus. The traditional Chinese version of the University of Pennsylvania smell identification test (UPSIT-TC) and the smell threshold test (STT) were used to identify and discriminate smell, respectively.
Results
Position sense threshold between the groups differed significantly (
p
< 0.001), with the PD (
p
< 0.001) and MCI (
p
= 0.004) groups showing significantly higher than the control group. The control group had significantly higher mean UPSIT-TC scores than the PD (
p
< 0.001) and MCI (
p
= 0.006) groups. The control group had a significantly lower mean STT threshold than the PD and MCI groups (
p
< 0.001 and
p
= 0.008, respectively). UPSIT-TC scores significantly correlated with disease progression in PD (r = − 0.50,
p
= 0.008) and MCI (r = 0.44,
p
= 0.04).
Conclusions
Proprioceptive and olfactory sensitivities were reduced in individuals with PD and MCI, and these deficits were related to disease severity. These findings support previous findings indicating that perceptual loss may be a potential biomarker for diagnosing and monitoring disease progression in individuals with neurodegenerative diseases.
Mapping the Neglected Space Dvorkin, Assaf Y.; Bogey, Ross A.; Harvey, Richard L. ...
Neurorehabilitation and neural repair,
02/2012, Letnik:
26, Številka:
2
Journal Article
Recenzirano
Background. Spatial neglect affects perception along different dimensions. However, there is limited availability of 3-dimensional (3D) methods that fully map out a patient’s volume of deficit, ...although this could guide clinical management. Objective. To test whether patients with neglect exhibit simple contralesional versus complex perceptual deficits and whether deficits are best described using Cartesian (rectangular) or polar coordinates. Methods. Seventeen right-hemisphere persons with stroke (8 with a history of neglect) and 9 healthy controls were exposed to a 3D virtual environment. Targets placed in a dense array appeared one at a time in various locations. Results. When tested using rectangular array of targets, subjects in the neglect group exhibited complex asymmetries across several dimensions in both reaction time and target detection rates. Paper-and-pencil tests only detected neglect in 4 of 8 of these patients. When tested using polar array of targets, 2 patients who initially appeared to perform poorly in both left and near space only showed a simple left-side asymmetry that depended almost entirely on the angle from the sagittal plane. A third patient exhibited left neglect irrespective of the arrangements of targets used. An idealized model with pure dependence on the polar angle demonstrated how such deficits could be misconstrued as near neglect if one uses a rectangular array. Conclusions. Such deficits may be poorly detected by paper-and-pencil tests and even by computerized tests that use regular screens. Assessments that incorporate 3D arrangements of targets enable precise mapping of deficient areas and detect subtle forms of neglect whose identification may be relevant to treatment strategies.
Highlights • PDs had more error in hand position after non-visually guided movements than HAs. • PDs showed an increase in the variance of the perceptual error (VOE) than HAs. • Dependence of error ...and VOE on movement duration was different in PDs than HAs. • Modeling results indicated widespread impairments in PDs’ sensorimotor integration process. • Deficits may contribute to the observed clinical motor phenomena hypokinesia.
Improved survival for children with acute lymphocytic leukemia (ALL) has allowed investigators to focus on the adverse or side effects of treatment and to develop interventions that promote cure ...while decreasing the long-term effects of therapy. Although much attention has been given to the significant neurocognitive sequelae that can occur after ALL therapy, limited investigation is found addressing fine motor function in these children and motor function that may contribute to neurocognitive deficits in ALL survivors.
Fine motor and sensory-perceptual performances were examined in 82 children with ALL within 6-months of diagnosis and annually for 2 years (year 1 and year 2, respectively) during therapy.
Purdue Pegboard assessments indicated significant slowing of fine motor speed and dexterity for the dominant hand, nondominant hand, and both hands simultaneously for children in this study. Mean Visual-Motor Integration (VMI) scores for children with low-risk and high-risk ALL decreased from the first evaluation to year 1 and again at year 2. Mean VMI scores for children with standard risk ALL increased from the first evaluation to year 1 and then decreased at year 2. Significant positive correlations were found between the Purdue and the VMI at both year 1 and year 2, suggesting that the Pegboard performance consistently predicts the later decline in visual-motor integration. Significant correlations were found between the Purdue Pegboard at baseline and the Performance IQ during year 1, though less consistently during year 2. A similar pattern was also observed between the baseline Pegboard performance and performance on the Coding and Symbol Search subtests during year 1 and year 2.
In this study, children with ALL experienced significant and persistent visual-motor problems throughout therapy. These problems continued during the first and second years of treatment. These basic processing skills are necessary to the development of higher-level cognitive abilities, including nonverbal intelligence and academic achievement, particularly in arithmetic and written language.
Stroke is the largest single cause of severe physical disability and rehabilitation to reduce functional deficits is the most effective treatment. Occupational therapists play a central role in ...rehabilitation as members of a multidisciplinary team. Occupational therapy is a client-centered profession that uses meaningful activities across the spectrum of physical and mental domains to reduce limitations after stroke. Where remediation is not possible, occupational therapists implement compensatory strategies to promote independence. Rehabilitation is based on the concept of brain plasticity, which implies that it is possible to modulate or facilitate cerebral reorganization by external inputs. Occupational therapy activities are specifically geared to promote this re-education process and encourage the development of lost skills while accommodating for specific physical, cognitive or affective impairments. Principles of motor, sensory, cognitive and affective rehabilitation are incorporated into effective task-specific activities and environments are adapted to create the optimum conditions for successful rehabilitation. Several promising new rehabilitation approaches, based on neuropsychology and technological advances, have been developed to complement therapy inputs and exploit the brain's capacity to recover from stroke.
The effects of circumscribed lesions of the superior temporal cortical motion areas on speed discrimination were tested in three macaque monkeys using both moving random-textured patterns and moving ...bars. The lesions, which included the middle temporal visual area, the adjacent medial superior temporal visual area and the fundus superior temporal visual area, produced a severe and lasting deficit in speed discrimination when tested with the random patterns. In contrast, deficits were smaller when tested with moving bars. Control lesions of the inferior temporal cortex in two monkeys had little effect on speed discrimination. There was no clear deficit following inferior temporal or superior temporal sulcus lesions on a vernier acuity task. These experiments indicate that the middle temporal and adjacent areas play a crucial role in speed discrimination and that lesion effects depend on the cues available to the animals.
The researchers conducted this study to compare the sensory responses of children whose primary diagnosis was Attention Deficit Hyperactivity Disorder (ADHD) and children without disabilities on the ...Sensory Profile, a parent-reporting measure of children's sensory responses in daily life (Dunn, 1999). Parents of 70 children 3 to 15 years old with a primary diagnosis of ADHD and parents of children without disabilities matched by age and gender completed the Sensory Profile. Researchers completed a series of Multivariate Analyses of Variance (MANOVA) with post hoc testing to compare the performance of the two groups of children. Children with ADHD differed significantly from children without disabilities in their sensory responsiveness based on Sensory Profile results. The Sensory Profile can contribute to diagnostic and program planning processes and increase understanding of the nature of the disorder of ADHD.
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