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aquatic rehabilitation [keywords]
- Efficacy of a physiotherapy rehabilitation program for individuals undergoing arthroscopic management of femoroacetabular impingement - the FAIR trial: a randomised controlled trial protocol. [Journal Article]
- BMC Musculoskelet Disord 2014; 15(1):58.
Femoroacetabular impingement is a common cause of hip/groin symptoms and impaired functional performance in younger sporting populations and results from morphological abnormalities of the hip in which the proximal femur abuts against the acetabular rim. Many people with symptomatic femoroacetabular impingement undergo arthroscopic hip surgery to correct the bony abnormalities. While many case series over the past decade have reported favourable surgical outcomes, it is not known whether formal rehabilitation is needed as part of the management of patients undergoing this surgical procedure. This randomised controlled trial will investigate the efficacy of a progressive physiotherapist-supervised rehabilitation program (Takla-O'Donnell Protocol) in improving health-related quality of life, physical function and symptoms in individuals undergoing arthroscopic management of femoroacetabular impingement.100 people aged 16-35 years undergoing hip arthroscopy for symptomatic femoroacetabular impingement will be recruited from surgical practices in Melbourne, Australia and randomly allocated to either a physiotherapy or control group. Both groups will receive written information and one standardised post-operative physiotherapy visit whilst in hospital as per usual care. Those in the physiotherapy group will also receive seven individual 30-minute physiotherapy sessions, including one pre-operative visit (within 2 weeks of surgery) and six post-operative visits at fortnightly intervals (commencing two weeks after surgery). The physiotherapy intervention will incorporate education and advice, manual techniques and prescription of a progressive rehabilitation program including home, aquatic and gym exercises. The control group will not receive additional physiotherapy management. Measurements will be taken at baseline (2 weeks pre-operatively) and at 14 and 24 weeks post-surgery. Primary outcomes are the International Hip Outcome Tool and the sports subscale of the Hip Outcome Score at 14 weeks post-surgery. Secondary outcomes include the Copenhagen Hip and Groin Outcome Score, the activities of daily living subscale of the Hip Outcome Score, the Heidelberg Sports Activity Score, a modified Tegner Activity Scale and participant-perceived overall change.The findings from this randomised controlled trial will provide evidence for the efficacy of a specific physiotherapist-supervised rehabilitation program in improving outcomes following arthroscopic management of symptomatic femoroacetabular impingement.Australian New Zealand Clinical Trials Registry reference number: ACTRN12613000282785.
- Effects of therapeutic exercise and hydrotherapy on pain severity and knee range of motion in patients with hemophilia: a randomized controlled trial. [Journal Article]
- Int J Prev Med 2014 Jan; 5(1):83-8.
Pain and limited range of motion (ROM) are the crucial subsequent results of joint hemorrhages in individuals with bleeding disorders and hemophilia. Exercise interventions are particularly recommended in treatment of such patients. The purpose of this study was to detect the influences of conventional exercise therapy and hydrotherapy on the knee joint complications in patients with hemophilia.A total of 40 patients engaging hemophilia A were randomized into one of three groups: Therapeutic exercise (N = 13), hydrotherapy (N = 14) or control (N = 13). While the first two groups followed their specific programs for 4 weeks, routine life-style was maintained by subjects in the control group in this period. To evaluate the pain level and knee ROM the visual analog scale and standard goniometer were utilized, respectively. The outcome was measured at baseline and after completing the prescribed protocols. Data analysis was performed using one-way analysis of variance and Scheffe statistical tests (P < 0.05).Both experimental groups experienced more significant decreasing in pain level (P < 0.001) and knee flexion and extension ROM (P < 0.001) in comparison to the control group. Although the pain was significantly (P < 0.01) more alleviated in participants treated through hydrotherapy in comparison to exercise therapy, the difference in ROM improvement was not statistically significant (P > 0.05).Using hydrotherapy in addition to usual rehabilitation training can result in beneficial effect in terms of pain and knee joint ROM. However, it appears that hydrotherapy is more effective in reducing pain.
- Questions Vol. 49, No. 6 - December 2013 Which type of exercise therapy is effective after hip arthroplasty? A systematic review of randomized controlled trialsn. [Journal Article]
- Eur J Phys Rehabil Med 2013 Dec; 49(6):921-3.
Background:Early multidisciplinary rehabilitation can improve the recovery after total hip arthroplasty (THA). However, optimal exercise therapy has not been defined. We aimed to answer the question: "Which type and/or timing of exercise therapy is effective following THA?".
Methods:We searched four databases: MEDLINE, PEDro, Cochrane Library, and Cinahl since January 2008 till December 2012. Literature before 2008 was not searched for, because it was previously analyzed by two systematic reviews. Eligible criteria for studies were: Randomized Controlled Trials (RCTs); English language; interventions on type and/or timing of physical exercise initiating after THA; outcome measures including at least one among impairment, activity, participation, quality of life, or length of stay in hospital.
Results:Eleven papers on nine RCTs were identified. Trial quality was mixed. PEDro scores ranged from four to eight. Exercise therapy varied greatly in type and timing. Each of the nine RCTs addressed a specific issue and overall the results were sparse. In the early postoperative phase favorable outcomes were due to ergometer cycling and maximal strength training. Inconclusive results were reported for aquatic exercises, bed exercises without external resistance or without its progressive increase according to the overload principle, and timing. In the late postoperative phase (> 8 weeks postoperatively) advantages were due to weight-bearing exercises.
Conclusion:Insufficient evidence exists to build up a detailed evidence-based exercise protocol after THA. Sparse results from few RCTs support specific exercise types which should be added to the usual mobility training in THA patients.
- Analysis of blood gases, serum fat and serum protein: a new approach to estimate survival chances of stranded Harbor seal (Phoca vitulina) pups from the German North Sea. [Journal Article, Research Support, Non-U.S. Gov't]
- Acta Vet Scand 2014; 56(1):10.
Facing numerous challenges, such as illness, storms or human disturbance, some harbor seal (Phoca vitulina) pups lose contact to their dams and are found abandoned along the North Sea coast. In Schleswig-Holstein, pups with the prospect of surviving rehabilitation are admitted to the Seal Center Friedrichskoog. Despite elaborate clinical health assessments on admission, including differential hematology, in 2010, 17% of 108 admitted pups did not survive the first 20 days. The death rate during the years 2006 and 2009 varied between 9 and 19%. To broaden the spectrum of variables which could be predictive for survival, blood gas and serum analyses were performed for 99 pups using venous blood. Variables included total CO2, pH, partial CO2, HCO3-, base excess and anion gap as well as glucose, urea nitrogen, sodium, potassium and chloride. Moreover, total serum protein and fat (triglyceride) concentrations were measured for all pups on admission.Repeated measurements of 12 randomly selected individuals revealed a significant (p = 0.002) positive influence of time in rehabilitation on triglyceride concentrations. This trend probably shows the improvement of the pups' nutritional status as a consequence of the shift from milk replacer formula to fish. No such positive influence was detected for total protein concentrations though. Hematologic values, including blood gases, were not predictive for survival.For the first time blood gas values are reported in this study for a large sample size (N = 99) of seal pups (regardless of their health status). The ranges and medians calculated from the data can serve as a stepping stone towards the establishment of reference values for neonate harbor seals. However, future investigations on the development of blood gases in harbor seals with different health conditions and ages over time are necessary to allow for a better understanding of acid-base regulation in harbor seals.
- EFFECTS OF HABITAT ALTERATION ON THE EPIZOOTIOLOGY OF MYXOBOLUS CEREBRALIS, THE CAUSATIVE AGENT OF SALMONID WHIRLING DISEASE. [JOURNAL ARTICLE]
- J Parasitol 2014 Jan 2.
Abstract Whirling disease, caused by the myxozoan parasite, Myxobolus cerebralis, is a serious health threat to salmonid fish and its control remains problematic. The parasite has a 2-host life cycle involving a salmonid and the aquatic oligochaete, Tubifex tubifex. A commonly used strategy to control parasites that require an obligatory invertebrate host is to eliminate or reduce the host population size to a point where parasite transmission can no longer occur. Large numbers of T. tubifex are frequently found in degraded habitats that are characterized by an abundance of fine sediments, organic matter, and a lack of aquatic invertebrate diversity. If such environments are rehabilitated, then the normal flora and fauna should reestablish and the numbers of T. tubifex should decline due to their inability to compete with the reestablished invertebrates. During an epizootiological study on Rock Creek, located in west-central Montana, 2 opportunities were available to examine the effects of habitat restoration on the transmission of M. cerebralis. The Puyear Ranch re-establishment project was a major endeavor conducted on the main channel of Rock Creek, a little more than midway upstream. Another significant restoration was conducted on Upper Willow Creek, a tributary of Rock Creek, located closer to the headwaters. Sentinel trout studies, along with examining T. tubifex for the parasite and measuring various water quality parameters, revealed that the restoration of the Puyear Ranch locality had no significant effect on reducing the intensity of M. cerebralis in trout. This was likely due to the restored area being located mid-river, just downstream from a "hotspot" of infected T. tubifex. In comparison, there was a significant reduction in the intensity of M. cerebralis in sentinel fish after the Upper Willow Creek restoration project was completed. Unlike the Puyear Ranch locality, there was no "hotspot" of infected T. tubifex above the area rehabilitated on Upper Willow Creek. Further, the relative abundance of T. tubifex and M. cerebralis-infected worms was reduced. Although further study is needed, it appears that habitat rehabilitation can reduce the transmission of M. cerebralis. Since the triactinomyxon stage of the parasite released from T. tubifex (which infects trout) can float for many km, the rehabilitation of a "hotspot" may reduce the infection of trout downstream where they inhabit healthy environment with no M. cerebralis-infected T. tubifex in the vicinity. Thus, rehabilitation of a relatively small area could significantly impact the drainage for many km beyond the improved habitat.
- Effects of deposit-feeding tubificid worms and filter-feeding bivalves on benthic-pelagic coupling: implications for the restoration of eutrophic shallow lakes. [Journal Article, Research Support, Non-U.S. Gov't]
- Water Res 2014 Mar 1.:135-46.
Benthic-pelagic coupling is a key factor in the dynamics of shallow lakes. A 12-week mesocosm experiment tested the hypothesis that deposit-feeding tubificid worms stimulate the growth of pelagic algae while filter-feeding bivalves promote the growth of benthic algae, using the deposit-feeding tubificid Limnodrilus hoffmeisteri and the filter-feeding bivalve Anodonta woodiana. A tube-microcosm experiment using a (32)P radiotracer tested for differential effects of tubificids and bivalves on the release of sediment phosphorus (P). In this experiment A. woodiana was replaced by Corbicula fluminea, a smaller bivalve from the same functional group whose size was more appropriate to the experimental tubes needed for the tracer study. The first experiment recorded greater nutrient concentrations in the overlying water, higher biomass of pelagic algae as measured by chlorophyll a (Chl a), lower light intensity at the sediment and lower biomass of benthic algae in the worm treatments than in the controls, while nutrients and Chl a of pelagic algae were lower and the light intensity and Chl a of benthic algae were higher in the bivalve treatments than in the controls. In the second experiment, (32)P activity in the overlying water was higher in both treatments than in the controls, but highest in the worm treatment indicating that both animals accelerated P release from the sediment, with the biggest effect associated with the presence of worms. Our study demonstrates that worms promote pelagic algal growth by enhancing the release of sediment nutrients, while bivalves, likely through their grazing on pelagic algae increasing available light levels, stimulate benthic algal growth despite enhanced P release from the sediment and thus aid the establishment of clear water states. The rehabilitation of native bivalve populations may therefore enhance the recovery of eutrophic shallow lakes.
- Physical therapy for a child with sudden-onset choreoathetosis: a case report. [Journal Article]
- Pediatr Phys Ther 2014; 26(1):85-93.
This case report describes the physical therapy examination, intervention, and outcomes for a 5-year-old girl who developed choreoathetosis following mitral valve repair.This child was admitted to an inpatient short-term rehabilitation program with marked choreoathetosis and dependence for all functional mobility. She received physical therapy twice a day for 5 weeks. Physical therapy intervention included therapeutic exercise emphasizing stabilization and closed chain exercises, aquatic therapy, and functional training to improve gross motor skills and mobility. Tests and measures included the Selective Control Assessment of the Lower Extremity, 66-item Gross Motor Function Measure, and Pediatric Evaluation of Disability Inventory.At discharge, this child demonstrated improvements in her Selective Control Assessment of the Lower Extremity, Gross Motor Function Measure, and Pediatric Evaluation of Disability Inventory scores. She was independent in all functional mobility tasks.This case study describes physical therapy tests and measures, intervention, and positive outcomes for a child with sudden-onset choreoathetosis.
- Strategic rehabilitation planning of piped water networks using multi-criteria decision analysis. [Journal Article, Research Support, Non-U.S. Gov't]
- Water Res 2014 Feb 1.:124-43.
To overcome the difficulties of strategic asset management of water distribution networks, a pipe failure and a rehabilitation model are combined to predict the long-term performance of rehabilitation strategies. Bayesian parameter estimation is performed to calibrate the failure and replacement model based on a prior distribution inferred from three large water utilities in Switzerland. Multi-criteria decision analysis (MCDA) and scenario planning build the framework for evaluating 18 strategic rehabilitation alternatives under future uncertainty. Outcomes for three fundamental objectives (low costs, high reliability, and high intergenerational equity) are assessed. Exploitation of stochastic dominance concepts helps to identify twelve non-dominated alternatives and local sensitivity analysis of stakeholder preferences is used to rank them under four scenarios. Strategies with annual replacement of 1.5-2% of the network perform reasonably well under all scenarios. In contrast, the commonly used reactive replacement is not recommendable unless cost is the only relevant objective. Exemplified for a small Swiss water utility, this approach can readily be adapted to support strategic asset management for any utility size and based on objectives and preferences that matter to the respective decision makers.
- Adaptations of a competitive enzyme-linked immunosorbent assays for the detection of antibodies to influenza a virus in horse sera for use in wild aquatic birds. [Journal Article]
- Indian J Virol 2012 Dec; 23(3):261-9.
We applied a competitive enzyme-linked immunosorbent assay for the detection of antibodies for influenza A in equine sera to their detection in sera from wild aquatic birds. Suboptimal results were obtained for the optical density (OD) of the monoclonal antibody (MAb) control and reproducibility between duplicate analyses in the initial assessment. It was therefore necessary to modify the assay to deliver increased reliability and reproducibility while maintaining adequate sensitivity. We optimized reagent concentrations to obtain optimal OD values (close to 2) for the monoclonal antibody control and used 2, 2'-Azino-bis: 3-Benzthiazoline-6-Sulphonic Acid as an alternative chromogen to potentially reduce variability in duplicate analyses. The original assay was compared with the optimized versions, with and without post coating, for the detection of avian influenza viral antibodies in 240 sera obtained from wild plumed whistling ducks. A separate analytical sensitivity study on diluted positive field sera of plumed whistling ducks and a test of antigen stability after post coating were also performed. Some quantitative differences were detected between the original and modified assays. The original assay recorded higher percentage inhibition results which were potentially indicative of increased sensitivity. However, when reagent concentrations were increased in the original assay to the same levels as used in the modified versions, there were no quantitative differences for practical purposes. The original assay produced a median (OD) value of 0.81 for the (MAb) controls that is at the limit of acceptability. By contrast, the modified assays always produced acceptable optical density values for MAb controls. Our overall results indicated the modified assays were potentially more reliable (OD values close to 2), and of adequate sensitivity compared to the original assay in the detection of avian influenza viral antibodies in wild bird sera. Although further optimization of antigen and MAb concentrations should also be considered to increase the sensitivity of a modified assay, while maintaining acceptable optical density values for the MAb control. Post coating had a minimal quantitative effect on the results and stabilized the plates for 214 days. We therefore recommend the incorporation of post coating.
- Rehabilitation and improvement of Guilin urban water environment: function-oriented management. [Journal Article, Research Support, Non-U.S. Gov't]
- J Environ Sci (China) 2013 Jul 1; 25(7):1477-82.
Economic development and population growth have deeply damaged the urban water environment of Guilin City, China. Main problems involved structural damage and functional deterioration of the urban waters. An integrated technical scheme was developed to rehabilitate the urban water environment and to enhance the waters' functions during 1998-2008. Improvement of waters' functions included water system reconstruction, water pollution control, water safety assurance, and aquatic ecological restoration. The water system was reconstructed to connect different waters and clean water supplies to the lakes. Moreover, water pollution was controlled to improve water quality by endogenous pollutant elimination and extraneous pollutant interception. In addition, ecological measures put in place serve to enhance water system functions and better benefit both nature and humans. The project has brought about sound ecological, economic and social benefits in Guilin City, which can potentially be extended to similar cities.