Alteration of Knee Joint Connective Tissues during Contracture Formation in Spastic Rats after an Experimentally Induced Spinal Cord Injury

2007 ◽  
Vol 48 (4) ◽  
pp. 180-187 ◽  
Author(s):  
Hideki Moriyama ◽  
Osamu Yoshimura ◽  
Seiichi Kawamata ◽  
Hidenori Takemoto ◽  
Yukari Saka ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Knee Joint ◽  
Connective Tissues ◽  
Cord Injury ◽  
Contracture Formation ◽  
Experimentally Induced

The effects of heat, icing, and stretching on knee joint capsule in rat contracture model of spinal cord injury

Physiotherapy ◽  
2015 ◽  
Vol 101 ◽  
pp. e663
Author(s):  
H. Iwasawa ◽  
N. Sakitani ◽  
M. Nomura ◽  
D. Watanabe ◽  
K. Watanabe ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Knee Joint ◽  
Joint Capsule ◽  
Cord Injury

scholarly journals Our experience regarding rehabilitative, orthopedic integrative interdisciplinary approach in patients with disabling neurological posttraumatic sequelae. Case series and some related literature pointing

2019 ◽  
Vol 10 (10.2) ◽  
pp. 74-81
Author(s):  
Aurelian Anghelescu ◽  
Florin Bica ◽  
Ionut Colibeaseanu ◽  
Raluca Poganceanu ◽  
Gelu Onose
Keyword(s):  
Traumatic Brain Injury ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Brain Injury ◽  
Knee Joint ◽  
Heterotopic Ossification ◽  
Knee Flexion ◽  
Functional Results ◽  
Flexion Contracture ◽  
Cord Injury

Abstract Introduction Traumatic brain injury (TBI) and / or spinal cord injury (SCI) usually occur in a polytraumatic context, and may produce catastrophic central nervous system (CNS) damages and secondarily extensive dysfunctional biomechanical alterations. This study aims to illustrate the interdisciplinary collaboration between neurorehabilitation and orthopedic clinics in our hospital, focusing on the results of surgical interventions intended to correct the fixed-flexion deformity of knees, in patients with disabling sequelae after CNS severe lesions. Material and methods Between 2005-2018, in the Neuromuscular Rehabilitation Clinic of Teaching Emergency Hospital "Bagdasar-Arseni", 13 young patients (mean age 37.4 +/- 12.6; median 31; limits 26-43) with multiple articular stiffness and joint deposturing sequelae after severe CNS trauma have been transferred from other medical units. Twelve had bilateral knee flexion contractures, two associated additional elbow stiffness, and in three patients ectopic ossifications of the hips, with ankylosis in extension or painful flexion were found. Patients were subsequently transferred for iterative orthopedic interventions: hamstring lengthening (pes anserinus and femoral biceps tendon transpositions) in 12 cases, associated with posterior knee capsulotomy, traction and/or resection of neurogenic heterotopic ossification around the knee or hip joints and casting in 8 of them. All orthopedic interventions were followed by progressive rehabilitation programs. Spasticity was assessed with modified Ashworth scale (mAS). In pre-/ and post orthopedic surgery, all patients were assessed using an adaptation for adults of the Gross Motor Function Classification Scale, Expanded and Revised (GMFCS – E&R). Results Twelve patients had knee joint stiffness and chronic flexion contracture: 77% were severely limited in their walking ability, depending on wheelchair (GMFCS – E&R level IV), respectively 23% were bedridden, non-ambulate and totally dependent in all aspects of care (GMFCS – E&R level V). Knee orthopedic serial interventions were followed by iterative, individualized rehabilitation treatments, and 50% subjects have regain their capacity to walk independently (GMFCS – E&R level II), respectively 50% succeeded to walked with assistive devices (GMFCS – E&R level III). Discussion Both neuro-muscular system deficits and joint disorders can produce locomotor system abnormalities, joint complications and limb dysfunctional problems. These disturbances represent targets and therapeutic objectives for rehabilitation. Chronic knee flexion contracture, stiff elbows and/or hips, periarticular neurogenic heterotopic ossification: all represents major challenges in the complex management of patients with sequelae after CNS severe traumatic events. Posterior capsulotomy addressed to a stiffed, distorted knee joint, corrects the limb axis and expands the range of motion (through the angle gained by the eliminated flexion contracture), and sometimes restores the patient's ability to walk. Serial orthopedic interventions, followed by sustained postoperative rehabilitation, had a decisive influence on obtaining good functional results. Conclusions Comprehensive, multiprofessional approach and collaboration between neurorehabilitation and orthopedic teams are essential for the therapeutic management of patients with severe contractures post neuraxial lesions. Proper evaluation and goal setting are mandatory for rehabilitative management, pre-/ and post orthopedic corrective surgery. Harmonized timing for iterative interventions, followed by postoperative structured, sustained (often for life-time) rehabilitation are essential for obtaining functional results. Adequate prophylaxis of complications represents a main therapeutic objective, as well. Key words: traumatic brain injury (TBI), spinal cord injury (SCI), vegetative status, spasticity, contracture, capsulotomy, orthopaedic surgery, neurorehabilitation

scholarly journals Histopathological Changes in Knee Joint Components after Spinal Cord Injury in Rats

2012 ◽  
Vol 24 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Ippei Kitade ◽  
Masahiro Hoso ◽  
Taro Matsuzaki ◽  
Pleiades Tiharu Inaoka ◽  
Akio Kamijyo ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Knee Joint ◽  
Histopathological Changes ◽  
Cord Injury

Effect of powered gait orthosis on walking in individuals with paraplegia

2012 ◽  
Vol 37 (4) ◽  
pp. 261-267 ◽  
Author(s):  
Mokhtar Arazpour ◽  
Monireh Ahmadi Bani ◽  
Reza Vahab Kashani ◽  
Farhad Tabatabai Ghomshe ◽  
Mohammad Ebrahim Mousavi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Knee Joint ◽  
Step Length ◽  
Joint Kinematics ◽  
Knee Joints ◽  
Powered Gait Orthosis ◽  
Cord Injury ◽  
Knee Joint Kinematics ◽  
Spatial Parameters

Background:The important purpose of a powered gait orthosis is to provide active joint movement for patients with spinal cord injury.Objectives:The aim of this study was to clarify the effect of a powered gait orthosis on the kinematics and temporal–spatial parameters in paraplegics with spinal cord injury.Study Design:Quasi-experimental.Methods:Four spinal cord injury individuals experienced gait training with a powered gait orthosis for a minimum of 6 weeks prior to participating in the following walking trials: walking with an isocentric reciprocating gait orthosis and walking with both separate and synchronized movements with actuated orthotic hip and knee joints in a powered gait orthosis. Specific parameters were calculated and compared for each of the test conditions.Results:Using separate and synchronized actuated movement of the hip and knee joints in the powered gait orthosis increased gait speed and step length and reduced lateral and vertical compensatory motions when compared to the isocentric reciprocating gait orthosis, but there were no significant differences in these parameters. Using the new powered gait orthosis improved knee and hip joint kinematics.Conclusions:The powered gait orthosis increased speed and step length as well as hip and knee joint kinematics and reduced the vertical and lateral compensatory motions compared to an isocentric reciprocating gait orthosis in spinal cord injury patients.Clinical relevanceThis new powered gait orthosis has the potential to improve hip and knee joint kinematics, the temporal–spatial parameters of gait in spinal cord injury patients walking.

scholarly journals Development of a Knee Actuated Exoskeletal Gait Orthosis for Paraplegic Patients with Incomplete Spinal Cord Injury: A Single Case Study

2020 ◽  
Vol 11 (1) ◽  
pp. 58
Author(s):  
Yoon Heo ◽  
Hyuk-Jae Choi ◽  
Seok-Jin Hwang ◽  
Jong-Won Lee ◽  
Chil-Yong Kwon ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Knee Joint ◽  
Single Case ◽  
Activity Level ◽  
Trunk Muscles ◽  
Training Methods ◽  
Incomplete Spinal Cord Injury ◽  
Number Of Patients ◽  
Cord Injury

Gait training for paraplegic patients is effective in preventing various complications due to prolonged sitting. In these patients, the use of powered exoskeletal-gait-orthosis (EGO) consumes lower energy than traditional training methods using non-powered EGO, such as a reciprocating-gait-orthosis (RGO). Thus, long-term training is possible and effective in increasing the activity level of the trunk muscles. However, more than 60% of paraplegic patients have incomplete injuries with residual function, which is inversely related to the functional role of the orthosis. We hypothesized that the gait ability in incomplete paraplegia could be improved by knee joint activation, and we developed a lightweight knee-actuated EGO (KAEGO). We verified its effectiveness in one patient with an incomplete spinal cord injury by comparing the metabolic cost of transport (COT) measured by a six minute walk test to a traditional non-powered EGO. We found that with increasing assist torque to the knee joint, the COT decreased by up to 24.5%, and the gait performance, including walking speed and travel distance, significantly improved up to 37% compared to that of the non-powered EGO. Future studies should verify the KAEGO system’s effectiveness in a larger number of patients with various injury levels.

Spinal cord injury leads to region specific tidemark advancement in articular cartilage of the knee joint in rats

Physiotherapy ◽  
2015 ◽  
Vol 101 ◽  
pp. e1103-e1104
Author(s):  
M. Nomura ◽  
H. Iwasawa ◽  
N. Sakitani ◽  
K. Watanabe ◽  
D. Watanabe ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Articular Cartilage ◽  
Knee Joint ◽  
Cord Injury
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