Assessment of the results of surgical treatment and postoperative physiotherapy in patients with degenerations of the cervical spine

Background. Cervical spine pain syndromes are a serious contemporary problem, both medical and social. They lead to limiting professional life in highly developed countries. Surgical treatment of cervical degenarations and discopathy is the method of choice when conservative treatment has not improved. The aim. The aim of this study was to attempt to assess the early results of surgical treatment of patients treated for osteoarthritis of the cervical spine. Material and methods. A group of 36 patients was examined, including 20 women and 16 men surgically treated for osteoarthritis of the cervical spine. Patients were divided into two groups. The study group received additional developed recommendations and a list of exercises in the field of independent post-hospital physiotherapy. The evaluated parameters were evaluated twice: before surgery and 2 months after surgery. The following research tools were used to evaluate treatment results: DASH questionnaire, NDI functional assessment scale, visual analog pain scale (VAS). Conclusions. The applied treatment resulted in a decrease in the intensity of pain, a decrease in the degree of disability of the limb and an improvement in the functional status of patients. In the group of patients with additional recommendations on the principles of rehabilitation and prevention, a higher degree of improvement was obtained in the scope of: intensity of pain radiating to the limbs and functional state.

Relatos de Séries de Casos de Adultos Institucionalizados com Deficiência Múltipla: Como Avaliar a Funcionalidade?

RESUMO: O objetivo deste artigo é propor e aplicar uma forma de classificação neurofuncional, baseada em posicionamentos e transferências em adultos institucionalizados com deficiência múltipla grave. O método utilizado foi o estudo transversal, descritivo, em uma instituição de longa permanência de Curitiba, estado do Paraná. Foi realizada filmagem dos participantes nas posições da escala Gross Motor Function Measure (GMFM), transferências de posturas e deslocamento. A pontuação de 1 a 5 pontos foi dada a partir da escala Aquatic Functional Assessment Scale (AFAS), como uma adaptação em solo. Utilizou-se a Classificação Internacional da Funcionalidade (CIF) como ferramenta para detalhar as posições quanto aos qualificadores de facilitadores e restritores para cada participante. Foram avaliados cinco participantes com deficiência múltipla, com idades entre 21 e 29 anos, com predomínio do sexo feminino (80%). Apenas um participante tinha a marcha assistida e 3 (60%) apresentaram estereotipia de mãos ou tronco. As transferências entre as posições não foram realizadas de forma independente por nenhum participante. A maior pontuação encontrada pela AFAS foi de 14 pontos e a pior foi de 5 pontos. Os resultados indicam que a CIF foi sensível para perceber os movimentos ou posicionamentos restritores e facilitadores para cada um dos participantes, e ela pode ser capaz de auxiliar na escolha das melhores formas de avaliação.

Validation study of the Functional Assessment Scale for Acute Hamstring injuries in Spanish professional soccer players

Objective: To cross-culturally adapt and validate the Functional Assessment Scale for acute hamstring injury for professional Spanish-speaking soccer players. Design: Clinical measurement study. Cross-cultural adaptation was conducted following international recommendations. Indicators of validity, reliability and responsiveness are provided. Subjects: The Spanish version of the Functional Assessment Scale for acute hamstring injury scale was administered to 165 participants: 45 professional soccer players with acute hamstring muscle injury diagnosis, 40 healthy subjects, 40 individuals at-risk for a hamstring muscle injury and 40 patients with injuries of the lower limb other than hamstring muscle injury. Main measures: The Functional Assessment Scale for acute hamstring injury. Reference measures: Spanish version of the Quality of Life Short-Form 36 questionnaire (SF-36) and the Lower Limb Functional Index (LLFI). Results: Cronbach’s alpha (internal consistency) for the Spanish version of the Functional Assessment Scale for acute hamstring injury scale was >0.8. The intraclass correlation coefficient using the two-way random model (ICC2,1) (test–retest) was 0.993 (95% confidence interval (CI): 0.991–0.995; P < 0.05). In the exploratory factor analysis, a one-factor solution explained 85% of the variance. Subjects with hamstring muscle injury scored significantly lower than the other groups in the Spanish version of the Functional Assessment Scale for acute hamstring injury scale ( P < 0.001). The Spanish version of the Functional Assessment Scale for acute hamstring injury scale score within the hamstring muscle injury group showed moderate and significant correlations with SF-36 physical components (Spearman’s rs > 0.6; P < 0.001), and LLFI score at baseline ( rs = 0.42; P < 0.01). The standard error of measurement (SEM) and minimum detectable change threshold (MDC95%) were 2.6 and 7.2 points, respectively. The responsiveness indicators have an effect size of 3.62, and the standardized response mean is 3.24. Conclusion: The Spanish version of the Functional Assessment Scale for acute hamstring injury scale showed satisfactory psychometric properties. It can be considered a reliable and valid instrument to assess the functional impact of acute hamstring muscle injury in professional Spanish-speaking football players.

DEVELOPMENTAL INDIVIDUAL-DIFFERENCES RELATIONSHIP-BASED (DIR) FLOORTIME DALAM MENINGKATKAN KOMUNIKASI DUA ARAH PADA KASUS AUTISM SPECTRUM DISORDER (ASD)

<p><em>Autism Spectrum Disorder (ASD) is a developmental disorder that has communication disorders as its characteristic. Greenspan introduced the DIR Floortime model which is proven to be able to improve the communication circles of ASD child and teens. This study aims to see the role of DIR Floortime in improving two-way communication of adolescent with ASD. With single-subject experimental design, this study consisted of 10 pre-intervention sessions, 20 intervention sessions and 10 post-intervention sessions, 2 sessions in 1 day with 20 minutes duration. Two-way communication capability is measured using Functional Assessment Scale and number of communication circles during the session. Based on an assessment of JW, a 14-year-old teenager with Autism Spectrum Disorder, it is found: JW has a dominant sensory-seeking in the tactile and auditory areas. JW mental age is equal to 6 year-old child. JW has reached the third development milestone, two-way purposeful communication, but JW is not optimal yet in this milestone. From the results, the DIR Floortime is able to improve two-way purposeful communication significantly in adolescent with Autism Spectrum Disorder. In addition, DIR Floortime is also able to increase circles of communication significantly in adolescent with Autism Spectrum Disorder. Specifically, there is an increase in the quantity and also improvement in the quality of opening the communication circles. While the ability to close the communication circles is only improved in quality. JW is able to respond the researcher with series of behavior after the DIR Floortime intervention is given.</em></p><p><strong><em>Keywords: </em></strong><em> </em><em>DIT Floortime, two-way communication, circle of communication, autism spectrum disorder, adolescent</em></p>