The Liver Knows: Preoperative MELD Score as a Predictor of Outcome in Patients Undergoing Left Ventricular Assist Device Implantation. A Single-Center Retrospective Cohort Study.

Background And Aims: Right-side heart failure (RSHF) jeopardizes left ventricular assist device (LVAD) short- and long-term outcomes. The model for end-stage liver disease (MELD) score is an effective means of evaluating liver dysfunction. This study aims to investigate the predictive utility of preoperative MELD on post-LVAD implantation outcomes, specifically focusing on the incidence of RSHF.

Hemiplegic shoulder pain, a combined approach with suprascapular nerve block and intra-articular corticosteroid injections: a case series.

Background: Hemiplegic shoulder pain (HSP) is a prevalent and disabling condition affecting patients after stroke or traumatic brain injury. There is currently no consensus regarding infiltrative strategies. A combined approach, involving suprascapular nerve block and intra-articular corticosteroid injection, has been proposed for HSP and capsulitis, yet evidence remains limited.

Modulation of persistent inward currents in alpha motoneurons with joint angle depends on muscle length.

During voluntary movement, activity of alpha motoneurons is modulated to account for changes in muscle force-generating capacity induced by variations in muscle length. To date, research has primarily focused on the modulation of ionotropic inputs, whereas the role of another key contributor to alpha motoneuron activity, persistent inward currents (PICs), has been largely overlooked. In this human study involving young male participants ( = 19), high-density surface electromyography signals were recorded from the gastrocnemius medialis and soleus muscles at different ankle positions, and subsequently decomposed into motor unit spiking activity.

Complications of intrathecal baclofen therapy for spasticity: A single-centre cohort of 170 individuals.

Background: Intrathecal baclofen (ITB) therapy effectively reduces severe spasticity but is associated with complications that can be serious. The evolution of these complications over time and their predictive factors are not well known.

Objectives: The primary aim was to describe the incidence of ITB complications in adults with neurological disorders and disabling spasticity.

A Firing Cannon: Bilateral Lower Limb Ischemia as a Manifestation of Cardiac Myxoma.

 Cardiac myxomas are the most common primary cardiac neoplasms.  We present a case of a middle-aged lady with cardiac myxoma in her left atrium awaiting semi-elective surgery. During the preoperative period, the patient presented emergently with acute bilateral lower limb ischemia.

Status of surface electromyography assessment as part of clinical gait analysis in the management of patients with cerebral palsy - Outcomes of a Delphi process.

Background: The assessment of gait disorders in patients with neuromotor conditions, such as cerebral palsy (CP), has been a focus of clinical and research attention, with electromyography (EMG) offering a nuanced understanding of neurological and neuromuscular disorders. However, the interpretation of EMG data in the context of gait analysis remains challenging due to the complexity of neuromotor dynamics and variability in assessment methodologies.

Research Question: To which consensus can we get in a group of experts in the fields of neurological and neuromuscular disorders, biomechanics, and clinical gait analysis to establish standardized protocols and a common language for the measurement and analysis of EMG data in gait disorders, particularly in people living with CP?

Methods: A three-round Delphi process was conducted from February to September 2023 to gather opinions of 53 experts on the use of surface EMG data during gait in the context of CP.

Measurement properties of movement smoothness metrics for upper limb reaching movements in people with moderate to severe subacute stroke.

Background: Movement smoothness is a potential kinematic biomarker of upper extremity (UE) movement quality and recovery after stroke; however, the measurement properties of available smoothness metrics have been poorly assessed in this group. We aimed to measure the reliability, responsiveness and construct validity of several smoothness metrics.

Methods: This ancillary study of the REM-AVC trial included 31 participants with hemiparesis in the subacute phase of stroke (median time since stroke: 38 days).

Motor performance, motor impairments, and quality of life after eccentric resistance training in neurological populations: A systematic review and meta-analyses.

Background: Many overlapping factors impair motor performance and quality of life in neurological patients. Eccentric resistance training (ET) has potential benefits for improving motor performance and treating motor impairments better than some traditional rehabilitation approaches.

Objective: To estimate the effect of ET in neurological settings.

Prolapse repair for aortic regurgitation in tricuspid aortic valves.

Objective: Cusp prolapse is an important cause of aortic regurgitation (AR) in tricuspid aortic valves (TAVs) and can be caused by myxomatous degeneration or cusp fenestration. Long-term data for prolapse repair in TAVs are scarce. We analyzed the results of aortic valve repair in patients with TAV morphology and AR caused by prolapse and compared the results for cusp fenestration and myxomatous degeneration.

Hyperbaric oxygen in children with cerebral palsy: A systematic review of effectiveness and safety.

Purpose: To report current evidence regarding the effectiveness of hyperbaric oxygen therapy (HBOT) on the impairments presented by children with cerebral palsy (CP), and its safety.

Materials And Methods: PUBMED, The Cochrane Library, Google Scholar, and the Undersea and Hyperbaric Medical Society database were searched by two reviewers. Methodological quality was graded independently by 2 reviewers using the Physiotherapy Evidence Database assessment scale for randomized controlled trials (RCTs) and the modified Downs and Black (m-DB) evaluation tool for non RCTs.

Use of Electroneuromyography in the Diagnosis of Neurogenic Thoracic Outlet Syndrome: A Systematic Review and Meta-Analysis.

Neurogenic thoracic outlet syndrome (NTOS) is a disabling condition. Its diagnosis remains challenging and is mainly guided by examination. Yet, electrophysiological evaluations are the gold standard for diagnosis of entrapment syndromes.

Social Media in Health Studies: A Systematic Review of Comparative Learning Methods.

Learning modifications particularly increased due to the SARS-CoV-2 pandemic, which made it necessary to offer distance health education for many months. Social media allows students to have interactive activities such as discussing specific subjects or sharing data with each other, and also to have interactions with their teachers and tutors. So, we aimed to compare the effects of the use of social media on knowledge, skills and perceptions in health students compared to other methods.

A practical guide to optimizing the benefits of post-stroke spasticity interventions with botulinum toxin A: An international group consensus.

This consensus paper is derived from a meeting of an international group of 19 neurological rehabilitation specialists with a combined experience of more than 250 years (range 4-25 years; mean 14.1 years) in treating post-stroke spasticity with botulinum toxin A. The group undertook critical assessments of some recurring practical challenges, not yet addressed in guidelines, through an exten-sive literature search.

Chronic effects of muscle and nerve-directed stretching on tissue mechanics.

Tissue-directed stretching interventions can preferentially load muscular or nonmuscular structures such as peripheral nerves. How these tissues adapt mechanically to long-term stretching is poorly understood. This randomized, single-blind, controlled study used ultrasonography and dynamometry to compare the effects of 12-wk nerve-directed and muscle-directed stretching programs versus control on maximal ankle dorsiflexion range of motion (ROM) and passive torque, shear wave velocity (SWV; an index of stiffness), and architecture of triceps surae and sciatic nerve.

COVID-19 pandemic. What should Physical and Rehabilitation Medicine specialists do? A clinician's perspective.

COVID-19 pandemic is rapidly spreading all over the world, creating the risk for a healthcare collapse. While acute care and intensive care units are the main pillars of the early response to the disease, rehabilitative medicine should play an important part in allowing COVID-19 survivors to reduce disability and optimize the function of acute hospital setting. The aim of this study was to share the experience and the international perspective of different rehabilitation centers, treating COVID-19 survivors.

Effect of chronic stretching interventions on the mechanical properties of muscles in patients with stroke: A systematic review.

Background: Muscle contractures are common after stroke and their treatment usually involves stretching. However, recent meta-analyses concluded that stretching does not increase passive joint amplitudes in patients with stroke. The effectiveness of treatment is usually evaluated by measuring range of motion alone; however, assessing the effects of stretching on the structural and mechanical properties of muscle by evaluating the torque-angle relationship can help in understanding the effects of stretching.

What causes increased passive stiffness of plantarflexor muscle-tendon unit in children with spastic cerebral palsy?

Purpose: The term 'stiffness' is commonly used in the literature to refer to various components of 'hyperresistance' by which spastic muscles oppose to their passive lengthening, especially in children with cerebral palsy (CP). Originally, stiffness consists of mechanical resistance to passive movement in the absence of any muscle activation. Increased muscle stiffness in CP therefore refers to alterations to the mechanical properties of the tissue.

Detection of pronator muscle overactivity in children with unilateral spastic cerebral palsy: Development of a semi-automatic method using EMG data.

Background: The pronator teres and pronator quadratus muscles are frequently injected with neuromuscular blocking agents to improve supination in children with spastic cerebral palsy and limited active elbow supination. However, determining by simple clinical examination whether these muscles are overactive during active movement is difficult.

Objective: This study aimed to develop a semi-automatic method to detect pronator muscle overactivity by using surface electromyography (EMG) during active supination movements in children with cerebral palsy.

Influence of low muscle activation levels on the ankle torque and muscle shear modulus during plantar flexor stretching.

During stretching studies, surface electromyography (sEMG) is used to ensure the passive state of the muscle, for the characterization of passive muscle mechanical properties. Different thresholds (1%, 2% or 5% of maximal) are indifferently used to set "passive state". This study aimed to investigate the effects of a slight activity on the joint and muscle mechanical properties during stretching.

Recursive Decomposition of Electromyographic Signals With a Varying Number of Active Sources: Bayesian Modeling and Filtering.

Objective: This paper describes a sequential decomposition algorithm for single-channel intramuscular electromyography (iEMG) generated by a varying number of active motor neurons.

Methods: As in previous work, we establish a hidden Markov model of iEMG, in which each motor neuron spike train is modeled as a renewal process with inter-spike intervals following a discrete Weibull law and motor unit action potentials are modeled as impulse responses of linear time-invariant systems with known prior. We then expand this model by introducing an activation vector associated with the state vector of the hidden Markov model.

3-D lower extremity bone morphology in ambulant children with cerebral palsy and its relation to gait.

Changes in lower-extremity bone morphology are potential mid- to long-term secondary consequences of cerebral palsy (CP), affecting activity. Little is known about the 3-D morphology of lower-extremity bones in children with CP and the association with gait deviations. The main aim of this study was to describe and compare 3-D lower-extremity bone morphology in ambulant children with unilateral or bilateral CP.