Rehabilitation and biomechanics

摘要

In the area of rehabilitation and biomechanics, several articles divided into five categories, including therapeutic heat, foot and ankle orthotics, exercise in elderly arthritis patients, muscle strengthening in rheumatoid arthritis, and arthroplasty and immobilization are reviewed. Superficial heat was demonstrated to increase intra-articular temperature, and therefore, may be detrimental. On the other hand, local deep microwave hyperthermia appears to have potential therapeutic benefits. The role and effectiveness of foot orthotic devices are reviewed. The problem and treatment of forefoot varus is emphasized. A new technique of measuring subpedal pressure in the shoe is presented, demonstrating reduced foot pressures by certain types of footwear. Rheumatoid arthritis and osteoarthritis were present in 23percnt; of a nursing home population, but were a substantial factor for placement in only 15percnt;. However, this group had higher pain scores, depended more on wheelchair use, and was more likely to have significant functional limitations. Exciting new data on strengthening the quadriceps in the frail elderly, whose mean age was 90.2 years, are reviewed. The relationship of quadriceps muscle strength and maximum voluntary strength as a function of age and gender and the effects of an endurance training program in 15 physically compromised nursing home residents is discussed. A static and a dynamic training program for rheumatoid arthritis patients were compared. The dynamic group significantly increased muscle strength, endurance, and aerobic capacity as compared to the static group, without any increase in disease activity. The results further showed that a home program was beneficial. Interesting data presented show that using a Cybex isokinetic dynamometer (Lumex, Bayshore, NY) test was reliable for normal controls and for rheumatoid arthritis patients who were stronger. A second attempt, however, was more representative of the weaker subjects, suggesting that initial isokinetic strength measurement in studies of rheumatoid arthritis patients may be lower than actual baseline, resulting in overestimation of strength gains. The study on the effect of continuous passive motion on outcome in total knee arthroplasty showed that the average hospital stay of the continuous passive motion group was shortened by nearly 4 days compared with the average stay of the control group, and further suggested a possible protective role in the prevention of pulmonary emboli.