Deformidades de los pies en niños / Foot deformities in children

Las alteraciones en los pies son una consulta frecuente en ortopedia pediátrica. La gran mayoría corresponde a condiciones que no constituyen patología y habitualmente no necesitan tratamiento, como el pie plano flexible. Por otro lado, existen deformidades patológicas que necesitarán un adecuado estudio y tratamiento. Según su morfología podemos clasificarlas en cavo-varo, plano-valgo y misceláneas. Su origen puede ser congénito o adquirido y de diversas etiologías, destacando el pie bot, metatarso varo, hallux valgus juvenil y aquellas secundarias a enfermedades neuromusculares, entre otras. Conocer la historia natural de cada deformidad nos permite decidir el momento más adecuado para cada tratamiento. Los antecedentes mórbidos y perinatales del paciente son muy importantes, así como el nivel de actividad física y/o deportiva. El examen físico debe incluir observar la marcha, extremidades inferiores, tobillo y pie. En el pie se debe analizar cada segmento por separado (antepié, mediopié y retropié) y las articulaciones respectivas. Es muy importante distinguir entre deformidades rígidas y flexibles. El tratamiento incluye la observación (condiciones benignas y autolimitadas), calzado adecuado, insertos plantares, órtesis, yesos correctores, cirugía de partes blandas y cirugía ósea; todo complementado por un adecuado programa de rehabilitación funcional y deportivo.

Foot disorders are a frequent cause of consultation in pediatric orthopaedics. The vast majority correspond to conditions that don't constitute pathology and usually don ́t need treatment, such as flexible flat foot. On the other hand, there are pathological deformities that will require a proper study and treatment. According to their morphology we can classify them in cavo-varus, plano-valgus and miscellaneous. Its origin can be congenital or acquired and due to various etiologies, highlighting clubfoot, metatarsus adductus, juvenile hallux valgus and those secondary to neuromuscular diseases, among others. Knowing the natural history of each deformity allows us to decide the most appropriate time for each treatment. Patient's morbility and perinatal history is very important, as well as their level of physical and/or sports activity. Physical exam should include gait obsevation, lower limbs, ankles and feet. In the foot, each segment should be analyzed separately (forefoot, midfoot and hindfoot) and their joints. It ́s very important to distinguish between rigid and flexible deformities. Treatments include observation (benign and self-limited conditions), adequate footwear, insoles, orthosis, corrective casting, soft tissue surgery and bone surgery; all complemented by an adequate functional and sports rehabilitation programs

Quantification of Muscle Metabolites Using Proton Magnetic Resonance Spectroscopy (1 H-MRS) for Incomplete Spinal Cord Injury Patients: Preliminary Study

@#Introduction: This preliminary study aimed to non-invasively evaluate choline (CHO), creatine (Cr) and intramyocellular lipid (IMCL) metabolites in skeletal muscles at pre- and post-functional electrical stimulation (FES) exercise among incomplete spinal cord injury (SCI) of American Spinal Injury Association Impairment Scale (ASIA-AIS) D patients using proton magnetic resonance spectroscopy or 1 H-MRS. Methods: These metabolites were measured from the vastus lateralis and semitendinosus muscles of three incomplete SCI ASIA-AIS D patients who completed the FES exercise and later underwent 3 Tesla (T) MRI (repetition time/echo time; TR/TE of 3500ms/100ms, field-ofview; FOV of 20cm, slice thickness of 6mm) and 1 H-MRS (TR/TE of 2000ms/31ms, voxel size of 20mm x 20mm x 35mm). Results: Out of those selected metabolites, only CHO value of vastus lateralis showed a statistically significant difference between pre- and post FES exercise 1 H-MRS scanning (p = 0.01). Conclusion: Therefore, this preliminary finding has postulated that the quantification of muscle metabolites using 1 H-MRS imaging could be used as a potential indicator in evaluating the muscle strength for incomplete SCI ASIA-AIS D patients after the completion of FES cycling exercise.

Malignant transformation of ovarian mature teratoma: 04 cases report, review of the literature

Mature ovarian teratomas or dermoid cysts are the most common ovarian germinal tumors and account for 20 to 25% of ovarian organ tumors. The malignant transformation of a mature teratoma is a rare event (1 to 3%), mainly found in the post-menopausal period. This is carcinomatous degeneration (80% of cases) or sarcomatous differentiated tissues of the dermoid cyst. The diagnosis of certainty is established by anatomopathological study of the surgical piece. Treatment of carcinoma teratomas is surgical and same to ovarian malignant epithelial tumors. We report four cases we managed in our health care center with a review of the literature.

Study on the expression of Toll-like receptor 4 and its effect on prognosis in fat embolism mice model / 上海交通大学学报（医学版）

Objective · To investigate the effect of Toll-like receptor 4 (TLR4) in the pathological injury in fat embolism mice model. Methods · One hundred and twenty male C57BL/6 mice were randomly divided into 10 groups. One group was set as blank control group, and others were injected separately with 1, 2…9 μL/g of allogeneic perirenal fat via tail vein, respectively. The mortality of each group was counted, median lethal dose (LD50) of fat injection in mice was calculated by Bliss method, and the fat embolism LD50 mice model was established. The TLR4 protein expression in the pulmonary tissue of surviving mice was detected by Western blotting. Sixty male C57BL/6 mice were randomly divided into the control group (the same dose of saline was given via tail vein) and the experimental groups (group 2 h, group 8 h, group 24 h and group 48 h, the LD50 fat was given via tail vein).The TLR4 protein expression at different time after fat injection was detected by Western blotting. The mortality of 20 TLR4 gene-knockout mice (TLR4-/-mice) was recorded and compared with 60 wild-type mice after LD50 fat injection. Results · The LD50 of fat embolism mice model was (3.93±0.78) μL/g.After the injection of 1-7 μL/g fat, the expressions of TLR4 protein in the pulmonary tissue of all seven groups were significantly increased, compared with the control group (all P=0.000). In the fat embolism LD50 mice model, compared with the control group, the expressions of TLR4 protein in group2 h were significantly increased (P=0.005). Then, expression level of TLR4 protein was gradually reduced after 2 h, and there was no significant difference between the control group and group 48 h. The mortality of TLR4-/- mice injected with LD50 fat was lower than that of wild-type mice (P=0.043).Conclusion · TLR4 protein involves in the pathologic process of fat embolism syndrome. The knockout of TLR4 gene can reduce the mortality of fat embolism mice. TLR4 and its correlated non-infectious inflammatory response may be an important molecular mechanism of biochemical injury in fat embolism syndrome. Blocking the activation of TLR4-mediated signaling pathway can significantly improve the prognosis, which provides new basis for the prevention, evaluation and treatment of fat embolism syndrome.

Study on the expression of Toll-like receptor 4 and its effect on prognosis in fat embolism mice model / 上海交通大学学报（医学版）

Objective • To investigate the effect of Toll-like receptor 4 (TLR4) in the pathological injury in fat embolism mice model. Methods • One hundred and twenty male C57BL/6 mice were randomly divided into 10 groups. One group was set as blank control group, and others were injected separately with 1, 2…9 μL/g of allogeneic perirenal fat via tail vein, respectively. The mortality of each group was counted, median lethal dose (LD50) of fat injection in mice was calculated by Bliss method, and the fat embolism LD50 mice model was established. The TLR4 protein expression in the pulmonary tissue of surviving mice was detected by Western blotting. Sixty male C57BL/6 mice were randomly divided into the control group (the same dose of saline was given via tail vein) and the experimental groups (group 2 h, group 8 h, group 24 h and group 48 h, the LD50 fat was given via tail vein). The TLR4 protein expression at different time after fat injection was detected by Western blotting. The mortality of 20 TLR4 gene-knockout mice (TLR4-/- mice) was recorded and compared with 60 wild-type mice after LD50 fat injection. Results • The LD50 of fat embolism mice model was (3.93±0.78) μL/g. After the injection of 1-7 μL/g fat, the expressions of TLR4 protein in the pulmonary tissue of all seven groups were significantly increased, compared with the control group (all P=0.000). In the fat embolism LD50 mice model, compared with the control group, the expressions of TLR4 protein in group 2 h were significantly increased (P=0.005). Then, expression level of TLR4 protein was gradually reduced after 2 h, and there was no significant difference between the control group and group 48 h. The mortality of TLR4-/- mice injected with LD50 fat was lower than that of wild-type mice (P=0.043). Conclusion • TLR4 protein involves in the pathologic process of fat embolism syndrome. The knockout of TLR4 gene can reduce the mortality of fat embolism mice. TLR4 and its correlated non-infectious inflammatory response may be an important molecular mechanism of biochemical injury in fat embolism syndrome. Blocking the activation of TLR4-mediated signaling pathway can significantly improve the prognosis, which provides new basis for the prevention, evaluation and treatment of fat embolism syndrome.

Abnormality of θ oscillation in auditory event-related potential P300 in patients with clinical high risk of psychosis or first-episode schizophrenia / 上海交通大学学报（医学版）

Objective • To explore the relationship between θ oscillation of auditory event-related potential P300 and clinical symptoms in the patients with clinical high risk (CHR) of psychosis or first episode schizophrenia (FES). Methods • A total of 18 patients with CHR of psychosis (CHR group), 18 patients with FES (FES group) and 19 healthy controls (control group) were recruited to complete the standard auditory Oddball paradigm as well as electroencephalogram (EEG) recording with 64-channel EEG cap. Fz, Cz and Pz electrodes were selected to compare the amplitudes and peak latent periods among the three groups, and time-frequency analysis of the θ oscillation in P300 was performed. Results • There was significant difference in the amplitudes of P300 among the three groups (P=0.004). The amplitudes of P300 in FES group (P=0.001) and CHR group (P=0.026) were both significantly lower than that of control group. There was no difference between CHR group and FES group in P300 amplitude (P>0.05). θ Oscillation induced power was significantly different among the three groups (P=0.022). The induced power value of FES group was significantly lower than that of control group (P=0.008); and it was marginally lower in CHR group as compared to that of control group (P=0.054). There was no difference between CHR group and FES group (P>0.05). There was trending difference in θ oscillation evoked power among the three groups (P=0.054). The correlation analysis showed that the total and subscale scores of Positive and Negative Syndrome Scale in FES group were significantly correlated with the amplitudes of P300 at Cz and Pz electrodes (P<0.05). Conclusion • There are significant abnormalities in the amplitude of auditory P300 and θ oscillation of P300 in both CHR and FES patients; however, the change in CHR patients is less severe than that of FES patients. The impaired θ oscillation of P300 in CHR patients is limited to induced power, but evoked power is not impaired.

Radiation dosimetry estimates of18F-fluoroestradiol based on whole-body PET imaging of mice / 中国癌症杂志

Background and purpose:In preparation for using this tracer in humans, this study estimated thedosimetry of18F-FES with the method established by MIRD based on whole-body PET imaging of mice.Methods:Three female mice receivedⅣ tail injections of18F-FES and were scanned for 160 min in an Inveon dedicated PET/CT scanner. This study selected some important organs (brain, lung, liver, heart wall, small intestine, large intestine, kidney and urinary bladder), computed their residence times. Then, the residence times in mice organs were converted to human values using scale factors based on differences between organ and body weights. OLINDA/EXM 1.1 software was used to compute the absorbed human doses in multiple organs for both adult female and adult male body phantoms. Results:The highest absorbed doses in gallbladder wall, urinary bladder wall, small intestine, upper large intestine and liver are 0.072 5, 0.044 5, 0.043 0, 0.031 5 and 0.028 2 mGy/MBq, respectively. The organs which have the lowest ab-sorbed doses were brain (0.005 2 mGy/MBq), followed by skin (0.001 1 mGy/MBq), breast (0.001 1 mGy/MBq), heart wall (0.001 2 mGy/MBq) and thyroid (0.001 2 mGy/MBq). The mean absorbed doses for the other major organs ranged from 0.009 5 to 0.023 5 mGy/MBq. The total mean effective dose is 0.019 0 mSv/MBq and the mean effective doses equivalent is 0.025 0 mGy/MBq. A 370-MBq injection of18F-FES leads to an estimated effective dose of 7.03 mSv for the female. There was no statistical difference in the doses results obtained from direct measurement of18F-FES ab-sorption in normal people between previous publications by others and our work.Conclusion:The whole-body mouse imaging can be used as a preclinical tool for initial estimation of the absorbed doses of18F-FES in humans. Furthermore, the potential radiation risk associated with18F-FES imaging is well within the accepted limits.

Technological Tools for Observational Evaluation - the Experience with the Software for Functional Evaluation Scale for Duchenne Muscular Dystrophy – A Pilot Study Software for Observational Evaluation.

Systematic observation is an indispensable tool in clinical neurology evaluation, but data organization and record are extensive and time-consuming, requiring method and training. Reliable scales facilitate this task and technology can be decisive in the implementation of observational data routines. In this study, we aimed to show the experience of a software development to optimize the application of a clinical observational scale. For this proposal it was necessary to consider the needs of the target population, text and image storing and reports generation, using computers with basic configuration, questionnaires and the measurement of time. The software allowed significant reduction in evaluation time and favored the cost-benefit of the task. The proposed methodology was adequate for this type of study.

Clinical Application of FES for Swallowing: Intensity Levels and the Placement of Electrode / 대한연하장애학회지

When treating dysphagia, “Functional electrical stimulation” is used for the purpose of improving muscle function, which is useful for swallowing. During swallowing, contraction of suprahyoid muscle is one of the first events that triggers the swallowing reflex and helps the bolus prevent aspiration during swallowing. Moreover, one of the aims of Functional Electrical Stimulation (FES) on the neck is to augment the hyolaryngeal elevation. However, depending on the current intensity and electrodes placement, the outcomes may vary. Although FES is a relatively new treatment method in comparison to traditional treatment techniques for dysphagia, presenting clear evidence and effectiveness is uncertain due to the application of various techniques. Therefore, this study is designed to know the effects of FES according to intensity of stimulation and placement of electrode.

Digital controller design considering hardware constraints: application in a paraplegic patient

INTRODUCTION: A methodology was developed for implementing closed-loop control algorithms and for evaluating the behavior of a system, considering certain component restrictions used in laboratory implementation. METHODS: Mathematical functions representing a model of the biological system were used for knee extension/flexion movements. A Proportional Integral Derivative (PID) controller and another one using the root locus method were designed to control a patient’s leg position by applying functional electrical stimulation (FES). The controllers were simulated in Matlab and ISIS Proteus. After the simulations were performed, the codes were embedded in a microcontroller, and tests were conducted on a paraplegic volunteer. To the best of the authors’ knowledge, this is the first time that ISIS Proteus software resources have been used prior to implementing a closed-loop system designed to control the leg position of patients. RESULTS:This method obviates the application of initial controller tests directly to patients. The response obtained in the experiment with a paraplegic patient complied with the specifications set in terms of the steady-state error, the settling time, and the percentage overshoot. The proposed procedure was successfully applied for the implementation of a controller used to control the leg position of a paraplegic person by electrical muscle stimulation. CONCLUSION:The methodology presented in this manuscript can contribute to the implementation of analog and digital controllers because hardware limitations are typically not taken into account in the design of controllers.

Oxidative stress enhances the expression of sulfur assimilation genes: preliminary insights on the Enterococcus faecalis iron-sulfur cluster machinery regulation

The Firmicutes bacteria participate extensively in virulence and pathological processes. Enterococcus faecalis is a commensal microorganism; however, it is also a pathogenic bacterium mainly associated with nosocomial infections in immunocompromised patients. Iron-sulfur [Fe-S] clusters are inorganic prosthetic groups involved in diverse biological processes, whose in vivo formation requires several specific protein machineries. Escherichia coli is one of the most frequently studied microorganisms regarding [Fe-S] cluster biogenesis and encodes the iron-sulfur cluster and sulfur assimilation systems. In Firmicutes species, a unique operon composed of the sufCDSUB genes is responsible for [Fe-S] cluster biogenesis. The aim of this study was to investigate the potential of the E. faecalis sufCDSUB system in the [Fe-S] cluster assembly using oxidative stress and iron depletion as adverse growth conditions. Quantitative real-time polymerase chain reaction demonstrated, for the first time, that Gram-positive bacteria possess an OxyR component responsive to oxidative stress conditions, as fully described for E. coli models. Likewise, strong expression of the sufCDSUB genes was observed in low concentrations of hydrogen peroxide, indicating that the lowest concentration of oxygen free radicals inside cells, known to be highly damaging to [Fe-S] clusters, is sufficient to trigger the transcriptional machinery for prompt replacement of [Fe-S] clusters.

The correlation of 18F-fluoroestradiol uptake in patients with breast cancer to in vitro immunohistochemical assay of ER status / 中国癌症杂志

Background and purpose:16α-[18F]lfuoroestradiol (18F-FES) is an in vivo speciifc imaging agent for estrogen receptor (ER). We investigated the concordance between tumor ER status as determined by FES-PET and in vitro immunohistochemical assays. Methods: 18F-FES was prepared by ourselves. Twenty-six patients were enrolled (17 primary and 9 metastatic/recurrent). Patients underwent both 18F-FES and 18F-FDG PET/CT. Results:We found good overall agreement (96.15%) between in vitro ER assays and FES-PET. The ER status diagnosis sensitivity of 18F-FES was 93.33%and the speciifcity was 100%when using cut-off value of SUVmax≥1.5. There was a positive correlation between in vitro ER, PR assays and the SUVmax of 18F-FES while in vitro HER-2/neu assays correlatived negatively with 18F-FES SUVmax. Conclusion:These results suggested 18F-FES may be useful for studying the ER expression of all malignant lesions in patients with breast cancer and guiding individual therapy.

Mitochondrial Protein Nfu1 Influences Homeostasis of Essential Metals in the Human Fungal Pathogen Cryptococcus neoformans

Mitochondrial protein Nfu1 plays an important role in the assembly of mitochondrial Fe-S clusters and intracellular iron homeostasis in the model yeast Saccharomyces cerevisiae. In this study, we identified the Nfu1 ortholog in the human fungal pathogen Cryptococcus neoformans. Our data showed that C. neoformans Nfu1 localized in the mitochondria and influenced homeostasis of essential metals such as iron, copper and manganese. Marked growth defects were observed in the mutant lacking NFU1, which suggests a critical role of Nfu1 in Fe-S cluster biosynthesis and intracellular metal homeostasis in C. neoformans.

Relationship between peak and mean amplitudes of the stimulating output voltage for functional control of the knee by spinal cord patients and healthy volunteers

INTRODUCTION: Functional electrical stimulation (FES) may evoke movements in people with movement impairments due to neurological lesion. The mean value of electrical current or voltage during FES depends on the stimulatory profile parameters. To investigate the relationship between peak and mean amplitudes of the stimulator output voltage while causing a knee extension angle change from 90º to 40º to choose the best and safest profile to be applied in people who have suffered a spinal cord injury. METHODS: Healthy (N = 10) volunteers and those with spinal cord injuries (N = 10) participated in this study. Each FES profile (P1, P2, P3 and P4) had 1-kHz pulses (100 µs or 200 µs on and 900 µs or 800 µs off) with burst frequencies of 50 Hz (3 ms on and 17 ms off) or 70 Hz (3 ms on and 11 ms off) and peak amplitudes set between 53-125V for healthy volunteers and 68-198 V for volunteers with spinal cord injury. RESULTS: The highest mean amplitude were obtained using a FES profile with active/total pulse period of 200 us/1000 us and burst frequency of 3ms/14ms. The best results of mean amplitude were observed using a FES profile duty cycle of 10% for pulses (100 µs/1000 µs) and 15% for bursts (3 ms/20 ms). CONCLUSION: The FES profile (100 µs - 50 Hz) seems to be the most suitable for both groups, inasmuch as it presents smaller mean amplitudes and peak amplitudes similar to other FES profiles.

Influência de parâmetros da estimulação elétrica funcional na contração concêntrica do quadríceps / Influence of functional electrical stimulation parameters in quadriceps concentric contraction

INTRODUÇÃO: Sistemas de estimulacão elétrica funcional (FES) são usados na pràtica clínica para o fortalecimento muscular, assim como para a recuperacão e preservacão funcional dos músculos enfraquecidos. Porém, uma das dificuldades encontradas na sua aplicacão é a falta de padrões adequados para a realizacão de um movimento pré-estabelecido, uma vez que os parâmetros da estimulacão (frequência, intensidade de corrente e duracão do pulso) são variados heuristicamente. O presente trabalho investigou a influência dos paraêmetros da FES usada no estabelecimento da posicão angular e forca produzida na extensão de joelho. MÉTODOS: O procedimento experimental foi dividido em duas fases chamadas Fase I e Fase II. A amostra total do estudo foi composta por 41 voluntàrios saudàveis de ambos os sexos (27 na Fase I e 14 na Fase II). Durante a Fase I cada voluntàrio foi estimulado com 18 combinacões diferentes de parâmetros para a FES, com o objetivo de determinar um modelo capaz de prever o movimento realizado para cada padrão de estimulacão. RESULTADOS: As diferentes duracões de pulso aplicadas não resultaram em alteracões significativas nos movimentos produzidos. Dentre os valores de frequência investigados, 50 Hz foi escolhida para a Fase II, por ter apresentado maior diferenca estatisticamente significativa para os valores de intensidade de corrente avaliados. Durante a Fase II, a intensidade de corrente da FES foi ajustada segundo um modelo linear estabelecido durante a primeira fase e que considerou características antropométricas dos sujeitos; encontrando-se um coeficiente de correlação r = 0,798 entre o ângulo pré-estabelecido e o ângulo alcancado. CONCLUSÃO: Este trabalho apresenta um modelo para a determinação de parâmetros de FES que permitem estabelecer variações angulares da articulação do joelho associadas à eletroestimulação. Considerando a frequência e a duração de pulsos constantes, se estima, usando uma equação de primeira ordem ...

INTRODUCTION: Functional electrical stimulation (FES) is used in clinical practice for muscle strengthening, as well as for functional recovery and preservation of weakened muscles. However, one of the problems in clinical application is the lack of adequate standards for determining the attainment of a predetermined movement, since the stimulation parameters are often adjusted heuristically. The present study investigated the influence of some parameters (frequency, current intensity and pulse duration) of the FES used to establish the joint angle and force produced in knee extension. METHODS: The experimental procedure was divided in two phases (Phase I and Phase II). The total sample included 41 healthy volunteers of both sexes (27 and 14 in Phase I and Phase II). During Phase I 18 profiles of FES were applied in the quadriceps muscle of subjects, changing the above-mentioned FES parameters. RESULTS: It was observed that the pulse duration of the electrical stimulation pulse did not exhibit significant relevance in the evoked movements. Among the discrete values of frequency investigated, the stimulation at 50 Hz was selected because it showed higher statistical significant difference considering the values of current intensity measured. During the Phase II, devoted to place the knee joint angle in a pre-determined value, the current intensity of the FES was adjusted according to the linear model established during the Phase I, which considered anthropometric characteristics of the subjects. In this Phase we found a correlation coefficient r = 0,798 between the pre-determined angle and the reached one. CONCLUSION: This paper presents a model for the determination of FES parameters for establishing angular variations of the knee associated with electrical stimulation. Considering frequency and pulse duration constants we estimate, using a first order equation and correlation coefficient of 0.72, the current intensity dependent of desired angle variation.

Adaptação transcultural e avaliação das propriedades psicométricas da Falls Efficacy Scale - International em idosos Brasileiros (FES-I-BRASIL) / Cross-cultural adaptation and evaluation of the psychometric properties of the Falls Efficacy Scale - International Among Elderly Brazilians (FES-I-BRAZIL)

OBJETIVOS: Adaptar culturalmente a Falls Efficacy Scale-International (FES-I) e avaliar suas propriedades psicométricas em uma amostra de idosos brasileiros da comunidade. MÉTODOS: Conforme recomendações da Rede Européia de prevenção às quedas, o instrumento foi traduzido para o português do Brasil e adaptado culturalmente para a população brasileira (FES-I-Brasil). A FES-I-Brasil foi aplicada em 163 idosos (73,44±5,51 anos), e foram coletados dados demográficos e relacionados à história de quedas. Dentre esses idosos, 58 foram distribuídos aleatoriamente para avaliação da confiabilidade. A confiabilidade foi analisada pelo Índice de Correlação Intraclasse (ICC) e a consistência interna pelo α de Cronbach. A estrutura interna da FES-I-Brasil foi avaliada pela análise fatorial exploratória. O modelo de regressão logística foi utilizado para identificar quais tarefas da escala eram mais relevantes para discriminar quedas. Para análise de sensibilidade e especificidade da FES-I-Brasil, empregou-se a curva Receiving Operator Characteristic (ROC). RESULTADOS: A consistência interna da FES-I-Brasil foi α=0,93, e a confiabilidade foi ICC=0,84 e 0,91 (intra e interexaminadores, respectivamente). A análise fatorial sugeriu dois fatores que verificavam preocupação em cair durante atividades de socialização e de vida diária (básicas e instrumentais) e tarefas relacionadas ao controle postural. Uma pontuação >23 pontos na FES-I-Brasil sugeriu associação com histórico de queda esporádica, ao passo que uma pontuação >31 pontos ensejou uma associação com queda recorrente. CONCLUSÕES: A FES-I-Brasil apresentou-se semântica, linguística e psicometricamente adequada para avaliar o medo de cair na população de idosos brasileiros da comunidade.

OBJECTIVES: To culturally adapt the Falls Efficacy Scale - International (FES-I) and assess its psychometric properties in a sample of community-dwelling elderly Brazilians. METHODS: The instrument was translated into Brazilian Portuguese and culturally adapted to the Brazilian population (FES-I-Brazil) as recommended by the Prevention of Falls Network Europe. FES-I-Brazil was applied to 163 elderly people (73.44±5.51 years), and the demographic data and history of falls were also collected. From this group, 58 participants were randomly distributed to evaluate reliability. The reliability was analyzed using the intraclass correlation coefficient (ICC) and the internal consistency, using Cronbach's alpha coefficient (α). The internal structure of FES-I-Brazil was evaluated by means of exploratory factor analysis. The logistic regression model was used to determine which tasks on the scale were more relevant for discriminating falls. To analyze the sensitivity and specificity of FES-I-Brazil, the receiver operating characteristic (ROC) curve was used. RESULTS: The internal consistency of FES-I-Brazil was α=0.93, and the intra- and inter-examiner reliability were ICC=0.84 and 0.91, respectively. Factor analysis suggested two factors: concern about falling during social activities and activities of daily living (basic and instrumental), and postural control tasks. FES-I-Brazil scores >23 suggested an association with a previous history of sporadic falls, whereas scores >31 suggested an association with recurrent falls. CONCLUSIONS: FES-I-Brazil was shown to be semantically, linguistically and psychometrically appropriate to evaluate the fear of falling in the community-dwelling Brazilian elderly population.

Functional Electrical Stimulation for Pharyngeal Dysphagia : A Feasibility Study / The Japanese Journal of Rehabilitation Medicine

In this study, we investigated a surface electrode stimulation method to support laryngeal elevation in patients with pharyngeal dysphagia, from the viewpoint of functional electric stimulation (FES). Informed consent was obtained from 15 healthy men and 4 patients with pharyngeal dysphagia. Digastric and stylohyoid muscles were stimulated by silver-textile surface electrodes covering the muscle belly. Laryngeal elevation by the electrical stimulation (ES) during liquid (water, 3ml) swallowing movement was measured by digital video camera. The laryngeal elevation trajectory demonstrated a hysteresis loop. The elevation distance of the larynx increased with a rise of stimulus strength. Laryngeal elevation by ES was 76.0% in the normal subjects and 86.6% in patients when measured during liquid swallowing. Applying FES for laryngeal elevation may assist in improving the swallowing reflex.

Functional Electrical Stimulation for Motor Function Rehabilitation (review) / 中国康复理论与实践

@# Functional electrical stimulation (FES) has already used in many aspects of rehabilitation medicine, including the rehabilitation of motor function especially after stroke or spinal cord injury. This paper reviewed the parameters for and the effects on motor function rehabilitation.

Os efeitos da estimulação elétrica funcional na assimetria cortical inter-hemisférica / The effects of functional electrical stimulation on cortical interhemispheric asymmetry

O objetivo do presente estudo foi avaliar os efeitos da estimulação elétrica funcional na assimetria cortical inter-hemisférica. Para tal, simultaneamente ao registro da atividade eletroencefalográfica, realizou-se eletroestimulação no antebraço direito para estimulação da extensão do indicador. A amostra consistiu de 45 sujeitos randomizados em 3 grupos de 15 sujeitos cada: grupo controle (submetido a 24 blocos de estimulação com intensidade de corrente zero), grupo 1 (24 blocos) e grupo 2 (36 blocos). A assimetria entre os pares de eletrodos F3-F4, C3-C4 e P3-P4 foi analisada ao longo dos grupos através de uma Anova. Os resultados apontaram para uma interação grupo x eletrodo e uma tendência de diminuição da assimetria inter-hemisférica após a eletroestimulação.

The aim of the present study was to assess the effects of functional electrical stimulation (FES) on cortical interhemispheric asymmetry. Electrostimulation was performed on the right forearm to stimulate the extension of the index finger. EEG activity was recorded simultaneously. The sample included 45 subjects randomly divided into 3 groups of 15 subjects each: control group (submitted to 24 blocks of stimulation at a null intensity current), group 1 (24 blocks) and group 2 (36 blocks). Interhemispheric asymmetry between F3-F4, C3-C4 and P3-P4 was analyzed through an Anova. Results pointed out to a group x electrode interaction and a general tendency of asymmetry decrease after stimulation.

Implantable Functional Electrical Stimulation with Inductive Power and Data Transmission System / 영남의대학술지

Functional electrical stimulation (FES) has developed over the last 35 years to become a scientifically, technologically and clinically recognized field of interest in clinical medicine. FES has been applied to locomotion, grasping, ventilation, incontinence, and decubitus healing. However, all of these achievements illustrate the initial applications of FES; its true potential has not yet been realized. Recently, FES systems, which are miniaturized stimulation devices, have been utilized in the clinical setting. However, because the stimulating electrodes of the current FES devices are percutaneous electrodes, which are susceptible to wire breakage, and skin infection an implantable FES stimulating electrode has been introduced in the U.S. and Japan. In the present study, an external power supply method using radio frequency (RF) coupling and data transmission was developed for the control of the implantable FES device. In addition, we review the current understanding of FES devices and their application in clinical medicine.