Effects of audio feedback on sitting behaviors of community-dwelling manual wheelchair users with spinal cord injuries.

The purpose of this study was to investigate whether audio feedback obtained from a data logger could help community-dwelling manual wheelchair users (MWUs) to engage in pressure-relieving behaviors more frequently. Twenty community-dwelling MWUs completed the study. Data loggers with force sensors were installed on each participant's wheelchair. The frequency of pressure-relief activities and sitting time were recorded on two occasions one week apart with or without audio feedback. The results showed that MWUs spent approximately 9.2 hours per day sitting in their wheelchairs and performed an average of 5.1 transfers from their wheelchair. MWUs receiving audio feedback showed a significant increase in pressure-relieving activities, which included push-up frequency and side-to-side lean frequency with less uninterrupted sitting time. Although the audio alarm device served as a useful tool in promoting pressure-relieving behaviors, our subject population still showed low frequency of pressure-relief activities. This might indicate that other factors besides pressure may explain why our subjects are free from pressure ulcers. Educational materials should include not only information related to pressure but to other risk factors believed to contribute to the development of pressure sores.

Ischemic stroke in Williams-Beuren syndrome: a case report.

A 15-year-old girl was admitted because of an acute onset of facial palsy and right hemiparesis. The patient had a history of moderate mental retardation and developmental delay. On admission, her vital signs were stable, except for high blood pressure. Magnetic resonance imaging demonstrated an infarct involving the left internal capsule and putamen. Because of the patient's young age, an extensive stroke survey was performed. Williams-Beuren syndrome was finally confirmed by fluorescent in situ hybridization. Compared with the previously reported cases, no evidence of cerebral arterial stenosis or cardiac abnormalities was found by noninvasive imaging techniques. Because Williams-Beuren syndrome is a complex, multiple congenital anomaly syndrome with prominent cardiovascular features, regular assessment and antihypertensive treatment are necessary to minimize the lifelong cardiovascular risk in patients with this syndrome.

Effects of different stretching techniques on the outcomes of isokinetic exercise in patients with knee osteoarthritis.

We recruited 132 subjects with bilateral knee osteoarthritis (Altman Grade II) to compare the effects of different stretching techniques on the outcomes of isokinetic muscle strengthening exercises. Patients were randomly divided into four groups (I-IV). The patients in Group I received isokinetic muscular strengthening exercises, Group II received bilateral knee static stretching and isokinetic exercises, Group III received proprioceptive neuromuscular facilitation (PNF) stretching and isokinetic exercises, and Group IV acted as controls. Outcomes were measured by changes in Lequesne's index, range of knee motion, visual analog pain scale, and peak muscle torques during knee flexion and extension. Patients in all the treated groups experienced significant reductions in knee pain and disability, and increased peak muscle torques after treatment and at follow-up. However, only patients in Groups II and III had significant improvements in range of motion and muscle strength gain during 60 degrees/second angular velocity peak torques. Group III demonstrated the greatest increase in muscle strength gain during 180 degrees/second angular velocity peak torques. In conclusion, stretching therapy could increase the effectiveness of isokinetic exercise in terms of functional improvement in patients with knee osteoarthritis. PNF techniques were more effective than static stretching.

Sacral myeloradiculitis (Elsberg syndrome) secondary to eosinophilic meningitis caused by Angiostrongylus cantonensis.

Elsberg syndrome secondary to eosinophilic meningitis caused by Angiostrongylus cantonensis is uncommon. Clinicians should consider a wide differential diagnosis including tumour, spinal cord infarction, necrosis, vasculitis, drug induced or other sources of infection. In addition, acute urinary retention is a urological emergency and clinicians should keep in mind the prevention of bladder overdistension. The intervention of rehabilitation programmes and clean intermittent catheterisation education for bladder management, in accordance with the patient's condition, is also important. Earlier rehabilitation is important to ensure a speedy recovery and to prevent further complications.