Postural Responses to Achilles Tendon Vibration Depend on Feet Positioning.

Mechanical vibration of the Achilles tendon is widely used to analyze the role of proprioception in postural control. The response to this tendon vibration (TV) has been analyzed in the upright posture, but the feet positions have varied in past research. Moreover, investigators have addressed only temporal parameters of the center of pressure (CoP). We investigated the effect of TV on both temporal and spectral characteristics of the CoP motion. Eighteen healthy young adults, stood barefoot, with one foot on each side of a dual platform, wearing glasses with opaque lenses. We applied 20 seconds of Achilles TV (bilaterally with inertial vibrators at a frequency of 80 Hz and an amplitude of .2-.5 mm). We analyzed CoP signals pre-vibration (PRE,4-seconds), during vibration (VIB,20 seconds), and after vibration cessation (REC,20 seconds). We repeated this protocol in natural and standardized positions (15° feet angular opening). For determining CoP amplitude and velocity, we divided the 20 seconds into five phases of four seconds each and calculated spectral parameters for the whole 20-second signals. There was an adaptation process in the speed of the CoP mediolateral (p < .01) and anteroposterior (p < .01) and in the displacement of the CoP anteroposterior (p < .01), with higher values in the VIB condition. Velocity and displacement decreased progressively in the REC condition. Median and peak frequencies were higher in the VIB condition when compared to the REC condition, but only in the mediolateral direction (p = .01). The standardized foot position led to increased speed in CoP mediolateral, anteroposterior, and mediolateral displacement (p < .01). CoP spectral characteristics were not affected by foot positioning. We concluded that adaptation of CoP motion in the presence of TV and after its cessation are observable both in time and frequency domains. Feet positioning influenced CoP motion in the presence of TV and after its cessation but it did not affect its spectral characteristics.

COVID-19 lockdowns' effects on the quality of life, perceived health and well-being of healthy elderly individuals: A longitudinal comparison of pre-lockdown and lockdown states of well-being.

PURPOSE: . The concept of lockdown in relation to COVID-19 is thought to have an indirect impact on the quality of life and well-being of the elderly due to its consequences on the physical, psychological, and cognitive health of individuals. However, previous published studies on this subject are limited in terms of methodological approach used, including the absence of pre-confinement status and the type of experimental design, which is often cross-sectional. The present study proposes a longitudinal design with pre-confinement measures. It assesses changes in quality of life, perceived health, and well-being by comparing the period before lockdown (T1 = December 2019), three months after the start of the first lockdown (T2 = June 2020), and during the second lockdown (T3 = January 2021) due to COVID-19. MATERIALS AND METHODS: . This study is conducted with a group of 72 healthy elderly persons. They completed an electronic (online) survey assessing personal factors, activities, and participation as well as responding to the EuroQol-5D and Warwick-Edinburgh Mental Well-being Scale. RESULTS: . A decrease in quality of life, perceived health and well-being was observed between T1 and T2 and between T1 and T3, but no difference was reported between the two lockdown periods. The variables associated with these changes included energy level, level of happiness, physical activity, change in medical condition, memory difficulties, level of perceived isolation and age. CONCLUSION: . This study will help to target variables that may have a deleterious effect on older adults for consideration in future confinement settings and for preventive purposes.

Identification of physically fatiguing tasks performed during aircraft open-basket ground de-icing activities.

BACKGROUND: Airplane de-icing technicians work from either an open-basket or closed-basket. OBJECTIVE: The objective of this study is to identify the tasks that have an influence on the physical fatigue of open-basket aircraft de-icing technicians. METHODS: In a Canadian airport during the winter of 2016-2017, a field study was conducted in which the heart rate of 12 volunteer participants was collected. The data was analyzed along with the 22 tasks that make up the activity of open-basket aircraft de-icing. For each participant, the mean absolute cardiac cost per task was compared. The evolution of the cardiac signal based on the resting heart rate and steady state limit was also characterized. RESULTS: According to the cumulative results fatigue occurs for periodic tasks as well as double tasks. More precisely, the most physically fatiguing tasks are spraying de-icing and anti-icing fluids, moving the basket and truck, as well as tactile control and de-icing quality control at ground level. CONCLUSIONS: Similar studies would need to be conducted in other aircraft de-icing facilities to improve the generalization of the results.

Assessing the visual vertical: how many trials are required?

BACKGROUND: The visual vertical (VV) consists of repeated adjustments of a luminous rod to the earth vertical. How many trials are required to reach consistency in this measure? This question has never been addressed despite the widespread clinical use of the measurement in stroke rehabilitation. METHODS: VV perception was assessed (10 trials) in 117 patients undergoing rehabilitation after a first hemisphere stroke. The intraclass correlation coefficient (ICC) and standard error of measurement (SEM) were calculated for each patient category: with contralesional VV bias (n = 48), ipsilesional VV bias (n = 17) and normal VV (n = 52). RESULTS: For patients with VV biases, 6 trials were required to reach high inter-trial reliability (contralesional: ICC = 0.9, SEM = 1.36°; ipsilesional: ICC = 0.896, SEM = 0.96°). For patients with normal VV, a minimum of 10 trials was required (ICC = .728, SEM = 1.13°). A set of 6 trials correctly classified 96 % of patients. CONCLUSIONS: In the literature, 10 is the most frequently used number of trials used to assess VV orientation. Our study shows that 10 trials are required to adequately measure VV orientation in non-selected subacute stroke patients. For complex protocols imposing a decrease in the number of trials in each condition, 6 trials are needed to identify VV biases in most patients.

Balance during walking on an inclined instrumented pathway following incomplete spinal cord injury.

OBJECTIVES: To study the postural adaptations of subjects with incomplete spinal cord injury (iSCI) and non-injured subjects during overground walking on level and inclined surfaces. METHODS: Six subjects with iSCI and seven non-injured subjects walked on an inclined surface (slope: 15%) and a level surface at their natural gait speed and at a slow gait speed (non-injured subjects only). Maximal stabilizing and minimal destabilizing forces were calculated to quantify dynamic balance during walking. Correlational analysis identified the variables that influence these stabilizing and destabilizing forces. RESULTS: Subjects with iSCI and good sensorimotor recovery were similar to non-injured subjects with respect to maximal stabilizing and minimal destabilizing forces when they walked at the same speed. The MaxSF was mainly explained by the center of pressure speed and step length, whereas the minimal destabilizing force was moderately correlated with body mass and height. CONCLUSION: The influence of gait speed on balance should be considered with a group comparison. With regard to dynamic balance, highly functioning subjects with iSCI do not seem to be sufficiently challenged while walking at their preferred gait speed. Asking individuals with subtle impairments to walk faster following an iSCI may reveal postural adaptations and have an effect on balance abilities.

Surgery and radiotherapy for typical carcinoid of the nasopharynx: a case report.

BACKGROUND: Carcinoid tumours are rare, particularly in the head and neck region. When occurring in this area, they mainly affect the larynx. The first case of primary well-differentiated carcinoid tumour arising from the nasopharynx was documented in 2009 and treated by combined external beam radiation and cold somatostatin analogue with a fatal outcome. To our knowledge, no case of this type of lesion has been successfully treated with surgery and radiotherapy until now. OBJECTIVE: To make physicians aware that typical carcinoid nasopharyngeal tumour can be treated by surgery and adjuvant radiotherapy. METHOD: We report the management of a typical carcinoid nasopharyngeal tumour in a 68-year-old female successfully treated with endoscopic surgery and adjuvant radiotherapy. We also review the relevant literature. CONCLUSION: Patients with close margins at the time of the surgery may need adjuvant radiotherapy to prevent recurrence. After a negative octreotide scintigraphy, periodical follow-up only is sufficient.

[Early treatment with Nd:YAG laser for Valsalva retinopathy: results of five cases and literature review]. / Traitement précoce par laser Nd:YAG de la rétinopathie de Valsalva : résultats à propos de cinq cas et revue de la littérature.

INTRODUCTION: According to the literature, the treatment of retinopathy of Valsalva (VR) by laser is recommended when the macular hemorrhage has not regressed after 3 weeks. PATIENTS AND METHODS: We report five cases of VR treated early (≤ 24 hours) by Nd:YAG laser membranotomy (LM). Clinical examination was performed before and after LM (D1, D7, M1, M3 and M6). Optical coherence tomography (OCT) analysis was performed to determine the precise location of the macular hemorrhage. RESULTS: Good visual recovery was obtained early by LM with a stable outcome at 6 months. The hemorrhage was located under the internal limiting membrane (ILM) and posterior hyaloid in two patients and only under the ILM in three patients. DISCUSSION: The literature review and our study confirm the good functional results for patients treated by LM for VR. Furthermore, very few side effects are reported with this type of treatment compared with the natural course of the disease, which may certainly regress spontaneously, but carries a risk of secondary preretinal fibrosis. However, to obtain optimal efficacy, the treatment should be carried out as soon as possible, in order to avoid clotting of the hematoma, preventing any subsequent evacuation by laser. CONCLUSION: LM for VR is an effective, safe and inexpensive technique compared to the surgical management of these patients presenting with a persistant premacular hematoma after a period of observation.

[Serous central chorioretinopathy and tadalafil: a case report]. / Choriorétinite séreuse centrale et tadalafil, à propos d'un cas.

We report a case of central serous chorioretinopathy in a 46-year-old man with no risk factors except for erectile dysfunction agent use: Tadalafil (Cialis(®)). An association between tadalafil and central serous chorioretinopathy could involve phosphodiesterase type 5 inhibitors and be a risk factor of central serous chorioretinopathy.

[Papillary retinal nerve fiber layer thickness measurement using optical coherence tomography in children with ocular hypertension and juvenile glaucoma]. / Mesure de l'épaisseur de la couche des fibres nerveuses rétinienne péripapillaires par tomographie à cohérence optique chez les enfants hypertones et glaucomateux.

PURPOSE: To compare retinal nerve fiber layer (RNFL) measurements taken with OCT in normal, ocular hypertensive, and glaucomatous eyes of children 4-18 years old. MATERIALS AND METHODS: The study included 181 eyes: 106 normal, 37 with ocular hypertension, and 38 with juvenile glaucoma. Diagnostic groups were classified based on intraocular pressure, optic nerve head appearance, visual field examination, and central corneal thickness measurement. RNFL measurements were taken using the Zeiss Stratus OCT. RESULTS: The RNLF average thickness was 94.2 + or -13.2 microm in glaucomatous eyes, 105.4 + or - 6.8 microm in ocular hypertensive eyes, and 104.8 + or - 10.3 microm in normal eyes. RNFL average thickness, inferior thickness, and superior thickness showed statistically significant differences between normal and glaucomatous eyes (p<0.01) and between glaucomatous [corrected] and ocular hypertensive eyes (p<0.01). There was no difference found between normal and ocular hypertensive eye. CONCLUSION: OCT has already shown its diagnostic efficiency in adult glaucoma. This study shows that OCT is useful in childhood glaucoma diagnosis, helping to differentiate between ocular hypertension and beginning juvenile glaucoma.

Surgical management of maxillary sinonasal inverted papilloma.

OBJECTIVE: The extent of the surgery required when sinonasal inverted papilloma (IP) originates in the maxillary sinus is still the subject of debate. The principal aim of the study was to evaluate the efficacy of exclusive endoscopic removal or when combined with a limited vestibular anterior antrostomy of the maxillary IP. METHODS: A retrospective analysis was carried out of 64 patients with IP treated in our university tertiary referral center from 1993-2007. Endoscopic removal of the IP was done for all patients, either exclusively or combined with an open approach. All patients were followed up for more than 1 year and the local control rate has been compared between patients with maxillary IP and others, and with both approaches. RESULTS: The overall recurrence rate was 14% (9/64), for a mean follow up of 48 months (12-120 months). Twenty-three patients (23/64) had maxillary IP. Ten of them had endoscopic resection alone, 13 had a combined approach (1 with lateral rhinotomy). There were 4 recurrences (17%) three of which had had endoscopic surgery alone. We did not perform a medial maxillectomy in the first instance. There were no cases of epiphora or atrophic rhinitis. conclusion: We showed that the combined method (endoscopic assisted by a minimal vestibular approach) was an efficient and safe method to treat maxillary sinus IP. This approach could preserve the lacrimal duct and the inferior turbinate when these structures were not involved, even when there was a large maxillary sinus extension of the disease.