Effect of a distal weight-bearing implant on visual analog scale scores in 23 transfemoral amputees.

The objective of this interrupted time series clinical trial was to evaluate the effect of a distal weight-bearing implant on well-being in patients with transfemoral amputations using the visual analog scale (VAS). A total of 29 patients from five hospitals with previous transfemoral amputations were surgically implanted with an osseoanchored implant with a distal spacer that allows a direct load on the residuum over the distal surface of the socket. Patients were followed for a 14-month period and assessed presurgically and postsurgically using the VAS. The Wilcoxon test was used to evaluate the differences between variables. VAS mean scores improved significantly after intervention. Significant and clinically meaningful improvements in the VAS score suggest overall improvement in well-being for patients after receiving a distal weight-bearing implant.

Alteraciones del control postural en fases iniciales del latigazo cervical / Postural control disorders in initial phases of whiplash

Fundamentos y objetivo: El vértigo de intensidad variable es un síntoma frecuente en pacientes que han presentado un síndrome del latigazo cervical (SLC) y que presentan alteraciones del equilibrio bien documentadas. El objetivo del estudio fue evidenciar alteraciones del control postural en las fases precoces del SLC tras el accidente. Pacientes y método: Se incluyó a 99 mujeres; 54 habían presentado un SLC en las 2 semanas previas, mientras que 45 voluntarias sanas formaron el grupo control. En ambos grupos se realizó una posturografía estática sobre una plataforma de fuerza y se estudió en 4 fases secuenciales la prueba de Romberg para valorar el área de barrido (AB) como variable dependiente. Para evaluar el dolor y la funcionalidad cervical se usaron la escala analógica visual (EVA) y el Northwick Park Neck Pain Questionnaire (NPH). Resultados: El AB aumentó de forma significativa en cada una de las fases consecutivas en ambos grupos. Las diferencias de las medias del área de barrido fueron estadísticamente significativas en todas las fases del Romberg (p=0,009 a p=0,000). No se evidenció correlación entre el AB y el dolor o la funcionalidad cervical. Existió una correlación positiva con el AB en Romberg gomaespuma ojos cerrados y el tiempo de incapacidad laboral temporal (r=0,414; p=0,009). Conclusiones: Los pacientes diagnosticados de un SLC reciente muestran alteración del control postural valorado mediante posturografía estática secuencial, lo que sugiere que la alteración del equilibrio no es sólo consecuencia de la evolución tardía del SLC, por lo que debería promoverse la instauración temprana de un plan terapéutico específico si el paciente refiriera vértigos y/o síntomas relacionados (AU)

Background and objective: Dizziness of variable intensity is a frequent complaint in patients who suffered whiplash and largely documented balance disturbances. The objective of the study was to identify balance disorders in early stage of whiplash after road traffic accidents. Patients and method: Ninety nine women were included in the study. Fifty four women had suffered whiplash within two weeks and 45 were included in a healthy control group. Static posturography on a force platform was carried out in all study participants, by means of the Romberg test in four sequential phases, using the postural sway area (SA) as a dependent variable. Visual Analogic Scale (VAS) and Northwick Park Neck Pain Questionnaire (NPH) were used to evaluate pain and function. Results: Postural sway area increased significantly in each of the consecutive phases in both groups. The differences of the means of the postural sway area were statistically significant in all Romberg phases (p=.009 to P=.000). No correlation was found between SA and VAS or NPH scores. There was a positive correlation between the postural sway area standing on a thick foam cushion placed over the plate with closed eyes and the number of days of transitory incapacity (r=0.414; P=.009). Conclusions: Patients with recent whiplash show a postural control disturbance revealed trough a sequential static posturography analysis. This suggests that the balance disorder is not only a consequence of late whiplash syndrome evolution. Therefore, we should promote early instauration of a specific therapeutic approach if and when the patient refers dizziness and related symptoms (AU)

[Postural control disorders in initial phases of whiplash]. / Alteraciones del control postural en fases iniciales del latigazo cervical.

BACKGROUND AND OBJECTIVE: Dizziness of variable intensity is a frequent complaint in patients who suffered whiplash and largely documented balance disturbances. The objective of the study was to identify balance disorders in early stage of whiplash after road traffic accidents. PATIENTS AND METHOD: Ninety nine women were included in the study. Fifty four women had suffered whiplash within two weeks and 45 were included in a healthy control group. Static posturography on a force platform was carried out in all study participants, by means of the Romberg test in four sequential phases, using the postural sway area (SA) as a dependent variable. Visual Analogic Scale (VAS) and Northwick Park Neck Pain Questionnaire (NPH) were used to evaluate pain and function. RESULTS: Postural sway area increased significantly in each of the consecutive phases in both groups. The differences of the means of the postural sway area were statistically significant in all Romberg phases (p=.009 to P=.000). No correlation was found between SA and VAS or NPH scores. There was a positive correlation between the postural sway area standing on a thick foam cushion placed over the plate with closed eyes and the number of days of transitory incapacity (r=0.414; P=.009). CONCLUSIONS: Patients with recent whiplash show a postural control disturbance revealed trough a sequential static posturography analysis. This suggests that the balance disorder is not only a consequence of late whiplash syndrome evolution. Therefore, we should promote early instauration of a specific therapeutic approach if and when the patient refers dizziness and related symptoms.