Objective. To compare the effects of two types of ankle-foot orthoses on gait of patients with cerebrovascular accident (CVA) and to evaluate their preference in using each AFO type. Design. Thirty individuals with acute hemiparetic CVA were tested without an AFO, with an off-the-shelf carbon AFO (C-AFO), and with a custom plastic AFO (P-AFO) in random order at the time of initial orthotic fitting. Gait velocity, cadence, stride length, and step length were collected using an electronic walkway and the subjects were surveyed about their perceptions of each device. Results. Subjects walked significantly faster, with a higher cadence, longer stride, and step lengths, when using either the P-AFO or the C-AFO as compared to no AFO (P < 0.05). No significant difference was observed between gait parameters of the two AFOs. However, the subjects demonstrated a statistically significant preference of using P-AFO in relation to their balance, confidence, and sense of safety during ambulation (P < 0.05). Moreover, if they had a choice, 50.87 ± 14.7% of the participants preferred the P-AFO and 23.56 ± 9.70% preferred the C-AFO. Conclusions. AFO use significantly improved gait in patients with acute CVA. The majority of users preferred the P-AFO over the Cf-AFO especially when asked about balance and sense of safety.
A correlation between curve types and symptomatic foraminal stenosis exists. Adult scoliosis patients with sciatic nerve pain typically present with foraminal stenosis at the concavity of the caudal fractional curve. Similarly, patients with femoral nerve pain present with foraminal stenosis at the concavity of the caudal fractional curve when the main structural curve is thoracic, thoracolumbar, or lumbar (apex L2 or higher).
more units of blood. Minor bleeding events were defined as epistaxis, hemoccult stools, hematuria or hematoma Results or Clinical Course: Analysis of 1766 records demonstrated 1412 patients on warfarin, 218 on fondaparinux, 101 on rivaroxaban and 35 on enoxaparin. Patients treated with warfarin had major bleed incidence 0.85% (n¼12), minor bleed incidence 3.5 % (n¼49) and DVT/PE incidence 2.4% (n¼ 34).Those on fondaparinux had major bleed incidence 0.9% (n¼2), minor bleed incidence 2.3% (n¼ 5) and DVT/PE incidence 0.4% (n¼1). Those on rivaroxaban had no major bleeds, minor bleed incidence of 2% (n¼2) and no DVT/PE. Those on enoxaparin had major bleed incidence 2.8% (n¼1), minor bleed incidence 2.8% (n¼1) and no DVT/PE. Conclusions: Rivaroxaban and enoxaparin were most effective in that there were no incidences of DVT/PE; this was followed by fondaparinux. Warfarin was least effective with greater incidence of DVT/PE. Safety as measured by major bleeds was least in enoxaparin treated group, followed by fondaparinux and warfarin. Rivaroxaban was safest with no major bleeds and it was also favorable due to oral administration and not needing dose monitoring.
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