In spite of some quantitative differences, the kinematics of the hand during reaching and pointing in quadriplegic patients are surprisingly similar to those of control subjects. Spinal Cord (2000) 38, 354 - 362.

No abstract

No abstract

SummaryThis study was concluded on paraplegic and tetraplegic patients of all aetiologies except neoplasic, where paralysis developed within 48 hours. All patients were admitted to the rehabilitation department within 90 days after the onset of paralysis. In a preliminary review of 328 files, there were 27 cases of clinical deep vein thrombosis (DVT) and 10 with pulmonary embolism (PE), 6 of which were fatal. A prospective study was conducted, based on systematic detection of asymptomatic DVT with phlebography. Among the 147 patients, 20 previously presented with DVT. The 127 others underwent phlebography which showed 39 DVT in 29 patients. Eighty seven patients with negative phlebography underwent a second study a month later which showed 14 DVT in 12 patients. Only one minor pulmonary embolism occurred in these 147 patients. The incidence of DVT after acute spinal cord injury and the frequent absence of clinical manifestations were confirmed. Prophylactic anticoagulant therapy is useful but insufficient. This study demonstrates that systematic and repeated detection of DVT by phlebography may reduce the incidence of P E.

Polio survivors are aging and facing multiple pathologies. With age, walking becomes more difficult, partly due to locomotor deficits but also as a result of weight gain, osteoarticular degeneration, pain, cardiorespiratory problems or even post polio syndrome (PPS). These additional complications increase the risk of falls in this population where the risk of fractures is already quite high. The key joint is the knee. The muscles stabilizing this joint are often weak and patients develop compensatory gait strategies, which could be harmful to the locomotor system at medium or long term. Classically, knee recurvatum is used to lock the knee during weight bearing; however, if it exceeds 10 degrees , the knee becomes unstable and walking is unsafe. Thus, regular medical monitoring is necessary. Orthoses play an important role in the therapeutic care of polio survivors. The aim is usually to secure the knee, preventing excessive recurvatum while respecting the patient's own gait. Orthoses must be light and pressure-free if they are to be tolerated and therefore effective. Other joints present fewer problems and orthoses are rarely indicated just for them. The main issue lies in the prior evaluation of treatments' impact. Some deformities may be helpful for the patients' gait and, therefore, corrections may worsen their gait, especially if a realignment of segments is attempted. It is therefore essential to carefully pre-assess any change brought to the orthoses as well as proper indications for corrective surgery. In addition, it is essential for the patient to be monitored by a specialized team.