Functional Performance And Rehabilitation Expert Guide

Functional Performance And Rehabilitation

Fpr is a membership site where Function is the basis for Performance and Rehabilitation. Fpr takes the approach to performance and rehabilitation where sound clinical and evidence based rationale is used for corrective exercise to negate movement impairments and dysfunctions. Fpr looks through a functional pair of lenses at other parts of the body and how those body parts contribute to movement dysfunction. All this is brought to the members through articles, videos, and presentations. Fpr has a mission to collect the newest research articles on performance and rehabilitation topics that members perhaps dont have time to read on their own. Fpr will not only read articles but will develop an application to the learned concepts for allied health professions, coaches, and athletes to utilize. The end result is members training and rehabilitation programs become more functional and efficient. The key to designing any functional rehabilitation or performance program is to first assess what the functional deficits are. With this exercise you get the benefits of core stabilization, glute activation, and lower trap stabilization. You achieve core stabilization by having your patient/client maintain a neutral spine positioning through a flexionextension dynamic movement but you also obtain neutral spine from the glute max activation.

Functional Performance And Rehabilitation Summary

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Postoperative Treatment in a Cast versus Functional Rehabilitation

The issue of complete casting compared with functional rehabilitation on the Achilles tendon with relation to the stresses on the tendon is a difficult one. Complete immobility without stress leads to tissue atrophy and adhesions, whereas too much stress too early is likely to jeopardize the tendon repair and lengthen the repair or provoke a re-rupture. Functional rehabilitation may include the use of an orthosis, a splint, or a modified shoe. Many different functional rehabilitation protocols are advocated for six to eight postoperative weeks, and it is difficult to compare such studies. The general trend from the functional rehabilitation regimens indicates no apparent increase in rerupture rate. Pooled data from five prospective comparative studies investigating cast immobilization versus functional brace regimens18,69,71-73 revealed an incidence of re-rupture rate of 5.0 in the cast immobilization group and 2.3 in the functional brace group (p 0.26).74 Further, a postoperative...

Islet Viability and Function

The oxygen levels to which the islet cells are exposed are important from two standpoints, viability and function. Because oxygen is consumed at a high rate by islet cells, particularly when stimulated by increased glucose concentration, steep gradients in oxygen concentration can develop. Thus, the oxygen concentration decreases from that of the local blood supply as it diffuses across the tissue, the immunoisolation membrane, and throughout the islet. Consequently, islet cells may be exposed to hypoxic, or even anoxic, conditions.60 This can lead to loss of cell viability and to a reduction in the insulin secretion capacity. Further studies should focus on finding a practically applicable method to reduce the barrier between encapsulated islets and the bloodstream in order to improve both the functional performance and the survival of encapsulated islet grafts. However, an interchange between vascularization and hence nutrient supply and retrievability will always be present.

Potential Role For Autologous Skeletal Myoblasts In Myocardial Repair

Successful engraftment of autologous skeletal myoblasts into injured myocardium has been reported in multiple animal models of cardiac injury. These studies have demonstrated survival and engraftment of myoblasts into infarcted or necrotic hearts (Liechty et al., 2000), differentiation of the myoblasts into striated cells within the damaged myocardium (Liechty et al., 2000), and improved myocardial functional performance (Mahon et al., 1999 Liechty et al., 2000 MacLellan and Schneider, 2000). Other studies have shown that the survival of transplanted myo-blasts can be improved by heat-shock pretreatment (Maier et al.,

Stem cells in the context of retinal degenerations

To assess the feasibility of MSC for cell replacement in retinal degenerative disease, our laboratory performed both in vitro and in vivo analyses. The in vitro analyses of rat CD90+ MSC have involved the use of activin A and taurine to induce differentiation and resulted in the expression of rhodopsin, opsin and recoverin (Kicic et al., 2003a). The rat MSC were transduced with rAAV.GFP prior to transplantation into the subretinal space of 4-5 week old normal RCS rats in order to demonstrate the viability of combining gene therapy with cell replacement (Kicic et al., 2003a). This was performed because autologous transplantation may necessitate the correction of the genes responsible for the retinal degenerative condition in order to prevent the transplanted cells from degenerating. The transplanted cells showed no morphological differentiation into photoreceptors and thus we suspect that the rhodopsin positive transplanted cells are immature photoreceptors. Despite little...

Patrice L Weiss1 Rachel Kizony12 Uri Feintuch23 and Noomi Katz2

Technologies are poised to have a major impact on evaluation and intervention for cognitive, motor and functional rehabilitation due to the unique attributes of VR-based therapy. These attributes make it highly suitable for the achievement of many rehabilitation goals including the encouragement of experiential, active learning, the provision of challenging but safe and ecologically valid environments, the flexibility of individualized and graded treatment protocols, the power to motivate patients to perform to their utmost capability and the capacity to record objective measures of performance.

Lower Extremity Composite Free Flaps

The only composite flap reported from the medial thigh is a gracilis free flap that that was used in one case to reconstruct the Achilles tendon and provide vascularized soft tissue.37 The flap was fitted to the tendon defect by folding the grac-ilis tendon on itself and suturing it to the muscle belly. A skin graft covered the muscle. There was excellent functional restoration of the tendon and an acceptable soft tissue contour.

Mechanisms of Action

It is tempting to assume that the implanted cells, being multipotent, simply replace the missing components of the damaged tissue. However, there is increasing evidence that this may not be the only or even the primary mechanism. In some experimental conditions, paracrine effects and immune regulation of the implanted cell populations play a role in functional restoration that appears to be much greater than their structural contribution to the repair tissue.70-73 For instance, the transplantation of c-kit positive bone marrow cells in a mouse model of diabetes mellitus reduced hyperglycemia mainly by triggering regeneration of the recipient's own pancreatic cells rather than by a direct contribution of the donor's cells to the regenerated tissue.70 In another study, the administration of human cord blood-derived CD34 positive cells to immunocompromised mice subjected to experimental stroke 48 hours earlier induced neovascularisation in the ischaemic zone, thereby providing an...

Conclusions

Cell-based treatments are an attractive clinical application for a range of medical needs and have already been used therapeutically for many years in malignant haematological diseases and skin grafting. However, for liver diseases, stem cell therapy treatment approach is still in its infancy. Despite recent progress in the laboratory and in the clinical trials, there are still many gaps in our understanding of basic stem cell biology that must be addressed before stem cell therapy can be applied to its fullest potential in the clinic. However, a number of clinical trials using different populations of stem cells to treat a growing number of diseases have already started. Clinical trials in which bone marrow stem cells are injected in the cardiac muscle of patients with myocardial infarction are the most numerous and have been performed with some success.62 For therapeutic stem cell transplantation to occur, many problems remain to be resolved. It must be defined which patient groups...

Outcome

Concerning endoscopic calcaneoplasty, we reported the results of our first 20 patients in 2001.12 All patients had typical complaints of inflammation of the retrocalcaneal bursa unresponsive to nonoperative management for more than 6 months. All patients presented positive parallel pitch lines (Fig. 14.3). The mean follow-up was 3.9 years (range 2-6.5). There were no surgical complications. One patient had a fair result, 4 patients had good results, and the remaining 15 patients had excellent results. Endoscopic calca-neoplasty for chronic retrocalcaneal bursitis is a minimally invasive technique that can be performed in an outpatient setting combined with a functional rehabilitation program in which patients have a short recovery time and quickly resume work and sports.18

Acupuncture

A recent systematic review concluded that there is moderate evidence that back schools have better short-term effects than other treatments for chronic low back pain, and moderate evidence that back schools in an occupational setting are more effective compared to placebo or waiting list controls.50 Functional restoration programs combine intense physical therapy with cognitive-behavioral interventions and increasing levels of task-oriented rehabilitation and work simulation.41 Patients with chronic low back pain may require referral to a multidisciplinary pain clinic for optimal management. Such clinics can offer cognitive-behavioral therapy, patient education classes, supervised exercise programs, and selective nerve blocks to facilitate return to normal function.14 Complete relief of symptoms may be an unrealistic goal instead, patients and physicians should try to optimize daily functioning.