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Biomedical subjects

Charles Saltzman

Publications and source records attributed to Charles Saltzman.

7 recordsLinked to original sources
PubMed2005

Ankle ROM and stiffness measured at rest and during gait in individuals with and without diabetic sensory neuropathy.

INTRODUCTION: The purpose of our study was to examine the relationship between ankle dorsiflexion (DF) range of motion (ROM) and stiffness measured at rest (passively) and plantar loading during gait in individuals with and without diabetes mellitus (DM) and sensory neuropathy. Specifically, we sought to address three questions for this at-risk patient population: (1) Does peak passive DF ROM predict ankle DF ROM used during gait? (2) Does passive ankle stiffness predict ankle stiffness used during gait? (3) Are any of the passive or gait-related ankle measures associated with plantar loading? METHODS: Ten subjects with DM and 10 age and gender matched non-diabetic control subjects participated in this study. Passive ankle DF ROM and stiffness were measured with the Iowa Ankle ROM device. Kinematic, kinetic and plantar pressure data were collected as subjects walked at 0.89 m/s. RESULTS: We found that subjects with DM have reduced passive ankle DF ROM and increased stiffness compared to non-diabetic control subjects, however, subjects with DM demonstrated ankle motion, stiffness and plantar pressures, similar to control subjects, while walking at the identical speed, 0.89 m/s (2 mph). These data indicate that clinical measures of heel cord tightness and stiffness do not represent ankle motion or stiffness utilized during gait. Our findings suggest that subjects with DM utilize strategies such as shortening their stride length and reducing their push-off power to modulate plantar loading.

Ankle Joint↗
PubMed2004

The impact of osteoarthritis: implications for research.

Osteoarthritis, the clinical syndrome of joint pain and dysfunction caused by joint degeneration, affects more people than any other joint disease. There are no consistently effective methods for preventing osteoarthritis or slowing its progression, and symptomatic treatments provide limited benefit for many patients. Osteoarthritis disables about 10% of people who are older than 60 years, compromises the quality of life of more than 20 million Americans, and costs the United States economy more than $60 billion per year. The incidence of osteoarthritis rises precipitously with age; as a result, the prevalence and burden of this disorder is increasing rapidly. Study of the patterns osteoarthritis incidence and prevalence shows that it occurs frequently in the hand, foot, knee, spine and hip, but rarely in the ankle, wrist, elbow, and shoulder, and the most important universal risk factors are age, excessive joint loading, and joint injury. Analysis of the impact of osteoarthritis raises questions that include: Why does the incidence increase progressively with age? Why are some joints rarely affected? How do mechanical forces cause joint degeneration? What biologic and mechanical factors slow or accelerate the rate of joint degeneration? Answering these questions could lead to effective methods of preventing osteoarthritis and slowing its progression.

Age Factors↗
PubMed2004

PEMF as treatment for delayed healing of foot and ankle arthrodesis.

BACKGROUND: Arthrodesis is the most common surgical treatment for foot and ankle arthritis. In adults, these procedures are associated with a 5% to 10% rate of nonunion. Pulsed electromagnetic field (PEMF) stimulation was approved by the Federal Drug Administration (FDA) for treatment of delayed unions after long-bone fractures and joint arthrodesis. The purpose of this study was to examine the results of PEMF treatment for delayed healing after foot and ankle arthrodesis. METHODS: Three hundred and thirty-four foot and ankle arthrodeses were done. Nineteen resulted in delayed unions that were treated with a protocol of immobilization, limited weightbearing, and PEMF stimulation for a median of 7 (range 5 to 27) months. All patients were followed clinically and radiographically. RESULTS: The use of PEMF, immobilization, and limited weightbearing to treat delayed union after foot and ankle arthrodesis was successful in 5 of 19 (26%) patients. Of the other 14 patients with nonunions, nine had revision surgery with autogenous grafting, continued immobilization, and PEMF stimulation. Seven of these eventually healed at a median of 5.5 (range 2 to 26) months and two did not heal. One patient had a below-knee amputation, and four refused further treatment. CONCLUSIONS: The protocol of PEMF, immobilization, and limited weightbearing had a relatively low success rate in this group of patients. We no longer use this protocol alone to treat delayed union after foot and ankle arthrodesis.

Adult↗
PubMedDate not supplied

Accuracy of a custom-designed activity monitor: implications for diabetic foot ulcer healing.

The relationship between repetitive trauma and propensity for ulceration and ulcer healing is unknown in part because of the lack of accurate information on activity level. The Step Activity Monitor (SAM) is a newly designed accelerometer to record activity level, but its accuracy is questionable. The purpose of this study was to determine the accuracy of the SAM under varying footwear and walking surface conditions. Ten healthy subjects consented to walk over 530 m of flat ground and up and down two flights of stairs, while wearing an athletic shoe or a fiberglass total contact cast (TCC). The accelerometer, programmed for a subject's cadence and leg motion, was secured to the distal, lateral aspect of the right lower leg. Two observers using hand-held digital counters followed the subject and recorded steps taken with the right leg on all walking surfaces. With the use of a repeated measures analysis of variance (ANOVA), the SAM and hand-held digital counters similarly recorded steps taken, regardless of walking surface condition. While the SAM was highly accurate (94 to 96 percent), the percent error was greater (p = 0.007) for the stair-climbing condition with the use of the TCC because of two subjects using a step-to-gait pattern. Overall, the SAM is an accurate accelerometer that will accurately record activity level, even with the application of a TCC. However, its accuracy may vary with deviations from a normal gait pattern.

Acceleration↗