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Results for “HIP CONTRACTURE”

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At least 253 records · Page 14Linked to original sources
PubMed1976

Effects of nerve stimulation on human muscle.

A phasic program of femoral nerve stimulation was used to reduce refractory knee flexion contractures in five patients. In one, rectus femoris was tenotomized before starting stimulation to reduce hip flexion contracture. Muscle biopsies were performed before and after 5 to 12 weeks of intermittent stimulation at separated sites on the same muscle. In the four patients where muscle contraction was isometric, type I fibers increased 3.7%, 6.4%, 48.4%, anand 30.4%, respectively. Both fiber types in each patient showed an increase in size ( p less than .001). In the tenotomized muscle, where contraction was isotonic at a shortened length, the proportion of type I fibers decreased from 40.2% to 25.4%, and their mean diameter also decreased (p less than .001). These observations suggest that the physical conditions of contraction may be more important than the pattern of neuronal discharge in determining the metabolic profile of human muscle fibers.

Axons↗
PubMed1998

Biomechanical gait alterations independent of speed in the healthy elderly: evidence for specific limiting impairments.

OBJECTIVES: It is not known whether changes in the biomechanics of elderly gait are related to aging per se, or to reduced walking speed in this population. The goals of the present study were to identify specific biomechanical changes, independent of speed, that might impair gait performance in healthy older people by identifying age-associated changes in the biomechanics of gait, and to determine which of these changes persist at increased walking speed. DESIGN: Stereophotogrammetric and force platform data were collected. Differences in peak joint motion (kinematic) and joint moment and power (kinetic) values between healthy young and elderly subjects at comfortable and increased walking speed were measured. SETTING: A gait laboratory. SUBJECTS: Thirty-one healthy elderly (age 65 to 84 years) and 31 healthy young adult subjects (age 18 to 36 years), all without known neurologic, musculoskeletal, cardiac, or pulmonary problems. MAIN OUTCOME MEASURES: All major peak kinematic and kinetic variables during the gait cycle. RESULTS: Several kinematic and kinetic differences between young and elderly adults were found that did not persist when walking speed was increased. Differences that persisted at both comfortable and fast walking speeds were reduced peak hip extension, increased anterior pelvic tilt, and reduced ankle plantarflexion and ankle power generation. CONCLUSION: Gait performance in the elderly may be limited by both subtle hip flexion contracture and ankle plantarflexor concentric weakness. Results of the current study should motivate future experimental trials of specific hip flexor stretching and ankle plantarflexor concentric strengthening exercises to preserve and potentially improve walking performance in the elderly.

Adolescent↗
PubMedDate not supplied

[Results of surgical therapy of knee flexion contractures in patients with myelomeningocele].

This study reports the results of 98 operations for correcting knee-flexion-contractures, which were performed between 1972 and 1989 in 60 patients with myelomeningocele. 13 knees had hamstring lengthening and 85 knees had radical flexor release. In 4 patients, who had flexion-contractures of more than 50 degrees, the soft tissue release was combined with supracondylar extension osteotomy. 58 patients had additional hip-flexion-contractures and 39 patients had feet deformities. The average age at time of surgery was 8 years, 3 months. The average follow-up-period was 65 months with a minimum of 1 year and a maximum of 13 years. In 92 knees a permanent extension ability could be achieved. In 6 knees a recurrence of flexion-contracture occurred making a second surgery necessary. The main problem in the postoperative period were 13 skin necroses, which were seen mainly after an s-shaped incision. As a conclusion a perpendicular midline incision is recommended. After surgery 11 patients could be provided for the first time with an orthoses. In the remaining the upright body position or the erection of the orthoses could be improved.

Adolescent↗
PubMed2003

A computer simulation of human walking in persons with joint contractures.

Joint contractures decrease the patient's ability to walk, but usually other parts of the body compensate the affected joint contractures. When we restore the gait performance in paraplegic patients by means of functional electrical stimulation, however, we cannot expect complications of compensation. A computer simulation was done to clarify how the contractures affect the gait pattern when no complications of compensation were expected. A seven-segment link mechanical model was used for simulation of human walking in the sagittal plane. In turn, using a personal computer stance and swing-leg joint contractures of the ankle, knee, and/or hip were simulated. When stance-leg contracture was simulated, step length became short with increasing hip flexion contracture. The trunk was tilted backward during knee flexion or ankle plantarflexion contracture simulation. When the swing-leg contracture was simulated, step length became short with increasing knee flexion contracture. We found that hip or knee flexion contracture of < or = 15 degrees, or ankle plantarflexion contracture of < 0 degrees was required to maintain positive step length and forward movement of the center of gravity. These findings suggest that 15 degrees of hip and knee flexion contracture, and 0 degrees of ankle plantarflexion contracture are critical when gait restoration is performed by functional electrical stimulation.

Ankle↗
PubMed2006

Windswept hip deformity in children with cerebral palsy.

Windswept hip deformity describes an abduction and external rotation position of one hip with the opposite hip in adduction and internal rotation. Windswept hip deformity may occur in association with hip dislocation and scoliosis. We analysed the prevalence of this deformity in a total population of children with cerebral palsy, and the impact of hip prevention and early treatment of contractures on the prevalence and severity of windswept hip deformity. The frequency of windswept hip deformity was 12% in the control group and 7% in the study group, comprising children in the hip prevention programme. The children with this deformity in the study group had a lower frequency of scoliosis and none had hip dislocation. It thus seems that the hip prevention programme results in a decrease in the number of children with windswept hip deformity, and a decrease in the severity of the deformity.

Adolescent↗
PubMed1979

Ischemia of the lower extremity after total hip replacement.

Following total hip replacement, three patients had early and one had late ischemia of the ipsilateral extremity. Three required vascular surgery and one, a lumbar sympathectomy for relief of pain at rest. In each instance there had been multiple previous procedures on the same hip resulting in extensive scarring, shortening, flexion contracture, or fusion. The ischemia after total hip replacement was probably the result of interruption of critical collateral circulation about the hip or of traction on the femoral vessels tethered by scar when the short limb was lengthened or when the hip contracture was corrected. Evaluation by Doppler pressures and arteriography was helpful. Careful preoperative evaluation, early recognition of signs of ischemia, and prompt institution of appropriate management are essential to prevent this complication and to treat it adequately once it occurs.

Aged↗
PubMed2002

Etiology of the so-called "idiopathic scoliosis". Biomechanical explanation of spine deformity. Two groups of development of scoliosis. New rehabilitation treatment; possibility of prophylactics.

INTRODUCTION: Between various etiological factors of idiopathic scoliosis we also studied the biomechanical causes connected with the hip and pelvic regions. At all children with idiopathic scoliosis there is a real or functional abduction contracture of the right hip (sometimes plus flexions- and out-rotation contracture). The right hip abduction contracture is connected with "syndrome of contractures" at newborns and babies. MATERIAL: 629 children treated in University Pediatric Orthopaedic Department, Lublin/Poland were divided into two groups: *I group of development of scoliosis- 220 children aged from 4 to 10. Real abduction contracture of the right hip 4-6-8 degree, adduction of the left hip 35-40-45 degree. Rotation deformity, both scoliosis (Lumbar L and thoracic Th) at the same time. Progression. **II group of development of scoliosis - 409 children aged from 10-12 to 14. Adduction of the right hip 10-15 even 20 degrees, adduction of the left hip 35-40-45 degree. Lumbar left convex scoliosis, no rotation deformity or small, no thoracic scoliosis, or small, no progression or small. INFORMATION ABOUT "SYNDROME OF CONTRACTURES": Clinical symptoms of _syndrome of contractures" were described exactly by Mau and others. At scoliotic patients we see in the region of right hip the following tissues contracted and shortened: *tractus iliotibialis, *fascia lata, * fascias of m.gluteus medius and minimus, *m. sartorius, *m. rectus, *capsules of right hip joint. CLINICAL RESEARCH: Since 1980s we added the tests for the adduction of both hips in straight position of the joint to the standard examination of scoliotic patient. Depending on the value of adduction movements of both hips we divided all patients into two above mentioned groups (I and II). EVALUATION OF PRESENT REHABILITATION TREATMENT IN OUR MATERIAL:Children were divided into three groups depending on range of scoliosis: A. Scoliosis L 5 degrees - 10 degrees, Th 5 degrees - 10 degrees. These children did not perform (wrong!) extension exercises 10% B. Scoliosis L 15 degrees - 25 degrees, Th 15 degrees - 25 degrees. These children performed (wrong!) extension exercises 30% C. Scoliosis L 25 degrees - 35 degrees or more, Th 25 degrees - 35 degrees or more. Older children. Extension (wrong!) exercises long time (1-2-3 years!) 60% CONCLUSIONS: 1 . The so-called idiopathic scoliosis are connected with the right hip real or functional abduction contracture (sometimes plus flexion and out-rotation contracture). 2. There are two groups of development of idiopathic scoliosis. The first group - small children, early rotation deformity, both scoliosis (L and Th), progression. The second group is connected only with the habit of permanent standing "at ease" on the right leg. Older children. L scoliosis, sometimes Th scoliosis. 3. X-ray pictures of spine with pelvis are necessary for proper diagnosis.4. Abduction contracture of the right hip is connected with "syndrome of contractures" of new-borns and babies.5. We see necessity to introduce new stretching-flexion asymmetric exercises and a special sports program for the children endangered with scoliosis. 6. We proved that the "new prophylactics" through "new clinical test" and "new rehabilitation treatment" at school children (5-6-7-8 years old) gives positives results.

Adolescent↗
PubMed1988

Paraparesis in a patient with Crohn disease resulting from septic arthritis of the hip and psoas abscess.

A psoas abscess is a recognized complication of Crohn disease. Less commonly, septic arthritis has been described with this entity. The occurrence of both these complications together in Crohn disease is quite rare. A 56-year-old patient with Crohn disease presented with weakness and pain in both lower extremities. Computerized body tomograms demonstrated a large psoas abscess with fistulous connections to the bowel as well as extending into the capsule of the left hip joint. X-ray examination revealed evidence of acute septic arthritis. Electromyographic studies demonstrated lumbosacral plexus involvement bilaterally. The patient subsequently underwent ileocolectomy with drainage of the left psoas abscess, followed by extensive inpatient rehabilitation. Some immediate strength improvement was noted bilaterally. At discharge, the patient remained paraparetic. In patients with known history of Crohn disease, a psoas abscess should be considered when there are symptoms of lower extremity pain, hip flexion contractures, and progressive weakness.

Abscess↗