Alireza Hamidian Jahromi, Petros Konofaos
Facial nerve (FN) impacts the function of the facial musculature by creating muscle tone at rest as well as the muscles' voluntary and involuntary contractions. Temporary or permanent loss of FN function could be due to different etiologic factors. Acute facial paralysis (FP) could be significantly stressful for the patient and the family and apart from supportive measures management options are quite restricted. While botulinum toxin (BTX) injection in the FP setting has been used mostly to address the compensatory hyperkinesia in the non-paralyzed side of the face, there are evidence to suggest contralateral injection of the non-paralyzed face with BTX may improve/enhance the recovery time of the FP in cases where the FP has a reversible cause...
May 2021: World Journal of Plastic Surgery
Deena Harji, Benjamin Fernandez, Lara Boissieras, Arthur Berger, Maylis Capdepont, Frank Zerbib, Eric Rullier, Quentin Denost
BACKGROUND: Low anterior resection syndrome (LARS) following sphincter-preserving surgery for rectal cancer has a high prevalence, with an impact on long term bowel dysfunction and quality of life. We designed the BOwel REhAbiLitation program (BOREAL) as a proactive strategy to assess and treat patients with LARS. The BOREAL program consists of a stepwise approach of escalating treatments; medical management (Step 0-1), pelvic floor physiotherapy, biofeedback and transanal irrigation (Step 2), sacral nerve neuromodulation (Step 3), percutaneous endoscopic caecostomy and anterograde enema (Step 4) and definitive colostomy (Step 5)...
July 15, 2021: Colorectal Disease
Cinara Sacomori, Luz Alejandra Lorca, Mónica Martinez-Mardones, Roberto Ignacio Salas-Ocaranza, Guillermo Patricio Reyes-Reyes, Marta Natalia Pizarro-Hinojosa, Jorge Plasser-Troncoso
BACKGROUND: There is scarcity of trials about preventative strategies for low anterior resection syndrome (LARS) in rectal cancer patients. The aim of this study is to evaluate the effectiveness of a pre- and post-surgical pelvic floor rehabilitation program on the bowel symptoms, pelvic floor function, and quality of life of rectal cancer patients. METHODS: A randomized controlled trial with parallel groups (pelvic floor rehabilitation versus control group), with a blinded evaluator...
July 13, 2021: Trials
V A Krutova, A V Nadtochy, N V Naumova, E A Boldovskaya
Pelvic floor surgery is currently recognized as the only effective method for treating genital prolapse but it is not able to restore fully the qualitative characteristics of perineal tissues. The risk of recurrence of the pathological process in the long-term period remains a serious negative aspect. Optimization of pelvic floor rehabilitation after surgical correction of perineal ptosis remains an urgent problem in the female population. The validated method of questioning is a priority in assessing the dynamics of clinical manifestations of failure of the anatomical and functional structures of the pelvic floor, their impact on the life quality of patients before and after the biofeedback method (BFB therapy) and electrical impulse stimulation (EIS) of muscles...
2021: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
Otto Alexander Maneschg, Mirella Telles Salgueiro Barboni, Zoltán Zsolt Nagy, János Németh
BACKGROUND: Visual fixation may be affected in amblyopic patients and, moreover, its stability may be associated with the effects of amblyopic treatments on visual performance in patients with strabismus. Therefore, fixation stability is a relevant biomarker that might predict the recurrence of amblyopia after a therapeutic intervention. Microperimetric biofeedback fixation training (BFT) can stabilize visual fixation in adult patients with central vision loss. It was the purpose of the present study to evaluate the effects of BFT on fixation stability in adult amblyopic patients after surgical intervention to treat strabismus...
June 24, 2021: BMC Ophthalmology
Adi Litmanovich, Dmitri Nordkin, Anna Vakarev, Igor Waksman
A 14-year-old girl, a rear seat passenger on a jet-ski not wearing suitable protective gear, was 'jumping' waves at a low velocity when she was ejected backwards off the vehicle, suffering a complex and unusual hydrostatic perineal injury as a result of the high-pressure water stream propelling the jet-ski. She presented to the emergency room with rectal bleeding and perineal and abdominal pain. Initial investigations revealed signs of anorectal injury and both intraperitoneal and extraperitoneal free air and fluid, suggesting a possible rectal perforation...
June 21, 2021: BMJ Case Reports
Karolynn Echols, Jennifer Rich
Non-venous pelvic pain is a dilemma that can frustrate even the most patient of providers. Managing these conditions can be even more bewildering as they require a multidisciplinary approach in most cases. Diet and lifestyle modifications in addition to physical therapy, biofeedback, medications, surgery and integrative medicine modalities can be used alone or in combination to relieve symptoms and should be individualized after proper evaluation and diagnosis. Because most of these conditions are located in the area of pudendal nerve distribution, pudendal nerve blocks have been very successful in helping to control the pain symptoms and should be used judiciously...
March 2021: Techniques in Vascular and Interventional Radiology
Khaled A Reyad, Ahmed M Behiri, Karim K El Lamie, Mohamed A Sayed, Hala M Abd Elsabour Sabah
Background: Combined median-ulnar nerve injury at the level of distal forearm (below the musculotendinous junction) causes a detrimental effect on hand functions, which have a great impact on patients' hands as well as a financial burden. Many previous authors advocated early or immediate tendon transfer in solitary median or ulnar nerve injuries. Methods: This study included 20 patients with combined distal ulnar-median nerve injury, who were divided into 2 groups...
May 2021: Plastic and Reconstructive Surgery. Global Open
Marie Shella De Robles, Christopher J Young
BACKGROUND: Lateral internal sphincterotomy (LIS) remains the gold standard surgical approach for the management of chronic anal fissures (CAF). The procedure however, is complicated by the risk of postoperative incontinence. Intrasphincteric Botulinum Toxin (BT) has gained popularity as an alternative approach, despite being inferior to LIS with regards to cure rates. In the real world, patients at high risk for postoperative incontinence are likely to be offered BT as a preliminary procedure...
May 5, 2021: Asian Journal of Surgery
Jesse C Christensen, Christopher E Pelt, K Bo Foreman, Paul C LaStayo, Andrew E Anderson, Jeremy M Gililland, Ryan L Mizner
BACKGROUND: This study aimed to evaluate clinical and biomechanical changes in self-report survey, quadriceps strength and gait analysis over 3- and 6-months post-total knee arthroplasty (TKA) and confirm the immediate effects of two forms of kinetic biofeedback on improving inter-limb biomechanics during a physically demanding decline walking task. METHODS: Thirty patients with unilateral TKA underwent testing at 3- and 6-months following surgery. All underwent self-report survey, quadriceps strength and gait analysis testing...
April 16, 2021: Knee
Sean F Mungovan, Sigrid V Carlsson, Gregory C Gass, Petra L Graham, Jaspreet S Sandhu, Oguz Akin, Peter T Scardino, James A Eastham, Manish I Patel
Urinary incontinence is a common and predictable consequence among men with localized prostate cancer who have undergone radical prostatectomy. Despite advances in the surgical technique, urinary continence recovery time remains variable. A range of surgical and patient-related risk factors contributing to urinary incontinence after radical prostatectomy have been described, including age, BMI, membranous urethral length and urethral sphincter insufficiency. Physical activity interventions incorporating aerobic exercise, resistance training and pelvic floor muscle training programmes can positively influence the return to continence in men after radical prostatectomy...
April 8, 2021: Nature Reviews. Urology
Yu-Jie Xie, Shuang Wang, Qun-Jie Gong, Jian-Xiong Wang, Fu-Hua Sun, Akira Miyamoto, Xia Ou, Li Wang, Shi-Qi Wang, Chi Zhang
There has been no systematic review evaluating the efficacy of electromyography (EMG) biofeedback after knee surgery recently. This meta-analysis aimed to determine whether EMG-biofeedback is effective for improving the range of motion (ROM), physical function, and pain relief in patients after knee. Randomized controlled trials (RCTs) assessing the effect of EMG-biofeedback after any knee surgery were retrieved from EMBASE, PubMed, Cochrane Library, Physiotherapy Evidence Database,, ProQuest...
March 15, 2021: Journal of Biomechanics
Michael D Chuong, Rupesh Kotecha, Minesh P Mehta, Sonia Adamson, Tino Romaguera, Matthew D Hall, Diane Alvarez, Alonso N Gutierrez, Vivek Mishra, Fernando De Zarraga, Kathryn E Mittauer
Stereotactic ablative body radiation therapy (SABR) is a well-established alternative to surgery for early stage non-small-cell lung cancer (NSCLC). While SABR is typically delivered in 3 to 5 fractions, randomized trials have shown single-fraction SABR to be a reasonable alternative. We present the case of a 66-year-old male with history of cholangiocarcinoma who was subsequently diagnosed with peripheral early stage NSCLC and treated in mid-inspiration breath hold (BH) to 34 Gy in 1 fraction on a magnetic resonance (MR)-guided linear accelerator, with treatment delivery completed in 17 minutes...
February 26, 2021: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
S Ascanelli, M Portinari, M Canella, S Solari, F Dall'Omo, S Danese, A De Troia, P Carcoforo
BACKGROUND: Biofeedback is the most widespread rehabilitative therapy for the treatment of anismus after failed conservative treatment. Osteopathy represents an alternative therapy for constipation. The aim of this study was to evaluate short- and long-term results of osteopathic treatment as compared to biofeedback in patients with dyssynergic defecation. METHODS: This was a prospective cohort pilot study on 30 patients with dyssynergic defecation enrolled at the Colorectal Clinic of the University Hospital of Ferrara, Italy, from May 2015 to May 2016 and followed until May 2020...
February 27, 2021: Techniques in Coloproctology
Rachelle Alyce LeBlanc, Daniel Aalto, Caroline C Jeffery
OBJECTIVES: Paradoxical vocal fold motion (PVFM) is a common condition where the vocal folds inappropriately adduct during inspiration. This results in dyspnea and occasionally significant distress. The condition is thought to be primarily functional, with behavioural therapy considered mainstay in the non-acute setting. However, practice variations and limited access to speech language pathology (SLP) services can pose management challenges. We aimed to examine the efficacy of surgeon performed visual biofeedback as first-line treatment for PVFM...
February 18, 2021: Journal of Otolaryngology—Head & Neck Surgery
Lu Bai, Enyan Yu
Cancer-related cognitive impairment (CRCI) refers to a series of cognitive impairment symptoms associated with alternations in brain structure and function, caused by a non-central nervous system malignant tumor and its related treatment. CRCI may present as memory loss, impaired concentration, difficulty in multitasking and word retrieval, and reduced comprehension speed. CRCI has become one of the prevalent factors that compromise the quality of life for cancer survivors. Different treatments, including surgery, chemotherapy, radiotherapy, endocrine therapy, and targeted drugs, may contribute to CRCI...
January 2021: Annals of Translational Medicine
Kotaro Maeda, Toshiki Mimura, Kazuhiko Yoshioka, Mihoko Seki, Hidetoshi Katsuno, Yoshihiko Takao, Akira Tsunoda, Tetsuo Yamana
Examination for fecal incontinence is performed in order to evaluate the condition of each patient. As there is no single method that perfectly assesses this condition, there are several tests that need to be conducted. These are as follows: anal manometry, recto anal sensitivity test, pudendal nerve terminal motor latency, electromyogram, anal endosonography, pelvic magnetic resonance imaging (MRI) scan, and defecography. In addition, the mental and physical stress most patients experience during all these examinations needs to be taken into consideration...
2021: Journal of the anus, rectum and colon
Melissa Hite, Thomas Curran
Defecatory disorders can include structural, neurological, and functional disorders in addition to concomitant symptoms of fecal incontinence, functional anorectal pain, and pelvic floor dyssynergia. These disorders greatly affect quality of life and healthcare costs. Treatment for pelvic floor disorders can include medications, botulinum toxin, surgery, physical therapy, and biofeedback. Pelvic floor muscle training for pelvic floor disorders aims to enhance strength, speed, and/or endurance or coordination of voluntary anal sphincter and pelvic floor muscle contractions...
January 2021: Clinics in Colon and Rectal Surgery
Jennifer A Kaplan, Vlad V Simianu
Dyssynergic defecation can be a complex, burdensome condition. A multidisciplinary approach to these patients is often indicated based on concomitant pathology or symptomatology across the pelvic organs. Escalating treatment options should be based on shared decision making and include medical and lifestyle optimization, pelvic floor physical therapy with biofeedback, Botox injection, sacral neuromodulation, rectal irrigation, and surgical diversion.
January 2021: Clinics in Colon and Rectal Surgery
Binit Katuwal, Jasneet Bhullar
Fecal incontinence (FI) is defined as uncontrolled passage of feces or gas for at least 1-month duration in an individual who previously had control. FI is a common and debilitating condition affecting many individuals. Continence depends on complex relationships between anal sphincters, rectal curvatures, rectoanal sensation, rectal compliance, stool consistency, and neurologic function. Factors, such as pregnancy, chronic diarrhea, diabetes mellitus, previous anorectal surgery, urinary incontinence, smoking, obesity, limited physical activity, white race, and neurologic disease, are known to be the risk factors for FI...
January 2021: Clinics in Colon and Rectal Surgery
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