American journal of physical medicine & rehabilitation / Association of Academic Physiatrists (Am J P M R)

Publications in this journal

• Article: Virtual Walking Training Program Using a Real-world Video Recording for Patients with Chronic Stroke: A Pilot Study.

  Ki Hun Cho, Wan Hee Lee
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  ABSTRACT: OBJECTIVE: The purpose of this study was to investigate the effectiveness of the virtual walking training program using a real-world video recording on walking balance and spatiotemporal gait parameters in patients with chronic stroke. DESIGN: Fourteen patients with chronic stroke were randomly assigned to either the experimental group (n = 7) or the control group (n = 7). The subjects in both groups underwent a standard rehabilitation program; in addition, the experimental group participated in the virtual walking training program using a real-world video recording for 30 mins a day, three times a week, for 6 wks, and the control group participated in treadmill gait training for 30 mins a day, three times a week, for 6 wks. Walking balance was measured using the Berg Balance Scale (BBS) and the Timed Up and Go test. Gait performance was measured using an electrical walkway system. RESULTS: In walking balance, greater improvement on the Berg Balance Scale (experimental group: 4.14 vs. control group: 1.85) and the Timed Up and Go test (-2.25 vs. -0.94) was observed in the experimental group compared with the control group (P <; 0.05). In the spatiotemporal gait parameters, greater improvement on velocity (25.40 vs. 9.74) and cadence (26.71 vs. 11.11) was observed in the experimental group compared with the control group (P <; 0.05). CONCLUSIONS: This study demonstrated the positive effects of the virtual walking training program using a real-world video recording on gait performance. These findings suggest that the virtual walking training program using a real-world video recording may be a valid approach to enhance gait performance in patients with chronic stroke.
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 05/2013; 92(5):371-384.
• Article: Human Umbilical Cord Blood-Derived Mesenchymal Stem Cells in the Cultured Rabbit Intervertebral Disc: A Novel Cell Source for Disc Repair.

  D Greg Anderson, Dessislava Markova, Howard S An, Ana Chee, Motomi Enomoto-Iwamoto, Vladimir Markov, Biagio Saitta, Peng Shi, Chander Gupta, Yejia Zhang
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  ABSTRACT: OBJECTIVE: Back pain associated with symptomatic disc degeneration is a common clinical condition. Intervertebral disc (IVD) cell apoptosis and senescence increase with aging and degeneration. Repopulating the IVD with cells that could produce and maintain extracellular matrix would be an alternative therapy to surgery. The objective of this study was to determine the potential of human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) as a novel cell source for disc repair. In this study, we intended to confirm the potential for hUCB-MSCs to differentiate and display a chondrocyte-like phenotype after culturing in micromass and after injection into the rabbit IVD explant culture. We also wanted to confirm hUCB-MSC survival after transplantation into the IVD explant culture. DESIGN: This study consisted of micromass cultures and in vitro rabbit IVD explant cultures to assess hUCB-MSC survival and differentiation to display chondrocyte-like phenotype. First, hUCB-MSCs were cultured in micromass and stained with Alcian blue dye. Second, to confirm cell survival, hUCB-MSCs were labeled with an infrared dye and a fluorescent dye before injection into whole rabbit IVD explants (host). IVD explants were then cultured for 4 wks. Cell survival was confirmed by two independent techniques: an imaging system detecting the infrared dye at the organ level and fluorescence microscopy detecting fluorescent dye at the cellular level. Cell viability was assessed by staining the explant with CellTracker green, a membrane-permeant tracer specific for live cells. Human type II collagen gene expression (from the graft) was assessed by polymerase chain reaction. RESULTS: We have shown that hUCB-MSCs cultured in micromass are stained blue with Alcian blue dye, which suggests that proteoglycan-rich extracellular matrix is produced. In the cultured rabbit IVD explants, hUCB-MSCs survived for at least 4 wks and expressed the human type II collagen gene, suggesting that the injected hUCB-MSCs are differentiating into a chondrocyte-like lineage. CONCLUSIONS: This study demonstrates the abiity of hUBC-MSCs to survive and assume a chondrocyte-like phenotype when injected into the rabbit IVD. These data support the potential for hUBC-MSCs as a cell source for disc repair. Further measures of the host response to the injection and studies in animal models are needed before trials in humans.
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 05/2013; 92(5):420-429.
• Article: Relationship Between Obesity and Plantar Pressure Distribution in Youths with Down Syndrome.

  Massimiliano Pau, Manuela Galli, Marcello Crivellini, Giorgio Albertini
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  ABSTRACT: OBJECTIVE: This study aimed to characterize the effect of obesity on foot-ground contact in young individuals affected by Down syndrome (DS) during quiet upright stance. DESIGN: This is a cross-sectional study on 118 individuals with Down syndrome, 59 with obesity aged 3-18 yrs and 59 with normal weight, age- and sex-matched forming the control group. Both groups were evaluated while standing on a pressure-sensitive mat. Foot-ground contact was characterized using contact area and mean pressure calculated for the rearfoot, the midfoot, and the forefoot. RESULTS: The results show that obesity significantly influences the foot-ground interaction, with some differences related to sex. In particular, the females with obesity exhibited larger contact areas and higher plantar pressures (in the forefoot and the midfoot) with respect to the control group, whereas in the males with obesity, only the plantar pressures were found higher than those of the controls. Flatfoot is the prevalent arch type for both groups, but its incidence seems to be unrelated to obesity. CONCLUSIONS: The modifications introduced by obesity in foot-ground contact pressure and area may represent a factor capable of aggravating existing negative podiatric issues associated with Down syndrome. Thus, planning periodical monitoring of foot-ground contact during childhood and adolescence is recommended to avoid possible problems related to adverse effects of repeated excessive mechanical stresses on the plantar region.
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 04/2013;
• Article: Effects of Whole-Body Vibration on Muscle Architecture, Muscle Strength, and Balance in Stroke Patients: A Randomized Controlled Trial.

  Pedro J Marín, Cristina M Ferrero, Héctor Menéndez, Juan Martín, Azael J Herrero
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  ABSTRACT: OBJECTIVE: The aim of the present study was to analyze the effects of whole-body vibration on lower limb muscle architecture, muscle strength, and balance in stroke patients during a period of 3 mos. DESIGN: The inclusion criteria were having had ischemic or hemorrhagic stroke at least 6 mos before the study and a National Institutes of Health Stroke Scale score of greater than 1 and less than 20. The patients were randomly divided into two groups: an experimental group (n = 11, six men and five women; age, 62.4 ± 10.7 yrs; height, 1.64 ± 0.07 m; mass, 69.4 ± 12.9 kg) and a sham group (n = 9, five men and four women; age, 64.4 ± 7.6 yrs; height, 1.62 ± 0.07 m; mass, 75.0 ± 15.8 kg). The experimental group received a whole-body vibration treatment, with an increase in frequency, sets, and time per set during 17 sessions. The sham group performed the same exercises as that of the experimental group but was not exposed to vibration. Outcome variables included the muscle architecture (the rectus femoris, the vastus lateralis, and the medial gastrocnemius), the maximal isometric voluntary contraction of the knee extensors, and the Berg Balance Scale. RESULTS: There were no significant differences between the groups on the primary outcomes of lower limb muscle architecture, muscle strength, and balance. CONCLUSIONS: It seems that whole-body vibration exercise does not augment the increase in neuromuscular performance and lower limb muscle architecture induced by isometric exercise alone in stroke patients.
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 04/2013;
• Article: A Patient-Centered Care Ethics Analysis Model for Rehabilitation.

  Matthew R Hunt, Carolyn Ells
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  ABSTRACT: There exists a paucity of ethics resources tailored to rehabilitation. To help fill this ethics resource gap, the authors developed an ethics analysis model specifically for use in rehabilitation care. The Patient-Centered Care Ethics Analysis Model for Rehabilitation is a process model to guide careful moral reasoning for particularly complex or challenging matters in rehabilitation. The Patient-Centered Care Ethics Analysis Model for Rehabilitation was developed over several iterations, with feedback at different stages from rehabilitation professionals and bioethics experts. Development of the model was explicitly informed by the theoretical grounding of patient-centered care and the context of rehabilitation, including the International Classification of Functioning, Disability and Health. Being patient centered, the model encourages (1) shared control of consultations, decisions about interventions, and management of the health problems with the patient and (2) understanding the patient as a whole person who has individual preferences situated within social contexts. Although the major process headings of the Patient-Centered Care Ethics Analysis Model for Rehabilitation resemble typical ethical decision-making and problem-solving models, the probes under those headings direct attention to considerations relevant to rehabilitation care. The Patient-Centered Care Ethics Analysis Model for Rehabilitation is a suitable tool for rehabilitation professionals to use (in real time, for retrospective review, and for training purposes) to help arrive at ethical outcomes.
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 04/2013;
• Article: Comparison of Ultrasound-Guided Intra-articular Injections by Long Axis in Plane Approach on Three Different Sites of the Knee.

  Ki Deok Park, Jae Ki Ahn, Sang-Chul Lee, Jihae Lee, Jongwoo Kim, Yongbum Park
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  ABSTRACT: OBJECTIVE: The objective of this study was to examine the accuracy of ultrasound-guided intra-articular (IA) injections on three different sites of the knee using midmedial, midlateral, and superolateral portals. DESIGN: Ultrasound-guided IA injection and a radiographic evaluation were performed on 120 knees with osteoarthritis. Five milliliters of a mixed material consisting of 1% lidocaine (1 ml), 20 mg of triamcinolone (1 ml), and nonionic contrast (3 ml) was injected into the IA space of the knee through three different portals. After each injection, a radiographic evaluation was performed to determine whether the injected material had reached the IA space or infiltrated into the soft tissue. RESULTS: Of 40 injections administered through the midmedial portal, 38 were confirmed as having been placed in the IA space on the first attempt (95% accuracy rate). Thirty-nine of 40 injections administered through the midlateral portal were IA on the first attempt (98.5% accuracy rate), as were 40 of 40 injections administered through a superolateral portal (100% accuracy rate). No significant differences (P > 0.05) were observed in the accuracy rate obtained with placement through the midmedial, midlateral, and superolateral portals. CONCLUSIONS: All three ultrasound-guided IA injections may be used to access the knee joint, with a high rate of accuracy.
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 04/2013;
• Article: RE: Botulinum Toxin Type A Injection Into the Gastrocnemius Muscle for Spastic Equinus in Adults with Stroke.

  Alessandro Picelli, Nicola Smania
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 04/2013;
• Article: RE: BOTULINUM TOXIN TYPE A INJECTION INTO THE GASTROCNEMIUS MUSCLE FOR SPASTIC EQUINUS IN ADULTS WITH STROKE.

  Chetan P Phadke, Farooq Ismail, Chris Boulias
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 04/2013;
• Article: Discontinuation of Anticoagulation Therapy in Patients Who Have Experienced an Acute Intramuscular Bleed and Are Also at Risk for a Stroke.

  Myron M Laban, Christina Hughes
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 04/2013;
• Article: Use of Rimabotulinum Toxin for Focal Hypertonicity Management in Children with Cerebral Palsy with Nonresponse to Onabotulinum Toxin.

  Joline E Brandenburg, Linda E Krach, Mark E Gormley
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  ABSTRACT: OBJECTIVE: The aim of this study was to review the effect of rimabotulinum toxin (BoNT-B) for focal hypertonicity management in children with cerebral palsy and secondary nonresponse to onabotulinum toxin treated at the authors' tertiary care academic medical center. DESIGN: A retrospective review of the medical treatment of children was conducted at the authors' institution (March 16, 2001, to August 2, 2002) using the key words botulinum toxin B and Myobloc (Solstice Neurosciences Inc, South San Francisco, CA). Demographic information was analyzed using descriptive statistics (number [percentage] and mean [range]). The Pearson χ test was used to evaluate differences in incidence of adverse events. RESULTS: Eighty-two children had BoNT-B injections (116 treatments). Overall, 26.8% (19/71) of the children or their parents/guardians reported no or minimal response to the injections, with 89.5% (17/19) of these children having secondary nonresponse to onabotulinum toxin. Adverse events were frequent but did not require hospitalization of any patient. No significant differences were found in incidence of adverse events related to BoNT-B dosing, medical fragility, or Gross Motor Function Classification System level. CONCLUSIONS: More than one-fourth of the children receiving BoNT-B injections had nonresponse, with most having previous nonresponse to onabotulinum toxin. Adverse events related to BoNT-B injections were frequent and unpredictable but not severe.
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 04/2013;
• Article: Is Kyphosis Related to Mobility, Balance, and Disability?

  Regina Eum, Suzanne G Leveille, Dan K Kiely, Douglas P Kiel, Elizabeth J Samelson, Jonathan F Bean
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  ABSTRACT: OBJECTIVE: The aim of this study was to determine the association of increased kyphosis with declines in mobility, balance, and disability among community-living older adults. DESIGN: The 18-mo follow-up visit data from 2006 to 2009 for 620 participants from the population-based Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly Boston Study of older adults was used. Cross-sectional multivariable regression analyses were performed to assess the relationship between kyphosis (measured using the kyphosis index) and measures of mobility performance (Short Physical Performance Battery), balance (Berg Balance Scale score), and disability (self-reported difficulty walking a quarter of a mile or climbing a flight of stairs). The authors then evaluated the men and the women separately. Adjustment variables included demographic factors (age, sex, race, and education), body mass index, self-rated health, comorbidities (heart disease, diabetes, stroke, and depressive symptoms), back pain, knee pain, and falls self-efficacy. RESULTS: After full adjustment, greater kyphosis index was associated with lower Short Physical Performance Battery scores (adjusted β = -0.08, P = 0.01) but not with lower Berg Balance Scale (adjusted β = -0.09, P = 0.23) or self-reported disability (adjusted β = 1.00; 95% confidence interval, 0.93-1.06) scores. In sex-specific analyses, kyphosis index was associated with only the Short Physical Performance Battery in the women. CONCLUSIONS: Greater kyphosis is associated with poorer mobility performance but not with poorer balance or self-reported disability. This association with the Short Physical Performance Battery was observed only among the women. Mechanisms by which increased kyphosis influences physical performance should be explored prospectively.
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 04/2013;
• Article: Ultrasound-Guided vs. Fluoroscopy-Guided Caudal Epidural Steroid Injection for the Treatment of Unilateral Lower Lumbar Radicular Pain: A Prospective, Randomized, Single-Blind Clinical Study.

  Yongbum Park, Ji-Hae Lee, Ki Deok Park, Jae Ki Ahn, Jaehyun Park, Haemi Jee
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  ABSTRACT: OBJECTIVE: The aim of this study was to compare the short-term effects and advantages of ultrasound-guided caudal epidural steroid injections with fluoroscopy-guided epidural steroid injections for unilateral radicular pain in the lower lumbar spine. DESIGN: A total of 120 patients with unilateral radicular pain were enrolled and randomly assigned to either the fluoroscopy or the ultrasound group. Complication frequencies during the procedures, treatment effects, functional improvement, and adverse events were compared after the procedures. RESULTS: The verbal numerical rating scale and the Oswestry Disability Index improved 2 and 12 wks after the injections in both groups. Statistical differences were not observed in the verbal numerical rating scale, the Oswestry Disability Index, or the effectiveness of the procedure between the groups. Two cases of intravascular injections were observed in the fluoroscopy group, without the prevalence of complication between the groups. CONCLUSIONS: The ultrasound approach with color Doppler mode may avoid intravascular injection-induced complications. The results showed similar improvements in short-term pain relief, function, and patient satisfaction with both ultrasound and fluoroscopic guidance.
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 04/2013;
• Article: Examining the Influence of Three Types of Social Support on the Mental Health of Mexican Caregivers of Individuals with Traumatic Brain Injury.

  Lillian Flores Stevens, Paul B Perrin, Shaina Gulin, Heather Rogers, Teresita Villaseñor Cabrera, Miriam Jiménez-Maldonado, Juan Carlos Arango-Lasprilla
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  ABSTRACT: OBJECTIVE: The aim of this study was to examine the influence of three types of social support (appraisal, belonging, and tangible) on caregiver mental health (anxiety, burden, depression, and satisfaction with life) among Mexican caregivers of individuals with traumatic brain injury. DESIGN: This is a cross-sectional study of 90 family caregivers from Hospital Civil Fray Antonio Alcade in Guadalajara, Mexico. RESULTS: More months spent caregiving was associated with decreases in all three types of social support. Older age and fewer years of education were associated with lower appraisal social support. More hours per week spent caregiving was associated with lower caregiver state anxiety and greater satisfaction with life. Appraisal, belonging, and tangible social support were all significantly correlated with more salubrious caregiver mental health outcomes, except satisfaction with life. Appraisal social support independently predicted lower caregiver depression. CONCLUSIONS: Particularly in Latin America, strong social support networks and family connections seem closely tied to key mental health outcomes such as depression. Rehabilitation interventions aimed at strengthening perceptions of social support of caregivers of individuals with traumatic brain injury that specifically target availability of advice may improve mental health and contribute to more optimal informal care for individuals with traumatic brain injury.
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 04/2013;
• Article: Ultrasonographic Findings of Neuroma Formation at Both Divisions of the Sciatic Nerve in a Transfemoral Amputee.

  Mooyeon Oh-Park, Ian Wendel, Thomas E Lammertse, Cristin McKenna
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 04/2013;
• Article: Management of the Extrahepatic Symptoms of Chronic Hepatitis C: Feasibility of a Randomized Controlled Trial of Exercise.

  Olivia McKenna, Caitriona Cunningham, Conor Gissane, Catherine Blake
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  ABSTRACT: OBJECTIVE: The aim of this study was to explore the feasibility and the efficacy of a physiotherapy-led exercise program in changing the health status of a sample of patients with chronic hepatitis C. DESIGN: A single-blind randomized controlled trial was conducted in a sample of patients with iatrogenically acquired hepatitis C in Ireland. Twenty-two participants were recruited and randomly assigned to exercise (n = 10) and control (n = 12) groups. Both groups received a generic exercise advice leaflet, and the exercise group attended 12 exercise sessions for 6 wks. A battery of physical performance measures and patient-reported outcome measures were assessed at baseline and 6 wks, with 1-yr follow-up of the self-reported measures. RESULTS: Significant group by time interactions during the 6-wk period were found for pain (F1,20 = 5.15, P = 0.034), grip strength (F1,20 = 5.94, P = 0.024), aerobic capacity (F1,20 = 5.73, P = 0.024), and depression (F1,20 = 6.16, P = 0.022), with the exercise group showing greater positive change. The exercise group also had superior gains in the 36-Item Short-Form Health Survey vitality and social function scores (P < 0.05). The short-term gains were not sustained at 1 yr. CONCLUSIONS: This pilot study shows the feasibility of exercise in hepatitis C management, improving physical fitness, psychologic function, and quality-of-life without worsening symptoms in the short term.
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 04/2013;
• Article: Feasibility of a Virtual Exercise Coach to Promote Walking in Community-Dwelling Persons with Parkinson Disease.

  Terry Ellis, Nancy K Latham, Tamara R Deangelis, Cathi A Thomas, Marie Saint-Hilaire, Timothy W Bickmore
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  ABSTRACT: OBJECTIVE: The short-term benefits of exercise for persons with Parkinson disease (PD) are well established, but long-term adherence is limited. The aim of this study was to explore the feasibility, acceptability, and preliminary evidence of the effectiveness of a virtual exercise coach to promote daily walking in community-dwelling persons with Parkinson disease. DESIGN: Twenty subjects with Parkinson disease participated in this phase 1, single-group, nonrandomized clinical trial. The subjects were instructed to interact with the virtual exercise coach for 5 mins, wear a pedometer, and walk daily for 1 mo. Retention rate, satisfaction, and interaction history were assessed at 1 mo. Six-minute walk and gait speed were assessed at baseline and after the intervention. RESULTS: Fifty-five percent of the participants were women, and the mean age was 65.6 yrs. At the study completion, there was 100% retention rate. The subjects had a mean satisfaction score of 5.6/7 (with 7 indicating maximal satisfaction) with the virtual exercise coach. Interaction history revealed that the participants logged in for a mean (SD) of 25.4 (7) days of the recommended 30 days. The mean adherence to daily walking was 85%. Both gait speed and the 6-min walk test significantly improved (P < 0.05). No adverse events were reported. CONCLUSIONS: Sedentary persons with Parkinson disease successfully used a computer and interacted with a virtual exercise coach. Retention, satisfaction, and adherence to daily walking were high for 1 mo, and significant improvements were seen in mobility.
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 04/2013;
• Article: Influence of Dual-Task Constraints on Whole-Body Organization During Walking in Children Who Are Overweight and Obese.

  Ya-Ching Hung, Simone V Gill, Geneva S Meredith
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  ABSTRACT: OBJECTIVE: The aim of this study was to examine the influence of dual-task constraints on movement and force control in children who are overweight and obese. DESIGN: Twelve children who are overweight and obese (4-12 yrs old) and 12 age-matched children with normal weight participated. The children walked along a path at a self-selected pace under two conditions: walking carrying nothing (baseline condition) and walking while carrying a box (dual-task condition). RESULTS: The overweight/obese group showed less normalized hand vertical motion and shoulder range of motion compared with the control group (all P's < 0.05). However, in comparison with the baseline condition, the overweight/obese group decreased gait velocity and stride length and increased step width, lateral hand movement, lateral spine movement, and medial/lateral ground reaction force during the dual-task condition (all P's < 0.05). CONCLUSIONS: These findings indicate that children who are overweight and obese modify lateral movements and force organization when faced with dual-task constraints, which may influence their ability to maintain safety when dual tasking is required.
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 04/2013;
• Article: Reporting of Allocation Method and Statistical Analyses That Deal with Bilaterally Affected Wrists in Clinical Trials for Carpal Tunnel Syndrome.

  Matthew J Page, Denise A O'Connor, Veronica Pitt, Nicola Massy-Westropp
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  ABSTRACT: The authors aimed to describe how often the allocation method and the statistical analyses that deal with bilateral involvement are reported in clinical trials for carpal tunnel syndrome and to determine whether reporting has improved over time. Forty-two trials identified from recently published systematic reviews were assessed. Information about allocation method and statistical analyses was obtained from published reports and trialists. Only 15 trialists (36%) reported the method of random sequence generation used, and 6 trialists (14%) reported the method of allocation concealment used. Of 25 trials including participants with bilateral carpal tunnel syndrome, 17 (68%) reported the method used to allocate the wrists, whereas only 1 (4%) reported using a statistical analysis that appropriately dealt with bilateral involvement. There was no clear trend of improved reporting over time. Interventions are needed to improve reporting quality and statistical analyses of these trials so that these can provide more reliable evidence to inform clinical practice.
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 04/2013;
• Article: Effectiveness of Extracorporeal Shock Wave Therapy in Chronic Plantar Fasciitis: A Meta-analysis.

  Jan Nathleen C Dizon, Consuelo Gonzalez-Suarez, Marcelle Theresa G Zamora, Ephraim D V Gambito
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  ABSTRACT: The objective of this study was to evaluate the effectiveness of extracorporeal shock wave therapy (ESWT) in treating chronic plantar fasciitis. An online database search was conducted for studies using ESWT in managing chronic plantar fasciitis. Eleven high-quality randomized controlled trials were included in the meta-analysis and showed that ESWT was more effective in reducing morning pain (weighted mean difference, -0.77 [95% confidence interval {CI}, -1.30 to -0.25]; odds ratio, 0.65 [95% CI, 0.42-1.00]). Moderate-intensity ESWT was more effective in decreasing overall and activity pain (weighted mean difference, -6.6 [95% CI, -6.74 to -6.46], and weighted mean difference, 0.47 (95% CI, 0.30-0.74). Both moderate- and high-intensity ESWT were more effective in improving functional outcome, with odds ratios of 0.51 (95% CI, 0.30-0.84) and 0.47 (95% CI, 0.29-0.75). The adverse effects that were seen more in ESWT were pain on the calcaneal area and calcaneal erythema. This study concludes that moderate- and high-intensity ESWT were effective in the treatment of chronic plantar fasciitis.
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 04/2013;
• Article: Acute Effect of Whole-Body Vibration at Optimal Frequency on Muscle Power Output of the Lower Limbs in Older Women.

  Arrigo Giombini, Andrea Macaluso, Luca Laudani, Annalisa Di Cesare, Alberto Piccinini, Fabio Pigozzi, Vincenzo Maria Saraceni
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  ABSTRACT: OBJECTIVE: The aim of this study was to identify the frequency of whole-body vibration (WBV) that elicits the greatest improvement in lower limb power output after an acute exposure in older women, with the hypothesis that an individualized optimal vibration frequency (OVF) would be more effective than a fixed vibration frequency. DESIGN: Maximal power output was measured during a double leg press on an isoinertial dynamometer in nine women with a mean (SD) age of 71 (3) yrs, 1 and 5 mins after WBV on a platform at three different frequencies, in a random order: 20 Hz, 50 Hz, and OVF, determined for each subject by identifying the frequency corresponding to the maximal electromyographic muscle response. RESULTS: The mean (SD) OVF was 33 (2.5) Hz. The 25.9% increase in maximal power output after 1 min of WBV at OVF was significantly higher (P < 0.05) than the 14.3% increase after 1 min of WBV at 20 Hz. Similarly, the 32.1% increase in maximal power output after 5 mins of WBV at OVF was significantly higher (P < 0.01) than the 16.1% and 16.3% increase after 5 mins of WBV at 20 Hz and 50 Hz, respectively. CONCLUSIONS: Frequency of WBV should be prescribed in an individualized fashion, within the range of 30-35 Hz in this target population of older women.
  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 04/2013;