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Over a 42-month period, 210 patients had a lower midline incision, usually extending around the umbilicus, that was closed with a continuous, running number 2 polypropylene suture. Patients in this study had various predisposing factors for wound disruption. Over 60% were operated upon because of gynecologic cancer. Additional high-risk factors included obesity in 56%, diabetes in 28%, previous irradiation or chemotherapy in 17%, and ascites in 8%. The operative procedures performed ranged from hysterectomies with node sampling to bowel resections and exenterations; wound complications were noted in seven patients. One patient had an incisional hernia. No eviscerations occurred. The closure is safe, expedient, and cost-efficient, and distributes tension equally over a continuous line.

Background Postural control, that depends on many sensory contributors and motor skills, is altered in people with fibromyalgia (FM) 1–3. Knowing those contributors that could be impaired in this population is important to design an appropriate balance therapy. Objectives Due to the fact that people with FM use to present a strength loss 7, our main goal was to explore the relation between postural control and lower limb strength in this population. Further, the sensory inputs contributors to the postural control were assessed. Methods A cross-sectional study was conducted in a sample of 40 FM patients. A force platform was used to assess postural control under five bipedal conditions: i) eyes-open (EO); ii) dual task (recalling a typical day in their life) (DT); iii) eyes-close (EC); iv) eyes-open over a foam (FEO); v. eyes-close over a foam (FEC). Three variables, “Ellipse”, “RMS” and “Sample Entropy” (SampEn), were recorded (for both directions). Further, maximal quadriceps (qdc) and hamstring (hmsg) isometric strength were assessed using a dynamometer. Spearman correlations were conducted to establish the relationship between postural control and strength and a repeated-measures MANOVA, to analyze differences between conditions. Results When EO and DT (performed with eyes open) were compared, no significant differences were obtained. However when patients closed their eyes, an increase in ellipse and RMS_AP and a decrease in variability were obtained. The same was true when the tests were performed over a foam (altering proprioception), Table 1. Furthermore, no significant correlations (p>0.05) were observed between strength and balance except for a weak significant correlation between hmsg strength and RMS_AP (rs=-0.33, p Conclusions Postural control worsens in FM people when some sensory inputs are altered or missed. Further, there is no correlation between lower limb strength and balance in this population. References Akkaya N, Akkaya S, Atalay NS, Acar M, Catalbas N, Sahin F. Assessment of the relationship between postural stability and sleep quality in patients with fibromyalgia. Clin Rheumatol. 2013;32(3):325–331. Jones KD, King LA, Mist SD, Bennett RM, Horak FB. Postural control deficits in people with fibromyalgia: a pilot study. Arthritis Res Ther. 2011;13(4):R127. Russek LN, Fulk GD. Pilot study assessing balance in women with fibromyalgia syndrome. Physiother Theory Pract. 2009;25(8):555–565. Gόes SM, Stefanello JM, Homann D, Lodovico A, Hubley-Kozey CL, Rodacki AL. Torque and muscle activation impairment along with insulin resistance are associated with falls in women with fibromyalgia. J Strength Cond Res Strength Cond Assoc. 2016; 30(11), 3155–3164. Acknowledgements Grant GV2016/140. Conselleria Educaciό Ciencia i esports. Valencia, Spain. Disclosure of Interest None declared

King LA, St George RJ, Carlson-Kuhta P, Nutt JG, Horak FB. Preparation for compensatory forward stepping in Parkinson's disease. Objective To characterize preparation for compensatory stepping in people with Parkinson's disease (PD) compared with healthy control subjects, and to determine whether levodopa medication improves preparation or the execution phases of the step. Design Observational study. Setting Outpatient neuroscience laboratory. Participants Nineteen participants with idiopathic PD tested both in the on and off levodopa states and 17 healthy subjects. Intervention Moveable platform with posterior translations of 24cm at 56cm/s. Main Outcome Measures Compensatory steps forward, in response to a backward surface translation (24cm amplitude at 56cm/s), were categorized according to the presence of an anticipatory postural adjustment (APA) before stepping: no APA, single APA, or multiple APAs. The following step parameters were calculated: step latency, step length, center of mass (CoM) average velocity, and CoM displacement at the step initiation. Results Lateral APAs were evident in 57% and 42% of trials for people with PD in the off and on medication states, respectively, compared with only 10% of trials for control subjects. Compared with subjects with PD who did not have APAs, those subjects with PD who did make an APA prior to stepping had significantly later (mean ± SEM, 356±16ms vs 305±8ms) and shorter (mean ± SEM, 251±27mm vs 300±16mm) steps, their CoM was significantly farther forward (185±7mm vs 171±5mm) at foot-off, and they took significantly more steps to regain equilibrium. Levodopa did not affect the preparation or execution phase of compensatory stepping. Poor axial scores and reports of freezing in the United Parkinson's Disease Rating Scale were associated with use of 1 or more APAs before compensatory stepping. Conclusions Lateral postural preparation prior to compensatory stepping in subjects with PD was associated with inefficient balance recovery from external perturbations.