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This article describes a 3D virtual diagnostic analysis for treatment planning an esthetically driven functional rehabilitation by using computer-aided design and computer-aided manufacturing (CAD-CAM) technology. In this protocol, a digitally planned diagnostic waxing (exocad DentalCAD) was used to visualize the proposed tooth position and the presence of areas without sufficient material thickness for the prospective additive restorations. This approach uses an additively manufactured clear resin guide to selectively reduce surfaces of a tooth erupted beyond the proposed occlusal plane. By using a 3D-printed occlusal reduction guide, the digital diagnostic waxing is accurately represented, tooth reduction controlled, and adequate occlusal clearance for the required restorative material thickness provided with a minimally invasive approach.

The incidence of Achilles tendon rupture is increasing. Postoperative rehabilitation after repairing acute Achilles tendon rupture is very important because the choice of treatment during the rehabilitation period can influence the results. Moreover, the method of functional rehabilitation varies and is developing steadily. Recent studies recommend a functional rehabilitation protocol, and this approach is accepted widely. This study aimed to introduce our most accelerated functional rehabilitation protocol following surgery for acute Achilles tendon rupture and to review the results retrospectively. From July 2014 to July 2016, 67 patients underwent surgery for acute Achilles tendon rupture by one surgeon. Age, sex, body mass index, injury mechanism, rehabilitation method and progress, time to return to previous physical activity, and complications were evaluated. The mean time to be able to squat fully was 10 ± 4.7 (4-20) weeks. Full squatting was possible in 92.8% (52 patients). The mean time to perform a single-limb heel rise and repetitive single-limb heel rise was 12.6 ± 3.9 (6-24) and 23.3 ± 7.7 (8-40) weeks, respectively. The mean time to return to sports was 20.6 ± 5.2 (12-32) weeks. The major complication rate was 3.5% (one re-rupture and one tendon elongation). The mean pre- and postoperative Achilles Tendon Total Rupture Score was 29.5 ± 3.7 (20-38) and 79.3 ± 18.5 (20-98) points, respectively. The increase was significant (p < .01). In conclusion, immediate full weightbearing and ankle motion exercise after repair of acute Achilles tendon rupture can provide a good rehabilitation option with a low re-rupture rate and satisfactory functional results.

Vertical augmentation of the mandible to prepare dental implant therapy is still a challenge, especially with large mandible defects. Reconstruction with fibula free flap is a regularly applied approach in such cases, but it does not always yield optimal results: the resulting crestal height might differ significantly from the crestal height of the patient's intact bone, which makes esthetic and functional rehabilitation difficult. Osteodistraction of the integrated flap is a known but rarely discussed approach where the already integrated flap undergoes additional distraction. Through the four cases reported here, we would like to demonstrate that the osteodistraction of the transplanted fibula free flap is a useful and efficient method of secondary augmentation for cases where the flap itself fails to produce the desired crestal height, and no other method is applicable. The cases show that the method allows outcomes that are highly satisfactory, both in the functional and esthetic sense.

Rotator cuff related disorders (RCRD) are common. Exercise-based rehabilitation can improve outcomes, yet uncertainty exists regarding the characteristics of these exercises. This scoping review paper summarises the key characteristics of the exercise-based rehabilitation of rotator cuff related disorders (RCRD). An iterative search process was used to capture the breadth of current evidence and a narrative summary of the data was produced. 57 papers were included. Disagreement around terminology, diagnostic standards, and outcome measures limits the comparison of the data. Rehabilitation should utilise a biopsychosocial approach, be person-centred and foster self-efficacy. Biomedically framed beliefs can create barriers to rehabilitation. Pain drivers in RCRSD are unclear, as is the influence of pain during exercise on outcomes. Expectations and preferences around pain levels should be discussed to allow the co-creation of a programme that is tolerated and therefore engaged with. The optimal parameters of exercise-based rehabilitation remain unclear; however, programmes should be individualised and progressive, with a minimum duration of 12 weeks. Supervised or home-based exercises are equally effective. Following rotator cuff repair, rehabilitation should be milestone-driven and individualised; communication across the MDT is essential. For individuals with massive rotator cuff tears, the anterior deltoid programme is a useful starting point and should be supplemented by functional rehabilitation, exercises to optimise any remaining cuff and the rest of the kinetic chain. In conclusion, exercise-based rehabilitation improves outcomes for individuals with a range of RCRD. The optimal parameters of these exercises remain unclear. Variation exists across current physiotherapy practice and post-operative rehabilitation protocols, reflecting the wide-ranging spectrum of individuals presenting with RCRD. Clinicians should use their communication and rehabilitation expertise to plan an exercise-based program in conjunction with the individual with RCRSD, which is regularly reviewed and adjusted.

Objective: Exercise is an essential rehabilitative strategy after stroke butits implementation is limited as its very early use can exacerbate damage and is restricted by patient disability. Remote Ischemic Conditioning (RIC) is a safe alternative for post-stroke neuroprotetion. The present study investigated the neurorehabilitative benefits of early RIC followed by exercise (RICE) therapy.Methods: 48 adult male Sprague-Dawley rats were divided into groups: 1) sham, 2) stroke, 3) stroke with RICE at day 3 (RIC 6 hours after reperfusion followed by exercise days 3 to 28), 4) stroke with exercise at day 3 (exercise days 3 to 28), and 5) stroke with RICE at day 1 (RIC 6 hours after reperfusion followed by exercise days 1 to 28), 6) stroke with exercise at day 1 (exercise days 1 to 28 after reperfusion). Long-term functional outcomes were determined by grid walk, rota-rod, adhesive tape touch, and Morris water maze. Levels of mRNA and proteins of neuroplasticity, synaptogenesis, and angiogenesis, were determined.Results: As compared to exercise only, animals that underwent RICE had significant improvements in functional outcomes after stroke. These improvements were most significant in groups that had the later initiation of exercise. In addition, all treatment groups showed significant increases in mRNA and protein expression of the target molecules for neuroplasticity, synaptogenesis, and angiogenesis, while further significant increases were observed after RICE following ischemic stroke.Conclusions: RICE, a novel therapy that supplements RIC prior to exercise, is superiorly effective in inducing rehabilitation after stroke as compared to the traditional exercise monotherapy rehabilitation in rats with ischemic brain injury.

Place: United States; International audience; BACKGROUND: We aimed to compare postoperative pain, functional recovery, and patient satisfaction among patients receiving one-stage medial bilateral or medial unilateral UKA (unicompartmental knee arthroplasty). Our main hypothesis was that during the first 72 postoperative hours, patients who underwent medial bilateral UKA did not consume more analgesics than those who underwent medial unilateral UKA.METHODS: A prospective case-control study was undertaken involving 148 patients (74 one-stage medial bilateral vs 74 medial unilateral Oxford UKA). The primary outcome was evaluation of the postoperative total consumption of analgesics from 0 to 72 hours. Next, the postoperative evolution of pain scores and functional recovery were assessed. Oxford Knee Scores were assessed preoperatively at 6 and 12 months with the occurrence of clinical or radiological complications. Finally, patient satisfaction was evaluated at the final follow-up.RESULTS: The cumulative sums of analgesic consumption (0-72 hours) calculated in the morphine equivalent dose were 21.61 ± 3.70 and 19.11 ± 3.12 mg in the patient and control groups, respectively (P = .30). Moreover, there were no significant differences in terms of pain scores (P = .45), functional recovery (P = .59, .34), length of stay (P = .18), Oxford Knee Scores (P = .68, .60), complications (P = .50), patient satisfaction (P = .66), or recommendations for intervention (P = .64).CONCLUSION: Patients who undergo one-stage medial bilateral UKA do not experience more pain and do not consume more analgesics than those who undergo medial unilateral UKA. A bilateral procedure is not associated with a lower recovery or a higher rate of complications, as functional outcomes at 6 and 12 months are similar to those of unilateral management.

The optimal postoperative management of Achilles tendon (AT) rupture remains unknown. The past 2 decades have witnessed a trend toward less rigid immobilization, earlier weightbearing, and accelerated functional rehabilitation postoperatively. The objective of this study was to identify all high-quality studies pertaining to rehabilitation after AT repair and characterize the various rehabilitation protocols that have been described. A systematic review of the English-language literature was performed according to PRISMA guidelines. All included studies represented level 1, 2, or 3 evidence and examined postoperative rehabilitation protocols following the repair of an acute AT rupture. A total of 1187 subjects were included. Surgical technique, rehabilitation protocol, and outcome assessment varied widely between studies. Early postoperative weightbearing with less rigid immobilization appears to accelerate short-term functional recovery. An aggressive rehabilitation program may also be advantageous in the short term, but further studies are needed to determine the long-term effects of these accelerated physical therapy and return-to-play protocols.

There is an ever-evolving debate about the best treatment option for Achilles tendon ruptures. There was a relative consensus that operative treatment yielded the best outcomes. Much of this is based on results in athletic populations. Conservative treatment was considered only for the elderly and those with very inactive lifestyles. There has been an evolution, however, with more surgeons utilizing an aggressive functional rehabilitation with conservative management. Surgical intervention still is the treatment of choice for elite-level athletes. The treatment of choice for patient populations other than elite athletes remains an individual choice between patient and physician.

Background: Neck pain is a real public health problem. Its treatment uses different techniques, such as functional rehabilitation, whose results are not widely popularized, from developing countries in Black Africa. Objective: To assess the result of rehabilitation of chronic common neck pain (CCNP) at the CNHU-HKM in Cotonou. Methods: Cross-sectional, retrospective, descriptive and analytical study. It was carried out from May to September 2020, based on the files of former patients followed in functional rehabilitation department at CNHU-HKM in Cotonou, from 2015 to 2019, for CCNP. The result of rehabilitation was assessed based on the progress, between the start and the end of the rehabilitation sessions, of pain intensity, mobility of the cervical spine, muscle strength and functional capacity of the patient. Anova and chi-square tests were used for the analysis of factors associated with the result of rehabilitation. Results: The sample consisted to 73 patients. They were predominantly female (58.90%), with a mean age of 53.60 ± 14.08 years. The neck pain, at least of moderate intensity (97.26%), was present since 12.54 ± 8.54 months, on average. Patients have done 10 to 20 functional rehabilitation sessions, the result of which was satisfactory in 67.12%. This result was mainly associated with patient’s age, sports practice and the seniority of pain progression. Discussion-Conclusion: Rehabilitation results in the management of CCNP are interesting. They prove the need to sensitize patients and prescribers on the importance of early treatment of CCNP.

Considering the advances in functional rehabilitation in recent decades, therapist-oriented home rehabilitation (TOHR) has been increasingly used in the field of physical therapy because it increases patient compliance and reduces health system costs. The objective of this study was to investigate the effects of TOHR on functional capacity, muscle strength, and quality of life (QoL) in adults with sickle cell anemia (SCA).Forty adults with SCA underwent manually guided TOHR for 12 weeks. Before and at the end of training, the following variables were assessed in the participants: distance covered in the 6-min walk test (6MWD); maximal inspiratory pressure (MIP); maximal expiratory pressure (MEP); handgrip strength (HGS); quadriceps strength (QS); and QoL using the Short Form-36 physical component summary (SF-36After TOHR, significant increases were observed in the mean values for the 6MWD, MIP, MEP, HGS, QS, and SF-36This study shows that TOHR can potentially increase functional capacity, muscle strength, and QoL in adults with SCA. Furthermore, there appears to be a relationship between 6MWD gains and muscle strength gains with TOHR.

The aim of the research is to analyze the approaches to the problems of functional and structural rehabilitation of historic monumental buildings. The research examined the possibility of changing the destination of a historic building, which involves both functional rehabilitation (rehabilitation and adaptation of thermal energy, acoustics, water repellent and fire protection) and structural rehabilitation, by replacing or partially modifying the building or, if the structural system allows, complete restoration of its parts; local structural restoration (consolidation); structural modification, by introducing adjacent or incidental construction elements, which together with the existing structure can form another structural system and even change the structural concept using the procedures that can increase strength and stability. As a result of the research, it was established that changing the destination of a building involves both functional rehabilitation, by compartmentalizing the new function, rehabilitation and thermal, energy, acoustic, water repellent adaptation and fire safety of the building undergoing reconversion, and structural rehabilitation. When protecting historical monuments, a series of principles and rules must be observed regarding the owners’ interventions, the holders of the administration right, the concessionaires and the tenants.

espanolIntroduccion En el deporte de alto rendimiento, las habilidades fisicas juegan un papel fundamental en el desarrollo de atletas de nivel elite, dichas habilidades pueden ser adaptadas a ciclos de carga especificos con el fin de desarrollar periodos de adaptacion y optimizacion de estas cualidades. En la actualidad, los conceptos de movimiento, evaluacion funcional, rehabilitacion funcional y entrenamiento funcional han sido los mas utilizados en el area deportiva, se realizan adaptaciones especificas de enfoques integrales del movimiento corporal humano basado en factores neuromusculares, sinergias musculares, aprendizaje motor, control motor, fuerza, potencia, velocidad mediada por metodologias de entrenamiento especifico. Metodologia se realizo un estudio de reflexion basado en una revision de literatura que tenia como fin describir un marco en el desarrollo y creacion de circuitos funcionales de movimiento por habilidad fisica, se realizo la revision de evidencia cientifica en bases de datos como Pubmed, EBSCO, Medline, Scopus, Google academico y con terminos DeCS: High Performance Sport, Functional Training, Physical Theraphy, Physical abilities, Movement screening, Circuit Training, strength, Change of direction, Sprint, neuromuscular training Resultados con la evidencia consultada, se realizo una reflexion y un modelo de intervencion basado en habilidades como calidad de movimiento, fuerza, potencia, velocidad, cambio de direccion, control neuromuscular, propiocepcion y core implementados mediante metodologias funcionales de entrenamiento. Conclusion Se presenta una reflexion sobre metodologias de trabajo funcional en deportistas basados en habilidades especificas del rendimiento deportivo que se incorporan en un modelo de rendimiento basado en evidencia cientifica especifica que pueden ser aplicados mediante circuitos funcionales de movimiento. EnglishIntroduction In high performance sport, physical skills play a fundamental role in the development of elite level athletes, these skills can be adapted to specific load cycles in order to develop adaptation periods and optimization of these qualities. Currently, the concepts of movement, functional evaluation, functional rehabilitation and functional training have been the most used in the sports area, specific adaptations are made of comprehensive approaches to human body movement based on neuromuscular factors, muscle synergies, motor learning, motor control, strength, power, speed mediated by specific training methodologies. Methodology A reflection study was carried out based on a literature review that aimed to describe a framework in the development and creation of functional circuits of movement by physical ability. A review of scientific evidence was conducted in databases such as Pubmed, EBSCO, Medline, Scopus, Google academic and with DeCS terms: High Performance Sport, Functional Training, Physical Therapy, Physical abilities, Movement screening, Circuit Training, strength, Change of direction, Sprint, neuromuscular training Results with the consulted evidence, a reflection was made and an intervention model based on skills such as quality of movement, strength, power, speed, change of direction, neuromuscular control, proprioception and core implemented using functional training methodologies. Conclusion A reflection is presented on functional work methodologies in athletes based on specific sports performance skills that are incorporated into a performance model based on specific scientific evidence that can be applied through functional movement circuits.

Plantar fasciitis (PF) is an inflammatory process of the plantar fascia, commonly encountered among runners. The purpose of this study is to evaluate whether the manual therapy (MT) alternated with the use of cryoultrasound in the treatment of PF is an effective option in reducing the symptomatology. The test was performed on 10 subjects (two groups), having the following rehabilitation protocol: Group A – MT and cryoultrasound; Group B – MT and cryotherapy. Both treatments proved to be effective, the difference in pain intensity on the VAS scale between the two groups measured at E3 being 10.48% in favor of group A

The objective of dentists is to preserve the teeth back to its functional form at any cost based on the requirements and willingness of the patient. This case report emphasizes more on restoring fractured endodontically treated teeth, where the fracture had extended subgingivally deeper to the middle-third of the palatal root segment. Excluding all other restoration methods based on the challenges, the present case was treated using posterior high strength glass ionomer restoration for margin elevation in the radicular segment and miracle mix restoration on the coronal portion of the tooth. Finally, the porcelain fused crown covers the crown completely for further functional usage. The margin is the challenge in this defect management for saving the tooth back to its functional form according to the patient’s willingness.

Korabiusz Katarzyna, Stecko Monika, Wawryków Agata. Multiple sclerosis - an overview of the most commonly used methods of physiotherapy. Journal of Education, Health and Sport. 2020;10(8):408‑412. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.08.049 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.08.049 https://zenodo.org/record/4007117 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 01.08.2020. Revised: 05.08.2020. Accepted: 29.08.2020. &nbsp

Aim: The aim of this study was to assess quality of life of patient with maxillectomy after wearing maxillary obturators using the Obturator Functioning Scale (OFS). Methodology: Fourty patients who underwent surgical resection of the maxilla were selected, randomized into two groups. In one group, the patients were rehabilitated with a maxillary obturator that was having a silicone bulb while in the second group, they received a conventional maxillary obturator with an acrylic bulb. A questionnaire that included the indices of the Obturator Functioning Scale (OFS) was used to evaluate the functional rehabilitation of patients in the study as it was given twice to each patient; one time before fabrication of the obturator and the second time after its construction. Results: obturator fabrication resulted in significant improvement of all the domains of the obturator functioning scale questionnaire in each group. However, on comparing the effect of both types of the obturator on the quality of life, there was no statistical significance. Conclusion: within limitation of this study, quality of life in patients after maxillary resection could be improved using maxillary obturators

Introduction. Infectious and autoimmune rheumatic diseases (ARDs) are closely linked. Apart from the challenging, sometimes differential, diagnosis between these conditions, it is recognized that microbes play an important role in the pathogenesis of the latter. Material and method. We present the case of a 45-year-old female patient from our rehabilitation department, with complex pathology (infectious, neurological, rheumatological and orthopedic pathology) that began more than 15 years ago. The patient’s pathological history began insidiously at theage of 30 when she was diagnosed with neurotoxoplasmosis. She received anticoagulant, antiepileptic, steroidal, antibiotic and antihelmintic treatment. After four years, the patient shows insidious onset of inflammatory pain in the large joints and in 2010 is diagnosed with seropositive rheumatoid arthritis, according to American College of Rheumatism/European League against rheumatism (ACR/EULAR) criteria with symmetric impairment of the large joints (shoulder, elbow, hip, knee, ankle). Despite the treatment with disease-modifying anti-rheumatic drugs (DMARDs) received, in the following years she needed 4 arthroplasties in the large joints due to osteonecrosis. Conclusions. On clinical grounds, infections, especially chronic infections, can cause a plethora of autoimmune phenomena, thus mimicking ARDs. Therefore, the differential diagnosis between ARDs and infectious diseases is sometimes challenging as they often display similar clinical manifestations. It is highlighted that the immune system can be our friend or our foe considering that its function and dysregulation are the common denominators in autoimmune and infectious diseases. In the era of new drugs and new therapeutic strategies, safety of the patients should always be our first concern.

Amelogenesis imperfecta (AI) is a group of hereditary conditions that affects the quality and quantity of dental enamel that is occasionally associated with other general conditions.1 Patients with AI manifests increased dental sensitivity resulting in poor oral hygiene and compromised masticatory functions. Correct diagnosis and management is highly needed to restore the quality of oral health. We presented here a case of full mouth rehabilitation in a 7 year child with Amelogenesis Imperfecta. Keywords: Amelogenesis Imperfecta, Enamel hypoplasia, Enamel hypomaturation.

Introduction: Spinal pain is a leading cause of disability worldwide and there is convergent epidemiological data describing neck pain as a recurrent and episodic condition. Recent work suggests th...

Surgical reconstruction after a total maxillectomy remains challenging. The standard treatment is the microvascular free flap. In cases of surgical contraindication, oral rehabilitation is usually performed with a palatal obturator prosthesis (PAP). Acceptable anatomical and functional outcomes in terms of speech, mastication, aesthetic appearance, stability, and comfort are not often achieved with a PAP. This technical note describes a technique for reconstruction after total bilateral maxillectomy involving the implantation of a custom-made bone-anchored titanium prosthesis obtained by 3D printing. Good functional and anatomical outcomes were achieved with this technique. It combines the advantages of the obturator prosthesis (short duration of surgery and hospitalization, low morbidity) and free flap (aesthetic/anatomical reconstruction and irremovable comfortable functional rehabilitation). This technique constitutes a new therapeutic alternative for the restoration of large defects after total maxillectomy when free flaps are contraindicated.

Background Postoperative exercise is effective for improving activities of daily living (ADL) in patients undergoing total knee arthroplasty (TKA), and exercise has been included in standard care after surgery provided in Japan. However, it is unknown whether standard care has room to develop for improving ADL. The goal of this study was to investigate the effect of an intensive functional rehabilitation (IFR) program in addition to standard care on the recovery of ADL following surgery. Methods A total of 104 inpatients with knee osteoarthritis undergoing TKA were randomly assigned to either the experimental or the control group. The experimental group (n = 57) were given standard care and participated in the IFR program immediately after surgery (e.g., stand up and sit down, strengthen the knee extensor muscle, climbing onto a platform, and walking laterally). The control group (n = 47) were given standard care only. Primary outcomes were the score of Functional Independence Measure (FIM) and the Barthel Index (BI) at 2 weeks postoperatively. Matching using the propensity score was performed to control the influence of the patient characteristic on the outcome. Results As a result of matching, 42 patients were extracted. The averages (standard deviation) of the FIM motor score were 79.0 (10.8) for the experimental group and 80.5 (9.4) for the control group. The BI scores were 88.1 (13.3) for the experimental group and 91.0 (10.1) for the control group. The experimental and control groups did not show significant intergroup differences in either score. Conclusions Our study shows that as compared to standard care, IFR program for 2 weeks in addition to standard care after surgery did not significantly improve ADL in patients undergoing TKA.

At present, science has provided us with a tool that facilitates the planning for the dentist of an aesthetic and functional rehabilitation work and that also allows the patient to visualize how his work would be in the mouth. In this way the patient has a clearer picture of what he can expect from his treatment and feel completely satisfied. These tools are the different software systems that digitally design a smile. The importance of this literature review work is to inform professionals of the technological advances that are available to us, to facilitate the work of the dentist and obtain, every day, more happy patients with the result of their treatments. The main objective of this article is to make known that by using digital systems to design a smile, we can facilitate the visualization of the patient towards what their treatment will be, and also help the professional with the planning of treatment with functional restorations and aesthetic The present literature review work has a qualitative retrospective cross-sectional approach of non-experimental design. At present, the professional could use the digital design system to facilitate the way in which the patient observes his smile design and its consequent dental treatment so as not to create false expectations. In this way the dentist can choose what type of software to use, within the brands that are in the market.

Each sports branch is characterized by an increasingly fierce competition on the way to performance, the need to overcome the adversary involving from the athletes an intense effort of speed, strength, endurance, ability to concentrate under stress conditions, all these demands increasing the chances of occurrence of the injuries. The study follows the importance of the implementation of proprioceptive training as a component part of the functional rehabilitation program, thus highlighting itsbeneficial effects: diminishing the symptoms, increasing joint mobility and muscle strength, regaining static and dynamic stability, essential parameters of sportsmen’s reintegration. The following tests were applied to the subject: joint assessment, muscle testing, Single Leg Balance Test (SLB), Single Legged Hop Test (SLH), 6 Meter Timed Hop Test, Star Excursion BalanceTest (SEBT) and evaluation of symptomatology and gait using The Foot and Ankle Disability Index (FADI) Score and Sports Module questionnaire. After applying the rehabilitation program, we found that the subject developed a significant improvement of thebalance on unstable surfaces (trampoline, balance board), maintaining the position in unipodal support for a duration of 4 times greater than after the initial evaluation. Also, the speed of execution for the jumps forwards over the distance of 6 meters was improved, the time difference between testing with the healthy limb (4.39 seconds) and that with the affected limb (4.67 seconds) beingbelow 10%. Therefore, we can conclude that the recovery program led to the elimination of joint instability, the results obtained representing essential indices of functional performance

The various treatment options for the aesthetic and functional rehabilitation of partially edentulous patients are conventional fixed partial dentures, implant supported fixed partial dentures and removable partial dentures. In some cases, removable partial dentures may be the only choice which is available other than implants and fixed partial denture. Removable cast partial dentures are used as definitive removable prostheses when indicated, but location of clasps is not aesthetically pleasant. So, when patient is concerned about aesthetics, flexible partial dentures which is aesthetically superior may be considered. But for the success of flexible removable partial denture, proper diagnosis, treatment planning, insertion, wearing and maintenance of this prosthesis is very important.

Objective: To analyzed and verify the usability and ergonomic adaptability of a medical device, as well assess its functionality for the purposes of tibiotarsal rehabilitation. Background: Therapheet is a device that uses pneumatic technology to perform tibiotarsal joint rehabilitation exercises in passive mode. This device still has many limitations, has it does not have a suitable chair, nor a proper foot and knee fixation system. Its high mechanical complexity and oversized components make it difficult to perform a functional rehabilitation, moreover pneumatic technology does not seem to be the most suitable for continuous and precise movements. Method: XSens® MTw Awinda technology was used to analyze the movements made by the volunteers. The kinematic analysis kit made it possible to measure the angles and accelerations performed by the dominant foot. Results: There is no combination of the knee and back angle that favors all rehabilitation exercises, so an adjustment adapted to each exercise and each patient will be the most appropriate. Conclusion: The application of ergonomics and anthropometry allowed to fill some gaps in the device, leading to the development of support for the patient’s lower limb and servomotor implementation. Application: Design of a rehabilitation device for the tibiotarsal joint.

Dental fluorosis is a developmental defect affecting amelogenesis. It presents clinically in different forms depending on the concentration, duration, and time of exposure to fluoride. Several therapeutic modalities have been described to manage mild and moderate forms of dental fluorosis; however, limited literature is available on the restorative management of severe forms of dental fluorosis, specifically in young individuals. This clinical report describes a complete prosthodontic rehabilitation of an adolescent patient with severe dental fluorosis affecting his permanent dentition. The patient was treated with a combination of monolithic, minimally-veneered zirconia crowns and direct composite resins. At the 1-year follow-up appointment, there were no complications, and both the patient's oral health and the integrity of the restorations remained stable. This article is protected by copyright. All rights reserved.

To examine relationships between functional outcomes after pediatric acquired brain injury (ABI) and measures of rehabilitation dose.An observational study of children receiving residential neurorehabilitation after severe ABI.Basic total rehabilitation dose shows a paradoxicalContent-aware measures of rehabilitation dose are robustly causally related to pertinent aspects of outcome. These findings are step toward a goal of comparative effectiveness research in pediatric neurorehabilitation.

The purpose of this study is identify the teacher\'s disease process to a better understanding of how the category is characterized and survives the confrontation of work situations from the moment they quit the teaching exercise because of illness, that is, after they readapt . Among the factors that prompted this research there are the issues: Is a readapted teacher discriminated as to affect its identity as a professional? How does he/she feel during and after the process of rehabilitation? Can he/she adapt satisfactorily to work? Does the work he/she does today in public schools in Uberlândia meet his/her expectations concerning the given teaching job? From the deepening discussed in theoretical reference, we have found foundations in Marx\'s literature on work when he shows values on the production of material life, that is, the work does not come only from biological needs, but above all a social enjoyment, human fulfillment that enables the production of values and ideas. In light of this support, our attempt was to address the issues of productive and unproductive labor, social experiences of the teaching profession and working conditions that sustain the identity positions, created through discourses that construct idealized images of responsibility of education improvement, which shall be pursued by teachers to become effective certain government policies. Finally, we present and discuss the stories / experiences by functional rehabilitation in the emphasis of the work of these professionals within the public schools in Uberlândia, between the years 2000-2014. Este estudo pretende identificar o processo de adoecimento docente para uma melhor compreensão de como a categoria se caracteriza e sobrevive aos enfrentamentos das situações de trabalho na medida em que se afastam do exercício docente por causa do adoecimento, ou seja, depois que se readaptam. Entre os fatores que instigaram essa pesquisa destacam-se as questões: que significado encontram os professores readaptados no trabalho que realizam dentro do ambiente escolar? O que sentiram durante e após o processo de readaptação? Conseguiram se adaptar de forma satisfatória aos novos afazeres? O trabalho que exercem hoje nas escolas municipais de Uberlândia contempla suas expectativas em relação ao exercício docente prescrito? Como os outros professores da escola veem esse profissional? Desse modo, serve-nos o fundamento teórico do pensamento de Marx sobre trabalho, evidenciando sua tese essencial acerca da produção da vida material: o trabalho não advém somente das necessidades biológicas, mas, sobretudo, de um aprazimento social, de realização humana que possibilita a produção de valores e de ideias. À luz dessa sustentação nos preocupamos em abordar as questões do trabalho produtivo e improdutivo, as experiências sociais do ofício docente e as condições de trabalho que sustentam as posições identitárias, criadas por meio de discursos que constroem imagens idealizadas da responsabilidade de melhoria da educação, a serem perseguidas pelos docentes para que se efetive determinadas políticas governamentais. Por fim, apresentamos e discutimos as histórias/experiências atravessadas pela readaptação funcional sob a ênfase do trabalho realizado por esses profissionais dentro das escolas municipais de Uberlândia entre 2000 e 2014. Mestre em História

Orientador: Rita Moura Fortes Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Civil, Arquitetura e Urbanismo Resumo: Revestimentos de cimento asfáltico de petróleo são utilizados como pavimentos de vias, as quais necessitam de manutenção preventiva e corretiva. Neste último contexto surgiu o microrrevestimento asfáltico a frio, que tem sido aplicado com sucesso como sistema corretivo de deficiências funcionais do pavimento. Como a mistura é composta por aproximadamente 75% de agregados, estes passam a ter um papel relevante. Esta pesquisa apresenta um estudo da influência da granulometria dos agregados no desempenho do microrrevestimento asfáltico a frio no ensaio de deslocamento lateral e vertical. Esta avaliação foi realizada com auxílio do Simulador de Tráfego, conhecido como L WT - Load Wheel Tester, tendo sido desenvolvido um estudo para verificação da repetitividade deste equipamento e dos ensaios. Na moldagem foram empregadas composições de agregados especificadas pelas faixas granulométricas das normas usuais. Deste modo, este estudo apresenta diretrizes para a escolha adequada da granulometria quando da elaboração de projetos de microrrevestimento asfáltico a frio Abstract: Surface layer are used as asphalt pavements, which need preventive and corrective maintenance. In this last context the cold micro surfacing appeared, that has been applied with success as system corrective of pavement functional deficiencies. As the mixture is composed for approximately 75% of aggregate these theme is very important. This research presents a study of the influence of the aggregate gradations in the cold micro surfacing performance in the lateral and vertical displacement. This evaluation was accomplished using Traffic Simulator, called LWT - Load Wheel Tester. Also it was developed a study repeatability of this equipment and the proceedings. This research used the usual aggregate gradations presented in the respective standards. Finally, this study presents guidelines for the appropriate choice of gradation to use in design of cold micro surfacing Mestrado Transportes Mestre em Engenharia Civil

© The Author(s)., [Background]: The increase in the survival of oncology patients include multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. An implementation of the conventional clinical practice, developed through multimodal physical exercise and functional rehabilitation program intervention, may be useful in controlling dyspnoea. This study aims to evaluate the effects of a multimodal exercise and functional rehabilitation program on fatigue, pain, functional capacity, and quality of life in cancer patients with cancer-related asthenia. [Methods]: This is a protocol for an experimental, prospective, randomised study using a parallel, fixed assignment scheme, with an experimental group and a control group in patients from the oncology hospitalisation unit at the Salamanca University Hospital Complex in Spain, using consecutive sampling to select 50 participants with oncological asthenia who are hospitalised at the time of inclusion. After the baseline evaluation, the participants will be randomised into two groups. Both groups will receive standard clinical practice care and the normal health education program at discharge, but in addition, the participants assigned to the experimental group will also complete a multimodal exercise and functional rehabilitation program lasting one month. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of asthenia (FACT-An scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the attention and executive functions (Trail-Making Test), fear/avoidance of movement (TAMPA scale), pain (VAS scale), and body composition (waist, hip, brachial, thigh, wrist, and ankle circumferences). [Discussion]: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with asthenia. The current study addresses to improve the conventional clinical practice by proposing a multimodal physical exercise and functional rehabilitation program intervention, which will be implemented by an interdisciplinary team, to try to improve the autonomy of cancer patients with cancer-related asthenia., This study was funded by the Regional Health Management of Castile and León, Spain, with project file number 2181/A/2020, and has undergone peer-review by the funding body.

In this article, we aimed to elaborate a universal clinical multidisciplinary protocol in order to facilitate the management of the peg-shaped maxillary lateral incisors, via a case of two upper lateral incisors affected by microdontia. A meticulous clinical analysis, wax up and mock up are crucial to ensure optimal rehabilitation.

Aims The aim of this meta-analysis was to assess the prognosis after early functional rehabilitation or traditional immobilization in patients who underwent operative or nonoperative treatment for rupture of the Achilles tendon. Methods PubMed, Embase, Web of Science, and Cochrane Library were searched for randomized controlled trials (RCTs) from their inception to 3 June 2020, using keywords related to rupture of the Achilles tendon and rehabilitation. Data extraction was undertaken by independent reviewers and subgroup analyses were performed based on the form of treatment. Risk ratios (RRs) and weighted mean differences (WMDs) (with 95% confidence intervals (CIs)) were used as summary association measures. Results We included 19 trials with a total of 1,758 patients. There was no difference between the re-rupture rate (RR 0.84 (95% CI 0.56 to 1.28); p = 0.423), time to return to work (WMD -1.29 (95% CI -2.63 to 0.05); p = 0.060), and sporting activity (WMD -1.50 (95% CI -4.36 to 1.37); p = 0.306) between the early functional rehabilitation and the traditional immobilization treatment strategies. Early rehabilitation up to 12 weeks yielded significantly better Achilles tendon Total Rupture Scores ((ATRS) WMD 5.11 (95% CI 2.10 to 8.12); p < 0.001). Patients who underwent functional rehabilitation had significantly lower limb symmetry index of heel-rise work ((HRW) WMD -4.19 (95% CI -8.20 to 0.17); p = 0.041) at one year. Conclusion Early functional rehabilitation is safe and provides better early function and the same functional outcome in the longer term. Cite this article: Bone Joint J 2021;103-B(6):1021–1030.

Introduction To identify the preoperative factors that influence functional rehabilitation after Major Lower Limb (MLL) amputation. Method This retrospective study analyzed all patients referred post-amputation to an amputee rehabilitation centre over a period of 1 year. The level of functional outcome at 6 and 12 months were recorded using SIGAM (Special Interest Group in Amputee Medicine) grading. Data on various preoperative factors were collected and analyzed for association with functional outcome. Results A total of 71 cases were analyzed. The mean age was 65.18 (range 24 - 91) years and 45 were males (63.4 %). Peripheral arterial disease was the major cause of amputation (80.3%). The level of amputation was above / through knee in 60.6%. Contralateral limb problems were present in 28.2%. Functional mobility was achieved by 38% of the MLL amputees within 6 months of rehabilitation, which increased to 46.5% at 12 months. Pre amputation mobility was a significant factor for a good functional outcome (p-value 0.002). An increasing value of BLARt (Blatchford Leicester Allman-Russell Tool) score showed a significant correlation with poor functional outcome. Conclusions Pre amputation mobility and BLARt score can be used in the prediction of functional outcome and can aid in better pre-operative decision making and rehabilitation planning.

Atypical swallowing is a my functional problem consisting of an altered tongue position during the act of swallowing, connection with the presence of malocclusions such as anterior open bite made it a topic of strong interest and discussion in science.Anterior open bite is considered a malocclusion that still defies correction, especially in terms of stability, midline Diastema create an unpleasant appearance for individuals, sometimes it may lead to phonetic problems, particularly in cases with wide space. This article describes a clinical rare case of a severe anterior open bite and an unusual midline Diastema which resulted from an atypical swallowing and shows the importance to set up an early my functional rehabilitation procedure to correct the oral habit and to prevent such malocclusion with consequences on aesthetics and self-confidence.

Rehabilitation is one of the most useful ways of treating patients who have suffered a stroke. Its precocity in the management of patients often allows having a good functional prognosis. In case of a sequela stroke complicated by and significant comorbidities, functional recovery is difficult. Despite this we are surprised to have a convincing result. We report a case of sequelae of a straight stroke complicated by right transtibial amputation in a 57-year-old patient over two years after the accident. The initial assessment found a bedridden patient with significant musculoskeletal impairment. After ten months of follow-up requiring the intervention of a multidisciplinary team, the final assessment revealed a significant functional recovery, despite the persistence of some difficulties limiting the total autonomy of the patient.

Acute injuries of the proximal radius and ulna can be challenging to manage. This review article summarizes the classification, injury patterns, treatment and outcome of fractures of the olecranon, coronoid process, adult Monteggia fracture dislocations and radial head fractures. Undisplaced fractures and stable injuries can be treated conservatively and displaced and complex injuries should be treated surgically to permit early range of motion with a functional rehabilitation programme.

Robotic total knee arthroplasty (TKA) improves the accuracy of implant positioning and reduces outliers in achieving the planned limb alignment compared to conventional jig-based TKA. Robotic TKA does not have a learning curve effect for achieving the planned implant positioning. The learning curve for achieving operative times comparable to conventional jig-based TKA is 7–20 robotic TKA cases. Cadaveric studies have shown robotic TKA is associated with reduced iatrogenic injury to the periarticular soft tissue envelope compared to conventional jig-based TKA. Robotic TKA is associated with decreased postoperative pain, enhanced early functional rehabilitation, and decreased time to hospital discharge compared to conventional jig-based TKA. However, there are no differences in medium- to long-term functional outcomes between conventional jig-based TKA and robotic TKA. Limitations of robotic TKA include high installation costs, additional radiation exposure, learning curves for gaining surgical proficiency, and compatibility of the robotic technology with a limited number of implant designs. Further higher quality studies are required to compare differences in conventional TKA versus robotic TKA in relation to long-term functional outcomes, implant survivorship, time to revision surgery, and cost-effectiveness. Cite this article: EFORT Open Rev 2019;4:611-617. DOI: 10.1302/2058-5241.4.190022

The progressing inflammatory periodontal disease, if left untreated, results in attachment loss. This can also affect the bifurcation or trifurcation of a multirooted teeth. Thus, the treatment and long-term retention of mandibular molar teeth exhibiting furcation involvement has always been a key challenge, especially when there is furcation involvement progressed to a class II furcation. Hemisection denotes the removal of compromised root and its associated crown portion with the loss of periodontal attachment and to maintain the original tooth structure to attain the fixed prosthesis. This case report demonstrates the successful management of hemisection of 36 with occlusal rehabilitation and it was aimed to follow a conservative treatment approach to retain as much as original tooth structure possible against the conventional option of extracting the natural tooth. Keywords: Endodontic-periodontal lesion, Furcation invasion, Class II furcation, Fixed partial denture, Prosthetic rehabilitation.

Background: Persistent quadriceps weakness and activation failure are common in individuals with anterior cruciate ligament (ACL) reconstruction. A growing body of evidence indicates that this chronic quadriceps dysfunction could be partly mediated due to reduced corticospinal excitability. However, current rehabilitation approaches do not directly target corticospinal deficits, which may be critical for restoring optimal clinical outcomes after the surgery. This case study tested the feasibility of operant conditioning of torque responses evoked by transcranial magnetic stimulation (TMS) to improve quadriceps function after ACL reconstruction. Hypothesis: Operant conditioning of motor evoked torque responses would improve quadriceps strength, voluntary activation, and corticospinal excitability. Study Design: Case study and research report. Level of Evidence: Level 5. Methods: A 24-year-old male with an ACL reconstruction (6 months postsurgery) trained for 20 sessions (2-3 times per week for 8 weeks) to increase his TMS-induced motor evoked torque response (MEP torque) of the quadriceps muscles using operant conditioning principles. Knee extensor strength, voluntary quadriceps muscle activation, and quadriceps corticospinal excitability were evaluated at 3 time points: preintervention (pre), 4 weeks (mid), and immediately after the intervention (post). Results: The participant was able to successfully condition (ie, increase) the quadriceps MEP torque after 1 training session, and the conditioned MEP torque gradually increased over the course of 20 training sessions to reach about 500% of the initial value at the end of training. The participant’s control MEP torque values and corticospinal excitability, which were measured outside of the conditioning paradigm, also increased with training. These changes were paralleled by improvements in knee extensor strength and voluntary quadriceps muscle activation. Conclusion: This study shows that operant conditioning of MEP torque is a feasible approach to improving quadriceps corticospinal excitability and quadriceps function after ACL reconstruction and encourages further testing in a larger cohort of ACL-reconstructed individuals. Clinical Relevance: Operant conditioning may serve as a potential therapeutic adjuvant for ACL rehabilitation.

AimsThe objectives of this study were to compare postoperative pain, analgesia requirements, inpatient functional rehabilitation, time to hospital discharge, and complications in patients undergoing conventional jig-based unicompartmental knee arthroplasty (UKA) versus robotic-arm assisted UKA.Patients and MethodsThis prospective cohort study included 146 patients with symptomatic medial compartment knee osteoarthritis undergoing primary UKA performed by a single surgeon. This included 73 consecutive patients undergoing conventional jig-based mobile bearing UKA, followed by 73 consecutive patients receiving robotic-arm assisted fixed bearing UKA. All surgical procedures were performed using the standard medial parapatellar approach for UKA, and all patients underwent the same postoperative rehabilitation programme. Postoperative pain scores on the numerical rating scale and opiate analgesia consumption were recorded until discharge. Time to attainment of predefined functional rehabilitation outcomes, hospital discharge, and postoperative complications were recorded by independent observers.ResultsRobotic-arm assisted UKA was associated with reduced postoperative pain (p < 0.001), decreased opiate analgesia requirements (p < 0.001), shorter time to straight leg raise (p < 0.001), decreased number of physiotherapy sessions (p < 0.001), and increased maximum knee flexion at discharge (p < 0.001) compared with conventional jig-based UKA. Mean time to hospital discharge was reduced in robotic UKA compared with conventional UKA (42.5 hours (sd 5.9) vs 71.1 hours (sd 14.6), respectively; p < 0.001). There was no difference in postoperative complications between the two groups within 90 days’ follow-up.ConclusionRobotic-arm assisted UKA was associated with decreased postoperative pain, reduced opiate analgesia requirements, improved early functional rehabilitation, and shorter time to hospital discharge compared with conventional jig-based UKA.

[Purpose] Limited data are available regarding the outcomes of non-operative treatment for hip fractures. We investigated the factors associated with functional rehabilitation outcomes in patients undergoing non-operative treatment for hip fractures. [Participants and Methods] We investigated 57 patients with hip fractures who underwent non-operative treatment. We retrospectively analyzed medical or rehabilitation outcomes and functional outcomes (assessed using the Functional Independence Measure tool). We examined the association between functional outcomes and other factors and compared the medical and rehabilitation outcomes between mobile and immobile patients at the time of discharge. [Results] Of the 57 patients investigated, 15 (26.3%) were mobile at discharge. We observed a significant association between the Functional Independence Measure subscores (Motor and Cognitive) and serum albumin levels. Serum albumin levels and the Functional Independence Measure subscores (Motor and Cognitive) were significantly higher in mobile than in immobile patients. [Conclusion] We observed that functional outcomes at discharge in patients undergoing non-operative treatment for hip fractures were associated with serum albumin ratios and the Functional Independence Measure-Cognitive score.

Purpose. A comparative analysis of the results of two-stage optico-functional rehabilitation of patients with a high risk of postoperative asthenopic syndrome (AS).Materials and methods. 36 patients (72 eyes) who had no binocular vision at a distance of 5 m and had a symmetrical position of the eyes, or a position close to symmetry, were randomly divided into 2 equal groups of comparison. Patients in both groups underwent functional treatment followed by the correction of refractive errors with FemtoLASIK technology. To eliminate accommodation dysfunctions, a medical device OXYS was used. Diploptic treatment was carried out using a Speckle-M laser apparatus and Bagolini raster glasses. To expand fusional reserves, a prism compensator (OKP-20, Russia) and a Speckle-M laser apparatus were used. The patients of the first group underwent a fast course of medical and functional rehabilitation for 5 working days (2 times a day with a break of 2–3 hours). As an additional pharmacological support, daily instillations of phenylephrine hydrochloride 2.5 % without preservatives were prescribed. The other group received the same functional treatment for 10 working days.Results. After the fast and the standard rehabilitation courses, the patients revealed an increase in absolute accommodation and a decrease in the coefficient of micro fluctuations, an expansion of fusional reserves, an increase in stereovision acuity, and an increased number of cases of binocular vision. No statistically significant difference of clinical and functional parameters obtained as a result of the fast and the standard rehabilitation courses was revealed.Conclusions. Functional and medicament treatment of patients with refractive disorders and the absence of binocular vision prior to FemtoLASIK is shown to be effective. This treatment reduces the risk of postoperative AS and increases the patient’s satisfaction with the results of the surgery.

With the introduction of functional rehabilitation and early weight bearing, the management of acute midsubstance Achilles tendon ruptures has seen a paradigm shift in conservative methods. The re-rupture rates for non-surgical treatment are similar to those for surgical treatment with the advantage of a decrease in complications. The treatment should be tailored to each individual patient with a shared decision-making process between the surgeon and patient, taking into consideration their occupation, lifestyle, sporting aspirations and expectations. Generally, most patients can be treated non-operatively in centres offering functional rehabilitation. However, surgical repair should be preferred at centres that do not employ functional rehabilitation as it decreases the re-rupture risk in such patients. High-demand, active individuals and athletes should be considered for surgery as non-operative treatment can lead to statistically significant deficits in high-speed plantar flexion strength and hopping ability in the absence of robust sports-oriented functional rehabilitation. If surgical treatment is considered, minimally invasive techniques should be employed to alleviate the risk of wound complications.

Congenital absence of maxillary lateral incisors is a frequent clinical challenge which must be solved by a multidisciplinary approach in order to obtain an esthetic and functional restorative treatment. Noninvasive treatments, that are in accordance with the patients' expectations, should be the first therapeutic alternative. If the deciduous tooth is present, minimally invasive dental extraction followed by immediate dental implant placement and provisional restoration is indicated. In this restorative treatment, an adequate emergency profile can be achieved by peri‐implant soft‐tissue‐conditioning techniques. Moreover, the association of restorative materials, such as composite resins and dental ceramics, provides more predictable esthetic results. Clinical Considerations The present case report presents a rehabilitation of bilateral congenital absence of maxillary lateral incisors through a multidisciplinary approach. Dental implants, long‐term provisional restoration, tooth bleaching, minimally veneered high‐translucent monolithic zirconia crowns, feldspathic veneers, and composite restorations were used by the dental team to achieve the expected functional and esthetic outcomes. Conclusions Different treatment modalities are available for the rehabilitation of congenital absence of teeth. However, it is important that a dental team consider performing minimally invasive treatments, as many of these treatments are done on young patients. Clinical Significance Patient‐centered treatments involving minimally invasive approaches in a multidisciplinary environment would be appropriate in order to achieve predictable results.