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Background: Management of foot-drop following stroke can be addressed with ankle-foot orthosis (AFO) or functional electrical stimulation (FES) of the peroneal nerve. There is limited evidence regarding the efficacy of FES as a substitute for a conventional ankle-foot orthosis.Objective: The aim of this study was to compare efficacy of FES against AFO in management of foot-drop in patients following stroke.Materials and Methods: Twenty patients (ten per group) were enrolled in this prospective crossover trial. Group A patients received gait training with AFO during first week followed by training with FES during second week and vice-versa for group B. Outcome parameters following AFO/FES training included Ten-meter, Six-minute walk test and spatiotemporal gait parameters. Patient satisfaction level was assessed using feedback questionnaire. Friedman test and Wilcoxon signed-rank test were performed to compare outcomes between barefoot, AFO and FES. The P value < 0.05 was considered statistically significant.Results: Nineteen males and one female aged 45.5 ± 9.45 years were recruited. Statistically significant improvement was observed in Ten-meter and Six-minute walk tests, gait speed, Timed up and go test (TUG), stance-swing ratio and single-limb support among users of FES as compared to AFO and barefoot. There was no statistical difference observed in other gait parameters. Physiological cost index (PCI) showed trend in improvement among FES users. Patient satisfaction scores were higher for FES users.Conclusions: Quantitative and qualitative results were in favour of FES as compared to AFO and barefoot suggesting that FES can be a potential orthotic intervention in hemiplegic patients. [ABSTRACT FROM AUTHOR]

Background: In a patient who has undergone a major amputation of one lower limb, the role and function of the precious limb is of paramount importance. We assume that once the patient has been rehabilitated with a prosthesis, the static plantar pressure distribution is equal over both the amputated limb and the precious limb. There is not much published literature that actually compares the distribution of the static plantar pressure over the precious limb available in India. This study aimed at studying the characteristics of static plantar pressure distribution after a major amputation in the precious foot of diabetic patients with and without prosthesis once they have been rehabilitated. Objectives: 1) To compare the relationship between static plantar pressure distribution in the precious limb with and without the prosthesis in diabetic patients who have undergone a below knee amputation and have been rehabilitated. 2) To identify areas of high pressure over the precious limb and suggest appropriate modifications in the prosthetic footwear so as to reduce the static plantar pressure in those high-pressure regions. Results: The static plantar pressure distribution was found to be significantly higher without the advocated prosthetic device on the amputated limb over the 1st, 2nd, 3rd, 4th, and 5th metatarsal-. The ratio of the forefoot versus the hind foot pressures with and without a prosthesis was also noted to be significant (p = 0.002). Conclusions: This variation in the pressure distribution over the precious foot disproved our hypothesis that there is an equal spatial redistribution in static plantar peak pressures in the precious limb following rehabilitation with a prosthetic device in a diabetic patient who has undergone a below knee amputation and that a prosthesis alone is not adequate to protect the precious limb. [ABSTRACT FROM AUTHOR]

Byline: George. Tharion, K. Indirani, M. Durai, M. Meenakshi, Suresh. Devasahayam, Nadipi. Prabhav, Cassandra. Solomons, Suranjan. Bhattacharji Background: Olfactory ensheathing cells (OEC) are considered to be the most suitable cells [...]

Objective: To compare the efficacy of individual and combined treatment of olfactory ensheathing cells (OECs) and acidic fibroblast growth factor (aFGF) in a rat model of spinal cord injury (SCI). Materials and Methods: Adult female Albino Wistar rats were anesthetized with ketamine (90 mg/kg) and xylazine (10 mg/kg) by intraperitoneal injection and T10 laminectomy was performed to expose the spinal cord, before drop-weight injury. Following injury, 2 μg of aFGF was administered at the site of injury and cultured rat olfactory mucosal OEC were transplanted as a single dose of 1 × 106 cells on the 9th day after SCI, used individually as well as in combination therapy. The outcome of the treatments was assessed using the hind-limb motor recovery-Basso, Beattie, Bresnahan (BBB) scale, transcranial motor-evoked potential, and histological studies. Results: All the treated groups showed improvement in hind-limb motor recovery when compared to the control group in BBB (P < 0.05). There was increased electromyography amplitude in treated rats as compared to controls (P < 0.05). Retrograde and anterograde tract tracing showed an increase of preserved axons and possible regeneration. Combination of aFGF with OEC transplantation demonstrated more beneficial effects following SCI than with individual therapy. Conclusion: aFGF and OEC transplantation have neuroprotective and regenerative therapeutic potentials for the future clinical applicatio. [ABSTRACT FROM AUTHOR]

Objective: To assess the effect of interactive video gaming (IVG) with Nintendo Wii (Wii) supplemented to conventional therapy in rehabilitation of children with cerebral palsy (CP). Design: Randomized, controlled, assessor-blinded study. Participants: Children with CP; 10 children each in the control and intervention groups. Intervention: IVG using Wii, given as a supplement to conventional therapy, for 45 min per day, 6 days a week for 3 weeks. The children in the control group received conventional therapy alone. Outcome Measures: Posture control and balance, upper limb function, visual-perceptual skills, and functional mobility. Results: Significant improvement in upper limb functions was seen in the intervention group but not in the control group. Improvements in balance, visual perception, and functional mobility were not significantly different between control and intervention groups. Conclusions: Wii-based IVG may be offered as an effective supplement to conventional therapy in the rehabilitation of children with CP. [ABSTRACT FROM AUTHOR]

Background and Purpose Phantom limb pain (PLP) can be disabling for nearly two thirds of amputees. Hence, there is a need to find an effective and inexpensive treatment that can be self administered. Among the non-pharmacological treatment for PLP, transcutaneous electrical nerve stimulation (TENS) applied to the contralateral extremity and mirror therapy are two promising options. However, there are no studies to compare the two treatments. The purpose of this study is to evaluate and compare mirror therapy and TENS in the management of PLP in subjects with amputation. Methods The study was an assessor blinded randomized controlled trial conducted at Physiotherapy Gymnasium of Physical Medicine and Rehabilitation Department, Christian Medical College, Vellore. Twenty-six subjects with PLP consented to participate. An initial assessment of pain using visual analogue scale (VAS) and universal pain score (UPS) was performed by a therapist blinded to the treatment given. Random allocation into Group I-mirror therapy and Group II-TENS was carried out. After 4 days of treatment, pain was re-assessed by the same therapist. The mean difference in Pre and Post values were compared among the groups. The change in pre-post score was analyzed using the paired t test. Results Participants of Group I had significant decrease in pain [VAS ( p = 0.003) and UPS ( p = 0.001)]. Group II also showed a significant reduction in pain [VAS ( p = 0.003) and UPS ( p = 0.002)]. However, no difference was observed between the two groups [VAS ( p = 0.223 and UPS ( p = 0.956)]. Discussion Both Mirror Therapy and TENS were found to be effective in pain reduction on a short-term basis. However, no difference between the two groups was found. Substantiation with long-term follow-up is essential to find its long-term effectiveness. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective(s): In the past few decades, variety of foetal, embryonic and adult stem and progenitor cells have been tried with conflicting outcome for cell therapy of central nervous system injury and diseases. Cellular characteristics and functional plasticity of Globose basal stem cells (GBCs) residing in the olfactory epithelium of rat olfactory mucosa have not been studied in the past by the neuroscientists due to unavailability of specific markers for GBCs. In the present research, we standardized some techniques to isolate GBCs from rat olfactory epithelium in pure form using a highly selective GBC-III antibody passaged through fluorescence activated cell sorter (FACS). We also characterized these cells immunohistologically using various pluripotent stem cell markers. This work also throws some light on ionic channels present on these stem cells which are responsible for their neuron induction potential. Materials and methods: Globose basal stem cells were isolated from rat olfactory epithelium using GBC-III antibody and were characterized as multipotent stem cells using various neural progenitor markers. Ionic channels on GBCs were studied with voltage clamping. Results: GBCs could be isolated in pure (99% purity) form and were found to be stained positive for all neural progenitor cell markers. Voltage gated Na+ channels were completely absent, which proves the unexcitable nature of GBCs. Leaky K+ channels were found to be present on the GBC which was of no significance. Conclusion: This research work can be helpful in understanding the nature of these stem cells and utilising them in future as potent candidates for neuro-regenerative therapies. [ABSTRACT FROM AUTHOR]

Introduction: Olfactory mucosa which is situated in the roof of the nasal cavity possesses an extremely peculiar and exceptional type of pluripotent stem cells called Globose Basal Cells (GBCs) which help in lifelong regeneration of the olfactory mucosa. Previous literature doesn't provide much knowledge on the cytological, histochemical and electrophysiological properties of these cells, as they have never been isolated in pure form. Material and Methods: Olfactory mucosa was obtained from six Albino Wistar rats by using standardized surgical and chemical separation procedures. GBCs were isolated by using different chemical, surgical and fluorescent techniques. Results: In this research work, we standardized the techniques for isolating these stem cells in pure form from rat olfactory mucosa by tagging them with GBC-III antibody and separating them from other epithelial cells by using Fluorescence Activated Cell Sorter (FACS). GBC-III antibody is a mouse monoclonal IgM antibody which recognizes a 40 kDa surface antigen, which is a laminin receptor surface protein present on the GBCs. It is a highly specific marker for GBCs, unlike the earlier antibodies used, like GBC-I, which were nonspecific markers for GBCs and showed positive reactions, even with Horizontal Basal Cells (HBCs), sustentacular cells (Sus) and duct cells. This study also standardized the techniques for surgically excising the olfactory mucosa from the nasal septum and chemically separating the olfactory epithelium from the lamina propria. Conclusion: GBCs are an important group of cells which can be exploited in future to study and treat neuro-degenerative disorders like multiple sclerosis, brain ischaemia, etc. and spinal cord trauma, as they reside in a niche similar to the microenvironment in the central nervous system and have the similar ectodermal development as the neuronal and non-neuronal cells of the CNS. Moreover, olfactory epithelium is easily accessible for autologous transplantation of GBCs for different CNS disorders. [ABSTRACT FROM AUTHOR]