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Purpose: Quantifying the quality of life in clubfoot patients during bracing following the Ponseti method compared with healthy controls., Methods: Data collected during the brace period of the Ponseti method and of a reference sample was retrospectively analyzed to investigate health-related quality of life scale (TAPQOL) in clubfoot patients compared with healthy controls. The TAPQOL instrument consists of 12 subscales comprising the 4 domains of health-related quality of life namely physical, social, emotional and cognitive functioning., Results: Responses of 80 parents of clubfoot patients and 238 parents of healthy controls were analyzed. On average both study groups scored high on the 4 domains of the TAPQOL instrument. The clubfoot group scored significantly (p<0.0125) lower on the subscales motor functioning, sleep, lung and skin problems during bracing. No difference was observed between the study groups in the year the bracing had ended., Conclusion: Dutch clubfoot patients show an overall good health related quality of life. However, during the brace phase of the Ponseti treatment they score lower in subscales in the physical functioning domain. These results can be used in the counselling of parent and might alleviate some concerns that parents have about the bracing period., Level of Evidence: Level III, Case control study., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Purpose: To determine the face and construct validity as well as educational value and user-friendliness of the Simendo knee arthroscopy virtual reality simulator., Methods: Sixty participants were recruited and equally divided into novices (0 arthroscopic procedures), intermediates (1-59 arthroscopic procedures), and experts (60 or more arthroscopic procedures). Participants were excluded if they had previously trained with the studied simulator. Construct validity, that is, the ability to discriminate between different levels of expertise, was examined by a navigation task. All participants were asked to perform 5 navigation trials within 10 minutes. Face validity, educational value, and user-friendliness were examined by questionnaires before and after the navigation trials. Face validity is the subjective impression of how closely the simulation replicates the real environment., Results: The novices were significantly slower than the intermediates in the first (P < .001) and the third (P = .031) trial. The novices were significantly slower than the experts in all trials (P = .016), except for the fifth (P = .054). The experts were significantly faster than the intermediates in every trial except for the fourth (P = .069). Median task time for the fifth trial was 63 seconds (44-80 seconds) for novices, 58 seconds (46-80 seconds) for intermediates, and 41 seconds (33-55 seconds) for experts. Ninety-two percent of all participants agreed that the simulator can be used to train for surgical inspection, and 95% indicated sufficient user-friendliness., Conclusions: Based on the results, this knee simulator can be applied to train the basic arthroscopic hand-eye coordination skills at the start of resident education programs. Further testing is necessary to determine whether the skills are retained., Clinical Relevance: The simulator is partly validated, which contributes to training of basic arthroscopic skills without compromising patient safety., (Copyright © 2019 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)

Introduction: Prosthetic joint infection (PJI) is a relatively uncommon (average incidence 0.5-2%) but devastating complication, with significant morbidity and leading to tremendously increased health care costs. In 2013, delegates from nine hospitals covering a large region in the South-East Netherlands composed one combined treatment protocol for acute PJI of total hip and knee arthroplasty (THA and TKA). This protocol was based on the definition of acute PJI according to Workgroup of the American Musculoskeletal Infection Society (MSIS) and the principles of debridement, antibiotics, irrigation and retention (DAIR). Methods: Patients with a THA or TKA treated with DAIR because of suspicion of PJI were selected from the online PJI database. PJI was defined as at least two phenotypically identical pathogens, isolated in cultures from at least two separate tissues, obtained from the affected prosthetic joint. Acute PJIs, occurring within 90 days after primary implantation, between January 2014 and December 2016, were analyzed. We analyzed the PJI incidence rate, patient clinical and microbiological characteristics of PJI, outcome of the DAIR treatment and adherence to the regional protocol. Results: A total of 310 primary THA or TKA with a suspected PJI were registered in the regional PJI database, 236 met the definition of acute PJI, representing overall incidence of 1.12%. Following the regional treatment protocol replacement of exchangeable parts took place in 45% in 2014 to 70% in 2016. After 12 months follow-up, prosthesis retention was achieved in 87% and 3% of the patients died within one year after the primary surgery. Conclusion: Results of the regional cohort are in line with the available literature. Regional collaboration and regular feedback on registered data resulted in better adherence to the combined treatment protocol. Despite our attempts to improve PJI care, PJI remains a serious complication of THA and TKA with a significant mortality rate and burden for the patient., Competing Interests: Competing Interests: The authors have declared that no competing interest exists.

Clinical and radiological related outcomes have been reported for Chevron osteotomy as correction for mild to moderate hallux valgus, but only for relatively small patient series. Moreover, evaluation of the patient's point of view has mostly been conducted by means of more physician-based outcome measures. The goal of this study was to evaluate the effect of the Chevron osteotomy for hallux valgus on patients' daily lives using the Foot and Ankle Outcome Score (FAOS) as a validated and a hallux valgus specific patient reported outcome measure (PROM). Secondary outcome measures were radiological correction, complication rate, and re-operations. All 438 Chevron procedures (336 patients), at two surgical hospital sites in the period between January 2010 and October 2014, were retrospectively evaluated with a follow-up of at least 6 months. Patients were invited to fill in a cross-sectional online FAOS. For the FAOS, a total response of 60% was achieved. The FAOS ranged between 71 and 88 with a follow-up of on average 36 months. Patients with an undercorrection of their hallux valgus (11.6% of the procedures) scored significantly lower on three subscales of the FAOS (range between 61 and 77 versus 72-84). Patients who had a reoperation (12.6% of the procedures) also scored significantly lower on four subscales: 58-100 versus 73-89. Postoperative radiological measurements improved significantly with a mean difference of 6.1 (5.9; 6.4) degrees for the intermetatarsal angle and 13.7 (13.0; 14.5) degrees for the hallux valgus angle. In this large study cohort, Chevron osteotomy for hallux valgus offers good PROM scores on FAOS. These scores were significantly lower in patients with radiological undercorrection or with a reoperation. Results of the FAOS appear to modulate with physician based outcomes and therapeutic incidents. Improvement of outcome may therefore well be possible by increased attention on these surgical details., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The current study investigated the human ability to synchronize movements with event sequences containing continuous tempo changes. This capacity is evident, for example, in ensemble musicians who maintain precise interpersonal coordination while modulating the performance tempo for expressive purposes. Here we tested an ADaptation and Anticipation Model (ADAM) that was developed to account for such behavior by combining error correction processes (adaptation) with a predictive temporal extrapolation process (anticipation). While previous computational models of synchronization incorporate error correction, they do not account for prediction during tempo-changing behavior. The fit between behavioral data and computer simulations based on four versions of ADAM was assessed. These versions included a model with adaptation only, one in which adaptation and anticipation act in combination (error correction is applied on the basis of predicted tempo changes), and two models in which adaptation and anticipation were linked in a joint module that corrects for predicted discrepancies between the outcomes of adaptive and anticipatory processes. The behavioral experiment required participants to tap their finger in time with three auditory pacing sequences containing tempo changes that differed in the rate of change and the number of turning points. Behavioral results indicated that sensorimotor synchronization accuracy and precision, while generally high, decreased with increases in the rate of tempo change and number of turning points. Simulations and model-based parameter estimates showed that adaptation mechanisms alone could not fully explain the observed precision of sensorimotor synchronization. Including anticipation in the model increased the precision of simulated sensorimotor synchronization and improved the fit of model to behavioral data, especially when adaptation and anticipation mechanisms were linked via a joint module based on the notion of joint internal models. Overall results suggest that adaptation and anticipation mechanisms both play an important role during sensorimotor synchronization with tempo-changing sequences. This article is part of a Special Issue entitled SI: Prediction and Attention., (Copyright © 2015 Elsevier B.V. All rights reserved.)

This study addressed the role of subcortical brain structures in temporal adaptation and anticipation during sensorimotor synchronization. The performance of patients with cerebellar or basal ganglia lesions was compared with that of healthy control participants on tasks requiring the synchronization of drum strokes with adaptive and tempo-changing auditory pacing sequences. The precision of sensorimotor synchronization was generally lower in patients relative to controls (i.e., variability of asynchronies was higher in patients), although synchronization accuracy (mean asynchrony) was commensurate. A computational model of adaptation and anticipation (ADAM) was used to examine potential sources of individual differences in precision by estimating participants' use of error correction, temporal prediction, and the amount of variability associated with central timekeeping and peripheral motor processes. Parameter estimates based on ADAM indicate that impaired precision was attributable to increased variability of timekeeper and motor processes as well as to reduced temporal prediction in both patient groups. Adaptive processes related to continuously applied error correction were, by contrast, intact in patients. These findings highlight the importance of investigating how subcortical structures, including the cerebellum and basal ganglia, interact with a broader network of cortical regions to support temporal adaptation and anticipation during sensorimotor synchronization., (© 2015 New York Academy of Sciences.)

Auditory information plays an important role in fine motor control such as speech and musical performance. The purpose of this study was to assess expertise-dependent differences in the role of temporal information of auditory feedback in the production of sequential movements. Differences in motor responses to the transient delay of tone production during musical performance between expert pianists and non-musicians were evaluated. Compared to expert pianists, non-musicians showed more pronounced movement disruptions following the delayed auditory feedback. For example, in response to a perturbation the inter-keystroke interval was prolonged and the key-press was longer in non-musicians, while the expert pianist marginally shortened both measures. These distinct differences between groups suggest that extensive musical training influences feedback control in sequential finger movements. Furthermore, there was a significant positive correlation between the age at which the expert pianists commenced their musical training and the amount of disruption. Overall, these findings suggest that expert pianists have a higher level of robustness against perturbations and depend less on auditory feedback during the performance of sequential movements., (Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.)