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Cast Immobilization (cast + immobilization)
Selected AbstractsEvaluation and economic impact analysis of different treatment options for ankle distortions in occupational accidentsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2010Amaryllis Audenaert Grad Eng PhD Abstract Rationale, aims and objectives, Appropriate use of diagnostic and treatment modalities are essential for rational use of resources. The aim of this study is to evaluate the use of diagnostic modalities and different treatment options and their economic impacts following an acute ankle distortion resulting from an occupational accident. We evaluated the type-of-treatment impact on the victims' course of recovery as well as its impact on the associated accident costs. Research was carried out in Belgium. Methods, An ankle distortion victims' database consisting of 200 cases of (Belgian) occupational accidents during the period 2005,2007 was analysed. Results, Patients who were prescribed immobilization or the use of adjuvant support or physical therapy (118 cases) were not employed during a period of 37 days on average, with a mean total cost of 3140.14 Euros caused by the ankle sprain. Patients without any adjuvant therapy (82 cases) were characterized by an unemployment rate of 15 days on average, and a total cost of 1077.86 Euros. Cast immobilization, although its application is not supported by evidence-based literature, was still applied in 36% of the population studied and resulted in the longest average absence of work of 42 days with an obvious significant increase in medical and total costs. Conclusions, Our results show a high rate of inappropriate use of cast immobilizations for ankle distortions. From an economic point of view and for the same clinical endpoint (being full resumption of the occupational activities), simple conventional treatment, consisting of rest, ice, compression and elevation at diagnosis with allowance of early weight bearing in the further clinical course, leads to the quickest full resumption of activities in combination with the lowest medical costs, if compared with any other kind of treatment. [source] Alterations in inorganic phosphate in mouse hindlimb muscles during limb disuse,NMR IN BIOMEDICINE, Issue 2 2008Neeti Pathare Abstract Muscle disuse induces a wide array of structural, biochemical, and neural adaptations in skeletal muscle, which can affect its function. We recently demonstrated in patients with an orthopedic injury that cast immobilization alters the resting Pi content of skeletal muscle, which may contribute to loss of specific force. The goal of this study was to determine the direct effect of disuse on the basal phosphate content in skeletal muscle in an animal model, avoiding the confounding effects of injury/surgery. 31P and 1H MRS data were acquired from the gastrocnemius muscle of young adult mice (C57BL6 female, n,=,8), at rest and during a reversible ischemia experiment, before and after 2 weeks of cast immobilization. Cast immobilization resulted in an increase in resting Pi content (75%; p,<,0.001) and the Pi to phosphocreatine (PCr) ratio (Pi/PCr; 80%, p,<,0.001). The resting concentrations of ATP, PCr and total creatine (PCr,+,creatine) and the intracellular pH were not significantly different after immobilization. During ischemia (30,min), PCr concentrations decreased to 54,±,2% and 52,±,6% of the resting values in pre-immobilized and immobilized muscles, respectively, but there were no detectable differences in the rates of Pi increase or PCr depletion (0.55,±,0.01,mM min,1 and 0.52,±,0.03,mM min,1 before and after immobilization, respectively; p,=,0.78). At the end of ischemia, immobilized muscles had a twofold higher phosphorylation potential ([ADP][Pi]/[ATP]) and intracellular buffering capacity (3.38,±,0.54 slykes vs 6.18,±,0.57 slykes). However, the rate of PCr resynthesis (kPCr) after ischemia, a measure of in vivo mitochondrial function, was significantly lower in the immobilized muscles (0.31,±,0.04,min,1) than in pre-immobilized muscles (0.43,±,0.04,min,1). In conclusion, our findings indicate that 2 weeks of cast immobilization, independent of injury-related alterations, leads to a significant increase in the resting Pi content of mouse skeletal muscle. The increase in Pi with muscle disuse has a significant effect on the cytosolic phosphorylation potential during transient ischemia and increases the intracellular buffering capacity of skeletal muscle. Copyright © 2007 John Wiley & Sons, Ltd. [source] Evaluation and economic impact analysis of different treatment options for ankle distortions in occupational accidentsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2010Amaryllis Audenaert Grad Eng PhD Abstract Rationale, aims and objectives, Appropriate use of diagnostic and treatment modalities are essential for rational use of resources. The aim of this study is to evaluate the use of diagnostic modalities and different treatment options and their economic impacts following an acute ankle distortion resulting from an occupational accident. We evaluated the type-of-treatment impact on the victims' course of recovery as well as its impact on the associated accident costs. Research was carried out in Belgium. Methods, An ankle distortion victims' database consisting of 200 cases of (Belgian) occupational accidents during the period 2005,2007 was analysed. Results, Patients who were prescribed immobilization or the use of adjuvant support or physical therapy (118 cases) were not employed during a period of 37 days on average, with a mean total cost of 3140.14 Euros caused by the ankle sprain. Patients without any adjuvant therapy (82 cases) were characterized by an unemployment rate of 15 days on average, and a total cost of 1077.86 Euros. Cast immobilization, although its application is not supported by evidence-based literature, was still applied in 36% of the population studied and resulted in the longest average absence of work of 42 days with an obvious significant increase in medical and total costs. Conclusions, Our results show a high rate of inappropriate use of cast immobilizations for ankle distortions. From an economic point of view and for the same clinical endpoint (being full resumption of the occupational activities), simple conventional treatment, consisting of rest, ice, compression and elevation at diagnosis with allowance of early weight bearing in the further clinical course, leads to the quickest full resumption of activities in combination with the lowest medical costs, if compared with any other kind of treatment. [source] |