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Rehabilitation Protocol (rehabilitation + protocol)

Distribution by Scientific Domains

Life Sciences	50%

Selected Abstracts

Penile rehabilitation protocol after robot-assisted radical prostatectomy: assessment of compliance with phosphodiesterase type 5 inhibitor therapy and effect on early potency

BJU INTERNATIONAL, Issue 3 2010
Daniel J. Lee
Study Type , Therapy (case series) Level of Evidence 4 OBJECTIVE To evaluate factors that affect compliance in men who enrol in a phosphodiesterase type 5 inhibitor (PDE5I) protocol after nerve-sparing robot-assisted prostatectomy (RAP), and report on short-term outcomes, as PDE5Is may help restore erectile function after RAP and patient adherence to the regimen is a factor that potentially can affect outcome. PATIENT AND METHODS We prospectively followed 77 men who had nerve-sparing RAP and enrolled in a postoperative penile rehabilitation protocol. The men received either sildenafil citrate or tadalafil three times weekly. The minimum follow-up was 8 weeks. Potency was defined as erection adequate for penetration and complete intercourse. Compliance was defined as men adhering to the regimen for ,2 months. RESULTS The mean age of the cohort was 57.8 years and the median follow-up was 8 months. In all, 32% of the men discontinued the therapy <2 months after RAP and were deemed noncompliant with an additional 39% discontinuing therapy by 6 months, with the high cost of medication being the primary reason (65%). Long-term compliance and preoperative erectile dysfunction were independent predictors of potency return after adjusting for age and nerve sparing. CONCLUSIONS The high cost of medication remains a significant barrier to maintaining therapy. Noncompliance to PDE5I therapy in a tertiary care centre was much higher than reported in clinical trial settings. With longer-term follow-up, we need to further define the factors that improve overall recovery of sexual function after RAP. [source]

Effect of elbow position on canine flexor digitorum profundus tendon tension

JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 2 2005
Tatsuro Tanaka
Abstract Tendon injury in the finger remains a clinical challenge to hand surgeons. A canine model is commonly used to study biological effects of tendon injuries and their treatment. There is an important anatomical difference between human and canine anatomy that may be overlooked, however, namely that most of the flexor digitorum profundus (FDP) muscle in dogs takes its origin from the medial epicondyle of the humerus, whereas in humans this muscle arises purely from the forearm. Therefore, elbow position can affect the tension of this muscle in dogs, while having no effect in humans. The purpose of this study was to measure the effect of elbow position on tendon tension in the canine digit in vitro. Elbow position had a significant effect on tendon tension. Digit motion with the elbow fully flexed resulted in significantly higher tendon tension compared to digit motion with the elbow flexed 90° or fully extended, regardless of digit or wrist position (p < 0.05). The tension with the elbow flexed 90° was also significantly higher than with the elbow fully extended (p < 0.05). The maximum tendon tension with the elbow fully flexed was more than eight times larger than that of the fully extended elbow (p < 0.05). We conclude that, in the canine model, elbow position is an important parameter that affects the passive tension applied to the flexor digitorum profundus, and, by implication, to any repair of that tendon. Dog flexor tendon rehabilitation protocols should therefore specify elbow position, in addition to wrist and digit position. © 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source]

Surgical exposures for distal humerus fractures: A review

CLINICAL ANATOMY, Issue 8 2008
J. Whitcomb Pollock
Abstract The majority of distal humerus fractures have complex fracture patterns, with displaced articular segments, requiring operative intervention. The goals of surgery are anatomic reduction and rigid internal fixation via an operative approach that balances maximum required exposure with minimum soft tissue or bony disruption that may necessitate postoperative protection. The selection of a surgical approach depends on multiple factors, including, facture pattern, extent of articular involvement, associated soft tissue injury, rehabilitation protocols, and surgeon preference. This review focuses on the various surgical approaches to the distal humerus. Clin. Anat. 21:757,768, 2008. © 2008 Wiley-Liss, Inc. [source]