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In case of transtibial amputation, the deficit resulting from the loss of the lower limb can be partly compensated with a prosthetic foot and adapted rehabilitation. New prosthetic feet have been developed for transtibial amputees to mimic ankle adaptability to varying terrain. Among them, Microprocessor Prosthetic Ankles (MPA) have a microprocessor to control an electric or a hydraulic actuator to adapt ankle kinematics in stairs and slopes. The objective is to investigate parameters extracted from the moment-angle curve (MAC) and use them to compare 3 MPA during level and slope locomotion against energy storing and return (ESR) foot. Five persons with lower limb transtibial amputation successively fitted with 3 MPA (Propriofoot™, Elan™, Meridium™) compared to their ESR foot. The participants had 2 weeks of adaptation before data acquisition and then a 3 week wash-out period. Range of motion, equilibrium point, hysteresis, late stance energy released, and quasi-stiffness were computed on level ground and 12% slope (upward and downward) thanks to the MAC at the ankle. The study shows the relevance of MAC parameters to evaluate the behavior of MPA. In particular, compared to ESR, all MPA tested in the present study demonstrated a better angle adaptation between walking conditions but a decrease of available energy for the propulsion. Among MPA, main results were: (i) for the Propriofoot™: an adaptation of the ankle angle without modification of the pattern of the MAC (ii) for the Elan™: a limited adaptation of the range of motion but a modification of the energy released (iii) for the Meridium™, the highest adaptation of the range of motion but the lowest available energy of propulsion. One of the main findings of the research is to show and quantify the relationship between range of motion and energy available when using different prosthetic feet in different walking conditions. [ABSTRACT FROM AUTHOR]

Objectives: Life after severe burns is conditioned by the remaining sequelae. The pathophysiology and risk factors of Heterotopic Ossification (HO) after burns are still poorly understood. The aim of this study was to determine: 1) the incidence of HO after burns and 2) the risk factors associated with HO development, in a large retrospective study. Methods: A case-control study of patients admitted to the burns intensive care unit of Percy Hospital, Paris, from the 1st January 2009 to the 31st December 2013 and then admitted to one of three centres specialised in the rehabilitation of patients with burns. Multivariate analysis was carried out to analyse the relationship between HO development and demographic and clinical data. Results: 805 patients were included. 32 patients (4.0%) developed a total of 74 heterotopic ossifications, that is a little higher incidence than the incidence found in the literature. The epidemiological characteristics of the population studied was similar to the literature. HOs were mainly localized around the elbows, followed by the hips, shoulders and knees. Each case-patient was paired with 3 control-patients. There were significant associations between HO development and the length of stay in the burns intensive care unit, the extent and depth of the burns, the occurrence of pulmonary or cutaneous infections, use of curare and use of an air-fluidized bed. Conclusion: In addition to recognized risk factors (duration of stay in the intensive care burns unit, extent and depth of burns, pulmonary and cutaneous infections), the use of curare and the use of a fluidized bed (with the duration of use) were significantly associated with HO formation. [ABSTRACT FROM AUTHOR]

Though in the last few decades only a few new drugs have come available for the treatment of spasticity, new insights may revise the role and individual value of several pharmacological treatments. Diazepam, baclofen and tizanidine are the most prescribed drugs for the treatment of spasticity. Intrathecal baclofen and local infiltration of botulin toxin are added values in selective patients. Gabapentin is a novelty, and the working mechanism of cannabis has been elucidated. Dantrolene sodium appears to owe its selectivity from the recently discovered ryanodine receptor, with a peripheral effect in muscles. In this review the pathophysiology and epidemiology of spasticity, pharmacology, clinical efficacy and unwanted effects of the different drugs for spasticity are updated. [ABSTRACT FROM AUTHOR]