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Second Stage Of Labor
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
In women with epidural anesthesia, the evidence is mixed; however, a large RCT supports the lying-down position in nulliparas with epidural anesthesia. In the largest trial on position in the second stage for nulliparous women with epidural anesthesia, there were 14% fewer spontaneous vaginal births in the upright group in comparison to the lying-down group [5]. In a smaller RCT, compared with a supported sitting position, lateral position was associated with a lower chance of an operative vaginal delivery (OVD) [6]. Kneeling and sitting upright are associated with a similar duration of second stage and other outcomes, except for a more favorable maternal experience and less pain associated with kneeling [7]. In a Cochrane review of eight RCTs, there was no significant difference in OVD, cesarean delivery (CD), postpartum hemorrhage, or duration of second stage based on position during labor [8]. Maternal satisfaction with the overall childbirth experience was slightly lower in the upright group; however, 57% less babies were born with low cord pH in the upright group [8].
5.00: Movement
Published in Fiona Broadley, Supporting Life Skills for Young Children with Vision Impairment and Other Disabilities, 2020
Encourage her to pull herself onto her knees, against you or using a piece of furniture. Use a favourite musical toy or even a snack as a lure. Kneeling will help develop stability in the hips and lower body. Once you have this established, try encouraging her to pull to standing. Kneel on the floor in front of a low chair or sofa. Sit her on your knee, facing the sofa, with her feet flat on the floor and her knees and hips at 90 degrees. Use something to lure her to reach out and stretch and, as she does, holding her solidly round the hips, move her hips up and forwards to line up over her feet. Her knees should now be straight and she can lean forward and support herself against the sofa. Keep hold of her hips while she is developing her strength and stability. Give her plenty of praise and make sure she feels her efforts are rewarded.
Suicide
Published in Burkhard Madea, Asphyxiation, Suffocation,and Neck Pressure Deaths, 2020
Frank Musshoff, Burkhard Madea, Elke Doberentz
Hanging is still the most common suicide method among men and women, even in high age groups. There are many variations of hanging. When considered in relation to the body weight, only a relatively small force is necessary to obstruct the carotid arteries. In this way hanging in a sitting, kneeling or even lying position is possible. An exceptional case of hanging in a lying position is presented here.
An infrapatellar nerve block reduces knee pain in patients with chronic anterior knee pain after tibial nailing: a randomized, placebo-controlled trial in 34 patients
Published in Acta Orthopaedica, 2019
Mandala S Leliveld, Saskia J M Kamphuis, Michael H J Verhofstad
Although pain during kneeling was reduced in both groups, pain was not totally diminished and no statistically significant reduction was seen for pain during the other activities (squatting, sitting with bent knees, jumping, running, walking on stairs, walking, and at rest). A possible explanation is that not all patients were able or willing to do these activities, which affected the statistical power. Moreover, the starting pain level was lower than in other activities, thus a smaller effect size can be expected. The study could be underpowered for these activities; however, they were not the primary outcome. In some patients pain can be multi-modal and might as well have originated from intra-articular injury (Hernigou and Cohen 2000) or irritation of Hoffa’s fat pad (Jankovic et al. 2013).
An exploratory study of the long-term impact of difficulty kneeling after total knee replacement
Published in Disability and Rehabilitation, 2019
Daniel Fletcher, Andrew J. Moore, Ashley W. Blom, Vikki Wylde
Kneeling was found to be an important activity for many aspects of life, including activities of daily living, leisure and social activities, interaction with family and self-care. The experience of difficulty kneeling can disrupt the taken-for-granted features of everyday life, leading to biographical disruption for patients and their family [30]. Kneeling is also important in enabling people to get up after a fall, which is a common problem in adults aged 60 years [31]. Participants expressed fear and nervousness about falling, particularly when doing activities outside such as fishing or gardening where there is a risk that there is no-one to help. Falling and fear of falling can substantially reduce health-related quality of life and lead to needless restriction in participation in physical and social activities, physical deconditioning, social isolation and psychological distress [32].
No Relationship Between Joint Position Sense and Force Sense at the Shoulder
Published in Journal of Motor Behavior, 2018
David Phillips, Andrew Karduna
Thoracic, scapular and humeral kinematics were sampled at 120 Hz with a magnetic tracking device (Polhemus Liberty, Colchester, VT), which included a transmitter, three sensors, and a digitizer. The sensors were mounted on the manubrium of the sternum, the flat area of the acromion, as well as on the distal humerus via a custom-molded Orthoplast cuff and Velcro strap (Ludewig and Cook, 2000; Suprak et al., 2006). The transmitter was positioned posterior and contralateral to the testing arm of the subject. The subject sat on an ergonomically designed kneeling chair (Better Posture Kneeling Chairs, Jobri, Konawa, OK) for both protocols.