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Care
Published in Henry J. Woodford, Essential Geriatrics, 2022
Crutches are usually only for short-term use. They come in three main varieties. Axillary crutches are placed under the arm. Elbow crutches have retaining cuffs around the forearm, which gives the advantage of making them easier to use on stairs and allows easier door opening by the user. Gutter crutches have supports that allow weight to be transferred through the forearms rather than the hands. These are for use by people with reduced grip strength. Crutches provide little assistance with balance and are often not suitable for people with frailty. Their main use is to offset weight from painful limbs – e.g. following a fracture.
I Am No Stranger to Pain
Published in Michael S. Margoles, Richard Weiner, Chronic PAIN, 2019
In September of 1993 my ex-wife left me. She was my bookkeeper, office manager, and head nurse. Because she did not have myofascial pain syndrome, she was more active in managing various aspects of the practice than I was. When she left, the weight of her responsibilities fell on me. I was also emotionally devastated by the fact that my wife of 26 years had left me. My overall activity level stepped up by an extra 40–50%. I also needed to stay up extra hours to accomplish all the work that she and I used to do as a team. Shortly after she left, I began to experience pain in both sides of my back, buttocks, and both of my legs that was severe and incapacitating. I tried a number of pain killers and found that none of the schedule three analgesics (Vicodin®, Lorcet® 10, and others) had much positive effect on my pain problem. I consulted a physician friend of mine who prescribed MS Contin® (time-release morphine) at 300 mg/day. The medication gave some help, but the side effects of constipation, difficulty urinating, and nausea were very bothersome. For a time I needed to use crutches to get around. It was embarrassing to see patients while I was on crutches and on the very pain medication I prescribed for a number of them.
Life Care Planning for the Amputee
Published in Roger O. Weed, Debra E. Berens, Life Care Planning and Case Management Handbook, 2018
He is likely to develop a minor skin infection from time to time with prosthetic wear and use. This infection should be easily treated with not wearing the prosthesis for a few days and the use of oral antibiotics. Crutches are necessary for this period of time.
Needs and wishes for the future lower limb exoskeleton: an interview study among people with spinal cord injury with community-based exoskeleton experience
Published in Disability and Rehabilitation, 2023
Rosanne B. van Dijsseldonk, Johanna E. Vriezekolk, Noël L. W. Keijsers, Alexander C. H. Geurts, Ilse J. W. van Nes
Regardless of the purpose of the future exoskeleton, all participants mentioned that the future exoskeleton should be easier to use. Therefore, participants were advised to improve the remote-control watch, balance, step and speed adjustments, and donning and doffing of the exoskeleton. Improvements to the remote-control watch were mentioned most frequently, for instance improving readability in sunlight and/or changing control options. Suggested control options were via speech or via touch (e.g., touching the thigh to walk and touching the bottom to sit down). Some participants suggested to relocate the control to the crutches, as long as the crutches are needed for balance support. This crutch-control would preferably include a small screen on which different speeds, step heights, and step frequencies could be selected. In addition, participants mentioned that keeping balance with the exoskeleton (especially in stance) required much physical and mental effort. To be able to focus on other things, such as a conversation or use of kitchen utensils, balance improvements in the future exoskeleton were desired.
Stem cell therapy for knee osteoarthritis: a narrative review of a rapidly evolving treatment with implications for physical therapy management
Published in Physical Therapy Reviews, 2019
Sophie Ruth Allen, Anthony Wright
One study detailed the results of a phase I–II trial using autologous MSCs to treat knee OA [28]. This study, along with others, confirmed the safety and feasibility of MSC treatment. The study tested 15 patients with grade II–III knee OA according to the Kellgren–Lawrence classification and treated them with autologous bone marrow-derived stem cells [28]. Bone marrow was harvested from patients’ iliac crests under anaesthesia and the cells were culture expanded for 21 days to obtain around 40 × 106 viable MSCs. A single dose of 40.9 × 106 ± 0.4 × 106 cells in a final volume of 10 mL was then administered into the patients’ knees via a medial parapatellar approach. Participants were then discharged from hospital and recommended to use crutches for 8 days.
Good stability of a cementless, anatomically designed femoral stem in aging women: a 9-year RSA study of 32 patients
Published in Acta Orthopaedica, 2018
Erik Aro, Jessica J Alm, Niko Moritz, Kimmo Mattila, Hannu T Aro
This is a follow-up study of the 2-year single-center RSA study on female patients with hip osteoarthritis (Aro et al. 2012). The subjects underwent a preoperative screening of skeletal status (Mäkinen et al. 2007). The study protocol, inclusion and exclusion criteria, and the screening process have been reported previously (Aro et al. 2012). Patients underwent cementless total hip arthroplasty at the Turku University Hospital between August 2003 and March 2005. The surgery was performed using an anterolateral Hardinge approach. All patients received a custom-modified CE-certified ABG-II hip prosthesis with an anatomically designed hydroxyapatite-coated femoral stem with a non-modular neck, a hydroxyapatite-coated hemispherical acetabular cup, and ceramic-ceramic bearing surfaces (Stryker) (Aro et al. 2012, Finnilä et al. 2016). After surgery, patients were instructed to use crutches and partial weight-bearing up to 6 weeks.