Global study finds high success rate for hip and knee replacements

After reviewing thousands of case studies going back 25 years across six countries, generalisable survival data is now available for the first time to estimate how long hip and knee replacements are likely to last.

The findings of researchers, funded by the National Joint Registry, from the Musculoskeletal Research Unit at the University of Bristol have been published in The Lancet. These findings show that eight out of ten total knee replacements and six out of ten total hip replacements will still be in place after 25 years.

“Over two million hip and knee replacements have been performed in the UK since 2003 and patients often ask clinicians how long their hip or knee replacement will last, but until now, we have not had a generalisable answer.” said lead author Dr. Jonathan Evans, National Joint Registry Research Fellow and Clinical Research Fellow at the Bristol Medical School; Translational Health Sciences (THS), based at Southmead Hospital.

Full story at Medical Xpress

How to stretch your hands and wrists

Wrist pain can be frustrating and inconvenient. It can also make work or basic day-to-day activities, such as using a computer or cooking a meal, more difficult.

Exercises can improve mobility and decrease the chance of injury or reinjury. Wrist stretches are easy to do at home or at the office. When done properly, they can benefit a person’s overall wrist and hand health.

Anyone experiencing chronic pain or pain with numbness should visit a doctor for a thorough diagnosis.

Full story at Medical News Today

DEFINING THE SHAPE OF COOL

People are great at detecting cold temperatures and also the cool sensation induced by natural substances like menthol, which is common in remedies used to soothe aching muscles. But it hasn’t been entirely clear how we do this.

About a year ago, a group of researchers led by Seok-Yong Lee, Associate Professor of Biochemistry in the Duke University School of Medicine, figured out the architecture of the human and animal cold-sensing protein, an ion channel called TRPM8, which gave them some insight into its function but also raised more questions.

Now, Lee’s team has determined the structure TRPM8 assumes when it is bound to menthol and to another synthetic cooling agent called icilin. The findings, which will appear in Science on Feb. 8, could pave the way toward new treatments for chronic pain and migraine and help patients who suffer from extreme cold sensitivity.

Full story at Duke.edu

Crazy Little Thing Called (APTA) Love

APTA members are sharing the APTA love—and their stories are all about finding community in the association, no matter the paths they took to get there.

In the spirit of Valentine’s Day, APTA asked members to share their “APTA love stories” by recounting how they first came to join the association, and what made them feel a true connection to the organization and fellow members. The results are being posted to social media and have been collected on a special “APTA Love Stories” webpage.

The stories reflect the diversity of the APTA membership. From a then-DPT student who questioned a program’s membership requirement only to come to see the value in the connections she made, to an aspiring physical therapist (PT) who asked to join APTA before she’d even entered school, to longtime PTs who’ve spent their careers involved in the association, the details are varied. The common thread: each member discovered the ways APTA builds connections, strengthens the profession, and provides opportunities for professional growth.

Full story at APTA

Spinal cord is ‘smarter’ than previously thought

We often think of our brains as being at the centre of complex motor function and control, but how ‘smart’ is your spinal cord?

Turns out it is smarter than we think.

It is well known that the circuits in this part of our nervous system, which travel down the length of our spine, control seemingly simple things like the pain reflex in humans, and some motor control functions in animals.

Now, new research from Western University has shown that the spinal cord is also able to process and control more complex functions, like the positioning of your hand in external space.

Full story at Medical Xpress

Best exercises and remedies for plantar fasciitis

Foot stretches and exercises can help plantar fasciitis by relieving pain, improving muscle strength, and promoting flexibility in the foot muscles and ligaments.

Overuse, strain, and inflammation on the plantar fascia ligament that connects the heel to the toes cause the foot injury that doctors refer to as plantar fasciitis. The tissue that the condition affects is under the arch of the foot but can cause a stabbing pain in the heel.

Plantar fasciitis usually resolves within 6 to 18 months without treatment. With 6 months of consistent, nonoperative treatment, people with plantar fasciitis will recover 97 percent of the time.

Full story at Medical News Today

LAMPREYS CAN REGENERATE SEVERED SPINES MORE THAN ONCE

The study opens up a new path for identifying pro-regenerative molecules and potential therapeutic targets for human spinal cord injury.

Spontaneous recovery from spinal cord injury is almost unheard of in humans and other mammals, but many vertebrates fare better. The eel-like lamprey, for instance, can fully regenerate its spinal cord even after being severed—within three months the lamprey is swimming, burrowing, and flipping around again, as if nothing had happened.

“We’ve determined that central nervous system regeneration in lampreys is resilient and robust after multiple injuries. The regeneration is nearly identical to the first time, both anatomically and functionally,” says senior author Jennifer Morgan, director of the University of Chicago-affiliated Marine Biological Laboratory’s Eugene Bell Center for Regenerative Biology and Tissue Engineering.

Morgan’s lab has been focusing on the descending neurons, which originate in the brain and send motor signals down to the spinal cord. Some of these descending neurons regenerate after central nervous system injury in lamprey, while others die.

Full story at futurity.org

FRAILTY A KEY RISK FACTOR FOR DEMENTIA

Researchers at Dalhousie University have found that frailty, more so than amyloid plaques and tangles in the brain, is a key risk factor for developing Alzheimer’s disease and other forms of dementia.

PhD candidate Lindsay Wallace, lead author, and her supervisor Dr. Kenneth Rockwood, are optimistic their findings will be influential, as they were published this week in Lancet Neurology — one of the highest-impact journals in the field.

This study is the first to examine amyloid plaques and tangles in post-mortem brain tissues, in relation to both the subjects’ frailty index and the severity of their dementia symptoms when they were alive. The frailty index is a score of relative frailty based on the accumulation of deficits in physical health and ability to function.

Full story at Dalhousie University News

Children with cerebral palsy to benefit from ‘artificial muscles’

A team of researchers from the University of Delaware has received nearly $200,000 in start-up funding to develop a motorized ankle foot device for children with cerebral palsy (CP) that includes a novel artificial muscle.

The brace is the first lower extremity device designed to correct alignment or provide support using soft muscle-like “smart materials,” known as dielectric elastomer actuators, that contract in response to electric current.

Made from off-the-shelf elastic materials, these artificial muscles closely mimic the function of the body’s skeletal muscle and can help children with CP that struggle to complete a range of motion under their own power. The device is lightweight, compact and noiseless, too, reducing the size of the orthosis needed while increasing the wearer’s degree of freedom in movement — a vast improvement over heavier, more rigid technologies.

Full story at news-medical.net

New solutions needed to improve care and reduce cost of high-need, high-cost patients

By many estimates, only 5% of U.S. patients are high-need, high-cost (HNHC), yet they account for about 50% of health care spending. It has become a national priority to understand the needs of this patient cohort, identify drivers of their utilization, and implement solutions to improve their clinical outcomes while reducing their costs.

High-need, high-cost patients often have multiple chronic conditions, complex psychosocial needs, and limited ability to perform activities of daily living. Care delivery solutions, including care management, telemedicine, and home health visits, have had mixed levels of success for various outcome measures, including system-centric ones such as total cost of services and utilization of secondary care (emergency department [ED] use and inpatient hospitalization) as well as patient-centered ones such as self-assessed health status.

A possible explanation for the variable success could be that many solutions are designed primarily by health system administrators, not the patient “customers” who best understand their own needs. Little has been published about patients’ views on the care models that target their complex health care needs, which aspects of current care delivery high-need, high-cost patients find beneficial, nor how health systems can partner with patients to design and implement solutions. Better serving high-need, high-cost patients must begin with improving our understanding of their needs and perspectives.

Full story at news-medical.net