American journal of physical medicine & rehabilitation
-
Am J Phys Med Rehabil · Jul 2004
Clinical Trial Controlled Clinical TrialEvaluation of rocker sole by pressure-time curves in insensate forefoot during gait.
The rocker sole reduces plantar pressure in the insensate forefoot during gait, but the reasons have remained unclear. This study aimed to derive new variables descriptive of the effects of the rocker sole. ⋯ To evaluate the effectiveness of a rocker sole, physiatrists may regress sigmoid pressure-time curves as cubic functions of time in the insensate forefoot, check simultaneous inflections of the curves in areas rotated by the rocker sole, and compare their concavity and regression parameters in areas rotated at different distances from the axis of rotation. By doing so, physiatrists may be better able to improve the design of rocker sole and other forms of forefoot orthoses.
-
Am J Phys Med Rehabil · Jul 2004
Case ReportsVentilator weaning by lung expansion and decannulation.
This case series of ventilator-dependent patients with neuromuscular disease who had no ventilator-free breathing ability demonstrates that decannulation and switching to continuous noninvasive intermittent positive-pressure ventilation combined with regular lung expansion therapy can result in improvements in pulmonary function and at least partial ventilator weaning. These six patients were also managed using mechanical insufflation-exsufflation for regular lung expansion and cough assistance. Thus, some ventilator users with neuromuscular disease can benefit from tracheostomy tube decannulation and transition to noninvasive intermittent positive-pressure ventilation and assisted coughing for ventilator weaning to predominantly nocturnal-only use.