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Sökning: WFRF:(Juthberg Robin)

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1.
  • Ackermann, Paul W, et al. (författare)
  • Reduced time to surgery improves patient-reported outcome after achilles tendon rupture
  • 2018
  • Ingår i: The American Journal of Sports Medicine. - Stockholm : Karolinska Institutet, Dept of Molecular Medicine and Surgery. - 0363-5465 .- 1552-3365.
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Patient outcome after an acute Achilles tendon rupture (ATR) continues to be suboptimal and heterogeneous. Thus, prognostic factors are called for to optimize evidence-based ATR treatment protocols, however, the influence of delayed time from injury to surgery (TTS) on patient outcome after ATR remains largely unknown. Purpose: To determine whether patient outcomes and adverse events after surgical repair of acute ATR are related to delayed TTS. Study Design: Cohort study; Level of evidence, 3. Methods: Two hundred and twenty-eight ATR patients treated with uniform anesthetic and surgical techniques, within 10 days after injury, were retrospectively assessed. TTS depended on a free slot in the operating theatre and neither surgeon nor patient could affect TTS. Patients were assigned into three groups according to trichotomized TTS; short- (<48hours), intermediate- (48-72hours) and long TTS (>72hours). Patient-reported outcome at one-year was assessed using the validated Achilles tendon Total Rupture Score, with scores>80 on a 0- to 100-point scale indicating an overall good outcome. The incidences of adverse events (peri- and postoperative) and deep venous thrombosis were assessed. Results: Shorter TTS was significantly associated with increased rate of good outcome and reduced risk of adverse events. Seventy-one percent (95% CI, 60%-83%) of the patients with short TTS attained a good outcome compared to 44% (95% CI, 33%-56%) of the patients 3 with long TTS (p=.002), and with the intermediate TTS group in between (63%, 95% CI, 47%-78%). The incidence of adverse events was significantly reduced among patients with short TTS 1.4% (95% CI, 1%-4%) as compared to those with intermediate TTS 11% (95% CI, 2%-21%) (p=.035) and to patients with long TTS 14.8% (95% CI, 7%-23%) (p=.003). The risk of sustaining a deep venous thrombosis was not statistically significant different among the three groups (p=.15). Conclusion: Patients with acute ATR operated on within 48 hours after injury yielded better outcomes and a lower number of adverse events compared to patients operated on after 72 hours. These results conform to evidence-based recommendations from other surgical disciplines and should be used as guidelines for optimizing ATR treatment protocols.
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2.
  • Euler, Luisa, et al. (författare)
  • Textile Electrodes : Influence of Electrode Construction and Pressure on Stimulation Performance in Neuromuscular Electrical Stimulation (NMES)
  • 2021
  • Ingår i: Engineering in Medicine &amp; Biology Society (EMBC), 2021 43rd Annual International Conference of the IEEE. - : IEEE. - 9781728111797 ; 2021, s. 1305-1308
  • Konferensbidrag (refereegranskat)abstract
    • The major reason for preventable hospital death isvenous thromboembolism (VTE). Non-pharmacologicaltreatment options include electrical stimulation or compressiontherapy to improve blood flow in the extremities. Textileelectrodes offer potential to replace bulky devices commonlyused in this field, thereby improving the user compliance. In thiswork, the performance of dry and wet knitted electrodes incombination with pressure application to the electrode wasevaluated in neuromuscular electrical stimulation (NMES). Amotor point stimulation on the calf was performed on ninehealthy subjects to induce a plantarflexion and the requiredstimulation intensity as well as the perceived pain were assessed.The performance of the different electrode constructions wascompared and the influence of the pressure application wasanalysed. The results show that wet textile electrodes (0.9 %saline solution) perform significantly better than dry electrodes.However, opportunities were found for improving theperformance of dry textile electrodes by using an uneven surfacetopography in combination with an intermediate to highpressure application to the electrode (> 20 mmHg), e.g. by usinga compression stocking. Moreover, the smaller of the two testedelectrode areas (16 cm2; 32 cm2) appears to be favourable interms of stimulation comfort and efficiency.
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3.
  • Opolka, Yohann, 1994-, et al. (författare)
  • Transcutaneous Electrical Nerve Stimulation Integrated into Pants for the Relief of Postoperative Pain in Hip Surgery Patients: A Randomized Trial
  • 2024
  • Ingår i: Pain Research & Management. - 1203-6765 .- 1918-1523. ; 2024:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. The efect of transcutaneous electrical nerve stimulation (TENS) on pain and impression of change was assessed during a 2.5-hour intervention on the frst postoperative days following hip surgery in a randomized, single-blinded, placebo-controlled trial involving 30 patients.Methods. Mixed-frequency TENS (2 Hz/80 Hz) was administered using specially designed pants integrating modular textile electrodes to facilitate stimulation both at rest and during activity. The treatment outcome was assessed by self-reported pain Numerical Rating Scale (NRS) and Patient Global Impression of Change (PGIC) scores at four time points. The ability to perform a 3-meter walk test and the use of analgesics were also evaluated. Group comparison and repeated-measure analysis were carried out using nonparametric statistics.Results. The active TENS group exhibited signifcantly higher PGIC scores after 30 minutes, which persisted throughout the intervention (all p ≤ 0.001). A reduction in NRS appeared after one hour of active TENS, persisting throughout the intervention (all p ≤ 0.05). The median group diferences in pain ratings were greater than the minimum clinically important diference, and the analysis of pain trajectories confrmed clinical signifcance at the individual level. Moreover, patients in the active TENS group were more likely able to perform a 3-meter walk test by the end of the intervention (p = 0.04). Analysis of the opioid-sparing effect of TENS was inconclusive (p = 0.066). No postoperative surgical complications or TENS-related side efects were observed during the study.Conclusion. Mixed-frequency TENS integrated in pants could potentially be an interesting addition to the arsenal of treatments for multimodal analgesia following hip surgery. This trial is registered with NCT05678101.
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