Methodist Rehabilitation Center

Background: Plantar fasciitis leading cause of heel pain, frequently affects individuals engaged in prolonged standing, such as salespersons. The interplay between intrinsic foot muscle (IFM) strength and ankle foot dorsiflexion is critical in maintaining plantar fascia integrity and reducing mechanical overload. Objective: A review on the role of IFM strength and ankle dorsiflexion in plantar fascia health, emphasizing occupational implications for salespersons. Methods: A narrative review after studying databases including PubMed, Scopus and Google Scholar (2020–2025). Studies examining the relationship between IFM function, ankle dorsiflexion, and plantar fasciopathy were analyzed. Results: Limited dorsiflexion and weak intrinsic musculature increase plantar fascia strain via altered arch mechanics and early heel-off during gait. IFM-strengthening exercises and dorsiflexion mobility programs significantly improve symptoms, posture, and foot function. Salespersons exhibit elevated plantar fasciitis prevalence due to prolonged standing and cumulative load. Conclusion: Optimal plantar fascia health relies on adequate IFM strength and ankle mobility. Integrating strengthening, stretching, and ergonomic interventions offers preventive and therapeutic benefits for salespersons.

The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) is the most widely accepted system for characterizing sensorimotor impairments after spinal cord injury (SCI). There have been a number of ISNCSCI revisions, with the most recent edition published in 2019. Newer concepts, including the revised definitions of the zones of partial preservation (ZPPs) and documentation of non-SCI conditions, require training and practice for successful utilization. The International Standards Committee developed an ISNCSCI workbook of 26 practice cases, each with detailed explanations of the correct classification components. In this article, we present seven cases, which were selected from the workbook to reinforce the changes implemented in 2019. Hypothetical ISNCSCI cases were created to illustrate important classification rules, definitions, and nuances. All cases were reviewed by members of the American Spinal Injury Association (ASIA) International Standards Committee, and if any discrepancies were identified, they were discussed until a consensus was reached. To confirm agreement, cases were also entered into online algorithms, which are compliant with the 2019 ISNCSCI revision. The seven cases in this article highlight newer classification concepts and include a discussion of key elements. Each case reinforces the revised definitions of the ZPPs, such as the applicability of sensory ZPPs in all injuries without sensory sacral sparing and applicability of motor ZPPs in all injuries without voluntary anal contraction (VAC). Non-SCI-related impairments and their impact on the classification are reviewed in Cases 4-7. The seven cases presented in this article feature key concepts from the 2019 ISNCSCI revision. These cases, as well as the full ISNCSCI workbook, can serve as valuable training tools to improve classification accuracy.

Objective: This research aimed to evaluate the nutritional status and influence on the dietary profile in the gut microbiota, in an attempt to identify possible effects of grape juice consumption among school children aged 6-10. Design: Anthropometric parameters (weight, height, Body Mass Index, waist circumference, triceps, and subscapular skinfold) weremeasured at baseline. A Food Frequency Questionnaire (FFQ) was carried out to evaluate the dietary profile. Feces were analyzed by culture methods and the alpha diversity was determined by the Shannon Index. Participants: 36 volunteer school children aged 6 to 10 years from two different cities in the South of Brazil. Main outcome measure: Gut microbiota diversity according to anthropometric parameters, nutrition profile and delivery patterns. Analysis: For statistical analysis, t or u test and correlation were used through the statistical software SPSS® version 22.0. Results: The volunteers presented a eutrophic nutritional status, but 41.7% in the City 2 were overweight. There was a significant difference in the consumption of polyphenols (p<0.003), microbiotadiversity, breastfeeding, and delivery patterns by city. However, the dietary profile does not include the portions of daily nutrients recommended in both cities. The volunteers from City 1 presented a greater alpha diversity, which may be related to higher micronutrient intake, breastfeeding, and predominant natural/vaginal delivery Conclusion: We observed that the normal delivery and the dietary profile seems to be important factors to the gut microbiota diversity in these children. Keywords: grape juice; dietary profile; gut microbiota.

Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center, Jackson, Mississippi, USA Received 20 October 2019 Accepted 20 October 2019 Correspondence to Dobrivoje S. Stokic, MD, DSc, Methodist Rehabilitation Center, 1350 E. Woodrow Wilson Dr, Jackson, 39216 MS, USA, Tel: +1 601 364 3314; fax: +1 601 364 3305; e-mail: [email protected]

ABSTRACT In this study, a custom device was developed to analyse the pitching shoulder’s external rotation (ER) and internal rotation (IR) passive flexibility. We analysed three novel measures: the resistance onset angle (ROA = angle where the shoulder begins stretching), rotational stiffness, and torque at the end range of motion (ROM). The purpose was to conduct a bilateral analysis to determine if there are significant differences between the throwing and non-throwing shoulder. Participants were 30 upper level pitchers (13 division I, 17 minor league). During testing, pitchers laid supine on a treatment table and the arm was secured to a rotational wheel with the shoulder abducted 90° and elbow flexed 90°. Dependent t-tests revealed significant (p < 0.01) and relatively extreme bilateral differences for all three variables. The throwing shoulder had: increased ER ROA (9°), decreased IR ROA (5.3°), increased ER stiffness (17%), increased IR stiffness (34%), increased ER torque (21%), and increased IR torque (30%). Secondary correlation analysis was completed to determine if the torque-angle variables were good predictors of the end ROM. Stiffness correlations were weak for ER (r = 0.35, p = 0.048) and IR (r = 0.42, p = 0.017) but ROA correlations were strong for ER (r = 0.85, p < 0.001) and IR (r = 0.86, p < 0.001).

Although attending to spiritual and religious needs is part of high quality care of pediatric cancer patients, oncology clinicians may not understand the role of the chaplain, resulting in underutilization of resources and failure to fully integrate the chaplain into the clinical team. We provide a description of what the chaplain does in the care of pediatric oncology patients. We conducted a qualitative content analysis of chaplain chart notes over a one-year period on the pediatric oncology service at a freestanding children's hospital. Using criteria designed to capture multiple potential factors in chaplain referral, we selected 30 patients for thematic analysis. In 2016, 166 pediatric patients were diagnosed with cancer and received ongoing care at our institution. From the 30 patients selected, 230 chaplain encounters were documented in the medical chart. Three major themes emerged. (1) The chaplains provided a rich description of spiritual and psychosocial aspects of the patient and family's experience; (2) chaplains provided diverse interventions, both religious and secular in nature; and (3) chaplains provided care within a longitudinal relationship. All three themes depend on the empathic listening by a chaplain. The chaplains' observations about patient and family beliefs, experiences, and emotional/spiritual states have the potential to inform the interdisciplinary care of the patient. Chaplain documentation provides insight into how spiritual care interventions and close relationships may promote patient and family well-being. In future work, we will explore how to give voice to their insights in caring for pediatric oncology patients.

Epidural spinal cord stimulation (SCS) is currently regarded as a breakthrough procedure for enabling movement after spinal cord injury (SCI), yet one of its original applications was for spinal spasticity. An emergent method that activates similar target neural structures non-invasively is transcutaneous SCS. Its clinical value for spasticity control would depend on inducing carry-over effects, because the surface-electrode-based approach cannot be applied chronically. We evaluated single-session effects of transcutaneous lumbar SCS in 12 individuals with SCI by a test-battery approach, before, immediately after and 2 h after intervention. Stimulation was applied for 30 min at 50 Hz with an intensity sub-threshold for eliciting reflexes in lower extremity muscles. The tests included evaluations of stretch-induced spasticity (Modified Ashworth Scale [MAS] sum score, pendulum test, electromyography-based evaluation of tonic stretch reflexes), clonus, cutaneous-input-evoked spasms, and the timed 10 m walk test. Across participants, the MAS sum score, clonus, and spasms were significantly reduced immediately after SCS, and all spasticity measures were improved 2 h post-intervention, with large effect sizes and including clinically meaningful improvements. The effect on walking speed varied across individuals. We further conducted a single-case multi-session study over 6 weeks to explore the applicability of transcutaneous SCS as a home-based therapy. Self-application of the intervention was successful; weekly evaluations suggested progressively improving therapeutic effects during the active period and carry-over effects for 7 days. Our results suggest that transcutaneous SCS can be a viable non-pharmacological option for managing spasticity, likely working through enhancing pre- and post-synaptic spinal inhibitory mechanisms, and may additionally serve to identify responders to treatments with epidural SCS.