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Fulltext Accuracy of a digital weight scale relative to the nintendo wii in measuring limb load asymmetry

Kumar NS, Omar B, Joseph LH, Hamdan N, Htwe O, Hamidun N

J Phys Ther Sci, 2014 Aug;26(8):1205-7.
PMID: 25202181 DOI: 10.1589/jpts.26.1205

[Purpose] The aim of the present study was to investigate the accuracy of a digital weight scale relative to the Wii in limb loading measurement during static standing. [Methods] This was a cross-sectional study conducted at a public university teaching hospital. The sample consisted of 24 participants (12 with osteoarthritis and 12 healthy) recruited through convenient sampling. Limb loading measurements were obtained using a digital weight scale and the Nintendo Wii in static standing with three trials under an eyes-open condition. The limb load asymmetry was computed as the symmetry index. [Results] The accuracy of measurement with the digital weight scale relative to the Nintendo Wii was analyzed using the receiver operating characteristic (ROC) curve and Kolmogorov-Smirnov test (K-S test). The area under the ROC curve was found to be 0.67. Logistic regression confirmed the validity of digital weight scale relative to the Nintendo Wii. The D statistics value from the K-S test was found to be 0.16, which confirmed that there was no significant difference in measurement between the equipment. [Conclusion] The digital weight scale is an accurate tool for measuring limb load asymmetry. The low price, easy availability, and maneuverability make it a good potential tool in clinical settings for measuring limb load asymmetry.
Barriers and facilitators for increased accessibility to quality rehabilitation services in low- and middle- income countries: a systematic review

Htwe O, Yuliawiratman BS, Tannor AY, Nor Asikin MZ, Soh E, DE Groote W, et al.

Eur J Phys Rehabil Med, 2024 Mar 29.
PMID: 38551518 DOI: 10.23736/S1973-9087.24.08154-1

INTRODUCTION: With an increasing number of people experiencing limitations in functioning during their life course, the need for comprehensive rehabilitation services is high. In 2017, the WHO Rehabilitation 2030 initiative noted that the need for the establishment and expansion of rehabilitation services is paramount in order to obtain well-being for the population and to ensure equal access to quality healthcare for all. The organization of rehabilitation services is however facing challenges especially in low-and middle-income countries with a very small proportion of people who require rehabilitation actually getting them. Various surveys conducted in low-and -middle income countries have revealed existing gaps between the need for rehabilitation services and the actual receipt of these services. This systematic review aimed to determine the barriers and facilitators for increasing accessibility to rehabilitation services in low- and middle-income countries. Recommendations for strengthening rehabilitation service organization are presented based on the available retrieved data.
EVIDENCE ACQUISITION: In this systematic review, an electronic search through three primary databases, including Medline (PubMed), Scopus and Web of Science (WOS) was conducted to identify original studies reporting on barriers and facilitators for rehabilitation service organization in low-and middle-income countries. Date of search: 25th April 2021 (PubMed), 3rd May 2021 (Scopus and Web of Science). All studies including barriers or/and facilitators for rehabilitation services in low- and middle income countries which were written in English were included in the review. The articles written in other languages and grey literature, were excluded from this review.
EVIDENCE SYNTHESIS: Total of 42 articles were included from year 1989 to 2021. Numerous barriers were identified that related to education, resources, leadership, policy, technology and advanced treatment, community-based rehabilitation (CBR), social support, cultural influences, political issues, registries and standards of care. National health insurance including rehabilitation and funding from government and NGOs are some of the facilitators to strengthen rehabilitation service organization. Availability of CBR programs, academic rehabilitation training programs for allied health professionals, collaboration between Ministry of Heath (MOH) and Non-governmental Organizations (NGOs) on telerehabilitation services are amongst other facilitators.
CONCLUSIONS: Recommendations for improving and expanding rehabilitation service organization include funding, training, education, and sharing of resources.
Clinical evaluation of the anterior translation of glenohumeral joint using ultrasonography: an intra- and inter-rater reliability study

Joseph LH, Hussain RI, Pirunsan U, Naicker AS, Htwe O, Paungmali A

Acta Orthop Traumatol Turc, 2014;48(2):169-74.
PMID: 24747625 DOI: 10.3944/AOTT.2014.3184

The aim of this study was to investigate the intra- and inter-rater reliability of ultrasonography (US) to measure anterior translation of the humeral head (ATHH) among healthy subjects and patients with sacroiliac joint dysfunction.
Clinical presentation of post-COVID pain and its impact on quality of life in long COVID patients: a cross-sectional household survey of SARS-CoV-2 cases in Bangladesh

Kabir MF, Yin KN, Jeffree MS, Ahmedy FB, Zainudin MF, Htwe O, et al.

BMC Infect Dis, 2024 Apr 04;24(1):375.
PMID: 38575878 DOI: 10.1186/s12879-024-09267-3

BACKGROUND: Pain is one of the prevalent Long COVID Symptoms (LCS). Pain interferes with the quality of life (QoL) and induces disease burden.
PURPOSE: The study aimed to elicit the clinical presentation of pain and determine the relationships between QoL and pain in LCS.
METHODS: This household cross-sectional study of 12,925 SARS-CoV-2 cases between July and December 2021 was carried out in eight administrative divisions of Bangladesh. Stratified random sampling from the cases retrieved from the Ministry of Health was employed. Symptom screening was performed through COVID-19 Yorkshire Rehabilitation Scale, and long COVID was diagnosed according to World Health Organization (WHO) criteria. The analyses were conducted using IBM SPSS (Version 20.00).
RESULTS: The prevalence of pain in long COVID was between 01 and 3.1% in the studied population. The study also found five categories of pain symptoms as LCS in Bangladesh: muscle pain 3.1% (95% CI; 2.4-3.8), chest pain 2.4% (95% CI; 1.8-3.1), joint pain 2.8% (95% CI; 2.2-2.3), headache 3.1% (95% CI; 2.4-3.8), and abdominal pain 0.3% (95% CI; 0.01-0.5). People with LCS as pain, multiple LCS, and longer duration of LCS had significantly lower quality of life across all domains of the WHOQOL-BREF (P
Collagen-coated polylactic-glycolic acid (PLGA) seeded with neural-differentiated human mesenchymal stem cells as a potential nerve conduit

Sulong AF, Hassan NH, Hwei NM, Lokanathan Y, Naicker AS, Abdullah S, et al.

Adv Clin Exp Med, 2014 May-Jun;23(3):353-62.
PMID: 24979505

Autologous nerve grafts to bridge nerve gaps pose various drawbacks. Nerve tissue engineering to promote nerve regeneration using artificial neural conduits has emerged as a promising alternative.
Fulltext Comparison between the effect of immersive virtual reality training versus conventional rehabilitation on limb loading and functional outcomes in patients after anterior cruciate ligament reconstruction: A prospective randomized controlled trial

Gsangaya MR, Htwe O, Selvi Naicker A, Md Yusoff BAH, Mohammad N, Soh EZF, et al.

Asia Pac J Sports Med Arthrosc Rehabil Technol, 2023 Oct;34:28-37.
PMID: 37841643 DOI: 10.1016/j.asmart.2023.09.002

PURPOSE: Anterior cruciate ligament injury (ACL) commonly occurs during sporting events. It causes pain, instability and reduction in range of movement of the knee which results in altered balance, reduced strength as well as loading to the involved knee. The challenge to get the patient back to competitive sports level much depends on the rehabilitation process. Post ACLR rehabilitation is challenging due to the long rehabilitation time as well as boring repetitive exercises. The aim of this study is to compare between the effectiveness of using immersive virtual reality (PlayStation VR) in addition to the conventional rehabilitation as an aid in rehabilitation of patients after ACLR in terms of objective functional assessment and pain and subjective knee function scoring.
METHODS: This randomised controlled trial was undertaken in a tertiary hospital in Malaysia from July 2019 until July 2020. Thirty patients were randomised into a group undergoing purely conventional rehabilitation (Group 1) and a group undergoing both conventional rehabilitation and immersive virtual reality assisted rehabilitation (Group 2). The immersive virtual reality assisted rehabilitation was started at 3 months post operatively for 3 months duration. Limb loading, balance, range of motion, functional hop tests of the knee, pain and subjective scoring of the knee with the International Knee Documentation Committee (IKDC) Scores were measured preoperatively and at 6 months.
RESULTS: There were significant differences in terms of improvement of pain scores (p = 0.012) as well as IKDC Scores (p = 0.024) in Group 2 as compared to Group 1. However, there were no significant differences with regards to limb loading, balance, range of motion and functional hop tests of the knee (p > 0.05). No adverse events were observed during the study period.
CONCLUSION: Immersive virtual reality can be used as an adjunct in rehabilitation of patients after ACL reconstruction in terms of improving their pain as well as their subjective knee evaluation. Large randomised control trial is recommended to further investigate the efficacy.
Fulltext Congenital bilateral agenesis of the tibialis anterior muscles: a rare case report

Htwe O, Swarhib M, Pei TS, Naicker AS, Das S

Rom J Morphol Embryol, 2012;53(3):657-9.
PMID: 22990563

Congenital bilateral agenesis of the tibialis anterior muscles is a rare condition. We present a case of congenital absence of bilateral tibialis anterior muscles in a 6-year-old boy who presented with an abnormal gait. He was previously diagnosed to have bilateral congenital talipes equinovarus (CTEV) deformity for which he underwent corrective surgery two times. However, he still had a residual foot problem and claimed to have difficulty in walking. On examination, he walked with a high stepping gait and muscle power of both lower limbs was 5/5 on the medical research council scale (MRCS) except for both ankle dorsiflexors and long toe extensors. The sensation was intact. Magnetic Resonance Imaging (MRI) study of both legs revealed that tibialis anterior muscles were not visualized on both sides suggestive of agenesis of the tibialis anterior muscles. The rest of the muscles appeared mildly atrophied. The electrophysiological study showed normal motor and sensory conduction in both upper and lower limbs. Electromyographic (EMG) study of the vastus medialis was within normal limit and no response could be elicited for EMG of tibialis anterior muscles suggesting possible absence of tibialis anterior muscles, bilaterally. The patient underwent split tibialis posterior tendon transfer to achieve a balanced and functional foot and was well on discharge. The present case describes the normal anatomy and embryology of tibialis anterior muscles as well as possible causes of its agenesis along with its clinical implications.
Corrigendum to 'Therapeutic effects of connective tissue manipulation on wound healing and bacterial colonization count among patients with diabetic foot ulcer' [Journal of Bodywork & Movement Therapies 20 (2016) 650-656]

Joseph LH, Gan JH, Paungmali A, Dixon J, Holey L, Naicker AS, et al.

J Bodyw Mov Ther, 2019 Jul;23(3):440.
PMID: 31563348 DOI: 10.1016/j.jbmt.2019.03.007
Fulltext Defects in nerve conduction velocity and different muscle fibre-type specificity contribute to muscle weakness in Ts1Cje Down syndrome mouse model

Bala U, Leong MP, Lim CL, Shahar HK, Othman F, Lai MI, et al.

PLoS One, 2018;13(5):e0197711.
PMID: 29795634 DOI: 10.1371/journal.pone.0197711

BACKGROUND: Down syndrome (DS) is a genetic disorder caused by presence of extra copy of human chromosome 21. It is characterised by several clinical phenotypes. Motor dysfunction due to hypotonia is commonly seen in individuals with DS and its etiology is yet unknown. Ts1Cje, which has a partial trisomy (Mmu16) homologous to Hsa21, is well reported to exhibit various typical neuropathological features seen in individuals with DS. This study investigated the role of skeletal muscles and peripheral nerve defects in contributing to muscle weakness in Ts1Cje mice.
RESULTS: Assessment of the motor performance showed that, the forelimb grip strength was significantly (P<0.0001) greater in the WT mice compared to Ts1Cje mice regardless of gender. The average survival time of the WT mice during the hanging wire test was significantly (P<0.0001) greater compared to the Ts1Cje mice. Also, the WT mice performed significantly (P<0.05) better than the Ts1Cje mice in the latency to maintain a coordinated motor movement against the rotating rod. Adult Ts1Cje mice exhibited significantly (P<0.001) lower nerve conduction velocity compared with their aged matched WT mice. Further analysis showed a significantly (P<0.001) higher population of type I fibres in WT compared to Ts1Cje mice. Also, there was significantly (P<0.01) higher population of COX deficient fibres in Ts1Cje mice. Expression of Myf5 was significantly (P<0.05) reduced in triceps of Ts1Cje mice while MyoD expression was significantly (P<0.05) increased in quadriceps of Ts1Cje mice.
CONCLUSION: Ts1Cje mice exhibited weaker muscle strength. The lower population of the type I fibres and higher population of COX deficient fibres in Ts1Cje mice may contribute to the muscle weakness seen in this mouse model for DS.
Efficacy of Human Cell-Seeded Muscle-Stuffed Vein Conduit in Rat Sciatic Nerve Repair

Ramli K, Gasim AI, Ahmad AA, Htwe O, Mohamed Haflah NH, Law ZK, et al.

Tissue Eng Part A, 2019 10;25(19-20):1438-1455.
PMID: 30848172 DOI: 10.1089/ten.TEA.2018.0279

We investigated the efficacy of a muscle-stuffed vein (MSV) seeded with neural-transdifferentiated human mesenchymal stem cells as an alternative nerve conduit to repair a 15-mm sciatic nerve defect in athymic rats. Other rats received MSV conduit alone, commercial polyglycolic acid conduit (Neurotube®), reverse autograft, or were left untreated. Motor and sensory functions as well as nerve conductivity were evaluated for 12 weeks, after which the grafts were harvested for histological analyses. All rats in the treatment groups demonstrated a progressive increase in the mean Sciatic Functional Index (motor function) and nerve conduction amplitude (electrophysiological function) and showed positive withdrawal reflex (sensory function) by the 10th week of postimplantation. Autotomy, which is associated with neuropathic pain, was severe in rats treated with conduit without cells; there was mild or no autotomy in the rats of other groups. Histologically, harvested grafts from all except the untreated groups exhibited axonal regeneration with the presence of mature myelinated axons. In conclusion, treatment with MSV conduit is comparable to that of other treatment groups in supporting functional recovery following sciatic nerve injury; and the addition of cells in the conduit alleviates neuropathic pain. Impact Statement It is shown that pretreated muscle-stuffed vein conduit is comparable to that of commercial nerve conduit and autograft in supporting functional recovery following peripheral nerve injury. The addition of neural-differentiated mesenchymal stem cells in the conduit is shown to alleviate neuropathic pain.
Fulltext Evaluation of limb load asymmetry using two new mathematical models

Kumar SN, Omar B, Joseph LH, Htwe O, Jagannathan K, Hamdan NM, et al.

Glob J Health Sci, 2015;7(2):1-7.
PMID: 25716372 DOI: 10.5539/gjhs.v7n2p1

Quantitative measurement of limb loading is important in orthopedic and neurological rehabilitation. In current practice, mathematical models such as Symmetry index (SI), Symmetry ratio (SR), and Symmetry angle (SA) are used to quantify limb loading asymmetry. Literatures have identified certain limitations with the above mathematical models. Hence this study presents two new mathematical models Modified symmetry index (MSI) and Limb loading error (LLE) that would address these limitations. Furthermore, the current mathematical models were compared against the new model with the goal of achieving a better model. This study uses hypothetical data to simulate an algorithmic preliminary computational measure to perform with all numerical possibilities of even and uneven limb loading that can occur in human legs. Descriptive statistics are used to interpret the limb loading patterns: symmetry, asymmetry and maximum asymmetry. The five mathematical models were similar in analyzing symmetry between limbs. However, for asymmetry and maximum asymmetry data, the SA and SR values do not give any meaningful interpretation, and SI gives an inflated value. The MSI and LLE are direct, easy to interpret and identify the loading patterns with the side of asymmetry. The new models are notable as they quantify the amount and side of asymmetry under different loading patterns.
Facilitators and Barriers to the Rehabilitation Workforce Capacity Building in Low- to Middle-Income Countries

Naicker AS, Htwe O, Tannor AY, De Groote W, Yuliawiratman BS, Naicker MS

Phys Med Rehabil Clin N Am, 2019 11;30(4):867-877.
PMID: 31563176 DOI: 10.1016/j.pmr.2019.07.009

An increase in population and chronic conditions leading to disability require increasing emphasis on rehabilitation and health intervention. Poorer countries do not usually have the rehabilitation workforce needed to promote societal inclusion and participation. The roles of the rehabilitation workforce were often not clearly defined, leading to task shifting among rehabilitation professionals. Barriers to capacity building were poor availability of human resources and insufficient training program/supports for their professional development. Facilitators were local government support and international non-governmental organizations collaboration. Recommendations for capacity building effort are for collaboration with the developed nations to encourage funding, training, education, and sharing of resources.
Human bone marrow-derived MSCs spontaneously express specific Schwann cell markers

Ramli K, Aminath Gasim I, Ahmad AA, Hassan S, Law ZK, Tan GC, et al.

Cell Biol Int, 2019 Mar;43(3):233-252.
PMID: 30362196 DOI: 10.1002/cbin.11067

In peripheral nerve injuries, Schwann cells (SC) play pivotal roles in regenerating damaged nerve. However, the use of SC in clinical cell-based therapy is hampered due to its limited availability. In this study, we aim to evaluate the effectiveness of using an established induction protocol for human bone marrow derived-MSC (hBM-MSCs) transdifferentiation into a SC lineage. A relatively homogenous culture of hBM-MSCs was first established after serial passaging (P3), with profiles conforming to the minimal criteria set by International Society for Cellular Therapy (ISCT). The cultures (n = 3) were then subjected to a series of induction media containing β-mercaptoethanol, retinoic acid, and growth factors. Quantitative RT-PCR, flow cytometry, and immunocytochemistry analyses were performed to quantify the expression of specific SC markers, that is, S100, GFAP, MPZ and p75 NGFR, in both undifferentiated and transdifferentiated hBM-MSCs. Based on these analyses, all markers were expressed in undifferentiated hBM-MSCs and MPZ expression (mRNA transcripts) was consistently detected before and after transdifferentiation across all samples. There was upregulation at the transcript level of more than twofolds for NGF, MPB, GDNF, p75 NGFR post-transdifferentiation. This study highlights the existence of spontaneous expression of specific SC markers in cultured hBM-MSCs, inter-donor variability and that MSC transdifferentiation is a heterogenous process. These findings strongly oppose the use of a single marker to indicate SC fate. The heterogenous nature of MSC may influence the efficiency of SC transdifferentiation protocols. Therefore, there is an urgent need to re-define the MSC subpopulations and revise the minimal criteria for MSC identification.
Improved functional assessment of osteoarthritic knee joint after chondrogenically induced cell treatment

Ude CC, Ng MH, Chen CH, Htwe O, Amaramalar NS, Hassan S, et al.

Osteoarthritis Cartilage, 2015 Aug;23(8):1294-306.
PMID: 25887366 DOI: 10.1016/j.joca.2015.04.003

OBJECTIVES: Our previous studies on osteoarthritis (OA) revealed positive outcome after chondrogenically induced cells treatment. Presently, the functional improvements of these treated OA knee joints were quantified followed by evaluation of the mechanical properties of the engineered cartilages.
METHODS: Baseline electromyogram (EMGs) were conducted at week 0 (pre-OA), on the locomotory muscles of nine un-castrated male sheep (Siamese long tail cross) divided into controls, adipose-derived stem cells (ADSCs) and bone marrow stem cells (BMSCs), before OA inductions. Subsequent recordings were performed at week 7 and week 31 which were post-OA and post-treatments. Afterwards, the compression tests of the regenerated cartilage were performed.
RESULTS: Post-treatment EMG analysis revealed that the control sheep retained significant reductions in amplitudes at the right medial gluteus, vastus lateralis and bicep femoris, whereas BMSCs and ADSCs samples had no further significant reductions (P < 0.05). Grossly and histologically, the treated knee joints demonstrated the presence of regenerated neo cartilages evidenced by the fluorescence of PKH26 tracker. Based on the International Cartilage Repair Society scores (ICRS), they had significantly lower grades than the controls (P < 0.05). The compression moduli of the native cartilages and the engineered cartilages differed significantly at the tibia plateau, patella femoral groove and the patella; whereas at the medial femoral condyle, they had similar moduli of 0.69 MPa and 0.40-0.64 MPa respectively. Their compression strengths at all four regions were within ±10 MPa.
CONCLUSION: The tissue engineered cartilages provided evidence of functional recoveries associated to the structural regenerations, and their mechanical properties were comparable with the native cartilage.
KEYWORDS: Cartilage; Cell therapy; Function; Osteoarthritis; Regeneration
Massive Traumatic Skin Defect Successfully Treated with Autologous, Bilayered, Tissue-Engineered MyDerm Skin Substitute: A Case Report

Mohamed Haflah NH, Ng MH, Mohd Yunus MH, Naicker AS, Htwe O, Abdul Razak KA, et al.

JBJS Case Connect, 2018 6 15;8(2):e38.
PMID: 29901479 DOI: 10.2106/JBJS.CC.17.00250

CASE: A 22-year-old man sustained a laceration that measured 180 cm, after debridement, over the anterolateral aspect of the right leg following a road traffic accident. The wound was treated with MyDerm (Universiti Kebangsaan Malaysia), a cell-based, bilayered, bioengineered dermal substitute that contains no animal-derived components and is fully autologous. For its construction, only a small area of skin was harvested from the left groin, which was closed primarily with absorbable sutures.
CONCLUSION: MyDerm is an alternative option for the treatment of a massive skin defect in patients who desire removal of only a negligible amount of skin from the donor site and when use of an autograft is insufficient.
Fulltext Neural-differentiated mesenchymal stem cells incorporated into muscle stuffed vein scaffold forms a stable living nerve conduit

Hassan NH, Sulong AF, Ng MH, Htwe O, Idrus RB, Roohi S, et al.

J Orthop Res, 2012 Oct;30(10):1674-81.
PMID: 22411691 DOI: 10.1002/jor.22102

Autologous nerve grafts to bridge nerve gaps have donor site morbidity and possible neuroma formation resulting in development of various methods of bridging nerve gaps without using autologous nerve grafts. We have fabricated an acellular muscle stuffed vein seeded with differentiated mesenchymal stem cells (MSCs) as a substitute for nerve autografts. Human vein and muscle were both decellularized by liquid nitrogen immersion with subsequent hydrolysis in hydrochloric acid. Human MSCs were subjected to a series of treatments with a reducing agent, retinoic acid, and a combination of trophic factors. The differentiated MSCs were seeded on the surface of acellular muscle tissue and then stuffed into the vein. Our study showed that 35-75% of the cells expressed neural markers such as S100b, glial fibrillary acidic protein (GFAP), p75 NGF receptor, and Nestin after differentiation. Histological and ultra structural analyses of muscle stuffed veins showed attachment of cells onto the surface of the acellular muscle and penetration of the cells into the hydrolyzed fraction of muscle fibers. We implanted these muscle stuffed veins into athymic mice and at 8 weeks post-implantation, the acellular muscle tissue had fully degraded and replaced with new matrix produced by the seeded cells. The vein was still intact and no inflammatory reactions were observed proving the biocompatibility and biodegradability of the conduit. In conclusion, we have successfully formed a stable living nerve conduit which may serve as a substitute for autologous nerves.
Olfactory ensheathing cells seeded muscle-stuffed vein as nerve conduit for peripheral nerve repair: a nerve conduction study

Lokanathan Y, Ng MH, Hasan S, Ali A, Mahmod M, Htwe O, et al.

J Biosci Bioeng, 2014 Aug;118(2):231-4.
PMID: 24598302 DOI: 10.1016/j.jbiosc.2014.02.002

We evaluated bridging of 15 mm nerve gap in rat sciatic nerve injury model with muscle-stuffed vein seeded with olfactory ensheathing cells as a substitute for nerve autograft. Neurophysiological recovery, as assessed by electrophysiological analysis was faster in the constructed biological nerve conduit compared to that of autograft.
Rehabilitation in Malaysia

Naicker AS, Mohamad Yatim S, Engkasan JP, Mazlan M, Yusof YM, Yuliawiratman BS, et al.

Phys Med Rehabil Clin N Am, 2019 11;30(4):807-816.
PMID: 31563172 DOI: 10.1016/j.pmr.2019.07.006

This article reviews the epidemiology, rehabilitation intervention strategies, and rehabilitation resources for persons with disabilities (PWD) in Malaysia. Currently, the registered number of PWD is 409,269 individuals, 1.3% of the total population, which is far less than the World Health Organization estimation of 10%. The rehabilitation implementation strategies include health policies, health promotion, and prevention programs. Health-related services for PWD are provided by many government agencies, including health, welfare, education, manpower, housing, and the private sector and nongovernment organizations. It is hoped national health programs can ensure special care and rehabilitation for PWD, optimizing self-reliance and social integration.
Fulltext Reliability, agreement, and validity of digital weighing scale with MatScan in limb load measurement

Kumar SN, Omar B, Htwe O, Joseph LH, Krishnan J, Jafarzedah Esfehani A, et al.

J Rehabil Res Dev, 2014;51(4):591-8.
PMID: 25144172 DOI: 10.1682/JRRD.2013.07.0166

Limb loading measurements serve as an objective evaluation of asymmetrical weight bearing in the lower limb. Digital weighing scales (DWSs) could be used in clinical settings for measurement of static limb loading. However, ambiguity exists whether limb loading measurements of DWSs are comparable with a standard tool such as MatScan. A cross-sectional study composed of 33 nondisabled participants was conducted to investigate the reliability, agreement, and validity of DWSs with MatScan in static standing. Amounts of weight distribution and plantar pressure on the individual lower limb were measured using two DWSs (A, B) and MatScan during eyes open (EO) and eyes closed (EC) conditions. The results showed that intra- and interrater reliability (3, 1) were excellent (0.94-0.97) within and between DWS A and B. Bland-Altman plot revealed good agreement between DWS and MatScan in EO and EC conditions. The area under the receiver operating characteristic curve was significant and identified as 0.68 (p = 0.01). The measurements obtained with DWSs are valid and in agreement with MatScan measurements. Hence, DWSs could be used interchangeably with MatScan and could provide clinicians an objective measurement of limb loading suitable for clinical settings.
Fulltext Severe psoriatic acroosteolysis in the absence of psoriatic arthropathy

Sakthiswary R, Naicker AS, Htwe O, Shahrir MS, Sazliyana SS

BMJ Case Rep, 2011;2011.
PMID: 22669957 DOI: 10.1136/bcr.09.2011.4794

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