Purpose To evaluate the difference between corneal endothelial cell density at the moment of preservation and keratoplasty in imported donor corneas, and analyze the correlated factors of the difference. Methods Eighty‐seven corneas imported between March 2009 and February 2011 were evaluated. Corneal endothelial cell density at the moment of preservation was obtained from the medical record and was measured just before the keratoplasty. Results All of the corneas showed decrease of endothelial cell density. Mean endothelial cell density of imported donor corneas at the moment of preservation and keratoplasty was 2789±235 cells/mm2 and 2592±254 cells/mm2(p=<0.001). Mean endothelial cell loss was 197±148 cells/mm2, which was significantly correlated with preservation to surgery time, death to surgery time and preservation period more than 7 days(p=0.042, p=0.045, p=0.036 respectively). Conclusion Decrease of death to surgery time and keratoplasty before 7days of preservation period are needed for better surgical outcome.

This case follows the complications, treatment, and results of a 69 years old male patient who sustained complete right quadriceps tendon tear secondary to a fall. Due to cardiovascular complications, surgery was delayed for a month, and reconstructive surgery was extensive. Methods He was assessed as suffering from significantly decreased range of motion (ROM), decreased strength, and secondary, unilateral lymphedema. Physical therapy began 10 weeks post surgery and consisted of a 3 month rehabilitation program to increase ROM, strength, and balance, as well as to reduce edema. Results Measures were assessed at initial evaluation and final discharge. Right knee Active Range of Motion (AROM) flexion increased from 60 to 86 degrees and extension improved from 26 to 15 degrees. Knee joint circumference was reduced from 49 cm to 45.4 cm. Lower Extremity Functional scale improved from 13/80 to 35/80. Timed Up and Go improved from 18 seconds with bilateral crutches to 7 seconds without crutches. Tandem balance progressed from less than 1 second to greater than 1 minute. Single Limb Stance from less than 1 second to 29 seconds on the right. Conclusion The case report describes the interventions status post delayed quadriceps tendon repair for an older adult that was effectively in improving AROM, functional mobility, and balance.

Purpose The purpose of this case report was to describe the effects of a 6-week physical therapy program consisting of strengthening exercises, balance training, stretching and self-managing education of an adult with bilateral knee osteoarthritis (OA) and cerebral vascular accident (CVA) during an outpatient episode of care. Methods The individual was a 62-year-old female with a history of bilateral knee osteoarthritis and recent history of mild CVA. The subject participated in a 6-week physical therapy program consisting of strengthening exercises, balance training, stretching and self-managing education. The subject was seen 3 times a week, with a day of recovery between each therapy session. The Lower Extremity Functional Scale (LEFS), Berg Balance Scale (BBS), Manual Muscle Test (MMT), Time Up and Go (TUG), Numeric Pain Rating Scale (NPRS), 10-Meter Walk Test (10MWT) and Five Time Sit to Stand Test (FTSST) were used to assess progress in this subject. Results Outcome measures were used at evaluation and were administered every two weeks. The Timed Up and Go improved from 22 seconds to 12 seconds. The Five Time Sit to Stand Test improved from 39 seconds to 16 seconds, while the Berg Balance Scale improved from 43 to 52 points. Lower Extremity Functional Scale improved by 9 points and gait speed improved by 0.27m/s. The Numeric Pain Rating Scale was monitored throughout the course of treatment, which served as a guide that pain was not exacerbated and that the exercise program was well tolerated by the subject. Conclusion This case report describes an exercise program that significantly decreasing pain, while improving balance, functional strength, and gait kinematics with no adverse effect in a subject with bilateral knee osteoarthritis with recent mild CVA. We believe that a significant reduction of pain induces a better functional performance in the subject with OA and CVA.

Purpose The purpose of this study was to identify the effect of aging on the dynamic balance of gait initiation (GI) between healthy elderly adults and young adults. Methods This study used descriptive analysis. Total 17 subjects, 8 healthy elderly and 9 young adults were recruited from the local community, San Angelo, Texas. EMG sensors (Biometrics Ltd., Ladysmith, VA, USA) were attached to the TA and Sol muscles bilaterally to measure peak amplitude and time to peak amplitude. Subjects were instructed to stand comfortably while barefoot on the High Resolution (HR) mat (Tekscan Inc., South Boston, MA, USA) to assess 1) COP anterior-posterior excursion, 2) COP medial-lateral excursion, 3) COP area, 3) COP backward motion distance, 4) COP motion to swing limb distance. The subjects were then given a verbal cue to start walking from a quiet standing. Results The healthy young group illustrated greater lateral and backward movement of COP as well as COP A-P and L-R excursion than the elderly group. In addition, the healthy young group showed greater peak amplitude of bilateral TA muscles during GI. Time to peak TA muscle amplitude was much faster in the healthy young group than the elderly group during GI. Conclusion The limited dynamic balance observed in the elderly group compared to healthy young adults during the task of GI. This finding suggests that sway analysis during GI could be used as a screening tool to identify the impaired dynamic balance for people who present balance deficits.

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