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Tan AKS, Chung IDW, Lee WQ, Lie DTT. Latissimus dorsi and teres major transfer in reverse shoulder arthroplasty: A systematic review. JSES REVIEWS, REPORTS, AND TECHNIQUES 2024; 4:379-384. [PMID: 39157216 PMCID: PMC11329039 DOI: 10.1016/j.xrrt.2024.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/20/2024]
Abstract
Background This paper aims to conduct a systematic review of the current literature to evaluate the clinical outcomes of concurrent latissimus dorsi and teres major (LD/TM) tendon transfer in reverse shoulder arthroplasty (RSA), and to compare that to isolated RSA. Methods A comprehensive search on PubMeb, Web of Science, Embase and CINAHL was performed from inception up to January 20, 2023, in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Cohort studies, case-control studies, randomized controlled trials and case series that were written in English, which involved patients who underwent RSA with LD/TM transfer were included. Quality of studies was appraised using the Cochrane Risk Of Bias In Nonrandomized Studies of Interventions tool. Systematic review of Constant-Murley Score (CMS) and range of movement (ROM) was conducted. Results Eight studies with a total of 265 patients were included. The average mean follow-up time was 42.5 months, with a range of 6 months to 136 months. Of the studies that reported outcomes of RSA with LD/TM transfer, five reported the CMS, five reported external rotation (ER) ROM and six reported forward flexion ROM. Comparing postoperative to preoperative scores, there was an improvement above the minimal clinically important difference for CMS (mean difference (MD) range = 22.40 to 41.80), ER (MD range = 29° to 36°) and forward flexion (MD range = 50° to 75°). Three studies that compared postoperative ER between RSA with and without LD/TM reported no significant difference. Conclusion RSA with LD/TM transfer has good clinical outcomes postoperatively, but there is insufficient comparative data to suggest that it is superior or inferior to an isolated RSA.
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Affiliation(s)
- Ashton Kai Shun Tan
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Isaac De Wei Chung
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Wen Qiang Lee
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
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Gözaçan Karabulut D, Maden Ç, Karabulut Y, Aslan M. Effects of Video-Based Exercises and Conventional Physiotherapy on Upper Extremity Functionality, Selective Motor Control, and Proprioception in Unilateral Cerebral Palsy: A Randomized Controlled Trial. Games Health J 2024; 13:305-312. [PMID: 39069879 DOI: 10.1089/g4h.2024.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024] Open
Abstract
Objective: The present study was conducted to evaluate the effects of video-based exercises added to conventional physiotherapy (CPT) on upper extremity functionality, selective motor control, and proprioception in individuals with unilateral cerebral palsy (UCP). Materials and Methods: Thirty patients with UCP were randomized into two groups: the intervention group (15 individuals with a mean age of 9.2 ± 3.8 years) and the control group (15 individuals with a mean age of 8.3 ± 4.1 years). The intervention group received 8 weeks of video-based exercises, and the control group received 8 weeks of conventional physiotherapy. Upper extremity functional abilities, upper extremity selective motor control, proprioception, and entertainment levels were evaluated before and after the intervention for all groups. Results: While a significant change was observed in the mean scores of the ABILHAND-Kids, Selective Control of the Upper Extremity Scale right-left scores, shoulder flexion, shoulder abduction, and elbow flexion proprioception angles after the video-based exercises in the intervention group (P < 0.05), a significant change was observed only in the 60-degree flexion angle in the control group (P = 0.001). In the comparison between the groups, there were significant differences in post-intervention value only in shoulder flexion and abduction angles, whereas there was no difference between the groups in elbow flexion angles (P > 0.05). Conclusion: Incorporating video-based exercises into the upper extremity rehabilitation processes of individuals with UCP is beneficial in terms of upper extremity functionality, selective motor control, and proprioception.
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Affiliation(s)
- Demet Gözaçan Karabulut
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gaziantep Islam Science and Technology University, Gaziantep, Turkey
| | - Çağtay Maden
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gaziantep Islam Science and Technology University, Gaziantep, Turkey
| | - Yalçın Karabulut
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Mehmet Aslan
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
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Vanderstukken F, Spanhove V, Cools A, Borms D. Humeral Torsion in Relation to Shoulder Range of Motion in Elite Field Hockey Players. J Sport Rehabil 2024; 33:340-345. [PMID: 38684206 DOI: 10.1123/jsr.2023-0295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 03/06/2024] [Accepted: 04/02/2024] [Indexed: 05/02/2024]
Abstract
CONTEXT Sport-specific adaptations in shoulder rotation range of motion (ROM) and the relationship with humeral torsion have been described in overhead-throwing sports. However, information is lacking for other shoulder-loading sports such as field hockey. Therefore, this study's purpose was to evaluate humeral torsion in elite, male field hockey players and explore its association with shoulder ROM. DESIGN Cross-sectional study. METHODS Twenty-five male, elite field hockey players were included. Humeral torsion and shoulder external and internal rotation ROM were evaluated bilaterally by ultrasound and an inclinometer smartphone application, respectively. RESULTS Field hockey players showed a significantly increased humeral retroversion on the dominant compared with the nondominant side (P < .001; Cohen d = 1.75), along with a significantly increased external (P = .004; Cohen d = -0.64) and decreased internal rotation ROM (P = .003; Cohen d = 0.65). This finding illustrates a shift in total shoulder rotational ROM arc. Correlation analysis showed a significant moderate association between the increased humeral retroversion and decreased internal rotation ROM on the dominant side (r = .523). CONCLUSIONS Elite male field hockey athletes show sport-specific adaptations regarding humeral torsion and shoulder rotation ROM, similar to throwing athletes. These findings increase our insight into the field hockey athlete's shoulder, which is essential to optimize performance and assist in correctly interpreting shoulder rotational ROM measurements.
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Affiliation(s)
- Fran Vanderstukken
- Department of Rehabilitation Sciences (Physiotherapy), Faculty of Medicine and Health Sciences, University Hospital Ghent, Gent, Belgium
| | - Valentien Spanhove
- Department of Rehabilitation Sciences (Physiotherapy), Faculty of Medicine and Health Sciences, University Hospital Ghent, Gent, Belgium
| | - Ann Cools
- Department of Rehabilitation Sciences (Physiotherapy), Faculty of Medicine and Health Sciences, University Hospital Ghent, Gent, Belgium
| | - Dorien Borms
- Department of Rehabilitation Sciences (Physiotherapy), Faculty of Medicine and Health Sciences, University Hospital Ghent, Gent, Belgium
- Department of Human Structure and Repair, Faculty of Medicine and HealthSciences, University Hospital Ghent, Gent, Belgium
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Çalik M, Erdoğanoğlu Y, Çalik M, Vural M. Shoulder proprioception changes in postmastectomy patients: an observational study. Support Care Cancer 2024; 32:444. [PMID: 38896143 DOI: 10.1007/s00520-024-08651-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 06/10/2024] [Indexed: 06/21/2024]
Abstract
PURPOSE Breast cancer surgery can cause changes in the anatomical structure of the shoulder and in shoulder mobility, leading to the increased possibility of long-term arm morbidity such as lymphedema. This study aims to evaluate the active shoulder joint position sense (AJPS) with and without lymphedema in postmastectomy patients. METHODS A total of 66 women, including 22 patients with lymphedema, 22 patients without lymphedema, and 22 healthy controls, were enrolled in the study. Pain severity was evaluated with the Numeric Pain Scale and edema severity was measured with circumferentially at 10 cm intervals. The normal range of motion of the shoulder joint was evaluated with the universal goniometer and the AJPS was assessed by active position repetition testing at 55°, 90°, and 125° shoulder flexion targets using the smartphone application "Clinometer." RESULTS AJPS at 55°, 90°, and 125° shoulder flexion target angles with and without lymphedema were different in all target angles compared to healthy controls (p < 0.01). There was a difference between the absolute error value of AJPS at 55° flexion (p < 0.05), and no difference at 90° and 125° flexion between the with and without lymphedema groups (p > 0.05). CONCLUSION This study shows that the AJPS was negatively affected in with and without lymphedema postmastectomy patients compared to healthy controls. This result emphasizes the importance of adding personalized methods for the restoration of joint position sense in addition to rehabilitation programs generally applied to the patient group.
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Affiliation(s)
- Meryem Çalik
- Bakırköy Dr Sadi Konuk Training Hospital, Physical Therapy and Rehabilitation Department, Lymphedema Unit, University of Health Sciences, Zuhuratbaba Mah. Tevfik Sağlam Cad. No:11, Bakırköy, Istanbul, Turkey.
| | - Yıldız Erdoğanoğlu
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Antalya Bilim University, Çıplaklı Mah. Akdeniz Bulvarı, No: 290/A, Döşemealtı, Antalya, Turkey
| | - Mahmut Çalik
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department İstanbul, Haliç University, Levent Mahallesi, 15 Temmuz Şehitler Caddesi, No: 14/12, Eyüpsultan, İstanbul, Turkey
| | - Meltem Vural
- Bakırköy Dr Sadi Konuk Training Hospital, Physical Therapy and Rehabilitation Department, Lymphedema Unit, University of Health Sciences, Zuhuratbaba Mah. Tevfik Sağlam Cad. No:11, Bakırköy, Istanbul, Turkey
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Takigami S, Inui A, Mifune Y, Nishimoto H, Yamaura K, Kato T, Furukawa T, Tanaka S, Kusunose M, Ehara Y, Kuroda R. Estimation of Shoulder Joint Rotation Angle Using Tablet Device and Pose Estimation Artificial Intelligence Model. SENSORS (BASEL, SWITZERLAND) 2024; 24:2912. [PMID: 38733018 PMCID: PMC11086391 DOI: 10.3390/s24092912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024]
Abstract
Traditionally, angle measurements have been performed using a goniometer, but the complex motion of shoulder movement has made these measurements intricate. The angle of rotation of the shoulder is particularly difficult to measure from an upright position because of the complicated base and moving axes. In this study, we attempted to estimate the shoulder joint internal/external rotation angle using the combination of pose estimation artificial intelligence (AI) and a machine learning model. Videos of the right shoulder of 10 healthy volunteers (10 males, mean age 37.7 years, mean height 168.3 cm, mean weight 72.7 kg, mean BMI 25.6) were recorded and processed into 10,608 images. Parameters were created using the coordinates measured from the posture estimation AI, and these were used to train the machine learning model. The measured values from the smartphone's angle device were used as the true values to create a machine learning model. When measuring the parameters at each angle, we compared the performance of the machine learning model using both linear regression and Light GBM. When the pose estimation AI was trained using linear regression, a correlation coefficient of 0.971 was achieved, with a mean absolute error (MAE) of 5.778. When trained with Light GBM, the correlation coefficient was 0.999 and the MAE was 0.945. This method enables the estimation of internal and external rotation angles from a direct-facing position. This approach is considered to be valuable for analyzing motor movements during sports and rehabilitation.
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Affiliation(s)
| | - Atsuyuki Inui
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (S.T.); (Y.M.); (H.N.); (K.Y.); (T.K.); (T.F.); (S.T.); (M.K.); (Y.E.); (R.K.)
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Swanson BT, Hagenbruch M, Lapaan B, Skipalskiy K. Combined Effects of Glenohumeral Mobilization, Stretching, and Thoracic Manipulation on Shoulder Internal Rotation Range of Motion. Int J Sports Phys Ther 2024; 19:394-409. [PMID: 38699673 PMCID: PMC11065457 DOI: 10.26603/001c.95040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 02/07/2024] [Indexed: 05/05/2024] Open
Abstract
Background/purpose Interventions including posterior glenohumeral mobilizations (PGM), sleeper stretches, and thoracic manipulation are commonly used to address posterior shoulder tightness. The purpose of this study was to assess the effects of adding thoracic manipulation to PGM and sleeper stretches on passive range of motion (PROM), joint mobility, and infraspinatus electromyographic (EMG) activity in shoulders with decreased internal rotation (IR) PROM. Design Randomized Sequential Intervention Laboratory Study. Methods Forty individuals with clinically significant IR loss attended two study sessions. Participants were randomized to receive five 30 seconds bouts of either grade III PGM or sleeper stretching. Following a seven-day washout period, all participants attended a second session and received a prescriptive supine HVLA manipulation targeting the T3-4 segment, followed by the previously randomized intervention. Outcome measures included internal rotation PROM, horizontal adduction PROM, posterior glenohumeral joint translation assessed via ultrasound imaging, and EMG activity of the infraspinatus during a PGM. All outcome measures were assessed pre- and immediately post-intervention and compared statistically. Results There were significant within-group, but not between-group, differences for IR and horizontal adduction PROM following a single session of PGM or sleeper stretch. When combined with thoracic manipulation, significantly smaller within session changes of IR PROM were observed for both PGM (mean difference 4.4, p=0.017) and sleeper stretches (mean difference 6.4, p=0.0005). There were no significant between group differences for horizontal adduction PROM, humeral head translation, or EMG activity across all time points. Discussion Both GH posterior mobilizations and sleeper stretches improved IR and horizontal adduction PROM in a single session. The addition of thoracic manipulation prior to local shoulder interventions resulted in smaller gains of both IR and horizontal adduction ROM. Level of evidence Level 2.
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7
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Menezes-Reis R, Beirigo EK, Maciel TDS, de Souza Borges NC, de Santiago HAR, Bezerra Leite W. Functional capacity and risk of injury in CrossFit practitioners measured through smartphone apps. J Bodyw Mov Ther 2024; 38:205-210. [PMID: 38763564 DOI: 10.1016/j.jbmt.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 09/03/2023] [Accepted: 09/05/2023] [Indexed: 05/21/2024]
Abstract
BACKGROUND CrossFit is a high intensity functional training that tends to challenge physical limits. The objectives of this study were to assess functional capacity, prevalence and risk of injury in CrossFit practitioners. METHODS This cross-sectional, observational and prospective study evaluate the rate of injuries that occurred in CrossFit practitioners in the last 12 months and their functional capacities. The sample was given for convenience, with a total of 22 participants. Functional capacities and risk of injury were measured by functional tests using PHAST and Clinometer applications. The prevalence of injuries was cataloged using the Nordic Musculoskeletal Questionnaire. RESULTS 5% of the injuries occurred in the neck; 9% in shoulder, hip, thighs, ankles and feet; 14% in the lumbar spine and knees. The worst functional results were for the shoulder medial rotation ROM test, where 86-95% of the athletes were classified as "Bad"; the dorsiflexion ROM test also performed poorly in 68% of athletes. CONCLUSION This study shows that the CrossFit practice suggests that the injury prevalence is relatively low, affecting mainly knees, lumbar spine, wrists and hands. However, the risk of injuries shown by the functional musculoskeletal assessment is higher, especially in the shoulder and ankle, and it is important for the practitioner to realize a specific functional assessment before starting training.
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Affiliation(s)
- Rafael Menezes-Reis
- Federal University of Amazonas, Institute of Health and Biotechnology, Coari-AM, Brazil
| | | | | | | | | | - William Bezerra Leite
- Federal University of Amazonas, Institute of Health and Biotechnology, Coari-AM, Brazil.
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Wang J, Wang R, Zhao P, Han T, Cui X, He Y, Li M. The reliability and validity of a novel wearable inertial sensor to measure the cervical proprioception. Med Eng Phys 2024; 125:104125. [PMID: 38508802 DOI: 10.1016/j.medengphy.2024.104125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/29/2023] [Accepted: 02/15/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Proprioceptive function assessment is crucial in clinical practice for patients with chronic non-specific neck pain (CNNP) as it is a major issue affecting their condition. PURPOSE To verify the reliability and validity of baiobit sensor in measuring the neck proprioceptive function of CNNP patients. METHODS Fifty-three CNNP patients were recruited (36 females, 17 males; age range 21-60 years) and were assessed for cervical joint position error by two blinded raters using the Baiobit sensor and laser pointer devices. The second measurement was conducted by the same rater 48 h later. Intra and inter-rater reliability of the Baiobit sensor was evaluated using the intra-class correlation coefficient (ICC), while the validity of the Baiobit sensor was established using the Spearman correlation coefficient. RESULTS The Baiobit sensor demonstrated moderate to excellent intra-rater reliability in flexion, extension, left lateral flexion, right lateral flexion, and right rotation (ICCs=0.71∼0.85, 95 %CIs: 0.50∼0.91), left-rotation shows poor to good intra-rater reliability (ICC=0.56, 95 %CI: 0.25∼0.75). The Baiobit sensor also demonstrated moderate to excellent inter-rater reliability in flexion, extension, left lateral flexion, right lateral flexion, and right rotation (ICCs=0.80∼0.88, 95 %CIs: 0.65∼0.91), left-rotation shows poor to good intra-rater reliability (ICC=0.59, 95 %CI: 0.29∼0.76). Validity analysis showed that the Baiobit sensor had a range of low to high validity (r = 0.46∼0.88) for measuring cervical proprioception function, with lower validity observed in the left flexion direction. The Baiobit showed good absolute reliability with low SEM and MDC90 values (0.35°∼2.42°). CONCLUSION The new device could be used as an alternative tool to evaluate neck proprioception.
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Affiliation(s)
- Jialin Wang
- Sports Rehabilitation Research Center, China Institute of Sport Science, 11 Gymnasium Road, Dongcheng District, Beijing, China
| | - Ruirui Wang
- College of Sports Medicine and Physical Therapy, Beijing Sport University, 48 Xinyi Road, Haidian District, Beijing, China
| | - Peng Zhao
- Sports Rehabilitation Research Center, China Institute of Sport Science, 11 Gymnasium Road, Dongcheng District, Beijing, China.
| | - Tianran Han
- Sports Rehabilitation Research Center, China Institute of Sport Science, 11 Gymnasium Road, Dongcheng District, Beijing, China
| | - Xinwen Cui
- Sports Rehabilitation Research Center, China Institute of Sport Science, 11 Gymnasium Road, Dongcheng District, Beijing, China
| | - Yuwei He
- College of Sports Medicine and Physical Therapy, Beijing Sport University, 48 Xinyi Road, Haidian District, Beijing, China
| | - Meng Li
- College of Sports Medicine and Physical Therapy, Beijing Sport University, 48 Xinyi Road, Haidian District, Beijing, China
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Darevsky DM, Hu DA, Gomez FA, Davies MR, Liu X, Feeley BT. Algorithmic assessment of shoulder function using smartphone video capture and machine learning. Sci Rep 2023; 13:19986. [PMID: 37968288 PMCID: PMC10652003 DOI: 10.1038/s41598-023-46966-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/07/2023] [Indexed: 11/17/2023] Open
Abstract
Tears within the stabilizing muscles of the shoulder, known as the rotator cuff (RC), are the most common cause of shoulder pain-often presenting in older patients and requiring expensive advanced imaging for diagnosis. Despite the high prevalence of RC tears within the elderly population, there is no previously published work examining shoulder kinematics using markerless motion capture in the context of shoulder injury. Here we show that a simple string pulling behavior task, where subjects pull a string using hand-over-hand motions, provides a reliable readout of shoulder mobility across animals and humans. We find that both mice and humans with RC tears exhibit decreased movement amplitude, prolonged movement time, and quantitative changes in waveform shape during string pulling task performance. In rodents, we further note the degradation of low dimensional, temporally coordinated movements after injury. Furthermore, a logistic regression model built on our biomarker ensemble succeeds in classifying human patients as having a RC tear with > 90% accuracy. Our results demonstrate how a combined framework bridging animal models, motion capture, convolutional neural networks, and algorithmic assessment of movement quality enables future research into the development of smartphone-based, at-home diagnostic tests for shoulder injury.
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Affiliation(s)
- David M Darevsky
- Bioengineering Graduate Program, University of California San Francisco, San Francisco, CA, USA
- Bioengineering Graduate Program, University of California Berkeley, Berkeley, CA, USA
- Medical Scientist Training Program, University of California San Francisco, San Francisco, CA, USA
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, USA
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, USA
- Neurology and Rehabilitation Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Daniel A Hu
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, USA
| | - Francisco A Gomez
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, USA
| | - Michael R Davies
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, USA
| | - Xuhui Liu
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, USA
| | - Brian T Feeley
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, USA.
- San Francisco Veterans Affairs Health Care System, San Francisco, USA.
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Hwang S, Ardebol J, Ghayyad K, Pak T, Bonadiman JA, Denard PJ, Menendez ME. Remote visual estimation of shoulder range of motion has generally high interobserver reliability but limited accuracy. JSES Int 2023; 7:2528-2533. [PMID: 37969522 PMCID: PMC10638579 DOI: 10.1016/j.jseint.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Abstract
Background Surgeon visual estimation of shoulder range of motion (ROM) is commonplace in the outpatient office setting and routinely reported in clinical research, but the reliability and accuracy of this practice remain unclear. The purpose of this study is to establish the reliability and accuracy of remote visual estimation of shoulder ROM in healthy volunteers and symptomatic patients among a large group of shoulder surgeons. Our hypothesis is that remote visual estimation would be reliable and accurate compared with the digital goniometer method. Methods Fifty shoulder surgeon members of the PacWest Shoulder and Elbow Society independently determined the active shoulder forward flexion (FF), internal rotation at 90° abduction (IR90), external rotation at 90° abduction, external rotation at the side , and maximal spinal level reached with internal rotation (IRspine) through visual estimation of video recordings taken from 10 healthy volunteers and 10 symptomatic patients. Variations in measurements were quantified using the interobserver reliability through calculation of the intraclass correlation coefficient. Accuracy was determined through comparison with digital goniometer measurements obtained with an on-screen protractor application using Bland-Altman mean differences and 95% limits of agreement. Results The interobserver reliability among examiners showed moderate to excellent correlation, with intraclass correlation coefficient ranging from 0.768 to 0.928 for the healthy volunteers and 0.739 to 0.878 for the symptomatic patients. Accuracy was limited, with upper limits of agreement exceeding the established minimal clinically important differences (MCIDs) for FF (20° vs. MCID of 14°) and IR90 (25° vs. 18°) in the healthy volunteers and for FF (33° vs. 16°), external rotation at 90° abduction (21° vs. 18°), and IR90 (31° vs. 20°) in the symptomatic patients. Conclusion Despite generally high intersurgeon reliability in the visual estimation of shoulder ROM, there was questionable accuracy when compared to digital goniometer measurements,with measurement errors often exceeding established MCID values. Given the potential implications for the clinical response to treatment and the significance of research findings, the adoption of validated instruments to measure ROM and the standardization of examination procedures should be considered.
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Affiliation(s)
| | | | | | | | - Joao A. Bonadiman
- Instituto de Ortopedia e Traumatologia, Hospital São Vicente de Paulo, Passo Fundo, RS, Brazil
- Instituto Brasil de Tecnologias da Saúde, Rio de Janeiro, RJ, Brazil
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Soeters R, Damodar D, Borman N, Jacobson K, Shi J, Pillai R, Mehran N. Accuracy of a Smartphone Software Application Compared With a Handheld Goniometer for Measuring Shoulder Range of Motion in Asymptomatic Adults. Orthop J Sports Med 2023; 11:23259671231187297. [PMID: 37533501 PMCID: PMC10392163 DOI: 10.1177/23259671231187297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/05/2023] [Indexed: 08/04/2023] Open
Abstract
Background Typically, shoulder range of motion (ROM) measurements are performed in a clinic setting, where physicians, physical therapists (PTs), and occupational therapists make use of a goniometer. Purpose To determine the accuracy of a smartphone-based ROM software application (app) in assessing active shoulder ROM and compare the measurements with traditional goniometry as measured by a PT. Study Design Cohort study (diagnosis); Level of evidence, 2. Methods This prospective, nonblinded study was conducted at a single institution with adult asymptomatic participants with full active ROM of both shoulders. Participants were enrolled between June 1 and 15, 2021. Each participant self-assessed their active shoulder ROM using the PeerWell smartphone app. A single PT concurrently measured each participant's active shoulder ROM using a handheld universal goniometer. Bilateral shoulder ROM (forward flexion, abduction [AB], external rotation, internal rotation [IR], and extension) was measured 2 times for each participant. Interrater reliability between the smartphone app and PT measurements as well as intrarater reliability for each method of measurement were assessed using the intraclass correlation coefficient (ICC), and limits of agreement were analyzed for the difference in measurement methods. Results Data were analyzed for 60 shoulders (30 right, 30 left) from 30 participants (mean age, 31.4 ± 11.7 years; 73% female). The interrater reliability between the 2 methods was excellent for all movements (ICCs, 0.90-0.96). For all movements except shoulder AB, the mean difference in the measurements between the 2 methods was <1.3°; the mean difference in AB ROM was 2.08°. For all movements except IR, both PTs and the app showed excellent intrarater reliability (ICCs >0.90); for IR, good intrarater reliability (ICC ≥0.75) was observed. Conclusion The PeerWell smartphone app provided measurements comparable with manual measurements taken by a PT using a goniometer. These data provide evidence that the smartphone app is a reliable and valid tool for measuring shoulder ROM and show promise for measuring and monitoring patient ROM remotely.
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Affiliation(s)
| | - Dhanur Damodar
- Rush University/Midwest Orthopedics at Rush, Chicago, Illinois, USA
| | | | | | - Jing Shi
- Medical Affairs Consulting Inc, San Francisco, California, USA
| | - Raji Pillai
- Medical Affairs Consulting Inc, San Francisco, California, USA
| | - Nima Mehran
- Kaiser Permanente-Los Angeles Medical Center, Los Angeles, California, USA
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Impact of the COVID-19 Pandemic on Sports Medicine Patient Care. Arthroscopy 2023; 39:161-165. [PMID: 36347417 PMCID: PMC9636596 DOI: 10.1016/j.arthro.2022.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/08/2022]
Abstract
The COVID-19 pandemic has necessitated new practices in sports medicine patient care. Telehealth has been validated as a reliable tool for consultations and physical examinations and increases access to care in a cost-efficient manner. Social distancing and avoiding team members who have tested positive are the most effective ways to reduce spread. For screening, daily self-reported symptom checklists and fever monitoring help identify potentially infected athletes who should be instructed to isolate and seek care. Polymerase chain-reaction (PCR) testing for the virus via nasopharyngeal swab is not recommended for screening and should be reserved for symptomatic individuals with fever, cough, or shortness of breath. Face masks and personal protective equipment (PPE) may be beneficial in high-risk settings, but there is little evidence to support use in athletic populations. Median return to play after COVID-19 in elite athletes has been reported as 18 days (range: 12 to 30), with 27% not fully available at 28 days. Chest pain at diagnosis was the only symptom associated with time loss longer than 28 days. Finally, canceled competitions or time loss results in grief, stress, and frustration for athletes, as well as loss of a social support network and routine training regimens. Mental health support services may be indicated.
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Wang L, Yu G, Zhang R, Wu G, He L, Chen Y. Positive effects of neuromuscular exercises on pain and active range of motion in idiopathic frozen shoulder: a randomized controlled trial. BMC Musculoskelet Disord 2023; 24:50. [PMID: 36670364 PMCID: PMC9854051 DOI: 10.1186/s12891-023-06173-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Frozen shoulder (FS) is characterized by pain and significant loss of active and passive shoulder motion. Strengthening exercises are among the standard exercises used for FS. Neuromuscular exercise (NME) effectively improved pain and the range of motion in shoulder. However, no prior research has looked into the effects of NME compared to strengthening exercises in FS rehabilitation. The aim of the present study was to evaluate the effects of NME compared to strengthening exercises on pain and active range of motion (AROM) in individuals with idiopathic frozen shoulder. METHODS Forty individuals with idiopathic frozen shoulder were randomly assigned to either the experimental group (NME with regular physical therapy, n = 20) or the control group (strengthening exercises with regular physical therapy, n = 20). In both groups, the interventions were performed once a day, 5 days a week for 8 weeks. Pain scores on the visual analogue scale (VAS) and AROM of the shoulder were assessed at baseline and after the 8-week treatment. The primary analysis was the group × time interaction. RESULTS Two-by-two mixed analysis of variance (ANOVA) revealed a significant group × time interaction for VAS (F = 29.67; p < 0.01); AROM in flexion (F = 12.05; p < 0.01), internal rotation (F = 6.62; p < 0.05) and external rotation (F = 16.93; p < 0.01) in favor of the experimental group. The two-by-two mixed ANOVA revealed a significant main effect of time for VAS (F = 1648.47; p < 0.01); AROM in flexion (F = 591.70; p < 0.01), extension (F = 114.57; p < 0.01), abduction (F = 1602.04; p < 0.01), internal rotation (F = 664.14; p < 0.01) and external rotation (F = 1096.92; p < 0.01). No other significant differences were found. CONCLUSIONS NME is superior to strengthening exercises in terms of pain and AROM of shoulder flexion, internal rotation and external rotation in individuals with idiopathic FS. NME could be used to treat individuals with FS. TRIAL REGISTRATION Trial registration number: ChiCTR2100054453. Registration date: 17/12/2021.
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Affiliation(s)
- Lu Wang
- grid.414373.60000 0004 1758 1243Department of Rehabilitation, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730 China
| | - Ge Yu
- grid.414373.60000 0004 1758 1243Department of Rehabilitation, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730 China
| | - Ran Zhang
- grid.414373.60000 0004 1758 1243Department of Rehabilitation, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730 China
| | - Guangyan Wu
- grid.414373.60000 0004 1758 1243Department of Rehabilitation, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730 China
| | - Lei He
- grid.414373.60000 0004 1758 1243Department of Rehabilitation, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730 China
| | - Yaping Chen
- grid.414373.60000 0004 1758 1243Department of Rehabilitation, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730 China
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ALBAROVA-CORRAL MI, CARDIEL-SÁNCHEZ S, FANLO-MAZAS P, RUIZ-DE-ESCUDERO-ZAPICO A, VIORRETA-PINTANEL P, MALO-URRIÉS M. A comparative study on shoulder pain, function, range of motion, and structure between handball players and non-throwing subjects. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.21.04710-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Beshara P, Davidson I, Pelletier M, Walsh WR. The Intra- and Inter-Rater Reliability of a Variety of Testing Methods to Measure Shoulder Range of Motion, Hand-behind-Back and External Rotation Strength in Healthy Participants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14442. [PMID: 36361321 PMCID: PMC9653808 DOI: 10.3390/ijerph192114442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
This study determined the intra- and inter-rater reliability of various shoulder testing methods to measure flexion range of motion (ROM), hand-behind-back (HBB), and external rotation (ER) strength. Twenty-four healthy adults (mean age of 31.2 and standard deviation (SD) of 10.9 years) without shoulder or neck pathology were assessed by two examiners using standardised testing protocols to measure shoulder flexion with still photography, HBB with tape measure, and isometric ER strength in two abduction positions with a hand-held dynamometer (HHD) and novel stabilisation device. Intraclass correlation coefficient (ICC) established relative reliability. Standard error of measurement (SEM) and minimum detectable change (MDC) established absolute reliability. Differences between raters were visualised with Bland-Altman plots. A paired t-test assessed for differences between dominant and non-dominant sides. Still photography demonstrated good intra- and inter-rater reliability (ICCs 0.75-0.86). HBB with tape measure demonstrated excellent inter- and intra-rater reliability (ICCs 0.94-0.98). Isometric ER strength with HHD and a stabilisation device demonstrated excellent intra-rater and inter-rater reliability in 30° and 45° abduction (ICCs 0.96-0.98). HBB and isometric ER at 45° abduction differed significantly between dominant and non-dominant sides. Standardised shoulder ROM and strength tests provide good to excellent reliability. HBB with tape measure and isometric strength testing with HHD stabilisation are clinically acceptable.
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Affiliation(s)
- Peter Beshara
- Department of Physiotherapy, Prince of Wales Hospital, Sydney, NSW 2031, Australia
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
- Surgical & Orthopaedic Research Laboratories, Prince of Wales Hospital, Sydney, NSW 2031, Australia
| | - Ingrid Davidson
- Department of Physiotherapy, Prince of Wales Hospital, Sydney, NSW 2031, Australia
| | - Matthew Pelletier
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
- Surgical & Orthopaedic Research Laboratories, Prince of Wales Hospital, Sydney, NSW 2031, Australia
| | - William R. Walsh
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
- Surgical & Orthopaedic Research Laboratories, Prince of Wales Hospital, Sydney, NSW 2031, Australia
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Theile H, Walsh S, Scougall P, Ryan D, Chopra S. Smartphone goniometer application for reliable and convenient measurement of finger range of motion: a comparative study. AUSTRALASIAN JOURNAL OF PLASTIC SURGERY 2022. [DOI: 10.34239/ajops.v5n2.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ObjectiveGoniometer measurements are commonly used in hand clinics to follow progress or as an outcome measure for acute and chronic conditions. The use of an Apple iPhone goniometer application (smartphone app) may provide a practical alternative for clinicians. This study sought to assess accuracy in range-of-motion measurements obtained by a smartphone app compared to a traditional universal goniometer (UG) in healthy and diseased hands.
MethodsPatients with various hand disease processes were recruited through a tertiary hospital hand clinic, as well as healthy volunteers. Middle and little fingers were assessed at the metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints for flexion and extension. Measurements were taken using a UG and a smartphone app by two independent evaluators using a standardised proforma.
ResultsTwenty patients were recruited (50% male, 50% female; 13 healthy volunteers and seven with hand pathology). There were no significant differences in measurements using the smartphone app. The only significant difference found using the UG was for little finger PIP joint flexion; however, the difference was only 2.5°. Comparison of the average measurements using a UG and smartphone app found significant differences for six joints, with none of these > 5° (largest 4.6°).
ConclusionThe smartphone app is as reliable as traditional UG and would be a practical tool for everyday use in hand clinics. Its uptake may provide broader utility for patient self-measurement and telemedicine.
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Abstract
BACKGROUND Brachial plexus birth injuries (BPBI) can result in lasting impairments of external rotation and cross-body adduction (CBA) that disrupt functional activities such as dressing, grooming, or throwing a ball. The purpose of this study was to compare the quantification of shoulder humerothoracic (HT) external rotation (ER), and glenohumeral (GH) CBA by 3 methods - physician visual estimate, goniometer measurement by an occupational therapist, and motion capture. METHODS Twenty-six patients with BPBI (average age of 9.9±3.2 y) participated in this study. Mallet scores and visual estimates of passive HT ER and GH CBA were recorded by a physician. The passive measures were repeated by an occupational therapist using a goniometer while motion capture measures were simultaneously collected. Active HT ER was also measured by motion capture. The passive measures were compared with analyses of variance with repeated measures, intraclass correlations, and Bland-Altman plots. External rotation Mallet scores determined by motion capture and by the physician were compared. RESULTS The measures of GH CBA were not statistically different and demonstrated good agreement, but substantial variation. For HT ER, all measures were significantly different and demonstrated poor agreement and substantial variation. When the joint angles measured by motion capture were used to determine the Mallet score, 79% of external rotation Mallet scores assigned by the physician were incorrectly categorized, with the physician always scoring the participant higher than predicted motion capture Mallet score. CONCLUSIONS Both GH CBA and HT ER measures demonstrated substantial variability between measurement types, but only HT ER joint angles were significantly different. In addition, more than three-quarters of external rotation Mallet scores were misclassified by the physician. Motion capture measurements offer the benefit of less susceptibility to patients' compensatory and/or out-of-plane movements and should be considered for clinical assessment of shoulder range of motion in children with BPBI. If motion capture is unavailable, the use of a goniometer provides more accurate clinical measures of shoulder motion than visual estimates and care should be taken to minimize and account for compensatory movement strategies. LEVEL OF EVIDENCE Level IV Case series.
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Handgrip Strength Exercises Modulate Shoulder Pain, Function, and Strength of Rotator Cuff Muscles of Patients with Primary Subacromial Impingement Syndrome. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9151831. [PMID: 36082154 PMCID: PMC9448609 DOI: 10.1155/2022/9151831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 08/11/2022] [Accepted: 08/17/2022] [Indexed: 12/03/2022]
Abstract
Background Impingement syndrome was shown to be associated with shoulder pain in 44–70% of patients worldwide. It usually occurs due to imbalance and insufficient activation of the rotator cuff (RC) muscles. Aim This study explores the relative effects of handgrip-strengthening exercises on shoulder function, pain, strength, and active range of motion as part of the treatment program for the patients with primary subacromial impingement syndrome. Materials and Methods A total of 58 patients aged 18-50 years with primary subacromial impingement syndrome were randomly enrolled to participate in this single-blind randomized clinical trial. Out of them, only forty patients have eligibly matched the inclusion criteria and randomly assigned to one of two groups to undergo a standardized therapeutic program consisting of two sessions a week for 8 weeks. The control group prescribed ultrasound therapy, ice, and stretching exercises, while the experimental group followed the same program with the addition of handgrip-strengthening exercises (HGSE). Both patients of conventional therapy (control) and handgrip-strengthening exercises (experimental group) were advised to adhere also to stretching and HGSE exercises once a day at home for eight weeks. The outcomes were the shoulder function, pain intensity, muscle strength, and active range of motion of the shoulder joint. Results Patients treated with conventional interventions plus handgrip-strengthening exercises showed the significant improvement over time in shoulder pain and function, strength of rotator cuff muscles, and pain-free range of motion forward flexion, abduction, and external and internal rotation through eight weeks in the experimental group compared to control patient group treated with conventional interventions. In addition, patients of both control and experimental groups showed no significant difference in the adherence to respective home-based stretching and HGSE exercises once a day at home for eight weeks. Conclusions Adding handgrip-strengthening exercises to conventional intervention increases the efficacy of treatment for patients with primary subacromial impingement syndrome in terms of shoulder function, pain, muscle strength, and active range of motion.
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Feder KM, Rahr HB, Lautrup MD, Egebæk HK, Christensen R, Ingwersen KG. Effectiveness of an expert assessment and individualised treatment compared with a minimal home-based exercise program in women with late-term shoulder impairments after primary breast cancer surgery: study protocol for a randomised controlled trial. Trials 2022; 23:701. [PMID: 35987857 PMCID: PMC9392220 DOI: 10.1186/s13063-022-06659-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/13/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
In breast cancer patients, late-term upper limb sequelae, such as shoulder pain and impaired shoulder function, remain common after primary breast cancer surgery. The aim of this trial is to evaluate whether an expert assessment of shoulder impairments, followed by an individualised treatment plan, is superior to a minimal physiotherapeutic rehabilitation program in reducing shoulder symptoms, among women with late-term shoulder impairments after primary breast cancer.
Methods/design
The study is designed as a stratified, parallel-group, assessor-blinded, randomised, controlled trial conducted in Denmark; 130 participants with late-term shoulder impairments 3–7 years after primary surgery for breast cancer will be recruited. Participants will be randomised (allocation 1:1) to either an expert assessment of shoulder impairments followed by an individualised treatment plan or to follow a minimal physiotherapeutic rehabilitation program delivered in a pamphlet. The primary outcome will be a change in shoulder pain and function from baseline to 12 weeks after initiating the treatment, as measured by the patient-reported outcome Shoulder Pain and Disability Index (SPADI) questionnaire.
Discussion
There has been an insufficient focus in research and clinical practice on late-term shoulder impairment in women following surgery for breast cancer. This trial will focus on interventions towards late-term shoulder impairments and is expected to provide evidence-based knowledge to physiotherapists and women about the management of shoulder pain and impaired shoulder function.
Trial registration
ClinicalTrials.gov NCT05277909. Registered on 11 March 2022.
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Shimizu H, Saito T, kouno C, Shimoura K, Kawabe R, Shinohara Y, Mukaiyama K, Changyu C, Kato M, Nagai-Tanima M, Aoyama T. Validity and reliability of a smartphone application for self-measurement of active shoulder range of motion in a standing position among healthy adults. JSES Int 2022; 6:655-659. [PMID: 35813133 PMCID: PMC9264016 DOI: 10.1016/j.jseint.2022.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Tomoki Aoyama
- Corresponding author: Tomoki Aoyama, MD, PhD, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
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21
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Balser F, Desai R, Ekizoglou A, Bai S. A Novel Passive Shoulder Exoskeleton Designed With Variable Stiffness Mechanism. IEEE Robot Autom Lett 2022. [DOI: 10.1109/lra.2022.3144529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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22
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Miyachi Y, Ito M, Furuta K, Ban R, Hanamura S, Kamiya M. Reliability and validity of lower limb joint range of motion measurements using a smartphone. NAGOYA JOURNAL OF MEDICAL SCIENCE 2022; 84:7-18. [PMID: 35392008 PMCID: PMC8971043 DOI: 10.18999/nagjms.84.1.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 05/12/2021] [Indexed: 11/28/2022]
Abstract
This study aimed to examine the reliability and validity of using a smartphone to measure the multi-joint range of motion of the lower limbs. We measured the straight leg raise angle, ankle dorsiflexion angle, and hip internal rotation angle in each of the 40 lower extremities of 20 healthy adults. Measurements were compared between a conventional method using a goniometer and a smartphone application method. The intraclass correlation coefficient (ICC) was used to evaluate the reliability of each smartphone measurement, and Bland-Altman analysis was used to examine measurement errors. The criterion-related validity of the two methods was also examined. Intra-rater reliability (ICC 0.668-0.939) was substantial to almost perfect, with no systematic errors found for all items, and the standard errors of measurement were acceptable. Inter-rater reliability (ICC 0.701-0.936) was also substantial to almost perfect, but the straight leg raise angle and hip internal rotation angle showed fixation errors. For these two measurements, with more than one examiner, the limit of agreement of error needs to be considered. No systematic errors were found in the ankle dorsiflexion angle, and the standard error of measurement was within the acceptable range. A moderate to strong correlation (r = 0.626-0.915) was found between the conventional and smartphone methods, demonstrating good criterion-related validity. However, in the ankle dorsiflexion angle measurements, the reliability and validity were shown to be lower than the other two items. This suggested the necessity of changing the measurement conditions in order to use the ankle dorsiflexion angle in clinical practice.
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Affiliation(s)
- Yousuke Miyachi
- Graduate School of Life and Health Sciences, Chubu University, Kasugai, Japan
,Department of Rehabilitation, Asahi Hospital, Kasugai, Japan
| | - Morihiro Ito
- Graduate School of Life and Health Sciences, Chubu University, Kasugai, Japan
,Department of Biomedical Sciences, College of Life and Health Science, Chubu University, Kasugai, Japan
| | - Kunihiro Furuta
- Department of Rehabilitation, Sikatsu Orthopedic Hospital, Kitanagoya, Japan
| | - Rua Ban
- Department of Rehabilitation, Asahi Hospital, Kasugai, Japan
| | | | - Mitsuhiro Kamiya
- Department of Orthopedic Surgery, Asahi Hospital, Kasugai, Japan
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Pottorf OA, Lee DJ, Czujko PN. Reliability and Concurrent Validity of Mobile Health Technology for Patient Self-Monitoring in Physical Rehabilitation. JSES Int 2022; 6:506-511. [PMID: 35572423 PMCID: PMC9091929 DOI: 10.1016/j.jseint.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Forearm pronation and supination are important for everyday functional tasks and some recreational activities. Healthcare providers use reliable and valid tools during the physical rehabilitation process to measure joint range of motion (ROM), assess functional mobility, guide decisions for skilled interventions, and progress a plan of care. Since the onset of the COVID-19 pandemic, both healthcare providers and patients benefited from mobile health technologies that have emerged, which can be used by patients in the home to monitor ROM and assist the healthcare provider in guiding the rehabilitation process when utilizing telehealth. Purpose The goal of this study was to investigate the reliability and concurrent validity of a smartphone application for obtaining goniometric measurements of forearm pronation and supination. Methods This study consisted of 83 participants that were recruited on a voluntary basis from an academic institution. An iPhone with the application Clinometer and a standard goniometer (SG) were utilized to obtain goniometric measurements of forearm pronation and supination. The intraclass correlation coefficient (ICC) was used to analyze intrarater reliability, and the Pearson correlation coefficient was used to analyze concurrent validity. Scatterplots with regression lines were created to visually display the results. Results The smartphone demonstrated strong correlations for both pronation and supination (r = 0.71, P < .001; r = 0.73, P < .001). This study demonstrated overall good-excellent intrarater reliability and good concurrent validity for the smartphone application with a higher test-retest reliability in the measurement of forearm pronation compared to supination. Conclusions This study concludes that the reliability and concurrent validity of the smartphone was consistent with the SG for assessing forearm pronation and supination. It may be of value to further investigate interrater reliability between patient and healthcare practitioner, and report on the ease of use to assess ROM with a smartphone.
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Sahu D, Shah D, Joshi M, Shaikh S, Gaikwad P, Shyam A. Validation of an on-screen application-based measurement of shoulder range of motion over telehealth medium. J Shoulder Elbow Surg 2022; 31:201-208. [PMID: 34352402 DOI: 10.1016/j.jse.2021.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/13/2021] [Accepted: 06/28/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Shoulder range-of-motion (ROM) assessment is vital for the follow-up evaluation of operated patients and for the outcome-based research studies. The aim of this study was to investigate the accuracy and reliability of a remote on-screen application (app)-based method of shoulder ROM measurement through a telehealth medium. MATERIALS AND METHODS A consultant shoulder surgeon, a board-certified orthopedic resident, and a graduate medical doctor served as the examiners. The cohort consisted of 24 healthy volunteers and 16 symptomatic patients with expected shoulder ROM deficits. Shoulder ROM was first examined physically using a goniometer in the clinic and then over Zoom remote conferencing using the protractor extension app of the Chrome browser. RESULTS Instrument validity was examined by comparing the goniometer method with the protractor app-based method of the expert shoulder consultant using Bland-Altman analysis. It showed only minor mean differences between the healthy volunteers and the patients in elevation (2.0° and 5.0°, respectively), abduction (2.0° and 3.0°, respectively), external rotation with the elbow adducted (1.9° and 0.2°, respectively), external rotation with the elbow abducted at 90° (0.4° and 4°, respectively), and internal rotation with elbow abducted at 90° (2.3° and 1.2°, respectively), with limits of agreement that were below the well-established minimal clinically important difference values. The intraclass correlation coefficient (ICC) values varied between 0.83 and 0.96 for the volunteers and between 0.90 and 0.98 for the patients, indicating excellent correlation between the 2 methods. The interobserver reliability between 2 examiners for the protractor app-based method as evaluated by ICC scores was excellent; it ranged between 0.86 and 0.98 for the volunteers and between 0.88 and 0.99 for the patients. Comparison of the protractor app-based method with the gold-standard goniometer method for the resident and the graduate doctor showed excellent ICC values. CONCLUSION A protractor app-based method of measuring shoulder ROM over a telehealth medium is accurate and reliable compared with a clinical goniometer method. This validated method can be used during remote telehealth consultation with significant benefits of saving patients travel and time during the COVID-19 (coronavirus disease 2019) pandemic and even later.
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Affiliation(s)
- Dipit Sahu
- Sir H.N. Reliance Foundation Hospital, Mumbai, India; Mumbai Shoulder Institute, Mumbai, India; HBT Medical College & Dr RN Cooper Hospital, Mumbai, India.
| | - Darshil Shah
- Sir H.N. Reliance Foundation Hospital, Mumbai, India
| | - Moksha Joshi
- Mumbai Shoulder Institute, Mumbai, India; HBT Medical College & Dr RN Cooper Hospital, Mumbai, India
| | - Sana Shaikh
- Sir H.N. Reliance Foundation Hospital, Mumbai, India
| | | | - Ashok Shyam
- Sancheti Institute of Orthopaedics and Rehabilitation, Pune, India
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Kennedy JS, Reinke EK, Friedman LGM, Cook C, Forsythe B, Gillespie R, Hatzidakis A, Jawa A, Johnston P, Nagda S, Nicholson G, Sears B, Wiesel B, Garrigues GE, Hagen C, Hong I, Roach M, Jones N, Mahendraraj K, Michaelson E, Bader J, Mauter L, Mengers S, Renko N, Strony J, Hart P, Steele E, Naylor A, Gaudette J, Sprengel K. Protocol for a multicenter, randomised controlled trial of surgeon-directed home therapy vs. outpatient rehabilitation by physical therapists for reverse total shoulder arthroplasty: the SHORT trial. Arch Physiother 2021; 11:28. [PMID: 34886910 PMCID: PMC8662891 DOI: 10.1186/s40945-021-00121-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 09/16/2021] [Indexed: 11/23/2022] Open
Abstract
Background Reverse total shoulder arthroplasty (RTSA) has emerged as a successful surgery with expanding indications. Outcomes may be influenced by post-operative rehabilitation; however, there is a dearth of research regarding optimal rehabilitation strategy following RTSA. The primary purpose of this study is to compare patient reported and clinical outcomes after RTSA in two groups: in one group rehabilitation is directed by formal, outpatient clinic-based physical therapists (PT group) as compared to a home therapy group, in which patients are instructed in their rehabilitative exercises by surgeons at post-operative appointments (HT group). Secondary aims include comparisons of complications, cost of care and quality of life between the two groups. Methods This randomised controlled trial has commenced at seven sites across the United States. Data is being collected on 200 subjects by clinical research assistants pre-operatively and post-operatively at 2, 6, and 12 weeks, 6 months, 1 and 2 year visits. The following variables are being assessed: American Shoulder and Elbow Surgeons (ASES), pain level using the numeric pain scale, the Single Assessment Numeric Evaluation (SANE) score, and shoulder active and passive range of motion for analysis of the primary aim. Chi square and t-tests will be used to measure differences in baseline characteristics of both groups. Repeated measures linear mixed effects modeling for measurement of differences will be used for outcomes associated with ASES and SANE and scores, and range of motion measures. Secondary aims will be analyzed for comparison of complications, cost, and quality of life assessment scores using data obtained from the PROMIS 29 v. 2, questionnaires administered at standard of care post-operative visits, and the electronic health record. Subjects will be allowed to crossover between the PT and HT groups, and analysis will include both intention-to-treat including patients who crossed over, and a second with cross-over patients removed, truncated to the time they crossed over. Discussion RTSA is being performed with increasing frequency, and the optimal rehabilitation strategy is unclear. This study will help clarify the role of formal physical therapy with particular consideration to outcomes, cost, and complications. In addition, this study will evaluate a proposed rehabilitation strategy. Trial registration This study is registered as NCT03719859 at ClincialTrials.gov. Supplementary Information The online version contains supplementary material available at 10.1186/s40945-021-00121-2.
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Affiliation(s)
- June S Kennedy
- Department of Physical and Occupational Therapy, Duke University Health System, 3475 Erwin Rd, Durham, NC, 27705, USA.
| | - Emily K Reinke
- Department of Orthopaedic Surgery, Duke University Medical Center, 3475 Erwin Rd, Durham, NC, 27705, USA
| | - Lisa G M Friedman
- Department of Orthopedics, Geisinger Medical Center, 100 N Academy Ave, Danville, PA, 17822, USA
| | - Chad Cook
- Department of Orthopaedic Surgery, Duke University Medical Center, 3475 Erwin Rd, Durham, NC, 27705, USA.,Duke Clinical Research Institute, Duke University, 200 Morris Street, Durham, NC, 27701, USA.,Duke Department of Population Health Sciences, Duke University, 215 Morris St, Durham, NC, 27701, USA
| | - Brian Forsythe
- Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St., Suite 400, Chicago, IL, 60612, USA
| | - Robert Gillespie
- Department of Orthopaedic Surgery, University Hospitals Cleveland, 11000 Euclid Ave, Cleveland, OH, 44106, United States
| | | | - Andrew Jawa
- Boston Sports and Shoulder Center, 40 Allied Dr., Suite 102, Dedham, MA, 02026, USA
| | - Peter Johnston
- Centers for Advanced Orthopaedics, 25500 Point Lookout Road, Leonardtown, MD, 20650, USA
| | - Sameer Nagda
- Anderson Orthopaedic Clinic, 2445 Army Navy Drive, Arlington, VA, 22206, USA
| | - Gregory Nicholson
- Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St., Suite 400, Chicago, IL, 60612, USA
| | - Benjamin Sears
- Western Orthopaedics, 1830 Franklin St, 450, Denver, CO, 80218, USA
| | - Brent Wiesel
- MedStar Orthopaedic Institute, 3800 Reservoir Road Northwest, Washington, DC, 20007, USA
| | - Grant E Garrigues
- Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St., Suite 400, Chicago, IL, 60612, USA
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Wii or Kinect? A Pilot Study of the Exergame Effects on Older Adults' Physical Fitness and Psychological Perception. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412939. [PMID: 34948547 PMCID: PMC8701390 DOI: 10.3390/ijerph182412939] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/24/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022]
Abstract
Exergames are now often implemented among older adults for health purposes. This study aimed to investigate whether playing Kinect and Wii exergames has effects on older adults’ physical fitness and psychological perceptions towards exergames. A total of 23 older participants aged above 60 years were recruited and randomly assigned into two groups, in which they played either Kinect or Wii Bowling exergames for three sessions in one week. Physiological and psychological measures were collected including heart rate, blood pressure, shoulder flexibility, as well as perceived benefits and intentions for future use. Findings indicated that exergames are equivalent to light-intensity exercises, and hence pose no or minimal risk to older adults. Older adults had a positive attitude towards exergames and have a strong willingness to engage in exergaming on a regular basis. Although no significant platform difference was identified, observation and qualitative findings suggested that Wii might provide a more intense physical activity than Kinect, while Kinect might obtain a higher perception among older adults than Wii. The study has several practical implications for both health professionals and exergame designers targeting the ageing population.
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Beshara P, Anderson DB, Pelletier M, Walsh WR. The Reliability of the Microsoft Kinect and Ambulatory Sensor-Based Motion Tracking Devices to Measure Shoulder Range-of-Motion: A Systematic Review and Meta-Analysis. SENSORS (BASEL, SWITZERLAND) 2021; 21:8186. [PMID: 34960280 PMCID: PMC8705315 DOI: 10.3390/s21248186] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 01/23/2023]
Abstract
Advancements in motion sensing technology can potentially allow clinicians to make more accurate range-of-motion (ROM) measurements and informed decisions regarding patient management. The aim of this study was to systematically review and appraise the literature on the reliability of the Kinect, inertial sensors, smartphone applications and digital inclinometers/goniometers to measure shoulder ROM. Eleven databases were screened (MEDLINE, EMBASE, EMCARE, CINAHL, SPORTSDiscus, Compendex, IEEE Xplore, Web of Science, Proquest Science and Technology, Scopus, and PubMed). The methodological quality of the studies was assessed using the consensus-based standards for the selection of health Measurement Instruments (COSMIN) checklist. Reliability assessment used intra-class correlation coefficients (ICCs) and the criteria from Swinkels et al. (2005). Thirty-two studies were included. A total of 24 studies scored "adequate" and 2 scored "very good" for the reliability standards. Only one study scored "very good" and just over half of the studies (18/32) scored "adequate" for the measurement error standards. Good intra-rater reliability (ICC > 0.85) and inter-rater reliability (ICC > 0.80) was demonstrated with the Kinect, smartphone applications and digital inclinometers. Overall, the Kinect and ambulatory sensor-based human motion tracking devices demonstrate moderate-good levels of intra- and inter-rater reliability to measure shoulder ROM. Future reliability studies should focus on improving study design with larger sample sizes and recommended time intervals between repeated measurements.
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Affiliation(s)
- Peter Beshara
- Department of Physiotherapy, Prince of Wales Hospital, Sydney, NSW 2031, Australia
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia; (M.P.); (W.R.W.)
- Surgical & Orthopaedic Research Laboratories, Prince of Wales Hospital, Sydney, NSW 2031, Australia
| | - David B. Anderson
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia;
| | - Matthew Pelletier
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia; (M.P.); (W.R.W.)
- Surgical & Orthopaedic Research Laboratories, Prince of Wales Hospital, Sydney, NSW 2031, Australia
| | - William R. Walsh
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia; (M.P.); (W.R.W.)
- Surgical & Orthopaedic Research Laboratories, Prince of Wales Hospital, Sydney, NSW 2031, Australia
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Francisco-Martínez C, Prado-Olivarez J, Padilla-Medina JA, Díaz-Carmona J, Pérez-Pinal FJ, Barranco-Gutiérrez AI, Martínez-Nolasco JJ. Upper Limb Movement Measurement Systems for Cerebral Palsy: A Systematic Literature Review. SENSORS 2021; 21:s21237884. [PMID: 34883885 PMCID: PMC8659477 DOI: 10.3390/s21237884] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 11/19/2021] [Accepted: 11/24/2021] [Indexed: 01/06/2023]
Abstract
Quantifying the quality of upper limb movements is fundamental to the therapeutic process of patients with cerebral palsy (CP). Several clinical methods are currently available to assess the upper limb range of motion (ROM) in children with CP. This paper focuses on identifying and describing available techniques for the quantitative assessment of the upper limb active range of motion (AROM) and kinematics in children with CP. Following the screening and exclusion of articles that did not meet the selection criteria, we analyzed 14 studies involving objective upper extremity assessments of the AROM and kinematics using optoelectronic devices, wearable sensors, and low-cost Kinect sensors in children with CP aged 4–18 years. An increase in the motor function of the upper extremity and an improvement in most of the daily tasks reviewed were reported. In the population of this study, the potential of wearable sensors and the Kinect sensor natural user interface as complementary devices for the quantitative evaluation of the upper extremity was evident. The Kinect sensor is a clinical assessment tool with a unique markerless motion capture system. Few authors had described the kinematic models and algorithms used to estimate their kinematic analysis in detail. However, the kinematic models in these studies varied from 4 to 10 segments. In addition, few authors had followed the joint assessment recommendations proposed by the International Society of Biomechanics (ISB). This review showed that three-dimensional analysis systems were used primarily for monitoring and evaluating spatiotemporal variables and kinematic parameters of upper limb movements. The results indicated that optoelectronic devices were the most commonly used systems. The joint assessment recommendations proposed by the ISB should be used because they are approved standards for human kinematic assessments. This review was registered in the PROSPERO database (CRD42021257211).
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Affiliation(s)
- Celia Francisco-Martínez
- Electronics Engineering Department, National Technology of Mexico in Celaya, Celaya 38010, Mexico; (C.F.-M.); (J.A.P.-M.); (J.D.-C.); (F.J.P.-P.); (A.I.B.-G.)
| | - Juan Prado-Olivarez
- Electronics Engineering Department, National Technology of Mexico in Celaya, Celaya 38010, Mexico; (C.F.-M.); (J.A.P.-M.); (J.D.-C.); (F.J.P.-P.); (A.I.B.-G.)
- Correspondence: ; Tel.: +52-(461)-111-2862
| | - José A. Padilla-Medina
- Electronics Engineering Department, National Technology of Mexico in Celaya, Celaya 38010, Mexico; (C.F.-M.); (J.A.P.-M.); (J.D.-C.); (F.J.P.-P.); (A.I.B.-G.)
| | - Javier Díaz-Carmona
- Electronics Engineering Department, National Technology of Mexico in Celaya, Celaya 38010, Mexico; (C.F.-M.); (J.A.P.-M.); (J.D.-C.); (F.J.P.-P.); (A.I.B.-G.)
| | - Francisco J. Pérez-Pinal
- Electronics Engineering Department, National Technology of Mexico in Celaya, Celaya 38010, Mexico; (C.F.-M.); (J.A.P.-M.); (J.D.-C.); (F.J.P.-P.); (A.I.B.-G.)
| | - Alejandro I. Barranco-Gutiérrez
- Electronics Engineering Department, National Technology of Mexico in Celaya, Celaya 38010, Mexico; (C.F.-M.); (J.A.P.-M.); (J.D.-C.); (F.J.P.-P.); (A.I.B.-G.)
| | - Juan J. Martínez-Nolasco
- Mechatronics Engineering Department, National Technology of Mexico in Celaya, Celaya 38010, Mexico;
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Kocak UZ, Guran O, Kalkan S, Kaya E, Kurt M, Karatosun V, Unver B. Assessing the knee flexion range of motion after total knee arthroplasty: Technology versus senses. J Bodyw Mov Ther 2021; 28:547-551. [PMID: 34776193 DOI: 10.1016/j.jbmt.2021.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 06/11/2021] [Accepted: 09/24/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Following total knee arthroplasty surgery, attention should be paid to post-operative knee range of motion to achieve daily activities. Goniometer assessment is widely used to assess the range of motion in the post-operative period. This study aimed to determine the inter-rater ability of a smartphone application and visual estimation of the knee joint after total knee arthroplasty among different professions that commonly work together and compare whether any method is superior to another. METHOD Range of motion measurements was performed by four clinicians as two physiotherapists and two orthopedic fellows. They utilized the Goniometer Reports application for smartphones, universal goniometer, and visual estimation to measure angles of knees which was operated. A two-way mixed model of intra-class correlation coefficient (ICC) with a 95% confidence level was used to assess inter-rater reliability. RESULTS Thirteen patients (11 female) and 20 knees (10 right) were assessed. The ICCs were found excellent both for between methods and between raters. CONCLUSION Our results show that technology seems a more accurate way to determine the knee range of motion after knee arthroplasty compared to senses. However, in lack of technological resources or time, or to avoid possible infection, visual estimation also could provide useful information.
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Affiliation(s)
- Umut Ziya Kocak
- Izmir Katip Celebi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir, Turkey
| | - Ortac Guran
- Sancaktepe Education and Research Hospital, Istanbul, Turkey
| | - Serpil Kalkan
- Afyon Health Sciences University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Afyon, Turkey
| | - Erol Kaya
- Merzifon Kara Mustafa Pasa City Hospital, Amasya, Turkey
| | - Merve Kurt
- Izmir Katip Celebi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir, Turkey; Dokuz Eylul University, Institute of Health Sciences, Izmir, Turkey.
| | | | - Bayram Unver
- Dokuz Eylul University, School of Physical Therapy and Rehabilitation, Izmir, Turkey
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30
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Rosen M, Meijer K, Tucker S, Wilcox CL, Plummer HA, Andrews JR, Ostrander RV. Shoulder Range of Motion Deficits in Youth Throwers Presenting With Elbow Pain. Sports Health 2021; 14:478-482. [PMID: 34414823 DOI: 10.1177/19417381211036387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Glenohumeral internal rotation deficit (GIRD) and total arc of motion difference (TAMD) have been associated with elbow injuries in throwing athletes. HYPOTHESIS Youth pitchers with elbow pain will have greater GIRD and TAMD compared with youth pitchers without elbow pain. STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 3. METHODS Glenohumeral range of motion of 25 consecutive throwing athletes presenting with elbow pain and that of a matched control group of 18 asymptomatic throwing athletes were compared. Bilateral glenohumeral internal rotation, external rotation, and horizontal adduction at 90° were measured and GIRD and TAMD were then calculated. An analysis of variance was performed to compare range of motion between throwers with and without elbow pain. RESULTS The average GIRD of the elbow pain group was 32.7° compared with 14.5° in the control group (P < 0.05). The average TAMD in the elbow pain group was 28.3° compared with 6.7° in the control group (P < 0.05). GIRD and TAMD were present in 88% (22 of 25) and 96% (24 of 25) of the elbow pain group versus 33.3% (6 of 18) and 55.6% (10 of 18) of the control group, respectively. CONCLUSION Compared with asymptomatic youth pitchers, those presenting with elbow pain have a statistically significant GIRD and TAMD. CLINICAL RELEVANCE This study suggests that a GIRD and TAMD may predispose youth pitchers to present with symptomatic elbow pain.
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Affiliation(s)
- Michael Rosen
- Andrews Institute for Orthopaedics and Sports Medicine, Gulf Breeze, Florida.,Andrews Research and Education Foundation, Gulf Breeze, Florida
| | - Karim Meijer
- Andrews Institute for Orthopaedics and Sports Medicine, Gulf Breeze, Florida.,Andrews Research and Education Foundation, Gulf Breeze, Florida.,Texas Sports Medicine & Orthopaedic Group, Dallas, Texas
| | - Scott Tucker
- Andrews Institute for Orthopaedics and Sports Medicine, Gulf Breeze, Florida.,Andrews Research and Education Foundation, Gulf Breeze, Florida
| | - C Luke Wilcox
- Andrews Institute for Orthopaedics and Sports Medicine, Gulf Breeze, Florida.,Andrews Research and Education Foundation, Gulf Breeze, Florida
| | - Hillary A Plummer
- Andrews Institute for Orthopaedics and Sports Medicine, Gulf Breeze, Florida.,Andrews Research and Education Foundation, Gulf Breeze, Florida
| | - James R Andrews
- Andrews Institute for Orthopaedics and Sports Medicine, Gulf Breeze, Florida.,Andrews Research and Education Foundation, Gulf Breeze, Florida
| | - Roger V Ostrander
- Andrews Institute for Orthopaedics and Sports Medicine, Gulf Breeze, Florida.,Andrews Research and Education Foundation, Gulf Breeze, Florida
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Pinnamaneni S, Lamplot JD, Rodeo SA, Swensen-Buza S, Lawton CD, Dines JS, Young WK, Taylor SA. The Virtual Shoulder Physical Exam. HSS J 2021; 17:59-64. [PMID: 33967643 PMCID: PMC8077973 DOI: 10.1177/1556331620975033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/30/2020] [Indexed: 01/25/2023]
Affiliation(s)
| | - Joseph D. Lamplot
- Sports Medicine Division, Department of Orthopedics, Emory University, Atlanta, GA, USA
| | - Scott A. Rodeo
- Sports Medicine Institute, Hospital for Special Surgery, New York City, NY, USA
| | | | - Cort D. Lawton
- Sports Medicine Division, Ortho Illinois, Algonquin, IL, USA
| | - Joshua S. Dines
- Sports Medicine Institute, Hospital for Special Surgery, New York City, NY, USA
| | - Warren K. Young
- Sports Medicine Institute, Hospital for Special Surgery, New York City, NY, USA
| | - Samuel A. Taylor
- Sports Medicine Institute, Hospital for Special Surgery, New York City, NY, USA
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Lawton CD, Swensen-Buza S, Awender JF, Pinnamaneni S, Lamplot JD, Young WK, Rodeo SA, Nawabi DH, Taylor SA, Dines JS. The Elbow Physical Examination for Telemedicine Encounters. HSS J 2021; 17:65-69. [PMID: 33967644 PMCID: PMC8077976 DOI: 10.1177/1556331620975040] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 10/28/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Cort D. Lawton
- Sports Medicine Division, Ortho Illinois, Algonquin, IL, USA
| | | | | | | | - Joseph D. Lamplot
- Department of Orthopedics, Sports Medicine Division, Emory University, Atlanta, GA, USA
| | - Warren K. Young
- Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA
| | - Scott A. Rodeo
- Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA
| | - Danyal H. Nawabi
- Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA
| | - Samuel A. Taylor
- Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA
| | - Joshua S. Dines
- Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA
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Pérez-de la Cruz S, de León ÓA, Mallada NP, Rodríguez AV. Validity and intra-examiner reliability of the Hawk goniometer versus the universal goniometer for the measurement of range of motion of the glenohumeral joint. Med Eng Phys 2021; 89:7-11. [PMID: 33608127 DOI: 10.1016/j.medengphy.2021.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 12/20/2020] [Accepted: 01/24/2021] [Indexed: 11/17/2022]
Abstract
AIM The aim of this study was to establish the validity of an external measurement system (the Hawk goniometer). This is a digital device which measures joint ranges compared to the universal goniometer for the measurement of shoulder range of motion in healthy adults. MATERIAL AND METHODS a correlational study with 157 healthy volunteers completed six shoulder movements (forward flexion, abduction, extension, adduction and internal and external rotation) with each shoulder. The degree of agreement between each goniometer and Hawk measurement was assessed using Intra-class Correlation Coefficients (ICC) and Bland-Altman 95% limits of agreement (LOA). RESULTS the tests showed a very strong relationship between the readings of both devices (CI between 0.81 and 0.99) and there were no significant differences between the mean readings of both devices. An intraclass correlation coefficient (ICC) of above 0.9 was obtained, indicating a high intra-evaluator reliability of the Hawk goniometer in repeated measurements of shoulder range of motion. CONCLUSIONS the Hawk goniometer is a valid and reliable element for the objective measurement of the range of motion at the shoulder joint.
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Affiliation(s)
| | - Óscar Arellano de León
- Physical Education Department, Training and Improvement Division, National Police School, Ávila, Spain
| | - Néstor Pérez Mallada
- Nursing and Physiotherapy School San Juan de Dios, Universidad Pontificia de Comillas. Ciempozuelos, Madrid. Spain
| | - Antonio Vargas Rodríguez
- Physical Education Department, Training and Improvement Division, National Police School, Ávila, Spain
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Yoma M, Herrington L, Mackenzie TA, Almond TA. Training Intensity and Shoulder Musculoskeletal Physical Quality Responses in Competitive Swimmers. J Athl Train 2021; 56:54-63. [PMID: 33176360 PMCID: PMC7863595 DOI: 10.4085/1062-6050-0357.19] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Shoulder pain is the main cause of missed or modified training in competitive swimmers. Shoulder musculoskeletal maladaptations occur to some extent as a consequence of training loads during swimming that may increase the risk of shoulder injury. Further evidence is needed to understand the training intensities at which these maladaptations occur. OBJECTIVE To determine the acute effect of training intensity on the shoulder musculoskeletal physical qualities associated with shoulder injury in competitive swimmers. DESIGN Cross-sectional study. SETTING Indoor swimming pool. PATIENTS OR OTHER PARTICIPANTS Sixteen asymptomatic national- and regional-level swimmers (7 females, 9 males; age = 14.6 ± 3.9 years, height = 160.5 ± 12.7 cm, mass = 55.3 ± 12.5 kg). MAIN OUTCOME MEASURE(S) Bilateral active shoulder-rotation range of motion (ROM), joint position sense, latissimus dorsi length, combined elevation test, and shoulder-rotation isometric peak torque and handgrip peak force normalized to body weight were measured before and immediately after low- and high-intensity swim-training sessions. The intensity of the sessions was determined by the distance swum over or at the pace threshold and confirmed by the swimmer's rating of perceived exertion. RESULTS After the high-intensity training session, shoulder external-rotation ROM (dominant side: P < .001, change = -7.8°; d = 1.10; nondominant side: P = .002, change = -6.5°, d = 1.02), internal-rotator isometric peak torque (dominant side: P < .001, change = -11.4%, d = 0.42; nondominant side: P = .03, change = -6.6%, d = 0.20), and external-rotator isometric peak torque (dominant side: P = .004, change = -8.7%, d = 0.27; nondominant side: P = .02, change = -7.6%, d = 0.25) were reduced. No changes were found in any of the outcome measures after the low-intensity session. CONCLUSIONS Shoulder active external-rotation ROM and rotation isometric peak torque were decreased immediately after a high-intensity training session, possibly increasing the risk of injury during subsequent training. Monitoring these variables may help practitioners adjust and manage training loads to decrease the risk of shoulder injury.
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Affiliation(s)
- Matias Yoma
- Centre for Health Sciences, School of Health and Society, University of Salford, Manchester, United Kingdom
| | - Lee Herrington
- Centre for Health Sciences, School of Health and Society, University of Salford, Manchester, United Kingdom
| | - Tanya Anne Mackenzie
- Centre for Health Sciences, School of Health and Society, University of Salford, Manchester, United Kingdom
| | - Timothy Alejandro Almond
- Centre for Health Sciences, School of Health and Society, University of Salford, Manchester, United Kingdom
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Jones CW, Barrett M, Erickson J, Chatindiara I, Poon P. Larger polyethylene glenospheres in reverse shoulder arthroplasty: are they safe? JSES Int 2020; 4:944-951. [PMID: 33345238 PMCID: PMC7738592 DOI: 10.1016/j.jseint.2020.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Reverse shoulder arthroplasty is gaining popularity owing to its proven longevity and good outcome scores. Scapular notching remains a concern. This study aimed to assess the safety of larger polyethylene glenospheres with increased eccentricity in comparison with the more conventional metal bearings. The secondary effects on scapular notching, clinical outcomes, range of movement, and complications were also analyzed. Methods We conducted a 10-year retrospective review of 145 SMR reverse shoulder arthroplasties (LimaCorporate, Udine, Italy) in 132 patients with radiographs at a minimum of 2 years postoperatively. The primary outcome measure was the survivorship of the larger polyethylene glenospheres. Secondary outcomes were the presence and size of notching, subjective satisfaction score, American Shoulder and Elbow Surgeons score, Oxford Shoulder Score, range of motion, and shoulder-related complications. Results No failures of the polyethylene glenospheres were noted in the 10-year period. At a minimum of 2 years’ follow-up, notching was noted in 16 (25%) of the metal glenospheres vs. 9 (11.1%) of the polyethylene glenospheres (P = .028). The mean Oxford Shoulder Score was lower for the metal glenospheres (P = .005). Range of motion, complications, and overall satisfaction were similar in both groups. Conclusion The inverted bearing configuration demonstrated no failures at a minimum of 2 years’ follow-up. A larger study is required to determine whether the decreased incidence and size of early notching are related to the bearing size or material.
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Affiliation(s)
- Carl W Jones
- Department of Orthopaedics, North Shore Hospital, Takapuna, New Zealand
| | - Matthew Barrett
- Department of Orthopaedics, North Shore Hospital, Takapuna, New Zealand
| | - John Erickson
- Department of Orthopaedics, North Shore Hospital, Takapuna, New Zealand
| | - Idah Chatindiara
- Department of Orthopaedics, North Shore Hospital, Takapuna, New Zealand
| | - Peter Poon
- Department of Orthopaedics, North Shore Hospital, Takapuna, New Zealand
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36
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Keskinoğlu C, Aydın A. Wearable wireless low-cost electrogoniometer design with Kalman filter for joint range of motion measurement and 3D modeling of joint movements. Proc Inst Mech Eng H 2020; 235:222-231. [PMID: 33183138 DOI: 10.1177/0954411920971398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Joint movements are the key factor for the mobility of the people during daily activities. The evaluation of the joint movements is determined by the range of motion (ROM) parameters. The ROM might change due to age, gender, and some diseases. Therefore, it is essential to measure ROM accurately and compare it with the normal values of the healthy people. In this study, a low-cost, wireless, and wearable electrogoniometer was designed for highly precise and accurate measurements. The stability of the measurements is guaranteed with the quaternion based Kalman filter. The measurements of the developed system are compared with the traditional goniometer. The concordance correlation coefficient is calculated as a similarity metric, and the result is obtained as 1. In addition, a GUI was prepared to present 3D visualization of the movements in real-time with the ROM measurements and give visual feedback to the physiotherapists during physical examinations and to the patient during the home therapy sessions. The measurements also can be recorded using the GUI for retrospective analysis.
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Affiliation(s)
- Cemil Keskinoğlu
- Department of Biomedical Engineering, Cukurova University, Adana, Turkey
| | - Ahmet Aydın
- Department of Biomedical Engineering, Cukurova University, Adana, Turkey
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37
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Lamplot JD, Pinnamaneni S, Swensen-Buza S, Lawton CD, Dines JS, Nawabi DH, Young W, Rodeo SA, Taylor SA. The Virtual Shoulder and Knee Physical Examination. Orthop J Sports Med 2020; 8:2325967120962869. [PMID: 33614791 PMCID: PMC7871077 DOI: 10.1177/2325967120962869] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/03/2020] [Indexed: 01/25/2023] Open
Abstract
The COVID-19 crisis has forced a sudden and dramatic shift in the way that clinicians interact with their patients, from outpatient encounters to telehealth visits utilizing a variety of internet-based videoconferencing applications. Although many aspects of pre–COVID-19 outpatient sports medicine care will ultimately resume, it is likely that telehealth will persist because of its practicality and because of patient demand for access to efficient and convenient health care. Physical examination is widely considered a critical obstacle to a thorough evaluation of sports medicine patients during telehealth visits. However, a closer reflection suggests that a majority of the examination maneuvers are possible virtually with limited, if any, modifications. Thus, we provide a comprehensive shoulder and knee physical examination for sports medicine telehealth visits, including (1) verbal instructions in layman’s terms that can be provided to the patient before or read verbatim during the visit, (2) multimedia options (narrated videos and annotated presentations) of the shoulder and knee examination that can be provided to patients via screen-share options, and (3) a corresponding checklist to aid in documentation.
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Affiliation(s)
- Joseph D Lamplot
- Department of Orthopaedics, Emory University, Atlanta, Georgia, USA
| | | | | | | | - Joshua S Dines
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Danyal H Nawabi
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Warren Young
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Scott A Rodeo
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Samuel A Taylor
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
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Koong DP, Lee J, Cheng TL, Little DG. Validity and reliability of smartphone inclinometer applications for measurement of elbow range of motion in paediatric patients. J Child Orthop 2020; 14:488-494. [PMID: 33204358 PMCID: PMC7666793 DOI: 10.1302/1863-2548.14.200123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Precise measurement of elbow range of motion (ROM) post-injury or surgery forms an important part of determining prognosis and the need for further intervention. Clinicians are increasingly incorporating smartphone use in our medical practice; we sought to determine if a smartphone goniometer application is a valid and reliable tool for assessment of elbow ROM in the paediatric patient, compared to visual and goniometer assessment. METHODS In total, 20 paediatric patients (40 elbows) between six and 15 years of age with an elbow or forearm injury were included in this prospective series. Elbow flexion, extension, pronation and supination were measured independently by two orthopaedic clinicians. Measurements were taken from injured as well as unaffected side using a standardized technique, first with visual estimation and then using a universal goniometer (UG) and smartphone goniometer application Angle Meter via Google Play store (Smart Tool Factory, Istanbul, Turkey). RESULTS There was excellent interobserver reliability for all three modalities, with average intraclass correlation coefficient (ICC) values greater than 0.90. Visual estimation had the lowest average ICC of 0.92, compared to 0.97 for UG and smartphone. Overall, there was excellent intraobserver reliability between the smartphone application and the gold standard UG for all elbow movements with ICCs ranging between 0.98 to 0.99 and mean absolute difference ranging from 1.1 ± 1.0° to 2.6 ± 1.9°. The smartphone application showed superior agreement over visual estimation when compared to the gold standard UG with lower mean differences and 95% limits of agreement (LOA) falling within 10°. CONCLUSIONS Our study demonstrates that a smartphone application is a valid and reliable assessment tool for measurement of elbow ROM in paediatric patients, and better than visualization alone. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Denis P. Koong
- Department of Orthopaedic Surgery, The Children’s Hospital at Westmead, Sydney, NSW, Australia,Correspondence should be sent to Denis Pak-Han Koong, Department of Orthopaedic Surgery, The Children’s Hospital at Westmead, Locked Bag 4001, Westmead NSW 2145, Australia. E-mail:
| | - Jillian Lee
- Department of Orthopaedic Surgery, The Children’s Hospital at Westmead, Sydney, NSW, Australia
| | - Tegan L. Cheng
- Department of Orthopaedic Surgery, The Children’s Hospital at Westmead, Sydney, NSW, Australia,The University of Sydney, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, Sydney, NSW, Australia
| | - David G. Little
- Department of Orthopaedic Surgery, The Children’s Hospital at Westmead, Sydney, NSW, Australia,The University of Sydney, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, Sydney, NSW, Australia
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Faramarzi Kohneh Shahri Y, Ghani Zadeh Hesar N. Validity and reliability of smartphone-based Goniometer-Pro app for measuring the thoracic kyphosis. Musculoskelet Sci Pract 2020; 49:102216. [PMID: 32861369 DOI: 10.1016/j.msksp.2020.102216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/26/2020] [Accepted: 06/27/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND CONTEXT It is important to precisely measure thoracic kyphosis while examining the patients and studying effectiveness of therapeutic treatments. PURPOSE The present study evaluates validity as well as intra- and inter-rater reliability of health-related Goniometer-Pro android app in measuring thoracic kyphosis. METHODS A total number of 31 subjects were examined to validate using markers and measures of the proposed method to mark the spinous process, palpation, and radiologic imaging in the sagittal plane to obtain the thoracic curvature using Cobb method. Moreover, 40 subjects were examined for reliability by applying an evaluator at three occasions with an interval of one week (intra-rater) and three different evaluators at the same place and day (inter-rater). RESULTS Findings indicated that there was no significant difference between Cobb angle and the angle from the proposed method in thoracic curvature (p > 0.5). However, significant correlation was observed for the thoracic (r = 0.81, P = 0.000) with an ICC of 0.89. Intra- and inter-rater measurements were significantly correlated. CONCLUSION Our proposed method using Goniometer-Pro android app is highly reliable and accurate in determining thoracic curvature values.
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Affiliation(s)
| | - Narmin Ghani Zadeh Hesar
- Department of Sport Physiology and Corrective Exercises, Faculty of Sport Sciences, Urmia University, Urmia, Iran.
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de Brito Macedo L, Borges DT, Melo SA, da Costa KSA, de Oliveira Sousa C, Brasileiro JS. Reliability and concurrent validity of a mobile application to measure thoracolumbar range of motion in low back pain patients. J Back Musculoskelet Rehabil 2020; 33:145-151. [PMID: 31127756 DOI: 10.3233/bmr-181396] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Smartphone devices have been used to measure range of motion (ROM) in different joints. OBJECTIVE To verify the concurrent validity of thoracolumbar ROM using a mobile application and a digital inclinometer, as well as the intrarater reliability of individuals with and without back pain. METHODS One investigator was responsible for measuring the ROM during the evaluations performed on 20 asymptomatic subjects and 20 symptomatic subjects in two consecutive days. RESULTS Regarding to the concurrent validity, the Intraclass Correlation Coefficients (ICC) were classified as very good for all analyzed movements. For intrarater reliability, the mobile application had ICC varying between good and very good for the symptomatic subjects and very good for asymptomatic subjects. CONCLUSIONS The mobile application may be considered a valid and reliable tool to assess thoracolumbar ROM for both asymptomatic and chronic low back pain subjects.
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Burns D, Razmjou H, Shaw J, Richards R, McLachlin S, Hardisty M, Henry P, Whyne C. Adherence Tracking With Smart Watches for Shoulder Physiotherapy in Rotator Cuff Pathology: Protocol for a Longitudinal Cohort Study. JMIR Res Protoc 2020; 9:e17841. [PMID: 32623366 PMCID: PMC7381014 DOI: 10.2196/17841] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/26/2020] [Accepted: 04/26/2020] [Indexed: 12/12/2022] Open
Abstract
Background Physiotherapy is essential for the successful rehabilitation of common shoulder injuries and following shoulder surgery. Patients may receive some training and supervision for shoulder physiotherapy through private pay or private insurance, but they are typically responsible for performing most of their physiotherapy independently at home. It is unknown how often patients perform their home exercises and if these exercises are performed correctly without supervision. There are no established tools for measuring this. It is, therefore, unclear if the full benefit of shoulder physiotherapy treatments is being realized. Objective The proposed research will (1) validate a smartwatch and machine learning (ML) approach for evaluating adherence to shoulder exercise participation and technique in a clinical patient population with rotator cuff pathology; (2) quantify the rate of home physiotherapy adherence, determine the effects of adherence on recovery, and identify barriers to successful adherence; and (3) develop and pilot test an ethically conscious adherence-driven rehabilitation program that individualizes patient care based on their capacity to effectively participate in their home physiotherapy. Methods This research will be conducted in 2 phases. The first phase is a prospective longitudinal cohort study, involving 120 patients undergoing physiotherapy for rotator cuff pathology. Patients will be issued a smartwatch that will record 9-axis inertial sensor data while they perform physiotherapy exercises both in the clinic and in the home setting. The data collected in the clinic under supervision will be used to train and validate our ML algorithms that classify shoulder physiotherapy exercise. The validated algorithms will then be used to assess home physiotherapy adherence from the inertial data collected at home. Validated outcome measures, including the Disabilities of the Arm, Shoulder, and Hand questionnaire; Numeric Pain Rating Scale; range of motion; shoulder strength; and work status, will be collected pretreatment, monthly through treatment, and at a final follow-up of 12 months. We will then relate improvement in patient outcomes to measured physiotherapy adherence and patient baseline variables in univariate and multivariate analyses. The second phase of this research will involve the evaluation of a novel rehabilitation program in a cohort of 20 patients. The program will promote patient physiotherapy engagement via the developed technology and support adherence-driven care decisions. Results As of December 2019, 71 patients were screened for enrollment in the noninterventional validation phase of this study; 65 patients met the inclusion and exclusion criteria. Of these, 46 patients consented and 19 declined to participate in the study. Only 2 patients de-enrolled from the study and data collection is ongoing for the remaining 44. Conclusions This study will provide new and important insights into shoulder physiotherapy adherence, the relationship between adherence and recovery, barriers to better adherence, and methods for addressing them. International Registered Report Identifier (IRRID) DERR1-10.2196/17841
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Affiliation(s)
- David Burns
- Division of Orthopaedic Surgery, University of Toronto, Toronto, ON, Canada.,Holland Bone and Joint Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Helen Razmjou
- Holland Bone and Joint Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Working Condition Program, Holland Orthopedic and Arthritic Centre, Toronto, ON, Canada.,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - James Shaw
- Women's College Research Institute, Toronto, ON, Canada.,Joint Centre for Bioethics, University of Toronto, Toronto, ON, Canada
| | - Robin Richards
- Division of Orthopaedic Surgery, University of Toronto, Toronto, ON, Canada.,Holland Bone and Joint Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Stewart McLachlin
- Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Michael Hardisty
- Division of Orthopaedic Surgery, University of Toronto, Toronto, ON, Canada.,Holland Bone and Joint Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Patrick Henry
- Division of Orthopaedic Surgery, University of Toronto, Toronto, ON, Canada.,Holland Bone and Joint Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Cari Whyne
- Division of Orthopaedic Surgery, University of Toronto, Toronto, ON, Canada.,Holland Bone and Joint Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Ahn SY, Ko H, Yoon JO, Cho SU, Park JH, Cho KH. Determining the Reliability of a New Method for Measuring Joint Range of Motion Through a Randomized Controlled Trial. Ann Rehabil Med 2020; 43:707-719. [PMID: 31918533 PMCID: PMC6960083 DOI: 10.5535/arm.2019.43.6.707] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 07/02/2019] [Indexed: 11/12/2022] Open
Abstract
Objective To compare the reliability and validity of the Korean range of motion standard protocol (KRSP) for measuring joint range of motion (ROM) with those of the conventional ROM measurement using a goniometer. Methods We conducted a randomized controlled trial involving 91 healthy elderly individuals. We compared two strategies of measuring joint ROM to evaluate the reliability and validity of each standardized protocol: first, the KRSP based on the Chungnam National University guidelines and second, handheld goniometric measurement. In the first strategy, 3 examiners (1 rehabilitation doctor, 1 physical therapist, and 1 physical therapy student) independently measured joint ROM in 46 randomly selected subjects; in the second strategy, another 3 examiners (1 rehabilitation doctor, 1 physical therapist, and 1 physical therapy student) measured joint ROM in 45 randomly selected subjects. The reliability of each protocol was calculated using intraclass correlation coefficient, ICC(2,1), and root mean square error (RMSE). Results Both protocols showed good to excellent intra-rater reliability. With goniometer use, the inter-rater reliability was low—ICC(2,1), 95% confidence interval ranged from 0.643 (0.486–0.783) to -0.078 (-0.296–0.494)— and RMSE was high. With the KRSP, the inter-rater reliability ranged from 0.846 (0.686–0.931) to 0.986 (0.972–0.994) and RMSE was low. Conclusion ROM measurements using the KRSP showed excellent reliability. These results indicate that this protocol can be the reference standard for measuring ROM in clinical settings as an alternative to goniometers.
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Affiliation(s)
- So Young Ahn
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Hanbit Ko
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Jeong Oh Yoon
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Sun Ung Cho
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Jong Hyun Park
- Biomedical Engineering Center, Chungnam National University College of Medicine, Daejeon, Korea
| | - Kang Hee Cho
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea.,Biomedical Engineering Center, Chungnam National University College of Medicine, Daejeon, Korea
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Effects of self-stretching with mobilization on shoulder range of motion in individuals with glenohumeral internal rotation deficits: a randomized controlled trial. J Shoulder Elbow Surg 2020; 29:36-43. [PMID: 31627965 DOI: 10.1016/j.jse.2019.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 08/02/2019] [Accepted: 08/07/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND The combined effects of cross-body stretching and dorsal glide mobilization have not been examined previously, although both stretching and mobilization maneuvers are effective for improving shoulder range of motion (ROM). Thus, the aim of this study was to demonstrate the effects of stretching with mobilization (SWM) on glenohumeral (GH) internal rotation (IR) and horizontal adduction (HA) ROM. METHODS Forty individuals with GH IR deficits were randomized to perform simultaneous combined cross-body stretching and dorsal glide mobilization (SWM group, comprising 10 male and 10 female patients) or cross-body stretching alone (stretching group, comprising 10 male and 10 female patients). GH IR ROM, HA ROM, and shoulder mobility were assessed before and immediately following interventions. Group and time differences were analyzed using 2-way repeated-measures analysis of variance. RESULTS Greater changes in GH IR ROM (6°, P < .001), HA ROM (10°, P < .001), and shoulder mobility (-2 cm, P = .018) were observed in the SWM group than in the stretching group, although significant increases were observed in GH IR ROM (SWM group, P < .001; stretching group, P < .001), HA ROM (SWM group, P < .001; stretching group, P = .042), and shoulder mobility (SWM group, P < .001; stretching group, P < .001) after both interventions. CONCLUSION This study shows that SWM could be a useful exercise for shoulder ROM recovery in individuals with GH IR deficits.
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Validity and Reliability of a New Optoelectronic System for Measuring Active Range of Motion of Upper Limb Joints in Asymptomatic and Symptomatic Subjects. J Clin Med 2019; 8:jcm8111851. [PMID: 31684077 PMCID: PMC6912542 DOI: 10.3390/jcm8111851] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 10/21/2019] [Accepted: 10/29/2019] [Indexed: 01/22/2023] Open
Abstract
The aim of this study was to evaluate the validity of the Veloflex infrared dynamic angle-meter (Veloflex-IDA) and the intra- and inter-rater reliability when measuring the ranges of motion (ROMs) of the upper limb joints. Thirty-five healthy and 20 symptomatic participants were evaluated. Twelve upper limb movements were measured in two sessions with the Veloflex-IDA, which is a device composed of a camera that tracks the trajectory of retro-reflective markers. In addition, a goniometer was used in the first session to evaluate concurrent validity. Validity and agreement were evaluated by Pearson correlation coefficient (r) and Bland-Altmann plots. Intra- and inter-rater reliability were evaluated using intra-class correlation (ICC), standard error of measurement (SEM), and minimal detectable change (MDC). Both instruments showed excellent correlation for all movements (r range from 0.992 to 0.999). The intra- and inter-rater reliability were excellent (ICC range from 0.95 to 0.99 and 0.90 to 0.98, respectively). Intra-rater reliability showed SEMs <1.38% and <5.19% and inter-rater reliability SEMs <2.26% and <5.22% for asymptomatic and symptomatic, respectively. Veloflex-IDA is a valid and reliable alternative to measure the upper limb joints' ROM and it can be used in clinical practice and research after basic training.
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de Ridder R, De Blaiser C, Verrelst R, De Saer R, Desmet A, Schuermans J. Neurodynamic sliders promote flexibility in tight hamstring syndrome. Eur J Sport Sci 2019; 20:973-980. [PMID: 31578925 DOI: 10.1080/17461391.2019.1675770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
ABSTRACT Hamstring injury prevention puts emphasis on optimizing the muscle's strength-length relationship. To assure appropriate muscle length, flexibility training is imperative. As neurodynamics play an important role herein, the goal of this study was to explore the intervention effect of home-based neurodynamic slider program on hamstring flexibility. Fifty physically active male subjects were randomly assigned to either performing a neurodynamic sliding technique (3 × 20 reps) or a static stretching protocol (3 × 30″) on a daily basis for a 6-week period. Hamstring flexibility was assessed by means of the Straight Leg Raise at baseline, immediately after the intervention and after 4 weeks follow up. There was no between group baseline difference in hamstring flexibility. The repeated measure ANOVA showed a significant interaction effect for group × time (p < 0.001). Independent sample t-test showed a significantly higher increase in flexibility gain in the neurodynamic group immediately after the intervention (p < 0.001), as well as at 4 weeks retention analysis (p = 0.001) compared to the static stretch group. In conclusion, neurodynamic sliders might be more efficient than regular static stretching in affecting hamstring flexibility in the long run.
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Affiliation(s)
- Roel de Ridder
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Cedric De Blaiser
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Ruth Verrelst
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Roeland De Saer
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Andreas Desmet
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Joke Schuermans
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
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Roldán-Jiménez C, Martin-Martin J, Cuesta-Vargas AI. Reliability of a Smartphone Compared With an Inertial Sensor to Measure Shoulder Mobility: Cross-Sectional Study. JMIR Mhealth Uhealth 2019; 7:e13640. [PMID: 31493320 PMCID: PMC6754695 DOI: 10.2196/13640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 05/09/2019] [Accepted: 06/29/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The shoulder is one of the joints with the greatest mobility within the human body and its evaluation is complex. An assessment can be conducted using questionnaires or functional tests, and goniometry can complement the information obtained in this assessment. However, there are now validated devices that can provide more information on the realization of movement, such as inertial sensors. The cost of these devices is usually high and they are not available to all clinicians, but there are also inertial sensors that are implemented in mobile phones which are cheaper and widely available. Results from the inertial sensors integrated into mobile devices can have the same reliability as those from dedicated sensors. OBJECTIVE This study aimed to validate the use of the Nexus 4 smartphone as a measuring tool for the mobility of the humerus during shoulder movement compared with a dedicated InertiaCube3 (Intersense) sensor. METHODS A total of 43 subjects, 27 affected by shoulder pathologies and 16 asymptomatic, participated in the study. Shoulder flexion, abduction, and scaption were measured using an InertiaCube3 and a Nexus 4 smartphone, which were attached to the participants to record the results simultaneously. The interclass correlation coefficient (ICC) was calculated based on the 3 movements performed. RESULTS The smartphone reliably recorded the velocity values and simultaneously recorded them alongside the inertial sensor. The ICCs of the 3 gestures and for each of the axes of movement were analyzed with a 95% CI. In the abduction movement, the devices demonstrated excellent interclass reliability for the abduction humeral movement axis (Cronbach alpha=.98). The axis of abduction of the humeral showed excellent reliability for the movements of flexion (Cronbach alpha=.93) and scaption (Cronbach alpha=.98). CONCLUSIONS Compared with the InertiaCube3, the Nexus 4 smartphone is a reliable and valid tool for recording the velocity produced in the shoulder.
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Affiliation(s)
- Cristina Roldán-Jiménez
- Clinimetric Group F-14 Biomedical Research Institute of Malaga, Malaga, Spain.,Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, Malaga, Spain
| | - Jaime Martin-Martin
- Clinimetric Group F-14 Biomedical Research Institute of Malaga, Malaga, Spain.,Legal Medicine Area, Department of Human Anatomy, Legal Medicine and History of Science, Faculty of Medicine, University of Malaga, Malaga, Spain
| | - Antonio I Cuesta-Vargas
- Clinimetric Group F-14 Biomedical Research Institute of Malaga, Malaga, Spain.,Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, Malaga, Spain.,Institute of Health & Biomedical Innovation, Faculty of Health, Queensland University Technology, Queensland, Australia
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Keogh JWL, Cox A, Anderson S, Liew B, Olsen A, Schram B, Furness J. Reliability and validity of clinically accessible smartphone applications to measure joint range of motion: A systematic review. PLoS One 2019; 14:e0215806. [PMID: 31067247 PMCID: PMC6505893 DOI: 10.1371/journal.pone.0215806] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 04/09/2019] [Indexed: 12/01/2022] Open
Abstract
Measuring joint range of motion is an important skill for many allied health professionals. While the Universal Goniometer is the most commonly utilised clinical tool for measuring joint range of motion, the evolution of smartphone technology and applications (apps) provides the clinician with more measurement options. However, the reliability and validity of these smartphones and apps is still somewhat uncertain. The aim of this study was to systematically review the literature regarding the intra- and inter-rater reliability and validity of smartphones and apps to measure joint range of motion. Eligible studies were published in English peer-reviewed journals with full text available, involving the assessment of reliability and/or validity of a non-videographic smartphone app to measure joint range of motion in participants >18 years old. An electronic search using PubMed, Medline via Ovid, EMBASE, CINAHL, and SPORTSDiscus was performed. The risk of bias was assessed using a standardised appraisal tool. Twenty-three of the eligible 25 studies exceeded the minimum 60% score to be classified as a low risk of bias, although 3 of the 13 criteria were not achieved in >50% of the studies. Most of the studies demonstrated adequate intra-rater or inter-rater reliability and/or validity for >50% of the range of motion tests across all joints assessed. However, this level of evidence appeared weaker for absolute (e.g. mean difference ± limit of agreement, minimal detectable change) than relative (e.g. intraclass correlation, correlation) measures; and for spinal rotation than spinal extension, flexion and lateral flexion. Our results provide clinicians with sufficient evidence to support the use of smartphones and apps in place of goniometers to measure joint motion. Future research should address some methodological limitations of the literature, especially including the inclusion of absolute and not just relative reliability and validity statistics.
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Affiliation(s)
- Justin W. L. Keogh
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- Sports Performance Research Institute New Zealand (SPRINZ), AUT University, Auckland, New Zealand
- Cluster for Health improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
- * E-mail:
| | - Alistair Cox
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Sarah Anderson
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Bernard Liew
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Alicia Olsen
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Ben Schram
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
- Water Based Research Unit, Bond Institute of Health and Sport, Bond University, Gold Coast, QLD, Australia
| | - James Furness
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
- Water Based Research Unit, Bond Institute of Health and Sport, Bond University, Gold Coast, QLD, Australia
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Smartphone applications in orthopaedic surgery: a review of the literature and application analysis. CURRENT ORTHOPAEDIC PRACTICE 2019. [DOI: 10.1097/bco.0000000000000745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Effects of Adding Interferential Therapy Electro-Massage to Usual Care after Surgery in Subacromial Pain Syndrome: A Randomized Clinical Trial. J Clin Med 2019; 8:jcm8020175. [PMID: 30717426 PMCID: PMC6406802 DOI: 10.3390/jcm8020175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 01/27/2019] [Accepted: 01/30/2019] [Indexed: 11/17/2022] Open
Abstract
Subacromial pain syndrome (SAPS) is a prevalent condition that results in loss of function. Surgery is indicated when pain and functional limitations persist after conservative measures, with scarce evidence about the most-appropriate post-operative approach. Interferential therapy (IFT), as a supplement to other interventions, has shown to relieve musculoskeletal pain. The study aim was to investigate the effects of adding IFT electro-massage to usual care after surgery in adults with SAPS. A randomized, single-blinded, controlled trial was carried out. Fifty-six adults with SAPS, who underwent acromioplasty in the previous 12 weeks, were equally distributed into an IFT electro-massage group or a control group. All participants underwent a two-week intervention (three times per week). The control group received usual care (thermotherapy, therapeutic exercise, manual therapy, and ultrasound). For participants in the IFT electro-massage group, a 15-min IFT electro-massage was added to usual care in every session. Shoulder pain intensity was assessed with a 100-mm visual analogue scale. Secondary measures included upper limb functionality (Constant-Murley score), and pain-free passive range of movement. A blinded evaluator collected outcomes at baseline and after the last treatment session. The ANOVA revealed a significant group effect, for those who received IFT electro-massage, for improvements in pain intensity, upper limb function, and shoulder flexion, abduction, internal and external rotation (all, p < 0.01). There were no between-group differences for shoulder extension (p = 0.531) and adduction (p = 0.340). Adding IFT electro-massage to usual care, including manual therapy and exercises, revealed greater positive effects on pain, upper limb function, and mobility in adults with SAPS after acromioplasty.
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Reina N. Connected orthopedics and trauma surgery: New perspectives. Orthop Traumatol Surg Res 2019; 105:S15-S22. [PMID: 30591420 DOI: 10.1016/j.otsr.2018.05.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 04/28/2018] [Accepted: 05/07/2018] [Indexed: 02/02/2023]
Abstract
Information is everywhere in the surgeon's life. It can improve medical practice and allow for personalized care. To answer the question, "How should the surgeon be connected?" we must assess the role and limitations of digital information in daily practice, particularly through mobile applications or mHealth. These tools and their scope must be defined in order to measure their impact on our clinical practice. New regulations on medical data have been introduced imposing that privacy be maintained. Connected applications can assist the surgeon in making the diagnosis and deciding on the treatment. These tools are already being used widely. Decision algorithms based on machine learning are also a promising way to optimize patient care. Connected applications make the clinical follow-up easier by allowing more reliable, relevant and frequent data transmission. They also provide access to information and training, either early academic learning or continuing medical education. We must adapt to these new modes of learning. Thus, smartphones, tablets and digital applications now have a central role in modern orthopedic surgery. Surgeons have information, technical resources and storage for research data at their disposal, while patients can establish a link with their doctor (current or future) and find lay information about their condition.
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Affiliation(s)
- Nicolas Reina
- Institut Locomoteur, hôpital Pierre-Paul-Riquet, CHU de Toulouse, 31059 Toulouse, France.
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