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Calvo E, Calvo ET. Shoulder arthroscopy: Where we come from, where we are now and what is ahead. How artificial intelligence and machine-learning technologies will transform our field. Knee Surg Sports Traumatol Arthrosc 2024; 32:1923-1925. [PMID: 38895853 DOI: 10.1002/ksa.12318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 06/21/2024]
Affiliation(s)
- Emilio Calvo
- Shoulder and Elbow Reconstructive Surgery Unit, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Elena T Calvo
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain
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Berhouet J, Samargandi R. Emerging Innovations in Preoperative Planning and Motion Analysis in Orthopedic Surgery. Diagnostics (Basel) 2024; 14:1321. [PMID: 39001212 PMCID: PMC11240316 DOI: 10.3390/diagnostics14131321] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/15/2024] [Accepted: 06/20/2024] [Indexed: 07/16/2024] Open
Abstract
In recent years, preoperative planning has undergone significant advancements, with a dual focus: improving the accuracy of implant placement and enhancing the prediction of functional outcomes. These breakthroughs have been made possible through the development of advanced processing methods for 3D preoperative images. These methods not only offer novel visualization techniques but can also be seamlessly integrated into computer-aided design models. Additionally, the refinement of motion capture systems has played a pivotal role in this progress. These "markerless" systems are more straightforward to implement and facilitate easier data analysis. Simultaneously, the emergence of machine learning algorithms, utilizing artificial intelligence, has enabled the amalgamation of anatomical and functional data, leading to highly personalized preoperative plans for patients. The shift in preoperative planning from 2D towards 3D, from static to dynamic, is closely linked to technological advances, which will be described in this instructional review. Finally, the concept of 4D planning, encompassing periarticular soft tissues, will be introduced as a forward-looking development in the field of orthopedic surgery.
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Affiliation(s)
- Julien Berhouet
- Service de Chirurgie Orthopédique et Traumatologique, Centre Hospitalier Régional Universitaire (CHRU) de Tours, 1C Avenue de la République, 37170 Chambray-les-Tours, France
- Equipe Reconnaissance de Forme et Analyse de l'Image, Laboratoire d'Informatique Fondamentale et Appliquée de Tours EA6300, Ecole d'Ingénieurs Polytechnique Universitaire de Tours, Université de Tours, 64 Avenue Portalis, 37200 Tours, France
| | - Ramy Samargandi
- Service de Chirurgie Orthopédique et Traumatologique, Centre Hospitalier Régional Universitaire (CHRU) de Tours, 1C Avenue de la République, 37170 Chambray-les-Tours, France
- Department of Orthopedic Surgery, Faculty of Medicine, University of Jeddah, Jeddah 23218, Saudi Arabia
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Kim A, Beom J, Yang EJ, Choi WJ, Ji M, Yi C. Factors affecting upper limb functional recovery after mastectomy with immediate breast reconstruction: a prospective study. Physiother Theory Pract 2024:1-11. [PMID: 38616681 DOI: 10.1080/09593985.2024.2343043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/08/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Little is known about the differences in postoperative shoulder function following two common approaches for immediate breast reconstruction (IBR): abdominal-based breast reconstruction and implant-based breast reconstruction (ABR and IMBR). It was hypothesized that postoperative upper limb function would differ between the ABR and IMBR due to incomplete detachment of the pectoral muscles. PURPOSE This study aimed to investigate the factors for shoulder function recovery post-IBR and compare recovery outcomes between ABR and IMBR. METHODS This single-center prospective follow-up study included 60 patients who underwent IBR for 4 months postoperatively. Patients were invited to complete functional measurements 1 and 4 months postoperatively. The primary outcome was improvement in upper limb disability based on the Q-DASH score. Secondary outcomes were functional shoulder recovery markers: shoulder flexibility, strength, movement accuracy, scapular alignment, body schema accuracy, and neuropathic pain. Repeated-measures analyzes of variance and linear regression were performed. RESULTS Within-group differences were found for most variables (p < .05) except for neuropathic pain (p = .929). However, there was no overall main group effect (p > .05). Multivariate regression analysis established significant models for ABR and IMBR (R2 = 0.430, p = .002 and R2 = 0.442, p < .001, respectively). However, the variables included in the model showed between-group differences. CONCLUSION Postoperative shoulder function was comparable between the two IBR approaches. However, different factors were associated with improved upper limb disability between ABR and IMBR. Acute rehabilitation focused on resolving muscle tightness and pain may help mitigate upper limb disabilities following IBR.Trial registration number: KCT 0006501.
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Affiliation(s)
- Asall Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea
| | - Jaewon Beom
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea
| | - Eun Joo Yang
- Institute of Convergence Science, Yonsei University, Seoul, South Korea
| | - Woochol Joseph Choi
- Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Gangwon-do, South Korea
| | - Myungki Ji
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea
| | - Chunghwi Yi
- Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Gangwon-do, South Korea
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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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Dejaco B, de Jong LD, van Goor H, Staal JB, Stolwijk N, Lewis J. The concurrent validity and reliability of virtual reality to measure shoulder flexion and scaption range of motion. Physiotherapy 2023; 120:95-102. [PMID: 37429093 DOI: 10.1016/j.physio.2023.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 06/15/2023] [Accepted: 06/18/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Shoulder pain commonly has a detrimental impact on patient's work and social activities. Although pain is the most common reason for seeking care, a reduction in shoulder range of motion (ROM) is another common impairment. ROM assessment is used as an evaluation tool and multiple methods are available to measure shoulder ROM. Virtual reality (VR) has been introduced into shoulder rehabilitation, mostly when exercise and ROM measurement is indicated. This study evaluated the concurrent validity and system reliability of active ROM measurements of VR for people with and without shoulder pain. METHODS Forty volunteers participated in this study. Virtual goniometry was used to assess active shoulder ROM. Participants performed flexion and scaption to six predetermined angles. Measurements from the VR goniometer and smartphone inclinometers were recorded simultaneously. To assess reliability, two identical test sequences were performed. RESULTS The concurrent validity ICCs were 0.93 for shoulder flexion and 0.94 for shoulder scaption. The VR goniometer application on average systematically overestimated the ROM compared to the smartphone inclinometer. The mean difference between goniometer values was -11.3 degrees for flexion and -10.9 for scaption. The system reliability was excellent with an overall ICC of 0.99 for the flexion movements and 0.99 for the scaption movements. CONCLUSION Although the VR system demonstrated excellent reliability, and high ICC's for concurrent validity, the large range between the lower and upper 95% CI limits suggests it lacks measurement precision. This suggests VR, as used in this study, should not be used interchangeably with other measurement tools. CONTRIBUTION OF THE PAPER.
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Affiliation(s)
- Beate Dejaco
- Research Group Musculoskeletal Rehabilitation, HAN University of Applied Sciences, Nijmegen, The Netherlands; Department of Physiotherapy, Sports Medical Centre Papendal, Arnhem, the Netherlands.
| | - Lex D de Jong
- Department of Orthopaedics, Rijnstate Hospital, Arnhem, the Netherlands
| | - Harry van Goor
- Department of Surgery, Radboud ▲University Medical Center, ▲Nijmegen, the Netherlands
| | - J Bart Staal
- Research Group Musculoskeletal Rehabilitation, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Niki Stolwijk
- Research Group Musculoskeletal Rehabilitation, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Jeremy Lewis
- Therapy Department, Central London Community Healthcare National Health Service Trust, London, United Kingdom; Department of Musculoskeletal Research, Clinical Therapies, University of Limerick, Ireland
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Marigi EM, Triplet JJ, Alder KD, Cheema A, Sperling JW, Sanchez-Sotelo J. Impact of sickle cell disease in shoulder arthroplasty: a matched cohort analysis. J Shoulder Elbow Surg 2023; 32:247-252. [PMID: 36115611 DOI: 10.1016/j.jse.2022.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 07/22/2022] [Accepted: 07/27/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Sickle cell disease (SCD) is a genetic disorder of abnormal hemoglobin synthesis that is known to cause glenohumeral avascular necrosis (AVN). Little has been published on the use of shoulder arthroplasty (SA) for the treatment of glenohumeral AVN in SCD. We report on the clinical and radiographic results and postoperative complications following SA in the patient cohort. METHODS A retrospective review was performed identifying 17 primary SAs (9 hemiarthroplasties, 7 anatomic total SAs, and 1 reverse total SA) in patients with a confirmed diagnosis of SCD and a minimum of 2-year follow-up. This cohort was matched (1:2) according to age, sex, body mass index, type of prosthesis, and year of surgery with patients who had undergone hemiarthroplasty or total SA for osteoarthritis (OA) or reverse total SA for cuff tear arthropathy. Outcomes included the visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons score, range of motion, and strength measurements in forward elevation (FE), external rotation (ER), and internal rotation (IR). RESULTS Our cohort included 9 (52.9%) men with a mean age of 43 yr. The average follow-up time was 5.9 yr. In patients with SCD, SA provided significant improvements in VAS pain (9.1-3.8; P < .001), FE (95°-128°; P < .001), ER (24°-38°; P < .001), IR score (3.2-5.2; P < .001), FE strength (4.2-4.8; P < .001), ER strength (4.1-4.7; P < .001), IR strength (4.1-4.7; P < .001), and American Shoulder and Elbow Surgeons scores (48.6-73.5; P < .001). When compared to the matched cohort, the SCD group demonstrated higher preoperative (9.1 vs. 3.8; P < .001) and postoperative VAS scores (3.8 vs. 1.3; P < .001). Other clinical outcomes demonstrated no significant differences. There were 5 (29%) complications, 2 (11.8%) episodes of sickle cell crisis, and 3 (18%) reoperations in the SCD cohort. When compared to the matched cohort, there were no statistical differences with respect to complications (29% vs. 12%; P = .140) or reoperations (18% vs. 12%; P = .387). CONCLUSIONS SA is an effective treatment modality for glenohumeral AVN in patients with SCD. Patients may expect improvements in pain, function, motion, and strength. However, final postoperative pain relief may be less than those treated with SA without SCD. Unique perioperative management is necessary to mitigate the risk of postoperative sickle cell crises.
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Affiliation(s)
- Erick M Marigi
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Jacob J Triplet
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Kareme D Alder
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Adnan Cheema
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - John W Sperling
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
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Kim A, Yang EJ, Ji M, Beom J, Yi C. Distorted body schema after mastectomy with immediate breast reconstruction: a 4-month follow up study. PeerJ 2022; 10:e14157. [PMID: 36213497 PMCID: PMC9536299 DOI: 10.7717/peerj.14157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/08/2022] [Indexed: 01/21/2023] Open
Abstract
Background After breast cancer, some patients report residual pain-related upper limb disability without physical impairment. Although pain and altered proprioception are known to affect the working body schema (WBS), there is little available evidence investigating the WBS of breast cancer survivors (BrCS). WBS-body representations in the brain-affect the "neuromatrix" that modulates pain sensitivity and the threshold for threatening stimuli. The aim of this study was to investigate whether WBS was disrupted after mastectomy with immediate breast reconstruction (IBR) for breast cancer and whether pain and proprioceptive changes affected WBS. Methods Thirty-five BrCS participated in the 4-month follow-up study. They were observed at 1 and 4 months postoperatively. The main outcome measures were the left right judgement test (LRJT) results, absolute angle error, pectoralis minor length index (PMI), pain, and Quick-Disabilities of the Arm, Shoulder, and Hand (Q-DASH) score. They were measured at each observation, and parametric tests were performed to identify the nature of WBS. Results Both the reaction time and accuracy of the hand LRJT were poorer than those of the foot and back LRJT (p < 0.001). The hand LRJT reaction time and accuracy were unchanged over the total follow-up period (p = 0.77 and p = 0.47, respectively). There was a weak correlation between the LRJT reaction time and PMI (r = -0.26, p = 0.07), pain severity (r = 0.37, p = 0.02), and Q-DASH score (r = 0.37, p = 0.02). There was also a weak correlation between LRJT accuracy and Q-DASH score (r = -0.31, p = 0.04). The LRJT accuracy of BrCS who underwent surgery on their dominant side was higher than that of BrCS who underwent surgery on their non-dominant side (p = 0.002). Regression analysis found a weak but significant relationship between the early hand LRJT results and late pain severity (adjusted R2 = 0.179, p = 0.007). A similar relationship was found between early hand LRJT results and Q-DASH score (adjusted R2 = 0.099, p = 0.039). Conclusion To the best of our knowledge, this is the first study providing the nature of WBS after mastectomy with IBR. In this population, it is necessary to postoperatively preserve WBS integrity for pain and upper limb disability.
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Affiliation(s)
- Asall Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea,Department of Physical Therapy, The Graduate school, Yonsei University, Wonju, South Korea
| | - Eun Joo Yang
- Department of Rehabilitation Medicine, Daelim Catholic Hospital, Seoul, South Korea
| | - Myungki Ji
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jaewon Beom
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Chunghwi Yi
- Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, South Korea
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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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Musa RM, Hassan I, Abdullah MR, Latiff Azmi MN, Abdul Majeed APP, Abu Osman NA. A longitudinal analysis of injury characteristics among elite and amateur tennis players at different tournaments from electronic newspaper reports. Front Public Health 2022; 10:835119. [PMID: 36033746 PMCID: PMC9399393 DOI: 10.3389/fpubh.2022.835119] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 07/11/2022] [Indexed: 01/21/2023] Open
Abstract
The non-complexity of tennis, coupled with its health benefits, renders it appealing and encourages varying competitions at different levels of age, gender, and expertise. However, the rapid increase in the participation rates witnesses a surge in injury occurrences, prompting the need for in-depth analysis to facilitate immediate intervention. We employed a media content analysis technique in which tennis-associated articles published in the last 5 years were examined. A total of 207 news reports were gathered and screened for analysis. Subsequently, 71 articles were excluded from the study due to content duplications or summary updates of existing news articles, while 23 news articles were also excluded from the study due to inappropriateness. Finally, 113 news reports directly related to injury in tennis were coded and analyzed. We examined various types of injuries reported from the screened articles with respect to their status (fresh, recurrent, and recovery) across expertise levels i.e., elite, or amateur. Similarly, the incidence of injury occurrences based on the types of tournaments the players engage in was also investigated. A chi-square analysis was employed to achieve the objectives of the study. Occurrences of tennis-associated injuries are disseminated across expertise levels [χ ( 18 ) 2 = 16.542; p = 0.555], with knee, hip, elbow, and shoulder injuries being highly prevalent in both elite and amateur players. Nevertheless, it was noted that elite players suffered a staggering 72.60% of injury-related problems, while amateur players sustained 27.40% of injuries. Moreover, the status of injury spreads based on types of tournaments [χ ( 4 ) 2 = 3.374; p = 0.497], with higher occurrences of fresh and recurrent injuries, while low recovery rates were observed. The findings further demonstrated that injuries are sustained regardless of tournament types [χ ( 36 ) 2 = 39.393; p = 0.321]. However, most of the injuries occurred at international tournaments (85%). Whereas, only 5.30% of the injuries occurred at national/regional tournaments while 9.70% were unidentified. It could be deduced from the findings of this investigation that elite players are more prone to injuries compared with amateur players. Furthermore, the most common tennis-related injuries affect the lower, trunk, and upper regions of the body, respectively. A large number of the reported tennis injuries are fresh and recurrent, with a few recoveries. The international tennis tournaments are highly attributed to injury occurrences as opposed to the national/regional tournaments. The application of the media-based data mining technique is non-trivial in projecting injury-related problems that could be used to facilitate the development of an injury index peculiar to the tennis sport for prompt intervention.
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Affiliation(s)
- Rabiu Muazu Musa
- Centre for Fundamental and Continuing Education, Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia
| | - Isyaku Hassan
- Faculty of Languages and Communication, Universiti Sultan Zainal Abidin, Gong Badak Campus, Kuala Nerus, Terengganu, Malaysia
| | - Mohamad Razali Abdullah
- East Coast Environmental Research Institute Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia
| | - Mohd Nazri Latiff Azmi
- Faculty of Languages and Communication, Universiti Sultan Zainal Abidin, Gong Badak Campus, Kuala Nerus, Terengganu, Malaysia
| | - Anwar P. P. Abdul Majeed
- Innovative Manufacturing, Mechatronics and Sports Laboratory, Faculty of Manufacturing Engineering, Universiti Malaysia Pahang, Pekan, Malaysia
- School of Robotics, XJTLU Entrepreneur College (Taicang), Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Noor Azuan Abu Osman
- Centre for Applied Biomechanics, Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
- Chancellery, Universiti Tenaga Nasional, Kajang, Malaysia
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Marigi EM, Lenartowicz KA, Jennewine B, Throckmorton TW, Sperling JW. Clinical and radiographic outcomes of hybrid glenoid fixation with a central porous titanium post: analysis of 713 consecutive shoulders. J Shoulder Elbow Surg 2022; 31:1524-1532. [PMID: 35093521 DOI: 10.1016/j.jse.2021.12.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 12/13/2021] [Accepted: 12/19/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Hybrid glenoid component fixation represents an emerging technology in total shoulder arthroplasty (TSA) design. However, there is a paucity of larger-scale studies reporting the outcomes following implantation of these components. This study aimed to determine the outcomes following primary TSA using hybrid glenoid component fixation with a central porous titanium post. METHODS A retrospective review of 2 institutional databases identified patients aged ≥ 18 years who underwent primary elective hybrid TSA between 2009 and 2018 with a minimum of 2 years of follow-up. Outcomes evaluated included the visual analog scale pain score, range of motion, American Shoulder and Elbow Surgeons (ASES) score, complications, and implant survivorship free from reoperation or revision. Postoperative imaging was assessed for glenoid radiolucent lines and evidence of aseptic glenoid component loosening (AGL). RESULTS A total of 713 shoulders in 666 patients with a mean age of 61 ± 6 years were included in the study at a mean follow-up period of 4.3 years (range, 2.0-9.1 years); male shoulders comprised 50.9% of shoulders. Notable clinical improvements were observed with respect to the visual analog scale pain score (7.0 to 1.4, P < .001), active forward elevation (91° to 155°, P < .001), active external rotation (21° to 50°, P < .001), and the ASES score (38.6 to 82.7, P < .001), with all exceeding the substantial clinical benefit threshold for TSA. The active internal rotation score also showed significant improvement (3.1 to 5.7, P < .001). Glenoid radiolucent lines were identified in 57 TSAs (8.2%), with 1 radiographically loose glenoid component (0.1%). There were 54 complications (7.6%), with postoperative rotator cuff tear as the most common complication (n = 15, 2.1%); only 4 cases (0.6%) of glenoid-related complications (AGL) were observed. The Kaplan-Meier rate of survival free from revision surgery was 98.7% at 1 year, 98.5% at 2 years, and 96.7% at 5 years. CONCLUSIONS Hybrid glenoid component fixation of anatomic TSA with a central porous titanium post demonstrated statistically significant and clinically meaningful improvements in pain, range of motion, and ASES scores. Although AGL remains a concern, only 0.6% of TSAs sustained glenoid-related complications at a mean follow-up period of 4.3 years and the rate of survivorship free from revision was 96.7% at 5 years. These favorable clinical findings support the theoretical advantages of hybrid glenoid fixation; however, large comparative investigations with long-term follow-up are needed to validate these results.
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Affiliation(s)
- Erick M Marigi
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Brenton Jennewine
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee-Campbell Clinic, Memphis, TN, USA
| | - Thomas W Throckmorton
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee-Campbell Clinic, Memphis, TN, USA
| | - John W Sperling
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
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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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13
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Correia FD, Molinos M, Luís S, Carvalho D, Carvalho C, Costa P, Seabra R, Francisco G, Bento V, Lains J. Digitally Assisted Versus Conventional Home-Based Rehabilitation After Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial. Am J Phys Med Rehabil 2022; 101:237-249. [PMID: 33935152 PMCID: PMC8826616 DOI: 10.1097/phm.0000000000001780] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the clinical impact of a 12-wk home-based digitally assisted rehabilitation program after arthroscopic rotator cuff repair against conventional home-based rehabilitation. DESIGN The digital therapy group performed independent technology-assisted sessions complemented with 13 face-to-face sessions, and the conventional therapy group had conventional face-to-face physical therapy (30 sessions). Primary outcome was functional change between baseline and 12 wks, measured through the Constant-Murley score. Secondary outcomes were the change in the QuickDASH Scale and shoulder range of motion. RESULTS Fifty participants enrolled; 41 completed the 12-wk program (23 digital therapy group vs. 18 conventional therapy group), and 32 (15 vs. 17) were available for the 12-mo follow-up assessment. No differences were found between groups regarding study endpoints at the end of the 12-wk program. However, follow-up results revealed the superiority of the digital therapy group for QuickDASH (P = 0.043), as well as an interaction between time and group in the Constant-Murley score (P = 0.047) in favor of the digital therapy group. CONCLUSIONS The results demonstrate that digital therapeutics can be used to achieve similar, if not superior, short- and long-term outcomes as conventional approaches after arthroscopic rotator cuff repair, while being far less human resource intensive than conventional care.Level of evidence: II.
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14
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Johansson F, Asker M, Malmberg A, Fernandez-Fernandez J, Warnqvist A, Cools A. Eccentric and Isometric Shoulder Rotation Strength and Range of Motion: Normative Values for Adolescent Competitive Tennis Players. Front Sports Act Living 2022; 4:798255. [PMID: 35252855 PMCID: PMC8891455 DOI: 10.3389/fspor.2022.798255] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
The aim of this cross-sectional study was to investigate isometric internal rotation (IR), external rotation (ER), abduction (ABD), and eccentric external rotation (eccER) shoulder strength and rotational range of motion (ROM) in adolescent male and female competitive tennis players. Additional aims of the study were to provide a tennis-specific normative database based on a large sample of players to deepen the knowledge regarding shoulder strength and ROM for adolescent competitive tennis players, and to discuss differences based on sex, age, and level of play. Shoulder strength and ROM was assessed in 301 adolescent competitive tennis players, 176 boys and 125 girls with a mean age of 14.6 and 14.4 years, respectively. Outcome variables of interest were isometric IR and ER strength, ABD strength, eccER shoulder strength, intermuscular strength ratios ER/IR and eccER/IR, IR ROM, ER ROM, and total range of motion (TROM). A General Linear Model two-way ANOVA was used to analyze differences in sex, age, and level of play. The findings of this study demonstrated age, side, and sex differences in the shoulder isometric strength, the eccER strength and ROM in adolescent competitive tennis players. Furthermore, when strength was expressed as ratios ER/IR and eccER/IR both sexes showed a lower ratio for eccER/IR in national players (0.95 ± 0.22 and 0.95 ± 0.23) compared to regional players (1.01 ± 0.32 and 1.07 ± 0.29) for male and female players, respectively. In conclusion, this paper presents a tennis-specific normative database for shoulder rotation strength and ROM in adolescent male and female competitive players. The key points in this evaluation are strength values normalized to body mass, intermuscular ratios, and TROM.
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Affiliation(s)
- Fredrik Johansson
- Tennis Research and Performance Group, Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
- Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden
- *Correspondence: Fredrik Johansson
| | - Martin Asker
- Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden
- Handball Research Group, Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
| | - Andreas Malmberg
- Tennis Research and Performance Group, Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
| | | | - Anna Warnqvist
- Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Ann Cools
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Gent, Belgium
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15
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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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16
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Shah NV, Gold R, Dar QA, Diebo BG, Paulino CB, Naziri Q. Smart Technology and Orthopaedic Surgery: Current Concepts Regarding the Impact of Smartphones and Wearable Technology on Our Patients and Practice. Curr Rev Musculoskelet Med 2021; 14:378-391. [PMID: 34729710 PMCID: PMC8733100 DOI: 10.1007/s12178-021-09723-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW While limited to case reports or small case series, emerging evidence advocates the inclusion of smartphone-interfacing mobile platforms and wearable technologies, consisting of internet-powered mobile and wearable devices that interface with smartphones, in the orthopaedic surgery practice. The purpose of this review is to investigate the relevance and impact of this technology in orthopaedic surgery. RECENT FINDINGS Smartphone-interfacing mobile platforms and wearable technologies are capable of improving the patients' quality of life as well as the extent of their therapeutic engagement, while promoting the orthopaedic surgeons' abilities and level of care. Offered advantages include improvements in diagnosis and examination, preoperative templating and planning, and intraoperative assistance, as well as postoperative monitoring and rehabilitation. Supplemental surgical exposure, through haptic feedback and realism of audio and video, may add another perspective to these innovations by simulating the operative environment and potentially adding a virtual tactile feature to the operator's visual experience. Although encouraging in the field of orthopaedic surgery, surgeons should be cautious when using smartphone-interfacing mobile platforms and wearable technologies, given the lack of a current academic governing board certification and clinical practice validation processes.
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Affiliation(s)
- Neil V Shah
- Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA.
| | - Richard Gold
- Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
- School of Medicine, Saint George's University, True Blue, West Indies, Grenada
| | - Qurratul-Ain Dar
- Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
| | - Bassel G Diebo
- Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
| | - Carl B Paulino
- Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
- Department of Orthopaedic Surgery, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
| | - Qais Naziri
- Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, 450 Clarkson Ave, MSC 30, Brooklyn, NY, 11203, USA
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17
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Nishikawa D, Jorda D, Almazan D, Cornell B. Reliability of visual inspection and palpation to assess relative flexibility of the shoulder. J Bodyw Mov Ther 2021; 28:570-575. [PMID: 34776198 DOI: 10.1016/j.jbmt.2021.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 06/07/2021] [Accepted: 07/13/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Movement compensations during internal rotation of the shoulder can provoke pain. Reliably observing and measuring compensations in the shoulder using visual and palpatory methods can result in more efficacious treatments of shoulder pathology. Despite this, the reliability of these measures and the relationship between them is unknown. METHODS Bilateral shoulders of 33 Doctor of Physical Therapy (DPT) students were measured. Two third-year DPT student examiners used visual inspection and physical palpation to identify the first signs of internal rotation (IR) passive stiffness. Measurements were taken and recorded by a third examiner using the GetMyROM (Version 1.1) iPhone application. RESULTS Good intra-rater reliability for both examiners was identified for physical palpation (ICC = 0.896, 95% CI = 0.830, 0.936, ICC = 0.901, 95% CI = 0.839, 0.939) and visual inspection (ICC = 0.813, 95% CI = 0.699, 0.884, ICC = 0.782, 95% CI = 0.667, 0.880). Moderate interrater reliability was found between the examiners for physical palpation (ICC = 0.681, 95% CI = 0.479, 0.797) while poor interrater reliability was found between examiners for visual inspection (ICC = 0.481, 95% CI = 0.234, 0.648). The correlation between physical palpation and visual inspection indicated moderate reliability for both examiners (r = 0.815, p = 0.01, r = 0.832, p = 0.01). CONCLUSION The findings of this research study indicate that both physical palpation and visual inspection are reliable methods for measuring relative flexibility of shoulder IR when performed by the same examiner. However, the reliability for both methods decreases when performed by different examiners. Additionally, a strong correlation was found between both measures.
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Affiliation(s)
- Derek Nishikawa
- Department of Physical Therapy, Mount Saint Mary's University, 10 Chester Place, Los Angeles, CA, 90007, USA
| | - Darryl Jorda
- Department of Physical Therapy, Mount Saint Mary's University, 10 Chester Place, Los Angeles, CA, 90007, USA
| | - Dillon Almazan
- Department of Physical Therapy, Mount Saint Mary's University, 10 Chester Place, Los Angeles, CA, 90007, USA; Optum Physical Therapy, 23430 Hawthorne Blvd., Suite 105, Torrance, CA, 90505, USA
| | - Benjamin Cornell
- Department of Physical Therapy, Mount Saint Mary's University, 10 Chester Place, Los Angeles, CA, 90007, USA.
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Boisvert-Plante V, Noutsios CD, Perez J, Ingelmo P. The Telemedicine-Based Pediatric Examination of the Neck and Upper Limbs: A Narrative Review. J Pain Res 2021; 14:3173-3192. [PMID: 34675645 PMCID: PMC8519790 DOI: 10.2147/jpr.s336168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/28/2021] [Indexed: 11/23/2022] Open
Abstract
With the COVID-19 pandemic hastening the adoption of telemedicine into clinical practice, it has also prompted an abundance of new literature highlighting its capabilities and limitations. The purpose of this review is to summarize the current state of the literature on telemedicine applied in the context of a musculoskeletal examination of the neck and upper limbs for children 3 to 18 years old. The PubMed and ScienceDirect databases were searched for relevant articles from January 2015 to August 2021 using a combination of keywords and nested searches. General examination components including inspection, guided self-palpation, range of motion, sensory and motor examination, as well as special testing are described. Although the literature is focused mainly on adult populations, we describe how each component of the exam can be reliably incorporated into a virtual appointment specific to pediatric patients. Caregivers are generally needed for most consultations, but certain maneuvers can be self-performed by older children and adolescents alone. There is general feasibility, validity, and substantial reliability in performing most examination components of the upper limbs remotely, except for the shoulder exam. Compared to those made in person, clinical diagnoses established virtually were found to be either the same or similar in most cases, and management decisions also had high agreement. Despite this, there is evidence that some pediatric providers may not be able to collect all the information needed from a telemedicine visit to make a complete clinical assessment. Lastly, currently available smartphone applications measuring joint range of motion were found to have high reliability and validity. This narrative review not only establishes a foundation for a structured pediatric musculoskeletal examination, but also aims to increase physicians' confidence in incorporating telemedicine into their standard of care.
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Affiliation(s)
| | | | - Jordi Perez
- Alan Edwards Pain Management Unit, Montreal General Hospital (McGill University Health Centre), Montreal, QC, Canada
- Alan Edwards Centre for Pain Research, McGill University, Montreal, QC, Canada
| | - Pablo Ingelmo
- Alan Edwards Centre for Pain Research, McGill University, Montreal, QC, Canada
- Edwards Family Interdisciplinary Complex Pain Centre, Montreal Children’s Hospital (McGill University Health Centre), Montreal, QC, Canada
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Yi D, Lim H, Yim J. Effect of Microcurrent Stimulation on Pain, Shoulder Function, and Grip Strength in Early Post-Operative Phase after Rotator Cuff Repair. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57050491. [PMID: 34067980 PMCID: PMC8152281 DOI: 10.3390/medicina57050491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 01/27/2023]
Abstract
Background and Objectives: The purpose of this study was to investigate the effects of microcurrent stimulation on pain, shoulder function, and grip strength in patients with rotator cuff repair. Materials and Methods: This randomized single-blind controlled trial was conducted on inpatients of the rehabilitation department, and included 28 patients who underwent rotator cuff repair. Participants were randomly assigned to the experimental group (n = 14), treated with microcurrent stimulation, and the control group (n = 14), treated with false microcurrent stimulation. The microcurrent stimulation administered to the experimental group underwent general physical therapy and microcurrent stimulation three times a week for 4 weeks. Results: Changes in pain, range of motion in shoulder, simple shoulder test, and grip strength were assessed before and after the intervention. Both groups showed a significant decrease in pain and shoulder function (t = 27.412, 22.079, 19.079, and 18.561; p < 0.001), and grip strength showed a significant increase (t = −8.251 and −9.946; p < 0.001). The experimental group that underwent microcurrent stimulation exhibited a significant effect on pain, shoulder function, and grip strength compared with the control group that underwent false microcurrent stimulation (t = −2.17, −2.22, and 2.213; p = 0.039, 0.035, and 0.036). Conclusions: This study confirmed that microcurrent stimulation is effective for the treatment of rotator cuff repair patients.
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Affiliation(s)
- Donghyun Yi
- Department of Physical Therapy, Graduate School of Sahmyook University, Seoul 01795, Korea; (D.Y.); (H.L.)
| | - Hwanyong Lim
- Department of Physical Therapy, Graduate School of Sahmyook University, Seoul 01795, Korea; (D.Y.); (H.L.)
| | - Jongeun Yim
- Department of Physical Therapy, Sahmyook University, Seoul 01795, Korea
- Correspondence: ; Tel.: +82-2-3399-1635
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20
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Public perceptions and disparities in access to telehealth orthopaedic services in the COVID-19 era. J Natl Med Assoc 2021; 113:405-413. [PMID: 33814179 DOI: 10.1016/j.jnma.2021.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/10/2021] [Accepted: 02/22/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND We used online crowdsourcing to explore public perceptions and attitudes towards virtual orthopaedic care, and to identify factors associated with perceived difficulty navigating telehealth services during the COVID-19 pandemic. METHODS A modified version of the validated Telemedicine Satisfaction and Usefulness Questionnaire was completed by 816 individuals using crowd-sourcing methods. Multivariable logistic regression modelling was used to determine population characteristics associated with perceived difficulty using telehealth technology. RESULTS Most respondents (85%) believed that telehealth visits would be a convenient form of healthcare delivery, and 64% would prefer them over in-person office visits. The majority (92%) agreed that telehealth would save them time, but 81% had concerns regarding the lack of physical contact during a musculoskeletal examination. More respondents would feel comfortable using telehealth for routine follow-up care (81%) compared to initial assessment visits (59%) and first postoperative appointments (60%). Roughly 1 in 15 (7%) expressed difficulty with using telehealth; these respondents were more often unmarried, lower-income, and more medically infirm, and reported greater symptoms of depression. After multivariable adjustment, lower income and poor health were retained as predictors of difficulty with navigating telehealth technology (p = 0.027,p = 0.036, respectively). CONCLUSION The majority of the public appears receptive to telehealth for orthopaedic care for both new patient visits and follow-up appointments. The finding that people with multiple chronic conditions and psychosocial needs struggle to engage with telehealth suggests that those who arguably stand to benefit the most from continued care are the ones being unintentionally left out of this digitization boom.
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21
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Development and User Evaluation of a Smartphone-Based System to Assess Range of Motion of Wrist Joint. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2020; 2:339-342. [PMID: 33083772 PMCID: PMC7563568 DOI: 10.1016/j.jhsg.2020.09.004] [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: 06/25/2020] [Accepted: 09/16/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Measuring range of motion (ROM) in the wrist joint is an essential part of hand and wrist functional evaluations, especially before and after surgery. However, accurate measurements require experience and time. To reduce patient and surgeon burdens related to ROM measurement, a smartphone-based system, which enables participants to measure the ROM of the wrist joint semiautomatically using self-taken pictures on a smartphone, was developed and evaluated in this study. Methods In the developed system, participants were asked to take a picture of their wrist by using the other hand to position the joint first into full flexion and then into full extension. The hand and arm regions were automatically extracted in the program, and the ROM was estimated after the area of the hand and forearm was cropped. To verify the accuracy of ROM measurements in this system, the proposed method was tested on 66 images of hands from 33 participants; measurements were compared with those taken by hand surgeons. A limit of agreement and an intraclass correlation coefficient (ICC) were used for evaluation. Results The smallest averages (95% limits of agreement) of flexion and extension were 11.32° (95% confidence interval [CI], 8.88° to 13.76°) and 11.01° (95% CI, 8.64° to 13.39°), respectively. The ICC (1,1) for 3 measurements taken by one assessor was 0.99 (95% CI, 0.986–0.992), and the ICC (2,1) for 2 measurements taken by both assessors was 0.97 (95% CI, 0.947–0.977). Conclusions In this study, we developed a system to measure the semiautomatic ROM of the wrist joint using a smartphone image. Its accuracy was within a clinically usable error range that was comparable with that of a hand surgeon. Clinical relevance This system can reduce the burden of ROM measurement for both patients and doctors.
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22
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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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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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