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Garcia JR, Cannon D, Rodriguez HC, Grewal G, Lewis S, Lapica H, Levy JC. Comparison of reverse shoulder arthroplasty and total shoulder arthroplasty for patients with inflammatory arthritis. J Shoulder Elbow Surg 2023; 32:573-580. [PMID: 36206983 DOI: 10.1016/j.jse.2022.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 08/07/2022] [Accepted: 08/27/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND End-stage glenohumeral joint arthritis is common in patients with inflammatory arthritis. Reverse shoulder arthroplasty (RSA) and anatomic total shoulder arthroplasty (TSA) are both indicated in this setting. RSA is often considered based on the impacts of long-standing inflammatory arthritis including glenoid and humeral bone erosion and rotator cuff insufficiency. However, acromial and scapular spine fractures following RSA have been reported more commonly in these patients, which can have a significant impact on outcomes. Currently, no study has directly compared the efficacy and complication rates of RSA vs. TSA in patients with inflammatory arthritis. This study aimed to investigate differences in clinical outcomes and complications in patients undergoing RSA vs. TSA with glenohumeral inflammatory arthritis. METHODS We performed a retrospective review of 86 patients with inflammatory arthritis treated with primary RSA (n = 43) or TSA (n = 43) with a minimum of 2 years' follow-up. American Shoulder and Elbow Surgeons scores, Simple Shoulder Test scores, visual analog scale scores for pain and function, active range of motion, and patient self-ratings of upper-extremity normality (Subjective Assessment of Normal Evaluation [SANE]) were collected preoperatively and at minimum 2-year follow-up. Radiographic classification of preoperative glenoid and humeral bone loss was performed, and postoperative complications were observed. Revision and complication details were compared. RESULTS The study cohort had an average age of 72.1 years (range, 31-92 years) and average follow-up period of 51.6 months (range, 22-159 months). Both the RSA and TSA cohorts demonstrated improvements in patient-reported outcome measures and ranges of motion; however, patients treated with TSA showed a greater postoperative final Simple Shoulder Test score (P < .001), visual analog scale score for function (P = .0347), active elevation (P = .0331), active external rotation (P < .001), active internal rotation (P = .005), and Single Assessment Numeric Evaluation (SANE) score (P = .0161). Analysis of complication rates demonstrated no statistically significant difference between cohorts. Four acromial fractures occurred in the RSA group. When RSA patients who sustained acromial fractures were removed from the analysis, there were minimal differences in outcomes between the RSA and TSA cohorts. CONCLUSION TSA in patients with inflammatory arthritis leads to improved clinical outcomes but higher early revision rates when compared with RSA. RSA outcomes are negatively impacted by a high rate of postoperative acromial fractures.
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Affiliation(s)
- Jose Rafael Garcia
- Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Dylan Cannon
- Holy Cross Orthopedic Institute, Fort Lauderdale, FL, USA
| | | | - Gagan Grewal
- Department of Orthopedic Surgery, Larkin Community Hospital, South Miami, FL, USA
| | - Steven Lewis
- Holy Cross Orthopedic Institute, Fort Lauderdale, FL, USA
| | - Hans Lapica
- Holy Cross Orthopedic Institute, Fort Lauderdale, FL, USA
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Brandl A, Bartsch K, James H, Miller ME, Schleip R. Influence of Rolfing Structural Integration on Active Range of Motion: A Retrospective Cohort Study. J Clin Med 2022; 11:jcm11195878. [PMID: 36233746 PMCID: PMC9570915 DOI: 10.3390/jcm11195878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 09/27/2022] [Accepted: 10/02/2022] [Indexed: 12/05/2022] Open
Abstract
Background: Recent work has investigated significant force transmission between the components of myofascial chains. Misalignments in the body due to fascial thickening and shortening can therefore lead to complex compensatory patterns. For the treatment of such nonlinear cause−effect pathology, comprehensive neuromusculoskeletal therapy such as the Rolf Method of Structural Integration (SI) could be targeted. Methods: A total of 727 subjects were retrospectively screened from the medical records of an SI practice over a 23-year period. A total of 383 subjects who had completed 10 basic SI sessions met eligibility criteria and were assessed for active range of motion (AROM) of the shoulder and hip before and after SI treatment. Results: Shoulder flexion, external and internal rotation, and hip flexion improved significantly (all p < 0.0001) after 10 SI sessions. Left shoulder flexion and external rotation of both shoulders increased more in men than in women (p < 0.0001) but were not affected by age. Conclusions: An SI intervention could produce multiple changes in the components of myofascial chains that could help maintain upright posture in humans and reduce inadequate compensatory patterns. SI may also affect differently the outcome of some AROM parameters in women and men.
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Affiliation(s)
- Andreas Brandl
- Department of Sports Medicine, Faculty for Psychology and Human Movement Science, Institute for Human Movement Science, University of Hamburg, 20148 Hamburg, Germany
- Department for Medical Professions, Diploma Hochschule, 37242 Bad Sooden-Allendorf, Germany
- Osteopathic Research Institute, Osteopathie Schule Deutschland, 22297 Hamburg, Germany
| | - Katja Bartsch
- Department of Sport Science and Sports, Friedrich-Alexander University Erlangen-Nürnberg, 91058 Erlangen, Germany
| | - Helen James
- Department of Physical Therapy, California State University, Fresno, CA 93740, USA
| | - Marilyn E. Miller
- Department of Physical Therapy, University of St. Augustine for Health Sciences at San Diego, San Diego, CA 92069, USA
| | - Robert Schleip
- Department for Medical Professions, Diploma Hochschule, 37242 Bad Sooden-Allendorf, Germany
- Conservative and Rehabilitative Orthopedics, Department of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany
- Correspondence: ; Tel.: +49-89-289-24561
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Lingampally PK, Doss ASA, Kadiyam VR. Wearable neck assistive device strain evaluation study on surface neck muscles for head/neck movements. Technol Health Care 2022; 30:1503-1513. [PMID: 35723128 DOI: 10.3233/thc-220101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND This article examines a dynamic wearable assistive device for individuals suffering from pain in the neck. As a part of the clinical treatment, static braces/cervical collars are suggested, however, these collars aid the person in maintaining the upright position of the head but restrict the head motion to a single configuration. To address this problem, a dynamic wearable assistive cervical collar is fabricated based on human anatomical head/neck data. OBJECTIVE The objective of this study is to observe the strain acting on the neck surface muscles for bending and compression neck movements with and without the neck brace using a strain sensor. METHODS To evaluate the perform of this device, experimental trials were conducted on test subjects to find out the angular tilt of the head with the device worn using the cervical range of motion (CROM) device. In addition, a neck surface muscle strain study is also conducted using strain sensors to investigate the strain produced while using the wearable assistive device. The strain on the neck surface muscle is measured using NI-9236 strain DAQ (data acquisition system). In this experimental study, a group of aged individuals with minor neck pain were recruited to study the head/neck movements. RESULTS It was found that by using the proposed assistive device, test subjects were able to mimic 65% of human head/neck movements like flexion, extension, lateral bending, and rotation, and the strain generated from the neck surface muscle was minimal. CONCLUSION The results show that using the designed assistive device reduced the strain on neck surface muscle, and strain obtained is within the range of 40 × 10-6 to 80 × 10-6, and may aid in recovery of the individuals suffering with neck pain.
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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 (Basel) 2021; 21:s21237884. [PMID: 34883885 PMCID: PMC8659477 DOI: 10.3390/s21237884] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Abstract
CONTEXT Inadequate hip active range of motion (AROM) may stifle the energy flow through the kinematic chain and decrease pitching performance while increasing the risk for pitcher injury. OBJECTIVE To examine the relationship of hip AROM and pitching biomechanics during a fastball pitch in adolescent baseball pitchers. DESIGN Cross-Sectional study. SETTING Biomechanics laboratory. PARTICIPANTS A voluntary sample of 21 adolescent baseball pitchers (16.1 ± 0.8 yrs.; 183.9 ± 5.2 cm; 77.9 ± 8.3 kg). Main Outcome Measure (s): Bilateral hip internal rotation (IR), external rotation (ER), flexion, extension, and abduction AROM were measured. Three-dimensional biomechanics were assessed as participants threw from an indoor pitching mound to a strike zone net at regulation distance. Pearson correlation coefficients were used to determine correlations between hip AROM and biomechanical metrics. RESULTS Statistically significant negative correlations were found at foot contact between back hip ER AROM and back hip abduction angle (p=0.030, r=-0.474), back hip ER AROM and torso rotation angle (p=0.032, r=-0.468),and back hip abduction AROM and lead hip abduction angle (p=0.037, r=-0.458). Back hip extension AROM was positively correlated with increased stride length (p=0.043, r=0.446). Lead hip abduction AROM was also positively correlated with normalized elbow varus torque (p=0.034, r=0.464). CONCLUSIONS There were several relationships between hip AROM and biomechanical variables during the pitching motion. The findings support the influence hip AROM can have on pitching biomechanics. Overall, greater movement at the hips allows for the kinematic chain to work at its maximal efficiency, increasing pitch velocity potential.
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Affiliation(s)
- Maxwell L Albiero
- Maxwell L. Albiero, Medical Student, Medical College of Wisconsin, Wisconsin, Milwaukee, WI,
| | - Wesley Kokott
- Wesley Kokott, DPT, OCS, COMT, Senior Physical Therapist, Aurora Sports Health, Lake Geneva, WI,
| | - Cody Dziuk
- Cody Dziuk, Research Technologist II, Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI,
| | - Janelle A Cross
- Janelle A. Cross, PhD, Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI,
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Hoppe-Ludwig S, Armitage J, Turner KL, O'Brien MK, Mummidisetty CK, Koch LM, Kocherginsky M, Jayaraman A. Usability, functionality, and efficacy of a custom myoelectric elbow-wrist-hand orthosis to assist elbow function in individuals with stroke. J Rehabil Assist Technol Eng 2021; 8:20556683211035057. [PMID: 34471545 PMCID: PMC8404626 DOI: 10.1177/20556683211035057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 07/08/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction After stroke, upper limb impairment affects independent performance of activities of daily living. We evaluated the usability, functionality, and efficacy of a myoelectric elbow-wrist-hand orthosis to provide support, limit unsafe motion, and enhance the functional motion of paralyzed or weak upper limbs. Methods Individuals with stroke participated in a single-session study to evaluate the device. Ability to activate the device was tested in supported and unsupported shoulder position, as well as the elbow range of motion, ability to maintain elbow position, and ability to lift and hold a range of weights while using the device. Results No adverse events were reported. 71% of users were able to operate the device in all three active myoelectric activation modes (Biceps, Triceps, Dual) during testing. Users were able to hold a range of wrist weights (0.5–2 lbs) for 10–120 seconds, with the largest percentage of participants able to hold weights with the device in Biceps Mode. Conclusions The myoelectric elbow-wrist-hand orthosis improved range of motion during use and was efficacious at remediating upper extremity impairment after stroke. All users could operate the device in at least one mode, and most could lift and hold weights representative of some everyday objects using the device.
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Affiliation(s)
- Shenan Hoppe-Ludwig
- Max Nader Center for Rehabilitation Technologies & Outcomes Research, Shirley Ryan AbilityLab, Chicago, USA.,Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, USA
| | - Jodi Armitage
- Max Nader Center for Rehabilitation Technologies & Outcomes Research, Shirley Ryan AbilityLab, Chicago, USA.,Northwestern Memorial Hospital, Chicago, USA
| | - Kristi L Turner
- Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, USA
| | - Megan K O'Brien
- Max Nader Center for Rehabilitation Technologies & Outcomes Research, Shirley Ryan AbilityLab, Chicago, USA.,Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, USA.,Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, USA
| | - Chaithanya K Mummidisetty
- Max Nader Center for Rehabilitation Technologies & Outcomes Research, Shirley Ryan AbilityLab, Chicago, USA.,Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, USA
| | - Lori McGee Koch
- Max Nader Center for Rehabilitation Technologies & Outcomes Research, Shirley Ryan AbilityLab, Chicago, USA.,Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, USA
| | - Masha Kocherginsky
- Department of Preventive Medicine (Biostatistics), Northwestern University, Chicago, USA
| | - Arun Jayaraman
- Max Nader Center for Rehabilitation Technologies & Outcomes Research, Shirley Ryan AbilityLab, Chicago, USA.,Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, USA.,Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, USA
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Huang X, Lin D, Liang Z, Deng Y, He Z, Wang M, Tan J, Li Y, Yang Y, Huang W. Mechanical Parameters and Trajectory of Two Chinese Cervical Manipulations Compared by a Motion Capture System. Front Bioeng Biotechnol 2021; 9:714292. [PMID: 34381767 PMCID: PMC8351596 DOI: 10.3389/fbioe.2021.714292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 06/29/2021] [Indexed: 12/29/2022] Open
Abstract
Objective: To compare the mechanical parameters and trajectory while operating the oblique pulling manipulation and the cervical rotation–traction manipulation. Methods: An experimental research measuring kinematics parameter and recording motion trajectories of two cervical manipulations were carried out. A total of 48 healthy volunteers participated in this study, who were randomly divided into two groups of 24 representing each of the two manipulations. A clinician performed two manipulations in two groups separately. A motion capture system was used to monitor and analyze kinematics parameters during the operation. Results: The two cervical manipulations have similar thrust time, displacement, mean velocity, max velocity, and max acceleration. There were no significant differences in active and passive amplitudes between the two cervical rotation manipulations. The thrust amplitudes of the oblique pulling manipulation and the cervical rotation–traction manipulation were 5.735 ± 3.041° and 2.142 ± 1.742°, respectively. The thrust amplitudes of the oblique pulling manipulation was significantly greater than that of the cervical rotation–traction manipulation (P < 0.001). Conclusion: Compared with the oblique pulling manipulation, the cervical rotation–traction manipulation has a less thrust amplitudes.
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Affiliation(s)
- Xuecheng Huang
- National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.,Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Medical Biomechanics, Southern Medical University, Guangzhou, China.,Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Dongxin Lin
- National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.,Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Medical Biomechanics, Southern Medical University, Guangzhou, China
| | - Zeyu Liang
- National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.,Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Medical Biomechanics, Southern Medical University, Guangzhou, China
| | - Yuping Deng
- National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.,Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Medical Biomechanics, Southern Medical University, Guangzhou, China
| | - Zaopeng He
- Hand and Foot Surgery and Plastic Surgery, Affiliated Shunde Hospital of Guangzhou Medical University, Foshan, China
| | - Mian Wang
- National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.,Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Medical Biomechanics, Southern Medical University, Guangzhou, China
| | - Jinchuan Tan
- National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.,Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Medical Biomechanics, Southern Medical University, Guangzhou, China
| | - Yikai Li
- School of Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Yang Yang
- National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.,Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Medical Biomechanics, Southern Medical University, Guangzhou, China
| | - Wenhua Huang
- National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.,Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Medical Biomechanics, Southern Medical University, Guangzhou, China
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Bayle N, Maisonobe P, Raymond R, Balcaitiene J, Gracies JM. Composite active range of motion (CX A) and relationship with active function in upper and lower limb spastic paresis. Clin Rehabil 2020; 34:803-811. [PMID: 32336148 PMCID: PMC7263039 DOI: 10.1177/0269215520911970] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study is to evaluate a novel composite measure of active range of motion (XA) and determine whether this measure correlates with active function. DESIGN Post hoc analysis of two randomized, placebo-controlled, double-blind studies with open-label extensions exploring changes in active function with abobotulinumtoxinA. SETTING Tertiary rehabilitation centers in Australia, Europe, and the United States. SUBJECTS Adults with upper (n = 254) or lower (n = 345) limb spastic paresis following stroke or brain trauma. INTERVENTIONS AbobotulinumtoxinA (⩽5 treatment cycles) in the upper or lower limb. MAIN MEASURES XA was used to calculate a novel composite measure (CXA), defined as the sum of XA against elbow, wrist, and extrinsic finger flexors (upper limb) or soleus and gastrocnemius muscles (lower limb). Active function was assessed by the Modified Frenchay Scale and 10-m comfortable barefoot walking speed in the upper limb and lower limb, respectively. Correlations between CXA and active function at Weeks 4 and 12 of open-label cycles were explored. RESULTS CXA and active function were moderately correlated in the upper limb (P < 0.0001-0.0004, r = 0.476-0.636) and weakly correlated in the lower limb (P < 0.0001-0.0284, r = 0.186-0.285) at Weeks 4 and 12 of each open-label cycle. Changes in CXA and active function were weakly correlated only in the upper limb (Cycle 2 Week 12, P = 0.0160, r = 0.213; Cycle 3 Week 4, P = 0.0031, r = 0.296). Across cycles, CXA improvements peaked at Week 4, while functional improvements peaked at Week 12. CONCLUSION CXA is a valid measure for functional impairments in spastic paresis. CXA improvements following abobotulinumtoxinA injection correlated with and preceded active functional improvements.
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Affiliation(s)
- Nicolas Bayle
- EA 7377 BIOTN, Service de Rééducation Neurolocomotrice, Université Paris-Est Créteil, Hospital Albert Chenevier-Henri Mondor, Créteil, France
| | | | | | | | - Jean-Michel Gracies
- EA 7377 BIOTN, Service de Rééducation Neurolocomotrice, Université Paris-Est Créteil, Hospital Albert Chenevier-Henri Mondor, Créteil, France
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Corrigan MC, Foulds RA. Evaluation of admittance control as an alternative to passive arm supports to increase upper extremity function for individuals with Duchenne muscular dystrophy. Muscle Nerve 2020; 61:692-701. [PMID: 32128840 DOI: 10.1002/mus.26848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/26/2020] [Accepted: 02/29/2020] [Indexed: 02/04/2023]
Abstract
The degree of upper extremity active range of motion provided by an admittance control robot compared with a commercially available passive arm support for individuals with DMD who have limited arm function was investigated in this study. The reachable workspace evaluation was used to assess active range of motion provided by both devices. A visual analog scale was also used to secure participant-reported outcome measures. The admittance control robot significantly increased reachable surface area scores compared with the passive arm support for the dominant arm (Wilcoxon T = 5, P = .022, r2 = 0.263) and for the nondominant arm (paired-samples t test, t(9) = 4.66, P = .001, r2 = 0.71). The admittance control robot also significantly decreased participant-reported exertion compared with the passive arm support. Results of this study substantiated the benefits of admittance control for individuals with DMD compared with a commercially available passive arm support.
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Affiliation(s)
- Madeline C Corrigan
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA
| | - Richard A Foulds
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA
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10
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Vomacka MM, Calhoun MR, Lininger MR, Ko J. Dorsiflexion Range of Motion in Copers and Those with Chronic Ankle Instability. Int J Exerc Sci 2019; 12:614-622. [PMID: 31156741 PMCID: PMC6533100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The Cumberland Ankle Instability Tool (CAIT) is used to classify individuals as ankle sprain copers, or as one suffering from chronic ankle instability (CAI). However, literature examining factors contributing to these classifications on the CAIT is lacking, as the CAIT itself does not offer explanations for specific anthropometric measures that influence a patient's classification. Therefore, the purpose was to determine if there was a difference between dorsiflexion active range of motion (AROM) between copers, those with CAI, and a healthy control group. Twenty-two individuals with recent ankle sprains were recruited by a convenience sampling method and placed in the coper (5 females, 5 males, age: 21.9 ± 1.5 years, height: 173.74 ± 7.69 cm, weight: 69.75 ± 10.50 kg) or CAI (10 females, 2 males, age: 21.8 ± 2.3 years, height: 173.99 ± 10.86 cm, weight: 68.14 ± 10.63 kg) groups. The remaining 10 individuals (4 females, 6 males, age: 23.2 ± 1.5 years, height: 178.05 ± 12.92 cm, weight: 75.65 ± 8.00 kg) who participated in the study served as control, as they had never sustained a previous ankle sprain. Dorsiflexion AROM measurements were evaluated using an inclinometer during a weight-bearing lunge. Three measurements were taken for each participant and used for statistical analysis. There was no statistically significant difference in average dorsiflexion AROM between the coper, control, and CAI groups (F2,29 = 2.063, p = 0.15, ω = 0.06, 1 - β = 0.40). Further research is needed to determine if limited dorsiflexion AROM is indeed a contributing factor to an individual's classification as a coper or suffering from CAI, as defined by the CAIT.
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Affiliation(s)
- Madison M Vomacka
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ, USA
| | - Melena R Calhoun
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ, USA
| | - Monica R Lininger
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ, USA
| | - Jupil Ko
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ, USA
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Nath R, Somasundaram C. Excellent Recovery of Shoulder Movements After Decompression and Neurolysis of Long Thoracic Nerve in Teen Patients With Winging Scapula. Eplasty 2019; 19:e15. [PMID: 31080543 PMCID: PMC6489425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Introduction: In teens, athletes, in general, have been found to have shoulder pain and or winging scapula resulting from long thoracic or spinal accessory nerve injuries. Accident (fall) and stretch injuries due to overuse and poor sports techniques mainly cause these injuries that affect their upper extremity movements and functions. Here, we report a significant improvement in scapula winging and shoulder active range of motion in 16 teen patients after long thoracic nerve decompression and neurolysis. Patients and Methods: This was a retrospective study of 16 teen patients who had severe winging scapula and poor shoulder movements and function. Therefore, they underwent decompression and neurolysis of long thoracic nerve with us, between 2005 and 2016. The average patient age was 17 years (range, 14-19 years). These patients had been suffering from paralysis for an average of 15 months (range, 2-48 months). All patients underwent a preoperative electromyographic assessment in addition to clinical evaluation to confirm the long thoracic nerve injury. Results: Scapula winging was severe in 10 of 16 patients (63%), moderate in 2 patients (12%), and mild in 4 patients (25%) in our present study. Mean shoulder abduction (128°) and flexion (138°) were poor preoperatively. Shoulder abduction and flexion improved to 180° in 15 patients (94%) and good (120°) in 1 patient (6%) at least 2 months after surgery. In 11 patients (69%), the winged scapula was completely corrected postsurgically and it was less prominent in other 5 patients. Conclusion: Long thoracic nerve decompression and neurolysis significantly improved scapular winging in all 16 teen patients in our present study, producing "excellent" shoulder movements in 15 patients (94%) and "good" result in 1 patient (6%).
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Affiliation(s)
- Rahul K. Nath
- Texas Nerve and Paralysis Institute, Houston,Correspondence:
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Rhyu HS, Han HG, Rhi SY. The effects of instrument-assisted soft tissue mobilization on active range of motion, functional fitness, flexibility, and isokinetic strength in high school basketball players. Technol Health Care 2018; 26:833-842. [PMID: 30103358 DOI: 10.3233/thc-181384] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although many studies have focused on stretching techniques for athletes, no comprehensive studies have investigated the use of the instrument-assisted soft tissue mobilization (IASTM) technique in young basketball players. The active properties of muscle and subjective reporting of functional ability were used to identify the effects of IASTM on the calf muscle. Active range of motion (AROM), functional fitness, and isokinetic lower strength in the knees and ankles were measured in 40 healthy young basketball players. They were divided into the IASTM group (n= 20) and a control group (CG, n= 20). Twenty asymptomatic young basketball players were treated with IASTM six times per week for 8 weeks. The remaining 20 participants did not receive a treatment intervention between tests and served as the control. Ankle AROM (two knee positions of 0∘ and 45∘ flexion), functional fitness at the knee and ankle (side-step and vertical jump), and isokinetic peak torque were determined during ankle dorsiflexion (DF) and plantar flexion (PF) and knee extension (EX) and flexion (FX). The data were analyzed using repeated-measures analysis of variance. Significant differences were observed between the two groups in IASTM and control AROM 0∘ knee flexion (right: DF; p< 0.001 and PF; p< 0.001; left: DF; p< 0.001 and PF; p= 0.011), AROM 45∘ knee flexion (right: DF; p< 0.001 and PF; p= 0.009; left: DF; p< 0.001 and PF; p= 0.001), functional fitness (side step; p= 0.001, sit and reach; p= 0.025, vertical jump; p= 0.001), ankle isokinetic strength 30∘/sec (right: DF; p= 0.001 and PF; p= 0.001; left: DF; p< 0.001 and PF; p= 0.002), ankle isokinetic strength 120∘/sec (right: DF; p= 0.049 and PF; p= 0.001; left: DF; p= 0.023 and PF; p< 0.001), knee isokinetic strength 60∘/sec (right: EX; p= 0.001, FX; p= 0.001 and hamstring and quadriceps ratio [H/Q]; p= 0.001, left: EX; p= 0.001, FX; p= 0.001 and H/Q; p= 0.001), and knee isokinetic strength 180∘/sec (right: EX; p= 0.001, FX; p= 0.001 and H/Q; p= 0.001; left: EX; p= 0.001, FX; p= 0.010 and H/Q; p= 0.001). These results suggest that IASTM improves functional fitness and lower body muscle strength in young basketball players.
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Affiliation(s)
- Hyun-Seung Rhyu
- Department of Physical Education, Jungwon University, Goesan, Korea
| | | | - Soung-Yob Rhi
- Health and Exercise Science, Institute of Sports Science, Seoul National University, Seoul, Korea
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Kluczynski MA, Isenburg MM, Marzo JM, Bisson LJ. Does Early Versus Delayed Active Range of Motion Affect Rotator Cuff Healing After Surgical Repair? A Systematic Review and Meta-analysis. Am J Sports Med 2016; 44:785-91. [PMID: 25943112 DOI: 10.1177/0363546515582032] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The timing of passive range of motion (ROM) after surgical repair of the rotator cuff (RC) has been shown to affect healing. However, it is unknown if early or delayed active ROM affects healing. PURPOSE To determine whether early versus delayed active ROM affects structural results of RC repair surgery. STUDY DESIGN Systematic review and meta-analysis. METHODS A systematic review of articles published between January 2004 and April 2014 was conducted. Structural results were compared for early (<6 weeks after surgery) versus delayed (≥6 weeks after surgery) active ROM using chi-square and Fisher exact tests, as well as relative risks (RRs) and 95% CIs. The analyses were stratified by tear size and repair method. RESULTS A total of 37 studies (2251 repairs) were included in the analysis, with 10 (649 repairs) in the early group and 27 (1602 repairs) in the delayed group. For tears ≤3 cm, the risk of a structural tendon defect was higher in the early versus delayed group for transosseous plus single-row suture anchor repairs (39.7% vs 24.3%; RR, 1.63 [95% CI, 1.28-2.08]). For tears >3 cm, the risk of a structural tendon defect was higher in the early versus delayed group for suture bridge repairs (48% vs 17.5%; RR, 2.74 [95% CI, 1.59-4.73]) and all repair methods combined (40.5% vs 26.7%; RR, 1.52 [95% CI, 1.17-1.97]). For tears >5 cm, the risk of structural tendon defect was higher in the early versus delayed group for suture bridge repairs (100% vs 16.7%; RR, 6.00 [95% CI, 1.69-21.26]). There were no statistically significant associations for tears measuring ≤1, 1-3, or 3-5 cm. CONCLUSION Early active ROM was associated with increased risk of a structural defect for small and large RC tears, and thus might not be advisable after RC repair.
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Affiliation(s)
| | - Maureen M Isenburg
- University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - John M Marzo
- University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Leslie J Bisson
- University at Buffalo, The State University of New York, Buffalo, New York, USA
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Kim TH, Kim EH, Cho HY. The effects of the CORE programme on pain at rest, movement-induced and secondary pain, active range of motion, and proprioception in female office workers with chronic low back pain: a randomized controlled trial. Clin Rehabil 2014; 29:653-62. [PMID: 25269569 DOI: 10.1177/0269215514552075] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 08/28/2014] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate the effects of the CORE programme on pain at rest, movement-induced pain, secondary pain, active range of motion, and proprioception deficits in female office workers with chronic low back pain. DESIGN Randomized controlled trial. SETTING Rehabilitation clinics. SUBJECTS A total of 53 participants with chronic low back pain were randomized into the CORE group and the control group. INTERVENTION CORE group participants underwent the 30-minute CORE programme, five times per week, for eight weeks, with additional use of hot-packs and transcutaneous electrical nerve stimulation, while the control group used only hot-packs and transcutaneous electrical nerve stimulation. MAIN MEASURES Participants were evaluated pretest, posttest, and two months after the intervention period to measure resting and movement-induced pain, pressure pain as secondary pain, active range of pain-free motion, and trunk proprioception. RESULTS Pain intensity at rest (35.6 ±5.9 mm) and during movement (39.4 ±9.1 mm) was significantly decreased in the CORE group following intervention compared with the control group. There were significant improvements in pressure pain thresholds (quadratus lumborum: 2.2 ±0.7 kg/cm(2); sacroiliac joint: 2.0 ±0.7 kg/cm(2)), active range of motion (flexion: 30.8 ±14.3°; extension: 6.6 ±2.5°), and proprioception (20° flexion: 4.3 ±2.4°; 10° extension: 3.1 ±2.0°) in the CORE group following intervention (all p < 0.05). These improvements were maintained at the two-month follow-up. The control group did not show significant improvements in any measured parameter. CONCLUSION The CORE programme is an effective intervention for reducing pain at rest and movement-induced pain, and for improving the active range of motion and trunk proprioception in female office workers with chronic low back pain.
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Affiliation(s)
- Tae Hoon Kim
- The Post-Professional DPT Program, The Richard Stockton College of New Jersey, Galloway, NJ, USA
| | - Eun-Hye Kim
- Department of Physical Therapy, Korea University, Seoul, South Korea
| | - Hwi-young Cho
- Department of Physical Therapy, Gachon University, Incheon, South Korea
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Collin P, Matsumura N, Lädermann A, Denard PJ, Walch G. Relationship between massive chronic rotator cuff tear pattern and loss of active shoulder range of motion. J Shoulder Elbow Surg 2014; 23:1195-202. [PMID: 24433628 DOI: 10.1016/j.jse.2013.11.019] [Citation(s) in RCA: 180] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 10/07/2013] [Accepted: 11/06/2013] [Indexed: 02/01/2023]
Abstract
BACKGROUND Management of massive chronic rotator cuff tears remains controversial, with no clearly defined clinical presentation as yet. The purpose of the study was to evaluate the effect of tear size and location on active motion in patients with chronic and massive rotator cuff tears with severe muscle degeneration. METHODS One hundred patients with massive rotator cuff tears accompanied by muscle fatty infiltration beyond Goutallier stage 3 were prospectively included in this study. All patients were divided into 5 groups on the basis of tear pattern (supraspinatus, superior subscapularis, inferior subscapularis, infraspinatus, and teres minor). Active range of shoulder motion was assessed in each group and differences were analyzed. RESULTS Active elevation was significantly decreased in patients with 3 tear patterns involved. Pseudoparalysis was found in 80% of the cases with supraspinatus and complete subscapularis tears and in 45% of the cases with tears involving the supraspinatus, infraspinatus, and superior subscapularis. Loss of active external rotation was related to tears involving the infraspinatus and teres minor; loss of active internal rotation was related to tears of the subscapularis. CONCLUSIONS This study revealed that dysfunction of the entire subscapularis and supraspinatus or 3 rotator cuff muscles is a risk factor for pseudoparalysis. For function to be preserved in patients with massive chronic rotator cuff tears, it may be important to avoid fatty infiltration with anterior extension into the lower subscapularis or involvement of more than 2 rotator cuff muscles.
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Affiliation(s)
- Philippe Collin
- Saint-Grégoire Private Hospital Center, Saint-Grégoire, France.
| | - Noboru Matsumura
- Department of Orthopedic Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - Alexandre Lädermann
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Patrick J Denard
- Southern Oregon Orthopedics, Medford, OR, and Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA
| | - Gilles Walch
- Santy Orthopaedic Center and Jean-Mermoz Private Hospital, Lyon, France
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