EP66 Active hip range of motion in FAIS patients: IMU-based evidence of deficits beyond bony conflict.

Femoroacetabular impingement syndrome (FAIS) is characterized by hip pain and restricted range of motion (ROM), typically due to structural conflict between the femoral neck and the acetabulum. This study aimed to quantify active ROM limitations in FAIS patients, comparing them with healthy controls to establish normative values, particularly in non-conflicting directions. Methods: A total of 53 FAIS patients scheduled for hip arthroscopy were compared to 49 healthy matched controls. Active ROM was assessed using inertial measurement unit (IMU) sensors, with measurements taken in standing and prone positions. Outcomes included flexion, external rotation, internal rotation, and total rotation ROM, alongside demographic and radiographic data. Gender-based ROM differences were also analyzed. Results: FAIS patients demonstrated significant reductions in flexion, internal rotation, and total rotation ROM in the involved hip, with large effect sizes, while external rotation remained unaffected. ROM in the uninvolved hip was also lower than in controls but showed increased external rotation. Gender differences were observed, with females exhibiting significantly higher internal rotation and, in healthy controls, greater total rotation than males. Conclusions: FAIS patients have significant active ROM restrictions in non-conflicting directions, suggesting broader joint limitations potentially tied to early hip osteoarthritis or capsular and musculoskeletal adaptations. Gender differences highlight the importance of individualized ROM assessment. This study introduces IMU-based ROM evaluation as a promising tool for diagnosing and monitoring FAIS, providing insights into functional impairments that can be used to guide targeted interventions.

Treatment of a rotator cuff tear with concomitant complete brachial plexopathy after glenohumeral dislocation: a case report

OBJECTIVES: To investigate the effect of different durations of stretching (five or 15 seconds) on active and passive range of motion (ROM) in the lower extremity during a five week...

This study was conducted to determine the effect of increasing age on four shoulder movements and to explore the need for normative data for shoulder range of motion (ROM) in people aged 50 years and older. Forty-one participants were conveniently recruited according to four age categories: 50–59 years, 60–69 years, 70–79 years and 80 years and over. Goniometric measurement of bilateral active and passive ROM for flexion, abduction, internal rotation and external rotation was analysed using paired sample t-tests and compared with the norms of the American Academy of Orthopaedic Surgeons (AAOS) using one sample t-tests. Passive ROM was greater than active ROM for all movements (p<0.001). Active and passive ROM were significantly (p<0.01) lower than the AAOS norms, except for passive external rotation (p = 0.07). The General Linear Model procedure was used to determine the effect of age, gender, activity level, work history and body mass index on active ROM. The results showed that age (p = 0.001) and work history (p = 0.012) significantly influenced flexion, work history (p = 0.008) significantly influenced abduction and gender (p = 0.018) significantly influenced internal rotation. None of the independent variables influenced active external rotation. Preliminary normative data are presented as percentiles by age and work history for clinical reference. Comparing patients' ROM measurements with age-related and activity-related norms will assist occupational therapists in establishing realistic goals during rehabilitation.

In Vivo Hip Morphology and Kinematics in Elite Baseball Pitchers

Objective measurement of range of motion of the glenohumeral joint is important for the rehabilitation and prevention of shoulder injury. The primary purpose of this study was to determine whether significant differences exist between the dominant (tennis playing) and nondominant extremity in active internal and external rotation range of motion in elite junior tennis players 11-17 years of age. Two hundred three elite junior tennis players (113 males, 90 females) were bilaterally measured for internal and external rotation at 90 degrees of abduction in a supine position with a specific methodology attempting to isolate glenohumeral motion, while minimizing or negating scapulothoracic motion. A standard universal goniometer was utilized to measure active range of motion (AROM). Dependent t tests were used to compare differences between extremities. No significant difference was found for males or females between the dominant and nondominant arm in external rotation. Analysis of internal rotation (AROM) differences showed significantly less (p < .001) internal rotation (AROM) on the dominant arm for both males and females. Significantly less (p < .001) dominant arm total rotational range of motion was also found in both males and females. The loss of dominant arm internal rotation (AROM) has clinical application for both the development of rehabilitation and preventative flexibility/range of motion programs.

BackgroundAmong the thumb deformities observed in rheumatoid arthritis (RA), boutonnière deformities are the most common and account for 70% of all deformities present. However, it is difficult to determine the...

The purpose of this study was to assess the acute effects of vibration and stretching on passive and active forward split range of motion in elite adult female synchronized swimmers. Eleven athletes performed a passive forward split test measuring the height of the anterior superior iliac spine on both sides and an active split test on both sides by adopting an inverted split position. Then athletes were assigned randomly by right or left leg to receive vibration on one leg while stretching. The contralateral leg was stretched but did not receive vibration and served as the control. The treatment involved a 40-s exposure to vibration of the forward leg in a split and 40 s of vibration to the rear leg in a split. The athletes were then post-tested using the same protocols. The results indicated that the vibration had a statistically significant influence on passive forward split flexibility, but not active split flexibility. The results of this study confirm earlier work and further demonstrate the efficacy of vibration in enhancing range of motion in a passive split position. Given that it is often difficult to achieve large changes in range of motion with already highly trained elite athletes, this methodology shows considerable promise. Vibration may not be powerful enough to evoke changes in active range of motion in spite of the changes in passive range of motion.

PURPOSE: This case study discusses a 71 year old male subject who underwent a Reverse Total Shoulder Replacement (RTSR), a fairly new surgical procedure performed to address shoulder dysfunction. This procedure involves utilizing a concave prosthetic component on the humerus and a convex component on the scapula instead of the convex humeral and concave scapular components typically used in conventional shoulder joint replacements. Since the procedure is just now beginning to be performed in the United States, it is important to make health professionals aware of the technique, why it is utilized, and what outcomes may be expected. METHODS: The subject of this case study was five days post surgery upon initial physical therapy evaluation. Only passive range of motion (ROM) was allowed for the first month of treatment, within the following ranges: external rotation (ER) to 25° in neutral, ER to 60° at 90° of abduction, and internal rotation of hand to hip only. More aggressive treatment including active assisted ROM and active ROM was initiated after one month along with light strengthening including shoulder isometrics and scapular stability exercises. Therapy progressed to more aggressive strengthening of the entire upper extremity and scapular region, and also included Russian electrical stimulation to the deltoid for neuromuscular re-education. RESULTS: After fifty therapy sessions, passive shoulder ROM had noticeably increased for all shoulder motions. Active ROM of shoulder flexion improved from 90° to 150° and abduction increased from 80° to 130°. Active ER ROM only minimally improved; from neutral to 60°. The subject was able to return to most activities of daily living, and was able to functionally swing a golf club without increased pain. CONCLUSIONS: Results seen with this subject do not necessarily compare favorably to a standard shoulder joint replacement. The subject required a lengthy course of rehabilitation and had residual limitations in ROM and muscle strength. These deficits, however, could be due to the subject's significantly deteriorated deltoid and rotator cuff strength that was present prior to the surgery. Because RTSR surgery may become more prevalent in the future, therapists need to be aware of this new procedure and incorporate therapeutic interventions that may lead to positive outcomes.

Measuring joint range of motion has traditionally occurred with a universal goniometer, inclinometer, or expensive laboratory systems. The popularity of the inertial measurement unit (IMU) is growing, enabling the small and even single portable device to measure the range of motion. Until now, they were not used to assess hip joint range of motion. Our study aimed to check the validity of IMUs in assessing hip range of motion and compare them to other measurement devices-universal goniometer and inclinometer. Twenty participants completed three hip movements (flexion in standing and prone internal and external rotation) on both hips. Two testers independently assessed each movement with a goniometer, digital inclinometer, and IMU at different time points. To assess the agreement of active hip ROM between devices, Intraclass Correlation Coefficient (ICC) and Bland-Altman analysis were used. Furthermore, inter-rater and intra-rater reliability were also assessed by using ICC and Bland-Altman analysis. Limits of agreement (LOA) were calculated using Bland-Altman plots. The IMU demonstrated good to excellent validity (ICC: 0.87-0.99) compared to the goniometer and digital inclinometer, with LOAs < 9°, across all tested movements. Intra-rater reliability was excellent for all devices (ICC: 0.87-0.99) with LOAs < 7°. However, inter-rater reliability was moderate for flexion (ICC: 0.58-0.59, LOAs < 22.4) and poor for rotations (ICC: -0.33-0.04, LOAs < 7.8°). The present study shows that a single inertial measurement unit (RSQ Motion, RSQ Technologies, Poznan, Poland) could be successfully used to assess the active hip range of motion in healthy subjects, comparable to other methods accuracy.

The impact upper extremity impairments (UE) have on UE function in breast cancer survivors (BCS) is unclear. The purpose of this study was to evaluate the associations between upper extremity active range of motion (AROM), passive range of motion (PROM), and strength with self-reported function in BCS. BCS (n = 24) completed the Disabilities of Arm, Shoulder and Hand (DASH) and the Pennsylvania Shoulder Score (PSS). AROM and PROM of shoulder flexion, extension, external rotation (ER) at 0° and 90° of abduction, and internal rotation (IR) at 90° of abduction were measured using a digital inclinometer. Strength was measured using a hand-held dynamometer for scapular abduction and upward rotation, scapular depression and adduction, flexion, IR, ER, scaption, and horizontal adduction. All constructs of AROM, PROM, and strength were correlated with the DASH and PSS. DASH was moderately to highly correlated with 2 of 5 AROM, 2 of 5 PROM, and 6 of 7 shoulder strength measures. PSS was moderately to highly correlated with 2 of 5 AROM, 2 of 5 PROM, and 4 of 7 shoulder strength measures. Regression analysis showed that AROM explained 40% of the DASH scores and strength explained 20% of scores on the PSS. This study characterizes the impact that shoulder motion, flexibility, and strength losses have on shoulder function in BCS. Deficits in AROM and shoulder strength explained the greatest proportion of shoulder disability. Future clinical trials should consider incorporating AROM and strengthening techniques to improve shoulder use after breast cancer treatments.

Background Repetitive loading to the hip joint in athletes has been reported as a factor in the development of degenerative joint disease and intra-articular injury. Little information is available on the bilateral symmetry of hip rotational measures in unilaterally dominant upper extremity athletes. Hypothesis Side-to-side differences in hip joint range of motion may be present because of asymmetrical loading in the lower extremities of elite tennis players and professional baseball pitchers. Study Design Cohort (cross-sectional) study (prevalence); Level of evidence, 1. Methods Descriptive measures of hip internal and external rotation active range of motion were taken in the prone position of 64 male and 83 female elite tennis players and 101 male professional baseball pitchers using digital photos and computerized angle calculation software. Bilateral differences in active range of motion between the dominant and nondominant hip were compared using paired t tests and Bonferroni correction for hip internal, external, and total rotation range of motion. A Pearson correlation test was used to test the relationship between years of competition and hip rotation active range of motion. Results No significant bilateral difference (P > .005) was measured for mean hip internal or external rotation for the elite tennis players or the professional baseball pitchers. An analysis of the number of subjects in each group with a bilateral difference in hip rotation greater than 10° identified 17% of the professional baseball pitchers with internal rotation differences and 42% with external rotation differences. Differences in the elite male tennis players occurred in only 15% of the players for internal rotation and 9% in external rotation. Female subjects had differences in 8% and 12% of the players for internal and external rotation, respectively. Statistical differences were found between the mean total arc of hip range of internal and external rotation in the elite tennis players with the dominant side being greater by a clinically insignificant mean value of 2.5°. Significantly less (P < .005) dominant hip internal rotation and less dominant and nondominant hip total rotation range of motion were found in the professional baseball pitchers compared with the elite male tennis players. Conclusion This study established typical range of motion patterns and identified bilaterally symmetric hip active range of motion rotation values in elite tennis players and professional baseball pitchers. Asymmetric hip joint rotational active range of motion encountered during clinical examination and screening may indicate abnormalities and would indicate the application of flexibility training, rehabilitation, and further evaluation.

Active range of motion in the cervical spine increases after spinal manipulation (toggle recoil)

The relationship between kinesiophobia and self-reported outcomes and physical function differs between women and men with femoroacetabular impingement syndrome

The purpose of this study was to describe the relationship between deficits in active range of motion (ROM) at the elbow and both agonist muscle strength and antagonist muscle tone in patients with stroke. Twenty-three patients with non-flaccid hemiparesis participated. Active elbow flexion and extension ROM were measured gravity eliminated bilaterally and ROM deficits were calculated for the paretic side. Isometric elbow flexion and extension strength were measured on the paretic side using a hand-held dynamometer. Elbow flexor and extensor muscle tone were graded manually using the Modified Ashworth Scale. The Spearman correlations between active elbow flexion ROM deficits and elbow flexion force, and between active elbow extension ROM deficits and elbow extension force were -.929 and -.772 respectively. The correlations between the elbow flexion ROM deficits and elbow extensor muscle tone, and between the elbow extension ROM deficits and elbow flexor muscle tone were .287 and .480 respectively. Regression analysis revealed a curvilinear relationship between active elbow flexion ROM deficits and elbow flexion force (R =.881), and a linear relationship between active elbow extension ROM deficits and elbow extension force (R = .771). In patients like those tested, agonist muscle force (strength) may be more important than passive antagonist restraint (tone) as a determinant of ROM deficits. Because a limited amount of muscle force is required for full active ROM, increases in muscle strength beyond some threshold will not be accompanied by further improvements in active ROM.