Changes In ROM Research Articles

Investigation of Predisposing Risk Factors in Adolescent Male Water Polo Players.

Shoulder injuries are prevalent in adolescent water polo (WP) players. Study aimed to determine whether preseason shoulder characteristics (range of motion [ROM], flexibility, and strength) and core endurance can identify athletes at risk of future shoulder injuries. Shoulder characteristics, including changes in ROM (internal rotation [IR], external rotation [ER], and total), strength (IR and ER), pectoralis minor flexibility, shoulder capsule flexibility, and core endurance, would be risk factors for shoulder reinjury in athletes with previous overuse injuries compared with noninjured athletes. Prospective cohort study. Level 3. At baseline, 53 male youth WP players (mean age, 16.6 ± 3.5 years) were assigned to Group 1 (with previous shoulder injuries [G1, n = 26]) and Group 2 (without previous shoulder injuries [G2, n = 27]). ROM, flexibility, strength, and core muscle endurance were assessed preseason. After a 12-month follow-up, players were again divided into those who developed new shoulder injuries (G3, n = 27) and those who remained healthy (G4, n = 26). Total of 26 players (49%) had previous shoulder injuries at baseline. At baseline, decreased pectoralis minor flexibility, IR, total ROM, and core endurance were found in players with a previous shoulder injury compared with players without a previous shoulder injury (P < 0.05). At baseline, a significant difference was present in proposed risk factors (shoulder and core endurance parameters) between players with and without a previous shoulder injury. Shoulder IR ROM and years of experience were significant predictors of shoulder injury. Early detection of modifiable proposed risk factors may help prevent reinjury in young athletes. Screening at an early age can help identify and address pre-existing injuries, support youth athletes' return to sport after a shoulder injury, prevent new injuries, and improve performance.

The efficacy of the Novel Hybrid Passive Spring Damper Ankle Foot Orthosis regard to kinetic and kinematic parameters of patients with Multiple Sclerosis: An intervention study

ABSTRACT Drop foot is a common consequence of Multiple Sclerosis (MS), which may be improved somewhat by an ankle-foot orthosis (AFO). This study aimed to examine the immediate effect of using the recently developed Novel Hybrid Passive Spring Damper AFO (the novel HPSDAFO) on the kinetic and kinematic parameters of patients with MS (PwMS) in the sagittal plane. Twelve PwMS who suffered a unilateral drop foot participated in this study and fitted with the novel HPSDAFO. They walked with the novel HPSDAFO on the affected side and shoe on the affected side at a self-selected speed. Walking by the novel HPSDAFO, the symmetry of all of the evaluated sagittal kinetic and kinematic parameters improved noticeably. The range of ankle plantarflexion and knee flexion increased significantly at the stance phase. Power generation increased at all three joints. The peak of ankle dorsiflexion at early stances and the first peak of knee extension moments increased significantly but decreased at the hip joint. Changes in sagittal ROM, moment, and power generation in the plane and the improved symmetry revealed a more normal walking by using the novel HPSDAFO on the affected limb of PwMS.

The effect of different types of cupping therapy on acute changes in ankle dorsiflexion

IntroductionCupping therapy involves lifting and separating fascial tissue to facilitate stretching and promote blood flow. Although cupping is a common treatment modality for pain, various protocols exist and studies are inconsistent in regards to whether cupping improves outcomes such as range of motion. We aimed to determine the acute effect of different types of cupping therapy on ankle dorsiflexion. MethodsThirty-five generally healthy adults (mean ± SD; age: 22.1 ± 4.52 y; baseline ankle ROM: 34.68 ± 4.22°) were randomly assigned to one of four cupping therapy treatment groups: static, dynamic, static sham, or dynamic sham. Ankle ROM was measured using a digital inclinometer pre- and immediately post-intervention. ANCOVA was used to determine whether ROM differed between groups post-treatment when controlling for baseline ROM and the minimal detectable change (MDC) was used to determine clinical meaningfulness of the changes. ResultsBaseline ROM was significantly associated with post-intervention ROM (post-ROM: 38.41 ± 4.95°; p < .001), indicating an overall increase in ROM regardless of the intervention received. There was no difference in ROM between therapy groups post-intervention after controlling for baseline ROM. The dynamic cupping group experienced a change in ROM (baseline ROM: 34.11 ± 4.62°, post-ROM: 39.19 ± 6.44°) above the MDC (5.08°). ConclusionOur findings support cupping as a modality for improving ankle ROM in individuals with limited ROM. Dynamic cupping may be effective for improving ankle ROM due to the addition of functional movement. Clinicians may consider dynamic cupping as a potential intervention to address limited ankle ROM.

Immediate effects of a novel hand rehabilitation board on fine motor skills in children with cerebral palsy: A pilot study.

In children with cerebral palsy (CP), fine motor skills limit forearm supination and active extension of the elbow, wrist, or fingers. Therapeutic interventions focusing on improving the ranges at these joints while facilitating active movements are the key to augmenting fine motor skills. This pilot study examines if children with CP (with UE involvement) exposed to the Novel Hand Rehabilitation (NHR) Board will demonstrate 1) changes in spasticity and passive ROM of forearm and wrist/finger muscles, and 2) improvement in fine motor abilities. The forearm and wrist/fingers of children with spastic CP (N = 15; M = 7, F = 8) aged 49-72 months (65.33±6.355 months) were positioned on the NHR board till their tolerance limit or a minimum duration of 30 minutes. The outcome measures, i.e., spasticity (Modified Ashworth Scale), passive range of motion (PROM) of wrist and fingers, and fine motor skills (PDMS-2 - Fine motor scale), were recorded. The spasticity of forearm pronators (0.001) and wrist flexors (0.008) reduced significantly, but not in wrist extensors. Post-intervention improvements in wrist extension (p = 0.005) and ulnar deviation ROM (p = 0.007) were significant. In thumb, changes were non-significant for the CMC flexion, but extension (0.003) and abduction (0.001) as well as MCP extension (0.004) were significant. The post-intervention MCP extension ROM for the 2nd (0.001), 3rd (0.007), and 4th fingers (0.014) were also substantial, but not for PIP and DIP joints. The post-intervention percentage change in the Grasping and Visual-motor integration subtests of PDMS-2 was 11.03% (p = 0.002) and 5.09% (p = 0.001) respectively. The immediate effects on fine motor skills in children with CP after the NHR board application were positive and encouraging. Hence, the NHR board can be recommended as an intervention to improve the fine motor abilities of children with CP.

Ab. No. 89 Reproducibility of a Smartphone-Based Application for Assessing Knee Range of Motion

Introduction: Smartphone applications using in-built gyroscope chips are attractive options that can facilitate self-assessment of knee range of motion without having to wear a sensor-based device. Methods: A cross-sectional study was conducted to compare this smartphone-based app with universal goniometer (UG) in assessing active knee range of motion in sitting and lying position. Consecutive patients with knee osteoarthritis or those who had knee replacement or the healthy accompanier and hospital staff above 18 years of age and consenting to volunteer were approached for the study at a tertiary care academic hospital in India. The comparisons were repeated measurements with UG and test-app under same conditions, UG versus test-app, physiotherapist versus patient’s accompanier with test-app in the same phone, in different phones, and a physiotherapist measuring on different stool heights using test-app. We report mean difference between two measurements with 95% limits of agreement and intraclass correlation coefficient (ICC) calculated using one-way random effects. Result: The 95% LoA between the UG and test-app in supine flexion was -7.5° to +4.5° and extension was ±4°. The test retest 95% LoA of the test-app in supine flexion and sitting flexion across all scenarios was within ± 8.5°. The test-retest 95% limits of agreement of extension in sitting and supine position across all scenarios was within ±6.5°. Test-retest reliability (ICC) of knee flexion ranged between 0.70 to 0.99 and extension between 0.16 to 0.97 across all scenarios. Conclusion: The smartphone-based app is reliable to differentiate between various ranges of motion of knee with measurement errors no greater than universal goniometer. This app has the potential to measure changes in ROM that are above 8° of flexion and above 7° in extension.This app can enhance the ability to remotely measure and monitor knee ROM of pathologic knee.

Acute and prolonged hip kinematic changes after three different Kinesio Taping® interventions: A randomized placebo-controlled trial

Abstract Study aim: This study aimed to compare the acute and prolonged effects of three different Kinesio Taping (KT) techniques (underactive/overactive muscle correction [UMC]/[OMC] and functional correction [FC]) on hip ROM in the sagittal plane and compare them to those of the placebo Kinesio Taping (PKT) application. Materials and methods: The sample consisted of 56 young healthy participants of both genders who were randomly divided into four equal groups. Measurements were performed using Kinovea software for video analysis during the performance of an active straight leg raise and the modified Thomas test at three timepoints: before the intervention and 60 min and 48 h after the intervention. Results: Mixed-model ANOVA revealed a statistically significant interaction between group and timepoint (F = 6.210; p &lt; 0.001; ηp 2 = 0.285 for ipsilateral hip extension ROM; F = 2.064; p = 0.036; ηp 2 = 0.117 for contralateral hip flexion ROM). The results revealed acute and prolonged ROM changes after the application of three different KT techniques compared to those after the control procedure, but these changes were not significant. Conclusions: These findings support the use of KT as a modality for enhancing ROM. In muscle techniques, the factor of the anchor placement direction, with the same percentage of Kinesio tape tension, generates different effects. These effects were greater after 48 h than immediately after application. In changing the segmental posture or joint alignment, FC proved to be more intense than the KT muscle techniques, with an immediate effect that persisted even after two days.

Middle trapezius tendon transfer using Achilles allograft for irreparable isolated supraspinatus tendon tears effectively restores the superior stability of the humeral head without restricting range of motion: a biomechanical study

BackgroundMiddle trapezius tendon (MTT) transfer has been suggested for promising treatment of irreparable isolated supraspinatus tendon tears (IISTTs). However, there have been no attempts to assess the biomechanical efficacy of MTT transfer. This study aims to evaluate the biomechanical efficacy of MTT transfer in the setting of IISTTs. MethodsEight fresh-frozen cadaveric shoulders were tested in three conditions (1) intact rotator cuff, (2) IISTTs, and (3) Middle trapezius tendon transfer (MTT) using Achilles allograft for IISTTs. Total humeral rotational range of motion, superior translation of the humeral head, and subacromial contact characteristics were measured at 0°, 20°, and 40° glenohumeral abduction (representing 0°, 30°, and 60° shoulder abduction). Superior translation and subacromial contact pressures were measured at 0°, 30°, 60° and 90° external rotation (ER). Two different MTT muscle loading conditions were investigated. A linear mixed-effects model and Tukey post hoc test were used for statistical analysis. ResultsTotal range of motion was significantly increased after IISTT at 20° abduction (P =.037). There were no changes in total ROM following MTT transfer compared to the IISTT condition (P>.625 for all comparisons). The IISTT condition significantly increased superior translation compared to the intact rotator cuff condition in 0° and 20° abduction with all ER angles (P<.001), 40° abduction/30° ER (P=.016), and 40° abduction/60° ER (P=.002). MTT transfer significantly decreased superior translation of the humeral head at all abduction angles compared to the IISTTs condition (P<.026). MTT transfer significantly decreased peak contact pressure by 638.7 kPa (normal loading) and 726.8 kPa (double loading) at 0° abduction/30° ER compared to the IISTTs condition (P<.001). Mean contact pressure was decreased by 102.8 kPa (normal loading) and 118.0 kPa (double loading) at 0° abduction/30° ER (P<.001) and 101.0 kPa (normal loading) and 99.2 kPa (double loading) at 0° abduction/60° ER (P<.001). MTT transfer at 20° abduction/30° ER with 24N loading significantly decreased contact pressure by 91.2 kPa (P=.035). ConclusionsThe MTT transfer biomechanically restored the superior humeral head translation and reduced the subacromial contact pressure in a cadaveric model of IISTT, while not restricting total ROM. These findings suggest that MTT transfer may have potential as a surgical treatment for IISTTs.

Total Knee Arthroplasty in Haemophilia: Long-Term Results and Survival Rate of a Modern Knee Implant with an Oxidized Zirconium Femoral Component.

(1) Background: Total Knee Arthroplasty (TKA) in patient with haemophilia (PWH) has usually been performed with the use of cobalt-chrome femoral and titanium tibial components, coupled with standard polyethylene (PE) inserts. The aim of this retrospective study was to evaluate the long-term outcomes and survival rates of TKA in a series of consecutive PWH affected by severe knee arthropathy at a single institution. (2) Methods: We followed 65 patients undergoing 91 TKA, implanted using the same implant, characterized by an oxidized zirconium femoral component, coupled with a titanium tibial component, and a highly crosslinked PE. At 1, 6, and 12 months; then every year for 5 years; and finally, every other 3 years, all patients were scored for pain (VAS), function (HJHS; KSS), ROM, and radiographic changes. Kaplan-Meier survivorship curves were used to calculate the implant survival rates. (3) Results: The mean follow-up was 12.3 years (4.2-20.6). All clinical and functional scores improved significantly from preoperatively to the latest follow-up (VAS: from 6.9 to 1.3; HJHS: from 13.4 to 1.9; KSS: from 19.4 to 79; ROM: from 42.4° to 83.6°). The overall survivorship of the implants was 97.5% at the latest follow-up. (4) Conclusions: The present series showed a high survival rate of specific implants potentially linked to the choice of an oxidized zirconium coupled with a highly crosslinked PE. We promote the use of modern implants in these patients in order to ensure long-lasting positive outcomes.

Visible trephine-based foraminoplasty in PTED leads to asymmetrical stress changes and instability in the surgical and adjacent segments: a finite element analysis

This study aimed to construct a multi-segment lumbar finite element model (FEM) of PTED surgery to analyze the changes in stress and ROM after visible trephine-based foraminoplasty. The CT scans of a 35-year-old healthy male were used to develop a multi-segment lumbar FEM with Mimic, Geomagic Studio, Hypermesh and MSC.Patran. Different foraminoplasty was performed on the model, and these were grouped into normal group (A), the ventral resection group (B), the apex resection group (C), the ventral + apex + isthmus resection group (D), and the SAP + isthmus + lateral recess resection group (E). A vertical load of 500N and a torque of 10N·M were applied to the upper surface of the L3 vertebral body to simulate the biomechanical characteristics under the motion of flexion, extension, lateral bending, and rotation. The von Mises stress maps of the intervertebral f, vertebral body, facet joints, and the ROM of the L3-S1 intervertebral disk were calculated and analyzed. The changes of peak stress on the vertebral body for each group were not significant in the same motion state. Significant stress differences were observed in the L4/5 intervertebral disks, while no obvious stress changes were observed for the L3/4 and L5/S1 intervertebral disks. The stress of the L3/4 and L5/S1 facet joints decreased after L4/5 foraminoplasty, while the stress of L4/5 facet joints displayed an overall increasing trend. Significant asymmetrical stress changes of bilateral facet joints were observed in all three segments, particularly during bilateral rotation movements. The ROM of L3-S1 gradually increased from Group A to Group E, especially during flexion, left lateral bending, and right rotation, with the highest elevation observed for the L45 ROM. Our FEM indicated that enlarged resection and exposure of the articular surface could lead to significant asymmetrical stress changes in the bilateral facet joints and ROM instability of the surgical and adjacent segments. These findings suggested that unnecessary and excessive resection should be avoided in PTED to reduce the incidence of low back pain and the risk of postsurgical degeneration.

Evaluating Risk Factors for Biceps Tendon Injuries in Softball Players: A Systematic Review.

Softball players commonly suffer overuse injuries due to the demands of repetitive throwing. The biceps tendon plays an important role in stabilizing the shoulder during the windmill pitch. The purpose of this study was to evaluate the measures used to identify and study biceps tendon pathology in softball players. This was a systematic review. PubMed MEDLINE, Ovid MEDLINE, and EMBASE were searched. Studies that investigated biceps tendon injuries in softball players. None. Range of motion (ROM), strength, and visual analog scale data were collected. Of 152 search results, 18 were included. A total of 536 of 705 athletes (76%) were softball players (average age 14-25 years). Five of 18 articles (27.7%) studied changes in external rotation with the shoulder at 90 degrees of abduction, and 4 of 18 (22.2%) studied internal rotation. Two of 18 studies (11.1%) examined ROM or strength changes in forward flexion. While researchers agree that the windmill pitch places significant stress on the biceps tendon, our study finds that the metrics used to evaluate shoulder pathology in these players primarily evaluate the rotator cuff without isolating the biceps tendon. Future studies should include clinical tests and biomechanical metrics more specific to identifying biceps and labral pathology (eg, strength, fatigue, and ROM in glenohumeral forward flexion, elbow flexion, and forearm supination) and attempt to clarify differences in pathology between pitchers and position players to better characterize the frequency and severity of biceps tendon pathology in softball players.

Assessment of Spinal Stability after Discectomy Followed by Annulus Fibrosus Repair and Augmentation of the Nucleus Pulposus: A Finite Element Study

Lumbar disc herniation (LDH) is a common condition which can lead to back pain. Although surgical treatments for LDH are well established, complications such as spinal instability and narrowing of adjacent facet joints are still frequently reported. The purpose of this study was to use finite element models to evaluate the stability of the L3–L4 segment after conservative or aggressive percutaneous transforaminal endoscopic discectomy (PTED) with and without an artificial material filler to correct LDH. Compared to the intact model, aggressive PTED reduced the stability of the segment (increased ROM) and narrowed the space between facet joints in the medial/lateral (ML) direction during flexion (maximum 6.7 degrees change in ROM and 90.5% spacing between facet joints), extension (maximum 2.1 degrees and 38.6%), and axial rotation (maximum 4.2 degrees and 90.1%). Aggressive PTED had a similar effect in the anterior/posterior (AP) direction during lateral bending (maximum 2.0 degrees and 44.2%). Augmenting the nucleus pulposus with a polyurethane filler after aggressive PTED improved spinal stability in both the ML and AP directions in all simulated motions, with results similar to the intact model. However, using a hydrogel filler did little to stabilize the spine, likely because the material is too soft to support the heavy, sustained loading. In conclusion, this study found that if an aggressive discectomy is required, augmenting the nucleus pulposus with a PU filler provides sufficient support to stabilize the spine, while hydrogel fillers offer little support.

An experimental-numerical method for the calibration of finite element models of the lumbar spine

We present a systematic and automated stepwise method to calibrate computational models of the spine. For that purpose, a sequential resection study on one lumbar specimen (L2-L5) was performed to obtain the individual contribution of the IVD, the facet joints and the ligaments to the kinematics of the spine. The experimental data was prepared for the calibration procedure in such manner that the FE model could reproduce the average motion of the 10 native spines from former cadaveric studies as well as replicate the proportional change in ROM after removal of a spinal structure obtained in this resection study. A Genetic Algorithm was developed to calibrate the properties of the intervertebral discs and facet joints. The calibration of each ligament was performed by a simple and novel technique that requires only one simulation to obtain its mechanical property. After calibration, the model was capable of reproducing the experimental results in all loading directions and resections.

Kinematics of Cervical Spine during Rowing Ergometer at Different Stroke Rates in Young Rowers: A Pilot Study.

Background: Research on biomechanics in rowing has mostly focused on the lumbar spine. However, injuries can also affect other body segments. Thus, the aim of this pilot study was to explore any potential variations in the kinematics of the cervical spine during two different stroke rates on the rowing ergometer in young rowers. Methods: Twelve young rowers of regional or national level were recruited for the study. The experimental protocol consisted of two separate test sessions (i.e., a sequence of 10 consecutive strokes for each test session) at different stroke rates (i.e., 20 and 30 strokes/min) on an indoor rowing ergometer. Kinematics of the cervical spine was assessed using an inertial sensor capable of measuring joint ROM (angle of flexion, angle of extension, total angle of flexion–extension). Results: Although there were no differences in the flexion and total flexion–extension movements between the test sessions, a significant increase in the extension movement was found at the highest stroke rate (p = 0.04, d = 0.66). Conclusion: Young rowers showed changes in cervical ROM according to stroke rate. The lower control of the head during the rowing stroke cycle can lead to a higher compensation resulting in an augmented effort, influencing sports performance, and increasing the risk of injury.

A Single-Center Study Comparing the Effects of Thoracic Spine Manipulation vs Mobility Exercises in 26 Office Workers with Chronic Neck Pain: A Randomized Controlled Clinical Study.

BackgroundNeck pain is associated with computer work, poor posture, imbalanced neck muscles, and fatigue, particularly in office workers. This study from a single center aimed to compare the effects of thoracic spine mobility exercise and thoracic spine manipulation to improve cervical spine range of motion in 26 office workers who had chronic neck pain for more than 12 weeks.Material/MethodsThe participants were 26 office workers with neck pain lasting >12 weeks. These participants were randomly assigned to undergo TSME (n=13) or TSM (n=13). Both groups underwent cervical joint mobilization and deep cervical flexor muscle exercises for 25 min a day, twice weekly, for 6 weeks. The TSME group additionally performed TSME 15 min a day, twice a week, for 6 weeks, while the TSM group received TSM 2 times a day, twice a week, for 6 weeks. Cervical and thoracic spine ROM, numeric pain rating scale (NPRS), and neck disability index (NDI) were measured before and after interventions. The ROM of cervical and thoracic spine was measured using a dual inclinometer.ResultsBoth groups showed significant changes in cervical spine ROM, thoracic spine ROM, NPRS, and NDI after intervention compared to before intervention (P<0.05). Cervical spine right lateral flexion and right rotation differed significantly between the groups (P<0.05), while thoracic spine ROM, NPRS, and NDI did not.ConclusionsTSME and TSM have similar effects in improving pain and disability in office workers with non-specific chronic neck pain.

The effectiveness of mobilization and manipulation on patients suffering from cervical spine injuries

Patients with neck pain undergoing cervical mobilization and manipulation were monitored for changes in ROM and pain. The cervical spine was manipulated and mobilized. An inclinometer was used to measure cervical range of motion. VAS was used to gauge the severity of the pain in the cervical region (VAS). A total of 35 patients agreed to participate. The participants' ages ranged from 15 to 70, with an average of 46.5 years. Neck pain and limited cervical range of motion were common symptoms among the participants in this study. We saw a decrease in pain intensity and an increase in cervical range of motion in our patients. All metrics had significant pre-treatment variations (p0.01 at the first, fourth, and tenth visits). Patients with neck pain may benefit from the use of cervical spine Mobilization and Manipulation procedures, according to the findings of this study.

The effects of blood flow restriction resistance training on indices of delayed onset muscle soreness and peak power

BACKGROUND: Low-load resistance training with blood flow restriction (LL + BFR) attenuated delayed onset muscle soreness (DOMS) under some conditions. OBJECTIVE: The purpose of this study examined the effects of reciprocal concentric-only elbow flexion-extension muscle actions at 30% of peak torque on indices of DOMS. METHODS: Thirty untrained women (mean ± SD; 22 ± 2.4 years) were randomly assigned to 6 training days of LL + BFR (n= 10), low-load non-BFR (LL) (n= 10), or control (n= 10). Participants completed 4 sets (1 × 30, 3 × 15) of submaximal (30% of peak torque), unilateral, isokinetic (120∘s-1) muscle actions. Indices of DOMS including peak power, resting elbow joint angle (ROM), perceived muscle soreness (VAS), and pain pressure threshold (PPT) were assessed. RESULTS: There were no changes in peak power, ROM, or VAS. There was a significant interaction for PPT. Follow-up analyses indicated PPT increased for the LL + BFR condition (Day 5 &gt; Day 2), but did not decrease below baseline. The results of the present study indicated LL + BFR and LL did not induce DOMS for the elbow extensors in previously untrained women. CONCLUSION: These findings suggested LL + BFR and LL concentric-only resistance training could be an effective training modality to elicit muscular adaptation without inducing DOMS.

Effectiveness of muscle energy technique and movement with mobilization in adhesive capsulitis of shoulder

Background: Adhesive capsulitis is a clinical diagnosis made from the history of the gradual onset of severe shoulder pain with the progressive limitation of active and passive Glenohumeral movements. Muscles energy techniques helps to mobilize restricted joints by stretching hypertonic muscles, capsules, ligaments and fascia. Mobilization with Movement technique combines technique, with a sustained application of a manual technique “gliding” force to a joint with concurrent physiologic (osteo-kinematic) motion of the joint, either actively performed by the subject or passively performed by the therapist. Aim: To compare the effectiveness of Muscle energy technique versus Mulligan’s technique on improvement of pain, mobility and functional ability for subjects with ACSMethodology: 42 individuals with ACS were included and allocated to two groups (n=21). Groups were administrated with Muscle energy technique along with conventional therapy, Mobilization with Movement along with Conventional therapy and for 4 weeks (5 days per week). ROM, SPADI and NPRS were used to assess changes between baseline and post intervention.Result and Conclusion: The MWM (Group B) was associated with statistically significant greater change in ROM and SPADI score than MET (Group A) and. There was statistically significant change observed NPRS in both the groups: MWM along with Conventional therapy improves ROM of shoulder and functional disability in patients with Adhesive capsulitis.

How is spinal range of motion affected by disc- and facet degeneration and spinopelvic anatomy?

BackgroundWe aimed to investigate how disc- and facet joint degeneration relate to ROM and spinopelvic alignment parameters. Their interrelation, however, is not yet understood, although eminent in patient specific modeling approaches and surgical decision making. Further is not yet sufficiently understood whether spinal alignment parameters relate to the degenerative states. MethodsThe ROM of lumbar spinal segments was quantified using flexion/extension radiographs of 90 patients. The grades of degeneration of discs (IDD, Pfirrmann grades, n=440) and facet joints (FJD, Weishaupt classification, n=406) were assessed in CT and MRI scans. ResultsThe grade of IDD was significantly related to changes in ROM (p<0.01) whereas no association was observed with the amount of FJD. Grade V IDD was associated with a significant decrease in motion (p<0.01) compared to all other IDD grades (II-IV), which did not differ significantly among each other. The combined occurrence of IDD and FJD revealed the largest angular segmental ROM in segments with the lowest IDD (II) and lowest FJD (0). The lowermost ROM was present in fused segments (control), followed by those with severe IDD (V). In combination with FJD, the destabilizing effect of initial IDD was only observed if FJD was already in an advanced state. ConclusionsWhile the degree of facet joint degeneration seems not significantly associated with limitations in spinal motion, severe lumbar disc degeneration limits segmental motion, nearly equal to spinal fusion. This should affect counseling patients undergoing spinal fusion with questions on the probability of adjacent segment degeneration compared to the natural course.

Impacts of postoperative changes of segmental mobility on neurological improvement after laminoplasty for cervical ossification of the posterior longitudinal ligament.

Several studies have demonstrated that the dynamic factor at the mobile segment affects the severity of myelopathy in patients with cervical ossification of the posterior longitudinal ligament (C-OPLL), and posterior decompression supplemented with posterior instrumented fusion at the mobile segment provides good neurological improvement. However, there have been few reports of changes in range of motion at the mobile segment (segmental ROM) after laminoplasty (LP). The aim of this study was thus to retrospectively investigate changes in segmental ROM after LP and the impacts of these changes on neurological improvement in patients with C-OPLL.A total of 51 consecutive patients who underwent LP for C-OPLL since May 2010 and were followed for at least 2 years after surgery were included in this study. Neurological status was assessed using the Japanese Orthopaedic Association (JOA) score before surgery and at 2-year follow-up. Segmental ROM at the responsible level for myelopathy was measured preoperatively and at 2-year follow-up using lateral flexion-extension radiographs of the cervical spine.The mean JOA score improved significantly from 10.7 points preoperatively to 13.5 points at 2 years after surgery (mean recovery rate, 45.0%). The mean segmental ROM decreased significantly from 6.5 degrees before surgery to 3.2 degrees at 2 years after surgery. In the good clinical outcome group (recovery rate of the JOA score ≥50%; n = 22), the mean segmental ROM decreased significantly from 5.8 degrees preoperatively to 3.0 degrees postoperatively. It also decreased significantly from 7.1 degrees to 3.4 degrees in the poor clinical outcome group (recovery rate of the JOA score <50%; n = 29).This study showed that segmental ROM was stabilized after LP in most patients with C-OPLL. Neither preoperative nor postoperative segmental ROM showed significant differences between the good and poor clinical outcome groups and neither a postoperative increase nor decrease of segmental ROM significantly affected the recovery rate of the JOA score.

어깨 관절 부딪힘 증후군 환자의 신장성 수축 운동이 통증 및 기능, 관절가동범위와 근력 변화에 미치는 영향

Purpose: The purpose of this study is to investigate how participation in the eccentric contraction exercise program affects pain & function, range of motion, and muscle strength in patients with subacromial impingement syndrome.<BR> Method: The subjects of the study were 20 female patients diagnosed with subacromial impingement syndrome in the age of 40s-50s. They were allocated wirelessly to the ECG group and the AGG group. Data processing was two-way repeated ANOVA, paired t-test and independent t-test. A significant level of hypothesis verification was set-up (p<.05).<BR> Results: The results of this study are as follows. 1) OSS was significantly improved in all of the timing, interaction, and group (p<.001). And in comparison between groups, ECG improved significantly (p<.01). 2) The change in ROM of Flexion was significantly improved in timing (p<.001), interaction (p<.05), and group (p<.001). ECG was significantly improved in comparison between groups (p<.001). The change in ROM of Abduction was significantly improved in timing (p<.001), interaction (p<.05), and group (p<.001). And ECG was significantly improved in comparison between groups p(<.001). The change in ROM of external rotation was significantly improved in all of the timing, interaction, and group (p<.001). In comparison between groups, ECG was significantly improved (p<.001). 3) The change in external rotation strength was significantly improved in time, interaction (p<.001), and group (p<.01). In the comparison between groups, ECG was found to be significantly improved (p<.001).<BR> Conclusion: Therefore, the eccentric contraction exercise program implemented in this study appears to be an effective treatment method for symptomatic improvement in patients with subacromial impingement syndrome, and future studies will require comparative studies involving gender, various age groups, and more patients with impingement syndrome.