Differences In Passive Range Of Motion Research Articles

The Effect of a Multidimensional Home Rehabilitation Program for Post-Total Knee Arthroplasty Elderly Patients.

Patients with total knee arthroplasty (TKA) experience pain, decreased muscle strength, and decreased knee function, resulting in increases in depression and decreased subjective well-being. A multidimensional home program may prevent these adverse events. The aim of this study was to test the effect of a home rehabilitation program that included education, exercise, aroma massage, and phone counseling for post-TKA patients. We used a randomized control group pretest/posttest design. Fifty-nine patients participated, with 29 in the experimental group and 30 in the control group. Pain, knee joint range of motion (ROM), quadriceps strength, depression, and subjective well-being were measured as outcome variables. Data were analyzed using repeated-measures analysis of variance and generalized estimating equations. The experimental group showed significant improvement in knee pain, active ROM, muscle strength, depression, and subjective well-being with no significant between-groups difference in passive ROM. The multidimensional home rehabilitation program can be an effective nursing intervention for physical and emotional recovery of patients with TKA.

Athletic Shoulder Test Differences Exist Bilaterally in Healthy Pitchers.

BackgroundThere is a lack of valid and reliable tests that assess upper extremity strength and function for rehabilitation and injury prevention purposes in throwing athletes. The Athletic Shoulder (ASH) test has been proposed as a reliable measure of shoulder strength, but has not yet been studied in baseball pitchers.Hypothesis/PurposeThe purpose of this study was to establish values for healthy baseball pitchers performing the ASH test, compare those values with other common tests of shoulder strength and function, and compare ASH test performance bilaterally. It was hypothesized that the dominant arm would perform significantly better on the ASH test compared to the non-dominant arm. A secondary purpose of the study was to evaluate if ASH test performance was related to fastball velocity in baseball pitchers. It was hypothesized that ASH test performance would positively correlate with fastball velocity.Study DesignCross-Sectional StudyMethodsCollege and high school baseball pitchers were recruited to complete shoulder range of motion (ROM), isokinetic shoulder strength, and isometric shoulder strength testing using the ASH test. The ASH test was used to assess force production as a proxy for strength bilaterally at four levels of shoulder abduction (0°, 90°, 135°, and 180°), using a force plate. Approximately one-week later subjects returned for a bullpen session where fastball velocity was recorded with a radar gun. Bilateral differences in passive ROM, isokinetic, and isometric shoulder strength were examined using paired t-tests while linear relationships between isometric shoulder strength and fastball velocity were assessed using Pearson correlations.ResultsThirty-five healthy pitchers participated in the study (19.7 ± 1.8 years). Pitchers demonstrated significantly greater isometric shoulder strength at the 90° and 135° abduction positions with the throwing arm compared to the non-throwing arm. Pitchers also demonstrated commonly observed musculoskeletal adaptations in the throwing arm such as increased passive external rotation, decreased passive internal rotation, and greater internal and external rotator strength during isokinetic testing. Peak force production during the ASH test was not related to fastball velocity.ConclusionThe ASH test is capable of detecting bilateral shoulder strength adaptations commonly observed in other clinical tests in healthy pitchers. Pitchers demonstrated greater isometric peak force during the ASH test at levels of shoulder abduction similar to those observed in pitching. While these results may be intriguing for clinical use, peak force from the ASH test was not correlated to fastball velocity in pitchers, and therefore should be used with caution for predictions in this realm.Level of Evidence2Clinical RelevanceA need exists for objective measures of shoulder strength for rehabilitation and injury risk monitoring in throwing athletes that are easy to administer, have high reliability and validity, and provide minimal re-injury risk to athletes recovering from injury.What is known about the subjectData from the ASH test has been published previously in non-throwing athletes and was shown to be valid and reliable in that group. However, the test has not been explored widely in throwing athletes who are known to have significant musculoskeletal adaptations to the throwing shoulder.What this study adds to existing knowledgeThe results from this study confirm that the ASH test is sensitive enough to detect the adaptations that are present in the healthy throwing athlete’s shoulder. Due to the prior proven validity and reliability and these results, the test can be used to monitor throwing arm strength and function during rehabilitation or as a pre/intra-season screening tool to help describe arm health.

Comparison of Cruciate-Sacrificing vs Posterior-Stabilized Total Knee Replacement Using a Contemporary Total Knee System.

The use of highly conforming polyethylene tibial inserts in cruciate-retaining total knee arthroplasty (TKA) often requires posterior cruciate ligament (PCL) release/sacrifice for balancing (CS TKA). The CS TKA relies on the posterior capsule, collateral ligaments, and articular conformity without a cam or post to achieve stability. Using prospectively collected data we compared clinical outcomes of CS TKA to posterior-stabilized (PS) TKA utilizing a contemporary TKA system. Sixty-nine consecutive CS TKAs were compared to 45 consecutive PS TKAs at 2-year minimum follow-up. CS knees were balanced with the PCL released. Preoperative/postoperative range of motion (ROM), Knee Society Scores (KSS), stair function, and squatting ROM were analyzed. At minimum 2-year follow up, CS and PS TKA demonstrated significant improvement in ROM (P < .001), KSS (Pain, P < .001; Function, P < .001), and KSS stair function (P < .001), with no revisions. There was no difference in preoperative to postoperative improvements for passive knee ROM (10° (0°-20°) vs 13° (5°-25°); P= .16), KSS Pain (34 (21-42) vs 38 (24-46); P= .22), KSS Function (35 (30-50) vs 35 (18-50); P= .34), and KSS stair function (10 (10-20) vs 10 (0-20); P= .37) for CS and PS TKA, respectively. CS TKA had higher squatting ROM (P= .02) at minimum 2-year follow-up compared to PS TKA. Both PS and CS TKA provided significant improvement in clinical outcomes, with no differences in passive ROM, KSS, or stair function postoperatively. Our data support that with proper articular conformity and balancing, cruciate-retaining TKA in a PCL-deficient knee (CS TKA) is appropriate. This may be design specific and further prospective randomized studies are needed to corroborate these findings.

An Analysis of In Vivo Hip Kinematics in Elite Baseball Batters Using a Markerless Motion-Capture System

PurposeThe aim of this study was to investigate the kinematics of the asymptomatic baseball batter’s hips by comparing passive range of motion (PROM) and real-time active hip range of motion (AROM) and determine whether differences in ROM exist between lead and trail hips.MethodsParameters of passive hip ROM were obtained using a goniometer and physical examination standards. Active hip ROM during batting swings was captured with the Dynamic Athletic Research Institute’s markerless motion-capture system.ResultsTwenty-nine elite-level baseball players were recruited for participation. Comparison of lead and trail hips showed no significant differences in PROM. Statistically significant differences in AROM were found between lead and trail legs with large effect sizes for flexion (mean difference [MD°], 11.22), extension (MD°, 30.30), abduction (MD°, 6.24), adduction (MD°, 18.63), external rotation (MD°, 14.87) and total arc of rotation (MD°, 17.17) (P < .001 for all). External rotation in the lead hip approached maximum passive endpoint during early phases of the swing, whereas trail hip extension reached maximum passive endpoint during follow-through.ConclusionThere is a significant difference in the AROM of the lead and trail hips during the batting swing, with active extension in the trail hip, active external rotation of the lead hip, and total arc of rotation of the lead hip nearing their respective passive endpoints and suggesting a potential for bony interaction in the hips of baseball batters.Level of EvidenceLevel 3, Cross-Sectional Study.

Is a Suction Drain Necessary in Arthroscopic Rotator Cuff Repair?

Background: The purpose of this study was to evaluate the efficacy of suction drain use following arthroscopic rotator cuff repair by comparing early pain score and range of motion (ROM) between groups with and without suction drains. Methods: The study included 153 patients with rotator cuff tears who underwent arthroscopic repairs at our clinic from April 2014 to March 2015. Following surgery, a suction drain was used in 85 patients (group D) and not used in 68 patients (group ND). There was no statistical difference between the groups in terms of age, gender, or total operation time. The clinical outcome with regard to pain (assessed by pain scores and analgesic requests) and passive ROM was assessed preoperatively and postoperatively. Results: Immediate postoperative analgesic requirement was significantly higher in group D (p=0.001), although there was no difference in pain outcomes between the groups during the 3-month follow-up period. A statistically significant difference in passive ROM was observed at the postoperative 2- and 6-week follow-ups (p=0.036, 0.035, and 0.034 in forward elevation (FE), external rotation at the side (ER) and 90 ER at weeks 2, respectively; 0.045 and 0.009 in FE and ER at weeks 6, respectively); however no significant difference was observed at the end of 3 months. During the study period, no complication was reported in either group. Conclusions: Use of suction drains after arthroscopic rotator cuff repair provided little benefit in terms of ROM or pain in the early postoperative period (up to 3 months).

Passive hip movement measurements related to dynamic motion during gait in hip osteoarthritis.

Reduced sagittal plane range of motion (ROM) has been reported in individuals with hip osteoarthritis (OA) both during walking and passive testing. The purpose of this study was to determine if a relationship exists between hip extension ROM recorded during gait and passive hip extension ROM in individuals with moderate and severe hip OA, in comparison to an asymptomatic group. Sagittal plane hip ROM was calculated using skin surface marker trajectories captured during treadmill walking at self-selected speed. Passive hip ROM was measured using standardized position and recording procedures with a goniometer. Sagittal plane extension, flexion, and overall ROM were measured dynamically and passively. A two-way mixed model analysis of variance determined significant differences between groups and between passive and dynamic ROM (α = 0.05). Pearson correlations determined relationships between passive and dynamic ROM. Significant group by ROM interactions were found for flexion and extension ROM (p < 0.05). For extension, the severe OA group had less dynamic and passive ROM compared to the other groups and greater passive than dynamic ROM (p < 0.05). For flexion, significant differences in passive ROM existed between all three groups (p < 0.05) whereas no differences were found for dynamic flexion (p < 0.05). Significant correlations between dynamic and passive hip extension were found in the moderate (r = 0.596) and severe OA (r = 0.586) groups, and no correlation was found in the asymptomatic group (r = 0.139). Passive ROM explains variance in dynamic ROM measurements obtained during gait in individuals with moderate and severe hip OA which have implications for the design of treatment strategies targeting walking pathomechanics. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1790-1797, 2016.

The effect of tibio-femoral traction mobilization on passive knee flexion motion impairment and pain: a case series

The purpose of this case series was to explore the effects of tibio-femoral (TF) manual traction on pain and passive range of motion (PROM) in individuals with unilateral motion impairment and pain in knee flexion. Thirteen participants volunteered for the study. All participants received 6 minutes of TF traction mobilization applied at end-range passive knee flexion. PROM measurements were taken before the intervention and after 2, 4, and 6 minutes of TF joint traction. Pain was measured using a visual analog scale with the TF joint at rest, at end-range passive knee flexion, during the application of joint traction, and immediately post-treatment. There were significant differences in PROM after 2 and 4 minutes of traction, with no significance noted after 4 minutes. A significant change in knee flexion of 25.9°, which exceeded the MDC95, was found when comparing PROM measurements pre- to final intervention. While pain did not change significantly over time, pain levels did change significantly during each treatment session. Pain significantly increased when the participant's knee was passively flexed to end range; it was reduced, although not significantly, during traction mobilization; and it significantly decreased following traction. This case series supports TF joint traction as a means of stretching shortened articular and periarticular tissues without increasing reported levels of pain during or after treatment. In addition, this is the first study documenting the temporal aspects of treatment effectiveness in motion restoration.

Joint Range of Motion in Flaccid Hemiplegia

The effect of muscle tone on passive range of motion (PROM) in affected joints and comparison joints on the unaffected side was investigated in 15 patients with flaccid paralysis hemiplegia. PROM was measured in the shoulder and hip in flexion, extension, abduction, adduction and internal and external rotation using the plastic universal goniometer. PROM in the elbow and knee was assessed in flexion and extension. Wrist PROM was measured in flexion, extension and radial and ulnar deviation. Additionally, ankle dorsiflexion, plantarflexion, eversion and inversion PROM were assessed. Decreased muscle tone significantly affected shoulder ( p = 0.006), wrist ( p = 0.032) and hip ( p = 0.003) PROM. Significant differences between the affected and unaffected sides were found in shoulder PROM in extension ( p = 0.014), adduction ( p = 0.001) and internal ( p = 0.034) and external rotation ( p = 0.007). Wrist PROM was significantly different in flexion ( p = 0.048) and extension ( p = 0.001), and hip PROM was significantly different in abduction ( p = 0.029), adduction ( p = 0.012) and external rotation ( p = 0.001). Surprisingly, although muscle tone had no influence on ankle PROM, there was a significant difference in ankle plantarflexion PROM ( p = 0.013). In conclusion, in flaccid hemiplegia, decreased muscle tone affects the PROM in the shoulder, wrist and hip. Differences in PROM between the unaffected and affected side are evident in shoulder extension, adduction and internal and external rotation, wrist flexion and extension, hip abduction, adduction and external rotation, and ankle plantarflexion.