Dominant Side Research Articles

Phase Angle as Surrogate Marker of Muscle Weakness in Kidney Transplant Candidates Referred to Prehabilitation.

Phase angle (PhA), a marker of nutritional status obtained by bioelectrical impedance analysis (BIA), is associated with the integrity of cell membranes. Damage to muscle fiber membranes can impact muscle strength, which is related to adverse outcomes in adults with advanced chronic kidney disease (CKD). The main objective of this study was to determine the usefulness of the PhA in identifying muscle weakness in candidates for kidney transplants (KTs). Secondly, it aimed to examine the associations of PhA with other parameters of body composition, exercise performance, and muscle structure. Sensitivity, specificity, and area under the receiver operating characteristics curve were used to evaluate the PhA (index test) as a biomarker of muscle weakness. Muscle strength was estimated with maximal voluntary isometric contraction of the quadriceps (MVCI-Q) of the dominant side. Muscle weakness was defined as MVIC-Q < 40% of body weight. A total of 119 patients were evaluated (mean age 63.7 years, 75.6% men). A phase angle cut-off of 5.1° was identified to classify men with a higher likelihood of having low muscle strength in upper limbs (MVIC-Q 40% of their body weight). Male KT candidates with PhA < 5.1° had poorer exercise capacity, lower muscle strength, less muscle mass, and smaller muscle size. A PhA < 5.1° was significantly associated with an eight-fold higher muscle weakness risk (OR = 8.2, 95%CI 2.3-29.2) in a binary regression model adjusted by age, frailty, and hydration status. Remarkably, PhA is an easily obtainable objective parameter in CKD patients, requiring no volitional effort from the individual. The associations of PhA with aerobic capacity, physical activity, muscle mass, and muscle size underscore its clinical relevance and potential utility in the comprehensive evaluation of these patients.

Normative values and the influence of sex, hand dominance, and direction of movement on active wrist joint position sense in young healthy adults

BackgroundActive wrist joint position sense (JPS) is a feasible method for determining wrist proprioception. However, the normative values and factors affecting wrist JPS are not known. ObjectivesTo identify normative values of active wrist JPS in young healthy adults and explore the influence of sex, hand dominance and direction of wrist movement. DesignCross-sectional study. MethodJPS of 100 individuals aged 18–40 years, (male: female = 51:49) were measured at two wrist positions (20° flexion/extension) using the active wrist JPS test. Absolute error (in degrees) was calculated and summarized using descriptive measures. Kruskal-Wallis analysis of variance was performed to determine the differences in JPS error based on sex, dominance and direction of wrist movement. ResultsMean absolute JPS flexion error on the dominant side was 3.47°(SD = 3.91°), and non-dominant side was 3.26°(SD = 3.23°). Mean absolute JPS extension error on the dominant side was 3.35°(SD = 3.43°), and non-dominant side was 4.59°(SD = 4.82°). Compared to males, females had more absolute error for flexion and extension on the dominant side. No significant difference was found in the absolute error between the dominant and non-dominant sides or between flexion and extension. ConclusionThese normative values of active JPS in young healthy adults can help clinicians while assessing proprioceptive impairments of the wrist. Differences in JPS errors due to sex were found, but not due to dominance or direction of movement. These findings can guide future research on mechanisms involved in wrist JPS.

Clinical value of 68Ga-pentixafor PET/CT in patients with primary aldosteronism and bilateral lesions: preliminary results of a single-centre study

BackgroundSubtype diagnosis of primary aldosteronism (PA) is used to determine treatment, and the potential utility of 68Ga-pentixafor PET/CT for investigation of PA has long been recognized. The study aimed to evaluate the clinical value of 68Ga-pentixafor PET/CT in the diagnosis and prognosis of patients with bilateral lesions identified by CT.MethodsIn total, 25 patients with PA and bilateral lesions on CT were retrospectively evaluated. All patients underwent 68Ga-Pentixafor PET/CT and adrenal vein sampling. The analysis focused on establishing the relationship between bilateral adrenal lesions SUVmax and the ratio of bilateral adrenal lesions SUVmax (CON) and clinical diagnosis, treatment outcomes, and KCNJ5 gene status.ResultsThe concordance rate between 68Ga-Pentixafor PET/CT and adrenal venous sampling was 65.2% (15/23). The lateralization results of 68Ga-pentixafor PET/CT supported the clinical decisions of 20 patients with PA, 90% of whom showed effectiveness in treatment. The SUVmax on the dominant side of the surgically treated patients was higher than that of patients treated with drugs. The SUVmax of the KCNJ5 mutant group was higher than that of the KCNJ5 wild group, and 68Ga-Pentixafor uptake was correlated with KCNJ5 gene status.Conclusions68Ga-Pentixafor PET/CT proves beneficial for patients with PA with bilateral lesions on CT. The treatment is generally effective based on the results of PET lateralization. Simultaneously, a certain relationship exists between 68Ga-Pentixafor PET/CT and KCNJ5 gene status, warranting further analysis.

Humeral Torsion in Relation to Shoulder Range of Motion in Elite Field Hockey Players.

Sport-specific adaptations in shoulder rotation range of motion (ROM) and the relationship with humeral torsion have been described in overhead-throwing sports. However, information is lacking for other shoulder-loading sports such as field hockey. Therefore, this study's purpose was to evaluate humeral torsion in elite, male field hockey players and explore its association with shoulder ROM. Cross-sectional study. Twenty-five male, elite field hockey players were included. Humeral torsion and shoulder external and internal rotation ROM were evaluated bilaterally by ultrasound and an inclinometer smartphone application, respectively. Field hockey players showed a significantly increased humeral retroversion on the dominant compared with the nondominant side (P < .001; Cohen d = 1.75), along with a significantly increased external (P = .004; Cohen d = -0.64) and decreased internal rotation ROM (P = .003; Cohen d = 0.65). This finding illustrates a shift in total shoulder rotational ROM arc. Correlation analysis showed a significant moderate association between the increased humeral retroversion and decreased internal rotation ROM on the dominant side (r = .523). Elite male field hockey athletes show sport-specific adaptations regarding humeral torsion and shoulder rotation ROM, similar to throwing athletes. These findings increase our insight into the field hockey athlete's shoulder, which is essential to optimize performance and assist in correctly interpreting shoulder rotational ROM measurements.

The Clinical Results of Percutaneous Drilling in the Treatment of Chronic Lateral Epicondylitis.

Lateral epicondylitis is one of the leading orthopedic problems encountered in daily practice. Treatments are more symptomatic than curative. Percutaneous drilling is a minimally invasive method that provides satisfactory results. The aim of this study was to evaluate patients who had undergone percutaneous drilling for chronic lateral epicondylitis. The study included 31 patients who underwent surgical percutaneous drilling because of chronic lateral epicondylitis between 2018 and 2021. The patients were evaluated with respect to demographic characteristics, including age, gender, body mass index (BMI), occupation, education level, hobbies, dominant side, and smoking status. The VAS (Visual Analog Scale) pain scores, PRTEE score (Patient-Rated Tennis Elbow Evaluation - a lateral epicondylitis function scale), and Roles-Maudsly score were examined preoperatively and at one and 12 months postoperatively together with grip strength measured with a Jamar hand dynamometer. Statistically significant improvements were determined in the VAS score during activity from 8.9 preoperatively to 2.06 at 12 months postoperatively (p<0.01), and in the PRTEE score, from 64.12 preoperatively to 20.61 at 12 months postoperatively (p<0.01). The Roles-Maudsly score at 12 months postoperatively was determined to be excellent in 13 (41.9%) patients, and good in 14 (45.2%). Mean grip strength increased from 69.55 before treatment to 90.97 at the end of 12 months postoperatively. Autobiological treatments are at the forefront of current treatments for tendinopathies. Percutaneous drilling is a closed method and can be considered an ideal method in the treatment of tendinosis caused by inflammation and mesenchymal stem cells (MSCs) contained in hematoma. It is also an advantageous treatment method for patients with aesthetic concerns as it does not leave any scar tissue and has a low risk of complications.

Effect of different resistance increments during warm-up on the snatch performance of male weightlifters

This study investigated the effect of different resistance increments during warm-up on snatch performance of male weightlifters. Nine male college weightlifters were recruited. The 3 warm-up protocols were performed every 7 days with a randomized order: 1. Power snatch exercise with 10 % resistance increment (50 %, 60 %, 70 %, and 80 % of one-repetition maximum); 2. Power snatch exercise with 15 % resistance increment (50 %, 65 %, and 80 % of one-repetition maximum); 3. Self-selected resistance increment. Participants were tested based on 85 % maximum weight snatch after warm-up. Snatch performance was measured using peak vertical ground reaction force. Postural stability was measured using center-of-pressure displacement. Activation of seven shoulder, back, and leg muscles was measured using electromyography on the dominant side. In snatch performance, the 10 % increment protocol had a significantly higher peak vertical ground reaction force during the second-pull phase than the 15 % increment (d = 0.92, p < 0.05) and self-selected (d = 1.32, p < 0.05) protocols. In postural stability, no significant differences in center-of-pressure displacement among the three protocols were observed. For muscle activation, the 10 % increment protocol resulted in significantly higher activation of shoulder (d = 1.2–2.2, p < 0.05) during the second-pull phase than the other two protocols and higher activation of hip muscles (d = 1.73, p < 0.05) than self-selected protocol. To conclude, a warm-up protocol combining slow progression is preferable in improving power output during snatch in male weightlifters, probably through facilitating the activation of proximal limb muscles. It can enhance training quality while potentially reducing the risk of sports injuries.

Return to Play Assessment After Lateral Ankle Sprains - German Male Elite Youth Football (Soccer) Academy Baseline Data.

Lateral ankle sprain (LAS) is one of the most common types of injury in football (soccer). Normative baseline data of performance tests for Return to Play (RTP) decision are still lacking. The primary aim of this study was to generate baseline values for uninjured elite youth football players for a multifactorial RTP assessment and compare with previously published data. A secondary aim was to investigate the use of the Limb Symmetry Index (LSI) as a method to determine whether an athlete passes a performance test or not. Observational Cohort study. Baseline data of performance tests (Y-Balance [YBT-LQ], Heel Rise [HRT]; Singe Leg Squat [SLST]; Single Leg Drop Jump [SLDJ]; Side Hop [SHT]; Figure of 8 Hop [F-8]; Modified Agility T-Test [MAT]) were assessed in 20 elite youth football players, aged 16-21 years. Additionally, the traditional LSI (dividing the result of the non-dominant leg by the result of the dominant leg and multiplying by 100) and directionally corrected LSI (the worst value is divided by the better value and multiplied by 100) were calculated. The test values were compared to previously reported study results. LSI and side-to-side comparisons between dominant and non-dominant leg sides were analyzed using the Wilcoxon test. Male elite youth football players achieved better results in the dynamic performance tests (SHT, F-8, and MAT) compared to reference values of the cohorts previously described in the literature: YBT-LQ total score (cm) dominant (dom) 99.3±8.3, non-dominant (ND) 99.5±10.4; HRT (average number) dom. 27.1±5.4, ND 25.2±5.1); SLDJ height (cm) dom 15±5, ND 15±5 and contact time (sec) dom 0.29±0.08, ND 0.29±0.07, Reactive Strength Index (RSI) dom 0.52±0.12, ND 0.50±0.13); SHT (sec) dom 7.12±0.73, ND 7.39±0.93; F-8 (sec) dom 10.52±1.02, ND 10.37±1.04; and MAT (sec) 5.82±0.22. Directionally corrected LSI differed significantly from the traditional calculated LSI (p<0.05). The findings of this study highlight the need to determine specific baseline data for RTP testing in male elite youth football players after LAS. The traditional LSI should not be used as a "stand alone method" for determining RTP. LSI calculations should consider the direction of asymmetry to determine passing a performance test or not. 3b.

Muscle activity and hypoalgesia in blood flow restricted versus unrestricted effort-matched resistance exercise in healthy adults.

This study assessed muscle activity (root mean square, RMS, and median frequency, MDF) to evaluate the acute response to blood flow restriction (BFR) resistance exercise (RE) and conventional moderate intensity (MI) RE. We also performed exploratory analyses of differences based on sex and exercise-induced hypoalgesia (EIH). Fourteen asymptomatic individuals performed four sets of unilateral leg press with their dominant leg to volitional fatigue under two exercise conditions: BFR RE and MI RE. Dominant side rectus femoris (RF) and vastus lateralis (VL) muscle activity were measured using surface electromyography (sEMG) through exercise. RMS and MDF were calculated and compared between conditions and timepoints using a linear mixed model. Pressure pain thresholds (PPT) were tested before and immediately after exercise and used to quantify EIH. Participants were then divided into EIH responders and nonresponders, and the differences on RMS and MDF were compared between the two groups using Hedges' g. RMS significantly increased over time (RF: p = 0.0039; VL: p = 0.001) but not between conditions (RF: p = 0.4; VL: p = 0.67). MDF decreased over time (RF: p = 0.042; VL: p < 0.001) but not between conditions (RF: p = 0.74; VL: p = 0.77). Consistently lower muscle activation was found in females compared with males (BRF, RF: g = 0.63; VL, g = 0.5. MI, RF: g = 0.72; VL: g = 1.56), with more heterogeneous findings in MDF changes. For BFR, EIH responders showed greater RMS changes (Δ RMS) (RF: g = 0.90; VL: g = 1.21) but similar MDF changes (Δ MDF) (RF: g = 0.45; VL: g = 0.28) compared to nonresponders. For MI, EIH responders demonstrated greater increase on Δ RMS (g = 0.61) and decrease on Δ MDF (g = 0.68) in RF but similar changes in VL (Δ RMS: g = 0.40; Δ MDF: g = 0.39). These results indicate that when exercising to fatigue, no statistically significant difference was observed between BFR RE and conventional MI RE in Δ RMS and Δ MDF. Lower muscle activity was noticed in females. While exercising to volitional fatigue, muscle activity may contribute to EIH.

A Preliminary Study on the Effects of 4-Week Training Program with Interactive Floor Support on Plantar Pressure Distribution in Sedentary Individuals

Objective: Our purpose was to investigate on the effects of foot exercises by using interactive floor support as a modality of rehabilitation technology on plantar pressure distribution in sedentary individuals. Methods: Participants who were aged between 18-35, who agreed to participate voluntarily and had no pathology developed in the lower extremities in the past 6 months were included in this study. In order to determine the plantar pressure distribution change of all participants, the first and last evaluation was measured with Emed® Pedobarography. Balance and proprioception exercises on both lower extremities for 12 sessions (for four weeks, three sessions per week, lasts 15 minutes each) were performed with an interactive floor device. Results: A total of 15 healthy and sedentary subjects (12 female, 3 male, with a mean of 20,27±0,961 years and 21,31 ± 3,027 kg/m2 BMI) completed the four-week training protocol. Maximum force of total and hindfoot in both feet significantly decreased after 4-week training (p.05). Conclusion: Based on our results, the present study revealed that the 4-week training programme with interactive floor support for ankle joint could decrease maximum force of total and hindfoot on the bottom of the dominant and non-dominant side feet in healthy and sedentary individuals. Future investigation should be conducted to clarify the effects of long-term training programs with interactive floor support on plantar pressure distribution in patients with foot deformities.

Effects of hand dominance on myoelectric signal of non‑fatigued lumbar multifidus muscle during single arm lifts.

Some evidence indicates that lower back muscles located at the non‑dominant side of the body are more fatigue resistant than their opposite counterparts presumably due to preferential use of the dominant hand. The aim of the study was to determine if any distinction exists in the surface electromyographic activity of corresponding contralateral non‑fatigued lumbar multifidus (LM) muscles as a function of hand dominance. The relative to maximum root mean square, the median frequency (MdF) and spike shape parameters were computed from the surface myoelectric signals of ipsilateral and contralateral lumbar multifidus muscle of 46 adult healthy subjects (27 right‑handed, 19 left‑handed) during voluntary contractions evoked by the single arm lifts in prone position. Activation of LM as a contralateral muscle to lifted arm was greater than as ipsilateral muscle, independently of handedness. Regardless if LM performed ipsi‑ or contralateral action to the lifted arm, the mean spike amplitude, slope, number of peaks per spike and spike duration were greater and mean spike frequency as well as MdF were smaller in the muscle of dominant than non‑dominant side. Combined changes of spike shape measures indicate increased recruitment, lower firing rates and higher synchronization of motor units in the LM of dominant side as compared to its counterpart.

Evaluation of adrenal vein anatomy by adrenal venous sampling in patients with primary aldosteronism in Chinese.

Accurate cannulation of the adrenal vein is challenging during adrenal venous sampling (AVS) because of the variations in adrenal vein anatomy. This study aimed to investigate the adrenal venous morphology in Chinese and improve the success rate of AVS. A total of 221 participants with primary aldosteronism (PA) who underwent AVS were enrolled. Compare the morphology among subgroups divided according to sex, body mass index (BMI), and with or without adenoma. The success rate of right, left, and bilateral AVS was 98.60%, 97.20%, and 96.85%, respectively. The triangular pattern was the most common (39.37%) on the right side, while the glandlike pattern (70.14%) on the left. The proportion of adrenal venous morphology varies among patients with different sexes (χ2=21.335, P<.001), BMI (χ2=10.642 P=.031), and with or without adenoma (χ2=10.637, P=.031) on the right side, and the male, obese and adenoma group showed a higher proportion of glandlike pattern than triangular pattern. If only dependent on computed tomography, 9.05% of patients incorrectly diagnose the dominant side, 14.48% of patients would have inappropriate surgery meanwhile 25.34% of patients would miss the surgical opportunity. In conclusion, the most common types of right and left adrenal venous morphology were triangular pattern and glandlike pattern, respectively. Sex, BMI, and the presence of adenoma affected right adrenal venous morphology. Adequate knowledge of the adrenal venous morphology is critical for improving the success rate of AVS and making an appropriate treatment for PA.

Reliability of scapular position and periscapular muscle strength tests in healthy subjects with forward neck and rounded shoulder posture

BACKGROUND: People with forward head posture (FHP) and rounded shoulder posture (RSP) may experience shifts in scapular position and alterations in the strength of the muscles surrounding the scapula. Therefore, a reliable scapula position and scapula muscle strength test are required to identified scapula problem and provided appropriate intervention programs. OBJECTIVE: This study aimed to determine the reliability of scapular position measurements obtained using a modified digital inclinometer and palpation meter, as well as muscle strength using a hand-held dynamometer (HHD) in individuals with FHP and RSP. METHODS: Thirty healthy subjects underwent scapular position tests (upward rotation, anterior tilt, depression, and protraction) and strength tests of periscapular muscles (serratus anterior, upper trapezius, middle trapezius, and lower trapezius) on both the dominant and non-dominant sides. The reliability of the measurements was confirmed by computing the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal clinically important difference (MCID). Test and re-tests were conducted over a period of one week and actual values for each measurement were also obtained and assessed. RESULTS: The ICC ranged from 0.802 to 0.935 for the scapular position tests and from 0.808 to 0.949 for muscle strength tests on the dominant and non-dominant sides. For scapular position tests, SEM values ranged from 0.3 cm to 0.6 cm (protraction and depression), from 1.0∘ to 1.7∘ (upward rotation and anterior tilt) and MCID values ranged from 0.7 cm to 1.6 cm (protraction and depression), from 2.8∘ to 4.7∘ (upward rotation and anterior tilt). Regarding muscle strength tests, SEM and MCID values were in the range 14.4N–27.3N and 39.9N–75.7N, respectively. CONCLUSIONS: Scapular position and periscapular muscle strength can be reproducibly measured in healthy subjects individuals with FHP and RSP. These instruments can hence be recommended for evaluating these functional traits in subjects with FHP and RSP.

Impact of using a local protocol for preoperative screening exams in hip arthroplasty surgeries: cross-sectional study

Purpose: To evaluate the adoption of a protocol for patients undergoing primary total hip arthroplasty (PTA). Methods: 72 medical records of patients undergoing ATPQ were evaluated between 2016 and 2022. This is a cross-sectional retrospective study. The eligible patients were divided into two groups: group 1 – 36 arthroplasties before the adoption of the protocol; group 2 – 36 arthroplasties after the adoption of the protocol. Statistical analysis was performed using SPSS 13.0. Results: The mean age of the patients was 61 ± 11.7 years, being 42 males and 30 females. Pre-existing comorbidities were: systemic arterial hypertension (58%) and diabetes (18%) patients. The dominant side was operated on in 65% of cases. Patients were treated with cementless prosthesis (54%) of the cases and with hybrid prosthesis (40.3%). Only nine (12.5%) patients had infection. A significant difference was observed with the presence of infection in the group after the implementation of the protocol with a lower incidence. There was a lower infection rate in group 2 submitted to the application of the protocol, however, statistically the significance was not confirmed. Conclusion: It is concluded that the design of the institutional protocol has the potential to reduce postoperative infections in hip arthroplasty surgeries.

Signal to noise ratio of masticatory muscle activity of functional and non-functional oral tasks.

Electromyographic activity (EMG) of masticatory muscles during wakefulness is understudied. It is unclear if single channel ambulatory EMG devices are sensitive enough to detect masticatory muscle activity (MMA) during wakefulness. To compare the MMA of various oral tasks recorded with a single channel EMG device ((Grindcare4-datalogger Prototype device) (GC4-β)) and a conventional EMG (cEMG) device. EMG activity of 30 standardised oral tasks was recorded unilaterally from the masseter and anterior temporalis muscle in 24 healthy volunteers using GC4-β and a cEMG device. To compare the EMG data, signal-to-noise ratios (SNR) were calculated as a way to normalise EMG activity across tasks. Analysis of variance was used to compare the SNR between the devices, muscles and oral tasks. SNR measured from GC4-β was overall significantly higher than the cEMG device (p =.001). The SNR for maximum voluntary contraction (MVC) was significantly higher than all other tasks (p <.001). SNR for temporalis with GC4-β was significantly higher for MVC, hard food, soft food, gum chewing (dominant side), rhythmic clenching and upper lip biting compared to the cEMG device (p <.021). The SNR for masseter with GC4-β was significantly higher for hard food and gum chewing (dominant side), rhythmic clenching, rhythmic biting of an object and yawning compared to the cEMG device (p <.022). This study provides novel insight into the EMG patterns of numerous oral tasks enhancing knowledge of physiological differences between the masticatory muscles. Further, single channel EMG devices can effectively measure the EMG activity of various oral tasks during wakefulness.

Orthopedic Injuries in Beach Tennis Players in Brazil.

Objective To analyze the epidemiological data of orthopedic injuries in beach tennis players. Methods We conducted a cross-sectional study, through a questionnaire, with 185 beach tennis players during tournaments and training sessions in two cities. The questionnaire comprised anthropometric data, as well as data on length of time practicing the sport and reported orthopedic injuries. Results We excluded 25 of the 185 interviewees. Of the 160 players studied, 51.9% were male and 48.1%, female. The average age was of 40.4 years, the average height was of 1.73 m, the average weight was of 75.6 kg, and the average body mass index (BMI) was of 25.2 kg/m 2 . Orthopedic injuries were reported by 48.8% of the participants, 30.0% in the lower limbs, 11.3% in the spine, and 25.0% in the upper limbs, with an incidence of 0.82 per one thousand hours of practice. Correlating the incidence of injuries with age, weight, height, and BMI, we only found relevance between the higher average age in patients with lower- and upper-limb injuries. Players who had no previous experience with other racket sports had fewer injuries. Other parameters, such as gender, use of the two-handed backhand , dominant side, participation in competitions, and practice of other sports did not show statistically significant differences. Conclusion Orthopedic injuries were found in almost half of the beach tennis players, primarily in the lower limbs. Age, experience with other racket sports, category, hours of training per week, and length of time playing the sport influenced the incidence of orthopedic injuries.

Displaced humeral shaft fractures: Assessment of fracture union and complications following dual plate fixation using an anterior approach

The humeral bone is subject to torsional forces. In case of displaced shaft fractures, internal fixation remains the standard of care. This retrospective two-center study assessed the fracture union rate and complications after dual 3.5 mm locking compression plate (LCP) fixation using an anterolateral approach. Over a 9-year period, 38 patients underwent surgery in two centers. They had a mean age of 53.7 years (15–97, ± standard deviation (SD) 26) and there were three open fracture cases (7.9 %). The dominant side was affected in 21 cases (55.3 %) and there were 11 polytrauma patients (29 %). Mean operative time was 78 min (40–124, ± 19.8 SD). Patients were treated with dual 3.5 mm LCP fixation (6 screws on either side of the fracture line, anterolateral approach without a tourniquet). The first two orthogonal views showing at least 3 cortical bridges out of 4 determined fracture healing, as assessed by two independent raters. Pre- and postoperative complications were tabulated. Clinical outcomes included range of motion (ROM) and return to activities, while functional outcomes were assessed with the Disability of the Arm Shoulder and Hand (DASH), the Constant score, the Subjective Shoulder Score (SSV) and the Mayo Elbow Performance Score (MEPS). Minimum follow-up was 1 year. Four patients were given a shoulder immobilizer to wear for 3 weeks; immediate mobilization was the standard of care for the other patients. Fracture union was achieved in all cases within a mean of 11.7 weeks (6–28 ± 7.1 SD) without any heterotopic ossification of the brachialis muscle. There were eight patients with preoperative radial nerve palsy and two cases of postoperative palsy. There was one surgical site infection (2.6 %). Return to work for active patients was possible in 87 % of cases within a mean of 23 weeks (6–72 ± 11 SD). The Constant score was 84.6 (35–100, ± 13.4 SD), the SSV score was 80.7 (60–100, ± 8.2 SD), the DASH score was 13.5 (0–38.3, ± 8.8 SD) and the MEPS score was 85 (55–100, ± 11.9 SD). Traditional fixation methods provide little control over torsional forces, leading to non-union rates between 3 % and 12 % and delayed union (12 to 20 weeks). The simplicity of the technique described here, and the short operative time, may help explain the low infection rate. Dual plate fixation makes it possible to use more screws and allows nerve exploration and decompression in case of preoperative nerve palsy. Dual plate fixation to treat humeral shaft fractures is a simple and reliable technique.

Differences in ankle and knee muscle architecture and plantar pressure distribution among women with knee osteoarthritis.

The aim of this study was to compare the plantar pressure distribution and knee and ankle muscle architecture in women with and without knee osteoarthritis (OA). Fifty women with knee OA (mean age=52.11±4.96years, mean Body mass index (BMI)=30.94±4.23kg/m2) and 50 healthy women as a control group (mean age=50.93±3.78years, mean BMI=29.06±4.82kg/m2) were included in the study. Ultrasonography was used to evaluate knee and ankle muscles architecture and femoral cartilage thickness. The plantar pressure distribution was evaluated using the Digital Biometry Scanning System and Milleri software (DIASU, Italy). Static foot posture was evaluated using the Foot Posture Index (FPI), and pain severity was assessed using the Visual Analog Scale. The OA group exhibited lower muscle thickness in Rectus Femoris (RF) (p=0.003), Vastus Medialis (VM) (p=0.004), Vastus Lateralis (p=0.023), and Peroneus Longus (p=0.002), as well as lower Medial Gastrocnemius pennation angle (p=0.049) and higher Fat thickness (FT) in RF (p=0.033) and VM (p=0.037) compared to the control group. The OA group showed thinner femoral cartilage thickness (p=0.001) and higher pain severity (p=0.001) than the control groups. FPI scores were higher (p=0.001) in OA group compared to the control group. The plantar pressure distribution results indicated an increase in total surface (p=0.027), total load (p=0.002), medial load (p=0.005), and lateral load (p=0.002) on dominant side in OA group compared to the control group. Knee and ankle muscle architecture, knee extensor muscle FT, and plantar pressure distribution in the dominant foot differed in individuals with knee OA compared to the control group.

Isokinetic Ankle Inversion and Eversion Muscle Strength in Korean Men’s Professional Basketball Players

PURPOSE: In this study, the isokinetic strength of ankle inversion and eversion in Korean professional basketball players (KBL) was assessed, distinguishing between their dominant and non-dominant legs, as well as across different positions.METHODS: A meticulously designed study was conducted involving 25 KBL players (12 guards, 11 forwards, and 2 centers) with an average age of 27.8 ± 5.3 years. The CSMI Norm isokinetic dynamometer, a highly accurate instrument, was used to measure bilateral isokinetic concentric strength at 60°·s-¹ and 150°·s-¹. The study measured peak torque (Nm), body mass normalized peak torque (Nm·kg-¹), bilateral strength asymmetry, and the eversion-to-inversion strength ratio in both dominant and non-dominant legs.RESULTS: Peak torques, normalized peak torques, and eversion-to-inversion strength ratios were not significantly different between the dominant and non-dominant legs at the two angular speeds. There was also less than a 10% asymmetry in strength between the two legs. However, a position-specific analysis revealed that guards had a significantly higher normalized peak torque (0.35 vs. 0.30 Nm·kg-1, p = .048) for ankle inversion of the dominant leg at 150°·s-¹ compared to forwards.CONCLUSIONS: The results suggest that healthy KBL players exhibit symmetrical ankle inversion and eversion muscle strength between their dominant and non-dominant sides, with possible positional differences in strength. These findings serve as a reference for the assessment of inversion and eversion strength in basketball players.

Complications related to short peripheral intravenous catheters in patients with acute stroke: a prospective, observational, single-cohort study.

Patients with acute stroke often require venous access to facilitate diagnostic investigations or intravenous therapy. The primary aim of this study was to describe the rate and type of complications associated with the placement of a short peripheral catheter (SPC) in patients with acute ischemic or hemorrhagic stroke. A prospective, observational, single-cohort study was conducted at Niguarda Hospital, Italy, with enrolment in the Emergency Department. Adult patients with an ischemic or hemorrhagic stroke requiring an SPC were enrolled. Complications, such as infiltration, occlusion, phlebitis and dislodgment, were recorded daily. Descriptive statistics were used, and the incidence rate ratio (IRR) was estimated to assess the difference in complications, considering catheter calibre, dominant side, exit site, limb, and limb mobility, ictus type (ischemic/haemorrhagic), impairment deficit (language, motor, visual) and EA-DIVA score. A total of 269 participants and 755 SPC were analysed. Removal of SPC due to at least one local complication occurred in 451 (60%). Dislodgment was the major cause of SPC removal (31%), followed by infiltration (18%), occlusion (6%), and phlebitis (5%). The SPC calibre (22G), exit-site other than antecubital and forearm, visual deficit and EA-DIVA ≥ 8 were associated with a higher rate of SPC complications: IRR, 1.71 [1.31; 2.31]; 1.27 [1.01; 1.60], 1.38 [1.06; 1.80], 1.30 [1.04; 1.64], respectively. No other differences in complication rates were observed according to the insertion site, i.e. dominant side, left side, plegic/hyposthenic limb, or exit site. This study provides novel insights into the frequency and types of complications associated with SPC in patients with acute stroke. Compared to the literature, a higher dislodgment rate was observed, being the first cause of SPC removal, whereas no differences in the number of infiltrations, occlusions, and phlebitis were recorded.

Multimodal sensorimotor assessment of hand and forearm asymmetries: a reliability and correlational study.

Effective rehabilitation of upper limb musculoskeletal disorders requires multimodal assessment to guide clinicians' decision-making. Furthermore, a comprehensive assessment must include reliable tests. Nevertheless, the interrelationship among various upper limb tests remains unclear. This study aimed to evaluate the reliability of easily applicable upper extremity assessments, including absolute values and asymmetries of muscle mechanical properties, pressure pain threshold, active range of motion, maximal isometric strength, and manual dexterity. A secondary aim was to explore correlations between different assessment procedures to determine their interrelationship. Thirty healthy subjects participated in two experimental sessions with 1 week between sessions. Measurements involved using a digital myotonometer, algometer, inclinometer, dynamometer, and the Nine-Hole Peg test. Intraclass correlation coefficients, standard error of the mean, and minimum detectable change were calculated as reliability indicators. Pearson's correlation was used to assess the interrelationship between tests. For the absolute values of the dominant and nondominant sides, reliability was 'good' to 'excellent' for muscle mechanical properties, pressure pain thresholds, active range of motion, maximal isometric strength, and manual dexterity. Similarly, the reliability for asymmetries ranged from 'moderate' to 'excellent' across the same parameters. Faster performance in the second session was consistently found for the Nine-Hole Peg test. No systematic inter-session errors were identified for the values of the asymmetries. No significant correlations were found between tests, indicating test independence. These findings indicate that the sensorimotor battery of tests is reliable, while monitoring asymmetry changes may offer a more conservative approach to effectively tracking recovery of upper extremity injuries.