Flexion Range Of Motion Research Articles

Early Results of All-Dorsal Arthroscopic Scapholunate Ligamentoplasty

Abstract Introduction We report early outcomes of all-dorsal arthroscopic scapholunate ligamentoplasty (ADAL) in 12 patients. Materials and Methods Dorsal internal brace and capsulodesis were performed in all patients. In half of the patients, a palmaris gracilis tendon graft was used to reconstruct the dorsal aspect of the scapholunate complex. Patients were evaluated for pain, wrist range of motion, grip strength, clinical scores, and radiological appearance at a mean follow-up of 15.9 months. Results We obtained similar results in the technique with and without tendon graft. Visual analog scale (VAS 10) score improved from 6 to 1. Wrist range of motion in Flexion–extension increased from 123 to 144 degrees. Postoperative grip strength was 180% more than preoperative, with a mean Mayo wrist score of 79.5 and quick Disabilities of the Arm, Shoulder and Hand (quickDASH) of 14.9. The radiolunate angle decreased from 29 to 10 degrees, the scapholunate (SL) angle from 83 to 52 degrees, and the scapholunate gap from 6 to 3mm. Conclusion ADAL has many advantages compared with other scapholunate ligamentoplasties, including minimal invasiveness, association with internal brace and dorsal capsulodesis, and lower risk of carpal fracture or avascular necrosis. Its short-term results are promising.

Effect of a tailor-made hydrotherapy on physical functions in patients after unilateral unicompartmental knee arthroplasty—A feasibility study

IntroductionUnicompartmental knee arthroplasty (UKA) is one of the treatment options for patients whose osteoarthritis involves one out of the 3 compartments. Patients who underwent UKA benefited from shorter hospital stays, better range of motion, and lower risk of postoperative complications compared with patients who underwent total knee arthroplasty (TKA). Hydrotherapy is being introduced complementary to conventional postoperative rehabilitation programs. No report on the use of hydrotherapy evaluating physical functions on patients who underwent UKA leads us to carry out the present study. This is a feasibility study to investigate the effects of hydrotherapy on physical functions in patients after primary unilateral UKA.MethodsA retrospective cohort study recruited 68 patients who underwent primary unilateral UKA. Nineteen patients were allocated to the hydrotherapy group and 49 patients were in the convention group. Patients in the hydrotherapy group received hydrotherapy and conventional physiotherapy, and the convention group was given conventional physiotherapy only. The primary outcome was Knee Society Function Score (KFS) measured before surgery, six months, and one year after UKA. Self-reported walking tolerance, Timed Up and Go Test (TUGT), and 30-s Chair Stand Test (30CST) were conducted before and after the completion of rehabilitation. Pain and range of motion were also covered.ResultsHydrotherapy group showed significantly higher KFS at 6 months (P = 0.038) and one year (P = 0.030) after operation. Range of motion flexion and extension in the hydrotherapy group were significantly improved at postoperative 4 weeks and the last session of rehabilitation. Self-reported walking tolerance in the hydrotherapy group was significantly longer at the last session (P = 0.011). No significant difference was found in TUGT, 30CST, and pain between the two groups after rehabilitation. In both groups, all outcomes were significantly better as compared to preoperative findings.ConclusionPatients who underwent UKA after hydrotherapy complementary to conventional physiotherapy showed significant improvements in functions, range of motion, and time to tolerating walking before rest. Pain, mobility, balance, leg strength, and endurance were comparable between the two groups. Combination of hydrotherapy with conventional postoperative physiotherapy rehabilitation yielded even better outcomes than conventional physiotherapy alone. Further research with advanced study design, larger sample size and longer follow-up periods for patients who underwent UKA is recommended.Trial registrationNCT06459960, retrospectively registered on 13.06.2024 (ClinicalTrials.gov).

Effect of Ultrasound Combined with Dry Needling on Myofascial Pain in the Upper Trapezius : a Controlled Randomised Study

INTRODUCTION. Myofacscial Pain Syndrome (MPS) Upper trapezius is a condition of tightness in the upper trapezius characterized by the appearance of myofascial trigger points in the upper trapezius muscle fibers. This causes pain and decreased elastitrapezius muscle fibers, resulting in cervical motion limitations. AIM. To determine the effect of the addition of ultrasound to Dry needling intervention on reducing pain and increasing cervical range in the condition of upper trapezius MPS. MATERIALS AND METHODS. This type of research is a quasi-experiment with a randomized pre-test-post-test control group design that uses 2 sample groups, where the treatment group is given Ultrasound Therapy and Dry needling intervention, and the control group is given Dry needling intervention only. The sample obtained was 30 people according to the inclusion criteria, then randomized into 2 groups, namely 15 people in the treatment group and 15 people in the control group. Data collection was obtained through measurement of tenderness using Visual Analog Scale (VAS) and measurement of Range of Motion (ROM) using a goniometer. RESULTS AND DISCUSSION. Based on the independent sample t-test for the VAS scale, the value of p = 0.619 (mean difference of 3.767 control 3.553 treatment), and based on the Mann-Whitney test, the value of p = 0.074 for flexion ROM (mean difference of 17.00 control 12.33 treatment), p = 0.311 for lateral flexion ROM (mean difference of 9.33 treatment 8.00 control), and p = 0.494 for rotation ROM (mean difference of 13.33 treatment 11.67 control), which means that there is no significant difference in effect between the treatment and control groups. CONCLUSION. The addition of ultrasound to the dry needling intervention resulted in an increase of 9.33 in lateral flexion and 13.33 in rotation which means this number is greater when compared to dry needling alone with an increase of 8.00 in lateral flexion and 11.67 in rotation. However, the addition of ultrasound did not result in a decrease in tenderness and a greater improvement in cervical flexion where the value of 3.767 in dry needling alone compared to the value of 3.553 in the addition of ultrasound and 17.00 12.33.

Short-Term Effect of Different Physical Therapy Modalities on Neck Mobility in Healthy Young Adults

Purpose: To investigate the short-term effects of hot pack, intermittent traction and low-level laser combined with stretching exercises and stretching exercises alone on neck mobility in individuals with no past pain history but flexibility loss. Material and Methods: Sixty (60) participants were randomly divided into 4 groups. All participants performed cervical stretching exercises. Cervical intermittent traction wad added to Group I, low level laser therapy was added to group II, hot pack was added to group III. Cervical range of motion (ROM), occiput-wall distance (OWD) and, coronoid process- tragus distance (TCD) was assessed at the beginning and end of the study. Results: The results of this study showed that all physical therapy modalities were effective in increasing lateral flexion ROM and OWD score (p.05) to stretching exercises alone in increasing neck mobility. Conclusion: In conclusion, both stretching exercises alone and combined with hot pack, intermittent traction, and low-level laser increased neck mobility in healthy individuals. Even if not combined with any modality, stretching exercises alone may increase neck mobility.

Influence of Photobiomodulation Therapy Combined with Pelvic Floor Exercises on Postpartum Coccydynia: A Randomized Controlled Trial.

Objective: This study was conducted to investigate whether the addition of photobiomodulation therapy (PBMT) to pelvic floor exercises (PFEs) is more effective in treating postpartum coccydynia compared with either modality alone. Background: Postpartum coccydynia is a widespread condition that significantly affects the quality of life. Inflammation as a response to childbirth trauma and weakening of the muscles and ligaments attached to the coccyx are presumed causes of postpartum coccydynia. Finding effective modalities to manage this condition will help the quality of life for most women. Methods: Sixty women aged 25-35 years with postpartum coccydynia ≥6 weeks were randomly allocated to Group A (PBMT + hot pack + PFEs), Group B (PBMT + hot pack), and Group C (placebo PBMT + hot pack + PFEs). All groups received 12 sessions over 4 weeks of hot packs plus their allocated active treatment (PBMT and/or PFEs). Outcomes were pain intensity (visual analog scale), lumbar flexion range of motion (ROM) (modified Schober test), and self-reported disability (Oswestry Disability Index). The assessors were blinded to group allocation. Results: All the measured outcomes showed significant differences (p < 0.001), with the superiority of Group A over the other groups (p < 0.001). Within groups, all groups showed statistically significant improvement from baseline across outcomes (p < 0.05). Conclusions: Adding PBMT to PFEs is recommended in the management of postpartum coccydynia as this combination resulted in greater reductions in pain and disability, along with improved lumbar flexion ROM.

Acute effects of tissue flossing on boxers with chronic knee pain.

To explore the acute intervention effects of tissue flossing on chronic knee pain (CKP) in boxers. Eighteen boxers with CKP (12 male/6 female) were randomly divided into an experimental group (EG) with tissue flossing (n = 9) and a control group (CG) (n = 9). The visual analog scale (VAS), Lysholm knee function score, flexion range of motion (ROM), maximal isometric extensor muscle strength, and stability of the knee were measured pre- and post-intervention (EG: 3-minute tissue flossing, CG: rest). VAS (F = 15.849, p = 0.001, η 2 p = 0.498) and Lysholm knee function (F = 9.327, p = 0.008, η 2 p = 0.357) significantly improved more in the EG than in the CG. There was a significant difference for maximal isometric extensor muscle strength (F = 17.769, p = 0.001, η 2 p = 0.542) and knee stability (F = 13.844, p = 0.002, η 2 p = 0.464) but no significant difference for ROM (F = 1.218, p = 0.287, η 2 p = 0.075) between the EG and CG. Tissue flossing can reduce knee pain, improve knee function, increase knee extensor strength, and improve knee stability in boxers with CKP.

Association of Antihypertensive and Statin Medication Usage With Postoperative Stiffness After Arthroscopic Rotator Cuff Repair: A Retrospective Cohort Study.

Angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), and statins may be able to modulate postoperative stiffness, a major cause of morbidity after arthroscopic rotator cuff repair (aRCR). To determine whether there is an association between ACEi, ARB, or statin usage and stiffness after aRCR. Cohort study; Level of evidence, 3. Patients who underwent primary aRCR between January 2016 and December 2019 were categorized into 4 groups depending on the usage of ACEi (n = 45), ARB (n = 27), statins (n = 53), or none of these medications (controls; n = 113). Range of motion in flexion, abduction, internal rotation (IR), and external rotation (ER) was recorded preoperatively and at 6 weeks and 3, 6, and 12 months postoperatively. Functional outcomes were assessed with the American Shoulder and Elbow Surgeons (ASES) score, the Single Assessment Numeric Evaluation (SANE), and the Simple Shoulder Test (SST) preoperatively and at 1 and 2 years postoperatively. The groups were compared using t test or Mann-Whitney U test for continuous data and chi-square or Fisher exact test for categorical data. Preoperatively, compared with controls, the ACEi group had decreased flexion (P = .038), abduction (P = .001), ER (P = .009), and IR (P = .015); the ARB group had decreased abduction (P = .012) and IR (P = .019); and the statins group had decreased abduction (P = .015), ER (P = .008), and IR (P = .011). Postoperatively, compared with controls, the ACEi group had decreased 6-month abduction (P = .034) that resolved by 12 months and 3-month ER (P = .004) that persisted into 6 months, the ARB group had greater ER at 12 months (P = .006), and the statins group had increased 6-week abduction (P = .017) that normalized by 3 months. Patients taking ACEi had lower postoperative ASES (30 vs 58.6; P = .001) and SANE scores (28.4 vs 52.3; P = .002) at 1 year and lower SST scores at 2 years (74.7 vs 85.5; P = .002) versus controls. Patients who used ACEi showed an increased risk of stiffness 6 months postoperatively and had worse SST scores at 2 years after aRCR, while those who used ARB demonstrated improved postoperative ER and IR, with no changes in functional outcomes at longer-term follow-ups.

Treatment Order and Retention of Self-Myofascial Release and Static Stretching on Passive Hip Flexion Range of Motion

Context: Many healthcare professions incorporate foam rolling (FR) and static stretching (SS) to improve tissue extensibility. Currently, it is unknown if the order an individual performs FR and SS influences flexibility or whether flexibility is retained. This study aimed to determine if FR before, or, following SS influences passive hip flexion range of motion (ROM), and if changes are retained. Design: Between-group experimental design. Methods: Thirty-five participants with less than 90° of passive hip flexion ROM volunteered. Over 8 days, 6 days separated by 24 hours, and then 1 week (day 7) and 2 weeks (day 8) following the last treatment, ROM was measured before and following 1 of 5 treatments; FR/SS, SS/FR, SS, FR, or nothing (control). Participants laid supine on a table where a bubble inclinometer was placed on the tibia of the dominant leg with the hip passively flexed to establish pretreatment ROM. Participants then received the treatments. Passive hip flexion ROM was assessed from pretreatment on day 1 to posttreatment on day 6, day 7 (1 wk), and day 8 (2 wk). Results: Passive hip flexion ROM increased for those receiving FR/SS, SS/FR, FR, and SS. ROM with FR and SS/FR was retained at day 7 but not day 8. Hip flexion ROM for FR/SS and SS were not retained at day 7 nor 8. SS/FR resulted in greater ROM than FR on day 6. SS/FR, FR/SS, SS, and FR were greater than the control at day 6. SS/FR was also greater than the control on days 7 and 8. Conclusion: This study revealed that FR the hamstring muscles after SS produces the greatest gains in passive hip flexion and would be appropriate in noninjured patients with less than 90°.

Effect of Postural Correction Exercises and Pelvic Tilt Exercises on Pain, ROM and Function in Pregnant Females with Lower Back Pain

The study aimed to evaluate the effects of postural correction exercises and pelvic tilt exercises on pain intensity, range of motion (ROM), and functional abilities in pregnant women with lower back pain. A quasi-experimental study was conducted at Family Welfare Hospital and Ali Clinic Lahore, Pakistan. A total of 24 pregnant women with lower back pain, meeting the inclusion and exclusion criteria, were allocated into two equal groups. Group 1 (Postural Correction Exercises) and Group 2 (Pelvic Tilt Exercises). Each group consisted of 12 participants. Both groups underwent a comprehensive pre-intervention assessment to establish baseline measurements using the Visual Analog Scale (VAS) for pain, goniometry for ROM, and the Oswestry Disability Index (ODI) for functional abilities. The data was normally distributed between groups, necessitating the use of the One-way ANOVA test, which revealed significant improvements in both groups (p &lt; 0.001). One-way ANOVA showed significant decreases in VAS and ODI scores and significant increases in trunk flexion and extension ROM in both groups (p = 0.001). The effect size for changes in pain was moderate (Cohen d = 0.78), and for functional disability, it was large (Cohen d = 0.85), favoring Group 2. Both postural correction and pelvic tilt exercises are effective for managing lower back pain in pregnant women, improving pain levels, ROM, and functional abilities. Pelvic tilt exercises demonstrated a more pronounced impact on functional disability improvements. These findings support the inclusion of these exercise regimens in prenatal care.

Factors associated with poor hip flexion range of motion after total hip arthroplasty in patients with ankylosing spondylitis: a retrospective study on 538 consecutive hips

BackgroundThis study aimed to report the mid-term functional outcomes of total hip arthroplasty (THA) for the treatment of advanced hip involvement in ankylosing spondylitis (AS) and identify the factors associated with poor hip flexion range of motion (ROM) after THA in patients with AS.MethodsWe retrospectively investigated the mid-term functional outcomes in 313 AS patients (538 hips) who underwent primary THA from 2012 to 2017, with a mean follow-up of 7 years (range, 4–9 years). Postoperative functional outcomes were assessed by hip flexion ROM, Harris hip score (HHS), and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). The hips were divided into poor (≤ 90°) and good hip flexion ROM (> 90°) groups based on the degree of hip flexion ROM recorded at the most recent follow-up. We grouped factors related to postoperative hip flexion ROM into three categories: preoperative (or patient-related), intraoperative (or surgery-related), and postoperative factors. Multivariate logistic regression was performed to identify the independent factors associated with postoperative poor hip flexion ROM.ResultsThe overall flexion-extension ROM improved significantly with a median from 0° (0 ~ 120°) to 100° (30 ~ 130°) after THA (P < 0.001), and the mean HHS increased from 37 to 90 (P < 0.001). There were 102 hips (19%) with a hip flexion ROM of no more than 90°. The poor hip flexion ROM group had significantly lower postoperative HHS and WOMAC than the good hip flexion ROM group (85 ± 6 vs. 91 ± 4, P < 0.001; 63 ± 16 vs. 32 ± 16, P < 0.001). The result of multivariate logistic regression showed that male sex (odds ratio [OR] = 9.42, 95% confidence interval [CI], 1.23 to 72.03), bony ankylosis (OR = 3.02, 95%CI, 1.76 to 5.17), cup anteversion angle (OR = 0.96, 95%CI, 0.93 to 0.98), cup inclination angle (OR = 0.96, 95%CI, 0.93 to 0.99), American Society of Anesthesiologists (ASA) class III (OR = 6.23, 95%CI, 1.83 to 21.70), knee involvement (OR = 7.80, 95%CI, 2.75 to 22.16), and noise (OR = 0.45, 95%CI, 0.25 to 0.81) were independent factors associated with poor hip flexion ROM after THA in patients with AS.ConclusionNearly one out of the five hips in patients with AS have a poor hip flexion ROM after THA. Care has to be taken in acetabular component positioning during THA and its effect on the postoperative hip flexion function should be considered in the patients. The optimum treatment strategy is that THA should be performed before ankylosis in patients with AS.

Comparative study of open elbow arthrolysis with and without hinge external fixation for the treatment of post-traumatic elbow stiffness

BackgroundThe present study aimed to compare the functional outcomes of hinged external fixators and non-external fixation in open elbow arthrolysis (OEA) for post-traumatic elbow stiffness (PTES) and to evaluate their applicability and limitations in patients with posttraumatic elbow stiffness.MethodsThe clinical data of patients with PTES treated with OEA at our hospital between March 2015 and June 2022 were retrospectively analyzed. The assessed variables were the operation time, intraoperative blood loss volume, duration of hospitalization, and treatment costs. The elbow range of motion (ROM), Mayo Elbow Performance Score (MEPS), shortened disabilities of the arm, shoulder and hand questionnaire (Q-DASH) score, Oxford Elbow score (OES), Broberg and Morrey score (BMS), visual analog scale (VAS) for pain, and complications such as pin tract infection and heterotopic ossification were compared between patients with and without hinge external fixation. We also compared the baseline characteristics and functional outcomes of patients with and without hinge external fixation.ResultsA total of 156 patients (48 patients with hinged external fixators and 108 patients without external fixators) diagnosed with PTES were included in this study. The mean follow-up was 15.8 ± 3.6 months. Compared with patients without external fixators, those with external fixators showed significantly greater improvements in elbow flexion and extension ROM (59.6° ± 26.1° vs. 46.2° ± 26.2°, p = 0.004) but had a significantly longer duration of hospitalization (p < 0.001), significantly longer operation time (p < 0.001), significantly higher treatment costs (p < 0.001), and significantly greater intraoperative blood loss volume (p < 0.001). There were no significant differences between the two groups in terms of improvement in elbow rotation ROM, MEPS score, VAS score for pain, OES score, Q-DASH score, BMS score, or incidence of complications.ConclusionThe use of a hinged external fixator in open arthrolysis for posttraumatic elbow stiffness may result in short-term improvements in flexion-extension range of motion but is accompanied by increased blood loss, longer operative time, extended hospitalization, and higher costs. Further studies are needed to confirm these findings.Clinical trial numberNot applicable.

Outcomes of Unrestricted Weight-Bearing During Interval Period With Cement-on-Cement Articulating Antibiotic-Loaded Spacers in Two-Stage Revision for Knee Prosthetic Joint Infection.

Two-stage revision is known as the gold-standard method for knee prosthetic joint infection (PJI), but the most suitable treatment method remains controversial. Typically, weight-bearing is restricted during the interval between the stages. The aim of this study was to evaluate the clinical outcomes of unrestricted weight bearing with cement spacers fabricated using the Knee Articulating Spacer Mold (KASM®; Ortho Development Corporation, Draper, UT, USA) for knee PJI. We retrospectively reviewed 16 patients who underwent two-stage revision surgery for knee PJI between April 2015 and March 2020. The procedure involved the removal of the infected prosthetic joints and the insertion of cement spacers made using KASM®. The evaluation focused on the possibility of full-weight bearing gait during the interval between the first and second stages, surgical time, blood loss, complications, and postoperative outcomes, including the Knee Society Score (KSS), Knee Society Function Score, and range of motion (ROM). All patientswere able to walk with full weight-bearing. However,cement spacer dislocationoccurred in one patient(6.3%). During the interval between stages, infection occurred in one patient (6.3%) and debridement was performed. Average interval between the stages was 92.7 days (range, 55-166 days). After the reimplantation, reinfection occurred in two patients (12.5%) out of the 16. Among the 14 patients with successful reimplantation, the average operative time was 116.1 min (range, 76-153 min) and the average perioperative blood loss was 476.1 mL (range, 89.5-859 mL). The KSS was 86.4 (range, 62-100), the Knee Society Function Score was 73.6 (range, 45-100), and flexion ROM was 111.8° (range, 95°-130°) at the latest follow-up.The mean follow-up period was 871 days (range, 117-1103 days). Unrestricted weight-bearing gait using cement spacers during the waiting period for two-stage revision surgery for knee PJI led to favorable outcomesin this case series, which lacked a control group.Further studies are needed to assess whether the benefits of weight-bearing outweigh the risks and improve overall outcomes.

Short-term effects of Kinesiotaping combined with a rehabilitation program for rotator cuff-related shoulder pain: a randomized, assessor-blinded clinical trial

ABSTRACT Objectives This study aimed to determine the clinical efficacy of Kinesiotaping (KT) combined with a rehabilitation program to reduce symptoms and functional limitations in patients with Rotator Cuff-Related Shoulder Pain (RCRSP) in Vietnam. Methods In total, 82 participants who were diagnosed with RCRSP were randomly allocated into two groups. Both groups received a standard rehabilitation program; additionally, the intervention group was treated with KT. Outcomes, assessed at baseline, and 3, 7, and 14 days postintervention, included pain intensity (Visual Analogue Scale, VAS), functional disability (Shoulder Pain and Disability Index, SPADI), and active range of motion (ROM). Results The KT group exhibited significant improvements in all outcome measures. VAS scores decreased by an average of 13.3 points in the KT group at 14 days, which was notably greater than that in the control group (95% CI: −17.77 to −8.82). SPADI scores also improved significantly in the KT group, with reductions of −11.36, −15.27, and −13.3 at days 3, 7, and 14, respectively. Regarding ROM, the KT group showed notable improvements in flexion and external rotation, with flexion ROM differences of 10.78, 10.35, and 11.8 degrees at the respective time points. No significant changes were observed in the abduction or internal rotation ROM. After adjusting for age, baseline scores, and gender, there was a statistically significant interaction between Group and Time on the VAS, SPADI, and ROM abduction. Conclusion Incorporating KT into a standard rehabilitation program for RCRSP demonstrated enhanced efficacy in reducing pain and improving shoulder function. The results suggest that KT can be a valuable component of the treatment regimen for RCRSP.

Experimental ex vivo characterization of the biomechanical effects of laminectomy and posterior fixation of the lumbo-sacral spine

Laminectomy and posterior fixation are well-established surgical techniques to decompress nervous structures in case of lumbar spinal stenosis. While laminectomy is suspected to increase the instability of the spine, posterior fixation is associated with some complications such as adjacent segment degeneration. This study aimed to investigate how laminectomy and posterior fixation alter the biomechanics of the lumbar spine in terms of range of motion (ROM) and strains on the intervertebral discs. Twelve L2-S1 cadaveric spines were mechanically tested in flexion, extension, and lateral bending in the intact condition, after two-level laminectomy and after L4-S1 posterior fixation. The ROM of the spine segment was measured in each spine condition, and each loading configuration. The strain distribution on the surface of all the intervertebral discs was measured with Digital Image Correlation. Laminectomy significantly increased the ROM in flexion (p = 0.028) and lateral bending (p = 0.035). Posterior fixation decreased the ROM in all the loading configurations. Laminectomy did not significantly modify the strain distribution in the discs. Posterior fixation significantly increased the principal tensile and compressive strains in the disc adjacent the fixation both in flexion and in lateral bending. These findings can elucidate one of the clinical causes of the adjacent segment degeneration onset.

Analysis of posterior hip joint impingement about developmental dysplasia of the hip after total hip arthroplasty.

Total hip arthroplasty is the preferred treatment for advanced hip osteoarthritis, yet complications like hip dislocation (0.2%-10%) persist due to factors such as implant design, positioning, surgical technique, and patient-specific conditions. Impingement between prosthetic components or the acetabulum and proximal femur is a primary cause of instability. A retrospective analysis of 120 patients (130 hips) undergoing total hip arthroplasty at XX Hospital (2011-2023) categorized patients by lateral center-edge angle: developmental dysplasia of the hip, borderline developmental dysplasia of the hip, and normal hip. ct imaging facilitated virtual 3D bone models for motion analysis, excluding cases with prior hip surgery or spinal fusion. Statistical analyses utilized the Mann-Whitney U test and one-way ANOVA. The developmental dysplasia of the hip group showed the highest posterior impingement frequency, significantly affecting range of motion in flexion, adduction, and external rotation compared to borderline developmental dysplasia of the hip and normal hip groups. Variations in femoral neck anteversion, lesser trochanter version, and ischiofemoral space were notable. Posterior impingement commonly occurred between the lesser trochanter and ischial tuberosity. Posterior bony impingement emerged as a predominant factor reducing range of motion and increasing dislocation risk, particularly in developmental dysplasia of the hip patients, challenging the conventional "safe zone" for implant positioning. Personalized surgical strategies tailored to individual bone morphology are crucial for enhancing total hip arthroplasty outcomes and minimizing complications, although limitations include the exclusion of soft tissue influences and focusing solely on range of motion until impingement occurs.

Physical Performance Effects Associated with a 16-Week Therapeutic Yoga Intervention in Survivors of Cancers in the South Texas Region: A Pilot Study.

Yoga is recognized as a complementary practice that improves physical, mental, and spiritual health in survivors of cancer. The present study assessed associations between a holistic approach and physical function for 30 survivors of cancer in south Texas. Cancer survivors (86% female) of diverse backgrounds (62% underrepresented minorities) performed a battery of physical function tests, including a 6-minute walk test, to assess cardiorespiratory function, isometric shoulder and elbow-flexor strength, dominant-arm grip strength, dominant-arm shoulder range of motion via inclinometer, sit-and-reach test to assess trunk and lower-extremity flexibility, and a 30-second sit-to-stand test to assess lower-extremity endurance. Participants were reassessed 16 weeks after starting the intervention. The intervention involved a 75-minute live-streamed therapeutic yoga program, including meditation, three times a week and daily psychosocial support text messaging through a telehealth platform to increase efficacy in promoting health-enhancing behaviors. Repeated-measures analysis of variance was used to assess changes in physical performance between sessions. Statistically significant improvements were observed for the 6-minute walk test (+35.68 m; p = 0.020), elbow-flexor strength (+7.44 kg; p < 0.001), dominant-hand grip strength (+3.19 kg; p < 0.004), sit-and-reach test (+5.25 cm; p = 0.010), and dominant-arm shoulder range of motion in flexion (+11.18 degrees, p = 0.012) and abduction (+17.06 degrees, p = 0.036). A 16-week live-streamed therapeutic yoga intervention performed three times a week, coupled with daily psychosocial support messaging, was associated with improved cardiorespiratory endurance by increasing the distance walked in 6 minutes, improving upper-extremity strength and range of motion, and increasing the flexibility of back and hamstring muscles.

The Effect of Graded Motor Imagery on Pain and Function in Individuals with Knee Osteoarthritis: A Comparative Randomized Controlled Trial.

To examine whether graded motor imagery (GMI) was as effective as transcutaneous electrical nerve stimulation (TENS) in improving pain and functionality in patients with knee osteoarthritis (PwKOA). Forty-six PwKOA were randomized (1:1) into the GMI and the TENS groups. Both groups participated in home-based and functional exercises. A visual analog scale (VAS), the pressure pain threshold, range of motion (ROM), muscle strength, the Timed Up and Go Test, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were evaluated at baseline, after 8 weeks of treatment, and after a 6-week follow-up period. The within-group comparisons showed significant improvements in outcomes for both treatments. However, the difference between the groups was significant in favor of the GMI group in knee flexion ROM, knee extensor muscle strength, and WOMAC-pain and WOMAC-function parameters at the end of the treatment, and VAS-activity, knee flexor muscle strength, and WOMAC-stiffness values showed greater improvement in the GMI group compared with the TENS group at the end of the 6-week follow-up (for all, p < 0.05). GMI seems to be a more effective adjuvant than TENS. If applied in PwKOA, pain and functional recovery improved, and results were maintained for up to 6 weeks.

Effects of prior shelf procedure on subsequent conversion total hip arthroplasty

BackgroundIt is unclear if shelf acetabuloplasty provides adequate bone coverage when conversion total hip arthroplasty (THA) is required in patients with developmental dysplasia of the hip (DDH). We aimed to investigate the short-term results of conversion THA after shelf acetabuloplasty.MethodsForty-six patients requiring conversion THAs after a prior shelf acetabuloplasty were matched to THAs for osteoarthritis secondary to Crowe I DDH in a 1:1 ratio. Surgical factors, clinical scores, cup placement, and bone coverage of the cup were evaluated.ResultsThe preoperative Japanese Orthopaedic Association (JOA) score and flexion range of motion (ROM) were lesser in the shelf group (JOA: 49.2 ± 22.4 vs. 60.1 ± 14.5, p < 0.01, flexion ROM: 69 ± 22.4 vs. 82.1 ± 17.5, p < 0.01). There were no significant differences in JOA (88.7 ± 8.7 vs. 92.1 ± 8.0,p = 0.053) and flexion ROM (93.5 ± 17.3° vs. 99.5 ± 8.0, p = 0.08) after the index THA.All cups in both groups were placed at the anatomical hip centre. The cup centre edge angle (cup CE) was significantly lower in the shelf group (21.3°vs. 28.4, p = 0.0011), and ratio of cup coverage over the cup was lower in the shelf group (77.0% vs. 86.9%, p < 0.0001). There was no significant difference in the number of cases where acetabular bone grafting was performed (87.0% vs. 80.4%, p = 0.46). The operative time tended to be longer in the shelf group (117 ± 30.3 min vs. 106.6 ± 25.3 min, p = 0.06), and there was no significant difference in intraoperative blood loss (294.3 ± 33.8 vs. 313.3 ± 25.9, p = 0.50).ConclusionConversion THA after prior shelf acetabuloplasty provided encouraging short-term results with no major complications. Prior shelf acetabuloplasty did not complicate subsequent THA. Bone coverage of the acetabular component was inadequate in total hip arthroplasty, even with prior shelf acetabuloplasty.

Effect of Structured Core Stabilization Exercise Program on Pain and Muscle Performance in Individuals with Scapular Dyskinesia

Purpose: The purpose of this research was to determine the effect of structured core stabilization exercise program on pain and muscle performance in individuals with scapular dyskinesis. Methods: The study commenced obtaining ethical clearance from an institutional committee, briefing participants about the research and intervention, and obtaining informed consent. In accordance with the inclusion and exclusion criteria, 90 participants were enrolled for the research among which 80 participants enrolled in this study and were allocated into 2 groups at random- Group A (Control group) as well as Group B (Experimental group) by using the envelope method. Treatment was provided for about 6 weeks to both groups.Pre and post test examination was done using Individual Muscle Testing (IMT), core strength testing with Pressure Biofeedback (PB), shoulder joint range of motion (ROM) with Goniometry, in addition with Visual Analogue Scale (VAS) for pain. Statistical methods were utilised to analyse the results. Findings: This research found substantial improvements in pain, individual muscle testing and shoulder range of motion for flexion and abduction in two groups (p-value &amp;lt;0.0001), whereas, for internal and external rotation, group A showed p value of 0.0193 and 0.0098, whereas, group B showed p value of &amp;lt;0.0001 and 0.2399.Group B showed more improvement in pressure biofeedback unit (p&amp;lt;0.0001) as compared to Group A (p value 0.0208). Conclusion: The present research observed that a structured core stabilization exercise program had shown a significantly enhanced improving muscle performance and reducing pain in individuals with scapular dyskinesis.

Additive effect of glenohumeral joint hydrodilatation applied in addition to suprascapular nerve blockage in patients with adhesive capsulitis

BackgroundWe aimed to investigate the efficacy of shoulder hydrodilatation (HD) applied in addition to suprascapular nerve blockage (SSNB) on severity of pain, shoulder joint range of motion (ROM), functional status, handgrip (HG) strength in patients with adhesive capsulitis (AC).MethodsForty-eight patients who were diagnosed with AC based on physical examination findings included in the study. The patients were randomized into two groups as combination of SSNB + HD and SSNB alone. Injections were performed under ultrasonography guidance.Shoulder ROM angles were measured with a goniometer. Pain intensity was evaluated with visual analog scale. Functional status was evaluated with Quick Disability of Arm, Shoulder, and Hand (QDASH). HG strength was measured by a Jamar dynometer. After the injection, a home-based exercise program was given to all patients. Patients were evaluated at baseline, 1st and 3rd month.ResultsAbduction and external rotation ROM angles were statistically significantly limited in SSNB group, at baseline (p = 0.020, p = 0.018, respectively). In terms of other parameters, both groups were similar at baseline (p > 0.05). At comparison of baseline-1st month, a significant improvement was observed in VAS score, abduction and flexion ROM and QDASH score, in both groups (p < 0.05), however, there was no statistically significant difference between the groups. There is a statistically significant decrease in VAS score in both groups, at all times, but, no significant difference between the groups. At the comparison of baseline-3rd month measurements, it was observed that all of the parameters significantly improved in both groups, and there was no statistically significant difference between the groups except for abduction and external rotation ROM (p > 0.05). Abduction ROM and external rotation ROM were significantly higher in the SSNB group than SSNB + HD group at 3rd month.ConclusionsBoth SSNB + HD and SSNB alone provide significant improvement clinically especially in shoulder pain. HD added to SSNB does not seem to provide any additional benefit. SSNB is an effective treatment option for up to 3 months in patients with AC, mainly in abduction and external rotation limitation.