Functional Outcomes In Individuals Research Articles

Impact of Advanced High-Power Pain Threshold Static Ultrasound and Muscle Energy Technique on Pain Thresholds and Functional Improvement in Myofascial Trigger Points

bands and hypersensitive Trigger Points (TrPs), contributing to musculoskeletal pain. The objective of this study is to investigate and assess the effectiveness of Advanced High-Power Pain Threshold Static Ultrasound (AHPPTSU) and Muscle Energy Technique (MET) in altering pain thresholds and enhancing functional outcomes in individuals with myofascial trigger points. Methods: In this randomized clinical trial involving 86 individuals with TrPs in the upper trapezius muscle, the participants were divided into experimental and control groups. 33 males and 53 females, underwent six sessions of treatment over two weeks. A repeated measure Analysis of variance was used to compare baseline values and altered values at 1 and 2 weeks. Results: The study demonstrated that the Pressure Pain Threshold (PPT) and the Neck Pain Disability Index (NPDI) score, showed a significant improvements in participants receiving AHPPTUS in experimental group compared to the other group. Experimental group showed a significantly greater improvement in PPT (p=0.001) and both groups experienced a significant enhancement in function. However, when comparing the two groups, experimental group showed a significantly greater improvement (p=0.001). Importantly, no adverse effects were reported in either group. Conclusion: In the treatment of myofascial trigger point, AHPPTSU can be considered as an alternative therapy method, which is more effective than previously used High-Power Pain Threshold Static Ultrasound (HPPTSU) therapy and it also shortens the total treatment protocol to 2 weeks.

Assessment of Pain and Functional Outcomes in Individuals with Patellofemoral Pain Syndrome

Patellofemoral pain syndrome is a pathological condition of the patellofemoral joint characterized by knee pain in the peripatellar, anterior, and even retro patellar regions. Between 15% and 45% of persons in their 20s to 40s experience patellofemoral pain. Objective: To assess pain and functional outcomes in individuals with patellofemoral pain syndrome. Methods: At Mayo Hospital and the University of Lahore Teaching Hospital, 87 people enrolled in this cross-sectional study using a non-probability convenience sampling technique during the period of 20th January 2024 to 20th July 2024. Both male and female patients between ages of 20 to 40 years with a positive patellar grind test were included. The numeric pain rating scale and Kujala score were used for data collection to assess pain and functional outcomes respectively. Data were analyzed using IBM SPSS Statistics 25.0. All qualitative variables were shown as frequency and percentages; all quantitative data were provided as Mean ± S.D. Results: Mean age of participants was 30.68 ± 5.62 years. Out of 87 participants, there were 41 (47.1%) females and 46 (52.9%) males. The mean score of the Numeric Pain Rating Scale was 6.31 ± 1.56 and the Kujala score was 46.37 ± 10.36. Out of 87 participants, 6 (6.9%) had mild pain, 62 (71.3%) had moderate pain and 19 (21.8%) had severe pain. The NPRS and Kujala Score have a very weak correlation of 0.049 with a p-value of 0.655. Conclusion: It was concluded that this study had a significant impact of patellofemoral pain syndrome on pain and functional outcomes in affected individuals.

Robotic exoskeleton-assisted gait training in patients with motor incomplete myelopathy

Objectives: To assess the effect of gait training with robotic exoskeleton-assisted rehabilitation systems on gait parameters, balance, and overall disability in motor incomplete myelopathy. Design: Prospective pre-post study. Setting: Neurological rehabilitation unit in a tertiary university teaching hospital. Participants: Thirty-four motor incomplete myelopathy patients [22 males, mean age 36.7 y (12.7)] were included in this prospective, pre-post study. Twenty-two had nontraumatic etiology, and 17 had tetraplegia. American Spinal Injury Association impairment scale suggested 23 as C and 11 as American Spinal Injury Association impairment scale-D. The mean duration of the lesion was 333 days. Intervention: Twenty-four sessions of robotic gait training (1-h session, 5–6 sessions/wk) for 4–6 weeks. Outcome measures: Gait speed was assessed using a 10-meter walk test (10MWT), endurance with a 2-minute walk test (2MWT) and 6-minute walk test (6MWT), walking ability by Walking Index in Spinal Cord Injury-walking index for spinal cord injury II, functionality using Spinal cord Independence Measure-SCIM III, and balance by Timed-up-and-go (TUG) test. Results: At baseline, 20 patients were nonwalkers-NWB, and 14 were walkers-WB. The walking index for spinal cord injury II and SCIM III suggested significant improvement in both groups by the end of the study (P<0.05). Among the WB group, 10MWT, 2MWT, and TUG showed significant improvement (P=0.004, 0.02, and 0.01, respectively) with training. Patients in NWB group were able to perform 10MWT, 2MWT, 6MWT, and TUG by the end of the study. Conclusions: Gait training with robotic exoskeleton-assisted rehabilitation systems can lead to a significant improvement in gait endurance, speed, balance, and functional outcomes in individuals with incomplete myelopathy. The effect is more pronounced among already ambulatory patients.

Effect of Extracorporeal Shock Wave Therapy in Conjunction with Kinetic Chain Based Exercises on Pain, Kinesiophobia, and Functional Outcome in Chronic Subacromial Pain Syndrome Participants -A Case Series

Background and Objectives: Chronic Subacromial Pain Syndrome (CSAPS) is a common condition characterized by persistent shoulder pain and functional limitations. Despite existing non-operative treatments, patients often experience chronic pain, fear of movement (kinesiophobia) and impact shoulder function. The primary objective of this study is to evaluate the effects of extracorporeal shock wave therapy in conjunction with kinetic chain-based exercises on pain, kinesiophobia, and shoulder functional outcomes in individuals with CSAPS. Methodology: This case series included ten participants with unilateral shoulder pain lasting at least three months. Participants received extracorporeal shock wave therapy biweekly for six weeks alongside a structured kinetic chain exercise program. Outcome measures included the Numeric Pain Rating Scale for pain, the Tampa Scale for fear of movement, and the Shoulder Pain and Disability Index for functional assessment. Pre- and post-intervention data were analyzed using paired t-tests to determine statistical significance. Results and Discussion: Statistically significant improvements (p<0.05) were observed after the intervention. The average NPRS score reduced from 7.5±0.84 to 1.90±0.99, showing a significant reduction in pain. The SPADI scores exhibited a significant improvement, decreasing from 66.79±9.48 to 51.90±8.90, indicating a reduction in both shoulder pain and disability. The TSK scores decreased from 48.10±3.03 to 37.60±4.47, indicating a decrease in kinesiophobia. Conclusion: The combination of ESWT and kinetic chain exercises resulted in significant enhancements in pain reduction, reduction in fear of movement, and improvement in shoulder function. This demonstrates the potential effectiveness of this integrated strategy in controlling CSAPS.

Adjunctive clozapine with bright light mitigates cognitive deficits by synaptic plasticity and neurogenesis in sub-chronic MK-801 treated mice

Schizophrenia impacts about 1 % of the global population, with clozapine (CLZ) being a critical treatment for refractory cases despite its limitations in effectiveness and adverse effects. Therefore, the search for more effective treatments remains urgent. Light treatment (LT) recognized for enhancing cognition and mood, presents a promising complementary approach. This study investigated the effects of CLZ and LT on cognitive impairments in a sub-chronic MK-801 induced schizophrenia mouse model. Results showed that both CLZ and CLZ + LT treatment elevate cognitive performance of sub-chronic MK-801 treated mice in serial behavioral tests over two months. Histological analysis revealed increased dendritic spine density and branching, and synaptic repair in the hippocampus with CLZ and CLZ + LT interventions. Furthermore, both treatments increased brain-derived neurotrophic factor (BDNF) expression in the hippocampus, likely contributing to cognitive amelioration in MK-801 treated mice. Additionally, BrdU labeling revealed that CLZ + LT further enhances neurogenesis in the dentate gyrus (DG) and lateral ventricle (LV) of sub-chronic MK-801 treated mice. These findings may have implications for the development of noninvasive and adjunctive treatment strategies aimed at alleviating cognitive impairments and improving functional outcomes in individuals with schizophrenia.

A Review of Knee Ankle-Foot Orthoses in Managing Neuromuscular Disorders: Focus on Children with Cerebral Palsy

Neuromuscular disorders (NMDs) significantly impact the musculoskeletal system, leading to lower extremity muscle weakness and impaired coordination, notably affecting the quadriceps. These impairments compromise knee stability during standing and walking, increasing fall risks and hindering mobility and independence. Knee-ankle-foot orthoses (KAFOs) are vital in enhancing gait efficiency and knee stability. Traditional locked KAFOs rigidly immobilize the knee throughout the gait cycle, offering maximal stability but limited natural movement. Advances in orthotic technology have led to the development of stance control KAFOs (SCKAFOs), which dynamically lock the knee only during the stance phase, promoting a more natural and energy-efficient gait. The E-MAG Active and NEURO TRONIC knee joints are prominent examples of SCKAFOs, featuring sophisticated electronic control mechanisms to improve functional outcomes in individuals with NMDs. This review also focuses on the application of SCKAFOs in children with cerebral palsy (CP), the most common neuromotor disorder affecting movement, posture, and muscle tone due to early brain injury. The prevalence and diverse etiologies of CP necessitate individualized therapeutic interventions. The review aims to evaluate the efficacy and satisfaction of orthotic management in pediatric CP, providing evidence-based recommendations for optimizing orthotic interventions and enhancing quality of life for affected children and their families.

A Systematic Review on the Application of Virtual Reality for Muscular Dystrophy Rehabilitation: Motor Learning Benefits.

Using virtual reality (VR) for Muscular Dystrophy (MD) rehabilitation promises to be a novel therapeutic approach, potentially enhancing motor learning, functional outcomes, and overall quality of life. This systematic review primarily aimed to provide a comprehensive summary of the current understanding regarding the application of VR in supporting MD rehabilitation. A systematic search was performed in PubMed, Scopus, Cochrane Library, and Web of Science to identify relevant articles. The inclusion criteria encompassed studies involving individuals diagnosed with MD who underwent VR interventions, with a primary focus on assessing functional improvement. Methodological quality of the studies was assessed by using the Physiotherapy Evidence Database (PEDro) scale. Seven studies, involving 440 individuals with Duchenne Muscular Dystrophy (DMD), were included in the review. Among these studies, six primarily explored the motor learning potential of VR, while one study investigated the impact of VR training on functional abilities. In conclusion, the qualitative synthesis supports VR-based interventions' potential positive effects on motor learning, performance improvement, and functional outcomes in individuals with DMD. However, current usage mainly focuses on assessing the potential mechanisms' benefits, suggesting the importance of expanding clinical adoption to harness their therapeutic potential for MD patients.

The Impact of Rare Copy Number Variants on Real-World Functional Outcomes in Individuals With Psychosis

The Impact of Rare Copy Number Variants on Real-World Functional Outcomes in Individuals With Psychosis

The Role of Rare Copy Number Variants in the Functional Outcomes of Individuals With Neurodevelopmental Conditions

The Role of Rare Copy Number Variants in the Functional Outcomes of Individuals With Neurodevelopmental Conditions

Effects of Serious Games in Older Adults With Mild Cognitive Impairment.

The rising prevalence of mild cognitive impairment (MCI) has spurred interest in innovative cognitive rehabilitation approaches, including serious games. This review summarizes randomized clinical trials (RCTs) exploring the impact of serious games on MCI patients. We conducted a comprehensive data search using key terms such as "gamification," "digital therapy," "cognition," "mild cognitive impairment," and "Alzheimer's disease." We exclusively considered published RCTs, excluding animal studies and basic research. We identified eight RCTs. Four RCTs examined the effects of serious games using cognitive training for MCI patients. Notably, one study found that non-specific training (Nintendo Wii) significantly enhanced cognitive function and quality of life compared to cognition-specific computer training (CoTras). Among the remaining three RCTs, one specifically demonstrated that personalized serious game-based cognitive training yielded superior cognitive outcomes and reduced depressive symptoms. One RCT focused on serious games incorporating physical exercise, highlighting the effectiveness of kinetic-based exergaming in enhancing overall cognition. Three RCT focused on combined cognitive training and physical exercise. A double-blind RCT revealed that progressive resistance training or standalone physical exercise outperformed the combined approach in improving executive function and global cognition. Two additional RCTs reported positive outcomes, including improvements in cognitive function and electroencephalogram patterns associated with game-based interventions. Serious games, whether focusing on cognitive training, physical exercise, or a combination of both, have potential to improve cognitive and functional outcomes in individuals with MCI. Further research and standardization of protocols are needed to better understand the full potential of serious games in MCI.

Feasibility Telerehabilitation at Home on Body Composition, Anthropometric Measures and Muscular Strength After Interruption 4-5 Years of Spinal Cord Injury: Serial Cases Study on Islamic State of Iraq and Syria War Survivors in Iraq.

Introduction: The war caused huge devastation to rehabilitation centers in Mosul City, leading to a significant gap in rehabilitation services, which was further compounded by the COVID-19 pandemic. Objectives: We sought to incorporate simple and safe clinical exercises by utilizing common household items, thereby maximizing effectiveness through a combination of psychological simulation and physical impact while ensuring safety, and evaluate its efficacy as a home telerehabilitation program (HTRP) for participants with spinal cord injury (SCI) following a 4- to 5-year rehabilitation interruption. Methods: Eighteen volunteers, including 13 with SCI (injuries sustained 53.4-55 months prior), were split into an experimental group (Exp., n = 8), a first control group (first Con., n = 5), and a second control group of healthy individuals (second Con., n = 5), averaging 21.2 years old. The HTRP focused on muscles and whole-body joints, conducted with five weekly sessions gradually increasing from 45 to 120 min, with sufficient rest. Assessments occurred every 3 months. Results: The Friedman test indicated no significant effect of HTRP on weight, body mass index, 3 of 4 anthropometric measures, and 4 of 19 muscle strength tests, p > 0.05, and small effect sizes (ES). However, significant effects were observed in pelvic strength (p < 0.001, ES = 0.73), exceeding control groups (first Con. 1.6%, second Con. 1.0%). Muscle strength in the lower extremities, head, and trunk showed significant improvements (p < 0.05, ES = 18.3-81.8%), it is indicating functional enhancement despite morphological weaknesses, particularly in individuals with SCI. Conclusion: The HTRP demonstrated weak effects on muscle morphology but strong effects on functionality, highlighting its potential for long-term management and improvement of muscle functional outcomes in individuals with SCI, even after prolonged rehabilitation interruptions.

Relationship between cognitive function and functional outcomes in remitted major depression

BackgroundFew studies have focused on functional impairment in depressed patients during symptomatic remission. The exact relationship between cognitive performance and functional outcomes of patients with Major depressive disorder (MDD) remains unclear.MethodsParticipants diagnosed with MDD were included and interviewed at both baseline and follow-up. Cognitive function was assessed during acute episodes using the Cambridge Neuropsychological Test Automated Battery (CANTAB), which targeted attention (Rapid Visual Processing - RVP), visual memory (Pattern Recognition Memory - PRM), and executive function (Intra-Extra Dimensional Set Shift - IED). The 17-item Hamilton Depression Scale (HAMD) was used for symptom assessment. Participants were divided into two groups based on their SDSS (Social Disability Screening Schedule) scores, and the differences between their demographic information, HAMD scores, and baseline CANTAB test results were compared. Logistic regression analysis was used to identify cognitive predictors of social function during symptomatic remission.ResultsAccording to the SDSS score at follow-up, 103 patients were divided into the normal social function group (n = 81,78.6%) and the poor social function group (n = 22, 21.4%) during clinical remission. Participants with poorer social function performed worse in the visual memory (PRM) and executive function tests (IED) at the baseline. Logistic regression analysis suggested that performance on the PRM (95%CI = 0.31–0.93, p = 0.030) and IED (95%CI = 1.01–1.13, p = 0.014) tests, instead of less severe symptoms, significantly contributed to functional outcomes.ConclusionBetter performance in visual memory and executive function during acute episodes may predict better social functional outcomes in individuals with MDD. A potential early intervention to improve social function in individuals with MDD could include the treatments for executive function and visual memory.

A Multi-centered Retrospective Study on the Efficacy of Pulsed Radiofrequency Nerve Ablation in the Treatment of Recalcitrant Plantar Fasciitis: A Mid-term Outcome.

Background Plantar fasciitis, a condition marked by persistent and often excruciating heel pain, frequently poses a formidable hurdle when conservative treatment approaches fall short. This multi-centered retrospective study embarks on a journey to explore the potential effectiveness of pulsed radiofrequency nerve ablation (RFNA), an innovative and less invasive procedure, as a novel avenue for treating recalcitrant plantar fasciitis. This investigation centers around a group of 24 patients who have faced the persistence of this challenging ailment. By meticulously scrutinizing patient outcomes and conducting a comprehensive analysis of safety aspects, this study aspires to offer enlightening revelations regarding the promise and practicality of pulsed RFNA as a therapeutic solution for tackling this intricate and tenacious condition. Methods This retrospective study included 24 patients who had undergone pulsed RFNA for recalcitrant plantar fasciitis between June 1, 2020, and June 1, 2022, at Hospital Pengajar Universiti Putra Malaysia (HPUPM), Hospital Universiti Teknologi Mara (UiTM), and Hospital Serdang. Patients were selected from the Orthopedic Clinics at HPUPM, Hospital UiTM, and Hospital Serdang and were screened according to the inclusion and exclusion criteria. Patient data was extracted from the hospital information systemand electronic medical records. Pre-procedure and post-procedure assessments were conducted at one, three, and six months on the selected patients using the visual analog scaleand American Orthopaedic Foot and Ankle SocietyAnkle-Hindfoot Scoring systems. All selected patient data was traced and tabulated accordingly. Results This study evaluates the effectiveness of pulsed RFNA in treating recalcitrant plantar fasciitis in 24 participants (39 feet). Results show a significant reduction in pain and improvement in functionality at one, three, and six months post-RFNA. Demographic factors (age, gender, and specific diagnosis) did not significantly impact outcomes. The study supports pulsed RFNA as an effective treatment for recalcitrant plantar fasciitis, emphasizing consistent benefits across various patient characteristics. Conclusion In conclusion, the study demonstrates the notable effectiveness of pulsedRFNAin improving pain reduction and functional outcomes for individuals with recalcitrant plantar fasciitis. The findings, consistent across various demographic factors, support pulsed RFNA as a promising and uniform treatment option for those who do not respond to conservative measures.

Effectiveness of Interventions on Work Outcomes After Road Traffic Crash-Related Musculoskeletal Injuries: A Systematic Review and Meta-analysis.

Musculoskeletal injuries are common after road traffic crash (RTC) and can lead to poor work-related outcomes. This review evaluated the impact of interventions on work-related (e.g. sick leave), health, and functional outcomes in individuals with a RTC-related musculoskeletal injury, and explored what factors were associated with work-related outcomes. Searches of seven databases were conducted up until 9/03/2023. Eligible interventions included adults with RTC-related musculoskeletal injuries, a comparison group, and a work-related outcome, and were in English. Meta-analyses were conducted using RevMan and meta-regressions in Stata. Studies (n = 27) were predominantly conducted in countries with third-party liability schemes (n = 26), by physiotherapists (n = 17), and in participants with whiplash injuries (94%). Pooled effects in favour of the intervention group were seen overall (SMD = - 0.14, 95% CI: -0.29, 0.00), for time to return to work (-17.84 days, 95% CI: -24.94, - 10.74), likelihood of returning to full duties vs. partial duties (RR = 1.17, 95% CI: 1.01, 1.36), decreased pain intensity (- 6.17 units, 95% CI: -11.96, - 0.39, 100-point scale), and neck disability (- 1.77 units, 95% CI: -3.24, - 0.30, 50-point scale). Interventions after RTC can reduce time to return to work and increase the likelihood of returning to normal duties, but the results for these outcomes were based on a small number of studies with low-quality evidence. Further research is needed to evaluate a broader range of interventions, musculoskeletal injury types, and to include better quality work-related outcomes.

Transforming Rehabilitation for Scapular Dyskinesia: The role of Modified Robbery Exercises in enhancing Muscle Function, reducing Disability, and improving Quality of Life

Background: Scapular dyskinesia affects shoulder function, with significant implications for individuals, especially athletes. Rehabilitation approaches, including modified robbery exercises, aim to address this by improving scapular kinematics and muscle function. This study evaluates the effectiveness of modified robbery exercises supplemented with electromyography (EMG) biofeedback on muscle activation patterns and functional outcomes in individuals with scapular dyskinesia. Methods: A randomized controlled trial was conducted with 40 participants (20 in the control group receiving modified robbery exercises and ergonomic training, and 20 in the experimental group receiving modified robbery exercises with EMG biofeedback). Both interventions lasted 6 weeks, with sessions three times per week. Outcome measures included pain levels (Visual Analog Scale), muscle activation (EMG), functional disability (DASH questionnaire), and health-related quality of life (EQ-5D index and VAS). Independent samples t-tests were used to compare baseline and post-intervention differences between groups. Results: Post-intervention, the experimental group demonstrated significantly greater improvements in muscle activation for the Serratus Anterior, Upper Trapezius, and Lower Trapezius (p&lt;0.001 for SA), indicating the benefit of EMG biofeedback. Both groups experienced pain reduction and functional improvements; however, the experimental group showed a more pronounced decrease in DASH scores (p=0.002) and a notable improvement in EQ-5D Index scores (p=0.008), pointing to enhanced functional outcomes and quality of life. Conclusions: Modified robbery exercises with EMG biofeedback are more effective than traditional exercises alone in improving muscle activation, reducing functional disability, and enhancing the quality of life in individuals with scapular dyskinesia. This study supports the integration of EMG biofeedback into rehabilitation programs for scapular dyskinesia, offering a promising approach for clinicians aiming to optimize recovery outcomes.

Identity recognition from faces and bodies in schizophrenia spectrum disorders

Deficits in facial identity recognition and its association with poor social functioning are well documented in schizophrenia, but none of these studies have assessed the role of the body in these processes. Recent research in healthy populations shows that the body is also an important source of information in identity recognition, and the current study aimed to thoroughly examine identity recognition from both faces and bodies in schizophrenia. Sixty-five individuals with schizophrenia and forty-nine healthy controls completed three conditions of an identity matching task in which they attempted to match unidentified persons in unedited photos of faces and bodies, edited photos showing faces only, or edited photos showing bodies only. Results revealed global deficits in identity recognition in individuals with schizophrenia (ηp2 = 0.068), but both groups showed better recognition from bodies alone as compared to faces alone (ηp2 = 0.573), suggesting that the ability to extract useful information from bodies when identifying persons may remain partially preserved in schizophrenia. Further research is necessary to understand the relationship between face/body processing, identity recognition, and functional outcomes in individuals with schizophrenia-spectrum disorders.

Abstract WP136: Impaired Venous Outflow Impacts Functional Outcomes in Acute Small Subcortical Infarcts: A Single-Center Retrospective Analysis

Introduction: Acute small subcortical infarcts (SSI), colloquially acute lacunar stroke, are a radiographic diagnosis representing a myriad of pathophysiologic processes. One such pathophysiologic subgroup is venous collagenosis which serves as a pathologic indicator that aberrant venous outflow may contribute to SSI development. We aimed to identify whether impaired venous outflow (IVO) impacted functional outcomes in individuals presenting with SSI. Methods: We performed a single-center retrospective study of individuals who presented to the Rhode Island Hospital Comprehensive Stroke Center. Included individuals were ≥ 18 years with the diagnosis of SSI, as defined per consensus criteria, on brain MRI diffusion weighted imaging. The primary exposure is the presence of impaired venous outflow (IVO) defined radiologically in accordance with prior studies, as hyperintensity of the jugular, sigmoid, or transverse sinuses along the skull base on MR angiogram time of flight, Figure. The primary outcome was a favorable function outcome at hospital discharge defined as a modified Rankin Scale (mRS) of ≤ 3. Standard descriptive and regression statistical techniques were used for data interpretation. Results: We identified 39 patients who met criteria with 12 (30.8%) with IVO. Age and vascular risk factors did not significantly differ amongst the cohort. Twenty-six (66.7%) had a favorable hospital discharge outcome favorable functional outcome with IVO being less common [IVO present: 5/26 (19.2%) versus LVO absent: 21/26, (80.8%), p = 0.034]]. After adjusting for age and hypertension, IVO was associated with an odds ratio of 8.33 (95%CI 1.41-49.3, p =0.019). Conclusion: We found that IVO may be an independent contributor to fewer favorable functional outcomes. This data highlights that not only the arterial vessels are of relevance in acute SSI.

Comparison of Functional Outcomes and Complications of Inlay and Onlay Reverse Shoulder Arthroplasty in Neer Type 4 Proximal Humerus Fractures and Cuff Tear Arthropathy: A Multicentric Study.

This multicenter retrospective study was conducted with the objective of comparing the outcomes and complications between inlay and onlay reverse shoulder arthroplasty (RSA) in patients presenting Neer Type 4 proximal humerus fractures and cuff tear arthropathy. The primary aim of this investigation was to assess and juxtapose the clinical as well as functional outcomes of individuals who underwent onlay reverse shoulder arthroplasty with those who underwent inlay reverse shoulder arthroplasty. A retrospective cohort study was conducted, involving patients who had undergone reverse shoulder arthroplasty between the period of 2016 and 2022. The study divided the population into two groups: Group A received inlay humeral components, while Group B received onlay humeral components. Functional outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) and Constant scores. Range of motion, infection, periprosthetic fractures, and nerve injuries were also assessed. The study included 67 patients in Group A and 62 patients in Group B. Group A had significantly better functional outcomes, as indicated by higher ASES and Constant scores (p < 0.05). Group A also had greater shoulder joint motion (p < 0.05). Periprosthetic fractures were significantly more common in Group B (p < 0.05). However, complication rates, including infection and instability, did not significantly differ between the groups (p > 0.05). Nerve injuries occurred in both groups, with slightly higher occurrence in Group B. Inlay humeral components in reverse shoulder arthroplasty for Neer Type 4 fractures and cuff tear arthropathy resulted in better functional outcomes, increased range of motion, and lower incidence of periprosthetic fractures compared to onlay components. Onlay components showed potential advantages in reducing instability rates. Further studies with larger samples and standardized protocols are needed to confirm these findings.

Does subscapularis tears combined with supraspinatus tears affect postoperative functional outcomes?

Aims: Roughly 50% of rotator cuff tears includes a tear in the subscapularis tendon. We conducted a comparative analysis of the functional outcomes following arthroscopic repair in patients with a tear in both the supraspinatus and subscapularis tendons, as well as those with a rupture solely in the supraspinatus tendon. Our hypothesis posits that the functional outcomes after surgery for rotator cuff tears, specifically those with tears including subscapularis tendon, are inferior compared to tears that only involve the supraspinatus tendon. Methods: We classified patients who had arthroscopic repair for a rotator cuff tear in our clinic from January 2017 to April 2022 into two groups. The study comprised patients who received arthroscopic surgery for a diagnosed rotator cuff injury. The study excluded individuals who were younger than 18, individuals with large tears that could not be repaired, individuals with paralabral cysts, individuals with glenohumeral arthritis, individuals who had undergone labrum tear repair or slap lesion repair, individuals with concomitant neurovascular damage, and individuals who had a follow-up period of less than 6 months, patients who benefit from physiotherapy and medical treatment for 6 months. Following the application of exclusion criteria, a total of 39 patients were selected to participate in the study. The presence of a rotator cuff injury was verified through arthroscopy after being detected using clinical tests such as Jobe, drop arm test, Neer sign, lift-off and belly-press tests, and radiographic evidence such as magnetic resonance imaging. Patients who received subscapularis repair together with a supraspinatus tear were categorised as Group 1 (n=14), while those who just had supraspinatus surgery without any subscapularis tears were categorized as Group 2 (n=25). We recorded the demographic information. At the last postoperative outpatient clinic follow-up, both groups were compared in terms of mortality, laboratory parameters, radiological findings, visual analogue scale (VAS), Constant-Murley score1, American Shoulder and Elbow Surgeons score (ASES)2, and University of California Los Angeles (UCLA) scores.3 Postoperative satisfaction levels were categorised into four groups: very satisfied, satisfied, undecided, and dissatisfied. Results: The groups did not show any significant differences in terms of age, gender distribution, and follow-up periods (p&amp;gt;0.05). There was no statistically significant disparity observed between the groups in relation to VAS, Constant-Murley score, ASES, and UCLA ratings assessed during the final postoperative outpatient clinic follow-up (p&amp;gt;0.05). There were no instances of re-rupture observed in any patient throughout the postoperative follow-up period. The postoperative satisfaction ratings show no significant difference between the two groups (p&amp;gt;0.05). Conclusion: Our findings indicate that the outcomes of patients who received a surgical repair of rotator cuff tendons including subscapularis were at least as successful as those who underwent surgery for just supraspinatus tendon rupture. There is no basis to believe that arthroscopic repair will have a detrimental impact on the functional outcomes of individuals with rotator cuff tears which includes subscapularis tendon tears.

Virtual Reality Intervention and Its Impact on Upper Extremity Function in the Stroke Population: A Scoping Review.

The aim of this scoping review was to examine virtual reality (VR) interventions used within rehabilitation and their effect on the functional outcomes of individuals with stroke. Specifically, this study sought to determine the impact of VR on the upper extremity (UE) use of participants as it relates to body function, occupational participation, and overall UE function (UEfxn). Twenty-six articles were selected for inclusion and results were extracted to determine common themes of outcomes among the effects of VR intervention (VRI). Thematic analysis included details about the VRIs used, as well as the change in UE outcomes post-VRI. Overall, positive change in UEfxn was found across many of the studies, indicating that VR technologies may be an effective intervention technique for individuals, poststroke. Findings of this review encourage clinicians to conduct further research regarding VR technology for UE rehabilitation poststroke.