Improve Joint Mobility Research Articles

Impact of Serial Casting on Autonomic Nervous System Responses during Virtual Reality Tasks in Children with Cerebral Palsy: A Pilot Study Comparing Orthoses and Barefoot Conditions.

Cerebral palsy (CP) is a group of movement disorders that impair posture and mobility, often leading to spasticity and joint contractures. Interventions like serial casting are commonly used to improve joint mobility and manage spasticity in children with CP. However, its effects on the autonomic nervous system (ANS) remain unclear. This study aimed to evaluate the effects of serial casting and ankle-foot orthoses (AFOs) on ANS responses during a virtual reality (VR) standing task, comparing these interventions with a barefoot condition. Thirty children with CP were randomized into three groups (n = 10 per group): serial casting, AFOs, and barefoot. Heart rate variability (HRV) was used to assess ANS responses across three phases: seated rest, VR task, and recovery. The results showed that the serial casting group exhibited higher sympathetic activity during rest compared to the other groups, but had a reduced sympathetic response during the VR task. Additionally, the serial casting group displayed a more pronounced parasympathetic rebound during recovery, similar to the orthoses and barefoot groups. While serial casting provides essential joint stability, it alters ANS response patterns, leading to heightened sympathetic activation at rest, without providing significant improvements in ANS behavior during physical activity.

The Potential of Intra-Articular Therapies in Managing Knee Osteoarthritis: A Systematic Review.

Knee osteoarthritis (KOA) is a common degenerative and progressive joint disorder that negatively influences patients' quality of life. Intra-articular therapies, such as hyaluronic acid (HA) and platelet-rich plasma (PRP), have garnered attention for their potential to manage osteoarthritis OA symptoms effectively. This systematic review aims to identify the effectiveness and safety of HA and PRP treatment modalities in treating KOA. A literature search was conducted across MEDLINE (PubMed), Web of Science Core Collection, and Science Direct Collection Elsevier. Twenty-three randomized controlled trials, cohort studies, and observational studies were included in the review. The selection criteria focused on studies published in English within the last 10 years, involving subjects with KOA treated with intra-articular injections of HA or PRP and reporting on pain, function, or overall treatment efficacy outcomes. The analysis showed that both HA and PRP significantly improve functionality and reduce pain in KOA patients. High molecular weight HA consistently reduced pain and improved joint mobility in various studies. PRP had better long-term outcomes when combined with HA, leading to greater pain reduction and functional improvement. Both therapies had generally favorable safety profiles, with only minor adverse events reported. However, there were potential biases identified across the studies, such as selection, performance, detection, and reporting biases, which impacted the reliability of the results. Intra-articular treatments with HA and PRP show promise in managing knee osteoarthritis, with personalized treatment plans and further research needed to confirm these findings.

Using an experimental technique to develop children's flexibility

The purpose of the study is to increase the level of flexibility in children 9-10 years old in physical education classes at school. Materials and methods: Quasi-experimental, non-randomized study. The pedagogical experiment was conducted based on the Ilyinskaya rural school in Russia from September 3 to December 27, 2022. The study involved students from the third grade in the number of 36 people. Children from the control group were engaged in the usual physical education program at school, and children from the experimental group, after a short running warm-up, performed a set of exercises to develop flexibility. To determine the flexibility indicators, control standards from the physical education program at school were used sit and reach tests, lateral spagat and shoulder rotation test with cane. Results. After the study, the indicators of children from the experimental group showed a significant increase in all 3 tests. The indicators of flexibility in the "Sit down and reach" test increased by 36.4% (p<0.05), the indicators of the "Lateral spagat" test increased from 12.5±2.1 to 8.9±1.9 (p<0.05), and the data of the "Shoulder rotation test" test increased by 18.7% (p<0.05). The children in the control group also improved, but not significantly, on all three tests. The indicators in the "Sit down and stretch" test decreased by 7.4% (p>0.05), the indicators in the "Lateral spagat" test decreased from 12.8±1.8 to 11.7±2.0 (p>0.05), and the data in the "Shoulder rotation test" test changed for the better by 9.9% (>0.05). Conclusion. If used a set of exercises to develop flexibility in physical education classes at school when working with children 9-10 years old, then their indicators will significantly improve joint mobility, passive flexibility, active flexibility, schoolchildren, physical culture, sensitive periods. Keywords: Physical Fitness; Motor Skills; Range of Motion, Articular; Child.

DAVID SPINE CONCEPT AND MEDICAL OUTCOMES STUDY QUESTIONNAIRES TO ASSESS ADOLESCENT PATIENTS HAVING BACK PAIN

The objective of this study was to investigate the effectiveness of DAVID Spine exercises program on the overall health of the selected patients using a specific survey. The World Health Organization describes adolescence as “young people between the ages of 10 and 19 years” [1] Adolescent back pain has been reported to be as common as that of adult populations [2][3][4] and has been attributed to several factors such as gender, age, sitting for long periods, working at computers, school seating and psychological factors [5-10]. Based on this premise, 11 female participants (n=11), aged between 12 and 17 years, who have frequently experience back pain and have no previous experience in physical training, were included in this study. The research began with the hypothesis that implementing personalized physical exercises program using DAVID Spine Concept devices [11] it can enhance strength of the muscle responsible for supporting the spine, improve joint mobility, it reduces the back pain and overall enhance quality of life. To validate the principles set in the purpose and tasks of this study, we used a Visual Analog Scale (VAS) for pain and a standard medical outcomes questionnaire (Short Form-36), provided by DAVID-EVE software library.

Efficacy of Ultrasound-Guided Hydrodissection for Treating De Quervain's Tenosynovitis

ObjectiveThis study evaluated the effectiveness of ultrasound-guided hydrodissection treatment for De Quervain's stenosing tenosynovitis, characterized by the narrowing of the first extensor compartment of the wrist. Notably, approximately 2% of cases involve a fibrous septum that divides the compartment. Subjects and MethodsNinety-five patients diagnosed with De Quervain's disease using ultrasound underwent hydrodissection treatment. When a septum was present, the needle was redirected into each sub-compartment to distribute the therapeutic solution evenly and facilitate the breaking of the septum. ResultsNinety patients reported significant improvements in pain and functionality within 2 months of the initial treatment, with a marked decrease in the mean visual analog scale score from 7.65 ± 1.31 to 1.65 ± 2.32. A second infiltration, administered 2 months later, further alleviated pain and enhanced hand functionality. However, 5 patients with septum required surgical intervention after nonconclusive results from the infiltrative treatment. ConclusionsThis study confirms that ultrasound-guided hydrodissection is an effective treatment for approximately 95% of patients with De Quervain's disease, achieving substantial pain relief and improved joint mobility after the first treatment. These findings support the continued use of ultrasound guidance to enhance the precision and efficacy of treatment in complex cases.

Clinical Efficacy of Intra-articular Tranexamic Acid Injection in the Management of Hemophilia with Total Hip Arthroplasty: A 24-month Retrospective Cohort Study.

Total hip arthroplasty (THA) effectively treats end-stage hemophilic hip arthropathy. Given hemophilia's unique characteristics, perioperative bleeding remains a significant risk for patients undergoing THA. Tranexamic acid (TXA), an efficient antifibrinolytic agent, may benefit the outcomes of THA for patients with hemophilia (PWH). This study aims to explore the clinical efficacy of intra-articular injection of TXA in treating perioperative bleeding in PWH and assess its additional clinical benefits. The retrospective study comprised data of PWH who received THA from January 2015 to December 2021 in the research center. A total of 59 individuals were included in the study, divided into a TXA group (n = 31) and a non-TXA group (n = 28). We compared various parameters, including total blood loss (TBL), visible blood loss (VBL), occult blood loss (OBL), intraoperative coagulation factor VIII (FVIII) consumption, perioperative total FVIII consumption, hemoglobin (HB), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), length of hospital stay, hospitalization costs, length of surgery, total protein, activated partial thromboplastin time (APTT), D-dimer, rate of joint swelling, hip joint range of motion (ROM), visual analogue scale (VAS), and Harris hip joint function scale (HHS) between the two groups. Follow-up assessments were conducted for up to 24 months. A Student's t test was utilized for the statistical analysis. This study demonstrated that intra-articular TXA effectively reduced TBL (1248.19 ± 439.88 mL, p < 0.001), VBL (490.32 ± 344.34 mL, p = 0.003), and OBL (757.87 ± 381.48 mL, p = 0.004) in PWH who underwent THA. TXA demonstrated effectiveness in reducing VAS scores on POD1, POD7, and POD14 and joint swelling rates on POD1, POD7, POD14, and at discharge (p < 0.05). Additionally, the TXA group achieved higher HHS ratings at all follow-up time points (p < 0.05), showing superior hip joint mobility, lower postoperative inflammation levels, reduced factor VIII consumption during surgery, and less postoperative nutritional loss. No statistically significant differences were observed between the two groups in terms of hospital stay, hospitalization costs, surgery duration, and coagulation indicators. Intra-articular injection of TXA reduces perioperative bleeding in PWH undergoing THA while also improving joint mobility, post-operative rehabilitation, and quality of life. This may provide value for the future application of TXA in PWH.

Single-Joint Type Hybrid Assistive Limb for Knee Training in the Acute Postoperative Phase After Opening Wedge High Tibial Osteotomy: A Feasibility and Safety Trial.

Opening wedge high tibial osteotomy (OWHTO) influences the knee extensor mechanism, the range of passive motion of knee extension and persistent quadriceps, and anterior knee pain and weakness. Rehabilitation should focus on quadriceps strength and improving joint mobility. The single-joint hybrid assistive limb device (HAL-SJ) is a wearable exoskeleton cyborg. In this study, we investigated the feasibility and safety of HAL-SJ training after the early postoperative period following OWHTO and whether the use of this device can improve functional outcomes, including knee muscle extensor strength and knee extension range of motion without knee pain. Patients who had been diagnosed with knee osteoarthritis and had undergone OWHTO were assessed for eligibility in this prospective trial conducted at our institution between June 2015 and November 2020. The participants were split into two groups, i.e., 10 patients in the hybrid assistive limb (HAL) group and eight patients in the control group. We initiated HAL-SJ therapy on postoperative day 8 and continued it until the patient's discharge. During the hospitalization period, patients engaged in HAL-SJ-assisted knee extension exercises. This exercise routine encompassed five sets, each comprising 10 repetitions, and was conducted twice a week. We conducted assessments aimed at detecting any potential adverse events that could be linked to HAL training. Assessment of the knee extension angle via the visual analog scale (VAS) and strength assessments using a hand-held dynamometer (HHD) were conducted. To compare clinical outcomes before and after OWHTO, knee extension angle, the VAS, HHD, Japanese Orthopaedics Association (JOA) score, and the Japanese Knee Osteoarthritis Measure (JKOM) were assessed at four distinct time points. No adverse events were observed during the study. The assessment of clinical outcomes before and after OWHTO demonstrated a gradual improvement in outcomes. The single-joint hybrid assistive limb device in patients who underwent OWHTO appears to be potentially safe. It contributed to enhanced muscle activity efficiency by reducing knee pain and improving knee extension angles in the early postoperative phase.

A retrospective study on the correction of distal arthrogryposis with a progressive extension brace.

Camptodactyly, clasped thumbs, and windblown hands are distinctive features of distal arthrogryposis (DA). Current therapeutic interventions often yield suboptimal effects, predisposing patients to relapses and complications. This study explicates a corrective approach involving a progressive extension brace for the management of DA and evaluates its clinical outcomes. Between 2015 and 2023, progressive extension braces were used in 32 DA patients, with an average follow-up of 4.8 years. Patients were stratified by age into four groups: 0-1, 1-3, 3-7, and above 7 years. The correction of camptodactyly was assessed based on the total active movement (TAM) of metacarpophalangeal joints (MPJ) and proximal interphalangeal joints (PIPJ), as well as the extensor lag of PIPJ. Clasped thumb correction was evaluated by measuring the thumb-to-index finger metacarpal angle (M1M2 angle) and the degree of deviation at the first MPJ (M1P1 angle). The quality of life for the children was measured using PedsQL 4.0, while parental satisfaction was gauged using the FACE questionnaire. Earlier intervention with a progressive extension brace yielded superior corrective results. Infants aged 0-1 year and toddlers aged 1-3 years achieved average TAM scores of 152° and 126° after correction; however, patients older than 3 years experienced a significant decrease in TAM with the same treatment. Infants and toddlers with DA showed improvement in the average extensor lag from 46° to 6°. The M1M2 angle increased from an average of 38° to 65°, with the M1P1 angle decreasing from an average of 43° to 5°. After the treatment, average PedsQL scores of 94.7 (parent-reported) and 89.3 (child-reported) were achieved. Among the 32 parents, 24 expressed high satisfaction, 5 expressed moderate satisfaction, and 3 expressed fair satisfaction. The early, progressive, and consistent use of an extension brace significantly improved joint mobility and corrected camptodactyly and clasped thumbs. It can be an effective approach to addressing hand deformities in patients with DA.

The efficacy of curcumin in relieving osteoarthritis: A meta-analysis of meta-analyses.

Osteoarthritis (OA) is one of the most prevalent degenerative joint diseases. Several meta-analyses have shown that curcumin could improve the function of the knee and alleviate pain in OA, while some meta-analyses demonstrate controversial results. Hence, we assessed curcumin's effects on knee OA in an umbrella meta-analysis. PubMed, Scopus, Embase, and Web of Science databases were employed to find English-language meta-analyses of randomized controlled trials investigating the effect of curcumin supplementation on OA outcomes up to September 2023. The visual analog scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain, function, and stiffness scales were analyzed. Effect sizes and 95% confidence intervals were utilized to obtain the overall effect size. A random-effects model was applied to perform the meta-analysis. Heterogeneity was determined by I2 statistics and the Cochrane Q-test. The pooled effect of the 11 included meta-analyses showed that curcumin could significantly decrease the VAS score (weighted mean difference [WMD] and standardized mean difference [SMD]), WOMAC-total (SMD and WMD), WOMAC-Function (SMD and WMD), WOMAC-Pain (SMD), and WOMAC-Stiffness scores (SMD) (p ≤ 0.001, ≤0.001, ≤0.001, 0.007, ≤0.001, 0.002, ≤0.001, ≤0.001, respectively). The results strongly support curcuminoid supplementation in relieving pain, improving joint mobility and stiffness, and shortening medication usage of OA patients.

Functional results of total knee prosthesis in the treatment of rheumatoid arthritis: A case report of 64 patients

This is a retrospective study of 64 total knee arthroplasties for inflammatory rheumatism, implanted in the Traumatology and Orthopedic Surgery Department (A) of the HASSAN II University Hospital in Fez Morocco, from February 2008 to December 2022. The aim of our work is to demonstrate the value of total knee arthroplasty in improving the quality of life of young patients with inflammatory rheumatic diseases, notably through pain relief and improved joint mobility. Our series included 44 patients, representing 64 arthroplasties. The mean age at the time of surgery was 48 years. All our patients were followed up at the consultation with a clinical and radiological examination. The IKS score was used to assess knee condition before and after surgery. The surgical procedure consisted of total knee arthroplasty using a total knee arthroplasty. Clinical results after a mean follow-up of 60 months were satisfactory, with a marked improvement in the postoperative IKS score.

Two-Stage Total Hip Arthroplasty Management in Advanced Legg-Calvé-Perthes Disease: A Case Report

Introduction: Legg-Calvé-Perthes-Disease (LCPD) most commonly affects boys between the ages of 4 and 8. It is an avascular necrosis of the upper femoral epiphysis. Its etiopathogenesis is unknown. Advanced cases necessitate innovative approaches beyond conservative measures. We report a challenging case involving radical treatment for advanced LCPD already complicated by hip and knee stiffness, managed with a two-stage total hip arthroplasty. Case presentation: We report the case of a 14-year-old with chronic left hip impairment and concurrent knee stiffness due to advanced LCPD. Initial conservative interventions proved ineffective. We decided to opt for a two-stage surgical strategy. The first stage involved femoral head ostectomy, cervico-cephalic prosthesis placement, and soft tissue tenotomy. Subsequent intensive rehabilitation achieved improved joint mobility. The second stage comprised total hip replacement using a ceramic-ceramic prosthesis. At last follow up, a favorable functional outcome was observed, and radiographs demonstrated a well-positioned and osteo-integrated prosthesis. Conclusions: LCPD is a serious condition, and the prognosis is significantly influenced by early diagnosis and appropriate management. In cases of advanced staged LCPD, prosthetic replacement becomes a suitable option, even in younger patients. Despite potential complications, the use of a two-stage approach, integrating surgical intervention and tailored rehabilitation, proved effective in restoring joint function. This case highlights the importance of personalized planning and a staged approach in addressing the multifaceted aspects of LCPD.

Sequential surgery for the treatment of type I knee ankylosis: a series of 62 cases.

The lack of systematic classification and standard treatment principles for knee ankylosis prevents optimal treatments. This study explored treatments for type I (mild) knee joint ankylosis. This retrospective study analysed patients with knee joint ankylosis admitted from March 2013 to January 2018 who underwent sequential arthroscopic release. The 62 patients had 12-36 (average, 18) months of follow-up. Thirty-eight patients were released; of these, 18 were assisted by limited incision with partial quadriceps femoris expansion myotomy and released according to arthroscopy. Six patients underwent lengthening and release of the quadriceps femoris. All surgeries combined with full-course rehabilitation resulted in improved joint mobility. The range of motion (ROM) of the knee joint recovered to a range of 0° to 85°-140° (mean: 118.32 ± 9.42°) from the preoperative range of 30°-70° (mean: 45° ± 15.50°). The clinical effect was evaluated according to the Judet criteria at the final follow-up. The outcomes at the last follow-up (at least for 1 year) were excellent in 55 cases, good in six cases, and fair in one case. Sequential arthroscopic release, minimal selective invasion of limited incision of partial quadriceps femoris expansion myotomy, assisted by pie-crusting technique to release, or quadriceps femoris lengthening, and release surgery for type I knee joint ankylosis, accompanied by early rehabilitation training provided satisfactory results without significant complications.

Efficacy and Safety of High Density LED Irradiation Therapy for Patients With Hand Osteoarthritis: A Single-Center Clinical Study.

To assess the safety and effectiveness of high-density light-emitting diode (LED) irradiation therapy in patients with hand osteoarthritis (OA) and compare the pre- and post-intervention symptoms. Twenty-three patients with hand OA underwent eight sessions of high-density LED irradiation therapy directed at the five most painful areas in the finger joints. Each session lasted for 18 minutes; and the sessions were conducted twice a week, for 4 weeks. We evaluated the degree of pain using the visual analogue scale, ring size, and passive range of motion (flexion+extension) for two most painful joints from the baseline to post-therapy (weeks 4 and 6). High-density LED irradiation therapy significantly reduced the pain posttreatment compared with that observed at the baseline (p<0.001). Although improvements were observed in ring size and joint range of motion at 4 and 6 weeks, they were not statistically significant (p>0.05). No adverse events were observed. We examined the safety and effectiveness of high-density LED irradiation therapy in reducing pain and hand swelling and improving joint mobility in patients with hand OA. These results suggest that high-density LED irradiation therapy has the potential to be an important strategy for managing hand OA.

Influencing factors on effectiveness of reverse total shoulder arthroplasty

To summarize the influencing factors on the effectiveness of reverse total shoulder arthroplasty (RTSA), so as to provide reference for clinical treatment. The related research literature of RTSA at home and abroad was extensively consulted, and the factors that may affect the effectiveness were summarized from the aspects of surgical technique, muscle condition, general condition of patients, psychological expectation, and lifestyle. For surgical techniques, different surgical approaches have their own advantages. The glenoid notch, poor bone ingrowth, increased bone resorption, and infection would lead to the loosening of glenoid prosthesis. In addition, the neck shaft angle and inclination angle of humeral prosthesis affect the occurrence of glenoid notch and the range of motion of joint internal/external rotation after operation, respectively. For muscle condition, the quality of teres minor and deltoid muscle has an important influence on joint stability after operation. Moderate increase of deltoid muscle tension can improve joint mobility after operation, and suture repair of subscapular tendon during operation can relieve joint pain and improve function, range of motion, and strength. For the general condition of patients, gender, age, and body mass index are all related to postoperative joint function and complications, and different occupations and postoperative exercise levels affect the recovery. The patients with severe degenerative diseases, poor preoperative function, and long disease duration have lower expectations and higher satisfaction with the effectiveness, and bad lifestyle has a negative impact on the effectiveness. The effectiveness of RTSA is related to surgical technique, muscle condition, general condition of patients, psychological expectation, and lifestyle. In order to avoid the loosening of glenoid prosthesis, the operator should choose humeral prosthesis with small neck shaft angle and large glenoid ball and put them down and inclined inferiorly during operation, and choose appropriate approach to eliminate space with drainage to reduce the risk of infection. After operation, patients should avoid activities that generate high anterior and posterior shear forces. In addition, the humeral prosthesis with a inclination angle of 10°-20° can achieve the best balance between the range of internal rotation and external rotation after operation. Proper deltoid tension can maintain joint stability and good range of motion. Suture of subscapular tendon is recommended.

Rehabilitation care for pain in elderly knee replacement patients.

Total knee arthroplasty (TKA) is recognized as the most effective surgical intervention for relieving pain and improving joint mobility and deformity in patients with knee osteoarthritis and other synovial diseases. The application of accelerated postoperative rehabilitation (enhanced recovery after surgery) has demonstrated its efficacy in improving patient outcomes, and early postoperative joint function exercise has become a key prognostic factor in knee replacement. The unexpected appearance of limb pain and swelling hindered the patient's tendency for early mobilization, leading in prolonged hospitalization, delayed functional recovery and negative psychological responses. To investigate the impact of incorporating programmed pain nursing with collaborative nursing on elderly patients undergoing knee replacement surgery. A retrospective analysis was conducted on a cohort of 116 patients who underwent TKA at our hospital between July 2019 and July 2021. The patients were divided into two groups: A control group (n = 58) receiving programmatic nursing, and an observed group (n = 58) receiving programmed nursing combined with a collaborative nursing model. A pain management team consisting of attending physicians, head nurses, and responsible nurses was established. Outcome measures included visual analogue scale (VAS) scores, activities of daily living (ADL) scale scores, and functional scores. The ADL scores of patients in both groups exhibited a continuous increase. However, there was no statistically significant difference in the ADL scores between the two groups at 48 h and the 7th d post-surgery (P > 0.05). Upon reexamination at the 3rd mo, the observation group demonstrated higher ADL scores compared to the control group (67.48 ± 14.69 vs 59.40 ± 16.06, P < 0.05). The VAS scores of both groups significantly decreased, with no significant difference observed between the groups at each time point (P > 0.05). The functional status of patients in both groups exhibited a gradual increase prior to intervention and at the 1st, 2nd, and 3rd month following discharge (P < 0.05). There was no statistically significant difference in knee joint function scores between the two groups at the 1st month after discharge (47.52 vs 45.81, P > 0.05). However, the knee joint function scores of patients in the observation group were significantly higher than those in the control group at the 2nd (59.38 vs 53.19, P < 0.05) and 3rd month (71.92 vs 64.34, P < 0.05) following discharge. The utilization of programmed pain nursing in conjunction with collaborative nursing for out-of-hospital care of TKA patients has demonstrated favorable outcomes, encompassing pain reduction, enhanced prognosis, and improved nursing quality for patients.

Surya Namaskar, Benefits in the Context of Physiological Perspective

Introduction: With the recent rise in awareness in increased understanding of the importance of physical activity in promoting overall health, greater emphasis has been placed on improving physical fitness to enhance quality of life. Asian Indians have been practicing Surya Namaskar, a part of Hatha Yoga, for hundreds of years. It is frequently employed in place of a typical workout regimen. It entails a series of asanas that are performed 12 times per cycle. Although Surya Namaskar was neither considered an asana nor a part of classical Yoga, it is now regarded as a component of current yogic practices. Before starting daily tasks, performing Surya Namaskar energizes the practitioner and gives them a fully charged day. The knowledge of energy cost and physiological responses of practicing Surya Namaskar is important and forms the basis for the recommendation of regular practice as part of any training. Based on available research, we emphasize the significance of Surya Namaskar in this review by stressing its impacts on the physiological components of the body. Methods: Different Ayurveda classics, modern classics, research papers, and journals were referred to fulfill this part. Results: With the help of research references, the evaluation outlines the practice’s physical advantages in terms of improving joint mobility, extending muscle power, and promoting vitality.

Comparative Study on Myofascial Release Technique and Muscle Energy Technique in Reducing Pain and Improving Functional Activity for People With Chronic Low Back Pain: Experimental Study

Background: Chronic Low Back Pain is a complex and multifactorial condition, often associated with muscularimbalances, trigger points, and myofascial restrictions. MRT focuses on releasing myofascial restrictions, whileMET utilizes muscle contractions to normalize muscle length and improve joint mobility. Both techniques haveshown promising results individually.Purpose: To compare the effectiveness of myofascial release technique and muscle energy technique in reducingpain and improving functional activity in individuals with chronic low back pain.Material and Method: This is an experimental study done using purposive sampling technique with inclusioncriteria of age between 30 to 55, Patients who were diagnosed with chronic low back pain (Duration of at least 12weeks). patients with history of Fractures and Musculoskeletal conditions were excluded. The sampling size of thestudy is (n=90) subjects for a period of 6 weeks [February 2023 to March 2023].Results: The results revealed significant improvement of functional activity in patients with chronic low back pain.Conclusion: This study finally concluded that MRT is more effective than MET in reducing pain and improvingfunctional activity for individuals with Chronic Low Back Pain.

Acute Effects of Stretching Exercises on Posterior Chain: Analysis of Shear Modulus by Elastography SSI.

The posterior chain muscles of the lower limb include the hamstrings and triceps surae, along with the Achilles tendon. This study aimed to investigate the acute effects of static stretching exercises commonly used in clinical and training settings on the shear modulus (µ) of these muscles and tendon using Supersonic Shear-Wave Imaging (SSI) elastography. Fifteen healthy adults participated in the study, performing stretching exercises for hamstrings and triceps surae. Shear modulus and joint range of motion (ROM) were measured before and after the stretching protocols. The hip and ankle mean ROM significantly increased by 19.27% and 24.10%, respectively. However, the stretching protocol did not significantly alter in µ of the hamstrings, the gastrocnemius muscles, and the Achilles tendon. K-means clustering analysis identified a group where the subjects with lower initial ROM showed higher amplitude gains and a significant decrease in the semimembranosus stiffness after stretching. These findings suggest that the stretching protocol was effective in improving joint mobility but not sufficient to elicit immediate mechanical changes in muscle and tendon stiffness. Neural adaptations and nonmuscular structures might contribute to increased ROM. The study highlights the importance of considering individual initial ROM and subsequent responses when evaluating the effects of stretching exercises on muscle and tendon properties.

OSTEOARTHRITIS OF KNEE JOINTS: THE EFFECT OF CONCOMITANT THERAPY IN COMORBID PATHOLOGY

Introduction. Osteoarthritis is the most common disease of the musculoskeletal system, characterized by chronic inflammation and involvement of all components of the joint in the pathological process. Osteoarthritis leads to a decrease in the quality of life, disability of the population, and an increase in mortality. According to experts, osteoarthritis affects about 240 million people worldwide, including approximately 10% of men and 18% of women over the age of 60. In another epidemiological study by American scientists, it was found that that symptomatic knee osteoarthritis occurs in approximately 7% of adults over the age of 25. The prevalence of osteoarthritis is higher in women than in men and increases with age (the trend is present until the age of 70). Approximately 9% of men and 30% of women have at least one joint affected, 11 % and 23% have at least two. Osteoarthritis ranks the 1st position in the structure of musculoskeletal pathology, the 2nd in the number of visits to a family doctor, giving the pass only to cardiovascular diseases, and the 3rd commonest cause of disability. The aim of this study is to analyze and emphasize modern findings regarding the pathogenetic links between osteoarthritis and concurrent comorbid conditions to provide a rationale for novel approaches to enhance the treatment of patients with this pathology. Furthermore, the study aims to evaluate the impact of treatment in patients with gonarthrosis who also present comorbid conditions, with a specific focus on the use of chondroprotective agents such as chondroitin sulphate and glucosamine sulphate, as well as prescription crystalline glucosamine sulphate. Additionally, the study assesses the effects of medications like sartans (e.g., vazar/losartan), statins (e.g., rosart), and nonsteroidal anti-inflammatory drugs (e.g., celecoxib, ibuprofen, diclofenac potassium) in this context. Materials and methods. For this study, we conducted a comprehensive scientific search across both printed and electronic publications and scientific databases. Our research focused on analyzing, comparing, and synthesizing information related to the interplay between osteoarthritis and comorbid pathologies. The study was conducted at the Rheumatology Center at M.V. Sklifosovskiy Poltava Regional Clinical Hospital, which is affiliated with the Department of Family Medicine and Therapy at the Poltava State Medical University. We enrolled a total of 100 participants, comprising both outpatients and inpatients. Among the participants, 81% were women, while 19% were men. Their ages ranged from 48 to 73 years, and all of them presented with primary gonarthrosis at the I-II X-ray stage according to the Kellgren and Lawrence classification in combination with comorbid pathologies. Results. During a 3-month follow-up period, patients under the age of 50 years had mild and moderate manifestations of metabolic syndrome and polymorbid conditions including chronic obstructive pulmonary diseases, lesions of the genitourinary system. Most often, one, rarely two comorbid diseases and one or two diseases that had no proven connection with osteoarthritis were detected. At the age of 50-60, such comorbid processes as arterial hypertension, coronary heart disease, heart failure, obesity, type 2 diabetes, diseases of the digestive system, and polymorbid processes as chronic obstructive pulmonary disease, lesions of the genitourinary system, skin, diseases of the upper respiratory tract, depressive states demonstrated an increasing prevalence. Conclusions. This study has demonstrated a significant clinical effect from applying 3-month therapy that we developed. The therapy, including crystalline glucosamine sulphate and celecoxib, yielded 92% positive response in patients of the main group with osteoarthritis and comorbid pathology. It resulted in a significant reduction in pain, improved joint mobility, enhanced ability to perform daily activities, and positive shifts in laboratory indicators. This led to an improvement in the quality of life, manifested by normalized blood pressure, reduced cardiac and joint pain, and diminished reliance on nonsteroidal anti-inflammatory and antihypertensive medications.

Efficacy of ultrasound-guided subacromial bursa steroid injection for treating shoulder pain in post-stroke hemiparetic patients

Purpose: To assess the efficacy of ultrasound-guided subacromial bursa (SAB) steroid injection for treating hemiplegic shoulder pain (HSP) after stroke (CS), as well as its impact on joint mobility, and inflammatory mediators.Methods: Seventy-two (72) patients with CS-related HSP were divided into two groups: study and control groups. The study group received ultrasound-guided SAB injection of triamcinolone acetonide in addition to conventional treatment, while control group received only conventional rehabilitation. Both groups received 4 weeks of treatment and were assessed using pain visual analogue scale (VAS) and passive range of motion (PROM) indices before treatment and at 1, 4, and 12 weeks after treatment. Additionally, the Fugl-Meyer motor function (FMA-U) scale score, activities of daily living (ADL) score, modified Barthel index (MBI), serum IL-1β, IL-6, nitric oxide (NO) levels, and incidence of adverse reactions were assessed before and after 4 weeks of treatment.Results: The study group had a significantly higher total efficacy/effectiveness (86.11 %) compared to control group (53.89 %). Both groups showed initial decreases and subsequent increases in VAS and PROM from week 1 to week 12 after treatment. However, the study group had significantly lower VAS scores, angle of forward flexion, abduction, and external rotation at all time points compared to control group (p &lt; 0.05). At week 4, the study group had significantly higher FMA-U, ADL, and MBI scores, as well as significantly lower IL-1β, IL-6, and NO levels when compared to control group (p &lt; 0.05).Conclusion: Ultrasound-guided SAB steroid injection improves the efficacy of HSP after CS, improves joint mobility, and reduces serum levels of IL-1β, IL-6, and NO. Further large-sample studies with increased sample sizes and longer investigation periods are needed to validate these findings.