Increase In Range Of Motion Research Articles

Effect of Single Session Three Therapistadministered Posterolateral Mobilisation with Movement Glide on Shoulder Range of Motion: A Case Report

Frozen shoulder, or adhesive capsulitis, is a condition characterised by pain and stiffness in the shoulder joint. It gradually worsens over time, making it difficult to move the shoulder. The exact cause is not always clear, but it can be associated with injury, surgery, or certain medical conditions. Treatment typically involves physiotherapy and pain management. The authors present a case of a 41-year-old male who complained of acute pain in the right shoulder joint over a period of 15 days. Examination revealed a restriction in shoulder Range Of Motion (ROM). The case was treated with a single session of three therapist-administered posterolateral Mobilisation With Movement (MWM) glides. No medication was prescribed to the patient and he was asked to follow-up in the Outpatient Department (OPD) for three days. The single session of posterolateral MWM glide, along with conventional physiotherapy, led to an increase in shoulder ROM and a reduction in pain. This approach can be considered a viable treatment option for frozen shoulder.

Gait analysis using three-dimensional motion and ground reaction force systems in patients with hemiplegia treated with botulinum toxin type A in ankle plantar flexors.

Objective: The efficacy of botulinum toxin type A (BoNT-A) injection on spasticity has usually been measured using the range of motion (ROM) of joints and Modified Ashworth Scale (MAS); however, they only evaluate muscle tone at rest. We objectively analyzed the gait of three patients with hemiplegia using three-dimensional motion analysis and ground reaction force (GRF) systems to evaluate muscle tone during gait. Materials and Methods: We measured passive ankle dorsiflexion ROM with knee extension and the MAS score for clinical evaluation, and gait speed, stride length, single-leg support phase during the gait cycle, joint angle, joint moment, and GRFs for kinematic evaluation before and one month after BoNT-A injection. Results: All patients showed an increase in ankle dorsiflexion ROM, improvement in MAS score, and increase in stride length. Case 1 showed an increase in gait speed, prolongation of the single-leg support phase, increase in hip extension angle and moment, and improvement in the vertical and anterior-posterior components of the GRFs. Case 2 showed an increase in gait speed, improvement in double knee action, increase in ankle plantar flexion moment, and improvement in propulsion in the progressive component of the GRFs. Case 3 exhibited a laterally directed force in the GRFs. Conclusion: We evaluated the effects of BoNT-A injections in three patients with hemiplegia using three-dimensional motion analysis and GRFs. The results of the gait analysis clarified the improvements and problems in hemiplegic gait and enabled objective explanations for patients.

Percussion Gun and Scapular Stabilization Exercises versus Scapular Stabilization Exercises in Participants with Upper Cross Syndrome: A Randomized Controlled Trial

Background: Upper cross syndrome (UCS) is a muscle imbalance caused by a postural problem. This needs correction to improve the posture and help to regain muscle strength. Scapular stabilization exercises are the exercises that positively help to prevent UCS. Aim: The purpose of the study was to investigate if there was a difference in the effect of percussion gun and scapular stabilization exercises versus only scapular stabilization exercises in participants with UCS within the age group of 19–25 years. Settings and Study Design: A randomized controlled trial was conducted on collegiate students between the age group of 19–25 years. Methodology: Individuals with UCS (n = 40) were randomly allocated to experimental (Group A) and control groups (Group B). Participants in the experimental group were treated with percussion gun and scapular stabilization exercises, while participants in the control group were given only scapular stabilization exercises. Outcome measures used were craniovertebral angle (CVA), shoulder angle (SHA), cervical range of motion (ROM), and the strength of cervical flexors, which were assessed. Results: Participants in both the groups showed a significant improvement in CVA, SHA, cervical ROM, and strength of cervical flexors. However, the experimental group revealed a more significant increase in CVA, SHA, cervical ROM, and strength of cervical flexors than the control group. Conclusion: Both the experimental and control groups have shown improvements in ROM, CVA, SHA, and muscle strength. However, the study concluded that the percussion gun, along with scapular stabilization exercises, revealed better results than only scapular stabilization exercises.

Compare the Effectiveness of Core Muscle Strengthening Versus Quadriceps Muscle Strengthening in the Patient With Patellofemoral Pain Syndrome RCT

The purpose of this study was to see the comparative effectiveness of core muscle strengthening versus quadriceps muscle strengthening in the patients of patellofemoral pain syndrome to reduce pain and increase Range of Motion (ROM). 36 patients who fulfilled the selection criteria were enrolled in the study. Written informed contest was taken from each individual participating in this prior to performing any examination. Patients with patellofemoral pain syndrome were divided randomly into three groups. In ‘group A’ Core muscles strengthening exercises were applied. In ‘group B’ quadriceps muscles strengthening exercises were applied. In ‘group C’ Conventional Physiotherapy was applied. Allocation of patients in three groups had done by computerized generated list. All groups received conventional therapy, which was remain same throughout the study. The conventional therapy included knee isometrics and hot pack for 15 minutes. Group A subjects were treated with conventional therapy and core muscle strengthening. Group B subjects were treated with conventional therapy and quadriceps muscles strengthening. Group C subjects were treated only with conventional therapy. Treatment frequency will be 3 times a week. The duration of treatment was b 3 weeks in all groups. Informed consent was taken from each patient and Performa was filled. Visual analogue scale (VAS) and Anterior knee pain scale (AKPS) used for scoring. Group A showed marked improvement and significant results as p value is less than 0.05 than group B and group C. When treating patellofemoral pain syndrome, strengthening the core muscles is more efficient at reducing pain and enhancing functional abilities than strengthening the quadriceps. The result of this study proved that core muscle strengthening with conventional therapy was more effective than quadriceps muscle strengthening with conventional therapy and conventional therapy only.

Physiotherapy Management of Low Back Pain in Indonesian Para Badminton Athlete: a Case Study

This study aims to determine the role of physiotherapy in the management of low back pain case in Indonesian para badminton athlete. The research method used in this research is a descriptive case study. The sample in this study is Mrs. R, aged 30, who is a professional para badminton athlete. The main complaints were pain and limited range of motion. Assessments were carried out using VDS for pain, Schobers test for ROM and ODI for functional activity ability. The physiotherapy interventions used were US, TENS, and William Flexion Exercise. The research procedure was that the researchers conducted examinations and measurements including physical examinations, specific examinations, and examination of functional activity ability. The researchers provided US, TENS, and William Flexion Exercise interventions, and then the researchers evaluated and processed data. After 6 therapy sessions at the NPC Indonesia clinic, pain assessment showed a decrease in silent pain from T1 score 1 to 0 in T6, in compression pain from T1 score 3 to T6 score 1, and in motion pain from T1 score 5 to T6 score 2. Evaluation of range of motion showed an increase in range of motion in trunk flexion from therapy 1 value of 5 cm to therapy 6 value 8 cm. In trunk extension movements from therapy 1 value of 7 cm to therapy 6 value 9 cm. Evaluation of functional activity showed an increase in functional activity from T1 with a total of 25 indicating severe disability to T6 with a total of 9 indicating mild disability.

Preoperative and Postoperative Segmental and Overall Range of Motion in Patients Undergoing Lumbar Spinal Fusion Using HA-Infused PEEK and HA-Treated Titanium Alloy Interbody Cages.

Retrospective observational radiographic analysis. Determine how single level lumbar interbody fusion (LIF) alters segmental range of motion (ROM) at adjacent levels and decreases overall ROM. This study included 54 patients who underwent single-level anterior (ALIF, 39%), thoraco-LIF (TLIF, 26%), posterior LIF (PLIF, 22%), or lateral LIF (LLIF, 13%) (L2-3/L3-4/L4-5/L5-S1: 4%/13%/35%/48%). Segmental ROM from L1-2 to L5-S1 and the overall lumbar ROM (L1-S1) were assessed from preoperative and postoperative flexion-extension radiographs. K-means cluster analysis was used to identify ROM subgroups. The overall L1-S1 ROM decreased 14% (25.5 ± 20.4° to 22.0 ± 17.2°, P = .104) postoperatively. ROM at the fusion level decreased 77% (4.8 ± 5.0° to 1.1 ± 1.1°, P < .001). Caudal adjacent segment ROM decreased 12% (5.2 ± 5.7° to 4.6 ± 4.4°, P = .345) and cranially ROM increased 34% (4.3 ± 5.0° to 5.7 ± 5.7°, P = .05). K-cluster analysis identified 3 distinct clusters (P < .05). Cluster 1 lost more ROM and had less improvement in patient-reported outcomes measures (PROMs) than average. Cluster 2 had less ROM loss than average with worse PROMs improvement. Cluster 3 did not have changes in ROM and better improvement in PROMs than average. Successful fusion was verified in 96% of all instrumented segments with >6months follow-up (ROM <4°). Following single-level L IF, patients should expect a loss of 3.3°, or 14% of overall lumbar motion with increases in ROM of the cranial segment. However, specific clusters of patients exist that experience different relative changes in ROM and PROMs.

Platelet-Rich Plasma Therapy: An Effective Approach for Managing Knee Osteoarthritis.

Platelet-rich plasma (PRP) is a promising non-invasive therapeutic intervention for knee osteoarthritis (KOA) that has generated significant interest due to anecdotal accounts of its efficacy, resulting in reduced recovery time in various orthopedic interventions. This systematic review examines the effectiveness of PRP in managing KOA. Specifically, it seeks to determine the extent to which PRP can treat KOA patients effectively, alleviate KOA symptoms, and improve patient outcomes. Additionally, the review aims to identify the optimal concentration and composition of PRP required to achieve therapeutic results in KOA. Furthermore, the review investigates whether PRP can modify the synovial environment structurally and immunologically to improve outcomes in KOA patients. We conducted a comprehensive literature search on PubMed, Orthogate, Clinicaltrials.gov, and Embase of clinical trials investigating PRP treatment in KOA patients in the last five years. The results indicated that PRP is effective in treating KOA patients. Evidence shows that PRP therapy can alleviate pain, enhance joint function, increase range of motion, and improve mobility in KOA patients. PRP was effective in treating KOA when the mean platelet concentration of PRP treatment was 4.83 to 5.91 times higher than the baseline whole blood platelet concentration. However, studies investigating PRP with a mean platelet concentration of 3.48 to 4.04 times higher than baseline failed to demonstrate statistically significant improvements. PRP therapy slowed down KOA progression, which validates its effectiveness in impeding further structural damage and arresting the degenerative impact of the disease. Nonetheless, further investigation is necessary to examine how PRP therapy can modify the progression of the disease. Furthermore, future research should identify the most effective platelet concentration levels that provide optimalsymptom relief. There is a need for further research to identify the specific PRP configuration that is most pertinent in a clinical setting, as there is a lack of standardization in PRP manufacturing protocols, including the variety of experimental setups and dosing schedules utilized in different studies.

Effects of dynamic and rigid implantation on biomechanical characteristics of different sagittal alignment lumbar after single- or double-level spinal fixations: a finite-element modeling study

BackgroundAlthough it is critical to understand the accelerated degeneration of adjacent segments after fusion, the biomechanical properties of the spine have not been thoroughly studied after various fusion techniques. This study investigates whether four Roussouly’s sagittal alignment morphotypes have different biomechanical characteristics after different single- or double-level spinal fixations.MethodsThe parametric finite element (FE) models of Roussouly’s type (1–4) were developed based on the radiological data of 625 Chinese community population. The four Roussouly's type models were reassembled into four fusion models: single-level L4–5 Coflex fixation model, single-level L4–5 Fusion (pedicle screw fixation) model, double-level Coflex (L4–5) + Fusion (L5–S1) model, and double-level Fusion (L4–5) + Fusion (L4–5) model. A pure moment of 7.5 Nm was applied to simulate the physiological activities of flexion, extension, lateral bending and axial rotation.ResultsBoth single-level and double-level spinal fixation had the greatest effect on lumbar range of motion, disc pressure, and annulus fibrosis stress in flexion, followed by lateral bending, extension, and axial rotation. In all models, the upper adjacent segment was the most influenced by the implantation and bore the most compensation from the fixed segment. For Type 2 lumbar, the L4–L5 Coflex effectively reduced the disc pressure and annulus fibrosis stress in adjacent segments compared to the L4–L5 Fusion. Similarly, the L4–L5 Coflex offered considerable advantages in preserving the biomechanical properties of adjacent segments for Type 1 lumbar. For Type 4 lumbar, the L4–L5 Coflex did not have superiority over the L4–L5 Fusion, resulting in a greater increase in range of motion at adjacent segments in flexion and extension. The difference between the two fixations was not apparent in Type 3 lumbar. Compared to the single-level Fusion, the changes in motion and mechanics of the lumbar increased after both the double-level Coflex + Fusion and Fusion + Fusion fixations, while the differences between two double-level fixation methods on adjacent segments of the four lumbar models were similar to that of the single-level fixation.ConclusionType 3 and Type 4 lumbar have good compensatory ability and therefore allow for a wider range of surgical options, whereas surgical options for small lordotic Type 1 and Type 2 lumbar are more limited and severe.

Modeling Stiffness and Stress in Serpentine Flexures for Use in a Compliant Bone Plate

Abstract Serpentine flexures offer several advantages for use in linear motion mechanisms, including distributed compliance to reduce stress and increase range of motion. In this work, we develop an analytical model for predicting the moment, vertical deflection, and maximum stress experienced in serpentine flexures in response to an input vertical force. Two classes of serpentines are introduced and modeled with linear motion boundary conditions enforced. Finite element analysis demonstrates a mean model error of 0.86% for these metrics across many flexure topologies. Experimental testing is performed to validate the force–deflection response of three steel serpentine compliant mechanisms. The model is able to predict the experimental stiffness data with a mean error at yield of 5.3%, compared to 6.5% with finite element analysis. Large displacement simulations show the model could remain below 10% error for deflections 3–7 times beyond the mechanisms’ deflection at yield. Finally, the model’s utility is demonstrated in the design of a novel single-piece compliant fracture fixation plate that leverages serpentine flexures to deliver controlled axial motion for long bone secondary healing. Model-derived stress-equivalent flexures are compared in their transverse and torsional rigidity. The proposed model and specific findings can be leveraged to design linear motion mechanisms that incorporate serpentine flexures across a wide range of applications.

Effect of physiotherapeutic procedures on the bioelectric activity of the masseter muscle and the range of motion of the temporomandibular joints in the female population with chronic pain: a randomized controlled trial

SummaryIntroductionPhysical therapy (PT) methods applied in dentistry are increasingly discussed nowadays. Taking into account a rapidly growing number of temporomandibular disorders (TMDs) and orofacial pain patients, it is reasonable to determine which of the available physiotherapeutic (PT) methods are more effective than others, especially in terms of their possible analgesic and myorelaxant effects.ObjectiveTo assess manual and physical factors influencing pain reduction or elimination and increased muscle tension in patients with TMD; yet the influence of the applied forms of PT on the range of motion (ROM) of temporomandibular joints (TMJ).Material and methodsA randomized, parallel-group, RCT, single-blind, equi-randomized (1:1) study was conducted in DC/TMD Group Ib patients (20–45 years of age). An experimental group (G1, n = 104) and a control group without TMD (G2, n = 104) were created according to CONSORT guidelines. Diagnostic measurements were performed in both groups (mass sEMG, temporomandibular joint range of motion-ROM, pain intensity - NRS). Group G1 was randomly divided (envelope method) into 4 therapeutic groups, in which therapy was carried out for 10 days: magnetostimulation (MS), magnetoledotherapy (MLE), magnetolaserotherapy (MLA), manual therapy (MT). Each time after the therapy, ROM and NRS measurements were performed, and after the 5th and 10th day sEMG.ResultsStatistically significant differences were found in the sEMG values of the masseter muscles, TMJ ROM and the pain intensity in G1 and G2 (p < 0.00). The largest decrease in sEMG (% MVC) of the masseter muscle occurred in the subgroup in which the manual therapy (MT) procedures were applied, p < 0.000. There was no clinically significant difference in and between other subgroups. There was a distinct mandible ROM increase noted in the MT group, with minimal changes in the MLA and MLE groups and no changes in the MS group. There was a clear increase in the lateral mobility of both right and left TMJ in the MT group. There were no differences in the course of the study in the MS group, and slight increases in the MLA and MLE groups. In the case of pain measurements, the greatest decrease in pain intensity was observed in the MT subgroup.ConclusionsAccording to our results manual therapy is an effective form of treatment in patients with pain, increased masticatory muscle tension and limitation in mandible ROM. Dental physiotherapy should become an integral part of multimodal TMD patients’ treatment.

Upaya Pencegahan Peningkatan Osteoarthritis pada Lansia Di Posyandu Kleben Desa Gedongan, Kec. Colomadu, Kab. Karanganyar

Osteoarthitis is a degenerative disease that occurs in several joints. Osteoarthitis is most often found in the Kleben elderly posyandu, Gedongan Village, Kec. Colomadu is knee osteoarthritis. The cause of knee osteoarthritis can be trauma or obesity. Apart from that, heavy activity or work also causes excessive work on the joints. There are many factors that influence the occurrence of knee osteoarthritis, namely age, gender and genetics. Therefore, efforts to prevent the increase in knee osteoarthritis are very necessary to reduce pain and increase range of motion. By carrying out counseling using hold relax stretching exercises and carried out independently for 3 weeks with a dose of 7x counts for 6-8x repetitions, results were obtained between pre and post, namely changes in reducing pain and increasing rage of motion in the elderly.

Effect of Scapular Stabilization Exercises with and without Thoracic Mobilization on Neck Pain and Range of Motion in Upper Cross Syndrome

Background: Neck pain is a common musculoskeletal disorder occurring in Upper Cross Syndrome which involves pain and discomfort around the neck region, which causes limitation in activities of daily living and impact the health of an individual and can also be a risk factor for reduced general productivity. Few studies have shown higher evidence in younger adults as a result of sustained exposure to abnormal posture, which increases the risk of musculoskeletal disorders. This intervention aims on the restoration of the muscle imbalance and to reduce pain and increase range of motion. Objective: To study the effect of Scapular Stabilization Exercises with and without Thoracic Mobilization on neck pain and range of motion in Upper Cross Syndrome in young adults. Method: This is a comparative study where 70 subjects were selected as per inclusion and exclusion criteria and assigned to group A (n=35; Exercise group) and group B (n=35; Exercise with Mobilization group) respectively. Scapular stabilization exercises were given to both the groups. The intervention was given for 4 days/week for 4 weeks. Pain and Range of Motion was assessed pre and post intervention using VAS and Goniometer. The data was collected and statistically analysed. Results: Both groups showed (p&lt;0.001) differences in all outcome measures between pre-test and post-test values of Group A and Group B. Results of this study indicated that after 4 weeks of upper thoracic mobilization in addition to scapular stabilization exercises, the Cervical ROM significantly increased in comparison to the scapular stabilization exercise group which in terms of flexion, extension, left and right lateral flexion, and left and right rotation. Conclusion: The study concludes that Thoracic Mobilization along with Scapular Stabilization exercises had a significant effect in reducing pain, increasing flexion, extension, lateral flexion, and rotation range of motion as compared to Scapular stabilization exercises only. Keywords: upper cross syndrome, neck pain, young adults, scapular stabilization exercises, thoracic mobilization, range of motion

Noninvasive magnetic resonance-guided focused ultrasound for tendon disruption: an in vivo Animal study

Purpose Surgical resection of the tendon is an effective treatment for severe contracture. Magnetic Resonance-guided Focused Ultrasound (MRgFUS) is a non-invasive ultrasonic therapy which produces a focal increase in temperature, subsequent tissue ablation and disruption. We evaluated MRgFUS as a clinically translatable treatment modality to non-invasively disrupt in vivo porcine tendons. Material and methods In vivo Achilles tendons (n = 28) from 15–20kg Yorkshire pigs (n = 16) were randomly assigned to 4 treatment groups of 600, 900, 1200 and 1500 J. Pretreatment range of motion (ROM) of the ankle joint was measured with the animal under general anesthesia. Following MRgFUS treatment, success of tendon rupture, ROM increase, temperature, thermal dosage, skin burn, and histology analyses were performed. Results Rupture success was found to be 29%, 86%, 100% and 100% for treatment energies of 600, 900, 1200 and 1500 J respectfully. ROM difference at 90° flexion showed a statistically significant change in ROM between 900 J and 1200 J from 16° to 27°. There was no statistical significance between other groups, but there was an increase in ROM as more energy was delivered in the treatment. For each of the respective treatment groups, the maximal temperatures were 58.4 °C, 63.3 °C, 67.6 °C, and 69.9 °C. The average areas of thermal dose measured were 24.3mm2, 53.2mm2, 77.8mm2 and 91.6mm2. The average areas of skin necrosis were 5.4mm2, 21.8mm2, 37.2mm2, and 91.4mm2. Histologic analysis confirmed tissue ablation and structural collagen fiber disruption. Conclusions This study demonstrated that MRgFUS is able to disrupt porcine tendons in vivo without skin incisions.

Acute effect of static stretching on non-muscular tissue stiffness and joint flexibility: a comparative study between older and young men.

Non-muscular tissue stiffness is assumed to have a negative impact on joint flexibility, and a reduction in non-muscular tissue stiffness may be important, especially in older adults. The present study aimed to compare the acute effects of static stretching on non-muscular tissue stiffness between older and young adults and to investigate whether a decrease in tissue stiffness improves joint flexibility. Twenty older (62-83years) and 20 young (21-24years) males participated. Ankle dorsiflexion static stretching (five sets of 90s each) was performed, and before and after stretching, the ankle dorsiflexion range of motion (RoM), passive ankle joint stiffness, and shear wave speed (SWS) (an index of stiffness) of the sciatic nerve, tibial nerve, and posterior thigh fascia were measured. Stretching led to an increase in RoM and a decrease in passive joint stiffness in both groups (P < 0.001) with no significant between-group differences (P ≥ 0.055). The between-group difference in the effect of stretching on SWS was evident only for the sciatic nerve, and a decline in sciatic nerve SWS was only observed in the older adult group (pre-stretching: 2.5 ± 0.3m/s; post-stretching: 2.3 ± 0.4m/s; P = 0.027). A significant positive repeated-measures correlation was observed between the sciatic nerve SWS and passive joint stiffness (P = 0.014, rrm = 0.540). The reduction in sciatic nerve stiffness by stretching was noticeable in older men and led to improved joint flexibility. These findings may provide insight into tissue adaptation by stretching and may be used to explore effective exercises for improving joint flexibility in older adults.

Donuk Omuzda Eklem Hareket Açıklığını Artırmak İçin Alet Destekli Yumuşak Doku Mobilizasyonu Kullanılabilir mi?

The aim of this review was to investigate studies using Instrument-Assisted Soft Tissue Mobilization (IASTM), to determine the effects of IASTM on shoulder mobility in frozen shoulder. Literature search was carried out on 21 March 2022 using PUBMED, Pedro, SCOPUS, Web of Science and Scholar databases. Appropriate clinical studies were identified from the above databases investigating the effects of IASTM on shoulder range of motion (ROM) in frozen shoulder and a narrative review was performed. Despite the very limited data on IASTM, which has just begun to increase in use in frozen shoulder, IASTM seems promising for ROM increase. Further studies with higher quality and larger samples are needed to confirm this view and recommend the appropriate IASTM technique for frozen shoulder.

The Influence of Compensatory Pelvic Tilt on Patient-reported Outcome Measurements in FAI Patients Who Received Arthroscopic Treatment.

Pelvic compensation is common in femoroacetabular impingement (FAI) patients to reduce symptoms and increase range of motion. However, little attention was given to the postoperative clinical effect of pelvic compensation. Therefore, this study aims to compare the outcomes between pelvic compensation and normal pelvic position in femoroacetabular impingement (FAI) patients after hip arthroscopy. The retrospective study was conducted from January 2019 to June 2022, recruited consecutive patients who were diagnosed with FAI and received subsequent arthroscopic treatment. All patients completed an X-ray in the anterior-posterior standing position before and 4 weeks after surgery. Patients with pelvic compensation were compared with those who did not. Functional outcomes included hip disability and osteoarthritis outcome score (HOOS), modified Harris (mHHS) score, and lower-extremity activity scale (LEAS). Secondary outcomes included the EuroQol Five Dimensions Questionnaire (EQ-5D) and patient satisfaction. The intraclass correlation coefficient (ICC) was used to analyze interobserver and intraobserver reliability. Ninety patients with a mean age of 39.40 years were included in the study. No significant compensation changes were noted within groups after the elimination of impingement. The functional scores showed no significant difference between groups (p(HOOS) = 0.352, p(mHHS) = 0.183, p(LEAS) = 0.865). The EQ-5D revealed statistically better performance in usual activities in the compensatory group (p = 0.044). There are no significant between-group differences in patients' satisfaction evaluations. As assessed by Patient-Reported Outcome Measures (PROMs), patients with compensatory pelvic tilt demonstrated similar clinical outcomes without extra adverse events to patients with normal pelvic positioning in short-term follow-ups. Furthermore, compensatory pelvic tilt did not significantly enhance the range of motion or functional outcome at short-term follow-ups.

Effect of Different Types of Ossification of the Posterior Longitudinal Ligament on the Dynamic Biomechanical Response of the Spinal Cord: A Finite Element Analysis.

Ossification of the posterior longitudinal ligament (OPLL) has been identified as an important cause of cervical myelopathy. However, the biomechanical mechanism between the OPLL type and the clinical characteristics of myelopathy remains unclear. The aim of this study was to evaluate the effect of different types of OPLL on the dynamic biomechanical response of the spinal cord. A three-dimensional finite element model of the fluid-structure interaction of the cervical spine with spinal cord was established and validated. The spinal cord stress and strain, cervical range of motion (ROM) in different types of OPLL models were predicted during dynamic flexion and extension activity. Different types of OPLL models showed varying degrees of increase in stress and strain under the process of flexion and extension, and there was a surge toward the end of extension. Larger spinal cord stress was observed in segmental OPLL. For continuous and mixed types of OPLL, the adjacent segments of OPLL showed a dramatic increase in ROM, while the ROM of affected segments was limited. As a dynamic factor, flexion and extension of the cervical spine play an amplifying role in OPLL-related myelopathy, while appropriate spine motion is safe and permitted. Segmental OPLL patients are more concerned about the spinal cord injury induced by large stress, and patients with continuous OPLL should be noted to progressive injuries of adjacent level.

Two Cases of Left Hip Heterotopic Ossification Treated with Surgery and their Outcomes Postoperatively

52-year-old woman was admitted to Trauma and Orthopedics department (TOD) due to septic arthritis (SA) in left hip joint (LHJ). Patient underwent three consecutive open debridement procedures. During the treatment, an intracerebral hematoma was discovered. Upon rehabilitation patient indicated severe pain in LHJ that impaired movement. Three months after admission CT showed heterotopic ossification (HO) in LHJ. Patient was recommended to complete treating postinfectious complications and refer to TOD for further evaluation and discussing treatment options. Five months after the first presentation, complete mechanical block could be seen in LHJ due to HO. Open left hip ossificate resection and LHJ redressation were performed. During procedure significant increase in range of motion (ROM) was obtained. Iatrogenic transection of the femoral nerve occurred and was treated surgically. After surgery, patient was subjected to early rehabilitation and later forwarded to rehabilitation department. Increase of active and passive ROM remained. 34-year-old man was admitted to TOD due to polytrauma, including multiple hip and acetabular fractures. Patient underwent three surgical interventions due to fractures. Month after admission, postoperative deep tissue infection in the fracture and Covid-19 were discovered and treated. Two years later, patient returned to TOD complaining about significant impairment of ROM in LHJ due to HO, which was surgically removed. Surgical treatment is rarely chosen for treatment of HO since alleviation of pain is not worth the risks, and HO can reoccur, preferring treatment with exercise and indomethacin, but when a significant increase of ROM is expected, surgical treatment is justified. These case reports show how surgical treatment of HO with mixed origin in patients with good expected outcomes and high involvement in their own rehabilitation should be at least considered. It is important to emphasize both pre and postoperative rehabilitation and prophylaxis.

The Acute Effects of Theragun™ Percussive Therapy on Viscoelastic Tissue Dynamics and Hamstring Group Range of Motion

Handheld percussive therapy (PT) massage guns have seen a rapid rise in use and with-it increased attention within injury prevention and sport performance settings. Early studies have proposed beneficial effects upon range of motion (ROM), however the mechanism behind these increases remains unreported. This study aimed to determine the influence of a minimal frequency PT dose upon ROM and myotonometry outcomes. Twenty participants (N = 20; 13 males and 7 females, height 1.78cm ± 9.62; weight 77.35kg ± 8.46) participants were allocated to either a PT group receiving 2 x 60-seconds (plus 30-seconds rest) via a Theragun™ Pro4 to the hamstrings covering a standardised 20 lengths from proximal to distal via the standard ball attachment at 1 bar of pressure or a control group (CON) of 2-minutes 30-seconds passive supine rest. Pre and post intervention outcomes were measured for ROM via passive straight leg raise (PSLR) and tissue dynamics via MyotonPro (Tone, Stiffness, Elasticity, Relaxation Time). Results showed significant within-group increases (p &lt; 0.0001, ηp2 0.656, +11.4%) in ROM following PT and between group difference against CON (P &lt; 0.026). Significant within-group differences in stiffness (p &lt; 0.016, ηp2 0.144, -6%), tone (p &lt; 0.003, ηp2 0.213, +2%) and relaxation time (p &lt; 0.002, ηp2 0.232, +6.3%) were also reported following PT. No significant difference was reported in elasticity (P &gt; 0.05) or any other between group outcomes. PT therapy can provide an acute increase in hamstring group ROM following a resultant decrease in tissue stiffness.

The Acute Effects of Theragun™ Percussive Therapy on Viscoelastic Tissue Dynamics and Hamstring Group Range of Motion.

Handheld percussive therapy (PT) massage guns have seen a rapid rise in use and with-it increased attention within injury prevention and sport performance settings. Early studies have proposed beneficial effects upon range of motion (ROM), however the mechanism behind these increases remains unreported. This study aimed to determine the influence of a minimal frequency PT dose upon ROM and myotonometry outcomes. Twenty participants (N = 20; 13 males and 7 females, height 1.78cm ± 9.62; weight 77.35kg ± 8.46) participants were allocated to either a PT group receiving 2 x 60-seconds (plus 30-seconds rest) via a Theragun™ Pro4 to the hamstrings covering a standardised 20 lengths from proximal to distal via the standard ball attachment at 1 bar of pressure or a control group (CON) of 2-minutes 30-seconds passive supine rest. Pre and post intervention outcomes were measured for ROM via passive straight leg raise (PSLR) and tissue dynamics via MyotonPro (Tone, Stiffness, Elasticity, Relaxation Time). Results showed significant within-group increases (p < 0.0001, ηp2 0.656, +11.4%) in ROM following PT and between group difference against CON (P < 0.026). Significant within-group differences in stiffness (p < 0.016, ηp2 0.144, -6%), tone (p < 0.003, ηp2 0.213, +2%) and relaxation time (p < 0.002, ηp2 0.232, +6.3%) were also reported following PT. No significant difference was reported in elasticity (P > 0.05) or any other between group outcomes. PT therapy can provide an acute increase in hamstring group ROM following a resultant decrease in tissue stiffness.