Joint Mobility In Patients Research Articles

Efficacy of allogeneic tendon material coracoclavicular ligament reconstruction combined with Kirschner wire and titanium alloy hook plate material fixation in the treatment of acromioclavicular joint dislocation.

To compare the effects of allogeneic tendon coracoclavicular ligament reconstruction combined with Kirschner wire fixation and clavicular hook plate fixation on early postoperative pain, postoperative shoulder joint function score and shoulder joint mobility in patients with acromioclavicular joint dislocation. From January 2020 to January 2023, 43 patients with acromioclavicular joint dislocation admitted to Xi 'an Honghui Hospital were included. Among them, 24 patients were treated with the clavicular hook plate technique (Hook Plate,HP) group, and 19 patients were treated with allogeneic tendon coracoclavicular ligament reconstruction combined with the Kirschner wire technique (Allogeneic Tendon, AT) group. The Constant-Murley score of shoulder joint function 6months after operation, postoperative shoulder joint activity, preoperative and postoperative pain, operation time, intraoperative blood loss and complications were compared between the two groups. All 43 patients were followed up for an average of 9.7 (9-12) months. The intraoperative blood loss in the allogeneic tendon group was less than in the hook plate group. The Constant-Murley shoulder function score was higher than that in the hook plate group 6 months after the operation. The abduction and lifting activity was greater than that in the hook plate group. The visual analogue scale scores at 3days and 14 days after operation were lower than those in the hook plate group. The difference was statistically significant (p < 0.001). There was 1 case (5.3%) of exudation around the Kirschner needle track in the allogeneic tendon reconstruction group, and 5 cases (20.8%) of complications in the hook plate group, including 1 case of internal fixation stimulation, 2 cases of acromion impingement syndrome, 1 case of acromioclavicular joint osteoarthritis, and 1 case of shoulder joint stiffness. The complication rate of the allogeneic tendon group was lower than that of the hook plate group. The clinical efficacy of allogeneic tendon coracoclavicular ligament reconstruction combined with Kirschner wire fixation in treating acromioclavicular joint dislocation (Rockwood type III-V) is better than hook plate internal fixation. The patients have less early postoperative pain and better recovery of shoulder joint function and shoulder joint mobility.

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.

Treatment of restriction syndrome joint mobility in patients with endocrine arthropathy

Treatment of restriction syndrome joint mobility in patients with endocrine arthropathy

Ebselen, an Active Seleno-Organic Compound, Alleviates Articular Cartilage Degeneration in a Rat Model of Knee Osteoarthritis.

Osteoarthritis (OA) is a prevalent articular disease mainly characterized by extracellular matrix degradation, apoptosis, and inflammation, which lead to cartilage destruction and abnormal bone metabolism. With undesirable side effects, current limited symptomatic treatments are aimed at relieving pain and improving joint mobility in patients with OA. Intra-articular (IA) hyaluronic acid (HA) injection, as a nonsurgical therapy, is commonly used in the clinical management of knee OA, but the efficacy of this therapeutic option remains controversial. Ebselen has tremendous pharmacological importance for some diseases due to its antioxidant, antiapoptotic, and anti-inflammatory features. However, there is no research examining the therapeutic effect of Ebselen in OA using the rat OA model. Therefore, we aimed to investigate the therapeutic effect of Ebselen on cartilage degeneration and its role in bone morphogenetic protein 2 (BMP2) and nuclear factor kappa B (NF-κB) signaling in the molecular pathogenesis of OA. We induced a knee OA model in rats with an IA injection of monosodium-iodoacetate (MIA). After the treatment of Ebselen, we evaluated its chondroprotective effects by morphological, histopathological, and immunohistochemical methods and an enzyme-linked immunosorbent assay. We report for the first time that Ebselen treatment alleviated articular cartilage degeneration in the rat knee OA model and reduced MIA-induced BMP2 and NF-κB expressions. In addition, our results unveiled that Ebselen decreased IL-β and IL-6 levels but did not affect COMP levels in the rat serum. Ebselen could be a promising therapeutic drug for the prevention and treatment of OA by alleviating cartilage degeneration and regulating BMP2 and NF-κB expressions.

Additive manufacturing structural redesign of hip prostheses for stress-shielding reduction and improved functionality and safety

Nowadays, the total hip arthroplasty (THA) is a widespread surgical procedure, representing the best option to restore hip joint mobility in patients suffering from trauma or joint diseases. One of the well-known possible drawbacks of THA is the stress-shielding phenomenon. Some years after the surgery, the femur starts to degrade because of its persistent unloaded condition induced by the high prosthesis stiffness, which carries the great part of the load normally taken by the bone. This condition is particularly invalidating in younger patients, with longer life expectation after the operation, requiring one or multiple additional operations to restore the proper prosthesis-bone firm connection.The present study tries to address this issue proposing an innovative prosthesis design, taking advantage of the shape freedom ensured by Additive Manufacturing techniques. Additionally, the structural integrity of the novel prosthesis is assessed using a ductile damage numerical approach.Different prosthesis geometries were investigated: one conventional and commercially available already, and two more innovative geometries. For each one, a bulk solution was compared to a lighter version characterized by an inner reticular structure with a body-centred cubic unit cell and by an equivalent density of about 5%, only feasible through the additive manufacturing fabrication.Extensive Finite Element numerical simulations were carried out to compare the percentage of the induced stress shielding for the different prosthesis geometries. Pros and cons of each geometry were pointed out and eventually the most promising solution in limiting the stress shielding phenomenon was chosen. At the same time, the structural integrity of the selected design was ensured, embedding a ductile damage model in the Finite Element analysis, calibrated on a SLM Ti6Al4V, the biocompatible alloy for the prosthesis fabrication. Structural safety was evaluated under four different loading conditions: walking, stumbling, the exceptional overload due to hammering insertion during surgery and the force which induced the collapse of the implant. Additionally, the safety margin was quantified through the definition of an overall safety factor under the maximum expected load.

Immediate effects of spinal manipulation in pain and global joint mobility in patients with chronic nonspecific low back pain

Objective: The aim of this study was to analyze the immediate effects of applying a manipulative intervention on chronic non-specific back pain and increasing global joint mobility. Method: A cross-sectional, randomized, single-blind study was carried out, consisting of 19 women aged between 18 and 55 years old, separated into two groups: Experimental Group (EG = 10) and Control Group (CG=9). The evaluation consisted of a physical examination, Rolland Morris questionnaire, fingertip-to-floor test, Visual Analogue Scale (VAS), and pressure algometry (L5) before and after the manipulative intervention. The EG was submitted to five vertebral manipulations, two in the bilateral pelvis region, one in the middle thoracic region (T5-T7) and two in the bilateral cervical region at the C3 level. The CG was submitted to two placebos manipulative techniques, being positioned in right and left lateral decubitus position for 10 seconds each, in the same position of global pelvic manipulation, but without the manipulative impulse (thrust). Results: The results were statistically significant in the EG in the reduction of sensation of pain (p&lt;0,001) and the increase of overall joint mobility (p&lt;0,05) when comparing pre and post intragroup moments. There were no statistically significant differences in relation to pain threshold evaluated in pressure algometry. Conclusion: It is concluded that a manipulative intervention is able to reduce the pain and to increase the global mobility immediately after its accomplishment.

Therapeutic efficacy of acupuncture combined with neuromuscular joint facilitation in treatment of hemiplegic shoulder pain.

BACKGROUNDStroke is a type of cerebrovascular disease with high prevalence, mortality, and onset of disability. As a neurodevelopmental therapy, neuromuscular joint facilitation (NJF) is widely used in the treatment of orthopedic and neurological disorders in the clinical practice. It is mainly used for central nervous system diseases or orthopedic diseases, movement disorders, and pain rehabilitation. According to related studies, NJF can also be used as a rehabilitation treatment in patients with hemiplegic shoulder pain (HSP).AIMTo investigate the clinical efficacy of acupuncture combined with NJF in patients with HSP.METHODSForty patients with HSP were randomly divided into a treatment group and a control group. The treatment group was treated with acupuncture combined with NJF and the control group was treated with acupuncture alone. All patients were assessed by using the visual analogue scale (VAS), Fugl-Meyer assessment (FMA), Barthel index (BI), and passive range of motion (PROM) before and after the training. All the clinical data were analyzed using SPSS 20.0 statistical software.RESULTSThere was no statistical difference in the general characteristics between the two groups. In the terms of duration of treatment, age, and pre-treatment indicators, the two groups were comparable (P > 0.05). After the treatment, VAS, PROM, BI, and FMA scores were significantly improved in the two groups of patients (P < 0.05). The VAS, PROM and FMA scores were significantly higher in the treatment group than in the control group (P < 0.05). However, there was no significant difference in BI scores between the two groups (P > 0.05).CONCLUSIONBoth acupuncture alone and acupuncture combined with NJF in the treatment of HSP are effective, and can improve the clinical symptoms of patients. Acupuncture combined with NJF can improve the upper limb motor function, relieve pain, and increase joint mobility in patients with HSP. The combination therapy is better than acupuncture alone. However, there is no significant difference in improving the score of patients’ self-care ability.

Shoulder joint mobility in patients with primary adhesive capsulitis after treatment with continuous mode of ultrasound: A systematic review of randomized controlled trials.

Background: Although the continuous mode of ultrasound therapy improves joint mobility, its role in primary adhesive capsulitis (AC) remains unclear. Therefore, this systematic review aims to address this evidence gap. Methods: The literature search included databases (SCOPUS, CINAHL, EMBASE, and PubMed) and in-text references of articles read full-text. Randomized controlled trials (RCT) on primary AC patients (published in the English language between 1979-2019) comparing the ROM changes (in degrees) mainly between continuous mode of US therapy with any other non-electrotherapeutic treatment were eligible for inclusion. The trials were reviewed narratively along with an assessment of the risk of bias. Results: Out of 174 search results, two eligible single-center trials comprising of 100 participants compared ROM in four separate directions at the 10th session and after three months post-intervention. The risk of selection bias, performance bias, and attrition bias was unclear among the trials. While in both the trials ROM (in all directions) improved in the respective intervention groups at follow up, most of these changes varied between the intervention groups in one trial. However, in the latter trial, participants in the treatment group had the worst ROM values at baseline with poor compliance to the adjunct exercise therapy. Conclusion: The contemporary evidence in the context remains inconclusive due to a lack of large multicentric well-conducted RCTs.

Hamstrings muscles tightness in adolescences with a thoracic hyperkyphosis: Comparison of muscles flexibility and joint mobility in patients with scheuermann juvenile kyphosis versus postural thoracic hyperkyphosis

Hamstrings muscles tightness in adolescences with a thoracic hyperkyphosis: Comparison of muscles flexibility and joint mobility in patients with scheuermann juvenile kyphosis versus postural thoracic hyperkyphosis

Assessment of sacroiliacal joint mobility in patients with low back pain

Sagittal alignment of the pelvis is typically characterized using three fundamental parameters. Among these, pelvic incidence is traditionally considered to be anatomically 'constant'. We aimed to analyze the pelvic parameters of low back pain patients with suspected sacroiliac joint laxity. Pelvic parameters were assessed in standing and seated EOS 2D/3D radiographs of 48 cases of persistent low back pain, and compared to upper body position using cluster analysis and t-test. Median pelvic incidence did not differ statistically between standing and sitting (47.8°-47.7°). However, in individual analysis 7 cases (15%) exhibited a forward tilt in their upper body with an increased pelvic incidence, and 7 cases (15%) showed a backward upper body tilt. No change was found in 34 cases. Our results indicate the pelvis should not be regarded as a rigid unit, as in some cases significant appreciable sacroiliac joint laxity can occur. Orv Hetil. 2017; 158(52): 2079-2085.

A prospective cohort study investigating the effect of generalized joint hypermobility on outcomes after arthroscopic anterior shoulder stabilization

ABSTRACTObjectives: Generalized joint laxity has been proposed as a significant risk factor for failure after arthroscopic anterior shoulder stabilization. The purpose of this study was to prospectively measure joint mobility in patients undergoing arthroscopic anterior shoulder stabilization and to determine whether hypermobility is a risk factor for worse outcomes compared with patients having normal joint mobility.Methods: Patients with anterior shoulder instability were prospectively enrolled. Generalized joint hypermobility was measured using the Beighton Hypermobility Score and the Rowe, UCLA, SANE, SST, and WOSI scores were administered and reported as patient outcomes preoperatively and following arthroscopic anterior shoulder stabilization at 6 weeks, 6 months, 12 months, and 24 months postoperatively. Patients were stratified into two groups based on their Beighton Hypermobility Score, with scores ≥ 4/9 indicative of joint hypermobility.Results: Sixteen patients with joint hypermobility (JH) and 18 non-hypermobile patients (NJH) were enrolled. At baseline, there were no significant differences in demographic characteristics or baseline patient-reported outcomes. Significantly more patients in the NJH group had SLAP tears (n = 10) compared to the JH group (n = 2) (p = .013). At all follow-up times, there were no significant differences between the NJH and JH groups with regard to patient-reported outcome scores (p > .05). In the JH group, 17% of patients reported recurrent instability at two years postoperatively compared to 25% of patients in the NJH group. There was no significant difference in failure rate (p = .67).Conclusion: There was no significant difference in patient-reported outcomes or recurrent instability in patients with versus without joint hypermobility undergoing arthroscopic anterior shoulder stabilization.

Effects of a Resting Foot Splint in Early Brain Injury Patients.

ObjectiveTo assess the effectiveness of the resting foot splint to prevent ankle contracture.MethodsWe performed a randomized controlled trial in 33 patients with brain injury with ankle dorsiflexor weakness (muscle power ≤grade 2). Both groups continued conventional customized physical therapy, but the patients in the foot splint group were advised to wear a resting foot splint for more than 12 hours per day for 3 weeks. The data were assessed before and 3 weeks after the study. The primary outcome was the change in ankle dorsiflexion angle after 3 weeks.ResultsBefore the study, there were no differences between groups in gender, age, time post-injury, brain injury type, initial edema, spasticity, passive range of ankle dorsiflexion, Fugl-Meyer score (FMS), or Functional Ambulation Classification. A significant improvement in ankle dorsiflexion angle, and FMS was found after 3 weeks in both groups. The splint group showed more spasticity than the control group after 3 weeks (p=0.04). The change of ankle dorsiflexion angle, foot circumference, spasticity, and FMS after adjusting initial value and spasticity were not significantly different between the 2 groups.ConclusionWearing a resting foot splint for 3 weeks did not affect joint mobility in patients with subacute brain injury regularly attending personalized rehabilitation programs. Further studies of larger sample sizes with well controlled in spasticity are required to evaluate the effects of the resting foot splint.

Intra-articular injection of hyaluronic acid for the reduction in joint adhesion formation in a rabbit model of knee injury

PurposeOur purpose was to evaluate the effectiveness of intra-articular injections of hyaluronic acid (HA) into immobilized joints for reducing rigidity and formation of joint adhesions following surgery and prolonged joint immobilization.MethodsTwenty-four New Zealand white rabbits were randomly divided into experimental (n = 12) and control groups (n = 12). A model of knee injury was created in the right hind leg, and external plaster fixation was performed for 8 weeks. The experimental and control groups received weekly intra-articular injections of 0.3 mL HA solution or normal saline, respectively, in the knee joint. The degree of adhesions, range of motion (ROM), and collagen content of the synovium of the knee joint were observed after 8 weeks.ResultsAt the end of 8 weeks, the experimental compared with control group had significantly higher mean ROM (70.3° ± 11.1° vs. 54.6° ± 11.2°, respectively; P = 0.002) and mean adhesion score. The experimental group compared with the control group had significantly lower mean adhesion score (2.2 ± 0.9 vs. 3.1 ± 0.7, respectively; P = 0.012) and collagen content (32.4 ± 4.7 vs. 39.0 ± 4.2 μg/mg, P = 0.001).ConclusionsIn a rabbit model of knee injury, intra-articular injection of HA decreased adhesion formation and collagen content and increased ROM after prolonged immobilization. These results indicate that HA may be clinically useful to prevent adhesions and improve joint mobility in patients who require joint immobilization for up to 8 weeks.

Morphofunctional characteristics of the foot in patients with diabetes mellitus and diabetic neuropathy

AimsTo determine the structural and biomechanical characteristics associated with the conditions diabetes mellitus and diabetic neuropathy. MethodsObservational study of 788 patients conducted between February 2007 and February 2009, which included subjects with and without diabetes mellitus who had no active ulcer at enrollment. Demographic variables and the general and specific history of diabetes mellitus were recorded. The patient's foot type according to the Foot Posture Index, joint mobility and deformity were recorded. ResultsNo associations were found between the different foot types (neutral, pronated and supinated) and the structural and demographic variables at a general level, except for the pronated foot that was associated with a higher body mass index, longer suffering from diabetes and the presence of neuropathy [p<0.001, OR (95% CI): 6.017 (4.198–8.624); p<0.001, OR (95% CI): 1.710 (1.266–2.309); p=0.010, OR (95% CI): 0.759 (0.615–0.937), respectively]. ConclusionsThe confluence of risk factors such as neuropathy, body mass index, duration of diabetes and limited joint mobility in patients with diabetes mellitus and pronated foot may be a high-risk anthropometric pattern for developing associated complications such as Charcot foot. A prospective analysis of these patients is required to define the risk for developing Charcot neuroarthropathy.

Randomized study assessing the influence of supervised exercises on ankle joint mobility in patients with venous leg ulcerations

IntroductionThe aim of the study was to assess the influence of a supervised programme of exercises on ankle joint mobility in patients with venous leg ulcerations.Material and methodsThe study was carried out between 2008 and 2009 at the Venous Ulcer Treatment Outpatient Clinic and Clinic of General and Vascular Surgery of the Dr Jan Biziel University Hospital no. 2 in Bydgoszcz. It was a randomized control study in which 32 patients with venous leg ulcerations were qualified. Patients with ulcerations were randomized to 2 groups – 16 patients were included in the group with a supervised programme of exercises and the other 16 patients were included in the control group performing physical exercises by themselves, without supervision. The ranges of ankle joint mobility were assessed before, during and after the end of the 9-week exercise programme. A 32 cm goniometer with a scale from 0° to 180° with accuracy to 1° was used for measurements.ResultsIn both groups a substantial increase of ankle joint mobility (p < 0.05) was observed. The total ankle joint mobility after completion of the exercises was significantly higher in the group performing exercises under the supervision of a nurse. Having a significant effect on the mobility of the ankle were the ulceration area, the extent of lipodermatosclerosis, and the intensity of symptoms and signs of CVI (p < 0.05).ConclusionsSupervised physical exercises broaden the range of ankle joint mobility. They should constitute an integral part of a holistic model of care for patients with venous leg ulcerations.

A combination therapy of massage and stretching increases parasympathetic nervous activity and improves joint mobility in patients affected by fibromyalgia

Objective: to investigate how therapeutic mas-sage, combined with stretching, can really con-tribute to the treatment of fibromyalgia (FM) symptoms. Design: Feasibility study. Setting: A single center. Participants: Twenty women having a preexisting diagnosis of FM based on American College of Rheumatology criteria were recruited. Intervention: Subjects received a total of 18 sessions of light massage administered by a physical therapist twice a week and then performed passive stretching exercises. Main out-come measures: heart rate (HR) and Heart Rate variability (HRV), the assessment of joint flexi-bility through elettrogoniometer, the Fibromyal-gia Impact Questionnaire (FIQ), the Pittsburgh Sleep Quality Index (PSQI), and the Borg scale or Rating of Perceived exertion (RPE). Evalua-tions were conducted at the screening visit (T0), immediately at the end of the session of mas-sage (T1) and after completion of 18 sessions (T2). Results: HRV showed an improvement in terms of decreased sympathetic tone and in-crease of parasympathetic tone at the end of treatment. Also joint flexibility showed a sig-nificant improvement at T2 compared with the screening. FIQ, PSQI, RPE did not change. Conclusions: the findings highlight the excellent compliance of FM patients to the combined therapy of massage and stretching, showing an amelioration of muscle stiffness and an improvement of autonomic nervous system with a decrease of sympathetic tone and an increase of parasympathetic tone. The questionnaires did not show any ameliorations, probably because in these patients the perception of quality of life is distorted compared with more objective pa-rameters, such as muscle rigidity, the articular mobility and the autonomic nervous system.

Intertester-Reliabilität von goniometrischer Messung und visueller Einschätzung der aktiven Gelenkbeweglichkeit bei Patienten mit neurologischen Erkrankungen

Hintergrund: Die physiotherapeutische Untersuchung der aktiven Beweglichkeit der Gelenke der unteren Extremität bei Patienten mit neurologischen Störungsbildern erfordert valide und reliable Messmethoden.

49. Limited joint mobility in patients with diabetes mellitus

49. Limited joint mobility in patients with diabetes mellitus

A quantitative assessment of limited joint mobility in patients with diabetes. Goniometric analysis of upper extremity passive range of motion.

The syndrome of limited joint mobility is a common but not widely recognized musculoskeletal complication of diabetes. The purpose of this study was to further characterize this syndrome using quantitative goniometric measures. Cross-sectional analysis of a sample population was performed to establish the prevalence, location, and severity of limited joint mobility and to determine its relationship to extraarticular manifestations and complications of diabetes. Passive range of motion of both upper extremities was measured by goniometry in 70 adult patients with insulin-dependent diabetes mellitus and 70 nondiabetic controls who were group-matched for age, sex, and general activity level. Joint mobility was assessed by both individual joint motions and a composite scoring technique. Analysis of individual joints and composite scores revealed significant differences between dominant and nondominant extremities in both the control and the diabetic groups. Diabetic patients were generally less flexible than nondiabetic subjects throughout the arm, especially in shoulder and finger joints. In the full study population, multivariate analysis revealed that advanced age, male sex, and the presence of diabetes were associated with decreased passive range of motion for a majority of joints (P < 0.05). In the diabetes group, passive range of motion was significantly correlated (P < 0.05) with age, sex, duration of diabetes, and to a variable extent, glucose control, but was not correlated with the presence of clinically significant neuropathy, retinopathy, nephropathy, or peripheral vascular disease, with activity level, or with hand dominance. Stepwise regression analysis failed to identify single key joint motion(s) to serve as possible screening tests in predicting generalized limited joint mobility of the upper extremity. Finally, the effect of limb usage on range of motion in flexion may differ in diabetic and nondiabetic subjects. Limited joint mobility is a generalized phenomenon occurring throughout the upper extremities of many diabetic patients. It is significantly related to age, sex, and to a variable extent duration of diabetes and glucose control. It is not related to the standard complications of diabetes as defined in this study.