Joint Range Of Motion Research Articles

A soft wearable exoglove for rehabilitation assistance: a novel application of knitted shape-memory alloy as a flexible actuator

We developed the knitted shape-memory alloy (SMA) as a flexible actuator and applied it to a soft wearable exoglove for rehabilitation assistance. Based on user needs and anthropometric data, we custom-designed the exoglove for three hemiplegic patients using the knitted-SMA actuator and evaluated its bending performance, gripping force and wearability under the four simulation conditions (S1–S4). To address the specific needs, both SMA plain- and double-knit modules were applied to the exoglove based on the patients’ finger joint range of motion (ROMs). The joint ROMs of all fingers increased by 13.71% and the skin temperature increased by 2.21 °C after actuating the glove (p = 0.006). The gripping force increased as much as 55.01%, when compared to the baseline. All patients were able to don and doff the developed glove independently, and positively evaluated their subjective satisfaction and thermal perception. The findings suggested the potential of the knitted SMA for the future development of soft wearable robots.

Cross-Education Effects of Isokinetic Eccentric Plantarflexor Training on Flexibility, Strength, and Muscle-Tendon Mechanics.

Large increases in joint range of motion (ROM) have been reported after eccentric resistance training; however, limited data exist describing the associated mechanisms or potential cross-education effects in the contralateral limb. Therefore, the effects of a 6-wk isokinetic eccentric plantarflexor training program were examined in 26 participants. Before and after the training program, dorsiflexion ROM, plantarflexor strength, and muscle-tendon unit (MTU) morphology and mechanics were measured in control ( n = 13) and experimental ( n = 13) young adult groups. Training consisted of 5 sets of 12 maximal isokinetic eccentric plantarflexor contractions twice weekly on the right limb. Significant ( P < 0.05) increases in dorsiflexion ROM (4.0-9.5°), stretch tolerance (40.3-95.9%), passive elastic energy storage (47.5-161.3%), and isometric (38.1-40.6%) and eccentric (46.7-67.0%) peak plantarflexor torques were detected in both trained and contralateral limbs in the experimental group. Significant increases in gastrocnemius medialis and soleus thickness (5.4-6.1%), gastrocnemius medialis fascicle length (7.6 ± 8.5%), passive plantarflexor MTU stiffness (30.1 ± 35.5%), and Achilles tendon stiffness (5.3 ± 4.9%) were observed in the trained limb only. Significant correlations were detected between the changes in trained and contralateral limbs for dorsiflexion ROM ( r = 0.59) and both isometric ( r = 0.79) and eccentric ( r = 0.73) peak torques. No significant changes in any metric were detected in the control group. Large ROM increases in the trained limb were associated with neurological, mechanical, and structural adaptations, with evidence of a cross-education effect in the contralateral limb being primarily driven by neurological adaptation (stretch tolerance). The large improvements in ROM, muscle size, and strength confirm that isokinetic eccentric training is a highly effective training tool, with potential for use in athletic and clinical populations where MTU function is impaired and current therapies are ineffective.

The effectiveness of the Copenhagen adduction exercise on improving eccentric hip adduction strength among soccer players with groin injury: a randomized controlled trial

ABSTRACT Introduction Groin injuries are common in soccer players and often involve adductor muscle strains. The Copenhagen Adduction Exercise (CAE) is a targeted intervention whose effectiveness in rehabilitation for these injuries warrants investigation. Objective To investigate the impact of a rehabilitation program, which includes the CAE, on eccentric hip adduction (EHAD) strength, hip joint range of motion (ROM), self-reported disability, and pain among soccer players with adductor-related groin pain. It was hypothesized that the addition of CAE to the rehabilitation program would yield greater improvements. Methods Employing a randomized controlled trial with a two-group parallel design, thirty male soccer players with a mean age of 26.4 ± 3.9 years were randomized into an intervention group (IG) including CAE (n = 15) and a control group (CG) without CAE (n = 15), based on a power analysis to ensure 80% power to detect significant differences. Both groups engaged in their respective rehabilitation programs twice a week for eight weeks. The primary outcome measured was EHAD strength, while secondary outcomes included hip joint ROM, self-reported disability measured by the Copenhagen Hip and Groin Outcome Score (HAGOS), and pain levels. Results Significant improvements within groups were observed across all measures (p < 0.001). The IG demonstrated a greater increase in EHAD strength (Mean Difference [MD] = 0.49 Nm/kg, 95% Confidence Interval [CI] [0.31, 0.66]), a more pronounced reduction in pain (MD = -1.60, 95% CI [−2.18, −1.02]), and betterment in all HAGOS subscale scores compared to the CG. There were no significant between-group differences in hip joint ROM. Conclusion Incorporating the CAE into rehabilitation programs significantly improves EHAD strength, decreases pain scores, and reduces self-reported disability in soccer players with adductor-related groin pain. Registration ClinicalTrials.gov identifier: NCT05589623

The Effect of Postural Restoration Institute Training on Selected Kinematic Variables of Lower Limbs and Pelvis During Walking in Middle-Aged Men With Nonspecific Chronic Low Back Pain: A Prospective Observational Study

Background and Aims Concerning the effectiveness of training on people with chronic low back pain, the present study aimed to evaluate the effect of postural restoration institute (PRI) training on lower limb kinematics during walking in middle-aged subjects with discogenic low back pain. Methods In this prospective observational quasi-experimental study, 42 people participated in three groups: people without low back pain (healthy group, n=14) and people with low back pain in two groups (intervention group, n=14; and control group, n=14). Kinematic data were recorded by 7 Qualisys cameras with a frequency of 100 Hz in the pretest and post-test. Analysis of variance with repeated measures was used in SPSS software version 23 at a significance level 0.05. Results The results showed that people with low back pain in the intervention and control groups walk with a slower velocity, lower cadence, and shorter step length than healthy individuals for both right and left limbs. However, after the PRI training, the intervention group showed a significant increase in those three variables. Furthermore, there were significant differences between the healthy group and the two groups of intervention and control in the range of motion (ROM) for the pelvis in the sagittal and frontal planes, the right hip joint in the horizontal plane, the right ankle in the frontal plane, the left hip joint in the sagittal and horizontal planes as well as the left ankle in the sagittal plane. After applying PRI, the differences between the healthy and the intervention groups regarding the pelvis ROM on the sagittal plane, the right ankle ROM on the sagittal plane, the left hip joint ROM on the frontal plane, and the left knee ROM on the sagittal plane were minimized and became insignificant. Conclusion The present study’s findings confirmed the effectiveness of using PRI training in improving biomechanical indicators, such as the range of joint movements and increasing the velocity and step length of walking, to treat and manage the performance of people with discogenic chronic low back pain.

Influence of Torsional Stiffness in Badminton Footwear on Lower Limb Biomechanics.

Torsional stiffness of athletic footwear plays a crucial role in preventing injury and improving sports performance. Yet, there is a lack of research focused on the biomechanical effect of torsional stiffness in badminton shoes. This study aimed to comprehensively investigate the influence of three different levels of torsional stiffness in badminton shoes on biomechanical characteristics, sports performance, and injury risk in badminton players. Fifteen male players, aged 22.8 ± 1.96 years, participated in the study, performing badminton-specific tasks, including forehand clear stroke [left foot (FCL) and right foot (FCR)], 45-degree sidestep cutting (45C), and consecutive vertical jumps (CVJ). The tasks were conducted wearing badminton shoes of torsional stiffness measured with Shore D hardness 50, 60, and 70 (referred to as 50D, 60D, and 70D, respectively). The primary biomechanical parameters included ankle, knee, and MTP joint kinematics, ankle and knee joint moments, peak ground reaction forces, joint range of motion (ROM), and stance time. A one-way repeated measures ANOVA was employed for normally distributed data and Friedman tests for non-normally distributed data. The 70D shoe exhibited the highest ankle dorsiflexion and lowest ankle inversion peak angles during 45C task. The 60D shoe showed significantly lower knee abduction angle and coronal motions compared to the 50D and 70D shoes. Increased torsional stiffness reduced stance time in the FCR task. No significant differences were observed in anterior-posterior and medial-lateral ground reaction forces (GRF). However, the 70D shoe demonstrated higher vertical GRF than the 50D shoe while performing the FCR task, particularly during 70% - 75% of stance. Findings from this study revealed the significant role of torsional stiffness in reducing injury risk and optimizing performance during badminton tasks, indicating that shoes with an intermediate level of stiffness (60D) could provide a beneficial balance between flexibility and stability. These findings may provide practical references in guiding future badminton shoe research and development. Further research is necessary to explore the long-term effects of altering stiffness, considering factors such as athletic levels and foot morphology, to understand of the influence of torsional stiffness on motion biomechanics and injury prevalence in badminton-specific tasks.

Development of a Headache Diary and Assessment of Tension-Type Headache Diagnostic Criteria and Oral Behaviors, Joint Range of Motion, and Tenderness to Palpation: An Observational Study

ObjectiveThe aim of this study was to design and use a headache diary in patients with frequent tension-type headaches (TTH). Another aim was to assess the relationship among oral behaviors, range of motion, and tenderness to palpation of the craniomandibular muscles. MethodsThirty-four patients participated in this prospective observational study for a 3-month period at the Adavall Clinic for Physiotherapy and Rehabilitation (Valladolid, Spain) in 2019. Oral behaviors were collected through the Oral Behavior Checklist in the Adavall-TTH diary. Range of motion was measured in the cervical region and in the temporomandibular joint. Tenderness to palpation was measured on 38 myofascial trigger points of the craniomandibular region. ResultsOral behaviors were directly related to the pain intensity of TTH, the number of days, and the headache diagnostic criteria. Cervical range of motion was indirectly related to the intensity of TTH and the number of days of TTH (from r = −0.341 to r = −0.418, P < .05). Tenderness to palpation was associated with intensity and different diagnostic criteria of TTH in different craniomandibular muscles (from r = 0.342 to r = 0.400, P < .05). ConclusionWe found associations between examination findings and TTH diagnostic criteria. The headache diary may be a useful tool in the diagnosis and management of TTH and for analyzing the relationship between oral activities and temporomandibular joint tenderness in TTH. Future research should test the validity and reliability of this diary.

Randomized controlled trial of compressive cryotherapy versus standard cryotherapy after total knee arthroplasty: pain, swelling, range of motion and functional recovery

BackgroundAfter total knee arthroplasty (TKA), patients have limited knee range of motion (ROM), trophic changes and pain. Cryotherapy and compression are recommended in the literature, but no study has shown that cryotherapy and compression combined leads to better results than cryotherapy alone. The primary objective was to compare knee ROM after 21 days of rehabilitation post-TKA between patients who underwent rehabilitation with compressive cryotherapy with those who had cryotherapy alone. The secondary objectives were to compare other trophic, pain and functional outcomes.MethodsForty patients were randomized into two groups: Standard Cryotherapy (SC = 20, median age 77 years), which applied cold packs along with their rehabilitation; and Compressive Cryotherapy (CC = 20, median age 76 years), which received cold compression. Knee joint’s passive and active ROM (primary outcome) were measured with a goniometer. Knee’s circumference, fluctuation test, pain at rest and during activity, 6-minute walking test (6MWT) and KOOS questionnaire were secondary outcomes. The groups were compared on D1 (baseline) and D21 of rehabilitation. A survival analysis has compared the groups on D1, D8, D15, D21.ResultsAll subjects had a significant improvement in all the parameters on D21 relative to D1 (p < .05), except for pain at rest (p = .065 for CC and p = .052 for SC). On D21, the CC group had a significantly larger improvement in the joint effusion (p = .002), pain during activity (p = .005), 6MWT (p = .018) and KOOS (p = .004) than the SC group. Based on the survival analysis, the CC group had significantly faster improvement in the joint ROM (p = .011 for flexion and p = .038 for extension) and knee circumference (p = .013) than the SC group.ConclusionsBoth cryotherapy methods improved joint ROM, trophic changes, pain and function. Adding dynamic compression to a cryotherapy protocol provided further benefits: a significantly faster improvement in passive knee flexion ROM, a greater reduction of swelling, and pain during activity. Similarly, walking distance and KOOS questionnaire were significantly better for CC.Trials registrationThe study was registered in the ClinicalTrials.gov database on 14/09/2023 (identifier: NCT06037824).

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.

An investigation into the frequency and risk factors of low back pain following surgical treatment of isolated calcaneal fractures.

This study aimed to determine the frequency of low back pain after calcaneal fractures treated with open reduction internal fixation (ORIF) and the risk factors that cause this condition. Thirty-one patients (27 males and 4 females) who underwent surgery for a unilateral calcaneal fracture between 2016 and 2020 and had no complaints of low back pain before fracture surgery were included in the study. The patients were divided into 2 groups: those who developed low back pain after the operation and those who did not. Patients were evaluated with the Life Quality Short Form SF-36, the Oswestry Disability Index (ODI), and American Orthopedic Foot-Ankle Association Score (AOFAS). Sanders' fracture type, joint range of motion (ROM) measurements of injured and uninjured limbs, maximal isometric muscle strength measurements, balance on 1 leg with pedobarographic measurements, and walking time were evaluated. The obtained data were compared among the 2 groups. Low back pain was observed in 71% of the patients and was detected after an average of 6 months from the operation. In ODI, 59.1% of the patients reported that low back pain limited their lives slightly. Patients with low back pain have lower AOFAS scores and worse SF-36 physical functionality than those without low back pain (P < .001, P=.016). Balance time on 1 foot in pedobarographic measurements, foot in ROM, ankle in ankle active, passive plantar flexion, inversion, active hip, passive internal, external rotation, muscle is the foot eversion force. In these measurements, the values of the injured side are intact. It was statistically significantly lower than the other side (interaction P < .1). Low back pain may occur after unilateral calcaneal fractures treated by ORIF. This may be caused by decreased angles of ankle dorsi and plantar flexion, foot inversion, hip abduction, and internal and external rotation. In the rehabilitation program, not only the ankle region but also the hip joint of the affected side should be included, and the kinetic chain that describes the interaction mechanism of the human body should not be forgotten. Level IV, Prognostic Study.

Investigation of the use of gelatine-glycerine and gelatine-polyvinyl alcohol mixtures as tissue consistency preservatives in cadavers fixed with modified SEFS solution

This study aimed to improve the effectiveness of SEFS, a fixing solution composed of soap and ethanol. This was achieved by modifying the formulation of SEFS. Additionally, this study aimed to preserve the consistency of organs by perfusing cadavers with mixtures of gelatine-glycerin (gelatine-Gls) and gelatine-polyvinyl alcohol (gelatine-PVA) through vascular access. The modified SEFS embalmed cadavers were divided into two groups: Group I was treated with gelatine-glycerin, and Group II was treated with gelatine-polyvinyl alcohol and each group comprised of two goats and three rabbits. Over one year, cadavers were objectively assessed for hardness, colour, and joint range of motion. Additionally, the cadavers were subjectively evaluated after dissection and palpation. For the modified SEFS embalmment haptic and optic examinations of the muscles revealed they maintained a vivid colour tone, closely resembling their natural colour. The thoracic organs displayed natural colour, with the lungs retaining their shape without collapse. Notably, the walls of the atrium and ventricles of the heart remained intact without inward collapse. The use of gelatine-PVA yielded better outcomes than gelatine-Gls in preserving the volumes of both chest and abdominal organs. This was particularly evident in the heart, lungs, liver, spleen, and kidney. Overall, the modified SEFS and gelatin-PVA mixtures were superior in maintaining certain properties better than expected from cadavers.

Estimation of Hand Function Impairment in Breast Cancer Survivors with Lymphedema

Breast cancer (BC) is one of the most frequent cancers in women, and breast cancer-related lymphedema (BCRL) is a common side effect of BC treatment. When the lymphatic drainage system is damaged, lymphedema develops, which further exacerbates swelling and leads to pain, an increase in limb circumference, a reduction in joint range of motion, and a decrease in the use of the affected hand for functional tasks. Handgrip strength is essential for performing upper limb functional daily activities. Less is known about the long-term effects of lymphedema on hand function. The objective of the study was estimation of hand function impairment in BC survivors with lymphedema. This study was carried out by randomly selecting 100 out of 1,200 women with lymphedema, aged between 40 and 80 years, and who underwent sentinel lymph node biopsy along with radiotherapy, were included in this study. The handgrip strength was tested using an electronic handheld dynamometer. The functional wrist and hand scales were used to evaluate hand function. The Michigan Hand Outcome Questionnaire (MHQ) was used to evaluate the hand's overall function. A statistical analysis was done using SPSS statistical software (version 23.0). Handgrip strength of the affected hand by BCRL when compared with the unaffected hand was reduced. Functional hand and wrist scale have shown very poor results of the affected hand when compared with the unaffected hand. Majority of participants in the MHQ were unsatisfied with the overall functioning of the hand (p &lt; 0.0001). This study concluded that there was significant hand function impairment in BC survivors with lymphedema. BCRL had a negative impact on daily activities of the individual and also affected the mental, emotional, and social aspects. BCRL also had an impact on overall self-reported physical function and quality of life.

The Acute and Long-Term Effects of Olympic Karate Kata Training on Structural and Functional Changes in the Body Posture of Polish National Team Athletes.

The aim of this study was to assess the acute and long-term effects of karate kata training on body posture (range of motion (ROM)) and musculoskeletal pain in elite karate athletes. Twelve kata athletes from the Polish national team participated in the study. A cross-sectional study protocol was used, with direct participatory observation (NMQ-7/6 questionnaire, spinal curvatures and spinal ROM testing, ROM of joints) and natural experiment (225 min of kata training) methods of assessment. Age and number of weekly kata sessions were found to correlate with ROM of the lumbar spine (R = (-0.6), p < 0.05). High increase in the prevalence of lumbar hypolordosis and posterior pelvic tilt was noted after karate training sessions. ROM of the inclination in the sagittal plane differed significantly between the first and second trials, by 10.0 degrees on average. Kata stances and their movement pattern seem to be related to the occurrence of disturbances in the ROM of the internal and external rotations of the hip joints and decreased depth of the lumbar lordosis, pelvic tilt, and their ROM. The locations of the long-term musculoskeletal complaints (NMQ-6) seem to result from compensatory changes that occur in the musculoskeletal structures as a result of elite-level kata training.

An improved methodology to restrict the range of motion of mechanical joints

Joints with rotational degrees of freedom, for instance, revolute, spherical, or universal joints, are commonly utilized in real-world scenarios. In the multibody systems methodology, mechanical joints usually are formulated as classical kinematic constraints such that there is no restriction of the range of motion (RoM) of the joint. Thus, the formulation must include additional restrictions to prevent the joints from performing unacceptable movements and to avoid unrealistic configurations of the connected bodies. Therefore, the aim of this work is to propose a methodology to restrict the RoM of mechanical joints. Joint resistance moments are applied to the bodies connected by the joint to mimic the dissipative behavior of the materials constituent of joints and to prevent unacceptable configurations of those bodies. The proposed methodology aims to extend and improve a previously published study, specifically in the definition of the RoM limits, calculation of the penalty moments, and establishment of their direction of application. Enhanced methods to deal with the detection of unacceptable joint configurations, namely the elliptical and polynomial approaches, are proposed. A parametrization procedure is described to correctly calculate the direction of the penalty moments to apply to the connected bodies. The methodology is investigated in the dynamic modeling and simulation of one demonstrative example of application, namely a simple pendulum. A parametric analysis is performed to assess the influence of the methodology parameters in the response of the model. The methodology allows the correct restriction of the RoM of joints, while preserving the mechanical energy of the system.

Factors Associated With a Lateral Ankle Sprain in Young Female Soccer Players: A Prospective Cohort Study.

Previous studies have attempted to determine if certain risk factors can predict the occurrence of a lateral ankle sprain (LAS) in female soccer players. Unfortunately, there is limited evidence with regard to risk factors associated with an LAS in female soccer players. To identify intrinsic risk factors for an LAS among young female soccer players. Cohort study; Level of evidence, 2. Participants were 161 young female soccer players in Japan who were evaluated for LAS risk factors during a preseason medical assessment. The assessment included anthropometric, joint laxity, joint range of motion, muscle flexibility, muscle strength, and balance measurements. Each athlete's history of LASs was also collected. The participants were monitored during a single-yearseason for LASs, as diagnosed by physicians. There were 26 instances of an LAS in 25 players (15.5%) during the season. Injured players were significantly more likely to have sustained a previous ankle sprain (P = .045) and demonstrated significantly worse balance than their peers without an LAS during the double- and single-leg balance tests (P = .008 for both). Athletes with lower hamstring-to-quadriceps muscle strength ratios were also significantly more likely to sustain an LAS (P = .02). Poor balance, a low hamstring-to-quadriceps ratio, and a history of ankle sprains were associated with an increased risk of LASs in young female soccer players in the current study. These findings may be useful for developing a program to prevent LASs in this population.

Implementing a contextually appropriate foot-ankle exercise programme in primary care for the prevention of modifiable risk factors for ulcers in people with diabetes: protocol for a hybrid type 2 study

IntroductionDiabetes is a highly prevalent disease that negatively impacts people’s health and quality of life. It can result in diabetic peripheral neuropathy (DPN) and foot complications, which in turn lead...

Pengaruh Program Neuro Rehabilitasi Terhadap Peningkatan Status Keseimbangan Dinamis Pada Kelompok Lansia

Old age is a cycle of maturation which is described by changes in abilities, both physical, mental, profound, psychosocial and sexual abilities. One of the developments experienced by older people is dynamic balance problems caused by external muscle problems, such as reduced muscle strength, adaptability and joint range of motion. Strengthening the muscles at the lowermost point through preparatory exercises can strengthen neuromuscular variations so that an increased level of dynamic balance is achieved. This study aims to determine the impact of providing a nerve restoration program (Static Bike and Exercise Therapy training program) on improving body balance status in the elderly group. Pre-test research strategy with a one collection pretest-posttest plan. The research used a purposive sampling test where the subjects were a group of elderly people in Gaden Village who did not experience mental disorders, were not undergoing special treatment and were given a Static Bike and Exercise Therapy training program 3 times a week for a period of 3 months. Estimation and evaluation of dynamic balance levels using the Time Up and Go Test (TUGT). The exploration results using the Shapiro Wilk normality test obtained a normal distribution of information, then a speculation test was carried out using the matched T test with the condition that a critical value was obtained if p&lt;0.001 (p&lt;0.05) at the strong balance level. This will show the impact of providing Static Bike and Exercise Therapy training programs on fair dynamic balance in the elderly.

Mid-term effects of unicompartmental knee arthroplasty combined with anterior cruciate ligament reconstruction for the medial compartment osteoarthritis with anterior cruciate ligament deficiency by proportioning with the pure medial compartment osteoarthritis

Objective: To evaluate the mid-term efficacy of one-stage unicompartmental knee arthroplasty (UKA) combined with anterior cruciate ligament (ACL) reconstruction in the treatment of medial compartment osteoarthritis (OA) with ACL deficiency. Methods: Retrospective cohort study. The clinical data of 13 patients (14 knees) who underwent UKA with ACL reconstruction for knee medial compartment OA combined with ACL deficiency in Wangjing Hospital of China Academy of Chinese Medical Sciences from January 2012 to January 2020 were retrospective analyzed. A 1∶1 proportioning study was conducted with 13 patients (14 knees) who underwent UKA due to medial compartment OA with intact ACL during the same period. The matching conditions were the same gender, age, surgical side, anesthesia method, comorbidities, and imaging lesions. There were 26 patients (28 knees) in the two groups, including 6 males (6 knees) and 20 females (22 knees), aged (58.9±4.2) years. The range of motion (ROM) and Oxford Knee Score (OKS) were used to evaluate the knee joint function at the last follow-up. The anteroposterior, lateral and axial X-ray films of the knee joint and the weight-bearing full-length X-ray films of the lower limbs were taken during follow-up. The hip knee ankle (HKA) angle, the posterior slope angle (PSA) of tibial prosthesis, and the anterior tibial translation (ATT) were recorded and compared between the two groups. The progression of lateral compartment OA, prosthesis loosening, and dislocation were evaluated. The mid-term follow-up clinical efficacy of the two surgical methods was compared, and the etiology of the patients was analyzed to verify the clinical efficacy and patient selection of one-stage UKA combined with ACL reconstruction. Results: The follow-up time of the two groups was (7.14±2.45) years. At the last follow-up, there was no significant difference in joint ROM between the combined group and the UKA group (120.90°±2.95° vs 122.29°±3.22°, P=0.260). There was no significant difference in OKS score between the two groups [(42.50±1.99) vs (43.21±2.26), P=0.380]. There was no significant difference in HKA angle and ATT distance between the two groups before operation (both P>0.05). At the last follow-up, the results were better than those before operation, and the differences were statistically significant (both P<0.05). At the last follow-up, there was no significant difference in HKA Angle between the combined group and the simple group (177.79°±1.25 ° vs 177.86°±1.29°, P=0.880). Tibial prosthesis PSA and ATT distance were not significantly different between the two groups [(4.57°±0.94° vs 4.50°±1.34°and (0.21±0.89) mm vs (0.14±1.35) mm, both P>0.05)]. There was no prosthesis loosening and obvious progression of lateral compartment OA in both groups at the last follow-up. Conclusion: For young patients with medial compartment OA secondary to ACL deficiency, UKA combined with ACL reconstruction is recommended, it can obtain good mid-term results.

A PHYSIOTHERAPY MANAGEMENT IN CASES OF LUMBAL NUCLEUS PULPOSUS (HNP) HERNIA USING MICROWAVE DIATHERMY (MWD) AND MC MODALITY KENZIE EXERCISE

Background: Pulpous Nucleus Hernia (HNP) is a condition where protraction occurs in the intervertebral disc due to injury or excessive mechanical load. HNP is a condition where the nucleus pulposus in the annulus fibrosus comes out or protrudes, puts compression on the nerves, and causes radicular pain, motor weakness, numbness, or tingling. Mc.Kenzie Exercise and the use of Microwave Diarrhea (MWD) modalities to overcome this problem. Microwave Diathermy (MWD) reduces pain caused by damaged tissue or abnormal tissue by stimulating the nociceptors, while giving McKenzie exercise aims to improve normal posture in the vetebra, reducing pressure on the intervertebral disc and vetebra ligaments. Method: The research method is a case study to determine the management of physiotherapy in cases of Lumbar Hernia Nucleus Pulposus (Hnp) Using Microwave Diathermy (Mwd) and Mc. Kenzie Exercise Results: Management of the physiotherapy process during 9 meetings using Microwave Diathermy (MWD) and Mc. Kenzie Exercise in lumbar HNP patients has been carried out according to standards with surgery, resulting in increased joint range of motion and increased functional activity. Conclusion: MWD modality, Mc. Kenzie exercise in HNP patients can increase the range of joint movement and functional activity in patients&#x0D; Keywords: Microwave diathermy (MWD), Mc. Kenzie exercise, Hernia Nuckleus Pulposus (HNP)

Energy saving, load bearing and attachment mechanism on ice and frozen ground of biomimetic mechanical foot.

The frozen ground robot can be widely and prospectively applied in plentiful fields, such as military rescue and planet exploration. Based on the energy-saving, load-bearing, and attachment functions of reindeer hooves, we studied the kinematics of reindeer feet and designed a biomimetic energy-saving attachment mechanical foot (mechanical foot I) and two contrast mechanical feet (mechanical feet II and III). The energy-saving and load-bearing performances of the biomimetic mechanical foot were tested on a motion mechanics platform, which revealed this mechanical foot was adaptive to three types of ground (frozen ground, ice, and water ice lunar soil). Mechanical foot I possesses the functions of elastic energy storage and power consumption reduction, and its power range is from -2.77 to -27.85 W. Compared with mechanical foot III, the load-bearing ability of mechanical foot I was improved by the dewclaws, and the peak forces in the X, Y, and Z directions increased by about 2.54, 1.25 and 1.31 times, respectively. When mechanical foot I acted with more- smooth surface, the joint range of motion (ROM) increased, changes of the three-directional force at the foot junction decreased. The forces were the lowest on ice among the three types of ground, the X-, Y- and Z-directional changes were about 62.96, 83.7, and 319.85 N respectively, and the ROMs for the ankle joint and metatarsophalangeal joint of mechanical foot I were about 17.93° and 16.10°, respectively. This study revealed the active adaptation mechanism between the biomimetic mechanical foot and ice or frozen ground, and thus theoretically underlies research on the biomimetic mechanical foot.

3D printing assisted MIPO for treatment of complex middle-proximal humeral shaft fractures

BackgroundThis study was designed to explore the clinical efficacy of 3-dimensional (3D) printing assisted minimally invasive percutaneous plate osteosynthesis (MIPO) technique by comparing the clinical outcomes with traditional open reduction and internal plating fixation (ORIF) for treating complex middle-proximal humerus fractures (AO 12C fracture type).Materials and methodsThe data of 42 participants who received a complicated middle-proximal humerus fracture from the beginning of 2018 to the end of 2022 were retrospectively analyzed. All patients were assigned to two groups: MIPO with detailed preoperative planning assisted by 3D printing technique (MIPO group), and traditional ORIF (ORIF group).ResultsThis study included 21 patients in the ORIF group and 21 patients in the MIPO group. All patients were followed-up for at least one year (mean: 16.12 ± 4.13 months), and no difference was observed in the range of shoulder joint motion (ROM), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores and Constant scores between the two groups. However, the occurrence of complications (surgical incision site infection, implant loosening, bone nonunion and radial nerve palsy) in ORIF group was remarkably higher compared to the MIPO group. All the cases achieved bone union within the MIPO group. Significant differences were found in surgical time, intraoperative blood loss and fracture healing time between the two groups.ConclusionPreoperative 3D printing assisted MIPO technique exhibits obvious advantages in high operational efficiency and low occurrence of complications, which is worthy of clinical application for treating complex middle-proximal humeral shaft fractures.