Lateral Rotation Research Articles

A Computer Modeling-Based Target Zone for Transposition Osteotomy of the Acetabulum in Patients with Hip Dysplasia.

This study aimed to determine the acetabular position to optimize hip biomechanics after transposition osteotomy of the acetabulum (TOA), a specific form of periacetabular osteotomy, in patients with hip dysplasia. We created patient-specific finite-element models of 46 patients with hip dysplasia to simulate 12 virtual TOA scenarios: lateral rotation to achieve a lateral center-edge angle (LCEA) of 30°, 35°, and 40° combined with anterior rotation of 0°, 5°, 10°, and 15°. Joint contact pressure (CP) on the acetabular cartilage during a single-leg stance and simulated hip range of motion without osseous impingement were calculated. The optimal acetabular position was defined as satisfying both normal joint CP and the required range of motion for activities of daily living. Multivariable logistic regression analysis was used to identify preoperative morphological predictors of osseous impingement after virtual TOA with adequate acetabular correction. The prevalence of hips in the optimal position was highest (65.2%) at an LCEA of 30°, regardless of the amount of anterior rotation. While the acetabular position minimizing peak CP varied among patients, approximately 80% exhibited normalized peak CP at an LCEA of 30° and 35° with 15° of anterior rotation, which were the 2 most favorable configurations among the 12 simulated scenarios. In this context, the preoperative head-neck offset ratio (HNOR) at the 1:30 clock position (p = 0.018) was an independent predictor of postoperative osseous impingement within the required range of motion. Specifically, an HNOR of <0.14 at the 1:30 clock position predicted limitation of required range of motion after virtual TOA (sensitivity, 57%; specificity, 81%; and area under the receiver operating characteristic curve, 0.70). Acetabular reorientation to an LCEA of between 30° and 35° with an additional 15° of anterior rotation may serve as a biomechanics-based target zone for surgeons performing TOA in most patients with hip dysplasia. However, patients with a reduced HNOR at the 1:30 clock position may experience limited range of motion in activities of daily living postoperatively. This study provides a biomechanics-based target for refining acetabular reorientation strategies during TOA while considering morphological factors that may limit the required range of motion.

Effects of passive shoulder-support exoskeleton entity and support force on user range of motion under external loads

This study investigates the effects of a passive shoulder-support exoskeleton entity and support force on the range of motion (ROM) of the shoulder and trunk. Twenty-six healthy participants underwent ROM assessments across three exoskeleton setting conditions (without the exoskeleton; wearing the exoskeleton but the support force deactivated; wearing the exoskeleton with the support force activated) and three external load conditions (0 kg, 3 kg, and 6 kg). Results show that while the exoskeleton entity constrained the shoulder ROM (vertical abduction/adduction, flexion/extension, and horizontal abduction/adduction) and trunk ROM (lateral flexion and rotation), the support force partially alleviated this constraint. External loads primarily restricted the mobility of the shoulder but not the trunk. Interaction effects revealed the complex interplay between external loads and exoskeleton settings on ROM and perceived difficulty, particularly in shoulder vertical abduction/adduction. This study underscores the necessity of considering exoskeleton entity, support force, and external loads in optimizing user joint mobility.The industrial exoskeleton represents a promising solution for enhancing workplace safety and productivity by mitigating work-related musculoskeletal disorders. This study assessed the impact of the exoskeleton's entity and support force on joint mobility across different load scenarios. Joint mobility is critical to perform industrial tasks that require high flexibility and agility.

Finite element analysis shows minimal stability difference between individualized mini-hemilaminectomy-corpectomy and partial lateral corpectomy in a dog model.

Use finite element analysis to evaluate the biomechanical effects of spinal decompression procedures in healthy Beagle dogs, comparing individualized mini-hemilaminectomy-corpectomy (iMHC), mini-hemilaminectomy, partial lateral corpectomy (PLC), and hemilaminectomy. A finite element model of the L1-L2 functional spinal unit was generated using CT data. For each decompression model, loads were applied in 0.2-Nm steps (maximum, 2.0 Nm) in 6 directions: flexion, extension, right and left lateral bending, and right and left axial rotation. The L1 spinous process tip displacement angle was quantified numerically. Among the 4 techniques, mini-hemilaminectomy exhibited the smallest displacement angles across all directions. Hemilaminectomy exhibited the largest displacement angles in extension, flexion, right rotation, and left rotation across all techniques. Left and right lateral bending displacement angles were marginally larger for iMHC than for hemilaminectomy at 0.4 Nm; however, at 2.0 Nm, displacement angles were similar. Mini-hemilaminectomy minimizes functional spinal unit instability to the greatest extent. Hemilaminectomy is more unstable than iMHC and PLC in flexion, extension, and rotation. Mini-hemilaminectomy-corpectomy and PLC are more unstable than hemilaminectomy in lateral bending, with iMHC being slightly more unstable than PLC or nearly equal. Mini-hemilaminectomy minimizes instability to the greatest extent in cases of ventrolateral spinal compression. In cases of ventral spinal compression, iMHC may be preferable to PLC for providing equivalent stability without impeding spinal cord visualization, but both techniques can cause instability depending on loading direction, so careful attention to postoperative instability is necessary when excessive vertebral body resection is involved.

Influence of the surrounding environment on the response of seated midsize male volunteers subjected to lateral sled accelerations

Predicting vehicle occupants’ posture during evasive manoeuvres is crucial for assessing their safety in the event of a collision. Volunteer experiments have been performed in the past under lateral accelerations, both within a vehicle cabin and on a seat mounted on a sled. However, discrepancies in the volunteer responses between both setups have been identified. This study hypothesizes that the response of the volunteers differs as a consequence of the proximity to the frame in the vehicle cabin, in comparison to the absence of such a structure on the sled.The present study conducted a novel sled experiment, on which five volunteers with anthropometry comparable to the 50th percentile male were subjected to 0.3 g lateral accelerations, with three different surrounding environments. In twelve pulses, an additional lateral structure was placed to the right or left side of the seated volunteers. The volunteers were asked to either brace or relax their muscles.The results show significant differences between the configurations with and without the structure placed on the right side. This effect was observed for both the lateral excursion of the upper body and the corresponding rotation when the volunteers were relaxed (p < 0.01). The average maximum lateral head rotation decreased from 27° to 14° with the structure on the right. No significant difference in head rotation was found for the braced muscle configuration.This study supports the hypothesis that the proximity to a surrounding environment influences human responses during dynamic loading. Nevertheless, there was no significant difference in maximum muscle activation between the configurations, but a faster reaction of the sternocleidomastoid muscle with the presence of the structure.

Assessment of the Gordon lateral rotation index in postoperative rotational evaluation of supracondylar humerus fractures: a study on validity, reliability, and applicability

Assessment of the Gordon lateral rotation index in postoperative rotational evaluation of supracondylar humerus fractures: a study on validity, reliability, and applicability

Greater squat stance width alters three-dimensional hip moment demands

Barbell squat exercise may be performed with different stance widths, which will influence lower limb kinematics and joint reaction forces. Consequently, three-dimensional hip moments may vary with stance width, influencing muscle loading, and the muscles trained when performing squat exercise. To examine how squat stance width affects hip moments, males (n = 11) and females (n = 13) performed barbell squats at narrow, medium, and wide stance widths. Motion capture and force platform data were used to calculate three-dimensional hip net joint moments (NJM) as indicators of the muscular moments required. Hip extensor NJM was greater for wide than medium (P < 0.001) and narrow (P < 0.001) stance squats. Hip adductor NJM was not different between squat stance widths (P = 0.414). Hip lateral rotator NJM was greater in medium versus narrow squats (P < 0.001), and in wide versus medium (P < 0.001) and narrow (P < 0.001) squats. Taken together, the rotational demands at the hip increase as stance width increases, due to higher hip extensor and lateral rotator NJM. In contrast hip adductor NJM is invariant. These data provide insight into the three-dimensional requirements that muscles must meet at the hip when squat exercise is performed at different stance widths.

Comparing the effects of neck stabilization exercises versus dynamic exercises among patients having nonspecific neck pain with forward head posture: a randomized clinical trial

BackgroundNonspecific neck pain (NSNP) is a well-established global burden affecting. It is also a common problem in Pakistan. The burden of neck pain is also increasing day by day due to poor work ergonomics, and increased use of computers and mobiles after the pandemic. An individual’s poor posture is often associated with forward head posture (FHP). Limited evidence is available about the effects of neck stabilization (NSE) and dynamic exercises (NDE) for nonspecific neck pain particularly in patients with FHP. This aimed to compare the effects of NSE versus NDE among patients having NSNP with FHP in reducing pain, disability, forward head posture and improving neck range of motion.MethodsIt is a single-blinded randomized clinical trial with 60 patients aged 18–40 years, with moderate intensity NSNP for > 3 weeks and < 6 months along with FHP with a moderate disability on neck disability index (NDI) randomly assigned to the treatment groups. Group 1 was doing NSE and group 2 was doing NDE. Transcutaneous Electical Nerve Stimulation, cold packs, and stretching exercises were given to both groups. A total of 9 sessions (3 sessions/ week) were given to participants. NDI questionnaire, Visual analogue scale (VAS), goniometry, and plumb line measurement tool were used as baseline and assessment at the end of 3rd week. The data was analyzed on SPSS version 21. Descriptive analysis was performed. Independent t-test was used for between group comparison and paired t-test used for within group comparison. A p-value less than 0.05 was considered statistically significant.ResultsAfter treatment within-group analysis of both NSE and NDE showed significant (p < 0.001) improvement in pain on VAS, all ROMs of the neck including flexion, extension, left and right lateral flexion and left rotation, plumb line and NDI score with very large effect size. However, between-group analysis showed non-significant differences (p > 0.05) for post-treatment mean VAS, neck ROM, NDI and plumb line measurement.ConclusionBetween NSE and NDE, no one is more beneficial than another. Both are equally effective in alleviating pain, increasing ROM, decreasing functional disability, and improving forward head posture in patients with NSNP.Trial RegistrationRegistered trial at ClinicalTrials.gov Identifier: NCT05298631, 28/03/2022, prospectively registered.

Research on flow field characteristics of curved pipe in bulk grain cyclone conveying based on gas solid coupling

AbstractIn the transportation of grain particles, elbow wear is a pressing concern. A novel approach to mitigate this involves introducing a lateral air supplement rotation mechanism that enables swirling transportation. We assessed the integration of this device at angles of 45°, 55°, and 65° to the central axis of the main pipeline. While the multiphase flow velocity within the main conduit was held constant at 20 m/s, the lateral device's airflow velocities were tested at 20, 30, and 40 m/s. Utilizing the CFD–DEM simulation for grain particle transportation around bends, our findings indicated that an optimal arrangement was with the lateral device at 55° relative to the main pipeline, with an airflow speed of 30 m/s. This setup fostered a forward particle spiral, drastically diminishing wear on the pipe wall. Experimental evaluations corroborated the simulation's outcomes.

Clinical history correlates with lateral atlantoaxial (C1-2) joint edema. A pilot study

BackgroundClinical evaluation in the determination of the etiology of axial spine pain is limited. ObjectiveTo determine if a set of three features of the clinical history are indicative of C1-2 joint edema on MRI. MethodsAll patients from one physician's practice who had axial cervical spine pain from 2021 to 2023 were evaluated. Cases were defined as those with all 3 of the ASL criteria, defined as Age >65, Superior cervical/suboccipital pain, and exacerbation of pain primarily by Lateral cervical spine rotation. Age-matched controls had axial cervical spine pain without meeting the ASL criteria. Edema around the atlantoaxial joint and/or odontoid was evaluated by STIR MR sequences. ResultsThe ASL criteria had a sensitivity of 82 % [95 % CI: 64–100 %], specificity of 79 %, [95 % CI: 63–95 %], positive predictive value of 74 % [95 % CI: 54–94 %], and negative predictive value of 86 % [95 % CI: 72–100 %] in diagnosing C1-2 joint edema. ConclusionA positive ASL criteria is sensitive and specific in the diagnosis of C1-2 joint edema, which may have clinical implications.

A mathematical model of the combination of lateral tilt and rotation of the vertebra

An important section of spinal biomechanics is the analysis of various types of movements in spinal segments, which are difficult to observe, and setting up experiments is quite complex. There are few articles devoted to this topic, and the methodological approaches outlined in these studies are so heterogeneous that they do not allow for a comparative analysis. In this situation, the abstract language of mathematics allows us to objectively answer the questions that arise. Aim of the study was to develop a mathematical model of a spinal segment to calculate the combination of rotation angles and lateral inclination of the vertebra, as well as to identify factors influencing these parameters. Material and methods. The developed mathematical model of the motion segment of the spine was used as the main tool for the study. The initial data for this model were the coordinates of the reference points of the vertebrae, which makes it possible to determine a number of parameters describing their complex structure. Using this model, the parameters of the combination of vertebral movement in the frontal and horizontal planes were calculated. Results and discussion. The developed model of the combination of movements in the spinal segment is adequate to the ideas about the nature of movements in the spinal segments. The coefficient of combination of lateral tilt and rotation of the vertebra for the cervical vertebrae is from 0.5 to 0.7, for the thoracic vertebrae from 0.3 to 0.5, and for the lumbar vertebrae from 0.0 to 0.1. Fluctuations in the value of this coefficient depend on the angle of inclination of the upper articular surfaces of the underlying vertebra. Reducing the size of the articular surfaces leads to a decrease in the magnitude of the angular movements of the vertebra, and their convergence leads to an increase in mobility in the spinal segments. A negative angle of inclination of the articular surfaces causes opposite rotation of the vertebra.

Impact of the Aortomitral Positional Anatomy on Atrioventricular Conduction Disorder Following Mitral Valve Surgery.

Variations in the aortomitral positional anatomy, including aortic root rotation appear to be related to variations in the location of the conduction system, including the bundle of His. However, little is known about their clinical significance. This study included 147 patients with normal ECGs who underwent mitral valve surgery. The aortomitral anatomy was classified using preoperative 3-dimensional transesophageal echocardiography, and postoperative conduction disorders, including atrioventricular block and bundle branch block, were analyzed. Variations classified as aortomitral appearance were designated as having a center appearance (85.7%, n=126/147) or lateral appearance (14.3%, n=21/147) on the basis of whether the aortic root was located at the center or was shifted to the left fibrous trigone side. Subsequently, those with a center appearance, aortic root rotation was classified as having a center rotation (83.3% [n=105/126]), in which the commissure of the left and noncoronary aortic leaflet was located at the center, lateral rotation (14.3% [n=18/126]), rotated to the left trigone side, or medial rotation (2.4% [n=3/126]), rotated to the right. The incidence of 3-month persistent new-onset conduction disorder was higher in the lateral appearance than the center appearance group (21.1% versus 5.0%; P=0.031) and higher in the lateral rotation than in the center or medial rotation groups (29.4% versus 1.0% versus 0.0%, respectively; P<0.001). Aortomitral variations can be classified using 3-dimensional transesophageal echocardiography. Lateral appearance and lateral rotation are risk factors for conduction disorders in mitral valve surgery.

Hip joint motion amplitude control based on exponential product formula

Background: Handball is a team sport, and during a game, there is a lot of direct squabbling and close contact between the players. Objective: The goal of the research is to determine how handball training affected several aspects of physical fitness. The study also investigates the relationship between playing handball, passive hip range of motion (ROM), and the development of radiologically detectable hip osteoarthritis (OA) in formerly elite handball players. The research employed the exponential product algorithm for evaluating bilateral radiographs to classify and diagnose hip OA. This technique most likely evaluated subchondral sclerosis, osteophyte formation, joint space narrowing, and other radiological signs of OA in the individuals’ hip joints. Methods: The relationship among the risk of hip OA in long-term top handball players is explored, as well as the connections among hip ROM, OA, and pain. The research was conducted using a sample size of 20 ex-professional handball players and 39 control subjects. Information on demographics, loading patterns during exercise, and history of lower limb joint injury were gathered via a questionnaire. The inclusion criteria for individuals consisted former professional handball players with significant elite-level competitive experience, as well as control subjects with no background of high-impact sports. Confounding characteristics such as age, gender, and previous lower limb joint injuries were carefully controlled for using extensive demographic and injury history evaluations. To identify and categorize hip OA, bilateral radiographs were analyzed using the exponential product algorithm. The goniometer was used to assess the bilateral passive hip ROM. Long-term participation in elite handball at a high level was found to have a strong correlation with the hip development of osteoarthritis (OA). Sixty percent of handball players had been identified with OA in at least one hip joint, compared to only thirteen percent of control patients. Results: Hip flexion and medial rotation in the handball players were significantly decreased, whereas abduction, extension, and lateral rotation were increased considerably compared to the control values. When doing daily activities, the hip joints of the handball players with OA were less painful than those of the OA-afflicted control participants. Retired handball players seem to be at a much higher risk than the general population for developing early hip OA. Conclusion: The repetitive nature of handball-specific movements may result in anomalies that are seldom seen in the general population, which makes diagnosing pain and discomfort a challenging diagnostic challenge for sports physicians.

The Effects of the Leg Position on the Nordic Hamstring Exercise Eccentric Force: A Randomized Cross-Over Study

Given the posterior chain configuration, it is anticipated that tibial positioning influences hamstring recruitment; medial hamstrings should be more activated during medial rotation, while lateral hamstrings should be more activated during lateral rotation. However, most studies showing this pattern have focused on concentric or isometric strength, leaving the influence on eccentric strength fairly unknown. Therefore, the aim of this study was to investigate the electromyographic response of the hamstring muscles during Nordic hamstring exercises in three leg positions: internal rotation, external rotation, and neutral. This study encompassed a randomized crossover study and used surface electromyography to analyze the activity of the biceps femoris and semitendinosus muscles during the Nordic hamstring exercise, in the three positions. Results indicated no statistically significant differences in muscle activation between positions or sides (p &gt; 0.05), though small effect sizes were observed for the biceps femoris in different positions (η2 = 0.01–0.03). Furthermore, the internal rotation position generally elicited the highest muscle activations. Notably, biceps femoris muscles exhibited higher activations compared to semitendinosus muscles, with the greatest differences seen in the internal rotation position. This suggests that tibial rotation influences hamstring recruitment patterns; however, it was lower than expected.

Automatic Detection of Fatigued Gait Patterns in Older Adults: An Intelligent Portable Device Integrating Force and Inertial Measurements with Machine Learning.

This study aimed to assess the feasibility of early detection of fatigued gait patterns for older adults through the development of a smart portable device. The smart device incorporated seven force sensors and a single inertial measurement unit (IMU) to measure regional plantar forces and foot kinematics. Data were collected from 18 older adults walking briskly on a treadmill for 60min. The optimal feature set for each recognition model was determined using forward sequential feature selection in a wrapper fashion through fivefold cross-validation. The recognition model was selected from four machine learning models through leave-one-subject-out cross-validation. Five selected characteristics that best represented the state of fatigue included impulse at the medial and lateral arches (increased, p = 0.002 and p < 0.001), contact angle and rotation range of angle in the sagittal plane (increased, p < 0.001), and the variability of the resultant swing angular acceleration (decreased, p < 0.001). The detection accuracy based on the dual signal source of IMU and plantar force was 99%, higher than the 95% accuracy based on the single source. The intelligent portable device demonstrated excellent generalization (ranging from 93 to 100%), real-time performance (2.79ms), and portability (32g). The proposed smart device can detect fatigue patterns with high precision and in real time. The application of this device possesses the potential to reduce the injury risk for older adults related to fatigue during gait.

Biomechanical Effects of Different Prosthesis Types and Fixation Ranges in Multisegmental Total En Bloc Spondylectomy: A Finite Element Study.

Multi-segmental total en bloc spondylectomy (TES) gradually became more commonly used by clinicians. However, the choice of surgical strategy is unclear. This study aims to investigate the biomechanical performance of different prosthesis types and fixation ranges in multisegmental TES. In this study, a validated finite element model of T12-L2 post-spondylectomy operations were carried out. The prostheses of these models used either 3D-printed artificial vertebrae or titanium mesh cages. The fixed range was two or three segment levels. Range of motion, stress distribution of the endplate and internal fixation system, intervertebral disc pressure, and facet joint surface force of four postoperative models and intact model in flexion and extension, as well as lateral bending and rotation were analyzed and compared. The type of prosthesis used in the anterior column reconstruction mainly affected the stress of the adjacent endplate and the prosthesis itself. The posterior fixation range had a greater influence on the overall range of motion (ROM), the ROM of the adjacent segment, the stress of the screw-rod system, and adjacent facet joint surface force. For the model of the same prosthesis, the increase of fixed length resulted in an obvious reduction of ROM. The maximal decrease was 70.23% during extension, and the minimal decrease was 30.19% during rotation. In three-segment TES, the surgical strategy of using 3D-printed artificial prosthesis for anterior column support and pedicle screws for posterior fixation at both two upper and lower levels respectively can reduce the stress on internal fixation system, endplates, and adjacent intervertebral discs, resulting in a reduced risk of internal fixation failure, and ASD development.

Positioning therapy for intensive care patients

The current S3 guideline, "Positioning Therapy and Mobilization of Critically Ill Patients in Intensive Care Units", introduces methodological changes and substantive updates compared to the previous version. Additionally, new evidence-based insights with specified PICO questions have been integrated, aiming for a more precise application of recommendations in clinical practice and thus enhancing the care of critically ill patients.A notable aspect is the more nuanced approach to early mobilization, which is recommended to commence within the first 72 hours of ICU admission. A staged concept and score-based mobilization schema facilitate improved patient rehabilitation. Mobilization should be standard of care, i.e., immobilization should be ordered by the physician. The guideline provides suggestions for the duration and additional mobilization measures to ensure patients stand, transfer actively from bed to chair, or walk as frequently as possible. These recommendations apply even during ECMO therapy, highlighting the importance of early mobilization.Further updates include semi-recumbent positions of at least 40° in intubated patients, with careful consideration of potential side effects. Continuous lateral rotation therapy (CLRT) is not advised due to the progress in intensive care therapy, shifting from deep sedation toward responsive patient management.Prone positioning (PP) involves rotating the patient 180° onto the ventral side. It is recommended as a therapeutic option for invasively ventilated patients with ARDS and impaired arterial oxygenation (PaO2/FiO2 <150mmHg), with a recommended minimum duration of 12 hours, ideally 16 hours. Special recommendations apply, for example, to COVID-19 patients with acute hypoxemic respiratory failure, where awake proning should be considered.Additionally, new chapters have been introduced focusing on assistive devices and neuromuscular electrical stimulation.

Open wedge high tibial osteotomy alters patellofemoral joint kinematics: A multibody simulation study.

Changes in lower limb alignment after open-wedge high tibial osteotomy (owHTO) influence joint kinematics. The aim of this study was to investigate the morphological and kinematic changes of the knee joint, in particular the patellofemoral joint, using a multibody simulation model. OwHTO with an open tibial wedge of 6-12 mm (1 mm intervals) was virtually performed on each of 13 three-dimensional (3D) computer-aideddesign models (CAD models) derived from computer tomography scans of full-leg cadaver specimens. For each owHTO, an individual biomechanical simulation model was built and knee flexion from 5° to 100° was simulated using a multibody simulation model of the native knee. Morphologic and alignment parameters as well as tibiofemoral and patellofemoral kinematic parameters were evaluated. Almost linear changes in tibial tuberosity trochlea groove(TT-TG) (0.42 mm/1 mm wedge height) were observed which led to pathological values (TT-TG > 20 mm) in 3 out of 13 knees. Furthermore, a 6 mm increase in osteotomy wedge height increased lateral patellofemoral rotation by 0.8° (range: 0.39° to 1.11°) and led to a lateral patellar translation of 0.8 mm (range: 0.37-3.11 mm) on average. Additionally, valgisation led to a medial translation of the tibia and a decrease in the degree of tibial internal rotation during knee flexion of approximately 0.3°/1 mm increase in osteotomy wedge height. The increase in TT-TG and the biomechanical effects observed influence patellofemoral tracking, which may increase retropatellar pressure and are potential risk factors for the development of anterior knee pain.

Estimation of Patellofemoral Joint Dysfunction in Obese Post menopausal Women

Purpose: The purpose of this research was to estimate Patellofemoral Joint Dysfunction in obese postmenopausal women. Methods: Depending on selection criteria, 100 obese postmenopausal women were selected by simple random sampling method. Written consent was taken and a detailed outcome assessment was done by using a Numerical Pain Rating Scale for pain assessment, Range of motion of hip, knee, ankle joint, Waldron Test, Eccentric Step-down Test, and Quadriceps angle. Statistical analysis was done and results were obtained. Findings: Among the 100 participants, 63% of women experienced pain during their daily activities. The mean pain intensity at rest was 2.25 ± 1.91, and during activity, it increased to 3.28 ± 6.60 (p value &amp;lt; 0.0001). The range of motion in the hip, knee, and ankle joints was reduced compared to that of individuals in the same age group without pain. Specifically, Hip extension-adduction, knee extension, and ankle plantarflexion-inversion-eversion had a p value of &amp;lt;0.0001. For hip flexion-abduction-medial and lateral rotation, knee flexion, and ankle dorsiflexion, the p values were 0.0003, 0.1952, 0.0001, 0.003, 0.0392, and 0.0333. Additionally, 35% of women had quadriceps angles greater than 180 degrees, while the remaining 65% had angles less than 180 degrees. 63% of women exhibited crepitus during activities like stair climbing and walking. 52% of women tested positive on the Waldron Test. 60% of women showed positive findings on the Eccentric Step-down Test. Conclusion: It concluded that there is significant Patellofemoral Joint Dysfunction in obese postmenopausal women.

The Influence of Social Media on Millennial Generation Community Participation in Sports Activities

Purpose: The purpose of this research was to estimate Patellofemoral Joint Dysfunction in obese postmenopausal women. Methods: Depending on selection criteria, 100 obese postmenopausal women were selected by simple random sampling method. Written consent was taken and a detailed outcome assessment was done by using a Numerical Pain Rating Scale for pain assessment, Range of motion of hip, knee, ankle joint, Waldron Test, Eccentric Step-down Test, and Quadriceps angle. Statistical analysis was done and results were obtained. Findings: Among the 100 participants, 63% of women experienced pain during their daily activities. The mean pain intensity at rest was 2.25 ± 1.91, and during activity, it increased to 3.28 ± 6.60 (p value &amp;lt; 0.0001). The range of motion in the hip, knee, and ankle joints was reduced compared to that of individuals in the same age group without pain. Specifically, Hip extension-adduction, knee extension, and ankle plantarflexion-inversion-eversion had a p value of &amp;lt;0.0001. For hip flexion-abduction-medial and lateral rotation, knee flexion, and ankle dorsiflexion, the p values were 0.0003, 0.1952, 0.0001, 0.003, 0.0392, and 0.0333. Additionally, 35% of women had quadriceps angles greater than 180 degrees, while the remaining 65% had angles less than 180 degrees. 63% of women exhibited crepitus during activities like stair climbing and walking. 52% of women tested positive on the Waldron Test. 60% of women showed positive findings on the Eccentric Step-down Test. Conclusion: It concluded that there is significant Patellofemoral Joint Dysfunction in obese postmenopausal women.

Ventilation quality and fiber optic glottic view of AuraGain laryngeal mask in neutral, moderate, and extreme lateral head and neck positions in anesthetized spontaneously breathing children

BackgroundWe investigated the effects of moderate (45°), and extreme (60°) right lateral rotation of the head and neck on the ventilatory performance of Ambu AuraGain Laryngeal mask airway in generally anesthetized spontaneously breathing children. MethodsFifty-two children (aged 2–9 years) were randomized in this open-label observational cohort, to receive Ambu® AuraGain either in moderate (45°) (Group I, n = 26) or extreme (60°) (Group II, n = 26) lateral rotation of the head and neck. The oropharyngeal leak pressure OLP (primary outcome), ventilation score, exhaled tidal volume, and fiberoptic glottic view score, were recorded with the head and neck in a neutral position, then in lateral position after insertion by 1,15,30 and 45 min., and at end of surgery. ResultsThe mean OLP in group I decreased from 23.81 ± 2.87 cmH2O in the neutral position to 23.77±3.78 cmH2O, (P = 0.941) 1 min. after lateral rotation. Whereas, In group II, it increased from 20.38 ± 4.18 cmH2O to 21.88±3.28 cmH2O, (P = 0.002). Afterward, the OLP was maintained decreased in group I and increased in group II (P < 0.05), with no intergroup differences. The ventilation score did not show significant intra or inter-group differences. After lateral rotation, the fiberoptic glottic score showed a trend towards better values in group II than in group I. ConclusionVentilation with AuraGain LMA can efficiently be implemented while the head and neck are in the neutral and laterally rotated positions in anesthetized spontaneously breathing children. Extreme lateral rotation (60°) was better tolerated than the moderate position (45°).