Limited Mobility Research Articles

Conservative treatment of knee arthrofibrosis according to acellular cytokine-based model : Aretrospective pilot evaluation.

Arthrofibrosis (AF) is arelatively frequent complication after knee surgery, leading to painful limitation of joint mobility. Currently, intense stretching is performed in many patients, without improvements in mobility. Anovel concept, established on acellular, cytokine-based model, advocates to consider the warning function of pain and to terminate forced joint mobilization to disrupt the cycle of arthrofibrosis. Based on these findings, our clinic developed acomprehensive antifibrotic treatment protocol. The aim of this analysis was to evaluate the patients treated so far. Patients treated at the Clinic Donaustadt, an academic teaching hospital of the Medical University of Vienna, Austria, according to the clinic's AF protocol, were evaluated by reviewing their records. Patellar mobility, range of motion, tightness, overheat, pain, general mobility, assistive devices, working status and the necessity of additional surgery were assessed at baseline, after 2months and after 12months (follow-up). Four patients were treated according to the AF protocol. After two months, patellar mobility and range of motion clearly increased in three out of four patients. At the follow-up examination, patella mobility further increased, extension was complete, flexion at least 120°, and symptoms such as tightness, overheating, nocturnal pain and pain after activity had disappeared in three out of four patients. None of the patients had analgesics or walking aids and three out of four patients had returned to work. Out of the four patients, three expressed high satisfaction with the AF protocol and reported no limitations in daily life, including recreational activities. Based on this pilot evaluation, the comprehensive conservative AF program seems to have high potential. Therefore, larger future studies should be conducted to validate this concept.

Comprehensive Insights into De Quervain’s Tenosynovitis: From Etiology to Rehabilitation

De Quervain's tenosynovitis, a common condition affecting the first dorsal compartment of the wrist, is characterized by pain, swelling, and restricted tendon mobility, often resulting from repetitive manual tasks or biomechanical strain. This review integrates insights from three recent studies, emphasizing the multifactorial etiology, advanced diagnostic techniques, and evolving treatment modalities. Etiological factors include mechanical strain, anatomical variations, and degenerative changes, with ultrasonography emerging as a critical tool for enhancing diagnostic accuracy and guiding therapeutic strategies. Conservative treatments such as splinting, corticosteroid injections, and occupational therapy remain the cornerstone of management, while surgical decompression offers definitive relief for refractory cases. Emerging rehabilitative approaches, including graded tendon-loading protocols, and innovations in imaging and therapy, highlight a shift toward more precise and patient-centered care. Despite advancements, challenges persist in optimizing treatment protocols and addressing long-term functional recovery. Further research is essential to refine diagnostic and therapeutic strategies, reduce recurrence rates, and improve patient outcomes.

Artificial intelligent based control strategy for reach and grasp of multi-objects using brain-controlled robotic arm system

ABSTRACT Brain-controlled robotic arm systems are designed to provide a method of communication and control for individuals with limited mobility or communication abilities. These systems can be beneficial for people who have suffered from a spinal cord injury, stroke, or neurological disease that affects their motor abilities. The ability of a person to control a robotic arm to reach and grasp multiple objects using their brain signals. This technology involves the use of an electroencephalogram (EEG) cap that captures the electrical activity in the user’s brain, which is then processed by an artificial intelligent to translate it into commands that control the movements of the robotic arm. With this technology, individuals who are unable to move their limbs due to paralysis or other conditions can still perform daily activities such as feeding themselves, drinking from a glass, or grasping objects. In this paper, we propose an artificial intelligent–based control strategy for reach and grasp of multi-objects using brain-controlled robotic arm system. The proposed control strategy consists of threefold process: feature extraction, feature optimization, and control strategy classification. Initially, we design an improved ResNet pre-trained architecture for deep feature extraction from the given EEG signal.

Effect of NiO Nanofiller on P(VdC‐Co‐AN) With PEG Polymer Blend Electrolyte for Energy Storage Applications

ABSTRACTSolid‐state polymer electrolytes with safety and high energy density are promising novel options for energy storage devices. Nevertheless, the low ionic conductivity and limited mobility of lithium ions at room temperature have significantly impeded their practical application. A flexible composite polymer electrolyte was fabricated using a solution casting method. This electrolyte consisted of a polymer blend of poly (vinylidene chloride‐co‐acrylonitrile) (PVdC‐co‐AN) and polyethylene glycol (PEG), incorporated with lithium perchlorate (LiClO4) as salt, propylene carbonate (PC) as plasticizer, and nickel oxide (NiO) nanoparticles as filler. The electrolyte is prepared by the various concentrations of NiO nanoparticles (Nps) (0, 5, 10, 15, and 20 wt.%). The prepared NiO is confirmed by the XRD analysis, and the incorporation of NiO in the polymer blend also determined. The polymer salt plasticizer and filler interactions are confirmed by the FTIR analysis. At room temperature, the sample containing 15% of NiO has a high ionic conductivity value of up to 10−3 S cm−1. The electrochemical and also thermal stability of this electrolyte is achieved at 4.8 V and 312°C. The mechanical stability is enhanced up to 29 MPa. The remarkable performance enhancement is attributed to the incorporation of NiO, which facilitated improved ionic conductivity, mechanical properties, and compatibility for energy storage applications.

Promising LOX proteins for cartilage-targeting osteoarthritis therapy.

Osteoarthritis (OA) is the most affected joint disease worldwide, touching millions of people every year. It is caused by a progressive degeneration of articular cartilage, causing pain and limited mobility. Among the pathways involved in cartilage homeostasis, "LOX" proteins (referring to three distinct protein families, very often confused in the literature) play a prominent role. The lipoxygenase enzyme family is involved in the inflammatory process of OA by inducing the production of several pro-inflammatory leukotrienes. Lectin-like oxidized low-density lipoprotein family are receptors located at the surface of chondrocytes, which interact with their ligand, ox-LDL, activating several catabolic pathways involved in OA pathophysiology. Finally, lysyl oxidase and lysyl oxidase-like are enzymes expressed intracellularly (in chondrocytes' cytoplasm) involved in elastin biosynthesis and collagen cross-linking in cartilage extracellular matrix. EMA and FDA have not yet approved any drug targeting the LOX proteins. In particular, today lysyl oxidase-like 2 is considered as a new promising target for OA modifying therapy. This review clarifies the main roles of different LOX proteins involved in the progression of OA. Potential LOX inhibitoion strategies for drug development in advanced OA therapy, particularly for local intraarticular delivery, were listed and discussed for each target type. This review, therefore, proposes promising strategies for future drug development in OA treatment.

Fangchinoline alleviates the progression of osteoarthritis through the nuclear factor kappa B signaling pathway.

Osteoarthritis is a progressive, chronic joint disease characterized by pain, stiffness, and limited mobility, which can lead to physical disability in severe cases. Owing to its complex pathological features, effective treatments for osteoarthritis are lacking. Fangchinoline is a natural alkaloid found in the tuberous roots of plants belonging to the Menispermaceae family. Fangchinoline reportedly possesses anti-inflammatory, antioxidant, and anticancer properties; however, its role in osteoarthritis progression remains unclear. In this study, we investigated the protective effects and potential mechanisms of fangchinoline against osteoarthritis. In vitro, we confirmed that fangchinoline alleviates interleukin-1β-induced cartilage inflammation, reduces the levels of metabolic factors, such as inducible nitric oxide synthase and matrix metalloproteinase-3, and modulates the expression of aggrecan, which enhances extracellular matrix synthesis. In vivo, we demonstrated that fangchinoline can ameliorate articular cartilage degeneration and reduce inflammatory destruction in a destabilization of the medial meniscus mouse model. The nuclear factor kappa B (NF-κB) signaling pathway in osteoarthritis has been a primary target for drug development, and our results suggest that fangchinoline exerts anti-inflammatory effects by inhibiting the activity of IKKα/β. Using an in vitro human cartilage culture model, we further validated that fangchinoline significantly mitigates cartilage degeneration and inflammation by modulating the NF-κB signaling pathway. This evidence highlights its dual action in preserving cartilage integrity and suppressing inflammatory responses. These findings collectively underscore fangchinoline as a potent inhibitor of NF-κB, capable of attenuating key pathological processes associated with osteoarthritis. Therefore, fangchinoline emerges as a promising therapeutic candidate for slowing the progression of osteoarthritis.

'"Health" Is Just One Piece in the Puzzle of Wellbeing': Shifting From Preventing Health Deterioration to Improving Wellbeing in a Participatory Action Research Project With Care-Experienced Older People.

Prevention of health deterioration is a key policy objective in Sweden informed by active and healthy ageing initiatives. However, the perspectives of older people with mobility and health limitations on current prevention initiatives are seldom gained meaning these initiatives may fail to align to with the priorities of people whose health has ostensibly already deteriorated. We aimed to explore older care-experienced people's perspectives on the topic of health deterioration prevention and highlight aspects that they think are important to prioritise. Eight older people with experience in giving or receiving formal or informal care were involved as lay co-researchers in a participatory action research project that involved recruiting 11 further older informants to participate in peer interviews or complete a logbook. In a series of 13, 2-h workshops held over 1 year, we undertook data generation, training, reflection and analytic activities inspired by framework analysis. The lay co-researchers found the topic of health deterioration to be negatively and narrowly focussed opting instead to pursue a focus on articulating aspects, or puzzle pieces, that influence the improvement of wellbeing. Six influential puzzle pieces (stigma, digitalisation, services, losses, meaning and interactions) were regarded as important to prioritise which together illustrated that wellbeing is continually shaped in an interplay with dominant, but manipulable, social norms. This study highlights how the language of active and healthy ageing, which pervades policy and practice, is imbued with ageist and ableist subtexts that can influence older people's wellbeing and lead to exclusionary experiences in society. We highlight wider societal trends, particularly digitalisation and effectivisation, whose negative impact on older people's wellbeing could be mitigated through inclusive co-design and resistance to normative influences. This project was initiated in dialogue with stakeholder representatives from pensioner organisations in a larger scale participatory action research project. The care-experienced lay co-researchers collaborated in all phases of this project-gaining funding, formulating research questions, planning the study design, generating data in peer interviews, analysing and interpreting data, disseminating findings, prioritising future research and co-authoring articles.

2799 Exploring the physiotherapy and exercise needs and preferences of nursing home residents with dementia: a qualitative study

Abstract Introduction Functional decline and restricted mobility are common issues among nursing home residents with dementia, resulting in frequent use of physiotherapy services. While these residents can typically articulate their therapy needs and preferences, these have not been investigated properly regarding physiotherapy and exercise, which may compromise therapy adherence. This study aims to explore the needs and preferences of nursing home residents with mild to moderate dementia in relation to physiotherapy and exercise interventions. Methods Semi-structured individual interviews were conducted with 15 nursing home residents diagnosed with mild to moderate dementia, who could understand and speak Dutch and were capable of providing informed consent. Thematic analysis was used to analyse interview data. Results From the interviews a total of 82 unique codes were identified, leading to four major themes: preferences regarding physiotherapeutic treatment, differences between physiotherapy and other exercises, preferences for unsupervised exercise, and communication and involvement preferences. Overall, residents wanted physiotherapy that included exercise and advice aimed at maintaining physical functioning and independence. Many participants indicated that a physiotherapist was not always required to supervise exercises as long as safety and quality were ensured. While residents wanted their family caregivers to stay informed about their therapy, they mostly preferred to exercise with someone other than a family caregiver. Conclusions Residents emphasised the importance of a physiotherapist providing information and understanding, and noted that sessions could be supervised by others if quality and safety are maintained. While residents preferred regular updates to their family, they did not want to exercise with them. A future coaching role for physiotherapists to oversee exercise interventions could enhance healthcare cost efficiency.

Current status and factors influencing kinesiophobia in patients with meniscus injury: a cross-sectional study

ObjectivesThis study aimed to examine the relationships between kinesiophobia and injury severity, balance ability, knee pain intensity, self-efficacy, and functional status in patients with meniscus injuries and to identify key predictors of kinesiophobia.DesignA single-center, prospective cross-sectional study.MethodsA cross-sectional study involving 123 patients diagnosed with meniscus injuries at Fujian Provincial Hospital was conducted. The knee range of motion test was used to determine limitations in knee joint mobility, whereas magnetic resonance imaging (MRI) was used to assess the severity of meniscus damage. Several validated scales were administered: the Tampa Scale of Kinesiophobia (TSK-17) to measure kinesiophobia, the visual analog scale (VAS) to assess pain intensity, the general self-efficacy scale (GSES) to evaluate self-efficacy, and the Lysholm knee score (LKS) to assess knee functional status. Additionally, balance ability was assessed using the Huber 360 Neuromuscular Control Training and Assessment System (DJO, USA). Spearman’s correlation analysis was applied to explore factors associated with kinesiophobia, whereas simple linear regression analysis was used to identify its predictors.ResultsAmong the 123 participants included in the study, 60.16% were identified as experiencing kinesiophobia. Among these participants, 69.10% had grade III meniscus injuries, and 33.3% exhibited limited joint movement. The key clinical characteristics were as follows: the median VAS score was 4 (IQR 2–6), the GSES score was 22 (IQR 20–29), and the LKS score was 45 (IQR 38–55). Kinesiophobia was significantly correlated with injury severity, limited joint movement, pain intensity, self-efficacy, and other functional parameters (P < 0.05). However, no significant correlation was detected between kinesiophobia and limits of stability. Simple linear regression analysis (R²=0.917) revealed several significant predictors of kinesiophobia, including injury severity (β = 2.08), pain intensity (β = 0.882), Romberg quotient (RQ) (β = 3.239), and limited joint movement (β = 0.868). In contrast, self-efficacy (β =-0.455) was negatively associated with kinesiophobia. Furthermore, Grade III injuries and RQ were found to be associated with markedly higher levels of kinesiophobia.ConclusionKinesiophobia is strongly associated with knee injury severity, limited joint movement, RQ, pain intensity, and self-efficacy, which are key predictors. Clinical interventions should focus on these factors to enhance rehabilitation outcomes.

Spinal ataxia and computed tomography findings in a Poitou donkey affected with congenital occipitoatlantoaxial malformation

SummaryA 3‐year‐old Poitou donkey was referred for a computed tomography (CT) examination of the cervical spine due to acute deterioration of spinal ataxia. Neurological assessment revealed restricted neck mobility, hypermetria and circumduction of all limbs, indicating a grade 2 out of 5 ataxia. Abnormalities of the neurologic examination were most likely associated with spinal cord disease between C1 and C5. CT examination identified an asymmetric, congenital, occipitoatlantoaxial malformation (OAAM). A static extradural compression of the spinal cord secondary to the malformation was present. This case report represents an inaugural documentation of OAAM in a Poitou donkey.

P-1272. Hepatitis A Investigation and Onsite Response in a Retirement Facility, New York City, 2023

Abstract Background Hepatitis A is a contagious liver infection that can be transmitted by contaminated food consumption. On August 13, 2023, a healthcare provider notified the New York City Health Department of a hepatitis A case in a food handler who worked at a retirement facility while infectious. Medical frailty, mobility, and transportation limitations complicated exposed persons’ access to postexposure prophylaxis (PEP) within the recommended 2-week window. During the COVID-19 pandemic, the Health Department developed capacity to provide onsite SARS-CoV-2 testing and vaccination services within congregate settings to prevent and respond to outbreaks. We used this infrastructure to deliver timely PEP to contacts and prevent an outbreak. Methods Using a risk-assessment algorithm, we evaluated the food handler’s hand hygiene, type and quantity of food prepared, and contact with ready-to-eat food. Anyone who ate food the worker prepared while infectious, defined as 2 weeks before symptom onset, was considered exposed. Following Advisory Committee on Immunization Practices guidance, 1 dose of single-antigen hepatitis A vaccine was advised for exposed adults, with coadministration of 0.1 mL/kg human immunoglobulin (IG) for those age &amp;gt; 40 years. Food handlers were required to receive PEP to prevent workplace exclusion. To enable timely PEP receipt, the Health Department worked with facility staff and a vendor to host an onsite clinic on August 23, 2023. Results We identified 84 exposed persons, including 42 (50%) residents, 10 (12%) food handlers, and 32 (38%) staff. Median age of those exposed was 74 years (interquartile range [IQR]: 58–88 years); residents’ median age was 89 years (IQR: 84–91 years). Of 84 exposed persons, 39 (46%) received PEP; 30 (77%) received vaccine and IG, 1 (3%) IG only, and 8 (21%) vaccine only. Seven exposed persons who received only vaccine were eligible for IG. All 10 (100%) exposed food handlers, 18 (43%) residents, and 11 (34%) staff received PEP. One secondary case was identified in a resident who declined PEP. Conclusion This intervention ensured residents were protected and prevented work exclusions. Providing timely, accessible clinical services within congregate settings, as was commonly done for COVID-19, might effectively prevent the spread of other infections. Disclosures All Authors: No reported disclosures

The acceptability of a novel seismocardiography device for measuring VO2 max in a workplace setting: a mixed methods approach

BackgroundWorkplace health screening rarely includes measures of cardiorespiratory fitness, despite it being a greater predictor of cardiovascular disease and all-cause mortality than other routinely measured risk factors. This study aimed to determine the comparative acceptability of using a novel seismocardiography device to measure cardiorespiratory fitness via VO2 max during a workplace health check.MethodsParticipants were invited to participate in workplace health screening sessions where VO2 max was assessed by both seismocardiography at rest and sub-maximal exercise testing, in order for acceptability of both to be compared across multiple domains. Questionnaires and focus group guides for participants and practitioners were developed based on the Theoretical Framework of Acceptability. Data were analysed using t-tests and deductive thematic analysis.ResultsThere was a significant difference in the acceptability domain of ‘affective attitude’ between the novel SCG device (M = 9.06 ± 1.14) and the sub-maximal exercise testing (M = 7.94 ± 1.79); t = 3.296, p = .001, d = 0.50, and in the domain of ‘burden’ between the novel SCG device (M = 9.16, ± 0.55) and the sub-maximal exercise testing (M = 7.41 ± 1.45); t = 7.033, p = < 0.001, d = 1.45. Practitioners and employees highlighted the potential of seismocardiography to create a more inclusive and accessible workplace offer, allowing those with restricted mobility or those with differing physical or emotional needs to participate in wellness testing; yet there was a lack of understanding in both groups around intervention effectiveness and coherence.ConclusionsSeismocardiography may offer an acceptable route to cardiorespiratory fitness testing in the workplace, due to the low effort requirement and simplicity of administration. This study suggests that practitioners delivering such services have a critical role to play in acceptability of health interventions at work, as employees will be heavily influenced by practitioner beliefs around coherence and effectiveness. Comprehensive delivery training is important for the adoption of new health-related technologies such as seismocardiography into workplace health screening.

Patient perspectives and utilization of telemedicine for chronic conditions in Pakistan barriers and facilitators towards its access

BackgroundTelemedicine, utilizing technology for remote healthcare, offers promise for chronic disease management. It enables virtual consultations, addressing geographical barriers and mobility limitations. This study explores patient perspectives on using telemedicine, particularly via smartphones, to improve access, continuity of care, and ultimately reduce chronic disease burden.MethodsA cross-sectional study was carried out from February 1, 2024, to April 1, 2024, to examine telemedicine consultations. The investigation was conducted at the Sehat Kahani head office, where 460 persons with chronic diseases were recruited. These participants were initially identified by Electronic Health Records (EHR) of Sehat Kahani and subsequently registered following randomization through systematic random sampling.ResultsThis study investigated telemedicine perceptions among 450 chronic disease patients (74.2% female, avg. age 40.6). Over 85.5% agreed on the necessity of telemedicine for chronic care. Notably, higher education, income ≥ 25,000 PKR, and health insurance significantly correlated with telemedicine use. And a larger portion of participants expressed positive perceptions of TM services in terms of faster medical care delivery (n = 369, 82%). These findings underscore telemedicine's potential to revolutionize chronic disease management.ConclusionThe study found that chronic disease patients in Pakistan have a positive opinion of telemedicine. Variables such as educational attainment, financial resources, and access to insurance exerted a substantial impact on the utilization of telemedicine. This implies that efforts should be made to mitigate inequalities in order to promote broader acceptance and implementation of telemedicine. Telemedicine shows potential for enhancing the management of chronic diseases in Pakistan.

Identification of WDR74 and TNFRSF12A as biomarkers for early osteoarthritis using machine learning and immunohistochemistry

BackgroundOsteoarthritis (OA) is a chronic joint condition that causes pain, limited mobility, and reduced quality of life, posing a threat to healthy aging. Early detection is crucial for improving prognosis. Recent research has focused on the role of ubiquitination-related genes (URGs) in early OA prediction. This study aims to integrate URG expression data with machine learning (ML) to identify biomarkers that improve diagnosis and prognosis in the early stages of OA.MethodsOA single-cell RNA sequencing datasets were collected from the GEO database. Single-cell analysis was performed to investigate the composition and relationships of chondrocytes in OA. The potential intercellular communication mechanisms were explored using the CellChat R package. URGs were retrieved from GeneCards, and ubiquitination scores were calculated using the AUCell package. Gene module analysis based on co-expression network analysis was conducted to identify core genes. Additionally, ML analysis was performed to identify core URGs and construct a diagnostic model. We employed XGBoost, a gradient-boosting ML algorithm, to identify core URGs and construct a diagnostic model. The model’s performance was evaluated using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. In addition, we explored the relationship between core URGs and immune processes. The ChEA3 database was utilized to predict the transcription factors regulated by core ubiquitination-related genes. The expression of select URGs was validated using qRT-PCR and immunohistochemistry (IHC).ResultsWe identified WDR74 and TNFRSF12A as pivotal ubiquitination-related genes associated with OA, exhibiting considerable differential expression. The diagnostic model constructed with URGs exhibited remarkable accuracy, with area under the curve (AUC) values consistently exceeding 0.9. The expression levels of WDR74 and TNFRSF12A were significantly higher in the IL-1β-induced group in an in vitro qPCR experiment. The IHC validation on human knee joint specimens confirmed the upregulation of WDR74 and TNFRSF12A in OA tissues, corroborating their potential as diagnostic biomarkers.ConclusionsWDR74 and TNFRSF12A as principal biomarkers highlighted their attractiveness as therapeutic targets. The identification of core biomarkers might facilitate early intervention options, potentially modifying the illness trajectory and enhancing patient outcomes.

Impact of Five Soy Proteins on Lean Chicken Breast Systems with Varying Moisture Contents: Cooking Loss, Texture, Microstructure, and T2 NMR

With increasing global meat consumption, meat–plant hybrid products have gained interest as a sustainable alternative. Soy proteins have been used in small quantities (2–3%) as meat extenders, yet limited data exist on their use at higher levels. Here, five commercial soy proteins (four isolates: SPI-A to -D; one concentrate: SPC) were used for meat replacement in lean meat batters with 0/40/80% added water. Cooking loss, texture, light micrographs, and T2 relaxation were analyzed. At 33% and 66% meat replacement, soy protein treatments maintained comparable or reduced cooking loss; SPI-D and SPC were the least and most effective, respectively. Complete replacement eliminated cooking loss in 0% and 40% water systems but failed to form self-supporting gels in the 80% system. At 33% replacement, SPI-A to -C generally increased hardness, whereas increasing the replacement level further to 66% decreased it. In the 0% and 80% systems, SPI-A treatments exhibited hardness comparable to controls, SPI-D treatments drastically reduced hardness, and SPC treatments maintained greater hardness than the controls even at 66% replacement. Micrographs offered potential explanations for these macroscopic measurements. NMR T2 data indicated that soy proteins restricted water mobility both pre- and post-cooking. Specifically, in the 40% and 80% systems, the T22 peaks (expelled liquid) of the hybrid samples containing 33% SPI-A were ~350 ms and 760 ms, compared to ~570 ms and 1170 ms for the meat controls, respectively. In conclusion, most soy proteins (except SPI-D) enhanced water binding, with SPI-A showing optimal texture and SPC showing promise as a more economical alternative.

Stretching authenticity in times of restricted mobility: Transtextuality, place anchoring, and boredom in romance reality show 90 Day Fiancé: Self-Quarantined

The article explores the impact of the COVID-19 pandemic on the production and narrative strategies of the 90 Day Fiancé franchise, focusing on its spin-off, 90 Day Fiancé: Self-Quarantined (2020). It examines how the programme adapted to mobility restrictions and lockdown policies through self-filming, remote interviewing, and focusing on mundane, pandemic-specific activities. Using theories of reality TV, documentary and authenticity, the study highlights the spin-off’s negotiation of authenticity via transtextuality, place anchoring and boredom. The article contributes to understanding how pandemic-era reality TV embraced flexibility and pragmatism, blending heightened authenticity with performative elements to maintain relatability and audience engagement.

Unmet Social Needs of Older Adults With Mobility Limitations Following Inpatient Rehabilitation Discharge in Nigeria: A Qualitative Narrative Inquiry Study.

Approximately, 30% to 60% of older adults experience functional decline following hospitalization, which has implications for their ability to meet social needs after discharge. Exploring the unmet social needs of older adults following discharge is warranted to rethink the elements of hospital discharge in low-resource countries. This study explored the unmet social needs of older adults with mobility limitations following discharge from an inpatient rehabilitation unit in a state hospital in Northern Nigeria. This narrative qualitative study is based on the social constructivism paradigm guided by the 3-Dimensional Narrative Inquiry Space (3-D NIS) methodology. We purposively selected and conducted telephone interviews with 12 older adults, aged 55years and older, with mobility limitations and discharged from inpatient rehabilitation units. The 3-D NIS guided the thematic analysis of the data. Two author coders independently conducted a thematic analysis of the transcripts. Reflexivity was maintained throughout the research process. Two related themes [6 sub-themes] emerged: "limitations in social functioning" [leisure activity, religious engagement, and instrumental activities of daily living modifications]; and "accepting the status quo" [Care/support from relatives, friends, and strangers, regrets and aspirations, and adaptation to psychological needs]. Seven tensions from the participants' transcripts were embedded in emotions, focused on belief, well-being, and spirituality, COVID-19 pandemic impact, desire to be "normal," limited finance, non-age-friendly homes and community settings, and undetailed rehabilitation discharge planning. This study highlights the substantial unmet social needs of older adults with mobility limitations following discharge from inpatient rehabilitation units in Northern Nigeria, underscoring the importance of a holistic approach to hospital discharge planning. Future research in low-resource countries should delve deeper into developing comprehensive discharge strategies that integrate social workers and rehabilitation professionals to effectively address these multifaceted social needs.

P-22 INSIDIOUS, RARE, AND MIMICKING BONE DISEASE: PROGRESSIVE PSEUDORHEUMATOID DYSPLASIA

Abstract Introduction Progressive pseudorheumatoid dysplasia (PPD) is a rare autosomal recessive skeletal dysplasia that primarily affects joint cartilage, leading to progressive stiffness and enlargement without inflammation. Symptoms typically manifest between ages 3 and 6. Here we report a case of PPD with a prolonged undiagnosed period, despite early symptom onset. Clinical Case A 43-year-old female office manager presented with significant joint mobility limitations and walking difficulties. Her medical history revealed that she first sought medical attention at the age of two due to leg deformities, where genu varum was detected and initially treated as rickets with vitamin D supplementation. At ages 7 and 9, the patient underwent limb lengthening and corrective surgeries for bilateral lower extremity deformities. By age 12, worsening gait required assistive devices. At age 33, a right femoral head fracture necessitated prosthesis implantation, followed by a similar procedure on the left hip at age 36. In the last five years, mobility limitations and pain in the left shoulder and knee have increased. Her medical history was otherwise unremarkable, though her parents were noted to be consanguineous. Physical exam revealed 147 cm height and significant scoliosis. Flexion contractures were observed in the proximal and distal interphalangeal joints of both hands, along with significant mobility limitations in the metacarpophalangeal joints, wrists, and elbows, especially in extension. Additionally, there was limited extension in both knees, more severe on the left, and contractures in the left ankle. No signs of arthritis were present. Laboratory results showed a 25-OH Vitamin D level of 17.53 µg/L, leading to replacement therapy initiation. Acute phase reactants were normal. Radiographic imaging (Figure 1) showed osteoporotic bones, platyspondyly, scoliosis, vertebral endplate irregularities, narrowed disc spaces, and peripheral osteophytes in the vertebral column. Furthermore, epiphyseal enlargement, uniform joint space narrowing, irregular joint surfaces, and periarticular osteopenia were observed bilaterally in the shoulders, elbows, knees, ankles, radiocarpal, midcarpal, carpometacarpal, metacarpophalangeal, and interphalangeal joints. Despite these findings, bone mineral density (BMD) of the L1-L4 vertebrae measured 1.337 g/cm² (Z-score: 1.2) via dual-energy X-ray absorptiometry (DEXA). Based on the clinical, laboratory, and imaging findings, a diagnosis of PPD was established, and the patient was referred for physical therapy and rehabilitation. Conclusion This case illustrates a patient with PPD, marked by significant involvement of the hand joints, large joints, and spine, accompanied by short stature. Patients with PPD are frequently undiagnosed or misdiagnosed. The absence of inflammatory features is crucial in distinguishing PPD from juvenile idiopathic arthritis. The lack of extraskeletal involvement further characterizes this disease.Figure 1Figure 1a shows osteoporotic bones, platyspondyly, scoliosis, vertebral endplate irregularities, narrowed disc spaces, and peripheral osteophytes in the vertebral column. Figure 1b and 1c show epiphyseal enlargement, uniform joint space narrowing, irregular joint surfaces, and periarticular osteopenia in both knees and hands.

Evaluation of the efficacy of a novel lumbar exoskeleton with multiple interventions for patients with lumbar disc herniation: a multicenter randomized controlled trial of non-inferiority

BackgroundLumbar disc herniation (LDH) occurs when the nucleus pulposus or annulus fibrosus protrudes into the intervertebral space, potentially compressing nerve roots and causing symptoms such as sciatica, restricted mobility, and lower extremity weakness. The development of portable lumbar exoskeleton devices offers a new approach, combining traction, range of motion (ROM) exercises, and resistance training in a single system, potentially reducing treatment complexity and enhancing LDH patient outcomes.ObjectiveThis study aims to evaluate the efficacy and safety of a novel lumbar exoskeleton device compared to traditional traction methods combined with rehabilitation therapy for patients with LDH.MethodsA multicenter, non-inferiority randomized controlled trial was conducted with 118 participants diagnosed with LDH. Participants were randomly assigned to the Exoskeleton Group or the Traction Group. The Exoskeleton Group used the novel device for traction, ROM, and resistance training, while the Traction Group underwent traditional traction and rehabilitation therapy. Outcomes included efficacy rate after 10 treatments, Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and lumbar ROM—were assessed at 3, 6, and 10 treatments.ResultsA total of 118 eligible participants were recruited. After 10 treatments, both groups showed significant improvements in VAS scores, ODI, and lumbar ROM compared to baseline (P &amp;lt; 0.001). However, there was no significant difference in the overall efficacy rate between the two groups (P = 0.748).ConclusionThe novel lumbar exoskeleton device demonstrates comparable efficacy and safety to traditional traction therapy combined with rehabilitation, offering a promising alternative for the conservative treatment of LDH.

Diagnosis and Treatment of Golfer's Elbow: A Review of Therapeutic Approaches

Introduction: Medial epicondylitis, or golfer's elbow, is caused by repetitive stress on the medial epicondyle tendons, leading to pain, reduced grip strength, and limited mobility. Poor biomechanics and overloading worsen the condition, which involves tendon degeneration and inflammation. Treatment begins with rest, physical therapy, and NSAIDs, while advanced cases may require injections, surgery, or innovative therapies targeting oxidative stress. Aim of study Objective:The objective of this paper is to analyze the causes, symptoms, and available treatment n methods for golfer's elbow (medial epicondylitis). The paper aims to compare the effectiveness of conservative methods and surgical interventions in treating this condition, as well as discuss the latest advancements in therapy State of Knowledge: Medial epicondylitis, or golfer's elbow, is a chronic tendon condition caused by repetitive stress. Diagnosis relies on clinical evaluation and imaging, while treatment begins with conservative methods like rest and physical therapy. For resistant cases, surgical options and innovative therapies. A multimodal, personalized approach ensures optimal recovery and long-term relief. Summary (Conclusion): Medial epicondylitis, or golfer's elbow, is caused by repetitive stress and degenerative changes in the flexor-pronator tendons. Effective diagnosis combines clinical evaluation and imaging. Conservative treatment, including rest, physical therapy, and pharmacological support, is the first-line approach. In refractory cases, surgical options like open repair and arthroscopy, along with innovative techniques such as collagen-augmented sutures and stem cell applications, show promising results. Complementary therapies, such as ESWT, PRP, and manual therapy, further enhance outcomes, particularly in chronic cases. A multimodal, personalized approach ensures optimal tendon healing, functional recovery, and long-term symptom relief.