Motion Deficits Research Articles

Traumatic Hip Dislocation in an NCAA DI Football Player with Occult Sequelae: A Case Report.

Background and PurposeAmerican football generates the most sports-related injuries in the United States, with tackling as the leading injury mechanism. Overall injury rate at the collegiate level has been reported as 8.61 per 1,000 athlete exposures (AEs) – twice the rate of high school levels; competition injury rates are reported as high as 36.94/1000 AEs. Traumatic hip dislocation is an uncommon injury typically arising from high-energy axial impact with only 2-5.5% occurring during sports activities.Case DescriptionA 22-year-old NCAA Division I football defensive back who experienced extreme left hip pain following contact with another player with his hip flexed during a game was diagnosed with a type 1 posterior hip dislocation, a grade 1 medial collateral ligament sprain with concomitant posterior thigh and hip muscle strains. Key impairments were limited left lower extremity motor performance, range of motion deficits, left hip pain, and diminished function and weight-bearing ability.OutcomesThe athlete reintegrated into typical defensive back off-season training approximately four to five months post injury without restrictions, however presented with new anterior hip pain seven months post injury revealing occult sequelae requiring surgical intervention. He was able to return to full play the following football season.DiscussionThis case report describes the successful return to sport of a Division I football player who sustained a traumatic posterior hip dislocation and complicated course including surgical intervention secondary to associated sequelae.Level of Evidence5

Assessing the Effects of Scapular Positioning on the Morphology of the Median Nerve During Upper Limb Tension Test 1 (ULTT1)

Research Objectives To determine if there is a significant difference in median nerve morphology of the ULTT1 between resting and two scapular testing positions. Design Cross-sectional study utilizing diagnostic ultrasound to view the median nerve. Diagnostic ultrasound is a non-invasive method of viewing certain anatomical structures, as allowed by the ultrasound frequency. Setting Private University research facility. Participants Thirty healthy males and females between age 18-65 were recruited from a sample of convenience. Exclusion criteria: neck, shoulder, elbow, wrist, or back pain; range of motion deficits that would prevent them from doing the testing positions; or neurological symptoms of the upper quarter. Interventions Subjects were tested using the ULTT1 in both blocked and depressed scapular positions with the height and width of the median nerve measured by diagnostic ultrasound. Main Outcome Measures Investigators used the ultrasound unit calipers to measure the height and width of the median nerve in resting and each scapular position. Results Paired t-tests with a p-value of < 0.05 were utilized to compare median nerve measurements in resting and each scapular position. No significant difference in height or width was found between resting, blocked, or depressed scapular positioning, with p-values >0.05. Conclusions Scapular position did not affect the morphology of the median nerve in this study. Author(s) Disclosures No financial gain from this study. To determine if there is a significant difference in median nerve morphology of the ULTT1 between resting and two scapular testing positions. Cross-sectional study utilizing diagnostic ultrasound to view the median nerve. Diagnostic ultrasound is a non-invasive method of viewing certain anatomical structures, as allowed by the ultrasound frequency. Private University research facility. Thirty healthy males and females between age 18-65 were recruited from a sample of convenience. Exclusion criteria: neck, shoulder, elbow, wrist, or back pain; range of motion deficits that would prevent them from doing the testing positions; or neurological symptoms of the upper quarter. Subjects were tested using the ULTT1 in both blocked and depressed scapular positions with the height and width of the median nerve measured by diagnostic ultrasound. Investigators used the ultrasound unit calipers to measure the height and width of the median nerve in resting and each scapular position. Paired t-tests with a p-value of < 0.05 were utilized to compare median nerve measurements in resting and each scapular position. No significant difference in height or width was found between resting, blocked, or depressed scapular positioning, with p-values >0.05. Scapular position did not affect the morphology of the median nerve in this study.

Shoulder Range of Motion Deficits in Youth Throwers Presenting With Elbow Pain.

Glenohumeral internal rotation deficit (GIRD) and total arc of motion difference (TAMD) have been associated with elbow injuries in throwing athletes. Youth pitchers with elbow pain will have greater GIRD and TAMD compared with youth pitchers without elbow pain. Cross-sectional study. Level 3. Glenohumeral range of motion of 25 consecutive throwing athletes presenting with elbow pain and that of a matched control group of 18 asymptomatic throwing athletes were compared. Bilateral glenohumeral internal rotation, external rotation, and horizontal adduction at 90° were measured and GIRD and TAMD were then calculated. An analysis of variance was performed to compare range of motion between throwers with and without elbow pain. The average GIRD of the elbow pain group was 32.7° compared with 14.5° in the control group (P < 0.05). The average TAMD in the elbow pain group was 28.3° compared with 6.7° in the control group (P < 0.05). GIRD and TAMD were present in 88% (22 of 25) and 96% (24 of 25) of the elbow pain group versus 33.3% (6 of 18) and 55.6% (10 of 18) of the control group, respectively. Compared with asymptomatic youth pitchers, those presenting with elbow pain have a statistically significant GIRD and TAMD. This study suggests that a GIRD and TAMD may predispose youth pitchers to present with symptomatic elbow pain.

Comparison of Bioabsorbable and Metallic Interference Screws for Graft Fixation During ACL Reconstruction: A Meta-analysis of Randomized Controlled Trials.

Background:Bioabsorbable interference screws and metallic interference screws are both widely used for graft fixation, but it remains unclear which screw type is superior.Purpose:To compare clinical outcomes and complications between bioabsorbable and metallic interference screws for anterior cruciate ligament reconstruction (ACLR).Study Design:Systematic review; Level of evidence, 1.Methods:The literature was searched for relevant randomized controlled trials published between 1966 and 2020. Two investigators independently assessed risk of bias in the included studies, and data were pooled to calculate mean differences (MDs) for continuous outcomes and risk ratios (RRs) for dichotomous outcomes, together with 95% CIs. Meta-analysis was performed using a random- or fixed-effects model, depending on the heterogeneity in the data.Results:Included were 14 randomized controlled trials involving 1032 patients who underwent ACLR: 528 patients with bioabsorbable screws and 504 patients with metallic screws. The 2 groups did not differ significantly in International Knee Documentation Committee score (RR, 1.04; 95% CI, 0.97 to 1.11), Lysholm score (MD, 0.59; 95% CI, –0.46 to 1.63), range of motion deficit (RR, 0.95; 95% CI, 0.67 to 1.34), positive pivot-shift test (RR, 0.87; 95% CI, 0.61 to 1.24), positive Lachman test (RR, 0.82; 95% CI, 0.48 to 1.39), or KT-1000 arthrometer value (MD, 0.01; 95% CI, –0.16 to 0.18). However, bioabsorbable screws were associated with a significantly higher risk of complications (RR, 1.70; 95% CI, 1.16 to 2.50), such as graft rupture, joint effusion, and infection.Conclusion:The results of this review showed that there was no difference between metallic and bioabsorbable screws for ACLR in terms of subjective knee function or knee laxity, but metallic interference screws had fewer complications.

The association between gird and overhead throwing biomechanics in cricket

The development of GIRD is a well-documented adaptation associated with repetitive overhead throwing in numerous sports. In occurrence with total rotational range of motion deficit, GIRD is considered pathological and increases shoulder injury risk. While cricketers demonstrate these deficits in rotational range; the association between GIRD and overhead throwing has yet to be explored. Therefore, the aim of this study was to determine the relationship between GIRD and overhead throwing biomechanics in cricketers. Passive shoulder rotational range of motion was measured in 15 cricketers (elite = 8, amateur = 7). Kinetic and kinematic data were obtained during overhead throws from a stationary and run-up approach. Linear regression was used to determine potential relationships between GIRD and discrete shoulder kinetics for both throwing approaches. One-dimensional statistical parametric mapping regression was conducted to assess relationships between GIRD and throwing kinematics. When throwing overhead from a stationary position, GIRD was associated with reduced hip abduction during the preparatory arc (p = 0.002); superior shoulder (p = 0.003) and elbow compressive (p = 0.009) forces, at cocking. In addition, GIRD was associated with increased posterior shoulder force during arm deceleration for both stationary (p = 0.013) and run-up approaches (p = 0.03) to overhead throwing. Cricketers with GIRD utilise a shorter stride, creating early pelvic rotation and a slow throwing arm with an associated reduction in forces about the shoulder and elbow at cocking, when throwing from a stationary position. Further, overload of the posterior shoulder occurs during arm deceleration, irrespective of throwing approach. These findings highlight potential shoulder injury risk.

SEX, PATELLAR TENDON GRAFT, AND EARLY MOTION DEFICITS PREDICT ARTHROFIBROSIS AFTER PEDIATRIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

Background:Arthrofibrosis remains a concerning early complication after anterior cruciate ligament reconstruction (ACLR) in children and adolescents. Previous studies suggest that those receiving patellar tendon (PT) autograft may be at higher risk than hamstrings tendon (HT), but there is little data regarding this complication in patients receiving quadriceps tendon (QT) autograft.Purpose:The purpose of this study is to identify risk factors for arthrofibrosis following pediatric ACLR with attention to graft type.Methods:The medical records of patients that underwent primary ACLR at a single tertiary children’s hospital were reviewed for this retrospective cohort study. Those with multiligament reconstructions, lateral extra-articular tenodesis procedures, or a modified MacIntosh reconstruction were excluded. Arthrofibrosis was defined as a deficit of 10 degrees of extension and/or 20 degrees of flexion at 3 months after ACLR. Demographic data, intra-operative findings and techniques, and post-operative motion and complications were recorded. Univariate analysis was followed by purposeful entry logistic regression to control for confounding factors.Results:A total of 378 patients were included in the analysis, of which there were 180 PT, 103 HT, and 95 QT grafts. The mean age was 15.9±1.7 years and 188 (49.7%) were female. In univariate analysis, the rate of arthrofibrosis was 1.9% for HT, 6.3% for QT, and 10.0% for PT (p=0.04). Females developed arthrofibrosis more frequently than males (10.6% vs. 3.2%, p=0.004). Additionally, those that ultimately experienced this complication had lower median flexion at 6 weeks after ACLR (88 vs. 110 degrees, p<0.001). After controlling for covariates in a multivariate model, PT graft raised the odds of arthrofibrosis 6.2 times compared to HT (95% CI 1.4-27.6, p=0.02), but there were no significant differences between QT and other graft types. Females were at 4.2 times higher odds than males (95% CI 1.6-10.8; p=0.003). Patients that were unable to attain 90 degrees of flexion 6 weeks after ACLR had 14.7 times higher odds of eventually developing arthrofibrosis (95% CI 5.4-39.8; p<0.001). Finally, those with an extension deficit of ≥5 degrees 6 weeks after ACLR had 4.7 times higher odds of experiencing this complication (95% CI 1.8-12.2, p=0.001).Conclusion:After adjusting for multiple covariates, PT autograft, female sex, and motion deficits at 6 weeks after ACLR (<90 degrees of flexion or extension deficit ≥5 degrees) were predictive of arthrofibrosis in children and adolescents. Quadriceps tendon autograft did not increase the risk of this complication.

Q&amp;A: Rating Costochondritis

Q&amp;A: Rating Costochondritis

Range of motion and muscle strength deficits of patients with total hip arthroplasty after surgery

Background: T he aim of this study was to compare muscle strength and range of motion of the operated and unoperated side and to determine the relationship between the functional status and muscle strength and range of motion in patients with Total Hip Arthroplasty (THA) 1–3 years after surgery. Material and methods: 5 0 patients with THA were assessed after surgery in this study. A universal goniometer was used to measure the range of motion (ROM). Muscle strength was measured by a hand-held dynamometer. The patients’ functional status was determined with the Oxford Hip Score. Results: The difference in hip abduction and knee extension muscle strength between operated and unoperated side was statistically significant (p&lt;0.05). Also, there was a difference between the operated and unoperated side in the hip ROM in favor of the unoperated side in all ROM except adduction (p&lt;0.05). There was a moderate correlation between OHS and muscle strength. Conclusions: This study emphasizes the importance that these patients need physiotherapy programs in the long term and should be followed up regularly by healthcare professionals in the rehabilitation area. Finally, restoring muscle strength and range of motion is recommended to improve the functional state in daily life activities.

Silicone and Pyrocarbon Artificial Finger Joints.

Artificial finger joint design has been developed through different stages through the past. PIP (proximal interphalangeal) and MCP (metacarpophalangeal) artificial finger joints have come to replace the amputation and arthrodesis options; although, these artificial joints are still facing challenges related to reactive tissues, reduced range of motion, and flexion and extension deficits. Swanson silicone artificial finger joints are still common due to the physician's preferability of silicone with the dorsal approach during operation. Nevertheless, other artificial finger joints such as the pyrocarbon implant arthroplasty have also drawn the interests of practitioners. Artificial finger joint has been classified under three major categories which are constrained, unconstrained, and linked design. There are also challenges such as concerns of infections and articular cartilage necrosis associated with attempted retention of vascularity. In addition, one of the main challenges facing the silicone artificial finger joints is the fracture occurring at the distal stem with the hinge. The aim of this paper is to review the different artificial finger joints in one paper as there are few old review papers about them. Further studies need to be done to develop the design and materials of the pyrocarbon and silicone implants to increase the range of motion associated with them and the fatigue life of the silicone implants.

Predictors of Arthrofibrosis After Pediatric Anterior Cruciate Ligament Reconstruction: What Is the Impact of Quadriceps Autograft?

Recent literature on arthrofibrosis after anterior cruciate ligament reconstruction (ACLR) in children and adolescents is limited, especially with regards to quadriceps tendon (QT) autograft. The purpose of this study was to identify predictors of arthrofibrosis after ACLR, with attention to the impact of graft type. Patients that underwent primary ACLR at a tertiary children's hospital were reviewed for this retrospective case-control study. Those with multiligament reconstructions, lateral extra-articular tenodesis procedures, allografts, or a modified MacIntosh reconstruction were excluded. Arthrofibrosis was defined as a deficit of 10 degrees of extension and/or 20 degrees of flexion at 3 months after ACLR. Univariate analysis was followed by purposeful entry logistic regression to adjust for confounding factors. A total of 378 patients (mean age 15.9±1.7 y, 49.7% female) were included in the analysis, of which there were 180 patellar tendon (PT), 103 hamstrings tendon (HT), and 95 QT grafts. The rate of arthrofibrosis was 1.9% for HT, 6.3% for QT, and 10.0% for PT (P=0.04). Females developed arthrofibrosis more frequently than males (10.6% vs. 3.2%, P=0.004). Those that ultimately experienced this complication had lower median flexion at 6 weeks after ACLR (88 vs. 110 degrees, P<0.001). In multivariate analysis, PT graft raised the odds of arthrofibrosis 6.2 times compared to HT [95% confidence interval (CI): 1.4-27.6, P=0.02], but there were no significant differences between QT and other grafts. Females were at 4.2 times higher odds than males (95% CI: 1.6-10.8; P=0.003). Patients that were unable to attain 90 degrees of flexion 6 weeks after ACLR had 14.7 times higher odds of eventually developing arthrofibrosis (95% CI: 5.4-39.8; P<0.001). Finally, those with an extension deficit of ≥5 degrees 6 weeks after ACLR had 4.7 times higher odds of experiencing this complication (95% CI: 1.8-12.2, P=0.001). The rate of arthrofibrosis with QT autograft is 6.3% after pediatric ACLR. PT autograft, female sex, and motion deficits at 6 weeks after ACLR were predictive of arthrofibrosis in children and adolescents. Level III-prognostic study.

Acute compartment syndrome in pediatric patients: a case series.

Pediatric acute compartment syndrome (ACS) is an orthopedic emergency which requires timely recognition and management. There are unique considerations in children, as they may present with a wide array of symptoms and capacities to communicate. We sought to investigate the presentations, treatments and outcomes of pediatric ACS, hypothesizing that decompressive fasciotomy results in good outcomes, even with delayed treatment (>24 h). We performed a retrospective review of pediatric ACS from 2009 to 2018. Exclusion criteria were age ≥18 years, exertional compartment syndrome, and incomplete data. Twenty-one patients (mean age 11 years) were included. Swelling (100%) and worsening pain (100%) were the most common presenting signs and symptoms followed by paresthesias (75%). Increasing analgesia requirements were documented in six (29%) patients. Compartment pressures were measured in 52% of patients. All patients were managed with decompressive fasciotomies, which were performed at a median time of 20 h from injury. Strength and range of motion deficits (10%) were the most commonly reported complications. There were no infections. All patients who were treated in a delayed fashion (≥24 h) were found to have a good functional recovery, but 38% had minor complications. Overall, patients had good outcomes, achieving full functional recovery with return to preinjury activity level. Pediatric ACS should be approached as a distinct clinical entity from adult ACS, where risks of infection and wound complications from delayed fasciotomy generally outweigh the benefits. We recommend considering decompressive fasciotomy for all cases of pediatric ACS, including those with prolonged time from injury to diagnosis.

Q&amp;A: Rating an Adductor Longus Tendon Tear

Q&amp;A: Rating an Adductor Longus Tendon Tear

Limiting the Pitch Count in Youth Baseball Pitchers Decreases Elbow Pain.

Background:Reducing the number of pitches thrown is regarded as the most effective way to prevent throwing injuries in youth baseball pitchers. However, few studies have compared the effectiveness of limiting the pitch count versus the limiting the number of innings pitched in terms of elbow injuries.Hypothesis:We hypothesized that, compared with inning limits, pitch count limits would lead to greater decreases in elbow pain, range of motion deficits, positive moving valgus stress test results, and the risk of capitellar osteochondritis dissecans (OCD).Study Design:Cohort study; Level of evidence, 3.Methods:This study retrospectively reviewed baseball pitchers aged 8 to 12 years in 2017 and 2018. Inning and pitch count limits in games were set to a daily maximum of 7 innings in 2017 and 70 pitches in 2018. Elbow pain, range of motion, and moving valgus stress test results were evaluated. The presence of capitellar OCD was assessed on ultrasonographic and radiographic images.Results:A total of 352 pitchers in 2017 and 367 pitchers in 2018 participated. The mean pitch count per game was lower in the pitch count limit (CL) group (52.5 ± 16.0) than in the inning limit (IL) group (98.2 ± 19.5) (P < .001). Compared with the IL group, the CL group had significantly lower rates of elbow pain (40.9% vs 31.9%, respectively; P = .01) and reduced flexion (19.0% vs 10.6%, respectively; P = .001). Multivariate analysis revealed a significant association between elbow pain and age in both the IL and the CL groups (P < .0001 and P = .02, respectively) and between OCD and elbow pain in the CL group (P = .04).Conclusion:A pitch count limit of ≤70 pitches per day for baseball pitchers ≤12 years could be more protective against elbow pain and reduced flexion than a limit of ≤7 innings per day, but it may not be effective for reducing the risk of capitellar OCD.

Posttraumatische Schultersteife

Posttraumatic stiffness of the shoulder joint is a frequent and socioeconomically relevant result of injury; however, prior to making the diagnosis as the only cause of a persisting impairment of motion, it is necessary to rule out other sequelae of trauma. Even intensive conservative treatment is mostly accompanied by the stagnation of the impairments of movement. In many cases the treatment of choice is early arthroscopic arthrolysis with a standardized approach and intensive follow-up treatment. In the surgical treatment of proximal humeral fractures with humeral head preservation, arthroscopic arthrolysis with simultaneous implant removal is a form of planned second intervention for improvement of shoulder function in cases of persisting motion deficits after bony consolidation. Despite sometimes substantial limitations of movement, a clinically relevant and lasting improvement of shoulder function can be achieved with arthroscopic arthrolysis in posttraumatic shoulder stiffness.

Histiocytosis in the pediatric spine: a clinical and radiographic analysis of 50 patients.

Descriptive, retrospective. Scientific level of evidence IV. The aim of this study was to evaluate a consecutive case series of 50 pediatric patients with LCH of the spine. Langerhans cell histiocytosis (LCH) is a rare disease characterized by abnormal proliferation of Langerhans cells in different organs. Incidence in children range from 2 to 10 cases per million. In the current literature, few series evaluate LCH in the pediatric spine. A consecutive case series of 50 pediatric patients with LCH of the spine treated at our hospital between 1984 and 2016, with a follow-up of at least 2years, was analyzed. Sex, age, clinical and radiographic presentation, number of lesions, treatment, complications, and outcome were assessed. Fifty patients, 26 boys and 24 girls, were evaluated. Mean age was 5years and 2months (6months to 13years and 3months). 27 patients had a single spinal lesion while 23 had 2 or more lesions. A total of 100 vertebrae were involved. The thoracic spine was the most affected. The most frequent lesion location was in the vertebral body in 88% of the cases. The symptoms were pain (87%), reduced range of motion, deformity, and neurologic deficit. Biopsy was performed in 48 patients. Thirty-nine patients received medical treatment, 28 used orthoses and six required surgery. Six patients (12%) recurred at a mean of 3years and 5months (range 2-12years). In all cases, neurological symptoms, torticollis, and deformities resolved after medical or surgical treatment. Because of the variable presentation of the disease, ranging from a solitary isolated vertebral lesion to polyostotic and multisystemic involvement, a multidisciplinary team is required to have an adequate management of these patients and to obtain good results.

Cortical thickness of primary visual cortex correlates with motion deficits in periventricular leukomalacia

Impairments of visual motion perception and, in particular, of flow motion have been consistently observed in premature and very low birth weight subjects during infancy. Flow motion information is analyzed at various cortical levels along the dorsal pathways, with information mainly provided by primary and early visual cortex (V1, V2 and V3). We investigated the cortical stage of the visual processing that underlies these motion impairments, measuring Grey Matter Volume and Cortical Thickness in 13 children with Periventricular Leukomalacia (PVL). The cortical thickness, but not the grey matter volume of area V1, correlates negatively with motion coherence sensitivity, indicating that the thinner the cortex, the better the performance among the patients. However, we did not find any such association with either the thickness or volume of area MT, MST and areas of the IPS, suggesting damage at the level of primary visual cortex or along the optic radiation.

Hamstring Structural Injury in Futsal Players. The Effect of Active Range of Motion (AROM) Deficit on Rehabilitation Period

Hamstring Structural Injury in Futsal Players. The Effect of Active Range of Motion (AROM) Deficit on Rehabilitation Period

ARTHROSCOPIC LATARJET STABILISATION PROCEDURE – CLINICAL AND RADIOLOGICAL SHORT TERM OUTCOMES IN THE FIRST 101 CASES

Introduction and aim Latarjet remains one of the most efficient stabilisation procedures in anterior shoulder instability. The goal of this study was to evaluate the clinical outcomes and radiological parameters after arthroscopic Latarjet. Material and methods Between 2011–2016 an arthroscopic Latarjet stabilisation was performed in 104 patients, who were controlled with clinical examination, X-ray and CT-scans at a minimum follow up of 13 months. Results 101 shoulders (97.1%) were available for clinical evaluation. The mean follow-up was 23.8 months (13 to 50). 96 shoulders (95%) had CT scan evaluation. Patients satisfaction was evaluated as 92%, SSV 88%, Walch-Duplay and Rowe scores respecitvely 77 and 80 points. The mean external rotation loss was 17° with no further motion deficits. Recurrence was reported in 4 (4%) patients. 2 out of 4 cases of recurrence had intraoperative complications (correlation in M-L Chi2 test p = 0.0107). Revision surgery was performed in 10 patients (9.8%). CT evaluation showed 95.8% of graft fusion rate, 1 case (1%) of total graft osteolysis, 2 cases (2.1%) of graft pseudoarthrosis and 2 cases (2.1%) of graft fracture. Conclusions The arthroscopic Latarjet demonstrates satisfactory results in short term follow-up. Some factors influencing the outcome are: intraoperative graft related complications (correlated strongly with recurrence), subjective return to sport anxiety and loss of external rotation (correlated with worsened clinical outcome).

Role of Kinematics Assessment and Multimodal Sensorimotor Training for Motion Deficits in Breast Cancer Chemotherapy-Induced Polyneuropathy: A Perspective on Virtual Reality Avatars.

Chemotherapy-induced polyneuropathy (CIPN), one of the most severe and incapacitating side effects of chemotherapeutic drugs, is a serious concern in breast cancer therapy leading to dose diminution, delay, or cessation. The reversibility of CIPN is of increasing importance since active chemotherapies prolong survival. Clinical assessment tools show that patients experiencing sensorimotor CIPN symptoms not only do they have to cope with loss in autonomy and life quality, but CIPN has become a key restricting factor in treatment. CIPN incidence poses a clinical challenge and has lacked established and efficient therapeutic options up to now. Complementary, non-opioid therapies are sought for both prevention and management of CIPN. In this perspective, we explore the potential that digital interventions have for sensorimotor CIPN rehabilitation in breast cancer patients. Our primary goal is to emphasize the benefits and impact that Virtual Reality (VR) avatars and Machine Learning have in combination in a digital intervention aiming at (1) assessing the complete kinematics of deficits through learning underlying patient sensorimotor parameters, and (2) parameterize a multimodal VR simulation to drive personalized deficit compensation. We support our perspective by evaluating sensorimotor effects of chemotherapy, the metrics to assess sensorimotor deficits, and relevant clinical studies. We subsequently analyse the neurological substrate of VR sensorimotor rehabilitation, with multisensory integration acting as a key element. Finally, we propose a closed-loop patient-centered design recommendation for CIPN sensorimotor rehabilitation. Our aim is to provoke the scientific community toward the development and use of such digital interventions for more efficient and targeted rehabilitation.

Physical therapy evaluation and treatment in distal radius fracture: a case report

Introduction: subjects who have suffered DRF submitted immobilization may have a loss in active range of motion and functional deficit. Objectives: evaluate changes in the wrist and verify the effectiveness of physical therapy intervention used in the treatment of DRF. Methods: a physiotherapy evaluation form, goniometry and Visual Analogue Scale were used to assess the patient. A treatment protocol was applied for seven sessions. Results: the results showed reduced pain and increased range of motion of the wrist. Conclusion: there were changes as pain and reduced range of motion of the wrist. The treatment protocol was effective for these changes.