Motion Of Shoulder Joint Research Articles

Effects of adding core stability training to conventional rehabilitation protocol on shoulder function after rotator cuff repair

Background. Rotator cuff tear (RCT) is a prevalent cause leading to shoulder disability and is widely recognized as one of the primary causes of pain as well as dysfunction in the shoulder. The core stabilization exercise program improved the strength of the shoulder muscles. The core stability training (CST) may be utilized during the early phases of shoulder rehabilitation. Purpose. To assess the impacts of adding CST to the conventional rehabilitation protocol on function, proprioception, as well as range of motion (ROM) of shoulder joint following rotator cuff repair (RCR). Methods. Fifty-two participants after RCR were assigned to two groups in a random manner; group I (n = 26) and group II (n = 26). Participants in groups I and II were engaged in a conventional rehabilitation protocol for 12 weeks after RCR. Group II additionally performed CST after the 8th week until the 12th week of RCR. Outcome measures were shoulder function using the Arabic shoulder pain and disability index (SPADI), shoulder joint position sense (JPS) (proprioception accuracy through detecting absolute angle of error) using digital inclinometer, ROM in shoulder flexion, abduction, internal rotation, as well as external rotation using the digital inclinometer. Unpaired t-test, chi square, and MANOVA test were implemented for data analysis. Results. Compared to the pre-treatment condition, the post treatment results revealed that there were statistical substantial improvements (p < 0.05) in SPADI score, absolute angle of error, and ROM flexion, abduction, external rotation and internal rotation) in both groups, even though there were substantial differences among both groups at all post-treatment measures (p < 0.05) in favor of group II. Conclusion. Incorporating CST into the conventional rehabilitation protocol after RCR leads to notable enhancements in shoulder joint function, proprioception, and ROM for flexion, abduction, internal rotation, as well as external rotation.

Developing biomimetic PVA/PAA hydrogels with cellulose nanocrystals inspired by tree frog structures for superior wearable sensor functionality

This study developed a wearable sensor device featuring biomimetic structures inspired by tree frog toe pads to measure shoulder joint movements effectively. A PVA/PAA double-network hydrogel was formulated by mixing PVA and PAA in a 3:7 ratio, resulting in a Young's modulus of 7.2 kPa, closely matching human skin's mechanical properties. To enhance moisture retention, the hydrogel was supplemented with 20 mL glycerin, increasing its weight retention rate to 95 % after 28 days, a 5.6-fold improvement over glycerin-free hydrogels. Additionally, the incorporation of 0.2 wt% cellulose nanocrystals (CNC) increased the cross-linking density, reducing the swelling ratio from 124 % to 106 % and minimizing the impact of swelling cycles on mechanical properties from 22 % to 4 %. Treefrog-inspired microstructures were fabricated on the sensor surface using laser cutting and casting techniques, significantly enhancing adhesion under humid conditions, with normal, lateral, and peel-off adhesion forces improving by 500, 700, and 700 %, respectively. The sensor demonstrated accurate measurement of shoulder joint movements with an error margin of 6.3 % for polar angles (45°-135°) and 7.8 % for azimuth angles (0°-45°). The accompanying smartphone application provided real-time feedback, helping to prevent exercise injuries and improve user awareness and control of shoulder movements, making it suitable for both rehabilitation and athletic training.

Arthroscopic shoulder surgery for gouty long head of biceps tendinitis: a case report

ObjectiveThe objective of the case report is to analyze the clinical manifestations and imaging features of gouty long head of biceps tendinitis, and to summarize the methods and effects of shoulder arthroscopic surgery.Clinical presentation and interventionThe clinical data of a 39-year-old Han Chinese female with gouty long head of the biceps tendinitis was retrospectively analyzed, and the clinical manifestations, imaging features, and diagnosis and treatment were analyzed. The patient presented with pain and limited movement of right shoulder joint. Computed tomography showed irregular high-density shadows above the glenoid and adjacent to the coracoid process of the right shoulder. Magnetic resonance imaging revealed superior labrum anterior and posterior injury with edema in the upper recess and axillary sac. After arthroscopic surgery, the “tofu residue” tissue of the long head of the biceps was removed, and the postoperative pathological examination proved that it was gout stone.ConclusionGouty long head of the biceps tendinitis is a rare disease. Arthroscopic surgery can probe the structural lesions of shoulder cavity in all aspects, improve the surgical accuracy, and reduce the trauma.

Short-Term Effects of Cold Therapy and Kinesio Taping on Pain Relief and Upper Extremity Functionality in Individuals with Rotator Cuff Tendonitis: A Randomized Study.

Background and Objectives: Rotator cuff tendonitis (RCT) is one of the most common shoulder pathologies. It causes pain, limits shoulder joint movements, and impairs function. Despite various treatment methods, there are currently no specific guidelines regarding the most effective intervention for RCT. To the best of our knowledge, no studies have compared the effects of Kinesio taping (KT) and cold therapy (CT) on individuals with RCT. To this end, this study aimed to investigate and compare the short-term effects of KT and CT on pain relief and upper extremity functionality in individuals with RCT. Materials and Methods: One hundred and fourteen individuals were assessed for eligibility. Fifty-two individuals with RCT who met the inclusion criteria and agreed to participate were randomly allocated into either the KT or the CT group. A standardized home exercise program was given to all the participants. Their pain intensity, upper extremity function, shoulder range of motion (ROM), and grip strength were evaluated initially and after the three days of KT or CT applications. Results: All the assessment values significantly improved in the KT group. In the CT group, only the pain scores (except for the numerical rating scale (NRS) pain score during activity) were significantly improved in the CT group at the end of the third day of application compared to the initial values (p < 0.05). For all the measurement outcomes, the effects of time × group interactions were statistically significant (p < 0.05) in favor of the KT group, except for the resting pain (p = 0.688). Conclusions: The findings suggest that KT and CT could be used as adjunctive modalities to exercise for resting and night pain relief in patients with RCT. KT also had positive effects on the activity pain, function, ROM, and grip strength. The use of KT along with an exercise program could be a more effective therapeutic choice than the use of CT for improving night pain, activity pain, and upper extremity function during the short-term rehabilitation of RCT patients.

Magnitude and direction of shoulder torque asymmetries between different angular velocities in competitive swimmers

ABSTRACT Asymmetries in swimming can be the result of poor technique or coordination between limbs, reducing the ability to produce propulsive force and increasing resistive drag. Therefore, this study aimed to compare the magnitude and determine the consistency of isokinetic peak torque asymmetries between the angular velocities of in the shoulder joint movements of internal and external rotation, flexion, and extension. Twenty-one competitive swimmers performed concentric actions at 60°/s (3 repetitions) and 180°/s (20 repetitions) in the movements of internal and external rotation, flexion, and extension of the shoulders using an isokinetic dynamometer, with the peak torque and asymmetry index being common metrics across the tests. The results showed a greater magnitude of asymmetry in internal rotation (16.86 vs. 9.86; p = 0.007) and flexion (12.06 vs. 7.35; p = 0.008) at 60 vs. 180°/s, respectively. The agreement levels of the direction of asymmetries between angular velocities were fair to substantial (Kappa: 0.40 to 0.69). Evaluating isokinetic torque in different movements and angular velocities resulted in different levels of asymmetry. Muscle force asymmetries can impact propulsion efficiency and movement coordination during swimming. Understanding muscle asymmetries allows the development of targeted and individualised training programmes to correct strength imbalances.

Surgical accidents and postoperative complications of recurrent shoulder dislocation treated by suture button fixation with bone occlusion

To summarize the surgical accidents and postoperative complications of the treatment of recurrent shoulder dislocation by suture button fixation and bone occlusion, and to provide clinical reference. The clinical data of 16 patients with recurrent shoulder dislocation treated with modified arthroscopic Latarjet suture button fixation and bone occlusion between July 2017 and April 2023 were retrospectively analyzed. Among them, 15 were male and 1 was female. The age ranged from 16 to 45 years, with an average of 26 years. Admission examination showed the range of motion of shoulder joint was normal; the shoulder joint fear test was positive; En-face CT scan measured 10%-20% of the glenoid defects, averaging 13.4%; and MRI examination revealed bone Bankart injury. The disease duration ranged from 2 to 20 years, with an average of 7.1 years. The shoulder joint was dislocated 8- 45 times, with an average of 17.4 times, and the shoulder joint was unstable. The occurrence of surgical accidents and postoperative complications as well as corresponding measures and outcomes were recorded. All the incisions healed by first intention without any complications such as incision infection or vascular injury. All 16 cases were followed up for an average of 3.6 years (range, 1-7 years), and no shoulder redislocation occurred. Four types of intraoperative surgical accidents and two types of postoperative complications occurred in the early stage of implementation of the technique. Intraoperative surgical accidents included 1 case of difficulty in passing subscapular muscle through coracotomy with large size, which was treated with exchange rod or finger through subscapular muscle split; 2 cases of coracoidal process fracture, of which 1 case was treated conservatively, and the other case was sutured to the base of tendon and fixed through tunnel; 1 case of glenoid fracture occurred in the glenoid tunnel, which was fixed with knot-free anchors; the posterior loop plate fixation was abnormal in 2 cases, of which 1 case was re-fixed and the other case was renovated. Postoperative complications included coracoid bone mass displacement in 1 case, conservative biceps rehabilitation was given to avoid premature external rotation; 1 case of radial nerve injury of healthy upper limb and musculocutaneous nerve injury of affected side was given oral medication and physiotherapy. The above conditions recovered well after corresponding treatment. Suture button fixation with bone occlusion is a safe method for the treatment of recurrent shoulder dislocation. Careful operation should be performed during coracoid interception and glenoid tunnel drilling, especially in the fixation process.

Evaluation of the effect of Bala Tailam Nasya and Baladi Kwatha Pana in the management of Avabahuka - A Pilot Study

Avabahuka is a disease mainly affects the Amsa Sandhi (shoulder joint) which is painful, affecting the normal routine life style of an individual. The sedentary and restless lifestyles of people, and lack of priority to physical exercise, have an effect on the body that can cause disease. The main Dosha involved Avabahuka is Vatadosha and the treatment adopted for this are like Snayu-Sandhi-Asthi-Gata-Vata treatment. In Frozen Shoulder synovial inflammation occurs followed by capsular fibrosis. The shoulder joint becomes gradually painful and stiff with a reduction in range of motion. The current pilot study aim is to investigate the impact of Nasya with Baladi Taila and Baladi Kwath in Avabahuka. There are references for Nasya Karma in Avabahuka. Acharya Sushruta and others have considered it as Vataja Vikara. Amsa Shosha can be considered a pre-disease stage in which loss or dryness of the Shleshaka Kapha is found, as well as other symptoms like Shula during movement of shoulder joint.

Development of a musculoskeletal shoulder model considering anatomic joint structures and soft-tissue deformation for dynamic simulation.

The shoulder joint has a high degree of freedom and an extremely complex and unstable kinematic mechanism. Coordinated contraction of the rotator cuff muscles that stop around the humeral head and the deltoid muscles and the extensibility of soft tissues, such as the joint capsule, labrum, and ligaments, contribute to shoulder-joint stability. Understanding the mechanics of shoulder-joint movement, including soft-tissue characteristics, is important for disease prevention and the development of a device for disease treatment. This study aimed to create a musculoskeletal shoulder model to represent the realistic behavior of joint movement and soft-tissue deformation as a dynamic simulation using a rigid-body model for bones and a soft-body model for soft tissues via a spring-damper-mass system. To reproduce the muscle-contraction properties of organisms, we used a muscle-expansion representation and Hill's mechanical muscle model. Shoulder motion, including the movement of the center of rotation in joints, was reproduced, and the strain in the joint capsule during dynamic shoulder movement was quantified. Furthermore, we investigated narrowing of the acromiohumeral distance in several situations to induce tissue damage due to rotator cuff impingement at the anterior-subacromial border during shoulder abduction. Given that the model can analyze exercises under disease conditions, such as muscle and tendon injuries and impingement syndrome, the proposed model is expected to help elucidate disease mechanisms and develop treatment guidelines.

A dataset for fatigue estimation during shoulder internal and external rotation movements using wearables

Wearable sensors have recently been extensively used in sports science, physical rehabilitation, and industry providing feedback on physical fatigue. Information obtained from wearable sensors can be analyzed by predictive analytics methods, such as machine learning algorithms, to determine fatigue during shoulder joint movements, which have complex biomechanics. The presented dataset aims to provide data collected via wearable sensors during a fatigue protocol involving dynamic shoulder internal rotation (IR) and external rotation (ER) movements. Thirty-four healthy subjects performed shoulder IR and ER movements with different percentages of maximal voluntary isometric contraction (MVIC) force until they reached the maximal exertion. The dataset includes demographic information, anthropometric measurements, MVIC force measurements, and digital data captured via surface electromyography, inertial measurement unit, and photoplethysmography, as well as self-reported assessments using the Borg rating scale of perceived exertion and the Karolinska sleepiness scale. This comprehensive dataset provides valuable insights into physical fatigue assessment, allowing the development of fatigue detection/prediction algorithms and the study of human biomechanical characteristics during shoulder movements within a fatigue protocol.

Factors influencing shoulder stiffness after open reduction and internal fixation of proximal humeral fractures.

The study aimed to investigate the factors associated with shoulder stiffness following open reduction and internal fixation (ORIF) of proximal humeral fractures. The retrospective study included a total of 151 patients who underwent ORIF of proximal humeral fractures between January 2016 and May 2021. Based on their shoulder joint motion at the latest follow-up, the patients were divided into two groups. The stiffness group (n=32; 8 males, 24 females; mean age: 62.4±9.3 years; range, 31 to 79 years), exhibited restricted shoulder forward flexion (<120°), limited arm lateral external rotation (<30°), and reduced back internal rotation below the L3 level. The remaining patients were included in the non-stiffness group (n=119; 52 males, 67 females; mean age: 56.4±13.4 years; range, 18 to 90 years). Various factors were examined to evaluate the association with shoulder stiffness following ORIF of proximal humeral fractures by multivariate unconditional logistic regression models. The mean follow-up duration was 31.8±12.6 (range, 12 to 68) months. Based on the results of the multivariate regression analysis, it was found that high-energy injuries [compared to low-energy injuries; adjusted odds ratio (aOR)=7.706, 95% confidence interval (CI): 3.564-15.579, p<0.001], a time from injury to surgery longer than one week (compared to a time from injury to surgery equal to or less than one week; aOR=5.275, 95% CI: 1.7321-9.472, p=0.031), and a body mass index (BMI) >24.0 kg/m2 (compared to a BMI between 18.5 and 24.0 kg/m2 ; aOR=4.427, 95% CI: 1.671-11.722, p=0.023) were identified as risk factors for shoulder stiffness following ORIF of proximal humeral fractures. High-energy injury, time from injury to surgery longer than one week, and BMI >24.0 kg/m2 were identified as independent risk factors for shoulder stiffness after proximal humeral fracture surgery, which should be treated with caution in clinical treatment.

Frozen shoulder release: Ten-step technique

Frozen shoulder is a condition associated with painful restriction of shoulder joint movement. This condition has a prevalence of 2–5% in the general population, seen most often in females and the diabetic population. It is essentially a self-limiting condition passing through stages of freezing, frozen, and thawing. It has been reported that up to 90% of patients recover with conservative measures. Patients with more severe initial symptoms, younger age at the time of onset, and reduction in motion despite four months of compliance with therapy are most likely to require surgery. The author presents ten-step techniques for frozen shoulder release in cases of failed conservative trials in the management of frozen shoulder.

Omuz İmplantı Sınıflandırmasında Görü Dönüştürücü Tabanlı Modellerin Performans Karşılaştırması

Total Shoulder Arthroplasty (TSA) is a surgical procedure addressing severe pain and restricted shoulder joint movement. During TSA surgery, X-ray images guide the selection of the prosthetic implant suitable for the patient from a variety of models produced by different manufacturers. However, prostheses may wear or loosen over time, thus requiring periodic evaluation and replacement. Currently, the process involves taking new X-ray images from patients, resulting in variability in expert opinions on implant types. Automated systems can provide objective assessments, saving time and effort. In this study, we present a performance comparison of Vision Transformer (ViT) based models for automatic shoulder implant classification from X-ray images. Fine-tuning pre-trained ViT models on a shared dataset showed high success in accuracy, precision, sensitivity, and F-measure metrics. This approach can provide reliable identification of shoulder implant manufacturers and model information and time efficiency, especially for specialists, contributing to improving treatment planning.

Short-term effects of a new resistance exercise approach on physical function during chemotherapy after radical breast cancer surgery: a randomized controlled trial

BackgroundApproximately 30% of post-operative breast cancer patients develop shoulder joint movement disorders affecting routine upper limb movement. This study discusses the impact of a neuromuscular joint facilitation (NJF) method on the physical function of breast cancer patients experiencing shoulder dysfunction during chemotherapy after radical surgery.MethodsThis study included 162 female patients who have unilateral breast cancer in a cancer hospital in China. They developed shoulder joint mobility disorders during chemotherapy within 1–3 months postoperatively. These patients were divided into three groups: NJF, conventional rehabilitation (conventional group), and control groups. The clinical examination included the maximum passive and active range of motion (ROM) of the shoulder (flexion, extension, abduction, adduction, and external and internal rotation). Other evaluations included a pain score using a visual analog scale (VAS), grip strength, and supraspinatus muscle thickness. All tests were evaluated pre-and post-intervention.ResultsThe NJF group showed a significant increase in all shoulder ROM angles post-intervention. In the conventional group, all other ROM values increased significantly, except passive external rotation ROM. In the control group, all other ROM values increased significantly, except passive and active external rotation ROM. All three groups had decreased VAS scores, increased grip strength, and supraspinatus muscle thickness post-intervention during active abduction. In the control group, the supraspinatus contraction rate decreased significantly at 60° and 90° abduction post-intervention compared to that at pre-intervention.ConclusionThis study revealed that NJF during chemotherapy had positive clinical intervention effects, improving shoulder joint mobility disorders, pain, grip strength, and external rotation following radical breast cancer surgery.Clinical trial registrationChinese Clinical Trial Registry; https://www.chictr.org.cn/ (ChiCTR2300073170), registered (03/07/2023).

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

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

Comparison of Functional Outcomes and Complications of Inlay and Onlay Reverse Shoulder Arthroplasty in Neer Type 4 Proximal Humerus Fractures and Cuff Tear Arthropathy: A Multicentric Study.

This multicenter retrospective study was conducted with the objective of comparing the outcomes and complications between inlay and onlay reverse shoulder arthroplasty (RSA) in patients presenting Neer Type 4 proximal humerus fractures and cuff tear arthropathy. The primary aim of this investigation was to assess and juxtapose the clinical as well as functional outcomes of individuals who underwent onlay reverse shoulder arthroplasty with those who underwent inlay reverse shoulder arthroplasty. A retrospective cohort study was conducted, involving patients who had undergone reverse shoulder arthroplasty between the period of 2016 and 2022. The study divided the population into two groups: Group A received inlay humeral components, while Group B received onlay humeral components. Functional outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) and Constant scores. Range of motion, infection, periprosthetic fractures, and nerve injuries were also assessed. The study included 67 patients in Group A and 62 patients in Group B. Group A had significantly better functional outcomes, as indicated by higher ASES and Constant scores (p < 0.05). Group A also had greater shoulder joint motion (p < 0.05). Periprosthetic fractures were significantly more common in Group B (p < 0.05). However, complication rates, including infection and instability, did not significantly differ between the groups (p > 0.05). Nerve injuries occurred in both groups, with slightly higher occurrence in Group B. Inlay humeral components in reverse shoulder arthroplasty for Neer Type 4 fractures and cuff tear arthropathy resulted in better functional outcomes, increased range of motion, and lower incidence of periprosthetic fractures compared to onlay components. Onlay components showed potential advantages in reducing instability rates. Further studies with larger samples and standardized protocols are needed to confirm these findings.

Preliminary application of foldable pedicled latissimus dorsi myocutaneous flap for repairing soft tissue defects in shoulder and back

To explore the feasibility and effectiveness of a foldable pedicled latissimus dorsi myocutaneous flap to repair soft tissue defects in the shoulder and back. Between August 2018 and January 2023, the foldable pedicled latissimus dorsi myocutaneous flaps were used to repair soft tissue defects in the shoulder and back of 8 patients. There were 5 males and 3 females with the age ranged from 21 to 56 years (mean, 35.4 years). Wounds were located in the shoulder in 2 cases and in the shoulder and back in 6 cases. The causes of injury were chronic infection of skin and bone exposure in 2 cases, secondary wound after extensive resection of skin and soft tissue tumor in 4 cases, and wound formation caused by traffic accident in 2 cases. Skin defect areas ranged from 14 cm×13 cm to 20 cm×16 cm. The disease duration ranged from 12 days to 1 year (median, 6.6 months). A pedicled latissimus dorsi myocutaneous flap was designed and harvested. The flap was divided into A/B flap and then were folded to repair the wound, with the donor area of the flap being pulled and sutured in one stage. All 7 flaps survived, with primary wound healing. One patient suffered from distal flap necrosis and delayed healing was achieved after dressing change. The incisions of all donor sites healed by first intention. All patients were followed up 6 months to 4 years (mean, 24.7 months). The skin flap has a good appearance with no swelling in the pedicle. At last follow-up, 6 patients had no significant difference in bilateral shoulder joint motion, and 2 patients had a slight decrease in abduction range of motion compared with the healthy side. The patients' daily life were not affected, and linear scar was left in the donor site. The foldable pedicled latissimus dorsi myocutaneous flap is an ideal method to repair the soft tissue defect of shoulder and back with simple operation, less damage to the donor site, and quick recovery after operation.

Electromyographic biofeedback therapy for improving limb function after stroke: A systematic review and meta-analysis.

Upper and lower limb impairment is common after stroke. Electromyographic biofeedback therapy is a non-invasive treatment, and its effectiveness in functional rehabilitation of the limb after stroke still remains uncertain. The objective of this study was to evaluate whether electromyographic biofeedback can improve upper and lower limb dysfunction in stroke patients. PubMed, Embase, Cochrane Library, and Physiotherapy Evidence Database (PEDro) were searched from inception to 1st May 2022. Inclusion criteria were randomized controlled clinical trials of electromyographic biofeedback therapy interventions reporting changes in upper and lower limb function in post-stroke patients. Data were extracted by two independent reviewers and pooled in random-effects models using Review manager (RevMan) software. Our analyses included 10 studies enrolling a total of 303 participants. Electromyographic biofeedback therapy can effectively improve limb function after stroke (standardized mean difference [SMD], 0.44; 95% confidence interval [CI], 0.12-0.77; P = 0.008) and in subgroup analyses, the effect sizes of short-term effect (SMD, 0.33; 95% CI, 0.02-0.64; P = 0.04) was significant, but the long-term was not (SMD, 0.61; 95% CI, -0.11-1.33; P = 0.10). In addition, Electromyographic biofeedback therapy can improve the active range of motion of shoulder (SMD, 1.49; 95% CI, 2.22; P<0.0001) and wrist joints (SMD, 0.77; 95% CI, 0.13-1.42; P = 0.02) after stroke. In this meta-analysis, electromyographic biofeedback therapy intervention can improve upper and lower limb function in patients with stroke. Short-term (less than one month) improvement after electromyographic biofeedback therapy was supported, while evidence for long-term (more than one month) benefits was lacking. Range of motion in the glenohumeral and wrist joints were improved. Stronger evidence for individualized parameters, such as optimal treatment parameters and intervention period, is needed in the future. [https://www.crd.york.ac.uk/prospero/display_record.php?recordID=267596], identifier [CRD42022354363].

Ayurvedic Panchakarma Management of Avabahuka - A Case Report

Background: Avabahuka is the disease of Amsa Sandhi (shoulder joint), which involves the neuromuscular system. The clinical features of Avabahuka are pain, stiffness, and restricted shoulder joint movement. In this study, Sahachar (Barleria prionitis Linn.) Taila was used for Snehana, and Patra Pottali (Ayurvedic Herbal Bolus) was used for Swedana containing leaves of medicinal plants. Aim and objective: To evaluate the efficacy of Snehana and Patra Pottali Swedana, along with Shamana Aushadhi in Avabahuka. Material and methods: A male patient, 40 years old, was diagnosed with an Avabahuka from a clinical point of view. There was a painful, restricted movement of the right shoulder joint radiating to the right elbow joint. X-ray of cervical region AP and lateral view shows mild straightening of cervical lordosis due to paraspinal muscle spasm and C5 – C6 disc space narrowing. He was treated with Panchakarma Snehana and Patra Pottali Swedana followed by Shamana Chikitsa for 7 days and follow-up after 14 days. Result: The patient was assessed with subjective and objective parameters. The scores of pain turned to reduced 3 to 1, stiffness 3 to 0, and range of movement; flexion 1300 to 1600, extension 500 to 600, abduction 1250 to 1450, adduction 350 to 550, internal rotation 700 to 850, and external rotation 800 to 900. Significant changes and improvements were observed in the clinical features of Avabahuka before and after treatment. Conclusion: The present study shows Ayurveda has better management for Avabahuka, which was observed by strategically combining the effects of Panchakarma and Shamana Chikitsa.

A Novel Passive Shoulder Exoskeleton Using Link Chains and Magnetic Spring Joints.

Work-related musculoskeletal disorders represent a major occupational disability issue, and 53.4% of these disorders occur in the back or shoulders. Various types of passive shoulder exoskeletons have been introduced to support the weight of the upper arm and work tools during overhead work, thereby preventing injuries and improving the work environment. The general passive shoulder exoskeleton is constructed with rigid links and joints to implement shoulder rotation, but there exists a challenge to align with the flexible joint movements of the human shoulder. Also, a force-generating part using mechanical springs require additional mechanical components to generate torque similar to the shoulder joint, resulting in increased overall volume and inertia to the upper arm. In this study, we propose a new type of passive shoulder exoskeleton that uses magnetic spring joint and link chain. The redundant degrees of freedom in the link chains enables to follow the shoulder joint movement in the horizontal direction, and the magnetic spring joint generates torque without additional parts in a compact form. Conventional exoskeletons experience a loss in the assisting torque when the center of shoulder rotation changed during arm elevation. Our exoskeleton minimizes the torque loss by customizing the installation height and initial angle of the magnetic spring joint. The performances of the proposed exoskeleton were verified by an electromyographic evaluation of shoulder-related muscles in overhead work and box lifting task.

Role of Ultrasound Guided Platelet Rich Plasma Therapy for Isolated Supraspinatus Tendinopathy

Background: Rotator cuff (RC) injuries are not so uncommon a cause of disability among the population. The RC stabilizes the shoulder, a highly unstable joint owing to great mobility. Supraspinatus (SS) is one of the RC tendons undergoing damage ranging from mild tendinosis to complete tear due to degeneration, trauma, or other causes. Supraspinatus tears (STs) have been classically treated conservatively with physical and pharmacotherapy and later on with the help of surgical repair. Non-surgical treatment with biologics like platelet-rich plasma (PRP) therapy has been tried with positive results but with limited data. We aim to identify the role of PRP therapy in patients with symptomatic supraspinatus tendinopathy (STP) for improving the range of motion as well as reducing the pain and physical disability.Methods: This study was done on fifty symptomatic STP patients who failed medical and physical therapy for at least three months. The improvement in the pain score following two sittings of PRP therapy was evaluated with numerical rating scale (NRS). The improvement of the function of shoulder joint movements for daily activities was assessed with the modified University of California-Los Angeles (UCLA) shoulder score. Moreover, NRS, tear size (TS, assessed with ultrasound), Constant Shoulder Score (CSS), and modified UCLA shoulder score were recorded at baseline, and subsequently at 1-month, 3-months, and 6-months following the second sitting of the PRP therapy.Results: At baseline, the CSS was 36.42±5.12, and was 61.58±6.35, 81.22±6.23, and 87±3.9 at 1-month, 3-months, and 6-months follow-up, respectively. The NRS was 8.18±0.96 before the procedure and 4.26±0.8, 2.02±0.62, 1.84±0.51 at 1-month, 3-months, and 6-months follow-up, respectively. The mean TS pre-procedure was 3.12±0.89, and a significant decrease in TS was seen at 1-month (2.87±0.88), 3-months (2.44±0.79), and 6-months (2.17±0.76). Modified UCLA score was 16.86±3.49 at baseline which improved to 24.66±3.17 at 1-month, 31.64±2.69 at 3-months, and 32.5±1.67 at 6-months.Conclusion: PRP results in healing of the torn SS tendon. It also reduces pain score, improve range of motion and quality of life of the patients.