Movement Dysfunction Research Articles

A study to identify any relationship between hand dominance and restrictions in range of motion in the protracted shoulder

BackgroundShoulder disorders are considered to be the most common musculoskeletal disorders. Shoulder pain is often linked to movement repetition, uncomfortable postures, prolonged maintenance of static postures and muscular fatigue. Excessive or abnormal muscle tension, are adapted when inefficient or abnormal postures are maintained over time, can lead to musculoskeletal dysfunction causing pain or movement restriction. Hence this study intent to identify movement dysfunction in the shoulder having postural deviation and relationship of the dysfunction to the functional dominance of the extremity.The aim is to identify any relationship between hand dominance and restrictions in range of motion in the protracted shoulder.ObjectiveTo find the restrictions in the range of motion in protracted shoulder and its impact in shoulder function and to find a relationship between altered posture of the shoulder and the hand dominance.Methods60 subjects with altered shoulder posture were selected based on the inclusion and exclusion criteria.Outcome MeasuresThe outcome measures used were scapular protraction formula and shoulder joint mobility using goniometer.Statistical AnalysisThe collected data was tabulated and analysed using descriptive and inferential statistics. To all parameters mean and standard deviation (SD) were used. Independent t-test was used to analyse significant changes between dominant and non-dominant shoulder.ResultsStatistical analysis of scapular protraction and range of motion (ROM) of shoulder flexion and abduction revealed that there is a High statistical significant difference of p<0.0001 seen between dominant and non-dominant upper extremity.In this study there is a significant difference in the end range shoulder flexion and abduction range of motion between dominant and non- dominant upper extremity, while measuring scapular protraction, which is clinically useful to the therapist to diagnose the altered posture of the shoulder.

Signatures of altered DNA methylation gene expression after central and peripheral nerve injury.

Nerve damage can lead to movement and sensory dysfunction, with high morbidity and disability rates causing severe burdens on patients, families, and society. DNA methylation is a kind of epigenetics, and a great number of previous studies have demonstrated that DNA methylation plays an important role in the process of nerve regeneration and remodeling. However, compared with the central nervous system, the peripheral nervous system shows stronger recovery after injury, which is related to the complex microenvironment and epigeneticchanges occurring at the site of injury. Therefore, what common epigenetic changes between the central and peripheral nervous systems remain to be elucidated. We first screened differential methylation genes after spinal cord injury and sciatic nerve injury using whole-genome bisulfite sequencing and methylated DNA immunoprecipitation sequencing, respectively. Subsequently, a total of 16 genes had the same epigenetic changes after spinal cord injury and sciatic nerve injury. The Gene Ontology analysis and Kyoto Encyclopedia of Genes and Genomes enrichment analysis were performed to identify the critical biological processes and pathways. Furthermore, a protein-protein interaction network analysis indicated that Dnm3, Ntrk3, Smurf1, Dpysl2, Kalrn, Shank1, Dlg2, Arsb, Reln, Bmp5, Numbl, Prickle2, Map6, and Htr7 were the core genes. These outcomes may provide novel insights into the molecular mechanism of the subacute phase of nerve injury. These verified genes can offer potential diagnostic and therapeutic targets for nerve injury.

Association Between Functional Movement Screen Scores and Injuries in Male College Basketball Players.

The functional movement screen (FMS) is an assessment tool for movement dysfunction, which is used to reduce the risk of injury. Although the relationship between the FMS composite score and injuries has been extensively studied, the association between FMS scores and injuries in only college basketball players remains unknown. To examine the relationship between the FMS score and injuries in basketball players. Cross-sectional study. University research laboratory. Eighty-one male college basketball players (average age 20.1 [1.3]y) participated. The FMS composite score was calculated from 7 movement tests. The incidence of injuries over a 1-year period prior to the test day was determined based on a questionnaire. Individuals were categorized into 2 groups: injury (with a serious basketball-related injury resulting in the loss of practice and game time for at least 4wk) and noninjury groups. Mann-Whitney U and chi-square tests were used to evaluate group differences in the composite FMS and 7 movement scores, respectively. Furthermore, the scores significant on univariate analyses were submitted to a multivariate logistic analysis, adjusting for participant characteristics. The composite FMS scores of the 2 groups were not significantly different (P = .38). Among the 7 tasks, only the deep squat and hurdle step showed significant group differences (P = .03 and P = .001, respectively). The multivariate logistic analysis revealed that deep squat (odds ratio, 6.48; 95% confidence interval, 1.23-34.01; P = .03) and hurdle step scores (odds ratio, 25.80; 95% confidence interval, 1.81-368.73; P = .02) were significantly associated with injuries, even after adjustment for participant characteristics. Deep squat and hurdle step scores may be associated with injuries in basketball players. Further research should be conducted to confirm that these 2 scores can predict the incidence of injuries in basketball players.

Euryops arabicus displays anti-inflammatory activities in experimental models.

Euryops arabicus (Asteraceae) is grown in Arab Peninsula. Its aerial parts possess ethnomedicinal applications against several inflammatory conditions. To evaluate the anti-inflammatory activity of Euryops arabicus (E. arabicus) organic extract as well as its major polymethoxylated flavonoids. Acute toxicity of the total extract of E. ararbicus was evaluated by assessing LD50. In vivo anti-inflammatory activity was evaluated in rats injected with carrageenan in the plantar area. Paw edema volume, histological changes and rats'stair climbing and motility were assessed. In vitro anti-inflammatory activity of the isolated compounds was evaluated in peripheral blood mononuclear cells (PBMCs) challenged with carrageenan. Inflammation markers were assessed in cellular lysates and collected media. The extract was found safe and considered unclassified with an oral LD50 > 2000 mg/kg in rats. Pretreatment of rats with a total extract of E. arabicus at doses of 100 and 250 mg/kg significantly inhibited carrageenan-induced increase in paw edema volume and histopathological changes. Also, it significantly ameliorated diminution of climbing and motility. Phytochemical studies led to the isolation and identification of five polymethoxylated flavonoids. The anti-inflammatory properties of the isolated compounds were evaluated in carrageenan-challenged peripheral blood mononuclear cells (PBMCs). All compounds exhibited appreciable antioxidant activities. Further, pre-incubation of the cells with the isolated metabolites significantly ameliorated the rise in cyclo-oxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS) and monocyte chemoattractant protein-1 (MCP-1) induced by carrageenan challenge. Further, the compounds inhibited the leakage of interleukin-1β (IL-1β), interleukin-6 (IL-6) and myeloperoxidase (MPO) in media collected from stimulated cells. E. arabicus exhibited in vivo anti-inflammatory effects in the carrageenan model as it ameliorated rat paw edema, histopathological changes and movement dysfunction. in vitro activity of isolated compounds was confirmed in stimulated PBMCs. Thus, the anti-inflammatory activity of E. arabicus can be attributed, at least partly, to its anti-oxidant, anti-inflammatory and anti-chemotactic properties.

Comparing targeted thrust manipulation with general thrust manipulation in patients with low back pain. A general approach is as effective as a specific one. A randomised controlled trial

BackgroundSpinal manipulation is commonly used to treat back pain. The application of spinal manipulation has traditionally involved an element of targeting the technique to a level of the spine where...

Prevalence of self-reported movement dysfunction among young adults with a history of ecstasy and methamphetamine use

BackgroundIllicit stimulant use is associated with long-lasting changes in movement and movement-related brain regions. The aim of our study was to investigate the prevalence of movement dysfunction in this population. We hypothesized that prevalence of self-reported movement dysfunction is higher among stimulant users than non-stimulant users. MethodsThree groups of adults completed a survey containing questions about demographics, health, drug use, and movement. The groups consisted of ecstasy users with no history of methamphetamine use (ecstasy group, n = 190, 20 ± 3 yrs.), methamphetamine users (methamphetamine group, n = 331, 23 ± 5 yrs.), and non-stimulant users (control group, n = 228, 25 ± 8 yrs.). Movement data was analyzed with logistic regression. ResultsIn the unadjusted logistic regression model, group had a significant effect on fine hand control, tremor, and voice/speech questions, but not on other movement domain questions. The prevalence of tremor and abnormal fine hand control was significantly higher in the ecstasy and methamphetamine groups than in the control group (p < 0.018), and changes in voice/speech was more prevalent in the ecstasy group than in the control group (p = 0.015). Age and use of cannabis and hallucinogens were confounding variables. However, inspection of chi-square tables suggests that the effect of these parameters on the movement data is likely to be minor. ConclusionsThe prevalence of self-reported tremor and changes in fine hand control and voice/speech is significantly higher in stimulant users than in non-stimulant users. Inclusion of these common and noticeable changes in body function may aid public health campaigns that target prevention or harm minimization.

Does Fungicide "Dodine" Unfold Protein like Kosmo-Chaotropic Agent?

The nontargeted action of fungicides affects the structure of protein, which leads to several serious diseases such as nausea, cancer, fetus malformations, movement dysfunction, and behavioral changes in human and animals. Hence, understanding of the structural change in protein induced by fungicides is of utmost importance to decode its mode of nontargeted action. In this study, we have investigated the structural change of myoglobin by an important fungicide, namely, dodine (n-dodecylguanidinium acetate), as well as its analogues n-hexylguanidinium acetate (HGA) and guanidinium chloride (GdmCl) using spectroscopic and thermodynamic methods. The amount of dodine and HGA required for the unfolding of myoglobin is significantly less than GdmCl. GdmCl, dodine, and HGA unfold the myoglobin by decreasing the content of the helical and tertiary structures. However, the decrease in the content of tertiary structure is significantly higher than that of the secondary structure for dodine and HGA, in contrast to GdmCl, where the decrease in secondary and tertiary contents of protein is not biased. Thermodynamic and spectroscopic data depict that the unfolding of the dodine and HGA is driven by the hydrophobic interaction, whereas the hydrogen bonding of GdmCl with the amino acids of protein plays a key role in the unfolding. The long alkyl chain of dodine and HGA get accommodated at the surface of the helices of myoglobin, inducing strong hydrophobic interaction, which causes its unfolding. This study depicts that dodine unfolds protein by the chaotropic effect in which its hydrocarbon chain destabilizes the protein by the hydrophobic effect, unlike in an earlier study, where dodine was claimed to be a kosmo-chaotropic agent as its hydrocarbon group stabilizes the protein.

Galectin-3 is required for the microglia-mediated brain inflammation in a model of Huntington\u2019s disease

Huntington’s disease (HD) is a neurodegenerative disorder that manifests with movement dysfunction. The expression of mutant Huntingtin (mHTT) disrupts the functions of brain cells. Galectin-3 (Gal3) is a lectin that has not been extensively explored in brain diseases. Herein, we showed that the plasma Gal3 levels of HD patients and mice correlated with disease severity. Moreover, brain Gal3 levels were higher in patients and mice with HD than those in controls. The up-regulation of Gal3 in HD mice occurred before motor impairment, and its level remained high in microglia throughout disease progression. The cell-autonomous up-regulated Gal3 formed puncta in damaged lysosomes and contributed to inflammation through NFκB- and NLRP3 inflammasome-dependent pathways. Knockdown of Gal3 suppressed inflammation, reduced mHTT aggregation, restored neuronal DARPP32 levels, ameliorated motor dysfunction, and increased survival in HD mice. Thus, suppression of Gal3 ameliorates microglia-mediated pathogenesis, which suggests that Gal3 is a novel druggable target for HD.

Changing the Narrative in Diagnosis and Management of Pain in the Sacroiliac Joint Area.

The sacroiliac joint (SIJ) is often considered to be involved when people present for care with low back pain where SIJ is located. However, determining why the pain has arisen can be challenging, especially in the absence of a specific cause such as pregnancy, disease, or trauma, when the SIJ might be identified as a source of symptoms with the help of manual clinical tests. Nonspecific SIJ-related pain is commonly suggested to be causally associated with movement problems in the SIJ(s)-a diagnosis traditionally derived from manual assessment of movements of the SIJ complex. Management choices often consist of patient education, manual treatment, and exercise. Although some elements of management are consistent with guidelines, this Perspective article argues that the assumptions on which these diagnoses and treatments are based are problematic, particularly if they reinforce unhelpful, pathoanatomical beliefs. This article reviews the evidence regarding the clinical detection and diagnosis of SIJ movement dysfunction. In particular, it questions the continued use of assessing movement dysfunction despite mounting evidence undermining the biological plausibility and subsequent treatment paradigms based on such diagnoses. Clinicians are encouraged to align their assessment methods and explanatory models with contemporary science to reduce the risk of their diagnoses and choice of intervention negatively affecting clinical outcomes.

Association between postoperative DTI metrics and neurological deficits after posterior fossa tumor resection in children.

Resection of posterior fossa tumors in children may be associated with persistent neurological deficits. It is unclear if these neurological deficits are associated with persistent structural damage to the cerebellar pathways. The purpose of this research was to define longitudinal changes in diffusion tensor imaging (DTI) metrics in white matter cerebellar tracts and the clinical correlates of these metrics in children undergoing resection of posterior fossa tumors. Longitudinal brain DTI was performed in a cohort of pediatric patients who underwent resection of posterior fossa tumors. Fractional anisotropy (FA) of the superior cerebellar peduncles (SCPs) and middle cerebellar peduncles (MCPs) was measured on preoperative, postoperative, and follow-up DTI. Early postoperative (< 48 hours) and longer-term follow-up neurological deficits (mutism, ataxia, and extraocular movement dysfunction) were documented. Statistical analysis was performed to determine differences in FA values based on presence or absence of neurological deficits. Statistical significance was set at p < 0.05. Twenty children (mean age 6.1 ± 4.1 years [SD], 12 males and 8 females) were included in this study. Follow-up DTI was performed at a median duration of 14.3 months after surgery, and the median duration of follow-up was 19.7 months. FA of the left SCP was significantly reduced on postoperative DTI in comparison with preoperative DTI (0.44 ± 0.07 vs 0.53 ± 0.1, p = 0.003). Presence of ataxia at follow-up was associated with a persistent reduction in the left SCP FA on follow-up DTI (0.43 ± 0.1 vs 0.55 ± 0.1, p = 0.016). Patients with early postoperative mutism who did not recover at follow-up had significantly decreased FA of the left SCP on early postoperative DTI in comparison with those who recovered (0.38 ± 0.05 vs 0.48 ± 0.06, p = 0.04). DTI after resection of posterior fossa tumors in children shows that persistent reduction of SCP FA is associated with ataxia at follow-up.

FUNCTIONAL MOVEMENT SCREEN™ in YOUTH SPORT PARTICIPANTS: EVALUATING the PROFICIENCY BARRIER for INJURY.

The number of youth participating in sport increases yearly; however, the evaluation of youths' movement ability and preparedness for sport remains inadequate or neglected. The Functional Movement Screen (FMS™) is an assessment of an individual's movement quality that has been utilized to evaluate risk of injury in collegiate and professional sport; however, there is minimal support regarding the predictive value of the screen in youth sport. The purpose of this study was to evaluate the mean and distribution of FMS™ performance in sport participants age 11-18, and to evaluate the existence of a composite FMS™ score proficiency barrier to predict injury risk. Prospective cohort study. One hundred, thirty-six participants (63 male, 73 female) age 11 to 18 years (16.01 + 1.35) were recruited from local schools and sport organizations. The FMS™ was administered prior to each participant's competitive season and scored by researchers who demonstrated reliability in assessments derived from the screen (κw = 0.70 to 1). Injury data were collected by the participants' Athletic Trainer over one season. An injury was defined as any physical insult or harm resulting from sports participation that required an evaluation from a health professional with time modified or time lost from sport participation. Females scored significantly higher than males for mean FMS™ composite score (t = 14.40; m = 12.62; p < 0.001), and on individual measures including: the hurdle step (t = 1.91; m = 1.65; p < 0.001), shoulder mobility (t = 2.68; m = 2.02; p < 0.001), active straight leg raise (t = 2.32; m = 1.87; p < 0.001), and the rotary stability components (t = 1.91; m = 1.65; p < 0.05). Two FMS™ composite scores (score < 14 and <15) significantly increased the odds of injury (OR = 2.955). When adjusting for sport, there was no score relating to increased odds of injury. Dysfunctional movement as identified by the FMS™ may be related to increased odds of injury during the competitive season in youth athletes. Consideration of an individual's movement within the context of their sport is necessary, as each sport and individual have unique characteristics. Addressing movement dysfunction may aid in injury reduction and potentially improve sport performance. 1b.

Functional Movement Screen Composite Scores in Firefighters: Effects of Corrective Exercise Training.

Firefighters require a high level of functional fitness to operate safely, effectively, and efficiently. The authors studied the distribution of functional movement screen (FMS) scores in firefighters and examined whether an 8-week corrective exercise program based on National Academy of Sport Medicine guidelines could improve them. All 524 active firefighters of a city completed the baseline FMS testing. Those who obtained a score of 14 or less, a sign of movement dysfunction, and volunteered to continue their participation were randomly assigned to either an experimental (n = 51) or a control (n = 45) group. Both groups participated in an 8-week training program. The control group used their own usual training routine, but the experimental group used the specific protocol designed for the study. The FMS scores of 43% of the population were less than 14. Repeated-measures analysis of variance revealed a significant interaction between FMS scores of the groups (F1,94 =165, P < .001). The experimental group showed a 69% improvement from pretest (10.6) to posttest (17.8), whereas the control group showed only a 3% improvement from pretest (11.8) to posttest (12.1). Preceding studies have shown that FMS scores less than 14 increase the injury risk. The findings showed that using our proposed training protocol, low FMS scores could be improved to 14 and higher. Considering the high injury rate of firefighters, the authors suggest administering FMS periodically and to use a training protocol such as ours, to increase functional fitness and reduce injury risk.

Gluteus medius activity during gait is altered in individuals with chronic ankle instability: An ultrasound imaging study

BackgroundAltered gait mechanics are frequently reported in individuals with chronic ankle instability (CAI), and increasing information suggests proximal muscle adaptations occur in this population. Ultrasound imaging (USI) offers a visual means to evaluate muscle activity during movement, and overcomes limitations of electromyography (EMG) to detect hip muscle activity. Research QuestionA descriptive laboratory study was conducted to determine if gluteus maximus (GMAX) and medius (GMED) muscle activity differed throughout gait in patients with CAI compared to healthy counterparts. MethodsTwenty young adults with CAI (21.6 ± 2.4 years, 10 males) and 20 healthy participants (21.2 ± 2.8 years, 10 males) walked on a treadmill at 1.35 m/s while researchers obtained 10-second clips of bilateral USI of the GMAX and GMED. USI clips were reduced to 55 frames consisting of 11 points over five full gait cycles. Muscle thickness values during walking were normalized to quiet bipedal standing USI images to obtain functional activity ratios (FARs). FARs with 90% confidence intervals (CI) were plotted as 10% interludes from 0 to 100% of the gait cycle to compare groups and limbs. Mean differences and Cohen’s d effect sizes were used to assess the extent of differences. The CAI group had decreased GMED activity bilaterally from 0 to 40% of walking gait compared to healthy counterparts with large effect sizes (d≥0.60). CAI group FARs were below quiet stance levels (FARs<1.0) throughout the entire gait cycle. There were no differences noted between groups or limbs for GMAX measures. SignificanceProximal stabilizing musculature was altered bilaterally in CAI individuals compared to healthy counterparts, which may contribute to movement dysfunction. Previous studies using EMG have not detected this extent of bilateral gluteal muscle alterations in CAI groups during gait, however our findings suggest USI was able to detect significant proximal alterations during walking in this population.

Motor imagery in high-functioning individuals with chronic anterior cruciate ligament deficiency: A cross-sectional study

BackgroundThere is increasing evidence that motor imagery performance (MIP) is impaired in conditions that have a component of movement dysfunction. However, MIP has not been investigated in people with chronic anterior cruciate ligament (ACL) deficiency who experience limited disability and function at high levels. HypothesisThis study had three objectives: (1) to assess implicit MIP in individuals with a chronic ACL deficient (ACLD) knee compared with healthy controls (i.e., intact anterior cruciate ligament); (2) to determine if the location of ACL deficiency affects MIP (dominant versus non-dominant leg); and (3) to determine if impairment in MIP is specific to the side (injured versus non-injured) of ACL deficiency. MethodsForty-five participants with chronic ACLD knee and 44 healthy controls completed a left/right judgement task of pictured knees using the “Recognise” app to evaluate implicit MIP. Accuracy and reaction time of judgements were compared between groups. Additionally, within the chronic ACLD knee group, we made comparisons between the dominant ACLD knee and non-dominant ACLD knee subgroups and between the injured knee and the non-injured knee of the ACLD group. ResultsThere were no differences in implicit MIP between the ACLD knee and the control group, the non-injured knee versus injured knee of the ACLD knee group, or the dominant ACLD knee versus non-dominant ACLD knee subgroups. ConclusionImplicit MIP is not disrupted in high functioning individuals with chronic ACLD knee.

Aberrant neurotransmissional mRNAs in cerebral ganglions of rotenone-exposed Lumbricus terrestris exhibiting motor dysfunction and altered cognitive behavior.

Rotenone (ROT) was shown to affect cerebral ganglions (CGs) of Lumbricus terrestris as a pioneering observation in our earlier investigation. Though ROT is a well-known neurotoxin causing neurodegeneration (ND), the precipitation of movement dysfunction remains largely unknown. We have designed the current study to analyze motor abnormalities in worms by exposing them to different concentrations (0.0-0.4ppm) of ROT for 7days. GABA, cholinergic receptor, serotonin transporter (SERT), acetylcholine esterase (AchE), and dopamine-β-hydroxylase that are well known for their involvement in neuromuscular junctions were investigated by qRT-PCR. Further, neuronal mitochondrial genes (cytochrome C oxidase-2, NADH deydrogenase-1, cytochrome-b) and actin-1 that are essential for regeneration and calreticulin (phagocytosis) were investigated. The levels of neurotransmitters, lipids, ATPase, neuronal behavior analyses, and fluorescence analysis (lipid droplets) were performed in CGs which showed significant variations at 0.3ppm. Ultrastructural changes in lipid droplet and neuromelatonin were prominent in 0.3ppm. Dose-dependent effect of ROT on behavior alteration and expression of m-RNAs studied suggested that at 0.3ppm, it could deteriorate motor and cognitive functions. We predict that perhaps, by virtue of its effect on cerebral ganglionic genes and their neurotransmitting potential, ROT may cause morbidities that resemble features characteristic of hemiparkinsonic degeneration.

Assessment of manual dysfunction in occupationally active women with carpal tunnel syndrome.

The aim of this study is to evaluate 2-point discrimination sense (2PD), strength and kinesthetic differentiation of strength (KDS), range of motion (ROM) and kinesthetic differentiation of movement (KDM) dysfunctions in occupationally active women with mild and moderate forms of carpal tunnel syndrome (CTS) compared to a healthy group. The 2PD sense, muscle strength and KDS, as well as the ROM and KDM of the radiocarpal articulation were assessed. The results of the 2PD sense assessment showed significantly higher values in all the examined fingers in the CTS women group compared to healthy women (p < 0.01). There was a significant difference in the percentage value of error in the strength and KDS of pincer and cylindrical grips (p < 0.01) in the CTS women group compared to healthy women. There was no difference in the ROM of flexion and extension between studied groups (p > 0.05). There was a significant difference in the percentage value of error in the KDM of flexion and extension movement of the radiocarpal articulation (p < 0.01) between the studied groups. There are significant differences in the 2PD sense, KDS and KDM in occupationally active women with mild and moderate forms of CTS compared to healthy women. There are no significant differences in ROM in professionally active women with mild and moderate forms of CTS compared to healthy women. Int J Occup Med Environ Health. 2019;32(2):185-96.

Inter-day reliability of the Upper Body Test for shoulder and pelvic girdle stability in adults

BackgroundThere are a limited number of tests for the assessment of shoulder and pelvic girdle stability. Reliable instruments are important to evaluate movement dysfunction at these joints in order to provide more objective parameters. ObjectiveTo evaluate the inter-day reliability of the Upper Body Test in young adults. MethodsA reliability study was carried out with three assessments of the shoulder and pelvic girdle stability within 48-h intervals (Monday, Wednesday, and Friday). The OctoBalance® platform was used to perform the Upper Body Test in 31 active young adults (24.5±8 years). Intraclass Correlation Coefficient (ICC2,2) two-way mixed model, Coefficient of Variation, and Bland–Altman plots were used to verify the reliability of the test. The standard error of measurement (SEM) and the minimum detectable difference (MDD95%) were calculated for clinical applicability. ResultsThe Intraclass Correlation Coefficient ranged from 0.87 to 0.94 – Featuring a mean difference of 0.89 (95%CI=−0.19–1.97) to left and 0.95 (95%CI=−0.38–2.27) for the right side, with a low variation coefficient (3.31–5.91%) between the second and third days of assessment. There was a statistically significant difference between the first assessment day and the other test sessions. The Bland–Altman analyses revealed low bias with scores within the limits of agreement. Minimum detectable difference scores were between 4.02 and 5.10, and standard error of measurement between 1.75 and 2.72, depending on the movement side. ConclusionThe Upper Body Test presented good inter-day reliability for assessing the stability of the shoulder and pelvic girdle in young active healthy adults.

Using the Selective Functional Movement Assessment for the Evaluation of Dancers' Functional Limitations and Dysfunctions: A Critically Appraised Topic.

Clinical Scenario: Dancers participate in a functionally demanding activity. Athletic participation typically requires the completion of a preparticipation examination, which involves a functional movement screen offering insight into potential injury recognition. The Selective Functional Movement Assessment (SFMA) was created to measure the status of movement-pattern-related pain and dysfunction using regionally interdependent movement to aggravate symptoms and exhibit limitations and dysfunctions. Still, a functional assessment has not been identified to recognize potential dysfunctions or limitations in this population. Clinical Question: Does the use of the SFMA improve overall evaluation of dancers by providing more information on a dancer's overall functional ability and limitations? Summary of Key Findings: The literature search discovered 12 studies and 3 books in which 4 studies were included (2 case reviews, 1 case report, and 1 original research study) based on the inclusion and exclusion criteria. Three of the studies provided clinical case studies utilizing the SFMA to improve the patient's dysfunctions, whereas 1 study examined the intrarater and interrater reliability of the SFMA. In 3 studies, participants displayed less movement dysfunction. The authors from 3 of the studies agreed the SFMA was a valuable tool for clinicians to use during evaluations, as it provided a more holistic view of the patient, discovering dysfunctional movement patterns that may better identify the source of injury. Clinical Bottom Line: Low-quality evidence, defined as poorly designed case studies, case series, and cohort studies, exist that supports improvement of overall evaluations when utilizing the SFMA. Although the studies were considered low-quality evidence, each included study displayed an effective use of the SFMA as an overall evaluation that correctly identified dysfunctional movement patterns. Strength of Recommendation: Grade C evidence exists that the SFMA contributes to the functional evaluation used in dancers.

INTRA- AND INTER-RATER RELIABILITY OF THE SELECTIVE FUNCTIONAL MOVEMENT ASSESSMENT (SFMA) IN HEALTHY PARTICIPANTS

The Selective Functional Movement Assessment (SFMA) is a popular assessment tool used to observe and detect components of dysfunctional movement patterns. The goal of the assessment is to identify impairments throughout the kinetic chain that may be contributing to movement dysfunction and/or pain. The purpose of this research was to determine the intra- and inter-rater reliability of the 10 top-tier movements of the SFMA using the categorical scoring system. It was hypothesized the intra- and inter-rater reliability of the SFMA would be acceptable with variations based on the objectivity of the scoring criteria and the experience of the rater. Cross-sectional reliability study. 25 (17 male, 8 female), physically active participants (age: 21.2 ± 1.6years, height: 177.1 ± 10.7cm, weight: 74.9 ± 13.9kg) were independently assessed in real time by three clinicians during two separate visits to the lab using a standard instructional script. Clinicians had varying levels of experience with the SFMA and the two visits occurred a minimum of 48 hours and maximum of seven days apart. Results from each clinician were compared within and between raters using the Kappa coefficient and ratings of absolute agreement. Overall, slight to substantial intra- and inter-rater reliability were observed using the categorical scoring tool, although variations existed depending on the movement pattern. Kappa coefficients for intra-rater reliability ranged from 0.21-1.00, while % absolute agreement ranged from 0.64-1.00. Inter-rater reliability for the same measures ranged from 0.11-0.89 and 0.52-0.96 respectively. Clinicians certified in the SFMA with the greatest amount of experience using the SFMA demonstrated higher intra-rater reliability. Similarly, higher inter-rater reliability was found between certified raters with the most experience. Certified SFMA raters with greater amounts of experience can demonstrate adequate intra- and inter-rater reliability using the categorical scoring method. 2, Reliability study.

Validation of joint angle measurements: comparison of a novel low-cost marker-less system with an industry standard marker-based system

Human motion tracking is widely used for the assessment of movement dysfunction in orthopaedic patients. Currently, most clinical motion analysis centres use marker-based three-dimensional (3D) systems as they are deemed to be the most accurate method. However, due to space, costs and logistics they are not available in many clinical settings. This study compared joint angles measured in functional tests using the novel low-cost Microsoft Kinect Perfect Phorm system with the established marker-based Nexus VICON system. When measuring right and left knee flexion, the average difference between the VICON and Kinect Perfect Phorm measurement was 13.2%, with a SD of 19.6. Both overestimation and underestimation of the joint angle was recorded in different participants. Although the average percentage difference during hip abduction tests was lower at −3.9%, the range of error was far greater (SD = 75). From this, it can be concluded that the level of accuracy presented in the new low-cost Kinect Perfect Phorm system is not yet suitable for clinical assessments. However, for general tests of performance, and for tracking cases where absolute accuracy is less critical, future versions of this software may have a place.