Passive Mobilization Research Articles

Effectiveness of a joint mobilizations protocol for shoulder subacromial pain syndrome: A pilot study

BackgroundSubacromial pain syndrome (SPS) is the most frequent shoulder pathology. The aims of this prospective randomized study were to evaluate the effects of some specific shoulder joint mobilizations (“spin correction”), and the effectiveness of a rehabilitation program, named Shoulder Global Concept, in SPS patients. Methods45 patients with SPS were randomly assigned to two groups, to benefit from a different first session of mobilizations: the experimental group received all specific mobilizations, while the control group received the same program but without the spin correction mobilizations. The second session was identical for both groups, with all specific mobilizations. Before and after the first two sessions, range of motion (ROM) in flexion, abduction, external and internal rotations, pain and functional status with Constant score and Quick Dash were evaluated. Evaluation was repeated with 24 patients after 11 rehabilitation sessions. Rehabilitation with Shoulder Global Concept included 13 mobilizations aiming at improving the ROM with passive and active-assisted mobilizations, static stretching, and muscle strengthening. ResultsAll ROM were improved at the end of the first session for both groups, but significantly more in the experimental group for glenohumeral (GH) abduction and external rotation (p < 0.05). Functional scores, pain and strength were significantly improved after 11 rehabilitation sessions with the Shoulder Global Concept. ConclusionThis manual therapy method was able to improve shoulder mobility in one session. The additional joint mobilizations (spin correction) specifically increased GH abduction and external rotation. Rehabilitation of SPS with Shoulder Global Concept allowed to improve functional capacity and decrease pain.

Explore the Family Responsibility and Career Dilemma of Professional Women in Marriage

This paper investigates the reasons why married women in the banking industry choose occupational mobility by qualitative research method, analyzing the factors that influence womens choices of doing or undoing gender. The investigator interviewed 20 female bank clerks in marriage as the object of the study. All the women have had higher education in the past. In the background of modern labor society and the social identity of gender, professional women in marriage are under the dilemma of their work and family which includes occupational promotion, spouse, childcare, and eldercare. The consideration of family factors such as spouse, children, and the elderly, ultimately leads to the choice of occupational mobility for these married women. Personal career prospects, aspirations for a better future, the need for better educational conditions and opportunities for children, and the need to support parents and in-laws, all influence women's choice to make active or passive career mobility. It is still difficult for women from higher education backgrounds to make free choices after marriage.

Overview of Cochrane Systematic Reviews for Rehabilitation Interventions in Individuals with Upper Limb Fractures: A Mapping Synthesis.

Background and Objectives. This overview of Cochrane systematic reviews (CSRs) reports on current evidence on the effectiveness of rehabilitation interventions for persons with upper limb fractures (ULFs), and the quality of the evidence. Materials and Methods. Following the inclusion criteria defined by the World Health Organization, all CSRs tagged in the Cochrane Rehabilitation database that were relevant for persons with ULFs were included. A mapping synthesis was used to group outcomes and comparisons of included CSRs, indicating the effect of rehabilitation interventions and the certainty of evidence. Results. A total of three CSRs were included in the evidence map. The certainty of evidence was judged as low to very low. Early occupational and hand therapy, cyclic pneumatic soft tissue compression, and cross-education, when started during immobilization, may improve grip strength and wrist range of motion, with results maintained up to 12 weeks from the cast removal, compared to no intervention. Approaches such as occupational therapy and passive mobilisation, started post-immobilization, are probably safe in terms of secondary complications. However, the overall evidence of rehabilitative interventions related to proximal humeral fractures has been judged insufficient for all the outcomes considered. A paucity of primary studies and CSRs for elbow fractures was noted. Conclusions. This overview provided the effect and the certainty of evidence of rehabilitation interventions available after ULFs using a mapping synthesis. To date, there is a need to further the effectiveness and safety of these interventions for persons with ULFs, improving methodological quality of the research in the field.

Effectiveness of manual therapy interventions in cystic fibrosis care: a pilot study

BackgroundCystic fibrosis (CF) is a severe genetic condition that affects multiple organ systems and imposes a substantial treatment burden. Regarding the lungs and airways, the progressive pathophysiological changes place a significant strain on the musculoskeletal components of the respiratory system for people with CF. This pilot study investigated the effectiveness of manual therapy interventions (MTIs) on thoracic mobility, respiratory muscle strength, lung function, and musculoskeletal pain. MethodA study with a pretest-posttest design was conducted with 15 eligible people with CF at the Sahlgrenska University Hospital CF Centre. After an initial set of diagnostic tests at baseline, the participants underwent eight weekly 30-min MTIs. The MTIs included passive joint mobilisation and soft tissue manipulation of primary and secondary anatomical areas of the musculoskeletal respiratory system. On the day of the final intervention, the baseline measurements were repeated. ResultsTrends of increased thoracic mobility were observed following the intervention, with a statistically significant increase in respiratory muscle strength. No change in lung function was observed. Musculoskeletal pain before and after the intervention showed a significant decrease in tender points, and all participants reported positive experiences with MTIs. ConclusionMTIs may improve thoracic mobility, alleviate pain, and enhance respiratory muscle strength in people with CF. Further research is needed to confirm their potential role as a CF physiotherapy supplement. Clinical trial idNCT04696198.

Quantifying Plantar Flexor Muscles Stiffness During Passive and Active Force Generation Using Shear Wave Elastography in Individuals With Chronic Stroke

ObjectivesThis study aims to investigate the mechanical properties of paretic and healthy plantar flexor muscles and assesses the spatial distribution of stiffness between the gastrocnemius medialis (GM) and lateralis (GL) during active force generation. MethodsShear wave elastography measurements were conducted on a control group (CNT, n=14; age= 59.9 ± 10.6 years; BMI= 24.5 ± 2.5 kg/m2) and a stroke survivor group (SSG, n = 14; age = 63.2 ± 9.6 years; BMI = 23.2 ± 2.8 kg/m2). Shear modulus within the GM and GL was obtained during passive ankle mobilization at various angles of dorsiflexion (P0= 0°; P1= 10°; P2= 20°; P3= -20° and P4= -30°) and during different levels of maximal voluntary contraction (MVC) (100%, 30%, 50%, 70%). Muscle activation of GM, GL, and tibialis anterior was also evaluated. ResultsThe results revealed a significant increase in passive stiffness within the paretic plantar flexor muscles under high tension during passive mobilization (p<0.05). Yet, during submaximal and maximal MVC, the paretic plantar flexors exhibited decreased active stiffness levels (p<0.05). A notable discrepancy was found between the stiffness of the GM and GL muscles, with the GM demonstrating greater stiffness from 0° of dorsiflexion in the SSG (p<0.05), and from 10° of dorsiflexion in the CNT (p<0.05). No significant difference in stiffness was observed between the GM and GL muscles during active conditions. ConclusionStroke affects the mechanical properties differently depending on the state of muscle activation. Notably, the distribution of stiffness among synergistic plantar flexor muscles varied in passive condition, while remaining consistent in active condition.

The management of metacarpal and phalangeal fractures of hand by K-wires and Joshi’s external stabilization system

Background: Hand injuries are quite common and affect 15% of people who go to the emergency room. The metacarpals and phalanges are the two bones that fracture most frequently, with a prevalence of between 10 and 15%. Use of K-wires with an external fixation system, such as Joshi's external stabilization system (JESS), is optional. According to the ligamentotaxis theory, JESS functions. Aim was to evaluate the clinical and radiological outcome of metacarpal and phalangeal fractures using k wires and jess. Methods: This prospective study was conducted in post graduate department of orthopaedics SKIMS medical college Bemina, on 40 patients with metacarpal and phalangeal fractures managed by Kirschner wires (K-wires) and JESS. The collected data was analyzed with the help of statistical package for social science (SPSS), version 21 Results: In present study the most of the study subjects were in the age group of 28-37 years (40%), there was male predominance with the male to female ratio 2.5:1, majority of the study subjects were labourer (38%), right side was involved most commonly (62%), the major cause of fracture was road traffic accident (58%) and most (96%) of the study subjects were operated within 24 hours of the injury. Conclusions: The study concluded that augmentation of JESS over K-wires provides a stable skeletal environment with early tissue healing and immediate active and passive mobilization of the uninjured adjacent joints and also provides rotational stability as the majority of the study subjects achieved excellent functional outcome.

Modified Bilhaut–Cloquet procedure for Wassel type III–IV polydactyly

BackgroundTo investigate the functional and aesthetic results of a new modified Bilhaut–Cloquet procedure for the treatment of Wassel type III–IV thumb polydactyly.MethodsThirteen patients with Wassel type III–IV thumb polydactyly who visited the Department of Orthopedics of Hebei Provincial Children's Hospital from 2019 to 2022 were selected. The surgical procedure involved a modified Bilhaut–Cloquet surgery, where two-thirds of the distal part of the dominant finger was retained as the p body of the reconstructed thumb. The triangular bone block of the ablated distal thumb that did not contain the epiphysis and articular cartilage was sutured and fixed, and the neurovascular flap of the ablated distal thumb was used as an augmenting segment of the reconstructed thumb, with the nail bed and nail matrix exquisitely sutured. The evaluation performed according to the Japanese Society for Surgery of the Hand (JSSH) system.ResultsAll 13 children showed bone healing, no wound infection, nonunion, or deformity healing. None of the children showed a significant reduction in the active and passive mobility of the thumb postoperatively compared with preoperatively. Postoperative evaluation was performed based on the JSSH score, with a mean of 17.15 points (14–19 points), with 11 children rated as excellent and two as good. No severe nail ridges, nail gaps, or nail split deformities of the thumb were observed postoperatively. Postoperative metacarpophalangeal and interphalangeal joint movements were not reduced compared with preoperative movements. All parents were satisfied with the appearance and function of the reconstructed thumb.ConclusionThe modified Bilhaut–Cloquet procedure designed in this study was satisfactory for Wassel type III–IV thumb polydactyly without affecting the stability of the interphalangeal joints and preserving joint mobility. The postoperative thumb has a comparable circumference and nail width and was cosmetically and functionally satisfactory, especially for the asymmetric two thumbs, which achieved favorable results.

A Lightweight Dynamic Hand Orthosis With Sequential Joint Flexion Movement for Postoperative Rehabilitation of Flexor Tendon Repair Surgery.

During the postoperative hand rehabilitation period, it is recommended that the repaired flexor tendons be continuously glided with sufficient tendon excursion and carefully managed protection to prevent adhesion with adjacent tissues. Thus, finger joints should be passively mobilized through a wide range of motion (ROM) with physiotherapy. During passive mobilization, sequential flexion of the metacarpophalangeal (MCP) joint followed by the proximal interphalangeal (PIP) joint is recommended for maximizing tendon excursion. This paper presents a lightweight device for postoperative flexor tendon rehabilitation that uses a single motor to achieve sequential joint flexion movement. The device consists of an orthosis, a cable, and a single motor. The degree of spatial stiffness and cable path of the orthosis were designed to apply a flexion moment to the MCP joint prior to the PIP joint. The device was tested on both healthy individuals and a patient who had undergone flexor tendon repair surgery, and both flexion and extension movement could be achieved with a wide ROM and sequential joint flexion movement using a single motor.

Reliability and Validity of Visual Estimation in Determining Thorax Rotation Mobility using the Quadruped Lumbar-Locked Position.

Thoracic rotation mobility is crucial for athletes in rotational sports such as baseball, golf, and swimming to maintain the proper biomechanics associated with the sport. Accurate differentiation between normal mobility and active and passive physiological deficits in the thoracic region is critical for identifying the need for intervention to the thorax. To establish the reliability and discriminant validity of visual estimation of thorax rotation range of motion across clinicians of differing experience levels in determining normal mobility and active or passive physiological deficits when utilizing the quadruped lumbar-locked position. Cross-sectional. Thirty-eight subjects (21 female, 17 male) with a mean age of 27 years ± 6.67 were assessed with the quadruped lumbar-locked thorax rotation test by three examiners with various clinical experience in real-time and again one week later. Bilateral active and passive lumbar-locked thorax rotation mobility was assessed by all raters and categorized as "Unrestricted" (≥50°) or "Restricted" (<50°) while a research assistant simultaneously measured the motion with a digital inclinometer. All raters were blinded to the results. All results were analyzed for intra-rater reliability and agreement. Test-retest intra-rater reliability ranged from 0.55-0.72 and percent absolute agreement ranged from 0.82-0.89. Inter-rater reliability ranged from 0.45-0.59 while percent absolute agreement between raters ranged from 0.74-0.84. There was a significant difference in range of motion between "Unrestricted" and "Restricted" categories for both active (Unrestricted=54.6-58.9; Restricted=40.4-44.4; p<0.001) and passive motion (Unrestricted=61.3-63.5; Restricted=39.2-39.7; p<0.001). The only interaction effect was for passive left rotation [Rater A Restricted x ® =34.3(30.4-38.2); Rater C Restricted (x ) ®=43.8(41.3-46.4); p=.000]. The quadruped lumbar-locked thorax rotation test demonstrates moderate to substantial test-retest intra-rater and inter-rater reliability regardless of clinical experience. The quadruped lumbar-locked thorax rotation test can accurately discriminate between individuals with active and passive physiological deficits regardless of rater experience using visual estimation. 3b.

Estimating Bus Passenger Mobility with Wi-Fi Data and Clustering

Thanks to Wi-Fi technology, it is possible to gather passive mobility data over a long time and to analyze travel behaviors variability. However, the main challenge is to identify relevant data, in a way that is efficient whatever the chosen period of network. Our research evaluates the replicability of a method, based on a partitioning algorithm, that allows to identify signals emitted by passengers from those emitted by non-passengers automatically. The findings show that this algorithm is easily replicable and useful to study individual mobility from passive data. It is hence a good opportunity for understanding travel demand.

Pulmonary expansion manoeuvres compared to usual care on ventilatory mechanics, oxygenation, length of mechanical ventilation and hospital stay, extubation, atelectasis, and mortality of patients in mechanical ventilation: A randomized clinical trial

Pulmonary expansion manoeuvres are therapeutic techniques used to prevent and reverse atelectasis; however, no randomized controlled trials have provided evidence supporting the use of this intervention among individuals on mechanical ventilation. Objective: To evaluate the effects of chest compression-decompression and chest block manoeuvres compared to usual care among patients on mechanical ventilation. Methods: The current study was a randomized clinical trial of adult subjects on mechanical ventilation for 12 to 48 hours. The control group received usual care (passive or active mobilization, manoeuvres for airway clearance and tracheal aspiration). The intervention group received usual care plus two lung expansion manoeuvres, i.e., chest decompression and chest block, while remaining on mechanical ventilation. Assessments were performed before and after usual care, immediately after the intervention and 30 minutes after the intervention. The primary outcome was static compliance. The secondary outcomes were the incidence of atelectasis, dynamic compliance, airway resistance, driving pressure, oxygenation, duration of mechanical ventilation, extubation success, length of hospital and ICU stay, and mortality. Results: Fifty-one participants (67±15 years old, 53% men, 26 in the control group and 25 in the intervention group) were evaluated. No differences in static compliance were observed between groups (intervention minus control) before and after expansion manoeuvres [3.64 ml/cmH2O (95% CI: -0.36–7.65, p = 0.074)]. Peripheral oxygen saturation differed between groups before and after expansion manoeuvres, with more favourable outcome observed in the control group [-1.04% (95% CI: -1.94 –-0.14), p = 0.027]. No differences were found in other outcomes. Conclusion: Chest compression-decompression and chest block manoeuvres did not improve ventilatory mechanics, the incidence of atelectasis, oxygenation, the duration of mechanical ventilation, the length of stay in the ICU and hospital, or mortality in individuals on mechanical ventilation. The findings of this study can be valuable for guiding evidence-based clinical practice and developing a therapeutic approach that provides real benefits for this population.

A Framework Integrating Augmented Reality and Wearable Sensors for the Autonomous Execution of Rehabilitation Exercises

Despite the resolution of pathology at admission, many hospitalized patients are discharged in a worse functional state, particularly in terms of walking capabilities, due to hospitalization inactivity. Early interventions to maintain the functional state through exercise such as passive mobilization, executed during hospitalization, have been proven to be effective in preventing physical and cognitive decline. Unfortunately, many patients can be excluded from such treatments due to the high number of people hospitalized and the limited availability of healthcare personnel. This paper presents a framework that allows the patient to autonomously perform the exercises without the assistance of qualified personnel. Such a framework exploits the advantages of an Augmented Reality (AR) device in which the patient can visualize real-time instructions on the exercises and directions on their execution. The monitoring of the patient’s movements during exercise is accomplished by means of dedicated wearable sensors fixed to the patient’s limb. The system was tested in preliminary experiments on healthy people.

A treatment strategy for recurrent (ankle injuries) in Muay Thai athletes

Objective: An efficient solution for stabilization is the mobilization of the joints for the arthrokinematics affected by the positional defect of the CAI (i.e. chronic ankle instability). This study put to comparison the impacts of ankle dorsi flexion range of motion (DFROM) as well as dynamic balance ability (DBA) in the patients who have CAI using PJM (i.e. passive joint mobilization), a technique typically been used in previous works, and active joint mobilization (AJM), a technique which could have a greater impact on cortical excitability with the spontaneous movement. Design: rehabilitation program to treat recurrent ankle. Methods: A total of 10 players from the Iraqi clubs Muay Thai team were registered, 5 from each of the AJM and PJM groups. A total of 12 intervention sessions overall, lasting 10 mins each, were given to each participant over the course of three weeks. AJM employed angular motion of the joints to produce the patient's voluntary motion regarding lateral malleolus posterior gliding as well as medial malleolus anterior gliding, respectively, while PJM utilized Maitland's mobilization approach to perform mobilization of the joints with the talus in the posterior direction. Tape was used for measuring the ankle's DFROM, and the balance system was used to assess the ankle's DBA. Results: With the exception of DBA-right and DBA-anterior variables with regard to PJM group, considerable enhancements were seen following intervention in AJM as well as groups of the PJM. DBA-anterior, DFROM, DBA-right, and DBA-posterior, measures showed statistically significant differences between the PJM group and the AJM group. Conclusions: Joint mobilization, such as voluntary movement, was more successful thanks to the overall improvement regarding DBA and DFROM. The ankle's neuromuscular system is significantly impacted in the case when voluntary movement is present.

The effect of manual therapy on ankle dorsiflexion range of motion: A pilot crossover randomized trial

IntroductionRestricted ankle dorsiflexion is common after lower limb injury. The aim of this pilot study was to investigate the effect of passive ankle joint mobilization and calf muscle massage on ankle dorsiflexion range of motion in adults with residual restricted dorsiflexion. The secondary aim was to assess the methodology of the pilot study to inform a larger clinical trial. MethodThe study design was a randomized crossover trial with assessor blinding. Twenty-five healthy participants with a history of lower limb injury were included in the study. Ankle joint mobilization and calf muscle massage were applied for 5 min in a random order, one to two weeks apart. Ankle dorsiflexion was measured by using the weight-bearing lunge pre- and post-intervention (cm). Paired t-tests were used to analyze the effect of the manual therapy interventions on restricted ankles. A minimal detectable difference 95% (MMD95) was calculated. The pilot study was analyzed for suitability of inclusion criteria, blinding of assessors and the manual therapist, and the washout period. ResultsA significant increase in dorsiflexion was demonstrated for ankle joint mobilization (change score = 0.51 ± 0.76, p = 0.003) and calf muscle soft tissue massage (change score = 0.91 ± 1.07, p < 0.001). There was no difference in change scores between manual therapy techniques (mobilization 0.51 ± 0.76, massage 0.91 ± 1.07, p = 0.12). Evaluation of the pilot study revealed limitations to be modified in future studies. ConclusionThese preliminary data indicate ankle joint mobilization and calf muscle soft tissue massage had similar effects on increasing ankle dorsiflexion range of motion in ankles with residual dorsiflexion restriction.

Shoulder pain management strategies and early functional outcome after arthroscopic rotator cuff tear repair. A randomized controlled study

BackgroundThe management of acute postoperative pain after rotator cuff surgery can be challenging. To our knowledge, there are no data available in the literature correlating satisfactory pain control with improvement in terms of function. The purposes of the present study were to evaluate: 1) pain pattern after arthroscopic rotator cuff repair in patients operated with two different techniques (transosseous vs transosseous equivalent); 2) safety/efficacy of three different pharmacological pain control strategies; 3) possible relationship between a correct shoulder pain management protocol in the early post-operative period and patients’ functional improvement. Methods114 patients underwent rotator cuff tear repair, either with a Transosseus or a Transosseus equivalent technique. 62 (54%) were male and 52 (46%) were female. The average age was 59 ± 9 years. They were randomly assigned into three different pain management protocols: Paracetamol as needed (max 3 tablets/day) for 1 week (Protocol A), Paracetamol + Codein 1 tablet three times per day for 7 days (Protocol B), or Paracetamol + Ibuprofen 1 tablet two times per day for 7 days (Protocol C). Immediate passive mobilization of the operated shoulder was allowed. VAS and Passive Flexion values were recorded at 7 (T1), 15 (T2) and 30 (T3) days post-surgery. DASH values were recorded at 90 days post-surgery. All patients were asked to register any kind of signs/symptoms that may appear during drug assumption according to each pain management protocols. ResultsAll the pain management protocols administered were well tolerated by all the study population, and no adverse signs/symptoms were highlighted during drug assumption.Pain pattern: in both surgical techniques, patients within Protocol A were associated with worst results in terms of mean VAS at each time point examined when compared to Protocol B and C (p < 0,05). In patients within Protocol A, no statistically significant differences were found at each point time examined comparing the two surgical techniques, with the exception of T2, where the TO was associated with an higher VAS value than TOE (p < 0.05). No differences were highlighted in Protocol B and C when comparing the values between two surgical techniques.ROM: in both surgical techniques, patients within Protocol A were associated with worst results in terms of mean PROM at each time point examined when compared to Protocol B and C (p < 0,05). In the TO group, patients within Protocol B had better PROM values at T1 (p < 0,05) and T2 (p < 0,05) compared to Protocol C, but no differences were highlighted at T3. In the TOE group, no statistically significant differences were found between patients within Protocol B and C at each time point examined.DASH: In the TO group, no statistically significant differences were found regarding the DASH values comparing Protocol B vs Protocol C, but they were highlighted comparing the values between Protocol A and Protocol B (p < 0,05), and between Protocol A and Protocol C (p < 0,05). Similar results were recorded in the TOE group. ConclusionPost-operative pain is influenced by the surgical technique used being transosseous more painful in the first 15 days after surgery. Oral anti-inflammatory drugs are a feasible strategy to appropriately control post-operative pain. An association between Paracetamol and either Codein or Ibuprofen can lead to better outcomes in terms of VAS reduction and early recovery of passive ROM.

How do Audible Message Notifications Influence the Quantity and Quality of Child-Directed Speech from Parents?

The impact of direct mobile phone usage on child-directed speech (CDS) has been frequently explored. However, little is known about the effects of passive mobile phone interaction regarding this aspect. Using a repeated measures design with counterbalancing and a yoked control design, the present study examines the influence of audible message notifications on the quantity and quality of CDS delivered by parents. Results indicate that receiving message notifications reduces both the amount and quality of CDS and that a familiar message notification has a greater effect on diminishing parent-child interaction than an unfamiliar message notification. The findings thus have implications for parents, highlighting the importance of reducing passive mobile phone usage to construct a better language-learning environment for toddlers.

Clinician and Patient Perspectives on the Use of Passive Mobile Monitoring and Self-Tracking for Patients With Serious Mental Illness: User-Centered Approach.

Early intervention in mental health crises can prevent negative outcomes. A promising new direction is remote mental health monitoring using smartphone technology to passively collect data from individuals to rapidly detect the worsening of serious mental illness (SMI). This technology may benefit patients with SMI, but little is known about health IT acceptability among this population or their mental health clinicians. We used the Health Information Technology Acceptability Model to analyze the acceptability and usability of passive mobile monitoring and self-tracking among patients with serious mental illness and their mental health clinicians. Data collection took place between December 2020 and June 2021 in 1 Veterans Administration health care system. Interviews with mental health clinicians (n=16) assessed the acceptability of mobile sensing, its usefulness as a tool to improve clinical assessment and care, and recommendations for program refinements. Focus groups with patients with SMI (n=3 groups) and individual usability tests (n=8) elucidated patient attitudes about engaging in health IT and perceptions of its usefulness as a tool for self-tracking and improving mental health assessments. Clinicians discussed the utility of web-based data dashboards to monitor patients with SMI health behaviors and receiving alerts about their worsening health. Potential benefits included improving clinical care, capturing behaviors patients do not self-report, watching trends, and receiving alerts. Clinicians' concerns included increased workloads tied to dashboard data review, lack of experience using health IT in clinical care, and how SMI patients' associated paranoia and financial instability would impact patient uptake. Despite concerns, all mental health clinicians stated that they would recommend it. Almost all patients with SMI were receptive to using smartphone dashboards for self-monitoring and having behavioral change alerts sent to their mental health clinicians. They found the mobile app easy to navigate and dashboards easy to find and understand. Patient concerns centered on privacy and "government tracking," and their phone's battery life and data plans. Despite concerns, most reported that they would use it. Many people with SMI would like to have mobile informatics tools that can support their illness and recovery. Similar to other populations (eg, older adults, people experiencing homelessness) this population presents challenges to adoption and implementation. Health care organizations will need to provide resources to address these and support successful illness management. Clinicians are supportive of technological approaches, with adapting informatics data into their workflow as the primary challenge. Despite clear challenges, technological developments are increasingly designed to be acceptable to patients. The research development-clinical deployment gap must be addressed by health care systems, similar to computerized cognitive training. It will ensure clinicians operate at the top of their skill set and are not overwhelmed by administrative tasks, data summarization, or reviewing data that do not indicate a need for intervention. RR2-10.2196/39010.

Active and Passive Cycling Decrease Subthalamic β Oscillations in Parkinson's Disease.

Preserved cycling capabilities in patients with Parkinson's disease, especially in those with freezing of gait are still poorly understood. Previous research with invasive local field potential recordings in the subthalamic nucleus has shown that cycling causes a stronger suppression of β oscillations compared to walking, which facilitates motor continuation. We recorded local field potentials from 12 patients with Parkinson's disease (six without freezing of gait, six with freezing of gait) who were bilaterally implanted with deep brain stimulation electrodes in the subthalamic nucleus. We investigated β (13-30 Hz) and high γ (60-100 Hz) power during both active and passive cycling with different cadences and compared patients with and without freezing of gait. The passive cycling experiment, where a motor provided a fixed cadence, allowed us to study the effect of isolated sensory inputs without physical exercise. We found similarly strong suppression of pathological β activity for both active and passive cycling. In contrast, there was stronger high γ band activity for active cycling. Notably, the effects of active and passive cycling were all independent of cadence. Finally, β suppression was stronger for patients with freezing of gait, especially during passive cycling. Our results provide evidence for a link between proprioceptive input during cycling and β suppression. These findings support the role of continuous external sensory input and proprioceptive feedback during rhythmic passive cycling movements and suggest that systematic passive mobilization might hold therapeutic potential. © 2023 International Parkinson and Movement Disorder Society.

The functional disabilities of the dominant and opposite hands in patients with systemic sclerosis.

Hand involvement in patients with systemic sclerosis (SSc) is responsible for 75% of the overall disability but varies greatly among individuals. No study has yet compared the functionalities between the two hands of SSc patients. We thus evaluated the joint limitations and extent of skin involvement in the dominant and contralateral hands. This prospective, descriptive, comparative single-centre study enrolled SSc patients diagnosed using the ACR/EULAR criteria. We assessed limitations in the joint range of motion during active and passive mobilisation; the first commissure opening angles; the Kapandji scale and Rodnan hand scores; the digital pressures; the finger brachial pressure indices; and the number of telangiectasias, calcinosis, digital ulcerations, and painful joints on each hand. Thirty patients were included. Spontaneous flexion joint limitations were significantly greater in the dominant hand (p<0.0001). The Kapandji score was lower (p<0.001) and the Rodnan hand score significantly higher, for the dominant hand (p<0.001). The digital pressure was similar between the hands. The dominant hand exhibited significantly more skin sclerosis and mean flexion deterioration, a lower Kapandji score, and a tendency toward reduced mean extension, compared with the other hand. No vascular pathology was noted in either hand. Larger studies are needed to confirm these results and to draw therapeutic conclusions.

Common modelling assumptions affect the joint moments measured during passive joint mobilizations

Joint resistance to passive mobilization has already been estimated in-vivo in several studies by measuring the applied forces and moments while manipulating the joint. Nevertheless, in most of the studies, simplified modelling approaches are used to calculate this joint resistance. The impact of these simplifications is still unknown. We propose a protocol that enables a reference 3D inverse dynamics approach to be implemented and compared to common simplified approaches. Eight typically developed children and eight children with cerebral palsy were recruited and underwent a passive testing protocol, while applied forces and moments were measured through a 3D handheld dynamometer, simultaneously to its 3D kinematics and the 3D kinematics of the different segments. Then, passive joint resistance was estimated using the reference 3D inverse dynamics approach and according to 5 simplified approaches found in the literature, i.e. ignoring either the dynamometer kinematics, the measured moments alone or together with the measured tangential forces, the gravity and the inertia of the different segments, or the distal segments kinematics. These simplifications lead to non-negligible differences with respect to the reference 3D inverse dynamics, from 3 to 32% for the ankle, 4 to 34% for the knee and 1 to 58% for the hip depending of the different simplifications. Finally, we recommend a complete 3D kinematics and dynamics modelling to estimate the joint resistance to passive mobilization.