Passive Range Research Articles

The association of early passive mobilization with intracranial pressure in the adult intensive care unit: A prospective, cohort study.

Early mobilization are key components of the ABCDEF Care Bundle and critical treatments to reduce acquired muscle weakness, delirium and prolonged intensive care unit (ICU) stay. This study aimed to determine whether routine early mobilization related to intracranial pressure in intensive care patients on mechanical ventilation, using optic nerve sheath diameter measurement (ONSD). This study was planned as a prospective, cohort study in the third-step adult ICU of a faculty hospital. The study included only patients who were intubated and followed up on a mechanical ventilator and were clinically stable. Passive range of motion (PROM) exercises were performed daily by the physiotherapists as part of routine care from the day of hospitalization. ONSD was assessed before, during and 10 min after PROM exercises. The study included 20 eligible patients out of the 142 who were evaluated upon admission to the ICU. The median age of the patients was 65 years, and nine (45%) of them were female. The analyses showed that there was no statistically significant change in ONSD during and at the end of the PROM (ONSD right eye p:.621, Partial η2: 0.025, ONSD left eye p:.935, Partial η2: 0.004). Similarly, there was no statistically significant change in haemodynamic parameters in during and at the end of the PROM (Heart beat p:.849, Partial η2: 0.009, Systolic Pressure p:.435, Partial η2: 0.043, Diastolic Pressure p:.128, Partial η2:0.103, Saturation p:.103, Partial η2: 0.113 and Respiratory rate p:.071, Partial η2:0.130). This study suggests that daily extremity physiotherapy exercises can be safely applied without causing increased intracranial pressure or haemodynamic instability in intensive care patients followed up on mechanical ventilation, including patients with vasopressor therapy. Early mobilization, including PROM, is considered safe in terms of intracranial pressure for intubated patients in the ICU.

Extensive Synovial Chondromatosis of the Temporomandibular Joint Extending to the Cranial Base.

A 42-year-old male presented to the Department of Oral and Maxillofacial Surgery with the chief complaint of pain and stiffness in the right temporomandibular joint (TMJ). The patient's height was 174 cm and his body weight was 65 kg. The patient's occupation was heavy equipment operator. According to the patient, the pain had initiated a week prior to his first visit and was exacerbated during mastication. Evaluation of the range of motion revealed extensive crepitus along the right TMJ. The active and passive range of motion were measured at 45 mm and 42 mm, respectively, indicating adequate mouth-opening capacity. Occlusion was also favorable, and no other clinical symptoms were shown intraorally.

Minor tungsten addition enhances corrosive resistance in CoCrFeNi high-entropy alloy at elevated seawater temperature

Most research on the corrosive CoCrFeNi high-entropy alloy (HEA) has mainly modulated element species and atomic concentration recently. However, the corrosive resistance of the passive film in the elevated temperatures environment inevitably need to be extensively explored for application. In this work, the microstructure and corrosion behavior in the elevated temperatures of face-centered cubic (FCC) CoCrFeNiWx (x = 0 and 0.2) HEAs are investigated. The mechanism of passivation layers on the corrosion behavior of HEAs is further discussed for comparison to the alloy of addition tungsten. Through potentiodynamic polarization curves in 3.5 wt% NaCl solution from 25 °C to 70 °C, the addition of tungsten can raise the critical pitting temperature, while maintaining a lower passivation current density and a larger passivation range at the same time. The high resolution X-ray photoelectron spectrometer (HRXPS), electrochemical impedance spectroscopy (EIS) and scanning electrochemical microscopy (SECM) are all conducted to analyze the passivation composition and chemical reaction of the present alloys detailly. The CoCrFeNiW0.2 HEA exhibits the uniform Cr2O3 layer on the FCC matrix; the proportion of dispersive WO3 layer on the μ phase precipitates form a double-layer passive film under elevated temperature in 3.5 wt% NaCl. It shows that the synergistic effect of the double-layer passive film significantly enhances the pitting and corrosive resistance in this HEA.

How does cruciate ligament rupture treatment affect range of motion in dogs?

This study aimed at evaluating the changes in passive range of motion (ROM) of the stifle joint associated with cranial cruciate ligament (CCL) rupture in dogs and assessing whether the surgical treatment carried out on the affected joints affected additional changes. A retrospective cohort study design was used. The clinical records of dogs treated with tibial tuberosity advancement (TTA), tibial plateau leveling osteotomy (TPLO) and tight rope (TR) were reviewed as were the extension angle (EA), flexion angle (FA) and lameness. The data recorded at T0, before surgery, were compared with the data at 1 month and 6 months post-surgery. The data were classified as normal or abnormal.The main results obtained one month after surgery indicated that dogs treated with TTA showed a significant worsening of flexion (the FA was abnormal in 69.6 % of dogs at T0 and 80.4 % at T1 with p = 0.0208). Dogs treated with TPLO achieved asignificant improvement in extension (the EA was normal in 16.7 % of dogs at T0 and in 33.3 % at T1 with p < 0.0001), and in flexion (the FA was normal in 23.8 % of dogs at T0 and 43.5 % at T6 with p = 0.0434). The dogs treated with TR showed a significant worsening of extension (the EA was abnormal in 68.8 % of dogs at T0 and in 81.3 % at T1 with p = 0.0024). Six months post-surgery, the ROM value was not normal in 100 % of the stifle joints; however, the lameness significantly improved with each procedure. This study confirmed the influence of surgical procedures on changes in ROM and provided useful indications for planning therapy to improve and speed up the postoperative rehabilitation process in dogs.

Variation of the Passive Film on Compositionally Concentrated Dual-Phase Al0.3Cr0.5Fe2Mn0.25Mo0.15Ni1.5Ti0.3 and Implications for Corrosion

AbstractThe passive film on a dual-phase Al0.3Cr0.5Fe2Mn0.25Mo0.15Ni1.5Ti0.3 FCC + Heusler (L21) compositionally concentrated alloy formed during extended exposure to an applied potential in the passive range in dilute chloride solution was characterized. Each phase, with its own distinct composition of passivating elements, formed unique passive films separated by a heterophase interface. High-resolution, surface sensitive characterization enabled chemical analysis of the passive film formed over individual phases. The film formed over the L21 phase had a higher concentration of Al, Ni, and Ti, while the film formed over FCC phase was of similar thickness but contained comparatively higher Cr, Fe, and Mo concentrations, consistent with the differences in bulk microstructure composition. The passive film was continuous across phase boundaries and the distribution of passivating elements (Al, Cr, and Ti) indicated both phases were independently passivated. Spatially resolved analysis of the surface chemistry of the dual-phase CCA revealed that the cation with the highest composition in passive film formed on the FCC phase was Cr (52.4 at. pct) and for the L21 phase was Ti (53.1 at. pct) despite the bulk concentration of each element being below 20 at. pct in their respective phases. Al, Cr, and Ti were enriched in both phases within the passive film relative to their respective bulk compositions. In parallel studies, single-phase alloys with compositions representative of the FCC and L21 phases were synthesized to evaluate the corrosion behavior of each phase in isolation. The corrosion behavior of the dual-phase alloy showed passivity evidenced by a pitting potential of 0.615 VSCE in 0.01 M NaCl. The pitting potential and other electrochemical parameters suggested a combination of behaviors of both single-phase samples, suggesting that the global corrosion behavior may be represented by a composite theory applied to phases, their area fractions, and interphase length. However, the interphase in the dual-phase CCA was a local corrosion initiation site and may limit localized corrosion protectiveness. The alloy design implications for optimization of second phase structure and morphology are discussed.

The Clinical Utility of the Seated Wall Angel as a Test with Scoring.

The seated wall angel (SWA) is an intervention to improve upper quarter mobility but has not been described as a clinical test with scoring. To explore the clinical utility of the SWA as a test with scoring. The authors hypothesized that SWA test scores would be lower on the injured than uninjured side, improve over time, and show stronger association with patient-reported shoulder function than shoulder mobility tests. Prospective cohort. Patients diagnosed with anterior shoulder instability and referred to physical therapy participated. Testing occurred after physical therapy examination (initial) and six weeks later (follow-up). Rehabilitation was not controlled. Testing included clinical tests (SWA, passive shoulder external rotation range of motion, total arc of motion) and patient-reported outcomes including the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, (ASES) and the Western Ontario Shoulder Instability Index (WOSI). The SWA test was scored 0 to 3 points bilaterally based on number of body contacts with the wall (i.e., elbows and fingertips, posterior fingers, posterior forearm). Passive range of motion was measured with a standard goniometer. SWA scores were compared between sides at initial testing and compared between testing timepoints on the injured side. Associations among injured side clinical test values and patient-reported outcome scores were examined. Mean (SD) SWA score on the injured side was significantly lower than the uninjured side at initial testing [1.6 (1.0) vs 2.2 (1.1), p = 0.045] and significantly increased at follow-up testing [2.4 (1.0), p = 0.041]. Only SWA test score was significantly correlated with ASES (r=0.597) and WOSI (r=-0.648) scores at initial testing, and SWA test score was significantly correlated with WOSI score at follow-up testing (r=-0.611). The clinical utility of the SWA test is supported by distinguishing the injured and uninjured sides and having stronger associations with patient-reported shoulder function than shoulder mobility tests.

The dose effectiveness of extracorporeal shockwave on plantar flexor spasticity of ankle in stroke patients: a randomized controlled trial

BackgroundExtracorporeal shockwave therapy (ESWT) has been proven beneficial for post-stroke spasticity (PSS) of ankle plantar flexor muscles. This study aims to investigate the dose-response effectiveness of focused-ESWT and the duration of its effect on the treatment of ankle PSS in stroke patients.MethodsIn this double-blinded randomized controlled trial, stroke patients diagnosed with PSS in the ankle plantar flexor muscles were randomly assigned to two groups. The experimental group received double-dose ESWT (4000 pulses per session) targeting spastic calf muscles, while the control group received half the dose (2000 pulses per session). Both groups underwent four sessions over two weeks. The outcomes, including modified Ashworth Scale (MAS), modified Tardieu Scale (MTS), passive range of motion (PROM) of the ankle, Timed Up and Go (TUG) Test, Barthel index and strain elastography were evaluated at baseline, 1st, 4th, 12th, and 24th week after ESWT.ResultsWithin-group analysis revealed significant improvements in MAS, PROM, TUG Test, and Barthel index for the double-dose ESWT group and improvements in Barthel index for the control group. Between-group analysis revealed greater improvements in TUG Test, Barthel Index and strain elastography for the double-dose ESWT group. Generalized estimating equations analysis indicated that the double-dose ESWT group achieved superior outcomes in the TUG Test, Barthel Index, and strain elastography across various time points and groups.ConclusionsDouble-dose ESWT showed better functional improvement and elastography compared to the control group. ESWT demonstrated dose-response effectiveness for PSS of ankle-equinus.Trial registrationNCT05878223.

How Does Standing Anteroposterior Stability Limits Correlate to Foot/ankle Functions in Bilateral Spastic Cerebral Palsy?

To determine whether foot and ankle functions are correlated with the limits of stability (LoS) while standing in individuals with bilateral spastic cerebral palsy (BSCP). Eighteen people who could walk and with BSCP and 18 people without disability participated. Anteroposterior LoS was measured using a force platform. To quantify ankle and foot functions, spasticity, isometric muscle strength, passive range of motion, and plantar light touch-pressure sensation were assessed. In the BSCP group, anteroposterior LoS was significantly decreased, and anterior LoS reduction was correlated with decreases in plantar flexor and toe flexor strength and in sensitivity of the forefoot to light touch-pressure sensation, whereas the posterior LoS reduction was correlated with reduced dorsiflexor strength. The present findings suggest that improvement in these foot and ankle functions in BSCP may increase LoS while standing.

Are there laterality differences in passive flexion and extension of the proximal limb joints in working Siberian Husky dogs?

Differences between left and right-side joint range of motion may affect canine locomotive ability and movement. Passive range of motion (PROM) joint measurement provides the limits that a particular joint can move in its physiological planes of motion without influence of muscle activity. To compare left and right-side flexion and extension of the glenohumeral, humeroulnar/humeroradial, coxofemoral and femorotibial joints and for laterality PROM differences. Siberian Husky dogs were selected (n = 18) of mixed gender, aged (1.4–11.8) years living and working together from a single kennel. Joint PROM was measured using goniometry, a validated, non-invasive method, by the same investigator previously tested for acceptable measurement repeatability. Dogs were conscious and placed in standing position. Triplicate measures of joint flexion and extension were taken on both sides of each dog for afore-mentioned joints. Median values of triplicate measures were computed. Paired t-tests compared laterality of joint PROM, gender, age (&lt; 6 vs. &gt; 6 years) effects. Inferential symmetry indices [SI] were calculated. There was no significant difference (p &gt; 0.05) between left and right-side flexion and extension measures for all joints. Gender had no significant effect (p &gt; 0.05) on joint flexion or extension measures for all joints. Age (&lt; 6 vs. &gt; 6 years) had a significant effect on right hip flexion (p &lt; 0.001) and for both left and right-side shoulder flexion (p &lt; 0.001); elbow flexion (p = 0.001 and p &lt; 0.001); hip extension (p = 0.02 and p &lt; 0.001) respectively. The shoulder joint showed greatest PROM asymmetry (SI = 3.63%). Bilateral PROM measures are important to consider in joint movement and assessment. These results warrant further investigation with larger cohorts of defined age groups.

Implementasi Range Of Motion (ROM) Pasif Untuk Meningkatkan Mobilitas Fisik Pada Pasien Dengan Stroke Hemoragik Di Rumah Sakit Vita Insani Pematangsiantar

Stroke is a functional brain disorder in the form of death of neurological nerve cells due to disruption of blood flow in one part of the brain. Hemorrhagic stroke is a ruptured blood vessel in the brain which results in intracranial bleeding. The prevalence of stroke cases every year is 13.7 million and around 5.5 million deaths occur due to stroke. One of the nursing problems that arises in cases of hemorrhagic stroke is impaired physical mobility. Efforts that can be made to overcome physical mobility disorders are passive range of motion (ROM). This research design uses the Case Study method. The sampling method used is purposive sampling. The samples taken were 2 respondents, namely patients with hemorrhagic stroke who were hospitalized at Vita Insani Hospital, Pematangsiantar. The results showed that there was an increase in mobility experienced by hemorrhagic stroke patients, a decrease in muscle strength, Mr. U scales (3) to (4) and in Mr. S scales (2) to (3). Passive range of motion (ROM) is effective in cases of hemorrhagic stroke in increasing physical mobility. Nurses are expected to be able to accompany patients to apply passive range of motion (ROM) in an effort to increase physical mobility in hemorrhagic stroke patients.

Assistive technologies, including orthotic devices, for the management of contractures in adults after a stroke.

Contractures (reduced range of motion and increased stiffness of a joint) are a frequent complication of stroke. Contractures can interfere with function and cause cosmetic and hygiene problems. Preventing and managing contractures might improve rehabilitation and recovery after stroke. To assess the effects of assistive technologies for the management of contractures in adults after a stroke. We searched CENTRAL, MEDLINE, Embase, five other databases, and three trials registers in May 2022. We also searched for reference lists of relevant studies, contacted experts in the field, and ran forward citation searches. Randomised controlled studies (RCTs) that used electrical, mechanical, or electromechanical devices to manage contractures in adults with stroke were eligible for inclusion in this review. We planned to include studies that compared assistive technologies against no treatment, routine therapy, or another assistive technology. Three review authors (working in pairs) selected all studies, extracted data, and assessed risk of bias. The primary outcomes were passive joint range of motion (PROM) with and without standardised force, and indirect measures of PROM. The secondary outcomes included hygiene. We also wanted to evaluate the adverse effects of assistive technology. Effects were expressed as mean differences (MDs) or standardised mean differences (SMDs) with 95% confidence intervals (CIs). Seven studies fulfilled the inclusion criteria. Five of these were meta-analysed; they included 252 adults treated in acute and subacute rehabilitation settings. All studies compared assistive technology with routine therapy; one study also compared assistive technology with no treatment, but we were unable to obtain separate data for stroke participants. The assistive technologies used in the studies were electrical stimulation, splinting, positioning using a hinged board, and active repetitive motor training using a non-robotic device with electrical stimulation. Only one study applied stretching to end range. Treatment duration ranged from four to 12 weeks. The overall risk of bias was high for all studies. We are uncertain whether: • electrical stimulation to wrist extensors improves passive range of wrist extension (MD -7.30°, 95% CI -18.26° to 3.66°; 1 study, 81 participants; very low-certainty evidence); • a non-robotic device with electrical stimulation to shoulder flexors improves passive range of shoulder flexion (MD -9.00°, 95% CI -25.71° to 7.71°; 1 study; 50 participants; very low-certainty evidence); • assistive technology improves passive range of wrist extension with standardised force (SMD -0.05, 95% CI -0.39 to 0.29; four studies, 145 participants; very low-certainty evidence): • a non-robotic device with electrical stimulation to elbow extensors improves passive range of elbow extension (MD 0.41°, 95% CI -0.15° to 0.97°; 1 study, 50 participants; very low-certainty evidence). One study reported the adverse outcome of pain when using a hinged board to apply stretch to wrist and finger flexors, and another study reported skin breakdown when using a thumb splint. No studies reported hygiene or indirect measures of PROM. Only seven small RCTs met the eligibility criteria of this review, and all provided very low-certainty evidence. Consequently, we cannot draw firm conclusions on the effects of assistive technology compared with routine therapy or no therapy. It was also difficult to confirm whether there is a risk of harm associated with treatment using assistive technology. Future studies should apply adequate treatment intensity (i.e. magnitude and the duration of stretch) and use valid and reliable outcome measures. Such studies might better identify the role of assistive technology in the management of contractures in adults after a stroke.

Impact of Ultrasound-Guided Suprascapular Nerve Block in Stroke Survivors With Hemiplegic Shoulder Pain Undergoing Neurorehabilitation: A Retrospective Case Series.

Background Hemiplegic shoulder pain (HSP) is one of the most common complications seen in stroke survivors. HSP is an important cause of disability in these patients and may act as a barrier to rehabilitation and functional recovery. Suprascapular nerve block (SSNB) has been shown to be an effective treatment option for managing HSP, and it may also improve overall functional and motor recovery. Methodology This is a retrospective case series. Six stroke patients with HSP received an ultrasound-guided SSNB as a part of their inpatient individualized neurorehabilitation program. They were evaluated before the intervention and at 4 and 12 weeks of follow-up. Primary outcome measures were the Shoulder Pain and Disability Index (SPADI) score, active range of motion (AROM), and the visual analog scale (VAS) score of the hemiplegic shoulder. Secondary outcome measures were the passive range of motion (PROM) and manual muscle testing (MMT) of the hemiplegic shoulder. Results Of the six patients, four (66.7%) were male, four (66.7%) had hypertension, and two (33.3%) were also suffering from diabetes mellitus. Improvement was seen in the VAS score and the pain subscale of SPADI in all six cases at 12 weeks of follow-up. VAS score improvement was between 40% and 100%, while SPADI pain subscale score improvement ranged from 21.74% to 100%. Total SPADI score improved in all cases, with improvement ranging from 7.94% to 54.55%. No Improvement was seen in four of the six cases in the SPADI disability subscale. AROM showed an improvement in three of the six cases, with the most improvement in flexion (up to 55.56%). PROM improved in all six cases for flexion and abduction and in four cases for external rotation. MMT of only two patients improved by at least two grades. Conclusions SSNB is a safe and effective treatment option for patients with HSP. Along with an improvement in pain, the addition of SSNB in neurorehabilitation may play an important role in aiding functional and motor recovery in stroke survivors with HSP.

Passive Rom Therapy to Improve Muscle Strength in Post-Op Upper/Lower Extremity Patients: a Case Study

Fractures are emergency conditions that must be treated quickly and accurately and in accordance with fracture management procedures. In general, clients with fractures must undergo surgery which in addition to causing pain also affects activity. After surgery, rehabilitation is needed to prevent contractures. Nursing care for patients with upper/lower extremity fractures must be prioritized and focused on providing comfort, preventing complications, and achieving optimal rehabilitation in rehabilitation. Patients are taught mobilization or movement exercises, namely Passive Range of Motion (ROM). Purpose: To determine the Effectiveness of Passive ROM Exercise in Postoperative Patients with Upper/Lower Extremity Fractures on Length of Stay at Sukoharjo Regional General Hospital. Design: This researcher studied the type of experimental research. The method used is a case study. Results: the results of the study showed that the majority of Active ROM respondents were treated for 2 days with a frequency of 5 respondents. Then the results showed that there was a difference in the effect of passive ROM on the length of stay for fracture patients at Sukoharjo Regional General Hospital.

Long-term repeated botulinum toxin a treatment over 12 years gradually changes gait characteristics: single-case study

Objective: To demonstrate the long-term efficacy of repeated botulinum toxin A injections into the same muscles for ameliorating lower limb spasticity and gait function. Design: Single-case study Patient: A 36-year-old woman with right cerebral haemorrhage received her first botulinum toxin A injection 1,296 days after onset. The patient underwent 30 treatments over 12 years after the first injection to improve upper and lower limb spasticity and abnormal gait patterns. The mean duration between injections was 147 days. Methods: The Modified Ashworth Scale, passive range of motion, gait velocity, and degree of abnormal gait patterns during treadmill gait were evaluated pre-injection and at 2, 6, and 12 weeks after every injection. Results: The follow-up period showed no injection-related adverse events. Comfortable overground gait velocity gradually improved over 30 injections. The Modified Ashworth Scale and passive range of motion improved after each injection. Pre-injection values of the degree of pes varus, circumduction, hip hiking, and knee extensor thrust improved gradually. However, the degree of contralateral vaulting, excessive lateral shift of the trunk, and insufficient knee flexion did not improve after 30 injections. Conclusion: Repeated botulinum toxin A injections effectively improve abnormal gait patterns, even when a single injection cannot change these values.

Short term temporal outcomes after intramedullary fixation of lateral malleolus fractures

Ankle fractures are a common intra-articular trauma. The gold standard treatment for unstable ankle fractures has been Open Reduction Internal Fixation with plating and lag screw(s). Advocates for intramedullary nailing of the fibula note decreased wound complications and greater biomechanical strength. We hypothesized that time to union and time to weight bearing would be decreased with a fibular intramedullary nail compared to prior ankle ORIF literature. A retrospective cohort study was conducted of 65 consecutive ankle fracture patients treated with a fibular nail. The median follow-up time was 18.3 months (IQR: 55.4 – 97.6 days). All patients (100%) achieved clinical and radiographic union at a median of 9.6 (IQR: 54 – 78 days) and 10.8 weeks (IQR: 58 – 95 days), respectively. Post-operatively patients bore weight in walking boot and athletic shoe at a median 6.1 and 9.4 weeks, respectively. Fifteen patients suffered complications (23.1%). Patients with history of prior or active smoking were significantly correlated to longer time to union (p=0.016). Time to union also took 0.43 days longer for each additional year of age (t-value 2.13, p-value = 0.038). Nineteen out of 65 patients (29.2%) participated in the Olerud-Molander Ankle Scoring and the median functional outcome score was 71 (IQR: 56 – 93). While fibular nailing has advanced passive range of motion and weight bearing in our institution, time to weight bearing is clouded by surgeon comfort. Further study comparing fibular fracture healing and weight bearing status in regards to intramedullary and plate fixation in needed. Level of EvidenceIV

How To Choose The Best Lateralization And Distalization Of The Reverse Shoulder Arthroplasty To Optimize The Clinical Outcome In Cuff Tear Arthropathy

PurposeLateralization shoulder angle (LSA) and distalization shoulder angle (DSA) are two parameters that had been described for a better planification of the arthroplasty, but the range of these angles are very wide. The purpose of this study was to investigate the best combination in terms of lateralization and distalization to optimize the outcome of Reverse total shoulder arthroplasty(RTSA) for cuff tear arthropathy (CTA) with a functional deltoid. MethodsThis retrospective cohort study, conducted between 2014 and 2018 at a specialized shoulder unit in Paris, focused on patients exclusively treated with RTSA for CTA, ensuring a minimum follow-up of 1 year. The primary outcome measure was the ASES score. Secondary outcome measures included range of motion and patient-reported outcomes at the final follow-up, such as the Constant score, SSV, SST, and VAS. Optimal RTSA outcomes were delineated by scores surpassing the patient's acceptable symptom state (PASS) for ASES, set in literature at 76. Patients were categorized into two groups based on ASES scores at the last follow-up: those below and those above 76. The capabilities of LSA and DSA to predict the outcome of interest were assessed and the corresponding optimal thresholds for having better outcome were calculated using the Receiver Operator Characteristic (ROC) curve. ResultsSixty-two patients were included in the study with a mean age of 74.51 ± 6.79. Correlation analysis revealed significant medium correlation between ASES and both LSA (r = -0.43, p = .001) and DSA (r = 0.39, p = .002). The DSA of patients with ASES > 76 was 48.55 ± 12.44 with an IQR of 39.5 – 57.5, as compared to lower values for patients with ASES < 76, which was 37.82 ± 9.8 (IQR 32 – 46.5) (p=0.009). Similarly, the LSA of patients with ASES > 76 was 86.43 ± 11.4 (IQR 79.5 – 93.5), as compared to higher values for patients with ASES < 76, which was 100.09 ± 7.63 (IQR 93 – 105.5) (p<0.001). The ROC curve confirmed LSA and DSA as good predictors for the ASES outcome, with AUCs of 0.851 and 0.741, respectively. The optimal LSA should be no more than 90.5° (Se=100%, Sp=67.7%). The optimal DSA should be no less than 37.5° (Se=78.4%, Sp=63.6%). ConclusionThe LSA and DSA angle could represent a helpful tool to optimize the clinical outcomes of an adaptable RTSA in CTA with a functional deltoid and a complete passive range of motion.

Effect of Dry Needling Plus Static Stretching on Plantar Flexors Spasticity in Chronic Stroke Patients.

Stroke is a leading cause of disability worldwide and is often accompanied by complications such as spasticity. Static stretching (SS) is a common physiotherapy intervention for reducing spasticity, whereas dry needling (DN) is a novel approach. However, the combined effects of DN and SS on spasticity have not been thoroughly investigated. Given the pivotal effect of spasticity on daily activities, mitigating spasticity can significantly contribute to restoring patient independence. This study will explore the impact of DN plus SS on spasticity, alpha motor neuron excitability, overall function, and quality of life in patients with chronic stroke. A double-blind, randomized, sham-controlled trial will be conducted in patients with post-stroke spasticity in the plantar flexor muscles. Twentyeight participants will be randomly assigned to either an intervention or control group. The intervention group will receive DN (60s × 3 days/week; 1 week) plus SS (20 min × 5 days/ week; 1 week). The control group will undergo sham DN (60s × 3 days/week; 1 week) and SS (20 min × 5 days/week; 1 week). DN plus SS or sham DN plus SS. Both groups will be assessed at baseline, immediately post-treatment, and after 1 week of follow-up. Outcome measures will include the Modified Modified Ashworth Scale, H-reflex latency, Hmax/Mmax ratio, active and passive ankle dorsiflexion range of motion, timed up and go test, and the EuroQol questionnaire. Results from this randomized, sham-controlled study will provide evidence for the effectiveness of DN in combination with SS for spasticity. The additional impact of DN in conjunction with SS, a widely used method for reducing muscle tone, remains unclear and warrants investigation. This study, with a high level of evidence, aims to address this knowledge gap.

Experimental investigation of comprehensive performance by tailoring the proportion of late transition metals in quinary Fe-Co-Ni-Si-B amorphous alloys

We fabricated the Fe-Co-Ni-Si-B multi-principal element alloys by vacuum melt-spinning method. The effects of late transition metals proportion in quinary alloy ribbons on the formation, phase structure, thermal stability, microhardness, corrosion resistance and soft magnetic properties were investigated. The melt-spun structure consists of an amorphous single phase for all the specimens. The surfaces of glassy ribbons are rather flat and flawless and the average surface roughness is 0.351 nm or below. The initial crystallization temperature (Tx) and supercooled liquid region (ΔTx) of alloy system decrease by degrees with increasing Co and Ni content, showing the maximum values of 753.0 K and 60.0 K for Fe60Co10Ni10Si6B14 alloy. But the glass transition temperature (Tg) seems to barely change and maintain approximately 692.0 K. All the as-received alloy ribbons exhibit good bending ductility and acceptable Vickers microhardness ranging from 671 to 785 HV0.5. The amorphous alloy ribbons present a gradually wide passive potential range (ΔE) with the decrease of Fe content, but the corrosion current density (Icorr) becomes larger. The smallest Icorr value is 1.785 μA·cm-2 for Fe60Co10Ni10Si6B14 alloy and the widest ΔE value is about 0.272 V for Fe26Co27Ni27Si6B14 alloy. The saturation magnetization of these glassy alloys reduces from 165.0 to 112.0 emu/g as the Fe content decreases. Meanwhile, the coercivity also changes from 14.25 to 6.70 A/m. This paper offers a brand-new perspective to understand the role of late transition metals on the various physicochemical properties of quinary Fe-Co-Ni-Si-B amorphous alloys.

Prospective randomized comparison of functional bracing versus rigid immobilization with early weightbearing after modified percutaneous achilles tendon repair under local anesthesia

ObjectiveThe optimal treatment and rehabilitation strategy for acute Achilles tendon rupture (ATR) remain a debate. This study aimed to compare the results of the two postoperative regimens after treatment for ATR with modified closed percutaneous repair under local anesthesia. MethodsIn a 4-year study, 72 consecutive patients with acute complete ATR were randomized after percutaneous repair into a functional group (FG), using a modified brace (28 males, three females; mean age 41.9 [29–71] years) and an immobilization group (IG), wearing a rigid plaster (28 males, two females; mean age 42.2 [29–57] years), for a period of 6 weeks. Except for immobilization, they followed the same weight-bearing and rehabilitation protocols. The follow-up period was 3 years. The complication rate, active and passive ankle range of motion, standing heel-rise test, clinical outcome using the American Foot and Ankle Society (AOFAS) hindfoot-ankle score, return to the previous activity level, and subjective assessment were assessed. ResultsThere was one rerupture in the IG and two transient sural nerve disturbances in the FG and one in the IG, and one suture extrusion in the IG, with no other complications. The average AOFAS scores were 96.9 ± 4.3 and 96.0 ± 4.9 in the FG and IG, respectively. Patients in the FG reached a final range of motion and muscular strength sooner without limping and were more satisfied with the treatment. No significant differences could be detected between groups according to the results in any of the assessed parameters. ConclusionEarly dynamic functional bracing in patients with ATR treated with modified closed percutaneous repair under local anesthesia resulted in earlier functional recovery with similar final results in terms of complications and functional outcomes, such as rigid postoperative immobilization with standardized rehabilitation and weight-bearing protocol. Level of evidenceI, Prospective randomized study

Changes in Lower Extremity Passive Range of Motion and Muscle Strength After Selective Percutaneous Myofascial Lengthening and Functional Physiotherapy in Children With Cerebral Palsy

Changes in Lower Extremity Passive Range of Motion and Muscle Strength After Selective Percutaneous Myofascial Lengthening and Functional Physiotherapy in Children With Cerebral Palsy