Range Of Motion In Patients Research Articles

Preoperative and Postoperative Segmental and Overall Range of Motion in Patients Undergoing Lumbar Spinal Fusion Using HA-Infused PEEK and HA-Treated Titanium Alloy Interbody Cages.

Retrospective observational radiographic analysis. Determine how single level lumbar interbody fusion (LIF) alters segmental range of motion (ROM) at adjacent levels and decreases overall ROM. This study included 54 patients who underwent single-level anterior (ALIF, 39%), thoraco-LIF (TLIF, 26%), posterior LIF (PLIF, 22%), or lateral LIF (LLIF, 13%) (L2-3/L3-4/L4-5/L5-S1: 4%/13%/35%/48%). Segmental ROM from L1-2 to L5-S1 and the overall lumbar ROM (L1-S1) were assessed from preoperative and postoperative flexion-extension radiographs. K-means cluster analysis was used to identify ROM subgroups. The overall L1-S1 ROM decreased 14% (25.5 ± 20.4° to 22.0 ± 17.2°, P = .104) postoperatively. ROM at the fusion level decreased 77% (4.8 ± 5.0° to 1.1 ± 1.1°, P < .001). Caudal adjacent segment ROM decreased 12% (5.2 ± 5.7° to 4.6 ± 4.4°, P = .345) and cranially ROM increased 34% (4.3 ± 5.0° to 5.7 ± 5.7°, P = .05). K-cluster analysis identified 3 distinct clusters (P < .05). Cluster 1 lost more ROM and had less improvement in patient-reported outcomes measures (PROMs) than average. Cluster 2 had less ROM loss than average with worse PROMs improvement. Cluster 3 did not have changes in ROM and better improvement in PROMs than average. Successful fusion was verified in 96% of all instrumented segments with >6months follow-up (ROM <4°). Following single-level L IF, patients should expect a loss of 3.3°, or 14% of overall lumbar motion with increases in ROM of the cranial segment. However, specific clusters of patients exist that experience different relative changes in ROM and PROMs.

Multilevel Laminoplasty for CSM: Is C3 Laminectomy Better Than C3 Laminoplasty at the Superior Vertebra?

In a multilevel cervical laminoplasty operation for patients with cervical spondylotic myelopathy (CSM), a partial or complete C3 laminectomy may be performed at the upper level instead of a C3 plated laminoplasty. It is unknown whether C3 technique above the laminoplasty affects loss of cervical lordosis or range of motion. Patients undergoing multilevel laminoplasty of the cervical spine (C3-C6/C7) at a single institution were retrospectively reviewed. Patients were divided into two cohorts based on surgical technique at C3: C3-C6/C7 plated laminoplasty ("C3 laminoplasty only", N = 61), C3 partial or complete laminectomy, plus C4-C6/C7 plated laminoplasty (N = 39). All patients had at least 1-year postoperative X-ray treatment. Of 100 total patients, C3 laminoplasty and C3 laminectomy were equivalent in all demographic data, except for age (66.4 vs. 59.4 years, p = 0.012). None of the preoperative radiographic parameters differed between the C3 laminoplasty and C3 laminectomy cohorts: cervical lordosis (13.1° vs. 11.1°, p = 0.259), T1 slope (32.9° vs. 29.2°, p = 0.072), T1 slope-cervical lordosis (19.8° vs. 18.6°, p = 0.485), or cervical sagittal vertical axis (3.1 cm vs. 2.7 cm, p = 0.193). None of the postoperative radiographic parameters differed between the C3 laminoplasty and C3 laminectomy cohorts: cervical lordosis (9.4° vs. 11.2°, p = 0.369), T1 slope-cervical lordosis (21.7° vs. 18.1°, p = 0.126), to cervical sagittal vertical axis (3.3 cm vs. 3.6 cm, p = 0.479). In the total cohort, 31% had loss of cervical lordosis >5°. Loss of lordosis reached 5-10° (mild change) in 13% of patients and >10° (moderate change) in 18% of patients. C3 laminoplasty and C3 laminectomy cohorts did not differ with respect to no change (<5°: 65.6% vs. 74.3%, respectively), mild change (5-10°: 14.8% vs. 10.3%), and moderate change (>10°: 19.7% vs. 15.4%) in cervical lordosis, p = 0.644. When controlling for age, ordinal regression showed that surgical technique at C3 did not increase the odds of postoperative loss of cervical lordosis. C3 laminectomy versus C3 laminoplasty did not differ in the postoperative range of motion on cervical flexion-extension X-rays (23.9° vs. 21.7°, p = 0.451, N = 91). There was no difference in postoperative loss of cervical lordosis or postoperative range of motion in patients who underwent either C3-C6/C7 plated laminoplasty or C3 laminectomy plus C4-C6/C7 plated laminoplasty.

Effects of Low-Level Laser Therapy on Shoulder Pain, Functional Disability and Range of Motion in Patients with Type II Slap Tear

BACKGROUND: Low-level lasers may occasionally replace surgery or medications without adverse effects, so studying them stands to reason. It heals, regenerates tissue, reduces inflammation, discomfort, and boosts immunity. Research is continuing. It may help physical therapy, healthcare, and the community by being cost-efficient, simple, and successful. OBJECTIVE: To compare the effects of low-level laser therapy and routine physical therapy on shoulder pain, functional disability, and range of motion in patients with Type II SLAP tear. METHODS: It was a Randomized Controlled Trial conducted at Physical therapy department, Sialkot Medical and Physiotherapy Center Branches Pasroor and Sambrail. The estimated sample size is 52, and adjusting for an expected 20% dropouts, the sample size was 62, allocated 31 in each group. Both male and female patients with Age between 50-70 years having Type II SLAP tear, Visual analogue scale (VAS) score above 3 and the patients diagnosed by physician, orthopedic physician or surgeon or rheumatologist were included. The included patients were allocated in group A, routine physical therapy, and Group B low level laser. All the patients were assessed at baseline, at 4th week of Treatment and at 8th week of Treatment for pain, shoulder pain and disability index and shoulder ranges. RESULTS: The results regarding age showed mean and standard deviation to be 1.8387±.77875 in routine physical therapy group while 1.8065±.79244 in low level laser therapy group. The comparison of mean SPADI total score at 8th week of assessment it was found to be respectively 58.3226±4.57083 and 50.3871±4.85577 with a significant mean difference of 7.935 in favor of low-level laser therapy as shown by p value 0.000. Other outcome measures including pain and shoulder ranges were also significantly improved in low level laser therapy group, p value &lt; 0.05. CONCUSSION: The findings of the study concluded that low level plays the therapy is significantly more effective improving pain disability and shoulder range of motions in patients with slap tear, except for abduction range of motion which was improved equally in both groups. Moreover, within routine physical therapy and low-level laser therapy group showed significant improvement at pre and post level of assessment except that of total shoulder and pain disability index score which was not improved significantly in routine physical therapy group without combination of low-level laser therapy.

Effect of Mobilization with Movement on Pain, Disability, and Range of Motion in Patients with Shoulder Pain and Movement Impairment: A Systematic Review and Meta-Analysis

Background: Shoulder pain is a disabling musculoskeletal disorder worldwide. Thus, it is important to identify interventions able to improve pain and disability. Objective: To investigate the effects of mobilization with movement (MWM) on pain, disability, and range of motion in patients with shoulder pain and movement impairment. Methods: A systematic search of different databases was performed. The systematic review protocol has been registered in PROSPERO (CRD42023404128). A random-effects model for meta-analysis was used to determine the mean difference (MD), standardized mean differences (SMD), and 95% confidence interval for the outcome of interest. Results: Twenty-six studies were included. Of these, eighteen were included in the meta-analysis. MWM improved pain during movement with a moderate effect SMD of (−0.6; 95% confidence interval, −1.1 to −0.1, I2 = 0%; N = 66;) and shoulder abduction MD of (12.7°; 1.3 to 24.0; I2 = 73%; N = 90) compared to sham MWM in the short term (0–6 weeks). Combined MWM and conventional rehabilitation improved pain at rest, with a MD of (−1.2; −2.2 to −0.2; I2 = 61%; N = 100), and disability SMD of (−1.3; confidence interval −2.2 to −0.4; I2 = 87%; N = 185) compared to conventional rehabilitation alone in the short term. Combined MWM and conventional rehabilitation also resulted in improvement in shoulder abduction and external rotation. Compared to Maitland, MWM resulted in improvement in the shoulder abduction MD (20.4°; confidence interval 4.3 to 36.5; I2 = 89%; N = 130) in the short term. There is no information regarding long-term effects. Conclusion: Evidence suggests that MWM may reduce shoulder pain and restore shoulder range of motion and function. Our findings are promising, but the evidence is not strong enough to recommend it pragmatically.

Forearm and elbow secondary surgical procedures in neonatal brachial plexus palsy: a systematic scoping review

IntroductionNeonatal Brachial plexus palsy (NBPP) is an injury during delivery that can lead to loss of motor function and limited range of motion in patients due to damage of nerves in the brachial plexus. This scoping review aims to explore types of procedures performed and assess outcomes of forearm and elbow secondary surgery in pediatric patients. MethodsSearches of PubMed, Cochrane, CINAHL, Web of Sciences and Scopus were completed to obtain studies describing surgical treatment of elbow and forearm in pediatric patients with NBPP. 865 abstracts and titles were screened by two independent reviewers resulting in 295 full text papers; after applying of inclusion and exclusion criteria 18 articles were included. The level of evidence of this study is level IV. Results10 main procedures were performed to regain function of the forearm and elbow in neonatal brachial plexus birth palsy patients. Procedures had different aims, with supination contracture (6) and elbow flexion restoration (5) being the most prevalent. The variance between pre-and postoperative soft tissue and bony procedures outcomes decreased and showed improvement with respect to the aim of each procedure category. For soft tissue procedures, a statistically significant increase was found between pre- and postoperative values for active elbow flexion, passive supination, and active supination. For bony procedures, there was a statistically significant decrease between pre- and postoperative values of passive and active supination. ConclusionsOverall, all procedures completed in the assessed articles of this study were successful in their aim. Bony procedures, specifically osteotomies, were found to have a wider range of results, whereas soft tissue procedures were found to be more consistent and reproducible with respect to their outcomes. Bony and soft tissue procedures were found vary in their aims and outcomes. This study indicates the need for further research to augment knowledge about indications and long-term benefits to each procedure.

Gravity-Assisted Manipulation (GAM) Technique for the Treatment of Knee Arthrofibrosis

Arthrofibrosis is a known complication after knee surgery, resulting in stiffness and decreased range of motion for patients. Manipulation under anesthesia is a commonly used technique to address postoperative arthrofibrosis after knee surgery. Often, direct pressure is applied to the knee during the manipulation. This can be difficult and can place undue stress above and below the joint. This Technical Note presents the technique for manipulation under anesthesia using gravity and the native knee motion alone to improve knee range of motion.

Lengthening Patients Previously Treated for Massive Lower Limb Reconstruction for Bone Tumors with the PRECICE 2 Nail.

The objective of this study was to determine the efficacy of the PRECICE 2® nail in the treatment of lower limb length discrepancy in patients with a history of bone tumors. This study reports on outcomes, complications, and the safety of the PRECICE 2 limb lengthening nail in a cohort of pediatric patients with limb length discrepancy after surgery for bone tumors. Seventeen patients were treated with intramedullary magnetic nails. The average patient age at the time of surgery was 19 (range 11-32). The PRECICE 2 nail was used on 14 femurs (6 retrograde and 8 anterograde) and 3 tibias. The average consolidation time was 141 days (range 50-360) with a mean CI of 31 ± 12 days/cm. The ASAMI bone score showed 14 (82%) excellent results, 1 (6%) good result, and 2 (12%) poor results. The ASAMI functional score showed 13 (84.6%) excellent results, 3 (11.5%) good results, and 1 (3.8%) fair result. Patients treated with chemotherapy for bone cancer did not show any increase in distraction time or consolidation time. A total of 3 (17%) problems, 1 obstacle (5.5%), and 1 complication (5.5%) were encountered in our case series. The PRECICE 2 nail allows for effective and accurate lengthening preserving the range of motion in patients treated for bone tumors.

Comparison Between Multisite Injection and Single Rotator Interval Injection of Corticosteroid in Primary Frozen Shoulder (Adhesive Capsulitis): A Randomized Controlled Trial

BACKGROUND: Steroid injection is a commonly used conservative treatment for primary frozen shoulder (PFS), but the optimal injection site remains undetermined. OBJECTIVES: We conducted a prospective randomized controlled trial of multisite combined injection (MCI) vs single rotator interval injection (SRI). STUDY DESIGN: A randomized double-blinded controlled trial. SETTING: Center for Joint Surgery, Department of Orthopaedic Surgery, the Second Affiliated Hospital of Chongqing Medical University. METHODS: Sixty-four patients with PFS were randomly assigned to 2 groups. The experimental group received MCI in the rotator interval, intraarticular, and subacromial bursa; the control group received an SRI. Both groups were injected with one mL of 40 mg triamcinolone acetonide and 4 mL of 2% lidocaine. The injection process was completed under ultrasound guidance. Follow-up points were 4, 8, and 12 weeks postinjection. The outcome measures included the Visual Analog Scale (VAS) score, the American Shoulder and Elbow Surgeons (ASES) score, the Constant-Murley Shoulder (CMS) score, passive range of motion of the shoulder, and patient satisfaction rating. RESULTS: Thirty patients in the MCI group and 29 patients in the SRI group were included in the data analysis. All the outcomes in the 2 groups were significantly better postinjection than preinjection. The MCI group had a lower VAS score than the SRI group at 4 weeks (3.1 ± 1.2 vs 4.3 ± 1.6) and 8 weeks (2.2 ± 1.2 vs. 3.4 ± 1.2) (P &lt; 0.05). Compared with the SRI group, the MCI group had a significant improvement in flexion and abduction (P &lt; 0.01). Additionally, the ASES and CMS scores in the MCI group were better than those in the SRI group at 4, 8 and 12 weeks (P &lt; 0.01). LIMITATIONS: Limitations include the sample size of this study is small and a that it was conducted at a single-center. CONCLUSIONS: Both MCI and SRI effectively alleviated pain and restored range of motion in patients with PFS. However, the MCI group had obviously lower early pain scores, better flexion and abduction, and better function scores than the SRI group; no additional adverse events were observed. KEY WORDS: Primary frozen shoulder, adhesive capsulitis, steroid injection, rotator interval, intraarticular, subacromial bursa

Virtual embodiment for improving range of motion in patients with movement-related shoulder pain: an experimental study

BackgroundRecent evidence supports the use of immersive virtual reality (VR) as a means of delivering bodily illusions that may have therapeutic potential for the treatment of musculoskeletal conditions. We wanted to investigate whether a single session of an embodiment-based immersive VR training program influences pain-free range of motion in patients with shoulder pain.MethodsWe designed a rehabilitation program based on developing ownership over a virtual body and then “exercising” the upper limb in immersive VR, while the real arm remains static. We then carried out a single-arm pre-post experiment in which 21 patients with movement-related musculoskeletal shoulder pain were exposed to the 15-min VR program and measured their active pain-free range of motion immediately before and afterwards.ResultsWe found that shoulder abduction and hand-behind-back movements, but not shoulder flexion, were significantly and clinically improved post-intervention and that the level of improvement correlated with the level of embodiment. Following this one session, at 1-week follow-up the improvements were not maintained.ConclusionsVirtual embodiment may be a useful therapeutic tool to help improve range of motion in patients with movement-related shoulder pain in the short term, which in turn could expedite rehabilitation and recovery in these conditions.

Anterior Fusion and Long-Term Cervical Mobility in Patients With Traumatic Spinal Cord Injury: An Observational Study.

Objective This study aims to determine and quantify the impairment of cervical mobility and range of motion in patients with traumatic spinal cord injury (SCI) and subsequent cervical subaxial fusion surgery. Methods A total of 89 patients who underwent interbody fusion of the cervical spine and were admitted to the Spinal Cord Injury Center of the BG Klinikum Hamburg, Germany between 2003 and 2018 were examined after their in-facility rehabilitation was successfully completed. Reclination, inclination, tilt, and rotation of the cervical spine were examined and documented in addition to overall patient characteristics and fusion extent. Results We could identify fusion length and age to be independently negatively correlated with the cervical range of motion in different degrees of movement. We could also show a significant decrease in cervical mobility within our patients when compared to healthy adults. The ability to tilt and rotate the cervical spine was particularly impaired. Conclusions Patients with traumatic SCI and intervertebral fusion suffer from significant impairment of mobility in different degrees of movement. This knowledge can be used to evaluate the rehabilitative challenges and reintegrative needs of individuals after traumatic SCI. Rehabilitation should be adjusted accordingly.

Mid-term outcomes following reverse total shoulder arthroplasty.

The utilization of reverse total shoulder arthroplasty now exceeds the incidence of anatomic shoulder arthroplasty. Previous mid-to-long-term studies on rTSA have reported a decrease in shoulder function as follow-up increased. The purpose of this study was to provide data on mid-term outcomes and implant survival in a series focusing on reverse total shoulder arthroplasty. Demographic information such as age at surgery, revision surgery status, BMI, and smoking status were recorded. The clinical endpoints measured in this study were range of motion scores (forward elevation, external rotation, internal rotation) and patient reported outcomes (VAS, ASES, SST). Radiographic variables captured included preoperative glenoid morphology, humeral lucency, and glenoid loosening. Fifty-six shoulders were included in this study. The overall mean age at surgery was 72.5 ± 7.2years with an average follow-up time of 6.8 ± 3.5years. The mean BMI was 28.1 ± 5.5. All measurements of range of motion saw significant and sustained improvements. Overall, forward elevation improved from 82° preoperatively to 133° postoperatively (p < 0.01). External rotation improved from 23° preoperatively to 36° (p < 0.01), while internal rotation improved from L3 to L1 (p = 0.05). ASES scores improved from 31 preoperatively to 70 postoperatively (p < 0.01). SST scores improved from 2 preoperatively to 7 (p < 0.01). VAS pain index scores improved from 6 to 2 following surgery (p < 0.01). Postoperative scapular notching was seen in 18 patients at final follow-up. Glenoid loosening was seen in 3 shoulders. Humeral loosening was seen in 18 shoulders. Tuberosity resorption was seen in 8 shoulders. The 5year survival estimate was 98%, and the 10year survival estimate was 83%. In this series, we found that rTSA provides mid-term improvements in range of motion in patients while reducing pain levels. When considered together, this demonstrates that most patients undergoing rTSA can have excellent use of their shoulder from age at surgery to end-of-life.

EFFECTIVENESS OF COMBINATION THERAPY AND SHOULDER GLIDES ON FROZEN SHOULDER: A CASE REPORT

Frozen shoulder is the gradual loss of movement in the shoulder (glenohumeral) joint. When the shoulder is frozen, the joint has become stiff and its movement is limited. It is also called adhesive capsulitis and commonly treated by manual therapy and exercise, usually delivered together as components of a physical therapy intervention. The differential diagnosis includes biceps tendinopathy, glenohumeral osteoarthritis, neoplasm, rotator cuff tendinopathy or tear (with or without impingement), and subacromial and subdeltoid. The case report is based on use of combination therapy and shoulder glides to reduce the pain and improve the Range of motion of the joint. Combination therapy comprises of transcutaneous electrical nerve stimulation and ultrasonic therapy at different intensities according to different musculoskeletal conditions. Outcome measure used were Numerical Pain Rating Scale for pain and universal goniometer for measuring range of motion. In conclusion, the study supports the use of combination therapy and shoulder glides are beneficial in reducing pain and improve shoulder Range of motion in patients with case of Frozen shoulder. Keywords: Frozen shoulder, transcutaneous electrical nerve stimulation, ultrasonic therapy, range of motion, numerical pain rating scale, pain.

Effect of Different Foam Rolling Sensitivities on the Amount of Change in Range of Motion: A Randomized Controlled Trial

Foam rolling (FR) is an easy-to-perform self-care activity to improve the range of motion in patients with injuries. However, even if FR is performed at the same intensity, the feeling differs depending on the patient. In addition, FR affects the contralateral side. This phenomenon is called cross education. Therefore, the main purpose of this study was to examine the relationship between FR sensitivities and FR efficacy. The secondary purpose was to determine how FR intensity perception influences cross education. In this study, FR sensitivity was calculated using the Visual Analogue Scale (VAS). The difference in the effect of FR sensitivity was evaluated using the correlation between the amount of change in PRE-test to POST- test ROM and VAS. The experimental procedure in this study first measures ankle dorsiflexion range of motion (ROM) on the left and right leg. Immediately after measurement, 3sets of FR were performed on one random leg. Participants wrote the VAS of FR for each set during the rest period of each FR intervention set. Immediately after 3 sets of FR, the ROM was measured in the left and right legs. Statistical analysis performed Two-way repeated measures ANOVA in group comparison. As a result, two-way ANOVA did not show a significant effect of group (F = 0.003, P = 0.95) or interaction effect (F = 2.28, P = 0.14). In contract, time had a significant effect (F = 39.65, P = 0.001). Post hoc result in [Dominant leg] PRE: 19.7 ± 7.6° POST: 22.2 ± 7.3° P = 0.001 Δ = 0.33. [Non-dominant leg] PRE: 20.0 ± 7.8° POST: 21.6 ± 7.8° P = 0.01, Δ = 0.21). On the other hand, Pearson’s correlation coefficient was used for the correlation between the amount of change in ROM and VAS. As a result, a dominant leg significant negative correlation was observed between the 3dr set of FR VAS score and the amount of change in ROM (r = -0.38, P = 0.04). Non-dominant leg significant correlations were observed third set of FR VAS score and amount of change in ROM (r = 0.41, P = 0.03). The result of this study suggested that it is necessary to perform FR with a comfortable stimulus on the dominant leg to maximize the effect of FR.

Efektivitas Terapi Latihan Fisik Terhadap Peningkatn Range Of Motion Pada Pasien Cedera Anterior Cruciate Ligament

In general, sports cannot avoid injuries, injuries can occur due to internal and external factors. One of the most common injuries is injury to the ligament, for example the anterior cruciate ligament (ACL) for which anterior cruciate ligament injury is the focus for rehabilitation programs, therefore how much benefit of physical exercise therapy to increase the range of motion.This study aims to determine the effectiveness of physical exercise therapy to increase the range of motion in patients with anterior cruciate ligament injuries at the Jogja Orthopedic sport clinic. The research method used in this study was a quasi-experimental method using a one group pretest-posttest design. Quasi-research is research with a quantitative approach in this study using the independent variable, namely physical exercise therapy and vice versa, the dependent variable, namely increasing the range of motion. The patient population in this study was 16 people. The sample in this study used a purposive sampling technique with the criteria that the patient was still in phase 1 after anterior cruciate ligament reconstruction. The research instrument used a goniometer to measure the scope of the knee joint, namely flexion and extension. Data analysis technique with the T-test through the prerequisite analysis test for normality test with Shapiro Wilk and homogeneity test. The results of the study showed (1) the effectiveness of increasing the range of motion in flexion movements by 0.261% and extension movements by 0.739%, with a significant value of 0.095 &gt; 0.05. Based on these results, it can be concluded that physical exercise therapy is effective for increasing the Range of Motion in anterior cruciate ligament injuries. (2) physical therapy has the effect of accelerating the process of increasing the range of motion.

Comparison of the Effectiveness of Walking and Quadriceps Isometric Exercises on Pain and Range of Motion in Patients with Knee Osteoarthritis

Pain is known as the main symptom of Osteoarthritis (OA) which affect on the functional impairment and patient’s quality of life. Alternatively, isometric quadriceps exercise and walking exercise could be employed to reduce the pain among knee OA patients. This study aimed to identify the comparison between walking exercise and isometric quadriceps exercise on pain and joint range of motion in knee osteoarthritis patients. This research was used quasi-experimental with non equivalent control group before–after design. The experimental and control group, involved 17respondents respectively with consecutive sampling technique. The results showed the walking exercise is significantly reduce pain and increase knee flexion range of motion (p 0.000). Similarly, the isometric quadriceps exercise is significantly decrease pain and increase knee flexion range of motion (p 0.000). Nevertheless, after being compared showed that walking exercise is no more effective reduce pain and increase knee flexion range of motion rather than isometric quadriceps exercise in knee osteoarthritis patients. A standard operational procedure for walking exercise and isometric quadriceps exercise is programmed.

Comparison of the Effectiveness of Walking and Quadriceps Isometric Exercises on Pain and Range of Motion in Patients with Knee Osteoarthritis

Pain is known as the main symptom of Osteoarthritis (OA) which affect on the functional impairment and patient’s quality of life. Alternatively, isometric quadriceps exercise and walking exercise could be employed to reduce the pain among knee OA patients. This study aimed to identify the comparison between walking exercise and isometric quadriceps exercise on pain and joint range of motion in knee osteoarthritis patients. This research was used quasi-experimental with non equivalent control group before–after design. The experimental and control group, involved 17respondents respectively with consecutive sampling technique. The results showed the walking exercise is significantly reduce pain and increase knee flexion range of motion (p 0.000). Similarly, the isometric quadriceps exercise is significantly decrease pain and increase knee flexion range of motion (p 0.000). Nevertheless, after being compared showed that walking exercise is no more effective reduce pain and increase knee flexion range of motion rather than isometric quadriceps exercise in knee osteoarthritis patients. A standard operational procedure for walking exercise and isometric quadriceps exercise is programmed.

Does primary treatment of proximal humerus fractures show favourable functional outcomes over secondary treatment with reverse shoulder arthroplasty?

This multicentre retrospective cohort study assessed whether functional outcomes after primary reverse shoulder arthroplasty (RSA) are favourable compared to secondary placement in elderly patients with displaced proximal humerus fractures (PHFs). Fifty-three patients with primary and 32 with secondary RSA were included. Patient-reported outcome measures (PROMs) were assessed: Constant-Murley Score (CMS), Oxford Shoulder Score (OSS), Disabilities of the Arm, Shoulder and Hand (DASH) score, and Visual Analogue Scale (VAS). In addition, range of motion (ROM) was compared between groups. For PROMs, the means (SD) for primary versus secondary were 25.4 (17.7), 29.4 (19.2) for DASH; 38 (8.6), 38 (9.1) for OSS; 63 (19.8), 59 (22.0) for CMS and 2 (2.0), 3 (2.3) for VAS. For ROM, the means were the following: forward flexion 113° (33.6), 106° (34.1); abduction 103° (33.4), 96° (37.3) and external rotation 20° (19.1), 20° (17.8). There were significant differences in favour of primary treatment in forward flexion (p = 0.003, B 19.85) and abduction (p = 0.034, B 17.34). ROM in patients with complex displaced PHFs after primary RSA is slightly better than that after secondary treatment. Therefore, RSA could be considered primary treatment, especially when optimal ROM is of great importance to the patient. level III, retrospective comparative study treatment study.

Effects of Muscle Energy Technique versus Shoulder Mobilization on Pain and Function in Patients with Subacromial Pain Syndrome

Abstract Background Subacromial pain syndrome is most leading cause of disability that includes the wide spectrum of disorders including subacromial tendinopathy, partial or full thickness tear of rotator cuff and subacromial bursitis. The manual therapy interventions for this condition are still debatable. Aim To evaluate the comparative effects of muscle energy technique (MET) versus posterior shoulder mobilization with movement (MWM) on pain, function and shoulder range of motion in patients with subacromial pain syndrome. Method Patients diagnosed with subacromial pain syndrome were recruited in this pragmatic parallel double blinded randomized clinical trial. The sample was selected through non-probability convenient sampling technique. Forty patients out of 56 meeting the eligibility criteria were equally divided into two groups, MET group (n = 20) and MWM group (n = 20), through a randomization web service. Data were collected at baseline and after successful completion of a six week trial treatment. Pain severity was measured by using a numeric pain rating scale, shoulder disability was measured by using the Shoulder Pain and Disability Index (SPADI) and ranges of motion were measured by using goniometry. Data was analyzed through SPSS 24. Results Outcome measures including pain, disability and shoulder range of motion were significantly (p ≤ 0.05) improved in both groups after the intervention. When comparing both groups, pain score was U = 82.0 (p ≤ 0.001) and disability score was t = –2.913 (p ≤ 0.006) favoring MET. Conclusion Both MET and MWM were effective for symptomatic management in this sample of 40 patients with subacromial impingement syndrome. MET seems to show some superior effects as compared to MWM.

Comparison of the Effects of Conventional Physical Therapy Versus Progressive Overload Training in Patients with Shoulder Impingement Syndrome; A Randomised Clinical Trial

Abstract&#x0D; Background: Rotator cuff tendinitis and shoulder impingement are regarded as the frequent intrinsic reasons for shoulder discomfort and disability. &#x0D; Objective: A study was conducted to compare the effects of conventional physical therapy and progressive overload training in patients with shoulder impingement syndrome.&#x0D; Methods: Thirty patients with shoulder impingement syndrome were included. These patients were randomised into two groups. One group received structured, progressive resistance training, and the other received conventional therapy. The intervention group participants participated in progressive resistance training three days per week for six weeks. The numeric pain rating scale was used to assess pain intensity and the range of motion measured by the goniometer. The statistical package for social sciences (SPSS), version 21 for Windows, was used for data analysis. An independent t-test was used to compare the effects between the two&#x0D; groups. &#x0D; Result: Out of 30 participants, there were twenty-four females and six males. The mean age of the participants was 44±5.1 years. Participants from the intervention group had better pain control (P &lt; 0.05) and improved range of motion (P &lt; 0.05) compared to the control group. &#x0D; Conclusion: We conclude in this group of patients, progressive overload training was more effective in alleviating pain and improving the range of motion in patients with shoulder impingement syndrome.

The effectiveness of manipulative therapy in reducing pain and improving range of motion in patients with shoulder injuries

The effectiveness of manipulative therapy in reducing pain and improving range of motion in patients with shoulder injuries