Automated prescription of therapeutic exercise for shoulder impingement syndrome using literature-driven rule generation architecture.

To examine the acute effect of gliclazide on exercise performance and recovery of muscle strength in healthy participants. We conducted a randomized, double-blind, placebo-controlled crossover clinical trial in 44 strength-trained men. They were allocated to gliclazide modified release (MR) (90mg, 8h before exercise sessions) or placebo, undergo three consecutive sessions of strength exercise (four sets, 80% of one-repetition maximum [1-RM] of bench press and free squat exercise). We evaluated total volume-load (VL) (#repetitions x 80%1-RM), range of motion (ROM), insulin and glucose levels, creatine kinase MM (CK-MM), lactate dehydrogenase (LDH), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α), hemodynamic parameters, perceived muscle soreness and recovery scores. Gliclazide enhanced strength exercise performance with improvements in total VL (bench press 23.3%, p<0.001; squat 23.2%, p<0.001), and improved muscle recovery 24-48h post-exercise: ROM (shoulder 1.1%, p<0.001; knee 1.6%, p=0.004), CK-MM (-13.2%, p<0.001), LDH (-12.8%, p<0.001), TNF-α (-17.4%, p<0.001), IL-6 (-5.3%, p<0.001), muscle soreness (-17.7%, p<0.001) and recovery scores (32.5%, p=0.001). However, hypoglycemia events were observed in 3 participants in the gliclazide group. In conclusion, Gliclazide MR 90mg, 8h before strength exercise, produced ergogenic effects (exercise performance and muscle recovery), although hypoglycemia was observed in 7% of subjects. Registration: "www.clinicaltrials.gov", "NCT04443777" (Primary Completion: 01/08/2020; Study Completion: 31/10/2023).

Combined partial knee arthroplasty versus total knee arthroplasty: A systematic review and meta-analysis of randomised control trials.

Non-union of the patella is relatively rare, occurring in 2.4-12.5% of cases, yet it frequently requires surgical treatment due to discomfort and functional impairment. The proximal fracture fragment is usually displaced by the quadriceps, resulting in a gap that hinders recovery. Managing non-union in comminuted patella fractures is extremely challenging due to the presence of numerous tiny pieces and difficulties in attaining stable fixation. The present case series presents an innovative cerclage wiring procedure, referred to as the “Wire Mesh Technique,” employed for patients with comminuted patellar fractures and non-union. The present case series included three male patients aged 35, 42, and 66 years, each exhibiting non-union of comminuted patella fractures subsequent to trauma. All patients experienced difficulty bearing weight and extending the affected knee, characterised by extensor lag and limited range of motion. Radiographic assessments confirmed non-union of the patella in every case. After clinical and radiographic evaluation, the wire mesh procedure was utilised to address insufficient healing and the complex arrangement of fragments. Postoperative rehabilitation included early in-bed mobilisation and quadriceps exercises starting on day zero, walkerassisted non-weight bearing on day two, and gradual range of motion exercises initiated on day ten. Full weight-bearing began at two months. Postoperative imaging showed optimal implant placement and medullary healing. Patients successfully regained weight-bearing capacity and experienced enhanced knee flexibility and motion. This approach reduces circular tension and improves stability, facilitating rapid mobilisation and positive outcomes in complicated patellar fracture non-unions.

Rotator cuff repair vs. reverse arthroplasty for massive tears: A patient-centered outcome analysis.

Optical Flow-Guided Analysis of Intrafractional Anatomical Variations in Pancreatic Tumors and Organs at Risk During Magnetic Resonance-Guided Adaptive Radiation Therapy Under Abdominal Compression.

“Subacromial Impingement Syndrome (SAIS)” refers to conditions disrupting the balance between structural rigidity and soft tissue inflammation, leading to irritation in the subacromial space, primarily affecting the rotator cuff and bursa. High-Intensity Laser Therapy (HILT) is a non-invasive, painless treatment that increases mobility and stimulates deeper tissues. It can be used with antiinflammatory and analgesic effects. In the present case report, a 62-year-old woman reported with right shoulder pain and limited motion for four months. Clinical metrics included a Pain Disability Index (PDI) score of 36, a Shoulder Pain and Disability Index (SPADI) score of 69%, and a Shoulder Function Index (SFInX) of 40, suggesting impingement syndrome. A high-intensity laser was applied to the site. The exercise regimen included posture improvement, pectoral and trapezius stretching, shoulder Range of Motion (ROM) exercises, gentle stretches, and finger stair exercises over four weeks. At treatment's end, significant functional improvements were noted, including reduced pain, increased ROM, and enhanced muscle strength.

Coronal obliquity in supracondylar humeral fracture of children may result in suboptimal reduction and delay in recovery of elbow range of motion-a retrospective comparative study.

Meta-analysis of surgical approaches to lateral ankle instability: Open Broström versus arthroscopic Broström versus lasso-loop repair.

Comparing Bristow and Latarjet procedures for anterior shoulder instability in competitive rugby players: a unique within-subject clinical analysis.

Three-Dimensional Pelvic Kinematics During Direct Anterior Approach Total Hip Arthroplasty on an Orthopaedic Table.

Pyrolytic carbon head hemiarthroplasty vs. cobalt-chromium head for proximal humerus fractures: a short-term follow-up study.

Is the graft position critical for functional outcomes following arthroscopy-assisted lower trapezius tendon transfer for posterosuperior irreparable rotator cuff tears? A comparison of anterior vs. posterior position of graft.

Musculoskeletal deformities in children with spinal muscular atrophy: a multicenter cross-sectional study with longitudinal follow-up.

Chronic cervical pain is a common disorder and is difficult to manage. Therefore, this study was conducted to investigate the effects of nociceptor hypostimulation versus hyperstimulation on electromyographic (EMG) activity of cervical muscles, myofascial trigger point (MTP) sensitivity, pain intensity, and disability in patients with chronic cervical pain. Sixty patients with chronic cervical pain were randomly assigned to hypostimulation, hyperstimulation, or control groups. The hypostimulation group received subthreshold stimulation, the hyperstimulation group received suprathreshold stimulation, and the control group received sham treatment. Stimulation was applied for 20min, three times per week, for 8weeks. Outcome measures included upper trapezius EMG activity (resting and maximal contraction), pain intensity, MTP pressure pain threshold, and cervical range of motion (flexion, lateral flexion, and rotation bilaterally). Outcomes were assessed at baseline, post-treatment (8weeks), and follow-up (8weeks). At baseline, no significant differences were observed among groups for any outcome (p>0.05). Post-treatment, the hypostimulation group demonstrated significantly greater improvements than both the hyperstimulation and control groups across all outcomes (p<0.05). These improvements were maintained at follow-up. Hyperstimulation resulted in short-term improvements in pain and cervical range of motion but not in EMG activity; these effects were not sustained at follow-up. Eight weeks of nociceptor hypostimulation produced significant and sustained improvements in cervical muscle EMG activity, MTP sensitivity, pain, and disability in adults aged 40-65years with chronic cervical pain. Hypostimulation was superior to hyperstimulation for the long-term management of chronic cervical pain involving upper trapezius MTPs. NCT06559358.

Background: Cerebral palsy is caused mainly by upper motor neuron injury and is characterized by spasticity, muscle weakness, reduced selective motor control, and secondary musculoskeletal impairments. Functional electrical stimulation has been proposed to improve lower-limb strength and functional outcomes in children with cerebral palsy. Objective: To evaluate the impact of functional electrical stimulation on lower limb strength in children with cerebral palsy. Methodology: A narrative review was conducted using a custom search strategy in Google Scholar for studies published between 2020 and 2025. Randomized controlled trials and crossover studies examining functional electrical stimulation as an independent intervention or adjunct to conventional therapy were included. Eligible studies involved children with cerebral palsy who received lower limb functional electrical stimulation and reported outcomes on muscle strength, gait, postural stability, and gross motor function. Due to heterogeneity in study designs, outcome measures, and intervention protocols, a quantitative meta-analysis was not conducted. Study characteristics, including Gross Motor Function Classification System level, cerebral palsy subtype, stimulation parameters, and comparisons with orthoses or therapeutic garments, were extracted. Results: Functional electrical stimulation may improve lower-limb strength and functional performance, particularly when combined with conventional therapy. Gains in muscle strength, range of motion, Gross Motor Function Measure scores, and reduced energy expenditure were reported. Improvements in gait and postural stability were seen, especially in hemiplegic and diplegic cerebral palsy. Results varied across studies, and functional electrical stimulation did not consistently outperform conventional orthotic interventions. Evidence on sustained benefits after discontinuation remains limited. Conclusion: Functional electrical stimulation is a promising adjunct intervention for lower-limb weakness and functional limitations in children with cerebral palsy. Variability in protocols and outcomes highlights the need for further high-quality research to determine optimal application strategies and long-term benefits.

Background: Rotator cuff injuries are a leading cause of upper extremity dysfunction, particularly in populations with occupational strain, such as security guards. These injuries are associated with pain, restricted range of motion, and diminished functional independence. Objective: To investigate the association between previous rotator cuff injuries and upper limb dysfunction among security guards. Methodology: An analytical cross-sectional study was conducted among 138 male security guards aged 45 to 60 years with a documented history of rotator cuff injury. A non-probability convenience sampling technique was used to recruit participants. Participants were excluded if they had a history of fractures, active infections, neurological disorders affecting cognition, or recent overhead shoulder trauma. The Disabilities of the Arm, Shoulder, and Hand scale and the Western Ontario Rotator Cuff Index were used to assess upper limb disability and shoulder-related quality of life. Clinical assessment of rotator cuff integrity was performed using the Lift-Off and the Empty Can tests. Descriptive statistics were used to present categorical variables as frequencies and percentages. The Mann–Whitney U test and Kruskal–Wallis test were used to evaluate differences in functional outcomes, while the Chi-square test was applied to determine the association between rotator cuff injury and shoulder disability among security guards. A p-value of less than 0.05 was considered statistically significant. Results: A significant proportion of participants exhibited upper extremity dysfunction, with 66.7% and 61.6% testing positive on the Lift-Off and Empty Can tests, respectively. Pain and reduced range of motion, particularly in abduction and flexion, were strongly associated with diminished occupational performance. Participants with positive test results had higher symptom severity and lower functional scores. Participants showed the symptom score by Disabilities of the Arm, Shoulder, and Hand scale, Western Ontario Rotator Cuff Index, and Sports performance across both tests showed significant results (p&gt;0.05), whereas Sports performance didn’t show significant results (p&gt;0.05). Conclusion: Rotator cuff injuries substantially impact shoulder function and occupational performance in security guards. Rotator cuff injuries are a leading cause of upper limb dysfunction, particularly in high-risk occupational groups like security guards. Almost half of the population of security guards suffered from rotator cuff injury.

Background: Subacute neck pain is a common musculoskeletal condition that can significantly affect daily functioning and quality of life. Traditional treatment often provides temporary relief, leading to a growing interest in alternative approaches such as cervicothoracic self-mobilization. This technique is believed to alleviate pain, improve mobility, and restore function through patient-directed movements. Objective: To compare the effects of cervicothoracic self-mobilization along with conservative treatment on pain intensity, cervical range of motion, and neck disability in individuals with subacute neck pain. Methodology: A randomized controlled trial was conducted with 66 participants diagnosed with subacute neck pain, and data were collected from Bajwa Hospital, Lahore. Participants with an age range of 20 to 45 years, both genders, those who had a history of sub-acute pain lasting at least three weeks, and reported a pain intensity of ≥3 on the Numerical Pain Rating Scale. Patients were excluded if they had a history of cervical fracture, tumor, or other inflammatory diseases. Individuals presenting with radiculopathy or neuropathy were also excluded. Additionally, patients diagnosed with vestibular dysfunction were excluded, as were pregnant or lactating females. Participants were randomly assigned to either a control group that received standard physical therapy or an experimental group that underwent cervicothoracic self-mobilization along with conservative treatment. Pre- and post-treatment assessments included the Numeric Pain Rating Scale, Neck Disability Index, and cervical range of motion. The intervention was conducted over six weeks, with the experimental group performing self-mobilization exercises three to five times per week. Results: Significant improvements were observed in the experimental group, with pain intensity decreasing from 7.81 to 4.51 (p&lt;0.001), neck disability reduced from 28.86 to 18.86 (p&lt;0.001), and improvement in cervical flexion and extension (p&lt;0.001). Conclusion: Cervicothoracic self-mobilization, along with conservative treatment, is an effective intervention in the reduction of pain, improving cervical range of motion, and decreasing neck disability in patients with subacute neck pain. This technique offers a practical, low-cost treatment option for improving functional outcomes.

The retrospective study by Yu et al (2025) demonstrates that electromyographic biofeedback therapy, when combined with conventional rehabilitation, provides significant advantages in stroke recovery. Compared with traditional treatment alone, patients receiving biofeedback showed greater improvements in upper and lower limb Fugl–Meyer scores, balance performance, and wrist and ankle joint range of motion at both 4 and 8 weeks. Importantly, reductions in scores on the Hospital Anxiety and Depression Scale, Hamilton Depression Rating Scale, and Hamilton Anxiety Rating Scale further highlight the psychological benefits of this approach. These findings confirm that electromyographic biofeedback not only accelerates functional recovery but also reduces post-stroke anxiety and depression, thereby addressing two critical dimensions of stroke rehabilitation. Given the relatively small sample size, further multicenter, long-term trials are needed to validate these promising outcomes and optimize individualized treatment strategies.

Background: Adhesive capsulitis, commonly known as frozen shoulder, is a painful musculoskeletal disorder marked by stiffness and restricted shoulder movement. Conventional treatment often involves pharmacological therapy and exercise rehabilitation. Interferential Therapy (IFT), when combined with these modalities, may enhance recovery outcomes. Objective: To evaluate the effectiveness of IFT in combination with non-steroidal anti-inflammatory drugs (NSAIDs) and therapeutic exercise on pain reduction, functional improvement, and range of motion (ROM) in patients with adhesive capsulitis. Methods: A total of 43 patients with adhesive capsulitis were treated with IFT, NSAIDs (naproxen 500 mg twice daily for 10 days with omeprazole 20 mg for gastric protection), and structured shoulder exercises. IFT was administered using a quadripolar current at 80–120 Hz for 20 minutes per session, with six sessions conducted over 14 days. Assessments were conducted at baseline, 2, 4, and 6 weeks using the Visual Analogue Scale (VAS), Shoulder Pain and Disability Index (SPADI), and goniometric ROM measurements. Results: Significant reductions in pain (VAS: baseline 7.15 → week 6: 2.90) and disability (SPADI: baseline 75.39 → week 6: 23.23) were observed. ROM improved progressively across all planes, with abduction increasing from 80.87° to 129.12°, and flexion from 80.27° to 125.12° by week 6. Internal and external rotation also showed marked improvements. Conclusion: IFT, when combines with NSAIDs and exercise therapy enhance recovery in adhesive capsulitis providing synergistic benefit in pain relief, functional restoration and joint mobility. J Shaheed Suhrawardy Med Coll 2024; 16(2): 53-55