Shoulder Joint Range Research Articles

Retrospective Evaluation of Clinical and Radiological Results of Patients Treated With Arthroscopic Transosseous Repair for Rotator Cuff Tear.

Surgical repair is recommended for symptomatic full-thickness rotator cuff tears to restore muscle function and alleviate pain. Advances in arthroscopic techniques and new implant designs have led to more reliable repair methods. The choice of technique is crucial for achieving favorable clinical outcomes. This study evaluates the short-term clinical and radiological outcomes of patients treated with the arthroscopic transosseous technique (ATO). Data from 43 patients who underwent full-thickness rotator cuff (RC) repair using the arthroscopic transosseous technique between February 2014 and April 2016 were prospectively collected and retrospectively reviewed. Included patients had medium-sized (1-3 cm) full-thickness supraspinatus tears extending to the infraspinatus and underwent tenotomy or biceps tenodesis. Functional outcomes were assessed using the Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, and constant score at their final follow-up appointment. Radiological evaluation included postoperative MRI to assess re-tear development. The mean follow-up period was 26.52±8.14 months. Postoperative VAS, ASES, and constant scores significantly improved compared to preoperative values (3.14±1.20, 88.4±8.12, and 88.9±10.6, respectively). The ATO technique provides strong mechanical and biological repair, yielding good functional outcomes for full-thickness rotator cuff tears (RCTs). It is an effective method for early recovery of shoulder joint range of motion (ROM) and pain reduction.

Relationship of Physical Factors to the Occurrence of Injuries in Young Gymnasts.

There is a large population of young athletes who participate in gymnastics, and the prevention of injury in junior athletes is considered important. However, few studies have prospectively investigated the relationship between physical factors and the occurrence of injury. To investigate the physical characteristics that are factors in the injury occurrence in elementary and junior high school gymnasts. Prospective observational study. A total of 36 healthy young gymnasts (at national competition level) were enrolled in the study. Once a week for 23 weeks, injuries were prospectively investigated using self-report questionnaires under the supervision of a research staff. Joint range of motion (hip, ankle, shoulder, and wrist), tightness (Thomas test, Ely test, straight leg raise [SLR], triceps surae, combined abduction test [CAT], horizontal flexion test [HFT]), and muscle elasticity (multifidus) were assessed to compare differences in physical function between injured and non-injured participants. Injuries occurred most commonly in the wrist (42.1%), lower back (30.2%), and foot (9.5%) among males, whereas heel (22.2%), knee (16.0%), and lower back (12.8%) were the most common injury sites among females. Wrist injuries in male athletes showed decreased shoulder joint range of motion, and lower back injuries showed decreased hip and shoulder joint range of motion. Lower back injuries in female athletes showed decreased hip extension mobility. Heel and knee joint injuries in females also showed increased range of motion and decreased tightness. The results of this study indicate that the factors related to flexibility differ according to injury location. Further studies are required to clarify the physical factors that influence injury occurrence by examining the effects of the gymnasts' muscle strength, age, individual factors, and left-right differences. 3.

Effect of Structured Core Stabilization Exercise Program on Pain and Muscle Performance in Individuals with Scapular Dyskinesia

Purpose: The purpose of this research was to determine the effect of structured core stabilization exercise program on pain and muscle performance in individuals with scapular dyskinesis. Methods: The study commenced obtaining ethical clearance from an institutional committee, briefing participants about the research and intervention, and obtaining informed consent. In accordance with the inclusion and exclusion criteria, 90 participants were enrolled for the research among which 80 participants enrolled in this study and were allocated into 2 groups at random- Group A (Control group) as well as Group B (Experimental group) by using the envelope method. Treatment was provided for about 6 weeks to both groups.Pre and post test examination was done using Individual Muscle Testing (IMT), core strength testing with Pressure Biofeedback (PB), shoulder joint range of motion (ROM) with Goniometry, in addition with Visual Analogue Scale (VAS) for pain. Statistical methods were utilised to analyse the results. Findings: This research found substantial improvements in pain, individual muscle testing and shoulder range of motion for flexion and abduction in two groups (p-value

Shoulder Joint Range of Motion Related to Dementia

Introduction: Dementia is caused by various diseases, including Alzheimer’s disease dementia (ADD) and dementia with Lewy bodies (DLB). We often encounter patients with dementia who have limited shoulder joint range of motion (ROM), especially those with behavioral and psychological symptoms of dementia (BPSD). But the relationship between the diseases of dementia and restricted shoulder joint ROM is currently unclear. Methods: We examined cognitive function and shoulder joint ROM in 234 new outpatients at 7 memory clinics in Japan. We assessed cognitive function using the Mini-Mental State Examination (MMSE) and Revised Hasegawa Dementia Scale (HDS-R) and BPSD using the Neuropsychiatric Inventory Questionnaire (NPI-Q). Patients were categorized by dementia diagnosis (ADD, DLB, other dementia, and control). Right, left, and total shoulder joint ROM was assessed using validated the Japanese Orthopaedic Association (JOA) score. Results: We found significant associations of lower right, left, and total shoulder joint ROM scores with male sex, advanced age, higher NPI-Q score, lower HDS-R, and MMSE scores. Little difference was found between right and left shoulder joint ROM scores. Restricted shoulder joint ROM was related to serial 7, verbal frequency domain scores on the HDS-R and repeat score on the MMSE. It was also related to the hallucinations, irritability/lability and nighttime disturbances scores on the NPI-Q. Furthermore, the dementia groups, especially the DLB group, showed worse shoulder joint ROM than the control group. Conclusions: Dementia was significantly related to restricted shoulder joint ROM. Maintaining communication and social interaction may help maintain shoulder joint ROM.

Effects of Manual Lymphatic Drainage Combined with Press-Release Method Orthopedic Manual Lymphatic Physiotherapy on Upper Extremity Edema and Shoulder Joint Range of Motion and Pain in Patients with Breast Cancer

Effects of Manual Lymphatic Drainage Combined with Press-Release Method Orthopedic Manual Lymphatic Physiotherapy on Upper Extremity Edema and Shoulder Joint Range of Motion and Pain in Patients with Breast Cancer

Efficacy of Mulligan thoracic sustained natural apophyseal glides on sub-acromial pain in patients with sub-acromial impingement syndrome: a single-blinded randomized controlled trial

ABSTRACT Purpose To investigate the effects of Mulligan thoracic sustained natural apophyseal glides (SNAGS) techniques and traditional exercises on pain, shoulder function, size of sub-acromial space, and shoulder joint range in patients with sub-acromial impingement syndrome. Methods Seventy-four patients with sub-acromial impingement syndrome (25 to 40 years) joined this research and were allocated randomly into two equal groups; experimental group A (Mulligan SNAGS and exercise) and control group B (exercise only). All patients were assessed by visual analogue scale (VAS) for pain intensity, Shoulder Pain and Disability Index (SPADI) for shoulder function, plain x-ray for the size of sub-acromial space, and goniometer for shoulder range of motion (ROM). The measurements were performed at two intervals (baseline and after four weeks of intervention). Results After 4 weeks of intervention, there were statistically significant differences between groups, in favor of Mulligan SNAGS, on sub acromial space size, pain intensity, shoulder function, and shoulder joint range of motion (p < 0.05). In within-group analysis, there were also statistically significant differences between pre- and post-treatment in all measured variables (p < 0.05). Conclusion Mulligan thoracic spine (SNAGS) mobilization into extension and traditional exercises improve sub acromial space size, pain intensity, shoulder function, and shoulder joint range of motion in patients with sub acromial impingement syndrome. It is recommended to mobilize the thoracic spine by mulligan SNAGS in the treatment of sub-acromial impingement syndrome.

Shoulder Proprioception: A Review.

The purpose of this review is to provide a comprehensive resource for shoulder proprioception assessment and its integration into clinical decision making as well as targeted rehabilitation protocols. Data for this review were acquired from peer-reviewed articles from computerized online databases, namely PubMed and Medline, published between 1906 and 2021. The development of digital/smart phone goniometers can improve shoulder joint range of motion (ROM) measurements and demonstrate comparable measurement accuracy to the universal standard goniometer. The inclinometer offers a portable and cost-effective method for measuring shoulder joint angles and arcs of motion in the vertical plane. Two types of dynamometers, the computerized isokinetic machine and the handheld hydraulic dynamometer, are reliable tools for objective shoulder rotator cuff strength assessment. Motion analysis systems are highly advanced modalities that create three-dimensional models of motion arcs using a series of cameras and reflective beads, offering unparalleled precision in shoulder proprioception measurement; however, they require time-consuming calibration and skilled operators. Advancements in wearable devices and compact mobile technology such as iPhone applications may make three-dimensional motion analysis more affordable and practical for outpatient settings in the future. The complex interplay between proprioception and shoulder dysfunction is not fully understood; however, shoulder proprioception can likely both contribute to and be caused by shoulder pathology. In patients with rotator cuff tears, glenohumeral osteoarthritis, and shoulder instability, clinicians can track proprioception to understand a patient's disease progression or response to treatment. Finally, rehabilitation programs targeting shoulder proprioception have shown promising initial results in restoring function and returning athletes to play.

Exercises with the StretchPole improve shoulder joint range of motion

The ‘StretchPole’ foam roller product is mainly used to loosen muscle groups and joints in the deeper layers of the body that are normally inaccessible to the human hand, and to realign the skeletal structure by lying on the pole and performing exercises. It is also used to strengthen the core, which plays an important role in postural maintenance and stability. The purpose of this study was to determine the effects of the ‘Solacon’ exercise routine using a StretchPole on shoulder joint range of motion. Forty healthy participants performed Solacon exercises using a StretchPole. The specific method of Solacon comprises six movements: (1) chest slide, (2) crescent, (3) cone, (4) twister, (5) shoulder alternating rotation, and (6) chin-in exercise. The joint range of motion of the bilateral shoulder joint flexion, abduction, horizontal abduction, and external rotation (1st and 2nd) were measured before and after the exercises. All measures were significantly higher after exercise compared to before exercise. Solacon exercises improve thoracic spine and scapular mobility and stretch the anterior thoracic muscle groups. The shoulder joint in the broad sense consists of the humerus, scapula, clavicle, sternum, and ribs. These in turn constitute the scapulohumeral joint, acromioclavicular joint, sternoclavicular joint, scapulothoracic joint and functional second shoulder joint. In addition, costovertebral joints and intervertebral joints are also involved because of the added motion of the ribs and the spine. We considered that the ranges of motion of shoulder joint flexion, abduction, horizontal abduction, and external rotation measured in this study were expanded.

Effect of Scapular Clock Exercise Versus Scapular PNF Exercise on Pain and ROM for Anterior Capsular Stiffness of Shoulder Joint

Background: Adhesive capsulitis is a also known as frozen shoulder. Adhesive Capsulitis is a condition thatcauses stiffness around the shoulder joint, excruciating agony, and limited shoulder range of motion. The onsetof this sickness is extremely slow, and the process of regaining pain-free shoulder function is likewise gradual.Most diabetes patients are affected by it. For participants with anterior capsular stiffness, the goal of this study isto examine the effects of scapular PNF exercise with scapular clock exercise on pain and range of motion.Purpose: The Purpose of the study is to determine the effectiveness of scapular clock exercise versus scapular PNFexercise in reducing pain and ROM for anterior capsular stiffness of shoulder joint.Materials and Methods: A sample of 20 were taken according to selection criteria for this experimental studywhich was divided into two groups, scapular clock exercise with IFT (n=10) and scapular PNF exercise with IFT(n=10) were given. Interventions were given as 6 sessions a week is given and continued for 4 weeks. The pre-testand post-test values were taken. The values were tabulated and statistically evaluated. Study period: November2022 to apirl 2023Result: The result revealed that the mean of scapular PNF exercise at the post-test was found to be higher than themean value of scapular clock exercise with a p-value of &lt;0.0001.Conclusion: The study shows that scapular PNF exercise with IFT had shown higher positive outcome in managinganterior capsular stiffness of shoulder joint.

High frequency neuronavigated repetitive transcranial magnetic stimulation in post-stroke shoulder pain: A double-blinded, randomized controlled study

ObjectiveThis study aimed to determine the effect of 5Hz neuronavigated repetitive transcranial magnetic stimulation (rTMS) to the affected primary motor cortex (M1) on pain, the effect of pain on activities of daily living, disability, mood, neurophysiological parameters and passive shoulder joint range of motion in patients with post-stroke shoulder pain. DesignTwenty two patients were randomized into an experimental group (rTMS, n=7) who received daily rTMS 5Hz 1000 pulses, five times/week for three weeks (15 sessions) to the affected M1 and a control group (n=11) who received sham stimulation. Outcome measures were Numeric Rating Scale (NRS), Brief Pain Inventory (BPI), Disabilities of the arm, shoulder, and hand questionnaire (Quick DASH), Hospital Depression Anxiety Scale (HADS), joint range of motion (ROM) measurements, neurophysiological parameters. Selected outcome measures were performed before treatment (T0), after the 5th session (T1) of rTMS treatment, after the 10th session (T2), after the 15th session (T3), and four weeks after the end of the treatment (T4). In the analysis of the outcomes, within-group comparisons were performed by using the Wilcoxon or Friedman test and between-group comparisons were performed by using the Mann-Whitney U test. ResultsThere was no statistically significant difference between and within groups in terms of change- and followup scores in the NRS measurements (p>0.05). BPI scale was found to be lower in rTMS group at T0 and T3 (p= 0.010). Quick-DASH scores at T4 were found to be significantly lower in rTMS group (p= 0.032). However, no difference was found within each group over time (p>0.05) and there was no statistical difference between the groups in terms of change scores (T3-T0 and T4-T0) (p>0.05) for BPI and Quick-DASH. In rTMS group, there was a statistically significant difference in shoulder external rotation at T3 compared to the baseline (T0) (p=0.039). However, the magnitude of external rotation change (T3-T0) with the treatment was comparable in the groups. No statistically significant change occurred in both treatment groups in other range of motion measurements. ConclusionHigh frequency neuronavigated rTMS to the affected M1 did not show any significant beneficial effect on pain, activities of daily living, disability, anxiety and depression, neurophysiological measurements and passive ROM over sham stimulation.

Pouzdanost i validnost merenja fleksije ramenog zgloba digitalnom i standardnom goniometrijskom metodom

Based on the literature review and clinical experiences, it can be concluded that measuring the amplitude of movement is one of the fundamental kinesiometric methods used in assessing joint functionality. The aim of this study was to examine the reliability and validity of measuring the shoulder joint's range of motion using the digital system KEMTAI compared to a goniometer with arms. This non-experimental observation was conducted on 40 participants whose flexion range in the shoulder joint was measured using both the goniometer with arms and the KEMTAI software system, which utilizes the examiner's mobile phone camera. The results indicated that the lowest mean value was obtained during the first measurement session (M1 = 154.68), while the highest was during the third session (M2 = 156.53). When using the KEMTAI software, the variability of mean values for the total tested population was significantly higher than when using the goniometer with arms. The results suggest that the KEMTAI software/system is reliable when comparing the average results of three measurements. Based on these findings, it is concluded that three experienced measurers demonstrated high reliability in measuring the shoulder joint's flexion range using the goniometer with arms. Despite the identified differences between the measurement results obtained using these two methods, it is considered that the KEMTAI software/system is applicable in practical work.

Arthroscopic treatment for rotator cuff injury and frozen shoulder with concomitant rotator cuff injury: analysis of efficacy and factors influencing prognosis.

To analyze the efficacy of arthroscopic treatment for patients with rotator cuff injuries and frozen shoulder combined with rotator cuff injuries and assess the factors influencing patient prognosis. A retrospective analysis was performed on 85 patients who underwent arthroscopic surgery at Hanzhong Central Hospital between October 2016 and October 2021, including 42 patients treated for rotator cuff injuries alone (Group A), and 43 patients for frozen shoulder combined with rotator cuff injuries (Group B). Both groups underwent general anesthesia with controlled hypotension during surgery. Treatment outcomes, including shoulder joint functional scores, pain scores, shoulder joint range of motion, and muscle strength were assessed and compared between the two groups before treatment, as well as at 2 weeks and 2 months post-treatment. Quality of life was also evaluated and compared at 2 months post-treatment. Patients were categorized into good and poor prognosis groups based on their outcome, and factors influencing patient prognosis were analyzed. Before treatment, both groups exhibited relatively low shoulder joint function scores and external rotation angles, coupled with higher pain scores; however, these differences were not significant between groups (all P>0.05). The surgery duration for Group B was notably longer than that of Group A (P<0.05). Nevertheless, there was no significant variance in intraoperative blood loss between the two groups (P>0.05). After a 2-week treatment duration, both groups demonstrated a significant improvement in shoulder joint function score, pain score, and shoulder joint range of motion compared to baseline, but with no statistically significant intergroup differences. However, two months after the treatment, patients in Group A exhibited marked improvements in shoulder joint function score, pain score, shoulder joint range of motion, and overall quality of life compared to Group B (all P<0.05). Furthermore, the therapeutic efficacy in Group A was superior to that in Group B at the 2-month follow-up (P<0.05). Age, comorbid diabetes, metabolic disorders such as thyroid dysfunction, and the extent of shoulder cuff injury were identified as independent risk factors influencing prognosis. Arthroscopic treatment is effective for both frozen shoulder combined with rotator cuff injury and rotator cuff injury alone, with better outcomes observed in patients with rotator cuff injury only. This technique warrants further promotion.

Prediction model of subacromial pain syndrome in assembly workers using shoulder range of motion and muscle strength based on support vector machine

Subacromial pain syndrome (SAPS) is the most common upper-extremity musculoskeletal problem among workers. In this study, a machine learning model was built to predict and classify the presence or absence of SAPS in assembly workers with shoulder joint range of motion (ROM) and muscle strength data using support vector machine (SVM). Permutation importance was used to determine important variables for predicting workers with or without SAPS. The accuracy of the support vector classifier (SVC) polynomial model for classifying workers with SAPS was 82.4%. The important variables in model construction were internal rotation and abduction of shoulder ROM and internal rotation of shoulder muscle strength. It is possible to accurately perform SAPS classification of workers with relatively easy-to-obtain shoulder ROM and muscle strength data using this model. In addition, preventing SAPS in workers is possible by adjusting the factors affecting model building using exercise or rehabilitation programs. Practitioner summary: This study aimed to create a machine learning model that can predict and classify SAPS using shoulder ROM and muscle strength and identify the variables that are of high importance in model construction. This model could be used to predict or classify workers’ SAPS and manage or prevent SAPS.

Effects of poling camber angle on the biomechanics of cross-country sit-skiing

Cross-country sit-skiers use double poling (DP) technique to drive the slide. The aim of this study is to analyze how poling camber angle affect the capacity of power output and biomechanical parameters of the DP process. Twenty-four non-disabled college students (24.67 ± 1.46 years old) were recruited to perform three successive 30-s maximal effort tests with different poling camber angles of 0°, 15°, 24° and 30° using a sit-skiing ergometer. The biomechanical parameters, output power and muscle activation of the subjects were analyzed. The results showed that DP output power increased with the increase of poling camber angle at 15° (597.78 ± 150.31 J), 24° (610.94 ± 158.96 J, P = 0.011) and 30° (629.10 ± 168.78 J, P < 0.001) compared with 0° (590.65 ± 148.95 J). However, effective output power decreased with the increase of camber angle. Poling with camber angle of 24° had the shortest cycle time 1.53 ± 0.17 s, compared with other abduction angle (0°, 1.57 ± 0.19 s, 15°, 1.55 ± 0.16 s, and 30°, 1.56 ± 0.19 s). Compared with 0° (1.02 ± 0.14 m), the cycle distance significantly increased at poling camber angles of 24° (1.07 ± 0.12 m, P = 0.029) and 30° (1.11 ± 0.13 m, P < 0.001). With the increase of poling camber angle, the shoulder and elbow joint range of motions and joint moments were significantly increased. This study found that poling with shoulder abducted increased the output power but decreased the efficiency. By analyzing the poling angle and poling force, we find that the optimal poling camber angle may depend on the terrain or the skiing speed. These results may guide the competition techniques and tactics in the matches, and may further influence the strength-training programs of cross-country sit-skiing athletes.

Delamination of rotator cuff tears impairs healing after repair: a systematic review and meta-analysis.

To compare the clinical outcomes and retear rates after rotator cuff repair (RCR) between delaminated and non-delaminated tears. This systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses guidelines using the PubMed, Cochrane Library, the Web of Science and Embase databases. Only articles on arthroscopic RCR with clinical outcome scores and data on the number of rotator cuff retears and complete healing were included. This study's relevant data were extracted and statistically analyzed. The methodological index for nonrandomized studies was used to assess the risk of bias in the included studies. After conducting a heterogeneity test and sensitivity analysis to determine whether the samples were heterogeneous, the study also detected publication bias. A sub-group test was used to evaluate the influences of the imaging follow-up period on retear rates. Ten eligible articles were identified with 2,061 patients (925 in the delaminated group and 1,136 in the non-delaminated group). The meta-analysis demonstrated that delamination was significantly associated with higher retear rates (P = 0.026; odds ratio = 1.873, 95% confidence interval 1.079-3.252; I2 = 51.6%) with an imaging follow-up period of > 1year and lower rates of complete healing (P = 0.036; odds ratio = 0.659, 95% confidence interval 0.446-0.973; I2 = 9.0%) in patients after rotator cuff repair. However, no significant differences were observed between the two groups based on American Shoulder and Elbow Surgeons score, Constant score, visual analog scale score, external rotation, internal rotation, or forward elevation. This meta-analysis found that delamination was significantly associated with higher retear rates with imaging follow-up period of > 1year, and lower rates of complete healing. In addition, the preoperative and postoperative clinical scores and shoulder joint range of motion were similar between patients with delaminated and non-delaminated tears. Level IV.

C3 (Clinical Case) Late Presentation of Radial Nerve Palsy Secondary to Extravasation of Peripherally Inserted Catheter in a Neonate: What Paediatricians Need to Know

Abstract Introduction/Background Peripherally inserted central catheters (PICC) are an essential and common procedure in neonatal intensive care units (NICUs). Peripheral nerve injuries secondary to PICC extravasation are a rare occurrence in neonates, who commonly recover with no sequalae. Rarely, extravasation results in compression and ischemia involving adjacent nerves, muscles or joints. Peripheral nerve injury may be induced by compression from tissue infiltration or irritation by the infiltrate. Timely diagnosis and treatment are essential to avoid complex or irreversible nerve damage, such as compartment syndrome, requiring extensive interventions. Isolated radial nerve injury in infants and neonates is limited to a few cases reported in the literature, which have been commonly related to in-utero compression or birth injury due to peripheral positioning. We report a late presentation of an isolated radial nerve injury secondary to PICC extravasation in a preterm infant, leading to neuropraxia and long-term impairment of hand function. Case Description An extreme preterm female infant (245/7 weeks’ gestation, 640 grams) was admitted to the NICU with a complex neonatal course. At 6 days after birth, a right antecubital PICC was inserted for vascular access and to provide parenteral nutrition. It was removed after 18 days following extravasation. Two months later, she developed a right wrist drop, flexed fingers, and edema of the right hand. Her right wrist flexion, elbow flexion, shoulder joint range of motion, and sensation remained intact. A Doppler study showed a small non-occlusive clot in the right brachial vein, attributed to the previous PICC. She was unable to voluntarily open her right hand or extend her metacarpophalangeal (MCP) or interphalangeal (IP) joints (see Figure A, below). Clinical diagnosis of radial nerve palsy was made, and she was referred to physiotherapy (PT) and occupational therapy (OT). Splinting, passive exercise and left-hand constraint resulted in some improvement of the right hand’s strength. At 12 months of age, she had left hand preference with limited active extension of right MCPs and IPs (Figure B). She received a Botox injection to the right-hand flexors to allow strengthening of the extensor muscles. Follow-up at 18 months showed full extension of the index and middle finger MCPs and IPs, but residual lag in ring and small finger IPs. Discussion To our knowledge, this is the first case report of isolated radial nerve injury in an infant following PICC extravasation and soft tissue infiltration. Interestingly, the clinical signs of radial nerve injury in this case presented almost two months after PICC extravasation. Additionally, the left-hand preference and limitation of the active extension of the fingers of the right hand remained at one year of corrected age. Given that this has exceeded the expected recovery time of radial nerve palsy, Botox injection was performed with good response and near age-appropriate development of fine motor skills at 18 months of corrected age. Paediatricians should be aware that the manifestation of potential nerve injury in neonates may have a delayed presentation. Neurology consultation to confirm the diagnosis and rule out other causes of muscle weakness, and referral to PT/OT, are crucial for managing infants and neonates with peripheral nerve injury because treatment is largely focused on splinting and passive motion exercise. Generally, radial nerve palsy carries a relatively good prognosis, with complete functional recovery within 1-6 months. The fact that this case developed long-term complications with impaired right-hand function, despite nerve recovery, raises concerns about the prognosis. Conclusion Peripherally inserted central venous catheters are an everyday procedure in the NICU. Radial nerve palsy secondary to venous catheter extravasation is rare in infants and neonates. Clinicians should be aware of the clinical signs of radial nerve palsy and initiate consultation and referral to physiotherapy and occupational therapy early. Families can be reassured of the good prognosis and functional recovery.

Relationship between throwing distance, shoulder joint range of motion, and upper limb muscle strength in boccia athletes

The purpose of this study was to examine the relationship between throwing distance, shoulder joint range of motion and upper limb muscle strength in boccia athletes. Participants were eight boccia athletes (cerebral palsy, cervical spinal cord injury, muscular dystrophy, spinal muscle atrophy) in whom throwing distance, ranges of motion at the shoulder joint, elbow joint and wrist joint and upper limb muscle strength were measured. Throwing distance was measured to the point where the ball landed so to remove any effect of the floor. Upper limb muscle strength was measured by isometric contraction using a handheld dynamometer. No correlation was found between throwing distance and range of motion of the shoulder joint, but correlations were found between throwing distance and strength of shoulder flexors (r = 0.76, p &lt; .05), shoulder abductors (r = 0.84, p &lt; .01), and elbow flexors (r = 0.77, p &lt; .05). Active training to improve muscle strength around the shoulder joint, regardless of the underlying disease, was considered likely to lead to improvements in competitiveness. Due to the severe dysfunction of boccia athletes, training methods are often restricted. Verification of more effective training methods is needed while managing risks according to the physical function of the athlete and the type of disability.

Effectiveness of abduction brace versus simple sling rehabilitation following rotator cuff repair: systematic review and meta-analyses.

To date, no conclusions have been reached regarding the type of brace worn after arthroscopic rotator cuff repair. To this end, a systematic review and meta-analysis of randomized controlled trials was conducted. According to the updated guidelines of the preferred reporting items of systematic review and meta-analysis (PRISMA), all related literature in PubMed, Embase, and Cochrane Central Register of Controlled Trials (Central), from their establishment to March 1, 2022, were searched systematically. Outcome measures included the Constant score, Western Ontario Rotator Cuff (WORC) index, visual analog scale (VAS) score, shoulder joint range of motion (ROM), and failure events of rotator cuff healing. The Cochrane risk-of-bias tool was used to evaluate the quality of randomized controlled trials (RCT). Two independent reviewers (Chen, Wu) reviewed 275 articles, of which only five met the inclusion criteria, and four were included in the meta-analysis, with a total of 302 patients. The overall risk of bias was high in two RCTs, unclear in one, and low in two. Considering the clinical outcomes, the Constant score (P = 0.08 MD, 3.06; 95% confidence interval [CI], -0.42 to 6.53), WORC (P = 0.23; MD, 3.32; 95%CI,-2.15 to 8.79) , visual analog scale (VAS) score (P=0.09; MD -1.27; 95%CI, -2.75 to 0.21), ROM (P = 0.1; MD, 4.75; 95%CI, -0.98 to 10.48), and failure events of rotator cuff healing (P = 0.78; odds ratio[OR], 0.86; 95%CI, 0.32 to 2.37) did not significantly differ between the abduction brace and simple sling after arthroscopic rotator cuff repair. The findings of this systematic review and meta-analysis suggest that wearing abduction braces after rotator cuff repair neither improved the Constant score , VAS, and WORC scores, and ROM of the shoulder joint, nor did it reduce the risk of retearing . Therefore, a simple sling may be a better option in terms of cost-effectiveness. It is expected that studies with larger and more homogeneous samples will help verify our results.

Efficacy of Low-level Laser Versus High-intensity Laser Therapy in the Management of Adhesive Capsulitis: A Randomized Clinical Trial.

Low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) are effective in alleviating pain and improving functionality in patients with adhesive capsulitis (AC); however, no study has compared the efficacy of these two laser treatments. To compare the effectiveness of LLLT and HILT in improving the shoulder joint range of motion and functional status and in reducing pain level in patients with AC. Prospective, randomized, parallel group, patient- and assessor-blinded. A total of 45 patients (aged: 18-65 years) with complaint of shoulder pain were evaluated for inclusion criteria, which included being aged 18-65 years and a diagnosis of AC based on physical examinations. Using computer-generated random numbers, eligible patients were randomized into two groups: HILT + stretching exercise and LLLT + stretching exercise groups. Both HILT and LLLT were performed three times/week for 3 weeks. Functional status and pain of the patients were evaluated with Shoulder Pain and Disability Index (SPADI) and Visual Analog Scale (VAS), while shoulder joint range of motion was measured with goniometry. All assessments were done before and 3 weeks after treatment. A total of 40 patients (20 in each group) completed the study. At baseline, there was no statistically significant difference in the demographic and clinical characteristics between both groups. Both the LLLT and HILT groups showed significant improvement in the VAS and SPADI scores 3 weeks after treatment; however, the improvement was significantly higher in the HILT group than the LLLT group. There was no significant improvement in goniometric scores in both groups compared with baseline. No injury or other musculoskeletal complications were recorded during or after the treatments. HILT + stretching exercise treatment was more effective than LLLT + stretching exercise for improving functional parameters and pain in patients with AC. ClinicalTrials.gov Identifier: NCT05469672. None.

Shoulder Joint Hybrid Assistive Limb Treatment for Chronic Stroke Patients with Upper Limb Dysfunction.

Upper extremity dysfunction after stroke affects quality of life. Focusing on the shoulder joint, we investigated the safety and effectiveness of rehabilitation using a shoulder joint hybrid assistive limb (HAL). Eight patients with chronic stroke and upper extremity functional disability were enrolled and used a shoulder joint HAL, which assisted shoulder movement based on the user's intention, through myoelectric activation of the shoulder flexor. Ten training sessions of 30-40 min each were performed to assist voluntary movement of upper limb elevation on the affected side through triggering the deltoid muscle. All patients completed the interventions without shoulder pain. Surface electromyography evaluation indicated post-intervention improvement in coordinated movement of the affected upper extremity. Significant improvements in voluntary and passive shoulder joint range of motion were obtained after the intervention, suggesting improvement in shoulder muscle strength. A significant decrease in the modified Ashworth scale and improvements in functional scores in the upper limb were also observed. Along with safe use for our study patients, the shoulder HAL provided appropriate motor learning benefits. Improvements in shoulder joint function and whole upper limb function were observed, suggesting that HAL could be an optimal treatment method.